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NOS

The Newcastle–Ottawa Scale (NOS) is a tool for assessing the quality of observational studies: cohort and case–control studies. Its star-based assessment covers three areas: selection, comparability, and outcome or exposure.

Applicable study designs

Observational studies: cohort and case–control studies.

Three blocks

  • Selection of participants.
  • Comparability of groups.
  • Outcome assessment in cohort studies or exposure assessment in case–control studies.

How the overall judgement is formed

A study earns up to nine stars (at most one per most items, up to two for comparability). More stars indicate higher methodological quality; the good/fair/poor thresholds are set by the review team.

When to use it

Used in reviews of observational studies to assess the methodological quality of included studies.

Primary source

Wells GA et al., Ottawa Hospital Research Institute

Updated: 01.10.2026.

NOS assessment in Sciente

The platform applies NOS to full-text project articles and shows a supporting excerpt beneath each judgement.

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