Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, Victoria, 3199, Australia.
Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, Victoria, 3199, Australia; Department of Plastic Surgery, Frankston Hospital, Peninsula Health, Hastings Road, Frankston, Victoria, 3199, Australia.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3628-3651. doi: 10.1016/j.bjps.2022.08.004. Epub 2022 Aug 5.
Systematic reviews (SR) and meta-analyses (MA) are described as the top level of evidence in clinical research and are commonplace in plastic surgery literature. Their quality is limited both by the reliability of primary studies and the method of aggregating data. This study analysed the overall quality of SR's in plastic surgery and identified influencing factors.
The paper critically appraised SR's published in three prominent plastic surgery journals between July 2019 and July 2020. Study selection and appraisal was performed in duplicate. Articles were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
Seventy-six studies were included. 52 (68%) were SR's only and 24 (32%) included meta-analysis (MA) as well. The most common subspecialty areas included breast, craniofacial and hand. 78% of studies followed the PRISMA guidelines. The median (min, max) AMSTAR score was 3.5 (0-7). SR's with MA had significantly higher AMSTAR scores (p<0.001) than SR's alone, with median scores of 5 and 3 respectively. Papers from China had significantly higher AMSTAR scores than the USA. Craniofacial SR's had significantly higher scores than all other subspecialty areas. Most SR's reviewed concluded that there is currently inadequate primary research to make a conclusion and recommended more research be carried out in that area.
This systematicreview found overall that the quality of research methodology in Plastic Surgery SRs is low, and their conclusions of limited value. Surgeons should be familiar with SR and MA methodology, so they can exercise better judgement in applying findings to clinical practice.
系统评价（SR）和荟萃分析（MA）被描述为临床研究的最高证据级别，在整形外科学文献中很常见。它们的质量受到原始研究的可靠性和汇总数据的方法的限制。本研究分析了整形外科学中 SR 的整体质量，并确定了影响因素。
本文对 2019 年 7 月至 2020 年 7 月期间在三家著名的整形外科学期刊上发表的 SR 进行了批判性评估。研究选择和评估均由两人进行。使用评估系统评价的测量工具（AMSTAR）对文章进行评估。
共纳入 76 项研究。52 项（68%）为仅 SR，24 项（32%）包含 MA。最常见的亚专科领域包括乳房、颅面和手部。78%的研究遵循 PRISMA 指南。中位数（最小，最大）AMSTAR 评分为 3.5（0-7）。具有 MA 的 SR 的 AMSTAR 评分明显高于仅具有 SR 的评分（p<0.001），中位数分别为 5 和 3。来自中国的论文的 AMSTAR 评分明显高于美国。颅面 SR 的评分明显高于其他所有亚专科领域。大多数综述得出的结论是，目前缺乏原始研究来得出结论，并建议在该领域开展更多的研究。
本系统评价发现，整形外科 SR 研究的整体研究方法质量较低，其结论的价值有限。外科医生应该熟悉 SR 和 MA 方法学，以便在将研究结果应用于临床实践时能够更好地进行判断。
