“…However, the methodological quality of the content validity studies was “adequate” and “very good” only for the Rating of Included Trials on the Efficacy-Effectiveness Spectrum (RITES) tool [ 47 ] and “doubtful” for Cho´s Clinical Relevance Instrument [ 79 ], the “external validity”-dimension of the Downs & Black-checklist [ 22 ], the “Selection Bias”-dimension of the Effective Public Health Practice Project (EPHPP) tool [ 98 ], and the “Clinical Relevance” tool [ 81 ]. The overall certainty of evidence for content validity was “very low” for 19 tools (mainly due to very serious risk of bias and serious indirectness) [ 63 – 76 , 78 , 82 , 86 , 88 , 100 ], “low” for three tools (mainly due to serious risk of bias or serious indirectness) [ 77 , 83 , 94 ] and “moderate” for six tools (mainly due to serious risk of bias or serious indirectness) [ 22 , 47 , 79 , 81 , 92 , 98 ]. All but one tool had an “indeterminate” content validity.…”