Methodological quality and risk of bias of meta-analyses of pharmacy services: A systematic review.

Autor: Bonetti AF; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, Brazil. Electronic address: alinefbonetti@gmail.com., Tonin FS; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, Brazil. Electronic address: stumpf.tonin@ufpr.br., Della Rocca AM; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, Brazil. Electronic address: anamdrocca@gmail.com., Lucchetta RC; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, Brazil. Electronic address: rc.lucch@yahoo.com.br., Fernandez-Llimos F; Center for Health Technology and Services Research (CINTESIS), Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal. Electronic address: fllimos@ff.up.pt., Pontarolo R; Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil. Electronic address: pontarolo@ufpr.br.
Jazyk: angličtina
Zdroj: Research in social & administrative pharmacy : RSAP [Res Social Adm Pharm] 2022 Mar; Vol. 18 (3), pp. 2403-2409. Date of Electronic Publication: 2020 Dec 23.
DOI: 10.1016/j.sapharm.2020.12.011
Abstrakt: Background: A suboptimal meta-analysis with misleading conclusions, frequently published in the healthcare journals, can compromise decision making in clinical practice.
Objective: To evaluate the reporting quality, methodological quality, and risk of bias of meta-analyses of pharmacy services.
Methods: Systematic searches to identify all the meta-analyses reporting the effect of pharmacy services were performed in PubMed, Scopus, and Web of Science. The reporting quality, the methodological quality, and the risk of bias of the included meta-analyses were evaluated using PRISMA checklist, R-AMSTAR, and ROBIS, respectively.
Results: A total of 109 meta-analyses were eligible for the study. The heterogeneity, the quality of evidence, and the quality analyses were poorly reported on authors' conclusions (14.3%, 14.7%, and 17.4%, respectively). The median scores of PRISMA and R-AMSTAR tolls were 24 (IQR 21.75-25), and 30 (IQR 27-32.5), respectively. Additionally, most of the studies were considered as high risk of bias (n = 83, 76.1%). No association between the date of publication and guideline compliance exists. PRISMA score was higher in studies published in high impact factor journals (rho = 0.313; p = 0.002), in articles that reported the quality of evidence obtained (p = 0.018), and in those that stated the need for future studies in their conclusions (p = 0.011). R-AMSTAR score was higher in studies published in high impact factor journals (rho = 0.338; p = 0.001), in those which reported the quality of evidence (p = 0.002), and in articles that described the quality analyses in their conclusions (p = 0.046). An association between the risk of bias and the recognition of the need for further studies in their conclusions (p = 0.041) was also found.
Conclusion: The rapid increase of the meta-analyses of pharmacy services was not associated with higher quality. Mechanistic meta-analyses with poor conclusions are commonly published. Quality of the analyses, strength of evidence, heterogeneity, and absence of confrontation with current guidelines are rarely considered when synthetizing evidence and making recommendations.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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