Use of quality assessment tools in systematic reviews was varied and inconsistent

Seehra, Jadbinder; Pandis, Nikolaos; Koletsi, Despina; Fleming, Padhraig S (2016). Use of quality assessment tools in systematic reviews was varied and inconsistent. Journal of clinical epidemiology, 69, pp. 179-184. Elsevier 10.1016/j.jclinepi.2015.06.023

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OBJECTIVES To assess the use of quality assessment tools among a cross-section of systematic reviews (SRs) and to further evaluate whether quality was used as a parameter in the decision to include primary studies within subsequent meta-analysis. STUDY DESIGN AND SETTING We searched PubMed for SRs (interventional, observational, and diagnostic) published in Core Clinical Journals between January 1 and March 31, 2014. RESULTS Three hundred nine SRs were identified. Quality assessment was undertaken in 222 (71.8%) with isolated use of the Cochrane risk of bias tool (26.1%, n = 58) and the Newcastle-Ottawa Scale (15.3%, n = 34) most common. A threshold level of primary study quality for subsequent meta-analysis was used in 12.9% (40 of 309) of reviews. Overall, fifty-four combinations of quality assessment tools were identified with a similar preponderance of tools used among observational and interventional reviews. Multiple tools were used in 11.7% (n = 36) of SRs overall. CONCLUSION We found that quality assessment tools were used in a majority of SRs; however, a threshold level of quality for meta-analysis was stipulated in just 12.9% (n = 40). This cross-sectional analysis provides further evidence of the need for more active or intuitive editorial processes to enhance the reporting of SRs.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics

UniBE Contributor:

Pandis, Nikolaos


600 Technology > 610 Medicine & health








Eveline Carmen Schuler

Date Deposited:

26 Apr 2016 14:54

Last Modified:

26 Jun 2016 02:13

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Meta-Analysis, Quality assessment, Review, Risk of bias, Systematic, Threshold




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