Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I Tool)

Sterne, J., Hernán, M., Reeves, B., Savović, J., Berkman, N., Viswanathan, M., et al. ROBINS-I: a tool for assessing risk of bias in non-randomized studies of interventions. BMJ 2016; 355; i4919; doi: 10.1136/bmj.i4919.

Template available Evaluated/validated

Description

This tool evaluates the risk of bias (RoB) in the results of non-randomized intervention studies. It can be used to evaluate quantitative observational trials, including cohort and case-control studies, controlled before-and-after studies, interrupted-time-series studies and quasi-randomized studies.

Steps for Using Method/Tool

The tool guides users through a series of signalling questions for each of the seven domains through which bias may be introduced:

  1. Bias due to confounding
  2. Bias in selection of participants into the study
  3. Bias in classification of interventions
  4. Bias due to deviations from intended interventions
  5. Bias due to missing data
  6. Bias in measurement of outcomes
  7. Bias in selection of the reported result

At the end of each section, an algorithm is provided to make a final judgement on the risk of bias. Each component is weighed equally to provide an overall risk of bias judgement.

Evaluation

Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., et al. (2016). ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions. BMJ (Clinical research ed.), 355, i4919. https://doi.org/10.1136/bmj.i4919

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