Harms Reporting Is Inadequate in Systematic Reviews Regarding Hip Arthroscopy.

Purpose: To investigate the quality of harms reporting in systematic reviews (SRs) regarding hip arthroscopy in the current literature. Methods: In May 2022, an extensive search of 4 major databases was performed identifying SRs regarding hip arthroscopy: MEDLINE (PubMed and Ovid), EMBASE, Epistemonikos, and Cochrane Database of Systematic Reviews. A cross-sectional analysis was conducted, in which investigators performed screening and data extraction of the included studies in a masked, duplicate fashion. AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2) was used to assess the methodologic quality and bias of the included studies. The corrected covered area was calculated for SR dyads. Results: A total of 82 SRs were included in our study for data extraction. Of these SRs, 37 reported under 50% of the harms criteria (37 of 82, 45.1%) and 9 did not report harms at all (9 of 82, 10.9%). A significant relation was found between completeness of harms reporting and overall AMSTAR appraisal (P = .0261), as well as whether a harm was listed as a primary or secondary outcome (P = .0001). Eight SR dyads had corrected covered areas of 50% or greater and were compared for shared harms reported. Conclusions: In this study, we found inadequate harms reporting in most SRs concerning hip arthroscopy. Clinical Relevance: With the magnitude of hip arthroscopic procedures being performed, adequate reporting of harms-related information in the research surrounding this treatment is essential in assessing the efficacy of the treatment. This study provides data in relation to harms reporting in SRs regarding hip arthroscopy.

Harms Reporting in Systematic Reviews of the Microvascular Free Flap in Head and Neck Reconstruction.

OBJECTIVE: To evaluate harms reporting in systematic reviews (SRs) of microvascular free flap (MFF) in head and neck reconstruction. DATA SOURCES: This cross-sectional analysis included searches from the following major databases from 2012 to June 1, 2022: MEDLINE (Pubmed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews. REVIEW METHODS: In a masked duplicate manner, screening was performed using Rayyan, and data were extracted using a pilot-tested Google form. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of reviews and the corrected covered area was calculated to detect primary study overlap across all reviews. Reviews were then grouped in pairs of 2, called dyads, and the corrected covered area was calculated again for each individual dyad. Dyads with high overlap (≥50%) were further investigated for the accuracy of harms reporting. RESULTS: Our initial search yielded 268 records, with 50 SRs meeting the inclusion criteria. A total of 46 (92%) of the included reviews demonstrated 50% or more adherence to the items assessed in our harms checklist. Our corrected covered area tool revealed 0.6% primary study overlap across all reviews, and 1 dyad with high overlap (≥50%). No statistically significant relationship was observed between the completeness of harms reporting and reviews listing harms as a primary outcome, reviews reporting adherence to Preferred Reporting Items of Systematic Reviews and Meta-Analyses, or a review's AMSTAR rating. CONCLUSION: This study identifies how harms reporting in SRs of MFF reconstruction of the head and neck can be improved and provides suggestions with the potential to mitigate the paucity in current literature.

Assessing the Reporting of Harms in Systematic Reviews Focused on the Therapeutic and Cosmetic Uses of Botulinum Toxin.

BACKGROUND AND OBJECTIVE: The expanding use of botulinum toxin (BoNT) in medical practice demonstrates the need to highlight whether there is adequate information regarding its safety profile. The aim of our study was to identify completeness of harms reporting for BoNT treatment within systematic reviews (SRs), assess quality of SRs using the AMSTAR-2 tool, and determine the degree of overlap among primary studies within each SR. METHODS: On May 31, 2022, we searched Embase, Epistemonikos, MEDLINE, and the Cochrane Database of Systematic Reviews for SRs on BoNT therapy. Screening and data extraction were performed in a masked, duplicate fashion. AMSTAR-2 was used to evaluate the methodological quality of included SRs. Corrected covered area (CCA) was calculated for SR dyads. RESULTS: Of the 90 included SRs, we found that 70 completed less than 50% of harms items. The most reported items were BoNT as a favorable intervention (73/90, 81.1%) and harms as a primary outcome (72/90, 80.0%). The least reported items were grades and severity scales used to classify harms (8/90, 8.9%) and number of treatment discontinuations in each arm (10/90, 11.1%). Eighty-three SRs were rated "critically low" (83/90, 92.2%), while 5 SRs were rated "high" (5/90, 5.6%) via AMSTAR-2 tool. Significant associations were found between completion of harms reporting and: (1) a "critically low" appraisal on AMSTAR-2 tool (p = 0.0060) and (2) whether harms was reported as a primary outcome (p = 0.0001). The total CCA overlap was determined to be 0.8%. CONCLUSION: Our results demonstrate that harms are underreported within BoNT SRs. Because healthcare professionals often refer to SRs to guide clinical decision making, it is important to continue to explore shortcomings among BoNT literature in future studies.

Assessing the Reporting and Frequency of Harms in Systematic Reviews Focused on Minimally Invasive Hysterectomies: A Cross-sectional Analysis.

OBJECTIVE: To assess the quality of harms reporting in systematic reviews (SRs) regarding minimally invasive hysterectomies (MIHs). DATA SOURCES: We performed a cross-sectional analysis on SRs addressing MIHs to assess completeness of harms reporting. Hysterectomies are common gynecologic procedures and are associated with complications. Such adverse events can directly affect physician decision making and patient outcomes. Thus, it is important that SRs equally weigh the harms and benefits surrounding MIHs. METHODS OF STUDY SELECTION: On May 15, 2022, we searched MEDLINE (PubMed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews for SRs with or without a meta-analysis on MIH for any indication. Eligible studies underwent full-text screening, data extraction, harms reporting assessment, and A Measurement Tool to Assess Systematic Reviews-2 quality assessment in a masked, duplicate fashion. The corrected covered area was calculated to indicate any overlap between SR dyads. TABULATION, INTEGRATION, AND RESULTS: A total of 52 SRs met the inclusion criteria for data extraction. We found that >44 of included SRs (of 52; 84.6%) reported >50% of the harms items. Completeness of harms reporting was significantly associated with harms specification as a primary outcome (p <.05). The corrected covered area was 0.60%. CONCLUSION: The harms reporting was more complete than hypothesized, but still had deficiencies throughout, such as inconsistent use of severity scales to classify harms. Even though MIH harms reporting in sample SRs was more complete than other fields of medicine, it was still suboptimal overall and requires refinement.

An analysis of harms reporting in systematic reviews regarding ketorolac for management of perioperative pain.

BACKGROUND: Owing to the frequent perioperative use of ketorolac tromethamine and its ability to minimise postoperative opioid requirements, it is important to continually reassess harms associated with its use. Our primary objective was to investigate the extent of harms reporting in systematic reviews (SRs) on ketorolac for perioperative pain. METHODS: In May 2022, we conducted a search of major databases, MEDLINE (PubMed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews to identify eligible SRs on ketorolac for perioperative pain. Screening and data extraction were performed in masked, duplicate fashion. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of included SRs. Corrected covered area (CCA) was calculated to determine overlap of primary studies between SR dyads. RESULTS: A total of 28 SRs evaluating 630 primary studies met the inclusion criteria. Seven SRs (7/28, 25%) reported no harms and 17 SRs (17/28, 60.7%) reported ≤50% of harms items. A significant association was found between completeness of harms reporting and whether harms were specified as a primary outcome (P<0.001). No other associations were statistically significant. Regarding methodological quality, 22 SRs were appraised as 'critically low' (22/28, 78.6%), 5 as 'low' (5/28, 17.9%), and 1 as 'high' (1/28, 3.6%). One SR dyad had a CCA >50% but neither reported harms. CONCLUSIONS: The extent of harms reporting in systematic reviews was inadequate. Given the importance that systematic reviews have on guiding perioperative decision-making, it is essential to improve the completeness of harms reporting.

Nurse Mentors Guide Medical Assistants Up the Clinical Ladder.

Health systems adopting a medical assistant clinical ladder program would do well to invest in program leaders. Nurse mentors tasked with leading advancement programs should formally advance their own coaching and mentoring skills. The following literature remarks describe potentially better practices for nurses who develop adult learners along advancement pathways. The proposed practice considerations may guide program leaders in equipping nurse leaders with basic mentorship fundamentals. The recommendations may be adapted to any health system's complex adaptive network.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses on breast cancer treatment, screening, and quality of life outcomes: A cross-sectional study.

BACKGROUND: While spin - i.e., a reporting practice that embellishes positive findings and understates negative ones - is prevalent in randomized controlled trials, it has yet to be investigated in the context of systematic reviews. Owing to their significant role in clinical decision making and patient outcomes, this study seeks to identify and evaluate the severity of spin in the abstracts of systematic reviews on breast cancer. METHODS: We searched MEDLINE and Embase for systematic reviews and meta-analyses focused on breast cancer treatment, screening, and post-treatment quality of life between 1987 and 2020. Investigators independently screened for study selection, extracted spin data, and appraised the methodological quality of reviews using AMSTAR 2. In this cross-sectional study, 11,717 articles were identified, of which 581 met inclusion criteria. Following randomization, the first 200 were evaluated and 21 % contained evidence of at least one of nine types of spin. RESULTS: We identified spin types one, three, four, five, and six but not two, seven, eight, or nine. In particular, pharmacological (AOR 4.36, 95 % CI [1.18-16.01]) and surgical (AOR, 10.10 95 % CI [1.60-63.68]) intervention-type studies were highly associated with spin. There were no other associations between study characteristics and spin. While these results are significant, they contain a wide confidence interval and the reader should draw conclusions accordingly. CONCLUSIONS: There is evidence of spin in meta-analyses and systematic reviews regarding breast cancer treatment and quality of life outcomes. Accordingly, readers of systematic review abstracts related to breast cancer could be misled by distorted presentation of findings. POLICY SUMMARY: This study aims to improve the standards of reporting in systematic reviews and meta-analyses related to cancer.