The Problem With Mechanistic Risk of Bias Assessments in Evidence Synthesis of Observational Studies and a Practical Alternative: Assessing the Impact of Specific Sources of Potential Bias

The trustworthiness of individual studies is routinely characterized in systemic reviews by evaluating risk of bias, often by mechanistically applying standardized algorithms. However, such instruments prioritize the repeatability of the process over a more thoughtful and informative but necessarily somewhat more subjective approach. In mechanistic risk of bias assessments, the focus is on determining whether specific biases are present, but...