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系统评价治疗水疱性皮肤病的质量。一项meta-流行病学研究。

Quality of systematic reviews on the treatment of vesiculobullous skin diseases. A meta-epidemiological study.

机构信息

Department of Medicine, Universidade Metropolitana de Santos, Santos, SP, Brazil.

Department of Medicine, Universidade Metropolitana de Santos, Santos, SP, Brazil.

出版信息

An Bras Dermatol. 2024 Mar-Apr;99(2):223-232. doi: 10.1016/j.abd.2023.06.003. Epub 2023 Nov 18.

DOI:10.1016/j.abd.2023.06.003
PMID:37985301
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10943289/
Abstract

BACKGROUND

Systematic reviews of Randomized Controlled Trials (RCTs) are considered high-level evidence to support a decision on therapeutic interventions, and their methodological quality is essential to provide reliable and applicable results.

OBJECTIVE

This meta-epidemiological study aimed to map and critically appraise systematic reviews assessing treatments for vesiculobullous skin diseases.

METHODS

We conducted a comprehensive search strategy on MEDLINE (via Pubmed) in December 2022 without restrictions to find systematic reviews evaluating pharmacological interventions for vesiculobullous skin diseases. The methodological quality was assessed using the AMSTAR-2 tool, and additional information was extracted. We identified nine systematic reviews published between 2002 and 2021, seven assessing pemphigus.

RESULTS

According to the AMSTAR-2 tool, 55.6% were classified as critically low quality, 22.2% as moderate quality, 11.1% as low and 11.1% as high quality. No review assessed the certainty of the evidence (GRADE); 86% of pemphigus reviews had at least two overlapping RCTs. There were some limitations regarding methodological flaws and the AMSTAR-2 tool use CONCLUSIONS: These findings reveal a frail methodological quality of systematic reviews about vesiculobullous diseases treatment that may impact the results. Therefore, methodological rigor is mandatory for future systematic reviews to avoid duplication of effort and increase the certainty of the evidence supporting decision-making.

摘要

背景

系统评价随机对照试验（RCT）被认为是支持治疗干预决策的高级别证据，其方法学质量对于提供可靠和适用的结果至关重要。

目的

本元流行病学研究旨在绘制和批判性评估评估水疱性皮肤病治疗方法的系统评价。

方法

我们于 2022 年 12 月在 MEDLINE（通过 Pubmed）上进行了全面的搜索策略，没有限制，以查找评估疱性皮肤病药物干预的系统评价。使用 AMSTAR-2 工具评估方法学质量，并提取其他信息。我们确定了 2002 年至 2021 年期间发表的九项系统评价，其中七项评估天疱疮。

结果

根据 AMSTAR-2 工具，55.6%被评为严重低质量，22.2%为中度质量，11.1%为低质量，11.1%为高质量。没有审查评估证据的确定性（GRADE）；86%的天疱疮综述至少有两个重叠的 RCT。在方法缺陷和 AMSTAR-2 工具使用方面存在一些局限性。

结论

这些发现揭示了疱性皮肤病治疗系统评价的方法学质量脆弱，这可能会影响结果。因此，未来的系统评价必须严格遵守方法学原则，以避免重复工作并提高支持决策的证据确定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/297eee51cee2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/6281d5016819/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/b7cf454eedc4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/297eee51cee2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/6281d5016819/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/b7cf454eedc4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df9/10943289/297eee51cee2/gr3.jpg

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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
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AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.AMSTAR 2：一种用于系统评价的关键评估工具，该系统评价包括医疗保健干预措施的随机或非随机研究，或两者皆有。
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