This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by T-L. Choi, P. Articles by Walder, B. Search for Related Content PubMed PubMed Citation Articles by T-L. Choi, P. Articles by Walder, B. Related Collections Economics and Health Care Research

---

ECONOMICS AND HEALTH SYSTEMS RESEARCH

Examining the Evidence in Anesthesia Literature: A Critical Appraisal of Systematic Reviews

Peter T-L. Choi, MD, FRCPC^*, Stephen H. Halpern, MD, FRCPC, Nariman Malik, BSc, Alejandro R. Jadad, MD, DPhil, FRCPC^§, Martin R. Tramèr, MD, DPhil^||, and Bernhard Walder, MD^||

Departments of Anaesthesia* and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; the Departments of Anesthesia and Health Administration, and the University Health Network§, University of Toronto, Toronto, Canada; and the Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland||

Address correspondence and reprint requests to Peter T-L Choi, MD, Department of Anaesthesia, McMaster University, 1200 Main Street West, Room HSC-2 U7, Hamilton, Ontario, Canada, L8N 3Z5. Address email to choip{at}mcmaster.ca

Systematic reviews are structured reviews that use scientific strategies to reduce bias in the collection, appraisal, and interpretation of relevant studies. We undertook a systematic review of published systematic reviews in perioperative medicine to summarize the areas currently covered by this type of literature, to evaluate the quality of systematic reviews in this field, and to assess some of the methodologic and reporting issues that are unique to systematic reviews. Computerized bibliographic databases, citation review, and hand searches were performed to identify eligible articles. Quality was assessed using the Overview Quality Assessment Questionnaire. Eight-two systematic reviews were found. Reviews in perioperative medicine tended to evaluate prophylactic or therapeutic interventions. No differences were seen in quality between reviews published in anesthesia and nonanesthesia journals. Nearly half of all systematic reviews had only minor or minimal flaws; however, methods can be improved with expanded search strategies, use of least two reviewers to assess each study, use of validated methods to evaluate quality, and assessment of potential sources of bias.

Implications: The quality of systematic reviews relating to perioperative medicine was examined systematically and found to be similar in quality to those in other specialties. Adoption of recently published criteria on writing and methods could further improve this type of literature.

This article has been cited by other articles:

				C. Minelli, J. R. Thompson, K. R. Abrams, A. Thakkinstian, and J. Attia The Quality of Meta-Analyses of Genetic Association Studies: A Review With Recommendations Am. J. Epidemiol., December 1, 2009; 170(11): 1333 - 1343. [Abstract] [Full Text] [PDF]

				D. Moher, A. Liberati, J. Tetzlaff, D. G. Altman, and and the PRISMA Group Reprint--Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement Physical Therapy, September 1, 2009; 89(9): 873 - 880. [Abstract] [Full Text] [PDF]

				D. Moher, A. Liberati, J. Tetzlaff, D. G. Altman, and the PRISMA Group Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement Ann Intern Med, August 18, 2009; 151(4): 264 - 269. [Full Text] [PDF]

				D. Moher, A. Liberati, J. Tetzlaff, D. G Altman, and for the PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement BMJ, July 21, 2009; 339(jul21_1): b2535 - b2535. [Full Text]

				Z.-Z. Feng, J. Shi, X.-W. Zhao, and Z.-F. Xu Meta-analysis of on-pump and off-pump coronary arterial revascularization. Ann. Thorac. Surg., March 1, 2009; 87(3): 757 - 765. [Abstract] [Full Text] [PDF]

				A. Macario, F. Dexter, J. Sypal, N. Cosgriff, and B. T. Heniford Operative Time and Other Outcomes of the Electrothermal Bipolar Vessel Sealing System (LigaSureTM) Versus Other Methods for Surgical Hemostasis: A Meta-Analysis Surgical Innovation, December 1, 2008; 15(4): 284 - 291. [Abstract] [PDF]

				M. Mrkobrada, H. Thiessen-Philbrook, R. B. Haynes, A. V. Iansavichus, F. Rehman, and A. X. Garg Need for Quality Improvement in Renal Systematic Reviews Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1102 - 1114. [Abstract] [Full Text] [PDF]

				A. X. Garg, D. Hackam, and M. Tonelli Systematic Review and Meta-analysis: When One Study Is Just not Enough Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 253 - 260. [Full Text] [PDF]

				N. Boluyt, J. H. van der Lee, V. A. Moyer, P. L. P. Brand, and M. Offringa State of the Evidence on Acute Asthma Management in Children: A Critical Appraisal of Systematic Reviews Pediatrics, December 1, 2007; 120(6): 1334 - 1343. [Abstract] [Full Text] [PDF]

				O. Mangoush, S. Purkayastha, S. Haj-Yahia, J. Kinross, M. Hayward, F. Bartolozzi, A. Darzi, and T. Athanasiou Heparin-bonded circuits versus nonheparin-bonded circuits: an evaluation of their effect on clinical outcomes Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1058 - 1069. [Abstract] [Full Text] [PDF]

				J. Lauritsen and A. M. Moller Publications in Anesthesia Journals: Quality and Clinical Relevance Anesth. Analg., November 1, 2004; 99(5): 1486 - 1491. [Abstract] [Full Text] [PDF]

				E. von Elm, G. Poglia, B. Walder, and M. R. Tramer Different Patterns of Duplicate Publication: An Analysis of Articles Used in Systematic Reviews JAMA, February 25, 2004; 291(8): 974 - 980. [Abstract] [Full Text] [PDF]

				T. Pedersen, A. M. Moller, and J. Cracknell The Mission of the Cochrane Anesthesia Review Group: Preparing and Disseminating Systematic Reviews of the Effect of Health Care in Anesthesiology Anesth. Analg., October 1, 2002; 95(4): 1012 - 1018. [Abstract] [Full Text] [PDF]