ObjectivesTo assess the methodological and reporting quality of surgical meta-analyses published in English in 2014.MethodsAll meta-analyses investigating surgical procedures published in 2014 were selected from PubMed and EMbase. The characteristics of these meta-analyses were collected, and their reporting and methodological quality were assessed by the PRISMA and AMSTAR, respectively. Independent predictive factors associated with these two qualities were evaluated by univariate and multivariate analyses.ResultsA total of 197 meta-analyses covering 10 surgical subspecialties were included. The mean PRISMA and AMSTAR score (by items) were 22.2±2.4 and 7.8±1.2, respectively, and a positive linear correlation was found between them with a R2 of 0.754. Those meta-analyses conducted by the first authors who had previously published meta-analysis was significantly higher in reporting and methodological quality than those who had not (P<0.001). Meanwhile, there were also significant differences in these reporting (P<0.001) and methodological (P<0.001) quality between studies published in Q1 ranked journals and (Q2+Q3) ranked jounals. On multivariate analyses, region of origin (non-Asiavs. Asia), publishing experience of first authors (ever vs. never), rank of publishing journals (Q1 vs. Q2+Q3), and preregistration (presence vs. absence) were associated with better reporting and methodologic quality, independently.ConclusionThe reporting and methodological quality of current surgical meta-analyses remained suboptimal, and first authors' experience and ranking of publishing journals were independently associated with both qualities. Preregistration may be an effective measure to improve the quality of meta-analysis, which deserves more attention from future meta-analysis reviewers.
Objective
To assess the methodological quality and reporting quality of meta-analysis published in Chinese Acupuncture & Moxibustion.
Methods
We searched CNKI database to collect meta-analysis published in Chinese Acupuncture & Moxibustion up to 2015. Methodological quality assessment was carried out using AMSTAR tool, and quality assessment was carried out by PRISMA checklist. Data analysis was performed by using SPSS 19.0 software.
Results
A total of 31 meta-analyses were enrolled. Among all the 31 meta-analyses, the first authors came from 19 institutions, and 21 meta-analysis were supported by fundings. All meta-analyses were about the evaluations of acupuncture intervention, involving 10 disease systems (ICD-10) and sub-health. The mean score of the methodological assessment was 7.42±1.13. In addition, the mean score of reporting quality was 18.79±2.04.
Conclusion
The meta-analyses published in Chinese Acupuncture & Moxibustion have high quality on methodology as well as reporting. Due to the limited quality and quantity of included studies, the above results are needed to be further assessed by more studies.
ObjectiveTo overview the systematic reviews on efficacy and safety of hyperbaric oxygen in treatment of diabetic foot.MethodsCNKI, CBM, VIP, WanFang Data, The Cochrane Library, PubMed and EMbase databases were searched to collect systematic reviews or meta-analyses on the efficacy and safety of hyperbaric oxygen therapy for diabetic foot from inception to November 17th, 2019. Two researchers independently screened literature and extracted data. Then, AMSTAR 2 tool and PRISMA statement were used to evaluate the methodological quality and reporting quality of included systematic reviews, and the outcome indicators were comprehensively analyzed.ResultsA total of 10 systematic reviews were included. The results of AMSTAR 2 suggested that 6 systematic reviews were of extremely low quality, 3 of low quality, and 1 of high quality. The PRISMA score ranged from 16.5 to 27. The results of the included systematic reviews showed that hyperbaric oxygen therapy might be superior to other interventions in ulcer healing rate and large amputation rate without increasing the risk of adverse events. ConclusionsThe existing systematic reviews/meta-analysis evidence shows that hyperbaric oxygen therapy may have certain curative effect on diabetic foot, however, its methodology and report quality evaluation are insufficient.
ObjectivesTo overview the systematic reviews/meta-analyses (SRs/MAs) of effectiveness and safety of spinal manipulation for low back pain or neck pain.
MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015), CBM, CNKI, WanFang Data and VIP to collect SRs/MAs of spinal manipulation for low back pain or neck pain from inception to January 30th, 2015. Two reviewers independently screened literature, extracted data, and then AMSTAR tool was used to assess the methodological quality of included SRs/MAs.
ResultsA total of 21 SRs/MAs were included. Twenty of them assessed the methodological quality of included original randomized controlled trials (RCTs) with different tools:2 used Jadad scale, 5 used PEDro scale, 6 used Cochrane bias risk assessment tool and 7 used other tools. The assessment results of AMSTAR tool suggested that:among 11 items, the item 1 of "Was an ‘a priori’ design provided" (18 SRs/MAs did not provide) and item 4 of "Was a list of studies (included and excluded) provided" (18 SRs/MAs did not provide) appeared to be the most problematic, followed by item 10 of "Was the likelihood of publication bias assessed" (14 SRs/MAs did not assess the publication bias) and item 11 of "Was the conflict of interest stated" (14 SRs/MAs did not provide the conflict of interest and 4 were incomplete).
ConclusionThe methodological quality of included SRs/MAs is poor. The limited evidence showed that spinal manipulation is more effective for acute low back pain than chronic low back pain, and the short term effect is better than the long term one. Different spinal manipulation techniques have various effects but are all safe. Chiropractic manipulation may have the best effect. Due to the limitation of quality and quantity of included SRs/MAs, there may be potential bias in the above conclusion that needs more high quality studies to verify.
ObjectiveTo overview the systematic reviews/meta-analyses (SRs/MAs) of efficacy and safety of dipeptidyl peptidase-4 inhibitors (DPP-4) in treatment of type 2 diabetes mellitus (T2DM).MethodsDatabase including The Cochrane Library, PubMed, EMbase, CBM, WanFang Data and CNKI were searched from inception to December 2016 to collect SRs/MAs of randomized controlled trials (RCTs) of DPP-4 for the treatment of T2DM. Two reviewers independently screened literature, extracted data, and evaluated the reporting and methodological qualities using the PRISMA checklist and the AMSTAR tool.ResultsTwenty-seven SRs/MAs of DPP-4 for the treatment of T2DM were included in this overview. The average score of AMSTAR was 7.04. The worst score were the item 1 (26 studies didn't provide an ‘a priori’ design), item 4 (10 studies didn't provide whether the status of publication used as an inclusion criterion?), item 10 and item 11 (15 studies didn't assess the likelihood of publication bias and the potential conflicts of interest). The PRISMA score ranged from 17.0 to 24.5. The main problems of reporting were protocol and registration, search, additional analyses and funding.ConclusionThe evidence shows that the reporting and methodological quality of the SRs/MAs of DPP-4 inhibitors for type 2 diabetes are not high.
ObjectivesTo conduct an overview of systematic reviews (SRs) on Tuina from 2013 to 2017, and to explore recent research improvements on Tuina.MethodsPubMed, Web of Science, The Cochrane Library, SpringerLink e-book database, CNKI, VIP, WanFang Data and CBM databases were searched to collect SRs including randomized controlled clinical trials on Tuina from January 1st, 2013 to December 31st, 2017. Two reviewers independently screened literature, extracted data, and used AMSTAR 2 tool and PRISMA statement to assess methodology quality and reporting quality of included studies, respectively. The R 3.4.3 software was used to analyze data.ResultsA total of 8 SRs studies were included in the overview. The studied diseases involved radiculopathy cervical spondylotic, myelopathy cervical spondylotic, constipation, child anorexia, child diarrhea and external humeral epicondylitis. The results of above SRs showed that massage might be superior to other interventions in clinical efficacy, curative effects or total effective rate. However, due to the low quality of included studies of SRs, further evidence from high-quality clinical studies is required to verify above conclusions. For the results of AMSTAR 2 assessment, all 8 SRs were rated as very low quality. The quantity of items accomplished for each SR ranged from 7 to 13, 2 SRs had low methodological quality (percentage of accomplishment or partial accomplishment <50.0%) and 6 SRs with high methodological quality (percentage of accomplishment or partial accomplishment ≥50.0%). All 8 SRs did not report item 2 "Whether to declare research methods", item 10 "Whether reports have included funding sources for each study" and item 11 "Whether reports used the correct statistical method". The results of PRISMA assessment showed that all SR had good quality of reporting. The accomplished items number of each SR ranged from 22 to 26. However, there were defects in item 5(0), item 16(25.0%) and item 23(25.0%). All SRs did not report item 5 "Whether to declare research program".ConclusionsThis study finds that Tuina has supportive evidence-based medical evidence for treating anorexia, cervical spondylosis and other diseases, however, the SRs of Tuina are yet needed to be improved in terms of standardized degree. Therefore, establishing a reporting consolidated standard for evidence-based medicine on Tuina in order to improve the quality of clinical studies so as to provide clinicians with high-quality evidence is the focus of our further research.
ObjectiveTo overview the reporting and methodology quality of systematic reviews/meta-analysis on acupuncture in the treatment of primary osteoporosis (POP).MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect systematic reviews/meta-analysis on acupuncture in the treatment of POP from inception to July 2018. Two reviewers independently screened literature, extracted data, and assessed the quality of systematic reviews. A Measurement Tool to Assess Systematic Reviews (AMSTAR) methodological quality score and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used to assess the methodological quality and reporting quality of the systematic reviews, along with the risk of homogeneity and publication bias.ResultsA total of 11 systematic reviews/meta-analysis were included and multiple evaluations of the radar plot showed that the quality average rank scored 7.68. The major problems in studies were lack of items registration, imperfect search strategies and selection bias and so on.ConclusionThe quality of systematic reviews/meta-analysis of acupuncture in the treatment of POP is insufficient, indicating that the methodological and reporting quality of systematic reviews should be further strengthened.
Objectives To evaluate the methodological bias and the reliability of the conclusions of systematic reviews (SRs) on urate-lowering therapy (ULT) for chronic gout. Methods PubMed, EMbase, The Cochrane Library, Epistemonikos, CBM, WanFang Data and CNKI databases were electronically searched to collect published systematic reviews and meta-analyses evaluating urate-lowering drugs in chronic gout from inception to April 8th 2017. Two reviewers independently screened literature, extracted data, assessed the methodological quality of included SRs using the AMSTAR tool, and assessed the quality of the body of evidence for each outcome using the GRADE approach. Results A total of 11 relevant SRs/Mets were included, containing 3 main outcome measures. All these SRs contained allopurinol. Ten SRs contained febuxostat, 3 SRs contained benzbromarone and 1 SR contained probenecid. Ten SRs assessed the risk of bias of included original studies. Eight SRs used the" assessing risk of bias”tool recommended by Cochrane Collaboration for this assessment while 2 used other tools. The assessment results of AMSTAR tool showed: the scores of 4 SRs were ≥9, and the others were ≤8. GRADE results showed: the quality of the evidence of 20 outcomes was low or very low, 10 outcomes was moderate and two outcomes was high. Conclusions Moderate quality evidence shows that febuxostat is beneficial in achieving target serum uric acid levels when comparing to allopurinol, and high quality evidence shows the incidence of gout flares is not significantly different between the two groups. High quality evidence also shows that the safety of febuxostat is better than allopurinol. Evidence of SRs is still insufficient to support the effectiveness and safety of other urate-lowering drugs. It is expected that more scientific and rigorous researches will be performed in the future, for which more high quality evidence will be produced to fill relevant gaps.
Objective To overview the systematic reviews/meta-analysis (SR/MA) for the effectiveness of yoga on patients with type 2 diabetes mellitus. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Cochrane Library, Embase, Web of Science, JBI and CINAHL databases were electronically searched to collect SR/MA on the intervention of yoga in diabetes mellitus from inception to November 6th, 2023. Two researchers independently screened the literature and extracted data. AMSTAR was used to evaluate the quality of methodology, and GRADE was used to evaluate the certainty of evidence, and the outcome indicators were statistically analyzed. Results A total of 14 SR/MA were included. The evaluation results of AMSTAR showed that 7 articles were of high quality and 7 articles were of moderate quality. The result of GRADE showed that there were 2 items of high-level evidence, 26 items of intermediate evidence, and the remaining 31 items were low-level or very low-level evidence. The results showed that yoga could significantly reduce fasting blood glucose (FBG) (moderate confidence), glycosylated hemoglobin (HA1C) (moderate confidence) and postprandial blood glucose (PPBG) levels (moderate confidence), and was also superior to other interventions in high-density cholesterol (HDL) (moderate confidence), low-density cholesterol (LDL) (moderate confidence), triglyceride (TG) (moderate confidence), total cholesterol (TC) (moderate confidence), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (moderate confidence), muscle strength (high confidence), cardiorespiratory fitness (moderate confidence) and weight (moderate confidence). Conclusion The existing evidence shows that yoga has a good effect on blood glucose control (moderate confidence) and also has a certain effect on lipid parameters (moderate confidence) and anthropometric indicators (moderate confidence), but the quality and confidence of the current research evidence are low. Future researchers should standardize the research design to provide more high-quality evidence for the prognosis and treatment of type 2 diabetes mellitus.
The AMSTAR 2, a critical appraisal tool, was developed for assessing systematic reviews which included randomized or non-randomized studies of healthcare interventions, or both. It was recently published in BMJ. This paper introduces AMSTAR 2 and interprets its usage by a published systematic review.
