Uttley Lesley, Weng Yuliang, Falzon Louise
School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
Information Technology Services, University of Sheffield, Sheffield, United Kingdom.
J Clin Epidemiol. 2025 Jan;177:111608. doi: 10.1016/j.jclinepi.2024.111608. Epub 2024 Nov 12.
In February 2023, the Journal of Clinical Epidemiology published 'The Problems with Systematic Reviews: A Living Systematic Review.' In updating this living review for the first time a new problem and several themes relating to research culture have emerged.
Literature searches were rerun to identify articles published or indexed between May 2022 and May 2023. Thematic analysis coded articles and problems across four domains of systematic review conduct (1. comprehensive, 2. rigour, 3. transparent, 4. objective).
One hundred fifty-two newly included articles bring the total number of relevant articles to 637. A new problem (the lack of gender diversity of systematic review author teams) brings the total number of problems with systematic reviews up to 68. This update also reveals emerging themes such as: fast science from systematic reviews on COVID-19; the failure of citation of methodological or reporting guidelines to predict high-quality methodological or reporting quality; and the influence of vested interests on systematic review conclusions. These findings coupled with a proliferation of research waste from "me-too" meta-research articles highlighting well-established problems in systematic reviews underscores the need for reforms in research culture to address the incentives for producing and publishing research papers. This update also reports where the identified flaws in systematic reviews affect their conclusions drawing on 77 meta-epidemiological studies from the total 637 included articles. These meta-meta-analytic studies begin the important work of examining which problems threaten the reliability and validity of treatment effects or conclusions derived from systematic reviews.
This living review has captured an emerging theme in the published literature relating to the composition of the review author team and highlights a potential effect on the equity reporting of the systematic reviews. We recommend that meta-research endeavors evolve from merely documenting well-established issues to understanding lesser-known problems or consequences to systematic reviews.
2023年2月，《临床流行病学杂志》发表了《系统评价的问题：一项动态系统评价》。在首次更新这项动态评价时，出现了一个新问题以及几个与研究文化相关的主题。
重新进行文献检索，以识别2022年5月至2023年5月期间发表或编入索引的文章。主题分析对系统评价实施的四个领域（1. 全面性，2. 严谨性，3. 透明度，4. 客观性）的文章和问题进行编码。
新纳入的152篇文章使相关文章总数达到637篇。一个新问题（系统评价作者团队缺乏性别多样性）使系统评价的问题总数达到68个。本次更新还揭示了一些新出现的主题，如：关于新冠病毒的系统评价中的快速科学；方法学或报告指南的引用未能预测高质量的方法学或报告质量；以及既得利益对系统评价结论的影响。这些发现，再加上“跟风”元研究文章产生的大量研究浪费，突出了系统评价中已存在的问题，强调了研究文化改革以解决研究论文产出和发表激励问题的必要性。本次更新还报告了在637篇纳入文章中的77项元流行病学研究中，系统评价中已识别的缺陷在何处影响其结论。这些元元分析研究开启了重要工作，即研究哪些问题会威胁到系统评价得出的治疗效果或结论的可靠性和有效性。
这项动态评价捕捉到了已发表文献中与评价作者团队构成相关的一个新出现的主题，并突出了对系统评价公平性报告的潜在影响。我们建议元研究努力从仅仅记录已存在的问题，发展到理解系统评价中鲜为人知的问题或后果。
