Methodological Concerns and Quality Appraisal of Contemporary Systematic Reviews and Meta-Analyses in Pediatric Urology
Methodological Concerns and Quality Appraisal of Contemporary Systematic Reviews and Meta-Analyses in Pediatric Urology
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DOI：
10.1016/j.juro.2011.03.044
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发表时间：
2011-07-01
影响因子：
6.6
通讯作者：
Lorenzo, Armando J.
中科院分区：
文献类型：
--
作者：
Braga, Luis H.;Pemberton, Julia;Lorenzo, Armando J.
目的：系统评价和荟萃分析对临床实践的影响取决于它们的质量。我们试图分析已发表的儿科泌尿学系统综述和荟萃分析的质量。材料和方法：我们检索PubMed （MEDLINE）和Embase检索2000年1月至2009年11月前5大儿科泌尿学期刊发表的所有系统综述和荟萃分析。两位审稿人独立选择文章进行全文审查。采用多系统评价评估11项工具对科学方法学质量进行评价。结果：267篇初步结果中，有220篇文章被排除，因为它们是调查、病例报告或叙述性综述。对其余47篇文章的全文评价进一步排除了32组纯成人患者，留下15组进行最终分析。2009年共发表7篇，占47% （p < 0.01）。只有1篇综述（7%）描述了完整的搜索策略，3篇（20%）允许纳入非英语研究。在8篇综述（53%）中，研究的选择由2名审稿人进行。五个系统评价（33%）描述了某种形式的质量评估。只有5篇综述（33%）描述了发表偏倚的评估，8篇（53%）检查了研究之间的异质性。根据AMSTAR标准，7篇系统评价（47%）被认为方法质量不公平，5篇（33%）质量尚可，3篇（20%）质量良好。结论：尽管最近在儿科泌尿学期刊上发表的系统综述和荟萃分析的数量有所增加，但几乎一半的综述缺乏良好的科学质量，这引起了人们对其在影响临床实践中的作用的担忧。应努力提高小儿泌尿学文献的系统评价和荟萃分析的方法学质量。
Purpose: The usefulness of systematic reviews and meta-analyses in influencing clinical practice depends on their quality. We sought to analyze the quality of published systematic reviews and meta-analyses in pediatric urology.Materials and Methods: We searched PubMed (MEDLINE) and Embase for all systematic reviews and meta-analyses published in the top 5 pediatric urology journals between January 2000 and November 2009. Two reviewers independently selected articles for full text review. Scientific methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 11-item tool.Results: Of 267 initial results 220 articles were excluded because they were surveys, case reports or narrative reviews. Full text evaluation of the remaining 47 articles further excluded 32 series of exclusively adult patients, leaving 15 for final analysis. Seven articles (47%) were published in 2009 (p < 0.01). Only 1 review (7%) described a full search strategy and 3 (20%) allowed inclusion of non-English studies. In 8 reviews (53%) selection of studies was performed by 2 reviewers. Five systematic reviews (33%) described some form of quality assessment. Only 5 reviews (33%) described assessment of publication bias, while 8 (53%) checked for heterogeneity among studies. According to AMSTAR criteria, 7 systematic reviews (47%) were considered of less than fair methodological quality, 5 (33%) fair to good quality and 3 (20%) good quality.Conclusions: Despite a recent increase in the number of systematic reviews and meta-analyses published in pediatric urology journals, almost half of these reviews lack good scientific quality, raising concerns about their role in influencing clinical practice. Efforts should be made to improve the methodological quality of systematic reviews and meta-analyses in the pediatric urology literature.