Abstract
Objective: Systematic reviews are increasingly used as sources of evidence in clinical cardiology guidelines. In the present study, we aimed to assess the quality of published systematic reviews in high impact cardiology journals.Methods: We searched PubMed for systematic reviews published between 2010 and 2019 in five general cardiology journals with the highest impact factor (according to Clarivate Analytics 2019). We extracted data on eligibility criteria, methodological characteristics, bias assessments, and sources of funding. Further, we assessed the quality of retrieved reviews using the AMSTAR tool.Results: A total of 352 systematic reviews were assessed. The AMSTAR quality score was low or critically low in 71% (95% CI: 65.7–75.4) of the assessed reviews. Sixty-four reviews (18.2%, 95% CI: 14.5–22.6) registered/published their protocol. Only 221 reviews (62.8%, 95% CI: 57.6–67.7) reported adherence to the EQUATOR checklists, 208 reviews (58.4%, 95% CI: 53.9–64.1) assessed the risk of bias in the included studies, and 177 reviews (52.3%, 95% CI: 45.1–55.5) assessed the risk of publication bias in their primary outcome analysis. The primary outcome was statistically significant in 274 (79.6%, 95% CI: 75.1–83.6) and had statistical heterogeneity in 167 (48.5%, 95% CI: 43.3–53.8) reviews. The use and sources of external funding was not disclosed in 87 reviews (24.7%, 95% CI: 20.5–29.5). Data analysis showed that the existence of publication bias was significantly associated with statistical heterogeneity of the primary outcome and that complex design, larger sample size, and higher AMSTAR quality score were associated with higher citation metrics.Conclusion: Our analysis uncovered widespread gaps in conducting and reporting systematic reviews in cardiology. These findings highlight the importance of rigorous editorial and peer review policies in systematic review publishing, as well as education of the investigators and clinicians on the synthesis and interpretation of evidence.
Highlights
Systematic reviews are conducted to synthesize evidence, identify literature gaps and suggest potential areas for research, in a concerted effort to shape clinical practice guidelines and improve patient care outcomes [1, 2]
The clinical practice guidelines in cardiology are increasingly reliant on systematic reviews because they are perceived as the highest level of evidence in the evidence-based pyramid [20,21,22]
We searched PubMed for systematic reviews published between 2010 and 2019 in five general cardiology/cardiovascular medicine journals with the highest impact factors according to the 2019 Clarivate Analytics Journal Impact Factor (JIF) list (Circulation [23.6], European Heart Journal [22.7], Journal of the American College of Cardiology [20.6], Circulation Research [14.5], and JAMA Cardiology [12.8])
Summary
Systematic reviews are conducted to synthesize evidence, identify literature gaps and suggest potential areas for research, in a concerted effort to shape clinical practice guidelines and improve patient care outcomes [1, 2]. Given their contribution to informing evidence-based practice, the quality of systematic reviews should not be an acceptable area of compromise as poor quality reviews might contribute to the use of low-efficacy or harmful interventions [3, 4]. Only one analysis by Rao et al surveyed 82 cardiology systematic reviews to determine their overall characteristics without in-depth quality assessment or critical appraisal [23]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
