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CAT Bedah Vaskular

This document provides a screening tool and criteria for evaluating the validity and relevance of research articles. It addresses whether a study is from a peer-reviewed journal, conducted in a similar location, sponsored by an unbiased organization, and would require changing current practice. It also determines the intent, clinical category (therapy, diagnosis, causation, prognosis), preferred study design, and level of evidence based on a grading system. The levels range from 1a (systematic reviews of randomized controlled trials) to 5 (expert opinion without critical appraisal).

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15 views10 pages

CAT Bedah Vaskular

This document provides a screening tool and criteria for evaluating the validity and relevance of research articles. It addresses whether a study is from a peer-reviewed journal, conducted in a similar location, sponsored by an unbiased organization, and would require changing current practice. It also determines the intent, clinical category (therapy, diagnosis, causation, prognosis), preferred study design, and level of evidence based on a grading system. The levels range from 1a (systematic reviews of randomized controlled trials) to 5 (expert opinion without critical appraisal).

Uploaded by

dikiprestya391
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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CAT

(Critical Appraisal of the Topics)


Screen for Initial Validity and Relevance
1. Is the article from a peer-reviewed journal ? No
2. Is the location of the study similar to mine so that the results, if
valid, would apply to my practice ? Yes
3. Is the study sponsored by an organization that might influence
the study design or results ? Yes
4. Will this information, if true, have a direct impact on the health
of my patients, and is it something they will care about ? Yes
5. Is the problem addressed one that is common to my practice,
and is the intervention or test feasible and available to me ?
Yes
6. Will this information, if true, require me to change my current
practice ? Yes
Determine the Intent of the Article
• Why the study was performed?
The outbreak of COVID-19 originated in Wuhan has become a global
epidemic of contagious diseases, which poses a serious threat to human life
and health, especially for those with underlined diseases. However, Impacts
of COVID-19 epidemic on HD center and HD patients are still unknown. In
this report, we reviewed the whole course of the epidemic emerged in the
HD center of Renmin Hospital, Wuhan University from January 14, 2020,
the day the first case was confirmed, to February 17, 2020, the day the
epidemic extinction.
Four major clinical categories :
• Therapy
• Diagnosis
• Causation
• Prognosis
Clinical category Description Prefered Study Design

Therapy Tests the effectiveness of a treatment, such Randomized, double-blinded,


as a drug, surgical procedure, or other placebo- controlled trial
intervention

Diagnosis Measures the validity (is it dependable?) and Cross-sectional survey


reliability (will the same results be obtained (comparing the new test with
every time?) of a diagnostic test, or a reference standard)
evaluates the effectiveness of a test in
detecting disease at a presymptomatic stage
when applied to a large population

Causation Assesses whether a substance is related to


Cohort or case-control
the development of an illness or condition

Prognosis
Determines the outcome of a disease Longitudinal cohort study
Level of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm

1a SR (with homogeneity*) SR (with homogeneity*) SR (with homogeneity*) of


of RCTs of inception cohort Level 1 diagnostic
studies; CDR† studies; CDR† with 1b
validated in studies from different
different clinical centres
populations

1b Individual RCT (with Individual inception Validating** cohort study


narrow Confidence cohort study with > with good††† reference
Interval‡) 80% follow-up; standards; or CDR†
CDR† validated in a tested within one
single population clinical centre

1c §All or none All or none case-series Absolute SpPins and


††SnNouts
Level of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
2a SR (with homogeneity* ) of SR (with homogeneity*) of SR (with homogeneity*) of
cohort studies either retrospective cohort Level >2 diagnostic studies
studies or untreated
control groups in RCTs
2b Individual cohort study Retrospective cohort Exploratory** cohort study with
(including low quality RCT; study or follow-up of good†††reference standards;
e.g., <80% follow-up) untreated control patients CDR† after derivation, or
in an RCT; Derivation of validated only on split-sample
CDR† or validated on or databases
split-sample only

2c Outcomes" Research;" Outcomes" Research"


Ecological studies
Level of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
3a SR (with homogeneity*) of SR (with homogeneity*) of 3b
case-control studies and better studies
3b Individual Case-Control Non-consecutive study; or
Study without consistently applied
reference standards

4 Case-series (and poor Case-series (and poor Case-control study, poor or


quality cohort and case- quality prognostic cohort non-independent reference
control studies§§ ) studies***) standard

5 Expert opinion without Expert opinion without Expert opinion without explicit
explicit critical appraisal, or explicit critical appraisal, critical appraisal, or based on
based on physiology, bench or based on physiology, physiology, bench research or
"research or "first principles bench research or "first ""first principles
"principles
Grades of Recommendation
A consistent level 1 studies

B consistent level 2 or 3 studies or


extrapolations from level 1 studies
C level 4 studies or extrapolations from
level 2 or 3 studies
D level 5 evidence or troublingly
inconsistent or inconclusive studies of
any level

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