COSMIN Methodology

Recommendation grades depended on content validity, internal consistency, and evidence for insufficient properties. Only six surveys provided sufficient development detail for COSMIN assessment. None of the six COSMIN-assessed surveys reported all required measurement properties. Each measurement property was rated as sufficient, insufficient, or indeterminate. The COSMIN Risk of Bias Checklist assessed methodological quality across ten measurement-property domains. COSMIN analysis was only possible when enough information was reported. All six COSMIN-assessed studies were judged to have high risk of bias.