Monday, October 19, 2020

Existing Tools to Assess the Quality of Prevalence Reviews are Variable, with Some Missing Key Elements

Prevalence studies allow us to better understand the extent and impact of a health issue, guiding priority-setting for health care interventions, research, and clinical guidelines. While established tools for assessing the quality of guidelines, systematic reviews, and original research on interventions exist, no clear option has emerged as a way to assess the quality and risk of bias in prevalence research. The several tools that have been proposed, write the authors of a new systematic review of these instruments, are not without limitations.

Migliavaca and colleagues sifted through a total of 1,690 unique references, ending with a total of 30 tools that were either created for the direct purpose of assessing prevalence studies (n = 8) or were adaptable to this aim (n = 22). A grand total of 710 items from all of the tools were then combined into 119 items assessing similar constructs under six general domains: Population and Setting, Condition Measurement, Statistics, Manuscript Writing and Reporting, Study Protocols and Methods, and Nonclassified (e.g., importance of the study, applicability of results).

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The authors conclude that there was a great variability among tools assessed; further, several tools left out key elements that could affect the quality of a study, such as the representativeness of a sample, total sample size, or how the condition was assessed. Further, some tools fail to distinguish between assessments of whether the measure is valid, reliable, reproducible, or unbiased - differences that the authors of this review argue are important enough to warrant separate items in the development of a new tool. Although the authors suggest that a new, more comprehensive tool will improve the assessment of prevalence studies in the future, they identify the Joanna Briggs Institute Prevalence Critical Appraisal Tool as the best of what's currently available (downloadable from a list of JBI checklists here).

Migliavaca, C.B., Stein, C., Colpani, V., Munn, Z., Falavigna, M., and the Prevalence Estimates Reviews - Systematic Review Methodology Group (PERSyst). (2020). J Clin Epidemiol 127:59-68.

Manuscript available at the publisher's website here.