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Systematic Review: Assess quality of included studies

Revised content order 2022

Assess the quality of the evidence

Cochrane uses the GRADE system to rate the certainty of the body of evidence and to grade the strength of recommendations. More information can be found in the GRADE guidelines, on the Melbourne Grade Centre website, or see the grade guidelines guidance. For systematic reviews, GRADE provides a standardised approach to the appraisal of discrete outcomes from your meta-analysis or meta-synthesis.

Cochrane recommends the following checklists for assessing the risk of bias of the individual studies included in your review, as these checklists work well with the GRADE system:

  • Randomised controlled trials: RoB 2.0
  • Non-randomised controlled trials: Newcastle-Ottawa scale or ROBINS-I. (ROBINS-I is quite complex so an expert on the team is desirable for its use).
  • Diagnostic studies: QUADAS-2
  • Prognostic studies: QUIPS

Further checklists for assessing the risk of bias of individual studies

Additional checklists from a range of organisations are available for assessing a variety of study designs. See the list below:

Supplementary appraisal tools

Critically Appraising for Antiracism Quality Appraisal Tool

Critical appraisal tools do not consider the potential impact of racial biases on a paper's quality. This supplementary tool has been developed in order to support appraisers in explicitly addressing racial bias.

Aboriginal and Torres Strait Islander Quality Appraisal Tool

The Aboriginal and Torres Strait Islander Quality Appraisal Tool consists of 14 questions that assess the quality of health research from an Aboriginal and Torres Strait Islander perspective.