| Popis: |
Background: Evidence-rating systems (ERSs) provide a framework for the systematic evaluation of the quality of individual interventional or observational studies and the overall body of evidence in meta-analyses. Authors and users of meta-analyses require a familiarity with ERSs to determine the level of confidence in the application of results. Many ERSs have been published, but no consensus exists regarding best practice for their use. Objective: The aim is to describe patterns of use of ERSs in meta-analyses of drug therapy published in contemporary high-impact medical journals.Methods: We design a review. Medline / PubMed was searched to identify meta-analyses evaluating drug therapy from the top 5 ranked general medical journals from 2012 to 2016. Methods of full-texts were reviewed to ensure the meta-analyses evaluated drug therapy and to identify the ERS used to rate individual studies and the overall body of evidence. Frequency of ERS use was analyzed using descriptive statistics.Results: The top-ranked journals were Ann Intern Med, BMJ, JAMA, Lancet and PLoS Medicine. Of the 309 results, manual review excluded 111 meta-analyses. In 198 evaluated meta-analyses, 86.4% (171) utilized an ERS; the most commonly used was the Cochrane Risk of Bias Tool in 80.7% (138) of all meta-analyses. An ERS was used to evaluate the body of literature in 19.1% (38) of meta-analyses; the most commonly used of three systems was the GRADE methodology. Overall, 14 unique ERSs, including author-defined systems, were usedConclusions: Most meta-analyses of drug effects in high-impact medical journals evaluated individual studies with an ERS, most commonly the Cochrane Risk of Bias Tool, while the use of ERSs to evaluate the body of literature was less frequent. The familiarity of authors and users of meta-analyses with commonly used ERSs may facilitate the evaluation and application of findings of meta-analyses. |
