Matino Davide, Chai-Adisaksopha Chatree, Iorio Alfonso
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
2Department of Experimental Medicine, University of Perugia, Perugia, Italy.
Diagn Progn Res. 2017 Mar 16;1:9. doi: 10.1186/s41512-017-0008-z. eCollection 2017.
Prognosis research refers to the investigation of association between a baseline health state, patient characteristic and future outcomes. The findings of several prognostic studies can be summarized in systematic reviews (SRs), but some characteristics of prognostic studies may result in difficulties when performing the analyses. This study aimed to investigate trends in the volume and quality of SRs of prognostic studies in the literature.
We conducted a systematic review in five high-impact clinical journals (Annals of Internal Medicine, BMJ, Circulation, JAMA, and Stroke) to identify SRs of prognosis studies focused on fundamental prognosis research and prognostic factor research published between 2000 and 2012. We excluded studies of clinical prediction guides or implementation studies. The quality of the SRs was rated based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the PRISMA checklists.
Over the 13-year period, 1065 SRs were published. Of these, 198 were SRs of prognosis studies. The proportion of all SRs to published articles increased from 0.86% in 2000 to 4.2% in 2012. Likewise, the proportion of prognosis SRs to all SRs increased from 10.3% in 2000 to 17.7% in 2012. MOOSE and PRISMA mean summary scores consistently increased over time for all journals, indicating that the quality of reporting in these SRs has steadily improved. However, several items were not consistently well reported by investigators.
This study shows that there is a growing number of SRs of prognosis studies. However, the quality is suboptimal when assessed with the generic reporting guidelines for observational studies. New reporting guidelines and risk of bias tools for prognosis studies are needed to improve the quality of future research in this field.
预后研究是指对基线健康状况、患者特征与未来结局之间的关联进行调查。多项预后研究的结果可在系统评价（SRs）中进行总结，但预后研究的某些特征可能会在进行分析时带来困难。本研究旨在调查文献中预后研究系统评价的数量和质量趋势。
我们在五种高影响力临床期刊（《内科学年鉴》《英国医学杂志》《循环》《美国医学会杂志》和《中风》）上进行了一项系统评价，以识别2000年至2012年间发表的聚焦于基础预后研究和预后因素研究的预后研究系统评价。我们排除了临床预测指南或实施研究。基于流行病学观察性研究的Meta分析（MOOSE）和PRISMA清单对系统评价的质量进行评分。
在这13年期间，共发表了1065篇系统评价。其中，198篇是预后研究的系统评价。所有系统评价占发表文章的比例从2000年的0.86%增至2012年的4.2%。同样，预后研究系统评价占所有系统评价的比例从2000年的10.3%增至2012年的17.7%。所有期刊的MOOSE和PRISMA平均总分随时间持续增加，表明这些系统评价的报告质量稳步提高。然而，一些项目调查人员并未始终如一地进行良好报告。
本研究表明，预后研究的系统评价数量在不断增加。然而，根据观察性研究的通用报告指南进行评估时，质量并不理想。需要新的预后研究报告指南和偏倚风险工具来提高该领域未来研究的质量。
