ArticleThe international journal of behavioral nutrition and physical activity2017
Questioning the application of risk of bias tools in appraising evidence from natural experimental studies: critical reflections on Benton et al., IJBNPA 2016.
Article in The international journal of behavioral nutrition and physical activity, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The impact of public policy on socioeconomic equity in physical activity: a systematic review.The international journal of behavioral nutrition and physical activity · 2026Pooled it
- Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review.Journal of clinical epidemiology · 2021Pooled it
- Title: Can changing the physical environment promote walking and cycling? A systematic review of what works and how.Health & place · 2019Pooled it
- What works to promote walking at the population level? A systematic review.British journal of sports medicine · 2018Pooled it
- Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head.Journal of epidemiology and community health · 2020Article
- Risk of bias tools in systematic reviews of health interventions: an analysis of PROSPERO-registered protocols.Systematic reviews · 2019Article
- Closing the loop: short term impacts on physical activity of the completion of a loop trail in Sydney, Australia.The international journal of behavioral nutrition and physical activity · 2019Article
- Applying the ROBINS-I tool to natural experiments: an example from public health.Systematic reviews · 2018Article
Corrections and comments
- Comment on
Authors and funding
3 authors.
Funding
Abstract
We recently read the article by Benton et al. which reviewed risk of bias in natural experimental studies investigating the impact of the built environment on physical activity (Benton et al., 2016; Int J Behav Nutr Phys Act 13:107). As a technical exercise in assessing risk of bias to understand study quality, we found the results of this study both interesting and potentially useful. However, it prompted a number of concerns with the use of risk of bias tools for assessing the quality of evidence from studies exploiting natural experiments. As we discuss in this commentary, the rigid application of such tools could have adverse effects on the uptake and use of natural experiments in population health research and practice.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.