DPhil Programme in Evidence-Based Healthcare, University of Oxford, Oxford, UK.
Abdominal Wall Surgery Unit and General and Digestive Surgery Research Group, Department of General Surgery, Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
World J Surg. 2019 Dec;43(12):3003-3012. doi: 10.1007/s00268-019-05139-z.
Systematic reviews play a crucial role in clinical decision making and resource allocation and are expected to be unbiased and consistent. The aim of this study is a review of systematic reviews on the use of prophylactic mesh to prevent parastomal hernia (PH) formation using ROBIS and AMSTAR tools to assess the risk of bias and methodological quality.
We included systematic reviews with or without meta-analysis of which the objective was to assess the use of a prophylactic mesh to prevent PH. A systematic search of the literature in five databases from inception until December 2017 was conducted. For each systematic review, methodologic quality and risk of bias were assessed using the AMSTAR and ROBIS tools, respectively. We estimated the inter-rater reliability for individual domains and for the overall methodological quality and risk of bias using Fleiss' k.
We identified 14 systematic reviews that met the inclusion criteria. Using the AMSTAR scale with a cutoff value, six reviews showed high methodologic quality and eight were of low quality. Using the ROBIS tool, the overall risk of bias was low in 50% of the reviews analyzed. In the remaining studies, the risk of bias was unclear.
The global evidence in favor of the use of a prophylactic mesh for preventing PH is not uniform regarding quality and risk of bias. Surgeons cannot be equally confident in the results of all systematic reviews published on this topic.
系统评价在临床决策和资源分配中起着至关重要的作用，预计其应具有无偏倚性和一致性。本研究旨在使用 ROBIS 和 AMSTAR 工具对预防造口旁疝（PH）形成的预防性网片使用的系统评价进行综述，以评估偏倚风险和方法学质量。
我们纳入了有或没有荟萃分析的系统评价，其目的是评估预防性网片预防 PH 的使用。对五个数据库从建库到 2017 年 12 月的文献进行了系统检索。对每个系统评价，使用 AMSTAR 和 ROBIS 工具分别评估方法学质量和偏倚风险。我们使用 Fleiss' k 评估个体域和整体方法学质量和偏倚风险的组内一致性。
我们确定了 14 项符合纳入标准的系统评价。使用 AMSTAR 量表的截断值，有 6 项系统评价显示方法学质量高，8 项为低质量。使用 ROBIS 工具，分析的 50%系统评价的总体偏倚风险较低。在其余研究中，偏倚风险不明确。
全球证据支持使用预防性网片预防 PH 的证据在质量和偏倚风险方面并不一致。外科医生不能对所有关于该主题的系统评价的结果同等置信。
