scholarly journals The Effects of Tai Chi Exercise Among Adults With Chronic Heart Failure: An Overview of Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinke Huang ◽  
Xiaohui Qin ◽  
Min Shen ◽  
Yanjuan Xu ◽  
Yong Huang
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Tai Chi ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Risk Of Bias ◽  
Quality Reporting ◽  
Evidence Quality ◽  
Meta Analyses

Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview.Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality.Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.

scholarly journals Quality of the Evidence Supporting the Role of Acupuncture for Stable Angina Pectoris: An Umbrella Review of Systematic Reviews

2021 ◽  
Vol 8 ◽  
Author(s):  
Min Shen ◽  
Jinke Huang ◽  
Tao Qiu
Keyword(s):  
Angina Pectoris ◽  
Systematic Reviews ◽  
Stable Angina ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Stable Angina Pectoris ◽  
Quality Reporting ◽  
Evidence Quality ◽  
Meta Analyses

Background: To systematically appraise and synthesize evidence, we conducted an overview of systematic reviews/meta-analyses (SRs/MAs) on acupuncture for stable angina pectoris (SAP).Methods: Eight databases were searched for SRs/MAs of acupuncture on SAP. The methodological quality, reporting quality, and evidence quality were evaluated by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, respectively.Results: A total of seven published SRs/MAs met the inclusion criteria. According to the evaluation results of AMSTAR-2, two studies were considered as of moderate quality; the remaining five were considered as of very low quality. According to the evaluation results of the PRISMA checklist, only one study reported the checklist in its entirety, while others had reporting deficiencies. According to GRADE, a total of 18 outcome indicators extracted from the included studies were evaluated. The evidence quality was very low in three, low in three, moderate in eight, and high in four.Conclusion: Acupuncture may be beneficial for SAP from the currently published evidence. However, this conclusion must be interpreted cautiously due to the generally low methodological quality, reporting quality, and evidence quality of the included studies. More rigorous, more standardized and comprehensive SRs/MAs are needed to provide strong evidence for convincing conclusions.

scholarly journals Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Zhang ◽  
Qianying Yu ◽  
Li Peng ◽  
Yuesi Qin ◽  
Mingyi Jing ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Risk Of Bias ◽  
High Quality ◽  
Chinese Herbal ◽  
Evidence Quality ◽  
Meta Analyses ◽  
Quality Evidence

Background: In recent years, systematic reviews/meta-analyses (SRs/MAs) of Chinese herbal medicine (CHM) for psoriasis have continuously emerged. Their methods and evidence quality, however, are yet to be evaluated, and whether their conclusions can provide clinicians with reliable evidence is still debatable.Objectives: This overview aims to evaluate the methodological quality, risk of bias, and reporting quality of relevant SRs/MAs, as well as the current evidence of CHM for treating psoriasis.Methods: We searched nine electronic databases from their respective time of establishment to January 20, 2021, as well as the reference lists of the included SRs/MAs, protocol registries, and gray literature. Two reviewers independently used the following: A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs.Results: This review included 14 SRs/MAs involving 45 outcomes, of which 12 (85.71%) SRs/MAs had a very low quality evaluated by AMSTAR 2 and 7 (50.00%) SRs/MAs had a high risk of bias assessed by ROBIS. The protocol and registration and funding statements were the major reporting flaws according to the PRISMA checklist. The evaluation with the GRADE system demonstrated no outcome of high-quality evidence, and inconsistent efficacy evaluations were found in this overview. Only 15 (33.33%) outcomes were moderate-quality evidence, supporting the claim that CHM plus Western medicine (WM) was superior to WM. Generally low quality of evidence showed no difference in the incidence of adverse events between the combined therapy and WM. However, the conclusion that CHM was superior to WM cannot be drawn due to the inconsistent results.Conclusion: Despite that CHM has the potential benefit and safety in the adjuvant treatment of psoriasis, the conclusion should be treated with caution because of the generally low quality of methodology and evidence. In the future, high-quality randomized controlled trials (RCTs) should be carried out, and the quality of relevant SRs should also be improved to promote their clinical application.

scholarly journals Scientific Evidence of Xuebijing Injection in the Treatment of Sepsis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Sa Tian ◽  
Defang Qin ◽  
Yixuan Ye ◽  
Huawei Yang ◽  
Shuguang Chen ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Scientific Evidence ◽  
Reporting Quality ◽  
Current Evidence ◽  
Quality Reporting ◽  
Xuebijing Injection ◽  
Evidence Quality ◽  
Meta Analyses

Objectives. To systematically collate, appraise, and synthesize the current evidence on the Xuebijing injection (XBJI) for sepsis. Methods. Eight databases were searched for systematic reviews (SRs) or meta-analyses (MAs) on XBJI for sepsis. Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2), Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods were used to assess the methodological quality, reporting quality, and evidence quality of the enrolled studies, respectively. Results. Out of the 13 studies that were included, all studies were rated critically low quality based on AMSTAR-2 results. Based on the results obtained from PRISMA, all studies were reported to be over 80%, while the GRADE system yielded three outcome measures rated high-quality, 16 were of moderate quality, and the rest were of low or critically low quality. Conclusions. The combination of XBJI and Western medicine (WM) showed significant synergy for the treatment of sepsis compared to WM alone. However, this conclusion should be treated with caution since the quality of the SRs/MAs providing the evidence was relatively low.

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Neurofibromatosis Type ◽  
Risk Of Bias ◽  
Measurement Tool ◽  
High Quality ◽  
Meta Analyses

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

scholarly journals A Methodological and Reporting Quality Assessment of Systematic Reviews/Meta-Analyses about Chinese Medical Treatment for Gastroesophageal Reflux Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Zipan Lyu ◽  
Zhongyu Huang ◽  
Fengbin Liu ◽  
Zhengkun Hou
Keyword(s):  
Medical Treatment ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Risk Of Bias ◽  
Selection Methods ◽  
Study Selection ◽  
Protocol Registration ◽  
Meta Analyses

Objective. To access the methodological and reporting quality of systematic reviews (SRs)/meta-analyses (MAs) about Chinese medical treatment for gastroesophageal reflux disease (GERD). Methods. The PubMed, Wanfang Data, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical (CBM), Web of Science, and Cochrane Library databases were searched from inception to June 2020. Two researchers independently screened the literature considering the eligibility criteria. Overview Quality Assessment Questionnaire (OQAQ), Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to assess the methodological and reporting quality of the included reports. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to evaluate the level of evidence in each report. Results. Thirty-three SRs/MAs met the inclusion criteria. The OQAQ results showed that defects in the methodological quality of 17/32 reports were major, with scores of 3 points. Analyzing a single item as the object, search strategies (item 2), and risk of bias in individual studies (item 4) was considered poor. The AMSTAR 2 results showed that 25.4% of the items were not reported, and 7.8% of the items were only partially reported. The overall assessment of AMSTAR 2 showed the majority of systematic reviews and meta-analyses were of low/very low (31/33, 93.9%) methodological quality, with a lack of protocol registration and excluded study list. The PRISMA results showed that 19.9% of items were not reported, and 15.2% of items were only partially reported, due to a lack of protocol registration and study selection methods. The methodological and reporting quality of the included studies was generally poor. Evidence evaluation with GRADE showed that most (31/33) of the included studies had low or very low levels of evidence. Conclusion. The methodological and reporting quality of SRs/MAs about Chinese medical treatment for GERD is generally poor. The main problems included incomplete search strategies, risk of bias in individual studies, the lack of protocol registration and excluded study list, and incorrect study selection methods.

scholarly journals Methodological Quality Assessment of Systematic Review or Meta-Analysis Using AMSTAR-2: the Long-Term Effectiveness or Efficacy of Opioids for Chronic Non-Cancer Pain

2019 ◽  
Author(s):  
Qian Li ◽  
Ke Deng ◽  
Xiaoyuan Jiang ◽  
Huan Tao ◽  
Hui Liu ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Cochrane Reviews ◽  
Meta Analyses

Abstract Background：Systematic review or meta-analysis, the strong study design of high quality evidence, give inconsistent conclusion of long-term effectiveness or efficacy of opioids for chronic non-cancer pain. We appraised the methodological quality of systematic reviews or meta-analyses. Methods: We found the relevant systematic reviews or meta-analyses by searching Medline, EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, the International prospective register of systematic reviews, Psyc ARTICLES/OVID, the Chinese Bio-Medical Literature Database, the China National Knowledge Infrastructure, and the Wan Fang Data and VIP Database on March 1st, 2019. The methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews-2(AMSTAR-2). Spearman correlation analysis and non-parametric tests were used to assess the association between quality and factors. Results: Twenty-one systematic reviews or meta-analyses were included in our study. One has no individual study. In terms of methodological quality, twelve reviews were critically low in overall confidence, four reviews were low, two reviews were moderate, two reviews were high. When referring to the systematic reviews or meta-analyses of relatively better methodological quality with more credible results and conclusions, the effectiveness or efficacy of opioids was small to questionable. Cochrane reviews performed better than non-Cochrane reviews in establishing prior protocol (100% vs 17%, P<0.05), providing an excluded studies list (100% vs 50%, P<0.05) and taking risk of bias into account when interpreting the results of the review (100% vs 75%, P<0.05). There was a strong correlation (ρ=0.526, P<0.05) between the impact factor of systematic reviews or meta-analyses in published journals and methodological quality. Conclusion The methodological quality of the included systematic reviews or meta-analyses is far from satisfactory and needs improvement, especially in establishing prior protocol and justifying significant deviations from the protocol, providing an excluded primary studies list, reporting the funding information of primary studies, and assessing the potential impact of risk of bias on individual studies.

scholarly journals Quality of Evidence Supporting the Role of Acupuncture for the Treatment of Irritable Bowel Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Jinke Huang ◽  
Mengxiong Lu ◽  
Yijun Zheng ◽  
Jinxin Ma ◽  
Xiangxue Ma ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Current Evidence ◽  
Assessment Development ◽  
Evidence Quality ◽  
Irritable Bowel ◽  
Meta Analyses

Objectives. To systematically collate, appraise, and synthesize the current evidence on acupuncture for irritable bowel syndrome (IBS). Methods. Systematic reviews (SRs)/meta-analyses (MAs) of acupuncture for IBS were searched in eight databases. For quality evaluation of the enrolled studies, Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) was used for methodological quality, Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) for reporting quality, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Results. Ten studies were included in our review. According to AMSTAR-2, only one study met all the criteria and was rated as high methodological quality, and the rest were rated as low or very low methodological quality. According to the PRISMA checklist, most of the items were fully reported, with the exception of Q5 (protocol and registration), Q8 (search), and Q27 (funding). With the GRADE system, no outcome measure was rated as high quality. Conclusions. Acupuncture may be a promising therapy for IBS. However, this conclusion must be treated with caution since the quality of SRs/MAs providing evidence is generally low.

scholarly journals A Critical Overview of Systematic Reviews and Meta-Analyses on Acupuncture for Poststroke Insomnia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jinke Huang ◽  
Manli Wu ◽  
Simin Liang ◽  
Xiaohui Qin ◽  
Min Shen ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Acupuncture Treatment ◽  
Descriptive Analysis ◽  
Control Group ◽  
Evidence Quality ◽  
Meta Analyses ◽  
Quality Evidence

Objectives. Acupuncture has increasingly been used for insomnia relief after stroke. We aimed to evaluate the methodological quality and summarize the evidence regarding the effectiveness of acupuncture for poststroke insomnia (PSI) from systematic reviews/meta-analyses (SRs/MAs). Methods. Eight databases were searched from inception through August 23, 2020. SRs/MAs on acupuncture treatment for PSI were included. Methodological quality assessment was performed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and evidence quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results. Six SRs/MAs on acupuncture treatment for PSI were included. The AMSTAR-2 showed that the methodological quality of all included SRs/MAs was rated as critically low. According to the evaluation results of GRADE, 38.9% (7/18) of outcomes were rated as very low-quality evidence, 22.2% (4/18) were low-quality evidence, and 8.9% (7/18) were moderate-quality evidence. Descriptive analysis results showed that acupuncture was an effective treatment modality for PSI. Conclusions. All included reviews indicated that acupuncture was more effective than the control group for the treatment of PSI, but the credibility of the results is limited owing to the generally low methodological and evidence quality of the included SRs/MAs. More high-quality evidence is needed to determine whether acupuncture is more effective than other treatments.

scholarly journals Systematic Reviews and Meta-Analysis in Spine Surgery—How Good Are They in Methodological Quality? A Systematic Review

2020 ◽  
pp. 219256822090681 ◽  
Author(s):  
Muthu Sathish ◽  
Ramakrishnan Eswar
Keyword(s):  
Systematic Review ◽  
Spine Surgery ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Cochrane Database ◽  
Critical Flaw ◽  
Meta Analyses

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.

scholarly journals Overview of systematic reviews - a new type of study. Part II

2014 ◽  
Vol 133 (3) ◽  
pp. 206-217 ◽  
Author(s):  
Valter Silva ◽  
Antonio Jose Grande ◽  
Alan Pedrosa Viegas de Carvalho ◽  
Ana Luiza Cabrera Martimbianco ◽  
Rachel Riera
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Quality Of Evidence ◽  
Overview Of Systematic Reviews ◽  
New Type ◽  
The Mean ◽  
Meta Analyses ◽  
General Profile

CONTEXT AND OBJECTIVE: Overviews of Systematic Reviews (OoRs) are a new type of study in which multiple evidence from systematic reviews (SRs) is compiled into an accessible and useful document. The aim here was to describe the state of the art and critically assess Cochrane OoRs that have been published.DESIGN AND SETTING: Descriptive study conducted at a research center.METHODS: The OoRs identified through the filter developed in Part I of this study were evaluated in five domains: methodological quality; quality of evidence; implications for practice; general profile of OoRs; and length of work.RESULTS: All 13 OoRs included had high methodological quality. Some OoRs did not present sufficient data to judge the quality of evidence; using sensitivity analysis, the quality of evidence of the OoRs increased. Regarding implications for practice, 64% of the interventions were judged as beneficial or harmful, while 36% of them showed insufficient evidence for judgment. It is expected (with 95% confidence interval) that one OoR will include 9,462 to 64,469 patients, 9 to 29 systematic reviews and 80 to 344 primary studies, and assess 6 to 21 interventions; and that 50 to 92% of OoRs will produce meta-analysis. The OoRs generated 2 to 26 meta-analyses over a period of 18 to 31 months.CONCLUSION: The OoRs presented high methodological quality; the quality of evidence tended to be moderate/high; most interventions were judged to be beneficial/harmful; the mean length of work was 24 months. The OoR profile adds power to decision-making.

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