Development of a tool to assess the methodological quality of studies reporting on archaeologically excavated human skeletons: An international Delphi study

Methodological bias can directly affect the interpretation of research data. Studies reporting on excavated skeletons represent a valuable source of information in medicine, dentistry, archaeology and anthropology, and forensic sciences. However, these studies represent a specific setting with their own methodology, for which no quality assessment tool is available. The aim was to develop a critical appraisal tool to assess the methodological quality of studies reporting on archaeologically excavated human skeletons. An international Delphi study was therefore conducted to support item generation and ensure content validity for a new tool. Experts from the following domains were consulted: dentistry, forensic sciences, archaeology and anthropology, general medicine, epidemiology, and statistics. Participants judged the relevance and comprehensiveness of items retrieved from the literature. Consensus was predefined as 75% agreement between experts, and achieved within two Delphi rounds. As a result, 44 and 32 participants completed the first and second Delphi rounds, respectively, achieving consensus on 17 items. This research provides the first evidence-based tool for the methodological assessment of studies reporting on archaeologically excavated skeletons. Clinicians and researchers can use this tool for critical appraisal of studies or when performing systematic reviews. Future research will focus on psychometric testing of the newly developed tool.