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ROBINS-E Tool: Risk of Bias in Studies of Exposures

Record ROBINS-E judgements for cohort studies of environmental, occupational or behavioural exposures, and download traffic light and summary plots for your review.

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Domains and how to use them
  1. D1: Bias due to confoundingControl of important confounders, how well they were measured, and inappropriate adjustment for post-exposure variables.
  2. D2: Bias arising from measurement of the exposureHow well the exposure measure reflects the exposure of interest, and error or misclassification.
  3. D3: Bias in selection of participants into the studyWhether selection into the study or analysis relates to both exposure and outcome.
  4. D4: Bias due to post-exposure interventionsInterventions after the start of exposure that were influenced by the exposure.
  5. D5: Bias due to missing dataMissing exposure, outcome or confounder data, and how it was handled.
  6. D6: Bias in measurement of the outcomeOutcome measurement errors and whether they could depend on exposure status.
  7. D7: Bias in selection of the reported resultWhether the result was chosen from several exposure measures, outcomes or analyses.

Answer the signalling questions in the official tool, then record your judgements here: ROBINS-E tool and template (riskofbias.info).

StudyD1D2D3D4D5D6D7Overall

Your entries are saved in this browser only. Nothing is uploaded.

By default the overall judgement equals the most severe domain judgement. You may raise it, for example to very high when many domains are at high risk (use the override).

Summary plot

Traffic light plot

StudyD1D2D3D4D5D6D7OverallExample cohort 1−+++−++−Example cohort 2×−+++−+×Example cohort 3−×−+−+−×Example cohort 4!−−+×++!D1: Bias due to confoundingD2: Bias arising from measurement of the exposureD3: Bias in selection of participants into the studyD4: Bias due to post-exposure interventionsD5: Bias due to missing dataD6: Bias in measurement of the outcomeD7: Bias in selection of the reported result+Low risk−Some concerns×High risk!Very high risk

Summary plot

D1. Bias due to confounding50%25%25%D2. Bias arising from measurement of the exposure25%50%25%D3. Bias in selection of participants into the study50%50%D4. Bias due to post-exposure interventions100%D5. Bias due to missing data25%50%25%D6. Bias in measurement of the outcome75%25%D7. Bias in selection of the reported result75%25%Overall25%50%25%0%25%50%75%100%Low riskSome concernsHigh riskVery high risk
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How to Use the ROBINS-E Tool

  1. 1

    Answer the official signalling questions

    Use the linked tool document for each study or result.

  2. 2

    Record your judgements

    One row per study, one column per domain; the overall judgement is suggested for you.

  3. 3

    Download the figures

    Traffic light and summary plots as PNG or SVG, plus a CSV of your table.

What is ROBINS-E?

ROBINS-E (Risk Of Bias In Non-randomized Studies of Exposures) gives a structured way to assess risk of bias in observational studies of the effects of exposures, published in 2024.

Its seven domains are confounding, measurement of the exposure, selection of participants, post-exposure interventions, missing data, measurement of the outcome and selection of the reported result. Each is judged as low risk, some concerns, high or very high risk.

How it is calculated

Sources

ROBINS-E Tool: FAQ

Which studies is ROBINS-E designed for?

The current version is for follow-up (cohort) studies of exposure effects. Variants for other designs, such as case-control studies, are planned by its developers.

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