We developed the CPR checklist following the first 3 procedures outlined by Streiner and Norman36 for development of quality assessment tools. Their process outlines 5 critical steps, as follows: (1) preliminary conceptual decisions; (2) item generation; (3) assessment of face validity; (4) field trials; and 5) generation of a refined instrument, allowing for the generation, refinement, and potential adaptation of a tool, created during a continuous improvement process. For our study, our work
All 9 randomly selected Delphi participants completed rounds I, II, and III (100%). All but 2 participated in clinical practice (mean, 11 years; SD = 5.9), and the group had participated in research for an average of 8.3 years (SD = 3.6). Participant backgrounds included 4 physicians, 2 epidemiologists, and 3 physical therapists and resided in 4 different continents. Most (6) practiced in academic settings, but research interests and practice backgrounds varied between orthopedics (4),
The goal of this project was to develop a consensus-based quality checklist for the creation of prescriptive, derivation-based CPRs. The final checklist (QUADCPR) is now available for researchers during the development of prescriptive, derivation-based CPR studies. The final checklist comprises 23 items that encompass 4 disparate constructs (sections), where each item is scored with the scores of “yes,” “no,” or “unclear.”
At present, 2 quality checklists have been used during systematic
The QUADCPR is designed to improve the design and reporting standards for prescriptive, derivation-based CPRs. Future studies should address inter- and intraobserver variability and validation of the checklist or further refinement of items and for scoring to allow for quantitative ratings of quality. In addition, based on the recent perspective involving selection of variables from a randomized controlled trial, future studies should investigate the sensitivity of the use of a derivation phase
No funding sources or conflicts of interest were reported for this study. Most recent rehabilitation-based CPRs have been associated with prescriptive studies. The recent proliferation of CPRs has occurred without guidelines for reporting. Checklists for reporting standards are typically developed using Delphi methodology. This study used a Delphi method to outline appropriate reporting standards for prescriptive CPRs. The checklist (QUADCPR) is designed to be used prospectively during developmentPractical Applications
We conducted a two-stage process for quality appraisal, separately assessing original derivation studies and validation studies. As there is currently no systematic framework for appraising prescriptive CPRs [12], derivation studies were assessed based on criteria guided by the PROBAST tool for prognostic and diagnostic CPRs, as well as published recommendations relating to prescriptive CPRs in rehabilitation practice [6,12,18,24]. Validation studies were assessed using nine criteria for studies with control groups outlined by the Cochrane Effective Practice and Organisation of Care group [25].
Finally, the participant group was formed by 11 experts. The Delphi method usually recommends nine expert opinions to obtain data saturation (Cook et al., 2010; García Valdés and Suárez Marín, 2013). The stages in which the Delphi method was developed were as follows (Fig. 1):
The interobserver reliability of a patient's status on a CPR is a potential threat to its validity [39,40] and ideally should be evaluated and reported similar to accepted standards for single-item tests [89]. Finally, during all phases of a CPR's development, the reporting of uncertainty intervals for outcome prevalence, CPR accuracy (e.g., sensitivity, specificity, +LR, −LR), and posterior probabilities would enable a more meaningful interpretation of a study's findings [27,36,42]. There are limitations of this study that need to be acknowledged.
