• Incorporating non-randomized e...

Treffer: Incorporating non-randomized evidence in cochrane intervention reviews: a scoping review.

Title:
Incorporating non-randomized evidence in cochrane intervention reviews: a scoping review.
Authors:
Axon E; Cochrane Central Executive Team, Cochrane, London, UK. Electronic address: eaxon@cochrane.org., Kanellopoulou A; Cochrane Central Executive Team, Cochrane, London, UK; Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece., Tsokani S; Cochrane Central Executive Team, Cochrane, London, UK; Department of Hygiene, Social and Preventive Medicine, and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece., Livingstone N; Cochrane Central Executive Team, Cochrane, London, UK., Hilgart J; Cochrane Central Executive Team, Cochrane, London, UK., Richardson R; Cochrane Central Executive Team, Cochrane, London, UK.
Source:
Journal of clinical epidemiology [J Clin Epidemiol] 2025 Jul; Vol. 183, pp. 111814. Date of Electronic Publication: 2025 May 03.
Publication Type:
Journal Article; Scoping Review
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: United States NLM ID: 8801383 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5921 (Electronic) Linking ISSN: 08954356 NLM ISO Abbreviation: J Clin Epidemiol Subsets: MEDLINE
Imprint Name(s):
Publication: New York : Elsevier
Original Publication: Oxford ; New York : Pergamon Press, c1988-
MeSH Terms:
Non-Randomized Controlled Trials as Topic*/methods , Evidence-Based Medicine* , Review Literature as Topic*, Humans ; Randomized Controlled Trials as Topic ; Research Design
Comments:
Erratum in: J Clin Epidemiol. 2025 Sep 5;187:111930. doi: 10.1016/j.jclinepi.2025.111930.. (PMID: 40913848)
Contributed Indexing:
Keywords: Cochrane; Cochrane Handbook; Non-randomized studies of interventions; Randomised controlled trials; Scoping review; Systematic review
Entry Date(s):
Date Created: 20250505 Date Completed: 20250629 Latest Revision: 20250906
Update Code:
20250907
DOI:
10.1016/j.jclinepi.2025.111814
PMID:
40324697
Database:
MEDLINE

Weitere Informationen

Background and Objective: "Non-randomized studies of interventions" (NRSI) can provide valuable insights into the real-world performance of interventions, especially when randomized controlled trials (RCTs) are impractical, unethical, or lack generalizability. We investigated how Cochrane authors have incorporated evidence from NRSI in their reviews and whether this has changed over time.
Study Design and Setting: We conducted a scoping review and identified Cochrane reviews, including NRSI which were published in the Cochrane Library in 2019 or 2023. We extracted data including how NRSI had been analyzed and assessed for risk of bias, and to what extent the authors had followed guidance in the Cochrane Handbook. This allowed us to identify the areas where review authors may need further guidance and support.
Results: We identified 87 Cochrane reviews, 60 published in 2019 and 27 in 2023. In general, adherence to the guidance was low. Our key findings were that less than half of the reviews justified the inclusion of NRSI (36 reviews, 41%), less than a third stated prioritizing adjusted effect measures (25 reviews, 29%), and six analyzed RCTs and NRSI in the same meta-analysis, with no justification of this approach. Despite being the recommended tool for use in Cochrane reviews, only 25 reviews (29%) used the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I). We did find that adherence to the guidance improved between 2019 and 2023 but remained low.
Conclusion: Cochrane should consider how to increase the use of NRSI guidance, especially with the launch of Cochrane's Scientific Strategy, which may lead to an increase in the demand for reviews including NRSI evidence.
(Copyright © 2025 Elsevier Inc. All rights reserved.)

Declaration of competing interest The author teams are all employed by Cochrane.