Behavioral Sciences Institute, Radboud University, Nijmegen, Netherlands.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
PLoS One. 2020 Oct 26;15(10):e0240032. doi: 10.1371/journal.pone.0240032. eCollection 2020.
Gaming disorder has been described as an urgent public health problem and has garnered many systematic reviews of its associations with other health conditions. However, review methodology can contribute to bias in the conclusions, leading to research, policy, and patient care that are not truly evidence-based. This study followed a pre-registered protocol (PROSPERO 2018 CRD42018090651) with the objective of identifying reliable and methodologically-rigorous systematic reviews that examine the associations between gaming disorder and depression or anxiety in any population. We searched PubMed and PsycInfo for published systematic reviews and the gray literature for unpublished systematic reviews as of June 24, 2020. Reviews were classified as reliable according to several quality criteria, such as whether they conducted a risk of bias assessment of studies and whether they clearly described how outcomes from each study were selected. We assessed possible selective outcome reporting among the reviews. Seven reviews that included a total of 196 studies met inclusion criteria. The overall number of participants was not calculable because not all reviews reported these data. All reviews specified eligibility criteria for studies, but not for outcomes within studies. Only one review assessed risk of bias. Evidence of selective outcome reporting was found in all reviews-only one review incorporated any of the null findings from studies it included. Thus, none were classified as reliable according to prespecified quality criteria. Systematic reviews related to gaming disorder do not meet methodological standards. As clinical and policy decisions are heavily reliant on reliable, accurate, and unbiased evidence synthesis; researchers, clinicians, and policymakers should consider the implications of selective outcome reporting. Limitations of the current summary include using counts of associations and restricting to systematic reviews published in English. Systematic reviewers should follow established guidelines for review conduct and transparent reporting to ensure evidence about technology use disorders is reliable.
游戏障碍已被描述为一个紧迫的公共卫生问题，其与其他健康状况的关联已进行了许多系统评价。然而，评价方法可能会导致结论产生偏差，从而导致研究、政策和患者护理并非真正基于证据。本研究遵循预先注册的方案（PROSPERO 2018 CRD42018090651），目的是确定可靠且方法严谨的系统评价，这些评价研究了任何人群中游戏障碍与抑郁或焦虑之间的关联。截至 2020 年 6 月 24 日，我们在 PubMed 和 PsycInfo 中搜索了已发表的系统评价，并在灰色文献中搜索了未发表的系统评价。根据几个质量标准（如是否对研究进行了偏倚风险评估，以及是否清楚描述了如何选择每个研究的结果），评价被分为可靠或不可靠。我们评估了这些评价中是否存在选择性结果报告。有 7 项综述符合纳入标准，共纳入了 196 项研究。由于并非所有综述都报告了这些数据，因此无法计算参与者的总数。所有综述都为研究指定了纳入标准，但未为研究内的结局指定纳入标准。只有一项综述评估了偏倚风险。所有综述都发现了选择性结果报告的证据-只有一项综述纳入了其纳入研究的所有阴性结果。因此，根据预先指定的质量标准，没有一项被归类为可靠。与游戏障碍相关的系统评价不符合方法学标准。由于临床和政策决策严重依赖可靠、准确和无偏倚的证据综合；研究人员、临床医生和决策者应考虑选择性结果报告的影响。目前总结的局限性包括使用关联数量并限制在英文发表的系统评价。系统评价者应遵循既定的评价实施和透明报告指南，以确保关于技术使用障碍的证据是可靠的。
