Article type
Abstract
Background: The version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2.0) is the endorsed instrument for evaluating the risk of bias in randomized trials incorporated within Cochrane Systematic Reviews of interventions (CSRI) [1]. Version 2 was launched in 2019, supplanting the initial version published in 2008 and subsequently updated in 2011. RoB 2.0 is organized into five bias domains and the main difference between RoB 2.0 and the original version (RoB table) is the incorporation of an overall risk-of-bias judgment in RoB 2.0, allowing users to categorize meta-analyses based on the risk of bias [2]. Despite being the recommended method by the Cochrane Handbook, previous investigations suggested a low speed of implementation of RoB 2.0 with only 24.1% of Cochrane reviews from 2022 adopting the updated tool [3].
Objectives: This study aimed to determine the adherence of all CSRI published in 2023 to the RoB 2.0 tool for assessing the risk of bias in included randomized clinical trials.
Methods: This research adopts a meta-research study design. The inclusion criteria encompassed CSRI published in 2023 and planning to incorporate randomized clinical trials.
Results: Analysis was conducted on 380 CSRI. Overall, only 18.16% (69/380) of Cochrane systematic reviews utilized the risk of bias 2.0 tool, whereas 81.84% (311/380) of reviews adopted the initial version of the tool.
Conclusions: CSRI published in 2023 demonstrate low adherence to the Cochrane's risk of bias 2.0 tool. Further initiatives are imperative to facilitate the successful implementation of the tool. If adherence to risk of bias 2.0 tool does not improve within CSRI, Cochrane should consider recommending both tools on further updated of the Cochrane Handbook of Systematic Reviews.
Relevance and importance to patients: Systematic reviews employ scientific methodologies to systematically gather, critically evaluate, and synthesize all pertinent studies related to a specific clinical question, aiming to mitigate bias. Given the susceptibility of the review process to bias, it is determinant to know the tool utilized to analyze the risk of bias in included studies, given that systematic reviews bridge the gap between optimal patient healthcare and the best available research evidence.
Objectives: This study aimed to determine the adherence of all CSRI published in 2023 to the RoB 2.0 tool for assessing the risk of bias in included randomized clinical trials.
Methods: This research adopts a meta-research study design. The inclusion criteria encompassed CSRI published in 2023 and planning to incorporate randomized clinical trials.
Results: Analysis was conducted on 380 CSRI. Overall, only 18.16% (69/380) of Cochrane systematic reviews utilized the risk of bias 2.0 tool, whereas 81.84% (311/380) of reviews adopted the initial version of the tool.
Conclusions: CSRI published in 2023 demonstrate low adherence to the Cochrane's risk of bias 2.0 tool. Further initiatives are imperative to facilitate the successful implementation of the tool. If adherence to risk of bias 2.0 tool does not improve within CSRI, Cochrane should consider recommending both tools on further updated of the Cochrane Handbook of Systematic Reviews.
Relevance and importance to patients: Systematic reviews employ scientific methodologies to systematically gather, critically evaluate, and synthesize all pertinent studies related to a specific clinical question, aiming to mitigate bias. Given the susceptibility of the review process to bias, it is determinant to know the tool utilized to analyze the risk of bias in included studies, given that systematic reviews bridge the gap between optimal patient healthcare and the best available research evidence.