{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:49:51Z","timestamp":1792612191599,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cochrane Evidence Synthesis and Methods"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The Cochrane risk\u2010of\u2010bias tool (RoB 2) is used to assess the risk of bias in randomized trials in systematic reviews. However, studies have shown that the tool is often incorrectly used and published reviews rarely include detail regarding how it was applied or offer reflections on using it. This paper is a transparent applied case example with lessons learned and limitations of using RoB 2 in a (non\u2010Cochrane) systematic review evaluating the effectiveness of remote therapies for alcohol and drug use disorders. We share our reflections on aspects to plan in advance (pre\u2010selecting the outcome(s) and their results and piloting the tool); factors to consider when applying the tool (multiple outcomes within a study and navigating resources); overcoming common problems within specific domains (developing a review\u2010specific guidance document). Through our worked example, this article illustrates how review teams can engage with the RoB 2 tool within a specific review context to enhance its correct application.<\/jats:p>","DOI":"10.1002\/cesm.70107","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:35:39Z","timestamp":1792611339000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Risk of Bias in Randomized Trials Using RoB 2: Reflections From a Systematic Review of Complex Interventions"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3604-2280","authenticated-orcid":false,"given":"Preethy","family":"D'Souza","sequence":"first","affiliation":[{"name":"EPPI Center University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5868-8336","authenticated-orcid":false,"given":"Wendy","family":"Macdowall","sequence":"additional","affiliation":[{"name":"Faculty of Public Health &amp; Policy London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8380-2476","authenticated-orcid":false,"given":"Helen E. D.","family":"Burchett","sequence":"additional","affiliation":[{"name":"Faculty of Public Health &amp; Policy London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-2814","authenticated-orcid":false,"given":"Irene","family":"Kwan","sequence":"additional","affiliation":[{"name":"EPPI Center University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-8649","authenticated-orcid":false,"given":"Katy","family":"Sutcliffe","sequence":"additional","affiliation":[{"name":"EPPI Center University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_10_3_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.5","author":"Higgins J. P. T.","year":"2024"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.14898"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsm1605385"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.09.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1695"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.06.0158"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2023.06.015"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.2165"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.09.021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-081199"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cesm.12031"},{"key":"e_1_2_10_14_1","volume-title":"Effectiveness and Critical Features of Remote Therapies Delivered as A Component of Drug and\/or Alcohol Treatment: A Systematic Review","author":"Sutcliffe K.","year":"2025"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.70021"},{"key":"e_1_2_10_16_1","volume-title":"EPPI\u2010Reviewer: Advanced Software for Systematic Reviews, Maps and Evidence Synthesis [Software]","author":"Thomas J.","year":"2020"},{"key":"e_1_2_10_17_1","unstructured":"Revised Cochrane Risk\u2010of\u2010Bias Tool for Randomized Trials (RoB 2) SHORT VERSION (CRIBSHEET) RoB 2 Development Group 2019 https:\/\/drive.google.com\/file\/d\/1Q4Fk3HCuBRwIDWTGZa5oH11OdR4Gbhdo\/view."},{"key":"e_1_2_10_18_1","unstructured":"Revised Cochrane risk\u2010of\u2010bias Tool for Randomized Trials (RoB 2) Cochrane; 2019 https:\/\/drive.google.com\/file\/d\/19R9savfPdCHC8XLz2iiMvL_71lPJERWK\/view."},{"key":"e_1_2_10_19_1","unstructured":"RoB 2 Learning Live Webinar Series Cochrane Training https:\/\/training.cochrane.org\/rob-2-learning-live-webinar-series."},{"key":"e_1_2_10_20_1","unstructured":"COMET Initiative: Core Outcome Measures in Effectiveness Trials (n.d.) https:\/\/www.comet-initiative.org\/."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03473.x"},{"key":"e_1_2_10_22_1","unstructured":"K.Sutcliffe H.Burchett W.Macdowall et al. The Effectiveness and Critical Features of Remote Therapies Delivered Alongside or as Part of Drug and\/or Alcohol Treatment: Protocol for a Systematic Review(Prospero 2022) https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42022339953."},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076754"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1988.tb00485.x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2024.111370"},{"key":"e_1_2_10_26_1","unstructured":"Current version of RoB 2 https:\/\/www.riskofbias.info\/welcome\/rob-2-0-tool\/current-version-of-rob-2."},{"key":"e_1_2_10_27_1","unstructured":"Risk of Bias 2 Cochrane Review Group Starter Pack https:\/\/methods.cochrane.org\/file\/rob-2-starter-pack-cochrane-reviewspdf."}],"container-title":["Cochrane Evidence Synthesis and Methods"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cesm.70107","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cesm.70107","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cesm.70107","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:35:42Z","timestamp":1792611342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cesm.70107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/cesm.70107"],"URL":"https:\/\/doi.org\/10.1002\/cesm.70107","archive":["Portico"],"relation":{},"ISSN":["2832-9023","2832-9023"],"issn-type":[{"value":"2832-9023","type":"print"},{"value":"2832-9023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70107"}}