Questions to ask in prognostic studies onofre Morán md, msc


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QUESTIONS TO ASK IN PROGNOSTIC STUDIES

  • Onofre Morán MD, MSc.

  • Professor, Faculty of Medicine, Universidad Autónoma de San Luis Potosí, S.L.P. México.

  • PhD Candidate

  • University of British Columbia, Vancouver, Canada.


Questions to ask in Prognostic studies

  • WHY:

    • Justified?
    • Hypothesis/purpose of the study?
  • HOW:

    • Was an inception cohort assembled?
    • Were objective outcome criteria used?
    • Was the outcome assessment “blind”?
    • Were DIAGNOSTIC SUSPICION BIAS and EXPECTATION BIAS avoided?


Questions to ask in Prognostic studies

  • WHO:

    • Is the studied sample CLEARLY described?
    • Is the referral pattern described?
    • Is there evidence of REFERRAL FILTER BIAS or DIAGNOSTIC ACCESS BIAS?
    • Do the authors account for every patient who was eligible for the study but did NOT enter it?
    • Was complete follow-up achieved?


Questions to ask in Prognostic studies

  • WHAT:

    • Was adjustment for known prognostic factors carried out (THERAPEUTIC ACCESS BIAS)?
    • Was there LEAD TIME BIAS considered?
    • Were losses to follow-up handled appropriately and was their clinical status determined?
    • Were all clinically relevant outcomes reported?


Questions to ask in Prognostic studies

  • HOW MANY?

    • Was statistical significance considered?
    • Were statistical test applied appropriately?
    • Was any measurement of risk provided?
    • Was the study large enough to detect important outcomes?
    • If no increased risk was found, was there any consideration of the power of the study?


Questions to ask in Prognostic studies

  • SO WHAT?

    • Are the results clinically significant?
    • Are the results (and patients) sufficiently described to be generalized to the clinical practice?
    • Is the therapeutic intervention feasible in your practice?


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