Assessing the quality of randomized trials:: Reliability of the Jadad scale

被引:519
作者
Clark, HD
Wells, GA
Huët, C
McAlister, FA
Salmi, LR
Fergusson, D
Laupacis, A
机构
[1] Univ Ottawa, Dept Med, Ottawa, ON, Canada
[2] Loeb Hlth Res Inst, Clin Epidemiol Unit, Ottawa, ON, Canada
[3] Univ Bordeaux 2, F-33076 Bordeaux, France
来源
CONTROLLED CLINICAL TRIALS | 1999年 / 20卷 / 05期
基金
英国医学研究理事会;
关键词
randomized trials; quality; methodology; meta-analysis; interrater agreement;
D O I
10.1016/S0197-2456(99)00026-4
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
An instrument was developed and validated by Jadad, et al. to assess the quality of clinical trials using studies from the pain literature. Our study determined the reliability of the Jadad scale and the effect of blinding on interrater agreement in another group of primary studies. Four raters independently assessed blinded and unblinded versions of 76 randomized trials. Interrater agreement was calculated among combinations of four raters for blinded and unblinded versions of the studies. A 4 x 2 x 2 repeated measures design was employed to evaluate the effect of blinding. The interrater agreement for the Jadad scale was poor (kappa 0.37 to 0.39), but agreement improved substantially (kappa 0.53 to 0.59) with removal of the third item (an explanation of withdrawals). Blinding did not significantly affect the Jadad scale scores. A more precise description of how to score the withdrawal item and careful conduct of a practice set of articles might improve interrater agreement. In contrast with the conclusions reached by Jadad, we were unable to demonstrate a significant effect of blinding on the quality scares. (C) Elsevier Science Inc. 1999.
引用
收藏
页码:448 / 452
页数:5
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