A tool to appraise all types of public health evidence: the Public Health Ontario MetaQAT

A Summary of

Relevance for Public Health

The tool is highly relevant for public health topics that often include many different types of evidence and study designs to answer one question, as the same process can be applied regardless of study design. The tool is appropriate for use with any public health topic. For example, organizations can use the tool to appraise evidence on brain injury, obesity or women's health issues. It supports the use of evidence for recommendation formulation, development of public health action, or scientific research, including public health researchers and practitioners, in that it provides a transparent process for quality appraisal and considerations for the application of evidence.


The purpose of the MetaQAT as described in a full publication is to address the limitations in current quality appraisal tools. The benefits of the MetaQAT tool are that it is both flexible enough to address a variety of public health questions, and sufficiently rigorous in terms of the critical appraisal of methodology. Existing quality appraisal tools in the published and grey literature were identified and reviewed to map concepts of quality appraisal for public health evidence. A four-domain appraisal framework was developed, consisting of relevancy, reliability, validity, and applicability. A suite of design-specific companion tools were chosen to provide further guidance to assess validity of common designs, if required. The MetaQAT tool allows users to simultaneously assess the many relevant study designs available for public health research, including non-standard designs.

Accessing the Method/Tool




On-line Access



Implementing the Method/Tool

Time for Participation/Completion

Information not available

Additional Resources and/or Skills Needed for Implementation


Steps for Using Method/Tool

MetaQAT users conduct the quality assessment process by answering questions in each domain of the framework. The meta-tool can be fit to individual projects by following the instructions in the guidance document. Written answers are recorded in the tool, detailing the main quality points relevant to each question. Overall comments for each domain are also recorded to facilitate summary of the assessment. In the validity domain, users are provided with suggestions for general internal validity issues to consider, and directed to a list of design specific companion tools to supplement the general content.

Who is involved

Anyone wanting to assess study relevance, reliability, validity, or applicability would find this tool useful.

Conditions for Use

Not specified

Evaluation and Measurement Characteristics


Has been evaluated.

This tool was evaluated for face validity, content validity, and criterion validity.


Not applicable


Information not available

Methodological Rating

Unknown/No evidence

Method/Tool Development


L. Rosella
C. Bowman
B. Pach
S. Morgan
T. Fitzpatrick
V. Goel

Method of Development

Existing published quality appraisal tools and grey literature were searched and reviewed to map concepts of quality appraisal for public health evidence. Face validity was assessed by consultation; content validity was assessed by comparison to existing tools; criterion validity was assessed by comparison of the content of assessments between two groups of appraisers.

Release Date


Contact Person/Source

Laura Rosella
Public Health Ontario
480 University Avenue
Toronto, ON M5G 1V2
Phone: (416) 978-6064
Email: laura.rosella@utoronto.ca

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.


Title of Primary Resource MetaQAT
File Attachment None
Type of Material Document
Format On-line Access
Cost to Access None.
Language English
Conditions for Use Not specified
Title of Supplementary Resource The development and validation of a meta-tool for quality appraisal of public health evidence: Meta Quality Appraisal Tool (MetaQAT)
File Attachment MetaQAT.pdf

Rosella, L., Bowman, C., Pach, B., Morgan, S., Fitzpatrick, T., & Goel, V. (2016). The development and validation of a meta-tool for quality appraisal of public health evidence: Meta Quality Appraisal Tool (MetaQAT). Public Health, 136, 57-65.

Type of Material Journal
Format Periodical
Cost to Access None.
Language English
Conditions for Use

©2015 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Have you used this resource? Share your story!