Compliance with QUOROM and quality of reporting of overlapping meta-analyses on the role of acetylcysteine in the prevention of contrast associated nephropathy: case study

doi:10.1136/bmj.38693.516782.7C

BMJ 2006;332:202-209 (28 January), doi:10.1136/bmj.38693.516782.7C (published 16 January 2006)

Research

Compliance with QUOROM and quality of reporting of overlapping meta-analyses on the role of acetylcysteine in the prevention of contrast associated nephropathy: case study

Giuseppe G L Biondi-Zoccai, interventionist, PhD student¹^,2, Marzia Lotrionte, cardiologist³, Antonio Abbate, internal medicine resident⁴, Luca Testa, cardiology fellow³, Enrico Remigi, postdoctoral fellow⁵, Francesco Burzotta, assistant professor³, Marco Valgimigli, PhD student⁶, Enrico Romagnoli, interventionist⁷, Filippo Crea, director³, Pierfrancesco Agostoni, research fellow⁸

¹ Hemodynamics and Cardiovascular Radiology Service, Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy, ² Institute of Medical Statistics and Biometrics, University of Milan, Milan, Italy, ³ Institute of Cardiology, Catholic University, Rome, Italy, ⁴ Department of Medicine, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA, USA, ⁵ School of Engineering, University of KwaZulu-Natal, Durban, South Africa, ⁶ Thorax Center, Erasmus University Medical Center, Rotterdam, the Netherlands, ⁷ Department of Cardiology, Catholic University Hospital, Campobasso, Italy, ⁸ AZ Middelheim Hospital, Antwerp, Belgium

Correspondence to: G G L Biondi-Zoccai gbiondizoccai{at}gmail.com

Abstract

Objective To appraise multiple systematic reviews on the sameclinical topic, focusing on predictors and correlates of qualityof reporting of meta-analysis (QUOROM) scores.

Design Case study.

Setting Reviews providing at least individual quantitative estimateson role of acetylcysteine in the prevention of contrast associatednephropathy.

Data sources PubMed, the database of abstracts of reviews ofeffects, and the Cochrane database of systematic reviews (updatedMarch 2005).

Main outcome measures Funding, compliance with the QUOROM checklist,scores on the Oxman and Guyatt quality index, and authors' recommendations.

Results 10 systematic reviews, published August 2003 to March2005, were included. Nine pooled events despite heterogeneityand five recommended routine use of acetylcysteine, whereasthe remaining studies called for further research. Compliancewith the 18 items on the QUOROM checklist was relatively high(median 16, range 11 to 17), although shorter manuscripts hadsignificantly lower scores (R = 0.73; P = 0.016). Reviewerswho reported previous not for profit funding were more likelyto score higher on the Oxman and Guyatt quality index. No associationwas found between QUOROM and Oxman and Guyatt scores (R = -0.06;P = 0.86), mainly because of greater emphasis of the Oxman andGuyatt scores on the appraisal of bias in selection and validityassessment (inadequate in five reviews).

Conclusions Multiple systematic reviews on the same clinicaltopic varied in quality of reporting and recommendations. Longermanuscripts and previous not for profit funding were associatedwith higher quality.

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