Table 3.

Quality assessment and risk of biasa

Eligible StudiesRisk of bias domains — ROBINS-I
Bias due to confoundingBias in selection of participants into the studyBias in classification of interventionsBias due to deviations from intended interventionsBias due to missing dataBias in measurement of outcomesBias in the selection of the reported resultOverall risk of bias
Singer, 201510ModerateModerateLowLowNILowLowModerate
Singer, 201411ModerateModerateLowLowNILowLowModerate
Larsen, 201112ModerateModerateLowSeriousNIModerateModerateModerate
Mullen, 201413SeriousSeriousModerateLowNIModerateModerateSerious
Maung, 201414SeriousSeriousModerateLowNIModerateModerateSerious
Choong, 201415SeriousSeriousModerateLowNIModerateModerateSerious
Smith, 201016SeriousSeriousModerateLowNIModerateModerateSerious
Varpula, 200717SeriousSeriousModerateSeriousNIModerateSeriousSerious
  • a Low — comparable with a well-performed RCT. Moderate — sound for a non-randomised study but not comparable with a well-performed RCT. Serious — important problems in this domain. Critical — too problematic to provide any useful evidence on the effects of the intervention. NI = no information. RCT = randomised controlled trial.