Introduction to the RoB 2 tool for assessing risk of bias in a randomized trial

Article type
Authors
Higgins J1, Sterne J1, Savovic J1, Page M2, Hróbjartsson A3
1University of Bristol
2Methods in Evidence Synthesis Unit, Monash University
3Cochrane Denmark and CEBMO
Abstract
Background: Randomized trials provide evidence about the effects of healthcare interventions. However, trial results can be undermined by flaws in design, conduct, analyses and selective reporting. Therefore, assessments of risk of bias in results of the included randomized trials are mandatory in Cochrane systematic reviews. The revised risk of bias tool (RoB 2), published in 2019, is the recommended method for doing this.

Objectives:
To explain the key concepts that underpin RoB 2 and gain experience in using it to assess risk of bias in randomized trials.

Description: We will present, implement and discuss the key features of RoB 2:
• specification of the result to be assessed and sources of information used;
• specification of the effect of interest (that of assignment to intervention, or adhering to intervention);
• five consolidated bias domains;
• signalling questions that lead to algorithm-guided risk of bias judgements within bias domains; and
• derivation of an overall risk of bias judgement for the assessed result.

We will explore the five bias domains included within RoB 2: bias arising from the randomization process, bias due to deviations from intended interventions, bias due to missing outcome data, bias in the measurement of the outcome and bias in the selection of the reported result.

A worked example will be used to provide hands-on training and facilitate discussion. Participants will have the option to complete their assessments in a semi-automated Excel template and are encouraged to bring their own portable device to access detailed guidance that is available at www.riskofbias.info. Please note that the facilitators are unable to provide printed copies of the materials.