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Gierisch JM, Beadles C, Shapiro A, et al. Health Disparities in Quality Indicators of Healthcare Among Adults with Mental Illness [Internet]. Washington (DC): Department of Veterans Affairs (US); 2014 Oct.

Cover of Health Disparities in Quality Indicators of Healthcare Among Adults with Mental Illness

Health Disparities in Quality Indicators of Healthcare Among Adults with Mental Illness [Internet].

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APPENDIX BNEWCASTLE-OTTAWA SCALE CODING MANUAL FOR COHORT STUDIES

The Newcastle-Ottawa Scale quality instrument is scored by awarding a point for each answer that is marked with an asterisk below. Possible total points are 4 points for Selection, 2 points for Comparability, and 3 points for Outcomes.

SELECTION

  1. Representativeness of the Exposed Cohort
    1. Truly representative of the average patient with mental illness (eg, severity of illness, comorbidities) in the community*
    2. Somewhat representative of the average (eg, severity of illness, comorbidities)in the community*
    3. Selected group of users eg HIV+, pregnant, elderly, significant physical disabilities
    4. No description of the derivation of the cohort
  2. Selection of the Non-Exposed Cohort
    1. Drawn from the same community as the exposed cohort*
    2. Drawn from a different source
    3. No description of the derivation of the non-exposed cohort
  3. Ascertainment of Exposure
    1. Secure record (eg, medical records)*
    2. Structured interview *
    3. Written self-report
    4. No description
  4. Demonstration that Outcome of Interest Was Not Present at Start of Study
    1. Yes*
    2. No

COMPARABILITY

  1. Comparability of Cohorts on the Basis of the Design or Analysis
    1. Study controls for SES (or some reasonable proxy of SES), age, race, gender*
    2. Study controls for any additional factor* (this criteria could be modified to indicate specific control for a second important factor)
    3. Inadequate degree of control

OUTCOME

  1. Assessment of Outcome
    1. Independent or blind assessment stated in the paper, or confirmation of the outcome by reference to secure records (x-rays, medical records, etc)*
    2. Record linkage (eg, identified through ICD codes on database records)*
    3. Self-report (ie, no reference to original medical records or x-rays to confirm the outcome)
    4. No description
  2. Was Follow-up Long Enough for Outcomes to Occur?
    1. Yes (select an adequate follow up period for outcome of interest)*
    2. No
  3. Adequacy of Follow-up of Cohorts
    1. Complete follow-up—all subjects accounted for*
    2. Subjects lost to follow-up unlikely to introduce bias—small number lost (LESS than 20% follow-up, or description provided of those lost)*
    3. Follow-up rate MORE than 20% and no description of those lost
    4. No statement

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