Q-Coh: A tool to screen the methodological quality of cohort studies in systematic reviews and meta-analyses

Abstract

The evaluation of the methodological quality of primary studies in a systematic review is a key process to enhance the likelihood of achieving valid results. When considering non-randomized designs as cohort studies, this process becomes even more critical, since these designs are more susceptible to bias than randomized controlled trials are. Taking this into account, a tool, named Q-Coh, was designed with the aim to screen the methodological quality of the primary studies with a cohort design priming specificity over sensitivity in a reasonable application time. After applying it to 21 prospective cohort studies by three raters, all domains had a moderate to good agreement, with all except one of them having statistically significant kappa values. Despite there is no gold standard for the methodological quality, arguments supporting its validity are given. Future research should assess the psychometric properties of Q-Coh in the context of real meta-analyses, evaluate the influence of the raters’ substantive and methodological expertise on these properties, and explore different ways of including the domains-based ratings of the quality provided by Q-Coh into meta-analyses.