“…Measurement error was not reported in any study and could therefore not be rated with COSMIN box C. Content validity (box D) was assessed by most studies with a high variability of scores, ranging from several studies rated as poor [ 13 , 16 , 28 , 35 , 37 , 38 , 45 – 47 , 49 – 52 ] to one single study rated as excellent [ 34 ]. Structural validity (box E) was also assessed by most studies with only the study on the Genetic Counseling Outcome Scale [ 18 ] being rated as good and all other studies receiving poor [ 28 , 30 , 31 , 34 , 36 , 37 , 41 ] or fair ratings [ 16 , 17 , 29 , 32 , 35 , 38 – 40 , 42 – 44 , 46 – 53 ]. Regarding hypothesis testing (box F) studies were either rated as poor [ 16 , 18 , 28 , 30 , 31 , 35 – 38 , 43 , 45 – 47 ] or fair [ 29 , 32 , 33 , 39 – 42 , 49 , 51 – 53 ].…”