Current guidance for conducting systematic reviews recommends that risk of bias  assessments be carried out independently by two reviewers, using established tools such as the Cochrane Risk of Bias Tool 2.0 for randomized controlled trials. It also emphasizes the importance of providing justification for judgments and integrating them into the synthesis. While this approach is ideal, in rapid review processes it may only be feasible if the timeline and number of included studies allow. When constraints exist, several streamlined alternatives can be considered to speed up the process.

One such approach involves using simpler, less time-intensive tools (e.g., Cochrane RoB Tool 1.0 instead of 2.0) and narrowing the assessment to the most critical outcomes, as outlined in the review protocol. Another option is for one reviewer to conduct the Risk of Bias assessment, with a second reviewer verifying the decisions. However, completely omitting Risk of Bias assessment is discouraged, as it plays a key role in interpreting the evidence and determining the review’s conclusions. (Nussbaumer-Streit et al., 2023)

Risk of bias (RoB) assessment tools recommended by Cochrane

PROBAST, Prediction model Risk Of Bias Assessment Tool; QUADAS, Quality Assessment of Diagnostic Accuracy Studies; RoB, risk of bias; ROBINS-E, Risk of Bias in Non-randomised Studies–of Exposures; ROBINS-I, ROBINS-of Interventions; ROBIS, Risk of Bias in Systematic Reviews.

Table adapted from Nussbaumer-Streit, B., Sommer, I., Hamel, C., Devane, D., Noel-Storr, A., Puljak, L., Trivella, M. and Gartlehner, G., 2023. Rapid reviews methods series: Guidance on team considerations, study selection, data extraction and risk of bias assessment. BMJ Evidence-Based Medicine, 28(6), pp.418–423