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To aid in interpretation of included studies, a quality review score was used to assign a study design level and ranking criteria based on the consistency and generalizability of reported elements (quality review criteria found in Table 1).
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For each study a quality score was given using a form developed specifically for this study.
For each included study, a quality assessment tool was completed to evaluate the overall quality of the study design and analysis.
The mean quality score of the Japanese studies was 6.7 and the proportion of high-quality studies (with a quality score higher than 8) was 32.6%.
This study was a quality improvement study that was approved by the Institutional Review Board of Hospital Israelita Albert Einstein (IRB).
According to our regional ethics committee, the present study was a quality assurance study that did not require any approval in order to be performed or published.
Studies with a quality assessment below 50% were excluded.
Six studies with a quality rating of 'D' were rejected outright.
Studies with a quality score of ≥16 were considered to have adequate quality [ 14].
However, none of these two studies included a quality of life assessment.
This distribution helps provide them with the basic materials they need to continue their studies in a quality leaning environment".
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