Part 4: Using RoB 2 in a Cochrane Review

Summary

This presentation discusses the implementation of the Risk of Bias (RoB) tool in Cochrane reviews, focusing on the gradual rollout and pilot phase for new reviews. It highlights the support available for review teams and editorial groups, including webinars, clinics, and direct assistance from the Methods Support Unit. Key points include the transition from RevMan 5 to RevMan Web for publishing reviews, the integration of RoB in various sections of the protocol, and the need for careful consideration of study designs and bias assessments. The presentation also emphasizes how RoB will impact data synthesis, analysis, and grading of evidence.

Takeaways

• 😀 Cochrane is gradually implementing Risk of Bias (Rob2) with a supported rollout to assist review teams in adapting to the new methodology.
• 😀 The Rob2 pilot is aimed at providing support for Cochrane review author teams and editorial teams, including Managing Editors and other members of CRGs.
• 😀 Reviews using Rob2 cannot be published in RevMan 5 but must be done in RevMan Web, which requires review teams to transition before entering data.
• 😀 The Rob2 pilot aims to help teams use Risk of Bias for the first time and gather feedback to improve its implementation in Cochrane Library.
• 😀 Review teams interested in joining the pilot should contact their CRG and can join at any stage of the review process, ideally during the protocol stage.
• 😀 After joining the pilot, CRGs and author teams will receive support, including kickoff calls, monthly web clinics, and guidance from the Methods Support Unit and RevMan Web team.
• 😀 Editorial teams are encouraged to draft their own comments on protocols and reviews using Rob2, with support from the Methods Support Unit to ensure proper assessment.
• 😀 Cochrane is engaging 44% of CRGs in the pilot, with 18 review teams already participating across 16 CRGs, and more teams joining as the pilot progresses.
• 😀 Once teams join the pilot, they must switch to RevMan Web before starting data entry. The RevMan Web knowledgebase provides extensive support for using the tool.
• 😀 Risk of Bias considerations must be included in various sections of the Cochrane protocol, including study types, assessment of risk of bias, data synthesis, and grading of evidence.
• 😀 It’s essential to specify key items such as which results will be assessed, the type of effect measurement, and the process for data storage (e.g., using publicly available storage like Figshare).

Q & A

What is the main purpose of the Rob2 pilot scheme in Cochrane?

The Rob2 pilot scheme in Cochrane aims to support review teams in using the Risk of Bias (RoB) tool for the first time, provide editorial support for assessing risk of bias, and gather feedback to inform the rollout and development of RoB2.

Why is it important for author teams to switch to RevMan Web when using RoB2?

Author teams need to switch to RevMan Web because reviews using RoB2 cannot be published in RevMan 5. All reviews must be completed and published using RevMan Web once RoB2 is implemented.

How does the RoB2 tool differ when used with different study designs like crossover or cluster RCTs?

RoB2 requires specific versions to be used depending on the study design. For example, crossover RCTs and cluster RCTs need specialized variations of the RoB2 tool to accurately assess bias in those designs.

What is the role of the Method Support Unit in the RoB2 pilot scheme?

The Method Support Unit provides comments and feedback to Cochrane Review Groups (CRGs) and author teams on the use of RoB2, offering guidance and answering questions related to methodological aspects of using the tool in systematic reviews.

What should be included in a Cochrane review protocol when using RoB2?

The protocol should specify the study type, the results to assess, the effect of interest, how the RoB will be assessed (e.g., number of reviewers and whether assessments are independent), and where the data generated by RoB2 will be stored, such as on publicly available platforms like Figshare.

How does the risk of bias tool impact the grading of evidence in Cochrane reviews?

Risk of bias is used to inform the grading of evidence in Cochrane reviews, helping to assess the quality and reliability of the evidence by considering potential biases in the studies included in the review.

What are the benefits of joining the RoB2 pilot for CRGs and author teams?

The pilot offers support in using RoB2 effectively, including feedback on protocols and reviews, methodological assistance during a kickoff call, and access to monthly clinics for ongoing help and knowledge sharing.

Can a review team join the RoB2 pilot if their review is beyond the protocol stage?

Yes, review teams can still join the RoB2 pilot even if their review is further along than the protocol stage. The pilot is open to reviews at any stage.

How does the RoB2 pilot help Cochrane Review Groups (CRGs) with editorial comments on protocols and reviews?

The pilot helps CRGs draft editorial comments and feedback on protocols and reviews using RoB2. Initially, the Method Support Unit assists with drafting comments, but over time, CRGs will be equipped to assess risk of bias independently.

What kind of support does RevMan Web provide to users during the RoB2 implementation?

RevMan Web offers comprehensive support for using RoB2, including access to a knowledge base, practical help in implementing the tool, and participation in webinars that address both the use of RevMan Web and the RoB2 tool.