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Table 4 Risk of bias/ quality assessment tools for primary studies used by included systematic reviews

From: Systems for rating bodies of evidence used in systematic reviews of air pollution exposure and reproductive and children’s health: a methodological survey

Tool used

Number of reviews using approach

Number of reviews that used modifications

Originally developed for

Exposure assessment (original version)

Co-exposures (original version)

Confounding (original version)

Newcastle–Ottawa Scale (NOS) [86]

9 [71, 77,78,79,80,81,82,83,84]

2 [71, 81]

Evaluating non-randomized studies in systematic reviews

Yes (general)a

No

Yes

Mustafic et al. (modified NOS) [87]

2 [79, 81]

0

Time-series and case-crossover studies of air pollution exposure

Yes

Possible (“long-term trends”)

Yes

Herzog et al. (modified NOS) [88]

1 [84]

0

Cross-sectional studies (developed for vaccine-related knowledge, attitude, and behavior)

Yes (general)a

No

Yes

Modesti et al. (modified NOS) [89]

1 [81]

0

Cross-sectional studies (developed for studies of blood pressure)

Yes (general)a

No

Yes

Office of Health Assessment and Translation (OHAT) [15, 66, 90]

4 [73, 75, 79, 81]

3 [73, 75, 81]

Systematic reviews and evidence integrations of environmental health research

Yes

Yes

Yes

Navigation Guide [5, 64]

2 [76, 81]

0

Systematic reviews of human studies in environmental health

Yes

No§

Yes

ACROBAT-NRSI [91] (later ROBINS-I) (97)

1 [72]

1 [72]

Non-randomized studies of interventions

Yes (“measurement of intervention”)

Yes (“co-interventions”)

Yes

Agency for Healthcare Research and Quality (AHRQ) [62]

1 [78]

0

Systematic reviews of studies of healthcare interventions

Yes (general)a

Yes (“co-interventions”)

Yes

Cochrane tool for RCTs (ROB 1) [92]

1 [78]

0

Systematic reviews of individual RCTs

No

No

Yes (randomization)

Hoy et al. [93]

1 [74]

0

Prevalence studies of low back and neck pain

No

No

No

ROBINS-E (preliminary version) [94]

1 [74]

0

Non-randomized studies of exposures

Yes

Yes

Yes

Centre for Evidence Based-Medicine (CEBM) [95, 96]

1 [70]

Unclear (insufficiently reported)

Clinical decision-making

Yes (general)a

No

Yes

Scottish Intercollegiate Guidelines Network (SIGN) [97]

1 [69]

1 [69]

Guideline development of clinical care (all study designs)

Yes (general)a

No

Yes

Own criteria [5, 68]

2 [5, 68]

N/A

N/A

Yes

No

Yes

  1. Abbreviations: ACROBAT-NRSI A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions, AHRQ Agency for Healthcare Research and Quality, CEBM Centre for Evidence Based-Medicine, NOS Newcastle Ottawa Scale, OHAT Office of Health Assessment and Translation, ROB Risk of bias, ROBINS-E Risk of bias in non-randomized studies of exposure, ROBINS-I Risk of bias in non-randomized studies of interventions, SIGN Scottish Intercollegiate Guidelines Network
  2. aYes (general) refers to tools that include a criterion relating to the validity of the exposure assessment method, without clear relevance to environmental exposures
  3. §In other case studies (e.g., on flame retardant exposure) other pollutants were considered under the confounding domain, but not in the version considered herein