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

Ref ID 782
First Author E. Igelstrom
Journal JOURNAL OF CLINICAL EPIDEMIOLOGY
Year Of Publishing 2021
URL https://www.sciencedirect.com/science/article/pii/S0895435621002675
Keywords • Low methodological quality
• General medical
• Observational studies
Problem(s) • Inclusion of observational / non-randomised studies
• Flawed risk of bias undertaken
• Low methodological (AMSTAR) quality
Article Type Empirical
Article Subtype Cross-sectional survey/Methodological systematic review
First Author Country United Kingdom
Aim To assess the use of the ‘Risk of Bias In Non-randomized Studies–of Interventions’ (ROBINS-I), a Cochrane risk of bias assessment tool, has been used in systematic reviews published between January 01 2020 to March 02, 2020.
Level of Investigation Analytical
Summary of Findings From 93 included systematic reviews indexed across Scopus, Web of Science, MEDLINE, Embase, and the Cochrane Database of Systematic Reviews between January 01 2020 to March 02, 2020. Quality of reviews (AMSTAR-2) 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).
Number of systematic reviews included 93
Number of eligible systematic reviews assessed 181
Treatment impacted No
Treatment impacted description
Interpretation impacted Not Applicable
Interpretation impacted description