Critical appraisal checklist: Cross sectional

Gwasanaeth Tystiolaeth
Evidence Service

Questions to assist with the critical appraisal of a cross-sectional study (Type IV

evidence)1

Paper citation:

A. What is this paper about?

Yes Can’t tell No
1. Is the study relevant to the needs of the Project? Yes
2. Does the paper address a clearly focused issue? In
terms of:
 aims of the investigation? Yes
 setting (location and dates)? Yes
 the population studied? Yes
 the variables measured? Yes
3. Is the choice of study method appropriate to the study Yes
question?

Is it worth continuing? (delete as appropriate) YES/NO/Discuss

Only complete the next section if the answer to the question above was ‘Yes’
1
Sources used: Critical Appraisal Skills Programme (CASP, Anglia and Oxford RHA) questions and Polgar A, Thomas SA. Chapter 22. Critical evaluation of published research in Introduction to
research in the health sciences. 3rd edition. Melbourne: Churchill Livingstone, 1995; Undertaking systematic reviews of research on effectiveness. University of York: NHS Centre for Reviews &
Dissemination, 2001; Weightman AL, Barker, JM, Lancaster J. Health Evidence Bulletins Wales Project Methodology 3. Cardiff: UWCM, 2000.

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B. Can I trust this paper?

Yes Can’t tell No
4. Is the population studied appropriate?
 Was the sample representative of its target population? Can't tell
 How was the sample selected – random, stratified? No, it's
consecutive
 If appropriate, was a power calculation made? No
5. Have confounding and bias been considered?
 Did the study achieve a good response rate? Yes (this journal
didn't use
questionaire)
 Were rigorous processes used to develop the questions? Yes (this journal
(e.g. were the questions piloted/validated?) didn't use
questionaire)
6. Is the study design and/or execution flawed to the Yes
extent that the results are unreliable?

Is it worth continuing? (delete as appropriate) YES/NO/Discuss

Only complete the next two sections if the answer to the question above was ‘Yes’

C. What did they find?

Yes Can’t tell No

7. Are tables/graphs adequately labelled and Yes
understandable?
8. Are you confident with the authors' choice and use of Yes

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statistical methods, if employed?

 If sub-group/interactions analyses have been undertaken
is there an explanation of how/why sub-groups have been
formed?
 Is there an explanation of how potential confounding No
factors have been controlled for?
 Is there an explanation of how missing data have been Yes
handled?
 Are both unadjusted and adjusted (ie for confounding) No
results given if appropriate?
 Is the precision of estimates (95% CI) given? Yes
 Do you believe the results? Yes

D. Are the results relevant locally?

Yes Can’t tell No
9. Can the results be applied to the local situation? Yes
Consider differences between the local and study populations
(eg cultural, geographical, ethical) which could affect the
relevance of the study.
10. Were all important variables considered? Yes
11. Accept for further use as Type IV evidence? Cant tell

If the answer to question 11 above was ‘Yes’ then record this study as ‘Included’ and proceed to data
extraction:

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Comments:

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