Major Mistakes and Errors in the Use of Trial Sequential Analysis in Systematic Reviews or Meta-analyses – Protocol for a Systematic Review
Abstract Background: Adequately conducted systematic reviews with meta-analyses are considered the highest level of evidence and thus directly defines many clinical guidelines. However, the risk of type I and II errors in meta-analyses are substantial. Trial Sequential Analysis is a method for controlling these risks. Erroneous use of the method might lead to research waste or misleading conclusions. Methods: The current protocol describes a systematic review aimed to identify common and major mistakes and errors in the use of Trial Sequential Analysis by evaluating published systematic reviews and meta-analyses that include this method. We plan to include all studies using Trial Sequential Analysis published from 2018 to 2021, an estimated 400 to 600 publications. We will search Medical Literature Analysis and Retrieval System Online (MEDLINE) and the Cochrane Database of Systematic Reviews (CDSR), including studies with all types of participants, interventions, and outcomes. The search will begin in July 2021. Two independent reviewers will screen titles and abstracts, include relevant full text articles, extract data from the studies into a predefined checklist, and evaluate the methodological quality of the study using the AMSTAR 2 (Assessing the methodological quality of systematic reviews). Discussion: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The identified mistakes and errors will form the basis of a reviewed guideline for the use of Trial Sequential Analysis. Appropriately controlling for type I and II errors might reduce research waste and improve quality and precision of the evidence that clinical guidelines are based upon.