Completeness of Reporting in Systematic Reviews and Meta-analyses in Vascular Surgery

Abstract

Systematic reviews and meta-analyses (SRMAs) are essential in informing clinical guidelines and decision-making. Complete reporting of SRMAs through compliance to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines promotes transparency, reproducibility, and consistency across the literature. The purpose of this meta-epidemiological study is to assess the completeness of reporting of SRMAs in vascular surgery. MEDLINE and Embase were used to search through four major vascular surgery journals and four high-impact general medical journals (Table I) for SRMAs published between 2018 and October 2022, evaluating clinical treatments for any pathology treated by a vascular surgeon. Data screening and extraction were conducted in duplicate. The reporting completeness of each included SRMA was measured with reference to the 27-item PRISMA checklist. All 27 items were evaluated, and an SRMA scored 1 for the item if it was fully reported, or 0 otherwise, such that the maximum achievable “PRISMA score” was 27. The principal summary measure was the mean PRISMA score of all included SRMAs. Secondary analyses were performed to determine whether PRISMA compliance varied by publication year, funding status, or prospective registration. Overall, 1653 articles were captured in the initial search with 162 SRMAs included in the final analysis. SRMAs were most commonly published in the Journal of Vascular Surgery (46.3%, Table I). All SRMAs had more than one incomplete PRISMA item. The mean PRISMA score was 21.2 (standard deviation: 2.9, 78.5% compliance). The items reported least frequently were a complete structured summary (1.2%), protocol/registration information (25.9%), a replicable search strategy (42.6%), a method for assessing risk of bias across studies, and corresponding results (57.4% and 50.0%, respectively, Table II). There were no differences in reporting completeness over the study period (P = .067). However, prospective registration and funding were associated with improved PRISMA scores (22.9 vs 20.6, P < .001; 22.2 vs 20.9, P = .032, respectively). Overall, the reporting of SRMAs in vascular surgery is less than ideal, with several key items being consistently under-reported. Prospective registration and funding are positively associated with improved reporting. Authors, reviewers, and journal editors should consider these findings moving forward to encourage completeness of SRMA reporting. Raising awareness surrounding the value of complete reporting of SRMAs can aid in enhancing the quality of evidence in vascular surgery SRMAs moving forward.Table ICharacteristics of SRMAs and mean PRISMA scoresCategoryNumber of SRMAs, nMean PRISMA score (SD)Year 20182721.9 (2.0) 20193420.5 (3.8) 20203620.9 (2.9) 20213020.6 (3.0) 20223522.1 (2.3)Publishing journal AVS3120.0 (3.3) EJVES3821.7 (3.2) JVS7521.1 (2.6) VES620.3 (1.0) BMJ625.2 (1.0) JAMA621.3 (2.6)Disease state AAA3621.8 (2.3) CAS1319.8 (3.7) CVI1120.5 (2.6) Dialysis access1419.9 (2.9) PAD3421.6 (2.9) tAAA921.4 (2.3) TBAD421.0 (3.6) VTE1121.4 (3.6) Multiple1522.7 (2.3) Other1519.7 (3.2)Funding status Funded3322.2 (2.9)a Nonfunded12920.9 (2.9)Registered protocol Yes4222.9 (2.7)a No12020.6 (2.8)AAA, Abdominal aortic aneurysm; AVS, Annals of Vascular Surgery; BMJ, British Medical Journal; CAS, crotid artery stenosis; CVI, chronic venous insufficiency; EJVES, European Journal of Vascular and Endovascular Surgery; JAMA, Journal of the American Medical Association; JVS, Journal of Vascular Surgery; PAD, peripheral arterial disease; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SRMA, systematic review and meta-analyses; tAAA: thoracoabdominal aortic aneurysm; TBAD, type B aortic dissection; VES, Vascular and Endovascular Surgery; VTE, venous thromboembolism.aP < .05. Open table in a new tab Table IIPRISMA statement compliance per section and itemPRISMA sectionTotal compliance, %PRISMA itemArticles where item fully reported, No. (%)Title96Title155 (96)Abstract1Structured summary2 (1)Introduction72Rationale161 (99)Objectives72 (44)Methods75Protocol and registration42 (26)Eligibility criteria143 (88)Information sources162 (100)Search69 (43)Study selection126 (78)Data collection process140 (86)Data items134 (83)Risk of bias in individual studies151 (93)Summary measures151 (93)Synthesis of results150 (93)Risk of bias across studies93 (57)Additional analyses104 (64)Results85Study selection159 (98)Study characteristics157 (97)Risk of bias within studies144 (89)Results of individual studies158 (98)Synthesis of results156 (96)Risk of bias across studies81 (50)Additional analyses104 (64)Discussion96Summary of evidence161 (99)Limitations149 (92)Conclusions158 (98)Funding90Funding146 (90)PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SRMA, systematic review and meta-analyses.Total compliance calculated as the total number of completely reported items in this category divided by the total number of items in this category, across all SRMAs. Open table in a new tab