Risk of bias judgements and strength of conclusions in meta-evidence from the Cochrane Colorectal Cancer Group
Risk of bias judgements and strength of conclusions in meta-evidence from the Cochrane Colorectal Cancer Group
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DOI：
10.1186/s13643-019-1001-0
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发表时间：
2019-04-08
影响因子：
3.7
通讯作者：
Engel, Alexander
中科院分区：
文献类型：
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作者：
Delaney, John;Cui, Rebecca;Engel, Alexander
背景：科克伦协作网记录了其分析的原始研究的偏倚风险（ROB）判断。本次审查的目的是执行审计的所有文献产生的科克伦结直肠癌组（CCCG），重点是干预类型是否有任何关系与ROB和审查的能力，以告知临床practice.Methods：从2000年1月至2018年7月底的最新版本的CCCG审查。将结论分类为通知临床实践（I）或不通知临床实践（N）。根据语言的确定性，I和N类别都被分为坚定（F）或缓和M。ROB判决被汇总。根据其介入程度，将评论分为医疗（M）、外科（S）、医疗和外科（MS）或其他（O），然后排除O评论。结果：共纳入95篇综述，涉及1892篇文献。62%（n = 59/95）告知临床实践（I）。38%（n = 36/95）未告知临床实践（N）。在N组中，53%（n = 19/36）完全不明确（坚定），而47%（n = 17/36）中度不明确（缓和）。在I组中，46%（n = 27/59）给出了坚定的结论，54%（n = 32/59）给出了缓和的结论。对7564例偏倚病例进行了评估。43%的偏倚风险较低，20%较高，37%不清楚。与包含手术干预的综述相比，仅考虑医疗干预的综述更有可能包含低偏倚风险的研究（p < 0.001）。结论：科克伦结直肠癌研究组发现偏倚风险低的病例不到一半。包含手术干预的综述不太可能显示低偏倚风险。偏倚风险与综述是否告知临床实践有关，但干预类型不是。结直肠文献的读者在考虑该领域的原始和元证据时应谨慎，特别是在评估手术干预的情况下。
Background: The Cochrane Collaboration records risk of bias (ROB) judgements on the original studies it analyses. The aim of this review is to perform an audit of all literature produced by the Cochrane Colorectal Cancer Group (CCCG), focusing on whether intervention type has any relationship with ROB and the ability of a review to inform clinical practice.Methods: The most recent version of every CCCG review from January 2000 to the end of July 2018 was included. Conclusions were categorized as informing clinical practice (I) or not (N). Both I and N categories were divided into firm (F) or tempered M based on the definitiveness of their language. ROB judgements were aggregated. Reviews were classed as Medical (M), Surgical (S), Medical & Surgical (MS) or Other (O) based on their intervention, with O reviews then excluded. Data were analyzed in SPSS.Results: Ninety-five reviews were included, covering 1892 studies. Sixty-two percent (n = 59/95) informed clinical practice (I). Thirty-eight percent (n = 36/95) did not inform clinical practice (N). Of the N group, 53% (n = 19/36) were completely equivocal (firm) while 47% (n = 17/36) were moderately so (tempered). In the I group, 46% (n = 27/59) gave a conclusion that was firm and 54% (n = 32/59) were tempered. Seven thousand five hundred sixty-four cases of bias were assessed. Risk of bias was low in 43%, high in 20% and unclear in 37%. A review that regarded a medical intervention alone was significantly more likely to be comprised of studies with a low risk of bias than a review that included a surgical intervention (p < 0.001).Conclusion: The Cochrane Colorectal Cancer Group finds the risk of bias to be low in less than half of its judgements. A review that included a surgical intervention was less likely to display low risk of bias. Risk of bias was associated with whether a review informed clinical practice, but intervention type was not Readers of colorectal literature should be cautious when considering original and meta-evidence in this field, particularly where a surgical intervention is assessed.