scholarly journals Systematic survey of the causal language use in systematic reviews of observational studies: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038571
Author(s):  
Mi Ah Han ◽  
Gordon Guyatt
Keyword(s):  
Systematic Reviews ◽  
Observational Studies ◽  
Language Use ◽  
Causal Effect ◽  
Data Extraction ◽  
Open Science ◽  
Third Party ◽  
Systematic Survey ◽  
Assessment Development ◽  
Causal Language

IntroductionSometimes, observational studies may provide important evidence that allow inferences of causality between exposure and outcome (although on most occasions only low certainty evidence). Authors, frequently and perhaps usually at the behest of the journals to which they are submitting, avoid using causal language when addressing evidence from observational studies. This is true even when the issue of interest is the causal effect of an intervention or exposure. Clarity of thinking and appropriateness of inferences may be enhanced through the use of language that reflects the issue under consideration. The objectives of this study are to systematically evaluate the extent and nature of causal language use in systematic reviews of observational studies and to relate that to the actual intent of the investigation.Methods and analysisWe will conduct a systematic survey of systematic reviews of observational studies addressing modifiable exposures and their possible impact on patient-important outcomes. We will randomly select 200 reviews published in 2019, stratified in a 1:1 ratio by use and non-use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Teams of two reviewers will independently assess study eligibility and extract data using a standardised data extraction forms, with resolution of disagreement by discussion and, if necessary, by third party adjudication. Through examining the inferences, they make in their papers’ discussion, we will evaluate whether the authors’ intent was to address causation or association. We will summarise the use of causal language in the study title, abstract, study question and results using descriptive statistics. Finally, we will assess whether the language used is consistent with the intention of the authors. We will determine whether results in reviews that did or did not use GRADE differ.Ethics and disseminationEthics approval for this study is not required. We will disseminate the results through publication in a peer-reviewed journals.RegistrationOpen Science Framework (osf.io/vh8yx).

scholarly journals Impact and use of reviews and ‘overviews of reviews’ to inform clinical practice guideline recommendations: protocol for a methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031442
Author(s):  
Carole Lunny ◽  
Cynthia Ramasubbu ◽  
Savannah Gerrish ◽  
Tracy Liu ◽  
Douglas M Salzwedel ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Data Extraction ◽  
Meta Analysis ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Meta Analyses ◽  
The Impact

IntroductionGuidelines are systematically developed recommendations to assist practitioner and patient decisions about treatments for clinical conditions. High quality and comprehensive systematic reviews and ‘overviews of systematic reviews’ (overviews) represent the best available evidence. Many guideline developers, such as the WHO and the Australian National Health and Medical Research Council, recommend the use of these research syntheses to underpin guideline recommendations. We aim to evaluate the impact and use of systematic reviews with and without pairwise meta-analysis or network meta-analyses (NMAs) and overviews in clinical practice guideline (CPG) recommendations.Methods and analysisCPGs will be retrieved from Turning Research Into Practice and Epistemonikos (2017–2018). The retrieved citations will be sorted randomly and then screened sequentially by two independent reviewers until 50 CPGs have been identified. We will include CPGs that provide at least two explicit recommendations for the management of any clinical condition. We will assess whether reviews or overviews were cited in a recommendation as part of the development process for guidelines. Data extraction will be done independently by two authors and compared. We will assess the risk of bias by examining how each guideline developed clinical recommendations. We will calculate the number and frequency of citations of reviews with or without pairwise meta-analysis, reviews with NMAs and overviews, and whether they were systematically or non-systematically developed. Results will be described, tabulated and categorised based on review type (reviews or overviews). CPGs reporting the use of the Grading of Recommendations, Assessment, Development and Evaluation approach will be compared with those using a different system, and pharmacological versus non-pharmacological CPGs will be compared.Ethics and disseminationNo ethics approval is required. We will present at the Cochrane Colloquium and the Guidelines International Network conference.

scholarly journals Methodological quality assessment in systematic reviews in health sciences that included observational studies: a cross-sectional study/ Avaliação da qualidade metodológica em revisões sistemáticas na área das ciências da saúde que incluíram estudos observacionais: um estudo transversal

2021 ◽  
Vol 4 (5) ◽  
pp. 23002-23018
Author(s):  
Carla Massignan ◽  
Luciana Butini Oliveira ◽  
Lia Rosana Honnef ◽  
Júlia Meller de Oliveira ◽  
Karyn Lehmkuhl ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Methodological Quality ◽  
Data Extraction ◽  
Sample Size Calculation ◽  
Health Science ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Protocol Registration

There is great variability in methodological quality assessment (MQ) systematic reviews (SRs). We identified how MQ assessment in SRs that included observational studies in Health Science is applied and explored associated characteristics. A search was conducted in PubMed and five trained reviewers randomly selected 1,025 references after sample size calculation. Only SR published in English (September 2019/2020) were included. Selection and data extraction were conducted in two phases. Data were analyzed descriptively and using logistic regressions. After eligibility criteria application, 205 SRs were included. Only 27.8% informed the protocol registration and 80.0% described having followed a reporting guideline. Proportion’ SRs did not seem to present MQ assessment (OR 4.22; 95% CI: 1.38-12.87; P =0.01). SRs that did not register the study protocol (9.70; 95% CI: 1.95-48.27; P 0.001), those that did not inform the included study design (5.96; 95% CI: 1.63-21.77; P 0.001) and those without MA (OR 8.90; 95% CI: 2.79-28.43; p0.001) increased the odds of not evaluating MQ. Newcastle-Ottawa (47.5%), Joanna Briggs Institute (8.2%) and National Institute of Health (7.1%) were the most commonly used MQ tools. Lack of protocol registration, absence of information about the design of included studies, absence of MA, and proportion’ SRs were associated with lack of MQ assessment.

scholarly journals Effect of Probiotic, Prebiotic, or Synbiotic Supplement on Children, Adolescents, or Infants: A Protocol of an Umbrella Review

2021 ◽  
Author(s):  
Shunlian 付顺链 Fu ◽  
Qian Zhou ◽  
Lijun Yuan ◽  
Zi-nan Li ◽  
Qiu Chen
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Random Effect ◽  
Control Group ◽  
Measurement Tool ◽  
Umbrella Review ◽  
Qualitative Comparison ◽  
Assessment Development ◽  
Meta Analyses

Abstract Background: Many systematic reviews and meta-analyses have studied the association between probiotics, prebiotics, or synbiotics and children, adolescents, or Infants. With the promotion of probiotics, prebiotics, or synbiotics in our life and medical practice, more and more attention has been paid to them. Therefore, it is necessary to make a systematic summary of them. When the information was obtained in the identified systematic review, it will be compared with a control group that do not use probiotics, prebiotics, or synbiotics. In addition, our aim is to assess the quality of the included systematic reviews.Methods: We will conduct a comprehensive systematic search by summarizing systematic reviews of randomized controlled trials which have studied effect of probiotic, prebiotic, or synbiotic supplement on children, adolescents, or Infants. Four electronic databases (Embase, PubMed, Medline, and Cochrane Database of Systematic Reviews) will be searched. Two reviewers will independently screen the retrieved papers. Two reviewers will independently extract the data by reference to the JBI Data Extraction Form for Review for Systematic Reviews and Research Syntheses. We will also assess methodological quality and assessment of certainty in the findings by A Measurement Tool to Assess Systematic Review version 2 (AMSTAR-2) and the GRADE (Grading of Recommendations Assessment, Development and Evaluation). We will calculate the corrected covered area (CCA). We will recalculate the summary effect and 95% CIs by using fixed-effect or random-effect models.Discussion: Through quantitative and qualitative comparison by conducting an umbrella review, we hope our results will service better for future clinical practice.Systematic review registration: This protocol have finished the registration in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42021244923).

scholarly journals Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review

2020 ◽  
Author(s):  
Elaine Toomey ◽  
Yvonne Conway ◽  
Christopher Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
Open Science ◽  
World Health ◽  
Limited Evidence ◽  
Surgical Masks ◽  
Guidance Documents ◽  
Single Use ◽  
The Impact

Background The COVID-19 pandemic has led to unprecedented demand for personal protective equipment. Shortages of surgical masks and filtering facepiece respirators has led to the extended use or re-use of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices has been questioned. Objectives To summarise guidance and synthesise systematic review evidence on extended use, re-use or reprocessing of single-use surgical masks or filtering facepiece respirators. Methods A targeted search of the World Health Organization, European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites was conducted to identify guidance. Four databases (Medline, Pubmed, Epistemonikos, Cochrane Database of Systematic Reviews) and three preprint repositories (Litcovid, MedRxiv and Open Science Framework) were searched for relevant systematic reviews. Record screening and data extraction was conducted by two reviewers. Quality of included systematic reviews was appraised using the AMSTAR-2 checklist. Findings were integrated and narratively synthesised to highlight the extent to which key claims in guidance documents were supported by research evidence. Results Six guidance documents were identified. All note that extended use or re-use of single-use surgical masks and respirators (with or without reprocessing) should be considered only in situations of critical shortage. Extended use was generally favoured over re-use because of reduced risk of contact transmission. Four high-quality systematic reviews were included: three focused on reprocessing (decontamination) of N95 respirators and one focused on reprocessing of surgical masks. There was limited evidence on the impact of extended use on masks and respirators. Vaporised hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions: There is limited evidence on the impact of extended use and re-use of surgical masks and respirators. Where extended use or re-use is being practiced, healthcare organisations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

scholarly journals A mega-aggregation framework synthesis of the barriers and facilitators to linkage, adherence to ART and retention in care among people living with HIV

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lynn Hendricks ◽  
Ingrid Eshun-Wilson ◽  
Anke Rohwer
Keyword(s):  
Behaviour Change ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Antiretroviral Treatment ◽  
Critical Appraisal ◽  
Data Extraction ◽  
Retention In Care ◽  
Barriers And Facilitators ◽  
Change Model ◽  
Qualitative Evidence

Abstract Background People living with human immunodeficiency virus (PLHIV) struggle with the challenges of living with a chronic disease and integrating antiretroviral treatment (ART) and care into their daily lives. The aims of this study were as follows: (1) to undertake the first mega-aggregation of qualitative evidence syntheses using the methods of framework synthesis and (2) make sense of existing qualitative evidence syntheses that explore the barriers and facilitators of adherence to antiretroviral treatment, linkage to care and retention in care for PLHIV to identify research gaps. Methods We conducted a comprehensive search and did all screening, data extraction and critical appraisal independently and in duplicate. We used the Kaufman HIV Behaviour Change model (Kaufman et al., 2014) as a framework to synthesise the findings using the mega-aggregative framework synthesis approach, which consists of 8 steps: (1) identify a clearly defined review question and objectives, (2) identify a theoretical framework or model, (3) decide on criteria for considering reviews for inclusion, (4) conduct searching and screening, (5) conduct quality appraisal of the included studies, (6) data extraction and categorisation, (7) present and synthesise the findings, and (8) transparent reporting. We evaluated systematic reviews up to July 2018 and assessed methodological quality, across reviews, using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. Results We included 33 systematic reviews from low, middle- and high-income countries, which reported on 1,111,964 PLHIV. The methodological quality of included reviews varied considerably. We identified 544 unique third-order concepts from the included systematic reviews, which were reclassified into 45 fourth-order themes within the individual, interpersonal, community, institutional and structural levels of the Kaufman HIV Behaviour Change model. We found that the main influencers of linkage, adherence and retention behaviours were psychosocial and personal characteristics—perceptions of ART, desires, fears, experiences of HIV and ART, coping strategies and mental health issues—interwoven with other factors on the interpersonal, community, institutional and structural level. Using this approach, we found interdependence between factors influencing ART linkage, retention and adherence and identified the need for qualitative evidence that explores, in greater depth, the complex relationships between structural factors and adherence, sociodemographic factors such as community violence and retention, and the experiences of growing up with HIV in low- and middle-income countries—specifically in children, youth, women and key populations. Conclusions This is the first mega-aggregation framework synthesis, or synthesis of qualitative evidence syntheses using the methods of framework synthesis at the overview level. We found the novel method to be a transparent and efficient method for assessing the quality and making sense of existing qualitative systematic reviews. Systematic review registration The protocol of this overview was registered on PROSPERO (CRD42017078155) on 17 December 2017.

scholarly journals Do we need to improve the reporting of evidence in tendinopathy management? A critical appraisal of systematic reviews with recommendations on strength of evidence assessment

2021 ◽  
Vol 7 (1) ◽  
pp. e000920
Author(s):  
Dimitris Challoumas ◽  
Neal L Millar
Keyword(s):  
Systematic Reviews ◽  
Assessment Tool ◽  
Data Extraction ◽  
Cochrane Collaboration ◽  
Mean Difference ◽  
Strength Of Evidence ◽  
The Mean ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cochrane Collaboration

ObjectiveTo critically appraise the quality of published systematic reviews (SRs) of randomised controlled trials (RCTs) in tendinopathy with regard to handling and reporting of results with special emphasis on strength of evidence assessment.Data sourcesMedline from inception to June 2020.Study eligibilityAll SRs of RCTs assessing the effectiveness of any intervention(s) on any location of tendinopathy.Data extraction and synthesisIncluded SRs were appraised with the use of a 12-item tool devised by the authors arising from the Preferred Reporting Items in Systematic Reviews and Meta-Analyses statement and other relevant guidance. Subgroup analyses were performed based on impact factor (IF) of publishing journals and date of publication.ResultsA total of 57 SRs were included published in 38 journals between 2006 and 2020. The most commonly used risk-of-bias (RoB) assessment tool and strength of evidence assessment tool were the Cochrane Collaboration RoB tool and the Cochrane Collaboration Back Review Group tool, respectively. The mean score on the appraisal tool was 46.5% (range 0%–100%). SRs published in higher IF journals (>4.7) were associated with a higher mean score than those in lower IF journals (mean difference 26.4%±8.8%, p=0.004). The mean score of the 10 most recently published SRs was similar to that of the first 10 published SRs (mean difference 8.3%±13.7%, p=0.54). Only 23 SRs (40%) used the results of their RoB assessment in data synthesis and more than half (n=30; 50%) did not assess the strength of evidence of their results. Only 12 SRs (21%) assessed their strength of evidence appropriately.ConclusionsIn light of the poor presentation of evidence identified by our review, we provide recommendations to increase transparency and reproducibility in future SRs.

Lead in Mineral or Multivitamin-Multimineral Products

2021 ◽  
pp. 106002802110233
Author(s):  
C. Michael White
Keyword(s):  
English Language ◽  
Data Extraction ◽  
The United States ◽  
Third Party ◽  
Reference Level ◽  
Study Selection ◽  
Pubmed Search ◽  
Zinc Supplements ◽  
Average Lead ◽  
Year 2000

Objective Assess the current daily interim reference level of lead and the amount contained in current mineral and multivitamin-multimineral (MVM) products. Data Sources PubMed search from 1980 to May 15, 2021, limited to the English language, via the search strategy ((mineral OR multivitamin OR calcium OR iron OR magnesium OR copper OR zinc OR chromium OR selenium) AND (heavy metals OR Pb OR lead)). Study Selection and Data Extraction Narrative review of studies assessing lead content in mineral or MVM products. Data Synthesis Products containing different calcium forms (dolomite, bone meal, natural carbonate) have historically had higher lead levels than others (refined carbonate, lactate, gluconate, acetate, sevelamer), but the gap has closed considerably since the year 2000. Although only limited assessments of magnesium and zinc supplements have been conducted, no alarming average lead amounts were found. MVM products assessed since 2007 had low median or mean lead concentrations. However, large interproduct differences exist, with many products having very little lead and some products having concerning amounts. Relevance to Patient Care and Clinical Practice It is difficult for pharmacists and consumers to know the amount of lead in an actual product unless it is tested in an independent third-party lab. The United States Pharmacopeia and NSF International will provide a seal on the products stating that the products have a low level of lead, but even so, children could receive more lead than the Food and Drug Administration’s Interim Reference Level. Conclusions The threat from lead exposure in mineral and MVM products have diminsihed considerably over time but some products can still have excessive amounts. Without third-party testing, it is difficult for clinicians and consumers to know which outlier products to avoid.

scholarly journals Consistency of causal claims in observational studies: a review of papers published in a general medical journal

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043339
Author(s):  
Camila Olarte Parra ◽  
Lorenzo Bertizzolo ◽  
Sara Schroter ◽  
Agnès Dechartres ◽  
Els Goetghebeur
Keyword(s):  
Medical Journal ◽  
Observational Studies ◽  
The Other ◽  
Research Papers ◽  
General Medical Journal ◽  
Outcome Relationship ◽  
Causal Statement ◽  
Data Source ◽  
Published Research ◽  
Causal Language

ObjectiveTo evaluate the consistency of causal statements in observational studies published in The BMJ.DesignReview of observational studies published in a general medical journal.Data sourceCohort and other longitudinal studies describing an exposure-outcome relationship published in The BMJ in 2018. We also had access to the submitted papers and reviewer reports.Main outcome measuresProportion of published research papers with ‘inconsistent’ use of causal language. Papers where language was consistently causal or non-causal were classified as ‘consistently causal’ or ‘consistently not causal’, respectively. For the ‘inconsistent’ papers, we then compared the published and submitted version.ResultsOf 151 published research papers, 60 described eligible studies. Of these 60, we classified the causal language used as ‘consistently causal’ (48%), ‘inconsistent’ (20%) and ‘consistently not causal’(32%). Eleven out of 12 (92%) of the ‘inconsistent’ papers were already inconsistent on submission. The inconsistencies found in both submitted and published versions were mainly due to mismatches between objectives and conclusions. One section might be carefully phrased in terms of association while the other presented causal language. When identifying only an association, some authors jumped to recommending acting on the findings as if motivated by the evidence presented.ConclusionFurther guidance is necessary for authors on what constitutes a causal statement and how to justify or discuss assumptions involved. Based on screening these papers, we provide a list of expressions beyond the obvious ‘cause’ word which may inspire a useful more comprehensive compendium on causal language.

scholarly journals Published patterns of spin in biomedical literature: a protocol for a meta-research study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043784
Author(s):  
Naichuan Su ◽  
Michiel van der Linden ◽  
Geert JMG van der Heijden ◽  
Stefan Listl ◽  
Stefan Schandelmaier ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scientific Journal ◽  
Open Science ◽  
Biomedical Literature ◽  
Measurement Tool ◽  
Delphi Consensus ◽  
Reporting Practices ◽  
Literature Reviews ◽  
Science Framework ◽  
Meta Analyses

IntroductionSpin is defined as reporting practices that distort the interpretation of results and create misleading conclusions by suggesting more favourable results. Such unjustifiable and misleading misrepresentation may negatively influence the development of further studies, clinical practice and healthcare policies. Spin manifests in various patterns in different sections of publications (titles, abstracts and main texts). The primary aim of this study is to identify reported spin patterns and assess the prevalence of spin in general, and the prevalence of spin patterns reported in biomedical literature based on previously published systematic reviews and literature reviews on spin.Methods and analysisPubMed, EMBASE and SCOPUS will be searched to identify systematic or literature reviews on spin in biomedicine. To improve the comprehensiveness of the search, the snowballing method will be used to broaden the search. The data on spin-related outcomes and characteristics of the included studies will be extracted. The methodological quality of the included studies will be assessed with selective items of the A MeaSurement Tool to Assess systematic Reviews-2 checklist. A new classification scheme for spin patterns will be developed if the classifications of spin patterns identified in the included studies vary. The prevalence of spin and spin patterns will be pooled based on meta-analyses if the classification schemes for spin are comparable across included studies. Otherwise, the prevalence will be described qualitatively. The seriousness of spin patterns will be assessed based on a Delphi consensus study.Ethics and disseminationThis study has been approved by the Academic Centre for Dentistry Amsterdam Ethics Review Committee (2020250). The study will be submitted to a peer-reviewed scientific journal.RegistrationOpen Science Framework: osf.io/hzv6e

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