Systematic reviews and meta-analyses in spine surgery, neurosurgery and orthopedics: guidelines for the surgeon scientist.
The research evidence in the realm of surgery is expanding at a rapid pace, and thus corresponds with an increasing need to critically appraise and synthesize the available literature. Particularly in fields such as spine surgery, neurosurgery and orthopedics which traditionally have little Class I randomized clinical data, reviews are important to pool the available evidence on clinical questions which are otherwise difficult to answer. Whilst systematic reviews and meta-analyses have the potential to provide critical and updated surgical evidence to guide clinical decisions, poorly performed analyses and misinterpretation of such reviews may have a detrimental effect on patient care and outcomes. We present a summary of the critical steps in performing a systematic review and meta-analysis, allowing the surgeon scientist to better interpret and perform their own systematic reviews and meta-analyses.
The NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.
Kevin
K
Phan
The NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.
Ralph J
RJ
Mobbs
Systematic review; academic surgery; clinical outcomes; evidence; forest plot; heterogeneity; meta-analysis; spine; surgery
Cochrane Database Syst Rev. 2007 Apr 18;(2):MR000001
17443625
Spine (Phila Pa 1976). 2009 Aug 15;34(18):1929-41
19680101
BMJ. 2008 Apr 26;336(7650):924-6
18436948
JAMA. 2013 Jun 5;309(21):2217-8
23736731
BMJ. 2003 Nov 8;327(7423):1083-4
14604930
Int J Clin Pract. 2009 Oct;63(10):1426-34
19769699
Ann Cardiothorac Surg. 2015 Mar;4(2):112-22
25870806
BMJ. 1994 Nov 19;309(6965):1351-5
7866085
Br J Neurosurg. 2015;29(5):705-11
25968330
J Clin Epidemiol. 2003 Sep;56(9):833-42
14505767
Control Clin Trials. 2000 Oct;21(5):476-87
11018564
BMJ. 1998 Jan 10;316(7125):140-4
9462324
J Clin Neurosci. 2015 Nov;22(11):1714-21
26190218
Eur Spine J. 2015 May;24(5):1017-30
25813010
Biometrics. 2000 Jun;56(2):455-63
10877304
J Public Health (Oxf). 2011 Mar;33(1):147-50
21345890
BMC Med Res Methodol. 2008 Nov 27;8:79
19036172
BMJ. 2003 Apr 5;326(7392):756-8
12676848
Ann Intern Med. 1992 Jan 1;116(1):78-84
1530753
Lancet. 1999 Nov 27;354(9193):1896-900
10584742
BMJ. 2008 Mar 29;336(7646):722
18369230
JAMA. 1996 Aug 28;276(8):637-9
8773637
N Engl J Med. 2008 Feb 21;358(8):794-810
18287602
Can J Surg. 2010 Aug;53(4):278-81
20646403
Clin J Am Soc Nephrol. 2008 Jan;3(1):253-60
18178786
BMJ. 1997 Dec 13;315(7122):1610-4
9437284
Int J Technol Assess Health Care. 1995 Fall;11(4):770-8
8567209
Br J Math Stat Psychol. 2009 Feb;62(Pt 1):97-128
18001516
Lancet. 1991 Apr 13;337(8746):867-72
1672966
Spine (Phila Pa 1976). 2015 May 15;40(10):E587-92
25955094
BMJ. 1997 Sep 13;315(7109):629-34
9310563
BMJ. 2001 Jun 16;322(7300):1479-80
11408310
Spine (Phila Pa 1976). 2008 Jan 1;33(1):90-4
18165753
BMJ. 2011 Oct 18;343:d5928
22008217
Syst Rev. 2012 Feb 09;1:2
22587842
Ann Intern Med. 1997 Mar 1;126(5):376-80
9054282
JAMA. 1994 Nov 2;272(17):1367-71
7933399
JAMA. 1990 Mar 9;263(10):1405-8
2304220
Control Clin Trials. 1995 Feb;16(1):62-73
7743790
Spine (Phila Pa 1976). 2003 Jun 15;28(12):1290-9
12811274
Lancet. 1998 Jan 10;351(9096):123-7
9439507