Department of Urology, Stanford Hospital and Clinics, Stanford, CA, USA.
Department of Urology, Stanford Hospital and Clinics, Stanford, CA, USA.
J Sex Med. 2019 Mar;16(3):394-401. doi: 10.1016/j.jsxm.2019.01.009. Epub 2019 Feb 14.
Erectile dysfunction (ED) is a common medical condition that requires high-quality evidence to guide clinical practice; however, systematic reviews (SRs) and meta-analyses (MAs) often vary in quality, raising concerns regarding the validity of their results.
To perform an objective analysis of SRs and MAs in ED treatment and management and to report on the quality of published literature.
A comprehensive search in PubMed/MEDLINE and EMBASE of 12 high-impact urology journals was used to identify relevant publications. 2 authors independently performed searches, screened citations for eligibility, extracted data for analysis, and graded methodologic quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) criteria.
The main outcome was AMSTAR score, which is a validated tool to evaluate the quality of SRs and MAs.
31 publications met inclusion criteria and were included in the analysis. The mean AMSTAR score (± SD) among all publications was 6.5 (±2.2) of 11, reflecting "fair to good" quality. 74.2% of systematic reviews and meta-analyses focused on pharmaceutical therapy for ED, with 51.6% studying the effect of phosphodiesterase-5 inhibitors. Only 1 SR/MA studied intracavernosal injection therapy and vacuum erection devices. No publications studied intraurethral injection therapy or implantable penile prostheses. Although not statistically significant, there has been a trend of increasing quality of SRs/MAs over time (P = .072).
The methodologic quality of SRs/MAs should be assessed to ensure high-quality evidence for clinical practice guidelines in ED treatment and management.
STRENGTH & LIMITATION: The data showed that methodologic quality of SRs/MAs in the treatment and management of ED is increasing over time. 12 high-impact urology journals were included in our search, which may introduce selection bias in our results.
This review highlights a need for increased effort to study second- and third-line treatments for patients who fail oral therapy. Greenberg DR, Richardson MT, Tijerina JD, et al. The Quality of Systematic Reviews and Meta-Analyses in Erectile Dysfunction Treatment and Management Published in the Sexual Medicine Literature. J Sex Med 2019;16:394-401.
勃起功能障碍（ED）是一种常见的医学病症，需要高质量的证据来指导临床实践；然而，系统评价（SRs）和荟萃分析（MAs）的质量往往存在差异，这引起了人们对其结果有效性的关注。
对 ED 治疗和管理的 SRs 和 MAs 进行客观分析，并报告已发表文献的质量。
通过对 12 种高影响力的泌尿科杂志中的 PubMed/MEDLINE 和 EMBASE 进行全面检索，以确定相关文献。两名作者独立进行检索、筛选合格文献、提取分析数据，并使用评估系统评价的测量工具（AMSTAR）标准对方法学质量进行分级。
主要观察指标是 AMSTAR 评分，这是一种评估 SRs 和 MAs 质量的有效工具。
31 篇文献符合纳入标准并纳入分析。所有文献的平均 AMSTAR 评分（±SD）为 6.5（±2.2）分，反映出“良好到中等”的质量。74.2%的系统评价和荟萃分析集中在 ED 的药物治疗上，其中 51.6%研究了磷酸二酯酶-5 抑制剂的作用。只有 1 项 SR/MA 研究了海绵体内注射治疗和真空勃起装置。没有出版物研究尿道内注射治疗或可植入阴茎假体。尽管没有统计学意义，但 SRs/MAs 的质量随着时间的推移呈上升趋势（P=0.072）。
应评估 SRs/MAs 的方法学质量，以确保 ED 治疗和管理的临床实践指南具有高质量的证据。
本研究数据表明，ED 治疗和管理的 SRs/MAs 的方法学质量随着时间的推移而不断提高。我们的检索纳入了 12 种高影响力的泌尿科杂志，这可能会使我们的结果存在选择偏倚。
本综述强调需要加大努力研究口服治疗失败的患者的二线和三线治疗方法。Greenberg DR、Richardson MT、Tijerina JD 等人。发表在性医学文献中的勃起功能障碍治疗和管理中的系统评价和荟萃分析的质量。J 性医学 2019;16:394-401。
