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Incorporating non-randomized evidence in cochrane intervention reviews: a scoping review
Emma Axon1, Afroditi Kanellopoulou2, Sofia Tsokani3
1Cochrane Central Executive Team, Cochrane, London, UK.
Journal of Clinical Epidemiology
|May 5, 2025
Summary
Cochrane authors
Area of Science:
- Evidence-based medicine
- Systematic reviews
- Health research methodology
Background:
- Non-randomized studies of interventions (NRSI) offer real-world insights when randomized controlled trials (RCTs) are not feasible.
- Cochrane reviews are a key source of synthesized health evidence.
Purpose of the Study:
- To investigate how Cochrane authors incorporate evidence from NRSI in their reviews.
- To assess changes in the use of NRSI guidance over time.
- To identify areas needing further support for review authors.
Main Methods:
- Scoping review of Cochrane reviews published in 2019 and 2023.
- Data extraction on NRSI analysis, risk of bias assessment, and adherence to Cochrane Handbook guidance.
- Utilized the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool.
Main Results:
- Low adherence to NRSI guidance was observed.
- Less than half of reviews justified NRSI inclusion (41%).
- Only 29% prioritized adjusted effect measures, and 29% used ROBINS-I.
- Improvement in adherence was noted between 2019 and 2023, but remained low.
Conclusions:
- Cochrane authors' use of NRSI guidance requires improvement.
- Increased demand for reviews including NRSI evidence is anticipated.
- Cochrane should enhance support and guidance for incorporating NRSI.
Keywords:
CochraneCochrane HandbookNon-randomized studies of interventionsRandomised controlled trialsScoping reviewSystematic reviewMore Related Videos
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