Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review

Igelström, Erik; Campbell, Mhairi; Craig, Peter; Katikireddi, Srinivasa Vittal

doi:10.1016/j.jclinepi.2021.08.022

Cited by 56 publications

(39 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A weighted mean and standard deviation were calculated using Excel software for the participant’s age, body mass index (BMI), and gestational age at the time of the blood draw, grouped by GDM or healthy controls. A formal risk of bias analysis was conducted using the Cochrane criteria for observational studies ( 20 , 21 ).…”

Section: Methodsmentioning

confidence: 99%

Systematic review of transcriptome and microRNAome associations with gestational diabetes mellitus

et al. 2023

View full text Add to dashboard Cite

PurposeGestational diabetes (GDM) is associated with increased risk for preterm birth and related complications for both the pregnant person and newborn. Changes in gene expression have the potential to characterize complex interactions between genetic and behavioral/environmental risk factors for GDM. Our goal was to summarize the state of the science about changes in gene expression and GDM.DesignThe systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.MethodsPubMed articles about humans, in English, from any date were included if they described mRNA transcriptome or microRNA findings from blood samples in adults with GDM compared with adults without GDM.ResultsSixteen articles were found representing 1355 adults (n=674 with GDM, n=681 controls) from 12 countries. Three studies reported transcriptome results and thirteen reported microRNA findings. Identified pathways described various aspects of diabetes pathogenesis, including glucose and insulin signaling, regulation, and transport; natural killer cell mediated cytotoxicity; and fatty acid biosynthesis and metabolism. Studies described 135 unique miRNAs that were associated with GDM, of which eight (miR-16-5p, miR-17-5p, miR-20a-5p, miR-29a-3p, miR-195-5p, miR-222-3p, miR-210-3p, and miR-342-3p) were described in 2 or more studies. Findings suggest that miRNA levels vary based on the time in pregnancy when GDM develops, the time point at which they were measured, sex assigned at birth of the offspring, and both the pre-pregnancy and gestational body mass index of the pregnant person.ConclusionsThe mRNA, miRNA, gene targets, and pathways identified in this review contribute to our understanding of GDM pathogenesis; however, further research is warranted to validate previous findings. In particular, longitudinal repeated-measures designs are needed that control for participant characteristics (e.g., weight), use standardized data collection methods and analysis tools, and are sufficiently powered to detect differences between subgroups. Findings may be used to improve early diagnosis, prevention, medication choice and/or clinical treatment of patients with GDM.

show abstract

Section: Methodsmentioning

confidence: 99%

Systematic review of transcriptome and microRNAome associations with gestational diabetes mellitus

et al. 2023

View full text Add to dashboard Cite

show abstract

“…This is helpful when considering if studies conditioned upon variables that we have considered mediators (and should not be conditioned upon) and those that we have considered confounding variables (and should be conditioned upon) [ 61 ]. Though ROBINS-I has been criticized for low interrater reliability [ 62 ] and is often misapplied [ 63 ], it facilitates thorough and systematic methodological evaluation of non-randomized studies using principles of causal thinking [ 64 ]. This methodological evaluation will be used to inform considerations of certainty through GRADE and causal assessment using the adapted Bradford Hill viewpoints.…”

Section: Methodsmentioning

confidence: 99%

Assessing the causal relationship between income inequality and mortality and self-rated health: protocol for systematic review and meta-analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Income inequality has been linked to health and mortality. While there has been extensive research exploring the relationship, the evidence for whether the relationship is causal remains disputed. We describe the methods for a systematic review that will transparently assess whether a causal relationship exists between income inequality and mortality and self-rated health. Methods We will identify relevant studies using search terms relating to income inequality, mortality, and self-rated health (SRH). Four databases will be searched: MEDLINE, ISI Web of Science, EMBASE, and the National Bureau of Economic Research. The inclusion criteria have been developed to identify the study designs best suited to assess causality: multilevel studies that have conditioned upon individual income (or a comparable measure, such as socioeconomic position) and natural experiment studies. Risk of bias assessment of included studies will be conducted using ROBINS-I. Where possible, we will convert all measures of income inequality into Gini coefficients and standardize the effect estimate of income inequality on mortality/SRH. We will conduct random-effects meta-analysis to estimate pooled effect estimates when possible. We will assess causality using modified Bradford Hill viewpoints and assess certainty using GRADE. Discussion This systematic review protocol lays out the complexity of the relationship between income inequality and individual health, as well as our approach for assessing causality. Understanding whether income inequality impacts the health of individuals within a population has major policy implications. By setting out our methods and approach as transparently as we can, we hope this systematic review can provide clarity to an important topic for public policy and public health, as well as acting as an exemplar for other “causal reviews”.

show abstract

“…A rating of “low” reflects the lowest risk of bias, “medium” represents an immediate and potential risk of bias in one domain, and “high” indicates the presence of bias risk in one or more of the domains. This tool has been successfully used by several reviews (Farrah et al, 2019 ; Igelström et al, 2021 ) and is sourced from a reliable institute (Cochrane); therefore, it was considered effective for use in this review. Details of the tool can be found at https://www.riskofbias.info/welcome/home/current-version-of-robins-i/robins-i-template-2016 .…”

Section: Methodsmentioning

confidence: 99%

Psychological and Emotional Effects of Digital Technology on Digitods (14–18 Years): A Systematic Review

Limone

Toto

2022

Front. Psychol.

View full text Add to dashboard Cite

BackgroundThe use of smartphones and other technologies has been increasing in digitods aged 14–18 years old. To further explain this relationship and explore the gap in research, this paper will appraise the available evidence regarding the relationship digital technology use and psychological/emotional outcomes and report on the strength of the associations observed between these variables.MethodologyTo select relevant studies, five separate computerized searches of online and electronic databases were performed. These included PubMed (MEDLINE, National Library of Medicine), ScienceDirect, Cochrane, Scopus, and Web of Science to attain literature from January 2017 to April 2022. The author independently reviewed studies for eligibility as per the inclusion/exclusion criteria and extracted the data according to a priori defined criteria. Risk of bias was assessed using the Agency for Healthcare Research and Quality (AHRQ) for healthcare studies and Cochrane Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) assessment tool.ResultsSeven studies were included in this review. A positive relationship was found between excessive digital technology usage and negative psychological and emotional outcomes in digitods aged 14–18 (p ≤ 0.005). A statistically significant difference was found between girls and boys, with girls experiencing more negative outcomes than boys.ConclusionsAs the evidence in this review is distinctive, it is imperative that further research be conducted to investigate any synergistic relationships among these variables on a larger scale in order to better advise public health initiatives to specifically target heightened digital technology usage in adolescents.

show abstract

Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review

Cited by 56 publications

References 48 publications

Systematic review of transcriptome and microRNAome associations with gestational diabetes mellitus

Systematic review of transcriptome and microRNAome associations with gestational diabetes mellitus

Assessing the causal relationship between income inequality and mortality and self-rated health: protocol for systematic review and meta-analysis

Psychological and Emotional Effects of Digital Technology on Digitods (14–18 Years): A Systematic Review

Contact Info

Product

Resources

About