{"id":74,"date":"2010-03-07T22:38:42","date_gmt":"2010-03-07T21:38:42","guid":{"rendered":"https:\/\/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:\/\/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:\/\/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:\/\/blogs.bmj.com\/adc\/2010\/03\/07\/fast-appraisals\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"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"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>FAST appraisals - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/03\/07\/fast-appraisals\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"FAST appraisals - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"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. 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