RESUMO
Background: Systematic reviews (SRs) worldwide suffer from methodological deficiencies, potentially biasing intervention decisions, and Peruvian SRs are no exception. Evaluating SRs led by Peruvian researchers is a crucial step to enhance quality and transparency in decision-making and to identify topics where SRs are either scarce or prioritized for research. Objective: To describe the characteristics and assess the methodological quality of SRs with Peruvian first authors. Methods: We conducted a scoping review within the Scopus database on January 5, 2023. We aimed to identify published SRs of interventions in which the first author had a Peruvian affiliation, published between 2013 and 2022. We evaluated the methodological quality of these SRs using the AMSTAR 2 tool. We assessed the factors associated with the AMSTAR 2 score using adjusted mean differences (aMD), including their 95 % confidence intervals (95 % CI). Results: We identified 95 eligible SRs, with a clear upward trend. SRs were primarily published in Q1 (43.2 %) and Q2 (23.2 %) journals, predominantly affiliated with institutions in Lima (90.5 %). Areas like infectious diseases (20.0 %) and dentistry (18.9 %) were most frequent. AMSTAR 2 assessments highlighted deficiencies, with few SRs reporting prior protocols (37.9 %), comprehensive search strategies (23.2 %), explanations for excluded studies (20.0 %), adequate descriptions of included studies (38.3 %), or funding sources (19.1 %). Notably, SRs in Q4 journals (aMD: -19.7, 95 % CI: -33.8 to -5.5) and those on surgical interventions (aMD: -22.6, 95 % CI: -34.7 to -10.4) had lower AMSTAR 2 scores. Conclusions: Although Peruvian-led SRs are increasingly being published, critical deficiencies are common, especially in reporting protocols, search strategies, study descriptions, and funding sources. Addressing these gaps is pivotal for enhancing the credibility and utility of these SRs in informing decision-making.
RESUMO
The objective of this study is to evaluate the effectiveness and safety of ozone therapy (OT) in the treatment of knee osteoarthritis (KOA), which is the most common form of the disease. We analysed systematic reviews (SRs) of randomised controlled trials (RCTs) using the "A MeaSurement Tool to Assess systematic Reviews" (AMSTAR2) instrument to evaluate their quality. We developed a narrative synthesis report with eight SRs (15 RCTs/3,685 patients) to summarise the findings. The AMSTAR2 analysis indicated that all reviews had critically low confidence ratings. Statistically significant effects in pain reduction using OT compared to placebo groups were reported in three SRs. OT was shown to be comparable to other therapies in one SR and not superior in the other five. Six SRs highlighted the need for additional RCTs with improved methodological quality to confirm the efficacy of OT for KOA. SRs found fewer consistent effects for improving joint function. Regarding safety, seven SRs reported a low prevalence of minor adverse events linked with OT. Finally, this umbrella review highlights the beneficial effects and safety of OT in the treatment of KOA, particularly in pain control. The low methodological quality of RCTs and SRs limits the possibility of drawing conclusions on the effectiveness of the procedure in comparison to other therapies. Ensure adequate compliance with guidelines such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and AMSTAR2 has the ability to improve the quality of SRs in this area.
RESUMO
Este estudo teve o objetivo de avaliar a qualidade metodológica e risco de viés das revisões sistemáticas e metanálises de estudos de intervenção (randomizados e não randomizados) na área de Periodontia. Buscas foram realizadas nas bases de dados: MedLine (PubMed), Embase (Elsevier), Web of Science, Scopus, Cochrane Library e LILACS para artigos de revisão sistemática, com ou sem metanálise, indexados no ano 2019 a 2020. Adicionalmente, foram realizadas buscas na literatura cinzenta, nas referências dos artigos selecionados e nos principais periódicos de área. As avaliações da qualidade metodológica e risco de viés foram realizadas através das ferramentas AMSTAR 2 e ROBIS, respectivamente. Os dados foram importados para o software IBM SPSS Statistics for Windows versão 25. Análises descritivas de frequência relativa e absoluta foram realizadas nas variáveis categóricas. Análises descritivas de média, desvio padrão e mínima/máxima foram realizadas nas variáveis contínuas. Cento e vinte e sete revisões sistemáticas cumpriram os critérios de elegibilidade e foram avaliadas. Na avaliação geral pelo ROBIS, 113 (90,6%) das revisões apresentaram alto risco de viés, 11 (7,1%) baixo risco de viés e 3 (2,4%) risco de viés indefinido. Segundo o AMSTAR 2, a qualidade metodológica foi alta em 13 revisões (10,2%), moderada em 1 (0,8%), baixa em 31 (24,4%) e criticamente baixa em 82 (64,6%). No geral, a qualidade das revisões sistemáticas de estudos de intervenção na área de Periodontia foi considerada baixa. Sugere-se que os pesquisadores que pretendam realizar revisões sistemáticas utilizem ao menos um dos dois instrumentos no processo de desenvolvimento do protocolo da revisão. Este simples processo, se respeitado e seguido em conjunto o PRISMA, tem o potencial de resultar na criação de protocolos mais completos e, consequentemente, em revisões de melhor qualidade.
This study aimed to assess the methodological quality and risk of bias of systematic reviews and meta-analyses of intervention studies (randomized and nonrandomized studies) in periodontics. The following databases were searched: MedLine (PubMed), Embase (Elsevier), Web of Science, Scopus, Cochrane Library, and LILACS for systematic review articles, with or without meta-analysis, indexed between 2019 to 2020. Additionally, we searched on grey literature, and a manually searched the references of selected articles and main journals in the area. AMSTAR 2 and ROBIS tools were used to assess the methodological quality and risk of bias, respectively. Data were imported into the IBM SPSS Statistics for Windows version 25 software. Categorical variables were descriptively analyzed by relative and absolute frequency. Continuous variables were analyzed by mean, standard deviation, and minimum/maximum. One-hundred twenty-seven systematic reviews were included and were evaluated. In the overall ROBIS assessment, 113 (90.6%) were at high risk of bias, 11 (7.1%) were at low risk of bias, and 3 (2.4%) had unclear risk of bias. According to AMSTAR 2, 13 reviews (10.2%) had high methodological quality, 1 (0.8%) moderate, 31 (24.4%) low and 82 (64.6%) critically low. Overall, the quality of systematic reviews of intervention studies in the field of periodontics was low. Systematic review authors could use at least one between both tools before creating the study protocol. This simple process, if followed together with PRISMA, has the potential aid authors in the creation of more complete protocols and, consequently, better quality reviews.