Skip Ribbon Commands
Skip to main content
We are currently experiencing intermittent issues impacting registration and login including access to online learning. We apologize for any inconvenience.
MetaQAT - Critical Appraisal Tool

The Public Health Ontario Meta-tool for Quality Appraisal of Public Health Evidence

The MetaQAT is a tool for appraising public health evidence. A meta-tool is a tool that orients the user to the appropriate use of several critical appraisal tools (CATs) and places them within a larger framework to guide their use. The extension of the appraisal process beyond internal validity led us to use the term “quality appraisal” when describing the meta-tool, rather than “critical appraisal”. The MetaQAT is a quality appraisal framework with a suite of suggested ‘companion’ critical appraisal tools. Dr. Laura Rosella, PHO Scientist, led the development of the MetaQAT. It is one of few quality appraisal tools designed specifically for public health evidence. 

The meta-tool consists of:

  • a background document,
  • user guide,
  • fillable form, and
  • links to companion tools.


Download the PHO MetaQAT


Fitting the MetaQAT to your project

The MetaQAT is designed to be a flexible tool, which means there are many ‘right’ ways to use it, therefore you may need to tailor the MetaQAT to your project.

The MetaQAT provides: 

  1. a framework for  assessing quality
  2. direction to existing  tools for detailed bias assessment
  3. templates to document the process.

These three things are necessarily generic. It is intended to be tailored to the diversity of work that is conducted across PHO.

There are 3 main ways to tailor the MetaQAT content:

  1. alter the prompting questions (not the main questions) to suit your project
  2. add prompting questions to 3. b) - the bias question - based on companion tool content
  3. skip the relevancy step if it redundant, for example if you are screening items using formal screening criteria

The Reliability, Validity, and Applicability domains should always be included, as should all of the main questions within each domain.



Rosella L, Bowman C, Pach B, Morgan S, Fitzpatrick T, Goel V. The development and validation of a meta-tool for quality appraisal of public health evidence: Meta Quality Appraisal Tool (MetaQAT). Public Health. 2016;136:57-65. Available from:

Excel Format

PHO MetaQAT form in spreadsheet format – can be used in conjunction with data extraction tables or other additional information

Individual Sections - read all three sections before using the MetaQAT

PHO MetaQAT guide and framework
PHO MetaQAT form
Companion tools and additional resources

PHO Grey literature critical appraisal tool

PHO Guide to Appraising Grey Literature


MetaQAT workshop at the Canadian Public Health Association Conference 2016

If you have any questions please contact us at
Page last reviewed:
Page last updated: 2018-08-01 11:40 AM
Uncontrolled print copy. Valid only on day of Print: [date]
Page updated on [date/time] 2018-08-01 11:40 AM
© , Ontario Agency for Health Protection and Promotion