An introduction to QUADAS-C: a tool for assessing risk of bias in comparative diagnostic accuracy studies_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Yuxiang ^1,2 ,  SHEN Jiantong ^1,3 , LIU Yujin ¹

1. Department of Huzhou University, School of Nursing Science, Huzhou 313000, P. R. China;
2. Department of Changxing County Hospital of Traditional Chinese Medicine, Changxing 313100, P. R. China;
3. Department of Huzhou University, Huzhou Branch of the Ministry of Education Virtual Research Center of Evidence-Based Medicine, Huzhou 313000, P. R. China;

Corresponding author：

SHEN Jiantong, Email: 02198@zjhu.edu.cn

Keywords：

QUADAS-C; QUADAS-2; Comparative diagnostic accuracy study; Systematic review

DOI：

10.7507/1672-2531.202204090

Video：

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The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) has been widely accepted in the assessment of diagnostic accuracy and quality. However, it is not suitable for assessing risk of bias in studies comparing diagnostic accuracy. The current common practice in systematic reviews is to derive comparative accuracy from non-comparative diagnostic accuracy studies, which is inherently biased. The QUADAS group developed the QUADAS-Compare (QUADAS-C) tool for assessing the risk of bias in comparative diagnostic accuracy studies. It was officially launched in October 2021. QUADAS-C retains the same 4-domain structure as QUADAS-2: patient selection, index test, reference standard, and flow and timing. It also includes an additional 14 signaling questions and 4 risk of bias questions. This allows researchers to identify high-quality research evidence and avoid bias in research design and conduct. This article interpreted the basic situation, evaluation items, evaluation standards, and usage methods and procedures associated with QUADAS-C to provide references for domestic users.

Citation： HUANG Yuxiang, SHEN Jiantong, LIU Yujin. An introduction to QUADAS-C: a tool for assessing risk of bias in comparative diagnostic accuracy studies. Chinese Journal of Evidence-Based Medicine, 2022, 22(9): 1108-1116. doi: 10.7507/1672-2531.202204090 Copy

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8.	邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
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1. 陈新林, 胡月, 莫传伟, 等. 诊断准确性研究报告指南—STARD2015简介. 中国循证医学杂志, 2016, 16(10): 1227-1230.
2. 田晨, 杨秋玉, 赖鸿皓, 等. 诊断性试验准确性比较研究. 中国循证医学杂志, 2022, 22(5): 590-594.
3. Leeflang MMG, Reitsma JB. Systematic reviews and meta-analyses addressing comparative test accuracy questions. Diagn Progn Res, 2018, 2: 17.
4. Dehmoobad SA, Leeflang M, Treanor L, et al. Comparative reviews of diagnostic test accuracy in imaging research: evaluation of current practices. Eur Radiol, 2019, 29(10): 5386-5394.
5. Yang B, Vali Y, Dehmoobad SA, et al. Risk of bias assessment of test comparisons was uncommon in comparative accuracy systematic reviews: an overview of reviews. J Clin Epidemiol, 2020, 127: 167-174.
6. Yang B, Mallett S, Takwoingi Y, et al. QUADAS-C: a tool for assessing risk of bias in comparative diagnostic accuracy studies. Ann Intern Med, 2021, 174(11): 1592-1599.
7. Yang B, Olsen M, Vali Y, et al. Study designs for comparative diagnostic test accuracy: a methodological review and classification scheme. J Clin Epidemiol, 2021, 138: 128-138.
8. 邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
9. Zifodya JS, Kreniske JS, Schiller I, et al. Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Cochrane Database Syst Rev, 2021, (2): CD009593.
10. Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 6.1 (updated September 2020). Cochrane, 2022. Available at: www. training. cochrane. org/handbook.
11. Yang B, Mustafa RA, Bossuyt PM, et al. GRADE Guidance: 31. Assessing the certainty across a body of evidence for comparative test accuracy. J Clin Epidemiol, 2021, 136: 146-156.
12. Sounderajah V, Ashrafian H, Rose S, et al. A quality assessment tool for artificial intelligence-centered diagnostic test accuracy studies: QUADAS-AI. Nat Med, 2021, 27(10): 1663-1665.

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An introduction to QUADAS-C: a tool for assessing risk of bias in comparative diagnostic accuracy studies

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