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Wang Z, Lu C, Wang Y, E F, Mentis AFA, Li X, Yang K. Association between ultra-processed foods consumption and the risk of hypertension: An umbrella review of systematic reviews. Hellenic J Cardiol 2024; 76:99-109. [PMID: 37543089 DOI: 10.1016/j.hjc.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Several systematic reviews (SRs) have investigated the association between ultra-processed foods (UPFs) and the risk of hypertension in various populations. However, the quality of the evidence remains unclear. This umbrella review was thus conducted to fill this gap. METHODS We searched for SRs with and without meta-analyses comparing high UPF versus low UPF consumption on the risk of hypertension in the Cochrane Library, Embase, PubMed, and Web of Science from inception to August 2022. This study was registered in PROSPERO (No. CRD42022352934). The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis 2009 (PRISMA 2009) statement were used to evaluate the methodological and reporting quality of the included SRs. Stata 15/SE was used to reanalyse the data using the random-effects model, and the risk of bias of observational studies from included SRs was reassessed using the Newcastle-Ottawa Scale (NOS) tool. The certainty of the evidence body was assessed using the GRADE recommendation. RESULTS Seven SRs were included in the umbrella review. Among them, nine observational studies (5 cross-sectional and 4 cohort studies), whose available data were resynthesised using meta-analysis. The methodological and reporting quality of the included SRs were relatively poor. The meta-analysis results revealed suggestive evidence of an association between high UPF consumption and the incidence of hypertension (odds ratio: 1.23, 95% confidence interval: 1.11 to 1.37, p < 0.001, 95% prediction interval: 0.92 to 1.64, critically low certainty) compared to low UPF consumption. CONCLUSION High UPF consumption is associated with an increased risk of hypertension. However, well-conducted SRs, including high-quality prospective cohort studies, are needed to further verify these findings.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yongsheng Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Fenfen E
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | | | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
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Wang Z, Lu C, Cui L, Fenfen E, Shang W, Wang Z, Song G, Yang K, Li X. Consumption of ultra-processed foods and multiple health outcomes: An umbrella study of meta-analyses. Food Chem 2024; 434:137460. [PMID: 37722333 DOI: 10.1016/j.foodchem.2023.137460] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/20/2023]
Abstract
Consumption of ultra-processed foods (UPFs) is associated with various adverse health outcomes, which significantly influence the global disease burden. This umbrella review aimed to fill the knowledge gap and guide public health practices by summarizing the association between UPFs and multiple health outcomes. A total of four databases were systematically searched from inception to December 2022, and 14 eligible systematic reviews (SRs) with meta-analyses (MAs) were identified. The SRs were published in 10 journals from 2020 to 2023, with 54,147-5,750,133 participants and 5-61 studies. The overall corrected covered area (CCA) was corresponded to a slight overlap. The results showed that an increased UPFs consumption is associated with multiple health outcomes (e.g., obesity, diabetes, hypertension, mortality). Only two SRs were "Moderate" regarding the overall methodological quality, while the other twelve were "Low" or "Critically low". Therefore, well-conducted SRs with high-quality prospective cohorts with a particular focus on special populations are needed to verify these findings further.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Lu Cui
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - E Fenfen
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Wenru Shang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Guihang Song
- Gansu Healthcare Security Administration, Lanzhou 730000, China
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
| | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
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Shahraki-Mohammadi A, Keikha L, Zahedi R. Investigate the relationship between the retraction reasons and the quality of methodology in non-Cochrane retracted systematic reviews: a systematic review. Syst Rev 2024; 13:24. [PMID: 38217029 PMCID: PMC10785437 DOI: 10.1186/s13643-023-02439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/19/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND This systematic review aimed to investigate the relationship between retraction status and the methodology quality in the retracted non-Cochrane systematic review. METHOD PubMed, Web of Science, and Scopus databases were searched with keywords including systematic review, meta-analysis, and retraction or retracted as a type of publication until September 2023. There were no time or language restrictions. Non-Cochrane medical systematic review studies that were retracted were included in the present study. The data related to the retraction status of the articles were extracted from the retraction notice and Retraction Watch, and the quality of the methodology was evaluated with the AMSTAR-2 checklist by two independent researchers. Data were analyzed in the Excel 2019 and SPSS 21 software. RESULT Of the 282 systematic reviews, the corresponding authors of 208 (73.75%) articles were from China. The average interval between publish and retraction of the article was about 23 months and about half of the non-Cochrane systematic reviews were retracted in the last 4 years. The most common reasons for retractions were fake peer reviews and unreliable data, respectively. Editors and publishers were the most retractors or requestors for retractions. More than 86% of the retracted non-Cochrane SRs were published in journals with an impact factor above two and had a critically low quality. Items 7, 9, and 13 among the critical items of the AMSTAR-2 checklist received the lowest scores. DISCUSSION AND CONCLUSION There was a significant relationship between the reasons of retraction and the quality of the methodology (P-value < 0.05). Plagiarism software and using the Cope guidelines may decrease the time of retraction. In some countries, strict rules for promoting researchers increase the risk of misconduct. To avoid scientific errors and improve the quality of systematic reviews/meta-analyses (SRs/MAs), it is better to create protocol registration and retraction guidelines in each journal for SRs/MAs.
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Affiliation(s)
- Azita Shahraki-Mohammadi
- Medical Library and Information Sciences, School of Allied Medical Sciences, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Leila Keikha
- Medical Library and Information Sciences, School of Allied Medical Sciences, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Razieh Zahedi
- Medical Librarianship and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Lu C, Ke L, Zhang Q, Deng X, Shang W, Zhao X, Li Y, Xie Y, Wang Z. Quality of systematic reviews with meta-analyses of resveratrol: A methodological systematic review. Phytother Res 2024; 38:11-21. [PMID: 37767776 DOI: 10.1002/ptr.8025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Recently, several meta-analyses (MAs) have focused on the health effects of resveratrol. However, the methodological and reporting quality of these MAs has not yet been fully evaluated so far. Therefore, the present study evaluated the quality of these MAs through a methodological systematic review. Systematic searches were conducted in PubMed, Embase, Web of Science, and Cochrane Library from inception until May 20, 2022, and PubMed was used to update the search until September 6, 2023. The methodological and reporting quality of the selected MAs was evaluated using AMSTAR-2 and PRISMA 2009. Fifty-one MAs published during 2013-2023 were included. In each review, the number of primary studies ranged from 3 to 37, and the number of participants ranged from 50 to 2114. Among the first-listed primary outcomes, only 23 (45.10%) were "positive." As for the methodological quality, most MAs (44, 86.27%) on resveratrol were rated critically low. Inadequate reporting of the included MAs mainly involved items 2 ("Structured summary"), 5 ("Protocol and registration"), 8 ("Search"), 9 ("Study selection"), 10 ("Data collection process"), 12 ("Risk of bias in individual studies"), and 24 ("Summary of evidence") based on the PRISMA 2009. Additionally, journal's impact factor, number of authors, and funding support were positively associated with the overall methodological quality but were not statistically significant (p > 0.05). Future MAs on resveratrol require better design, implementation, and reporting by following the Cochrane Handbook, AMSTAR-2, and PRISMA.
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Affiliation(s)
- Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lixin Ke
- Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Qiang Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiuxiu Deng
- Department of Gastroenterology, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Wenru Shang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaoxiao Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanyuan Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanming Xie
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Pinto JO, Peixoto B, Dores AR, Barbosa F. Measures of cognitive reserve: An umbrella review. Clin Neuropsychol 2024; 38:42-115. [PMID: 37073431 DOI: 10.1080/13854046.2023.2200978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.
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Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Menne MC, Su N, Faggion CM. Methodological quality of systematic reviews in dentistry including animal studies: a cross-sectional study. Ir Vet J 2023; 76:33. [PMID: 38098065 PMCID: PMC10720166 DOI: 10.1186/s13620-023-00261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The overall confidence in the results of systematic reviews including animal models can be heterogeneous. We assessed the methodological quality of systematic reviews including animal models in dentistry as well as the overall confidence in the results of those systematic reviews. MATERIAL & METHODS PubMed, Web of Science and Scopus were searched for systematic reviews including animal studies in dentistry published later than January 2010 until 18th of July 2022. Overall confidence in the results was assessed using a modified version of the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) checklist. Checklist items were rated as yes, partial yes, no and not applicable. Linear regression analysis was used to investigate associations between systematic review characteristics and the overall adherence to the AMSTAR-2 checklist. The overall confidence in the results was calculated based on the number of critical and non-critical weaknesses presented in the AMSTAR-2 items and rated as high, moderate, low and critical low. RESULTS Of initially 951 retrieved systematic reviews, 190 were included in the study. The overall confidence in the results was low in 43 (22.6%) and critically low in 133 (70.0%) systematic reviews. While some AMSTAR-2 items were regularly reported (e.g. conflict of interest, selection in duplicate), others were not (e.g. FUNDING n = 1; 0.5%). Multivariable linear regression analysis showed that the adherence scores of AMSTAR-2 was significantly associated with publication year, journal impact factor (IF), topic, and the use of tools to assess risk of bias (RoB) of the systematic reviews. CONCLUSION Although the methodological quality of dental systematic reviews of animal models improved over the years, it is still suboptimal. The overall confidence in the results was mostly low or critically low. Systematic reviews, which were published later, published in a journal with a higher IF, focused on non-surgery topics, and used at least one tool to assess RoB correlated with greater adherence to the AMSTAR-2 guidelines.
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Affiliation(s)
- Max C Menne
- Department of Prosthodontics and Biomaterials, University Hospital Münster, Waldeyerstraße 30, Münster, 48149, Germany
- Department of Oral and Maxillofacial Surgery, Fachklinik Hornheide, Dorbaumstraße 300, Münster, 48157, Germany
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, 1081LA, The Netherlands
| | - Clovis M Faggion
- Department of Periodontology and Operative Dentistry, University Hospital Münster, Waldeyerstraße 30, Münster, 48149, Germany.
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Li J, Guo J, Wang X, Zhang X, Zhang Y, Bu M, Yao X, She Y. Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int 2023; 34:1853-1866. [PMID: 37430003 PMCID: PMC10579121 DOI: 10.1007/s00198-023-06830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/08/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE To critically evaluate systematic reviews (SRs) of the Tai Chi (TC) exercise on bone health and provide more recently available evidence. METHODS SRs with or without meta-analysis (MA) of TC on bone health were comprehensively searched in eight electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database) and in the international prospective register of systematic reviews of (PROSPERO) from initiation to March 2023. Descriptive analyses of SRs were performed, and reporting and methodological quality of the included SRs were evaluated using the updated version of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). The certainty of the synthesized evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Eighteen SRs, 15 with MAs, were included. Forty-nine RCTs and 16 NRSIs with 3956 and 1157 participants, respectively, were included in these SRs. The reporting quality of the included SRs ranged from high to low, but most received critically low AMSTAR-2 scores. Efficacy of TC on nine bone health biomarkers has been explored, covering bone mineral density (BMD) and serum biomarkers. The results showed that compare to non-intervention, perimenopausal and postmenopausal participants who practiced TC may benefit in BMD of the lumbar spine [MD = 0.04, 95% CI (0.02, 0.07)], and femoral neck [MD = 0.04, 95% CI (0.02, 0.06)], but not BMD of the femoral proximal trochanter [MD = 0.02, 95% CI (0.00, 0.03)], ward's triangle [MD = 0.02, 95% CI (-0.01, 0.04)], and femoral shaft [SMD = 0.16, 95% CI (-0.11, 0.44)]. Elders practicing TC may benefit in BMD of the femoral neck [SMD = 0.28, 95% CI (0.10, 0.45)], femoral proximal trochanter [SMD = 0.39, 95% CI (0.05, 0.73)], and ward's triangle [SMD = 0.21, 95% CI (0.05,0.37)], but may not in BMD of lumbar spine [SMD = 0.03, 95% CI (-0.22, 0.27)]. CONCLUSION We have low certainty that for perimenopausal and postmenopausal women, compare to those with no exercise, TC could improve BMD of the lumbar spine, femoral neck. We also have low certainty that in elder population, TC practitioners may benefit in BMD of femoral neck, and Ward's triangle. REGISTRATION PROSPERO (CRD42020173543).
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Affiliation(s)
- Jie Li
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Jiaojiao Guo
- Hebei Academy of Traditional Chinese Medicine, Shijiazhuang, China
| | - Xi Wang
- School of Pharmacy, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Xuanping Zhang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Yan Zhang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Ming Bu
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Xiaoguang Yao
- Department of Surgery, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China.
| | - Yanfen She
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China.
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Zhang X, Chang T, Hu W, Shi M, Chai Y, Wang S, Zhou G, Han M, Zhuang M, Yu J, Yin H, Zhu L, Zhao C, Li Z, Liao X. Efficacy and safety of yoga for the management of chronic low back pain: an overview of systematic reviews. Front Neurol 2023; 14:1273473. [PMID: 37965167 PMCID: PMC10641484 DOI: 10.3389/fneur.2023.1273473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Background Yoga is a non-pharmacological conservative therapeutic modality that can be employed for the management of chronic low back pain (CLBP). In this overview, we have summarized and evaluated data from current systematic reviews (SRs) on the use of yoga for CLBP. Methods We comprehensively searched SRs on the use of yoga for CLBP in nine electronic databases from inception to September 2023. The methodological quality was evaluated using the Assessment of Multiple Systematic Review Scale-2 (AMSTAR-2). The reporting quality of the included SRs was evaluated using the Preferred Reporting Item for Systematic Review and Meta-Analysis-2020 (PRISMA-2020), and the quality of data was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Two independent researchers performed the screening, data extraction, and quality assessment process of SRs. Results A total of 13 SRs were included. The results of the AMSTAR-2 indicated that the methodological quality of the included studies was relatively low. The PRISMA-2020 checklist evaluation results indicated that methodological limitations in reporting, especially regarding data processing and presentation, were the main weaknesses. The GRADE assessment indicated that 30 outcomes were rated moderate, 42 were rated low level, and 20 were rated very low level. Downgrading factors were mainly due to the limitations of the included studies. Conclusion Yoga appears to be an effective and safe non-pharmacological therapeutic modality for the Management of CLBP. Currently, it may exhibit better efficacy in improving pain and functional disability associated with CLBP. However, the methodological quality and quality of evidence for SRs/MAs in the included studies were generally low, and these results should be interpreted cautiously.
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Affiliation(s)
- Xianshuai Zhang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Tianying Chang
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Wenlong Hu
- Shenzhen People's Hospital, Shenzhen, China
| | - Mingpeng Shi
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yating Chai
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Siyi Wang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Guohui Zhou
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Mingze Han
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Minghui Zhuang
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Jie Yu
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - He Yin
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Liguo Zhu
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Changwei Zhao
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Zhenhua Li
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Xing Liao
- Center for Evidence-Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Pan Y, Li H, Gao J, Mi Z, Chen H, Li Y. Tolvaptan for water retention in heart failure: a systematic review. Syst Rev 2023; 12:130. [PMID: 37516894 PMCID: PMC10386224 DOI: 10.1186/s13643-023-02293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023] Open
Abstract
OBJECTIVE The purpose of this systematic review is to collect, appraise, and synthesize existing evidence from systematic reviews and meta-analyses (SRs/MAs) on the effectiveness of tolvaptan for water retention in heart failure. METHODS A comprehensive literature search was performed on PubMed, EMBASE, web of science, Cochrane reviews for SRs/Mas published between the databases' establishment to November 17, 2021. All the records were managed with Endnote 20. Standardized forms were used to extract data. Revman 5.3 was used to make forest plots to show the characteristics of outcomes. The methodological and evidence quality were respectively evaluated by AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews 2) and GRADE (Grading of Recommendation of Assessment, Development, and Evaluation) system. RESULTS A total of 9 SRs/Mas between 2015 to 2020 met inclusion criteria. Serum sodium concentration and urine output were considered as primary outcomes and body weight change and all-cause mortality as second outcomes. Through conducting forest plots, it appeared that tolvaptan brought more positive effect than conventional therapies. It was pessimistic when it comes to the quality of the 9 studies. all the 9 articles were rated as low-quality because AMSTAR 2 evaluation showed that they each had at least one critical item (items 2, 4, 7, 9, 11, 13 and 15) defect. Besides, every article had a few non-critical item defects too. The result of GRADE assessment was not optimistic, so the overall quality of the evidences was low as well. CONCLUSION Tolvaptan can be recommended for water retention in HF patients, but more evidence is needed.
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Affiliation(s)
- Yujing Pan
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210023 China
| | - Haoyang Li
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210023 China
| | - Jin Gao
- College of Acupuncture and Chinese Tuina, Nanjing University of Chinese Medicine, Nanjing, 210023 China
| | - Zishuo Mi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023 China
| | - Hao Chen
- College of Acupuncture and Chinese Tuina, Nanjing University of Chinese Medicine, Nanjing, 210023 China
| | - Ying Li
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210023 China
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Li Z, Wang Y, Xu Q, Ma J, Li X, Tian Y, Wen Y, Chen T. Ginseng and health outcomes: an umbrella review. Front Pharmacol 2023; 14:1069268. [PMID: 37465522 PMCID: PMC10351045 DOI: 10.3389/fphar.2023.1069268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 06/09/2023] [Indexed: 07/20/2023] Open
Abstract
Background: Ginseng consumption has been associated with various health outcomes. However, there are no review articles summarizing these reports. Methods: PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI and Wanfang databases were searched from inception to 31 July 2022. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence in each meta-analysis, and the results were summarized in a narrative form. Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was relatively poor, with only five studies being low-quality, and 14 critically low-quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported. Conclusion: This umbrella review suggests that ginseng intake has beneficial therapeutic effects for diverse diseases. However, the methodological quality of studies needs to be improved considerably. In addition, it is imperative to establish the clinical efficacy of ginseng through high-quality randomized controlled trials.
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Affiliation(s)
- Zhongyu Li
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Wang
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Xu
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinxin Ma
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuan Li
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yibing Tian
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yandong Wen
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Chinese Medicine, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ting Chen
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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11
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Guo W, Cui H, Zhang L, Du R, Yuan H, Zheng S. Acupuncture for the Treatment of Migraine: An Overview of Systematic Reviews. Curr Pain Headache Rep 2023:10.1007/s11916-023-01120-7. [PMID: 37329483 DOI: 10.1007/s11916-023-01120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE OF REVIEW Over the past few years, there have been many systematic reviews (SRs) and meta-analyses (MAs) used to assess the safety and efficacy of acupuncture in the treatment of migraine. Our aim is to assess the methodological and reporting quality of SRs/MAs and make an evaluation about the available evidence of the safety and efficacy of acupuncture in the treatment of migraine. RECENT FINDINGS Migraine is one of the most common primary headaches, with various symptoms, threatening human health. Acupuncture is a specific treatment of Traditional Chinese Medicine (TCM), and a validated non-pharmaceutical option as well, widely used in the treatment of migraine, and has gained remarkable therapeutic effect. An overview can evaluate research methods and evidence for SRs/MAs in evidence-based medicine, although there is much relevant research, it's still a hard work to synthesis all the evidence or to make robust conclusions, the variation in the methodological and quality evidence in such SRs/MAs play a significant role. For this overview, we searched six electronic databases from inception until 8 September 2022, and without languages restrictions, the results showed that, acupuncture as a more safety and more convenient therapeutic, and it has been shown to be effective in the treatment of migraine, that is worthy of clinical promotion. However, there are also some limitations because of the low-quality evidence of most of the studies. In conclusion, most included SRs/MAs suggested that acupuncture was more effective than the control group in the treatment of migraine. However, the quality evidence of most of the studies still needs to be improved.
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Affiliation(s)
- Wenhui Guo
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China
| | - Hai Cui
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China
| | - Lu Zhang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China
| | - Ruosang Du
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China
| | - Hongwen Yuan
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China
| | - Shumei Zheng
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, 100069, China.
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Jin S, Park SM, Choi SY, Park SY, Kim JH. Quality assessment of systematic reviews with meta-analysis in undergraduate nursing education. Nurse Educ Today 2023; 126:105833. [PMID: 37187084 DOI: 10.1016/j.nedt.2023.105833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/04/2023] [Accepted: 04/22/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Little attention has been given to the methodological quality of meta-analyses in nursing education. This warrants further improvements in meta-analyses in nursing education. OBJECTIVE This study aimed to assess the methodological quality of meta-analysis in the field of undergraduate nursing education. DESIGN This was a methodological study to review the methodological quality of systematic reviews (SRs) with meta-analysis. METHODS Exhaustive literature searches were performed using five comprehensive databases. Between 1994 and 2022, 11,827 studies were identified, and 41 full-text articles met the inclusion criteria. Two researchers extracted data using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2. The Chi-square test was conducted to make comparisons before and after 2017, the year AMSTAR-2 was released. RESULTS A comprehensive literature retrieval strategy, inclusion and exclusion criteria, literature selection, and data extraction were observed in nursing education more than in other disciplines. Improvements to be made include pre-specifying the protocol, providing a list of excluded studies with their exclusion reasons, reporting the source of funding for the included studies, assessing and discussing the potential impact of risk of bias, as well as investigating and discussing publication bias and its impact. CONCLUSIONS The number of SRs with meta-analyses in nursing education is increasing. This warrants efforts to improve the quality of research. In addition, guidelines for reporting SRs in the field of nursing education should be constantly updated.
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Affiliation(s)
- Songxian Jin
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Seon-Min Park
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Seung-Yi Choi
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - So Young Park
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea.
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Li Z, Wang Y, Xu Q, Ma J, Li X, Yan J, Tian Y, Wen Y, Chen T. Berberine and health outcomes: An umbrella review. Phytother Res 2023; 37:2051-2066. [PMID: 36999891 DOI: 10.1002/ptr.7806] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/15/2023] [Accepted: 03/04/2023] [Indexed: 04/01/2023]
Abstract
Berberine is a plant extract widely used in clinical practice. This review aimed to summarize and to grade the available evidence on the association between berberine consumption and health-related outcomes. The PubMed, Cochrane Library, and Embase databases were searched for meta-analyses of randomized controlled trials (RCTs) assessing the efficacy and safety of berberine from inception to June 30, 2022. The AMSTAR-2 and GRADE system were used to assess the methodological quality and evidence level of the included meta-analyses. A total of 11 eligible meta-analyses were identified from 235 publications, which were published in peer-reviewed journals between 2013 and 2022. The results revealed that berberine significantly affects blood glucose levels, insulin resistance, blood lipids, body parameters and composition, inflammatory markers, colorectal adenomas, and Helicobacter pylori infections as compared to controls. Common side effects of berberine consumption include gastrointestinal symptoms, such as constipation and diarrhea. Berberine is a safe medicinal plant ingredient that improves various clinical outcomes; however, there is a need for improvement of methodological quality in published meta-analyses. Additionally, the clinical effects of berberine need to be confirmed in high-quality RCTs.
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Affiliation(s)
- Zhongyu Li
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Wang
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Xu
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinxin Ma
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuan Li
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiaxing Yan
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yibing Tian
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yandong Wen
- Department of Chinese Medicine, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ting Chen
- Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Motahari-Nezhad H, Al-Abdulkarim H, Fgaier M, Abid MM, Péntek M, Gulácsi L, Zrubka Z. Digital Biomarker-Based Interventions: Systematic Review of Systematic Reviews. J Med Internet Res 2022; 24:e41042. [PMID: 36542427 PMCID: PMC9813819 DOI: 10.2196/41042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/22/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The introduction of new medical technologies such as sensors has accelerated the process of collecting patient data for relevant clinical decisions, which has led to the introduction of a new technology known as digital biomarkers. OBJECTIVE This study aims to assess the methodological quality and quality of evidence from meta-analyses of digital biomarker-based interventions. METHODS This study follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline for reporting systematic reviews, including original English publications of systematic reviews reporting meta-analyses of clinical outcomes (efficacy and safety endpoints) of digital biomarker-based interventions compared with alternative interventions without digital biomarkers. Imaging or other technologies that do not measure objective physiological or behavioral data were excluded from this study. A literature search of PubMed and the Cochrane Library was conducted, limited to 2019-2020. The quality of the methodology and evidence synthesis of the meta-analyses were assessed using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), respectively. This study was funded by the National Research, Development and Innovation Fund of Hungary. RESULTS A total of 25 studies with 91 reported outcomes were included in the final analysis; 1 (4%), 1 (4%), and 23 (92%) studies had high, low, and critically low methodologic quality, respectively. As many as 6 clinical outcomes (7%) had high-quality evidence and 80 outcomes (88%) had moderate-quality evidence; 5 outcomes (5%) were rated with a low level of certainty, mainly due to risk of bias (85/91, 93%), inconsistency (27/91, 30%), and imprecision (27/91, 30%). There is high-quality evidence of improvements in mortality, transplant risk, cardiac arrhythmia detection, and stroke incidence with cardiac devices, albeit with low reporting quality. High-quality reviews of pedometers reported moderate-quality evidence, including effects on physical activity and BMI. No reports with high-quality evidence and high methodological quality were found. CONCLUSIONS Researchers in this field should consider the AMSTAR-2 criteria and GRADE to produce high-quality studies in the future. In addition, patients, clinicians, and policymakers are advised to consider the results of this study before making clinical decisions regarding digital biomarkers to be informed of the degree of certainty of the various interventions investigated in this study. The results of this study should be considered with its limitations, such as the narrow time frame. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/28204.
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Affiliation(s)
- Hossein Motahari-Nezhad
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
- Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - Hana Al-Abdulkarim
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
- Drug Policy and Economic Center, National Guard Health Affairs, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Meriem Fgaier
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
| | - Mohamed Mahdi Abid
- Research Center of Epidemiology and Statistics, Université Sorbonne Paris Cité, Paris, France
| | - Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
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Xu X, Xie H, Liu Z, Guo T, Zhang Y. Effects of acupuncture on the outcome of tinnitus: An overview of systematic reviews. Front Neurol 2022; 13:1061431. [PMID: 36468042 PMCID: PMC9716106 DOI: 10.3389/fneur.2022.1061431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/28/2022] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND To systematically summarize the evidence for the efficacy of acupuncture in tinnitus treatment, we assessed the methodological quality, reporting quality, and evidence quality of systematic reviews/meta-analyses (SRs/MAs) of acupuncture in the treatment of tinnitus. METHODS From inception to March 2022, we conducted a detailed and comprehensive search of eight electronic databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess methodological quality, reporting quality and evidence quality for inclusion in SRs/MAs, respectively. RESULTS Fourteen published SRs/MAs met the inclusion criteria and were included in the study. Eleven studies reported that acupuncture was effective in treating tinnitus, and three studies reported that no firm conclusions could be drawn about the effectiveness of acupuncture in treating tinnitus. The results of the AMSTAR-2 assessment showed that the methodological quality of the included studies was relatively low in general, with one being moderate quality and the rest being very low quality. The PRISMA checklist evaluation results showed that no studies fully report checklists, with protocol registration and search strategies being the main reporting weaknesses. The GRADE assessment showed that no results were high-quality evidence, 17 results were moderate-quality evidence, 25 results were low-quality evidence, and 12 results were very low-quality evidence. CONCLUSION Acupuncture seems to be a positive and effective treatment for tinnitus. However, the methodological quality and quality of evidence for SRs/MAs in the included studies were generally low, and this result must be viewed with caution. Therefore, more high-quality, large-scale, multi-center randomized controlled trials are needed in the future to verify the effectiveness of acupuncture in the treatment of tinnitus.
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Gui YR, Fan BJ, Li JL, Wang S, Dong J, Hou W. [Overview of systematic reviews and Meta-analysis of Aidi Injection combined with chemotherapy in treatment of non-small cell lung cancer]. Zhongguo Zhong Yao Za Zhi 2022; 47:3923-3932. [PMID: 35850851 DOI: 10.19540/j.cnki.cjcmm.20220328.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
At present, many systematic reviews(SRs)/Meta-analysis of Aidi Injection combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC) have been published, and the effectiveness has been proved.However, the methodological quality and evidence quality of these SRs/Meta-analysis have not been evaluated, and their guiding role in the clinical practice needs to be further verified.In this study, SRs/Meta-analysis of Aidi Injection combined with chemotherapy in the treatment of NSCLC were assessed to provide evidence overview and basis for the application and decision-making of this drug in clinical practice.PubMed, Cochrane Library, EMbase, CNKI, VIP, Wanfang, and SinoMed databases were searched for research articles on SRs/Meta-analysis of Aidi Injection combined with chemotherapy in the treatment of NSCLC.The methodological quality and evidence quality of included 15 articles on SRs/Meta-analysis were evaluated by using the AMSTAR-2 and GRADE system.The results of SRs/Meta-analysis suggested that Aidi Injection combined with chemotherapy had certain advantages over chemotherapy alone in improving short-term efficacy, improving quality of life, and reducing leukopenia, thrombocytopenia, and the incidence of gastrointestinal adverse events.The results of the AMSTAR-2 checklist showed low quality for 11 SRs/Meta-analysis and extremely low quality for another four SRs/Meta-analysis.The top problems included failure to provide the preliminary protocol or guide, unreported funding sources, and non-assessed risk of bias in the included articles on the results.According to the results of the GRADE assessment, 32 of the 148 outcome indicators were of intermediate quality, 40 were of low quality, and 76 were of extremely low quality.The critical factor leading to the downgrade was the risk of bias, followed by imprecision and publication bias.Aidi Injection combined with chemotherapy in the treatment of NSCLC can enhance efficacy and reduce toxicity.However, due to the low methodological quality and evidence quality of the included research articles, the efficacy and safety of Aidi Injection combined with chemotherapy in the treatment of NSCLC still need to be further confirmed by high-quality studies.In the follow-up original research and SRs/Meta-analysis, the corresponding quality evaluation standards should be strictly followed to improve the quality of evidence.
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Affiliation(s)
- Yue-Rong Gui
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
| | - Bing-Jie Fan
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
| | - Jing-Lei Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
| | - Shuo Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
| | - Jun Dong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
| | - Wei Hou
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China
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Hammel C, Pandis N, Pieper D, Faggion CM. Methodological assessment of systematic reviews of in-vitro dental studies. BMC Med Res Methodol 2022; 22:110. [PMID: 35413840 PMCID: PMC9006561 DOI: 10.1186/s12874-022-01575-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews of in-vitro studies, like any other study, can be of heterogeneous quality. The present study aimed to evaluate the methodological quality of systematic reviews of in-vitro dental studies. METHODS We searched for systematic reviews of in-vitro dental studies in PubMed, Web of Science, and Scopus databases published up to January 2022. We assessed the methodological quality of the systematic reviews using a modified "A MeaSurement Tool to Assess systematic Reviews" (AMSTAR-2) instrument. The 16 items, in the form of questions, were answered with yes, no, or py (partial yes). Univariable and multivariable linear regression models were used to examine the association between systematic review characteristics and AMSTAR-2 percent score. Overall confidence in the results of the systematic reviews was rated, based on weaknesses identified in critical and non-critical AMSTAR-2 items. RESULTS The search retrieved 908 potential documents, and after following the eligibility criteria, 185 systematic reviews were included. The most researched topics were ceramics and dental bonding. The overall rating for the confidence in the results was critically low in 126 (68%) systematic reviews. There was high variability in the response among the AMSTAR-2 items (0% to 75% positively answered). The univariable analyses indicated dental specialty (p = 0.03), number of authors (coef: 1.87, 95% CI: 0.26, 3.47, p = 0.02), and year of publication (coef: 2.64, 95% CI: 1.90, 3.38, p < 0.01) were significantly associated with the AMSTAR-2 percent score. Whereas, in the multivariable analysis only specialty (p = 0.01) and year of publication (coef: 2.60, 95% CI: 1.84, 3.35, p < 0.001) remained significant. Among specialties, endodontics achieved the highest AMSTAR-2 percent score. CONCLUSIONS The methods of systematic reviews of in vitro dental studies were suboptimal. Year of publication and dental specialty were associated with AMSTAR-2 scores. The overall rating of the confidence in the results was low and critically low for most systematic reviews.
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Affiliation(s)
- Christopher Hammel
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School, (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf, Germany.,Brandenburg Medical School, Center for Health Services Research, (Theodor Fontane), Rüdersdorf, Germany
| | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany.
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Lu C, Ke L, Li J, Wu S, Feng L, Wang Y, Mentis AFA, Xu P, Zhao X, Yang K. Chinese Medicine as an Adjunctive Treatment for Gastric Cancer: Methodological Investigation of meta-Analyses and Evidence Map. Front Pharmacol 2022; 12:797753. [PMID: 35082677 PMCID: PMC8784830 DOI: 10.3389/fphar.2021.797753] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Many meta-analyses (MAs) on Chinese medicine (CM) as an adjunctive treatment for gastric cancer have been published in recent years. However, the pooled evidence reported in MAs and their methodological quality remain unknown. Therefore, we designed a study to comprehensively evaluate and summarize the current evidence of CMs for gastric cancer in published MAs. Methods: A systematic search on MAs published in English from inception to 1st September 2021 was conducted in PubMed and Embase. The AMSTAR-2 tool was used to evaluate the methodological quality of the included MAs, and the results of the quality assessment were visualized using the evidence mapping method. Stata 17/SE was used for statistical analysis (Registration number: INPLASY202190005). Results: A total of 20 MAs (16 pairwise and 4 network MAs) were included from 118 records. These MAs were published in 14 journals from 2013 to 2021, with the number of patients and trials ranging from 688 to 6,857, and from 10 to 85, respectively. A large number of CMs (e.g., AiDi, FuFangKuShen, and HuaChanSu) in combination with chemotherapy for gastric cancer were identified among the included MAs. According to the pooled results reported in MAs, when compared to chemotherapy alone, CMs in combination with chemotherapy not only improve various outcomes on efficacy (e.g., objective response rate, quality of life) but also reduce various adverse reactions (e.g., leucopenia, nausea and vomiting). Only 2 MAs were low in terms of the overall methodological quality, while the other 18 MAs were all critically low. The methodology was required to be advanced significantly, mainly involving: study protocol and registration, explanation for the inclusion of study design, list of excluded studies with justifications, adequate details of included studies, reporting on funding sources of primary studies, and evaluation of the potential impact of risk of bias. In addition, MAs that received funds support (β = 2.68; 95%CI: 0.40 to 4.96; p = 0.024) or were published in journals with higher impact factor (β = 2.81; 95%CI: 0.69 to 4.92; p = 0.012) had a higher score on the overall methodological quality in the univariate analysis, but the results were not statistically significant according to the multivariate analysis. Conclusion: Combining CMs with chemotherapy can potentially improve clinical outcomes and reduce the relevant adverse effects in patients with gastric cancer. However, the methodological quality of relevant MAs requires significant improvement, and the current evidence needs to be validated through multinational trials that are well-designed and have a large sample size.
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Affiliation(s)
- Cuncun Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lixin Ke
- Hepatobiliary and Pancreatic Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jieyun Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Shuilin Wu
- Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Lufang Feng
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Youyou Wang
- National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Alexios Fotios A Mentis
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Peng Xu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoxiao Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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Storman D, Koperny M, Zając J, Polak M, Weglarz P, Bochenek-Cibor J, Swierz MJ, Staskiewicz W, Gorecka M, Skuza A, Wach AA, Kaluzinska K, Bała MM. Predictors of Higher Quality of Systematic Reviews Addressing Nutrition and Cancer Prevention. Int J Environ Res Public Health 2022; 19:ijerph19010506. [PMID: 35010766 PMCID: PMC8744691 DOI: 10.3390/ijerph19010506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/15/2021] [Accepted: 12/26/2021] [Indexed: 02/04/2023]
Abstract
Systematic reviews/meta-analyses (SR/MAs) are considered a reliable source of information in healthcare. We aimed to explore the association of several characteristics of SR/MAs addressing nutrition in cancer prevention and their quality/risk of bias (using assessments from AMSTAR-2 and ROBIS tools). The analysis included 101 SR/MAs identified in a systematic survey. Associations of each specified characteristic (e.g., information about the protocol, publication year, reported use of GRADE, or other methods for assessing overall certainty of evidence) with the number of AMSTAR-2 not met (‘No’ responses) and the number of ROBIS items met (‘Probably Yes’ or “Yes’ responses) were examined. Poisson regression was used to identify predictors of the number of ‘No’ answers (indicating lower quality) for all AMSTAR-2 items and the number of ‘Yes’ or ‘Probably Yes’ answers (indicating higher quality/lower concern for bias) for all ROBIS items. Logistic regression was used to identify variables associated with at least one domain assessed as ‘low concern for bias’ in the ROBIS tool. In multivariable analysis, SR/MAs not reporting use of any quality/risk of bias assessment instrument for primary studies were associated with a higher number of ‘No’ answers for all AMSTAR-2 items (incidence rate ratio (IRR) 1.26, 95% confidence interval (CI) 1.09–1.45), and a lower number of ‘Yes’ or ‘Probably Yes’ answers for all ROBIS items (IRR 0.76, 95% CI 0.66–0.87). Providing information about the protocol and search for unpublished studies was associated with a lower number of ‘No’ answers (IRR 0.73, 95% CI 0.56–0.97 and IRR 0.75, 95% CI 0.59–0.95, respectively) and a higher number of ‘Yes’ or ‘Probably Yes’ answers (IRR 1.43, 95% CI 1.17–1.74 and IRR 1.28, 95% CI 1.07–1.52, respectively). Not using at least one quality/risk of bias assessment tool for primary studies within an SR/MA was associated with lower odds that a study would be assessed as ‘low concern for bias’ in at least one ROBIS domain (odds ratio 0.061, 95% CI 0.007–0.527). Adherence to methodological standards in the development of SR/MAs was associated with a higher overall quality of SR/MAs addressing nutrition for cancer prevention.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (J.Z.); (P.W.); (M.J.S.)
| | - Magdalena Koperny
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Joanna Zając
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (J.Z.); (P.W.); (M.J.S.)
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Paulina Weglarz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (J.Z.); (P.W.); (M.J.S.)
| | | | - Mateusz J. Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (J.Z.); (P.W.); (M.J.S.)
| | - Wojciech Staskiewicz
- Students’ Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, 31-034 Krakow, Poland; (W.S.); (M.G.); (A.S.); (A.A.W.); (K.K.)
| | - Magdalena Gorecka
- Students’ Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, 31-034 Krakow, Poland; (W.S.); (M.G.); (A.S.); (A.A.W.); (K.K.)
| | - Anna Skuza
- Students’ Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, 31-034 Krakow, Poland; (W.S.); (M.G.); (A.S.); (A.A.W.); (K.K.)
| | - Adam A. Wach
- Students’ Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, 31-034 Krakow, Poland; (W.S.); (M.G.); (A.S.); (A.A.W.); (K.K.)
| | - Klaudia Kaluzinska
- Students’ Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, 31-034 Krakow, Poland; (W.S.); (M.G.); (A.S.); (A.A.W.); (K.K.)
| | - Małgorzata M. Bała
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (J.Z.); (P.W.); (M.J.S.)
- Correspondence:
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20
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Peña AM, Ladd CC, Anderson JM, Torgerson T, Hartwell M, Johnson BS, McMurray M, Vassar M. An analysis of the evidence underpinning the American Urologic Association clinical practice guidelines. Urology 2022; 161:42-49. [PMID: 34986408 DOI: 10.1016/j.urology.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the reporting quality of systematic reviews (SRs) underpinning the American Urologic Association (AUA) clinical practice guidelines (CPGs). METHODS We searched the AUA for CPGs from 2015-2021. We extracted all SRs from the reference sections and two independent investigators evaluated eligible SR/meta-analysis using the PRISMA (Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses) and AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) instruments. We compared SRs conducted by the Cochrane group to non-Cochrane SRs using a Mann-Whitney test. A multivariate regression was used to compare study characteristics. RESULTS Eighteen CPG's met inclusion criteria. We extracted 120 unique SRs, which accounted for 5.1% (n=120/2346) of all citations. Mean percent adherence to PRISMA and AMSTAR-2 was 65.4% and 55.2% respectively. SRs conducted by the Cochrane Collaboration scored higher on AMSTAR-2 compared to non-Cochrane (z = -4.41, p <0.01) and a positive correlation between PRISMA and AMSTAR-2 scores (r=0.56, p<0.001) was determined. CONCLUSION Our study indicated the quality of SRs used to develop AUA CPGs across both PRISMA and AMSTAR-2 was variable. Despite higher evaluations, Cochrane SRs accounted for less than 15% of SRs underpinning CPG recommendations. Given the importance placed on CPGs within clinical practice, we recommended a synergistic relationship between the AUA and the Cochrane Collaboration to increase the number of quality urologic SRs.
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Affiliation(s)
- Andriana M Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
| | - Chase C Ladd
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - J Michael Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Trevor Torgerson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Bradley S Johnson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Megan McMurray
- Southern Illinois University, Department of Urology, Springfield, Illinois
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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21
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Swierz MJ, Storman D, Zajac J, Koperny M, Weglarz P, Staskiewicz W, Gorecka M, Skuza A, Wach A, Kaluzinska K, Bochenek-Cibor J, Johnston BC, Bala MM. Similarities, reliability and gaps in assessing the quality of conduct of systematic reviews using AMSTAR-2 and ROBIS: systematic survey of nutrition reviews. BMC Med Res Methodol 2021; 21:261. [PMID: 34837960 PMCID: PMC8627612 DOI: 10.1186/s12874-021-01457-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AMSTAR-2 ('A Measurement Tool to Assess Systematic Reviews, version 2') and ROBIS ('Risk of Bias in Systematic Reviews') are independent instruments used to assess the quality of conduct of systematic reviews/meta-analyses (SR/MAs). The degree of overlap in methodological constructs together with the reliability and any methodological gaps have not been systematically assessed and summarized in the field of nutrition. METHODS We performed a systematic survey of MEDLINE, EMBASE, and the Cochrane Library for SR/MAs published between January 2010 and November 2018 that examined the effects of any nutritional intervention/exposure for cancer prevention. We followed a systematic review approach including two independent reviewers at each step of the process. For AMSTAR-2 (16 items) and ROBIS (21 items), we assessed the similarities, the inter-rater reliability (IRR) and any methodological limitations of the instruments. Our protocol for the survey was registered in PROSPERO (CRD42019121116). RESULTS We found 4 similar domain constructs based on 11 comparisons from a total of 12 AMSTAR-2 and 14 ROBIS items. Ten comparisons were considered fully overlapping. Based on Gwet's agreement coefficients, six comparisons provided almost perfect (> 0.8), three substantial (> 0.6), and one a moderate level of agreement (> 0.4). While there is considerable overlap in constructs, AMSTAR-2 uniquely addresses explaining the selection of study designs for inclusion, reporting on excluded studies with justification, sources of funding of primary studies, and reviewers' conflict of interest. By contrast, ROBIS uniquely addresses appropriateness and restrictions within eligibility criteria, reducing risk of error in risk of bias (RoB) assessments, completeness of data extracted for analyses, the inclusion of all necessary studies for analyses, and adherence to predefined analysis plan. CONCLUSIONS Among the questions on AMSTAR-2 and ROBIS, 70.3% (26/37 items) address the same or similar methodological constructs. While the IRR of these constructs was moderate to perfect, there are unique methodological constructs that each instrument independently addresses. Notably, both instruments do not address the reporting of absolute estimates of effect or the overall certainty of the evidence, items that are crucial for users' wishing to interpret the importance of SR/MA results.
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Affiliation(s)
- Mateusz J Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7 Street 31-034, Krakow, Poland
| | - Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7 Street 31-034, Krakow, Poland
| | - Joanna Zajac
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7 Street 31-034, Krakow, Poland
| | - Magdalena Koperny
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology Jagiellonian University Medical College , Kopernika 7 Street 31-034, Krakow, Poland
| | - Paulina Weglarz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7 Street 31-034, Krakow, Poland
| | - Wojciech Staskiewicz
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Gorecka
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Skuza
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Adam Wach
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Klaudia Kaluzinska
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | | | - Bradley C Johnston
- Departments of Nutrition, Epidemiology and Biostatistics, Texas A&M University, College Station, College Station, TX, USA.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7 Street 31-034, Krakow, Poland.
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22
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Love M, Staggs J, Walters C, Wayant C, Torgerson T, Hartwell M, Anderson JM, Lillie A, Myers K, Brachtenbach T, Derby M, Vassar M. An analysis of the evidence underpinning the national comprehensive cancer network practice guidelines. Crit Rev Oncol Hematol 2021; 169:103549. [PMID: 34838981 DOI: 10.1016/j.critrevonc.2021.103549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/18/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This study assesses the quality and completeness of systematic reviews (SRs) included by the National Comprehensive Cancer Network (NCCN) cancer screening clinical practice guidelines (CPGs). METHODS We evaluated SRs according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR-2 (A Measurement Tool to Assess systematic Reviews). RESULTS Seven NCCN CPGs were included with 109 SRs. The mean PRISMA percent completeness of included SRs was 71 % (range 0.1-1.0). The mean AMSTAR-2 percent completeness was 56 % (range 0.05-0.99). Of the 70 SRs assessed via AMSTAR-2, 42 (60 %) received a "critically low" rating, 11 (15.7 %) received "low" ratings, and 17 (24.3 %) received "moderate". None of the SRs received a "high" rating. CONCLUSION Lack of adherence to AMSTAR-2 and PRISMA reporting standards among the SRs included is prevalent. We suggest improved reporting of SR inclusion criteria and evaluation to bolster the reporting quality of SRs underpinning CPG recommendations.
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Affiliation(s)
- Mitchell Love
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States.
| | - Jordan Staggs
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Corbin Walters
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Cole Wayant
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Trevor Torgerson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - J Michael Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Anna Lillie
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Kate Myers
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Travis Brachtenbach
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Micah Derby
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of School of Educational Foundations, Leadership And Aviation, Oklahoma State University, Tulsa, OK, United States
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23
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Motahari-Nezhad H, Péntek M, Gulácsi L, Zrubka Z. Outcomes of Digital Biomarker-Based Interventions: Protocol for a Systematic Review of Systematic Reviews. JMIR Res Protoc 2021; 10:e28204. [PMID: 34821568 PMCID: PMC8663678 DOI: 10.2196/28204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/19/2021] [Accepted: 04/13/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Digital biomarkers are defined as objective, quantifiable, physiological, and behavioral data that are collected and measured using digital devices such as portables, wearables, implantables, or digestibles. For their widespread adoption in publicly financed health care systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE The paper presents the protocol for a systematic review that aims to assess the quality and strength of the evidence reported in systematic reviews regarding the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers. METHODS A comprehensive search for reviews from 2019 to 2020 will be conducted in PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of these reviews. To assess the quality of evidence, we will evaluate the systematic reviews using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. To detect the possible presence of reporting bias, we will determine whether a protocol was published prior to the start of the studies. A qualitative summary of the results by digital biomarker technology and outcomes will be provided. RESULTS This protocol was submitted before data collection. Search, screening, and data extraction will commence in December 2021 in accordance with the published protocol. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions, providing practical guidance for health care providers. Our results will help identify clinical areas in which the use of digital biomarkers has led to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28204.
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Affiliation(s)
- Hossein Motahari-Nezhad
- Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Obuda University, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Obuda University, Budapest, Hungary.,Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Obuda University, Budapest, Hungary.,Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
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24
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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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25
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Lu C, Ke L, Li J, Zhao H, Lu T, Mentis AFA, Wang Y, Wang Z, Polissiou MG, Tang L, Tang H, Yang K. Saffron (Crocus sativus L.) and health outcomes: a meta-research review of meta-analyses and an evidence mapping study. Phytomedicine 2021; 91:153699. [PMID: 34419735 DOI: 10.1016/j.phymed.2021.153699] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although a number of systematic reviews and meta-analyses of saffron (Crocus sativus L.) have been published, no study has comprehensively summarized the clinical evidence from meta-analyses, or assessed the reporting or methodological quality of these reviews. PURPOSE The present meta-research study was designed to fill the gaps in knowledge to inform future studies and allow enhanced clinical decision-making on saffron. METHODS The PubMed, Cochrane Library, Embase, and CNKI databases were systematically searched from inception to April 3 rd, 2021, for meta-analyses of clinical trials that assessed the efficacy and safety of saffron. PRISMA 2009 and AMSTAR-2 were employed to assess the reporting and methodological quality of meta-analyses identified in the search, respectively. The present study was registered on PROSPERO with registration number CRD42020220274. RESULTS Nineteen eligible systematic reviews with meta-analyses published in English were identified from 235 records. These meta-analyses were published in 12 peer-reviewed journals from 2013 to 2021. The heterogeneous results indicated that saffron significantly reduced fasting blood glucose, waist circumference, diastolic blood pressure, concentrations of total cholesterol and low-density lipoprotein cholesterol, and improved symptoms of depression, cognitive function and sexual dysfunction compared with controls (mainly placebos). Common side effects of saffron consumption included nausea, dry mouth, poor appetite, and headache, but no serious adverse reactions were reported. Primary analysis and sensitivity analysis confirmed that the reporting and methodological quality of reviews included in the study were highly correlated (p < 0.001). The quality of meta-analyses of saffron requires improvement by including a structured abstract, a prospective protocol and registration, explanation of the study designs within each study that is reviewed, the searches, risk of bias assessment, literature selection, and reporting of funding sources. CONCLUSION The available evidence indicates that saffron is a safe plant for administration as a medicine and can improve diverse clinical outcomes, but the scientific quality of the published systematic reviews needs to be improved. Moreover, the clinical effects of saffron need to be confirmed through high-quality randomized trials in multiple countries with large sample sizes.
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Affiliation(s)
- Cuncun Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China; Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Lixin Ke
- Hepatobiliary and pancreatic center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jieyun Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Haitong Zhao
- Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Tingting Lu
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Alexios Fotios A Mentis
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens 10183, Greece
| | - Youyou Wang
- National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Moschos G Polissiou
- Laboratory of Chemistry, Department of Science, Agricultural University of Athens, Athens 10183, Greece
| | - Liyao Tang
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Hao Tang
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China.
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26
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Wang YF, Xu ZM, Liu SJ, Dai LL, Guo CY, Wang LD, Qiu WR, Liang X, Wu MH, Jin XL, Liao X. [Overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treatment of cerebral ischaemic stroke]. Zhongguo Zhong Yao Za Zhi 2021; 46:2972-2983. [PMID: 34467687 DOI: 10.19540/j.cnki.cjcmm.20210326.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.
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Affiliation(s)
- Ye-Fei Wang
- Dongfang Hospital, Beijing University of Chinese Medicine Beijing 100078, China Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China
| | - Zhen-Min Xu
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Shao-Jiao Liu
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Ling-Ling Dai
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Chun-Yan Guo
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Liu-Ding Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Wen-Ran Qiu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Xiao Liang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Ming-Hua Wu
- Encephalopathy Center, Jiangsu Hospital of Traditional Chinese Medicine Nanjing 210029, China
| | - Xiang-Lan Jin
- Dongfang Hospital, Beijing University of Chinese Medicine Beijing 100078, China
| | - Xing Liao
- Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China
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Wang LD, Xu ZM, Liang X, Qiu WR, Liu SJ, Dai LL, Wang YF, Guo CY, Qi XH, Wang J, Ding YB, Zhang YL, Liao X. [Overview of systematic reviews of Panax notoginseng saponins in treatment of acute cerebral infarction]. Zhongguo Zhong Yao Za Zhi 2021; 46:2963-2971. [PMID: 34467686 DOI: 10.19540/j.cnki.cjcmm.20210325.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction. CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P. notoginseng saponins in the treatment of acute cerebral infarction. The retrieval time was from the time of database establishment to January 2021. After two researchers independently screened out the literature and extracted the data, AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews, GRADE system was used to grade the quality of evidences of the outcome indicators, and the efficacy evaluation was summarized. A total of 5 systematic reviews were included. AMSTAR-2 evaluation results showed that 3 items were relatively complete, while 4 items had a poor overall quality. P. notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function, enhancement of the total effective rate in clinic, and improvement of activities of daily living. GRADE evaluation results showed that the quality of evidence was from low quality to very low quality. In conclusion, in the treatment of acute cerebral infarction, P. notoginseng saponins can improve the clinical efficacy, with a good safety but a not high methodological quality and a low evidence quality. It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P. notoginseng saponins in the treatment of acute cerebral infarction.
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Affiliation(s)
- Liu-Ding Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China
| | - Zhen-Min Xu
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Xiao Liang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Wen-Ran Qiu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Shao-Jiao Liu
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Ling-Ling Dai
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Ye-Fei Wang
- Dongfang Hospital, Beijing University of Chinese Medicine Beijing 100078, China
| | - Chun-Yan Guo
- Graduate School, Beijing University of Chinese Medicine Beijing 100029, China
| | - Xiang-Hua Qi
- the Affiliated Hospital of Shandong University of Traditional Chinese Medicine Ji'nan 250014, China
| | - Jian Wang
- the Affiliated Hospital to Changchun University of Chinese Medicine Changchun 130021, China
| | - Yan-Bing Ding
- Chinese Medicine Hospital of Hubei Province Hubei 430074, China
| | - Yun-Ling Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China
| | - Xing Liao
- Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China
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Zhang J, Yu Q, Peng L, Qin Y, Jing M, Huang D, Guo J, Xiao M, Chen M. Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews. Front Pharmacol 2021; 12:680172. [PMID: 34276371 PMCID: PMC8281221 DOI: 10.3389/fphar.2021.680172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background: In recent years, systematic reviews/meta-analyses (SRs/MAs) of Chinese herbal medicine (CHM) for psoriasis have continuously emerged. Their methods and evidence quality, however, are yet to be evaluated, and whether their conclusions can provide clinicians with reliable evidence is still debatable. Objectives: This overview aims to evaluate the methodological quality, risk of bias, and reporting quality of relevant SRs/MAs, as well as the current evidence of CHM for treating psoriasis. Methods: We searched nine electronic databases from their respective time of establishment to January 20, 2021, as well as the reference lists of the included SRs/MAs, protocol registries, and gray literature. Two reviewers independently used the following: A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs. Results: This review included 14 SRs/MAs involving 45 outcomes, of which 12 (85.71%) SRs/MAs had a very low quality evaluated by AMSTAR 2 and 7 (50.00%) SRs/MAs had a high risk of bias assessed by ROBIS. The protocol and registration and funding statements were the major reporting flaws according to the PRISMA checklist. The evaluation with the GRADE system demonstrated no outcome of high-quality evidence, and inconsistent efficacy evaluations were found in this overview. Only 15 (33.33%) outcomes were moderate-quality evidence, supporting the claim that CHM plus Western medicine (WM) was superior to WM. Generally low quality of evidence showed no difference in the incidence of adverse events between the combined therapy and WM. However, the conclusion that CHM was superior to WM cannot be drawn due to the inconsistent results. Conclusion: Despite that CHM has the potential benefit and safety in the adjuvant treatment of psoriasis, the conclusion should be treated with caution because of the generally low quality of methodology and evidence. In the future, high-quality randomized controlled trials (RCTs) should be carried out, and the quality of relevant SRs should also be improved to promote their clinical application.
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Affiliation(s)
- Jie Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qianying Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuesi Qin
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Mingyi Jing
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Guo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Xiao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mingling Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Huang J, Liu H, Chen J, Cai X, Huang Y. The Effectiveness of Tai Chi in Patients With Breast Cancer: An Overview of Systematic Reviews and Meta-Analyses. J Pain Symptom Manage 2021; 61:1052-1059. [PMID: 33068706 DOI: 10.1016/j.jpainsymman.2020.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND As a mind-body exercise, Tai Chi (TC) may have a positive impact on physical function and psychological well-being in patients with breast cancer (BC). The aim of this current overview of systematic reviews (SRs) and meta-analyses (MAs) was to identify and summarize the existing evidence regarding the effectiveness of TC in patients with BC. METHODS A computerized search of electronic databases was performed to identify relevant SRs/MAs of TC related to BC from inception to June 2020. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklists were used to assess the methodological quality and reporting quality of SRs and MAs, respectively. The Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to assess the evidence quality of outcome measures. RESULTS Six SRs/MAs in which quantitative synthesis was used to assess various outcomes of TC related to BC were included in this overview. The quality of the SRs/MAs and the evidence quality of the outcome measures were generally unsatisfactory. The limitations of the past SRs/MAs were the lack of a protocol and registration, a list of excluded studies, or inadequately reported computational details of meta-analyses. The critical problems were that the qualitative data synthesis relied on the trials with small sample sizes and of critical low quality. CONCLUSIONS TC is possibly beneficial to BC treatment. However, further rigorous and comprehensive studies are required to provide robust evidence for definitive conclusions.
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Affiliation(s)
- Jinke Huang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haolin Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiajie Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaowen Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
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30
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Huang J, Qin X, Shen M, Xu Y, Huang Y. The Effects of Tai Chi Exercise Among Adults With Chronic Heart Failure: An Overview of Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:589267. [PMID: 33816570 PMCID: PMC8012482 DOI: 10.3389/fcvm.2021.589267] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview. Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality. Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.
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Affiliation(s)
- Jinke Huang
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohui Qin
- Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Min Shen
- Department of Neurology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China
| | - Yanjuan Xu
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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31
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Wurth R, Hajdenberg M, Barrera FJ, Shekhar S, Copacino CE, Moreno-Peña PJ, Gharib OAM, Porter F, Hiremath S, Hall JE, Schiffrin EL, Eisenhofer G, Bornstein SR, Brito JP, González-González JG, Stratakis CA, Rodríguez-Gutiérrez R, Hannah-Shmouni F. Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results? Postgrad Med J 2021; 98:372-379. [PMID: 33637639 PMCID: PMC7918809 DOI: 10.1136/postgradmedj-2020-139392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 12/22/2022]
Abstract
Aim The aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence. Design We conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included. Main outcome measures We extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed. Results A total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation. Conclusion The methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.
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Affiliation(s)
- Rachel Wurth
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Hajdenberg
- College of Arts and Sciences, Washington University in St Louis, St Louis, Missouri, USA
| | - Francisco J Barrera
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Skand Shekhar
- NICHD, National Institutes of Health, Bethesda, Maryland, USA.,Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pablo J Moreno-Peña
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Omar A M Gharib
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes Porter
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Swapnil Hiremath
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Janet E Hall
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Juan P Brito
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
| | - José Gerardo González-González
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | | | - René Rodríguez-Gutiérrez
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
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Lu C, Lu T, Pan B, Wang Q, Hou L, Zhang Q, Wang Y, Wang Y, Li X, Ruan Y, Chen L, Lai H, Qin T, Ge L, Yan K. Coronavirus disease (COVID 2019): protocol for a living overview of systematic reviews. Ann Palliat Med 2020; 10:1488-1493. [PMID: 33353349 DOI: 10.21037/apm-20-1130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/10/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic continues to grow worldwide, and systematic reviews (SRs)/meta-analyses (MAs) on COVID-19 can efficiently guide evidence-based clinical practice. However, SRs/MAs with weaknesses can mislead clinical practice and pose harm to patients, and too many useless SRs/MAs could pose confusion and waste sources. A "living" overview of SRs/MAs aims to provide an open, accessible and frequently updated resource summarizing the highest-level evidence of COVID-19, that can help evidence-users to quickly identify trusted evidence to guide the practice. This study aims to systematically give an overview SRs/MAs of COVID-19, assess their quality, and identify the best synthesis of evidence. METHODS Databases including Medline, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM) and WanFang were systematically searched on May 1, 2020 using relevant terms for identify SRs/MAs related to COVID-19. The study selection, data extraction and quality assessment will be performed by independent reviewers, and results will be crosschecked. The authoritative tools (AMSTAR-2, PRISMA and its extensions) will be used to assess the methodological quality and reporting quality of included SRs/MAs, and potential influence factors will be explored. The consistency of conclusions will be compared among reviews and the best evidence will be summarized. In addition, we will conduct exploratory meta-analyses (MAs) of individual studies when applicable. Data will be reported as number with (or) percentage, risk ratio (RR) or odds ratio (OR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) according to the specific results. R3.6.1 and Microsoft Excel 2016 will be used to analyze and manage data. RESULTS The results of this overview will be submitted to a peer-reviewed journal for publication. DISCUSSION In this study, we will present for the first time, an overview of SRs/MAs, which provides a comprehensive, dynamic evidence landscape on prevalence, prevention, diagnosis, treatment, and prognosis of COVID-19.
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Affiliation(s)
- Cuncun Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Tingting Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Bei Pan
- Gansu Provincial Hospital, Lanzhou, China
| | - Qi Wang
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Liangying Hou
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Qian Zhang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yunhua Wang
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yihui Wang
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiuxia Li
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yue Ruan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Lian Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Honghao Lai
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Tianzhu Qin
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Long Ge
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.
| | - Kehu Yan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.
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Huang F, Qiu M, Zhao S, Dai L, Xu Y, Yang Y, Lu L, Guo R, Tian Q, Fan Z, Wu S. Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot. J Pain Res 2020; 13:2633-2652. [PMID: 33116806 PMCID: PMC7585549 DOI: 10.2147/jpr.s254234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate systematic reviews (SRs) of acupuncture for low back pain (LBP) in terms of characteristics, reporting and methodological quality using a Veritas plot and to explore factors that may be associated with methodological quality and reporting quality. Study Design and Setting We searched 8 electronic bibliographic databases to find all SRs, and we evaluated the SRs' quality in 6 dimensions, including publication year, design type, homogeneity, risk of publication bias, methodological quality by Assessment of Multiple Systematic Reviews (AMSTAR) 2 and reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Excel 2010 and Adobe Illustrator CC were used to draw and optimize Veritas plots. Exploratory analysis was done using SPSS software version 23.0 to explore factors related to AMSTAR-2 and PRISMA scores. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence quality evaluation tool was used to grade all the outcome indicators in the included literature. Results We included 19 SRs in the analysis. Literature quality rank scores ranged from 9.67 to 17.00, with an average score of 13.18 ± 2.35. The average score of AMSTAR-2 was 7.47, and the average score of PRISMA was 18.47. Overall, the main issues were research strategies, inclusion and exclusion criteria, publication bias, and registration in PROSPERO. The results of exploratory analysis showed that duplication of literature selected and appropriate tools to assess the risk of bias were related to the AMSTAR-2 score, and the summary of evidence was related to the PRISMA score. The GRADE quality evaluation results showed mainly low quality. Conclusion The quality of SRs on acupuncture for low back pain should be improved, mainly by strengthening the methodological quality and reporting quality. The Veritas plot is an effective graphical evaluation method that is worth popularizing.
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Affiliation(s)
- Fan Huang
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Mingwang Qiu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Siyi Zhao
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Lin Dai
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Yanpeng Xu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Yunying Yang
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Liming Lu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China
| | - Rusong Guo
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.,Guangdong Province Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Qiang Tian
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.,Guangdong Province Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Zhiyong Fan
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.,Guangdong Province Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Shan Wu
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.,Guangdong Province Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
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Zhu X, Shen X, Hou X, Luo Y, Fu X, Cao M, Feng Z. Total glucosides of paeony for the treatment of rheumatoid arthritis: A methodological and reporting quality evaluation of systematic reviews and meta-analyses. Int Immunopharmacol 2020; 88:106920. [PMID: 32871476 DOI: 10.1016/j.intimp.2020.106920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/01/2020] [Accepted: 08/17/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the methodological, reporting and evidence quality of systematic reviews and meta-analyses of total glucosides of paeony (TGP) for rheumatoid arthritis (RA). METHODS We comprehensively searched the literature in numerous databases from inception to July 29th, 2020. Two appraisers collected data and assessed the methodological and reporting quality of the included reviews by revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool and the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA), respectively. The level of evidence quality was evaluated by employing the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale. RESULTS Eleven relevant articles were collected. The results from AMSTAR-2 showed that the methodological quality of all included reviews was critically low; no authors met the standard of those critical domains (0%), particularly in item 2, item 4 and item 7. The PRISMA scores ranged from 16.5 to 25, and one meta-analysis almost conformed to the PRISMA structure. According to GRADE, the 11 studies included 59 outcomes: 27 had very low quality, 22 had low quality, 10 had moderate quality, and none had high quality evidence. The most prominent downgrading factors were risk of bias, followed by publication bias, inconsistency, imprecision, and indirectness. CONCLUSIONS Although included studies summarized that TGP was effective and safe in the treatment of RA, the methodological and reporting quality and the quality of evidence was poor overall; decision-makers should be prudent when using TGP in treating RA patients. High-quality and multicenter studies investigating TGP for RA are urgently needed.
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Affiliation(s)
- Xiao Zhu
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei 443002, China
| | - Xiaolan Shen
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei 443002, China
| | - Xiaoqiang Hou
- Institute of Rheumatology, the First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443003, China
| | - Yanan Luo
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei 443002, China
| | - Xianyun Fu
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei 443002, China
| | - Meiqun Cao
- Shenzhen Institute of Geriatrics, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong 518035, China.
| | - Zhitao Feng
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, Medical College of China Three Gorges University, Yichang, Hubei 443002, China; Institute of Rheumatology, the First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443003, China.
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35
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Huang J, Qin X, Cai X, Huang Y. Effectiveness of Acupuncture in the Treatment of Parkinson's Disease: An Overview of Systematic Reviews. Front Neurol 2020; 11:917. [PMID: 32973668 PMCID: PMC7482669 DOI: 10.3389/fneur.2020.00917] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/16/2020] [Indexed: 01/08/2023] Open
Abstract
Background: The effects of acupuncture on Parkinson's disease (PD) outcomes remain unclear. The aim of this overview was to comprehensively evaluate the methodological quality and applicability of the results of systematic reviews (SRs)/meta-analyses (MAs) that examined the use of acupuncture to treat PD. Methods: Eight databases were searched to retrieve SRs/MAs on the use of acupuncture for the treatment of PD. Two reviewers independently screened and extracted the data using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) checklist to evaluate the methodological quality and using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria to assess the evidence quality of the included reviews. Results: A total of 11 SRs/MAs were included. According to the AMSTAR-2 checklist results, all included SRs/MAs were rated as very-low-quality studies. The GRADE criteria revealed 20 studies with very-low-quality evidence, 9 with low-quality evidence, 3 with moderate-quality evidence, and 0 with high-quality evidence. Descriptive analysis showed that acupuncture appears to be a clinically effective and safe treatment for PD. Conclusions: The use of acupuncture for the treatment of PD may be clinically effective and safe. This conclusion must be interpreted cautiously due to the generally low methodological quality and low quality of evidence of the included studies.
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Affiliation(s)
- Jinke Huang
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohui Qin
- Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine; Guangdong Provincial Academy of Chinese Medical Sciences), Guangzhou, China
| | - Xiaowen Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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Lu C, Lu T, Ge L, Yang N, Yan P, Yang K. Use of AMSTAR-2 in the methodological assessment of systematic reviews: protocol for a methodological study. Ann Transl Med 2020; 8:652. [PMID: 32566589 PMCID: PMC7290613 DOI: 10.21037/atm-20-392a] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Systematic reviews (SRs) with or without meta-analyses (MAs) are widely used in resolving questions in various healthcare areas (such as, traditional Chinese medicine, public health and surgery), and they are the cornerstone of evidence-based healthcare. However, the reliability of SRs is typically influenced by their methodological quality. AMSTAR (A Measurement Tool to Assess Systematic Reviews) and AMSTAR-2 tools can assess the methodological quality of SRs, and the use of AMSTAR has been investigated. However, AMSTAR-2 is now widely used to evaluate the methodological quality of SRs, but the use of AMSTAR-2 for determining the methodological quality of SRs has not yet been investigated and assessed thoroughly. Thus, we designed the present study to investigate the use of AMSTAR-2 in studies that assessed the methodological quality of a sample of SRs with the AMSTAR-2 and provide references to potential users of AMSTAR-2 tool. Methods Four commonly used electronic databases including PubMed, EmBase, the Cochrane Library, and Web of Science will be searched following a comprehensive search strategy to identify and retrieve studies that have used AMSTAR-2 tool for evaluating the methodological quality of SRs. Two independent authors will retrieve bibliometric information and methodological data, including all author names, time of publication, and journal names, whether a specific score value was given for each item, and whether overall quality assessment was performed. Descriptive statistical analyses will be used to present the study results, e.g., frequencies and percentages, mean and standard deviation (SD) or median and interquartile range (IQR). In addition, subgroup analyses will be performed to identify the methodological differences (e.g., the reporting of study designs included in SRs) between overviews and methodological studies. The risk ratio (RR) with 95% confidence interval (95% CI) will be calculated to measure the methodological differences. Cytoscape 3.7.1 software tool will be used to construct collaboration network maps. Further, Microsoft Office Excel 2016 and Stata 12.0 will be used to manage and analyze data. Discussion The results of this study will identify any gaps in the use of AMSTAR-2 and important bibliometric features, such as active researchers and journals, provide guidance to researchers in various healthcare areas (such as, traditional Chinese medicine and public health) for using AMSTAR-2 tool and help them in developing cooperation and submitting their manuscripts.
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Affiliation(s)
- Cuncun Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Tingting Lu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Long Ge
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Peijing Yan
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou 730000, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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Yu Y, Shi Q, Zheng P, Gao L, Li H, Tao P, Gu B, Wang D, Chen H. Assessment of the quality of systematic reviews on COVID-19: A comparative study of previous coronavirus outbreaks. J Med Virol 2020; 92:883-890. [PMID: 32301508 PMCID: PMC7264505 DOI: 10.1002/jmv.25901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
Several systematic reviews (SRs) have been conducted on the COVID-19 outbreak, which together with the SRs on previous coronavirus outbreaks, form important sources of evidence for clinical decision and policy making. Here, we investigated the methodological quality of SRs on COVID-19, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). Online searches were performed to obtain SRs on COVID-19, SARS, and MERS. The methodological quality of the included SRs was assessed using the AMSTAR-2 tool. Descriptive statistics were used to present the data. In total, of 49 SRs that were finally included in our study, 17, 16, and 16 SRs were specifically on COVID-19, MERS, and SARS, respectively. The growth rate of SRs on COVID-19 was the highest (4.54/month) presently. Of the included SRs, 6, 12, and 31 SRs were of moderate, low, and critically low quality, respectively. SRs on SARS showed the optimum quality among the SRs on the three diseases. Subgroup analyses showed that the SR topic (P < .001), the involvement of a methodologist (P < .001), and funding support (P = .046) were significantly associated with the methodological quality of the SR. According to the adherence scores, adherence to AMSTAR-2 items sequentially decreased in SRs on SARS, MERS, and COVID-19. The methodological quality of most SRs on coronavirus outbreaks is unsatisfactory, and those on COVID-19 have higher risks of poor quality, despite the rapid actions taken to conduct SRs. The quality of SRs should be improved in the future. Readers must exercise caution in accepting and using the results of these SRs.
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Affiliation(s)
- Yang Yu
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First Clinical Medical College, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Peng Zheng
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Lei Gao
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Haiyuan Li
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Pengxian Tao
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Baohong Gu
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Dengfeng Wang
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China.,The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Hao Chen
- The Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China
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O'Kelly F, DeCotiis K, Aditya I, Braga LH, Koyle MA. Assessing the methodological and reporting quality of clinical systematic reviews and meta-analyses in paediatric urology: can practices on contemporary highest levels of evidence be built? J Pediatr Urol 2020; 16:207-217. [PMID: 31917158 DOI: 10.1016/j.jpurol.2019.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/03/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Systematic reviews and meta-analyses provide a comprehensive summary of research studies and are used to assess clinical evidence, form policy and construct guidelines. This is pertinent to childhood surgery with issues of consent and condition prevalence. The aims of this study were to evaluate the methodological and reporting quality of these reviews and to identify how these reviews might guide clinical practice amongst those conditions most commonly encountered and managed by practicing paediatric urologists. METHODS A systematic search of the English literature was performed to identify systematic reviews and meta-analyses focusing on clinical paediatric urology (1/1/1992-1/12/2018) to include common paediatric urological conditions managed by paediatric urology residents/fellows. To these reviews, Assessing the Methodological Quality of Systematic Reviews (AMSTAR)-2 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) scores were applied. Univariate linear regression and descriptive statistical methods were performed. RESULTS From an initial literature review of 1723 articles, 227 were included in the analysis. Inter-reviewer agreement was high amongst 3 independent reviewers (κ = 0.92). Eighty-four percent of systematic reviews and meta-analyses were published since 2009 following publication of the PRISMA guidelines. The overall impact factor was 3.38 (0.83-17.58), with adherence to AMSTAR-2 criteria 48.46% and PRISMA criteria 70.1%. From a methodological perspective, 15% of reviews were of moderate quality, 65% were of low quality and 20% reviews were of critically low quality, with none found to have good quality reporting. CONCLUSIONS Despite the continued increase of systematic reviews and meta-analyses in paediatric urology from which many guidelines are based, a significant number of reviews contain poor methodology and, to a lesser extent, poor reporting quality. Journals should consider having specific 'a priori' criteria based on checklists before publication of manuscripts to ensure the highest possible reporting quality.
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Affiliation(s)
- F O'Kelly
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.
| | - K DeCotiis
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - I Aditya
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L H Braga
- Division of Urology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - M A Koyle
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Gao Y, Cai Y, Yang K, Liu M, Shi S, Chen J, Sun Y, Song F, Zhang J, Tian J. Methodological and reporting quality in non-Cochrane systematic review updates could be improved: a comparative study. J Clin Epidemiol 2020; 119:36-46. [PMID: 31759063 DOI: 10.1016/j.jclinepi.2019.11.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of the study was to compare the methodological and reporting quality of updated systematic reviews (SRs) and original SRs. STUDY DESIGN AND SETTING We included 30 pairs of non-Cochrane updated and original SRs, identified from a search of PubMed and Embase.com. We used Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) to assess methodological quality and Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) for reporting quality. Stratified analyses were conducted to compare the differences between updated SRs and original SRs and explore factors that might affect the degree of quality change. RESULTS Of the 60 non-Cochrane SRs, only two (3.3%) were of low quality, the remaining 58 (96.7%) were of critical low quality. There were no statistically significant differences in methodological quality between the updated SRs and original SRs, although the compliance rates of eight items of updated SRs were higher than that of original SRs. Updated SRs showed an improvement on 15 PRISMA items, but no items with statistically significant differences. The differences in fully reported AMSTAR-2 and PRISMA items between original SRs and updated SRs were also not statistically significant after adjusting for multiple review characteristics. CONCLUSION The methodological and reporting quality of updated SRs were not improved compared with original SRs, although the quality could be further improved for both updated SRs and original SRs.
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Affiliation(s)
- Ya Gao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yitong Cai
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Kelu Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Ming Liu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Shuzhen Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ji Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yue Sun
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Fujian Song
- Public Health and Health Services Research, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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