Online citations, reference lists, and bibliographies.
← Back to Search

[GRADE Guidelines: 18. How ROBINS-I And Other Tools To Assess Risk Of Bias In Nonrandomized Studies Should Be Used To Rate The Certainty Of A Body Of Evidence].

J. Morche, S. Freitag, F. Hoffmann, O. Rissling, G. Langer, B. Nussbaumer-Streit, I. Töws, G. Gartlehner, J. Meerpohl
Published 2020 ·

Cite This
Download PDF
Analyze on Scholarcy
OBJECTIVE To provide guidance on how systematic review authors, guideline developers, and health technology assessment practitioners should approach the use of the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool as a part of GRADE's certainty rating process. STUDY DESIGN AND SETTING The study design and setting comprised iterative discussions, testing in systematic reviews, and presentation at GRADE working group meetings with feedback from the GRADE working group. RESULTS We describe where to start the initial assessment of a body of evidence with the use of ROBINS-I and where one would anticipate the final rating would end up. The GRADE accounted for issues that mitigate concerns about confounding and selection bias by introducing the upgrading domains: large effects, dose-effect relations, and when plausible residual confounders or other biases increase certainty. They will need to be considered in an assessment of a body of evidence when using ROBINS-I. CONCLUSION The use of ROBINS-I in GRADE assessments may allow for a better comparison of evidence from randomized controlled trials (RCTs) and nonrandomized studies (NRSs) because they are placed on a common metric for risk of bias. Challenges remain, including appropriate presentation of evidence from RCTs and NRSs for decision-making and how to optimally integrate RCTs and NRSs in an evidence assessment.

This paper is referenced by
Incidence of the adverse effects of androgen deprivation therapy for prostate cancer: a systematic literature review
Kim Edmunds (2020)
The Effectiveness of Wearable Upper Limb Assistive Devices in Degenerative Neuromuscular Diseases: A Systematic Review and Meta-Analysis
M. Gandolla (2019)
Institutionalising an evidence-informed approach to guideline development: progress and challenges at the World Health Organization
U. Gopinathan (2018)
A Theoretical Framework and Competency-Based Approach to Training in Guideline Development
S. Sultan (2019)
Inter-rater reliability and concurrent validity of ROBINS-I: protocol for a cross-sectional study
M. Jeyaraman (2020)
How Might Procalcitonin Testing and Bougies Affect Your Clinical Practice? A Review of These Emergency Department–Based Investigations: November 2018 Annals of Emergency Medicine Journal Club
Ryan Radecki (2018)
A risk of bias instrument for non-randomized studies of exposures: A users' guide to its application in the context of GRADE.
R. Morgan (2019)
Frequency of infraposition and missing contact points in implant‐supported restorations within natural dentitions over time: A systematic review with meta‐analysis
S. Papageorgiou (2018)
The evolution of GRADE (part 3): A framework built on science or faith?
M. Mercuri (2018)
Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses. A systematic review and meta‐analysis
K. A. Apaza Alccayhuaman (2018)
Prevention of Cisplatin-Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis
A. Hamroun (2019)
Semantic Scholar Logo Some data provided by SemanticScholar