A systematic review of the quality of distal radius systematic reviews: Methodology and reporting assessment

Abstract

BackgroundMany systematic reviews (SRs) have been published about the various treatments for distal radius fractures (DRF). The heterogeneity of SRs results may come from the misuse of SR methods, and literature overviews have demonstrated that SRs should be considered with caution as they may not always be synonymous with high-quality standards. Our objective is to evaluate the quality of published SRs on the treatment of DRF through these tools.MethodsThe methods utilized in this review were previously published in the PROSPERO database. We considered SRs of surgical and nonsurgical interventions for acute DRF in adults. A comprehensive search strategy was performed in the MEDLINE database (inception to May 2017) and we manually searched the grey literature for non-indexed research. Data were independently extracted by two authors. We assessed SR internal validity and reporting using AMSTAR (Assessing the Methodological Quality of Systematic Reviews and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). Scores were calculated as the sum of reported items. We also extracted article characteristics and provided Spearman’s correlation measurements.ResultsForty-one articles fulfilled the eligibility criteria. The mean score for PRISMA was 15.90 (CI 95%, 13.9–17.89) and AMSTAR was 6.48 (CI 95% 5.72–7.23). SRs that considered only RCTs had better AMSTAR [7.56 (2.1) vs. 5.62 (2.3); p = 0.014] and PRISMA scores [18.61 (5.22) vs. 13.93 (6.47), p = 0.027]. The presence of meta-analysis on the SRs altered PRISMA scores [19.17 (4.75) vs. 10.21 (4.51), p = 0.001] and AMSTAR scores [7.68 (1.9) vs. 4.39 (1.66), p = 0.001]. Journal impact factor or declaration of conflict of interest did not change PRISMA and AMSTAR scores. We found substantial inter observer agreement for PRISMA (0.82, 95% CI 0.62–0.94; p = 0.01) and AMSTAR (0.65, 95% CI 0.43–0.81; p = 0.01), and moderate correlation between PRISMA and AMSTAR scores (0.83, 95% CI 0.62–0.92; p = 0.01).ConclusionsDRF RCT-only SRs have better PRISMA and AMSTAR scores. These tools have substantial inter-observer agreement and moderate inter-tool correlation. We exposed the current research panorama and pointed out some factors that can contribute to improvements on the topic.

No benefit for elbow blocking on conservative treatment of distal radius fractures: A 6-month randomized controlled trial

“…Regarding non-surgical treatment, a Cochrane review based on randomized controlled trials has concluded that controversy remains in terms of the type of immobilization to be applied after the initial fracture reduction [ 4 ]. A recent overview of systematic reviews about the treatment of DRF in adults demonstrated that only two studies were on conservative treatment and none of them underwent meta-analysis [ 5 ]. A major systematic review on the topic was carried out by Handoll et al which justified the absence of meta-analysis due to the low quality and heterogeneity in terms of interventions compared and outcome measurement of the included trials [ 4 ].…”

Treatment of radius or ulna fractures in the elderly: A systematic review covering effectiveness, safety, economic aspects and current practice

“…The lack of unequivocal results from previous studies could partly be explained by studies being under-powered and study population heterogeneous with regards to fracture patterns and patient age [7]. Numerous literature reviews have been performed for comparison of treatment methods for DRFs [8] but only few regard populations of higher ages [1, 2].…”

Declining Quality of Systematic Reviews in Orthopaedic Sports Medicine: An Updated Systematic Review

“…Regardless, as found in the previous study, the quality of reporting and methodology for orthopaedic sports medicine remains greater, if not in line, with orthopaedics in general. Zhi et al 19 reported an average PRISMA score of 77 of leading orthopaedic journals, Belloti et al 20 found an average PRISMA and AMSTAR scores of 59 in systematic reviews on distal radius fractures, and Sathish and Eswar 7 published a AMSTAR score of 68 of reviews in spine surgery.…”

“… 19 reported an average PRISMA score of 77 of leading orthopaedic journals, Belloti et al. 20 found an average PRISMA and AMSTAR scores of 59 in systematic reviews on distal radius fractures, and Sathish and Eswar 7 published a AMSTAR score of 68 of reviews in spine surgery.…”