Hall Amber M, Lee Sandra, Zurakowski David
From the Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Anesth Analg. 2017 Jun;124(6):2063-2067. doi: 10.1213/ANE.0000000000002074.
Meta-analysis, when preceded by a systematic review, is considered the "gold standard" in data aggregation; however, the quality of meta-analyses is often questionable, leading to uncertainty about the accuracy of results. In this study, we evaluate the quality of meta-analyses published in 5 leading anesthesiology journals from 2005 to 2014. A total of 220 meta-analyses published in Anesthesiology, Pain, British Journal of Anaesthesia, Anaesthesia, or Anesthesia & Analgesia were identified for inclusion. The quality of each meta-analysis was determined using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR). R-AMSTAR rated 11 questions related to systematic reviews and meta-analyses on a scale of 1-4, with 4 representing the highest quality. Overall meta-analyses quality was evaluated using a Spearmen regression analysis and found to positively correlate with time (rs = 0.24, P < .001). Similarly, a temporal association was found for conflict of interest (rs = 0.51, P < .001) and comprised a list of included and excluded studies (rs = 0.32, P < .001). In conclusion, the quality of meta-analyses published in leading anesthesiology journals has increased over the last decade. Furthermore, assessing the scientific quality of included studies in meta-analyses (P = .60) and using this assessment to formulate conclusions and/or recommendations (P = .67) remains relatively low (median R-AMSTAR: 2, interquartile range [IQR]: 2-3]; median R-AMSTAR: 2, IQR: 1-2, respectively).
荟萃分析若在系统评价之后进行,则被视为数据汇总的“金标准”;然而,荟萃分析的质量常常存疑,导致结果准确性存在不确定性。在本研究中,我们评估了2005年至2014年在5种领先的麻醉学杂志上发表的荟萃分析的质量。总共确定了220篇发表于《麻醉学》《疼痛》《英国麻醉学杂志》《麻醉》或《麻醉与镇痛》的荟萃分析纳入研究。每项荟萃分析的质量使用修订的多重系统评价评估(R-AMSTAR)来确定。R-AMSTAR对与系统评价和荟萃分析相关的11个问题进行评分,范围为1至4分,4分代表最高质量。总体荟萃分析质量使用斯皮尔曼回归分析进行评估,发现与时间呈正相关(rs = 0.24,P <.001)。同样,发现利益冲突存在时间关联(rs = 0.51,P <.001),并且包含纳入和排除研究列表也存在时间关联(rs = 0.32,P <.001)。总之,在过去十年中,领先麻醉学杂志上发表的荟萃分析质量有所提高。此外,评估荟萃分析中纳入研究的科学质量(P = 0.60)以及使用该评估来得出结论和/或提出建议(P = 0.67)的情况仍然相对较少(R-AMSTAR中位数:2,四分位间距[IQR]:2 - 3;R-AMSTAR中位数:2,IQR:1 - 2)。