Preferred Reporting Items For Systematic Reviews And Meta-Analyses Scores Research Articles

Re-evaluation of systematic reviews of acupuncture and moxibustion for children with cerebral palsy

To assess the methodological quality, report quality and evidence quality of the Meta-analysis and systematic reviews of acupuncture and moxibustion for children with cerebral palsy, aiming to provide decision-making basis for clinical treatment. The systematic reviews and Meta-analysis of acupuncture and moxibustion for children with cerebral palsy were searched in CNKI, Wanfang, VIP, SinoMed, Cochrane Library, PubMed and EMbase. The retrieval time was from the database establishment to June 30th, 2022. AMSTAR 2 (a measurement tool to assess systematic reviews) was used to evaluate the methodological quality， and PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and GRADE was used to evaluate the quality of evidence. A total of 14 systematic reviews were included, including 37 primary outcome indexes. According to AMSTAR 2 evaluation results, there were 4 low quality studies, 10 very low quality studies, and low scores on items 2, 4, 7, 10 and 16. PRISMA scores ranged from 15 to 25, and the main reporting problems reflected in structured abstracts, program and registration, retrieval, and funding sources, etc. According to the GRADE classification results, there were 3 high quality evidences, 7 medium quality evidences, 10 low quality evidences and 17 very low quality evidences. The main downgrading factors were limitations, imprecision and publication bias. Acupuncture and moxibustion has a certain effect for cerebral palsy in children, but the quality of methodology, reporting and evidence in the included literature is poor, and the comparison of curative effect between different acupuncture and moxibustion methods is unclear.

The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews

BackgroundStudies evaluating the effectiveness and safety of telerehabilitation in patients undergoing total knee arthroplasty (TKA) have increased. However, the study quality and results differ, systematic reviews are limited. We aimed to synthesise systematic reviews and meta-analyses to assess the effects of telerehabilitation in patients post-TKA.Materials and methodsSystematic reviews and meta-analyses regarding the effectiveness and safety of TKA telerehabilitation were retrieved from eight databases from establishment to 18 December 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS) and GRADE system were used to evaluate results, methods, bias and evidence quality.ResultsThirteen systematic reviews and meta-analyses were analysed. The AMSTAR 2 showed low methodological quality in seven studies and very low quality in six. Among the key items, item 2 had been registered on website before systematic review in four reviews. Concerning item 4, did not provide a comprehensive search strategy in 4 reviews. For item 7, none of the reviews provided a list of reasons for excluding an article. For item 9, regarding whether appropriate tools were used to assess the risk of bias of each included study, one review was assessed as ‘partially yes’, one review only included RCTs, and the remainder were assessed as ‘yes’. For item 11, one review did not specify the statistical methods used, and three reviews did not conduct a meta-analysis. For item 13, four reviews considered the risk of bias when interpreting or discussing the study results. For item 15, seven reviews did not evaluate publication bias. The PRISMA scores of the 13 reviews ranged from 17.5 to 26.0. The PRISMA indicated that 69.2% had no protocol registration, 38.5% did not provide other materials and evidence certainty, 23.1% did not provide certainty assessment, 30.8% did not report study bias. According to the ROBIS scale, diferrent domains have diferrent risks in all the reviews.ConclusionTelerehabilitation positively affects walking ability, knee extension and patient costs post-TKA surgery. Regarding the quality of life, patient satisfaction and the WOMAC, telerehabilitation had similar effects to conventional rehabilitation. Owing to the low quality of the studies, these conclusions should be interpreted cautiously, high-quality studies are needed in the future.

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

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

Is valve-sparing aortic root replacement better than total aortic root replacement? Anoverview of reviews.

Total aortic root replacement (TRR) is certainly beneficial for aortic root disease, but does it still have an advantageous prognosis for patients compared to valve-sparing aortic root replacement (VSRR)? An overview of reviews was conducted to assess each of their clinical efficacy/effectiveness. Systematic reviews (SRs)/Meta-analyses comparing the prognosis of TRR and VSRR in aortic root surgery were collected from 4 databases, all searched from the time of database creation to October 2022. Two evaluators independently screened the literature, extracted information and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) tool, Grading of Recommendations, Assessment, Development and Evaluations (GRADE), and Risk of Bias in Systematic Reviews (ROBIS) to evaluate the quality of reporting, methodological quality, risk of bias, and level of evidence of the included studies. A total of 9 SRs/Meta-analyses were ultimately included. In terms of the reporting quality of the included studies, PRISMA scores ranged from 14 to 22.5, with issues mainly in reporting bias assessment, risk of study bias, credibility of evidence, protocol and registration, and funding sources. The methodological quality of the included SRs/Meta-analyses was generally low, with key items 2, 7, and 13 having major flaws and non-key items 10, 12, and 16. In terms of risk of bias assessment, the overall assessment of the included 9 studies was high-risk. The quality of the evidence was rated as low to very low quality for the three outcome indicators selected for the GRADE quality of evidence rating: early (within 30 days postoperatively or during hospitalization) mortality, late mortality, and valve reintervention rate. VSRR has many benefits including reduced early and late mortality after aortic root surgery and reduced rates of valve-related adverse events, but the methodological quality of the relevant studies is low, and there is a lack of high-quality evidence to support this. https://www.PROSPERO, identifier: CRD42022381330.

Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism

To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment. The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence. A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias. Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

Quality analysis of prior systematic reviews of carpal tunnel syndrome: an overview of the literature.

Carpal tunnel syndrome (CTS) is a common condition greatly affects patients' quality of life and ability to work. Systematic reviews provide useful information for treatment and health decisions. This study aimed to assess the methodological quality of previously published systematic reviews on the treatment of CTS. Overview of systematic reviews conducted at the Brazilian public higher education institution, São Paulo, Brazil. We searched the MEDLINE and Cochrane Library database for systematic reviews investigating the treatment of CTS in adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and measurement tool to assess systematic reviews (AMSTAR) were applied by two independent examiners. Fifty-five studies were included. Considering the stratification within the AMSTAR measurement tool, we found that more than 76% of the analyzed studies were "low" or "very low". PRISMA scores were higher when meta-analysis was present (15.61 versus 10.40; P = 0.008), while AMSTAR scores were higher when studies performed meta-analysis (8.43 versus 5.59; P = 0.009) or when they included randomized controlled trials (7.95 versus 6.06; P = 0.043). The intra-observer correlation demonstrated perfect agreement (> 0.8), a Spearman's correlation coefficient of 0.829, and an ICC of0.857. The inter-observer correlation indicated that AMSTAR was more reliable than PRISMA. Overall, systematic reviews of the treatment of CTS are of poor quality. Reviews with better-quality conducted meta-analysis and included randomized controlled trials. AMSTAR is a better tool than PRISMA because it has a better performance and should be recommended in future studies. CRD42020172328 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020172328).

Quality of reporting among systematic reviews underpinning the ESC/ACC guidelines on ventricular arrhythmias and sudden cardiac death

ObjectivesThe main objective of this study was to assess the methodological and reporting quality of the systematic reviews (SRs) supporting the European Society of Cardiology (ESC) and the American College...

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting &amp; methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

Clinical Epidemiology in China series. Paper 3: The methodological and reporting quality of systematic reviews and meta-analyses published by China' researchers in English-language is higher than those published in Chinese-language

ObjectiveTo assess the methodological and reporting quality of Chinese- and English -language systematic reviews and meta-analyses (SRs/MAs) published by Chinese authors between 2016 and 2018. Study Design and SettingWe searched MEDLINE and Chinese Science Citation Database (CSCD) for SRs/MAs led by Chinese authors published between 2016 and 2018. We used random sampling to select 10% of the eligible SRs/MAs published in each year from CSCD, and then matched the same number of SRs/MAs in MEDLINE. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using the Assessment of Multiple Systematic Reviews (AMSTAR-2) tool. Stratified analyses were conducted to compare the differences of quality between Chinese- and English language SRs/MAs. ResultsWe identified 336 SRs/MAs (168 in Chinese and 168 in English). The reporting quality in Chinese-language SRs/MAs was slightly lower than English-language SRs/MAs (mean PRISMA scores: 20.58 vs. 21.71 in 2016, 19.87 vs. 21.24 in 2017, and 21.29 vs. 22.38 in 2018). Less than half of both Chinese- and English-language SRs/MAs complied with item 5 (protocol and registration), item 7 (information sources), item 8 (search) and item 27 (funding)). The methodological quality in Chinese -language SRs/MAs was also slightly lower than English -language SRs/MAs (mean AMSTAR-2 scores: 8.07 vs. 9.36 in 2016; 9.21 vs. 10.26 in 2017; 8.86 vs. 9.28 in 2018). Three items (item 2: established a protocol; item 4: use a comprehensive literature search; and item 10: report the sources of funding) were adhered to by less than 10% of both Chinese- and English -language SRs/MAs. Only one (0.6%) Chinese-language SRs/MA and nine (5.4%) English-language SRs/MAs were rated as high methodological quality. ConclusionThe reporting and methodological quality of English-language SRs/MAs conducted by authors from China between 2016 and 2018 were slightly better than those of Chinese -language SRs/MAs.

Total glucosides of paeony for the treatment of rheumatoid arthritis: A methodological and reporting quality evaluation of systematic reviews and meta-analyses

ObjectiveTo assess the methodological, reporting and evidence quality of systematic reviews and meta-analyses of total glucosides of paeony (TGP) for rheumatoid arthritis (RA). MethodsWe 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. ResultsEleven 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. ConclusionsAlthough 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.

The Usefulness of Meta-Analyses to Hip and Knee Surgeons.

Comprehensive systematic reviews of results from homogenous or heterogeneous clinical trials, meta-analyses are used to summarize and to interpret studies. Proponents believe that their use can increase study power and improve precision results. Critics emphasize that heterogeneity between studies and bias of individual studies compromise the value of results. The methodology of meta-analyses has improved over time, utilizing statistical analysis to reduce bias and examining heterogeneity. With an increasing trend of meta-analyses in orthopaedic literature, this study aimed to investigate quality and clinical utility of meta-analyses for total knee arthroplasty and total hip arthroplasty. A systematic review of total knee arthroplasty and total hip arthroplasty meta-analyses in 3 major orthopaedic journals from January 2000 to August 2017 was performed. Three authors independently reviewed eligible meta-analyses. A quality assessment was conducted using the Oxman-Guyatt Index. Reporting quality was assessed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two high-volume, fellowship-trained, attending surgeons specializing in total hip arthroplasty and total knee arthroplasty independently, in a blinded fashion, reviewed 24 of the highest-scored meta-analyses. There were 114 studies meeting eligibility criteria, 25 published from 2000 to 2009 and 89 published from 2010 to 2017, a 3.6-fold increase. The mean Oxman-Guyatt Index score was 3.89 points, with 12 high-quality studies, 87 moderate-quality studies, and 15 low-quality studies. The mean PRISMA score for all meta-analyses was 22.2 points, with 79% classified as low to moderate. Only 23 studies listed the Level of Evidence, and 8 were Level-I studies and 9 were Level-II studies. Studies with >15 randomized controlled trials were associated with higher PRISMA and Oxman-Guyatt Index scores. In 12 articles, we were unable to decipher the types of studies included. Only 39.4% of studies showed the risk of bias. Of the 24 studies identified as high quality per the PRISMA statement, 71% were determined to be either clinically unimportant or inconclusive. The number of total hip arthroplasty and total knee arthroplasty meta-analyses has markedly increased over the past decades. The majority of published meta-analyses from 3 major orthopaedic journals were not performed in accordance with established PRISMA guidelines. Many published meta-analyses are low to moderate quality, and clinicians should cautiously draw conclusions from poorly executed meta-analyses.

Reporting and Methodological Quality of Systematic Reviews and Meta-Analyses of Nursing Interventions in Patients With Alzheimer's Disease: General Implications of the Findings.

The aim of this study was to evaluate the reporting characteristics as well as the methodological quality of systematic reviews (SRs) and meta-analyses (MAs) of nursing interventions in patients with Alzheimer's disease and determine potential factors for high quality. Following the inclusion and exclusion criteria, we searched the databases PubMed, EMBASE, and The Cochrane Library from inception through October 1, 2017. Two reviewers independently selected articles and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and Assessment of Multiple Systematic Reviews (AMSTAR) checklist were adopted to evaluate reporting and methodological quality, respectively. A total of 64 eligible articles, published from 2001 to 2017, were included. The mean PRISMA and AMSTAR scores were 19.310 ± 4.167 and 6.390 ± 2.208, respectively. For the PRISMA checklist, the following characteristics had less than 50% compliance: protocol or registration, full electronic search strategy, summary measures, risk for bias across studies, and synthesis of results. For the AMSTAR checklist, the following characteristics had less than 50% compliance: a priori study design, comprehensive literature search, status of publication used as inclusion criteria, scientific quality, publication bias, and conflicts of interest stated. Logistic regression analyses indicated that systematic reviews including meta-analyses that followed PRISMA guidelines, had a protocol or registration, and had funding support were related to higher reporting quality; systematic reviews including meta-analyses that had a protocol or registration were related to higher methodological quality. The reporting and methodological quality of systematic reviews and meta-analyses of nursing interventions in patients with Alzheimer's disease were suboptimal, with some areas needing further improvement. More endorsement by journals of the reporting guidelines for SRs and MAs may improve article quality and the dissemination of reliable evidence to nurses. We recommend that authors, readers, reviewers, and editors become better acquainted with and adhere more strictly to the PRISMA and AMSTAR checklists.

Meta-analysis of meta-analyses in oncologic positron emission tomography.

As PET has become a standard of treatment in patients with cancer, publications of oncologic PET have grown sharply. We aimed to organize the data of meta-analyses of oncologic PET and assess the quality of studies. The inclusion criteria were studies that meta-analyzed to combine the data from multiple studies of oncologic PET. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to assess the reporting quality of the included studies. A total of 254 meta-analyses were eligible for inclusion in the study. The peak number of publications increased up to 42 in 2014. Lung (n=39, 15.4%) is the most common site of tumor included in meta-analysis with oncologic PET. Overall, 84% of studies were categorized into diagnostic test accuracy reviews (n=214). Studies published in 2010 or later (n=213) showed higher PRISMA scores than those published in 2009 or before. A large number of meta-analyses are published in the field of oncologic PET. Meta-analyses in oncologic PET seem to be cited more often than regular research papers. The overall quality of studies is low; however, they showed improvement after PRISMA statement.

Exploring reporting quality of systematic reviews and Meta-analyses on nursing interventions in patients with Alzheimer\u2019s disease before and after PRISMA introduction

BackgroundSystematic reviews (SRs) and meta-analyses (MAs) are distillation of current best available evidence, but are potentially prone to bias. The bias of SRs and MAs comes from sampling bias, selection bias and within study bias. So, their reporting quality is especially important as it may directly influence their utility for clinicians, nurses, patients and policy makers. The SRs and MAs on nursing interventions in patients with Alzheimer’s disease (AD) have been increasingly published over the past decade, but the reporting quality of article has not been evaluated after the introduction of Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) Statement.MethodsAccording to the inclusion and exclusion criteria, we searched the databases including PubMed, EMBASE and The Cochrane Library from inception through October 16th 2018. Two reviewers independently selected articles and extracted data. The PRISMA checklist was adopted to evaluate reporting quality. Comparisons were made between studies published before (2001–2009) and after (2011–2018) its introduction.ResultsA total of 77 eligible articles, 18 (23.4%) were published before the PRISMA Statement and 59 (76.6%) were published afterwards. There was higher score after publication of the PRISMA Statement than before (20.83 ± 3.78 vs 17.11 ± 4.56, P < 0.05). There was an improvement in the following items after the PRISMA statement was released (P < 0.05): title (item 1, 50.0% vs 74.6%, OR = 3.10, 95CI%: 1.00–9.61), search (item8, 27.8% vs 57.6%,OR = 3.25, 95CI%: 1.14–9.28), study selection (item 9, 44.4% vs 81.4%,OR = 6.28, 95CI%: 1.93–20.37), Data collection process (item 10, 50.0% vs 76.3%,OR = 3.45, 95CI%:1.10–10.84), risk of bias in individual studies (item 12, 50.0% vs 83.1%, OR = 5.78, 95CI%:1.71–19.52), risk of bias across studies (item15, 5.6% vs 28.8%,OR = 3.60, 95CI%:1.04–12.43), study characteristics (item 18, 77.8% vs 98.3%, OR = 28.13, 95CI%:3.35-236.19), risk of bias with studies (item 19, 50.0% vs 83.1%, OR = 5.78, 95CI%:1.71-19.52), results in individual studies (item 20, 72.2% vs 94.9%, OR = 11.09, 95CI%:1.99–61.82), conclusions (item 26, 77.8% vs 98.3%, OR = 28.13, 95CI%:3.35–236.19). After controlling for the confounding factors, there were higher PRISMA score for systematic reviews including meta-analyses, protocol or registration, can’t answer of RCT, journal source of SCI (Science Citation Index), manuscript length > 13 page and funding support.ConclusionSince the publication of the PRISMA Statement, there has been an improvement in the quality of reporting of SRs and MAs on nursing interventions in patients with AD. More endorsement by journals of the report guideline for SRs/MAs may improve articles reporting quality, and the dissemination of reliable evidence to nurses. We recommend authors, readers, reviewers, and editors to become more acquainted with and to more strictly adhere to the PRISMA checklist.

Findings and methodological quality of systematic reviews focusing on acupuncture for pregnancy-related acute conditions.

Major concerns regarding the use of medication during pregnancy justify the need for safer interventions. Acupuncture is an emerging alternative for several clinical conditions during this period. The objective of this study is to summarise evidence derived from systematic reviews (SRs) focusing on acupuncture for pregnancy-related acute conditions. Review of SRs. A systematic literature search was carried out in several electronic databases, aiming to include all SRs assessing the effects of acupuncture for acute conditions during pregnancy. Methodological quality and quality of the publication/reporting of each SR were assessed by the application of AMSTAR (Assessing the Methodological Quality of Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), respectively. The initial search retrieved 11 492 records, of which 16 SRs met our inclusion criteria. The average AMSTAR score was 7.3, the lowest score being 3 and the highest 11. The lowest PRISMA score was 12, the highest 25, and the average PRISMA score was 19.9. The results support the proposal that acupuncture might be considered an option for alleviating pain during labour, for correcting breech presentation, and for managing pelvic and back pain during pregnancy. There is insufficient evidence to recommend acupuncture for inducing labour, managing nausea and vomiting in early pregnancy, improving sleep quality, controlling nausea and vomiting associated with Caesarean delivery, and managing urinary infection. Acupuncture might be an option for alleviating pain during labour, for correcting breech presentation, and for managing pelvic and back pain during pregnancy. More studies are needed to confirm the effects of acupuncture for other pregnancy-related acute conditions.

Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder.

IntroductionWith efforts to combat opioid use disorder, there is an increased interest in clinical practice guidelines (CPGs) for opioid use disorder treatments. No literature exists examining the quality of systematic reviews used in opioid use disorder CPGs. This study aims to describe the methodological quality and reporting clarity of systematic reviews (SRs) used to create CPGs for opioid use disorder.MethodsFrom June to July 2016 guideline clearinghouses and medical literature databases were searched for relevant CPGs used in the treatment of opioid use disorder. Included CPGs must have been recognized by a national organization. SRs from the reference section of each CPG was scored by using AMSTAR (a measurement tool to assess the methodological quality of systematic reviews) tool and PRISMA (preferred reporting items for systematic reviews and meta-analyses) checklist.ResultsSeventeen CPGs from 2006–2016 were included in the review. From these, 57 unique SRs were extracted. SRS comprised 0.28% to 17.92% of all references found in the CPGs. All SRs obtained moderate or high methodological quality score on the AMSTAR tool. All reviews met at least 70% of PRISMA criteria. In PRISMA, underperforming areas included accurate title labeling, protocol registration, and risk of bias. Underperforming areas in AMSTAR included conflicts of interest, funding, and publication bias. A positive correlation was found between AMSTAR and PRISMA scores (r = .79).ConclusionAlthough the SRs in the CPGs were of good quality, there are still areas for improvement. Systematic reviewers should consult PRISMA and AMSTAR when conducting and reporting reviews. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations, recognizing that the quality of systematic reviews underpinning guidelines does not necessarily correspond to the quality of the guideline itself.

The quality of evidence on nutrition intervention published in Chinese journals: an assessment of meta-analyses on vitamin interventions.

The quality of meta-analyses (MAs) on nutrition intervention in mainland China remains uninvestigated. To assess the quality of the evidence regarding nutrition intervention in mainland China, we used vitamin intervention as an example to assess the overall methodological and reporting qualities of MAs on nutrition interventions published in Chinese journals. A cross-sectional study on MAs of vitamin interventions was performed. Four Chinese databases were searched from inception through September 2016 for all MAs of vitamin intervention. A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements were used to assess methodological and reporting qualities, respectively. A total of 43 MAs of vitamin interventions were included, but none of the studies had been updated. These reviews mainly focused on the effects of interventions involving vitamin D, B vitamins and vitamin E, and the most studied condition was "Endocrine, Nutritional and Metabolic diseases," such as diabetes, obesity, and nutritional rickets. The median AMSTAR score was 6 (0-7), and median PRISMA score was 18 (3-24). No study provided an 'a priori' design, a list of excluded studies, or a statement on conflict of interest, and less than 50.0% of included MAs stated the publication status and performed an adequate structure summary. The quality of the included MAs was disappointing regarding some items, and some lower quality reviews should be updated. Future MAs should improve on reporting conflicts of interest, harm, and publication bias.

Methodological quality, completeness of reporting and use of systematic reviews as evidence in clinical practice guidelines for paediatric overweight and obesity.

Paediatric obesity rates remain high despite extensive efforts to prevent and treat obesity in children. We investigated the quality of the methodology and reporting within systematic reviews (SRs) underpinning paediatric content in US clinical practice guidelines (CPGs). In June 2016 we searched guideline clearinghouses and professional organization websites for guidelines published by national or professional organizations in the United States from January 2007 onwards. In our primary, a priori analysis, we used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) instruments to score SRs and meta-analyses that included paediatric populations and were cited by included CPGs. In a secondary, post hoc analysis, we determined the extent to which US CPGs use available, relevant SRs and meta-analyses compared with non-US CPGs. Eight US-based CPGs with 27 references to 22 unique SRs were found. AMSTAR and PRISMA scores were low overall, with only three SRs having 'high' methodological quality. Items dealing with bias assessments and search strategies had especially low scores. US CPGs were also older on average and cited fewer SRs than their international counterparts. Low quality scores and dated guidelines should be a cause for concern among practicing clinicians and a call to action for future guideline developers, publishers and research institutions.

Low Reporting Quality of the Meta-Analyses in Diagnostic Pathology.

- Little is known regarding the reporting quality of meta-analyses in diagnostic pathology. - To compare reporting quality of meta-analyses in diagnostic pathology and medicine and to examine factors associated with reporting quality of diagnostic pathology meta-analyses. - Meta-analyses were identified in 12 major diagnostic pathology journals without specifying years and 4 major medicine journals in 2006 and 2011 using PubMed. Reporting quality of meta-analyses was evaluated using the 27-item checklist of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement published in 2009. A higher PRISMA score indicates higher reporting quality. - Forty-one diagnostic pathology meta-analyses and 118 medicine meta-analyses were included. Overall, reporting quality of meta-analyses in diagnostic pathology was lower than that in medicine (median [interquartile range] = 22 [15, 25] versus 27 [23, 28], P < .001). Compared with medicine meta-analyses, diagnostic pathology meta-analyses less likely reported 23 of the 27 items (85.2%) on the PRISMA checklist, but more likely reported the data items. Higher reporting quality of diagnostic pathology meta-analyses was associated with recent publication years (later than 2009 versus 2009 or earlier, P = .002) and non-North American first authors (versus North American, P = .001), but not journal publisher's location (P = .11). Interestingly, reporting quality was not associated with adjusted citation ratio for meta-analyses in either diagnostic pathology or medicine (P = .40 and P = .09, respectively). - Meta-analyses in diagnostic pathology had lower reporting quality than those in medicine. Reporting quality of diagnostic pathology meta-analyses is linked to publication year and first author's location, but not to journal publisher's location or article's adjusted citation ratios. More research and education on meta-analysis methodology may improve the reporting quality of diagnostic pathology meta-analyses.

Laparoscopic cholecystectomy for acute cholecystitis: early or delayed?: Evidence from a systematic review of discordant meta-analyses.

The laparoscopic cholecystectomy (LC) is an important approach of treating acute cholecystitis and the timing of performing this given treatment is associated with clinical outcomes. Although several meta-analyses have been done to investigate the optimal timing of implementing this treatment, the conflicting findings from these meta-analyses still confuse decision-making. And thus, we performed this systematic review to assess discordant meta-analyses and generate conclusive findings to facilitate informed decision-making in clinical context eventually. We electronically searched the PubMed, Cochrane Library, and EMBASE to include meta-analysis comparing early (within 7 days of the onset of symptoms) with delayed LC (at least 1 week after initial conservative treatment) for acute cholecystitis through August 2015. Two independent investigators completed all tasks including scanning and appraising eligibility, abstracting essential information using prespecified extraction form, assessing methodological quality using Oxford Levels of Evidence and Assessment of Multiple Systematic Reviews (AMSTAR) tool, and assessing the reporting quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), as well as implementing Jadad algorithm in each step for the whole process. A heterogeneity degree of ≤50% is accepted. Seven eligible meta-analyses were included eventually. Only one was Level I of evidence and remaining studies were Level II of evidence. The AMSTAR scores varied from 8 to 11 with a median of 9. The PRISMA scores varied from 19 to 26. The most heterogeneity level fell into the desired criteria. After implementing Jadad algorithm, 2 meta-analyses with more eligible RCTs were selected based on search strategies and implication of selection. The best available evidence indicated a nonsignificant difference in mortality, bile duct injury, bile leakage, overall complications, and conversion to open surgery, but a significant reduction in wound infection, hospitalization, and operation duration and improvement of the quality of life when compared early LC with delayed LC. However, number of work days lost, hospital costs, and patient satisfaction are warranted to be assessed further. With the best available evidence, we recommend early LC to be as the standard treatment option in treating acute cholecystitis.