Qualidade das revisões sistemáticas de síndrome do túnel do carpo: overview
Data
2022-12-05
Autores
Cavalcante, Marcelo Cortês 
Orientadores
Belloti, João Carlos
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A Síndrome do Túnel do Carpo (STC) é uma condição muito comum que impacta na qualidade de vida e no trabalho. As revisões sistemáticas (RS) são úteis para decisões sobre tratamento e orientam a maioria das decisões de saúde. Entretanto, RS nem sempre é sinônimo de boa qualidade. Objetivo: avaliar a qualidade metodológica das RS sobre o tratamento da STC. Método: Pesquisamos no Medical Literature Analysis and Retrieval System Online (MEDLINE) e na Cochrane Library por RS que incluíam o tratamento da STC em adultos. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e A Measurement Tool to Assess systematic Reviews (AMSTAR-2) foram aplicados por dois examinadores independentes. Resultados: Foram incluídos 55 estudos. Considerando a estratificação dentro do AMSTAR-2, foi verificado que mais de 76% dos estudos analisados foram classificados como de qualidade “baixa” ou “muito baixa”. Os escores das ferramentas são maiores quando meta-análise está presente (PRISMA 15,61 versus 10,40; P = 0,008; AMSTAR-2 8,43 versus 5,59; P = 0,009) ou quando incluíram somente Ensaios Clínicos Randomizados (ECR) (AMSTAR-2 7,95 versus 6,06; P = 0,043). A correlação intraobservador demonstrou concordância perfeita (> 0,8), Spearman: 0,829; correlação intra-classe, CIC: 0,857. A correlação interobservador indicou que o AMSTAR-2 é mais confiável que o PRISMA (Blant Altman, AMSTAR-2 -0,04; PRISMA -1,33; P = 0,001). Conclusão: As RS sobre o tratamento da STC são de baixa qualidade. Revisões de melhor qualidade conduziram meta-análises e incluíram somente ECR. A ferramenta AMSTAR-2 apresenta melhor capacidade psicométrica que PRISMA e deve ser preconizada em estudos futuros.
Introduction: Carpal Tunnel Syndrome (CTS) is a very common condition that impacts quality of life and work. Systematic reviews (SR) are useful for treatment decisions and guide most health decisions. However, SR is not always synonymous of good quality. Objective: This study aims to assess the methodological quality of published systematic reviews on CTS treatment. Method: We searched MEDLINE and the Cochrane Library for systematic reviews that included the treatment of CTS in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) tools were applied by two independent examiners. Results: Fifty-five studies were included. Considering the stratification within the AMSTAR-2 measurement tool, we found that more than 76% of the analyzed studies were “low” or “very low”. Scores are higher when meta-analysis is present (PRISMA 15.61 versus 10.40; P = 0.008; AMSTAR-2 8.43 versus 5.59; P = 0.009) or when only Randomized Controlled Trials (RCT) are included (AMSTAR-2 7.95 versus 6.06; P = 0.043). The intra-observer correlation demonstrated perfect agreement (> 0.8), Spearman: 0.829; intraclass correlation coefficient, ICC: 0.857. The inter-observer correlation indicated that AMSTAR-2 is more reliable than PRISMA (Blant Altman, AMSTAR-2 -0,04; PRISMA -1,33; P = 0,001). Conclusion: Systematic reviews on the treatment of Carpal Tunnel Syndrome are of poor quality. Better quality reviews conducted meta-analysis and included randomized controlled trials only. AMSTAR-2 has better psychometric capacity than PRISMA and should be recommended in future studies.
Introduction: Carpal Tunnel Syndrome (CTS) is a very common condition that impacts quality of life and work. Systematic reviews (SR) are useful for treatment decisions and guide most health decisions. However, SR is not always synonymous of good quality. Objective: This study aims to assess the methodological quality of published systematic reviews on CTS treatment. Method: We searched MEDLINE and the Cochrane Library for systematic reviews that included the treatment of CTS in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) tools were applied by two independent examiners. Results: Fifty-five studies were included. Considering the stratification within the AMSTAR-2 measurement tool, we found that more than 76% of the analyzed studies were “low” or “very low”. Scores are higher when meta-analysis is present (PRISMA 15.61 versus 10.40; P = 0.008; AMSTAR-2 8.43 versus 5.59; P = 0.009) or when only Randomized Controlled Trials (RCT) are included (AMSTAR-2 7.95 versus 6.06; P = 0.043). The intra-observer correlation demonstrated perfect agreement (> 0.8), Spearman: 0.829; intraclass correlation coefficient, ICC: 0.857. The inter-observer correlation indicated that AMSTAR-2 is more reliable than PRISMA (Blant Altman, AMSTAR-2 -0,04; PRISMA -1,33; P = 0,001). Conclusion: Systematic reviews on the treatment of Carpal Tunnel Syndrome are of poor quality. Better quality reviews conducted meta-analysis and included randomized controlled trials only. AMSTAR-2 has better psychometric capacity than PRISMA and should be recommended in future studies.
Descrição
Citação
CAVALCANTE, Marcelo Cortês. Qualidade das revisões sistemáticas de síndrome do túnel do carpo: overview. 2022. 87 f. Dissertação (Mestrado em Cirurgia Translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2022.