S. Gianola, PT, Clinical Epidemiology Unit, IRCCS, Orthopedic Institute Galeazzi, Via R. Galeazzi, 4. 20161 Milan, Italy.
Phys Ther. 2013 Nov;93(11):1456-66. doi: 10.2522/ptj.20120382. Epub 2013 Jun 6.
Systematic reviews (SRs) have become increasingly important for informing clinical practice; however, little is known about the reporting characteristics and the quality of the SRs relevant to the practice of rehabilitation health professionals.
The purpose of this study was to examine the reporting quality of a representative sample of published SRs on rehabilitation, focusing on the descriptive, reporting, and bias-related characteristics.
A cross-sectional study was conducted by searching MEDLINE for aggregative and configurative SRs indexed in 2011 that focused on rehabilitation as restorative of functional limitations. Two reviewers independently screened and selected the SRs and extracted data using a 38-item data collection form derived from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The data were analyzed descriptively.
Eighty-eight SRs published in 59 journals were sampled. The median compliance with the PRISMA items was 17 (63%) out of 27 items (interquartile ratio=13-22 [48%-82%]). Two thirds of the SRs (n=66) focused on interventions for which efficacy is best addressed through a randomized controlled trial (RCT) design, and almost all of these SRs included RCTs (63/66 [95%]). More than two thirds of the SRs assessed the quality of primary studies (74/88 [84%]). Twenty-eight reviews (28/88 [32%]) meta-analyzed the results for at least one outcome. One half of the SRs reported positive statistically significant findings (46%), whereas a detrimental result was present only in one review.
This sample of SRs in the rehabilitation field showed heterogeneous characteristics and a moderate quality of reporting. Poor control of potential source of bias might be improved if more widely agreed-upon evidence-based reporting guidelines will be actively endorsed and adhered to by authors and journals.
系统评价（SRs）在为临床实践提供信息方面变得越来越重要；然而，对于康复健康专业人员实践相关的 SR 报告特征和质量知之甚少。
本研究旨在检查一组具有代表性的康复相关发表的 SR 报告质量，重点关注描述性、报告和偏倚相关特征。
通过在 MEDLINE 中搜索 2011 年索引的聚集和构造型 SR，进行了一项横断面研究，这些 SR 主要关注康复作为功能限制的恢复。两名审查员独立筛选和选择 SR，并使用源自系统评价和荟萃分析的首选报告项目（PRISMA）的 38 项数据收集表提取数据。数据进行描述性分析。
从 59 种期刊中抽取了 88 篇 SR 进行采样。27 项中的 PRISMA 项目符合中位数为 17 项（13-22 项[48%-82%]）。三分之二的 SR（n=66）关注的是通过随机对照试验（RCT）设计最能解决疗效的干预措施，并且几乎所有这些 SR 都包括 RCT（63/66[95%]）。超过三分之二的 SR（74/88[84%]）评估了主要研究的质量。28 项综述（28/88[32%]）对至少一项结果进行了荟萃分析。一半的 SR 报告了有统计学意义的阳性结果（46%），而只有一篇综述显示出有害的结果。
康复领域的这组 SR 表现出异质性特征和中等的报告质量。如果更广泛地认可和遵守作者和期刊的基于证据的报告指南，对潜在偏倚来源的控制不佳可能会得到改善。
