Appendix B Table 2Quality Rating Criteria

DesignUSPSTF Quality Rating Criteria293NICE Methodology Checklists294
Systematic reviews and meta-analyses
  • Comprehensiveness of sources considered/ search strategy used
  • Standard appraisal of included studies
  • Validity of conclusions
  • Recency and relevance, especially for systematic reviews
  • Study addresses an appropriate and clearly focused question
  • Description of the methodology used is included
  • Literature search is sufficiently rigorous to identify all relevant studies
  • Study quality is assessed and taken into account
  • Enough similarities between selected studies to make combining them reasonable
Case-control studies
  • Accurate ascertainment of cases
  • Nonbiased selection of cases/controls with exclusion criteria applied equally to both
  • Response rate
  • Diagnostic testing procedures applied equally to each group
  • Measurement of exposure accurate and applied equally to each group
  • Appropriate attention to potential confounding variables
  • Study addresses an appropriate and clearly focused question
  • Cases and controls are taken from comparable populations
  • Same exclusion criteria are used for both cases and controls
  • Percentage of each group (cases and controls) that participated in the study is specified
  • Participants and nonparticipants are compared to establish their similarities or differences
  • Cases are clearly defined and differentiated from controls
  • Controls are clearly established as noncases
  • Measures are taken to prevent knowledge of primary exposure influencing case ascertainment
  • Exposure status is measured in a standard, valid, and reliable way
  • Main potential confounders are identified and taken into account in the design and analysis
  • Confidence intervals are provided
Randomized, controlled trials
  • Initial assembly of comparable groups employs adequate randomization, including first concealment and whether potential confounders were distributed equally among groups
  • Maintenance of comparable groups (includes attrition, crossovers, adherence, contamination)
  • Important differential loss to followup or overall high loss to followup
  • Measurements are equal, reliable, and valid (includes masking of outcome assessment)
  • Clear definition of interventions
  • All important outcomes considered
  • Study addresses an appropriate and clearly focused question
  • Assignment of subjects to treatment groups is randomized
  • Adequate concealment method is used
  • Subjects and investigators are kept blind about treatment allocation
  • Treatment and control groups are similar at the start of the trial
  • Only difference between groups is the treatment under investigation
  • All relevant outcomes are measured in a standard, valid, and reliable way
  • Percentage of individuals or clusters recruited into each treatment arm of the study who dropped out before completion is provided
  • All subjects are analyzed in the groups to which they were randomly allocated (often referred to as intention-to-treat analysis)
  • When the study is carried out at more than one site, results are comparable for all sites
Cohort studies
  • Initial assembly of comparable groups employs consideration of potential confounders with either restriction or measurement for adjustment in the analysis; consideration of inception cohorts
  • Maintenance of comparable groups (includes attrition, crossovers, adherence, contamination)
  • Important differential loss to followup or overall high loss to followup
  • Measurements are equal, reliable, and valid (includes masking of outcome assessment)
  • Clear definition of interventions
  • All important outcomes considered
  • Study addresses an appropriate and clearly focused question
  • Two groups being studied are selected from source populations that are comparable in all respects other than the factor under investigation
  • Study indicates how many of participants asked to take part did so, in each group being studied
  • Likelihood that some eligible subjects might have the outcome at the time of enrollment is assessed and taken into account in the analysis
  • Percentage of individuals or clusters recruited into each arm of the study who dropped out before completion is provided
  • Full participants and those lost to followup are compared, by exposure status
  • Outcomes are clearly defined
  • Assessment of outcome is made blind to exposure status
  • Where blinding is not possible, there is some recognition that knowledge of exposure status could have influenced the assessment of outcome
  • Measure of assessment of exposure is reliable
  • Evidence from other sources is used to demonstrate that the method of outcome assessment is valid and reliable
  • Exposure level or prognostic factor is assessed more than once
  • Main potential confounders are identified and taken into account in the design and analysis
  • Confidence intervals are provided
Diagnostic accuracy studies
  • Screening test is relevant, available for primary care, and adequately described
  • Study uses a credible reference standard, performed regardless of test results
  • Reference standard interpreted independently of screening test
  • Handles indeterminate results in a reasonable manner
  • Spectrum of patients included in study
  • Sample size
  • Administration of reliable screening test
  • Nature of the test being studied is clearly specified
  • Test is compared with an appropriate gold standard
  • Where no gold standard exists, a validated reference standard is used as a comparator
  • Patients for testing are selected either as a consecutive series or randomly, from a clearly defined study population
  • Test and gold standard are measured independently (blind) of each other
  • Test and gold standard are applied as close together in time as possible
  • Results are reported for all patients that are entered into the study
  • Prediagnosis is made and reported

From: Appendix B, Search Strategies

Cover of Screening for and Management of Obesity and Overweight in Adults
Screening for and Management of Obesity and Overweight in Adults [Internet].
Evidence Syntheses, No. 89.
LeBlanc E, O'Connor E, Whitlock EP, et al.

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