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. 2016 Jan:69:225-34.
doi: 10.1016/j.jclinepi.2015.06.005. Epub 2015 Jun 16.

ROBIS: A new tool to assess risk of bias in systematic reviews was developed

Penny Whiting  1 , Jelena Savović  2 , Julian P T Higgins  3 , Deborah M Caldwell  4 , Barnaby C Reeves  5 , Beverley Shea  6 , Philippa Davies  2 , Jos Kleijnen  7 , Rachel Churchill  4 ; ROBIS group
Collaborators, Affiliations

ROBIS: A new tool to assess risk of bias in systematic reviews was developed

Penny Whiting et al. J Clin Epidemiol. 2016 Jan.

Abstract

Objective: To develop ROBIS, a new tool for assessing the risk of bias in systematic reviews (rather than in primary studies).

Study design and setting: We used four-stage approach to develop ROBIS: define the scope, review the evidence base, hold a face-to-face meeting, and refine the tool through piloting.

Results: ROBIS is currently aimed at four broad categories of reviews mainly within health care settings: interventions, diagnosis, prognosis, and etiology. The target audience of ROBIS is primarily guideline developers, authors of overviews of systematic reviews ("reviews of reviews"), and review authors who might want to assess or avoid risk of bias in their reviews. The tool is completed in three phases: (1) assess relevance (optional), (2) identify concerns with the review process, and (3) judge risk of bias. Phase 2 covers four domains through which bias may be introduced into a systematic review: study eligibility criteria; identification and selection of studies; data collection and study appraisal; and synthesis and findings. Phase 3 assesses the overall risk of bias in the interpretation of review findings and whether this considered limitations identified in any of the phase 2 domains. Signaling questions are included to help judge concerns with the review process (phase 2) and the overall risk of bias in the review (phase 3); these questions flag aspects of review design related to the potential for bias and aim to help assessors judge risk of bias in the review process, results, and conclusions.

Conclusions: ROBIS is the first rigorously developed tool designed specifically to assess the risk of bias in systematic reviews.

Keywords: Evidence; Meta-analysis; Quality; Risk of bias; Systematic review; Tool.

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Figures

Fig. 1
Fig. 1
Suggested graphical presentation for ROBIS results from multiple reviews.
Fig. 2
Fig. 2
Suggested graphical presentation for ROBIS results from single review: each colored segment shows the concerns for one of the phase 2 ROBIS domains; the final segment (shaded darker) shows the phase risk of bias assessment.
See this image and copyright information in PMC

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