系统评价对儿童早期过敏预防补充喂养时机的质量。

Quality of systematic reviews on timing of complementary feeding for early childhood allergy prevention.

机构信息

Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.

Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf, Germany.

出版信息

BMC Med Res Methodol. 2023 Apr 4;23(1):80. doi: 10.1186/s12874-023-01899-4.

DOI:10.1186/s12874-023-01899-4

PMID:37016313

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10071735/

Abstract

BACKGROUND

Only rigorously prepared analyses can provide the highest level of evidence to inform decision-making. Several recent systematic reviews (SRs) examined the hypothesis that the early introduction of specific allergenic complementary foods (CFs) to infants may lead to a lower incidence of one or more allergic outcomes. However, the methodological rigour and quality of reporting of SRs in this area has not yet been systematically evaluated.

METHODS

We comprehensively searched PubMed, Medline (Ovid), and Web of Science Core Collection on 13th January 2022, using a pre-specified and tested search syntax for SRs with RCT evidence on the early introduction of allergenic CFs as a means for allergy prevention in infants and children. We examined the quality and risk of bias (RoB) using AMSTAR-2 and ROBIS tools, examined adherence to the Preferred Reporting Items for SRs and Meta-Analyses (PRISMA), and checked whether certainty of the evidence was assessed.

RESULTS

Twelve SRs were included. Application of both tools resulted in similar overall judgements in terms of direction and extent for nine of the 12 SRs. Nine SRs were found to be of critically low to low quality according to AMSTAR-2 and to be at high RoB according to ROBIS. One SR received a moderate quality rating (AMSTAR-2) and high RoB rating (ROBIS). However, for two SRs, judgements between AMSTAR-2 and ROBIS were at stark variance. Only two SRs fully adhered to the PRISMA checklist. Six SRs evaluated the certainty of the body of RCT evidence. Several SRs failed to consider unpublished studies either by an explicit a priori exclusion or by inadequate search strategies.

CONCLUSIONS

Well-conducted SRs are important for decision-making and informing guideline development, the quality of their methodology should therefore be considered. The methodological rigour and the reporting quality of SRs on the timing of CF for allergy prevention must be improved.

REGISTRATION

https://osf.io/7cs4b .

摘要

背景

只有经过严格准备的分析才能提供最高级别的证据，以辅助决策。最近有几项系统评价（SRs）检验了这样一个假设，即早期引入特定的变应原性补充食品（CFs）可能会降低一种或多种过敏结果的发生率。然而，该领域的 SRs 的方法学严谨性和报告质量尚未得到系统评估。

方法

我们于 2022 年 1 月 13 日全面检索了 PubMed、Medline（Ovid）和 Web of Science Core Collection，使用预先确定并经过测试的 SRs 搜索语法，这些 SRs 包含 RCT 证据，研究了早期引入变应原性 CFs 作为预防婴儿和儿童过敏的一种手段。我们使用 AMSTAR-2 和 ROBIS 工具评估了质量和偏倚风险（RoB），检查了对系统评价和荟萃分析的首选报告项目（PRISMA）的遵守情况，并检查了证据确定性是否得到评估。

结果

共纳入 12 项 SRs。在 12 项 SRs 中，有 9 项的应用这两种工具的总体判断在方向和程度上相似。根据 AMSTAR-2，9 项 SRs 的质量被认为是极低到低，根据 ROBIS，被认为是高度 RoB。一项 SR 获得了中度质量评分（AMSTAR-2）和高度 RoB 评分（ROBIS）。然而，对于两项 SRs，AMSTAR-2 和 ROBIS 之间的判断存在明显差异。只有两项 SRs 完全遵守了 PRISMA 清单。六项 SRs 评估了 RCT 证据的整体确定性。几项 SRs 没有考虑到未发表的研究，要么是通过明确的事先排除，要么是通过不充分的搜索策略。