非药物干预治疗化疗相关性恶心呕吐有效性的系统评价再评价

Efficacy of non-pharmaceutical interventions for chemotherapy-induced nausea and vomiting:an overview of systematic reviews

目的对非药物干预治疗化疗相关性恶心呕吐有效性的系统评价/Meta分析的方法学和结局指标质量进行再评价。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中关于非药物干预预防或治疗化疗相关性恶心呕吐疗效的系统评价/Meta分析,检索时限均为建库至2021年5月。纳入文献采用系统评价方法学质量评价工具(AMSTAR 2)进行方法学质量评价,纳入文献的结局指标采用证据质量评价工具进行证据分级。结果共纳入24篇文献,AMSTAR 2质量评价结果7篇为低级,其余17篇均为极低级,主要缺陷为缺乏前期研究设计方案、检索策略不全面、未提供排除文献清单以及未报告纳入研究资助来源等;结局指标的证据质量分级1个为高级,7个为中级,其余均为低级或极低级。结论非药物干预治疗化疗相关性恶心呕吐有效性的相关系统评价/Meta分析方法学质量以及证据强度普遍较低,研究结果可靠性差,未来需设计科学严谨的高质量随机对照试验和系统评价进一步对非药物干预的有效性进行验证。

Objective To re-evaluate the quality of methodology and outcome indicators for systematic reviews/meta-analysis about the effectiveness of non-pharmacological interventions for chemotherapy-related nausea and vomiting(CINV).Methods The Cochrane Library,PubMed,Embase,Web of Science,CNKI,Wanfang,VIP and CBM for systematic reviews/meta-analysis on the effectiveness of non-pharmaceutical intervention in the prevention or treatment of CINV from inception to May 2021 were searched.The methodological quality of the included literature was evaluated by the AMSTAR 2 quality evaluation tool,and the quality of the evidence for the outcome indicators was evaluated by GRADE system.Results A total of 24 articles were included,7 of the AMSTAR 2 quality evaluation results were low-level,and the remaining 17 were all very low-level.The main defects were the lack of preliminary study design scheme,incomplete search strategy,no list of excluded literature,and no report of included research funding sources,etc.Only 1 of the outcome indicators was classified as high quality,7 were classified as intermediate,and the rest were low or very low quality.Conclusions Methodological quality and strength of evidence of systematic reviews/meta-analysis on the effectiveness of non-pharmaceutical intervention for CINV are generally low,and the reliability of research results is poor.It is necessary to design scientific and rigorous high-quality RCTs and systematic reviews to further verify the effectiveness of non-pharmaceutical interventions in the future.