What QUADAS-2 is
QUADAS-2 is the tool for diagnostic accuracy studies (Whiting PF et al. Ann Intern Med 2011;155:529-36). It judges risk of bias in four domains: patient selection, index test, reference standard, and flow and timing. It judges concerns about applicability to your question in the first three.
The figure draws the two blocks side by side, each with its own heading, in both the traffic light and the summary plot, and numbers each block from D1.
QUADAS-2 domains
Risk of bias and applicability:
- D1 Patient selection
- D2 Index test
- D3 Reference standard
- D4 Flow and timing
- D1 Applicability concerns · Patient selection
- D2 Applicability concerns · Index test
- D3 Applicability concerns · Reference standard
Low · Unclear · High. Grey: cells not filled in yet.
Judgements and the summary
Each domain is low, high or unclear, for risk of bias and for applicability alike.
QUADAS-2 does not require an overall column. Its authors suggest summarizing like this: low risk if every domain is low, and “at risk of bias” if any is high or unclear; the same for applicability. The figure draws risk of bias and applicability, with no overall column; if your review wants one, use the custom instrument and state the rule in your methods.
How to make the QUADAS-2 figure
- The table above is already set to QUADAS-2. Replace the example studies with yours, or paste the table from Excel or Google Sheets (the robvis template works).
- Pick the judgement for each domain and, if the instrument has one, press “Fill in the overall judgement” and correct what needs correcting.
- Download the traffic light plot, the summary plot or both: PDF or SVG when the journal wants vector artwork; PNG or TIFF at the column width and 300 or 600 dpi when it wants an image.
Frequently asked questions
Why does the QUADAS-2 figure have no overall column?
Because QUADAS-2 does not require one. Its authors do suggest a summary: low if every domain is low, at risk if any is high or unclear. robvis draws an “Overall” column but leaves out applicability; here both blocks are drawn and there is no overall column. If your review uses that summary, draw it with the custom instrument.
What is judged under applicability?
Whether the patients, the index test or the target condition as defined by the reference standard match your review question. Flow and timing has no applicability part.
How do I paste my QUADAS-2 data?
One row per study: the name, the four risk of bias judgements, then the three applicability ones. “Low”, “High” and “Unclear” all work, as do their Spanish equivalents.
Can I use the figure in my paper?
Yes. Unless you are signed in to a revisia account with a verified email, what you download carries a small revisia mark under the figure, outside the drawing. With a verified email the figure comes out clean, in the preview and in every format. The account is free.