Evidence map›Paper›PMID 30473382›Full record

ArticleEnvironment international2019

A risk of bias instrument for non-randomized studies of exposures: A users' guide to its application in the context of GRADE.

Rebecca L Morgan, Kristina A Thayer, Nancy Santesso, Alison C Holloway, Robyn Blain, Sorina E Eftim, Alexandra E Goldstone, Pam Ross, Mohammed Ansari, Elie A Akl and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environment international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 130 papers, 67 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
130citing papers in PubMed, 67 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

130 citing papers in PubMed, 67 syntheses or guidelines pooled it.

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  16. Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2024
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  18. Physical activity and pain in people with cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
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70 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Rebecca L MorganDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Electronic address: morganrl@mcmaster.ca.
Kristina A ThayerIntegrated Risk Information System (IRIS) Division, National Center for Environmental Assessment (NCEA), Office of Research and Development, US Environmental Protection Agency, Building B (Room 211i), Research Triangle Park, NC 27711, USA. Electronic address: thayer.kris@epa.gov.
Nancy SantessoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Electronic address: santesna@mcmaster.ca.
Alison C HollowayDepartment of Obstetrics and Gynecology, McMaster University, Health Sciences Centre, Room 3N52A, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Electronic address: hollow@mcmaster.ca.
Robyn BlainICF International Inc., 9300 Lee Highway, Fairfax, VA, USA. Electronic address: Robyn.Blain@icfi.com.
Sorina E EftimICF International Inc., 9300 Lee Highway, Fairfax, VA, USA. Electronic address: Sorina.Eftim@icfi.com.
Alexandra E GoldstoneICF International Inc., 9300 Lee Highway, Fairfax, VA, USA. Electronic address: Ali.Goldstone@icfi.com.
Pam RossICF International Inc., 9300 Lee Highway, Fairfax, VA, USA. Electronic address: Pam.Ross@icfi.com.
Mohammed AnsariSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, ON K1H 8M5, Canada. Electronic address: tosansari@gmail.com.
Elie A AklDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada; Department of Internal Medicine, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad-El-Solh Beirut 1107 2020, Lebanon. Electronic address: ea32@aub.edu.lb.
Tommaso FilippiniDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy. Electronic address: tommaso.filippini@unimore.it.
Anna HansellMRC-PHE Centre for Environment and Health, Imperial College London, St Mary's Campus, Praed St, Paddington, London W2 1PG, UK; Public Health Directorate, Imperial College Healthcare NHS Trust, St Mary's Hospital, Paddington, London, W2 1PG, UK; Centre for Environmental Health and Sustainability, University of Leicester, George Davies Building, University Road, Leicester LE1 7RH, UK. Electronic address: a.hansell@imperial.ac.uk.
Joerg J MeerpohlInstitute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Breisacher Strasse 153, 79110 Freiburg, Germany. Electronic address: meerpohl@cochrane.de.
Reem A MustafaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada; Division of Nephrology and Hypertension, Department of Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
Jos VerbeekFinnish Institute of Occupational Health, Cochrane Work, Neulaniementie 4, 70701 Kuopio, Finland. Electronic address: Jos.Verbeek@ttl.fi.
Marco VincetiDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA. Electronic address: mvinceti@bu.edu.
Paul WhaleyLancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK. Electronic address: p.whaley@lancaster.ac.uk.
Holger J SchünemannDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada; Department of Medicine, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Electronic address: schuneh@mcmaster.ca.
GRADE Working Group

Funding

Intramural EPA EPA999999
6 · The paper itself

Abstract

The objective of this paper is to explain how to apply, interpret, and present the results of a new instrument to assess the risk of bias (RoB) in non-randomized studies (NRS) dealing with effects of environmental exposures on health outcomes. This instrument is modeled on the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) instrument. The RoB instrument for NRS of exposures assesses RoB along a standardized comparison to a randomized target experiment, instead of the study-design directed RoB approach. We provide specific guidance for the integral steps of developing a research question and target experiment, distinguishing issues of indirectness from RoB, making individual-study judgments, and performing and interpreting sensitivity analyses for RoB judgments across a body of evidence. Also, we present an approach for integrating the RoB assessments within the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework to assess the certainty of the evidence in the systematic review. Finally, we guide the reader through an overall assessment to support the rating of all domains that determine the certainty of a body of evidence using the GRADE approach.

Indexed as

BiasEnvironmental ExposureHumansRandom AllocationResearch DesignRisk AssessmentEnvironmental healthGRADENon-randomized studiesRisk of biasROBINSStudy limitations

Identifiers

PMID30473382
PMCPMC8221004

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.