No clear choice between Newcastle–Ottawa Scale and Appraisal Tool for Cross-Sectional Studies to assess methodological quality in cross-sectional studies of health-related quality of life and breast cancer
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OBJECTIVES: The aim of the study was to compare the inter-rater reliability, concurrent validity, completion time, and ease of use of two methodological quality (MQ) assessment tools for cross-sectional studies: an adapted Newcastle-Ottawa Scale (NOS) and the Appraisal Tool for Cross-Sectional Studies (AXIS). STUDY DESIGN AND SETTING: Two raters applied the NOS and AXIS to 63 cross-sectional studies of health-related quality of life and breast cancer. RESULTS: AXIS demonstrated poor inter-rater reliability (intraclass correlation coefficient [ICC] = 0.49) and required more than double the amount of time to complete compared with the NOS, which demonstrated moderate reliability (ICC = 0.73). For concurrent validity, weak and moderate positive relationships existed between NOS and AXIS (rater 1: r = 0.26; rater 2: r = 0.45). Ease of using the tools was affected by the indirectness of MQ assessments, perceived thoroughness of the tools' content, and user experience. CONCLUSION: This study was the first to assess the psychometric properties of a cross-sectional NOS and AXIS. The results did not support a clear choice between selecting either tool for evaluating MQ in cross-sectional studies.
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