Eshaghpour Ali, Li Allen, Javidan Arshia Pedram, Chen Natalie, Yang Sarah, Crowther Mark Andrew
Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Evid Based Med. 2020 Jun 3. doi: 10.1136/bmjebm-2019-111326.
Systematic reviews (SRs) have been reported with increasing frequency as a means of collating studies which may have been performed over different period of times, in different geographical areas and by different groups of investigators. As SRs have become more common, quality metrics such as Assessing the Methodological Quality of Systematic Reviews (AMSTAR) have become available for these reviews. AMSTAR is an 11-point checklist that assesses the methodological and reporting quality of a SR. In clinical practice, direct oral anticoagulants (DOACs) have been increasingly used for the treatment and prevention of both venous and arterial thromboembolism. We sought to evaluate the quality of SRs published on DOACs using the AMSTAR criteria. A comprehensive search of Medline, EMBASE and the Cochrane Database of Systematic Reviews from January 2013 to February 2019 was performed. Two reviewers independently screened titles and abstracts and subsequently full texts for eligibility. Data extraction was also completed in duplicate. Categories of extracted data included AMSTAR rating, journal of publication, year of publication, number of studies included in the SR, reporting adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, number of times the paper was cited and journal impact factor. A total of 3729 articles were identified, of which 250 were eligible for analysis. SR quality was highly variable with mean (SD) AMSTAR score of 5.68/11 (2.21). Reporting adherence to PRISMA guideline correlated with a moderate (5-8) or high quality (9-11) (OR=4.19, p<0.01) AMSTAR score. The methodological quality of DOACs was generally rated to be low-moderate, and improved adherence to AMSTAR methodological practices are strongly recommended.
系统评价（SRs）作为一种整理研究的方法，其报告频率日益增加，这些研究可能是在不同时间段、不同地理区域由不同研究团队开展的。随着系统评价越来越普遍，诸如评估系统评价方法学质量（AMSTAR）等质量指标已可用于这些评价。AMSTAR是一份11项的清单，用于评估系统评价的方法学和报告质量。在临床实践中，直接口服抗凝剂（DOACs）越来越多地用于静脉和动脉血栓栓塞的治疗和预防。我们试图使用AMSTAR标准评估关于DOACs的系统评价的质量。对2013年1月至2019年2月的Medline、EMBASE和Cochrane系统评价数据库进行了全面检索。两名评价者独立筛选标题和摘要，随后筛选全文以确定是否符合纳入标准。数据提取也重复进行。提取的数据类别包括AMSTAR评分、发表期刊、发表年份、系统评价中纳入的研究数量、报告是否遵循系统评价和Meta分析的首选报告项目（PRISMA）指南、论文被引用次数和期刊影响因子。共识别出3729篇文章，其中250篇符合分析条件。系统评价质量差异很大，平均（标准差）AMSTAR评分为5.68/11（2.21）。报告遵循PRISMA指南与中等质量（5 - 8）或高质量（9 - 11）（OR = 4.19，p < 0.01）的AMSTAR评分相关。DOACs的方法学质量总体评定为低到中等，强烈建议更好地遵循AMSTAR方法学实践。
