Khalid Mahnoor, Sutterfield Bethany, Minley Kirstien, Ottwell Ryan, Abercrombie McKenna, Heath Christopher, Torgerson Trevor, Hartwell Micah, Vassar Matt
Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States.
JMIR Dermatol. 2023 Dec 7;6:e43821. doi: 10.2196/43821.
Clinical practice guidelines (CPGs) inform evidence-based decision-making in the clinical setting; however, systematic reviews (SRs) that inform these CPGs may vary in terms of reporting and methodological quality, which affects confidence in summary effect estimates.
Our objective was to appraise the methodological and reporting quality of the SRs used in CPGs for cutaneous melanoma and evaluate differences in these outcomes between Cochrane and non-Cochrane reviews.
We conducted a cross-sectional analysis by searching PubMed for cutaneous melanoma guidelines published between January 1, 2015, and May 21, 2021. Next, we extracted SRs composing these guidelines and appraised their reporting and methodological rigor using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklists. Lastly, we compared these outcomes between Cochrane and non-Cochrane SRs. All screening and data extraction occurred in a masked, duplicate fashion.
Of the SRs appraised, the mean completion rate was 66.5% (SD 12.29%) for the PRISMA checklist and 44.5% (SD 21.05%) for AMSTAR. The majority of SRs (19/50, 53%) were of critically low methodological quality, with no SRs being appraised as high quality. There was a statistically significant association (P<.001) between AMSTAR and PRISMA checklists. Cochrane SRs had higher PRISMA mean completion rates and higher methodological quality than non-Cochrane SRs.
SRs supporting CPGs focused on the management of cutaneous melanoma vary in reporting and methodological quality, with the majority of SRs being of low quality. Increasing adherence to PRISMA and AMSTAR checklists will likely increase the quality of SRs, thereby increasing the level of evidence supporting cutaneous melanoma CPGs.
临床实践指南(CPG)为临床环境中的循证决策提供依据;然而,为这些CPG提供信息的系统评价(SR)在报告和方法学质量方面可能存在差异,这会影响对汇总效应估计值的信心。
我们的目的是评估用于皮肤黑色素瘤CPG的SR的方法学和报告质量,并评估Cochrane综述与非Cochrane综述在这些结果上的差异。
我们通过在PubMed上搜索2015年1月1日至2021年5月21日期间发表的皮肤黑色素瘤指南进行横断面分析。接下来,我们提取构成这些指南的SR,并使用PRISMA(系统评价和Meta分析的首选报告项目)和AMSTAR(评估系统评价的测量工具)清单评估其报告和方法学的严谨性。最后,我们比较了Cochrane和非Cochrane SR在这些结果上的差异。所有筛选和数据提取均以盲法、重复的方式进行。
在所评估的SR中,PRISMA清单的平均完成率为66.5%(标准差12.29%),AMSTAR清单的平均完成率为44.5%(标准差21.05%)。大多数SR(19/50,53%)的方法学质量极低,没有SR被评估为高质量。AMSTAR和PRISMA清单之间存在统计学显著关联(P<0.001)。Cochrane SR比非Cochrane SR具有更高的PRISMA平均完成率和更高的方法学质量。
支持皮肤黑色素瘤管理的CPG的SR在报告和方法学质量上存在差异,大多数SR质量较低。提高对PRISMA和AMSTAR清单的依从性可能会提高SR的质量,从而提高支持皮肤黑色素瘤CPG的证据水平。