For reviews that did not report overall RoB judgments, inferred overall judgments were calculated by taking the highest judgment in an individual domain, in accordance with the ROBINS-I guidance.[4] (link) For reviews that reported both domain-specific and overall judgments, the inferred overall judgment was compared to the reported judgment to identify instances where they differed.
We considered the following explanatory variables as potential predictors of RoB judgments: methodological quality as assessed using AMSTAR 2, whether RoB assessment was performed in duplicate, whether the authors reported industry funding or competing interests, and whether the review included RCTs.
Since the RoB assessments within the same review were expected to be similar, multilevel regression was used. The overall (or inferred overall) RoB judgments were treated as an ordinal outcome, and a separate generalized ordered logit model was fitted for each predictor with a review-level random intercept. Results were presented as odds ratios and population-average marginal predicted probabilities. Analyses were carried out in Stata MP/16.1[23] using the gllamm command[24] .