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. 2025 Aug 22;29:381. doi: 10.1186/s13054-025-05600-7

Table 3.

Results of risk of bias assessment using the Newcastle-Ottawa scale for assessing risk of bias of non-randomized studies

First author and year Representative exposed cohort?1 Selection of non-exposed cohort2 Ascertainment of exposure3 Outcome not present at start of study4 Comparability of cohorts5 Assessment of outcome6 Long enough follow-up?7 Adequacy of follow-up8 Overall risk of bias rating9
Barrett 2024 A A A A A, B B A A Low
Braun 2004 A C A A N/A B A D Low
Chang 2015 A A A A A, B B A A Low
Farrah 2021 A A A A A, B B A B Low
Fleischmann-Struzek 2021 A C A A N/A B A D Low
Gadre 2019 A C A A A, B B A D Low
Goodwin 2015 A C A A A, B B A A Low
Lee 2004 A C D A N/A B A D Not low
Letarte 2002 A C A A N/A B A B Low
Mageau 2019 A A A A A, B B A D Low
Nissenson 2005 A A A A B B A C Low
Pandolfi 2023 A C A A N/A B A A Low
Paoli 2018 A C A A N/A B A B Low
Prescott 2014 A A C A A B A B Low
Puceta 2024 A A A A A, B B A A Low
Rose 2023 A C A A N/A B A A Low
Sankaran 2024 A C A A N/A B A A Low
Schmidt 2022 A C A A N/A B, C A D Low
Stinehart 2024 A C A A N/A B A A Low
Tew 2021 A A A B A, B B A B Low
Thompson 2018 C A A A A, B B A D Low
Weycker 2003 A C A A N/A B A B Low
Winkler 2023 A A A A A, B B A D Low

1 Representativeness of the exposed cohort: A* = truly representative of the average ___ in the community. B* = somewhat representative of the average ____ in the community. C = selected group of users. D = no description of the derivation of the cohort

2 Selection of the non-exposed cohort: A* = drawn from the same community as the exposed cohort. B = drawn from a different source. C = no description of the derivation of the non-exposed cohort

3 Ascertainment of exposure: A* = secure record (e.g. surgical records). B* = structured interview. C = written self-report. D = no description

4 Demonstration that outcome of interest was not present at the start of study: A* = yes. B = no

5 Comparability of cohorts on the basis of design or analysis: A* = study controls for ___ (most important factor). B* = study controls for any additional factor

6 Assessment of outcome: A* = independent blind assessment. B* = record linkage. C = self-report. D = no description

7 Was follow-up long enough for outcomes to occur: A* = yes. B = no

8 Adequacy of follow-up of cohorts: A* = complete follow-up – all subjects accounted for. B* = subjects lost to follow up unlikely to introduce bias – small number lost, or description provided of those lost. C = follow up rate low and no description of those lost. D = no statement

9 Overall risk of bias rating: Low risk of bias = 3 or 4 stars in selection domain AND 1 or 2 stars in comparability domain AND 2 or 3 stars in outcome domain. Not low risk of bias = 2 stars in selection domain AND 1 or 2 stars in comparability domain AND 2 or 3 stars in outcome domain, or fewer stars across domains