Guidelines for the management of community ... - Brit Thoracic

BTS guidelines
APPENDIX 1 CHECKLIST USED BY REVIEWERS FOR
APPRAISING STUDIES
Study: ____________________________ Reviewer: ____________________
Please complete section 1 first. If study OK, complete one of sections 2a–d as
appropriate.
1. General: is the study relevant to our question?
% Were the patients studied similar (in age, gender, disease severity …) to target
patients?
% Were the outcome measures of interest to us and our patients?
% Was the clinical setting (primary care, intensive care …) similar to our setting?
% Was the study carried out in a healthcare system similar to ours?
% Is the study design recognisable and appropriate, with clear methods described?
% Is the study recent enough to take account of any important advances?
% If negative, was this study large enough to provide useful information?
APPENDIX 2 ADDITIONAL CHECKLIST USED FOR APPRAISING
STUDIES TO INFORM PNEUMONIA AETIOLOGY
Absolute requirements:
c Is this an original report?
c Were patients with CAP separately identified?
c Was the study designed to assess CAP aetiology?
c Was the patient sample representative (eg, sufficient numbers, consecutive
cases, exclusions clearly defined)?
c Was the study of sufficient duration to exclude seasonal bias?
Data qualification:
c Is the geographical area clear and relevant?
c Is the patient age group defined?
c Are microbial investigations clearly defined?
c Was the investigation biased towards a specific pathogen?
c Is the setting community, hospital, intensive care or a combination?
2a. Studies of cause and effect (randomised trial of treatment)
% Was assignment of patients to treatment truly randomised?
% Was the planned therapy concealed from those recruiting patients before
enrolment?
% Were all patients who entered the study accounted for?
% Were patients analysed in the groups to which they were initially randomised?
% Were patients and doctors blind to the therapy given?
% Were groups treated the same way, apart from the therapy?
% Were the groups similar at the start of the trial?
2b. Studies of aetiology (case-control study of a harmful agent)
% Were there two groups of cases, similar except for exposure to harmful agent?
% Was occurrence of the outcome measured in the same way for both groups?
% Were enough patients followed up for long enough for the outcome to develop?
% Did exposure clearly precede the outcome?
% Was there a dose-response gradient?
% Was there a re-challenge, or improvement after the drug stopped?
% Does the association make biological sense?
2c. Studies of diagnosis (evaluation of clinical findings or tests)
% Was the finding or result compared with a 24 carat gold standard for diagnosis?
% Was the finding or result determined blind to the gold standard?
% Was the gold standard determined blind to the finding or test result?
% Was the gold standard determined in all cases, not just those with an abnormal
result?
2d. Studies of prognosis, prognostic index (cohort studies)
% Was a defined sample of patients assembled at an early stage of the disease?
% Were patients followed up long enough for the outcome to develop?
% Was the outcome clearly defined, objective and assessed blind to exposure in all
cases?
% Was the performance of any prognostic index tested on a fresh set of cases?
3. Comments
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Thorax 2009;64(Suppl III):iii1–iii55. doi:10.1136/thx.2009.121434