Davies Benjamin M, McHugh M, Elgheriani A, Kolias Angelos G, Tetreault Lindsay, Hutchinson Peter J A, Fehlings Michael G, Kotter Mark R N
Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
Division of Neurosurgery and Spine Program Toronto Western Hospital, University Health Network & University of Toronto, Toronto, Canada.
PLoS One. 2017 Mar 1;12(3):e0172564. doi: 10.1371/journal.pone.0172564. eCollection 2017.
Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent condition. Variable reporting in interventional trials of study design and sample characteristics limits the interpretation of pooled outcomes. This is pertinent in DCM where baseline characteristics are known to influence outcome. The present study aims to assess the reporting of the study design and baseline characteristics in DCM as the premise for the development of a standardised reporting set.
A systematic review of MEDLINE and EMBASE databases, registered with PROSPERO (CRD42015025497) was conducted in accordance with PRISMA guidelines. Full text articles in English, with >50 patients (prospective) or >200 patients (retrospective), reporting outcomes of DCM were deemed to be eligible.
A total of 108 studies involving 23,876 patients, conducted world-wide, were identified. 33 (31%) specified a clear primary objective. Study populations often included radiculopathy (51, 47%) but excluded patients who had undergone previous surgery (42, 39%). Diagnositic criteria for myelopathy were often uncertain; MRI assessment was specified in only 67 (62%) of studies. Patient comorbidities were referenced by 37 (34%) studies. Symptom duration was reported by 46 (43%) studies. Multivariate analysis was used to control for baseline characteristics in 33 (31%) of studies.
The reporting of study design and sample characteristics is variable. The development of a consensus minimum dataset for (CODE-DCM) will facilitate future research synthesis in the future.
退行性颈椎脊髓病[DCM]是一种致残且日益普遍的疾病。研究设计和样本特征的介入试验报告存在差异,这限制了汇总结果的解释。在已知基线特征会影响结果的DCM中,这一点尤为相关。本研究旨在评估DCM中研究设计和基线特征的报告情况,作为制定标准化报告集的前提。
按照PRISMA指南对MEDLINE和EMBASE数据库进行系统评价,并在PROSPERO(CRD42015025497)注册。英文全文文章,前瞻性研究患者>50例或回顾性研究患者>200例,报告DCM结果的被视为合格。
共识别出全球范围内进行的涉及23,876例患者的108项研究。33项(31%)明确规定了主要目标。研究人群通常包括神经根病患者(51例,47%),但排除了既往接受过手术的患者(42例,39%)。脊髓病的诊断标准通常不明确;仅67项(62%)研究规定了MRI评估。37项(34%)研究提及了患者的合并症。46项(43%)研究报告了症状持续时间。33项(31%)研究使用多变量分析来控制基线特征。
研究设计和样本特征的报告存在差异。制定一个关于DCM的共识最小数据集(CODE-DCM)将有助于未来的研究综合分析。