How to critically appraise a randomized controlled trial

Name the population, comparison, outcome and follow-up period before judging a trial. Keep a short record of the effect estimate and its uncertainty. A study can report several outcomes, and concerns about one result may not apply equally to another. Read the methods and relevant supplementary material rather than relying on the abstract alone.

Cochrane RoB 2 assesses a particular trial result across randomization, deviations from intended interventions, missing outcome data, outcome measurement and selection of the reported result. Use the official guidance when a formal assessment is required. MedLit’s source-linked reading prompts are not a validated implementation of RoB 2 and should not be reported as one.

Suppose a fictional trial randomized 120 people and reported outcomes for 96. The missing count is 24, but the fraction alone cannot tell you the direction or size of bias. In your notes, separate what the report states from what you need to find: reasons for missingness, counts by group, and how the analysis handled unavailable outcomes. Bring the unanswered question to the discussion rather than converting it into a confident conclusion.

After reviewing the methods, ask how the studied population, comparator and follow-up relate to the setting you care about. Write down what would need to be different for the conclusion to change. A structured appraisal supports that conversation; it does not determine an individual patient’s care.

Paste the trial’s DOI or PubMed link into the workspace, connect an AI provider and review the retrieved source coverage. Inspect each generated judgment beside its supporting passage. If only an abstract is available, keep questions about unavailable methods unresolved. Use the journal club worksheet to record your own conclusions and disagreements.

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