Compliance with QUOROM and quality of reporting of overlapping meta-analyses on the role of acetylcysteine in the prevention of contrast associated nephropathy: case studyBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.38693.516782.7C (Published 26 January 2006) Cite this as: BMJ 2006;332:202
- Birck R, Krzossovk S, Markowetz F, Schulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003;362:598-603.
- Isenbarger DW, Kent SM, O’Malley PG. Meta-analysis of randomized clinical trials on the usefulness of acetylcysteine for prevention of contrast nephropathy. Am J Cardiol 2003;92:1454-8.
- Alonso A, Lau J, Jaber BL, Weintraub A, Sarnak MJ. Prevention of radiocontrast nephropathy with N-acetylcysteine in patients with chronic kidney disease: a meta-analysis of randomized, controlled trials. Am J Kidney Dis 2004;43:1-9.
- Kshirsagar AV, Poole C, Mottl A, Shoham D, Franceschini N, Tudor G, et al. N-acetylcysteine for the prevention of radiocontrast induced nephropathy: a meta-analysis of prospective controlled trials. J Am Soc Nephrol 2004;15:761-9.
- Pannu N, Manns B, Lee H, Tonelli M. Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int 2004:65:1366-74.
- Guru V, Fremes SE. The role of N-acetylcysteine in preventing radiographic contrast-induced nephropathy. Clin Nephrol 2004;62:77-83.
- Bagshaw SM, Ghali WA. Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: a systematic review and meta-analysis. BMC Med 2004;2:38.
- Misra D, Leibowittz K, Gowda RM, Shapiro M, Khan IA. Role of N-acetylcysteine in prevention of contrast-induced nephropathy after cardiovascular procedures: a meta-analysis. Clin Cardiol 2004;27:607-10.
- Nallamothu BK, Shojania KG, Saint S, Hofer TP, Humes HD, Moscucci M, et al. Is acetylcysteine effective in preventing contrast-related nephropathy? A meta-analysis. Am J Med 2004;117:938-47.
- Duong MH, MacKenzie TA, Malenka DJ. N-acetylcysteine prophylaxis significantly reduces the risk of radiocontrast-induced nephropathy: comprehensive meta-analysis. Catheter Cardiovasc Interv 2005;64:471-9.
The Oxman and Guyatt index of the scientific quality of research reviews was designed to evaluate the internal validity of a review.2 Scoring is based on 9 separate questions for which 3 distinct answers are eligible ("yes", "partially/can’t tell", "no"):
1. Where the search methods used to find evidence stated?
2. Was the search for evidence reasonably comprehensive?
3. Were the criteria for deciding which studies to include in the overview reported?
4. Was bias in the selection of studies avoided?
5. Were the criteria used for assessing the validity of the included studies reported?
6. Was the validity of all studies referred to in the text assessed using appropriate criteria?
7. Were the methods used to combine the findings of the relevant studies reported?
8. Were the findings of the relevant studies combined appropriately relative to the primary question the overview addresses?
9. Were the conclusions made by the author(s) supported by the data and/or analysis reported in the overview?
Question 10 summarizes the previous ones and, specifically, asks to rate the scientific quality of the review from 1 (being extensively flawed) to 3 (carrying major flaws) to 5 (carrying minor flaws) to 7 (minimally flawed). The developers of the index specify that if the "partially/can’t tell" answer is used one or more times in questions 2, 4, 6, or 8, a review is likely to have minor flaws at best and is difficult to rule out major flaws (ie a score≤4). If the "no" option is used on question 2, 4, 6 or 8, the review is likely to have major flaws (ie a score≤3).
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