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Systematic Reviews, a Guide: Appraisal of Articles

Quality Indicators

How do you assess the quality of a systematic review? The following list of quality indicators are taken from The EBBP Introduction to Systematic Reviews:

  • Is the question(s) or aim(s) clearly stated?
  • Have you stated your search strategy? This should include:

a. The search terms 

b. Databases and print resources consulted 

c. Years covered by the search

d. Any other limiting factors or identification strategies used

  • Have you reported explicit exclusion/inclusion criteria relating to the selection of primary studies? For example:

a. Study design

b. Populations

c. Interventions

d. Outcomes of interest

  • Is there any selection bias? All details that could point to this should be reported, such as:

a. The number of reviewers included

b. Whether the studies were examined independently

c. How disagreements between reviewers were resolved

d. Is there any evidence that the process was biased or inadequately implemented?

  • Was the system used to evaluate the quality of individual studies transparent? Are the following included?:

a. An explanation of the criteria used, eg what method of randomisation did you use?

b. Explain the assessment process

  • Is there sufficient detail of the individual studies used? Does your review demonstrate the suitability of studies to answer the question posed. Does it include a judgement on whether the conclusions reached are appropriate. Information required includes:

a. Study design

b. Sample size in each study group

c. Patient characteristics

d. Description of interventions

e. Settings

f. Outcome measures

g. Follow-up

h. Drop-out rate (withdrawals)

i. Effectiveness

j. Results

k. Adverse effects

  • Are the primary studies summarised appropriately? A narrative summary of results should always be included. This may or may not be accompanied by a quantitative summary (meta-analysis).
     
  • Are your conclusions supported by the evidence? Was the system used to evaluate the body of evidence suitably transparent?
     
  • What funding source was used and what was the role of the funder?

Screening for Quality

When reading the full text of each article identified for inclusion in the review as part of the Data Extraction process you should apply one of the following Scales/Assessment for quality to each study selected for inclusion, choose the method that best fits with the type of review you are conducting.