Why Would the Nurse Review Meta-analysis Studies First?
PLoS Ane. 2017; 12(5): e0177648.
Quality of meta-analysis in nursing fields: An exploration based on the JBI guidelines
Yuying Hou
1The Start Clinical Medical College of Lanzhou University, Lanzhou, China
Jinhui Tian
iiEvidence-Based Medicine Centre, Lanzhou University, Lanzhou, Communist china
Jun Zhang
3School of Nursing, Gansu University of Traditional Chinese Medicine, Lanzhou, Red china
Rongrong Yun
ivSchool of Nursing, Lanzhou University, Lanzhou, Mainland china
Zhigang Zhang
5Department of Intensive Intendance Unit, The First Hospital of Lanzhou University, Lanzhou, China
Kee-Hsin Chen
6Department of Nursing, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
7Evidence-Based Knowledge Translation Heart, Taipei Municipal Wanfang Infirmary, Taipei Medical University, Taipei, Taiwan
viiiSchool of Nursing, Taipei Medical University, Taipei, Taiwan
Caiyun Zhang
9Department of Nursing, The Commencement Hospital of Lanzhou Academy, Lanzhou, China
Bo Wang
10Department of Nursing, Rehabilitation Hospital of Gansu Province, Lanzhou, Cathay
Joel Joseph Gagnier, Editor
Received 2016 December 19; Accustomed 2017 April 30.
Abstract
Groundwork
Meta-analysis is often regarded as ane of the all-time sources of evidence for clinical nurses due to its rigorous design and scientific reflection of the true results of nursing interventions. The quality of a meta-assay is critical to the work of clinical decision-makers. Therefore, the objective of this report was to use the JBI guidelines to summarize the quality of RCT-based meta-analyses of reports published in domestic nursing professional journals, with a view to standardizing the research process and reporting methods.
Methods
We performed a comprehensive literature search for RCT-based meta-analyses published in Chinese professional nursing journals, from their inception to Dec 31, 2015, using bibliographic databases (e.m. CNKI, WanFang Database). March one, 2017, supplementary search 2016 literature. Candidate reviews were assessed for inclusion by two independent reviewers using pre-specified eligibility criteria. We evaluated the quality of reporting of the included meta-analyses using the systematic review literature reporting specification of JBI. Analyses were performed using Excel and STATA 12.0 software.
Results
Three hundred and twenty-two meta-analyses were included. According to the JBI guidelines, the overall quality of the meta-analysis report was poor. The quality of core periodical reports and the implementation of retrieval were improve than those of non-core journals. The nature of the authors and the availability of funding back up had no significant touch on the quality of the meta-analyses. Multi-unit of measurement and multi-author collaboration can help improve the quality of meta-analyses with significant impact.
Conclusion
The understanding and implementation of systematic evaluation and meta-analyses in domestic nursing professional journals is worthy of recognition, and at that place is more work that tin can exist done to improve the quality of these reports. Systematic review / Meta-assay (SR / MA) makers should include the findings of this study. Multi-institutional and multi-writer collaborations appear to improve inquiry capacity and provide more reliable testify support for clinicians.
Introduction
Bear witness-based nursing is one branch of testify-based medicine, in which caregivers conscientiously and judiciously combine scientific findings with clinical experience and patient desires in the clinical care decision-making process[i]. Equally the most important role of evidence-based nursing, clinical care bear witness can be divided into four levels, of which, systematic reviews/ meta-analyses (SR/ MA) stand for the beginning-level evidence, where the research blueprint is more rigorous and can reflect the bodily results of nursing intervention and are often regarded every bit one of the best prove sources past clinicians[2–3].
Systematic review is a new method of literature synthesis. Systematic reviews systematically evaluate a series of published and unpublished studies on a specific problem, using rigorous principles and methods of document evaluation, selecting documents that meet quality standards and conducting qualitative or quantitative synthesis, to depict the all-time conclusions. Systematic evaluation can exist qualitative or quantitative (i.e., a procedure involving meta-analysis)[four]. Although SR/ MA are one of the best sources of clinical evidence, only high-quality SR/ MA can provide a scientific footing for decisions made by clinicians, nurses and other determination makers. Poor quality SR/ MA may mislead decision-makers. Therefore, effective quality assessment is an important part of the proper use of SR/ MA, as well as circumspection with the use of whatever findings.
The Joanna Briggs Constitute (JBI) is a not-profit global organization that was founded in 1996. It is the second evidence-based intendance center following the establishment of the Evidence-Based Nursing Center at York Academy. It is also the largest international organisation to promote evidence-based care in the world. Equally with other international organizations, JBI is committed to standardizing the procedure of systematic reviews to raise both quality and reliability among collaborating agencies. JBI has developed a set of theories, methods and rigorous procedures for evaluating and synthesizing different types of evidence[five] and provides an overview of JBI systems that must be reported. A review of the JBI system, which focuses on the qualitative studies of intervention outcomes, should include xviii parts with 40 items, forth with respective flowcharts[six].
Given the usefulness of the JBI arrangement and the importance of meta-assay to conclusion-makers, the main aim of this study is to use the JBI guidelines to summarize the quality of the RCT-based meta-analyses published in domestic nursing professional journals, with a view to standardizing the research process and reporting methods. The secondary aim is to explore whether the quality of meta-analyses published in core journals and not-core journals differs, and identify factors that influence the quality of meta-analyses.
Materials and methods
Eligibility criteria
Earlier we searched the literature, nursing professional person journals were identified through State Administration of Press, Publication, Radio, Flick and Idiot box of The People's Republic of China. CNKI and Wanfang database were searched for the literatures of SR/ MA in these journals. The search menstruum included the get-go of each journal to Dec 31, 2015. March 1, 2017 supplementary seach 2016 literature. Repetitive literature, review, and methodological literature, systematic reviews of etiology/ diagnostics/ methodological studies, protocol, strange abstracts or translations of systematic or meta-analyses, not-interventional quantitative systematic review, non-RCT-based meta-analyses were excluded. Only RCT-based meta-analyses in the intervention grade were included.
Data brainchild
Two reviewers independently screened the articles based on the inclusion and exclusion criteria. Manufactures that did not encounter the inclusion criteria in title, abstract, full text, and author data were excluded. Microsoft Function Excel 2007 software was used to constitute the information extraction table, and the data was extracted independently by two reviewers. Data was collected from the included meta-analyses for study characteristics (due east.k. primary author and publication yr, journal type, agency, number of authors, number of outcomes, instruments used for quality assessment, funding, trial registries), retrieval information (e.g. number of bibliographic databases searched, additional search methods such as grey literature, hand searching, commendation mapping) and reports on the contents for each of the various items of JBI guidelines. Prior to data extraction and quality evaluation, the use of each evaluation calibration was assessed, and potential issues in data extraction and content consistency were evaluated before data extraction. The formal quality assessment process was independently completed and cantankerous-checked by two investigators and resolved in the case of differences past a 3rd party.
Information synthesis and quality appraisal
2 dimensions of meta-assay reporting and retrieval carry were explored. For the evaluation of retrieved documents, each entry was evaluated with "yep" or "no", and the number of "yes" was counted. Nosotros used the JBI guidelines to evaluate each included review to examine the by-item quality of written report. The JBI guidelines contain a full of xl items, and the response options for each domain were "compliance", "partial compliance", "nonconformity". Each included study was evaluated individually, and we counted each sufficiently reported item (respond "yes" / "compliance"). The odds ratio (OR) was used as the statistical effect and the 95% conviction interval (95% CI) was calculated, differences in the quality of meta-analyses in core and non-core journals and the factors that influence the quality of the meta-analyses were analyzed using STATA 12.0 software.
Results
Selection and meta-analysis samples
The detailed study retrieval steps according to the PRISMA statement was shown in Fig 1. In total, 936 SR/ MA were retrieved from 26 Chinese nursing journals. After reading the title and abstract, 314 studies were excluded. Following total-text review, 150 non-quantitative studies, 106 not-RCTs and 44 non-interventional studies were excluded, and a total of 322 meta-analyses were finally included.
Menses chart of studies pick procedure in this report.
Characteristics of meta-analysis
Tabular array 1 summarizes the characteristics of the included meta-analyses. The included 322 meta-analyses were from 20 of the 26 professional nursing journals in the country, including 15 core journals and five non-core journals. 296 manufactures (91.ix%) were published in cadre journals, and 26 manufactures (viii.1%) were published in non-core journals. Meta-analyses that met the requirements of this study were published after 2004, published in 2010 earlier the number of small and basically the aforementioned, after 2010, the number of published gradually increased5and faster. 83 (25.viii%) of the studies were funded, only just one study was registered; 255 (79.two%) of the studies had ≥3 authors; 133 (41.3%) of the authors were from hospitals, 95 (29.v%) of the authors were from universities, 93 (28.ix%) of the authors were multidisciplinary collaborations between schools and hospitals, and but 1 (0.3%) of the authors was from another institution. Of the included RCTs, the quality of the included RCTs was evaluated for 308 studies, 196 (60.9%) were evaluated using the Cochrane Handbook and 19 (five.9%) using the Jadad scale, and 16 (5%) were evaluated using the JBI standard.
Table 1
Characteristics of the included meta-analysis(n = 322).
| Feature | Core journals(n = 296) | Non-core journals(n = 26) | All(n = 322) |
|---|---|---|---|
| Publish Year | |||
| 2004 | one | 0 | 1 |
| 2005 | 1 | 0 | 1 |
| 2007 | 2 | 0 | 2 |
| 2008 | 1 | 0 | i |
| 2009 | i | i | 2 |
| 2010 | 10 | 0 | 10 |
| 2011 | ix | 0 | ix |
| 2012 | 21 | 3 | 24 |
| 2013 | 27 | one | 28 |
| 2014 | 59 | seven | 66 |
| 2015 | 65 | 14 | 79 |
| 2016 | 86 | 13 | 99 |
| Funding | |||
| Yes | 76 | seven | 83 |
| No | 220 | 19 | 239 |
| Registration | |||
| Yes | 1 | 0 | 1 |
| No | 295 | 26 | 321 |
| Number of authors | |||
| <3 | 56 | 11 | 67 |
| ≥iii | 240 | 15 | 255 |
| Author of the unit of measurement | |||
| Hospital | 116 | 17 | 133 |
| University | 90 | five | 95 |
| Infirmary and University | 90 | 3 | 93 |
| Other | 0 | 1 | 1 |
| Number of Authorities | |||
| <3 | 269 | 26 | 295 |
| ≥3 | 27 | 0 | 27 |
| RCT quality evaluation | |||
| Yeah | 283 | 25 | 308 |
| No | thirteen | i | 14 |
| Quality assessment criteria | All(north = 283) | All(n = 25) | All(north = 308) |
| Cochrane | 182 | 14 | 196 |
| Jadad | 13 | half-dozen | xix |
| JBI | sixteen | 0 | 16 |
| Other | 72 | 5 | 77 |
Retrieval implementation of meta-analysis
Table 2 summarizes the retrieval implementation of the included meta-analyses. In retrieving journals from the databases, the search implementation was ameliorate in cadre journals than non-core journals and this difference was statistically meaning (OR = 1.60, 95%CI: ane.18~2.17, P = 0.002). Amongst them, Pubmed / medline and Cochrane Library database retrieval condition was significantly improved and the differences were statistically significant (Pubmed / Medline: P = 0.006 Cochrane Library: P = 0.006). At that place was no statistically significant difference in other database searches.
Table 2
Retrieval implementation of meta-assay.
| Database | Core journals(n = 197) | Non-core journals(n = 26) | OR(95%CI) | ||
|---|---|---|---|---|---|
| Yes | No | Yes | No | ||
| Pubmed/Medline | 233 | 63 | 14 | 12 | 3.17(1.40,seven.20) |
| Cochrane Library | 157 | 139 | 6 | twenty | 3.76(one.47,ix.64) |
| CENTRAL | 10 | 286 | 1 | 25 | 0.87(0.xi,7.11) |
| EMBASE | 127 | 169 | 6 | 20 | ii.50(0.98,6.42) |
| CINAHL | 16 | 280 | 2 | 24 | 0.69(0.xv,three.16) |
| Web of Scientific discipline | 31 | 265 | 3 | 23 | 0.90(0.25,iii.16) |
| PSYCHINFO | 2 | 294 | 0 | 26 | 0.45(0.02,9.62) |
| EBSCO | 28 | 268 | 0 | 26 | v.63(0.33,94.79) |
| OVID | xxx | 266 | 2 | 24 | one.35(0.30,6.01) |
| BIOSIS | 4 | 292 | 0 | 26 | 0.82(0.04,15.56) |
| CBM | 188 | 108 | 12 | 14 | two.03(0.91,iv.55) |
| WanFang Database | 225 | 71 | 20 | 6 | 0.95(0.37,ii.46) |
| CNKI | 261 | 35 | 24 | 2 | 0.62(0.xiv,2.74) |
| VIP | 194 | 102 | 19 | 7 | 0.70(0.29,1.72) |
Reporting of meta-analysis: Compliance with the JBI guideline
Tabular array 3 summarizes the compliance of the included meta-assay reports with the JBI guidelines. None of the literature fully complied with the JBI guidelines. The overall completeness of the published articles in the core journals was higher than that of those published in the non-core journals and this difference was statistically significant (OR = one.37, 95%CI:one.10~1.seventy, P = 0.005). Among these reports, the completion charge per unit of detail 11, item 19 and item 33 was apparently improved and the difference was statistically significant (item11: P = 0.042; particular 19: P = 0.035; item 33: P = 0.017).
Table iii
Reporting of meta-analysis: Compliance with the JBI guideline.
| Itema | Core journals(northward = 296) | Non-core journals(north = 26) | OR(95%CI) | ||
|---|---|---|---|---|---|
| Yes | No | Yes | No | ||
| one | 147 | 149 | 11 | 15 | i.35(0.60,three.03) |
| 2 | 0 | 296 | 0 | 26 | ▬ |
| 3 | 296 | 0 | 26 | 0 | ▬ |
| iv | 296 | 0 | 26 | 0 | ▬ |
| 5 | 0 | 296 | 0 | 26 | ▬ |
| 6 | 294 | 2 | 26 | 0 | 2.22(0.ten,47.51) |
| vii | 0 | 296 | 0 | 26 | ▬ |
| 1 | 295 | 0 | 26 | 0.27(0.01,6.77) | |
| 0 | 296 | 0 | 26 | ▬ | |
| 0 | 296 | 0 | 26 | ▬ | |
| xiv | 282 | i | 25 | 1.24(0.16,nine.83) | |
| 8 | 0 | 296 | 0 | 26 | ▬ |
| nine | 43 | 253 | seven | nineteen | 0.46(0.xviii,i.xvi) |
| 10 | 0 | 296 | 0 | 26 | ▬ |
| eleven | 73 | 233 | 11 | 15 | 0.43(0.19,0.97) |
| 12 | 1 | 295 | 0 | 26 | 0.27(0.01,6.77) |
| thirteen | 294 | 2 | 26 | 0 | two.22(0.10,47.51) |
| 14 | 294 | 2 | 26 | 0 | two.22(0.10,47.51) |
| fifteen | 0 | 296 | 0 | 26 | ▬ |
| 16 | 296 | 0 | 26 | 0 | ▬ |
| 17 | 0 | 296 | 0 | 26 | ▬ |
| 18 | 196 | 100 | 15 | 11 | 1.44(0.64,iii.25) |
| nineteen | 218 | 78 | 14 | 12 | ii.twoscore(one.06,v.twoscore) |
| 20 | 211 | 85 | 18 | 8 | 1.10(0.46,ii.63) |
| 21 | 277 | nineteen | 24 | two | ane.21(0.27,5.53) |
| 22 | 241 | 55 | 22 | 4 | 0.80(0.26,2.41) |
| 23 | 26 | 270 | 0 | 26 | 5.nineteen(0.31,87.65) |
| 24 | 216 | lxxx | fifteen | 11 | i.98(0.87,4.49) |
| 25 | 1 | 295 | 0 | 26 | 0.27(0.01,half-dozen.77) |
| 26 | 296 | 0 | 26 | 0 | ▬ |
| 27 | 275 | 21 | 22 | 4 | 2.38(0.75,seven.55) |
| 28 | 51 | 245 | 4 | 22 | i.14(0.38,iii.46) |
| 29 | 1 | 295 | 0 | 26 | 0.27(0.01,6.77) |
| thirty | 216 | eighty | 15 | 11 | 1.98(0.87,4.49) |
| 31 | 296 | 0 | 26 | 0 | ▬ |
| 32 | 113 | 183 | eleven | xv | 0.84(0.37,1.90) |
| 33 | 250 | 46 | 17 | nine | ii.88(i.21,vi.85) |
| 34 | 201 | 95 | xiii | xiii | 2.12(0.94,iv.74) |
| 35 | 136 | 160 | eight | 18 | 1.91(0.81,iv.54) |
| 36 | xi | 285 | 0 | 26 | 2.13(0.12,37.25) |
| 37 | 15 | 281 | 0 | 26 | 2.92(0.17,50.xvi) |
| 38 | 296 | 0 | 26 | 0 | ▬ |
| 39 | 0 | 296 | 0 | 26 | ▬ |
| twoscore | 296 | 0 | 26 | 0 | ▬ |
Tabular array 4 summarizes the compliance of the included meta-analysis reports with the JBI guidelines of each item, stratified by published year. Overall, the completeness of the items is non relevant to the year of publication. Of the xl items, seven items (detail 3, detail 4, item 16, item 26, item 31, item 38, detail 40) that were included in the reports were fully compliant with the JBI guidelines. All reports were completely inconsistent in the post-obit items with the JBI guidelines: item 2, item 5, Inclusion criteria、Invention、types of written report in item seven, item eight, item 10, item fifteen, detail 17, item 39.
Table 4
Reporting of meta-analysis: Compliance with the JBI guideline, stratified by published year.
| Year | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Item | 2004 | 2005 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 |
| 1 | 0/aneb | 0/1 | two/2 | 0/ane | 1/two | 4/x | 5/9 | 15/24 | fifteen/28 | 40/66 | 37/79 | 39/99 |
| 2 | 0/1 | 0/i | 0/2 | 0/1 | 0/ii | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 3 | i/ane | 1/1 | 2/two | i/1 | 1/two | ten/10 | ix/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
| iv | 1/1 | 1/1 | 2/2 | 1/i | 1/2 | 10/10 | 9/9 | 24/24 | 28/28 | 65/66 | 78/79 | 99/99 |
| 5 | 0/1 | 0/i | 0/2 | 0/i | 0/2 | 0/x | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 6 | 1/i | one/1 | two/2 | 1/1 | 2/ii | 10/10 | nine/ix | 24/24 | 28/28 | 65/66 | 78/79 | 99/99 |
| 7 | 0/one | 0/1 | 0/two | 0/1 | 0/two | 0/10 | 0/ix | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 0/1 | 0/1 | 0/two | 0/1 | 0/2 | 0/10 | 0/9 | 0/24 | ane/28 | 0/66 | 0/79 | 0/99 | |
| 0/1 | 0/one | 0/two | 0/1 | 0/2 | 0/ten | 0/ix | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 | |
| 0/1 | 0/1 | 0/2 | 0/1 | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 | |
| 0/1 | 0/1 | 1/2 | 0/1 | 0/two | 2/10 | 0/9 | 1/24 | 2/28 | 3/66 | 6/79 | 0/99 | |
| eight | 0/1 | 0/ane | 0/2 | 0/1 | 0/2 | 0/10 | 0/nine | 0/24 | 1/28 | 0/66 | 0/79 | 0/99 |
| 9 | 1/1 | one/i | 0/2 | 0/1 | 0/ii | ane/x | 1/ix | two/24 | 2/28 | 8/66 | 11/79 | 22/99 |
| 10 | 0/1 | 0/1 | 0/2 | 0/ane | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 11 | 0/i | 0/1 | 0/two | 0/1 | 0/2 | 0/x | 0/ix | 0/24 | 0/28 | 0/66 | 1/79 | 83/99 |
| 12 | 0/ane | 0/1 | 0/two | 0/one | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 1/99 |
| 13 | one/1 | 1/i | 2/two | 1/i | 2/two | 10/10 | 9/9 | 24/24 | 28/28 | 65/66 | 78/79 | 99/99 |
| 14 | 1/1 | 1/i | 2/2 | 1/ane | 2/2 | ten/10 | ix/9 | 24/24 | 28/28 | 65/66 | 78/79 | 99/99 |
| fifteen | 0/i | 0/i | 0/two | 0/ane | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| sixteen | 1/1 | 1/one | 2/2 | 1/ane | ii/2 | ten/x | 9/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
| 17 | 0/ane | 0/i | 0/2 | 0/1 | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 18 | 0/1 | 0/ane | 0/2 | 0/1 | i/two | half-dozen/10 | 7/9 | 14/24 | 15/28 | 36/66 | 54/79 | 78/99 |
| nineteen | 0/i | 0/1 | 1/2 | 1/one | 1/2 | 6/10 | 8/9 | 18/24 | 22/28 | 53/66 | seventy/79 | 52/99 |
| twenty | 0/1 | 0/i | 0/2 | 0/1 | 1/ii | viii/10 | 8/nine | 16/24 | 16/28 | 51/66 | threescore/79 | 69/99 |
| 21 | 0/1 | 0/1 | 2/2 | 0/1 | 2/two | 10/10 | 9/9 | 21/24 | 24/28 | 63/66 | 74/79 | 96/99 |
| 22 | 0/1 | 0/1 | 1/ii | ane/one | 2/2 | 6/10 | 8/9 | 19/24 | 21/28 | 48/66 | 67/79 | 90/99 |
| 23 | 0/ane | 0/1 | 0/2 | 0/1 | 0/2 | 2/10 | 0/ix | 3/24 | 2/28 | 1/66 | 9/79 | nine/99 |
| 24 | 1/ane | 1/1 | i/ii | 1/1 | ane/2 | 7/10 | four/9 | 16/24 | xvi/28 | 48/66 | 55/79 | 81/99 |
| 25 | 0/ane | 0/1 | 0/ii | 0/i | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | one/79 | 0/99 |
| 26 | 1/one | one/i | two/2 | ane/1 | two/2 | 10/ten | nine/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
| 27 | ane/1 | i/1 | 1/2 | 1/1 | 1/2 | 9/ten | seven/nine | 21/24 | 27/28 | 60/66 | seventy/79 | 98/99 |
| 28 | 0/1 | 0/ane | 0/2 | 0/1 | 0/2 | 0/10 | 0/9 | ii/24 | 1/28 | viii/66 | 19/79 | 25/99 |
| 29 | 0/i | 0/1 | 0/2 | 0/i | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | one/79 | 0/99 |
| 30 | 1/ane | 1/ane | one/2 | 1/one | 0/2 | 7/10 | 4/9 | 16/24 | 16/28 | 48/66 | 55/79 | 0/99 |
| 31 | 1/1 | 1/1 | 2/2 | i/1 | two/ii | 10/x | 9/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
| 32 | i/one | 0/1 | 1/2 | i/one | 0/2 | 2/10 | 1/9 | 8/24 | 5/28 | 28/66 | 30/79 | 47/99 |
| 33 | 0/1 | 0/i | one/2 | i/1 | 2/ii | 9/ten | vi/9 | 22/24 | 24/28 | 52/66 | 67/79 | 83/99 |
| 34 | ane/ane | ane/1 | 1/2 | 1/1 | 2/ii | 4/10 | 4/9 | 17/24 | 18/28 | 44/66 | 55/79 | 68/99 |
| 35 | 0/1 | 0/ane | 0/2 | ane/1 | 0/two | 0/10 | two/9 | eight/24 | 7/28 | 27/66 | 25/79 | 74/99 |
| 36 | 0/1 | 0/one | 0/2 | 0/i | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 0/66 | 0/79 | xi/99 |
| 37 | 0/ane | 0/one | 0/two | 0/i | 0/2 | 0/10 | 0/9 | 0/24 | 0/28 | 2/66 | two/79 | 11/99 |
| 38 | 1/1 | i/1 | 2/ii | 1/one | two/two | 10/10 | 9/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
| 39 | 0/1 | 0/1 | 0/ii | 0/1 | 0/ii | 0/10 | 0/ix | 0/24 | 0/28 | 0/66 | 0/79 | 0/99 |
| 40 | 1/1 | i/i | 2/2 | ane/1 | 2/2 | ten/10 | ix/9 | 24/24 | 28/28 | 66/66 | 79/79 | 99/99 |
Variables associated with JBI guidelines, stratified by funding status
Overall, there was no meaning divergence in the quality of the reports with or without funding (OR = 1.thirteen, 95%CI: 0.98~i.xxx; P = 0.098), but the reporting completeness of detail 18 was significantly increased in studies that were funded (item 18: OR = one.78, 95%CI: 1.02~3.12, P = 0.043).
Variables associated with JBI guidelines, stratified past author institution status
The overall quality of the JBI written report from studies with multi-agency cooperation (Hospital and University) was higher than those from hospitals solitary and the departure was statistically meaning. The items with statistically significant differences were: item xviii, particular 20, particular 22, item 28, item 32, particular 33, item 34 and item 35. Furthermore, the overall quality of the JBI study in studies from universities was higher than those from hospitals. The items that had statistically meaning differences were: item 18, item 19, Item20, particular 23, item 27, Item28, Item33 and item 35. At that place was no statistically significant difference in other items. (Table 5)
Table 5
Stratified by author institution status.
| OR(95%CI) | P-Value | |
|---|---|---|
| Multi-agency cooperation (Hospital and University) VS Hospital | ||
| Overall | one.59(1.37~one.85) | 0.000 |
| Item18 | i.92(one.09~3.37) | 0.024 |
| Item20 | one.86(1.03~iii.34) | 0.039 |
| Item22 | 2.88(ane.34~six.eighteen) | 0.007 |
| Item28 | 2.82(ane.27~six.27) | 0.011 |
| Item32 | i.98(1.xiv~3.43) | 0.015 |
| Item33 | 2.39(1.thirteen~5.02) | 0.022 |
| Item34 | two.61(1.44~4.73) | 0.002 |
| Item35 | 1.79(1.04~three.07) | 0.035 |
| University VS Hospital | ||
| Overall | ane.68(ane.45~1.95) | 0.000 |
| Item18 | ii.xi(one.twenty~3.72) | 0.010 |
| Item19 | 2.48(one.33~iv.62) | 0.004 |
| Item20 | 2.32(i.27~4.24) | 0.007 |
| Item23 | 3.98(i.37~11.57) | 0.011 |
| Item27 | half dozen.48(i.45~28.91) | 0.014 |
| Item28 | 4.09(i.90~8.77) | 0.000 |
| Item33 | 2.24(1.09~4.62) | 0.029 |
| Item35 | 1.82(ane.07~3.eleven) | 0.028 |
Variables associated with JBI guidelines, stratified by the number of authors
Overall, the JBI report quality was superior when ≥3 authors were involved, compared to when in that location were <3 authors and this divergence was statistically pregnant. The completion rate of item 1, item 22, item 34 increased and the difference was statistically significant when ≥3 authors were involved.(Table vi)
Tabular array 6
Stratified by the number of authors.
| OR(95%CI) | P-Value | |
|---|---|---|
| ≥3 authors VS <3 authors | ||
| Overall | 1.74(ane.50~2.03) | 0.000 |
| Item9 | 4.70(i.41~15.sixty) | 0.012 |
| Item20 | 1.78(1.01~3.13) | 0.046 |
| Item28 | viii.53(2.02~35.96) | 0.004 |
| Item34 | 2.52(ane.45~4.37) | 0.001 |
Variables associated with JBI guidelines, stratified by the number of author units
Overall, the JBI written report quality was greater when ≥ii author units were involved, compared to when <2 author units were involved and this departure was statistically significant (OR = 1.27, 95%CI: 1.11~1.46, P = 0.001). Multi-unit cooperation led to a significant increase in the reporting completeness of item 22 and 34, with a statistically significant difference (particular 22: OR = ii.27, 95%CI: i.x~iv.71, P = 0.027; particular 34: OR = 2.12, 95%CI: 1.21~3.68, P = 0.008).
In summary, the quality of meta-analyses published in cadre journals was improve than that of non-core journals. The implementation of literature searches was ameliorate in the core journals than the non-core journals. The nature of the authors also affects the quality of the article. Overall quality of the JBI report from studies with multi-bureau cooperation (Hospital and University) was college than those from hospitals alone. Furthermore, the overall quality of the JBI report from studies with universities was superior to those from hospitals. The presence or absence of funding had no significant touch on the quality of the meta-analysis reports. When the number of authors was ≥three, the quality of the meta-analyses was better than when the number of authors <3, and multi-unit cooperation (≥2) was amend than a single unit.
Discussion
RCT-based meta-analyses published in Chinese nursing journals were retrieved from a diverseness of sources. Since 2010, there has been a rapid increase in the number of research articles. Ninety-ix meta-analyses based on RCT were published in 2016, bookkeeping for 30.7% of the total. From the number of authors and the writer'southward unit, more and more studies tended towards multi-institutional and multi-disciplinary cooperation. This trend is conducive to diversification and sustainable development.
The overall quality of the reports based on the JBI guideline in the literature was poor, and none of the studies were fully compliant with the JBI guidelines. However, the quality of articles published in core journals was significantly college than those in non-core journals, which indicates that the efforts of domestic core journals in understanding and implementing SR / MA are worthy of recognition, only likewise have a lot of room for improvement. Multidisciplinary collaboration and multi-researcher have significantly improved the quality of meta-analyses, which has implications for future enquiry and encourages multi-disciplinary collaboration to ameliorate research quality.
The quality of the 322 included meta-analyses was variable. The major problems were: 1) the inclusion of multiple items in the abstract that did not meet the JBI guidelines (item 5, inclusion criteria, invention and types of study in item 7, x, 12, 15), which may be related to the Chinese journals and their abstract requirements. There was a pregnant lack of registration number information. The registration of systematic reviews can reduce the risk of too many systematic reviews of the same topic[vii,8], just also improve the transparency and brownie of any updates. 2) In the text, 91.9% of the studies did not written report a complete search strategy, and the development of a reasonable and detailed search strategy can amend the recall rate and precision of the literature to ensure that the quality of the systematic evaluation, but also that the search results can be reproduced. 82.9% of the studies did not provide a PRISMA flow chart; 3) In the word section, simply 38.5% of the studies described in detail the implications of the findings for future studies; only 0.62% of the studies accost conflicts of interest, and potential stakeholder interest could bear upon research design, implementation, and positive reporting of outcomes. Ignoring conflicts of interest may exaggerate the interpretation of the results, with unpredictable consequences[9,10].
In improver, the included meta-analyses also had sure positive merits: ane) 71.vii% of the studies described in detail the methodological quality of the manufactures and improved the reliability of the results; two) 66.5% of the studies reported the significance of inquiry to clinical practice.
Multidisciplinary collaboration significantly improved the quality of meta-analysis reporting. The number of reports with ≥ 3 authors was significantly higher than those with <3 authors, which was in accordance with the minimum number of participants in the systematic review. The quality of the JBI report from studies with multi-agency cooperation (Hospital and University) was college than those from hospitals alone and the difference was statistically significant. Furthermore, the overall quality of the JBI written report in studies from universities was higher than those from hospitals. This may be related to the nature of the work of the authors, the degree of emphasis on scientific enquiry, the direction of the research, but also shows that multi-agency, cross-professional cooperation is a electric current and futurity enquiry tendency.
Limitations of this study
ane) The inclusion and screening of the literature is strongly subjective, and we still cannot completely dominion out missing and false detection; 2) Although the quality evaluation of this study was carried out by two independent assessors and the evaluators were trained and pre-evaluated before the evaluation, the influence of subjective factors cannot exist eliminated and may impact the objectivity of the evaluation.
Conclusions
Evaluation of 322 RCT-based meta-analyses in the domestic nursing field showed that overall reporting quality was poor based on the JBI guidelines. There were 34 of twoscore items with varying degrees of missing data. In recent years, the number of meta-analyses has been increasing rapidly. In order to provide loftier-quality evidence back up for clinicians and decision-makers, according to the shortcomings found in this study, future studies should have: ane) Strict compliance with the JBI guidelines for report writing, peculiarly the blueprint of the methodology should strictly abide past the relevant requirements of the JBI items to improve the force of prove; 2) Fellows engaged in SR / MA trained in epidemiology, statistics, and figurer science to improve the ability of researchers to bear prove-based inquiry, to control potential biases and to ensure reproducible and reliable results. 3) An increase in the number of multi-unit co-authors to ameliorate the quality of the study. 4) Improving the quality of original studies, which greatly influence the quality of the evidence from the SR / MA.
Supporting information
S1 Tabular array
PRISMA 2009 checklist.
(Physician)
Funding Argument
The authors received no specific funding for this work.
Data Availability
All relevant data are within the newspaper and its Supporting Information files.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441595/
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