Toward a comprehensive evidence map of overview of systematic review methods: paper 1—purpose, eligibility, search and data extraction

Lunny, Carole; Brennan, Sue; McDonald, Steve; McKenzie, Joanne E.

doi:10.1186/s13643-017-0617-1

Cited by 132 publications

(177 citation statements)

References 42 publications

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“…For this study, a systematic umbrella review was done of meta‐analyses examining antiplatelet therapy for any outcome in patients with PAD. This allows an in‐depth overview of a broad topic and facilitates comparisons between outcomes to examine their relative importance. It also highlights deficiencies in the literature.…”

Section: Methodsmentioning

confidence: 99%

Umbrella review and meta-analysis of antiplatelet therapy for peripheral artery disease

Ambler

Waldron

Contractor

et al. 2019

British Journal of Surgery

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Background: The literature on antiplatelet therapy for peripheral artery disease has historically been summarized inconsistently, leading to conflict between international guidelines. An umbrella review and meta-analysis was performed to summarize the literature, allow assessment of competing safety risks and clinical benefits, and identify weak areas for future research.Methods: MEDLINE, Embase, DARE, PROSPERO and Cochrane databases were searched from inception until January 2019. All meta-analyses of antiplatelet therapy in peripheral artery disease were included. Quality was assessed using AMSTAR scores, and GRADE analysis was used to quantify the strength of evidence. Data were pooled using random-effects models.Results: Twenty-eight meta-analyses were included. Thirty-three clinical outcomes and 41 antiplatelet comparisons in 72 181 patients were analysed. High-quality evidence showed that antiplatelet monotherapy reduced non-fatal strokes (3 (95 per cent c.i. 0 to 6) fewer per 1000 patients), In symptomatic patients, it reduced cardiovascular deaths (8 (0 to 16) fewer per 1000 patients), but increased the risk of major bleeding (7 (3 to 14) more events per 1000). In asymptomatic patients, monotherapy reduced non-fatal strokes (5 (0 to 8) fewer per 1000), but had no other clinical benefit. Dual antiplatelet therapy caused more major bleeding after intervention than monotherapy (37 (8 to 102) more events per 1000), with very low-quality evidence of improved endovascular patency (risk ratio 4⋅00, 95 per cent c.i. 0⋅91 to 17⋅68).Conclusion: Antiplatelet monotherapy has minimal clinical benefit for asymptomatic peripheral artery disease, and limited benefit for symptomatic disease, with a clear risk of major bleeding. There is a lack of evidence to guide antiplatelet prescribing after peripheral endovascular intervention.The AMSTAR (A MeaSurement Tool to Assess systematic Reviews) measurement tool 17,18 was used to assess the quality of included meta-analyses. AMSTAR is a validated

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Section: Methodsmentioning

confidence: 99%

Umbrella review and meta-analysis of antiplatelet therapy for peripheral artery disease

Ambler

Waldron

Contractor

et al. 2019

British Journal of Surgery

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“…Umbrella reviews are reviews of existing systematic reviews (Aromataris et al, 2015). Their purpose is to summarise evidence from multiple research syntheses (Becker & Oxman, 2011) and to provide a rapid and broad review of the evidence base within a specified field (Khangura, Konnyu, Cushman, Grimshaw, & Moher, 2012;Lunny, Brennan, McDonald, & McKenzie, 2017). They are increasingly conducted due to a steady increase in the number of systematic reviews undertaken.…”

Section: Introductionmentioning

confidence: 99%

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

Burgess

Mansell

Bishop

et al. 2019

European Journal of Pain

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Background Multiple cohort and systematic review studies exist, reporting independent predictive factors associated with outcome in musculoskeletal populations. These studies have found evidence for a number of “generic” factors that have been shown to predict outcome across musculoskeletal patient cohorts. This review provides a higher level review of the evidence with a focus on generic patient factors associated with functional musculoskeletal outcome with a view to informing predictive modelling. Objectives (a) Identify patient factors found to have evidence to support their association with functional outcome, and (b) review these findings across body areas/conditions to identify generic predictive factors. Databases and Data Treatment Electronic databases of MEDLINE, AMED, EMBASE, CINAHL and Cochrane were searched for eligible studies. Two reviewers independently extracted data and assessed quality using an established checklist for umbrella reviews. Results Twenty‐one systematic reviews met inclusion criteria, all were of moderate/high quality. Six independent predictors were found to have strong evidence of association with worse musculoskeletal functional outcome across anatomical body sites (worse baseline function, higher symptom/pain severity, worse mental well‐being, more comorbidities, older age and higher body mass index). Longer duration of symptoms, worse pain coping, presence of workers compensation, lower vitality and lower education were also found to have moderate evidence of association with worse functional outcome across body sites. Conclusions This study identifies a number of factors associated with musculoskeletal functional outcome. The generic predictive factors identified should be considered for inclusion into musculoskeletal prognostic models, including models used for case‐mix‐adjustment of patient reported outcome measure data. Significance This article identifies “generic” patient factors that predict functional outcome (measured using Patient Reported Outcome Measures (PROMs)) across musculoskeletal conditions. Findings provide support for the development and content of generic musculoskeletal prognostic models including models used to case‐mix adjust PROM data for baseline complexity. Generic musculoskeletal models and functional PROMs would facilitate more feasible comparison and benchmarking of musculoskeletal services in order to identify variation and address health inequalities.

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“…Overviews have evolved to address a growing need to filter the information overload, improve access to targeted information and inform healthcare decision-making [2, 3]. Overviews can be useful tools to support decision-making by clinicians, policy makers and developers of clinical guidelines [2, 4]. There are a range of factors to reflect upon prior to deciding whether to conduct an overview, including consideration of the methodological challenges and uncertainties.…”

Section: Introductionmentioning

confidence: 99%

An introduction to overviews of reviews: planning a relevant research question and objective for an overview

et al. 2018

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BackgroundOverviews of systematic reviews are a relatively new approach to synthesising evidence, and research methods and associated guidance are developing. Within this paper we aim to help readers understand key issues which are essential to consider when taking the first steps in planning an overview. These issues relate to the development of clear, relevant research questions and objectives prior to the development of an overview protocol.MethodsInitial discussions and key concepts for this paper were formed during a workshop on overview methods at the 2016 UK Cochrane Symposium, at which all members of this author group presented work and contributed to wider discussions. Detailed descriptions of the various key features of overviews and their different objectives were created by the author group based upon current evidence (Higgins J, Green S. Cochrane Handbook Syst Rev Interv. 2011;4:5, Pollock M, et al. Sys Rev. 2016;5:190-205, Pollock A, et al. Cochrane overviews of reviews: exploring the methods and challenges. UK and Ireland: Cochrane Symposium; 2016, Pieper D, et al. Res Syn Meth. 2014;5:187–99, Lunny C, et al. Sys Rev. 2016;5:4-12, Hartling L, et al. Comparing multiple treatments: an introduction to overviews of reviews. In 23rd Cochrane Colloquium; 2015, Hartling L, et al. Plos One. 2012;7:1-8, Ballard M, Montgomery P. Res Syn Meth. 2017;8:92-108) and author experiences conducting overviews.ResultsWithin this paper we introduce different types of overviews and suggest common research questions addressed by these overviews. We briefly reflect on the key features and objectives of the example overviews discussed.ConclusionsClear decisions relating to the research questions and objectives are a fundamental first step during the initial planning stages for an overview. Key stakeholders should be involved at the earliest opportunity to ensure that the planned overview is relevant and meaningful to the potential end users of the overview. Following best practice in common with other forms of systematic evidence synthesis, an overview protocol should be published, ensuring transparency and reducing opportunities for introduction of bias in the conduct of the overview.

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Toward a comprehensive evidence map of overview of systematic review methods: paper 1—purpose, eligibility, search and data extraction

Cited by 132 publications

References 42 publications

Umbrella review and meta-analysis of antiplatelet therapy for peripheral artery disease

Umbrella review and meta-analysis of antiplatelet therapy for peripheral artery disease

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

An introduction to overviews of reviews: planning a relevant research question and objective for an overview

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