Evaluating the role of quality assessment of primary studies in systematic reviews of cancer practice guidelines

被引:33
作者
Brouwers M.C. [1 ,2 ]
Johnston M.E. [1 ,2 ]
Charette M.L. [1 ,2 ]
Hanna S.E. [1 ]
Jadad A.R. [3 ]
Browman G.P. [1 ,2 ,4 ]
机构
[1] Dept. Clin. Epidemiol. Biostatist., McMaster University, Hamilton, Ont.
[2] Program in Evidence-based Care, Cancer Care Ontario, Hamilton, Ont.
[3] University of Toronto, University Health Network, Toronto, Ont.
[4] Hamilton Regional Cancer Centre, Hamilton, Ont.
关键词
Study Quality; Guideline Development; High Quality Study; High Quality Trial; Study Quality Assessment;
D O I
10.1186/1471-2288-5-8
中图分类号
学科分类号
摘要
Background: The purpose of this study was to evaluate the role of study quality assessment of primary studies in cancer practice guidelines. Methods: Reliable and valid study quality assessment scales were sought and applied to published reports of trials included in systematic reviews of cancer guidelines. Sensitivity analyses were performed to evaluate the relationship between quality scores and pooled odds ratios (OR) for mortality and need for blood transfusion. Results: Results found that that whether trials were classified as high or low quality depended on the scale used to assess them. Although the results of the sensitivity analyses found some variation in the ORs observed, the confidence intervals (CIs) of the pooled effects from each of the analyses of high quality trials overlapped with the CI of the pooled odds of all trials. Quality score was not predictive of pooled ORs studied here. Conclusions: Had sensitivity analyses based on study quality been conducted prospectively, it is highly unlikely that different conclusions would have been found or that different clinical recommendations would have emerged in the guidelines. © 2005 Brouwers et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 35 条
[11]  
Emerson J.D., Burdick E., Hoaglin D.C., Mosteller F., Chalmers T.C., An empirical study of the possible relation of treatment differences to quality scores in controlled randomized clinical trials, Control Clin Trials, 11, pp. 339-352, (1990)
[12]  
Verhagen A.P., De Vet H.C., Vermeer F., Widdershoven J.W.M.G., De Bie R.A., Kessels A.G.H., Boers M., Van Den Brandt P.A., The influence of methodologic quality on the conclusion of a landmark metaanalysis on thrombolytic therapy, Int J Technol Assess Health Care, 18, 1, pp. 11-23, (2002)
[13]  
Balk E.M., Bonis P.A.L., Moskowitz H., Schmid C.H., Ioannidis J.P.A., Wang C., Lau J., Correlation of quality measures with estimates of treatment effect in meta-analyses of randomized controlled trials, JAMA, 287, 22, pp. 2973-2982, (2002)
[14]  
Verhagen A.P., De Vet H.C., De Bie R.A., Lenssen A.F., Kessels A.G., Boers M., Van Den Brandt P., Impact of Quality Items on Study Outcome: Treatments in Acute Lateral Ankle Sprains. Conference Proceedings of the First Symposium on Systematic Reviews: Beyond the Basics, (1998)
[15]  
Juni P., Witschi A., Bloch R., Egger M., The hazards of scoring the quality of clinical trials for meta-analysis, JAMA, 282, 11, pp. 1054-1060, (1999)
[16]  
Browman G.P., Levine M.N., Mohide E.A., Hayward R.S., Pritchard K.I., Gafni A., Laupacis A., The practice guidelines development cycle: A conceptual tool for practice guidelines development and implementation, J Clin Oncol, 13, pp. 502-512, (1995)
[17]  
Browman G.P., Newman T.E., Mohide E.A., Graham I., Levine M.N., Cowan D.H., Progress of Clinical Oncology Guidelines Development Using the Practice Guidelines Development Cycle: The Role of Practitioner Feedback, J Clin Oncol, 16, 3, pp. 1226-1231, (1998)
[18]  
Browman G., Brouwers M., De Vito C., Johnston M., Graham I., Participation Patterns of Oncologists in the Development of Clinical Practice Guidelines, Curr Oncol, 7, 4, pp. 252-257, (2000)
[19]  
Pater J.L., Browman G.P., Brouwers M.C., Nefsky M.F., Evans W.K., Cowan D.H., Funding New Cancer Drugs in Ontario: Closing the loop in the Practice Guidelines Development Cycle, J Clin Oncol, 19, 14, pp. 3392-3396, (2001)
[20]  
Browman G.P., Development and aftercare of clinical guidelines: The balance between rigor and pragmatism, JAMA, 286, pp. 1509-1511, (2001)