Instruments assessing risk of bias of randomized trials frequently included items that are not addressing risk of bias issues

Wang, Ying; Ghadimi, Maryam; Wang, Qi; Hou, Liangying; Zeraatkar, Dena; Iqbal, Atiya; Ho, Cameron; Yao, Liang; Hu, Malini; Ye, Zhikang; Couban, Rachel; Armijo‐Olivo, Susan; Bassler, Dirk; Briel, Matthias; Gluud, Lise Lotte; Glasziou, Paul; Jackson, Rod; Keitz, Sheri A.; Letelier, Luz María; Ravaud, Philippe; Schulz, Kenneth F.; Siemieniuk, Reed A C; Brignardello‐Petersen, Romina; Guyatt, Gordon

doi:10.1016/j.jclinepi.2022.10.018

Cited by 13 publications

(6 citation statements)

References 25 publications

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“…Each domain was answered with ‘definitely yes’ (low risk of bias), ‘probably yes’, ‘probably no’ or ‘definitely no’ (high risk of bias). The major reason to choose the modified version of the Cochrane risk‐of‐bias tool is that existing instruments frequently include items that do not address the risk of bias 34 . We judged an overall high risk of bias if any domain had a high risk of bias.…”

Section: Methodsmentioning

confidence: 99%

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Exercise for sarcopenia in older people: A systematic review and network meta‐analysis

Shen

Shi

Nong

et al. 2023

J cachexia sarcopenia muscle

101

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Background Sarcopenia is a serious public health concern among older adults worldwide. Exercise is the most common intervention for sarcopenia. This study aimed to compare the effectiveness of different exercise types for older adults with sarcopenia. Methods Randomized controlled trials (RCTs) that examined the effectiveness of exercise interventions on patient-important outcomes for older adults with sarcopenia were eligible. We systematically searched MEDLINE, Embase and Cochrane Central Register of Controlled Trials via Ovid until 3 June 2022. We used frequentist random-effects network meta-analyses to summarize the evidence and applied the Grading of Recommendations, Assessment, Development, and Evaluations framework to rate the certainty of evidence. Results Our search identified 5988 citations, of which 42 RCTs proved eligible with 3728 participants with sarcopenia (median age: 72.9 years, female: 73.3%) with a median follow-up of 12 weeks. We are interested in patient-important outcomes that include mortality, quality of life, muscle strength and physical function measures. High or moderate certainty evidence suggested that resistance exercise with or without nutrition and the combination of resistance exercise with aerobic and balance training were the most effective interventions for improving quality of life compared to usual care (standardized mean difference from 0.68 to 1.11). Moderate certainty evidence showed that resistance and balance exercise plus nutrition (mean difference [MD]: 4.19 kg) was the most effective for improving handgrip strength (minimally important difference [MID]: 5 kg). Resistance and balance exercise with or without nutrition (MD: 0.16 m/s, moderate) were the most effective for improving physical function measured by usual gait speed (MID: 0.1 m/s). Moderate certainty evidence showed that resistance and balance exercise (MD: 1.85 s) was intermediately effective for improving physical function measured by timed up and go test (MID: 2.1 s). High certainty evidence showed that resistance and aerobic, or resistance and balance, or resistance and aerobic exercise plus nutrition (MD from 1.72 to 2.28 s) were intermediately effective for improving physical function measured by the five-repetition chair stand test (MID: 2.3 s). Conclusions In older adults with sarcopenia, high or moderate certainty evidence showed that resistance exercise with or without nutrition and the combination of resistance exercise with aerobic and balance training were the most effective interventions for improving quality of life. Adding nutritional interventions to exercise had a larger effect on handgrip strength than exercise alone while showing a similar effect on other physical function measures.

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Section: Methodsmentioning

confidence: 99%

“…The major reason to choose the modified version of the Cochrane risk-of-bias tool is that existing instruments frequently include items that do not address the risk of bias. 34 We judged an overall high risk of bias if any domain had a high risk of bias.…”

Section: Risk-of-bias Assessmentmentioning

confidence: 99%

Exercise for sarcopenia in older people: A systematic review and network meta‐analysis

Shen

Shi

Nong

et al. 2023

J cachexia sarcopenia muscle

101

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“…Analyzing bias helps to improve the quality of evidence available for decision-making processes and ensures that the scientific literature remains reliable, allowing researchers to build upon a solid foundation of unbiased evidence. By carefully evaluating and addressing bias, researchers can enhance the quality and impact of their work (Reveiz et al, 2015;Wang et al, 2022).…”

Section: Resultsmentioning

confidence: 99%

Integration of Environmental, Social, and Governance (ESG) criteria: their impacts on corporate sustainability performance

Barbosa

Crispim

Silva

et al. 2023

Humanit Soc Sci Commun

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In a corporate sustainability context, scholars have been studying internal and external relations provided by Environmental, Social, and Governance (ESG) criteria, mostly from the organizational perspective. Therefore, the main objective of this paper is to map and analyze the literature on the impacts of integrating ESG criteria on corporate sustainability performance from different points of view. The methodology used followed the Preferred Report Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, corroborated by a critical analysis. The results indicate that the integration of ESG criteria, observed from different perspectives, strengthens corporate sustainability performance. They also revealed narrowing gaps in the literature regarding methodological analysis. Most of the papers in the analyzed sample use company-level data and employ regression analysis in their analysis. The present study concludes that companies, regardless of nationality, follow the guidelines of ESG criteria integration and such procedure brings several benefits. It points to the lack of more confirmatory research approaches from a workers’ perspective, as the interest remains in the economic-environmental realm from the organizations’ point of view. The absence of such evidence points to a gap in the literature that suggests the need for new study initiatives.

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“…Heterogeneity reflects widely varying estimates of treatment effects across individual studies, indicating real differences in potential treatment effects (Yang et al, 2023); thus, higher heterogeneity in outcomes across studies is downgraded due to inconsistency across results. In terms of limitations, no study described specific information on allocation concealment and blinding, thereby reducing the quality of evidence assessment based on the study design, which may lead to biased estimates of treatment effects (Wang et al, 2024). In terms of imprecision, when a study sample size is small, CIs for outcomes tend to be wider, contributing to uncertainty of the results (Guyatt et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Shen Gui capsules for chronic heart failure: a systematic review and meta-analysis

Yan,

Zhang,

Wang

et al. 2024

Front. Pharmacol.

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BackgroundAlthough Shen Gui capsules (SGCP) are widely used as an adjuvant treatment for chronic heart failure (CHF), their clinical efficacy and safety remain controversial.PurposeTo assess the efficacy and safety of SGCP in the treatment of CHF through a systematic review and meta-analysis, to provide high-quality evidence for evidence-based medicine.MethodsSeven databases were searched for randomized controlled trials (RCTs) assessing SGCP for CHF, from inception to 9 January 2023. RCT quality of evidence was evaluated using the Cochrane Handbook for the Evaluation of Intervention Systems to assess risk of bias and Grading of Recommendations Assessment, Development, and Evaluation. A meta-analysis with subgroup and sensitivity analyses was performed using Review Manager 5.4 and Stata 12.ResultsNine RCTs representing 888 patients with CHF were included in the review. Meta-analysis revealed that SGCP combined with conventional heart failure therapy is more advantageous for improving left ventricular ejection fraction [LVEF; mean difference (MD) = 5.26, 95% confidence interval (CI) (3.78, 6.74), p < 0.0000] and increasing effective rate [relative risk (RR) = 1.21, 95%CI (1.14, 1.29), p < 0.001] compared with conventional therapy alone. The experimental treatment also reduced brain natriuretic peptide [MD = −100.15, 95%CI (−157.83, −42.47), p = 0.0007], left ventricular end-diastolic diameter [MD = −1.93, 95%CI (−3.22, −0.64), p = 0.003], and hypersensitive C-reactive protein [MD = −2.70, 95%CI (−3.12,−2.28), p < 0.001] compared with the control group. However, there was not a statistically significant difference in tumor necrosis factor-α [MD = −14.16, 95%CI (−34.04, 5.73), p = 0.16] or left ventricular end-systolic diameter [MD = −1.56, 95%CI (−3.13, 0.01), p = 0.05]. Nor was there a statistically significant between-groups difference in incidence of adverse events (p > 0.05).ConclusionSGCP combined with conventional heart failure therapy can improve LVEF and increase the effective rate to safely treat patients with CHF. However, further high-quality studies are needed to confirm these findings, due to the overall low quality of evidence in this literature.Clinical Trial Registration:https://www.crd.york.ac.uk/PROSPERO/logout.php, PROSPERO [CRD42023390409].

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Instruments assessing risk of bias of randomized trials frequently included items that are not addressing risk of bias issues

Cited by 13 publications

References 25 publications

Exercise for sarcopenia in older people: A systematic review and network meta‐analysis

Exercise for sarcopenia in older people: A systematic review and network meta‐analysis

Integration of Environmental, Social, and Governance (ESG) criteria: their impacts on corporate sustainability performance

Efficacy and safety of Shen Gui capsules for chronic heart failure: a systematic review and meta-analysis

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