Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Prognostic models for predicting relapse or recurrence of major depressive disorder in adults (Review)
Table 2. Risk of bias and applicability assessment of included studies
Study

Library
Cochrane
Backs- Berlan- Jo- Judd Klein 2018 Pintor Ruhe Van Loo 2015 Van Van Wang 2014
Der- ga hans- 2016 2009 2019 Loo Loo
mott 1999 son 2018 2020
2010 2015

Type of study Dev Dev Dev Dev Dev Val Dev Dev Dev Val Dev Val Dev Val

Better health.
Informed decisions.
Trusted evidence.
Domain 1: Participants

Risk of bias Low Low Low Low Low Low Low Low Low Low Low Low Low Low

Concern about applica- Low Un- Low Low Low Low Low Low Low Low Low Low Low Low
bility clear

Domain 2: Predictors

Risk of bias Low Low Low Low Low Low Un- Low Low Low Un- High Low Low
clear clear

Concern about applica- Low Low Low Low Low Low Low Low Low Low Low Low Low Low
bility

Domain 3: Outcome

Risk of bias Un- Un- Un- Low Low Low Un- Un- Un- Un- Un- Un- Un- Un-
clear clear clear clear clear clear clear clear clear clear clear

Concern about applica- Low Low Low Low Low Low Low Low Low Low Low Low Low Low
bility

Cochrane Database of Systematic Reviews

Domain 4: Analysis

Risk of bias High High High High Low Low High High High High High High High High

Overall assessment of High High High High Low Low High High High High High High High High
risk of bias
40
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Prognostic models for predicting relapse or recurrence of major depressive disorder in adults (Review)
Table 2. Risk of bias and applicability assessment of included studies (Continued)

Overall concern for ap- Low Un- Low Low Low Low Low Low Low Low Low Low Low Low
plicability clear

Library
Cochrane
Dev: Prognostic model development study; Val: External validation study of prognostic model

Table 3. Detailed risk of bias and applicability assessment

Better health.
Informed decisions.
Trusted evidence.
Study

Backs- Berlan- Jo- Judd Klein 2018 Pintor Ruhe Van Loo 2015 Van Van Wang 2014
Der- ga hans- 2016 2009 2019 Loo Loo
mott 1999 son 2018 2020
2010 2015

Type of study De- De- De- De- De- Valida- De- De- De- Valida- De- Valida- De- Valida-
velop- velop- velop- velop- velop- tion velop- velop- velop- tion velop- tion velop- tion
ment ment ment ment ment ment ment ment ment ment

Domain 1: Participants

A. Risk of bias

1.1. Appropriate data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
sources?

1.2. Appropriate inclu- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
sions and exclusion?

Risk of bias Low Low Low Low Low Low Low Low Low Low Low Low Low Low

Cochrane Database of Systematic Reviews

B. Applicability

Concern about applica- Low Un- Low Low Low Low Low Low Low Low Low Low Low Low
bility clear

Domain 2: Predictors

A. Risk of bias
41
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Prognostic models for predicting relapse or recurrence of major depressive disorder in adults (Review)
Table 3. Detailed risk of bias and applicability assessment (Continued)

2.1. Defined and as- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
sessed in similar way for

Library
Cochrane
all participants?

2.2. Assessments made Proba- Proba- Yes Yes Yes Yes No in- Yes Proba- Proba- No in- No in- Proba- Proba-
without knowledge of bly yes bly yes forma- bly yes bly yes forma- forma- bly yes bly yes
outcome? tion tion tion

Better health.
Informed decisions.
Trusted evidence.
2.3. All available at time Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes
of model’s intended
use?

Risk of bias Low Low Low Low Low Low Un- Low Low Low Un- High Low Low
clear clear

B. Applicability

Concern about applica- Low Low Low Low Low Low Low Low Low Low Low Low Low Low
bility

Domain 3: Outcome

A. Risk of bias

3.1. Determined appro- Yes Yes Yes Proba- Yes Yes No in- Yes Yes Yes Yes Yes Proba- Proba-
priately? bly yes forma- bly yes bly yes
tion

3.2. Pre-specified or Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
standard definition?

3.3. Predictors exclud- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Cochrane Database of Systematic Reviews

ed from outcome defini-
tion?

3.4. Defined and deter- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
mined similar for all par-
ticipants?

3.5. Determined with- No in- No in- No in- Proba- Yes Yes No in- No in- No in- No in- No in- No in- No in- No in-
out knowledge of pre- forma- forma- forma- bly yes forma- forma- forma- forma- forma- forma- forma- forma-
dictors? tion tion tion tion tion tion tion tion tion tion tion
42
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Prognostic models for predicting relapse or recurrence of major depressive disorder in adults (Review)
Table 3. Detailed risk of bias and applicability assessment (Continued)

3.6. Appropriate time in- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
terval between predic-

Library
Cochrane
tor assessment and out-
come determination?

Risk of bias Un- Un- Un- Low Low Low Un- Un- Un- Un- Un- Un- Un- Un-
clear clear clear clear clear clear clear clear clear clear clear

Better health.
Informed decisions.
Trusted evidence.
B. Applicability

Concern about applica- Low Low Low Low Low Low Low Low Low Low Low Low Low Low
bility

Domain 4: Analysis

4.1. Reasonable number Proba- No No No Proba- Yes No No No No No Proba- No in- Yes

of participants with out- bly yes bly yes bly yes forma-
come? tion

4.2. Predictors handled Yes Proba- Yes No Proba- Proba- No Proba- No No Proba- Proba- No No
appropriately? bly yes bly yes bly yes bly no bly yes bly yes

4.3. All enrolled partici- No No Yes No Yes Yes Yes No Proba- Proba- No Yes Yes Yes
pants included in analy- bly yes bly yes
sis?

4.4. Missing data han- No in- No in- No in- Yes Yes Yes No in- No No No Yes Yes Proba- Proba-
dled appropriately? forma- forma- forma- forma- bly no bly no
tion tion tion tion

4.5. Univariable analysis No No No No Yes NA No Yes Yes NA Yes NA No NA

avoided?

Cochrane Database of Systematic Reviews

4.6. Complexities in data Proba- Proba- Proba- Yes Yes Yes Proba- Yes Proba- Proba- Yes Proba- Proba- Proba-
accounted for? bly yes bly yes bly yes bly yes bly yes bly yes bly yes bly yes bly yes

4.7. Relevant perfor- No No No No Yes Yes No No No No No No No No

mance measures?

4.8. Overfitting and opti- No No No No Yes NA No No Yes NA Yes NA Yes NA

mism accounted for?
43
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Prognostic models for predicting relapse or recurrence of major depressive disorder in adults (Review)
Table 3. Detailed risk of bias and applicability assessment (Continued)

4.9. Final model corre- No in- No in- Proba- No in- Yes NA No in- No in- Proba- NA Proba- NA No in- NA
sponds to multivariable forma- forma- bly yes forma- forma- forma- bly no bly yes forma-

Library
Cochrane
analysis? tion tion tion tion tion tion

Risk of bias High High High High Low Low High High High High High High High High

Overall assessment of High High High High Low Low High High High High High High High High
risk of bias

Better health.
Informed decisions.
Trusted evidence.
Overall concern for ap- Low Un- Low Low Low Low Low Low Low Low Low Low Low Low
plicability clear

Validation refers to external validation

Cochrane Database of Systematic Reviews

44