Risk of bias and methodological appraisal practices in systematic reviews published in anaesthetic journals: a meta-epidemiological study

Detweiler, Byron; Kollmorgen, L.; Umberham, Blake; Hedin, Riley J.; Vassar, Matt

doi:10.1111/anae.13520

Cited by 32 publications

(25 citation statements)

References 94 publications

(116 reference statements)

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“…Systematic reviewers may be forced to omit important outcomes from data synthesis if particular outcomes were only rarely measured in primary studies. Previous evidence underscores the importance of methodological validity of systematic reviews and results from this investigation provide further support for needed mechanisms to improve methodological quality. Additionally, clinicians will be better able to care for patients if research studies have a standardised approach to outcome measurement and will be able to apply therapeutic protocols that have documented effectiveness based on standardised investigations.…”

Section: Discussionsupporting

confidence: 60%

A systematic review of outcomes in postoperative pain studies in paediatric and adolescent patients: towards development of a core outcome set

et al. 2018

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Systematic reviews of postoperative pain in children have called into question the consistency of outcomes measured by clinical triallists as well as the measurement instruments used for assessment. Core outcome set methodology may be a solution to improve standardisation. This study provides an evidence-based foundation for the development of a core outcome set for paediatric postoperative pain studies. We searched ClinicalTrials.gov to identify relevant postoperative pain studies in children. The search yielded 300 registered trials. The following data were then extracted from each of the trials: phase of trial; study type; study design; sample size; all outcomes; whether the outcome was listed as primary, secondary, or tertiary; the measurement instrument for each reported outcome; the specific metric for each outcome; and the type of clinical procedure. Following screening, 134 studies were included in our study. Pain measurement was the most commonly reported outcome (n = 123), followed by total postoperative analgesic dosage (n = 83) and side-effects (n = 25). Temporal trends indicated that pain assessment and unexpected events increased in use between 2000 and 2016, whereas postoperative analgesia measurement decreased. We found a lack of standardisation among outcomes and measurement instruments in paediatric postoperative pain studies. Development of a core outcome set may improve the quality of future trials and allow for more accurate study-to-study comparisons.

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Section: Discussionsupporting

confidence: 60%

A systematic review of outcomes in postoperative pain studies in paediatric and adolescent patients: towards development of a core outcome set

et al. 2018

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“…The risk of bias of individual studies was assessed using the bias domains described in the Cochrane Handbook for Systemic Reviews of Interventions, version 5.1.0 . The grades of recommendation, assessment, development and evaluation (GRADE) approach was used to rate the quality of evidence .…”

Section: Methodsmentioning

confidence: 99%

Pharmacological interventions for protecting renal function after cardiac surgery: a Bayesian network meta‐analysis of comparative effectiveness

et al. 2018

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Many drugs have been investigated as potentially protective of renal function after cardiac surgery. However, their comparative effectiveness has not been established. We performed an arm-based hierarchical Bayesian network meta-analysis including 95 randomised controlled trials with 28,833 participants, which allowed us to compare some agents not previously compared directly. Renal outcomes, including: the incidence of postoperative renal dysfunction and haemodialysis; serum creatinine level at 24 hours postoperatively; all-cause mortality; and length of hospital and ICU stay, were compared. Exploratory meta-regression was conducted for potential effect modifiers. A random effects model was selected according to the evaluation of model fit by deviance information criteria. Atrial natriuretic peptide (odds ratio (95%CrI) 0.28 (0.17-0.48); moderate-quality evidence), B-type natriuretic peptide, dexmedetomidine, levosimendan and N-acetyl cysteine significantly decreased the rate of postoperative renal dysfunction compared with placebo. Atrial natriuretic peptide (OR (95%CrI) 0.24 (0.10-0.58); low-quality evidence), B-type natriuretic peptide, and dexamethasone significantly decreased the need for haemodialysis. Levosimendan significantly decreased mortality, OR (95%CrI) 0.49 (0.27-0.91); low-quality evidence). The benefit of atrial natriuretic peptide was still apparent when baseline renal function was normal. None of the potential effect modifiers were significantly correlated with our renal outcomes. Atrial natriuretic peptide was ranked best regarding renal dysfunction, haemodialysis and length of hospital stay. Levosimendan was ranked best regarding mortality and ICU stay. However, our results should be interpreted cautiously given the assumptions made about transitivity and consistency.

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“…Validity of studies both on the level of primary studies, as well as within meta‐analyses, is influenced by different factors, among which are the different types of bias . Reporting biases arise when the dissemination of research findings is influenced by the nature and direction of their results.…”

Section: Biasmentioning

confidence: 99%

Restrictive or responsive? Outcome classification and unplanned sub‐group analyses in meta‐analyses

Klimek

Hoeks

2017

Anaesthesia

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Risk of bias and methodological appraisal practices in systematic reviews published in anaesthetic journals: a meta-epidemiological study

Cited by 32 publications

References 94 publications

A systematic review of outcomes in postoperative pain studies in paediatric and adolescent patients: towards development of a core outcome set

A systematic review of outcomes in postoperative pain studies in paediatric and adolescent patients: towards development of a core outcome set

Pharmacological interventions for protecting renal function after cardiac surgery: a Bayesian network meta‐analysis of comparative effectiveness

Restrictive or responsive? Outcome classification and unplanned sub‐group analyses in meta‐analyses

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