Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography

被引:1212
作者
Sanderson, Simon
Tatt, Lain D.
Higgins, Julian P. T.
机构
[1] Univ Cambridge, Publ Hlth Genet Unit, MRC, Biostat Unit, Cambridge, England
[2] Hoffmann La Roche AG, PBSE, Basel, Switzerland
基金
英国医学研究理事会;
关键词
observational studies; epidemiological studies; quality; bias; checklist; scales;
D O I
10.1093/ije/dym018
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Assessing quality and susceptibility to bias is essential when interpreting primary research and conducting systematic reviews and meta-analyses. Tools for assessing quality in clinical trials are well-described but much less attention has been given to similar tools for observational epidemiological studies. Methods Tools were identified from a search of three electronic databases, bibliographies and an Internet search using Google((R)). Two reviewers extracted data using a pre-piloted extraction form and strict inclusion criteria. Tool content was evaluated for domains potentially related to bias and was informed by the STROBE guidelines for reporting observational epidemiological studies. Results A total of 86 tools were reviewed, comprising 41 simple checklists, 12 checklists with additional summary judgements and 33 scales. The number of items ranged from 3 to 36 (mean 13.7). One-third of tools were designed for single use in a specific review and one-third for critical appraisal. Half of the tools provided development details, although most were proposed for future use in other contexts. Most tools included items for selection methods (92%), measurement of study variables (86%), design-specific sources of bias (86%), control of confounding (78%) and use of statistics (78%); only 4% addressed conflict of interest. The distribution and weighting of domains across tools was variable and inconsistent. Conclusion A number of useful assessment tools have been identified by this report. Tools should be rigorously developed, evidence-based, valid, reliable and easy to use. There is a need to agree on critical elements for assessing susceptibility to bias in observational epidemiology and to develop appropriate evaluation tools.
引用
收藏
页码:666 / 676
页数:11
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