Survey of the Reporting Characteristics of Systematic Reviews in Rehabilitation

Gianola, Silvia; Gasparini, Monica; Agostini, Michela; Castellini, Greta; Corbetta, Davide; Gozzer, Paolo; Li, Linda; Sirtori, Valeria; Taricco, Mariangela; Tetzlaff, Jennifer; Turolla, Andrea; Moher, David; Moja, Lorenzo

doi:10.2522/ptj.20120382

Cited by 27 publications

(15 citation statements)

References 32 publications

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“…The low methodological quality found within a large proportion of the so called systematic reviews in this area, is in general very disappointing, especially when comparing these findings to recent overviews that have confirmed the good methodological quality of systematic reviews within the areas of rehabilitation [64] and orthopedics [65] . These results suggest that not only are good RCTs and prospective studies with a control group needed, but also as important, there is a fundamental need to improve the quality not only of conducting, but also writing and presenting systematic reviews in the subject matter addressed within this paper.…”

Section: Discussionmentioning

confidence: 98%

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

Płaszewski¹,

Bettany‐Saltikov

2014

PLoS ONE

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BackgroundNon-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available.ObjectivesAnalysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis.DesignSystematic overview of systematic reviews.MethodsArticles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews.ResultsFrom 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established.ConclusionsHigher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence.Protocol registry numberCRD42013003538, PROSPERO

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Section: Discussionmentioning

confidence: 98%

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

Płaszewski¹,

Bettany‐Saltikov

2014

PLoS ONE

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“…Screening each article provides a more reliable estimate of SR prevalence than relying on the search filters for SRs, which we found retrieved many non-systematic reviews and other knowledge syntheses. We did not restrict inclusion based on the focus of the SR and, thus, unlike previous studies [ 14 , 15 ], were able to collect data on a broader cross-section of SRs.…”

Section: Discussionmentioning

confidence: 99%

“…Major events include the publication of the PRISMA reporting guidelines for SRs [ 7 , 8 ] and SR abstracts [ 9 ] and their subsequent endorsement in top journals, the launch of the Institute of Medicine’s standards for SRs of comparative effectiveness research [ 10 ], methodological developments such as a new tool to assess the risk of bias in randomized trials included in SRs [ 11 ], and the proliferation of open-access journals to disseminate health and medical research findings, in particular Systematic Reviews , a journal specifically for completed SRs, their protocols, and associated research [ 12 ]. Other studies have examined in more recent samples either the prevalence of SRs (e.g., [ 13 ]) or reporting characteristics of SRs in specific fields (e.g., physical therapy [ 14 ], complementary and alternative medicine [ 15 ], and radiology [ 16 ]). However, to our knowledge, since the 2004 sample, there has been no cross-sectional study of the characteristics of SRs across different specialties.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study

et al. 2016

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BackgroundSystematic reviews (SRs) can help decision makers interpret the deluge of published biomedical literature. However, a SR may be of limited use if the methods used to conduct the SR are flawed, and reporting of the SR is incomplete. To our knowledge, since 2004 there has been no cross-sectional study of the prevalence, focus, and completeness of reporting of SRs across different specialties. Therefore, the aim of our study was to investigate the epidemiological and reporting characteristics of a more recent cross-section of SRs.Methods and FindingsWe searched MEDLINE to identify potentially eligible SRs indexed during the month of February 2014. Citations were screened using prespecified eligibility criteria. Epidemiological and reporting characteristics of a random sample of 300 SRs were extracted by one reviewer, with a 10% sample extracted in duplicate. We compared characteristics of Cochrane versus non-Cochrane reviews, and the 2014 sample of SRs versus a 2004 sample of SRs. We identified 682 SRs, suggesting that more than 8,000 SRs are being indexed in MEDLINE annually, corresponding to a 3-fold increase over the last decade. The majority of SRs addressed a therapeutic question and were conducted by authors based in China, the UK, or the US; they included a median of 15 studies involving 2,072 participants. Meta-analysis was performed in 63% of SRs, mostly using standard pairwise methods. Study risk of bias/quality assessment was performed in 70% of SRs but was rarely incorporated into the analysis (16%). Few SRs (7%) searched sources of unpublished data, and the risk of publication bias was considered in less than half of SRs. Reporting quality was highly variable; at least a third of SRs did not report use of a SR protocol, eligibility criteria relating to publication status, years of coverage of the search, a full Boolean search logic for at least one database, methods for data extraction, methods for study risk of bias assessment, a primary outcome, an abstract conclusion that incorporated study limitations, or the funding source of the SR. Cochrane SRs, which accounted for 15% of the sample, had more complete reporting than all other types of SRs. Reporting has generally improved since 2004, but remains suboptimal for many characteristics.ConclusionsAn increasing number of SRs are being published, and many are poorly conducted and reported. Strategies are needed to help reduce this avoidable waste in research.

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“…Furthermore, optimal information size can be directly related to both clinical and statistical significance. Drawing conclusions from meta-analyses based only on statistical significance may be misleading, however, especially if associated with a high prevalence of small studies and poor reporting, as is typical of the rehabilitation literature [ 10 , 50 ]. There is a need to move beyond the p -value cliché and to focus on the magnitude of benefit since interventions of limited value sap valuable time and resources from other interventions that might have more substantial effects.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: the need to present minimal important differences units in meta-analyses

Gianola

Andreano

Castellini

et al. 2018

Health Qual Life Outcomes

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BackgroundThe results of meta-analyses are all too often elusive, making it difficult to interpret their relevance for clinical practice. Reporting them in minimal important difference (MID) units could improve the interpretation of evidence in meta-analyses. The aim of this study was to compare, via calculation of MID units, outcomes after multidisciplinary biopsychosocial rehabilitation (MBR) versus usual care for pain relief in chronic low back pain (LBP).MethodsWe re-analyzed the data of a published Cochrane review on MBR. To attribute a MID to each pain instrument, we first searched the literature for MIDs. The MID was imputed for instruments without an established MID. We compared outcomes after MBR versus usual care for chronic LBP in the short (< 3 months), mid (> 3 and < 12 months), and long (≥12 months) term. The results of the meta-analyses are reported in MID units and interpreted as follows: if the overall effect size was greater than 1, many patients gained clinically important benefits, if it lay between 0.5 and 1.0, an appreciable number benefited, and if it fell below 0.5 few did.ResultsImprovement in back pain was observed in an appreciable number of patients in the short- and medium-term after MBR: the MID was lower but still close to 1 (0.75 and 0.86 MID units, respectively). MBR probably had little or no benefit for the majority of patients in the long-term, where the MID approached 0 (0.27 MID units, confidence interval 0.07–0.48).ConclusionsMeta-analyses expressed in MID units may offer better insight into the clinical relevance of MBR: the intervention is highly recommended for reducing pain in the short- and medium-term but cannot be recommended for long-term pain reduction since the benefit decays rapidly.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0924-9) contains supplementary material, which is available to authorized users.

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Survey of the Reporting Characteristics of Systematic Reviews in Rehabilitation

Cited by 27 publications

References 32 publications

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: the need to present minimal important differences units in meta-analyses

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