Methodological Quality Assessment of Systematic Review or Meta-Analysis Using AMSTAR-2: the Long-Term Effectiveness or Efficacy of Opioids for Chronic Non-Cancer Pain

Li, Qian; Deng, Ke; Jiang, Xiaoyuan; Tao, Hongbing; Liu, Hui; Chen, Jin

doi:10.21203/rs.2.12469/v1

Cited by 3 publications

(5 citation statements)

References 43 publications

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“…To aid in evaluating the quality of meta-analyses, a number of critical appraisal tools are now available (eg, A Measurement Tool to Assess Systematic Reviews 2, AMSTAR 2) 12. Applied in a variety of areas of biomedical research, these tools have provided empirical evidence for areas of improvement in future meta-analyses, yet no reviews exist within the context of CPSP 13–15…”

Section: Introductionmentioning

confidence: 99%

Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

McGregor

Warner

Linde

et al. 2022

Reg Anesth Pain Med

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BackgroundIn an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain.ObjectiveTo inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses.Evidence reviewWe conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool.FindingsOur search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor.ConclusionsWith few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed.PROSPERO registration numberCRD42021230941.

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Section: Introductionmentioning

confidence: 99%

Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

McGregor

Warner

Linde

et al. 2022

Reg Anesth Pain Med

View full text Add to dashboard Cite

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“…AMSTAR-2 is a critical appraisal tool used to rate the quality of SR and it has been used across multiple medical disciplines including substance abuse 24 – 29 . Several studies have validated its use both in terms of its inter-rater reliability 24 and its construct 30 .…”

Section: Methodsmentioning

confidence: 99%

“…AMSTAR-2 is a critical appraisal tool used to rate the quality of SR and it has been used across multiple medical disciplines including substance abuse. [24][25][26][27][28][29] Several studies have validated its use both in terms of its inter-rater reliability 24 and its construct. 30 The appraisal tool rates SRs based on 16 categories and provides users with overall appraisal ratings ranging from high (0 or only one non-critical weakness) to critically low (more than 1 critical flaw).…”

Section: Amstar-2mentioning

confidence: 99%

Evaluating Spin in the Abstracts of Systematic Reviews and Meta-Analyses on Cannabis use Disorder

et al. 2022

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Background: Clinicians rely upon abstracts to provide them quick synopses of research findings that may apply to their practice. Spin can exist within these abstracts that distorts or misrepresents the findings. Our goal was to evaluate the level of spin within systematic reviews (SRs) focused on the treatment of cannabis use disorder (CUD). Methods: A systematic search was conducted in May 2020. To meet inclusion criteria, publications had to be either an SR or meta-analysis related to the treatment of cannabis use. Screening and data extraction was performed in a duplicate and masked fashion. Study quality was assessed using AMSTAR-2 Results: 16/24 SRs (66.7%) contained at least one form of spin in the abstract. The most common forms of spin identified were type 3-selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention (45.8%)-and type 8-the review's findings from a surrogate marker or a specific outcome to the global improvement of the disease (37.5%). No significant association between spin and intervention type, PRISMA requirements, or funding source was identified. Weak positive correlations were found between the presence of spin and abstract word count (r ¼.217) and between spin and AMSTAR-2 rating (r ¼ 0.143). "Moderate" was the most common AMSTAR-2 rating (9/24, 37.5%), followed by "low" (7/24, 29.2%) and "critically low" (7/24, 29.2%). One systematic review received an AMSTAR-2 rating of "high" (1/24, 4.2%). Conclusions: Spin was common among abstracts from the SRs focused on the treatments for CUD. Higher quality studies may help reduce the overall rate as well as standardizing treatment outcomes. To facilitate this, we encourage all authors, peer-reviewers, and editors to be more aware of the various types of spin as they can help reduce the overall amount of spin seen within the literature.

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“…Following spin data extraction, the quality of each systematic review was analysed using AMSTAR-2 (https://amstar.ca/). 18 AMSTAR-2 has previously been used to evaluate systematic reviews in multiple medical disciplines, including surgery, cancer, psychiatry, pain management and general medical interventions 18–22. Based on scores from the 16-item scale, reviews were given confidence ratings of high, moderate, low or critically low 18.…”

Section: Methodsmentioning

confidence: 99%

“…18 AMSTAR-2 has previously been used to evaluate systematic reviews in multiple medical disciplines, including surgery, cancer, psychiatry, pain management and general medical interventions. [18][19][20][21][22] Based on scores from the 16-item scale, reviews were given confidence ratings of high, moderate, low or critically low. 18 Inter-rater reliability scores (assessed by kappa) for AMSTAR-2 ranged from .31 to 1.0, 18 with additional studies supporting its reliability, finding moderate interrater reliability (median K=0.56) among multiple raters.…”

Section: Identification Of Spin and Data Extractionmentioning

confidence: 99%

Spin within systematic review abstracts on antiplatelet therapies after acute coronary syndrome: a cross-sectional study

et al. 2022

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ObjectivesSpin is a reporting practice in which study results are misrepresented by overestimating efficacy or underestimating harm. Prevalence of spin varies between clinical specialties, and estimates are based almost entirely on clinical trials. Little is known about spin in systematic reviews.DesignWe performed a cross-sectional analysis searching MEDLINE and Embase for systematic reviews and meta-analyses pertaining to antiplatelet therapies following acute coronary syndrome on 2 June 2020. Data were extracted evaluating the presence of spin and study characteristics, including methodological quality as rated by A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). All data extraction was conducted in a masked, duplicate manner from 2 June 2020 to 26 June 2020.Participants and settingNot applicable.Primary and secondary outcome measuresWe assessed abstracts of systematic reviews on antiplatelet therapy following acute coronary syndrome and evaluated the prevalence of the nine most severe types of spin. We additionally explored associations between spin and certain study characteristics, including quality.ResultsOur searches returned 15 263 articles, and 185 systematic reviews met inclusion criteria. Of these 185 reviews, 31.9% (59/185) contained some form of spin in the abstract. Seven forms of spin (1, 2, 3, 4, 5, 7 and 9) among the nine most severe were identified. No instances of types 6 or 8 were found. There were no statistically significant relationships between spin and the evaluated study characteristics or AMSTAR-2 appraisals.ConclusionsSpin was present in abstracts for systematic reviews and meta-analyses; subsequent studies are needed to identify correlations between spin and specific study characteristics. There were no statistically significant associations between spin and study characteristics or AMSTAR-2 ratings; however, implementing changes will ensure that spin is reduced in the field of cardiology as well as other fields of medicine.

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Methodological Quality Assessment of Systematic Review or Meta-Analysis Using AMSTAR-2: the Long-Term Effectiveness or Efficacy of Opioids for Chronic Non-Cancer Pain

Cited by 3 publications

References 43 publications

Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

Evaluating Spin in the Abstracts of Systematic Reviews and Meta-Analyses on Cannabis use Disorder

Spin within systematic review abstracts on antiplatelet therapies after acute coronary syndrome: a cross-sectional study

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