Sun Shouyuan, Zhao Liang, Zhou Xiaoli, Liu Xuewu, Xie Zongzhi, Ren Jun, Zhou Baoyuan, Pan Yawen
Lanzhou University Second Hospital, Lanzhou, China.
School of Nursing, Lanzhou University, Lanzhou, China.
Front Pharmacol. 2023 Feb 9;14:1047650. doi: 10.3389/fphar.2023.1047650. eCollection 2023.
The aim of this study is to critically appraise whether published systematic reviews/meta-analyses of traditional Chinese medicine for adults with ischemic stroke are of sufficient quality and to rate the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. A literature search was performed in the Cochrane Library, PubMed, Chinese National Knowledge Infrastructure, and SinoMed databases by March 2022. The inclusion criteria were systematic reviews/meta-analyses of traditional Chinese medicine in adults who suffered from ischemic stroke. A Measurement Tool to Access Systematic Reviews 2 (AMSTAR-2) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Abstract (PRISMA-A) statements were used to assess the methodological and reporting quality of the included reviews. The Grading of Recommendations, Assessment, Development, and Evaluation system was utilized to assess each report's evidence level. Of the 1,908 titles and abstracts, 83 reviews met the inclusion criteria. These studies were published between 2005 and 2022. The results of AMSTAR-2 showed that 51.4% of the items were reported, but the registration, reasons for the inclusion of study design, the list of excluded studies, and funding information were ignored in the majority of the reviews. The results of PRISMA-A showed that 33.9% of items were reported, and the information on registration, limitation, and funding was not available in many publications. The assessment of the evidence with the Grading of Recommendations, Assessment, Development, and Evaluation showed that more than half (52/83) of the included studies had either low or very low levels of evidence. The reporting quality in the abstract of systematic reviews/meta-analyses on traditional Chinese medicine for ischemic stroke is poor and does not facilitate timely access to valid information for clinical practitioners. Although the methodological quality is of a medium level, this evidence lacks certainty, especially with a high risk of bias in individual studies.
本研究旨在严格评估已发表的关于成人缺血性中风的中医药系统评价/荟萃分析的质量是否足够，并使用推荐分级、评估、制定和评价方法对证据质量进行评级。于2022年3月在考克兰图书馆、PubMed、中国知网和中国生物医学文献数据库中进行了文献检索。纳入标准为针对患有缺血性中风的成年人的中医药系统评价/荟萃分析。使用系统评价的测量工具2（AMSTAR-2）和系统评价与荟萃分析摘要的首选报告项目（PRISMA-A）声明来评估纳入评价的方法学和报告质量。采用推荐分级、评估、制定和评价系统来评估每份报告的证据水平。在1908篇标题和摘要中，83篇评价符合纳入标准。这些研究发表于2005年至2022年之间。AMSTAR-2的结果显示，51.4%的条目有报告，但大多数评价忽略了注册、纳入研究设计的理由、排除研究列表和资金信息。PRISMA-A的结果显示，33.9%的条目有报告，许多出版物中没有注册、局限性和资金方面的信息。用推荐分级、评估、制定和评价对证据进行的评估表明，超过一半（52/83）的纳入研究证据水平低或极低。关于缺血性中风的中医药系统评价/荟萃分析摘要中的报告质量较差，不利于临床医生及时获取有效信息。尽管方法学质量处于中等水平，但该证据缺乏确定性，尤其是个别研究存在较高的偏倚风险。
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