针对 COVID-19 干预措施的系统评价很少对证据的确定性进行分级。
Systematic reviews on interventions for COVID-19 have rarely graded the certainty of the evidence.
机构信息
PhD. Professor, Centro Universitário São Camilo, São Paulo (SP), Brazil; and Professor, Universidade Metropolitana de Santos (UNIMES), Santos (SP), Brazil.
MSc. Professor, Centro Universitário São Camilo, São Paulo (SP), Brazil; and Researcher, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo (SP), Brazil.
出版信息
Sao Paulo Med J. 2021 Aug-Sep;139(5):511-513. doi: 10.1590/1516-3180.2021.0107.27052021.
BACKGROUND
Numerous systematic reviews on coronavirus disease-19 (COVID-19) treatment have been developed to provide syntheses of the large volume of primary studies. However, the methodological quality of most of these reviews is questionable and the results provided may therefore present bias.
OBJECTIVE
To investigate how many systematic reviews on the therapeutic or preventive options for COVID-19 assessed the certainty of the evidence through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
METHODS
We conducted a sensitive search in MEDLINE (via PubMed) and included all systematic reviews that assessed any intervention for COVID-19. The systematic reviews included were examined to identify any planned and/or actual assessment using the GRADE approach (or absence thereof) regarding the certainty of the evidence.
RESULTS
We included 177 systematic reviews and found that only 37 (21%; 37/177) assessed and reported the certainty of the evidence using the GRADE approach. This number reduced to 27 (16.2%; 27/167) when Cochrane reviews (n = 10), in which an evaluation using GRADE is mandatory, were excluded.
CONCLUSION
Most of the systematic reviews on interventions relating to COVID-19 omitted assessment of the certainty of the evidence. This is a critical methodological omission that must not be overlooked in further research, so as to improve the impact and usefulness of syntheses relating to COVID-19.
背景
针对新型冠状病毒疾病（COVID-19）治疗，已经开展了许多系统评价，以对大量原始研究进行综合分析。然而，这些综述中的大多数方法学质量存在疑问，因此提供的结果可能存在偏倚。
目的
研究有多少针对 COVID-19 治疗或预防选择的系统评价通过 Grading of Recommendations Assessment, Development and Evaluation（GRADE）方法评估证据的确定性。
方法
我们在 MEDLINE（通过 PubMed）中进行了敏感搜索，并纳入了所有评估 COVID-19 任何干预措施的系统评价。检查纳入的系统评价，以确定是否有任何针对证据确定性的计划和/或实际的 GRADE 评估（或不存在）。
结果
我们纳入了 177 篇系统评价，发现只有 37 篇（21%；37/177）使用 GRADE 方法评估并报告了证据的确定性。当排除 Cochrane 综述（n=10）时，这一数字减少到 27 篇（16.2%；27/167），因为 Cochrane 综述中必须使用 GRADE 进行评估。
结论
针对 COVID-19 干预措施的大多数系统评价都忽略了对证据确定性的评估。这是一个关键的方法学遗漏，在进一步的研究中不容忽视，以提高与 COVID-19 相关的综合研究的影响和有用性。
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