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      Quality Assessment and Factor Analysis of Systematic Reviews and Meta-Analyses of Endoscopic Ultrasound Diagnosis

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          Abstract

          Background

          Comprehensive monitoring of the quality of systematic reviews (SRs) and meta-analyses (MAs) of endoscopic ultrasound (EUS) requires complete and accurate reporting and methodology.

          Objective

          To assess the reporting and methodological quality of SRs/MAs on EUS diagnosis and to explore the potential factors influencing articles’ quality.

          Methods

          The quality of the reporting and methodology was evaluated in relation to the adherence of papers to the PRISMA checklist and the AMSTAR quality scale. The total scores for every criterion and for every article on the two standards were calculated. Data were evaluated and analyzed using SPSS17.0 and RevMan 5.1 in terms of publication time, category of reviews, category of journals, and funding resource.

          Results

          A total of 72 SRs/MAs was included, but no Cochrane Systematic Reviews (CSRs) were obtained. The number of SRs/MAs ranged from 1 in 1998 to 15 in 2013; 88.1% used the QUADAS tool; the average overall scores by PRISMA statement and AMSTAR tool were 19.9 and 5.4, respectively. Scores on some items showed substantial improvement after publication of PRISMA and AMSTAR. However, no reviews followed the criterion of protocol and registration, and only 11.1% of articles fulfilled the criterion of literature search. SRs/MAs from the Science Citation Index (SCI) were of better quality than non-SCI studies. Funding resource made no difference to quality. Regression analysis showed that time of publication and inclusion in the SCI were significantly correlated with total scores on the two standards.

          Conclusion

          The reporting and methodological quality of SRs/MAs on EUS diagnosis has improved measurably since PRISMA and AMSTAR checklists released. It is hoped that CSR in this field will be produced. Literature searching and protocol criteria, as well as QUADAS-2 tool need to be addressed more in the future. Time of publication and SCI relate more to the overall quality of SRs/MAs than does funding resource.

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          The nuts and bolts of PROSPERO: an international prospective register of systematic reviews

          Alison Booth, Mike Clarke, Gordon Dooley … (2012)
          Background Following publication of the PRISMA statement, the UK Centre for Reviews and Dissemination (CRD) at the University of York in England began to develop an international prospective register of systematic reviews with health-related outcomes. The objectives were to reduce unplanned duplication of reviews and provide transparency in the review process, with the aim of minimizing reporting bias. Methods An international advisory group was formed and a consultation undertaken to establish the key items necessary for inclusion in the register and to gather views on various aspects of functionality. This article describes the development of the register, now called PROSPERO, and the process of registration. Results PROSPERO offers free registration and free public access to a unique prospective register of systematic reviews across all areas of health from all around the world. The dedicated web-based interface is electronically searchable and available to all prospective registrants. At the moment, inclusion in PROSPERO is restricted to systematic reviews of the effects of interventions and strategies to prevent, diagnose, treat, and monitor health conditions, for which there is a health-related outcome. Ideally, registration should take place before the researchers have started formal screening against inclusion criteria but reviews are eligible as long as they have not progressed beyond the point of completing data extraction. The required dataset captures the key attributes of review design as well as the administrative details necessary for registration. Submitted registration forms are checked against the scope for inclusion in PROSPERO and for clarity of content before being made publicly available on the register, rejected, or returned to the applicant for clarification. The public records include an audit trail of major changes to planned methods, details of when the review has been completed, and links to resulting publications when provided by the authors. Conclusions There has been international support and an enthusiastic response to the principle of prospective registration of protocols for systematic reviews and to the development of PROSPERO. In October 2011, PROSPERO contained 200 records of systematic reviews being undertaken in 26 countries around the world on a diverse range of interventions.
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            External Validation of a Measurement Tool to Assess Systematic Reviews (AMSTAR)

            Beverley Shea, Lex Bouter, Joan Peterson … (2007)
            Background Thousands of systematic reviews have been conducted in all areas of health care. However, the methodological quality of these reviews is variable and should routinely be appraised. AMSTAR is a measurement tool to assess systematic reviews. Methodology AMSTAR was used to appraise 42 reviews focusing on therapies to treat gastro-esophageal reflux disease, peptic ulcer disease, and other acid-related diseases. Two assessors applied the AMSTAR to each review. Two other assessors, plus a clinician and/or methodologist applied a global assessment to each review independently. Conclusions The sample of 42 reviews covered a wide range of methodological quality. The overall scores on AMSTAR ranged from 0 to 10 (out of a maximum of 11) with a mean of 4.6 (95% CI: 3.7 to 5.6) and median 4.0 (range 2.0 to 6.0). The inter-observer agreement of the individual items ranged from moderate to almost perfect agreement. Nine items scored a kappa of >0.75 (95% CI: 0.55 to 0.96). The reliability of the total AMSTAR score was excellent: kappa 0.84 (95% CI: 0.67 to 1.00) and Pearson's R 0.96 (95% CI: 0.92 to 0.98). The overall scores for the global assessment ranged from 2 to 7 (out of a maximum score of 7) with a mean of 4.43 (95% CI: 3.6 to 5.3) and median 4.0 (range 2.25 to 5.75). The agreement was lower with a kappa of 0.63 (95% CI: 0.40 to 0.88). Construct validity was shown by AMSTAR convergence with the results of the global assessment: Pearson's R 0.72 (95% CI: 0.53 to 0.84). For the AMSTAR total score, the limits of agreement were −0.19±1.38. This translates to a minimum detectable difference between reviews of 0.64 ‘AMSTAR points’. Further validation of AMSTAR is needed to assess its validity, reliability and perceived utility by appraisers and end users of reviews across a broader range of systematic reviews.
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              From Systematic Reviews to Clinical Recommendations for Evidence-Based Health Care: Validation of Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) for Grading of Clinical Relevance

              Jason Kung, Francesco Chiappelli, Olivia O Cajulis … (2010)
              Research synthesis seeks to gather, examine and evaluate systematically research reports that converge toward answering a carefully crafted research question, which states the problem patient population, the intervention under consideration, and the clinical outcome of interest. The product of the process of systematically reviewing the research literature pertinent to the research question thusly stated is the “systematic review”. The objective and transparent approach of the systematic review aims to minimize bias. Most systematic reviews yield quantitative analyses of measurable data (e.g., acceptable sampling analysis, meta-analysis). Systematic reviews may also be qualitative, while adhering to accepted standards for gathering, evaluating, and reporting evidence. Systematic reviews provide highly rated recommendations for evidence-based health care; but, systematic reviews are not equally reliable and successful in minimizing bias. Several instruments are available to evaluate the quality of systematic reviews. The 'assessment of multiple systematic reviews' (AMSTAR) was derived from factor analysis of the most relevant items among them. AMSTAR consists of eleven items with good face and content validity for measuring the methodological quality of systematic reviews, has been widely accepted and utilized, and has gained in reliability, reproducibility. AMSTAR does not produce quantifiable assessments of systematic review quality and clinical relevance. In this study, we have revised the AMSTAR instrument, detracting nothing from its content and construct validity, and utilizing the very criteria employed in the development of the original tool, with the aim of yielding an instrument that can quantify the quality of systematic reviews. We present validation data of the revised AMSTAR (R-AMSTAR), and discuss its implications and application in evidence-based health care.
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                Author and article information

                Contributors
                Jakob Pietschnig: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 23 April 2015
                Publication date Collection: 2015
                Volume: 10
                Issue: 4
                Electronic Location Identifier: e0120911
                Affiliations
                [1 ]The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
                [2 ]Evidence Based Medicine Center, School of Basic Medical Science of Lanzhou University, Lanzhou, Gansu, China
                [3 ]Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
                [4 ]The Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
                Universitat Wien, AUSTRIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: JHT KHY. Performed the experiments: DLL JXJ. Analyzed the data: DLL JXJ. Contributed reagents/materials/analysis tools: DLL JHT. Wrote the paper: DLL JHT KHY. Provided language and structural improvements to manuscript: JXJ.

                Article
                Publisher ID: PONE-D-14-25062
                DOI: 10.1371/journal.pone.0120911
                PMC ID: 4408104
                PubMed ID: 25905713
                SO-VID: 5c17c00b-cfd2-42d3-b318-af0c55957cc8
                Copyright statement: Copyright @ 2015
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                Date received : 22 June 2014
                Date accepted : 9 February 2015
                Page count
                Figures: 4, Tables: 4, Pages: 13
                Funding
                The authors have no support or funding to report.
                Categories
                Subject: Research Article
                Custom metadata
                Data Availability All relevant data are within the paper and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
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