*South Western Sydney Clinical School, University of New South Wales †Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, New South Wales ‡School of Public Health, University of Sydney, Sydney, New South Wales §Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
Ann Surg. 2015 Apr;261(4):685-94. doi: 10.1097/SLA.0000000000000836.
Meta-analyses are useful tools for summarizing surgical evidence as they aim to encompass multiple sources of information on a particular research question, but they may be prone to methodological and reporting biases. We evaluated the conduct and reporting of meta-analyses of surgical interventions.
We performed a systematic review of 150 meta-analyses of randomized trials of surgical interventions published between January 2010 and June 2011. A comprehensive search strategy was executed using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews. Data were independently extracted by 2 authors using the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses, a standardized quality of reporting guideline) and AMSTAR (a tool for methodological quality). Descriptive statistics were used for individual items, and as a measure of overall compliance, PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. A median of 8 trials (interquartile range = 8) was included in each meta-analysis. One third of all meta-analyses had an author with a background in epidemiology and/or statistics. Forty-four percent were published in PRISMA-endorsing journals with a median impact factor of 3.5. There was moderate compliance with PRISMA, with an average of 71% of items reported, but poorer compliance with AMSTAR, with 48% of items adequately described, on average.
Substantial gaps in the conduct and reporting of meta-analyses within the surgical literature exist, mainly in the specification of aims and/or objectives, the use of preplanned protocols, and the evaluation of potential bias at the review (rather than trial) level. Editorial insistence on using reporting guidelines would improve this situation.
荟萃分析是总结外科证据的有用工具，因为它们旨在包含关于特定研究问题的多种信息来源，但它们可能容易受到方法学和报告偏倚的影响。我们评估了外科干预荟萃分析的实施和报告情况。
我们对 2010 年 1 月至 2011 年 6 月期间发表的 150 项外科干预随机试验荟萃分析进行了系统回顾。使用 MEDLINE、EMBASE 和 Cochrane 系统评价数据库执行了全面的搜索策略。两位作者使用 PRISMA 声明（系统评价和荟萃分析的首选报告项目，标准化报告质量指南）和 AMSTAR（方法学质量工具）独立提取数据。使用个体项目的描述性统计数据，并作为报告总体一致性的衡量标准，计算 PRISMA 和 AMSTAR 分数作为充分报告领域的总和。每项荟萃分析平均纳入 8 项试验（四分位距=8）。三分之一的荟萃分析的作者具有流行病学和/或统计学背景。44%的荟萃分析发表在支持 PRISMA 的期刊上，平均影响因子为 3.5。PRISMA 的实施存在中等程度的差距，平均有 71%的项目报告，而 AMSTAR 的报告差距更大，平均只有 48%的项目得到充分描述。
外科文献中荟萃分析的实施和报告存在很大差距，主要是在目标的具体说明、使用预先计划的方案以及在审查（而不是试验）水平评估潜在偏倚方面。编辑坚持使用报告指南将改善这种情况。
