A systematic evaluation of the quality of meta-analyses in the critical care literature.
A systematic evaluation of the quality of meta-analyses in the critical care literature.
复制标题
DOI：
10.1186/cc3803
复制
发表时间：
2005-10-05
期刊：
影响因子：
15.1
通讯作者：
Doig, CJ
中科院分区：
文献类型：
--
作者：
Delaney, A;Bagshaw, SM;Ferland, A;Manns, B;Laupland, KB;Doig, CJ
元分析被认为是临床医生用于指导重症监护临床实践的现有最高级别的证据形式。本研究的目的是系统地评估涉及重症监护相关主题的元分析的质量。
为了确定可能符合纳入条件的元分析，我们使用与重症监护相关的广泛检索词对Medline、EMBASE和Cochrane系统评价数据库进行了系统检索，这些检索词包括：重症监护、危重症护理、休克、复苏、正性肌力药和机械通气。两位作者独立地将预先确定的纳入标准应用于每项已确定的元分析。为了评估报告质量，我们使用综述质量评估问卷（OQAQ）的各部分得分和总分对纳入的元分析进行了评估。我们还比较了QUOROM声明发表前后所发表报告的质量。
共纳入了139份元分析报告（κ = 0.93）。元分析报告的总体质量较差，估计平均OQAQ总分为3.3分（95%置信区间；3.0 - 3.6）。只有43份（30.9%）被评为具有极小或较小缺陷（>5分）。我们注意到在元分析关键特征的报告方面存在问题，例如进行全面的文献检索、在纳入研究时避免偏倚以及恰当地提及所纳入研究的有效性。然而，在QUOROM声明发布之后，已发表元分析的总体质量有所提高。
重症监护医生可获取的元分析报告总体质量较差。在考虑将这些研究结果应用于临床实践之前，医生应该对这些研究进行批判性评估。
Meta-analyses have been suggested to be the highest form of evidence available to clinicians to guide clinical practice in critical care. The purpose of this study was to systematically evaluate the quality of meta-analyses that address topics pertinent to critical care. To identify potentially eligible meta-analyses for inclusion, a systematic search of Medline, EMBASE and the Cochrane Database of Systematic Reviews was undertaken, using broad search terms relevant to intensive care, including: intensive care, critical care, shock, resuscitation, inotropes and mechanical ventilation. Predetermined inclusion criteria were applied to each identified meta-analysis independently by two authors. To assess report quality, the included meta-analyses were assessed using the component and overall scores from the Overview Quality Assessment Questionnaire (OQAQ). The quality of reports published before and after the publication of the QUOROM statement was compared. A total of 139 reports of meta-analyses were included (kappa = 0.93). The overall quality of reports of meta-analyses was found to be poor, with an estimated mean overall OQAQ score of 3.3 (95% CI; 3.0–3.6). Only 43 (30.9%) were scored as having minimal or minor flaws (>5). We noted problems with the reporting of key characteristics of meta-analyses, such as performing a thorough literature search, avoidance of bias in the inclusion of studies and appropriately referring to the validity of the included studies. After the release of the QUOROM statement, however, an improvement in the overall quality of published meta-analyses was noted. The overall quality of the reports of meta-analyses available to critical care physicians is poor. Physicians should critically evaluate these studies prior to considering applying the results of these studies in their clinical practice.
登录
查看更多内容
影响因子：
120.7
作者：
Guyatt, GH;Haynes, RB;Richardson, WS
通讯作者：
Richardson, WS
影响因子：
120.7
作者：
ANTMAN, EM;LAU, J;CHALMERS, TC
通讯作者：
CHALMERS, TC
影响因子：
158.5
作者：
LeLorier, J;Gregoire, G;Derderian, F
通讯作者：
Derderian, F
影响因子：
6.2
作者：
Kelly, KD;Travers, A;Rowe, BH
通讯作者：
Rowe, BH
DOI：
10.1016/s0197-2456(97)00024-x
发表时间：
1997-12-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Flather, MD;Farkouh, ME;Yusuf, S
通讯作者：
Yusuf, S