Papageorgiou Spyridon N, Papadopoulos Moschos A, Athanasiou Athanasios E
* Department of Oral Technology, School of Dentistry, University of Bonn, Germany.
Eur J Orthod. 2014 Feb;36(1):74-85. doi: 10.1093/ejo/cjt008. Epub 2013 Mar 14.
Ideally meta-analyses (MAs) should consolidate the characteristics of orthodontic research in order to produce an evidence-based answer. However severe flaws are frequently observed in most of them. The aim of this study was to evaluate the statistical methods, the methodology, and the quality characteristics of orthodontic MAs and to assess their reporting quality during the last years. Electronic databases were searched for MAs (with or without a proper systematic review) in the field of orthodontics, indexed up to 2011. The AMSTAR tool was used for quality assessment of the included articles. Data were analyzed with Student's t-test, one-way ANOVA, and generalized linear modelling. Risk ratios with 95% confidence intervals were calculated to represent changes during the years in reporting of key items associated with quality. A total of 80 MAs with 1086 primary studies were included in this evaluation. Using the AMSTAR tool, 25 (27.3%) of the MAs were found to be of low quality, 37 (46.3%) of medium quality, and 18 (22.5%) of high quality. Specific characteristics like explicit protocol definition, extensive searches, and quality assessment of included trials were associated with a higher AMSTAR score. Model selection and dealing with heterogeneity or publication bias were often problematic in the identified reviews. The number of published orthodontic MAs is constantly increasing, while their overall quality is considered to range from low to medium. Although the number of MAs of medium and high level seems lately to rise, several other aspects need improvement to increase their overall quality.
理想情况下，荟萃分析（MAs）应整合正畸研究的特征，以便得出基于证据的答案。然而，在大多数荟萃分析中经常观察到严重缺陷。本研究的目的是评估正畸荟萃分析的统计方法、方法学和质量特征，并评估过去几年它们的报告质量。检索电子数据库，查找截至2011年索引的正畸领域的荟萃分析（有无适当的系统评价）。使用AMSTAR工具对纳入文章进行质量评估。数据采用学生t检验、单因素方差分析和广义线性模型进行分析。计算95%置信区间的风险比，以表示多年来与质量相关的关键项目报告中的变化。本评价共纳入80项荟萃分析，涉及1086项原始研究。使用AMSTAR工具，发现25项（27.3%）荟萃分析质量低，37项（46.3%）质量中等，18项（22.5%）质量高。明确的方案定义、广泛的检索和对纳入试验的质量评估等特定特征与较高的AMSTAR评分相关。在已确定的综述中，模型选择以及处理异质性或发表偏倚往往存在问题。已发表的正畸荟萃分析数量在不断增加，而其总体质量被认为从低到中等。尽管中高水平的荟萃分析数量最近似乎有所增加，但其他几个方面仍需改进以提高其总体质量。
