Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Nov 6;3(1):44.
doi: 10.1186/s44158-023-00129-z.

Enhancing study quality assessment: an in-depth review of risk of bias tools for meta-analysis-a comprehensive guide for anesthesiologists

Alessandro De Cassai  1 , Annalisa Boscolo  2   3   4 , Francesco Zarantonello  2 , Tommaso Pettenuzzo  2 , Nicolò Sella  2 , Federico Geraldini  5 , Marina Munari  5 , Paolo Navalesi  2   3
Affiliations
Review

Enhancing study quality assessment: an in-depth review of risk of bias tools for meta-analysis-a comprehensive guide for anesthesiologists

Alessandro De Cassai et al. J Anesth Analg Crit Care. .

Abstract

Background: Yearly, a multitude of randomized controlled trials are published, overwhelming clinicians with conflicting information; this data saturation leads to confusion and hinders clinicians' everyday decision-making. Hence, it is crucial to assess the quality and reliability of the evidence in order to consolidate it. Through this synthesis, clinicians can guarantee that their decisions are informed by solid evidence. Meta-analysis, a statistical technique, can effectively combine data from multiple studies to furnish accurate and dependable evidence for clinical practice and policy decisions. Nonetheless, the reliability of the obtained results depends on the use of high-quality evidence.

Main body: Risk of bias is an assessment mandatory while performing a meta-analysis and is used to have an overview of the quality of the studies from which data are extracted. Several tools have been developed and are used to perform the risk of bias assessment. In this statistical round, we will provide an overview of the most used tools for both the randomized (Cochrane Risk of Bias 2 and Jadad) and the nonrandomized (Risk Of Bias In Non-randomized Studies and Newcastle-Ottawa Scale) clinical trials.

Conclusion: We provided an overview of the most used risk of bias tools used in meta-analysis.

Keywords: Bias; Meta-analysis; Statistical analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Example of Cochrane Risk of Bias 2 graphical representation
Fig. 2
Fig. 2
Example of Robins-I graphical representation
Fig. 3
Fig. 3
Example of Robins-E graphical representation
See this image and copyright information in PMC

References

    1. Innes S, Leboeuf-Yde C. A guide to evaluating systematic reviews for the busy clinicians or reluctant readers. Chiropractic Manual Ther. 2023;31(1):38. doi: 10.1186/s12998-023-00501-4. - DOI - PMC - PubMed
    1. Bornmann L, Mutz R. Growth rates of modern science: a bibliometric analysis based on the number of publications and cited references. J Assn Inf Sci Tec. 2015;66:2215–2222. doi: 10.1002/asi.23329. - DOI
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Higgins JPT. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed.) 2019;366:l4898. doi: 10.1136/bmj.l4898. - DOI - PubMed
    1. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods Group, & Cochrane Statistical Methods Group The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed.) 2011;343:d5928. doi: 10.1136/bmj.d5928. - DOI - PMC - PubMed
    1. ROBINS-E Development Group. Risk Of Bias In Non-randomized Studies - of Exposure (ROBINS-E). Launch version, 1 June 2022. Available from: https://www.riskofbias.info/welcome/robins-e-tool. Accessed 13 Sept 2023

LinkOut - more resources