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2005年至2014年发表于主要麻醉学杂志的Meta分析的质量评估

Quality Assessment of Meta-analyses Published in Leading Anesthesiology Journals From 2005 to 2014.

作者信息

Hall Amber M, Lee Sandra, Zurakowski David

机构信息

From the Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

出版信息

Anesth Analg. 2017 Jun;124(6):2063-2067. doi: 10.1213/ANE.0000000000002074.

Abstract

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).

摘要

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)。

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