Strength of the evidenceLevel of evidence (NHMRC, 2009): I ...



Critically Appraised Paper (CAP): External Published DIAGNOSTIC EvidenceNSW Speech Pathology Evidence Based Practice NetworkCLINICAL BOTTOM LINE: Clinical Question [patient/problem, outcome, assessment tool /diagnostic marker, and comparison]:Strength of the evidenceLevel of evidence (NHMRC, 2009): I II III-1 III-2 III-3 IVQuality of Evidence (based on Dollaghan, 2007): Appraisal points Comments – Strengths/weaknesses of studyParticipants similar/different to clinical practice?Reliability / Validity of assessment tool(s)?Blinding of assessors?Replication possible in clinical practice?+ / - Likelihood ratio (sensitivity and specificity) Date:Appraised By:Results: [including authors comment’s on reliability/validity of assessment tool or diagnostic marker(s)]:Participants:Method: [including description of assessment tool(s) / assessment procedure / assessment measures]:Citation:Form based on Worrall & Bennett, Evidence based Practice: Barriers & Facilitators for Speech-Language Pathologists, Journal of Medical Speech-Language Pathology 2:9, xi – xvi Revised DRAFT August 2013 based on Dollaghan (2007) – CADE Appendix B. Guidelines for completion of the CAP – DIAGNOSTIC (DRAFT – UNDER DEVELOPMENT)Clinical Bottom Line The consensus of the reviewers on implications of the paper on clinical practice. Whilst this may be somewhat subjective, it is hoped that robust discussion, the Level of Evidence and your comments on the design will enable you to produce a practical/realistic 'bottom line'. Many of the papers in Speech Pathology may have limitations, but the Clinical Bottom line should be aimed to help clinicians apply what evidence there is.Clinical QuestionThis should ideally include four components:the patient or problemthe diagnostic test or prognostic factorthe comparison test (optional)the outcomeMethodParticipantsResults Strength of the evidenceLevel of evidence (NHMRC, 2009): I II III-1 III-2 III-3 IVFROM (NHMRC, 2009 Table 3, p. 15) I = “A systematic review of level II studies” (NHMRC, 2009 Table 3, p. 15) II = “A study of test accuracy with an independent, blinded comparison with a valid reference standard, among consecutive persons with a defined clinical presentation” III-1 = “A study of test accuracy with an independent, blinded comparison with a valid reference standard, among non-consecutive persons with a defined clinical presentation” III-2 = “A comparison with reference standard that does not meet the criteria required for “Level II and III-1 evidence” III-3 = “Diagnostic case-control study IV = “study of diagnostic yield (no reference standard)Quality of Evidence (based on Dollaghan, 2007): Appraisal points (out of a possible 13 points) Comments on strengths / weaknesses of the study ................
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