title: Systematic reviews addressing microsurgical head and neck reconstruction.
abstract: BACKGROUND
  Systematic reviews frequently form the basis for clinical decision making and guideline development. Yet, the quality of systematic reviews has been variable, thus raising concerns about the validity of their conclusions. In the current study, a quality analysis of systematic reviews was performed, addressing microsurgical head and neck reconstruction.
  
  
  METHODS
  A PubMed search was performed to identify all systematic reviews published up to and including December 2012 in 12 surgical journals. Two authors independently reviewed the literature and extracted data from the included reviews. Discrepancies were resolved by consensus. Quality assessment was performed using AMSTAR.
  
  
  RESULTS
  The initial search retrieved 1020 articles. After screening titles and abstracts, 987 articles were excluded. Full-text review of the remaining 33 articles resulted in further exclusion of 18 articles, leaving 15 systematic reviews for final analysis. A marked increase in the number of published systematic reviews over time was noted (P = 0.07). The median AMSTAR score was 5, thus reflecting a "fair" quality. No evidence for improvement in methodological quality over time was noted.
  
  
  CONCLUSIONS
  The trend to publish more systematic reviews in microsurgical head and neck reconstruction is encouraging. However, efforts are indicated to improve the methodological quality of systematic reviews. Familiarity with criteria of methodological quality is critical to ensure future improvements in the quality of systematic reviews conducted in microsurgery.
authors.affiliation: From the *Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California; and †Albert Einstein College of Medicine, New York, New York.
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.forename: Joshua Y
authors.initials: JY
authors.lastname: Jacobson
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
mesh_terms: D006257:Head / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D009333:Neck / Q000601:surgery*; D011643:Publishing / Q000592:standards*; D058996:Quality Improvement; D019651:Plastic Surgery Procedures; D012196:Review Literature as Topic