Systematic review of the methodological and reporting quality of case series in surgery

Agha, Riaz; Fowler, Alexander J.; Lee, S.-Y.; Gundogan, Buket; Whitehurst, Katharine; Sagoo, H.; Jeong, Kyung Jin Lee; Altman, Douglas G.; Orgill, Dennis P.

doi:10.1002/bjs.10235

Cited by 21 publications

(13 citation statements)

References 34 publications

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“…Inadequate reporting has been associated with biased outcome measures in human medicine [ 54 ] and is suggested to increase risk of bias in veterinary studies [ 55 ]. A clear definition of study design and aims, sources of and selection criteria for patients, complete accounting of loss to follow-up and missing data, along with standardized a priori definitions and measurement of explanatory and outcome variables are suggested to minimize bias and improve evidentiary value [ 22 , 55 , 56 ]. Additionally, long latency outcomes are better assessed using time-to-event statistical methods [ 48 ]; conversion of continuous data such as STT-1 values into clinically meaningful categorical data would allow for similar statistical handling.…”

Section: Discussionmentioning

confidence: 99%

An Evidence-Based Rapid Review of Surgical Techniques for Correction of Prolapsed Nictitans Glands in Dogs

White¹

2018

Veterinary Sciences

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Prolapsed nictitans gland (PNG) is an important ocular condition of dogs. Various surgical interventions have been described, but effective technique is currently considered to be a matter of personal clinician preference. The aim of this rapid review was to evaluate existing peer-reviewed evidence of effectiveness for surgical techniques and their subsequent effects on quantitative and clinical lacrimal outcomes for PNG. We performed a structured bibliographic search of CAB Abstracts, PubMed, and Medline using terms relevant to dogs, nictitans gland, and surgery on 13 September 2017. Included studies were assessed for study design, reporting characteristics, surgical techniques, and surgical and lacrimal outcomes. Fifteen of three hundred fifteen identified studies were eligible for inclusion. Seven different replacement techniques were identified, along with gland excision. All studies were observational or descriptive, with the exception of a single crossover trial. Outcomes reporting was heterogeneous and provided limited detail on lacrimal outcomes or on breed propensity for recurrence. Insufficient data precluded comparison of techniques for either surgical failure rates or lacrimal outcomes, although proportional meta-analysis yielded an overall failure rate of 3% (95% CI 1–7%) for the Morgan’s pocket procedure. Improved reporting of veterinary surgical studies will improve evidence appraisal and synthesis, as well as reduce potential sources of bias.

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Section: Discussionmentioning

confidence: 99%

An Evidence-Based Rapid Review of Surgical Techniques for Correction of Prolapsed Nictitans Glands in Dogs

White¹

2018

Veterinary Sciences

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“…With a paucity in randomized controlled trials, the MA was heavily based on case series that suffer from several limitations including overstated conclusions. 47 According to the GRADE criteria, 61 of 77 studies included in the MA were of low and very low quality, with only one study rated as high quality. While permitting the description and observation of large effects (i.e.…”

Section: Discussionmentioning

confidence: 99%

Long-term sequelae of critical illness in sepsis, trauma and burns: A systematic review and meta-analysis

Haug

Tapking

Thiele

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:Sepsis, major trauma, and severe burn injury are life-threatening critical illnesses that remain significant contributors to worldwide morbidity and mortality. The three underlying etiologies share pathophysiological similarities: hyperinflammation, hypermetabolism, and acute immunomodulation. The aims of this study were to assess the current state of long-term outcome research and to identify key outcome parameters between the three forms of critical illness. METHODS:This systematic review and meta-analysis (MA) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed was searched from January 1, 1975, to December 31, 2019. Studies were assessed for eligibility by independent reviewers. Inclusion criteria were studies reporting at least a 6-month follow-up of health-related quality of life and organ-specific sequelae within the three etiologies: severe burn injury, sepsis, and major trauma. RESULTS:In total, 125 articles could be included in the systematic review and 74 in the MA. The mean follow-up time was significantly longer in burn studies, compared with sepsis and trauma studies. The majority of patients were from the sepsis group, followed by burns, and major trauma studies. In the overall health-related quality of life, as assessed by Short Form 36 and European Quality-of-Life Index, the three different etiologies were comparable with one another. CONCLUSION:The effects of critical illness on survivors persist for years after hospitalization. Well-reported and reliable data on the long-term outcomes are imperative, as they can be used to determine the treatment choice of physicians and to guide the expectations of patients, improving the overall quality of care of three significant patient cohorts.

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“…First, all included publications are non‐randomized studies which have inherent biases, including selection bias, which can, in particular, weaken the power of a MA. The majority of included studies were case series which often inherently suffer from several limitations including vague aims and overstated conclusions (Agha et al, 2016). This specifically limited the number of studies we could include as some studies failed to specify the anastomosis method used.…”

Section: Discussionmentioning

confidence: 99%

Use of venous couplers in microsurgical lower extremity reconstruction: A systematic review and meta‐analysis

et al. 2020

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Background Free tissue transfer for lower limb reconstruction has become a workhorse procedure for limb‐salvage. Compared with other recipient sites, the lower extremity has a higher risk of microvascular complications, in particular with venous anastomosis. The study's objective is to evaluate the evidence, safety, and efficacy of venous coupler use in microsurgical anastomosis in lower limb reconstruction to provide objective appraisal of the surgical techniques. Methods A systematic review (SR) and meta‐analysis (MA) were performed analyzing articles from PubMed, Cochrane, Embase, and Web of Science from January 1990, to August 2018. Abstracts and titles were screened and assessed for eligibility by independent reviewers. Following full‐text review, articles were included in the SR and MA. Case reports were excluded. Cochrane Collaboration and the Quality of Reporting of Meta‐analyses (QUOROM) guidelines were followed. Results Out of 15 included studies that met the inclusion criteria for the SR, 9 were included in MA. Patients treated with venous couplers did not experience more surgical complications (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.48–1.33; p = .38), total failure (RR 0.61; 95% CI 0.22–1.70; p = .34), venous compromise (RR 0.72; 95% CI 0.23–2.27; p = .57), arterial compromise (RR 0.85; 95% CI 0.25–2.88; p = .80), partial failure (RR 0.77; 95% CI 0.33–1.77; p = .54), or reoperation (RR 11.79; 95% CI 0.49–286.55; p = .13) in comparison with hand‐sewn anastomosis. Conclusions Outcomes of venous couplers in lower limb reconstruction are comparable to those of hand‐sewn anastomosis. However, this study was limited by the quality of the available literature. Additional prospective studies should aim to directly compare both techniques and potential further benefits in clinical trials.

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Systematic review of the methodological and reporting quality of case series in surgery

Abstract: The methodological and reporting quality of surgical case series needs improvement. The data indicate that evidence-based guidelines for the conduct and reporting of case series may be useful.

Cited by 21 publications

References 34 publications

An Evidence-Based Rapid Review of Surgical Techniques for Correction of Prolapsed Nictitans Glands in Dogs

An Evidence-Based Rapid Review of Surgical Techniques for Correction of Prolapsed Nictitans Glands in Dogs

Long-term sequelae of critical illness in sepsis, trauma and burns: A systematic review and meta-analysis

Use of venous couplers in microsurgical lower extremity reconstruction: A systematic review and meta‐analysis

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