We comprehensively searched PubMed, Medline (Ovid), and Web of Science Core Collection on 13th January 2022, using a pre-specified and tested search syntax for SRs with RCT evidence on the early introduction of allergenic CFs as a means for allergy prevention in infants and children. We examined the quality and risk of bias (RoB) using AMSTAR-2 and ROBIS tools, examined adherence to the Preferred Reporting Items for SRs and Meta-Analyses (PRISMA), and checked whether certainty of the evidence was assessed.
Twelve SRs were included. Application of both tools resulted in similar overall judgements in terms of direction and extent for nine of the 12 SRs. Nine SRs were found to be of critically low to low quality according to AMSTAR-2 and to be at high RoB according to ROBIS. One SR received a moderate quality rating (AMSTAR-2) and high RoB rating (ROBIS). However, for two SRs, judgements between AMSTAR-2 and ROBIS were at stark variance. Only two SRs fully adhered to the PRISMA checklist. Six SRs evaluated the certainty of the body of RCT evidence. Several SRs failed to consider unpublished studies either by an explicit a priori exclusion or by inadequate search strategies.
Well-conducted SRs are important for decision-making and informing guideline development, the quality of their methodology should therefore be considered. The methodological rigour and the reporting quality of SRs on the timing of CF for allergy prevention must be improved.
https://osf.io/7cs4b .
方法:我们全面搜索了PubMed,Medline(Ovid),和WebofScienceCoreCollection于2022年1月13日使用预先指定并经过测试的SRs搜索语法,RCT证据表明早期引入过敏性CFs作为预防婴儿和儿童过敏的手段。我们使用AMSTAR-2和ROBIS工具检查了偏倚的质量和风险(RoB),检查对SR和荟萃分析(PRISMA)首选报告项目的依从性,并检查是否评估了证据的确定性。
结果:包括12个SR。两种工具的应用导致12个SR中的9个在方向和范围方面的总体判断相似。根据AMSTAR-2,发现9个SR的质量低到低质量,根据ROBIS,RoB高。一个SR获得了中等质量评级(AMSTAR-2)和高RoB评级(ROBIS)。然而,对于两个SR,AMSTAR-2和ROBIS之间的判断存在明显差异。只有两个SR完全遵守PRISMA清单。六个SR评估了RCT证据的确定性。一些SR未能通过明确的先验排除或搜索策略不足来考虑未发表的研究。
结论:良好的SRs对于决策和指导指南制定非常重要,因此,应考虑其方法的质量。必须提高预防过敏的CF时机的方法学严谨性和SRs的报告质量。
背景:https://osf.io/7cs4b。