| خلاصه مقاله | The validity of systematic reviews to answer clinical questions: Introduction of AMSTAR 2, PRISMA, and GRADE systems
Aim: The aim of this presentation is to introduce AMSTAR 2, PRISMA, and GRADE systems to critically appraise systematic reviews.
Summary: Rapid outbreak of biomedical research publications makes it difficult for a clinician to find a definitive answer for his/her clinical questions simply by reviewing the available published studies which have sometimes contradictory results. Systematic reviews/meta-analyses, at the top of the level of evidence pyramid, are considered the best available ways to answer clinical questions; however, surge in publication of systematic reviews in recent years has revealed their potential shortcomings which influence their validity to answer our clinical questions. These shortcomings of systematic reviews can be classified into following three categories: 1) weakness in conducting the review; 2) weakness in reporting; 3) quality of the evidence that the review provides. To find out whether a given systematic review reliably answers a specific clinical question, these three aspects of the review should be assessed.
Recently, some systems/approaches have been introduced to critically appraise published systematic reviews and show that to what extent we can rely on a given systematic review to find answer for a clinical question. Here, we introduce three simple and practical systems that lack intricacies of other similar systems. We will discuss AMSTAR 2 tool (2017) for assessment of review conduction and PRISMA checklist for qualification of review report, and finally, GRADE system (2011) for evaluation of quality of evidence that the review provides.
Key learning points:
• Published systematic reviews may have weaknesses that potentially reduce their validity to answer clinical questions.
• AMSTAR 2 is a simple practical tool to assess the 16 methodological domains related to the necessary steps to be taken when performing a systematic review.
• PRISMA checklist is a useful tool for critical appraisal of systematic reviews regarding the minimum set of items required for reporting in a systematic review.
• GRADE is a systematic approach for rating the certainty of evidence in a systematic review. |