This is the full EPHPP Quality Assessment Tool for Quantitative Studies — a validated critical appraisal instrument developed by D. Ciliska, S. Micucci, M. Dobbins, and B.H. Thomas under the Effective Public Health Practice Project (EPHPP), funded by the Ontario Ministry of Health and Long-Term Care. The tool was formally published in 2004 and last revised in 2010.

For background on how the tool works, its validation, and how to use it, see the EPHPP Quality Assessment Tool reference page.

Important: This tool must be used alongside the QA Dictionary, which defines every criterion and rating. Download the QA Dictionary (PDF).

COMPONENT RATINGS

A) SELECTION BIAS

(Q1) Are the individuals selected to participate in the study likely to be representative of the target population?

  1. Very likely
  2. Somewhat likely
  3. Not likely
  4. Can’t tell

(Q2) What percentage of selected individuals agreed to participate?

  1. 80 – 100% agreement
  2. 60 – 79% agreement
  3. less than 60% agreement
  4. Not applicable
  5. Can’t tell
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3

B) STUDY DESIGN

Indicate the study design

  1. Randomized controlled trial
  2. Controlled clinical trial
  3. Cohort analytic (two group pre + post)
  4. Case-control
  5. Cohort (one group pre + post (before and after))
  6. Interrupted time series
  7. Other specify ________________
  8. Can’t tell

Was the study described as randomized? If NO, go to Component C.

No Yes

If Yes, was the method of randomization described? (See dictionary)

No Yes

If Yes, was the method appropriate? (See dictionary)

No Yes

RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3

C) CONFOUNDERS

(Q1) Were there important differences between groups prior to the intervention?

  1. Yes
  2. No
  3. Can’t tell

The following are examples of confounders:

  1. Race
  2. Sex
  3. Marital status/family
  4. Age
  5. SES (income or class)
  6. Education
  7. Health status
  8. Pre-intervention score on outcome measure

(Q2) If yes, indicate the percentage of relevant confounders that were controlled (either in the design (e.g. stratification, matching) or analysis)?

  1. 80 – 100% (most)
  2. 60 – 79% (some)
  3. Less than 60% (few or none)
  4. Can’t Tell
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3

D) BLINDING

(Q1) Was (were) the outcome assessor(s) aware of the intervention or exposure status of participants?

  1. Yes
  2. No
  3. Can’t tell

(Q2) Were the study participants aware of the research question?

  1. Yes
  2. No
  3. Can’t tell
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3

E) DATA COLLECTION METHODS

(Q1) Were data collection tools shown to be valid?

  1. Yes
  2. No
  3. Can’t tell

(Q2) Were data collection tools shown to be reliable?

  1. Yes
  2. No
  3. Can’t tell
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3

F) WITHDRAWALS AND DROP-OUTS

(Q1) Were withdrawals and drop-outs reported in terms of numbers and/or reasons per group?

  1. Yes
  2. No
  3. Can’t tell
  4. Not Applicable (i.e. one time surveys or interviews)

(Q2) Indicate the percentage of participants completing the study. (If the percentage differs by groups, record the lowest).

  1. 80 -100%
  2. 60 – 79%
  3. less than 60%
  4. Can’t tell
  5. Not Applicable (i.e. Retrospective case-control)
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3
Not Applicable

G) INTERVENTION INTEGRITY

(Q1) What percentage of participants received the allocated intervention or exposure of interest?

  1. 80 -100%
  2. 60 – 79%
  3. less than 60%
  4. Can’t tell

(Q2) Was the consistency of the intervention measured?

  1. Yes
  2. No
  3. Can’t tell

(Q3) Is it likely that subjects received an unintended intervention (contamination or co-intervention) that may influence the results?

  1. Yes
  2. No
  3. Can’t tell
RATE THIS SECTION
STRONG
MODERATE
WEAK
See dictionary
1
2
3
Not Applicable

H) ANALYSES

(Q1) Indicate the unit of allocation (circle one)

community organization/institution practice/office individua

(Q2) Indicate the unit of analysis (circle one)

community organization/institution practice/office individual

(Q3) Are the statistical methods appropriate for the study design?

  1. Yes
  2. No
  3. Can’t tell

(Q4) Is the analysis performed by intervention allocation status (i.e. intention to treat) rather than the actual intervention received?

  1. Yes
  2. No
  3. Can’t tell

GLOBAL RATING

COMPONENT RATINGS

Please transcribe the information from the gray boxes on pages 1-4 onto this page. See dictionary on how to rate this section.

A
SELECTION BIAS
STRONG
MODERATE
WEAK
1
2
3
B
STUDY DESIGN
STRONG
MODERATE
WEAK
1
2
3
C
CONFOUNDERS
STRONG
MODERATE
WEAK
1
2
3
D
BLINDING
STRONG
MODERATE
WEAK
1
2
3
E
DATA COLLECTION
METHOD
STRONG
MODERATE
WEAK
1
2
3
F
WITHDRAWALS AND
DROPOUTS
STRONG
MODERATE
WEAK
1
2
3
Not Applicable
G
INTERVENTION INTEGRITY
STRONG
MODERATE
WEAK
1
2
3
Not Applicable
H
ANALYSES
STRONG
MODERATE
WEAK
2
2
3

GLOBAL RATING FOR THIS PAPER (circle one):

  1. STRONG (no WEAK ratings)
  2. MODERATE (one WEAK rating)
  3. WEAK (two or more WEAK ratings)

With both reviewers discussing the ratings:

Is there a discrepancy between the two reviewers with respect to the component (A-F) ratings?

No Yes

If yes, indicate the reason for the discrepancy

  1. Oversight
  2. Differences in interpretation of criteria
  3. Differences in interpretation of study

Final decision of both reviewers (circle one):

  1. STRONG
  2. MODERATE
  3. WEAK

Downloads & Further Reading

📄 Download: Quality Assessment Tool (2010 edition)
📖 Download: QA Dictionary (December 2009)

For background on the tool’s development, methodology, and validation, see the EPHPP Quality Assessment Tool reference page.

If citing this tool in your research, please cite: Thomas, B.H., Ciliska, D., Dobbins, M., & Micucci, S. (2004). Worldviews on Evidence-Based Nursing, 1(3), 176–184. View on PubMed →

Mobile Menu