Assessment of risk of bias and applicability using the QUADAS-2 tool

Diagnostic test accuracy (DTA) reviews: a pathway


This lesson is part of an introductory series developed by Cochrane Screening & Diagnostic Test Methods Group to support authors in the production of DTA reviews. A full list of currently available or planned lessons is available here.

This lesson outlines the components of quality assessment of DTA studies and explains the rationale for undertaking quality assessment. It describes the structure of the QUADAS-2 tool and provides illustrative examples of how the tool may be tailored to a review question. Finally, the lesson identifies key issues to be considered when presenting the results of quality assessment in a test accuracy review.

After using this resource, you should be able to...
  • Outline the components of quality assessment of primary DTA studies
  • Understand how to tailor the QUADAS-2 tool to a DTA review question
  • Understand the process of making judgements about risk of bias and applicability as part of a DTA review
  • Appreciate key considerations when summarizing the results of a quality assessment

6.3 Assessment of risk of bias and applicability using the QUADAS-2 tool

Author information: 
Davenport, Clare; Leeflang, Mariska; Takwoingi, Yemisi; Deeks, Jon

Cite as: Davenport CF, Leeflang MM, Takwoingi Y, Deeks JJ. Use of QUADAS-2. Lesson 6.3: Cochrane Collaboration DTA Online Learning Materials. The Cochrane Collaboration, September 2014. Videocast (39 slides, 24 minutes, sound, colour). Available at <>.

Session compiled and narrated by Clare Davenport with technical support from Anne Walker and Paul Good, University of Birmingham. With grateful acknowledgement of the many members of the Cochrane DTA Reviews Working Group upon which the materials, in part, are based. Funded by the UK NIHR and the Cochrane Collaboration, with support from the University of Birmingham and the University of Amsterdam.