资金对卒中患者机械取栓系统评价的质量及解读的影响。

The impact of funding on the quality and interpretation of systematic reviews of mechanical thrombectomy in stroke patients.

作者信息

Ghozy Sherief, El-Qushayri Amr Ehab, Gbreel Mohamed Ibrahim, Farahat Ramadan Abdelmoez, Azzam Ahmed Y, Elfil Mohamed, Kobeissi Hassan, Dmytriw Adam, Al-Mufti Fawaz, Kadirvel Ramanathan, Kallmes David F

机构信息

Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA.

Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC program), 6396Oxford University, Oxford, UK.

出版信息

Interv Neuroradiol. 2022 Dec 14:15910199221145741. doi: 10.1177/15910199221145741.

DOI:10.1177/15910199221145741

PMID:36852503

Abstract

BACKGROUND

Funding may impact the quality and findings of systematic reviews (SRs). We aimed to compare the methodological quality of funded and non-funded SRs that investigated the outcomes in ischemic stroke patients undergoing mechanical thrombectomy.

METHODS

We conducted a comprehensive search strategy in different databases, including Ovid Cochrane Central Register of Controlled Trials, Ovid Embase, Ovid Medline (including epub ahead of print, in-process & other non-indexed citations), PubMed, Scopus and Web of Science Core Collection to retrieve all relevant SRs. Random sequence generation matched each funded SR with a non-funded one. A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2 tool was used to assess the bias and quality of the included SRs. We also used uni- and multivariate analysis to perform our analysis, and results were expressed in odds ratio (OR) and 95% confidence interval (CI).

RESULTS

We retrieved 150 articles, which were randomized and matched into 100 SRs, including 50 funded and 50 non-funded studies. By multivariate analysis, we found that including randomized clinical trials (RCTs) (OR: 5.7; 95% CI: 1.8-17.8; p = 0.003) and reporting conflict of interests (OR: 5.2; 95 CI: 1.1-24; p = 0.036) were the only significant differences between funded and non-funded SRs. No significant differences were found regarding the overall confidence for low-quality (OR: 0.54; 95% CI: 0.09-3.2; p = 0.49) and moderate/high-quality SRs (OR: 0.17; 95% CI: 0.02-1.87; p = 0.14).

CONCLUSION

Funded studies tend to include RCTs more often and report conflict of interests with no significant impact on overall confidence.

摘要

背景

资金可能会影响系统评价（SRs）的质量和结果。我们旨在比较研究接受机械取栓的缺血性中风患者结局的有资金支持和无资金支持的SRs的方法学质量。

方法

我们在不同数据库中开展了全面的检索策略，包括Ovid考克兰对照试验中心注册库、Ovid Embase、Ovid Medline（包括印刷版之前的电子版、在研及其他未索引的文献）、PubMed、Scopus和科学引文索引核心合集，以检索所有相关的SRs。随机序列生成将每个有资金支持的SR与一个无资金支持的SR进行匹配。使用系统评价评估测量工具（AMSTAR）-2工具来评估纳入的SRs的偏倚和质量。我们还使用单变量和多变量分析进行分析，结果以比值比（OR）和95%置信区间（CI）表示。

结果

我们检索到150篇文章，将其随机配对成100项SRs，包括50项有资金支持的研究和50项无资金支持的研究。通过多变量分析，我们发现纳入随机对照试验（RCTs）（OR：5.7；95%CI：1.8 - 17.8；p = 0.003）和报告利益冲突（OR：5.2；95%CI：1.1 - 24；p = 0.036）是有资金支持和无资金支持的SRs之间仅有的显著差异。在低质量（OR：0.54；95%CI：0.09 - 3.2；p = 0.49）和中/高质量SRs（OR：0.17；95%CI：0.02 - 1.87；p = 0.14）的总体可信度方面未发现显著差异。