{"id":74,"date":"2010-03-07T22:38:42","date_gmt":"2010-03-07T21:38:42","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc-archimedes\/?p=74"},"modified":"2010-03-09T17:12:57","modified_gmt":"2010-03-09T16:12:57","slug":"fast-appraisals","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2010\/03\/07\/fast-appraisals\/","title":{"rendered":"FAST appraisals"},"content":{"rendered":"<p>I&#8217;m fairly sure you&#8217;ll remember the <a title=\"Remeber Rambo?\" href=\"https:\/\/stg-blogs.bmj.com\/adc-archimedes\/2007\/07\/11\/remember-rambo-2\/\">RAMbo method<\/a> of reviewing the validity of single randomised controlled trials. And so I think that many readers will have been having sleepless afternoons, struggling through the lengths of a &#8216;User&#8217;s Guide&#8217; checklist for systematic reviews thinking &#8220;Which action hero can rescue me from this mire?&#8221;.<\/p>\n<p>Or perhaps not.<\/p>\n<p>But whichever, there is another rapid review acronym you should all learn to do it: FAST.<!--more-->Which is, in itself, rather nice, isn&#8217;t it?<\/p>\n<p>F &#8211; Find all studies? (Did they &#8211; if they didn&#8217;t, and you can think of where they might well have lost stuff, then you can throw it out.)<\/p>\n<p>A &#8211; Appraise them right? (If they were looking at the effects of treatments, and didn&#8217;t address risks of bias from poorly or non-randomised studies; or if they&#8217;re trying to look at prognosis and haven&#8217;t thought about drop-outs, then you can refuse to read further.)<\/p>\n<p>S- Synthesis &#8211; look at heterogeneity. (When you look at how they have pulled all the information together, was it so mixed up and messy that it shouldn&#8217;t have been done the way it has? Did they assess publication or other biases? If they didn&#8217;t then send the forest plot to the composter.)<\/p>\n<p>T &#8211; Transferability. This one takes a bit longer to explain. It might be a review of steroids for croup, that tells you &#8216;steroids work&#8217;. Hurray! But you can&#8217;t just prescribe &#8216;steroid&#8217; can you? How can you transfer the review result into clinical practice? A couple of suggestions have been offered, and both have common sense behind them.<\/p>\n<ol>\n<li>go for the strategy of the largest trial (it has the most weight in the review).<\/li>\n<li>go for the most often used dose\/drug\/approach (it was shown to be feasible the most often).<\/li>\n<\/ol>\n<p>So, next time you pick up a systematic review, instead of just believing it &#8211; ask some FAST questions to check.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I&#8217;m fairly sure you&#8217;ll remember the RAMbo method of reviewing the validity of single randomised controlled trials. And so I think that many readers will have been having sleepless afternoons, struggling through the lengths of a &#8216;User&#8217;s Guide&#8217; checklist for systematic reviews thinking &#8220;Which action hero can rescue me from this mire?&#8221;. Or perhaps not. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2010\/03\/07\/fast-appraisals\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[79,80,145],"tags":[],"class_list":["post-74","post","type-post","status-publish","format-standard","hentry","category-archimedes","category-critical-appraisal-note","category-meta-analysis"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/74","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=74"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/74\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=74"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=74"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=74"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}