Tools to assess risk of bias in systematic reviews of nursing intervention in China: Global implications of the findings

Juxia Zhang, Jiancheng Wang, Lin Han, Xin Cao, Linda Shields

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)



The number of systematic reviews (SRs) of nursing interventions is increasing in China. Authors of such studies are encouraged to use a risk of bias tool for assessing individual studies. Therefore, it is important to know how these tools have been applied in SRs in Chinese nursing.


The purpose of the study is to examine risk of bias tools used by Chinese nursing researchers to assess the quality of individual studies included in SRs of nursing interventions.


We searched the Chinese Biomedical Literature Database, Chinese Journal Full-Text Database, Chinese Academic Journal Full-Text Database, and Wanfang Database. Each relevant review found was subjected to quality assessment, data synthesis, and comprehensively described.


Two hundred eight SRs were identified, most (94.7%) of which used the words “systematic review” or “meta-analysis” in their titles. Most used quality assessment rather than risk of bias as their major method to gauge quality; 7.6% reported on six domains of the Cochrane risk of bias tool. Only four provided a risk of bias graph/summary figure.


Many SRs of nursing interventions are published in Chinese journals, and their assessment of risk of bias is usually either lacking or incomplete, potentially producing misleading results. This may also be the case in other countries. Assessment of risk of bias in SRs is a requisite. Authors who systematically review nursing literature should follow the latest Cochrane Collaboration Handbook.

Original languageEnglish
Pages (from-to) 380-391
Number of pages12
JournalNursing Outlook
Issue number4
Early online dateNov 2016
Publication statusPublished - Jul 2017


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