Östlundh, Linda

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United Arab Emirates University Scholarworks@UAEU Presentations Conferences and Symposia Fall 11-2019 Is there a need for implementation of more specified reporting guidelines for the search process in systematic reviews and meta-analyses? Linda Östlundh National Medical Library, United Arab Emirates University, Al Ain, lostlundh@uaeu.ac.ae Follow this and additional works at: https://scholarworks.uaeu.ac.ae/presentations  Part of the Medical Education Commons Recommended Citation Östlundh, L. (2019, November). Is there a need for implementation of more specified reporting guidelines for the search process in systematic reviews and meta-analyses? Presented at the 9th International Conference of Evidence-Based Health Care (EBHC), Sicily, Italy. This Presentation is brought to you for free and open access by the Conferences and Symposia at Scholarworks@UAEU. It has been accepted for inclusion in Presentations by an authorized administrator of Scholarworks@UAEU. For more information, please contact fadl.musa@uaeu.ac.ae. Is there a need for implementation of more specified reporting guidelines for the search process in systematic reviews and meta-analyses?Linda ÖstlundhDirector, the National Medical Library, United Arab Emirates, Al Ain lostlundh@uaeu.ac.aeSystematic reviews and meta-analyses❖ The foundation for systematic reviews and meta-analyses:- a comprehensive, systematic search, with the aim to exhaust all available studies matching a specific research question and pre-set inclusion criteria (Institute of Medicine, 2011; Deeks et al. 2011)- a transparent and detailed method documentation for reproducible search results (Deeks et al. 2011;Koffel & Rethlefsen, 2016; Institute of Medicine, 2011)❖ Connection between the quality of the search and the search documentation and the overall quality and risk of bias of SRs and MAs (Golder, Loke, & Zorzela, 2013; Opheim, 2019; Peters et al., 2015; Salvador-Oliván et al. 2019; Rethlefsen et al. 2015)Reporting guidelines/standards❖ 1996- The Cochrane Handbook ❖ 2009- PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- analyses)❖ 2011- IOM (Institute of Medicines Standards for Systematic Reviews)PRISMA❖ Preferred or required reporting guidelines for many high impact medical journals (The Lancet, Annals of Internal Medicine, JAMA, BMJ etc.)❖ General quality improvement of the method and method documentation with PRISMA (Panic,2013)❖ Further endorsement of standardize reporting methods like PRISMA and IOM is recommended (Koffel & Rethlefsen, 2016; Peters et al., 2015; Panic et al., 2013)Current research on reporting standards of search strategies in SRs and MAs ❖ The search in many SRs and MAs are still of poor quality and includes a very high percentage (up to 93%) of search technical errors (Golder, Loke, & Zorzela, 2013; Grossetta et al. 2019; Koffel & Rethlefsen, 2016; Opheim et al. 2019; Rethlefsen et al. 2015; Salvador-Oliván et al. 2019). ❖ Many SRs and MAs lack transparent, re-producible search documentation (up to 92%)  which reduces the usefulness of the reviews in evidence-based clinical settings (Golder, Loke, & McIntosh, 2008; Golder, Loke, & Zorzela, 2013; Knehans, Dell & Robinson, 2016; Koffel & Rethlefsen, 2016; Maggio, Tannery & Kanter, 2011; Peters et al. 2015) ❖ A poorly conducted and documented systematic search may lead to serious consequences for clinical decision making (Institute of Medicine, 2011)The Cochrane Handbook “Provide a line-by-line description of the search strategy including the date of every search for each database, web browser etc.” (Standard 3.4., Search documentation)All searches should be reproducible. A full search strategy for each database should be presented in an appendix.IOM StandardsThe PRISMA ChecklistMoher et al., 2009Is the current HbA1c level of 6.5% for diabetes diagnosis too highSystematic review and meta-analysis on the effect of soy on thyroid functionThe association between boarding in the emergency department and in-hospital mortalityCost-effectiveness of non-surgical weight loss interventions for diabetic obese patientsA systematic review to assess the relationship between sleep duration and mood in adolescentsPubMed result 4916 1501 1451 518 781Result from additional databases included7880 3424 6242 1157 1381Total no. of references after de-duplication 9324 1816 4321 1120 1532% of total no. of references not covered by PubMed 47,3% 17,3 % 66,4% 53,7% 49%Practical example: search result variationsSmall mistakes can lead to large variations(((("weight reduction"[Title/Abstract] OR "weight management"[Title/Abstract] OR "weight control"[Title/Abstract] OR "weight reductions"[Title/Abstract] OR "weight loss"[Title/Abstract] OR "weight losses"[Title/Abstract] OR "Weight Loss"[Mesh])) AND (obesity[Title/Abstract] OR obese[Title/Abstract] OR obesities[Title/Abstract] OR "Obesity"[Mesh:NoExp]  OR "Obesity, Abdominal"[Mesh] OR "Obesity, Metabolically Benign"[Mesh] OR "Obesity Hypoventilation Syndrome"[Mesh] OR "Obesity, Morbid"[Mesh] OR BMI[Title/Abstract] OR "body mass index"[Title/Abstract] OR "Body Mass Index"[Mesh] OR "Overweight"[Mesh:NoExp] OR overweight[Title/Abstract])) AND (T2D[Title/Abstract] OR "diabetes type II"[Title/Abstract] OR "type 2 diabetes"[Title/Abstract] OR "diabetes type 2"[Title/Abstract] OR T2DM[Title/Abstract] OR NIDDM[Title/Abstract] OR “diabetes mellitus, noninsulin-dependent”[Title/Abstract] OR “diabetes mellitus, non-Insulin-dependent”[Title/Abstract] OR “non-insulin-dependent diabetes mellitus”[Title/Abstract] OR “diabetes mellitus, noninsulin dependent”[Title/Abstract] OR “diabetes mellitus, non insulin dependent”[Title/Abstract] OR “diabetes mellitus, type II”[Title/Abstract] OR “noninsulin-dependent diabetes mellitus”[Title/Abstract] OR "diabetes mellitus type 2"[Title/Abstract] OR diabesity[Title/Abstract] OR "Diabetes Mellitus, Type 2"[Mesh:NoExp])) AND (("Costs and Cost Analysis"[Mesh] OR "Cost Savings"[Mesh] OR "Economics"[Mesh] OR "Health Care Costs"[Mesh] OR "Hospital Costs"[Mesh] OR "Health Expenditures"[Mesh] OR economic*[Title/Abstract] OR cost[Title/Abstract] OR costs[Title/Abstract] OR "Economics, Medical"[Mesh:NoExp] OR “burden of illness”[Title/Abstract] OR “Illness Burden”[Title/Abstract] OR utility[Title/Abstract] OR “life years”[Title/Abstract] OR “quality-adjusted life years”[Title/Abstract] OR “disability adjusted life years”[Title/Abstract] OR “cost-benefit analysis”[Title/Abstract] OR “cost-effectiveness analysis”[Title/Abstract] OR “cost-utility analysis”[Title/Abstract] OR “economic evaluation”[Title/Abstract] OR expenditure*[Title/Abstract] OR “illness Burdens”[Title/Abstract] OR "Models, Economic"[Mesh] OR "Cost of Illness"[Mesh]))❖ 374 out of 1120 references missed due to the lack of one “OR” operator.HbA1c“Hb A1c” OR “A1C” OR “GHb” OR “HbA1c” OR “HbA1” OR “Hb A1” OR “Hb-A1c” OR “hemoglobin A1c” OR “hemoglobin A1” OR “haemoglobin A1c” OR “haemoglobin A1c” OR “glycohemoglobin” OR “glyco hemoglobin” OR “glycohemoglobins” OR “glycohaemoglobin” OR “glyco haemoglobin” OR “glycohaemoglobins” OR “hemoglobin A(1)” OR “haemoglobin A(1)” OR “glycosylated hemoglobin” OR “glycosylated hemoglobins” OR “glycosylated haemoglobin” OR “glycosylated haemoglobins” OR “glycated hemoglobins” OR “glycated hemoglobin” OR “glycated haemoglobins” OR “glycated haemoglobin”Image from ShutterstockConclusions and limitations ❖ Conclusion - small variations or errors in the search strategy can have a large impact on the search result- documenting only one or a few of the included databases has a negative impact on the reproducibility and transparency of the systematic search and hinders the appraisal and risk of bias analysis of the study- implementation of more specified reporting guidelines for the search process could increase the overall quality and clinical usefulness of SRs and MAs❖ Limitations- more research on the quality impact of SRs and MAs only reporting on “at least one” database compared to reviews with comprehensive reporting of the entire search process and all information sources included is needed. 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Is there a need for implementation of more specified reporting guidelines for the search process in systematic reviews and meta-analyses?

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Is there a need for implementation of more specified reporting guidelines for the search process in systematic reviews and meta-analyses?

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