Critical Appraisal Guide : Does Repetitive Task Training Improve Functional Activity

After Stroke? A Cochrane Systematic Review and Meta-Analysis

Critical appraisal of systematic reviews also requires a slightly different approach to other
critical appraisal tasks, again using the same evidence-based principals. More emphasis is
placed on the methodology of the review, rather than the individual studies. If a meta-analysis
is included, it is important to ensure that the studies have been appropriately combined.

Validity

Yes, Abstract, Paragraph 1 (Objective) pg 9

Did the review explicitly address a
focused clinical question?
Yes, Methods Paragraph 1 pg 10, Result pg
Was the search for relevant studies 10
detailed and exhaustive?
Yes, Methods Paragraph 1,Line 8, pg 10,
Was the selection of primary studies Result Paragraph 1 and Figure 1 , pg 10-11
reproducible and free from bias?
Yes, Results paragraph 4, pg 13
Was the quality of included studies
assessed, and were they of a high
standard?
Were all the important outcomes Yes, Methods paragraph 3 and 4, pg 10
considered?

Are the individual studies adequately Yes, Result,Table II and III, pg 11-12
described?

Were the results of primary studies Yes, Result pg 11-13

combined appropriately?

How are the results presented and is this Yes, Result pg 13, figure 2 and 3
appropriate to the data?

Were the results similar from study to No,Results pg 13

study?

Has a sensitivity analysis been performed? Yes, Results pg 13 paragraph 5

Clinical Importance
Are the outcomes clinically relevant? Yes, Methods paragraph 3 and 4.

How large was the treatment effect in Yes, Result pg 13, figure 2 and 3
meta-analysis?

How precise was the estimate of treatment Yes, Result pg 13 Paragraph 13

effect?
Are the benefits worth the costs and Yes, Discussion paragraph 4 line 13 pg 15
potential toxicities?

Is a Relative Risk, Absolute Risk

Reduction or Number Needed to Treat
(harm) given?

Applicability
Are the results discussed in relation to Yes, Discussion paragraph 4 pg 14
existing knowledge, and is the discussion
biased?

How would I clearly express the results to

a colleague or my patient?

Does this paper answer your clinical No, Discussion paragraph 5 line 5 pg 14
question or have you changed your
question to suit the literature?

How similar were the patients in the Yes, Methods paragraph 1 pg 10

included trials to your patient or
population?

Is treatment feasible and available in your Yes, physiotherapy in hospital

clinical setting?