Conclusiveness of the Cochrane Reviews in Nutrition: a systematic analysis

Cohen, Shlomi; Mandel, Dror; Mimouni, Francis; Marom, Ronella; Lubetzky, Ronit

doi:10.1038/ejcn.2013.252

Cited by 15 publications

(21 citation statements)

References 5 publications

(8 reference statements)

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“…These findings are inconsistent with the hypothesis that the majority of reviews are inconclusive. [3][4][5] Reviews of RCTs were more likely to be conclusive than those of nonrandomized studies (63.8% vs 50.0%).…”

Section: Discussionmentioning

confidence: 99%

“…Reviews of RCTs, however, are likely to be conclusive and provide practical answers regarding what works (or what may work) in a particular clinical situation. 4 Although it is possible to make a decision based on conclusive reviews, the quality of included RCTs and the review itself should be assessed. 6,7 The methodological quality of review articles is assessed using the AMSTAR tool.…”

Section: Discussionmentioning

confidence: 99%

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Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis

et al. 2015

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Objective: To assess the conclusiveness of Cochrane reviews in the field of gynaecological cancer. Methods: The Cochrane Library was searched for reviews regarding gynaecological cancer published between 1 January 2000 and 1 November 2014. Data were extracted from each paper and the conclusiveness of each review was assessed. Results: The study included 66 reviews, 41 (62.1%) of which were conclusive. Of these, 58 included randomized controlled trials (RCTs), 37 (63.8%) of which were conclusive. Conclusive reviews of RCTs included significantly more patients than inconclusive reviews, but there was no difference in the number of included studies. Of the eight reviews of nonrandomized studies, four (50.0%) were conclusive. The majority of reviews recognized the need for additional studies. Conclusions: In the field of gynaecological cancer, reviews are more likely to be conclusive when they include RCTs, as well as large numbers of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis

et al. 2015

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“…It has been suggested that the goals of the Cochrane reviews are not always reached: indeed, not all Cochrane reviews are conclusive and even when they are it is often stated that there is a need for more and better studies [3–5]. Based on previous reports, 64–80% of Cochrane reviews are conclusive.…”

Section: Introductionmentioning

confidence: 99%

“…Based on previous reports, 64–80% of Cochrane reviews are conclusive. However, a majority emphasizes the need for further studies [3–5]. Therefore, approximately one out of three times the reader is not able to reach a clinically applicable conclusion.…”

Section: Introductionmentioning

confidence: 99%

“…Similar to previous definitions we characterized conclusiveness by the ability or not to reach a practical definitive conclusion stating that one treatment was significantly better or not than another treatment or placebo [3–5]. Based upon our own previous experience\personal bias we hypothesized that: (1) the majority of the EVGRs are inconclusive; (2) most reviews state the need for further and better studies; (3) the conclusiveness of a given review is affected by the number of RCTs included in the review and the cumulative number of patients retained for analysis.…”

Section: Introductionmentioning

confidence: 99%

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Conclusiveness of the Cochrane Eye and Vision Group Reviews

Mimouni

Segev

2015

BMC Res Notes

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BackgroundTo assess the conclusiveness of Cochrane Eye and Vision Group Reviews (EVGRs). We tested the hypotheses that: (1) the majority of EVGRs are inconclusive; (2) most reviews state the need for further and better studies; (3) the conclusiveness of a given review is affected by the number of randomized controlled trials (RCTs) included and the cumulative number of patients and eyes studied.MethodsA retrospective study of all EVGRs available in the Cochrane Library in June 2013. For each EVGR we recorded the number of RCTs found by the reviewers, the number of RCTs included for final analysis as fulfilling inclusion criteria, the total cumulative number of patients and eyes studied, the stated need for further and better studies, the reason stated for further studies and the type of conclusion reached by the reviewer(s). We used the Kruskal–Wallis test to determine differences between ‘‘conclusive’’ and ‘‘inconclusive’’ studies in terms of the outcome variables studied. The correlation between the number of included studies and cumulative sample size was studied using regression analysis.ResultsOut of 106 EVGRs, 52.8% were conclusive. In 83.9% of the conclusive EVGRs one treatment/strategy/drug was found to be better than the alternative. The average number of available and included RCTs was significantly higher in conclusive EVGRs (P = 0.007 and P = 0.003 respectively). The total cumulative number of patients and number of eyes studied was approximately ten times higher in the conclusive EVGRs (P < 0.001 and P < 0.015 respectively). A similar percentage of RCTs was included in both conclusive and inconclusive reviews (76 vs. 73%). The vast majority of EVGRs, whether conclusive (84%) or inconclusive (96%), stated the need for further and better studies (P = 0.042). Fifty eight percent of the EVGRs justified the need for further studies for at least two reasons. The reason that was stated the most was a need for a larger amount of RCTs (67%).ConclusionsIn approximately half of the cases, EVGRs allow the reader to reach a clinically applicable conclusion. Larger total cumulative participants, total cumulative number of eyes studied and number of RCTs performed all increase the likelihood of an EVGR to be conclusive.

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Revisiting established medicines: An overview of systematic reviews about ibuprofen and paracetamol for treating pain in children

Radman

Babić

Runjić

et al. 2019

European Journal of Pain

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Background and objective We explored how systematic reviews evaluated paracetamol and ibuprofen for treating pain in children, as these two non‐opioid analgesics are well‐established medicines included in most national essential medicines lists. Databases and data treatment We carried out an overview of systematic reviews (SRs) of randomized controlled trials (RCTs) of interventions (PROSPERO registration: 42016045367). We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR) and Database of Reviews of Effects (DARE) up to 23 August 2017. We used AMSTAR checklist to analyse methodological quality of included SRs. Results We found 17 SRs with 72 unique RCTs; the majority of those trials included under 100 children. Positive conclusive evidence was found in only one SR, regarding safety of paracetamol. Conclusions of other SRs for efficacy and safety of ibuprofen and paracetamol were inconclusive, unclear, or there was no opinion. Only one SR analysed efficacy of ibuprofen and other non‐steroidal anti‐inflammatory drugs (NSAIDs) in chronic pain and the conclusion was that there was no evidence from RCTs that NSAIDs were effective for chronic non‐cancer pain in children and adolescents. Most of the SRs addressed very narrow questions, included few trials, with few children and were of low or medium methodological quality. Conclusions Most SRs on two relevant medicines have inconsistent conclusions and doubt upon their effectiveness. Instead of focusing on very narrow questions, SRs should examine more comprehensive research topics to obtain a general sense of consistency, particularly when analysing established medicines. Significance Evidence behind two analgesics—ibuprofen and paracetamol—that are well‐established medicines for children in most countries appears limited, judging by the systematic reviews. The discrepancy between clinical use and the extensive evidence we reviewed may be a result of the selective criteria in the reviews examined. We need new, and better evidence syntheses supporting the use of these two medicines in wide indications regarding pain in children.

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Conclusiveness of the Cochrane Reviews in Nutrition: a systematic analysis

Abstract: The majority of CRs in Nutrition is conclusive, but most of them emphasize the need for further studies. The ability for a CR to reach a conclusion is affected by the cumulative patient sample size and number of RCT's included in the analysis.

Cited by 15 publications

References 5 publications

Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis

Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis

Conclusiveness of the Cochrane Eye and Vision Group Reviews

Revisiting established medicines: An overview of systematic reviews about ibuprofen and paracetamol for treating pain in children

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