Reporting quality and statistical analysis of published dose-response meta-analyses was suboptimal: a cross-sectional literature survey

Abstract Background Meta-analysis of RCTs has been widely employed to evaluate effectiveness of the interventions for breast cancer, but little is known of their reporting validity. Related studies showed that meta-analysis may mislead clinical practice when the reporting is uninformative. The purpose of the study was to assess the reporting quality of meta-analyses of RCTs for breast cancer intervention, and explore potential factors associated with the reporting.Method We searched Medline, Embase and Cochrane Database of Systematic reviews from inception to November 2019 for published meta-analysis of RCTs for breast cancer intervention. The PRISMA checklist (27-items) was used for the measuring of the reporting quality. The adherence of eligible meta-analyses under each reporting item from PRISMA were evaluated and those with an adherence ≥ 80% were regarded as well reported while less than 30% were poor reported. The proportion of reporting issues were summarized and compared in pre-defined settings measured by rate difference (RD).Result A total of 296 meta-analyses were included. For the 27 reporting items, there were only 6 items were identified as well-reported, while as much as 9 items were poorly reported by these meta-analyses. The reporting issues mainly embodied in the methods and results section. Our further analysis suggested that those published more recently (RD=-0.07, 95% CI: -0.12 to -0.03), complied with reporting guideline (RD=-0.04, 95% CI: -0.07 to -0.02), and pre-specified protocol (RD=-0.09, 95% CI: -0.09 to -0.01) were associated with less reporting issues.Conclusion The reporting of the meta-analyses for breast cancer intervention was uninformative to support the decision-making. Although improvement has seen over times, further efforts are still needed. Some easy-to-implement measures could be considered such as referring to a reporting guideline, develop a protocol in advance to help further researchers to improve the reporting of their meta-analysis.

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Survey of the Reporting Characteristics of Systematic Reviews in Rehabilitation

Physical Therapy ◽

10.2522/ptj.20120382 ◽

2013 ◽

Vol 93 (11) ◽

pp. 1456-1466 ◽

Cited By ~ 22

Author(s):

Silvia Gianola ◽

Monica Gasparini ◽

Michela Agostini ◽

Greta Castellini ◽

Davide Corbetta ◽

...

Keyword(s):

Systematic Reviews ◽

Controlled Trial ◽

Functional Limitations ◽

Reporting Quality ◽

Cross Sectional Study ◽

Quality Of Reporting ◽

Cross Sectional ◽

Item Data ◽

Meta Analyses

Background Systematic reviews (SRs) have become increasingly important for informing clinical practice; however, little is known about the reporting characteristics and the quality of the SRs relevant to the practice of rehabilitation health professionals. Objective The purpose of this study was to examine the reporting quality of a representative sample of published SRs on rehabilitation, focusing on the descriptive, reporting, and bias-related characteristics. Methods A cross-sectional study was conducted by searching MEDLINE for aggregative and configurative SRs indexed in 2011 that focused on rehabilitation as restorative of functional limitations. Two reviewers independently screened and selected the SRs and extracted data using a 38-item data collection form derived from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The data were analyzed descriptively. Results Eighty-eight SRs published in 59 journals were sampled. The median compliance with the PRISMA items was 17 (63%) out of 27 items (interquartile ratio=13–22 [48%–82%]). Two thirds of the SRs (n=66) focused on interventions for which efficacy is best addressed through a randomized controlled trial (RCT) design, and almost all of these SRs included RCTs (63/66 [95%]). More than two thirds of the SRs assessed the quality of primary studies (74/88 [84%]). Twenty-eight reviews (28/88 [32%]) meta-analyzed the results for at least one outcome. One half of the SRs reported positive statistically significant findings (46%), whereas a detrimental result was present only in one review. Conclusions This sample of SRs in the rehabilitation field showed heterogeneous characteristics and a moderate quality of reporting. Poor control of potential source of bias might be improved if more widely agreed-upon evidence-based reporting guidelines will be actively endorsed and adhered to by authors and journals.

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Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses Covering Treatments for Achilles Tendon Ruptures

Foot & Ankle Orthopaedics ◽

10.1177/24730114211000637 ◽

2021 ◽

Vol 6 (1) ◽

pp. 247301142110006

Author(s):

Marvin Carr ◽

David Dye ◽

Wade Arthur ◽

Ryan Ottwell ◽

Byron Detweiler ◽

...

Keyword(s):

Achilles Tendon ◽

Systematic Reviews ◽

Treatment Options ◽

Tendon Repair ◽

Reporting Quality ◽

Measurement Tool ◽

Cross Sectional ◽

Reporting Practices ◽

Study Characteristics ◽

Meta Analyses

Background: Approximately 18 in every 100 000 people have experienced a ruptured Achilles tendon. Despite the prevalence of this condition, treatment options remain contested. Hypothesis/purpose: The objective of this study was to evaluate the use of spin—reporting practices that may exaggerate benefit or minimize harm—in abstracts of systematic reviews related to Achilles tendon repair. We also evaluated whether particular study characteristics were associated with spin. Study design: Cross-sectional. Methods: We developed a search strategy for Ovid MEDLINE and Ovid Embase for systematic reviews focused on Achilles tendon treatment. Following title and abstract screening of these search returns, these reviews were evaluated for spin (according to a previously developed classification scheme) and received AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews–2) appraisals by 2 investigators in a masked, duplicate manner. Study characteristics for each review were also extracted in duplicate. Results: Our systematic search returned 251 articles of which 43 systematic reviews and meta-analyses were eligible for data extraction. We found that 65.1% of included studies contained spin (28/43). Spin type 3 was the most common type, occurring in 53.5% (23/43) of abstracts. Spin types 5, 6, 1, and 4 occurred in 16.3% (7/43), 9.3% (4/43), 7% (3/43), and 5.3% (1/43), respectively. Spin types 2, 7, 8, and 9 did not occur. AMSTAR-2 appraised 32.6% (14/43) of the studies as “moderate” quality, 32.6% (14/43) as “low” quality, and 34.9% (15/43) as “critically low” quality. No systematic reviews were rated as “high” quality. There was no significant association between the presence of spin and the following study characteristics: intervention type, article discussing Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) adherence, journal recommending PRISMA adherence, funding sources, journal 5-year impact factor, year the review was received for publication, or AMSTAR-2 critical appraisals. Conclusion: Spin was present in abstracts of systematic reviews and meta-analyses—covering Achilles tendon tear treatment. Steps should be taken to improve the reporting quality of abstracts on Achilles tendon treatment as well as other common orthopedic conditions. Clinical relevance: In order to avoid negative patient outcomes, articles should be free of spin within the abstract.

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Socioeconomic inequality in the risk of intentional injuries among adolescents: a cross-sectional analysis of 89 countries

Injury Prevention ◽

10.1136/injuryprev-2020-043905 ◽

2020 ◽

pp. injuryprev-2020-043905

Author(s):

Charlotte Probst ◽

Carolin Kilian ◽

Jürgen Rehm ◽

Andre F Carvalho ◽

Ai Koyanagi ◽

...

Keyword(s):

Food Insecurity ◽

Dose Response ◽

Interpersonal Violence ◽

Suicide Attempts ◽

Cross Sectional ◽

Individual Level ◽

Intentional Injuries ◽

Level Increase ◽

Specific Association ◽

Meta Analyses

IntroductionIn 2015, the elimination of hunger worldwide by 2030 was declared by the United Nations as a Sustainable Development Goal. However, food insecurity remains pervasive, contributing to socioeconomic health inequalities. The overall objective was to investigate the relationship between food insecurity and intentional injuries among adolescents.MethodsIndividual-level data from the Global School-based Student Health Survey from 89 countries were used (370 719 adolescents, aged 12–17 years). Multilevel logistic regressions were used to examine the sex-specific association between the level of food insecurity (none, medium and high) and intentional injuries (interpersonal violence and suicide attempts), accounting for the clustering of observations within surveys. Random-effects meta-analyses were used to analyse dose–response relationships.ResultsMedium and high food insecurity were associated with increased odds of reporting an injury from interpersonal violence among both sexes. A positive dose–response relationship was found, where each level increase in food insecurity was associated with a 30% increase in the odds of an injury due to interpersonal violence among boys (1.30; 95% CI 1.26 to 1.34) and a 50% increase among girls (1.53; 95% CI 1.46–1.62). The odds for suicide attempts increased by 30% for both sexes with each level increase in food insecurity (boys: 1.29; 95% CI 1.25–1.32; girls: 1.29; 95% CI 1.25–1.32).DiscussionThe findings indicate that socioeconomic inequalities exist in the risk of intentional injuries among adolescents. Although additional studies are needed to establish causality, the present study suggests that the amelioration of food insecurity could have implications beyond the prevention of its direct consequences.

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To which extent are per-and poly-fluorinated substances associated to metabolic syndrome?

Reviews on Environmental Health ◽

10.1515/reveh-2020-0144 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Maryam Zare Jeddi ◽

Rozita Soltanmohammadi ◽

Giulia Barbieri ◽

Aline S. C. Fabricio ◽

Gisella Pitter ◽

...

Keyword(s):

Metabolic Syndrome ◽

General Population ◽

Meta Analysis ◽

Small Body ◽

Epidemiological Studies ◽

Cross Sectional ◽

Random Effects Models ◽

Epidemiologic Evidence ◽

Adults And Children ◽

Meta Analyses

Abstract Exposure to per- and polyfluoroalkyl substances (PFAS), ubiquitous persistent environmental contaminants, has led to substantial global concern due to their potential environmental and human health effects. Several epidemiological studies have assessed the possible association between PFAS exposure and risk of metabolic syndrome (MetS), however, the results are ambiguous. The aim of this study was to assess the current human epidemiologic evidence on the association between exposure to PFAS and MetS. We performed a systematic search strategy using three electronic databases (PubMed, Scopus, and Web of Science) for relevant studies concerning the associations of PFAS with MetS and its clinical relevance from inception until January 2021. We undertook meta-analyses where there were five or more studies with exposure and outcomes assessments that were reasonably comparable. The pooled odd ratios (ORs) were calculated using random effects models and heterogeneity among studies was assessed by I2 index and Q test. A total of 12 cross-sectional studies (10 studies on the general population and two studies in the occupational settings) investigated the association between PFAS exposure and MetS. We pooled data from seven studies on the general population for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) and five studies for perfluorohexanesulfonate (PFHxS) and perfluorononanoic acid (PFNA). Predominately, most studies reported no statistically significant association between concentrations of PFAS and MetS. In the meta-analysis, the overall measure of effect was not statistically significant, showing no evidence of an association between concentrations of PFOA, PFOS, PFNA, and PFHxS and the risk of MetS. Based on the results of the meta-analysis, current small body of evidence does not support association between PFAS and MetS. However, due to limited number of studies and substantial heterogeneity, results should be interpreted with caution. Further scrutinizing cohort studies are needed to evaluate the association between various and less well-known PFAS substances and their mixture with MetS and its components in both adults and children in different settings.

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Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review

Nutrients ◽

10.3390/nu13020291 ◽

2021 ◽

Vol 13 (2) ◽

pp. 291

Author(s):

Tatsuro Inoue ◽

Keisuke Maeda ◽

Ayano Nagano ◽

Akio Shimizu ◽

Junko Ueshima ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Studies ◽

Clinical Outcomes ◽

Daily Living ◽

Community Dwelling ◽

Related Factors ◽

Cross Sectional ◽

Meta Analyses ◽

Community Dwelling Older Adults

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.

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Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000514471 ◽

2021 ◽

pp. 1-11

Author(s):

Diego Urrunaga-Pastor ◽

Diego Chambergo-Michilot ◽

Fernando M. Runzer-Colmenares ◽

Josmel Pacheco-Mendoza ◽

Vicente A. Benites-Zapata

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

High Altitude ◽

Web Of Science ◽

Meta Analysis ◽

Cross Sectional ◽

Language Restriction ◽

Newcastle Ottawa Scale ◽

Meta Analyses ◽

Ottawa Scale

Introduction: Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. Methods: We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Results: Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, I2: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, I2: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, I2: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. Conclusions: The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

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