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      The methodological quality of systematic reviews on the treatment of adult major depression needs improvement according to AMSTAR 2: A cross-sectional study

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          Abstract

          Background

          Several standards have been developed to assess methodological quality of systematic reviews (SR). One widely used tool is the AMSTAR. A recent update - AMSTAR 2 - is a 16 item evaluation tool that enables a detailed assessment of SR that include randomised (RCT) or non-randomised studies (NRS) of healthcare interventions.

          Methods

          A cross-sectional study of SR on pharmacological or psychological interventions in major depression in adults was conducted. SR published during 2012–2017 were sampled from MEDLINE, EMBASE and the Cochrane Database of SR. Methodological quality was assessed using AMSTAR 2. Potential predictive factors associated with quality were examined.

          Results

          In rating overall confidence in the results of 60 SR four reviews were rated “high”, two were “moderate”, one was “low” and 53 were “critically low”. The mean AMSTAR 2 percentage score was 45.3% (standard deviation 22.6%) in a wide range from 7.1% to 93.8%. Predictors of higher quality were: type of review (higher quality in Cochrane Reviews), SR including only randomized trials and higher journal impact factor.

          Limitations

          AMSTAR 2 is not intended to be used for the generation of a percentage score.

          Conclusions

          According to AMSTAR 2 the overall methodological quality of SR on the treatment of adult major depression needs improvement. Although there is a high need for summarized information in the field of mental health, this work demonstrates the need to critically assess SR before using their findings. Better adherence to established reporting guidelines for SR is needed.

          Abstract

          Public health; Epidemiology; Psychiatry; Depression; Evidence-based medicine; AMSTAR 2; Methodological quality; Risk of bias; Systematic review; Major depression.

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          How quickly do systematic reviews go out of date? A survival analysis.

          Kaveh Shojania, Margaret Sampson, Mohammed T Ansari … (2007)
          Systematic reviews are often advocated as the best source of evidence to guide clinical decisions and health care policy, yet we know little about the extent to which they require updating. To estimate the average time to changes in evidence that are sufficiently important to warrant updating systematic reviews. Survival analysis of 100 quantitative systematic reviews. Systematic reviews published from 1995 to 2005 and indexed in ACP Journal Club. Eligible reviews evaluated a specific drug or class of drug, device, or procedure and included only randomized or quasi-randomized, controlled trials. Quantitative signals for updating were changes in statistical significance or relative changes in effect magnitude of at least 50% involving 1 of the primary outcomes of the original systematic review or any mortality outcome. Qualitative signals included substantial differences in characterizations of effectiveness, new information about harm, and caveats about the previously reported findings that would affect clinical decision making. The cohort of 100 systematic reviews included a median of 13 studies and 2663 participants per review. A qualitative or quantitative signal for updating occurred for 57% of reviews (95% CI, 47% to 67%). Median duration of survival free of a signal for updating was 5.5 years (CI, 4.6 to 7.6 years). However, a signal occurred within 2 years for 23% of reviews and within 1 year for 15%. In 7%, a signal had already occurred at the time of publication. Only 4% of reviews had a signal within 1 year of the end of the reported search period; 11% had a signal within 2 years of the search. Shorter survival was associated with cardiovascular topics (hazard ratio, 2.70 [CI, 1.36 to 5.34]) and heterogeneity in the original review (hazard ratio, 2.15 [CI, 1.12 to 4.11]). Judgments of the need for updating were made without involving content experts. In a cohort of high-quality systematic reviews directly relevant to clinical practice, signals for updating occurred frequently and within a relatively short time.
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            The methodological and reporting quality of systematic reviews from China and the USA are similar.

            Jinhui Tian, Jun Zhang, Long Ge … (2017)
            To compare the methodological and reporting quality of systematic reviews by authors from China and those from the United States (USA).
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              Systematic review adherence to methodological or reporting quality

              Kusala Pussegoda, Lucy Turner, Chantelle Garritty … (2017)
              Background Guidelines for assessing methodological and reporting quality of systematic reviews (SRs) were developed to contribute to implementing evidence-based health care and the reduction of research waste. As SRs assessing a cohort of SRs is becoming more prevalent in the literature and with the increased uptake of SR evidence for decision-making, methodological quality and standard of reporting of SRs is of interest. The objective of this study is to evaluate SR adherence to the Quality of Reporting of Meta-analyses (QUOROM) and PRISMA reporting guidelines and the A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Overview Quality Assessment Questionnaire (OQAQ) quality assessment tools as evaluated in methodological overviews. Methods The Cochrane Library, MEDLINE®, and EMBASE® databases were searched from January 1990 to October 2014. Title and abstract screening and full-text screening were conducted independently by two reviewers. Reports assessing the quality or reporting of a cohort of SRs of interventions using PRISMA, QUOROM, OQAQ, or AMSTAR were included. All results are reported as frequencies and percentages of reports and SRs respectively. Results Of the 20,765 independent records retrieved from electronic searching, 1189 reports were reviewed for eligibility at full text, of which 56 reports (5371 SRs in total) evaluating the PRISMA, QUOROM, AMSTAR, and/or OQAQ tools were included. Notable items include the following: of the SRs using PRISMA, over 85% (1532/1741) provided a rationale for the review and less than 6% (102/1741) provided protocol information. For reports using QUOROM, only 9% (40/449) of SRs provided a trial flow diagram. However, 90% (402/449) described the explicit clinical problem and review rationale in the introduction section. Of reports using AMSTAR, 30% (534/1794) used duplicate study selection and data extraction. Conversely, 80% (1439/1794) of SRs provided study characteristics of included studies. In terms of OQAQ, 37% (499/1367) of the SRs assessed risk of bias (validity) in the included studies, while 80% (1112/1387) reported the criteria for study selection. Conclusions Although reporting guidelines and quality assessment tools exist, reporting and methodological quality of SRs are inconsistent. Mechanisms to improve adherence to established reporting guidelines and methodological assessment tools are needed to improve the quality of SRs. Electronic supplementary material The online version of this article (doi:10.1186/s13643-017-0527-2) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Katja Matthias
                Journal
                Journal ID (nlm-ta): Heliyon
                Journal ID (iso-abbrev): Heliyon
                Title: Heliyon
                Publisher: Elsevier
                ISSN (Electronic): 2405-8440
                Publication date PMC-release: 01 September 2020
                Publication date Collection: September 2020
                Publication date (Electronic): 01 September 2020
                Volume: 6
                Issue: 9
                Electronic Location Identifier: e04776
                Affiliations
                [a ]Federal Joint Committee (Healthcare), Gutenbergstraße 13, 10587 Berlin, Germany
                [b ]Witten/Herdecke University, School of Health, IFOM – Institute for Research in Operative Medicine, Ostmerheimer Str. 200, 51109 Cologne, Germany
                [c ]Federal Institute for Occupational Safety and Health, Nöldnerstr. 40-42, 10317 Berlin, Germany
                [d ]University of Potsdam, Research Focus Cognitive Sciences, Division of Social and Preventive Medicine, Am Neuen Palais 10, 14469 Potsdam, Germany
                Author notes
                [∗ ]Corresponding author. katja.matthias@ 123456g-ba.de
                Article
                Publisher ID: S2405-8440(20)31619-4 Publisher ID: e04776
                DOI: 10.1016/j.heliyon.2020.e04776
                PMC ID: 7479282
                PubMed ID: 32939412
                SO-VID: 7f927113-189b-4a31-8241-bfa7f961e87c
                Copyright © © 2020 The Authors. Published by Elsevier Ltd.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 19 December 2019
                Date revision received : 24 June 2020
                Date accepted : 19 August 2020
                Categories
                Subject: Review Article

                Keywords: public health,epidemiology,psychiatry,depression,evidence-based medicine,amstar 2,methodological quality,risk of bias,systematic review,major depression
                Data availability:
                Keywords: public health, epidemiology, psychiatry, depression, evidence-based medicine, amstar 2, methodological quality, risk of bias, systematic review, major depression

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