Kong Yuke, Wei Xuequan, Duan Lei, Wang Wenge, Zhong Zhenmei, Ming Zhenhua, Zeng Rong
a Department of Nephrology , Second Hospital of Lanzhou University , Lanzhou , Gansu , P.R. China .
b Department of Nephrology , Linxia People's Hospital , Linxia , Gansu , P.R. China , and.
Ren Fail. 2015 Aug;37(7):1089-93. doi: 10.3109/0886022X.2015.1056065. Epub 2015 Sep 2.
The method of systematic reviews/meta-analyses (SRs/MAs) has been widely used in acute kidney injury (AKI) studies. However, it is not quite clear about the quality of the evidence and existing problems.
To grade the evidence quality of published SRs/MAs of AKI by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, understand the current situation of evidence rating and analyze the possible problems.
Researchers systematically searched for articles about SRs/MAs of AKI published in the following four Chinese databases and four English databases, including Chinese Biomedicine Literature Database, Wanfang Database, China National Knowledge Internet Database, VIP Database, Pubmed, EMBASE, the Cochrane Library and Web of Science.
Totally, 81 SRs/MAs were included in this study and the overall quality of evidence was not satisfactory. The number of literatures of low and very low evidence quality was 33 (40.7%) and 41 (50.6%), respectively. Limitation was the main factor which caused the quality of research evidence degrading (92.6%), and other degradation factors were inconsistency (56.8%), publication bias (44.4%), indirectness (35.8%) and imprecision (32.1%). The quality of evidence for AKI has been significantly improved after the publication of the GRADE system in 2004.
Since 2004 when the GRADE system was published, the quality of evidence of AKI has been increased clearly. But quality of AKI evidence of SRs/MAs for intervention is still not satisfactory. Limitation and inconsistency were two major factors leading to degradation.
系统评价/荟萃分析（SRs/MAs）方法已广泛应用于急性肾损伤（AKI）研究。然而，证据质量及存在的问题尚不完全清楚。
采用推荐分级的评估、制定与评价（GRADE）系统对已发表的AKI的SRs/MAs证据质量进行分级，了解证据评级现状并分析可能存在的问题。
研究人员系统检索了发表在以下四个中文数据库和四个英文数据库中的关于AKI的SRs/MAs的文章，包括中国生物医学文献数据库、万方数据库、中国知网数据库、维普数据库、PubMed、EMBASE、考克兰图书馆和科学引文索引。
本研究共纳入81篇SRs/MAs，证据总体质量不尽人意。低质量和极低质量证据的文献数量分别为33篇（40.7%）和41篇（50.6%）。局限性是导致研究证据质量下降的主要因素（92.6%），其他质量下降因素包括不一致性（56.8%）、发表偏倚（44.4%）、间接性（35.8%）和不精确性（32.1%）。2004年GRADE系统发布后，AKI的证据质量有了显著提高。
自2004年GRADE系统发布以来，AKI的证据质量明显提高。但干预性SRs/MAs的AKI证据质量仍不尽人意。局限性和不一致性是导致质量下降的两个主要因素。
