title: AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty.
abstract: BACKGROUND
  In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting quality, methodological quality and generalizability of case series and cohorts in total hip and total knee arthroplasty with a focus on aseptic loosening.
  
  
  METHODS
  A web-based Delphi was conducted consisting of two internal rounds and three external rounds in order to achieve expert consensus on items considered relevant for reporting quality, methodological quality and generalizability.
  
  
  RESULTS
  The internal rounds were used to construct a master list. The first external round was completed by 44 experts, 35 of them completed the second external round and 33 of them completed the third external round. Consensus was reached on an 8-item reporting quality checklist, a 6-item methodological checklist and a 22-item generalizability checklist.
  
  
  CONCLUSIONS
  Checklist for reporting quality, methodological quality and generalizability for case series and cohorts in total hip and total knee arthroplasty were successfully created through this Delphi. These checklists should improve the accuracy, completeness and quality of case series and cohorts regarding total hip and total knee arthroplasty.
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands, Albinusdreef 2, Leiden, The Netherlands. b.g.c.w.pijls@lumc.nl
authors.forename: Bart G
authors.initials: BG
authors.lastname: Pijls
authors.forename: Olaf M
authors.initials: OM
authors.lastname: Dekkers
authors.forename: Saskia
authors.initials: S
authors.lastname: Middeldorp
authors.forename: Edward R
authors.initials: ER
authors.lastname: Valstar
authors.forename: Huub J L
authors.initials: HJ
authors.lastname: van der Heide
authors.forename: Henrica M J
authors.initials: HM
authors.lastname: Van der Linden-Van der Zwaag
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000592:standards*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000592:standards*; D016022:Case-Control Studies; D015331:Cohort Studies; D003697:Delphi Technique; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D020407:Internet; D007719:Knee Joint / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011475:Prosthesis Failure / Q000009:adverse effects / Q000209:etiology / Q000639:trends*; D011785:Quality Assurance, Health Care / Q000379:methods*