Quality assessment of randomised controlled trials in oral and maxillofacial surgery

Evaluation of quality and quantity of randomized controlled trials in hepatobiliary surgery: A scoping/mapping review

AIM

To evaluate the quantity and quality of randomized controlled trials (RCTs) in hepatobiliary surgery and for identifying gaps in current evidences.

METHODS

A systematic search was conducted in MEDLINE (via PubMed), Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) for RCTs of hepatobiliary surgery published from inception until the end of 2023. The quality of each study was assessed using the Cochrane risk-of-bias (RoB) tool. The associations between risk of bias and the region and publication date were also assessed. Evidence mapping was performed to identify research gaps in the field.

RESULTS

The study included 1187 records. The number and proportion of published randomized controlled trials (RCTs) in hepatobiliary surgery increased over time, from 13 RCTs (.0005% of publications) in 1970-1979 to 201 RCTs (.003% of publications) in 2020-2023. There was a significant increase in the number of studies with a low risk of bias in RoB domains (p < .01). The proportion of RCTs with low risk of bias improved significantly after the introduction of CONSORT guidelines (p < .001). The evidence mapping revealed a significant research focus on major and minor hepatectomy and cholecystectomy. However, gaps were identified in liver cyst surgery and hepatobiliary vascular surgery. Additionally, there are gaps in the field of perioperative management and nutrition intervention.

CONCLUSION

The quantity and quality of RCTs in hepatobiliary surgery have increased over time, but there is still room for improvement. We have identified gaps in current research that can be addressed in future studies.

Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment

We conducted a systematic review and meta-analysis of all published data to determine the impact of estradiol pretreatment on reproductive outcomes and ovary stimulation characteristics for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment with gonadotropin-releasing hormone (GnRH) antagonist protocol. MEDLINE, EMBASE, Cochrane Library, Web of Science, and China National Knowledge Infrastructure were searched, and any randomized controlled trials associated with estradiol pretreatment in GnRH antagonist protocol were included. Seven studies (1,236 patients) were included in the present study. The pooled data from the meta-analysis demonstrated no significant difference in ongoing pregnancy rate (odds ratio (OR): 0.92 (95% CI: 0.69-1.21; P = 0.53) and live birth rate OR: 0.98 (95% CI: 0.74-1.30; P = 0.90) between patients with and those without estradiol pretreatment in GnRH antagonist protocol. Duration of gonadotropin exposure, gonadotropin consumption, and the number of cumulus-oocyte complexes were not significantly different between groups. Luteal estradiol pretreatment in IVF/ICSI cycles with GnRH antagonist protocol in normal ovary responding population does not affect the reproductive outcomes. It is an encouraging option to facilitate cycle scheduling in GnRH antagonist protocol, for luteal estradiol pretreatment does not increase the duration of gonadotropin exposure or gonadotropin consumption.

Following the trend in maxillofacial surgery literature

Evidence-based medicine relies on the integration of high-quality research with clinical expertise and patient values. The hierarchy of evidence allows the clinician to assign value to research based on the methodological quality of the study design and its applicability to the clinical question. Improvements in the quality of research in oral and maxillofacial surgery aim to strengthen evidence-based medicine and patient care. Analysis of the trends in maxillofacial surgery publications can identify the strengths and weaknesses of the current body of research, and direct researchers to areas that require improvement. The aim of this study was to review the proportion of the types of articles published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) and the International Journal of Oral and Maxillofacial Surgery (IJOMS) between January 2010 and December 2019. These data were compared with a previously published review that summarised the proportion published in 2000 - 2009. The topics chosen for meta-analysis and the number of qualitative studies were also summarised. In total, 4931 articles were reviewed over the 10-year period. Compared with the previous 10 years, there was an increase in randomised controlled trials and meta-analyses, and a reduction in case series and case reports. Implantology and dentoalveolar surgery were the most common topics chosen for meta-analysis. Overall, the trend in the maxillofacial literature is towards a higher quality body of research.