Evidence map›Paper›PMID 41635947›Full record

ArticleResearch synthesis methods2026

The application of ROBINS-I guidance in systematic reviews of non-randomised studies: A descriptive study.

Zipporah Iheozor-Ejiofor, Jelena Savović, Russell J Bowater, Julian P T Higgins

Abstract read
In one paragraph

Article in Research synthesis methods, 2026. 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.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 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

8 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Review
  7. Review
  8. Review
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

4 authors.

Zipporah Iheozor-EjioforPopulation Health Sciences, Bristol Medical School, https://ror.org/0524sp257University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0003-2597-3266
Jelena SavovićPopulation Health Sciences, Bristol Medical School, https://ror.org/0524sp257University of Bristol, Bristol, UK.
Russell J BowaterPopulation Health Sciences, Bristol Medical School, https://ror.org/0524sp257University of Bristol, Bristol, UK.
Julian P T HigginsPopulation Health Sciences, Bristol Medical School, https://ror.org/0524sp257University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0002-8323-2514

Funding

National Institute for Health Research Applied Research Collaboration West NIHR200181
6 · The paper itself

Abstract

The ROBINS-I tool is a commonly used tool to assess risk of bias in non-randomised studies of interventions (NRSI) included in systematic reviews. The reporting of ROBINS-I results is important for decision-makers using systematic reviews to understand the weaknesses of the evidence. In particular, systematic review authors should apply the tool according to the guidance provided. This study aims to describe how ROBINS-I guidance is currently applied by review authors. In January 2023, we undertook a citation search and screened titles and abstracts of records published in the previous 6 months. We included systematic reviews of non-randomised studies of intervention where ROBINS-I had been used for risk-of-bias assessment. Based on 10 criteria, we summarised the diverse ways in which reviews deviated from or reported the use of ROBINS-I. In total, 492 reviews met our inclusion criteria. Only one review met all the expectations of the ROBINS-I guidance. A small proportion of reviews deviated from the seven standard domains (3%), judgements (13%), or in other ways (1%). Of the 476 (97%) reviews that reported some ROBINS-I results, only 57 (12%) reviews reported ROBINS-I results at the outcome level compared with 203 reviews that reported ROBINS-I results at the study level alone. Most systematic reviews of NRSIs do not fully apply the ROBINS-I guidance. This raises concerns around the validity of the ROBINS-I results reported and the use of the evidence from these reviews in decision-making.

Indexed as

Research DesignSystematic Reviews as TopicBiasDecision MakingEvidence-Based MedicineGuidelines as TopicHumansReview Literature as Topicbiasnon-randomisedobservationalROBINS-I

Identifiers

PMID41635947
PMCPMC12873613

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Registered trials

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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.