International Criteria for Reporting Study Quality for Sudden Cardiac Arrest/Death Tool

J Am Heart Assoc. 2024 Jun 4;13(11):e033723. doi: 10.1161/JAHA.123.033723. Epub 2024 May 23.


Background: Studies reporting on the incidence of sudden cardiac arrest and/or death (SCA/D) in athletes commonly lack methodological and reporting rigor, which has implications for screening and preventative policy in sport. To date, there are no tools designed for assessing study quality in studies investigating the incidence of SCA/D in athletes.

Methods and results: The International Criteria for Reporting Study Quality for Sudden Cardiac Arrest/Death tool (IQ-SCA/D) was developed following a Delphi process. Sixteen international experts in sports cardiology were identified and invited. Experts voted on each domain with subsequent moderated discussion for successive rounds until consensus was reached for a final tool. Interobserver agreement between a novice, intermediate, and expert observer was then assessed from the scoring of 22 relevant studies using weighted and unweighted κ analyses. The final IQ-SCA/D tool comprises 8 domains with a summated score of a possible 22. Studies are categorized as low, intermediate, and high quality with summated IQ-SCA/D scores of ≤11, 12 to 16, and ≥17, respectively. Interrater agreement was "substantial" between all 3 observers for summated IQ-SCA/D scores and study categorization.

Conclusions: The IQ-SCA/D is an expert consensus tool for assessing the study quality of research reporting the incidence of SCA/D in athletes. This tool may be used to assist researchers, reviewers, journal editors, and readers in contextualizing the methodological quality of different studies with varying athlete SCA/D incidence estimates. Importantly, the IQ-SCA/D also provides an expert-informed framework to support and guide appropriate design and reporting practices in future SCA/D incidence trials.

Keywords: SCA/D; athletes’ heart; sports cardiology; sudden cardiac death.

MeSH terms

  • Athletes
  • Consensus*
  • Death, Sudden, Cardiac* / epidemiology
  • Death, Sudden, Cardiac* / etiology
  • Death, Sudden, Cardiac* / prevention & control
  • Delphi Technique*
  • Humans
  • Incidence
  • Observer Variation
  • Research Design / standards
  • Sports Medicine / methods
  • Sports Medicine / standards