Table 9 Questions to guide assessment of the quality of local evidence
Main quality criteria | Sub-questions | Example of the assessment of the quality of local evidence: routinely collected data on TB treatment outcomes from TB Registers |
|---|---|---|
Is the evidence representative? | • Is there a clear description of the source of the evidence? • If the evidence is drawn from a sample of the population of interest, is there a clear description of how the sampling was conducted? • Was the sampling approach appropriate (where applicable)? • Is there a description of how any inferences or generalisations were made to the wider population? | TB Registers should routinely record information on each patient diagnosed with TB. The information is not based on a sample of the population of interest. It should therefore be representative of the demographics and treatment outcomes for people with TB in a particular setting, provided that it is completed for each person with TB |
Is the evidence accurate? | • Is there a clear description of who collected the data? • Were the data collectors appropriately trained and supported in this task? • What tools were used for data collection? • Were appropriate tools used? • When were the data collected? • Was the quality of the data collected monitored and was the quality shown to be adequate? • How were the data analysed? • Was the method of analysis reported clearly? • Were any data limitations discussed? | Most health authorities provide a manual, based on WHO guidance, for completion of the TB Register. This generally specifies what information should be collected and by whom. In using these data, policymakers need to check whether there is clear guidance on completion of the Register, whether TB programme staff have been trained in its use, whether there are mechanisms in place to check the quality of the data at clinic and district levels, and whether data compilation was done appropriately |
Are appropriate outcomes reported? | • Is there a clear description of the outcome/s measured? • Is the outcome measure reliable? • Were these outcomes measured appropriately? • Do these outcomes provide a reasonable assessment of the health issue? | A standard range of measures is generally included in TB Registers, based on WHO guidance. These are designed to assess the functioning of the TB programme. However, the data do not generally provide direct measures of issues such as patient satisfaction with the care provided by TB programme staff |