Table 3.
The general FEAT principles for critical appraisal of studies in evidence reviews and their specific interpretation for assessing threats to internal validity (risk of bias)
Principle | General interpretation for critical appraisal | Interpretation in relation to assessing threats to internal validity (risk of bias) |
---|---|---|
FOCUSED | Critical appraisal should be directed at key quality constructs that are relevant to the evidence review. Each construct should be appraised separately | In comparative quantitative systematic reviews, internal validity should always be assessed; the assessment of internal validity should be separate, not conflated with other quality constructs |
EXTENSIVE | All important elements of the target quality construct should be identified and evaluated | All relevant threats to internal validity (i.e. all important individual sources of bias and confounding) relevant to the studies being assessed should be included in the appraisal |
APPLIED | The appraisal process should logically inform the data synthesis, with accurate, consistent descriptions of the extent to which each element of each construct has been fulfilled | The internal validity assessment should inform the data synthesis in an appropriate format (e.g. to support sensitivity or subgroup analyses) |
TRANSPARENT | Judgements should be made against explicit, unambiguous criteria. The reason for each quality judgement made by the reviewers should be clearly justified and transparently reported | All internal validity judgements should be based on pre-specified and agreed criteria detailed in the review protocol; each judgement should be supported with a concise explanation and grounded in evidence of the practices used in the study that is being appraised |