Department of General Practice, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
Pediatr Allergy Immunol. 2011 Sep;22(6):548-58. doi: 10.1111/j.1399-3038.2011.01165.x.
Systematic reviews have gained popularity as a way to combine the increasing amount of research information. This study assessed the quality of systematic reviews and meta-analyses of sublingual immunotherapy (SLIT) for allergic rhinitis in children, published since 2000. Eligible reviews were identified by searching Medline/Pubmed, Embase, and the Cochrane Library, from 2000 through 2008. Methodological quality was assessed using the assessment of multiple systematic reviews instrument. Ten systematic reviews were included, one of which was published in the Cochrane Library. Eight reviews gave some details about the search strategy. None of the reviews included measures to avoid selection bias. In 60% of the reviews, the methodological quality of the included studies was (partly) assessed. Four reviews pooled the results of individual studies, neglecting clinical heterogeneity. Three of the 10 reviews provided information about sources of funding or grants from industry. Of the 10 reviews, the six reviews with the highest overall score scored 5-8 points, indicating moderate quality. Systematic reviews are useful to evaluate the efficacy of SLIT in children. Although more reviews have become available, the methodological quality could be improved. SLIT for children could be promising, but methodological flaws in the reviews and individual studies are too serious to draw definite conclusions.
系统评价作为一种综合日益增多的研究信息的方法已经越来越受到关注。本研究评估了自 2000 年以来发表的关于舌下免疫疗法(SLIT)治疗儿童过敏性鼻炎的系统评价和荟萃分析的质量。通过检索 Medline/Pubmed、Embase 和 Cochrane 图书馆,从 2000 年到 2008 年,确定了合格的综述。使用多系统评价评估工具评估方法学质量。纳入了 10 篇系统评价,其中 1 篇发表在 Cochrane 图书馆。8 篇综述对检索策略进行了详细描述。没有一篇综述包括避免选择偏倚的措施。在 60%的综述中,对纳入研究的方法学质量进行了(部分)评估。有 4 篇综述对个体研究的结果进行了汇总,忽略了临床异质性。在 10 篇综述中,有 3 篇提供了关于工业界资助或拨款来源的信息。在这 10 篇综述中,有 6 篇综述的总体评分最高为 5-8 分,表明质量中等。系统评价有助于评估 SLIT 在儿童中的疗效。尽管有更多的综述可供使用,但方法学质量仍有待提高。SLIT 对儿童可能有一定的疗效,但综述和个体研究中的方法学缺陷过于严重,无法得出明确的结论。