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Table 3 Risk of bias assessment of study by Salmon et al. [18]a

From: A systematic review of hospital accreditation: the challenges of measuring complex intervention effects

Domain

Support for judgement

Review author’s judgement

Selection bias

Random sequence generation

They state stratified randomisation, but give no information about the procedure

Unclear

Allocation concealment

Not mentioned

Unclear

Performance bias

Blinding of participants and personnel

Not mentioned and appears impossible/not possible to blind hospitals

Unclear

Detection bias

Blinding of outcome assessor

Not mentioned

Unclear

Attrition bias

Incomplete outcome date

The largest hospital did not complete the study. Follow- up time was shortened because controls wanted to receive the intervention

High risk

Reporting bias

Selective reporting

Outcome selection conducted by participants and accreditor. Many outcomes/ indicators were dropped from the follow- up measurement

High risk

Other bias

Other sources of bias

This was a cluster randomized trial, adjustment for clustering in analysis of results were not mentioned

Unclear

  1. aThe risk of bias assessment as described in the Cochrane Handbook for randomized controlled trails [20]
  2. Risk of bias assessment of the included primary study by Salmon el at [18]
  3. SOURCE: Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011