Table 6Strengths and Limitations of Systematic Reviews and Meta-Analyses using AMSTAR 213

StrengthsLimitations
Wyman-Chick, 201618
  • Research questions/inclusion criteria for the review included the components of PICO
  • Multiple databases searched, keywords provided for the literature search, specific journals searched, and reference lists of included studies searched
  • Data selection performed in duplicate
  • Included studies described in adequate detail
  • Methods for statistical combination of results described
  • Hedge’s correction for small sample size bias calculated before descriptive analyses conducted.
  • Review authors reported no conflicts of interest
  • It is unclear whether review methods were established prior to the conduct of the review
  • Did not explain their selection of the study designs for inclusion in the review
  • It is not clear if data extraction was performed in duplicate
  • Reasons for excluding studies not provided and there were no accompanying list of excluded studies
  • Did not conduct ROB assessment (i.e., Cochrane ROB tool for RCTs) with included studies
  • Sources of funding not reported for the included studies
  • Did not describe how different study designs (i.e., RCTs versus non-randomized designs) would be weighed or accounted for in meta-analysis
  • Heterogeneity discussed but limited details; did not state how the heterogeneity present may affect the results
  • Review authors did not assess the potential impact of ROB in individual studies on the results of the meta-analysis; excluding studies due to high risk of bias was not described
Xie, 2016a20
  • Research questions/inclusion criteria for the review included the components of PICO
  • Multiple databases searched, select keywords provided for the literature search, and reference lists of included studies searched
  • Data extraction performed in duplicate
  • Included studies described in adequate detail
  • Cochrane ROB (for RCTs) and MINORS (for non-randomized studies) used to assess ROB of included studies
  • Appropriate methods for statistical combination of results used
  • Sensitivity analysis conducted
  • Heterogeneity discussed for results with I2 ≥ 50% or p < 0.05
  • Begg’s test and funnel plots used to evaluate publication bias; evidence of publication bias was discussed.
  • Review authors reported no conflicts of interest
  • It is unclear whether review methods were established prior to the conduct of the review
  • Did not explain their selection of the study designs for inclusion in the review
  • Details on publication restrictions not provided
  • The literature search did not include trial registries or grey literature
  • It is unclear if study selection was performed in duplicate
  • Reasons for excluding studies not provided and there were no accompanying list of excluded studies
  • Sources of funding not reported for the included studies Review authors did not assess the potential impact of ROB in individual studies on the results of the meta-analysis; excluding studies due to high ROB was not described
Xie, 2016b19
  • Research questions/inclusion criteria for the review included the components of PICO
  • Multiple databases searched, select keywords provided for the literature search, and reference lists of included studies searched
  • Data selection performed in duplicate
  • Included studies described in detail
  • Cochrane ROB used to assess ROB of RCTs
  • Methods for statistical combination of results used adequately described
    Review authors reported no conflicts of interest
  • No predefined protocol about the process and objective of this review
  • Did not explain their selection of the study designs for inclusion in the review
  • Details on publication restrictions not provided
  • It is not clear if data extraction was performed in duplicate
  • The literature search did not include trial registries or grey literature
  • Reasons for excluding studies not provided and there were no accompanying list of excluded studies
  • Sources of funding not reported for the included studies
  • Heterogeneity discussed but limited details; did not state how the heterogeneity present may affect the results
  • Review authors did not assess the potential impact of ROB in individual studies on the results of the meta-analysis; excluding studies due to high ROB was not described Small study bias mentioned but limited details

MINORS = methodological index for nonrandomized studies; PICO = population, intervention, comparator, outcome; RCT = randomized controlled trial; ROB = risk of bias

From: Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Cover of Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines
Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet].
Lachance C, Spry C, MacDougall D.
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