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Pichardo-Rodriguez R, Altuna-Moscoso V, Aviles-Antezana K, Cahuana-Mendoza AL, Challco Alvarado AA, Gonzales-Rospigliosi C, Oscco-Coila S, Rafael-Tarazona E, Saavedra-Velasco M, Cordova-Cueva L, De La Cruz-Vargas JA, Munayco-Guillen F, García-Perdomo HA. Quality Assessment of Systematic Reviews Performed As An Undergraduate thesis in A Peruvian University: A Systematic Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:717-725. [PMID: 39072297 PMCID: PMC11277977 DOI: 10.2147/amep.s443710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/22/2024] [Indexed: 07/30/2024]
Abstract
Objective To determine the quality of systematic reviews submitted as a thesis in the Medical School of Ricardo Palma University. Methods We conducted a systematic review. We included systematic reviews submitted as theses from Ricardo Palma University, and we excluded narrative reviews, editorials, clinical experiments, and those with incomplete data. We performed a structured search on EMBASE, PubMed, Scopus, and Institutional Repository from the Ricardo Palma University and RENATI. The risk of bias assessment was performed through the AMSTAR-2 and the modified AMSTAR-2 tools. The primary outcome was review quality. A qualitative synthesis of the information was performed. Results One thousand four hundred eighty-seven theses were identified, and exclusion criteria were applied, whereby 11 theses were selected for review and thorough consultation. Of the 11 selected theses, and through the AMSTAR-2 and modified AMSTAR-2 tools, the findings reached were that 90.9% of the included theses presented critically low quality that was not modified even when the quality was reevaluated after its publication as a scientific article. Conclusion The systematic reviews presented as undergraduate thesis in the Medical School of Ricardo Palma University showed low and critically low quality. Improvement in systematic review training is required for both students and institutional advisors.
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Affiliation(s)
| | - Valeria Altuna-Moscoso
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | - Karen Aviles-Antezana
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | | | | | | | - Shirley Oscco-Coila
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | - Enzo Rafael-Tarazona
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | - Marcos Saavedra-Velasco
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | - Liz Cordova-Cueva
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
| | | | - Fernando Munayco-Guillen
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú
- Instituto Nacional de Oftalmología (INO), Lima, Peru
| | - Herney Andrés García-Perdomo
- Division of Urology/Uro oncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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Kanukula R, Page MJ, Turner SL, McKenzie JE. Identification of application and interpretation errors that can occur in pairwise meta-analyses in systematic reviews of interventions: a systematic review. J Clin Epidemiol 2024; 170:111331. [PMID: 38552725 DOI: 10.1016/j.jclinepi.2024.111331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES To generate a bank of items describing application and interpretation errors that can arise in pairwise meta-analyses in systematic reviews of interventions. STUDY DESIGN AND SETTING MEDLINE, Embase, and Scopus were searched to identify studies describing types of errors in meta-analyses. Descriptions of errors and supporting quotes were extracted by multiple authors. Errors were reviewed at team meetings to determine if they should be excluded, reworded, or combined with other errors, and were categorized into broad categories of errors and subcategories within. RESULTS Fifty articles met our inclusion criteria, leading to the identification of 139 errors. We identified 25 errors covering data extraction/manipulation, 74 covering statistical analyses, and 40 covering interpretation. Many of the statistical analysis errors related to the meta-analysis model (eg, using a two-stage strategy to determine whether to select a fixed or random-effects model) and statistical heterogeneity (eg, not undertaking an assessment for statistical heterogeneity). CONCLUSION We generated a comprehensive bank of possible errors that can arise in the application and interpretation of meta-analyses in systematic reviews of interventions. This item bank of errors provides the foundation for developing a checklist to help peer reviewers detect statistical errors.
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Affiliation(s)
- Raju Kanukula
- Methods in Evidence Synthesis Unit, School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Simon L Turner
- Methods in Evidence Synthesis Unit, School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Joanne E McKenzie
- Methods in Evidence Synthesis Unit, School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia.
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Lunny C, Kanji S, Thabet P, Haidich AB, Bougioukas KI, Pieper D. Assessing the methodological quality and risk of bias of systematic reviews: primer for authors of overviews of systematic reviews. BMJ MEDICINE 2024; 3:e000604. [PMID: 38826514 PMCID: PMC11141200 DOI: 10.1136/bmjmed-2023-000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/03/2024] [Indexed: 06/04/2024]
Affiliation(s)
- Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Cochrane Hyptertension Review Group, Cochrane Canada, Vancouver, BC, Canada
| | - Salmaan Kanji
- Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Pierre Thabet
- School of Pharmaceutical Sciences University of Ottawa, Hôpital Montfort, Ottawa, ON, Canada
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane Ruppin Clinics, Neuruppin, Brandenburg, Germany
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Mills CM, Trinca V. The Evidence for Screening Older Adults for Nutrition Risk in Primary Care: An Umbrella Review. CAN J DIET PRACT RES 2023; 84:159-166. [PMID: 36920030 DOI: 10.3148/cjdpr-2022-043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.
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Affiliation(s)
- Christine Marie Mills
- Aging & Health Program, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Vanessa Trinca
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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5
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Taha A, Taha-Mehlitz S, Ortlieb N, Ochs V, Honaker MD, Rosenberg R, Lock JF, Bolli M, Cattin PC. Machine learning in pancreas surgery, what is new? literature review. Front Surg 2023; 10:1142585. [PMID: 37383385 PMCID: PMC10293756 DOI: 10.3389/fsurg.2023.1142585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
Background Machine learning (ML) is an inquiry domain that aims to establish methodologies that leverage information to enhance performance of various applications. In the healthcare domain, the ML concept has gained prominence over the years. As a result, the adoption of ML algorithms has become expansive. The aim of this scoping review is to evaluate the application of ML in pancreatic surgery. Methods We integrated the preferred reporting items for systematic reviews and meta-analyses for scoping reviews. Articles that contained relevant data specializing in ML in pancreas surgery were included. Results A search of the following four databases PubMed, Cochrane, EMBASE, and IEEE and files adopted from Google and Google Scholar was 21. The main features of included studies revolved around the year of publication, the country, and the type of article. Additionally, all the included articles were published within January 2019 to May 2022. Conclusion The integration of ML in pancreas surgery has gained much attention in previous years. The outcomes derived from this study indicate an extensive literature gap on the topic despite efforts by various researchers. Hence, future studies exploring how pancreas surgeons can apply different learning algorithms to perform essential practices may ultimately improve patient outcomes.
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Affiliation(s)
- Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | - Stephanie Taha-Mehlitz
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
| | - Niklas Ortlieb
- Goethe University Frankfurt, Faculty of Business and Economics, Frankfurt am Main, Germany
| | - Vincent Ochs
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | - Michael Drew Honaker
- Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, NC, United States
| | - Robert Rosenberg
- Cantonal Hospital Basel-Landschaft, Centre for Gastrointestinal and Liver Diseases, Liestal, Switzerland
| | - Johan F. Lock
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Martin Bolli
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
| | - Philippe C. Cattin
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
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Alkhalaf A, Aljaroudi E, Al-Hulami M, Gaffar B, Almas K. Efficacy of Surgical Masks Versus N95 Respirators for the Prevention of COVID-19 in Dental Settings: A Systematic Review. Cureus 2023; 15:e37631. [PMID: 37200654 PMCID: PMC10186565 DOI: 10.7759/cureus.37631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 05/20/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). It spreads mainly through saliva droplets or nasal discharge. Dentists are among the professionals with the greatest risk of contracting and transmitting COVID-19. We compared the efficacy of surgical masks versus N95 respirators in preventing COVID-19 infection in dental settings. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched. Search terms corresponded to a predefined PICOS (patient/population, intervention, comparison, and outcomes) question. The risk of bias was evaluated using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2), ROBIS (Risk of Bias in Systematic Reviews), and Health Evidence tools. A total of 191 articles were screened, and nine of them were further evaluated for eligibility, of which five articles (fulfilled the selection criteria) and were included in this study. Two studies concluded that surgical masks could provide equivalent protection to N95 respirators. Another study found that N95 respirators were superior to surgical masks. The fourth study found that better protection can be achieved when using surgical masks by the aerosol source than when the recipient uses an N95 respirator, while the last study concluded that surgical masks or N95 respirators alone do not provide full protection. Thus, according to this systematic review, N95 respirators provide better protection against COVID-19 infection compared to surgical masks.
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Affiliation(s)
- Ali Alkhalaf
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Essa Aljaroudi
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Mohammed Al-Hulami
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Balgis Gaffar
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Khalid Almas
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
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De Santis KK, Pieper D, Lorenz RC, Wegewitz U, Siemens W, Matthias K. User experience of applying AMSTAR 2 to appraise systematic reviews of healthcare interventions: a commentary. BMC Med Res Methodol 2023; 23:63. [PMID: 36927334 PMCID: PMC10018966 DOI: 10.1186/s12874-023-01879-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND 'A Measurement Tool to Assess Systematic Reviews, version 2' (AMSTAR 2) is a validated 16-item scale designed to appraise systematic reviews (SRs) of healthcare interventions and to rate the overall confidence in their results. This commentary aims to describe the challenges with rating of the individual items and the application of AMSTAR 2 from the user perspective. DISCUSSION A group of six experienced users (methodologists working in different clinical fields for at least 10 years) identified and discussed the challenges in rating of each item and the general use of AMSTAR 2 to appraise SRs. A group discussion was used to develop recommendations on how users could deal with the identified challenges. We identified various challenges with the content of items 2-16 and with the derivation of the overall confidence ratings on AMSTAR 2. These challenges include the need (1) to provide additional definitions (e.g., what constitutes major deviations from SR protocol on item 2), (2) to choose a rating strategy for multiple conditions on single items (e.g., how to rate item 5 if studies were selected in duplicate, but consensus between two authors was not reported), and (3) to determine rules for deriving the confidence ratings (e.g., what items are critical for such ratings). Based on these challenges we formulated specific recommendations for items 2-16 that AMSTAR 2 users could consider before applying the tool. Our commentary adds to the existing literature by providing the first in-depth examination of the AMSTAR 2 tool from the user perspective. The identified challenges could be addressed by additional decision rules including definitions for ambiguous items and guidance for rating of complex items and derivation of confidence ratings. We recommend that a team consensus regarding such decision rules is required before appraisal procedure begins. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Dawid Pieper
- Brandenburg Medical School Theodor Fontane (MHB), Center for Health Services Research (ZVF-BB), Brandenburg an der Havel, Germany
| | - Robert C Lorenz
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Division 3 Work and Health, Berlin, Germany
| | - Waldemar Siemens
- Faculty of Medicine, Institute for Evidence in Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Sciences Stralsund, Stralsund, Germany.
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8
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Woldring JM, Luttik ML, Paans W, Gans ROB. The added value of family-centered rounds in the hospital setting: A systematic review of systematic reviews. PLoS One 2023; 18:e0280142. [PMID: 36662899 PMCID: PMC9858825 DOI: 10.1371/journal.pone.0280142] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Family engagement in care for adult inpatients may improve shared decision making in the hospital and the competence and preparedness of informal caregivers to take over the care at home. An important strategy to involve family members in hospital care processes is to include them in (ward) rounds, also called 'family-centered rounds'(FCRs). OBJECTIVES Summarize the evidence regarding the added value of FCRs from the perspectives of patients, family, and healthcare professionals. METHODS A review protocol was registered a priori with PROSPERO (number CRD42022320915). The electronic databases PubMed, CINAHL, and PsycInfo were searched for English-written systematic reviews with a focus on FCRs. The results and methods were presented in line with the PRISMA guidelines, and the methodological quality of the included reviews was assessed using the adapted version of the AMSTAR tool. RESULTS Of the 207 initial records, four systematic reviews were identified covering a total of 67 single studies, mainly performed in critical and pediatric care. Added values of FCR were described at review level, with references to single studies. All four systematic reviews reported an improvement in satisfaction among patients, family, and healthcare professionals, whereby satisfaction is linked to improved communication and interaction, improved situational understanding, inclusion of family in the decision-making process, and improved relationships within the care situation. CONCLUSION Although only limited research has been conducted on the value of FCRs in the adult non-critical care setting, and despite the existence of a variety of outcome measures, the results available from the pediatric and acute care setting are positive. The findings of the sole study in an adult non-critical patient population are in line with these results. Further research in adult non-critical care is required to verify its effects in this setting.
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Affiliation(s)
- Josien M. Woldring
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Critical Care, University Medical Centre Groningen, Groningen, The Netherlands
| | - Reinold O. B. Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Oliveira ALA, de Oliveira MEP, Guimarães LV, Trindade GM, Chaves GM, Gonçalves ACP, de Souza TJF, Moraes LS, Lujan VSC, Faria LSDP, Manuel V. Evaluation of right ventricle systolic function after tetralogy of Fallot repair: A systematic review comparing cardiac magnetic resonance and global longitudinal strain. Echocardiography 2023; 40:4-14. [PMID: 36478414 DOI: 10.1111/echo.15486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/23/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Most patients who undergo tetralogy of Fallot (TOF) repair experience late right ventricle (RV) dysfunction due to pulmonary valve regurgitation (PVR). Cardiac magnetic resonance (CMR) is the gold standard method for evaluating RV during follow-up. Global longitudinal strain (GLS) has been introduced as a novel method for the assessment of RV dysfunction. We aimed to compare the feasibility of GLS and CMR for assessing RV function after TOF repair. METHODS We systematically reviewed the English literature using PubMed, SciELO and Google Scholar for articles published between January 1, 2015, and December 31, 2020. Articles evaluating RV function comparing by GLS and CMR after TOF repair were included. RESULTS Nine studies including 465 patients were analyzed. Most patients were men (280; 60%), the male:female ratio was 1.5:1, and the age range was .8 to 57.7 years. The mean follow-up time was 6 to 32 months. The correlation between RV GLS and RV ejection fraction (EF) by CMR was negative for the articles and varied from moderate to strong (r = -.45, r = -.60, r = -.76). CONCLUSION Right ventricle GLS can be considered for routine follow-up of TOF repair patients, even though CMR remains the noninvasive gold standard method. Using a single parameter may not allow comparison of the accuracy of 3D RV EF by using CMR and GLS. Further studies with a larger number of patients undergoing TOF repair are required to evaluate the correlation between these examinations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Valdano Manuel
- Cardiothoracic Center, Clinica Girassol, Luanda, Angola.,Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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10
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Tanguay-Sela M, Rollins C, Perez T, Qiang V, Golden G, Tunteng JF, Perlman K, Simard J, Benrimoh D, Margolese HC. A systematic meta-review of patient-level predictors of psychological therapy outcome in major depressive disorder. J Affect Disord 2022; 317:307-318. [PMID: 36029877 DOI: 10.1016/j.jad.2022.08.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Psychological therapies are effective for treating major depressive disorder, but current clinical guidelines do not provide guidance on the personalization of treatment choice. Established predictors of psychotherapy treatment response could help inform machine learning models aimed at predicting individual patient responses to different therapy options. Here we sought to comprehensively identify known predictors. METHODS EMBASE, Medline, PubMed, PsycINFO were searched for systematic reviews with or without meta-analysis published until June 2020 to identify individual patient-level predictors of response to psychological treatments. 3113 abstracts were identified and 300 articles assessed. We qualitatively synthesized our findings by predictor category (sociodemographic; symptom profile; social support; personality features; affective, cognitive, and behavioural; comorbidities; neuroimaging; genetics) and treatment type. We used the AMSTAR 2 to evaluate the quality of included reviews. RESULTS Following screening and full-text assessment, 27 systematic reviews including 12 meta-analyses were eligible for inclusion. 74 predictors emerged for various psychological treatments, primarily cognitive behavioural therapy, interpersonal therapy, and mindfulness-based cognitive therapy. LIMITATIONS A paucity of studies examining predictors of psychological treatment outcome, as well as methodological heterogeneities and publication biases limit the strength of the identified predictors. CONCLUSIONS The synthesized predictors could be used to supplement clinical decision-making in selecting psychological therapies based on individual patient characteristics. These predictors could also be used as a priori input features for machine learning models aimed at predicting a given patient's likelihood of response to different treatment options for depression, and may contribute toward the development of patient-specific treatment recommendations in clinical guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Jade Simard
- Université du Québec à Montréal, Montreal, Quebec, Canada
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11
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Taha A, Enodien B, Frey DM, Taha-Mehlitz S. The Development of Artificial Intelligence in Hernia Surgery: A Scoping Review. Front Surg 2022; 9:908014. [PMID: 35693313 PMCID: PMC9178189 DOI: 10.3389/fsurg.2022.908014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/09/2022] [Indexed: 01/07/2023] Open
Abstract
Background Artificial intelligence simulates human intelligence in machines that have undergone programming to make them think like human beings and imitate their activities. Artificial intelligence has dominated the medical sector to perform various patient diagnosis activities and improve communication between professionals and patients. The main goal of this study is to perform a scoping review to evaluate the development of artificial intelligence in all forms of hernia surgery except the diaphragm and upside-down hernia. Methods The study used the Preferred Reporting Items for Systematic and Meta-analyses for Scoping Review (PRISMA-ScR) to guide the structuring of the manuscript and fulfill all the requirements of every subheading. The sources used to gather data are the PubMed, Cochrane, and EMBASE databases, IEEE and Google and Google Scholar search engines. AMSTAR tool is the most appropriate for assessing the methodological quality of the included studies. Results The study exclusively included twenty articles, whereby seven focused on artificial intelligence in inguinal hernia surgery, six focused on abdominal hernia surgery, five on incisional hernia surgery, and two on AI in medical imaging and robotics in hernia surgery. Conclusion The outcomes of this study reveal a significant literature gap on artificial intelligence in hernia surgery. The results also indicate that studies focus on inguinal hernia surgery more than any other types of hernia surgery since the articles addressing the topic are more. The study implies that more research is necessary for the field to develop and enjoy the benefits associated with AI. Thus, this situation will allow the integration of AI in activities like medical imaging and surgeon training.
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Affiliation(s)
- Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland
- Correspondence: Anas Taha
| | - Bassey Enodien
- Department of Surgery, GZO- Hospital, Wetzikon, Switzerland
| | - Daniel M. Frey
- Department of Surgery, GZO- Hospital, Wetzikon, Switzerland
| | - Stephanie Taha-Mehlitz
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
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Flowers H, Guitard P, King J, Fitzpatrick E, Bérubé D, Barette JA, Cardinal D, Cavallo S, O’Neil J, Charette M, Côté L, Gurgel-Juarez NC, Toupin-April K, Shallwani SM, Dorion M, Rahman P, Potvin-Gilbert M, Bartolini V. Traduction franco-canadienne de l’ Assessment of Systematic Reviews Revised (AMSTAR 2) : validation transculturelle et fidélité interjuges. Physiother Can 2022; 74:15-24. [PMID: 35185243 PMCID: PMC8816359 DOI: 10.3138/ptc-2019-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/03/2023]
Abstract
Objective: Produce a French-Canadian translation of AMSTAR 2, affirm its content validity, and examine interrater reliability. Methods: Based on Vallerand's methodological approach, we conducted forward and parallel inverse-translations. Subsequently, an expert panel evaluated the translations to create a preliminary experimental French-Canadian version. A second expert panel examined this version and proposed additional modifications. Twenty future health professionals then rated the second experimental version for ambiguity on a scale (from 1 to 7). The principal co-investigators then reviewed the problematic elements and proposed a pre-official version. To ascertain content validity, a final back-translation was conducted resulting in the official version. Four judges evaluated 13 systematic reviews using the official French-Canadian version of AMSTAR 2. The Kappa coefficient was used to evaluate interrater reliability. Results: This rigorous adaptation enabled the development of a Franco-Canadian version of AMSTAR 2. Its application demonstrated low ambiguity (mean 1.15; SD 0.26) as well as good overall interrater reliability (total κ > 0.64) across all items. Conclusion: The French-Canadian version of AMSTAR 2 can now support francophone clinicians, educators, and managers in Canada as they undertake evidence-based practice.
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Affiliation(s)
- Heather Flowers
- Programme d’audiologie et d’orthophonie, École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Paulette Guitard
- Programme d’ergothérapie, École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Judy King
- Programme de physiothérapie, École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Elizabeth Fitzpatrick
- Programme d’audiologie et d’orthophonie, École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Daniel Bérubé
- Programme d’audiologie et d’orthophonie, École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | | | - Dominique Cardinal
- Consortium national de formation en santé (CNFS), Université d’Ottawa, Ottawa (Ontario) Canada
| | - Sabrina Cavallo
- Programme d’ergothérapie, École de réadaptation, Université de Montréal, Montréal (Québec) Canada
| | - Jennifer O’Neil
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Marylène Charette
- École interdisciplinaire des sciences de la santé, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Laurence Côté
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | | | - Karine Toupin-April
- Institut de recherche du Centre hospitalier pour enfants de l’est de l’Ontario, Ottawa (Ontario) Canada
- Faculté de médecine et Faculté des sciences de la santé, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Shirin M. Shallwani
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Michelle Dorion
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Prinon Rahman
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Maude Potvin-Gilbert
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
| | - Vanessa Bartolini
- École des sciences de la réadaptation, Université d’Ottawa, Ottawa (Ontario) Canada
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Response to the Comment on "The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastro-intestinal Cancer Surgery: A PRISMA-Accordant Meta-analysis". Ann Surg 2021; 274:e946-e947. [PMID: 34596070 DOI: 10.1097/sla.0000000000005223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Perry R, Whitmarsh A, Leach V, Davies P. A comparison of two assessment tools used in overviews of systematic reviews: ROBIS versus AMSTAR-2. Syst Rev 2021; 10:273. [PMID: 34696810 PMCID: PMC8543959 DOI: 10.1186/s13643-021-01819-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/16/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AMSTAR-2 is a 16-item assessment tool to check the quality of a systematic review and establish whether the most important elements are reported. ROBIS is another assessment tool which was designed to evaluate the level of bias present within a systematic review. Our objective was to compare, contrast and establish both inter-rater reliability and usability of both tools as part of two overviews of systematic reviews. Strictly speaking, one tool assesses methodological quality (AMSTAR-2) and the other assesses risk of bias (ROBIS), but there is considerable overlap between the tools in terms of the signalling questions. METHODS Three reviewers independently assessed 31 systematic reviews using both tools. The inter-rater reliability of all sub-sections using each instrument (AMSTAR-2 and ROBIS) was calculated using Gwet's agreement coefficient (AC1 for unweighted analysis and AC2 for weighted analysis). RESULTS Thirty-one systematic reviews were included. For AMSTAR-2, the median agreement for all questions was 0.61. Eight of the 16 AMSTAR-2 questions had substantial agreement or higher (> 0.61). For ROBIS, the median agreement for all questions was also 0.61. Eleven of the 24 ROBIS questions had substantial agreement or higher. CONCLUSION ROBIS is an effective tool for assessing risk of bias in systematic reviews and AMSTAR-2 is an effective tool at assessing quality. The median agreement between raters for both tools was identical (0.61). Reviews that included a meta-analysis were easier to rate with ROBIS; however, further developmental work could improve its use in reviews without a formal synthesis. AMSTAR-2 was more straightforward to use; however, more response options would be beneficial.
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Affiliation(s)
- R. Perry
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - A. Whitmarsh
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - V. Leach
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - P. Davies
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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15
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Wu J, Zeng A, Chen Z, Wei Y, Huang K, Chen J, Ren Z. Effects of Virtual Reality Training on Upper Limb Function and Balance in Stroke Patients: Systematic Review and Meta-Meta-Analysis. J Med Internet Res 2021; 23:e31051. [PMID: 34636735 PMCID: PMC8548971 DOI: 10.2196/31051] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
Background Virtual reality (VR) training is a promising intervention strategy that has been utilized in health care fields like stroke rehabilitation and psychotherapy. Current studies suggest that VR training is effective in improving the locomotor ability of stroke patients. Objective This is the first meta-meta-analysis of the effects of VR on motor function in stroke patients. This study aimed to systematically summarize and quantify the present meta-analyses results of VR training and produce high-quality meta-meta-analysis results to obtain a more accurate prediction. Methods We searched 4 online databases (Web of Science, Scopus, PubMed, and Chinese National Knowledge Infrastructure) for meta-analysis studies. After accounting for overlap, 10 studies (accounting for almost 550 stroke patients) were obtained. Based on the meta-meta-analysis of these patients, this study quantified the impact of VR training on stroke patients’ motor performance, mainly including upper limb function, balance, and walking ability. We combined the effects under the random effect model and pooled the estimates as standardized mean differences (SMD). Results The results of the meta-meta-analysis showed that VR training effectively improves upper limb function (SMD 4.606, 95% CI 2.733-6.479, P<.05) and balance (SMD 2.101, 95% CI 0.202-4.000, P<.05) of stroke patients. However, the results showed considerable heterogeneity and thus, may need to be treated with caution. Due to the limited research, a meta-meta-analysis of walking ability was not performed. Conclusions These findings represent a comprehensive body of high-quality evidence that VR training is more effective at improving upper limb function and balance of stroke patients.
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Affiliation(s)
- Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | | | - Ziyan Chen
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Ye Wei
- Nanshan District Culture, Radio, Television, Tourism and Sports Bureau, Shenzhen, China
| | - Kunlun Huang
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Jiafeng Chen
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen, China
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Estevam JDA, Franco ESB, Kriebel CF, Peccin MS. Methodological Quality Analysis of Systematic Review for the Treatment of Rotator Cuff Disease. Rev Bras Ortop 2021; 56:485-489. [PMID: 34483393 PMCID: PMC8405256 DOI: 10.1055/s-0040-1710334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/20/2020] [Indexed: 10/25/2022] Open
Abstract
Objective To evaluate the methodological quality of systematic reviews for the surgical and nonsurgical treatment of individuals with rotator cuff syndrome; to compare, through the Assessing the methodological quality of systematic reviews (AMSTAR) instrument, the quality of studies found in the Cochrane Library, PubMed (Publisher Medline ), EMBASE andQinsightdatabases. Methods This is a descriptive and comparative cross-sectional study, in which two independent authors analyzed, through the AMSTAR instrument, the methodological quality of Cochrane and non-Cochrane systematic reviews on the treatment of individuals diagnosed with rotator cuff syndrome. Results A total of 76 systematic reviews were evaluated by the AMSTAR instrument. The overall mean score was 6.1 (±2.1) and the mean per database was 9.1 (±0.9) for the Cochrane reviews and 5.7 (±1.8) for the non-Cochrane reviews. The lowest-scoring item of AMSTAR was 11, related to the display of the conflict of interests of the publication. In a comparative analysis of the final variable score, there was a statistical difference between the Cochrane and non-Cochrane studies. Conclusion According to the present study, systematic reviews using the Cochrane methodology have a better methodological quality compared to non-Cochrane studies on the treatment of rotator cuff dysfunctions.
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Affiliation(s)
- Jhony de Almeida Estevam
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | | | - Carolina Falconi Kriebel
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - Maria Stella Peccin
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
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17
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Methodological quality of systematic reviews used in clinical practice guidelines: focus on clinical imaging. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Suttle CM, Lawrenson JG, Conway ML. Efficacy of coloured overlays and lenses for treating reading difficulty: an overview of systematic reviews. Clin Exp Optom 2021; 101:514-520. [DOI: 10.1111/cxo.12676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/30/2018] [Accepted: 02/11/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Catherine M Suttle
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK,
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK,
| | - Miriam L Conway
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK,
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Bühn S, Ober P, Mathes T, Wegewitz U, Jacobs A, Pieper D. Measuring test-retest reliability (TRR) of AMSTAR provides moderate to perfect agreement - a contribution to the discussion of the importance of TRR in relation to the psychometric properties of assessment tools. BMC Med Res Methodol 2021; 21:51. [PMID: 33706710 PMCID: PMC7953720 DOI: 10.1186/s12874-021-01231-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
Background Systematic Reviews (SRs) can build the groundwork for evidence-based health care decision-making. A sound methodological quality of SRs is crucial. AMSTAR (A Measurement Tool to Assess Systematic Reviews) is a widely used tool developed to assess the methodological quality of SRs of randomized controlled trials (RCTs). Research shows that AMSTAR seems to be valid and reliable in terms of interrater reliability (IRR), but the test retest reliability (TRR) of AMSTAR has never been investigated. In our study we investigated the TRR of AMSTAR to evaluate the importance of its measurement and contribute to the discussion of the measurement properties of AMSTAR and other quality assessment tools. Methods Seven raters at three institutions independently assessed the methodological quality of SRs in the field of occupational health with AMSTAR. Between the first and second ratings was a timespan of approximately two years. Answers were dichotomized, and we calculated the TRR of all raters and AMSTAR items using Gwet’s AC1 coefficient. To investigate the impact of variation in the ratings over time, we obtained summary scores for each review. Results AMSTAR item 4 (Was the status of publication used as an inclusion criterion?) provided the lowest median TRR of 0.53 (moderate agreement). Perfect agreement of all reviewers was detected for AMSTAR-item 1 with a Gwet’s AC1 of 1, which represented perfect agreement. The median TRR of the single raters varied between 0.69 (substantial agreement) and 0.89 (almost perfect agreement). Variation of two or more points in yes-scored AMSTAR items was observed in 65% (73/112) of all assessments. Conclusions The high variation between the first and second AMSTAR ratings suggests that consideration of the TRR is important when evaluating the psychometric properties of AMSTAR.. However, more evidence is needed to investigate this neglected issue of measurement properties. Our results may initiate discussion of the importance of considering the TRR of assessment tools. A further examination of the TRR of AMSTAR, as well as other recently established rating tools such as AMSTAR 2 and ROBIS (Risk Of Bias In Systematic reviews), would be useful. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01231-y.
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Affiliation(s)
- Stefanie Bühn
- Institute for Research in Operative Medicine, Faculty of Health - School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany.
| | - Peggy Ober
- LIFE Child, LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
| | - Tim Mathes
- Institute for Research in Operative Medicine, Faculty of Health - School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
| | - Anja Jacobs
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587, Berlin, Germany
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Faculty of Health - School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany
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20
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Hagège B, Tan E, Gayraud M, Fautrel B, Gossec L, Mitrovic S. Remission and low disease activity in psoriatic arthritis publications: a systematic literature review with meta-analysis. Rheumatology (Oxford) 2021; 59:1818-1825. [PMID: 32118267 DOI: 10.1093/rheumatology/keaa030] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/10/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Remission (REM) or low disease activity (LDA) is the treatment target in psoriatic arthritis (PsA). The objective of this study was to assess the reporting and prevalence of REM/LDA in published studies of PsA. METHODS This was a systematic literature review of all clinical papers published in PubMed, EMBASE or Cochrane database in English between 2012 and 2019 in the field of PsA. Data were collected regarding reporting of REM/LDA by very low disease activity/minimal disease activity (VLDA/MDA), Disease Activity index for Psoriatic Arthritis (DAPSA), or Disease Activity Score 28 joints (DAS28). The pooled rates of REM and LDA by each definition were calculated by random effect meta-analysis. RESULTS In all, 258 publications (corresponding to 114 651 patients), of which 81 (31%) were randomized controlled trials, were analysed: patients' mean age was 49.4 ( 4.4) years; with a mean disease duration of 8.5 ( 3.8) years. REM/LDA was reported in 91/258 (35.3%) publications. VLDA/MDA was used in 61/91 (67.0%) studies, DAPSA in 27/91 (29.6%) and DAS28 in 28/91 (30.7%), with 40/91 (43.9%) papers reporting several of these definitions. The pooled prevalence (lower-upper limits) of REM was 13.1% (10.9-15.4), 23.1% (16.8-30.1) and 42.1% (33.9-50.4) using VLDA, DAPSA-REM and DAS28, respectively. For LDA the pooled prevalence was 36.3% (32.3-40.5), 52.8% (41.8-63.6) and 60.4% (52.5-68.0) using MDA, DAPSA-LDA and DAS28, respectively. CONCLUSION REM/LDA status was reported in only1/3 of recent studies on PsA, with important variations in the frequency of these outcomes according to the definition used: 13.1-42.1% for REM, and 36.3-60.4% for LDA. This highlights the need for consensus.
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Affiliation(s)
- Benjamin Hagège
- Internal Medicine Department, Institut Mutualiste MontsourisParis, France
| | - Elina Tan
- Internal Medicine Department, Institut Mutualiste MontsourisParis, France
| | - Martine Gayraud
- Internal Medicine Department, Institut Mutualiste MontsourisParis, France
| | - Bruno Fautrel
- Rheumatology Department, Pitié Salpêtrière Hospital, Sorbonne Université-AP-HP, Paris, France.,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR S1136, Paris, France
| | - Laure Gossec
- Rheumatology Department, Pitié Salpêtrière Hospital, Sorbonne Université-AP-HP, Paris, France.,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR S1136, Paris, France
| | - Stéphane Mitrovic
- Internal Medicine Department, Institut Mutualiste MontsourisParis, France.,Rheumatology Department, Pitié Salpêtrière Hospital, Sorbonne Université-AP-HP, Paris, France.,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR S1136, Paris, France
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21
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Matthias K, Rissling O, Pieper D, Morche J, Nocon M, Jacobs A, Wegewitz U, Schirm J, Lorenz RC. The methodological quality of systematic reviews on the treatment of adult major depression needs improvement according to AMSTAR 2: A cross-sectional study. Heliyon 2020; 6:e04776. [PMID: 32939412 PMCID: PMC7479282 DOI: 10.1016/j.heliyon.2020.e04776] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/24/2020] [Accepted: 08/19/2020] [Indexed: 01/04/2023] Open
Abstract
Background Several standards have been developed to assess methodological quality of systematic reviews (SR). One widely used tool is the AMSTAR. A recent update - AMSTAR 2 - is a 16 item evaluation tool that enables a detailed assessment of SR that include randomised (RCT) or non-randomised studies (NRS) of healthcare interventions. Methods A cross-sectional study of SR on pharmacological or psychological interventions in major depression in adults was conducted. SR published during 2012–2017 were sampled from MEDLINE, EMBASE and the Cochrane Database of SR. Methodological quality was assessed using AMSTAR 2. Potential predictive factors associated with quality were examined. Results In rating overall confidence in the results of 60 SR four reviews were rated “high”, two were “moderate”, one was “low” and 53 were “critically low”. The mean AMSTAR 2 percentage score was 45.3% (standard deviation 22.6%) in a wide range from 7.1% to 93.8%. Predictors of higher quality were: type of review (higher quality in Cochrane Reviews), SR including only randomized trials and higher journal impact factor. Limitations AMSTAR 2 is not intended to be used for the generation of a percentage score. Conclusions According to AMSTAR 2 the overall methodological quality of SR on the treatment of adult major depression needs improvement. Although there is a high need for summarized information in the field of mental health, this work demonstrates the need to critically assess SR before using their findings. Better adherence to established reporting guidelines for SR is needed.
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Affiliation(s)
- Katja Matthias
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Olesja Rissling
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Dawid Pieper
- Witten/Herdecke University, School of Health, IFOM - Institute for Research in Operative Medicine, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Johannes Morche
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Marc Nocon
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Anja Jacobs
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health, Nöldnerstr. 40-42, 10317 Berlin, Germany
| | - Jaqueline Schirm
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
| | - Robert C Lorenz
- Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany.,University of Potsdam, Research Focus Cognitive Sciences, Division of Social and Preventive Medicine, Am Neuen Palais 10, 14469 Potsdam, Germany
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22
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Gates M, Gates A, Duarte G, Cary M, Becker M, Prediger B, Vandermeer B, Fernandes RM, Pieper D, Hartling L. Quality and risk of bias appraisals of systematic reviews are inconsistent across reviewers and centers. J Clin Epidemiol 2020; 125:9-15. [DOI: 10.1016/j.jclinepi.2020.04.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 03/20/2020] [Accepted: 04/16/2020] [Indexed: 12/11/2022]
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Aran G, Hicks C, Demand A, Johnson AL, Beaman J, Bailey Y, Haught M, Lane A, Sinnett P, Vassar M. Treating schizophrenia: the quality of evidence behind treatment recommendations and how it can improve. BMJ Evid Based Med 2020; 25:138-142. [PMID: 31672699 DOI: 10.1136/bmjebm-2019-111233] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To assess the methodological and reporting quality of systematic reviews that comprise the American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Schizophrenia and to determine the extent to which results from Cochrane systematic reviews published after guideline development would alter or confirm current recommendations. PARTICIPANTS Systematic reviews that underpinned recommendations in the APA guidelines and Cochrane systematic reviews. MAIN OUTCOME Three independent reviewers scored all systematic reviews referenced in the guideline for quality and reporting using AMSTAR and PRISMA checklist, respectively. Items in both tools were individually graded and compared to identify consistently low-performing areas within the systematic reviews. Post hoc analysis of the Cochrane systematic reviews since the latest revision of APA's guidelines were performed to determine whether their findings were congruent with recent recommendations. RESULTS The mean score of the 57 reviews on the PRISMA checklist was 70%. The mean AMSTAR score was 6.8, correlating with a moderate quality score. Post hoc analysis revealed that 171 Cochrane reviews had been published since the APA guideline release. Only half of the reviews of pharmacological interventions confirmed current recommendations. CONCLUSIONS AND RELEVANCE The methodological quality of the systematic reviews included in the APA guideline was deficient in key areas. Our study brings to light the importance of using high-quality evidence in the development of clinical practice guidelines. An updated APA guideline (last updated in 2009) is necessary to provide the highest quality treatment recommendations for clinicians in the management of schizophrenia. TRIAL REGISTRATION NUMBER UMIN-CTR, UMIN000023099.
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Affiliation(s)
- Greg Aran
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Chandler Hicks
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Alexander Demand
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Austin L Johnson
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jason Beaman
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
- Department of Psychiatry, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Yakiji Bailey
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Melissa Haught
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Aaron Lane
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Philip Sinnett
- Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Quality Assessment and Risk of Bias of Systematic Reviews of Prophylactic Mesh for Parastomal Hernia Prevention Using AMSTAR and ROBIS Tools. World J Surg 2020; 43:3003-3012. [PMID: 31440779 DOI: 10.1007/s00268-019-05139-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Systematic reviews play a crucial role in clinical decision making and resource allocation and are expected to be unbiased and consistent. The aim of this study is a review of systematic reviews on the use of prophylactic mesh to prevent parastomal hernia (PH) formation using ROBIS and AMSTAR tools to assess the risk of bias and methodological quality. METHODS We included systematic reviews with or without meta-analysis of which the objective was to assess the use of a prophylactic mesh to prevent PH. A systematic search of the literature in five databases from inception until December 2017 was conducted. For each systematic review, methodologic quality and risk of bias were assessed using the AMSTAR and ROBIS tools, respectively. We estimated the inter-rater reliability for individual domains and for the overall methodological quality and risk of bias using Fleiss' k. RESULTS We identified 14 systematic reviews that met the inclusion criteria. Using the AMSTAR scale with a cutoff value, six reviews showed high methodologic quality and eight were of low quality. Using the ROBIS tool, the overall risk of bias was low in 50% of the reviews analyzed. In the remaining studies, the risk of bias was unclear. CONCLUSIONS The global evidence in favor of the use of a prophylactic mesh for preventing PH is not uniform regarding quality and risk of bias. Surgeons cannot be equally confident in the results of all systematic reviews published on this topic.
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De Santis KK, Kaplan I. Assessing the Quality of Systematic Reviews in Healthcare Using AMSTAR and AMSTAR2. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1027/2151-2604/a000397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract. The current study assessed the consistency between A Measurement Tool to Assess Systematic Reviews (AMSTAR) and its updated version (AMSTAR2) applied to the same systematic reviews in healthcare. Data from k = 10 systematic reviews were coded by two raters using AMSTAR and AMSTAR2. AMSTAR and AMSTAR2 perfectly agreed on a subset of nine individual items and strongly correlated based on the total scores (percentage scores: ρ = .84, p = .002, k = 10; absolute scores: Spearman ρ = .83, p = .003, k = 10). The overall review quality was medium to high on AMSTAR, while the overall confidence in the results was low to critically low on AMSTAR2 for the same systematic reviews. AMSTAR2 can identify the sources of strengths, weaknesses, and biases in systematic reviews. However, the interpretation of the overall confidence in results of systematic reviews requires additional guidelines for users.
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Affiliation(s)
| | - Ilkay Kaplan
- Faculty 11 Human and Health Sciences, Institute of Psychology, University of Bremen, Germany
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Pérez E, Braën C, Boyer G, Mercille G, Rehany É, Deslauriers V, Bilodeau A, Potvin L. Neighbourhood community life and health: A systematic review of reviews. Health Place 2020; 61:102238. [PMID: 31735517 DOI: 10.1016/j.healthplace.2019.102238] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/17/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
Abstract
Neighbourhood community life has been widely recognized as an important determinant of population health. This systematic review of reviews provides an overview of the evidence for the ecological correlation between neighbourhood community life and population health. Nine databases were searched from 2008 to 2018 in order to identify systematic reviews of studies examining the association between neighbourhood community life and population health in urban neighbourhoods within the Organisation for Economic Co-operation and Development countries. Two reviewers completed selection and data extraction, then assessed the methodological quality of reviews using the Measurement Tool to Assess Systematic Reviews. We identified three high quality reviews and five of moderate quality. The reviews vary in quality of methodology, concepts, and measures. Most of the reviews examined the influence of social cohesion, social capital, and social interactions on health. Reviews found evidence supporting a consistently favourable correlation between social cohesion and physical activity, as well as a favourable trend in the relationship between social cohesion and healthy weight. They also found evidence of a favourable trend in the correlation between social capital and healthy weight. Reviews identified studies supporting a consistently favourable correlation between social interaction and depression. We identify evidence of a positive association between neighbourhood community life and several population health outcomes. Future research should define and conceptualize neighbourhood community life factors and health indicators to improve the comparison between studies and the process of evidence synthesis. This will also enable policy makers to take appropriate decisions.
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Affiliation(s)
- Elsury Pérez
- École de santé publique de l'Université de Montréal, Canada.
| | - Caroline Braën
- École de santé publique de l'Université de Montréal, Canada
| | - Ginette Boyer
- Chaire de recherche du Canada Approches communautaires et inégalités de santé (CACIS), Canada
| | | | - Émilie Rehany
- Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal, Canada
| | | | | | - Louise Potvin
- École de santé publique de l'Université de Montréal and Director, Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Canada
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Jaca A, Ndze VN, Wiysonge CS. Assessing the methodological quality of systematic reviews of interventions aimed at improving vaccination coverage using AMSTAR and ROBIS checklists. Hum Vaccin Immunother 2019; 15:2824-2835. [PMID: 31348722 PMCID: PMC6930111 DOI: 10.1080/21645515.2019.1631567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/10/2019] [Accepted: 05/26/2019] [Indexed: 10/26/2022] Open
Abstract
Introduction: Systematic reviews (SRs) are the backbone of evidence-based health care, but no gold standard exists to assess their methodological quality. Although the AMSTAR tool is accepted for analyzing the quality of SRs, the ROBIS instrument was recently developed. This study compared the capacity of both instruments to capture the quality of SRs of interventions for improving vaccination coverage.Methods: We conducted a comprehensive literature search in the Cochrane Library and PubMed. Two reviewers independently screened the search output, assessed study eligibility, and extracted data from eligible SRs; resolving differences through consensus. We conducted Principal Component Analysis (PCA) in Stata 14 to determine similarities and differences between AMSTAR and ROBIS.Results: A total of 2322 records were identified through the search and 75 full-text publications were assessed for eligibility, of which 57 met inclusion criteria. Using AMSTAR, we found 32%, 60% and 9% of SRs to have high, moderate and low quality, respectively. With ROBIS, we judged 74%, 14% and 12% of SRs to have low, unclear and high risk of bias. PCA showed that SRs with low risk of bias in ROBIS clustered together with SRs having high-quality in AMSTAR, and SRs with high risk of bias in ROBIS clustered with low-quality SRs in AMSTAR.Conclusions: Our findings suggest that there is an association between methodological quality and risk of bias in SRs of interventions focused on improving vaccination coverage. Therefore, either AMSTAR or ROBIS checklists can be used to evaluate methodological quality of SRs in vaccinology.
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Affiliation(s)
- Anelisa Jaca
- South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Valantine Ngum Ndze
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Charles Shey Wiysonge
- South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Lorenz RC, Matthias K, Pieper D, Wegewitz U, Morche J, Nocon M, Rissling O, Schirm J, Jacobs A. A psychometric study found AMSTAR 2 to be a valid and moderately reliable appraisal tool. J Clin Epidemiol 2019; 114:133-140. [PMID: 31152864 DOI: 10.1016/j.jclinepi.2019.05.028] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/15/2019] [Accepted: 05/24/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The objectives of this study were to determine the interrater reliability (IRR) of assessment of multiple systematic reviews (AMSTAR) 2 for reviews of pharmacological or psychological interventions for the treatment of major depression, to compare it to that of AMSTAR and risk of bias in systematic reviews (ROBIS), and to assess the convergent validity between the appraisal tools. STUDY DESIGN AND SETTING Two groups of four raters were each assigned one of two samples of 30 systematic reviews. All eight raters applied AMSTAR 2 to their sample. Each group also applied either AMSTAR or ROBIS. Fleiss' kappa and Gwet's AC1 were calculated, and agreement between the tools was assessed. RESULTS The median kappa values as a measure of IRR indicated a moderate agreement for AMSTAR 2 (median = 0.51), a substantial agreement for AMSTAR (median = 0.62), and a fair agreement for ROBIS (median = 0.27). Validity results showed a positive association for AMSTAR and AMSTAR 2 (r = 0.91) as well as ROBIS and AMSTAR 2 (r = 0.84). For the overall rating, AMSTAR 2 showed a high concordance with ROBIS and a lower concordance with AMSTAR. CONCLUSION The IRR of AMSTAR 2 was found to be slightly lower than the IRR of AMSTAR and higher than the IRR of ROBIS. Validity measurements indicate that AMSTAR 2 is closely related to both ROBIS and AMSTAR.
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Affiliation(s)
- Robert C Lorenz
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany; Division of Social and Preventive Medicine, University of Potsdam, Research Focus Cognitive Sciences, Am Neuen Palais 10, Potsdam 14469, Germany.
| | - Katja Matthias
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
| | - Dawid Pieper
- Witten/Herdecke University, School of Medicine, Faculty of Health, Evidence-based Health Services Research, IFOM - Institute for Research in Operative Medicine, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health, Nöldnerstr.40-42, 10317 Berlin, Germany
| | - Johannes Morche
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
| | - Marc Nocon
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
| | - Olesja Rissling
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
| | - Jacqueline Schirm
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
| | - Anja Jacobs
- Federal Joint Committee (Healthcare), Medical Consultancy Department, Gutenbergstr. 13, 10587 Berlin, Germany
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Pieper D, Puljak L, González-Lorenzo M, Minozzi S. Minor differences were found between AMSTAR 2 and ROBIS in the assessment of systematic reviews including both randomized and nonrandomized studies. J Clin Epidemiol 2019; 108:26-33. [DOI: 10.1016/j.jclinepi.2018.12.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/23/2018] [Accepted: 12/05/2018] [Indexed: 01/08/2023]
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An overview on the methodological and reporting quality of dose–response meta-analysis on cancer prevention. J Cancer Res Clin Oncol 2019; 145:1201-1211. [DOI: 10.1007/s00432-019-02869-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/19/2019] [Indexed: 12/22/2022]
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Methodological and reporting quality of systematic reviews referenced in the clinical practice guideline for pediatric high-blood pressure. J Hypertens 2019; 37:488-495. [DOI: 10.1097/hjh.0000000000001870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Chartres N, Bero LA, Norris SL. A review of methods used for hazard identification and risk assessment of environmental hazards. ENVIRONMENT INTERNATIONAL 2019; 123:231-239. [PMID: 30537638 DOI: 10.1016/j.envint.2018.11.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Approximately one quarter of all deaths globally are attributed to living or working in an unhealthy environment, with household and ambient air pollution, along with exposures to ultraviolet radiation and chemicals amongst the leading causes. At present there are no international standards for assessing the risks of these environmental hazards. The use of heterogeneous methods to identify health risks from environmental hazards may reduce the level of confidence the public has in the conclusions that are made. OBJECTIVES To describe and compare the processes and methods used by national and international organisations that conduct hazard identification and/or risk assessment (HI/RA) of environmental hazards and to identify knowledge gaps to inform the development of future methods. METHODS We searched the websites of 19 organisations (ten national, five international and four World Health Organization (WHO) units) and extracted data from all relevant, publicly available resources which described the processes and methods used in HI/RA of environmental hazards. We contacted each organisation for any additional information. RESULTS Five organisations were excluded from further analysis: three made recommendations but did not conduct HI/RA; one used heterogenous methods across their reviews for HI; and one WHO unit did not have any published guidelines. Of the 14 organisations analysed, five (36%) describe the process for establishing the questions to be answered in the assessments. Only one (7%) organisation uses systematic review methods, although five (36%) state that they use such methods. Ten (71%) assess the scientific quality of the included studies, however only three (21%) use explicit criteria. Only three (21%) organisations assess the quality of the body of evidence using explicit criteria. Four (29%) organisations describe the process for making the final HI conclusions and three (38%) the final RA conclusions. Eight (57%) have a conflict of interest policy and seven (50%) organisations describe a process for managing them. The US Office of Health Assessment and Translation and the World Health Organisation meet the most criteria for describing their processes and methods. CONCLUSIONS The processes and methods used by organisations conducting HI/RA of environmental hazards are inconsistent. There is a need for empirically based tools and methods to be adopted for the evaluation and synthesis of evidence, and the formulation of conclusions across all organisations that conduct HI or RA. These tools and methods will lead to increased transparency, comparability and validity of the assessments.
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Affiliation(s)
- Nicholas Chartres
- The University of Sydney, D17, The Hub, 6th floor, Charles Perkins Centre, NSW 2006, Australia.
| | - Lisa A Bero
- The University of Sydney, D17, The Hub, 6th floor, Charles Perkins Centre, NSW 2006, Australia.
| | - Susan L Norris
- Department of Innovation, Evidence and Research, World Health Organization, Av. Appia 20 CH-1211, Geneva 27, Switzerland.
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De Groot K, Triemstra M, Paans W, Francke AL. Quality criteria, instruments, and requirements for nursing documentation: A systematic review of systematic reviews. J Adv Nurs 2019; 75:1379-1393. [PMID: 30507044 DOI: 10.1111/jan.13919] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/11/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
AIM To obtain an overview of existing evidence on quality criteria, instruments, and requirements for nursing documentation. DESIGN Systematic review of systematic reviews. DATA SOURCES We systematically searched the databases PubMed and CINAHL for the period 2007-April 2017. We also performed additional searches. REVIEW METHODS Two reviewers independently selected the reviews using a stepwise procedure, assessed the methodological quality of the selected reviews, and extracted the data using a predefined extraction format. We performed descriptive synthesis. RESULTS Eleven systematic reviews were included. Several quality criteria were described referring to the importance of following the nursing process and using standardized nursing terminologies. In addition, some evidence-based instruments were described for assessing the quality of nursing documentation, such as the D-Catch. Furthermore, several requirements for formats and systems of electronic nursing documentation were found that refer to the importance of user-friendliness and development in consultation with nursing staff. CONCLUSION Aligning documentation with the nursing process, using standard terminologies, and using user-friendly formats and systems appear to be important for high-quality nursing documentation. The lack of evidence-based quality indicators presents a challenge in the pursuit of high-quality nursing documentation. IMPACT There is uncertainty in nursing practice about which criteria have to be met to achieve high-quality documentation. Aligning documentation with the nursing process, using standard terminologies, and using user-friendly formats and systems appear to be important. These findings can help nursing staff and care organizations enhance the quality of nursing documentation.
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Affiliation(s)
- Kim De Groot
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.,Thebe Wijkverpleging [Home care organisation], Tilburg, The Netherlands
| | - Mattanja Triemstra
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health research institute/VU Medical Centre, Amsterdam, The Netherlands
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Silva RDOS, Macêdo LA, Santos GAD, Aguiar PM, de Lyra DP. Pharmacist-participated medication review in different practice settings: Service or intervention? An overview of systematic reviews. PLoS One 2019; 14:e0210312. [PMID: 30629654 PMCID: PMC6328162 DOI: 10.1371/journal.pone.0210312] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 12/20/2018] [Indexed: 01/08/2023] Open
Abstract
Introduction Medication review (MR) is a pharmacy practice conducted in different settings that has a positive impact on patient health outcomes. In this context, systematic reviews on MR have restricted the assessment of this practice using criteria such as methodological quality, practice settings, and patient outcomes. Therefore, expanding research on this subject is necessary to facilitate the understanding of the effectiveness of MR and the comparison of its results. Aim To examine the panorama of systematic reviews on pharmacist-participated MR in different practice settings. Methods A literature search was undertaken in Biblioteca Virtual em Saúde (BVS), Embase, PubMed, Scopus, The Cochrane Library, and Web of Science databases through January 2018 using keywords for "medication review", "systematic review", and "pharmacist". Two independents investigators screened titles, abstracts, full texts; assessed methodological quality; and, extracted data from the included reviews. Results Seventeen systematic reviews were included, of which sixteen presented low to moderate methodological quality. Most of reviews were conducted in Europe (n = 7), included controlled primary studies (n = 16), elderly patients (n = 9), and long-term care facilities (n = 8). Seven reviews addressed MR as an intervention and thirteen reviews cited collaboration between physicians and pharmacists in the practice of MR. In addition, thirteen terminologies for MR were used and the main objective was to identify and solve drug-related problems and/or optimize the drug use (n = 11). Conclusion There is considerable heterogeneity in practice settings, population, definitions, terminologies, and approach of MR as well as poor description of patient care process in the systematic reviews. These facts may limit the comparison, summarization and understanding of the results of MR. Furthermore, the methodological quality of most systematic reviews was below ideal. Thus, international agreement on the MR process is necessary to assess, compare and optimize the quality of care provided.
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Affiliation(s)
- Rafaella de Oliveira Santos Silva
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Luana Andrade Macêdo
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Genival Araújo Dos Santos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Patrícia Melo Aguiar
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Divaldo Pereira de Lyra
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
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Methodological quality of systematic reviews on treatments for depression: a cross-sectional study. Epidemiol Psychiatr Sci 2018; 27:619-627. [PMID: 28462754 PMCID: PMC6998998 DOI: 10.1017/s2045796017000208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIMS Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments. METHODS A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis. RESULTS A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an 'a priori' design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report 'a priori' designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09-1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06-1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06-1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81-0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04-1.25), completed by more review authors (AOR 1.12, 95% CI 1.01-1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01-2.59) were associated with better performance in publication bias assessment. CONCLUSION The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.
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Medley N, Vogel JP, Care A, Alfirevic Z. Interventions during pregnancy to prevent preterm birth: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2018; 11:CD012505. [PMID: 30480756 PMCID: PMC6516886 DOI: 10.1002/14651858.cd012505.pub2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Preterm birth (PTB) is a major factor contributing to global rates of neonatal death and to longer-term health problems for surviving infants. Both the World Health Organization and the United Nations consider prevention of PTB as central to improving health care for pregnant women and newborn babies. Current preventative clinical strategies show varied efficacy in different populations of pregnant women, frustrating women and health providers alike, while researchers call for better understanding of the underlying mechanisms that lead to PTB. OBJECTIVES We aimed to summarise all evidence for interventions relevant to the prevention of PTB as reported in Cochrane systematic reviews (SRs). We intended to highlight promising interventions and to identify SRs in need of an update. METHODS We searched the Cochrane Database of Systematic Reviews (2 November 2017) with key words to capture any Cochrane SR that prespecified or reported a PTB outcome. Inclusion criteria focused on pregnant women without signs of preterm labour or ruptured amniotic membranes. We included reviews of interventions for pregnant women irrespective of their risk status. We followed standard Cochrane methods.We applied GRADE criteria to evaluate the quality of SR evidence. We assigned graphic icons to classify the effectiveness of interventions as: clear evidence of benefit; clear evidence of harm; clear evidence of no effect or equivalence; possible benefit; possible harm; or unknown benefit or harm. We defined clear evidence of benefit and clear evidence of harm to be GRADE moderate- or high-quality evidence with a confidence interval (CI) that does not cross the line of no effect. Clear evidence of no effect or equivalence is GRADE moderate- or high-quality evidence with a narrow CI crossing the line of no effect. Possible benefit and possible harm refer to GRADE low-quality evidence with a clear effect (CI does not cross the line of no effect) or GRADE moderate- or high-quality evidence with a wide CI. Unknown harm or benefit refers to GRADE low- or very low-quality evidence with a wide CI. MAIN RESULTS We included 83 SRs; 70 had outcome data. Below we highlight key results from a subset of 36 SRs of interventions intended to prevent PTB. OUTCOME preterm birthClear evidence of benefitFour SRs reported clear evidence of benefit to prevent specific populations of pregnant women from giving birth early, including midwife-led continuity models of care versus other models of care for all women; screening for lower genital tract infections for pregnant women less than 37 weeks' gestation and without signs of labour, bleeding or infection; and zinc supplementation for pregnant women without systemic illness. Cervical cerclage showed clear benefit for women with singleton pregnancy and high risk of PTB only.Clear evidence of harmNo included SR reported clear evidence of harm.No effect or equivalenceFor pregnant women at high risk of PTB, bedrest for women with singleton pregnancy and antibiotic prophylaxis during the second and third trimester were of no effect or equivalent to a comparator.Possible benefitFour SRs found possible benefit in: group antenatal care for all pregnant women; antibiotics for pregnant women with asymptomatic bacteriuria; pharmacological interventions for smoking cessation for pregnant women who smoke; and vitamin D supplements alone for women without pre-existing conditions such as diabetes.Possible harmOne SR reported possible harm (increased risk of PTB) with intramuscular progesterone, but this finding is only relevant to women with multiple pregnancy and high risk of PTB. Another review found possible harm with vitamin D, calcium and other minerals for pregnant women without pre-existing conditions. OUTCOME perinatal deathClear evidence of benefitTwo SRs reported clear evidence of benefit to reduce pregnant women's risk of perinatal death: midwife-led continuity models of care for all pregnant women; and fetal and umbilical Doppler for high-risk pregnant women.Clear evidence of harmNo included SR reported clear evidence of harm.No effect or equivalenceFor pregnant women at high risk of PTB, antibiotic prophylaxis during the second and third trimester was of no effect or equivalent to a comparator.Possible benefitOne SR reported possible benefit with cervical cerclage for women with singleton pregnancy and high risk of PTB.Possible harmOne SR reported possible harm associated with a reduced schedule of antenatal visits for pregnant women at low risk of pregnancy complications; importantly, these women already received antenatal care in settings with limited resources. OUTCOMES preterm birth and perinatal deathUnknown benefit or harmFor pregnant women at high risk of PTB for any reason including multiple pregnancy, home uterine monitoring was of unknown benefit or harm. For pregnant women at high risk due to multiple pregnancy: bedrest, prophylactic oral betamimetics, vaginal progesterone and cervical cerclage were all of unknown benefit or harm. AUTHORS' CONCLUSIONS Implications for practiceThe overview serves as a map and guide to all current evidence relevant to PTB prevention published in the Cochrane Library. Of 70 SRs with outcome data, we identified 36 reviews of interventions with the aim of preventing PTB. Just four of these SRs had evidence of clear benefit to women, with an additional four SRs reporting possible benefit. No SR reported clear harm, which is an important finding for women and health providers alike.The overview summarises no evidence for the clinically important interventions of cervical pessary, cervical length assessment and vaginal progesterone because these Cochrane Reviews were not current. These are active areas for PTB research.The graphic icons we assigned to SR effect estimates do not constitute clinical guidance or an endorsement of specific interventions for pregnant women. It remains critical for pregnant women and their healthcare providers to carefully consider whether specific strategies to prevent PTB will be of benefit for individual women, or for specific populations of women.Implications for researchFormal consensus work is needed to establish standard language for overviews of reviews and to define the limits of their interpretation.Clinicians, researchers and funders must address the lack of evidence for interventions relevant to women at high risk of PTB due to multiple pregnancy.
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Affiliation(s)
- Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | - Joshua P Vogel
- Burnet InstituteMaternal and Child Health85 Commercial RoadMelbourneAustralia
| | - Angharad Care
- The University of LiverpoolDepartment of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | - Zarko Alfirevic
- The University of LiverpoolDepartment of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Tonin FS, Borba HH, Leonart LP, Mendes AM, Steimbach LM, Pontarolo R, Fernandez-Llimos F. Methodological quality assessment of network meta-analysis of drug interventions: implications from a systematic review. Int J Epidemiol 2018; 48:620-632. [DOI: 10.1093/ije/dyy197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
| | - Helena H Borba
- Department of Pharmacy, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | - Roberto Pontarolo
- Department of Pharmacy, Universidade Federal do Paraná, Curitiba, Brazil
| | - Fernando Fernandez-Llimos
- Department of Social Pharmacy, Research Institute for Medicines (iMed.ULisboa), Universidade de Lisboa, Lisbon, Portugal
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Saletta JM, Garcia JJ, Caramês JMM, Schliephake H, da Silva Marques DN. Quality assessment of systematic reviews on vertical bone regeneration. Int J Oral Maxillofac Surg 2018; 48:364-372. [PMID: 30139710 DOI: 10.1016/j.ijom.2018.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/08/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti's method® and Cohen's kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean ±95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson's correlation coefficient=-0.84; P<0.01). Cohen's inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.
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Affiliation(s)
- J M Saletta
- Implant Department, Universidad Europea de Madrid, Madrid, Spain
| | - J J Garcia
- Implant Department, Universidad Europea de Madrid, Madrid, Spain; CIRO, Madrid, Spain
| | - J M M Caramês
- Oral Surgery and Implant Department, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Implantology Institute, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - H Schliephake
- Department of Oral and Maxillofacial Surgery, University Medicine, George-Augusta-University, Göttingen, Germany
| | - D N da Silva Marques
- Implantology Institute, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Centro de Estudos de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
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Zhang F, Shen A, Jin Y, Qiang W. The management strategies of cancer-associated anorexia: a critical appraisal of systematic reviews. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:236. [PMID: 30092794 PMCID: PMC6085669 DOI: 10.1186/s12906-018-2304-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/01/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer-related anorexia remains one of the most prevalent and troublesome clinical problems experienced by patients with cancer during and after therapy. To ensure high-quality care, systematic reviews (SRs) are seen as the best guide. Considering the methodology quality of SRs varies, we undertook a comprehensive overview, and critical appraisal of pertinent SRs. METHODS Eight databases (between the inception of each database and September 1, 2017) were searched for SRs on the management of cancer-related anorexia. Two researchers evaluated the methodological quality of each SR by using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Characteristics of the "high quality" SRs were abstracted, included information on relevant studies numbers, study design, population, intervention, control, outcome and result. RESULTS Eighteen SRs met the inclusion criteria. The R-AMSTAR scores of methodological quality ranged from 18 to 41 out of 44, with an average score of 30. Totally eight SRs scored ≥31 points, which showed high methodological quality, and would be used for data extraction to make summaries. Anamorelin had some positive effects to relieve cancer anorexia-cachexia syndrome (CACS) and improve the quality of life (QoL). Megestrol Acetate (MA) could improve appetite, and was associated with slight weight gain for CACS. Oral nutritional interventions were effective in increasing nutritional intake and improving some aspects of QoL in patients with cancer who were malnourished or at nutritional risk. The use of thalidomide, Eicosapentaenoic Acid, and minerals, vitamins, proteins, or other supplements for the treatment of cachexia in cancer were uncertain, and there was inadequate evidence to recommend it to clinical practices, the same situation in Chinese Herb Medicine and acupuncture (acupuncture and related therapies were effective in improving QoL) for treating anorexia in cancer patients, warranting further RCTs in these areas. CONCLUSIONS Anamorelin, MA, oral nutrition interventions, and acupuncture could be considered to be applied in patients with cancer-related anorexia. Future RCTs and SRs with high quality on the pharmaceutical or non-pharmaceutical interventions of anorexia in cancer patients are warranted.
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Affiliation(s)
- Fangyuan Zhang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, CN, Hexi District, 1 West Lake Road, Tianjin, China
| | - Aomei Shen
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, CN, Hexi District, 1 West Lake Road, Tianjin, China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, CN, Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China
| | - Wanmin Qiang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, CN, Hexi District, 1 West Lake Road, Tianjin, China
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Pieper D, Koensgen N, Breuing J, Ge L, Wegewitz U. How is AMSTAR applied by authors - a call for better reporting. BMC Med Res Methodol 2018. [PMID: 29914386 DOI: 10.1186/s12874‐018‐0520‐z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The assessment of multiple systematic reviews (AMSTAR) tool is widely used for investigating the methodological quality of systematic reviews (SR). Originally, AMSTAR was developed for SRs of randomized controlled trials (RCTs). Its applicability to SRs of other study designs remains unclear. Our objectives were to: 1) analyze how AMSTAR is applied by authors and (2) analyze whether the authors pay attention to the original purpose of AMSTAR and for what it has been validated. METHODS We searched MEDLINE (via PubMed) from inception through October 2016 to identify studies that applied AMSTAR. Full-text studies were sought for all retrieved hits and screened by one reviewer. A second reviewer verified the excluded studies (liberal acceleration). Data were extracted into structured tables by one reviewer and were checked by a second reviewer. Discrepancies at any stage were resolved by consensus or by consulting a third person. We analyzed the data descriptively as frequencies or medians and interquartile ranges (IQRs). Associations were quantified using the risk ratio (RR), with 95% confidence intervals. RESULTS We identified 247 studies. They included a median of 17 reviews (interquartile range (IQR): 8 to 47) per study. AMSTAR was modified in 23% (57/247) of studies. In most studies, an AMSTAR score was calculated (200/247; 81%). Methods for calculating an AMSTAR score varied, with summing up all yes answers (yes = 1) being the most frequent option (102/200; 51%). More than one third of the authors failed to report how the AMSTAR score was obtained (71/200; 36%). In a subgroup analysis, we compared overviews of reviews (n = 154) with the methodological publications (n = 93). The overviews of reviews were much less likely to mention both limitations with respect to study designs (if other studies other than RCTs were included in the reviews) (RR 0.27, 95% CI 0.09 to 0.75) and overall score (RR 0.08, 95% CI 0.02 to 0.35). CONCLUSIONS Authors, peer reviewers, and editors should pay more attention to the correct use and reporting of assessment tools in evidence synthesis. Authors of overviews of reviews should ensure to have a methodological expert in their review team.
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Affiliation(s)
- Dawid Pieper
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
| | - Nadja Koensgen
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Jessica Breuing
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Long Ge
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences of Lanzhou University, Lanzhou, 730000, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
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Pieper D, Koensgen N, Breuing J, Ge L, Wegewitz U. How is AMSTAR applied by authors - a call for better reporting. BMC Med Res Methodol 2018; 18:56. [PMID: 29914386 PMCID: PMC6006845 DOI: 10.1186/s12874-018-0520-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 06/10/2018] [Indexed: 12/15/2022] Open
Abstract
Background The assessment of multiple systematic reviews (AMSTAR) tool is widely used for investigating the methodological quality of systematic reviews (SR). Originally, AMSTAR was developed for SRs of randomized controlled trials (RCTs). Its applicability to SRs of other study designs remains unclear. Our objectives were to: 1) analyze how AMSTAR is applied by authors and (2) analyze whether the authors pay attention to the original purpose of AMSTAR and for what it has been validated. Methods We searched MEDLINE (via PubMed) from inception through October 2016 to identify studies that applied AMSTAR. Full-text studies were sought for all retrieved hits and screened by one reviewer. A second reviewer verified the excluded studies (liberal acceleration). Data were extracted into structured tables by one reviewer and were checked by a second reviewer. Discrepancies at any stage were resolved by consensus or by consulting a third person. We analyzed the data descriptively as frequencies or medians and interquartile ranges (IQRs). Associations were quantified using the risk ratio (RR), with 95% confidence intervals. Results We identified 247 studies. They included a median of 17 reviews (interquartile range (IQR): 8 to 47) per study. AMSTAR was modified in 23% (57/247) of studies. In most studies, an AMSTAR score was calculated (200/247; 81%). Methods for calculating an AMSTAR score varied, with summing up all yes answers (yes = 1) being the most frequent option (102/200; 51%). More than one third of the authors failed to report how the AMSTAR score was obtained (71/200; 36%). In a subgroup analysis, we compared overviews of reviews (n = 154) with the methodological publications (n = 93). The overviews of reviews were much less likely to mention both limitations with respect to study designs (if other studies other than RCTs were included in the reviews) (RR 0.27, 95% CI 0.09 to 0.75) and overall score (RR 0.08, 95% CI 0.02 to 0.35). Conclusions Authors, peer reviewers, and editors should pay more attention to the correct use and reporting of assessment tools in evidence synthesis. Authors of overviews of reviews should ensure to have a methodological expert in their review team.
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Affiliation(s)
- Dawid Pieper
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
| | - Nadja Koensgen
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Jessica Breuing
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Long Ge
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences of Lanzhou University, Lanzhou, 730000, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
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Ribeiro ELA, de Mendonça Lima T, Vieira MEB, Storpirtis S, Aguiar PM. Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews. Eur J Clin Pharmacol 2018; 74:1215-1233. [PMID: 29905899 DOI: 10.1007/s00228-018-2498-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 05/31/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To conduct an overview to summarize the efficacy and safety of aripiprazole for the treatment of schizophrenia. METHODS A literature search was performed in PubMed, the Cochrane Library, LILACS, and the Centre for Reviews and Dissemination, for articles published until March 31, 2017. We included systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy, and/or the safety of aripiprazole, for patients with schizophrenia. Two authors independently performed the study selection, data extraction, and quality assessment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the Risk of Bias in Systematic Review (ROBIS) tool were used to appraise the quality of evidence and the risk of bias in the reviews, respectively. RESULTS Fourteen studies fulfilled the inclusion criteria. Aripiprazole showed efficacy similar to that of both typical and atypical antipsychotic drugs (except olanzapine and amisulpride). Aripiprazole caused significantly lower weight gain and alterations in glucose and cholesterol levels, as compared to clozapine, risperidone, and olanzapine. In addition, aripiprazole caused significantly fewer general extrapyramidal side effects, less use of antiparkinsonian drugs, and akathisia, compared with typical antipsychotic drugs and risperidone. The overall quality of evidence in the reviews ranged from "very low" to "moderate," principally because of the risk of bias of original trials, inconsistency, and imprecision in the outcomes. According to the ROBIS tool, there are four reviews with "high" risk of bias and five with "unclear" risk of bias. CONCLUSIONS Aripiprazole exhibited efficacy similar to that of other antipsychotic drugs and a better safety profile than that of typical (i.e., less some extrapyramidal side effects) and atypical (i.e., less metabolic changes) antipsychotic drugs.
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Affiliation(s)
- Esther Letícia Amorim Ribeiro
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | - Tácio de Mendonça Lima
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | | | - Sílvia Storpirtis
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | - Patricia Melo Aguiar
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil.
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Faggion CM, Monje A, Wasiak J. Appraisal of systematic reviews on the management of peri-implant diseases with two methodological tools. J Clin Periodontol 2018; 45:754-766. [DOI: 10.1111/jcpe.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry; Faculty of Dentistry; University of Münster; Münster Germany
| | - Alberto Monje
- Department of Periodontology; Universidad Internacional de Cataluña; Barcelona Spain
| | - Jason Wasiak
- Faculty of Medicine; Melbourne School of Health Sciences; University of Melbourne; Melbourne Vic. Australia
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Banzi R, Cinquini M, Gonzalez-Lorenzo M, Pecoraro V, Capobussi M, Minozzi S. Quality assessment versus risk of bias in systematic reviews: AMSTAR and ROBIS had similar reliability but differed in their construct and applicability. J Clin Epidemiol 2018. [PMID: 29526556 DOI: 10.1016/j.jclinepi.2018.02.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The objective of the study was to assess the inter-rater reliability (IRR) of AMSTAR and ROBIS in judging individual domains and overall methodological quality/risk of bias of systematic reviews, the concurrent validity of the tools, and the time required to apply them. STUDY DESIGN AND SETTING This is a cross-sectional study. Five raters independently read 31 systematic reviews and applied AMSTAR and ROBIS. Fleiss' k for multiple raters for individual domains and overall methodological quality/risk of bias was calculated. Similar domains assessed by both tools and final scores were matched to explore the concurrent validity, using the Kendall tau correlation. RESULTS IRR ranged from fair to perfect for AMSTAR and from moderate to substantial for ROBIS. Kappa for overall quality/risk of bias was 0.73 (95% confidence interval [CI] 0.65-0.81) for AMSTAR and 0.64 (95% CI 0.54-0.74) for ROBIS. We judged most of the reviews at intermediate quality with AMSTAR (53%), while judgments were split in high (53%) and low (47%) risk of bias with ROBIS. The correlation between judgments on similar domains ranged from moderate to high, while it was fair on the overall judgment (K = 0.35, 95% CI 0.21-0.49). The mean time to complete ROBIS was about double that for AMSTAR. CONCLUSION AMSTAR and ROBIS offer similar IRR but differ in their construct and applicability.
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Affiliation(s)
- Rita Banzi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
| | - Michela Cinquini
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Valentina Pecoraro
- Ospedale Civile S. Agostino Estense, Azienda USL of Modena, Modena, Italy
| | - Matteo Capobussi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358:j4008. [PMID: 28935701 PMCID: PMC5833365 DOI: 10.1136/bmj.j4008] [Citation(s) in RCA: 4521] [Impact Index Per Article: 645.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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Affiliation(s)
- Beverley J Shea
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - George Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- University of Ottawa Heart Institute, Ottawa, Canada
| | - Micere Thuku
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
| | - Candyce Hamel
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
| | - Julian Moran
- The Hospital for Sick Children, the Genetics and Genome Biology Program, Toronto, Canada
| | - David Moher
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Vivian Welch
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Elizabeth Kristjansson
- Centre for Research in Educational and Community Services, School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - David A Henry
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
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Hasan H, Muhammed T, Yu J, Taguchi K, Samargandi OA, Howard AF, Lo AC, Olson R, Goddard K. "Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review". Cancer Epidemiol 2017; 50:141-149. [PMID: 28915472 DOI: 10.1016/j.canep.2017.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/22/2017] [Accepted: 08/22/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. METHODS A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. RESULTS Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. CONCLUSIONS Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review.
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Affiliation(s)
- Haroon Hasan
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada.
| | - Taaha Muhammed
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Jennifer Yu
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada
| | - Kelsi Taguchi
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada
| | - Osama A Samargandi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah, Saudi Arabia; Division of Plastic and Reconstructive Surgery, Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, B3H 4R2, Canada
| | - A Fuchsia Howard
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Andrea C Lo
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada; Department of Surgery, Faculty of Medicine, 950 West 10th. Avenue, Vancouver, British Columbia, V5Z 1M9, Canada
| | - Robert Olson
- British Columbia Cancer Agency - Centre for the North, 1215 Lethbridge Street, Prince George, British Columbia, V2M 7E9, Canada; Department of Surgery, Faculty of Medicine, 950 West 10th. Avenue, Vancouver, British Columbia, V5Z 1M9, Canada
| | - Karen Goddard
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada; Department of Surgery, Faculty of Medicine, 950 West 10th. Avenue, Vancouver, British Columbia, V5Z 1M9, Canada
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Gómez-García F, Ruano J, Gay-Mimbrera J, Aguilar-Luque M, Sanz-Cabanillas JL, Alcalde-Mellado P, Maestre-López B, Carmona-Fernández PJ, González-Padilla M, García-Nieto AV, Isla-Tejera B. Most systematic reviews of high methodological quality on psoriasis interventions are classified as high risk of bias using ROBIS tool. J Clin Epidemiol 2017; 92:79-88. [PMID: 28893571 DOI: 10.1016/j.jclinepi.2017.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/14/2017] [Accepted: 08/22/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES No gold standard exists to assess methodological quality of systematic reviews (SRs). Although Assessing the Methodological Quality of Systematic Reviews (AMSTAR) is widely accepted for analyzing quality, the ROBIS instrument has recently been developed. This study aimed to compare the capacity of both instruments to capture the quality of SRs concerning psoriasis interventions. STUDY DESIGN AND SETTING Systematic literature searches were undertaken on relevant databases. For each review, methodological quality and bias risk were evaluated using the AMSTAR and ROBIS tools. Descriptive and principal component analyses were conducted to describe similarities and discrepancies between both assessment tools. RESULTS We classified 139 intervention SRs as displaying high/moderate/low methodological quality and as high/low risk of bias. A high risk of bias was detected for most SRs classified as displaying high or moderate methodological quality by AMSTAR. When comparing ROBIS result profiles, responses to domain 4 signaling questions showed the greatest differences between bias risk assessments, whereas domain 2 items showed the least. CONCLUSION When considering SRs published about psoriasis, methodological quality remains suboptimal, and the risk of bias is elevated, even for SRs exhibiting high methodological quality. Furthermore, the AMSTAR and ROBIS tools may be considered as complementary when conducting quality assessment of SRs.
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Affiliation(s)
- Francisco Gómez-García
- Department of Dermatology, Reina Sofía University Hospital, 14004 Córdoba, Spain; IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Juan Ruano
- Department of Dermatology, Reina Sofía University Hospital, 14004 Córdoba, Spain; IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain.
| | - Jesus Gay-Mimbrera
- IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | | | - Juan Luis Sanz-Cabanillas
- Department of Dermatology, Reina Sofía University Hospital, 14004 Córdoba, Spain; IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Patricia Alcalde-Mellado
- IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain; School of Medicine, University of Cordoba, 14004 Córdoba, Spain
| | - Beatriz Maestre-López
- IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain; School of Medicine, University of Cordoba, 14004 Córdoba, Spain
| | | | - Marcelino González-Padilla
- Department of Dermatology, Reina Sofía University Hospital, 14004 Córdoba, Spain; IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Antonio Vélez García-Nieto
- Department of Dermatology, Reina Sofía University Hospital, 14004 Córdoba, Spain; IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Beatriz Isla-Tejera
- IMIBIC, Reina Sofía University Hospital, University of Cordoba, 14004 Córdoba, Spain; Department of Pharmacy, Reina Sofía University Hospital, 14004 Córdoba, Spain
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Ross A, Rankin J, Beaman J, Murray K, Sinnett P, Riddle R, Haskins J, Vassar M. Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder. PLoS One 2017; 12:e0181927. [PMID: 28771633 PMCID: PMC5542448 DOI: 10.1371/journal.pone.0181927] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/27/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION With efforts to combat opioid use disorder, there is an increased interest in clinical practice guidelines (CPGs) for opioid use disorder treatments. No literature exists examining the quality of systematic reviews used in opioid use disorder CPGs. This study aims to describe the methodological quality and reporting clarity of systematic reviews (SRs) used to create CPGs for opioid use disorder. METHODS From June to July 2016 guideline clearinghouses and medical literature databases were searched for relevant CPGs used in the treatment of opioid use disorder. Included CPGs must have been recognized by a national organization. SRs from the reference section of each CPG was scored by using AMSTAR (a measurement tool to assess the methodological quality of systematic reviews) tool and PRISMA (preferred reporting items for systematic reviews and meta-analyses) checklist. RESULTS Seventeen CPGs from 2006-2016 were included in the review. From these, 57 unique SRs were extracted. SRS comprised 0.28% to 17.92% of all references found in the CPGs. All SRs obtained moderate or high methodological quality score on the AMSTAR tool. All reviews met at least 70% of PRISMA criteria. In PRISMA, underperforming areas included accurate title labeling, protocol registration, and risk of bias. Underperforming areas in AMSTAR included conflicts of interest, funding, and publication bias. A positive correlation was found between AMSTAR and PRISMA scores (r = .79). CONCLUSION Although the SRs in the CPGs were of good quality, there are still areas for improvement. Systematic reviewers should consult PRISMA and AMSTAR when conducting and reporting reviews. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations, recognizing that the quality of systematic reviews underpinning guidelines does not necessarily correspond to the quality of the guideline itself.
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Affiliation(s)
- Andrew Ross
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Justin Rankin
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Jason Beaman
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Kelly Murray
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Philip Sinnett
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Ross Riddle
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Jordan Haskins
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States of America
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The measurement properties of pediatric observational pain scales: A systematic review of reviews. Int J Nurs Stud 2017; 73:93-101. [DOI: 10.1016/j.ijnurstu.2017.05.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/23/2017] [Accepted: 05/15/2017] [Indexed: 01/05/2023]
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Pollock A, Campbell P, Brunton G, Hunt H, Estcourt L. Selecting and implementing overview methods: implications from five exemplar overviews. Syst Rev 2017; 6:145. [PMID: 28720141 PMCID: PMC5516331 DOI: 10.1186/s13643-017-0534-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/28/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Overviews of systematic reviews are an increasingly popular method of evidence synthesis; there is a lack of clear guidance for completing overviews and a number of methodological challenges. At the UK Cochrane Symposium 2016, methodological challenges of five overviews were explored. Using data from these five overviews, practical implications to support methodological decision making of authors writing protocols for future overviews are proposed. METHODS Methods, and their justification, from the five exemplar overviews were tabulated and compared with areas of debate identified within current literature. Key methodological challenges and implications for development of overview protocols were generated and synthesised into a list, discussed and refined until there was consensus. RESULTS Methodological features of three Cochrane overviews, one overview of diagnostic test accuracy and one mixed methods overview have been summarised. Methods of selection of reviews and data extraction were similar. Either the AMSTAR or ROBIS tool was used to assess quality of included reviews. The GRADE approach was most commonly used to assess quality of evidence within the reviews. Eight key methodological challenges were identified from the exemplar overviews. There was good agreement between our findings and emerging areas of debate within a recent published synthesis. Implications for development of protocols for future overviews were identified. CONCLUSIONS Overviews are a relatively new methodological innovation, and there are currently substantial variations in the methodological approaches used within different overviews. There are considerable methodological challenges for which optimal solutions are not necessarily yet known. Lessons learnt from five exemplar overviews highlight a number of methodological decisions which may be beneficial to consider during the development of an overview protocol.
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Affiliation(s)
- Alex Pollock
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Research Unit, 6th Floor Govan Mbeki Building, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Pauline Campbell
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Research Unit, 6th Floor Govan Mbeki Building, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Ginny Brunton
- UCL Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL UK
| | - Harriet Hunt
- University of Exeter Medical School, St Luke’s campus, Exeter, Devon EX1 1TE UK
| | - Lise Estcourt
- NHS Blood and Transplant Oxford and Radcliffe Department of Medicine, University of Oxford, Level 2, John Radcliffe Hospital, Oxford, OX3 9BQ UK
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