scholarly journals The development of a new generic risk-of-bias measure for systematic reviews of surveys

Methodology ◽  
2020 ◽  
Vol 16 (4) ◽  
pp. 278-298
Author(s):  
Gabriel Nudelman ◽  
Kathleen Otto

It is important to evaluate risk of bias of the primary studies included in systematic reviews and meta-analyses. Since tools pertinent to surveys are scarce, the goal of the current research was to develop a measure to address this need. In Study 1, an initial list of 10 relevant topics was compiled from previous measures. In Study 2, the list was refined into an eight-item risk-of-bias measure via discussion and a pilot study. In Study 3, experienced researchers used the measure to asses 70 studies, demonstrating high interrater agreement (weighted Kappa = .82). Inexperienced raters also utilized the measure to code 26 different studies included in a prior meta-analysis, which resulted in adequate interrater agreement (weighted Kappa = .64) and excellent convergent validity (r = .66). Thus, the new measure, designed to be accessible and flexible, can increase standardization of risk-of-bias evaluations and contribute to the interpretation of systematic reviews and meta-analytic findings.

2005 ◽  
Vol 20 (8) ◽  
pp. 550-553 ◽  
Author(s):  
José Luis R. Martin ◽  
Víctor Pérez ◽  
Montse Sacristán ◽  
Enric Álvarez

AbstractSystematic reviews in mental health have become useful tools for health professionals in view of the massive amount and heterogeneous nature of biomedical information available today. In order to determine the risk of bias in the studies evaluated and to avoid bias in generalizing conclusions from the reviews it is therefore important to use a very strict methodology in systematic reviews. One bias which may affect the generalization of results is publication bias, which is determined by the nature and direction of the study results. To control or minimize this type of bias, the authors of systematic reviews undertake comprehensive searches of medical databases and expand on the findings, often undertaking searches of grey literature (material which is not formally published). This paper attempts to show the consequences (and risk) of generalizing the implications of grey literature in the control of publication bias, as was proposed in a recent systematic work. By repeating the analyses for the same outcome from three different systematic reviews that included both published and grey literature our results showed that confusion between grey literature and publication bias may affect the results of a concrete meta-analysis.


2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.


2017 ◽  
Vol 52 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Alby Elias ◽  
Vivek H Phutane ◽  
Sandy Clarke ◽  
Joan Prudic

Objective: Acute course of electroconvulsive therapy is effective in inducing remission from depression, but recurrence rate is unacceptably high following termination of electroconvulsive therapy despite continued pharmacotherapy. Continuation electroconvulsive therapy and maintenance electroconvulsive therapy have been studied for their efficacy in preventing relapse and recurrence of depression. The purpose of this meta-analysis was to examine the efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy in preventing relapse and recurrence of depression in comparison to antidepressant pharmacotherapy alone. Methods: We searched MEDLINE, Embase, PsycINFO, clinicaltrials.gov and Cochrane register of controlled trials from the database inception to December 2016 without restriction on language or publication status for randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. Two independent Cochrane reviewers extracted the data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses. The risk of bias was assessed using four domains of the Cochrane Collaboration Risk of Bias Tool. Outcomes were pooled using random effect model. The primary outcome was relapse or recurrence of depression. Results: Five studies involving 436 patients were included in the meta-analysis. Analysis of the pooled data showed that continuation electroconvulsive therapy and maintenance electroconvulsive therapy, both with pharmacotherapy, were associated with significantly fewer relapses and recurrences than pharmacotherapy alone at 6 months and 1 year after a successful acute course of electroconvulsive therapy (risk ratio = 0.64, 95% confidence interval = [0.41, 0.98], p = 0.04, risk ratio = 0.46, 95% confidence interval = [0.21, 0.98], p = 0.05, respectively). There was insufficient data to perform a meta-analysis of stand-alone continuation electroconvulsive therapy or maintenance electroconvulsive therapy beyond 1 year. Conclusion: There are only a few randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. The preliminary and limited evidence suggests the modest efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy with concomitant pharmacotherapy in preventing relapse and recurrence of depressive episodes for 1 year after the remission of index episode with the acute course of electroconvulsive therapy.


2021 ◽  
pp. 105381512199192
Author(s):  
Andréane Lavallée ◽  
Gwenaëlle De Clifford-Faugère ◽  
Ariane Ballard ◽  
Marilyn Aita

This systematic review and meta-analysis examined the effectiveness of parent–infant interventions for parents of preterm infants on parental sensitivity compared to standard care or active comparators. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration ID: CRD42016047083). Database searches were performed from inception to 2020 to identify eligible randomized controlled trials. Two review authors independently selected studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias assessment tool and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) guidelines. A total of 19 studies ( n = 2,111 participants) were included and 14 were suitable to be pooled in our primary outcome meta-analysis. Results show no significant effect of parent–infant interventions over standard care or basic educational programs, on parental sensitivity. Results may not necessarily be due to the ineffectiveness of the interventions but rather due to implementation failure or high risk of bias of included studies.


Medicina ◽  
2019 ◽  
Vol 56 (1) ◽  
pp. 6
Author(s):  
Carole A. Paley ◽  
Mark I. Johnson

Background and Objectives: It is estimated that 28 million people in the UK live with chronic pain. A biopsychosocial approach to chronic pain is recommended which combines pharmacological interventions with behavioural and non-pharmacological treatments. Acupuncture represents one of a number of non-pharmacological interventions for pain. In the current climate of difficult commissioning decisions and constantly changing national guidance, the quest for strong supporting evidence has never been more important. Although hundreds of systematic reviews (SRs) and meta-analyses have been conducted, most have been inconclusive, and this has created uncertainty in clinical policy and practice. There is a need to bring all the evidence together for different pain conditions. The aim of this review is to synthesise SRs of RCTs evaluating the clinical efficacy of acupuncture to alleviate chronic pain and to consider the quality and adequacy of the evidence, including RCT design. Materials and Methods: Electronic databases were searched for English language SRs and meta-analyses on acupuncture for chronic pain. The SRs were scrutinised for methodology, risk of bias and judgement of efficacy. Results: A total of 177 reviews of acupuncture from 1989 to 2019 met our eligibility criteria. The majority of SRs found that RCTs of acupuncture had methodological shortcomings, including inadequate statistical power with a high risk of bias. Heterogeneity between RCTs was such that meta-analysis was often inappropriate. Conclusions: The large quantity of RCTs on acupuncture for chronic pain contained within systematic reviews provide evidence that is conflicting and inconclusive, due in part to recurring methodological shortcomings of RCTs. We suggest that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings. It is essential that the quality of evidence is improved so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.


2021 ◽  
Vol 12 ◽  
Author(s):  
David T. Lardier ◽  
Kathryn E. Coakley ◽  
Kelley R. Holladay ◽  
Fabiano T. Amorim ◽  
Micah N. Zuhl

Objective: This meta-analysis and systematic review examined the effects of exercise interventions on alcohol consumption and binge drinking in individuals with alcohol use disorder (AUD).Data sources: PubMed, Web of Science, Google Scholar, SPORTDiscus, and ERIC databases.Study Inclusion and Exclusion Criteria: Peer-reviewed randomized controlled trials published in English between 1970 and 2021. All studies compared exercise (Ex) and treatment as usual (TAU) to TAU in adults with an alcohol-related diagnosis. All forms of exercise interventions were included (e.g., aerobic exercise, yoga, resistance exercise, etc.).Data Extraction: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines were followed. Risk of bias was assessed using the Cochrane risk-of-bias tool as described by the Cochrane Handbook for Systematic Reviews and Interventions.Results: The literature searches retrieved a combined 2527 studies, with 1,034 studies screened after removal of duplicates and 973 (94%) rejected after reviewing titles and abstracts. Full-text review was performed on 61 studies, with seven studies meeting inclusion criteria for qualitative and meta-analysis. Across seven studies (n = 492 participants), a significant effect (Z-value = −3.37; g = −0.30; 95% CI [−0.50—−0.09]; p = 0.001) was found for Ex+TAU on drinking volume. There was no effect of Ex+TAU on binge drinking. The effect of Ex+TAU on physical fitness (VO2max, ml•kg−1•min−1) was significant (Z-score = 3.70; g = 0.64; 95% CI [0.19–1.08]; p < 0.001).Conclusions: Exercise interventions may decrease alcohol consumption and improve fitness and can be an effective adjunctive treatment for individuals with alcohol-related diagnoses including AUD.


2019 ◽  
Author(s):  
Qian Li ◽  
Ke Deng ◽  
Xiaoyuan Jiang ◽  
Huan Tao ◽  
Hui Liu ◽  
...  

Abstract Background:Systematic review or meta-analysis, the strong study design of high quality evidence, give inconsistent conclusion of long-term effectiveness or efficacy of opioids for chronic non-cancer pain. We appraised the methodological quality of systematic reviews or meta-analyses. Methods: We found the relevant systematic reviews or meta-analyses by searching Medline, EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, the International prospective register of systematic reviews, Psyc ARTICLES/OVID, the Chinese Bio-Medical Literature Database, the China National Knowledge Infrastructure, and the Wan Fang Data and VIP Database on March 1st, 2019. The methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews-2(AMSTAR-2). Spearman correlation analysis and non-parametric tests were used to assess the association between quality and factors. Results: Twenty-one systematic reviews or meta-analyses were included in our study. One has no individual study. In terms of methodological quality, twelve reviews were critically low in overall confidence, four reviews were low, two reviews were moderate, two reviews were high. When referring to the systematic reviews or meta-analyses of relatively better methodological quality with more credible results and conclusions, the effectiveness or efficacy of opioids was small to questionable. Cochrane reviews performed better than non-Cochrane reviews in establishing prior protocol (100% vs 17%, P<0.05), providing an excluded studies list (100% vs 50%, P<0.05) and taking risk of bias into account when interpreting the results of the review (100% vs 75%, P<0.05). There was a strong correlation (ρ=0.526, P<0.05) between the impact factor of systematic reviews or meta-analyses in published journals and methodological quality. Conclusion The methodological quality of the included systematic reviews or meta-analyses is far from satisfactory and needs improvement, especially in establishing prior protocol and justifying significant deviations from the protocol, providing an excluded primary studies list, reporting the funding information of primary studies, and assessing the potential impact of risk of bias on individual studies.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jinke Huang ◽  
Xiaohui Qin ◽  
Min Shen ◽  
Yanjuan Xu ◽  
Yong Huang

Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview.Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality.Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.


2021 ◽  
Author(s):  
Chitima Boongird ◽  
Worapong Tearneukit ◽  
Thunyarat Anothaisintawee ◽  
Gareth McKay ◽  
Ammarin Thakkinstian

Abstract Introduction: Many existing systematic reviews and meta-analyses summarize the evidence of pharmacotherapies (PTs) and non-pharmacotherapies (NPTs) for wide range of available interventions for the management of Alzheimer dementia (AD). However, a succinct summary and efficacy comparison across the different types of treatments and interventions is lacking. We aim to identify the treatment or treatments with the highest efficacy of current pharmacological and non-pharmacological treatments for AD.Methods and analysis: Systematic reviews of randomized controlled trials (RCTs) will be selected according to the following criteria: conducted in elderly patients aged 60 years or older with AD, applied pairwise meta-analysis (PMA) or network meta-analysis (NMA) for pooled relative treatment effects for at least one pair of PTs and NPTs, and at least one of following outcomes was provided for patients/caregivers: cognitive function status, behavior, quality of life. The summary characteristics for each RCT will include the general design, participants, intervention, outcome measurements, duration of therapy and adverse events. The risk of bias will be assessed using Risk of Bias in Systematic Reviews (ROBIS) checklist and the risk of bias of individual RCTs will be assessed using the Revised Cochrane risk-of-bias tool.Ethics and Dissemination: Ethical approval will not be required because this study is based solely on published literature that meets accepted ethical standards, and there will be no concerns about privacy. Dissemination of the evidence obtained will include publication in a peer-reviewed international journal to improve clinical practices on the basis of robust scientific evidence.PROSPERO registration number: CRD42021228245


2020 ◽  
Vol 10 (10) ◽  
pp. 3607
Author(s):  
Hoofar Shokravi ◽  
Hooman Shokravi ◽  
Norhisham Bakhary ◽  
Mahshid Heidarrezaei ◽  
Seyed Saeid Rahimian Koloor ◽  
...  

A large number of research studies in structural health monitoring (SHM) have presented, extended, and used subspace system identification. However, there is a lack of research on systematic literature reviews and surveys of studies in this field. Therefore, the current study is undertaken to systematically review the literature published on the development and application of subspace system identification methods. In this regard, major databases in SHM, including Scopus, Google Scholar, and Web of Science, have been selected and preferred reporting items for systematic reviews and meta-analyses (PRISMA) has been applied to ensure complete and transparent reporting of systematic reviews. Along this line, the presented review addresses the available studies that employed subspace-based techniques in the vibration-based damage detection (VDD) of civil structures. The selected papers in this review were categorized into authors, publication year, name of journal, applied techniques, research objectives, research gap, proposed solutions and models, and findings. This study can assist practitioners and academicians for better condition assessment of structures and to gain insight into the literature.


Sign in / Sign up

Export Citation Format

Share Document