The Anatomical Quality Assessment (AQUA) Tool was designed to assess the quality and reliability of anatomical studies. The tool assesses the risks of bias in an anatomical study from the perspective of five key domains:
1. Aim and subject characteristics
2. Study design,
3. Characterization of methods,
4. Descriptive anatomy,
5. Results reporting

Each domain was set to end with a risk of bias question (judged as "Low", "High", or "Unclear").

The AQUA Tool judges the quality of an anatomical study by assessing risks of bias due to the methods and the reporting of results. As such, readers of an anatomical study (reviewers, clinicians, or other researchers) can assess its reliability on the basis of its risks of bias, as revealed by the tool. The developers of the tool would like to emphasize that the tool is not designed to provide an overall assessment of the quality of an anatomical paper (which is affected by study motivation, synthesis of the literature, methodological approach, data quality, discussion of findings, conclusions, limitations, etc.). It is also not intended to serve as a replacement for reviewer guidelines in journals.

The face validity of the AQUA Tool was assessed with the help of a Delphi panel which consisted of renowned anatomists from around the world. The final version of the tool is available below and on the Resources page. Also available there is a user guide for the AQUA Tool, as well as tabular and graphical display templates.

Currently, the AQUA Tool is undergoing rigorous evaluation. Any problems or weaknesses of the tool highlighted during this process will be taken into consideration for its further improvement.

The AQUA team strongly feels that the tool is an evolving instrument and requires continuous appraisal and modifications. We therefore welcome any comments, feedback, or recommendations from the scientific community to improve the tool.