Risk of Bias 2 in Cochrane Intervention Reviews: update on the pilot and implementation in Cochrane

Article type
Authors
Flemyng E1, Dwan K1, Moore TH2, Hall R1, Higgins JP3
1Cochrane
2Cochrane; Population Health Sciences Department, Bristol Medical School, University of Bristol
3Population Health Sciences Department, Bristol Medical School, University of Bristol
Abstract
Background:
Cochrane Reviews are required to assess the risk of bias in the studies that they identify and summarise. In 2008, the publication of the Cochrane Handbook of Systematic Reviews of Interventions and simultaneous rollout of the Review Manager 5 software launched the first version of the Cochrane Risk of Bias tool. Following formal evaluations of its use, a new version of the tool, Risk of Bias 2 (RoB 2), was developed and included in version 6 of the Cochrane Handbook of Systematic Reviews of Interventions that was published in 2019. In 2019 and 2020, as part of a supported, gradual implementation process for RoB 2, Cochrane has been piloting its use in reviews via an opt-in process. The Cochrane Editorial and Methods and Information and Technology Services Departments have been working closely with all pilot review groups to ensure the necessary guidance, training, tools and support are available to authors and editors. The pilot also helps us understand and overcome any dependencies, gather evidence on the usability of the tool and understand the impact it has on technology, publishing and presentation. Fundamentally, the pilot is helping us work towards a streamlined and efficient process from writing the protocol to publishing the full review in the Cochrane Library.

Objectives:
This poster will provide an update on developments and next steps on the RoB 2 roll-out in Cochrane, including:
1. Details on the number of Cochrane Reviews in the pilot and their feedback on using RoB 2.
2. Details on available guidance, training and support.
3. Updates on review production tools and developments to support RoB 2 use, including RevMan Web.
4. Details on how RoB 2 will be presented in full published reviews.
The poster will also provide feedback on the approach used to introduce RoB 2 within Cochrane; the gradual, roll-out of a new method by starting with keen early-adopters in a pilot and scaling-up. This will be of use to Cochrane as it considers plans to include more diverse and complex methods within its reviews.

Conclusions:
RoB 2 helps authors produce Cochrane Reviews with more concrete conclusions on the reliability of the evidence and therefore has the potential to improve the relevance and quality of reviews generally. The pilot and roll-out plan is observing what challenges the improved tool may pose to authors and editors so that the necessary guidance and infrastructure can be put in place to alleviate them before changes to policy are made.

Patient or healthcare consumer involvement:
As a methods implementation project within Cochrane processes, we have not involved patients. However, our ‘consumers’ are Cochrane Review author and editorial teams, who are involved as pilot teams within the project. Cochrane hosts monthly web clinics for the pilot teams to give them the opportunity to ask questions and so we can gain their feedback on guidance and developments as part of the pilot. We also actively seek their feedback via email.