QUADAS-3 Explanation and Elaboration: Guidance for Quality Assessment of Diagnostic Test Accuracy Studies
Publication date
2026-04-04
Authors
Davenport, Clare F
Rutjes, Anne W S
Mallett, Sue
Tomlinson, Eve
Yang, Bada
Holmes, Jude
Westwood, Marie E
Takwoingi, Yemisi
Reitsma, Johannes J B
Hyde, Christopher
Editors
Advisors
Supervisors
Document Type
Article
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taverne
Abstract
Assessing risk of bias and applicability is essential in diagnostic test accuracy reviews to produce reliable and relevant evidence that can guide clinical and policy decisions. To support this process, the authors have developed QUADAS-3, the latest version of the QUADAS tool, which is designed to assess the methodological strength and relevance of diagnostic test accuracy studies included in systematic reviews. This article explains how to use the QUADAS-3 tool. The article guides the reviewer through the initial stages of defining the questions and conceptualizing the ideal test accuracy trial, how the domains and signaling questions should be interpreted and assessed, and how judgments of risk of bias and concerns regarding applicability should be made. Authors of systematic reviews of diagnostic test accuracy studies should use this article as a guide for applying the QUADAS-3 tool.
Keywords
Taverne, Journal Article
Citation
Davenport, C F, Rutjes, A W S, Mallett, S, Tomlinson, E, Yang, B, Holmes, J, Westwood, M E, Takwoingi, Y, Reitsma, J B, Hyde, C, Bossuyt, P M M, Deeks, J J, Leeflang, M M G & Whiting, P F 2026, 'QUADAS-3 Explanation and Elaboration : Guidance for Quality Assessment of Diagnostic Test Accuracy Studies', Annals of Internal Medicine, vol. 179, no. 4, e2504943. https://doi.org/10.7326/ANNALS-25-04943