观察性研究Meta分析的NOS量表

TheNewcastle-OttawaScale(NOS)forAssessingtheQualityofNonrandomizedStudiesinMeta-Analysis,G.Wells,B.Shea,D.OConnell,J.Robertson,J.Peterson,V.Welch,M.Losos,P.Tugwell,DevelopmentApplicationsCurrentDevelopments,Development:ItemSelection,NewcastlequalityassessmentformOttawacomprehensivelistPanelreviewCriticalreviewbyexperts,Development:GroupingItems,CohortstudiesSelectionofcohortsComparabilityofcohortsAssessmentofoutcomeCase-ControlstudiesSelectionofcaseandcontrolsComparabilityofcasesandcontrolsAscertainmentofexposure,Development:IdentifyingItems,IdentifyhighqualitychoiceswithastarAmaximumofonestarforeachhitemwithintheSelectionandExposure/Outcomecategories;maximumoftwostarsforComparability,Newcastle-OttawaQualityAssessmentScale:Case-ControlStudies,Selection(4)Comparability(1)Exposure(3)AstudycanbeawardedamaximumofonestarforeachnumbereditemwithintheSelectionandExposurecategories.AmaximumoftwostarscanbegivenforComparability,1.Isthecasedefinitionadequate?a)yes,withindependentvalidationb)yes,egrecordlinkageorbasedonselfreportsc)nodescription2.Representativenessofthecasesa)consecutiveorobviouslyrepresentativeseriesofcasesb)potentialforselectionbiasesornotstated3.SelectionofControlsa)communitycontrolsb)hospitalcontrolsc)nodescription4.DefinitionofControlsa)nohistoryofdisease(endpoint)b)nodescriptionofsource,Selection,1person/record/time/processtoextractinformation,orreferencetoprimaryrecordsourcesuchasx-raysormedical/hospitalrecords,e.g.ICDcodesindatabaseorself-reportwithnoreferencetoprimaryrecordornodescription,Comparability,1.Comparabilityofcasesandcontrolsonthebasisofthedesignoranalysisa)studycontrolsfor_(selectthemostimportantfactor)b)studycontrolsforanyadditionalfactor(Thiscriteriacouldbemodifiedtoindicatespecificcontrolforasecondimportantfactor.),Exposure,1.Ascertainmentofexposurea)securerecord(egsurgicalrecords)b)structuredinterviewwhereblindtocase/controlstatusc)interviewnotblindedtocase/controlstatusd)writtenselfreportormedicalrecordonlye)nodescription2.Samemethodofascertainmentforcasesandcontrolsa)yesb)no3.Non-ResponseRatea)samerateforbothgroupsb)nonrespondentsdescribedc)ratedifferentandnodesignation,Newcastle-OttawaQualityAssessmentScale:CohortStudies,Selection(4)Comparability(1)Outcome(3)AstudycanbeawardedamaximumofonestarforeachnumbereditemwithintheSelectionandoutcomecategories.AmaximumoftwostarscanbegivenforComparability,Selection,1.Representativenessoftheexposedcohorta)trulyrepresentativeoftheaverage_(describe)inthecommunityb)somewhatrepresentativeoftheaverage_inthecommunityc)selectedgroupofusersegnurses,volunteersd)nodescriptionofthederivationofthecohort2.Selectionofthenonexposedcohorta)drawnfromthesamecommunityastheexposedcohortb)drawnfromadifferentsourcec)nodescriptionofthederivationofthenonexposedcohort3.Ascertainmentofexposuretoimplantsa)securerecord(egsurgicalrecords)b)structuredinterviewc)writtenselfreportd)nodescription4.Demonstrationthatoutcomeofinterestwasnotpresentatstartofstudya)yesb)no,Inthecaseofmortalitystudies,outcomeofinterestisstillthepresenceofadisease/incident,ratherthandeath;thatisastatementofnohistoryofdiseaseorincidentearnsastar,Comparability,1.Comparabilityofcohortsonthebasisofthedesignoranalysisa)studycontrolsfor_(selectthemostimportantfactor)b)studycontrolsforanyadditionalfactor(Thiscriteriacouldbemodifiedtoindicatespecificcontrolforasecondimportantfactor.),Outcome,1.Assessmentofoutcomea)independentblindassessmentb)recordlinkagec)selfreportd)nodescription2.Wasfollowuplongenoughforoutcomestooccura)yes(selectanadequatefollowupperiodforoutcomeofinterest)b)no3.Adequacyoffollowupofcohortsa)completefollowup-allsubjectsaccountedforb)subjectslosttofollowupunlikelytointroducebias-smallnumberlost-_%(selectanadequate%)followup,ordescriptionofthoselost)c)followuprate_%(selectanadequate%)andnodescriptionofthoselostd)nostatement,Applications:,AssessqualityofnonrandomizedstudiesIncorporateassessmentsininterpretationofmeta-analyticresultsDesign,contentandeaseofuse,LongTermHormoneReplacementTherapyandCoronaryHeartDiseaseEvents,ClearlyformulatedquestionComprehensivedatasearchUnbiasedselectionandabstractionprocessCriticalappraisalofdataSynthesisofdataPerformsensitivityandsubgroupanalysesifappropriateandpossiblePrepareastructuredreport,StepsofaCochraneSystematicReview,Objective,Istherearelationshipbetweenhormonereplacementtherapyandtheincidenceofcoronaryheartdiseaseinpostmenopausalwomen,InclusionCriteria,Typesofstudiescase-control,cohortorcross-sectionalstudiesPopulationpostmenopausalwomenInterventionwomenexposedtohormonereplacementtherapy(estrogenorestrogen+progesterone)ever,current,pastOutcomescoronaryheartdisease(events)fatal,non-fatal,both,ClearlyformulatedquestionComprehensivedatasearchUnbiasedselectionandabstractionprocessCriticalappraisalofdataSynthesisofdataPerformsensitivityandsubgroupanalysesifappropriateandpossiblePrepareastructuredreport,StepsofaCochraneSystematicReview,SearchStrategy,ElectronicSearchof:MEDLINE(1966toMay2000)CurrentContents(toMay2000)OtherDataSources:reviewofreferencescitedinretrievedarticles,ClearlyformulatedquestionComprehensivedatasearchUnbiasedselectionandabstractionprocessCriticalappraisalofdataSynthesisofdataPerformsensitivityandsubgroupanalysesifappropriateandpossiblePrepareastructuredreport,StepsofaCochraneSystematicReview,DataExtraction,2independentreviewersselectedtrials2independentreviewersextracteddatausingpre-determinedformsstudydesignpopulationcharacteristicsexposuretoimplantsoutcomesmeasuresresultsdifferencesresolvedbyconsensus,Results,16case-controlorcross-sectional14cohort,QuantificationofEffects,Exposure(ever,current,past)Outcome(fatal,non-fatal,both)Effectestimates(EE)RelativeRisk(RR)OddsRatio(OR)AdjustedeffectestimatesEffectsvspopulation,follow-upperiods,etc.(homogeneity),ClearlyformulatedquestionComprehensivedatasearchUnbiasedselectionandabstractionprocessCriticalappraisalofdataSynthesisofdataPerformsensitivityandsubgroupanalysesifappropriateandpossiblePrepareastructuredreport,StepsofaCochraneSystematicReview,Avila/90,Cauley/97,Grodstein/96,Henderson/91,Lafferty/94,Wilson/85,Wolf/96,Lauritzen/83,Ettinger/96,Petitti/87,Sourander/98,Bush/87,Criqui/98,Folsom/95,CohortStarTemplate,SelectionComparabilityOutcome,Adam/81,Beard/89,Croft/89,Grodstein/97,Heckbert/97,LaVecchia/87,Mann/94,Pfeffer/78,Rosenberg/76,Rosenberg/80,Rosenberg/93,Ross/81,Sidney/97,Szklo/84,Talbott/77,Thompson/89,Case-ControlStarTemplate,SelectionComparabilityExposure,AdjustedEffectEstimatesforCoronaryHeartDisease(AllEvents)(HRT:EstrogenCurrentUse)Case-ControlStudies,SelectionComparabilityExposure,AdjustedEffectEstimatesforCoronaryHeartDisease(AllEvents)(HRT:EstrogenPastUse)Case-ControlStudies,SelectionComparabilityExposure,AdjustedEffectEstimatesforCoronaryHeartDisease(AllEvents)(HRT:EstrogenEverUse)Case-ControlStudies,SelectionComparabilityExposure,AdjustedEffectEstimatesforCoronaryHeartDisease(AllEvents)(HRT:Estrogen+ProgestinEverUse)Case-ControlStudies,SelectionComparabilityExposure,AdjustedEffectEstimatesforCoronaryHeartDisea