gms | German Medical Science

EbM & Individualisierte Medizin
12. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Deutsches Netzwerk Evidenzbasierte Medizin e. V.

24.03. - 26.03.2011, Berlin

QUADAS-2: an updated quality assessment tool for diagnostic accuracy studies

Meeting Abstract

  • corresponding author presenting/speaker Heike Raatz - Basel Institute of Clinical Epidemiology and Biostatistics, Basel, Schweiz
  • author Penny Whiting - School of Social and Community Medicine, Bristol, Großbritannien
  • author Marie Westwood - Kleijnen Systematic Reviews Ltd, York, Großbritannien
  • author Anne W. Rutjes - Division of Clinical Epidemiology and Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Switzerland
  • author Susan Mallett - Centre for Statistics in Medicine, University of Oxford, Oxford, Großbritannien
  • author Mariska Leeflang - Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, Niederlande
  • author Johannes B. Reitsma - Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, Niederlande
  • author Jon Deeks - Unit of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, Großbritannien
  • author Jonathan Sterne - School of Social and Community Medicine, Bristol, Großbritannien
  • author Patrick Bossuyt - Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, Niederlande

EbM & Individualisierte Medizin. 12. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin. Berlin, 24.-26.03.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11ebm93

DOI: 10.3205/11ebm93, URN: urn:nbn:de:0183-11ebm937

Veröffentlicht: 23. März 2011

© 2011 Raatz et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: QUADAS was developed in 2003 to assess the quality of diagnostic test accuracy (DTA) studies included in systematic reviews [1]. Its 14 items assess risk of bias, variability and reporting quality. Personal experience, anecdotal reports, and feedback via Cochrane suggested that some elements required adaptation. We are therefore developing QUADAS-2.

Material/methods: The development of QUADAS-2 comprised the following steps:

1.
Evaluation of the evidence base
a. Review of use of QUADAS in systematic reviews
b. Feedback from reviewers who have used QUADAS
c. Updated review on sources of bias and variation
d. Review of studies that evaluated QUADAS
2.
Conceptual decisions
3.
Face-to-face consensus meeting
4.
Development, piloting and refinement of QUADAS-2

Results: Issues which arose consistently during the review of evidence included: the need for a tool which can assess comparative accuracy studies and studies which use follow-up as a reference standard and the requirement for an overall measure of study quality. There were suggestions for inclusion of sub-categories to cover bias and variation related to spectrum composition and patient selection. Clinical review bias, uninterpretable results, and withdrawals were highlighted as problematic and items relating to reporting quality were frequently omitted. Conceptual decisions made by the steering group and agreed at the face-to-face meeting included: separate rating of risk of bias and applicability, remove items relating to reporting, expand to cover comparative tests and follow-up as a reference standard, and aim to develop a set of independent criteria that work well together. It was agreed not to extend QUADAS-2 to cover prognostic studies or to develop topic specific items. We agreed to move from the rating of yes/no/unclear to low/high/unclear risk of bias. We discussed providing an overall summary rating of quality for each study but we agreed that an objective rating was not possible and therefore should be avoided.

Conclusion/implication: A draft version of QUADAS-2 is currently being piloted in a series of reviews. A finalized version is anticipated by the end of March 2011. This will be presented at the meeting.


References

1.
Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3:25. DOI: 10.1186/1471-2288-3-25 Externer Link