Quality assessment
The outcome quality was scored according to the MOMENT criteria
(Management of otitis media with effusion in cleft palate score system)
in a 6-point scale. The MOMENT criteria is a validated checklist used
for quality assessment at study level which has been employed in a
previous core outcome set development for women’s health and asks the
following 16, 17: was a primary outcome stated (one
point); was the primary outcome clearly defined for reproducible
measures (one point); were the secondary outcomes clearly stated (one
point); were the secondary outcomes clearly defined for reproducible
measures (one point); do the authors explain the choice of outcome (one
point); and are the methods used designed to enhance quality of measures
appropriate (one point) 18. High quality was
determined for studies that reached score 4 or more in these criteria.
Although composite outcomes were recorded, they were not scored as
primary outcomes because they are known to be frequently unreasonably
combined, inconsistently defined and inadequately reported19.
For this review, the studies were not excluded based on their quality as
the aim of this review was not to assess efficacy or causal associations
of mode of birth on outcomes, but simply to provide a summary of
outcomes reported in previous studies, and therefore was not considered
to be affected by study quality.