Good:Evaluates relevant available screening test; uses a credible reference standard; interprets reference standard independently of screening test; reliability of test assessed; has few or handles indeterminate results in a reasonable manner; includes large number (more than 100) broad-spectrum patients with and without disease; study attempts to enroll a random or consecutive sample of patients who meet inclusion criteria; screening cutoffs pre-stated.
Fair:Evaluates relevant available screening test; uses reasonable although not best standard; interprets reference standard independent of screening test; moderate sample size (50 to 100 subjects) and a “medium” spectrum of patients (i.e. applicable to most screening settings).
Poor:Has important limitation such as: uses inappropriate reference standard; screening test improperly administered; biased ascertainment of reference standard; very small sample size of very narrow selected spectrum of patients.

From: Appendix B, Detailed Methods

Cover of Screening for Osteoporosis
Screening for Osteoporosis: Systematic Review to Update the 2002 U.S. Preventive Services Task Force Recommendation [Internet].
Evidence Syntheses, No. 77.
Nelson HD, Haney EM, Chou R, et al.

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