All entries for Friday 30 April 2010

Congratulations Endodontics!

Follow-up to Reason to celebrate? from Liviu's blog

“Cause for optimism” in the freshly out of print Journal of Endodontics:

“A systematic evaluation of the quality of meta-analyses in endodontics” by Suebnukarn et al.

It is highly advisable to learn and understand the tools used by the authors of this review article before looking into the results.

1.   Systematic review

The National Library of Medicine (3):

“Systematic review: a form of structure literature review that addresses a question that is formulated to be answered by analysis of evidence, and involves objective means of searching the literature, applying predetermined inclusion and exclusion criteria to this literature, critically appraising the relevant literature, and extraction and synthesis of data from evidence base to formulate findings.”

Intending to help users of systematic reviews to critically appraise those, Shea et al. (2007)

developed the AMSTAR ('assessment of multiple systematic reviews') using factor anylsis. 11 items were implemented into the tool:

1. Was an 'a priori' design provided?

2. Was there duplicate study selection and data extraction?

3. Was a comprehensive literature search performed?

4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?

5. Was a list of studies (included and excluded) provided?

6. Were the characteristics of the included studies provided?

7. Was the scientific quality of the included studies assessed and documented?

8. Was the scientific quality of the included studies used appropriately in formulating conclusions?

9. Were the methods used to combine the findings of studies appropriate?

10. Was the likelihood of publication bias assessed?

11. Was the conflict of interest stated?

Shea et al. BMC Medical Research Methodology 2007 7:10   doi:10.1186/1471-2288-7-10

In 2009 Shea et al. concluded:

  “AMSTAR has good agreement, reliability, construct validity, and feasibility. These findings need confirmation by a broader range of assessors and a more diverse range of reviews.”

2.   Meta - analysis

The National Library of Medicine (3):

“Meta-analysis:  systematic methods that use statistical techniques for combining results from different studies to obtain a quantitative estimate of the overall effect of a particular intervention or variable on a defined outcome. This combination may produce a stronger conclusion than can be provided by any individual study. (Also known as data synthesis or quantitative overview.)“

The QUOROM statement (4) (Quality of Reporting of Meta-analyses) was introduced to address “standards for improving the quality of reporting of meta-analyses of clinical randomised controlled trials (RCTs)”.

3.   The CONSORT Statement

“The CONSORT Statement is intended to improve the reporting of a randomized controlled trial (RCT), enabling readers to understand a trial's design, conduct, analysis and interpretation, and to assess the validity of its results. It emphasizes that this can only be achieved through complete transparency from authors.” (5)

One can download templates of the CONSORT 2010 Statement at: http://www.consort-statement.org/consort-statement/overview0/ (5).

Results of the systematic evaluation of the quality of meta-analyses in endodontics proved “an estimated mean overall quality score for meat – analysis in the endodotic literature from 2001 to 2009 of 8,33”.

References

1.   Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, Porter AC, Tugwell P, Moher D, Bouter LM.; Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007 Feb 15;7:10.

2.   Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, Henry DA, Boers M.; AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews.; J Clin Epidemiol. 2009 Oct;62(10):1013-20. Epub 2009 Feb 20.

3.   Systematic Review definition [http://www.nlm.nih.gov/nichsr/hta101/ta101014.html] webcite

4.    Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF.; Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999 Nov 27;354(9193):1896-900.

5.   Consort statement [http://www.consort-statement.org/], webcite

6.   Suebnukarn S, Ngamboonsirisingh S, Rattanabanlang A.; A systematic evaluation of the quality of meta-analyses in endodontics. J Endod. 2010 Apr;36(4):602-8. Epub 2010 Feb 21.

Liviu Steier : 30 Apr 2010 19:30 |  Tags: 21St Century Endodontics In The |  Comments (0) |  Close comments |  Report a problem