Table 5.

COSMIN Risk of Bias Assessment–Validity^a

Box H. Criterion Validity	Cevidanes et al.25				Cevidanes et al.16				Nada et al.12				DeCesare et al.7				Gkantidis et al.21				Weissheimer et al.3
	E	G	F	P	E	G	F	P	E	G	F	P	E	G	F	P	E	G	F	P	E	G	F	P
Design requirements
Was the percentage of missing items given?			x				x				x				x				x				x
Was there a description of how missing items were handled?			x				x				x				x				x				x
Was the sample size included in the analysis adequate?				x				x		x						x				x		x
Can the criterion used or employed be considered as a reasonable “gold standard”?				x				x				x				x			x			x
Were there any important flaws in the design or methods of the study?			x				x			x					x			x					x
Statistical methods
For continuous scores: Were correlations, or the area under the receiver-operating curve calculated?			x				x				x				x				x				x
For dichotomous scores: Were sensitivity and specificity determined?			x				x				x				x				x				x
Score	Poor				Poor				Poor				Poor				Poor				Fair

^aCOSMIN box with four-point scale for methodological quality: E, excellent; G, good; F, fair; P, poor. A methodological quality score per box was obtained by taking the lowest rating of any item in a box (‘‘worst score counts''). A poor score on any item was thus considered to represent a fatal flaw. In the scoring system, items 1 and 2 (on the number of missing items and how missing items are handled) were scored less strictly than the other items as this information is often not reported in articles. In all boxes, a small sample size was considered poor methodological quality.24 COSMIN indicates Consensus-Based Standards for the Selection of Health Measurement Instruments.