As these tools were designed as pedagogic tools – for use in learning how to appraise in small groups, we do not assign a scoring system. We would advise that if you can’t answer ‘yes’ to the first 2/3 questions, then the evidence may be of poor quality. Classifying quality (or risk of bias) as high, moderate or low, based on the CASP tool would be perfectly acceptable.

The dominant opinion these days is that scores can be misleading, and it is better to report the actual domains where there are biases.