Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours

TLDR

Systematic reviews of observational studies on HIV prevalence and risk factors among men who have sex with men are valuable for health decisions, yet existing quality assessment tools are poorly established. The authors aimed to develop a concise, standardized quality assessment checklist for systematic reviews of observational studies on HIV prevalence among men who have sex with men. The QATSO tool comprises five items—external validity, reporting, bias, and confounding factors—and was refined through expert review and testing on systematic review manuscripts. QATSO is an inclusive, simple, and practical tool that facilitates comparability of observational studies, though it may oversimplify information, and can be adapted for future research.

Abstract

Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established.We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity.A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) Score consists of five items: External validity (1 item), reporting (2 items), bias (1 item) and confounding factors (1 item). Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers.A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future.