| Objective:?1?To evaluate the reporting quality of the systematic reviews and meta-analyses of nursing interventions in patients with Alzheimer's disease and to explore the factors of the reporting quality of the systematic reviews and meta-analyses of nursing interventions in patients with Alzheimer's disease;?2?To evaluate the methodological quality of the systematic reviews/meta-analyses of nursing interventions in patients with Alzheimer's disease and to explore the factors of the methodological quality of the systematic reviews and meta-analyses of nursing interventions in patients with Alzheimer's disease;?3?Taking this study as an example,it can provide references for health workers and health policy makers to evaluate and apply evidence-based evidence correctly,so as to promote the research process of systematic reviews and meta-analyses to be more scientific and rigorous,the reporting form to be more scientific and standardized,and produce more high-quality systematic reviews/meta-analyses to guide medical and health practice.Methods:?1?PubMed,Embase and The Cochrane Library databases were retrieved from inception to October 16th,2018,to collect systematic reviews/meta-analyses of nursing interventions in patients with Alzheimer's disease.The language was limited to English;?2?According to inclusion exclusion criteria,two researchers independently screened literature and extracted data.The main contents of extraction included:publication time,inclusion type,origin of the first author,number of authors,international cooperation,number of authors,number of units of the first author,type of journal,number of inclusion studies,whether the original research was RCT?randomized control trial?,whether the articles followed the PRISMA statement,whether the article is registered,whether the journal to which the article belongs is Science Citation Index?SCI?,whether the article comes from Cochrane Library,the impact factor?IF?of the journal to which the article belongs,the number of citations of the article,the number of pages of the article,and whether the article has financial support;?3?Reporting and methodological quality were assessed by PRISMA statement and AMSTAR checklist respectively.The basic situation was described with frequency and composition ratio;?4?Descriptive statistics are presented as the calculation rate,composition ratio,ratio ratio?OR?and its 95%confidence interval?CI?for categorical variables,and as mean±SD for continuous variables with normal distribution.Differences in categorical variables were explored using the?2 test or Fisher exact test.The independent Student's t test was used to compare mean qualities between dichotomous factors,and one-way analysis of variance?ANOVA?was used for multifactor variables using the StudentNewman-Keuls post hoc test.After controlling the confounding factors,covariance analysis factors were conducted to identify factors of affecting PRISMA score and AMSTAR score.After dividing PRISMA score and AMSTAR score into high-quality and low-quality groups,Logistic regression analysis was conducted to identify affecting study qualities factors.Results:1.Search Results:A total of 2413 articles were identified in initial search,whilst hand searching captured an additional 20 articles for potential inclusion.After removing duplicate articles,reviewing titles and abstracts,reviewing the full-text,there are a total of 77 articles to be included in this research finally.2.The results of reporting quality of systematic reviews and meta-analyses of nursing interventions for Alzheimer's patients:?1?The mean overall reporting quality score was 19.96±4.26,accounting for 74.0%of the full score;?2?The top five items with high reporting rate are:item 6?inclusion criteria,100.0%?,item 14?synthesis of results,100.0%?,item 4?purpose,97.4%?,item 7?information sources,97.4%?and item 2?structural summary,96.1%?;?3?The top five items with low reporting rate are:item15?risk of bias across studies,23.4%?,item 22?risk of bias across studies,23.4%?,item 5?protocol and registration,28.6%?,item 13?summary measures,46.8%?and item 21?synthesis of results,46.8%?;?4?The results showed that there was an improvement in the following items after the PRISMA statement was released,which was significant difference:title?item 1,50.0%vs74.6%,OR=3.10,95%CI:1.00-9.61?,search?item8,27.8%vs 57.6%,OR=3.25,95%CI:1.14-9.28?,study selection?item 9,44.4%vs 81.4%,OR=6.28,95%CI:1.93-20.37?,Data collection process?item10,50.0%vs 76.3%,OR=3.45,95%CI:1.10-10.84?,risk of bias in individual studies?item 12,50.0%vs 83.1%,OR=5.78,95%CI:1.71-19.52?,risk of bias across studies?item15,5.6%vs 28.8%,OR=3.60,95%CI:1.04-12.43?,study characteristics?item 18,77.8%vs 98.3%,OR=28.13,95%CI:3.35-236.19?,risk of bias with studies?item 19,50.0%vs 83.1%,OR=5.78,95%CI:1.71-19.52?,results in individual studies?item 20,72.2%vs 94.9%,OR=11.09,95%CI:1.99-61.82?,conclusions?item 26,77.8%vs 98.3%,OR=28.13,95%CI:3.35-236.19?;?5?The results of covariance analysis showed that there were significant differences in PRISMA scores among the following factors?P<0.05?:PRISMA scores increased by1.57 scores after the publication of PRISMAstatement,PRISMA scores of the article with meta-analyses for systematic reviews increased by 2.80 scores compared with that of the article with only systematic reviews,PRISMA scores with the number of studies??10?in the article were 1.72 scores lower than PRISMA scores with the number of studies?<10?in the article,PRISMA scores with unclear RCT type in the original study were 2.12scores lower than that without RCT in the original study,PRISMA scores with registered articles were 3.20 scores higher than that without registered articles,PRISMA scores of published journals with SCI journals were 2.88 scores higher than that of non-SCI journals,PRISMA scores with the number of pages>13 were 1.94 scores higher than that with the number of pages?13,and PRISMA scores of articles with financial support were2.50 scores higher than that of articles without financial support;?6?Logistic regression analysis showed that the reporting quality of meta-analyses with systematic reviews was significantly higher than that of only systematic reviews?OR=16.96,95%CI:2.49-115.52,P<0.01?,the reporting quality of registered article was higher than that of unregistered literature?OR=13.34,95%CI:2.61-68.30,P<0.01?,and the reporting quality with financial support was also significantly improved?OR=6.45,95%CI:1.31-31.80,P=0.02?.3.The results of methodological quality of systematic reviews and meta-analyses of nursing interventions for Alzheimer's patients:?1?The mean overall methodological quality score was 6.74±2.38,accounting for61.0%of the full score;?2?The top three items with high reporting rate are:item 9?appropriate methods used to combine studies,96.1%?,item 6?characteristics of included studies provided,93.5%?and item 5?list of studies provided,88.3%?;?3?The top three items with low reporting rate are:item 4?status of publication used as inclusion criteria,20.8%?,item 1?a priori study design stated,27.3%?and item 10?likelihood of publication bias assessed,24.7%?;?4?The results showed that there was an improvement in the following items after the PRISMA statement was released,which was significant difference:list of studies provided?item5,58.3%vs 93.8%,OR=29.84,95%CI:4.44-200.34?,scientific quality of included studies provided?item7,41.7%vs 84.6%,OR=11.75,95%CI:2.69-51.37?,conflict of interest stated?item 11,33.3%vs 75.4%,OR=6.92,95%CI:1.85-25.93?;?5?AMSTAR score had significant difference among the following factors?P<0.05?:AMSTAR scores increased by 1.53 scores after AMSTAR were published,AMSTAR scores increased by 1.20 scores compared with the AMSTAR scores of systematic reviews with meta-analyses,AMSTAR scores with the number of studies??10?in the article were 1.08 scores lower than AMSTAR scores with the number of studies?<10?in the article,AMSTAR scores of registered articles were 1.62 scores higher than that of unregistered articles,AMSTAR scores of published journals were 2.07 scores higher than that of non-SCI journals,AMSTAR scores with the number of pages>13 were 0.93 scores higher than that with the number of pages?13,and AMSTAR scores of articles with financial support were 1.15 scores higher than that of articles without financial support;?6?Logistic regression analysis showed that the methodological quality of systematic reviews and meta-analyses was significantly higher than that of only systematic reviews?OR=62.24,95%CI:3.78-1024.37,P<0.01?,the methodological quality of author number>4 was higher?OR=8.88,95%CI:1.25-63.06,P=0.03?,the methodological quality of study number??10?was worse?OR=0.04,95%CI:0.00-0.43,P=0.01?,and the methodological quality of registered article was higher than that of unregistered article?OR=30.60,95%CI:3.61-259.08,P<0.01?.4.The results of correlation analysis showed that there was a significant positive correlation between PRISMA score and AMSTAR score?r=0.88,P<0.01?.Conclusion:The quality of systematic reviews/meta-analyses of nursing interventions for patients with Alzheimer's disease is ideal.Further improvements are needed in the evaluation of inter-study bias,the report of research programs and prior registration,the generalization of effect indicators and the description of synthetic results.The quality of methodology is still acceptable,and further improvement is needed in the provision and publication of early design schemes,the embodiment of inclusion criteria and the evaluation of publication bias.Systematic reviews combined with meta-analysis registered,and the quality of documentary reports supported by funds has been significantly improved.Systematic reviews combined with meta-analysis,the number of authors>4,the number of included studies<10,and the quality of documentary methodologies registered has also been significantly improved.Health workers and health policy makers should evaluate the quality of evidence-based medical evidence.Researchers,peer review experts and journal editors should strictly abide by and rationally apply the PRISMA statement and AMSTAR scale when making,reviewing and reviewing systematic reviews/meta-analyses,so as to further improve the quality of research reports and methodologies,and make the results of research truly and scientifically serve medical and health practice. |
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