我们制作Meta分析的最终目的是为了使用，但因作者的水平和纳入文献的质量可能差距较大，因此质量也参差不齐。因此，使用Meta分析前一般是需要对其质量进行评价的，另外，有时还会针对某一疾病相关的Meta分析进行汇总评价，制作时亦需要进行质量的评价。各种类型的Meta分析的质量评价方法是不一致的，大家可以阅读相关的文献进行学习，例如曾宪涛老师的Meta分析系列就介绍了各种类型的Meta分析的质量评价。本文，列举几个例子，让大家看一下本部分的写作方法。
①The methodological quality of RCTs was assessed by the Cochrane riskof bias tool. The methodological quality of retrospective studies was assessedby the modified Newcastle-Ottawascale (NOS), which consists of three factors: patient selection,comparability of the study groups, and assessment of outcome. A score of 0-9(allocated as stars) was allocated to each study except RCTs. RCTs and observationalstudies achieving six or more stars were considered to be of high quality.
②Two review authors independently assessed the risk of bias using the Quality In Prognosis Studies(QUIPS) tool 15 with minor adaptations. The tool includes 32 key items divided into 6 domains:1) Study participation ××××××. Foreach study, each individual key item was assessed, and each domain was gradedin one of the following categories of risk of bias, based on whether the domainfully complied, partly complied, did not comply at all, or did not report in respect of the characteristic expressed by the items: 1) Low riskof bias; 2) Moderate risk of bias; 3) High risk of bias; 4) Unknown.
③Two investigators independently assessed each study’squality as “good,” “fair,” or “poor” by using predefined quality criteria based on USPSTF methods. We excluded all poor-quality randomized, controlled trialsand observational studies. In general, a good-quality study met all prespecified criteria. A fair-quality study did not meet at least 1 criterion but also did not have a known limitation that could invalidate its results. A poor-quality study had a fatal flaw or multiple important limitations. We supplemented the USPSTF criteria with criteria from the National Institute forHealth and Clinical Excellence for the quality assessment of observationalstudies. We resolved any disagreements through discussion.
④Quality was assessed using elements of the STROBEchecklist for cohort studies by 2 reviewers (××× and ×××). A third reviewer (×××) was enlisted to resolve disagreements regarding theabstracted data.
⑤Two reviewers independently assessed the quality of included studies according to the Jadad standards. The overall scores range from 0 to 5. Scores of 0, 2 and 3, 5 were regarded as low and high scores, respectively. Disagreements were also settled down by discussion among authors.
⑥Although many scales are available to assess the validity andquality of trials, none can provide an adequately reliable assessment. Therefore, we selected a number of basic criteria for assessing the validity ofthe studies, as suggested by the Cochrane Handbook, which are frequently used in meta-analysis of ×××.The assessment was conducted by two independent reviewers and all disparities between them were resolved by consensus.
|
