Analytic perspective

Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours

William CW Wong¹ , Catherine SK Cheung² and Graham J Hart³

¹Department of General Practice, 200 Berkeley Street, Carlton, Vic 3053, Australia

²Department of Community and Family Medicine, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, PR China

³Centre for Sexual Health and HIV Research, University College London, Mortimer Market Centre (off Capper St), London, WC1E 6JB, UK

author email corresponding author email

Emerging Themes in Epidemiology 2008, 5:23doi:10.1186/1742-7622-5-23

Published:	17 November 2008

Abstract

Background

Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established.

Methods

We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity.

Results

A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) Score consists of five items: External validity (1 item), reporting (2 items), bias (1 item) and confounding factors (1 item). Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers.

Conclusion

A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future.