Samargandi Osama A, Hasan Haroon, Thoma Achilleas
Vancouver, British Columbia, and Toronto and Hamilton, Ontario, Canada; and Jeddah, Saudi Arabia From the School of Population and Public Health, Faculty of Medicine, University of British Columbia; the Department of Radiation Oncology, BC Cancer Agency; the Pediatric Oncology Group of Ontario; the Division of Plastic Surgery and the Department of Clinical Epidemiology and Biostatistics, McMaster University; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Abdulaziz University.
Plast Reconstr Surg. 2016 Jan;137(1):225e-236e. doi: 10.1097/PRS.0000000000001898.
Well-conducted systematic reviews have a critical role in informing evidence-based decision-making in plastic surgery. The authors' objective was to assess the methodologic quality of systematic reviews in the plastic surgery literature.
The authors systematically assessed all systematic reviews in 10 high-impact plastic surgery journals using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from 2003 to 2013. These were evaluated for methodologic quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR), a validated 11-point instrument.
After removal of duplicates and screening titles and abstracts, 190 systematic reviews met eligibility criteria. The majority of systematic reviews were published in Plastic and Reconstructive Surgery (n = 88). The most common domain covered was reconstruction (17.9 percent). Using AMSTAR, the median score was 4 (interquartile range, 2.25 to 6.00) on a scale of 1 to 11. No increase in AMSTAR score was observed with time (p = 0.18). Almost half of all systematic reviews (48.4 percent) included at least two independent data extractors, and less than one-third of them (15.3 percent) searched unpublished studies or provided a list of both included and excluded studies (14.8 percent). The methodologic quality of included primary studies was evaluated in 35.3 percent.
Systematic reviews in plastic surgery demonstrated inadequate adherence to methodologic standards of quality, which raises concerns about validity. There has been an increase in the number of systematic reviews published in plastic surgery over the past decade, yet there has been no significant improvement observed in methodologic quality.
开展良好的系统评价在为整形手术中基于证据的决策提供信息方面发挥着关键作用。作者的目的是评估整形外科学术文献中系统评价的方法学质量。
作者使用MEDLINE、EMBASE、Cochrane对照试验中央注册库和Cochrane系统评价数据库，对2003年至2013年10种高影响力整形外科学术期刊中的所有系统评价进行了系统评估。使用一种经过验证的11分制工具“系统评价评估测量工具（AMSTAR）”对这些评价的方法学质量进行评估。
在去除重复文献并筛选标题和摘要后，190篇系统评价符合纳入标准。大多数系统评价发表于《整形与再造外科杂志》（n = 88）。涵盖的最常见领域是重建（17.9%）。使用AMSTAR，在1至11分的量表上，中位数得分为4（四分位间距，2.25至6.00）。未观察到AMSTAR得分随时间增加（p = 0.18）。几乎所有系统评价的一半（48.4%）包括至少两名独立的数据提取者，其中不到三分之一（15.3%）检索了未发表的研究或提供了纳入和排除研究的清单（14.8%）。在35.3%的研究中评估了纳入的原始研究的方法学质量。
整形手术中的系统评价显示对质量方法学标准的遵循不足，这引发了对有效性的担忧。在过去十年中，整形手术中发表的系统评价数量有所增加，但在方法学质量方面未观察到显著改善。
