Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group

Tulder, Maurits Van; Furlan, Andrea D; Bombardier, Claire; Bouter, L.M.

doi:10.1097/01.brs.0000065484.95996.af

Cited by 1,683 publications

(1,110 citation statements)

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“…The level of evidence was based on the guidelines of van Tulder et al (8) and was divided into the following levels: 1) strong evidence (consistent [Ͼ75%] findings among multiple [Ն2] high-quality studies); 2) moderate evidence (findings in 1 high-quality study and consistent findings in multiple low-quality studies); 3) limited evidence (findings in 1 high-quality study or consistent findings in multiple low-quality studies); and 4) conflicting evidence (provided by conflicting findings [Ͻ75% of the studies reported consistent findings]). When strong evidence was provided only by studies with a small sample size, we decided to judge those studies as not strongly associated.…”

Section: Methodologic Qualitymentioning

confidence: 99%

Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies

Belo¹,

Berger²,

Reijman³

et al. 2007

Arthritis & Rheumatism

164

130

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Objective. To provide an overview of prognostic factors of knee osteoarthritis (OA) progression. Methods. We searched Medline and Embase up to December 2003 according to a specified search strategy (keywords for disease, location, and study design). Studies that fulfilled predefined criteria were assessed for methodologic quality. Study characteristics and associations were extracted and the results were summarized according to a best evidence synthesis. Results. Of the 1,004 studies found, 37 met the inclusion criteria. Methodologic quality was assessed and only highquality studies were included (n ‫؍‬ 36). The best evidence synthesis yielded strong evidence that hyaluronic acid serum levels and generalized OA are predictive for progression of knee OA. Sex, knee pain, radiologic severity, knee injury, quadriceps strength, and regular sport activities were not predictive. Conflicting evidence for associations was found for several factors including body mass index and age. Limited evidence for an association with progression of knee OA was found for several factors, including the alignment (varus/valgus) of the joint. Limited evidence for no association with progression of OA was also found for several factors, including meniscectomy, several markers of bone or cartilage turnover, and the clinical diagnosis of localized OA. Conclusion. Generalized OA and level of hyaluronic acid seem to be associated with the radiologic progression of knee OA. Knee pain, radiologic severity at baseline, sex, quadriceps strength, knee injury, and regular sport activities seem not to be related. For other factors, the evidence was limited or conflicting.

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Section: Methodologic Qualitymentioning

confidence: 99%

Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies

Belo¹,

Berger²,

Reijman³

et al. 2007

Arthritis & Rheumatism

164

130

View full text Add to dashboard Cite

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“…Two studies 18,20 scored 11 on van Tulder qualitative assessment instrument, 17 and, therefore, were high quality studies. One study 19 scored 4 on van Tulder qualitative assessment instrument 17 and therefore, was lower quality study (Table 1).…”

Section: Methodological Quality Of Included Studiesmentioning

confidence: 96%

“…17 This instrument is designed to assess internal validity of clinical trials and should include 11 items. Trials fulfilling six or more items were considered to be high quality.…”

Section: Methodological Qualitymentioning

confidence: 99%

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Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

et al. 2008

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Objective: To evaluate the efficacy of prophylactic antibiotics in preventing infection associated with central venous catheters in preterm neonates.Study Design: The search strategy of the Cochrane Neonatal Review Group was used. The following databases were searched: Medline, Cochrane Central Register of Controlled Trials, CINAHL and EMBASE. In addition, we hand-searched abstracts of Pediatric Academic Societies annual meetings published in Pediatric Research (1990 to July 2007 and Canadian Pediatric Society annual meeting proceedings (1990( to July 2007. No language restrictions were applied. Included were randomized controlled trials of antibiotics given prophylactically to prevent infection in preterm infants (<37 completed weeks) less than 1-month old admitted to neonatal intensive care units. Both centrally or peripherally inserted central venous catheters were included. Assessment of methodological quality and extraction of data for included trials was undertaken independently by two authors. When suitable, data from trials were combined in a meta-analysis.Result: A total of three studies were found which addressed the role of prophylactic antibiotics to prevent catheter-related infection in neonates. Two studies used vancomycin as the prophylactic antibiotic and one study used amoxicillin. The meta-analysis of studies that used vancomycin had shown an absolute risk reduction of infection from 23 to 2.4%, which yields a number needed to treat equal to 5 (P ¼ 0.0001). Total duration of catheter stay and mortality, were both similar in the vancomycin and control groups. In the amoxicillin study, catheter-related sepsis was not significantly different between the treatment and control groups (P ¼ 0.40). The rate of colonization, however, was significantly higher in the control group (relative risk 0.48; 95% CI 0.12, 1.35). The incidence of necrotizing enterocolitis, intracranial hemorrhage, thrombosis and deaths were not statistically significant between groups.Conclusion: Prophylactic vancomycin appeared to be effective in preventing catheter-related sepsis in preterm neonates. The potential risks, however, of the emergence of resistance because of prophylactic antibiotics, and their continued effectiveness, need further evaluation, before routine use can be recommended.

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“…Methodological quality was determined by two reviewers (the first and fourth author) with the help of critical appraisal criteria in the Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group (van Tulder et al 2003).…”

Section: Assessment Of Methodological Qualitymentioning

confidence: 99%

Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

et al. 2009

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The objective was to investigate definitions of frailty used in studies of multi-component health promotion and disease-preventive (HPDP) intervention programmes for community-dwelling frail elderly persons and to review the content, organisation and effects of HPDP interventions. A systematic review of 19 articles was made, and the International Classification of Functioning, Disability and Health (ICF) was used as a structural framework for the analysis. The result shows that a consensus was reached on including various aspects of impairments in body functions and structures as an integral part of the frailty concept, with the exception of one subgroup: mental/cognitive functions. Additionally, opinions varied quite consistently regarding aspects of activity limitations and participation restrictions, personal and environmental factors. Ten of the 14 HPDP programmes covered various intervention elements referring to all four ICF components. Eleven programmes involved registered personnel only, while a more divergent pattern was seen in the remaining organisational aspects of the interventions: length of interventions and location plus age segments, participatory approach and contextual information, as well as the theoretical foundation of the interventions. Measures of body functions and structures were significantly improved in 5 out of 17 (29%) targeted aspects. For activity and participation, 12 out of 32 (38%) targeted aspects were positively changed, while the score for environmental factors was 7 out of 22 (32%), and for personal factors 8 out of 22 (36%). Our review suggests that further research is needed to explore and disentangle the complex interrelationships between various interventions and outcomes.

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Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group

Abstract: Systematic reviews need to be conducted as carefully as the trials they report and, to achieve full impact, systematic reviews need to meet high methodologic standards.

Cited by 1,683 publications

References 50 publications

Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies

Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies

Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: a systematic review

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