You have accessJournal of UrologyPediatrics: Congenital Anomalies - Kidney & Ureter1 Apr 2010456 ROOM FOR IMPROVEMENT: QUALITY APPRAISAL OF SYSTEMATIC REVIEWS AND META-ANALYSES IN PEDIATRIC UROLOGY ACROSS 5 TOP SPECIALTY JOURNALS Luis Braga, Julia Pemberton, Armando Lorenzo, Jorge DeMaria, and Gordon Guyatt Luis BragaLuis Braga Hamilton, Canada More articles by this author , Julia PembertonJulia Pemberton Hamilton, Canada More articles by this author , Armando LorenzoArmando Lorenzo Toronto, Canada More articles by this author , Jorge DeMariaJorge DeMaria Hamilton, Canada More articles by this author , and Gordon GuyattGordon Guyatt Hamilton, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.528AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Well designed systematic reviews (SR) and meta-analyses (MA) rank high in the hierarchy of levels of evidence, but their usefulness to influence clinical practice depends on their quality. We sought to analyze the quality of published SR and MA in Pediatric Urology. METHODS A search for all SR and MA in Pediatric Urology published between Jan 2000-Nov 2009 in 5 top specialty journals was conducted using Pubmed (MEDLINE) and EMBASE with the following limits: “Humans, Meta-Analysis, Review, Historical Article, English, and All Child: 0-18yrs”. Two reviewers independently selected articles for full-text review. Scientific methodological quality was assessed independently by 2 raters, using CEBM and AMSTAR tools. Disagreement was resolved by consensus. The overall scores for both tools were compared using Pearson correlation coefficient. RESULTS 267 titles and abstracts were initially reviewed of which 220 were excluded since they were narrative reviews, historical articles, case reports. Full text evaluation (n=47) resulted in further exclusion (n=32 - adults), leaving 15 for the final analysis. Seven of these were published in 2009 (47% vs 10% -previous years, p<0.01). Eleven (73%) reviews reported use of keywords only to search for articles. Only 1 (7%) review had a full search strategy described, while 4 (27%) reported use of grey literature and 3 (20%) inclusion of articles in a language other than English. In 8 (53%), selection of studies was performed by 2 reviewers, independently in 5 (33%) and blindly in none. Five (33%) reviews described some form of quality assessment of the included studies, 8 reported (53%) agreement between raters and 6 (40%) mentioned that discrepancy was resolved by consensus. Only 5 (33%) reviews reported assessment of publication bias by funnel plot while 8 (53%) checked for heterogeneity among studies and 10 (66%) presented some form of pooled statistics. Using AMSTAR criteria, 7 (47%) reviews were considered as having less than fair methodological quality, 5 (33%) fair to good quality and 3 (20%) good quality. When the CEBM tool was used, 6 (40%) reviews were rated as less than fair quality, 4 (27%) fair to good and 5 (33%) good. There was high agreement between the 2 measurement tools (r2=0.76). CONCLUSIONS Despite the recent increase in the number of SR and MA published in Pediatric Urology journals, almost half of these reviews lack good scientific quality, raising concerns about their role to influence clinical practice. Efforts should be made to improve the methodological quality of SR and MA in our field. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e180 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis Braga Hamilton, Canada More articles by this author Julia Pemberton Hamilton, Canada More articles by this author Armando Lorenzo Toronto, Canada More articles by this author Jorge DeMaria Hamilton, Canada More articles by this author Gordon Guyatt Hamilton, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...