Introduces topic (1), cites article to be appraised, and appraisal tool utilized (1), provides 2-3 sentences summarizing the overarching strengths and weaknesses of the article (2), and includes summary statement that indicates that the article was “include”, “seek further information” or “exclude” (1) 

 Chooses 2 criteria from the assigned appraisal tool that were found to be weaknesses or that introduced bias into the study. In a sentence state what the 2 criteria are that you will be expanding upon 

1. Explains each of the 2 criteria and why it is important 2. States whether and how the article meets the desired level of quality for the criteria 3. Cites the article, the appraisal tool, and other resources as necessary for explanation. 

Article is CAMELS and appriasal tool is CASP both attached below. 

CASP Randomised Controlled Trial Standard Checklist:
11 questions to help you make sense of a randomised controlled trial (RCT)

Main issues for consideration: Several aspects need to be considered when appraising a
randomised controlled trial:

Is the basic study design valid for a randomised
controlled trial? (Section A)

Was the study methodologically sound? (Section B)
What are the results? (Section C)
Will the results help locally? (Section D)

The 11 questions in the checklist are designed to help you think about these aspects

How to use this appraisal tool: The first three questions (Section A) are screening questions
about the validity of the basic study design and can be answered quickly. If, in light of your
responses to Section A, you think the study design is valid, continue to Section B to assess
whether the study was methodologically sound and if it is worth continuing with the appraisal by
answering the remaining questions in Sections C and D.

Record ‘Yes’, ‘No’ or ‘Can’t tell’ in response to the questions. Prompts below all but one of the
questions highlight the issues it is important to consider. Record the reasons for your answers
in the space provided. As CASP checklists were designed to be used as educational/teaching
tools in a workshop setting, we do not recommend using a scoring system.

About CASP Checklists: The CASP RCT checklist was originally based on JAMA Users’ guides to the
medical literature 1994 (adapted from Guyatt GH, Sackett DL and Cook DJ), and piloted with
healthcare practitioners. This version has been updated taking into account the CONSORT 2010
guideline (, accessed 16 September 2020).

Citation: CASP recommends using the Harvard style, i.e. Critical Appraisal Skills Programme
(2020). CASP (insert name of checklist i.e. Randomised Controlled Trial) Checklist. [online]
Available at: insert URL. Accessed: insert date accessed.

©CASP this work is licensed under the Creative Commons Attribution – Non-Commercial- Share
A like. To view a copy of this licence, visit

Critical Appraisal Skills Programme (CASP) part of Oxford Centre for Triple Value Healthcare Ltd


Study and citation: …………………………………………………………………………………………………………

Section A: Is the basic study design valid for a randomised controlled trial?

1. Did the study address a clearly focused
research question?
Was the study designed to assess the outcomes
of an intervention?
Is the research question ‘focused’ in terms of:
• Population studied
• Intervention given
• Comparator chosen
• Outcomes measured?

Yes No Can’t tell
o o


Results From the Child/Adolescent Anxiety
Multimodal Extended Long-Term Study (CAMELS):
Primary Anxiety Outcomes
Golda S. Ginsburg, PhD, Emily M. Becker-Haimes, PhD, Courtney Keeton, PhD, Philip C.
Kendall, PhD, ABPP, Satish Iyengar, PhD, Dara Sakolsky, MD, Anne Marie Albano, PhD,
Tara Peris, PhD, Scott N. Compton, PhD, John Piacentini, PhD, ABPP

Objective: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). Rates of
stable anxiety remission (defined rigorously as the absence of all DSM-IV TR anxiety disorders across all follow-up years) and predictors of anxiety
remission across a 4-year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive-behavioral therapy (CBT), their
combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child
and family variables, and interim negative life events.

Method: Data were from 319 youths (age range 10.9�25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or
generalized anxiety disorders and enrolled in the multi-site Child/Adolescent Anxiety Multimodal Study (CAMS). Participants were assessed annually by
independent evaluators using the age-appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family
functioning, life events, and mental health service use).

Results: Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely
to be in the chronically ill group (odds ratio ¼ 2.73; confidence interval ¼ 1.14�6.54; p < .02); treatment type was not associated with remission status
across the follow-up. Several variables (eg, male gender) predicted stable remission from anxiety disorders.

Conclusion: Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can
help tailor treatments to youth at greatest risk for chronic illness.

Clinical Trial Registration Information: Child and Adolescent Anxiety Disorders (CAMS).; NCT00052078.

Key words: anxiety, treatment, follow-up, cognitive-behavior therapy, sertraline

J Am Acad Child Adolesc Psychiatry 2018;57(7):471–480.


Journal of t
Volume 57

ediatric anxiety disorders are highly prevalent, are
associated with severe disability, and confer high
personal and economic costs.1-3 These illnesses

are chronic, as data from retrospective and prospective
studies show high degrees of continuity for anxiety disorders
as children reach adolescence and adulthood.4-6 Conse-
quently, identifying factors that interrupt the progression or
persistence of these illnesses is paramount. One key fac