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Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review

Journal of clinical epidemiology, 2021-12, Vol.140, p.22-32 [Peer Reviewed Journal]

2021 The Authors ;Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved. ;2021. The Authors ;2021 The Authors 2021 ;ISSN: 0895-4356 ;EISSN: 1878-5921 ;DOI: 10.1016/j.jclinepi.2021.08.022 ;PMID: 34437948

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Title:
Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review
Author: Igelström, Erik ; Campbell, Mhairi ; Craig, Peter ; Katikireddi, Srinivasa Vittal
Subjects: Bias ; Clinical Trials as Topic - standards ; Clinical Trials as Topic - statistics & numerical data ; Cochrane ; Epidemiology ; Humans ; Literature reviews ; Non-randomized studies ; Observational studies ; Original ; Quality assessment ; Reviews ; Risk assessment ; Risk Factors ; Risk of bias ; Systematic review ; Systematic review methods ; Systematic Reviews as Topic - methods ; Systematic Reviews as Topic - standards
Is Part Of: Journal of clinical epidemiology, 2021-12, Vol.140, p.22-32
Description: We aimed to review how ‘Risk of Bias In Non-randomized Studies–of Interventions’ (ROBINS-I), a Cochrane risk of bias assessment tool, has been used in recent systematic reviews. Database and citation searches were conducted in March 2020 to identify recently published reviews using ROBINS-I. Reported ROBINS-I assessments and data on how ROBINS-I was used were extracted from each review. Methodological quality of reviews was assessed using AMSTAR 2 (‘A MeaSurement Tool to Assess systematic Reviews’). Of 181 hits, 124 reviews were included. Risk of bias was serious/critical in 54% of assessments on average, most commonly due to confounding. Quality of reviews was mostly low, and modifications and incorrect use of ROBINS-I were common, with 20% reviews modifying the rating scale, 20% understating overall risk of bias, and 19% including critical-risk of bias studies in evidence synthesis. Poorly conducted reviews were more likely to report low/moderate risk of bias (predicted probability 57% [95% CI: 47–67] in critically low-quality reviews, 31% [19–46] in high/moderate-quality reviews). Low-quality reviews frequently apply ROBINS-I incorrectly, and may thus inappropriately include or give too much weight to uncertain evidence. Readers should be aware that such problems can lead to incorrect conclusions in reviews.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0895-4356
EISSN: 1878-5921
DOI: 10.1016/j.jclinepi.2021.08.022
PMID: 34437948
Source: MEDLINE
ProQuest Central

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Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review

2021 The Authors ;Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved. ;2021. The Authors ;2021 The Authors 2021 ;ISSN: 0895-4356 ;EISSN: 1878-5921 ;DOI: 10.1016/j.jclinepi.2021.08.022 ;PMID: 34437948

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