Quadas 2 tool 2025

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QUADAS-2 (PDF, 269kB) is the current version of QUADAS and the tool that we recommend for use in systematic reviews to evaluate the risk of bias and applicability of primary diagnostic accuracy studies.
QUADAS is a tool to assess the quality of diagnostic accuracy studies included in systematic reviews. We defined quality as being concerned with both the internal and external validity of a study.
Lack of consideration of other study characteristics: The QUADAS-2 tool focuses primarily on the risk of bias and applicability of the studies, but it does not consider other important study characteristics, such as the precision of the estimates or the generalizability of the results to different populations.
QUADAS-2 is applied in four phases: summarise the review question. tailor the tool to the review and produce review-specific guidance. construct a flow diagram for the primary study. assess risk of bias and concerns regarding applicability.
QUADAS-2 is designed to assess the quality of primary diagnostic accuracy studies; it is not designed to replace the data extraction process of the review and should be applied in addition to extracting primary data (e.g. study design, results etc) for use in the review.
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QUADAS is an evidence based tool to be used for the quality assessment of diagnostic accuracy studies. It consists of 14 items phrased as questions, each of which should be scored a yes, no or unclear that examine bias in the study.

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