Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
1] Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong [2] Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong.
NPJ Prim Care Respir Med. 2015 Jan 8;25:14102. doi: 10.1038/npjpcrm.2014.102.
Meta-analysis (MA) of randomised trials is considered to be one of the best approaches for summarising high-quality evidence on the efficacy and safety of treatments. However, methodological flaws in MAs can reduce the validity of conclusions, subsequently impairing the quality of decision making.
To assess the methodological quality of MAs on COPD treatments.
A cross-sectional study on MAs of COPD trials. MAs published during 2000-2013 were sampled from the Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effect. Methodological quality was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool.
Seventy-nine MAs were sampled. Only 18% considered the scientific quality of primary studies when formulating conclusions and 49% used appropriate meta-analytic methods to combine findings. The problems were particularly acute among MAs on pharmacological treatments. In 48% of MAs the authors did not report conflict of interest. Fifty-eight percent reported harmful effects of treatment. Publication bias was not assessed in 65% of MAs, and only 10% had searched non-English databases.
The methodological quality of the included MAs was disappointing. Consideration of scientific quality when formulating conclusions should be made explicit. Future MAs should improve on reporting conflict of interest and harm, assessment of publication bias, prevention of language bias and use of appropriate meta-analytic methods.
荟萃分析（MA）被认为是总结高质量疗效和安全性证据的最佳方法之一。然而，荟萃分析中的方法缺陷会降低结论的有效性，从而降低决策质量。
评估慢性阻塞性肺疾病（COPD）治疗荟萃分析的方法学质量。
对 COPD 试验荟萃分析进行横断面研究。从 Cochrane 系统评价数据库和评价摘要数据库中抽取 2000-2013 年发表的荟萃分析。使用经过验证的 AMSTAR（评估系统评价方法学质量）工具评估方法学质量。
抽取了 79 篇荟萃分析。只有 18%的荟萃分析在得出结论时考虑了原始研究的科学质量，49%的荟萃分析使用了适当的荟萃分析方法来合并研究结果。在药物治疗的荟萃分析中，问题尤为突出。在 48%的荟萃分析中，作者未报告利益冲突。58%的荟萃分析报告了治疗的有害影响。65%的荟萃分析未评估发表偏倚，仅 10%的荟萃分析检索了非英语数据库。
纳入的荟萃分析的方法学质量令人失望。在得出结论时应明确考虑科学质量。未来的荟萃分析应在报告利益冲突和危害、评估发表偏倚、预防语言偏倚和使用适当的荟萃分析方法方面加以改进。
