SP3.5 Trends in systematic reviews of kidney transplantation: a 10-year analysis of the evidence base

Abstract

Abstract Background Systematic reviews (SRs) are the highest form of evidence for all types of clinical questions in evidence-based practice. For the first time in 2018, the number of SR publications in transplantation outstripped those from randomised controlled trials (RCTs). This raises concerns of duplication or increased use of poor-quality evidence. We aimed to analyse the trends, strength and quality of evidence in SRs in kidney transplantation over a 10-year period. Methods Systematic reviews in kidney transplantation were identified from the Transplant Library, without language restriction. All full-text citations were exported to a custom Research Electronic Data Capture (REDCap) database prior to evaluation. The quality of evidence in all included SRs was assessed using AMSTAR-2. Results We included 454 reviews, of which, only 3 scored as ‘high quality’. We found 96.70% of SRs were identified as ‘critically low quality’, which increased in number over time. The number of reviews comprising non-RCT data increased in the most recent 5 years. Only 14.12% of SRs had made a clear recommendation for practice. Conclusions This review highlights several concerning statistics that need to be addressed. In the last 10 years, only 3 SRs in kidney transplantation were ‘high-quality’. The weaknesses identified in critical domains, alongside the increased use of non-RCT data and lack of conclusive recommendations, undermines the confidence in the results of the reviews and purpose of publication. As these reviews are instrumental to clinical decision-making and patient care, we advocate for improved reporting quality among SRs in the field of kidney transplantation.