BackgroundNarrative reviews are the commonest type of articles in the medical literature. However, unlike systematic reviews and randomized controlled trials (RCT) articles, for which formal instruments exist to evaluate quality, there is currently no instrument available to assess the quality of narrative reviews. In response to this gap, we developed SANRA, the Scale for the Assessment of Narrative Review Articles.MethodsA team of three experienced journal editors modified or deleted items in an earlier SANRA version based on face validity, item-total correlations, and reliability scores from previous tests. We deleted an item which addressed a manuscript’s writing and accessibility due to poor inter-rater reliability. The six items which form the revised scale are rated from 0 (low standard) to 2 (high standard) and cover the following topics: explanation of (1) the importance and (2) the aims of the review, (3) literature search and (4) referencing and presentation of (5) evidence level and (6) relevant endpoint data. For all items, we developed anchor definitions and examples to guide users in filling out the form. The revised scale was tested by the same editors (blinded to each other’s ratings) in a group of 30 consecutive non-systematic review manuscripts submitted to a general medical journal.ResultsRaters confirmed that completing the scale is feasible in everyday editorial work. The mean sum score across all 30 manuscripts was 6.0 out of 12 possible points (SD 2.6, range 1–12). Corrected item-total correlations ranged from 0.33 (item 3) to 0.58 (item 6), and Cronbach’s alpha was 0.68 (internal consistency). The intra-class correlation coefficient (average measure) was 0.77 [95% CI 0.57, 0.88] (inter-rater reliability). Raters often disagreed on items 1 and 4.ConclusionsSANRA’s feasibility, inter-rater reliability, homogeneity of items, and internal consistency are sufficient for a scale of six items. Further field testing, particularly of validity, is desirable. We recommend rater training based on the “explanations and instructions” document provided with SANRA. In editorial decision-making, SANRA may complement journal-specific evaluation of manuscripts—pertaining to, e.g., audience, originality or difficulty—and may contribute to improving the standard of non-systematic reviews.

中文翻译：

---

SANRA——叙事评论文章质量评估量表

背景叙述性评论是医学文献中最常见的文章类型。然而，与系统评价和随机对照试验 (RCT) 文章不同，它们有正式的工具来评估质量，目前没有可用的工具来评估叙述性评论的质量。针对这一差距，我们开发了 SANRA，即叙述性评论文章评估量表。方法一个由三名经验丰富的期刊编辑组成的团队根据表面效度、项目总相关性和可靠性得分修改或删除早期 SANRA 版本中的项目。以前的测试。由于评估者间可靠性差，我们删除了一个涉及手稿写作和可访问性的项目。构成修订量表的六个项目从 0（低标准）到 2（高标准）评级，涵盖以下主题：解释（1）重要性和（2）审查目的，（3）文献检索和（4）参考和呈现（5）证据水平和（6）相关终点数据。对于所有项目，我们开发了锚定义和示例来指导用户填写表格。修改后的量表由相同的编辑（对彼此的评级不知情）在一组连续 30 篇提交给一般医学期刊的非系统性综述手稿中进行测试。结果评估者确认完成量表在日常编辑工作中是可行的。所有 30 份手稿的平均总分为 12 分中的 6.0 分（标准差 2.6，范围 1-12）。校正的项目总相关性范围为 0.33（项目 3）至 0.58（项目 6），Cronbach 的 alpha 为 0.68（内部一致性）。类内相关系数（平均测量）为0。77 [95% CI 0.57, 0.88]（评分者间信度）。评估者经常在项目 1 和 4 上存在分歧。结论 SANRA 的可行性、评估者间的可靠性、项目的同质性和内部一致性足以满足六个项目的规模。需要进一步的现场测试，特别是有效性测试。我们建议根据 SANRA 提供的“解释和说明”文件进行评估员培训。在编辑决策中，SANRA 可以补充期刊对稿件的特定评估——例如涉及读者、原创性或难度——并且可能有助于提高非系统性评论的标准。需要进一步的现场测试，特别是有效性测试。我们建议根据 SANRA 提供的“解释和说明”文件进行评估员培训。在编辑决策中，SANRA 可以补充期刊对稿件的特定评估——例如涉及读者、原创性或难度——并且可能有助于提高非系统性评论的标准。需要进一步的现场测试，特别是有效性测试。我们建议根据 SANRA 提供的“解释和说明”文件进行评估员培训。在编辑决策中，SANRA 可以补充期刊对稿件的特定评估——例如涉及读者、原创性或难度——并且可能有助于提高非系统性评论的标准。