Dr Carlos Chacon — The Importance of a Systematic Review in Plastic...

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The Importance of a Systematic Review in Plastic Surgery

Systematic reviews are essential for assessing the quality of research in a specific area. They use rigorous scientific methods and minimize research bias by considering all the studies.

Planning involves defining robust pre-specified protocols and a PICO approach (population, intervention, comparison, and outcomes). It also requires a careful selection of studies.

Systematic reviews (SR) and meta-analyses are the most rigorous method of aggregating evidence. However, their quality could be improved by the reliability of primary studies and the method used to pool data.

To assess the overall quality of SRs published in three prominent plastic surgery journals between July 2019 and July 2020, we critically appraised their reporting standards using A Measurement Tool to Assess Systematic Reviews (AMSTAR). We also investigated factors that influence the underlying methodology of these reports.

There must be a more significant gap between the quality of SRs in plastic surgery and other surgical specialities. Better education, awareness among all stakeholders and enforcement through journal submission systems could help to improve this.

Systematic reviews (SRs) address the shortcomings of traditional reviews by utilizing rigorous, reproducible methods and recommended guidelines. They are designed to eliminate sources of bias and ensure as complete a review of the existing literature as possible.

SRs are essential for clinical practice and ensuring that surgeons are informed about current standards of care and new technologies. However, their reliability and applicability can be undermined if they are not performed and reported correctly.

Therefore, this systematic review was conducted using the PRISMA guidelines. Articles were retrieved from the MEDLINE, EMBASE and Scopus databases using appropriate search terms and included only those studies that met the inclusion criteria.

The primary objective was to evaluate the quality of reporting in RCTs published in the Journal of Plastic Surgery. Fifty-seven articles were assessed for compliance with the CONSORT reporting guideline. The median score was 11.5 out of 23 items. The most common items where compliance was the poorest were intervention/comparator details, randomization implementation and blinding.

Despite the increasing importance of patient safety in all health research, only some studies about this subject consider the specificities of plastic surgery patients. These include the fact that they are generally female, healthy, and young.

The authors, therefore, conducted a systematic review in the Journal of Plastic Surgery to identify actions related to patient safety in this speciality. The literature was searched using MEDLINE and SCIELO databases between 2012-2018, totalling 15 articles.

The results showed that most SRs in this domain could be better formulated. They often employ spin, a form of reporting bias in which the results of studies are presented as overstating the efficacy or understating the harms of interventions. This is often a cause for concern, as it can result in clinical recommendations not being justified by the evidence.

A systematic review is a literature research method that collates and analyses empirical evidence to answer a specific research question. This type of review is also known as a meta-analysis.

The methodology used for a systematic review can be complex and requires careful planning to justify the conclusions reached. Systematic reviews typically address a structured research question and follow strict criteria to minimize bias.

The authors of the study evaluated a total of 1820 articles that met the inclusion criteria. Most studies included were in aesthetic and breast surgery (27%) or craniofacial surgery (23%).