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Risk of Bias

Risk of Bias (RoB) assessment is a structured way to assess study limitations. In the GRADE process, the RoB assessment is conducted for each study. The RoBs to be addressed vary with study design. The following sections contain definitions and examples for each type of bias you will look for in the different types of studies. In addition, there are “signaling questions,” which rephrase the specific RoB as a question you can ask yourself as you read the study. For each potential RoB, read the methods section of the paper closely to determine if the study design explicitly avoided the risk. If you cannot tell from the methods section whether the design avoided the type of bias, select “Unclear” for that question. It is likely for many of these questions that the information provided in the methods section will be insufficient and you will need to select “Unclear.”