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      Evaluación de la calidad de estudios de metaanálisis sobre la eficacia de las intervenciones en revistas españolas de psicología Translated title: Evaluation of the quality of studies in meta-analysis of intervention effectiveness in Spanish psychology journals

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          Abstract

          RESUMEN En este trabajo se revisa la evaluación de la calidad de los estudios primarios incluidos en los metaanálisis publicados en las principales revistas españolas de psicología. Concretamente se analiza la codificación y evaluación de la calidad de los estudios en metaanálisis sobre eficacia de intervenciones, así como el propósito de esta evaluación y la relación entre la calidad y tamaños del efecto. Se encuentra que el 79% de los metaanálisis analizados incluyeron una evaluación de la calidad. Se discute la relación entre la menor calidad de los estudios en los metaanálisis y los resultados con mayores tamaños del efecto. Finalmente, se enfatiza la necesidad de mejorar el informe de los metaanálisis aportando evidencias de gran calidad.

          Translated abstract

          ABSTRACT In this paper, we reviewed primary study quality assessments in meta-analyses published in the main Spanish psychology journals. Specifically, we analyzed whether the coding and evaluation of the quality of the primary studies in meta-analysis based on the efficacy of interventions is a common practice. The purpose of this evaluation is also to report the relationship between quality and the reported results (effect sizes). It is found that 79% of the meta-analyses analyzed included a quality assessment. The relationship between the lowest quality of studies included in meta-analyses and larger effect sizes is also discussed. Finally, we stress the need to improve the reporting of meta-analyses including high-quality evidence.

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          ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions

          Non-randomised studies of the effects of interventions are critical to many areas of healthcare evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I (“Risk Of Bias In Non-randomised Studies - of Interventions”), a new tool for evaluating risk of bias in estimates of the comparative effectiveness (harm or benefit) of interventions from studies that did not use randomisation to allocate units (individuals or clusters of individuals) to comparison groups. The tool will be particularly useful to those undertaking systematic reviews that include non-randomised studies.
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            The hazards of scoring the quality of clinical trials for meta-analysis.

            Although it is widely recommended that clinical trials undergo some type of quality review, the number and variety of quality assessment scales that exist make it unclear how to achieve the best assessment. To determine whether the type of quality assessment scale used affects the conclusions of meta-analytic studies. Meta-analysis of 17 trials comparing low-molecular-weight heparin (LMWH) with standard heparin for prevention of postoperative thrombosis using 25 different scales to identify high-quality trials. The association between treatment effect and summary scores and the association with 3 key domains (concealment of treatment allocation, blinding of outcome assessment, and handling of withdrawals) were examined in regression models. Pooled relative risks of deep vein thrombosis with LMWH vs standard heparin in high-quality vs low-quality trials as determined by 25 quality scales. Pooled relative risks from high-quality trials ranged from 0.63 (95% confidence interval [CI], 0.44-0.90) to 0.90 (95% CI, 0.67-1.21) vs 0.52 (95% CI, 0.24-1.09) to 1.13 (95% CI, 0.70-1.82) for low-quality trials. For 6 scales, relative risks of high-quality trials were close to unity, indicating that LMWH was not significantly superior to standard heparin, whereas low-quality trials showed better protection with LMWH (P<.05). Seven scales showed the opposite: high quality trials showed an effect whereas low quality trials did not. For the remaining 12 scales, effect estimates were similar in the 2 quality strata. In regression analysis, summary quality scores were not significantly associated with treatment effects. There was no significant association of treatment effects with allocation concealment and handling of withdrawals. Open outcome assessment, however, influenced effect size with the effect of LMWH, on average, being exaggerated by 35% (95% CI, 1%-57%; P= .046). Our data indicate that the use of summary scores to identify trials of high quality is problematic. Relevant methodological aspects should be assessed individually and their influence on effect sizes explored.
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              Evaluating non-randomised intervention studies

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                Author and article information

                Journal
                clinsa
                Clínica y Salud
                Clínica y Salud
                Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1130-5274
                2174-0550
                2021
                : 32
                : 3
                : 95-102
                Affiliations
                [01] Madrid Madrid orgnameUniversidad Autónoma de Madrid Spain
                [02] Madrid Madrid orgnameUniversidad a Distancia de Madrid Spain
                Article
                S1130-52742021000300095 S1130-5274(21)03200300095
                10.5093/clysa2021a4
                3765a55b-5c20-4c97-ad98-3c245a782c89

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 23 September 2020
                : 06 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 58, Pages: 8
                Product

                SciELO Spain


                Meta-analysis,Primary study quality,Revistas españolas de psicología,Metaanálisis,Calidad de los estudios primarios,Spanish psychology journals

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