VA Northern California Health Care System, Mather.
Old Dominion University, Norfolk, VA.
Am J Speech Lang Pathol. 2022 Oct 25;31(5S):2291-2300. doi: 10.1044/2022_AJSLP-21-00288. Epub 2022 May 17.
A systematic review (SR) represents a rigorous process of identifying and summarizing current research to answer specific clinical questions. Not all SRs present high-quality information, because they do not adhere to established standards of conduct or reporting. This tutorial aims to (a) describe two tools developed in epidemiology for reporting (PRISMA 2020; Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and appraising (AMSTAR 2; A MeaSurement Tool to Assess Systematic Reviews) SRs and (b) exemplify the use of AMSTAR 2. First, we describe the intents of PRISMA 2020 and AMSTAR 2 and compare the items on each checklist. Next, we apply the AMSTAR 2 list of domains to critically appraise methodological quality in two randomly selected SRs, which describe aphasia treatment. Appraisal results are reported, including the AMSTAR 2 ratings for overall confidence in the results of each review. For each SR, the overall rating was , indicating that within the seven critical domains of AMSTAR 2, the SR had more than one critical weakness.
While PRISMA 2020 is a tool to guide preparation of SRs, to examine SR quality, the AMSTAR 2 is the tool of choice. Applied to two current aphasia treatment SRs, the AMSTAR 2 demonstrates that although both SRs were thorough, thoughtful summaries of a body of aphasia treatment literature, they did not achieve high ratings for methodological quality. Clinicians reading SRs are advised to familiarize themselves with quality assessment tools to assure that an SR meets expected criteria to document internal and external validity of the SR process, so resulting findings can be confidently applied for patients with aphasia.
系统评价(SR)是一种严格的过程,用于识别和总结当前的研究,以回答特定的临床问题。并非所有的 SR 都提供高质量的信息,因为它们没有遵守既定的行为或报告标准。本教程旨在:(a)描述在流行病学中开发的两种用于报告(PRISMA 2020;系统评价和荟萃分析的首选报告项目)和评估(AMSTAR 2;系统评价的评估工具)SR 的工具;(b)举例说明 AMSTAR 2 的使用。首先,我们描述了 PRISMA 2020 和 AMSTAR 2 的意图,并比较了每个清单上的项目。接下来,我们将 AMSTAR 2 清单中的领域应用于批判性评估两个随机选择的 SR 的方法学质量,这两个 SR 描述了失语症治疗。报告评估结果,包括对每个综述结果的整体信心的 AMSTAR 2 评分。对于每个 SR,总体评分为 ,这表明在 AMSTAR 2 的七个关键领域中,SR 有一个以上的关键弱点。
虽然 PRISMA 2020 是指导 SR 准备的工具,但要检查 SR 的质量,AMSTAR 2 是首选工具。应用于当前的两个失语症治疗 SR,AMSTAR 2 表明,尽管这两个 SR 都是对失语症治疗文献的全面、深思熟虑的总结,但它们在方法学质量方面没有获得高分。建议临床医生在阅读 SR 时熟悉质量评估工具,以确保 SR 符合预期的标准,以记录 SR 过程的内部和外部有效性,从而可以有信心地将研究结果应用于失语症患者。