Background: Quality of Diagnostic Accuracy Studies (QUADAS) was first developed in 2003 as an assessment tool to be used in the context of systematic reviews of diagnostic test accuracy (DTA) studies. Following a number of evaluations and feedback from users, the tool was further updated and a new version, known as QUADAS-2, published in 2011. QUADAS-2 differs from the original tool on a number of points, among them the strong emphasis that the tool is more like a guideline and should be customised for each review, as detailed in the background document. At present, no formal evaluation of the tool has been conducted and only isolated comments suggest potential difficulties and confusions.

Objectives: To investigate common problems encountered by users of QUADAS-2 when customising and applying the tool in the context of DTA reviews and to elicit hypotheses about the sources of these problems and possible solutions.

Methods: A brief on-line questionnaire has been devised to elicit the experience of systematic reviewers with QUADAS-2. Authors of Cochrane and non-Cochrane DTA reviews will be identified through electronic searches and invited to take part in the survey. Thematic analysis supported by descriptive statistics will be used to analyse the data and, whenever possible, the results will be compared with those from QUADAS-1 evaluations.

Results: The main result will be a narrative description of the common difficulties encountered by review authors in the process of customising and applying QUADAS-2 in DTA reviews; the sources of these difficulties; and suggestions how to overcome them. Current stage of the study: An on-line questionnaire has been devised and sent to experts in the field for feedback. Weexpect the final results from the survey to be available by the end of July 2013.