---
name: risk-of-bias
description: "Assess risk of bias in research studies for systematic reviews. Use when: (1) Conducting systematic reviews, (2) Evaluating study quality, (3) GRADE assessments, (4) Meta-analysis planning."
allowed-tools: Read, Write
version: 1.0.0
---

# Risk of Bias Assessment Skill

## Purpose
Systematically evaluate methodological quality and potential biases in research studies.

## Tools by Study Design

**RCTs**: Cochrane Risk of Bias 2 (RoB 2)
**Non-randomized**: ROBINS-I
**Diagnostic Studies**: QUADAS-2
**Prognostic Studies**: QUIPS

## RoB 2 Domains

1. **Randomization Process**
   - Adequate sequence generation?
   - Allocation concealment?

2. **Deviations from Interventions**
   - Blinding effective?
   - Adherence to protocol?

3. **Missing Outcome Data**
   - Complete data?
   - Appropriate handling?

4. **Outcome Measurement**
   - Blinded assessment?
   - Validated measures?

5. **Selective Reporting**
   - All outcomes reported?
   - Pre-registered?

## Risk Levels

- **Low**: Minimal bias
- **Some concerns**: Potential bias
- **High**: Serious bias likely

## Integration

Use with literature-reviewer agent for systematic quality assessment of included studies.

---
**Version:** 1.0.0