Multiple evaluation of radar plot on acupuncture for lumbar disc herniation: a systematic review/meta-analysis

doi:10.3969/j.issn.2095-4344.2740

Abstract

Abstract:

BACKGROUND: At present, there are few reports on systematic evaluation/meta reevaluation of acupuncture for lumbar disc herniation through radar plot in and outside China, which are insufficient to provide references for clinical decision-making.

OBJECTIVE: To evaluate systematic reviews/meta-analysis of acupuncture in the treatment of lumbar disc herniation qualitatively and quantitatively by using the multiple evaluation thinking of radar plot so as to provide visual and scientific decision-making means for clinical practice and medical research.

METHODS: Computer retrieval was performed in eight Chinese and English databases to collect data of systematic reviews/meta-analysis of acupuncture in the treatment of lumbar disc herniation. The retrieval time was from database establishment to August 2019. Moreover, the multiple evaluations were carried out from six dimensions, including publiscation year, research type, A Measurement Tool to Assess systematic Reviews (AMSTAR) 2 methodological quality score, Preferred Reporting Items for Systematic Reviews and Meta-Analys is (PRISMA) quality score, homogeneous, and publication bias risk so as to calculate average rank score. The quality of all included outcome indicators was graded using GRADE evidence quality assessment tools. Excel 2013 was used to draw and optimize the radar plot for intuitive analysis.

RESULTS AND CONCLUSION: A total of 11 qualified studies were included. According to data extraction, the radar plot showed that the included 11 articles scored 6.95 in the quality of the average rank. Some issues were found such as item registration, structured abstract, search strategy, exclusion literature list, and publication bias. Grading of recommendations assessment, development and evaluation (GRADE) evidence quality scores are low, with very low quality as the main reason. The literature quality of systematic reviews/meta-analysis of acupuncture in the treatment of lumbar disc herniation was not high. The methodological quality and reporting quality should be improved and continuously strengthened in order to further improve the quality of literature. As a visual and effective method of graphic evaluation, the radar plot can show the distribution of required data intuitively and concisely.

Key words: acupuncture, lumbar disc herniation, systematic review, meta-analysis, radar plot

CLC Number:

Qiu Mingwang, Fang Wanyi, Song Jiaying, Huang Fan, Zhao Siyi, Wen Junmao, Tian Qiang, Fan Zhiyong, Guo Rusong, Wu Shan. Multiple evaluation of radar plot on acupuncture for lumbar disc herniation: a systematic review/meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(24): 3904-3910.

Figures/Tables 5

2.3 雷达图多元评价条目 2.3.1 发表年份一项临床问题的研究文献越新，涵盖范围和时间跨度更大，对临床指导意义越强。鉴于此次研究纳入11篇系统评价/Meta分析文献，故将2018年发表文献秩数定为11，针刺治疗腰椎间盘突出症的系统评价/Meta分析文献出版时间较新最早为2008年，包含1篇[30]；最晚为2018年，包含2篇[8，31]；期间2012年[27，33]、2015年各纳入2篇[26，32]，2013年[25]、2014年[29]、2016年[34]、2017年各纳入1篇[28]。 2.3.2 研究类型随机对照试验(RCT)是评价某项治疗有效性的最高级别的临床证据[35]。通过此次研究发现，有6篇文献仅纳入随机对照试验(RCT)[8，25，27，31-32，34]，同时也有5篇文献不同程度地纳入了半随机对照试验(CCT)[26，28-30，33]，进而增加了偏倚风险的概率。 2.3.3 AMSTAR 2评价结果 AMSTAR 2方法学评分量表共11项条目。11篇文献的分值区间为6-9分。其中评价为6分的有3篇[8，32，34]，7分的有5篇[25，27，30-31，33]，8分的有2篇[26，29]，9分的有1篇[28]。导致大多数文章均没有得分的有以下几项：①所有文献均无前期设计方案[8，25-34]；②8篇文献没有说明是否考虑了如灰色文献、语言等发表情况[8，25-27，31-34]；③10篇文献均只提供了纳入文献的基本信息及来源[8，25-26，28-34]，未提供排除研究的文献清单，这对文献质量的判断有一定的不利；④4篇均未交代发表偏倚的可能性[8，25，,27，30]；⑤3篇文章均没有说明相关利益的冲突和研究中潜在的资助来源[27，29-30]。 2.3.4 PRISMA评价结果 PRISMA报告学评分量表共有27项条目。此次研究中，11篇纳入文献的分值区间为17.5-22分[8，25-34]。其中评价为17.5分的有1篇[34]，19分的有2篇[32-33]，19.5分的有2篇[26，28]，20分的有3篇[25，29-30]，21.5分的有1篇[8]，22分的有2篇[27，31]。影响大多数文献在PRISMA报告学评分量表中得分较少的项目有：①所有文献摘要均未完整地提供背景、资料来源、局限性等信息[8，25-34]；②所有纳入的文献方法中均未提供获得研究方案的途径和注册号[8，25-34]；③9篇文献没有描述检索所有文献的信息来源[25-27，29-34]；④10篇文献检索策略完整性不够[8，25-26，28-34]，未举例说明至少一个资料库的详细检索流程，甚至没有检索策略。 2.3.5 同质性同质性所纳入的11篇研究中[8，25-34]，所有纳入的文献同质性均偏高。 2.3.6 发表偏倚此次研究纳入文献有4篇没有进行发表偏倚研究[8，25，27，30]，其余均采用倒置的漏斗图进行发表偏倚报道的说明。纳入文献的6个维度多元评价及秩数情况，见表2。 "

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