Are reporting and methodological quality of systematic reviews from China lower than those from USA? A meta-epidemiological study

Article type
Year
Authors
Tian J1, Zhang J2, Ge L1, Yang K1, Song F3
1Evidence-Based Medicine Center of Lanzhou University, China
2School of Nursing, Gansu University of Chinese Medicine, China
3University of East Anglia, UK
Abstract
Background: Cochrane and evidence-based health programmes have successfully promoted the production of systematic reviews (SRs) globally. In particular, the number of published SRs from China has increased exponentially, and there are concerns about their methodological quality.

Objectives: To compare the quality of SRs of randomised controlled trials (RCTs) between China and the USA.

Methods: We searched PubMed and randomly selected 100 SRs from China and 100 SRs from the USA, according to the following eligibility criteria: they included only RCTs, were published in 2014 in English, and had a corresponding author with affiliations in China or in the USA. PRISMA and the AMSTAR tool were used to assess the reporting and methodological quality of the included SRs. We conducted ordered logistic regression analyses to compare the reporting and methodological quality of SRs between China and USA after adjusting for multiple review characteristics.

Results: Compared with SRs from the USA, SRs from China were more likely to contain a meta-analysis (97% vs 77%), more likely to be published in journals with lower impact factors (median 2.664 vs 3.711), less likely to be a Cochrane Review (8% vs 26%), and less likely to involve co-authors from other countries (12% vs 98%). There were considerable differences between China and the USA in reporting and methodological quality with respect to specific quality items. However, the reporting and methodological quality of SRs from China were not consistently lower or higher than those from the USA for all quality items. After adjusting for multiple review characteristics, neither country (China or USA) was statistically significantly associated with the summary PRISMA score (P = 0.075) or summary AMSTAR score (P = 0.779).

Conclusions: The overall quality of SRs of RCTs from China published in English were similar to those from the USA, although the quality of SRs from both countries could be improved further. Adequate systematic reviewing capacity is important for evidence-based clinical practice, health policy, and primary research in China as well as in other low- and middle-income countries.