Use and reporting of risk of bias tools in 825 systematic reviews of acupuncture: a cross-sectional study

2020 ◽  
pp. 096452842094604
Author(s):  
Youlin Long ◽  
Xin Wang ◽  
Wenzhe Xiao ◽  
Rui Chen ◽  
Qiong Guo ◽  
...  

Objective: To assess the use and reporting of risk of bias (RoB) tools in systematic reviews (SRs) of acupuncture. Study design and setting: We extracted and analyzed information relating to RoB in acupuncture SRs via Medline, Embase and the Chinese CNKI (Chinese National Knowledge Infrastructure), WanFang and VIP databases from their inception to 24 November 2017. Three subgroup analyses were used to check the influence of language, journal type and impact factor, following which we used descriptive analysis. Results: We included 825 acupuncture SRs, of which 48% used the Cochrane RoB tool. Only 36% used the latest version of the Cochrane Handbook (version 5.1.0 at time of writing) with higher proportions among Cochrane SRs (65%) versus non-Cochrane SRs (34%), and high impact factor journals (58%) versus low or no impact factor journals (28% and 38%, respectively). In the last decade, there were notable increases in the use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0, of 43% and 19%, respectively. Chinese-language SRs demonstrated proportionally higher tendencies to report an incorrect Cochrane Handbook version, increasing by 14% in the last 5 years. Additionally, 7% SRs did not report any results, and only 10% reported relatively complete and adequate RoB assessment. Cochrane SRs reported more complete assessments than Chinese-language or non-Cochrane English-language SRs. Conclusion: Use and reporting of RoB tools were suboptimal. Proportionally, use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0 was low but rising. Our results highlight the prevalence and concerns of using unsuitable tools and the issue of incomplete RoB reporting. RoB tool application requires further improvement.

2017 ◽  
Vol 27 (6) ◽  
pp. 619-627 ◽  
Author(s):  
V. C. H. Chung ◽  
X. Y. Wu ◽  
Y. Feng ◽  
R. S. T. Ho ◽  
S. Y. S. Wong ◽  
...  

Aims.Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments.Methods.A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis.Results.A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an ‘a priori’ design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report ‘a priori’ designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09–1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06–1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06–1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81–0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04–1.25), completed by more review authors (AOR 1.12, 95% CI 1.01–1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01–2.59) were associated with better performance in publication bias assessment.Conclusion.The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.


10.2196/16978 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e16978 ◽  
Author(s):  
Ryan Ottwell ◽  
Taylor C Rogers ◽  
J Michael Anderson ◽  
Austin Johnson ◽  
Matt Vassar

Background Spin is the misrepresentation of study findings, which may positively or negatively influence the reader’s interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews, specifically systematic reviews pertaining to the management and treatment of acne vulgaris. Objective The primary objective of this study was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts and to evaluate whether various study characteristics were associated with spin. Methods Using a cross-sectional study design, we searched PubMed and EMBASE for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or nonpharmacologic treatment of acne vulgaris. These studies were screened, and data were extracted in duplicate by two blinded investigators. We analyzed systematic review abstracts for the nine most severe types of spin. Results Spin was present in 31% (11/36) of abstracts. A total of 12 examples of spin were identified in the 11 abstracts containing spin, with one abstract containing two instances of spin. The most common type of spin, selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention, was identified five times (5/12, 42%). A total of 44% (16/36) of studies did not report a risk of bias assessment. Of the 11 abstracts containing spin, six abstracts (55%) had not reported a risk of bias assessment or performed a risk of bias assessment but did not discuss it. Spin in abstracts was not significantly associated with a specific intervention type, funding source, or journal impact factor. Conclusions Spin is present in the abstracts of systematic reviews and meta-analyses covering the treatment of acne vulgaris. This paper raises awareness of spin in abstracts and emphasizes the importance of its recognition, which may lead to fewer incidences of spin in future studies.


2020 ◽  
Vol 12 ◽  
pp. 1759720X2095996
Author(s):  
Irene XY Wu ◽  
Huan Wang ◽  
Lin Zhu ◽  
Yancong Chen ◽  
Charlene HL Wong ◽  
...  

Background: Healthcare providers need reliable evidence for supporting the adoption of new interventions, of which the source of evidence often originates from systematic reviews (SRs). However, little assessment on the rigor of SRs related to osteoarthritis interventions has been conducted. This cross-sectional study aimed to evaluate the methodological quality and predictors among SRs on osteoarthritis interventions. Methods: Four electronic databases (Cochrane Database of Systematic Reviews, MEDLINE, Embase, and PsycINFO) were searched, from 1 January 2008 to 10 October 2019. An SR was eligible if it focused on osteoarthritis interventions, and we performed at least one meta-analysis. Methodological quality was assessed using the validated AMSTAR 2 instrument. Multivariate regression analyses were conducted to assess predictors of methodological quality. Results: In total, 167 SRs were included. The most SRs were non-Cochrane reviews (88.6%), and 54.5% investigated non-pharmacological interventions. Only seven (4.2%) had high methodological quality. Respectively, eight (4.8%), 25 (15.0%), and 127 (76.0%) SRs had moderate, low, and critically low quality. Main methodological weaknesses were as follows: only 16.8% registered protocol a priori, 4.2% searched literature comprehensively, 25.7% included lists of excluded studies with justifications, and 30.5% assessed risk of bias appropriately by considering allocation concealment, blinding of patients and assessors, random sequence generation and selective reported outcomes. Cochrane reviews [adjusted odds ratio (AOR) 251.5, 95% confidence interval (CI) 35.5–1782.6], being updates of previous SRs (AOR 3.9, 95% CI 1.1–13.7), and SRs published after 2017 (AOR 7.7, 95% CI 2.8–21.5) were positively related to higher methodological quality. Conclusion: Despite signs of improvement in recent years, most of the SRs on osteoarthritis interventions have critically low methodological quality, especially among non-Cochrane reviews. Future SRs should be improved by conducting comprehensive literature search, justifying excluded studies, publishing a protocol, and assessing the risk of bias of included studies appropriately.


PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e74545 ◽  
Author(s):  
Humam Saltaji ◽  
Greta G. Cummings ◽  
Susan Armijo-Olivo ◽  
Michael P. Major ◽  
Maryam Amin ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard Ho ◽  
Fiona Y. T. Ke ◽  
Charlene H. L. Wong ◽  
Irene X. Y. Wu ◽  
Andy K. L. Cheung ◽  
...  

Abstract Background While well-conducted systematic reviews (SRs) can provide the best evidence on the potential effectiveness of acupuncture, limitations on the methodological rigour of SRs may impact the trustworthiness of their conclusions. This cross-sectional study aimed to evaluate the methodological quality of a representative sample of SRs on acupuncture effectiveness. Methods Cochrane Database of Systematic Reviews, MEDLINE, and EMBASE were searched for SRs focusing on the treatment effect of manual acupuncture or electro-acupuncture published during January 2018 and March 2020. Eligible SRs must contain at least one meta-analysis and be published in English language. Two independent reviewers extracted the bibliographical characteristics of the included SRs with a pre-designed questionnaire and appraised the methodological quality of the studies with the validated AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2). The associations between bibliographical characteristics and methodological quality ratings were explored using Kruskal-Wallis rank tests and Spearman’s rank correlation coefficients. Results A total of 106 SRs were appraised. Only one (0.9%) SR was of high overall methodological quality, zero (0%) was of moderate-quality, six (5.7%) and 99 (93.4%) were of low-quality and critically low-quality respectively. Among appraised SRs, only ten (9.4%) provided an a priori protocol, four (3.8%) conducted a comprehensive literature search, five (4.7%) provided a list of excluded studies, and six (5.7%) performed meta-analysis appropriately. Cochrane SRs, updated SRs, and SRs that did not search non-English databases had relatively higher overall quality. Conclusions Methodological quality of SRs on acupuncture is unsatisfactory. Future reviewers should improve critical methodological aspects of publishing protocols, performing comprehensive search, providing a list of excluded studies with justifications for exclusion, and conducting appropriate meta-analyses. These recommendations can be implemented via enhancing the technical competency of reviewers in SR methodology through established education approaches as well as quality gatekeeping by journal editors and reviewers. Finally, for evidence users, skills in SR critical appraisal remain to be essential as relevant evidence may not be available in pre-appraised formats.


2019 ◽  
Author(s):  
Ryan Ottwell ◽  
Taylor C Rogers ◽  
J Michael Anderson ◽  
Austin Johnson ◽  
Matt Vassar

BACKGROUND Spin is the misrepresentation of study findings, which may positively or negatively influence the reader’s interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews, specifically systematic reviews pertaining to the management and treatment of acne vulgaris. OBJECTIVE The primary objective of this study was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts and to evaluate whether various study characteristics were associated with spin. METHODS Using a cross-sectional study design, we searched PubMed and EMBASE for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or nonpharmacologic treatment of acne vulgaris. These studies were screened, and data were extracted in duplicate by two blinded investigators. We analyzed systematic review abstracts for the nine most severe types of spin. RESULTS Spin was present in 31% (11/36) of abstracts. A total of 12 examples of spin were identified in the 11 abstracts containing spin, with one abstract containing two instances of spin. The most common type of spin, <i>selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention,</i> was identified five times (5/12, 42%). A total of 44% (16/36) of studies did not report a risk of bias assessment. Of the 11 abstracts containing spin, six abstracts (55%) had not reported a risk of bias assessment or performed a risk of bias assessment but did not discuss it. Spin in abstracts was not significantly associated with a specific intervention type, funding source, or journal impact factor. CONCLUSIONS Spin is present in the abstracts of systematic reviews and meta-analyses covering the treatment of acne vulgaris. This paper raises awareness of spin in abstracts and emphasizes the importance of its recognition, which may lead to fewer incidences of spin in future studies.


2020 ◽  
Vol 9 (3) ◽  
pp. 207-211
Author(s):  
Sidra Sarwar ◽  
Sara Khalid ◽  
Tahir Mahmood ◽  
Hadeeqa Jabeen ◽  
Shahid Imran

Background: Musculoskeletal disorders are not only becoming prevalent among health care professionals in our country but are affecting their health and performance adversely. They are caused by poor ergonomics and awkward posture during work activities. The purpose of this study was to determine the frequency of neck and upper limb musculoskeletal disorders in dentists of Lahore, Pakistan. Material and Methods: This cross-sectional study was conducted during October 2017 to March 2018. The data was collected using convenient sampling technique from 162 Dentists including 52 males and 110 females of Children hospital Lahore, Punjab Dental hospital and Fatima Memorial Hospital, Lahore. Data was collected by using Mangalore Questionnaire for identification of musculoskeletal disorders. Descriptive analysis of the data was done using SPSS version 22.0. Results: Of 162 dentists, 115 (71%) suffered from musculoskeletal disorders. Shoulder was the most commonly affected region (30.9%) followed by neck (25.9%), arm (6.2%), wrist (4.3%), elbow (3.1%) and forearm (0.6%). Pain (45.7%) was found to be the most common complaint followed by muscle weakness (20.4%), paraesthesia (3.7%) and swelling (1.2%). Conclusions: It was concluded that majority of the dentists were suffering from musculoskeletal disorders with shoulder as the most affected region and pain as the most frequent complaint. Key words: Dentists, Musculoskeletal disorders, Neck pain, Upper extremity


Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 109
Author(s):  
Alberto Forte ◽  
Giuseppe Sarli ◽  
Lorenzo Polidori ◽  
David Lester ◽  
Maurizio Pompili

Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. Materials and methods: An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. Results: Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. Conclusions: New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 975.1-975
Author(s):  
H. Azzouzi ◽  
O. Lamkhanat ◽  
I. Linda

Background:Rheumatoid Arthritis (RA) is one of the risk factors for the calculation of the 10 years fracture probability assessed by the FRAX tool.Objectives:The aim was to study the association of disease activity and the 10 year fracture risk probability by the FRAX tool in our RA patients and their impact on fracture prevalence.Methods:Cross-sectional study of the association FRAX and disease activity score (DAS 28 CRP) was designed. Patients with RA were included. Mean DAS was calculated for each patient adjusted on his follow-up duration. Data about patients (demographic, disease characteristics and fracture assessment) were collected. The 10 year fracture risk probability for major osteoporotic fracture was calculated with and without BMD (bone mineral density) using the FRAX tool for Morocco. Descriptive analysis and regressions were performed with SPSS.20. p<0.05 was considered significant.Results:One hundred and ninety nine RA patients were included with mean age of 55.5±12 years. Women represented 91% and 40.1% had osteoporosis. Remission was observed in 86.4% with 95.5% taking methotrexate. 17.1% had vertebral fractures. FRAX and DAS were associated (p=0.03), and both explained vertebral fracture (VF) prevalence. When adjusted on disease parameters, FRAX with and without BMD explained the vertebral prevalence (p=0.02, OR=1.09[1.01-1.19]). However, age remains the only predictor of VF when adjusted on osteoporosis factors (DAS28CRP, menopause, BMI, smoking, diabetes, gender, steroid use, HAQ) and FRAX BMD.Conclusion:Persistent disease activity was associated to high 10 year fracture risk probability calculated by the FRAX tool in RA.Disclosure of Interests:None declared


Sign in / Sign up

Export Citation Format

Share Document