title: A Systematic Quality Evaluation of Meta-Analyses Related to Plastic Surgery.
abstract: BACKGROUND
  Meta-analyses are considered to be an important source of evidence. This review aims to systematically assess the quality of meta-analyses addressing topics in plastic surgery.
  
  
  METHODS
  Electronic databases were selected for systematic review. A search was performed focusing on communication addresses containing terms related to plastic surgery, and detailed inclusion criteria were used. Related data were extracted and recorded according to the items of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. To assess the quality of the meta-analyses over time, studies published before and after PRISMA were evaluated.
  
  
  RESULTS
  A total of 116 meta-analyses were included. There was 1 study that was fully in compliance with the PRISMA items. The main flaws impacting the overall quality of the included studies were in the following areas: structured summary (48%), protocol and registration (2%), full electronic search strategy (35%), risk of bias in individual studies (41%), additional analyses (27%), risk of bias within studies (47%), additional analysis (30%), and funding (47%). Study quality was evaluated using relative risks (RR) with a 95% confidence interval (95% CI); this revealed that there were few significant improvements in adherence to the PRISMA statement after its release, especially in selection (RR, 1.80; 95% CI, 1.08-2.99), results of individual studies (RR, 2.88; 95% CI, 1.41-5.91), synthesis of results (RR, 3.08; 95% CI, 1.32-7.17), and funding (RR, 1.65; 95% CI, 1.21-2.24).
  
  
  CONCLUSIONS
  There have been measurable improvements in the quality of meta-analyses over recent years. However, several serious deficiencies remain according to the PRISMA statement. Future reviewers should pay more attention to not only reporting the main findings but also encouraging compliance with proper standards.
authors.affiliation: From the *Division of Plastic Surgery, Peking Union Medical College Hospital, and †Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Nanze
authors.initials: N
authors.lastname: Yu
authors.forename: Panxi
authors.initials: P
authors.lastname: Yu
authors.forename: Xiao
authors.initials: X
authors.lastname: Long
authors.forename: Jiuzuo
authors.initials: J
authors.lastname: Huang
authors.forename: Yihong
authors.initials: Y
authors.lastname: Jia
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Wang
mesh_terms: D006801:Humans; D015201:Meta-Analysis as Topic; D019651:Plastic Surgery Procedures; D012107:Research Design / Q000592:standards* / Q000639:trends