The currency, completeness and quality of systematic reviews of acute management of moderate to severe traumatic brain injury: A comprehensive evidence map
| Autor: | Andrew I R Maas, David K. Menon, Carole Lunny, Russell L. Gruen, Loyal Pattuwage, Anneliese Synnot, Victor Volovici, Emma Donoghue, Ornella Clavisi, Peter Bragge, Maryse C. Cnossen, Stefania Mondello |
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| Přispěvatelé: | Neurosurgery, Public Health, Synnot, Anneliese [0000-0002-4008-4208], Menon, David [0000-0002-3228-9692], Clavisi, Ornella [0000-0002-6069-8266], Mondello, Stefania [0000-0002-8587-3614], Maas, Andrew [0000-0003-1612-1264], Apollo - University of Cambridge Repository, Hills, Robert K., Lee Kong Chian School of Medicine (LKCMedicine) |
| Rok vydání: | 2023 |
| Předmět: |
Critical Care and Emergency Medicine
Traumatic Brain Injury Psychological intervention Blood Pressure Hypothermia Pathology and Laboratory Medicine Vascular Medicine law.invention Database and Informatics Methods 0302 clinical medicine Randomized controlled trial law Brain Injuries Traumatic Medicine and Health Sciences Mannitol Science::Medicine [DRNTU] 030212 general & internal medicine Database Searching 10. No inequality Trauma Medicine Uncategorized Multidisciplinary Evidence-Based Medicine Organic Compounds Research Assessment Checklist 3. Good health Chemistry Systematic review Physical Sciences Medicine RANDOMIZED CONTROLLED-TRIALS SEVERE HEAD-INJURY INTRACRANIAL-PRESSURE MONITORS PLACEBO-CONTROLLED TRIAL DECOMPRESSIVE CRANIECTOMY THERAPEUTIC HYPOTHERMIA HYPERTONIC SALINE PHARMACOLOGICAL INTERVENTIONS PROPHYLACTIC HYPOTHERMIA MILD HYPOTHERMIA Engineering sciences. Technology Traumatic Injury Research Article Chemical Elements medicine.medical_specialty Drug Research and Development Systematic Reviews Traumatic brain injury Science MEDLINE Research and Analysis Methods 03 medical and health sciences Signs and Symptoms Diagnostic Medicine medicine Humans Clinical Trials Pharmacology business.industry Organic Chemistry Chemical Compounds Evidence-based medicine medicine.disease Randomized Controlled Trials Hypertonic saline Oxygen Alcohols Emergency medicine Systematic Review Clinical Medicine business Neurotrauma 030217 neurology & neurosurgery Systematic Reviews as Topic |
| Zdroj: | PLoS One (online), 13(6):e0198676. Public Library of Science PLoS ONE, Vol 13, Iss 6, p e0198676 (2018) PLoS ONE |
| ISSN: | 1932-6203 |
| DOI: | 10.26181/22800290.v1 |
| Popis: | ObjectiveTo appraise the currency, completeness and quality of evidence from systematic reviews (SRs) of acute management of moderate to severe traumatic brain injury (TBI).MethodsWe conducted comprehensive searches to March 2016 for published, English-language SRs and RCTs of acute management of moderate to severe TBI. Systematic reviews and RCTs were grouped under 12 broad intervention categories. For each review, we mapped the included and non-included RCTs, noting the reasons why RCTs were omitted. An SR was judged as 'current' when it included the most recently published RCT we found on their topic, and 'complete' when it included every RCT we found that met its inclusion criteria, taking account of when the review was conducted. Quality was assessed using the AMSTAR checklist (trichotomised into low, moderate and high quality).FindingsWe included 85 SRs and 213 RCTs examining the effectiveness of treatments for acute management of moderate to severe TBI. The most frequently reviewed interventions were hypothermia (n = 17, 14.2%), hypertonic saline and/or mannitol (n = 9, 7.5%) and surgery (n = 8, 6.7%). Of the 80 single-intervention SRs, approximately half (n = 44, 55%) were judged as current and two-thirds (n = 52, 65.0%) as complete. When considering only the most recently published review on each intervention (n = 25), currency increased to 72.0% (n = 18). Less than half of the 85 SRs were judged as high quality (n = 38, 44.7%), and nearly 20% were low quality (n = 16, 18.8%). Only 16 (20.0%) of the single-intervention reviews (and none of the five multi-intervention reviews) were judged as current, complete and high-quality. These included reviews of red blood cell transfusion, hypothermia, management guided by intracranial pressure, pharmacological agents (various) and prehospital intubation. Over three-quarters (n = 167, 78.4%) of the 213 RCTs were included in one or more SR. Of the remainder, 17 (8.0%) RCTs post-dated or were out of scope of existing SRs, and 29 (13.6%) were on interventions that have not been assessed in SRs.ConclusionA substantial number of SRs in acute management of moderate to severe TBI lack currency, completeness and quality. We have identified both potential evidence gaps and also substantial research waste. Novel review methods, such as Living Systematic Reviews, may ameliorate these shortcomings and enhance utility and reliability of the evidence underpinning clinical care. |
| Databáze: | OpenAIRE |
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