Res Synth Methods - Practicalities of using a modified version of the Cochrane Collaboration risk of bias tool for randomised and non-randomised study designs applied in a health technology assessment setting.

Tópicos

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Resumo

LABELLED: We describe our experience of using a modified version of the Cochrane risk of bias (RoB) tool for randomised and non-randomised comparative studies.OBJECTIVES: To assess time to complete RoB assessment. To assess inter-rater agreement. To explore the association between RoB and treatment effect sizeMETHODS: Cochrane risk of bias assessment was performed on a sample of full text primary reports included in a systematic review comparing operative techniques for radical prostatectomy. Inter-rater agreement was assessed using the kappa statistic.RESULTS: Twenty-four studies were judged as high overall RoB, 13 were judged as low RoB and 11 were unclear. The weighted Kappa value was 0.35 indicating fair agreement. The median (range) time taken to rate each study was 30 min (10-49). The effect estimate for all studies was 0.61 (95% credible interval (CrI) 0.46-0.83) and 0.73 (95% CrI 0.29-1.75) for low risk studies.CONCLUSIONS: Although the process was time consuming, using a modified version of the RoB tool proved useful for demonstrating conservative effect estimates. That we only achieved a fair agreement between reviewers demonstrates the urgent need for further validation to improve inter-rater agreement. We suggest additional RoB levels could improve inter-rater reliability.

Resumo Limpo

label describ experi use modifi version cochran risk bias rob tool randomis nonrandomis compar studiesobject assess time complet rob assess assess interrat agreement explor associ rob treatment effect sizemethod cochran risk bias assess perform sampl full text primari report includ systemat review compar oper techniqu radic prostatectomi interrat agreement assess use kappa statisticresult twentyfour studi judg high overal rob judg low rob unclear weight kappa valu indic fair agreement median rang time taken rate studi min effect estim studi credibl interv cri cri low risk studiesconclus although process time consum use modifi version rob tool prove use demonstr conserv effect estim achiev fair agreement review demonstr urgent need valid improv interrat agreement suggest addit rob level improv interrat reliabl

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