Sotiropoulos Georgios C, Machairas Nikolaos, Kykalos Stylianos, Stamopoulos Paraskevas, Prodromidou Anastasia, Katsargyris Athanasios
2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, "Laiko" General Hospital, Athens, Greece.
J BUON. 2017 Mar-Apr;22(2):535-542.
Meta-analyses are considered to provide level I-II evidence. Based on this premise, several statements have been developed to standardize guidelines and optimize results. The purpose of this study was to investigate the quality of the information delivered by meta-analyses.
Meta-analyses published in Annals of Surgery during an 11-year period were reviewed whereas individual publications of each meta-analysis were assessed. An Excel database encompassing 29 parameters was constructed based on the Quality of Reporting of Meta-analyses (QUOROM) statement.
The present study included 31 consecutive meta- analyses. The number of meta-analyses conforming with each of the parameters considered was as follows: information obtained from more than 2 databases 23/31; language of publication exclusively English 25/31; defined population, intervention, and principal outcomes 31/31; study design encompassing review of randomised controlled trials (RCTs) 10/31; quality assessment of contributing publications 10/31; handling of missing data 10/31; assessment of statistical heterogeneity 30/31; subgroup analysis 23/31; assessment of publication bias 26/31; agreement on selection and validity assessment 22/31; simple summary results 28/31; data available to calculate effect size and confidence interval 27/31; key findings summarized 30/31; clinical inferences based on internal and external validity 24/31; description of potential biases in the review process 23/31; future research agenda suggested 18/31.
Evidence derived from meta-analyses must be interpreted with caution. Although QUOROM guidelines were observed, quality assessments showed considerable variability.
荟萃分析被认为可提供I-II级证据。基于这一前提，已制定了若干声明以规范指南并优化结果。本研究的目的是调查荟萃分析所提供信息的质量。
回顾了11年间发表在《外科年鉴》上的荟萃分析，并对每项荟萃分析的单独出版物进行了评估。基于荟萃分析报告质量（QUOROM）声明构建了一个包含29个参数的Excel数据库。
本研究纳入了31项连续的荟萃分析。符合所考虑的每个参数的荟萃分析数量如下：从2个以上数据库获得的信息23/31；仅以英文发表25/31；定义的人群、干预措施和主要结局31/31；包括随机对照试验（RCT）综述的研究设计10/31；对纳入出版物的质量评估10/31；缺失数据的处理10/31；统计异质性评估30/31；亚组分析23/31；发表偏倚评估26/31；选择和有效性评估的一致性22/31；简单汇总结果28/31；可用于计算效应量和置信区间的数据27/31；关键发现总结30/31；基于内部和外部有效性的临床推断24/31；对综述过程中潜在偏倚的描述23/31；提出的未来研究议程18/31。
来自荟萃分析的证据必须谨慎解读。尽管遵循了QUOROM指南，但质量评估显示出相当大的变异性。
