Prediction study risk of bias assessment tool (PROBAST)

Article type
Authors
Wolff R1, Whiting P1, Mallett S2, Riley R3, Westwood M1, Kleijnen J4, Moons KGM5
1Kleijnen Systematic Reviews Ltd, UK
2Department of Primary Care Health Sciences, University of Oxford, UK
3School of Health and Population Sciences, and School of Mathematics, University of Birmingham, UK
4Kleijnen Systematic Reviews Ltd, UK; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
5Julius Center for Health Sciences and Primary Care, UMC Utrecht, The Netherlands
Abstract
Background: Quality assessment of included studies is a crucial step in any systematic review. Review and synthesis of prediction modelling studies is a relatively new and evolving area. The QUIPS tool for prediction finding studies has been recently updated. However, a tool facilitating quality assessment for prognostic and diagnostic prediction modelling studies is needed.

Objectives: To develop PROBAST, a tool for assessing the risk of bias and applicability of prediction modelling studies.

Methods: Risk of bias addresses the extent to which reported estimates of the predictive performance/accuracy (e.g. discrimination, calibration and (re)classification estimates) of the prediction model are potentially biased. Applicability refers to the extent to which the reported prediction model and the population used to measure model performance matches the review question and intended use of the model. For PROBAST, we have adopted a domain-based structure supported by signalling questions similar to QUADAS-2, which assesses risk of bias in diagnostic studies. We are using a Delphi process to develop PROBAST. Existing initiatives in the field of prediction research such as the REMARK (Reporting Recommendations for Tumor Marker Prognostic Studies) guidelines and the TRIPOD prediction model reporting guidelines formed part of the evidence base for the tool development. The scope of PROBAST was determined with consideration of existing tools, such as QUIPS. Forty experts and review authors in the field of prediction research are taking part in the Delphi process. We anticipate about five rounds of this process will be needed until agreement on the content of the final tool.

Results and Conclusions: The first rounds developing domains are now completed. The presentation will give an overview of the process, the current version of the tool (including the addressed domains and signalling questions) as well as an insight into underlying discussions.