scholarly journals Analysis of Evidence-Rating Systems Used in Meta-Analyses of Pharmacotherapy

2020 ◽  
Author(s):  
Alberto Frutos Pérez-Surio ◽  
José Manuel Vinuesa Hernando ◽  
Mercedes Arene Mendoza ◽  
María Ángeles Allende Bandrés ◽  
María Aránzazu Alcácera López ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Drug Effects ◽  
High Impact ◽  
Risk Of Bias ◽  
The Body ◽  
Systematic Evaluation ◽  
Rating Systems ◽  
Medical Journals ◽  
Evidence Rating ◽  
Meta Analyses

Abstract Background: Evidence-rating systems (ERSs) provide a framework for the systematic evaluation of the quality of individual interventional or observational studies and the overall body of evidence in meta-analyses. Authors and users of meta-analyses require a familiarity with ERSs to determine the level of confidence in the application of results. Many ERSs have been published, but no consensus exists regarding best practice for their use. Objective: The aim is to describe patterns of use of ERSs in meta-analyses of drug therapy published in contemporary high-impact medical journals.Methods: We design a review. Medline / PubMed was searched to identify meta-analyses evaluating drug therapy from the top 5 ranked general medical journals from 2012 to 2016. Methods of full-texts were reviewed to ensure the meta-analyses evaluated drug therapy and to identify the ERS used to rate individual studies and the overall body of evidence. Frequency of ERS use was analyzed using descriptive statistics.Results: The top-ranked journals were Ann Intern Med, BMJ, JAMA, Lancet and PLoS Medicine. Of the 309 results, manual review excluded 111 meta-analyses. In 198 evaluated meta-analyses, 86.4% (171) utilized an ERS; the most commonly used was the Cochrane Risk of Bias Tool in 80.7% (138) of all meta-analyses. An ERS was used to evaluate the body of literature in 19.1% (38) of meta-analyses; the most commonly used of three systems was the GRADE methodology. Overall, 14 unique ERSs, including author-defined systems, were usedConclusions: Most meta-analyses of drug effects in high-impact medical journals evaluated individual studies with an ERS, most commonly the Cochrane Risk of Bias Tool, while the use of ERSs to evaluate the body of literature was less frequent. The familiarity of authors and users of meta-analyses with commonly used ERSs may facilitate the evaluation and application of findings of meta-analyses.

scholarly journals A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020869 ◽  
Author(s):  
Marius Goldkuhle ◽  
Vikram M Narayan ◽  
Aaron Weigl ◽  
Philipp Dahm ◽  
Nicole Skoetz
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Grey Literature ◽  
High Impact ◽  
Impact Factors ◽  
High Impact Journal ◽  
Eligibility Criteria ◽  
Medical Journals ◽  
Cochrane Reviews ◽  
Meta Analyses

ObjectiveTo compare cancer-related systematic reviews (SRs) published in the Cochrane Database of SRs (CDSR) and high-impact journals, with respect to type, content, quality and citation rates.DesignMethodological SR with assessment and comparison of SRs and meta-analyses. Two authors independently assessed methodological quality using an Assessment of Multiple Systematic Reviews (AMSTAR)-based extraction form. Both authors independently screened search results, extracted content-relevant characteristics and retrieved citation numbers of the included reviews using the Clarivate Analytics Web of Science database.Data sourcesCancer-related SRs were retrieved from the CDSR, as well as from the 10 journals which publish oncological SRs and had the highest impact factors, using a comprehensive search in both the CDSR and MEDLINE.Eligibility criteria for selecting studiesWe included all cancer-related SRs and meta-analyses published from January 2011 to May 2016. Methodological SRs were excluded.ResultsWe included 346 applicable Cochrane reviews and 215 SRs from high-impact journals. Cochrane reviews consistently met more individual AMSTAR criteria, notably with regard to an a priori design (risk ratio (RR) 3.89; 95% CI 3.10 to 4.88), inclusion of the grey literature and trial registries (RR 3.52; 95% CI 2.84 to 4.37) in their searches, and the reporting of excluded studies (RR 8.80; 95% CI 6.06 to 12.78). Cochrane reviews were less likely to address questions of prognosis (RR 0.04; 95% CI 0.02 to 0.09), use individual patient data (RR 0.03; 95% CI 0.01 to 0.09) or be based on non-randomised controlled trials (RR 0.04; 95% CI 0.02 to 0.09). Citation rates of Cochrane reviews were notably lower than those for high-impact journals (Cochrane reviews: mean number of citations 6.52 (range 0–143); high-impact journal SRs: 74.45 (0–652)).ConclusionsWhen comparing cancer-related SRs published in the CDSR versus those published in high-impact medical journals, Cochrane reviews were consistently of higher methodological quality, but cited less frequently.

scholarly journals A review of trauma and orthopaedic randomised clinical trials published in high-impact general medical journals

2021 ◽  
Author(s):  
Luke Farrow ◽  
William T. Gardner ◽  
Andrew D. Ablett ◽  
Vladislav Kutuzov ◽  
Alan Johnstone
Keyword(s):  
Clinical Trials ◽  
Sample Size ◽  
Trial Design ◽  
Sample Size Calculation ◽  
High Impact ◽  
Risk Of Bias ◽  
Randomised Clinical Trials ◽  
Medical Journals ◽  
General Medical Journals

Abstract Introduction The recent past has seen a significant increase in the number of trauma and orthopaedic randomised clinical trials published in “the big five” general medical journals. The quality of this research has, however, not yet been established. Methods We therefore set out to critically appraise the quality of available literature over a 10-year period (April 2010–April 2020) through a systematic search of these 5 high-impact general medical journals (JAMA, NEJM, BMJ, Lancet and Annals). A standardised data extraction proforma was utilised to gather information regarding: trial design, sample size calculation, results, study quality and pragmatism. Quality assessment was performed using the Cochrane Risk of Bias 2 tool and the modified Delphi list. Study pragmatism was assessed using the PRECIS-2 tool. Results A total of 25 studies were eligible for inclusion. Over half of the included trials did not meet their sample size calculation for the primary outcome, with a similar proportion of these studies at risk of type II error for their non-significant results. There was a high degree of pragmatism according to PRECIS-2. Non-significant studies had greater pragmatism that those with statistically significant results (p < 0.001). Only 56% studies provided adequate justification for the minimum clinically important difference (MCID) in the population assessed. Overall, very few studies were deemed high quality/low risk of bias. Conclusions These findings highlight that there are some important methodological concerns present within the current evidence base of RCTs published in high-impact medical journals. Potential strategies that may improve future trial design are highlighted. Level of evidence Level 1.

scholarly journals Differentiating PSP from MSA using MR planimetric measurements: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Beatrice Heim ◽  
Florian Krismer ◽  
Klaus Seppi
Keyword(s):  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Index Test ◽  
Study Quality ◽  
Parkinsonian Syndromes ◽  
Quantitative Mr ◽  
Meta Analyses ◽  
Planimetric Measurements

AbstractDifferential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology. Quantitative MR planimetric measurements were reported to discriminate between progressive supranuclear palsy (PSP) and non-PSP-parkinsonism. Several studies have used midbrain to pons ratio (M/P) and the Magnetic Resonance Parkinsonism Index (MRPI) in distinguishing PSP patients from those with Parkinson's disease. The current meta-analysis aimed to compare the performance of these measures in discriminating PSP from multiple system atrophy (MSA). A systematic MEDLINE review identified 59 out of 2984 studies allowing a calculation of sensitivity and specificity using the MRPI or M/P. Meta-analyses of results were carried out using random effects modelling. To assess study quality and risk of bias, the QUADAS-2 tool was used. Eight studies were suitable for analysis. The meta‐analysis showed a pooled sensitivity and specificity for the MRPI of PSP versus MSA of 79.2% (95% CI 72.7–84.4%) and 91.2% (95% CI 79.5–96.5%), and 84.1% (95% CI 77.2–89.2%) and 89.2% (95% CI 81.8–93.8%), respectively, for the M/P. The QUADAS-2 toolbox revealed a high risk of bias regarding the methodological quality of patient selection and index test, as all patients were seen in a specialized outpatient department without avoiding case control design and no predefined threshold was given regarding MRPI or M/P cut-offs. Planimetric brainstem measurements, in special the MRPI and M/P, yield high diagnostic accuracy for the discrimination of PSP from MSA. However, there is an urgent need for well-designed, prospective validation studies to ameliorate the concerns regarding the risk of bias.

Association between muscle strength and risk factors for metabolic syndrome in children and adolescents: a systematic review

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tiago R. de Lima ◽  
Priscila C. Martins ◽  
Giuseppe L. Torre ◽  
Alice Mannocci ◽  
Kelly S. Silva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Metabolic Syndrome ◽  
Muscle Strength ◽  
Children And Adolescents ◽  
Lower Risk ◽  
Preliminary Evidence ◽  
Risk Of Bias ◽  
The Body ◽  
Reference List

AbstractThe aim of this systematic review was to identify and summarize evidence for the association between muscle strength (MS) and metabolic syndrome (MetS), and MS and combinations of risk factors for MetS in children and adolescents. Five databases (Medline/PubMed, EBSCO, Scielo, Scopus, and Web of Knowledge) were searched up to November 2019 with complementary reference list searches. Inclusion criteria were studies that investigated the relationship between MS and MetS or MS and combinations of risk factors for MetS in children and adolescents (≤19 years of age). Risk of bias was assessed using standard procedures. From the total of 15,599 articles initially identified, 13 articles were included, representing 11,641 children and adolescents. Higher MS values were associated with lower risk for MetS or combinations of risk factors for MetS (n=11/13 studies). Of the total of included studies, about 23.1% (03/13) were longitudinal and all included studies were classified as having a moderate risk of bias. This review provides preliminary evidence for a beneficial relationship between MS and MetS among children and adolescents. Additionally, although the body of evidence points to the beneficial relationship between higher MS and lower risk for combination of factors for MetS in children and adolescents, this relationship is inconclusive.

scholarly journals Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis

2021 ◽  
Vol 5 (1) ◽  
pp. e001129
Author(s):  
Bill Stevenson ◽  
Wubshet Tesfaye ◽  
Julia Christenson ◽  
Cynthia Mathew ◽  
Solomon Abrha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Head Lice ◽  
Efficacy And Safety ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

scholarly journals Design of Free Stalls for Dairy Herds: A Review

Ruminants ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 1-22
Author(s):  
Frank van Eerdenburg ◽  
Lars Ruud
Keyword(s):  
Optimal Design ◽  
Dairy Cattle ◽  
Animal Welfare ◽  
Milk Yield ◽  
High Impact ◽  
The Body ◽  
Dairy Herds ◽  
Productive Life ◽  
To Come ◽  
Available Information

Lying is an important behavior of dairy cattle. Cows should spend more than 50% of a day lying as it has a high impact on their milk yield and animal welfare. The design, size, and flooring properties of the free stalls influence the time cows spend lying, the way they lie down, and their rising movements. The purpose of this review is to provide an overview of the currently available information with the aim to assist farmers and advisors to come to an optimal design of the free stalls. The design of the free stalls should enable the cows to move and lie in positions as natural as possible. Cows should rest, with all parts of the body, on a clean, dry and soft bed, be able to stretch their front legs forward, lie on their sides with unobstructed space for their neck and head, and rest with their heads against their flanks without hindrance from a partition. When they stand, they should not be hindered by neck rails, partitions, or supports. A comfortable place for cows to lie down helps cows to stay healthy, improve welfare, and increase milk yield. Hence, the probability of a longer productive life for the cows increases and the number of replacements per year decreases.

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