Article type
Abstract
Background: every year around 10 million plastic surgery procedures are carried out worldwide, of which 1.6 million are breast augmentations with prostheses [1]. Numerous techniques and prosthetic materials have been developed and are currently available. Systematic reviews (SRs) have been conducted to identify the most efficacious and safe options for different indications. To fulfil their role of reliably informing health decision-making and identifying knowledge gaps, SRs must be methodologically rigorous and use a transparent process.
Objectives: to evaluate the methodological and reporting quality of systematic reviews of randomised clinical trials on esthetics and reconstructive breast surgery.
Methods: meta-research with a comprehensive search strategy to retrieve all relevant SRs from the Cochrane Database of Systematic Reviews, Epistemonikos and MEDLINE (vi PubMed on December 19, 2023. Methodological and reporting guidance adopted by these SRs was verified as well as their adequacy to items from AMSTAR-2 (methodological quality) and PRISMA 2020 (reporting quality). The protocol of this study was prospectively published at https://osf.io/preprints/osf/ucpgd.
Results: after the selection process, 15 SRs were included. Eight (60%) SRs referred to the use of a methodological guide, and five of them (33.3%) invertedly referred to PRISMA as the methodological guide. Reporting guidelines were referred by
none of the included SRs. The median adequacy to AMSTAR-2 items was 33.3% (Q1 – 23.3% / Q3 – 93.3%) and to PRISMA-2020 items, 42.9% (Q1 – 38.1% / Q3 – 95.2%) corresponding to low methodological and reporting quality, respectively. By AMSTAR-2 tool, the confidence in the results was critically low for 73.3% of included SRs. Although a small number of SRs were included, a high correlation between the methodological and reporting quality was observed (Spearman rho = 0.96, 95% bias-corrected confidence interval = 0.84 to 0.99).
Conclusions: the methodological and reporting quality of SRs on esthetic or reconstructive breast surgery is poor. Only half of the authors used valid guidance to conduct their SRs and none used guidance for reporting their results.
Relevance to patients: to properly support health care, we need systematic reviews with trustworthy results, so they need to adopt rigorous methods and transparent reporting.
Funding: Fapesp scholarship (137908/2020).
Objectives: to evaluate the methodological and reporting quality of systematic reviews of randomised clinical trials on esthetics and reconstructive breast surgery.
Methods: meta-research with a comprehensive search strategy to retrieve all relevant SRs from the Cochrane Database of Systematic Reviews, Epistemonikos and MEDLINE (vi PubMed on December 19, 2023. Methodological and reporting guidance adopted by these SRs was verified as well as their adequacy to items from AMSTAR-2 (methodological quality) and PRISMA 2020 (reporting quality). The protocol of this study was prospectively published at https://osf.io/preprints/osf/ucpgd.
Results: after the selection process, 15 SRs were included. Eight (60%) SRs referred to the use of a methodological guide, and five of them (33.3%) invertedly referred to PRISMA as the methodological guide. Reporting guidelines were referred by
none of the included SRs. The median adequacy to AMSTAR-2 items was 33.3% (Q1 – 23.3% / Q3 – 93.3%) and to PRISMA-2020 items, 42.9% (Q1 – 38.1% / Q3 – 95.2%) corresponding to low methodological and reporting quality, respectively. By AMSTAR-2 tool, the confidence in the results was critically low for 73.3% of included SRs. Although a small number of SRs were included, a high correlation between the methodological and reporting quality was observed (Spearman rho = 0.96, 95% bias-corrected confidence interval = 0.84 to 0.99).
Conclusions: the methodological and reporting quality of SRs on esthetic or reconstructive breast surgery is poor. Only half of the authors used valid guidance to conduct their SRs and none used guidance for reporting their results.
Relevance to patients: to properly support health care, we need systematic reviews with trustworthy results, so they need to adopt rigorous methods and transparent reporting.
Funding: Fapesp scholarship (137908/2020).