Table 3.

Quality Assessment of Included Studies Based on the QUADAS Tool for Studies of Diagnostic Accuracy27

CriterionGovaert et al,13 1998Carrat et al,23 1999Monto et al,11 2000Boivin et al12, 2000van Elden, et al,10 2001Zambon et al,19 2001Walsh et al, 21 2002Friedman and Attia,20 2004Senn et al,7 2005Stein et al,8 2005Ohmit and Monto,24 2006van den Dool et al,22 2008
N=no; NA=not applicable; QUADAS=Quality Assessment of Diagnostic Accuracy; U=unknown; Y=yes.
a Participants were classified as being representative of patients who will receive the test in practice if they were undifferentiated outpatients with symptoms of respiratory tract infection. Participants were classified as not being representative if they were a subset of inpatients.
b No temperature cutoff was given for definition of fever.
c Although not explicitly stated, it is unlikely that diagnostic laboratories verifying the presence of influenza had access to the clinical data of each patient.
1. Was the spectrum of participants representative of the patients who will receive the test in practice?
YaY aYaYaY aYaNaYaY aYaYaNa
2. Were selection criteria clearly described?
3. Was the reference standard likely to classify the target condition correctly?
4. Was the period between performance of the reference standard and the index test short enough to be reasonably sure that the target condition did not change between the 2 tests?
5. Did the whole sample or a random selection of the sample receive verification using the reference standard?
6. Did participants receive the same reference standard regardless of the index test result?
7. Was the reference standard independent of the index test?
8. Was the execution of the index test described in sufficient detail to permit its replication?
9. Were the index test results interpreted without knowledge of the results of the reference test?
10. Were the reference standard results interpreted without knowledge of the results of the index test?
11. Were the same clinical data available when the test results were interpreted as would be available when the test is used in practice?
12. Were uninterpretable, indeterminate, or intermediate test results reported?
13. Were withdrawals from the study explained?