Quality of Conduct and Reporting of Meta-analyses of... : Annals of Surgery (original) (raw)

Original Articles

Quality of Conduct and Reporting of Meta-analyses of Surgical Interventions

Adie, Sam PhD, MBBS, MSpMed, MPH, BSc (Med)*,†; Ma, David MBBS, BSc (Med)*; Harris, Ian A. PhD, MBBS, MMed (Clin Epi), FRACS*,†; Naylor, Justine M. PhD, BAppSc*,†; Craig, Jonathan C. PhD, MBChB, DCH, MM‡,§

*South Western Sydney Clinical School, University of New South Wales

†Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, New South Wales

‡School of Public Health, University of Sydney, Sydney, New South Wales

§Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.

Reprints: Sam Adie, PhD, MBBS, MSpMed, MPH, BSc (Med), Orthopaedic Department, Liverpool Hospital, Locked Bag 7103, Liverpool BC NSW 1871, Australia. E-mail: [email protected].

Disclosure: Dr Sam Adie was supported by scholarship grants from the National Health and Medical Research Council of Australia (Biomedical Postgraduate Scholarship) and the Royal Australasian College of Surgeons (Sir Roy McCaughey Research Fellowship). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors report no conflicts of interests.

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Background:

Meta-analyses are useful tools for summarizing surgical evidence as they aim to encompass multiple sources of information on a particular research question, but they may be prone to methodological and reporting biases. We evaluated the conduct and reporting of meta-analyses of surgical interventions.

Methods and Findings:

We performed a systematic review of 150 meta-analyses of randomized trials of surgical interventions published between January 2010 and June 2011. A comprehensive search strategy was executed using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews. Data were independently extracted by 2 authors using the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses, a standardized quality of reporting guideline) and AMSTAR (a tool for methodological quality). Descriptive statistics were used for individual items, and as a measure of overall compliance, PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. A median of 8 trials (interquartile range = 8) was included in each meta-analysis. One third of all meta-analyses had an author with a background in epidemiology and/or statistics. Forty-four percent were published in PRISMA-endorsing journals with a median impact factor of 3.5. There was moderate compliance with PRISMA, with an average of 71% of items reported, but poorer compliance with AMSTAR, with 48% of items adequately described, on average.

Conclusions:

Substantial gaps in the conduct and reporting of meta-analyses within the surgical literature exist, mainly in the specification of aims and/or objectives, the use of preplanned protocols, and the evaluation of potential bias at the review (rather than trial) level. Editorial insistence on using reporting guidelines would improve this situation.