三种偏倚风险工具在观察性研究综合分析中得出相反的结论。

Three risk of bias tools lead to opposite conclusions in observational research synthesis.

机构信息

Department of Psychobiology and Methodology of Health Sciences, Psychology Faculty, Universitat Autònoma de Barcelona, Carrer de la Fortuna, Edifici B, Bellaterra, Barcelona 08193, Spain.

Department of Business Management, School of Industrial Engineering, Universitat Politècnica de València, Dept. Organización de Empresas, Edificio 7D, Camino de Vera s/n, Valencia 46022, Spain.

出版信息

J Clin Epidemiol. 2018 Sep;101:61-72. doi: 10.1016/j.jclinepi.2018.05.021. Epub 2018 Jun 2.

DOI:10.1016/j.jclinepi.2018.05.021

PMID:29864541

Abstract

OBJECTIVES

The aim of this study was to assess the agreement and compare the performance of three different instruments in assessing risk of bias (RoB) of comparative cohort studies included in a health psychology meta-analysis.

STUDY DESIGN AND SETTING

Three tools were applied to 28 primary studies included in the selected meta-analysis: the Newcastle-Ottawa Scale, quality of cohort studies (Q-Coh), and risk of bias in nonrandomized studies of interventions (ROBINS-I).

RESULTS

Interrater agreement varied greatly from tool to tool. For overall RoB, 75% of the studies were rated as low RoB with the Newcastle-Ottawa Scale, 11% of the studies with Q-Coh, and no study was found to be at low RoB using ROBINS-I. No influence of quality ratings on the meta-analysis results was found for any of the tools.

CONCLUSION

Assessing RoB using the three tools may lead to opposite conclusions, especially at low and high levels of RoB. Domain-based tools (Q-Coh and ROBINS-I) provide a more comprehensive framework for identifying potential sources of bias, which is essential to improving the quality of future research. Both further guidance on the application of RoB tools and improvements in the reporting of primary studies are necessary.

摘要