QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies.

PF Whiting, AW Rutjes, ME Westwood, S Mallett, Jonathan Deeks, JB Reitsma, MM Leeflang, JA Sterne, PM Bossuyt

    Research output: Contribution to journalArticle

    5287 Citations (Scopus)


    In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.
    Original languageEnglish
    Pages (from-to)529-536
    Number of pages8
    JournalAnnals of internal medicine
    Issue number8
    Publication statusPublished - 18 Oct 2011


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