Editorial: When to Trust a Meta-analysis or Systematic Review About a Surgical Treatment, and Why

Leopold, Seth S.

doi:10.1097/corr.0000000000002117

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…We performed descriptive analyses only. A meta-analysis of the reported measures was not performed because all but two studies were retrospective observational studies, and it would have been inappropriate to pool data from retrospective studies because observational biases would be amplified [30]. Further, our goal was to provide a snapshot of what is currently known, rather than pool data to reach quantitative conclusions.…”

Section: Methodsmentioning

confidence: 99%

Prescription Patterns, Associated Factors, and Outcomes of Opioids for Operative Foot and Ankle Fractures: A Systematic Review

Badin

Ortiz-Babilonia

Gupta

et al. 2022

Clin Orthop Relat Res

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Background Pain management after foot and ankle surgery must surmount unique challenges that are not present in orthopaedic surgery performed on other parts of the body. However, disparate and inconsistent evidence makes it difficult to draw meaningful conclusions from individual studies. Questions/purposes In this systematic review, we asked: what are (1) the patterns of opioid use or prescription (quantity, duration, incidence of persistent use), (2) factors associated with increased or decreased risk of persistent opioid use, and (3) the clinical outcomes (principally pain relief and adverse events) associated with opioid use in patients undergoing foot or ankle fracture surgery? Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for our review. We searched PubMed, Embase, Scopus, Cochrane, and Web of Science on October 15, 2021. We included studies published from 2010 to 2021 that assessed patterns of opioid use, factors associated with increased or decreased opioid use, and other outcomes associated with opioid use after foot or ankle fracture surgery (principally pain relief and adverse events). We excluded studies on pediatric populations and studies focused on acute postoperative pain where short-term opioid use (< 1 week) was a secondary outcome only. A total of 1713 articles were assessed and 18 were included. The quality of the 16 included retrospective observational studies and two randomized trials was evaluated using the Methodological Index for Non-Randomized Studies criteria and the Jadad scale, respectively; study quality was determined to be low to moderate for observational studies and good for randomized trials. Mean patient age ranged from 42 to 53 years. Fractures studied included unimalleolar, bimalleolar, trimalleolar, and pilon fractures. Results Proportions of postoperative persistent opioid use (defined as use beyond 3 or 6 months postoperatively) rangedThe authors certify that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

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Section: Methodsmentioning

confidence: 99%

Prescription Patterns, Associated Factors, and Outcomes of Opioids for Operative Foot and Ankle Fractures: A Systematic Review

Badin

Ortiz-Babilonia

Gupta

et al. 2022

Clin Orthop Relat Res

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“…Our profession worships at the altar of the randomized controlled trial (RCT), with good reason. There is no higher-quality scientific information than the well-constructed and honestly run RCT (except a meta-analysis of combined trials) [7]. Surgeons make choices based on the results of RCTs, with the implicit assumption that their results will duplicate those in RCTs.…”

Section: How Do We Get There?mentioning

confidence: 99%

CORR Insights®: Can Bar Code Scanning Improve Data Capture in a National Register? Findings From the Irish National Orthopaedic Register

Vince

2022

Clin Orthop Relat Res

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“…Another umbrella review reported that adopting a vegetarian diet resulted in significant weight loss in people with type 2 diabetes mellitus (T2DM), but it only included one SRMA that focused specifically on dietary pulses and legumes [ 13 , 14 ]. Another umbrella review reported the positive health effects of adopting a vegetarian diet on cholesterol and body weight, but included studies of various designs (e.g., cross-sectional, case-control, cohort, and clinical trials) instead of just randomized controlled trials, which are of the highest quality of evidence [ 15 ]. A vegan diet was also found to reduce body weight significantly and lower the risk of all-cause mortality, but the meta-analysis results were pooled without accounting for the potential overlaps in primary study findings, therefore potentially overestimating the sample and effect sizes [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Plant-Based Diets on Anthropometric and Cardiometabolic Markers in Adults: An Umbrella Review

Chew,

Heng,

Tien

et al. 2023

Nutrients

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We conducted an umbrella review to consolidate the evidence of adopting plant-based diets on anthropometric and cardiometabolic outcomes. Six electronic databases (CINAHL, EMBASE, PubMed, Scopus, the Cochrane Library, and Web of Science) were searched for systematic reviews with meta-analysis (SRMAs) published from each journal’s inception until 1 October 2022. Effect sizes from SRMAs and primary studies were pooled separately using random effects models. Overlapping primary studies were removed for primary studies’ analyses. Seven SRMAs representing 51 primary studies were included, suggesting significant benefits of plant-based diets on weight (−2.09 kg, 95% CI: −3.56, −0.62 kg, p = 0.01, I2 = 95.6%), body mass index (−0.95 kg/m2, 95% CI: −1.26, −0.63 kg/m2, p = 0.002; I2 = 45.1%), waist circumference (−2.20 cm, 95% CI: −0.08, 0.00 cm, p = 0.04; I2 = 88.4%), fasting blood glucose (−0.11 mmol/L, 95% CI: −0.13, −0.09 mmol/L, p < 0.001, I2 = 18.2%), and low-density lipoprotein cholesterol (−0.31 mmol/L, 95% CI: −0.41, −0.20 mmol/L, p < 0.001, I2 = 65.6%). Changes in high-density lipoprotein cholesterol, triglycerides, and blood pressure were not statistically significant. Generally, plant-based diets were recommended to improve anthropometry, lipid profile, and glucose metabolism. However, findings should be interpreted with caution, because most of the reviews were rated to be of low credibility of evidence and were largely based on Western eating habits and traditions, which may limit the generalizability of findings.

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Editorial: When to Trust a Meta-analysis or Systematic Review About a Surgical Treatment, and Why

Cited by 6 publications

References 12 publications

Prescription Patterns, Associated Factors, and Outcomes of Opioids for Operative Foot and Ankle Fractures: A Systematic Review

Prescription Patterns, Associated Factors, and Outcomes of Opioids for Operative Foot and Ankle Fractures: A Systematic Review

CORR Insights®: Can Bar Code Scanning Improve Data Capture in a National Register? Findings From the Irish National Orthopaedic Register

Effects of Plant-Based Diets on Anthropometric and Cardiometabolic Markers in Adults: An Umbrella Review

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