Epidemiological characteristics and methodological quality of meta-analyses on diabetes mellitus treatment: a systematic review

Abstract

Objective: Well-conducted meta-analyses (MAs) are considered as one of the best sources of clinical evidence for treatment decision. MA with methodological flaws may introduce bias and mislead evidence users. The aim of this study is to investigate the characteristics and methodological quality of MAs on diabetes mellitus (DM) treatments. Design: Systematic review. Methods: Cochrane Database of Systematic Review and Database of Abstract of Reviews of Effects were searched for relevant MAs. Assessing methodological quality of systematic reviews (AMSTAR) tool was used to evaluate the methodological quality of included MAs. Logistic regression analysis was used to identify association between characteristics of MA and AMSTAR results. Results: A total of 252 MAs including 4999 primary studies and 13,577,025 patients were included. Over half of the MAs (65.1%) only included type 2 DM patients and 160 MAs (63.5%) focused on pharmacological treatments. About 89.7% MAs performed comprehensive literature search and 89.3% provided characteristics of included studies. Included MAs generally had poor performance on the remaining AMSTAR items, especially in assessing publication bias (39.3%), providing lists of studies (19.0%) and declaring source of support comprehensively (7.5%). Only 62.7% MAs mentioned about harm of interventions. MAs with corresponding author from Asia performed less well in providing MA protocol than those from Europe.Conclusions: Methodological quality of MA on DM treatments was unsatisfactory. There is considerable room for improvement, especially in assessing publication bias, providing lists of studies and declaring source of support comprehensively. Also, there is an urgent need for MA authors to report treatment harm comprehensively.

The quality of systematic reviews/meta‐analyses published in the field of bariatrics: A cross‐sectional systematic survey using AMSTAR 2 and ROBIS

“…This suggests that in many areas, the methodological quality of SR is low or critical low. Also, the overall methodological quality of 42 thematically diverse MA published in the Cochrane Library to April 2018 was low . Whereas in two studies, 50% of the included SR were assessed as “moderate” and “high” quality .…”

“…The SR/MA's quality seems to be low in many fields of medicine. Among studies published in medicine to September 2019, in which the AMSTAR 2 was used as an instrument to evaluate the quality of SR/MA, 23 of 31 papers produced results similar to our study . In the six studies, the methodological quality of most (around 60%) of SRs was critical low to low .…”

Quality assessment of systematic reviews on total hip or knee arthroplasty using mod-AMSTAR

“…Only four included studies provided their list of excluded studies (6.3%) [ 41 , 46 – 48 ], which was inferior to most other medical fields, except for nursing, pulmonary and diabetes mellitus treatment [ 5 , 6 , 18 ]. Journals generally limit the space available to publish the list of excluded studies, but some provide unlimited space (often online) to publish the list of excluded studies as supplementary material.…”

“…Any disagreement in the process of study selection or data collection was discussed, resolved by consensus, or determined with a third reviewer (JL). Ten bibliographical characteristics that have been suggested to influence the methodological quality of SRs from previous studies [ 6 , 17 , 18 ] and mod-AMSTAR sub-items were collected for each eligible review. We retrieved the impact factors (IFs) of the included reviews by searching the Journal Citation Reports in Web of Science (reviews published in English) and CNKI (reviews published in Chinese), specifically the IFs of the corresponding review publication year.…”

Aerobic exercise regulates blood lipid and insulin resistance via the toll‑like receptor 4‑mediated extracellular signal‑regulated kinases/AMP‑activated protein kinases signaling pathway

“…Diabetes mellitus is a severe glucose-associated metabolic disease that presents obvious genetic heterogeneity and frequently induces chronic damages of other tissues due to insulin secretion defects or/and biological function damage (1). Diabetes mellitus often results in ophthalmic diseases, cardiovascular disease and metabolic syndrome (2,3). A previous study indicated that diabetes mellitus may be regarded as a risk factor for incident chronic renal failure based upon a systematic review and meta-analysis (4).…”