How to Use the CASP Systematic Review Checklist
The
CASP (Critical Appraisal Skills Programme) Systematic Review Checklist is a
user-friendly tool designed to help researchers, clinicians, and students
critically appraise systematic reviews for
validity, relevance, and reliability. Unlike PRISMA (which guides reporting) or AMSTAR-2/ROBIS (which assess methodological quality/bias), CASP provides a
simplified, question-based approach for quick evaluation.
CASP Systematic Review Checklist: Step-by-Step Guide
1. Understand the Structure
The CASP checklist consists of
10 key questions, divided into
three sections:
- Validity (Are the results trustworthy?)
- Results (What are the findings?)
- Applicability (Can the results be applied to your context?)
Each question is answered with:
✅
Yes (Low risk of bias)
❌
No (Potential flaw)
❓
Can’t tell (Insufficient information)
2. Detailed Breakdown of the 10 Questions
Section A: Validity (Q1-Q5)
Q1. Did the review address a clearly focused question?
- Check if the PICO (Population, Intervention, Comparison, Outcome) is well-defined.
Q2. Did the authors look for the right type of studies?
- Were appropriate study designs (RCTs, cohort studies) included?
- Were key databases (PubMed, Cochrane) searched?
Q3. Do you think all relevant studies were included?
- Was the search strategy comprehensive (no language/date restrictions)?
- Was grey literature (unpublished studies, conference abstracts) considered?
Q4. Did the review authors assess the quality of included studies?
- Was a risk of bias tool (e.g., Cochrane RoB, Newcastle-Ottawa) used?
Q5. If the results were combined, was it reasonable to do so?
- Were studies homogeneous enough for meta-analysis?
- Was heterogeneity assessed (I² statistic, subgroup analysis)?
Section B: Results (Q6-Q8)
Q6. What are the overall results?
- Are effect sizes (RR, OR, mean difference) clearly reported?
Q7. How precise are the results?
- Are confidence intervals (CIs) provided?
Q8. Were all important outcomes considered?
- Did the review assess harms, costs, or patient-reported outcomes (if relevant)?
Section C: Applicability (Q9-Q10)
Q9. Can the results be applied to your population?
- Are the included studies similar to your patients/setting?
Q10. Were all key outcomes considered?
- Do the findings align with your clinical/research priorities?
3. How to Score & Interpret CASP
- No formal scoring system (unlike AMSTAR-2).
- More "Yes" answers = Higher confidence in the review.
- "No" or "Can’t tell" answers indicate limitations.
Example Assessment
| Question |
Response |
Comment |
| Q1 (Focused question) |
✅ Yes |
Clear PICO framework. |
| Q3 (All relevant studies) |
❌ No |
Only English studies included. |
| Q5 (Reasonable synthesis) |
❓ Can’t tell |
Heterogeneity not discussed. |
| Overall Impression |
Moderate reliability |
Limited by language bias. |
4. When to Use CASP?
✔
Quickly appraising SRs for clinical decision-making.
✔
Teaching critical appraisal (simpler than AMSTAR-2/ROBIS).
✔
Screening multiple reviews before deeper analysis.
CASP vs. Other Tools
| Feature |
CASP |
AMSTAR-2 |
ROBIS |
| Focus |
Quick appraisal |
Methodological quality |
Bias risk |
| Best for |
Beginners, clinicians |
Researchers, guideline developers |
Bias detection |
| Time Required |
5–10 mins |
15–30 mins |
20–40 mins |
Strengths of CASP
✔
Simple & intuitive (ideal for non-experts).
✔
Free and widely accessible.
✔
Covers key validity, results, and applicability issues.
Limitations
✖
Less detailed than AMSTAR-2 or ROBIS.
✖
No overall score (subjective interpretation needed).
Conclusion
The CASP checklist is a
practical, beginner-friendly tool to assess systematic reviews efficiently. While it doesn’t replace
AMSTAR-2 or ROBIS for in-depth appraisal, it’s perfect for
rapid screening or educational purposes.
