Improving the quality of systematic reviews of neurological conditions: an assessment of current practice and the development and validation of six new search strategies

2018 ◽  
Vol 25 (12) ◽  
pp. 1477-1485 ◽  
Author(s):  
K.-T. A. Bui ◽  
J. Abdaem ◽  
A. Muccilli ◽  
G. C. Gore ◽  
M. R. Keezer
Author(s):  
KA Bui ◽  
J Abdaem ◽  
GC Gore ◽  
MR Keezer

Background: A well-constructed search strategy is an important feature of any systematic review. We aimed to design and validate electronic database (e.g. Pubmed) search strategies (i.e. a hedge or series of words used to identify articles of interest) for six neurological conditions. Methods: We enumerated 10311 consecutive articles in the 21 highest impact factor English-language general neurology journals. We constructed a simple hedge, limited to one keyword, for each condition. We also constructed a complex hedge using a series of MeSH terms and keywords. Two reviewers independently reviewed (confirmed by a third reviewer) all articles and established which condition(s) were the article’s subject. We calculated sensitivity/specificity estimates for the simple and complex hedges, and compared these using McNemar’s test. Results: The results are summarized in the Table. Conclusions: Our complex hedges for most conditions dramatically improve sensitivity without compromising specificity. This study will help improve the accuracy of search strategies in future systematic reviews.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1377-1377
Author(s):  
Karima Benkhedda ◽  
Stephen Brooks ◽  
Linda Greene-Finestone ◽  
Shannon Kelly ◽  
Amanda MacFarlane ◽  
...  

Abstract Objectives To develop and validate a set of 3 quality assessment instruments (QAls) for evaluating the quality of nutrition studies, for each of the commonly used study designs: (1) randomized controlled trials (RCTs), (2) prospective cohort, and (3) case-control studies. Methods The QAI development and validation process included 8 steps: 1) identify and evaluate existing general QAls for adaptation with nutrition-specific quality appraisal items; 2) scan the literature to identify nutrition-specific quality appraisal issues; 3) generate nutrition-specific items to be added to each of the general QAIs, adapt existing guidance for general items for nutrition applications and develop guidance for added nutrition items; 4) review, by two experts in clinical and population nutrition, of the modified general QAIs with added nutrition-specific items and guidance; 5) assess reliability and validity of the QAI for each study design; 6) improve the usability and feasibility, of the QAIs by considering feedback from the validation exercise to refine the wording of the guidance; 7) develop a worksheet to help evaluate, a priori, topic-specific methodology to address risk of bias; and  8) validate the final QAIs using five peer-reviewed studies identified from published systematic reviews with reported quality assessment. Agreement and reliability were determined for each QAI. Results Results of the validation show good to perfect agreement among evaluators for the overall study rating and across domains. When compared to the study quality assessment reported in the systematic review, nutrition- specific items had the greatest impact on study ratings, generally resulting in a downgrade of the overall rating. Conclusions A set of nutrition-specific QAls were developed to assess the quality and robustness of nutrition studies. These tools incorporate general quality issues of study design and conduct, as well as address recognised nutrition study-specific issues. They will improve consistency in how nutrition studies are assessed particularly in nutrition-related systematic reviews. This will contribute to the overall quality of assessment of diet and Funding Sources This work was supported by Health Canada.


Author(s):  
Danah AlMubarak ◽  
Nikolaos Pandis ◽  
Martyn T Cobourne ◽  
Jadbinder Seehra

Summary Background This study aimed to assess the reporting of the methodological quality of search strategies undertaken in orthodontic quantitative systematic reviews (SRs) and hence their reproducibility. Materials and methods A search of a single electronic database (Medline via PubMed) was undertaken to identify interventional orthodontic SRs with meta-analysis published within a 10-year period. The Cochrane Library of Systematic Reviews was also sourced. Full articles were reviewed by two assessors against the eligibility criteria. The reporting quality of each search strategy was assessed using a previously validated checklist with a score of 1 or 2 given for each of the eight items. Cumulative totals were calculated. Guided by previous research, the authors agreed the following cut-offs to categorize the overall level of quality: 8–10 (poor), 10–12 (fair), and greater than 13 (good). Results A total of 127 SRs were analysed. The overall median quality score for the reporting of the search strategy was 14 [interquartile range (IQR): 13–15]. Cochrane SRs and those originating in Europe received higher aggregate scores, whereas no difference was evident based on Prospero registration. The continent of the corresponding author predicated the overall score. Non-Cochrane reviews achieved lower overall scores compared to Cochrane reviews (−1.0, 95% confidence interval: −1.65, −0.34, P = 0.003). The most frequently searched database was EMBASE (N = 93) and the median number of authors was 5 (IQR 4–6). Authors of 26.8% of SRs searched the grey literature. Language restrictions were applied to the search strategies of 88 (69.3%) SRs. Conclusions The reporting quality of search strategies undertaken in orthodontic SRs is at a good level but differences between Cochrane and non-Cochrane reviews currently exist. The reporting of searching of the grey literature and application of no language restrictions can be improved.


2016 ◽  
Vol 89 (1062) ◽  
pp. 20150878 ◽  
Author(s):  
Clovis M Faggion ◽  
Yun-Chun Wu ◽  
Yu-Kang Tu ◽  
Jason Wasiak

2007 ◽  
Vol 177 (4S) ◽  
pp. 7-7
Author(s):  
Brent K. Hollenbeck ◽  
J. Stuart Wolf ◽  
Rodney L. Dunn ◽  
Martin G. Sanda ◽  
David P. Wood ◽  
...  

2020 ◽  
Vol 26 (23) ◽  
pp. 2686-2691 ◽  
Author(s):  
Ioannis Doundoulakis ◽  
Christina Antza ◽  
Haralambos Karvounis ◽  
George Giannakoulas

Background: Anticoagulation in patients with pulmonary embolism. Objective: To identify how non-vitamin K antagonist oral anticoagulants are associated with multiple outcomes in patients with pulmonary embolism. Methods: We performed a systematic search of systematic reviews via multiple electronic databases from inception to August 19th, 2019, without language restriction. Two authors independently extracted data and assessed the methodological quality of the included systematic reviews using the ROBIS tool. Results: We found twelve systematic reviews. Eleven SRs collected their data from randomized clinical trials and one from observational studies. All the included studies were published between 2014 and 2019 in English. The methodological quality of the 12 systematic reviews was low to high. None of the systematic reviews, which are included in our overview of systematic reviews, has evaluated the overall quality of evidence outcome using the Grading of Recommendations Assessments, Development and Evaluation (GRADE) approach. Conclusion: This is the first effort to summarize evidence about non-vitamin K antagonist oral anticoagulants in an overview of systematic reviews focusing exclusively on patients with pulmonary embolism. The evidence suggests that the non-vitamin K antagonist oral anticoagulants seem to be more effective and safer than a dualdrug approach with LMWH- VKA.


2019 ◽  
Author(s):  
Francisco Jesús Represas Carrera Sr ◽  
Ángel Alfredo Martínez Ques Sr ◽  
Ana Clavería Fontán Sr

BACKGROUND Diabetes mellitus is currently a major public health problem worldwide. It is traditionally approached in a clinical inpatient relationship between the patient and the healthcare professional. However, the rise of new technologies, particularly mobile applications, is revolutionizing the traditional healthcare model through the introduction of telehealthcare. OBJECTIVE (1) To assess the effects of mobile applications for improving healthy lifestyles on the quality of life and metabolic control of diabetes mellitus in adult patients. (2) To describe the characteristics of the mobile applications used, identify the healthy lifestyles they target, and describe any adverse effects their use may have. METHODS Review of systematic reviews and meta-analysis, following the guidelines of the Cochrane Collaboration and the Joanna Briggs Institute. We included studies that used any mobile application aimed at helping patients improve self-management of diabetes mellitus by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care without the use of mobile devices. In May 2018, a search was conducted in Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct, updated in May 2019. The methodological quality of the studies was assessed using the Amstar-2 tool. RESULTS Seven systematic reviews of 798 articles were initially selected for analysis. The interventions had a duration of between 1 and 12 months. Mobile applications focused singly or simultaneously on different lifestyles aspects (diet, physical exercise, motivation, blood glucose levels, etc.). There are significant changes in HbA1c values, body weight and BMI, although in others, such as lipid profile, quality of life, or blood pressure, there is no clear improvement. CONCLUSIONS There is clear evidence that the use of mobile applications improves glycemic control in diabetic patients in the short term. There is a lack of evidence in its long-term benefits. It is thus necessary to carry out further studies to learn about the long-term effectiveness of mobile applications aimed at promoting the healthy lifestyles of diabetic patients. CLINICALTRIAL PROSPERO Register: CRD42019133685


2021 ◽  
pp. 1-22
Author(s):  
Sebastian Jugl ◽  
Aimalohi Okpeku ◽  
Brianna Costales ◽  
Earl J. Morris ◽  
Golnoosh Alipour-Haris ◽  
...  

In 2017, a National Academies of Sciences, Engineering, and Medicine (NASEM) report comprehensively evaluated the body of evidence regarding cannabis health effects through the year 2016. The objectives of this study are to identify and map the most recently (2016–2019) published literature across approved conditions for medical cannabis and to evaluate the quality of identified recent systematic reviews, published following the NASEM report. Following the literature search from 5 databases and consultation with experts, 11 conditions were identified for evidence compilation and evaluation: amyotrophic lateral sclerosis, autism, cancer, chronic noncancer pain, Crohn’s disease, epilepsy, glaucoma, human immunodeficiency virus/AIDS, multiple sclerosis (MS), Parkinson’s disease, and posttraumatic stress disorder. A total of 198 studies were included after screening for condition-specific relevance and after imposing the following exclusion criteria: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome definition, intervention definition, sample size, study setting, and reported effect size. Few completed randomized controlled trials (RCTs) were identified. Studies classified as systematic reviews were graded using the Assessing the Methodological Quality of Systematic Reviews-2 tool to evaluate the quality of evidence. Few high-quality systematic reviews were available for most conditions, with the exceptions of MS (9 of 9 graded moderate/high quality; evidence for 2/9 indicating cannabis improved outcomes; evidence for 7/9 indicating cannabis inconclusive), epilepsy (3 of 4 graded moderate/high quality; 3 indicating cannabis improved outcomes; 1 indicating cannabis inconclusive), and chronic noncancer pain (12 of 13 graded moderate/high quality; evidence for 7/13 indicating cannabis improved outcomes; evidence from 6/7 indicating cannabis inconclusive). Among RCTs, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic noncancer pain). The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions, and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions.


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