Salim Adeline, Mullassery Dhanya, Losty Paul D
Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Department of Paediatric Surgery, St George's Hospital, London, UK.
J Pediatr Surg. 2017 Nov;52(11):1732-1735. doi: 10.1016/j.jpedsurg.2017.07.022. Epub 2017 Aug 8.
Systematic reviews (SRs) and meta-analyses (MAs) studies may influence and direct surgical practice. Against this background we have analyzed the quality of systematic reviews and meta-analyses published in the specialty field of pediatric surgery using the Assessment of Multiple Systematic Reviews 11-item tool (AMSTAR).
MEDLINE and EMBASE databases and the three major journals in pediatric surgery were searched for SRs and MAs in pediatric surgery. Studies involving predominantly adult populations were excluded. Two reviewers independently scored included studies against AMSTAR criteria and disagreements were resolved by consensus. A total rating of 4 or less was considered 'poor' methodological quality, 5-8 as 'fair to good' and 9 or greater as 'good'.
Original searching retrieved 1,281 articles. 126 articles were included for final analysis. Examining recent trends, 4 studies were published in 1995-2000 compared to 78 in 2011-2014. Using AMSTAR scoring criteria, 35 reviews (28%) were regarded as 'poor' in terms of methodological quality, 59 (47%) 'fair', and 32 (25%) 'good' quality. We observed no improvement in AMSTAR score before and after the development of the tool (mean score pre-2008 6.8, post-2008 5.9, p = 0.136).
Despite an increase in the number of SRs / MAs published in pediatric surgery, a quarter of all studies were considered poor in terms of their quality and scientific validity. Journals must define and apply minimum criteria to ensure pediatric surgeons seeking to publish high quality SRs / MAs achieve these requirements.
系统评价（SRs）和荟萃分析（MAs）研究可能会影响并指导外科手术实践。在此背景下，我们使用多系统评价11项评估工具（AMSTAR）分析了小儿外科专业领域发表的系统评价和荟萃分析的质量。
在MEDLINE和EMBASE数据库以及小儿外科领域的三大主要期刊中检索小儿外科方面的SRs和MAs。排除主要涉及成人人群的研究。两名评价者根据AMSTAR标准对纳入研究进行独立评分，分歧通过协商解决。总评分4分及以下被认为方法学质量“差”，5 - 8分为“中等至良好”，9分及以上为“良好”。
初步检索共获得1281篇文章。最终纳入126篇文章进行分析。审视近期趋势，1995 - 2000年发表了4项研究，而2011 - 2014年有78项。根据AMSTAR评分标准，35项评价（28%）在方法学质量方面被视为“差”，59项（47%）为“中等”，32项（25%）为“良好”质量。我们观察到该工具开发前后AMSTAR评分没有改善（2008年前平均分为6.8，2008年后为5.9，p = 0.136）。
尽管小儿外科领域发表的SRs / MAs数量有所增加，但所有研究中有四分之一在质量和科学有效性方面被认为较差。期刊必须明确并应用最低标准，以确保寻求发表高质量SRs / MAs的小儿外科医生达到这些要求。
