国内护理领域系统评价/Meta分析的方法学与报告质量评价

Reporting and Methodological Quality of Systematic Reviews and Meta-Analyses in Nursing Field in China

目的评价国内护理领域系统评价/Meta分析方法学和报告质量,以期规范研究过程和报告方法。方法计算机检索CNKI,查找涉及护理领域的所有系统评价/Meta分析文献,检索时限从建库至2011年12月。由2位评价者独立筛查文献,并采用AMSTAR和PRISMA评价量表对纳入文献的方法学与报告质量进行评价并交叉核对,如遇分歧讨论解决。结果共纳入63篇文献,其中系统评价21篇,Meta分析42篇,分别发表在《护理研究》、《中华护理杂志》、《中国循证医学杂志》等13种期刊上。纳入文献中方法学质量存在的主要问题有:文献检索不够全面、对异质性产生的原因未进行综合分析和处理、未重视发表偏倚的识别。报告质量存在的主要问题表现在检索策略的报告不规范、纳入研究质量和偏倚风险报道不全面和研究结果表述不全(部分缺乏森林图、综合结果的估计值和可信区间、异质性检验结果)。结论目前国内护理领域系统评价/Meta分析的方法学质量及报告质量还存在不同程度的问题,尚需进一步提高方法学水平和规范报告质量。

Objective To evaluate reporting and methodological quality of systematic reviews or meta-analyses in nursing field in China. Methods CNKI database was searched for systematic reviews or meta-analyses in nursing field from the establishment date to December 2011. Two reviewers independently identified the literature according to inclu- sion and exclusion criteria, and then extracted the data using Excel software. The PRISMA and AMSTAR checklists were used to assess reporting characteristics and methodological quality, respectively. Results A total of 63 systematic reviews or meta-analyses involving 21 systematic reviews and 42 meta-analyses were identified. These articles were published on 13 journals such as The Chinese Nursing Research, the Chinese Journal of Nursing, and the Chinese Journal of Evidence- Based Medicine. The deficiencies of methodological quality mainly contained literature search, heterogeneity handling, recognition and assessment of publication bias. In addition, the deficiencies of reporting characteristics were reflected on incomplete reporting of literature search, quality assessment, risk of bias and results （some studies lacked forest plot, esti- mated value of pooled results, 95%CI or heterogeneity）. Conclusion As a whole, the included reviews and meta-analyses have more or less flaws with regard to the quality of reporting and methodology based on the PRISMA and AMSTAR checklists. Focusing on the improvement of reporting and methodological quality of systematic review or recta-analysis in nursing field in China is urgently needed in order to increase the value of these studies.