PICO:

Critical Appraisal of RCT

Siswo Poerwanto, PhD, MPH, MSc
Evidence Based Medicine
1. Identify a clinical
problem Patient

2. Ask a relevant, focused APPLY ASK

question
3. Acquire the necessary
resources to answer the Answerable
Evidence
Question
question
4. Appraise the evidence
obtained APPRAISE ACQUIRE
5. Apply to patient care Resources
APPRAISE
A. Validity
Can I trust this information?
B. Clinical Importance
If true, will the use of this information make an
important difference?
C. Applicability
Can I use the information in this instance?
Appraising RCT using CASP (critical appraisal
skills program)
Are the results of the trial valid? (Section A)
What are the results? (Section B)
Will the results help locally? (Section C)
 CASP
(Critical Appraisal Skills Program)
Untuk menilai berbagai hasil penelitian dari berbagai
Desain Study, misalnya
RCT
Cohort
CCS
Diagnosis
Section A: Are the results of the trial valid?
1. Did the trial address a clearly focused issue in terms of
P-I-C-O?
2. Was the assignment of patients to treatments
randomized? How was this carried out?
3.Were patients, health workers and study personnel
blinded?
4. Were the groups similar at the start of the trial
(baseline data)?
Other factors that might affect the outcome such as age,
sex, social class, these may be called baseline characteristics
Section A
5. Aside from the experimental intervention, were the
groups treated equally?
6. Were all of the patients who entered
the trial properly accounted for at its conclusion?
Section B: What are the results?
7. How large was the treatment effect?
Consider: What outcomes were measured (primary,
secondary)?
Is the primary & secondary outcome clearly specified?
What results were found for each outcome?
Is there evidence of selective reporting of outcomes
8. How precise was the estimate of the treatment
effect
What are the confidence limits (95% CI)?
Were they statistically significant (p-value)?
Section C: Will the results help locally?
9. Can the results be applied in your context (or to the
local population)
Do you have reason to believe that your population of
interest is different to that in the trial? If so, in what
way?
10. Were all clinically important outcomes considered?

11. Are the benefits worth the harms and costs?

tell No
Tugas Kelompok
Tiap kelompok memilih satu jurnal dengan desain
RCT dengan domain therapy yang sesuai dengan
pelayanan fisioterapi tertentu (musculoskeletal,
cardio-respirasi dsb)
Jawab setiap pertanyaan di Section A, B dan C tsb
diatas.
Waktu: 2 minggu. Minggu ke-2 dst: penyajian
kelompok untuk penilain akhir
Contoh : terlampir
Section C. APPLY TO PATIENT CARE

Patient
Values Medical Decision

Clinical Research
Expertise Evidence