Table 4.

Risk of bias assessment for cohort studies.

First author, year	Selection				Comparability	Outcome			Total points (/9)
	Representativeness of exposed cohort	Selection of non-exposed cohort	Ascertainment of exposure	Demonstration that outcome of interest was absent at start of study	Comparability of Cohorts on the Basis of the Design or Analysis	Assessment of Outcome	Length of follow-up	Adequacy of follow up of cohorts
Daneman2015	Elderly aged 65 years old and above	Same source as exposed cohort	Ontario database	Adequate	Inadequate (did not control for other important risk factors for aortic aneurysm and aortic dissection)	Record linkage	Adequate	Complete	7/9
Gopalakrishnan2020	Patients aged 50 years old and above	Same sources as exposed cohort	United States database	?Adequate	Inadequate (did not control for other important risk factors for aortic aneurysm and aortic dissection)	Record linkage	Adequate	Complete	7/9
Pasternak2018	Representative	Same sources as exposed cohort	Swedish registers	Adequate	Inadequate (did not control for other important risk factors for aortic aneurysm and aortic dissection)	Record linkage	Adequate	Complete	7/9