Quality of systematic reviews supporting the 2017 ACC/AHA and 2018 ESC/ESH guidelines for the management of hypertension

2021 ◽  
pp. bmjebm-2021-111675
Author(s):  
Raju Kanukula ◽  
Rupasvi Dhurjati ◽  
Kota Vidyasagar ◽  
Nusrath Rehana ◽  
Arun Talari ◽  
...  

ObjectiveTo assess the methodological and reporting quality of systematic reviews (SRs) that informed recommendations in the recent American and European hypertension guidelines.Design and settingsMeta-epidemiological study. We identified SRs that were cited for class I recommendations based on Level of Evidence-A in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) hypertension guidelines.Main outcome measuresMethodological and reporting quality of the SRs was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, respectively.ResultsA total of 40 SRs was included in the analysis (28 from 2017 ACC/AHA; 22 from 2018 ESC/ESH and 10 were included in both). Based on the AMSTAR-2 assessment, only 7.5% SRs were found to be of high methodological quality, 47.5% were of moderate, each 22.5% were of low and critically low quality. Based on the PRISMA checklist assessment, a mean of 24 items (SD (2.76) were reported appropriately, and only five SRs reported all 27 items appropriately.ConclusionMethodological and reporting quality of SRs were found to vary considerably. Lack of information on the funding source of included studies, use of a protocol, integration of risk of bias assessments while interpreting findings and reporting of excluded studies were major methodological deficiencies.

2017 ◽  
Vol 42 (8) ◽  
pp. 852-856 ◽  
Author(s):  
J. Wasiak ◽  
A. Y. Shen ◽  
R. Ware ◽  
T. J. O’Donohoe ◽  
C. M. Faggion

The objective of this study was to assess methodological and reporting quality of systematic reviews in hand and wrist pathology. MEDLINE, EMBASE and Cochrane Library were searched from inception to November 2016 for relevant studies. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using a measurement tool to assess systematic reviews, the Assessment of Multiple Systematic Reviews (AMSTAR). Descriptive statistics and linear regression were used to identify features associated with improved methodological quality. A total of 91 studies were included in the analysis. Most reviews inadequately reported PRISMA items regarding study protocol, search strategy and bias and AMSTAR items regarding protocol, publication bias and funding. Systematic reviews published in a plastics journal, or which included more authors, were associated with higher AMSTAR scores. A large proportion of systematic reviews within hand and wrist pathology literature score poorly with validated methodological assessment tools, which may affect the reliability of their conclusions. Level of evidence: I


2021 ◽  
pp. postgradmedj-2020-139392
Author(s):  
Rachel Wurth ◽  
Michelle Hajdenberg ◽  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Caroline E Copacino ◽  
...  

AimThe aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence.DesignWe conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included.Main outcome measuresWe extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed.ResultsA total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation.ConclusionThe methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.


2021 ◽  
Vol 11 (11) ◽  
pp. 1180
Author(s):  
Xandra García-González ◽  
Sara Salvador-Martín

Cardiovascular Diseases (CVs) are one of the main causes of mortality and disability around the world. Advances in drug treatment have greatly improved survival and quality of life in the past decades, but associated adverse events remain a relevant problem. Pharmacogenetics can help individualize cardiovascular treatment, reducing associated toxicities and improving outcomes. Several scientific societies and working groups periodically review available studies and provide consensus recommendations for those gene-drug pairs with a sufficient level of evidence. However, these recommendations are rarely mandatory, and the indications on how to adjust treatment can vary between different guidelines, which limits their clinical applicability. The aim of this review is to compile, compare and discuss available guidelines and recommendations by the main Pharmacogenetics Consortiums (Clinical Pharmacogenetics Implementation Consortium (CPIC); Dutch Pharmacogenetics Working Group (DPWG); the French Network of Pharmacogenetics (Réseau national de pharmacogénétique (RNPGx) and The Canadian Pharmacogenomics Network for Drug Safety (CPNDS) regarding how to apply pharmacogenetic results to optimize pharmacotherapy in cardiology. Pharmacogenetic recommendations included in European or American drug labels, as well as those included in the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) and the American Heart Association (AHA) treatment guidelines are also discussed.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053851
Author(s):  
Karem Slim ◽  
Flora Badon ◽  
Charles-Hervé Vacheron ◽  
Chadli Dziri ◽  
Thomas Marquillier

IntroductionImmunonutrition (IN) is generally used before major visceral surgery with the intent to reduce postoperative complications, especially infectious ones. However, the conclusions of published meta-analyses are conflicting. The purpose of this review is to synthesise the data of published systematic reviews on the effectiveness of IN.Methods and analysisThis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. This is an umbrella review of systematic reviews comparing IN (delivered orally 5–7 days preoperatively) with normal diet or isocaloric isonitrogenous feeding before visceral surgery performed on any of several viscera (colorectum, stomach, pancreas, liver, oesophagus). We search the systematic reviews included in the main bibliographic databases. To assess the efficacy of IN, several outcomes will be considered: the main outcome is infectious complications (surgical site infections, pulmonary infections or urinary infections) and secondary outcomes are overall morbidity, hospital length of stay and mortality. Identified reviews will be screened by two independent assessors. The methodological quality of relevant included reviews will be assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) instrument. The data extracted from included reviews will be synthesised using the r-Metafor package considering separate groups according to the viscus of interest. Publication bias will be evaluated, and subgroup analyses will be performed according to the quality of studies and preoperative nutritional status.Ethics and disseminationAn umbrella review based on published data from systematic reviews needs no ethical approval. Furthermore, no patient will be involved in the review. Once terminated, the review will be submitted for publication in an open access journal to ensure wide dissemination of the findings.PROSPERO registration numberCRD42021255177.


2021 ◽  
Author(s):  
Ting-Yu Lin ◽  
Ting-Yu Chueh ◽  
Tsung-Min Hung

Abstract BackgroundThe issues of replication and scientific transparency have been raised in exercise and sports science research. A potential means to address the replication crisis and enhance research reliability is to improve reporting quality and transparency. This study aims to formulate a reporting checklist as a supplement to the existing reporting guidelines, specifically for resistance exercise studies.MethodsSystematic reviews/meta-analyses, guidelines, and position stands related to resistance exercise since inception will be searched in PubMed and Scopus. Only studies published in English will be included. Two authors will independently screen titles/abstracts and then full-text articles against the inclusion criteria. Basic data will be extracted by the same two authors independently. The same two authors will independently extract items from systematic reviews, guidelines, and position stands that could potentially influence training efficiency, physiological/psychological functions, other health-related variables, or replication. Summaries of the findings and items extracted from the included systematic reviews/meta-analyses and included position stands or guidelines will be presented as tables. Using items adapted from the existing checklist Consensus on Exercise Reporting Template (CERT), a preferred reporting checklist for resistance exercise studies will be formulated. The protocol for this study was developed according to the reporting checklist for umbrella reviews published by Onishi and Furukawa in 2016.DiscussionThe proposed study is expected to build a reporting checklist with a high level of evidence, which can improve the reporting quality of future resistance exercise studies.Ethics and disseminationApproval from a human/animal research ethics committee is not required. The findings of the proposed study will be disseminated through conference presentations, our lab’s website in plain language, and, if possible, letters to the editor in peer-reviewed journals related to sport and exercise science.RegistrationThis study is registered with the EQUATOR Network under the title “Preferred Reporting Items for Resistance Exercise Studies (PRIRES).” PROSPERO registration number: CRD42021235259.


Author(s):  
Christine Baldwin ◽  
Rosemary Smith ◽  
Michelle Gibbs ◽  
C Elizabeth Weekes ◽  
Peter W Emery

ABSTRACT There is considerable heterogeneity across the findings of systematic reviews of oral nutritional supplement (ONS) interventions, presenting difficulties for healthcare decision-makers and patients alike. It is not known whether heterogeneity arises from differences in patient populations or relates to methodological rigor. This overview aimed to collate and compare findings from systematic reviews of ONSs compared with routine care in adult patients who were malnourished or at risk of malnutrition with any clinical condition and to examine their methodological quality. Three electronic databases were searched to July 2019, supplemented with hand-searching. Data on all outcomes were extracted and review methodological quality assessed using A MeaSurement Tool for Assessment of systematic Reviews (AMSTAR). Twenty-two reviews were included, 11 in groups from mixed clinical backgrounds and 11 in specific clinical conditions. Ninety-one meta-analyses were identified for 12 different outcomes but there was discordance between results. Significant benefits of ONSs were reported in 4 of 4 analyses of energy intake, 7 of 11 analyses of body weight, 7 of 22 analyses of mortality, 10 of 17 analyses of complications (total and infectious), 1 of 3 analyses of muscle strength, 4 of 9 analyses of body composition/nutritional status, 2 of 14 analyses of length of stay, and 2 of 5 analyses of hospital readmissions. Ten reviews were high quality (AMSTAR scores 8–11), 9 moderate (AMSTAR scores 3–8), and 3 poor (AMSTAR scores 0–3). Methodological deficiencies were limitations to searches, poor reporting of heterogeneity, and failure to incorporate quality of evidence into any recommendations. Discordance between reviews was not markedly reduced when only high-quality reviews were considered. Evidence for the effects of ONS in malnourished patients or those who are at risk of malnutrition is uncertain, and discordance in results can arise from differences in clinical background of patients or the etiological basis of malnutrition.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoxia Zhang ◽  
Hui Wang ◽  
Yanxu Chang ◽  
Yuefei Wang ◽  
Xiang Lei ◽  
...  

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA).Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA.Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored.Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.


2018 ◽  
Vol 17 (5) ◽  
pp. 99-119 ◽  
Author(s):  
E. V. Reznik ◽  
I. G. Nikitin

The American College of Cardiology and the American Heart Association updated the guideline for the prevention, detection, evaluation and management of high blood pressure in adults in 2017 The European Society of Cardiology and the European Society оf Hypertension updated guidelines for the management of arterial hypertension in 2018. This article reviews new positions of these documents, compares approaches to current issues of managing of the patients with arterial hypertension, pro and contra with previous versions of similar documents. It is necessary to update the National guidelines for management of patients with arterial hypertension, which should include the dignity of both European and American approaches.


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