Which two tools are correctly matched to their study designs for risk-of-bias assessment?

Which two tools are correctly matched to their study designs for risk-of-bias assessment?

• A. RoB 2 for non-randomized studies; ROBINS-I for randomized trials
• B. RoB 2 for randomized trials; ROBINS-I for non-randomized studies
• C. RoB 2 for non-randomized studies; Cochrane risk of bias for randomized trials
• D. RoB 2 for randomized trials; ROBINS-I for non-randomized studies

Answer: (D)

Matching risk-of-bias tools to study design is essential because different study designs are prone to different bias types. RoB 2 is designed specifically for randomized trials, with domains that target issues like the randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selective reporting. ROBINS-I is built for non-randomized studies of interventions and covers biases such as confounding, selection of participants, classification of interventions, deviations from intended interventions, missing data, measurement of outcomes, and selective reporting. Therefore, the correct pairing is RoB 2 for randomized trials and ROBINS-I for non-randomized studies, since each tool addresses the biases most likely to arise in its respective design. The other options mix tools with designs they aren’t best suited for (for example, applying RoB 2 to non-randomized studies or using an older Cochrane tool for randomized trials).

Matching risk-of-bias tools to study design is essential because different study designs are prone to different bias types. RoB 2 is designed specifically for randomized trials, with domains that target issues like the randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selective reporting. ROBINS-I is built for non-randomized studies of interventions and covers biases such as confounding, selection of participants, classification of interventions, deviations from intended interventions, missing data, measurement of outcomes, and selective reporting. Therefore, the correct pairing is RoB 2 for randomized trials and ROBINS-I for non-randomized studies, since each tool addresses the biases most likely to arise in its respective design. The other options mix tools with designs they aren’t best suited for (for example, applying RoB 2 to non-randomized studies or using an older Cochrane tool for randomized trials).