Dept.

of General Practice
University of Glasgow.
CRITICAL APPRAISAL CHECLIST !"R A# ARTICLE
"# PR"G#"SIS.
St$%y Design& Co'ort st$%y.
A%apte% fro(&
La$pacis A) *ells G) Ric'ar%son *S) T$gwell P. Users+ g$i%es to t'e (e%ical
literat$re. ,. How to $se an article on prognosis. JAMA -../0 121& 13/4132.
D"ES THE STUD5 ADDRESS A CLEAR 6UESTI"#7
Dept. of General Practice
University of Glasgow.
-. Is t'ere a clearly foc$sse% 8$estion7
Consider Patients
Disease/Condition
Outcome
5es Can+t tell #o
ARE THE RESULTS ,ALID7
1. *as a %efine%) representative sa(ple of patients
asse(9le% at a co((on :$s$ally early; point in t'e
co$rse of t'eir %isease7
5es Can+t tell #o
3. *as t'e follow4$p of t'ese patients s$fficiently
long an% co(plete7
/. *ere o9<ective an% $n9iase% o$tco(e criteria
$se%7
Consider:
Did the individual assessing the outcome criteria
know whether or not the patient had a potential
prognostic factor, i.e. were they blinded
=. *as t'ere a%<$st(ent for i(portant prognostic
factors7
Consider:
!as there standardisation for potentially important
prognostic factors e.g. age
!ere different sub"groups compared
!as there validation in an independent group of
patients
*HAT ARE THE RESULTS7
Dept. of General Practice
University of Glasgow.
>. How li?ely are t'e o$tco(e event:s; over a specifie%
perio% of ti(e7
2. How precise are t'e esti(ates of t'is li?eli'oo%7
Consider:
#re the results presented with confidence intervals
*ILL THE RESULTS HELP @E *ITH THIS PATIE#T7
A. *ere t'e st$%y patients si(ilar to t'is patient7 5es Can+t tell #o
.. *ill t'e res$lts lea% %irectly to selecting or avoi%ing
a treat(ent7
-B. Are t'e res$lts $sef$l for reass$ring or co$nselling
(y patient7
Consider:
!ill the evidence make a clinically important impact
on your conclusions about what to offer or tell this
patient
CARG"# DUSTER.
Dept. of General Practice
University of Glasgow.
Prognosis $he possible outcomes of a disease and the fre%uency with which they
can be e&pected to occur.
Prognostic factors Characteristics of a patient that may be used to more accurately predict
the outcome in that patient. $hese may be demographic 'e.g. age(,
disease"specific 'e.g. tumour stage( or co"morbid 'e.g. other diseases
accompanying the disease in %uestion(. Prognostic factors don)t have
to cause the outcome, *ust be associated strongly enough to predict
their development.
Co'ort st$%y +tudy design in which a group of individuals are followed up
prospectively over time to see if they develop a disease or outcome of
interest.