Bryce Shayden, Sloan Elise, Lee Stuart, Ponsford Jennie, Rossell Susan
School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia.
School of Psychology, Deakin University, Burwood, VIC, Australia.
J Psychiatr Res. 2016 Apr;75:91-106. doi: 10.1016/j.jpsychires.2016.01.004. Epub 2016 Jan 5.
Systematic reviews and meta-analyses are a primary source of evidence when evaluating the benefit(s) of cognitive remediation (CR) in schizophrenia. These studies are designed to rigorously synthesize scientific literature; however, cannot be assumed to be of high methodological quality. The aims of this report were to: 1) review the use of systematic reviews and meta-analyses regarding CR in schizophrenia; 2) conduct a systematic methodological appraisal of published reports examining the benefits of this intervention on core outcome domains; and 3) compare the correspondence between methodological and reporting quality.
Electronic databases were searched for relevant articles. Twenty-one reviews met inclusion criteria and were scored according to the AMSTAR checklist-a validated scale of methodological quality. Five meta-analyses were also scored according to PRISMA statement to compare 'quality of conduct' with 'quality of reporting'.
Most systematic reviews and meta-analyses shared strengths and fell within a 'medium' level of methodological quality. Nevertheless, there were consistent areas of potential weakness that were not addressed by most reviews. These included the lack of protocol registration, uncertainty regarding independent data extraction and consensus procedures, and the minimal assessment of publication bias. Moreover, quality of conduct may not necessarily parallel quality of reporting, suggesting that consideration of these methods independently may be important.
Reviews concerning CR for schizophrenia are a valuable source of evidence. However, the methodological quality of these reports may require additional consideration. Enhancing quality of conduct is essential for enabling research literature to be interpreted with confidence.
在评估认知康复（CR）对精神分裂症的益处时，系统评价和荟萃分析是证据的主要来源。这些研究旨在严格综合科学文献；然而，不能假定其具有高方法学质量。本报告的目的是：1）回顾关于精神分裂症CR的系统评价和荟萃分析的应用；2）对已发表的关于该干预对核心结局领域益处的报告进行系统的方法学评估；3）比较方法学质量与报告质量之间的对应关系。
在电子数据库中检索相关文章。21项评价符合纳入标准，并根据AMSTAR清单（一种经过验证的方法学质量量表）进行评分。还根据PRISMA声明对5项荟萃分析进行评分，以比较“实施质量”与“报告质量”。
大多数系统评价和荟萃分析都有优点，且方法学质量处于“中等”水平。然而，大多数评价未涉及一些潜在的、一致的薄弱环节。这些包括缺乏方案注册、独立数据提取和共识程序的不确定性以及对发表偏倚的最小评估。此外，实施质量不一定与报告质量平行，这表明独立考虑这些方法可能很重要。
关于精神分裂症CR的评价是有价值的证据来源。然而，这些报告的方法学质量可能需要进一步考虑。提高实施质量对于使研究文献能够被可靠解读至关重要。
