ObjectiveTo understand the current status of research methods in disease burden systematic reviews, identify limitations and shortcomings of existing research methods, and provide suggestions to address relevant issues. MethodsA computer search of the PubMed database was conducted to collect systematic reviews on disease burden, with search limits set from database inception to December 21, 2023. Two independent researchers utilized Endnote 20 for literature screening and Excel 2019 for data extraction and descriptive analysis. ResultsA total of 216 articles were included in the review, revealing a year-on-year increase in the number of systematic reviews on disease burden since 2004. The journal PharmacoEconomics published the most articles (n=22), while research on certain infectious diseases and parasitic infections was the most prevalent (n=51). Only 31 articles provided a complete account of the entire systematic review process. The reporting rates for inclusion/exclusion criteria, information retrieval, literature screening, and statistical analysis steps were all 100%. However, the rate of protocol registration was relatively low at 19%. Eighty-eight percent of the articles utilized software such as Excel and Epidata for data extraction, yet only 32% adhered to the reproducibility principles outlined in AMSTAR-2. In terms of quality assessment, 105 articles underwent evaluation, with the Joanna Briggs Institute checklist and Newcastle-Ottawa scale being the most commonly used quality assessment tools for epidemiological studies, while economic studies preferred the Drummond checklist (n=9). Regarding the details of inclusion/exclusion criteria, only 53% of studies reported their study design in detail, and less than one-sixth provided a comprehensive description of the interventions and control measures. Statistical analyses predominantly employed qualitative methods (80%), with quantitative analyses comprising a minority (20%), all of which were conducted using meta-analysis techniques, primarily utilizing R software (n=15). ConclusionThe number of systematic reviews on disease burden has shown a yearly increasing trend; however, most studies have failed to comprehensively adhere to the fundamental processes of systematic reviews, significantly limiting their quality. Currently, the primary issues include a lack of protocol registration, incomplete supplementary searches, mismatched quality assessment tools, and insufficiently comprehensive outcome measures. To address these challenges, it is essential to develop a methodological guideline for systematic reviews on disease burden that incorporates these concerns. Such a guideline would standardize researchers' practices and ensure strict adherence to systematic review methodologies, thereby enhancing the scientific rigor of the research and its support for clinical decision-making.
Objective To assess the methodological quality of systematic reviews/ meta-analysis of burden of illness, analyses the factors affecting it, so as to provide a reference basis for improving the methodological quality of related studies. Methods Systematic reviews/ meta-analysis of burden of illness were identified in PubMed, searching from its inception to 12 October 2024. Systematic reviews/ meta-analysis of burden of illness was included, the methodological quality of the included literature was evaluated using AMSTAR-2, and data were extracted using Excel 2021. Results A total of 308 systematic reviews/ meta-analysis were included, with a fluctuating upward trend in the number of publications from 2006 to 2024; of these, a total of 12 were rated as low quality. According to the AMSTAR-2 entries, the largest number of documents fully conformed to entry 16 (82.14%), followed by entry 5 (81.49%), and entry 8 (72.73%); one document conformed to entry 10 (0.32%), and relatively few conformed to entry 12 (68.83%), entry 13 (85.39%), and entry 15 (67.53%). ConclusionThe methodological quality of systematic reviews/ meta-analysis of burden of illness needs to be improved, and the main problems include the lack of pre-study protocols, the absence of a list of excluded literature, and the less than adequate explanation of heterogeneity and risk of bias, etc. There is still a need to further improve the methodological quality of the systematic reviews and to promote the long-term development of evidence based medicine.
ObjectiveTo assess the impact of different interventions on the disease burden of chronic obstructive pulmonary disease (COPD). MethodsThe CNKI, VIP, WanFang Data, PubMed, Web of Science, Cochrane Library were electronically searched to collect randomized controlled trials (RCTs) on the disease burden of COPD from inception to October, 2023. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, network meta-analysis was performed by using Stata 16 software and R programming language. ResultsA total of 69 RCTs involving 26 interventions were included. The results of the network meta-analysis showed that compared with invasive ventilation therapy, non-invasive positive pressure ventilation treatment (SMD=−3.84, 95%CI −5.16 to −2.52) and Erchenzhikeqingfei granules (SMD=−3.04, 95%CI −5.89 to −0.20) were reducing the hospitalization cost of COPD patients (P<0.05). The effects of Jianpi Yifei granules, midazolam, targeted oxygen therapy, non-invasive positive pressure ventilation, and nutritional support protocol on reducing mortality in patients with COPD were superior to conventional treatments (RR=4.50, 95%CI 1.02 to 19.79; RR=4.81, 95%CI 1.25 to 18.52; RR=6.92, 95%CI 3.34 to 14.32; RR=3.56, 95%CI 1.14 to 11.08; RR=2.70, 95%CI 1.86 to 3.92; RR=3.60, 95%CI 2.01 to 6.45). Surface under the cumulative ranking(SUCRA) showed that oxygen therapy prescription had the highest probability of becoming the best measure (75.2%) to reduce mortality in patients with chronic obstructive pulmonary disease, the non-invasive positive pressure ventilation treatment was the most effective intervention(87.4%) to reduce the hospitalization cost of COPD patients. ConclusionOxygen therapy prescription might be the best measure to reduce mortality and the non-invasive positive pressure ventilation treatment might be the best measure to reduce the hospitalization cost of COPD patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To summarize and categorize the epidemiological evaluation indicators of disease burden, and to explore and analyze the research gaps in the existing evaluation indicators of disease burden. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were searched by computer to obtain qualitative studies on evaluation indicators of disease burden. The search time limit was from the establishment of the database to October 2023. CASP was used to evaluate the methodological quality of the included studies, and thematic analysis was used to summarize the evaluation indicators of disease burden by NVivo 12 software. Results A total of 19 studies were included, of which 10 studies were of high quality and 9 studies were of medium quality. The evaluation indicators of disease burden were summarized into two three-level core themes: positive indicators and negative indicators. Five second-level analytic themes were used: disease indicators, life loss indicators, life expectancy indicators, cause removal indicators and health status indicators. Twenty-nine level-1 descriptive themes. Conclusion The evaluation indicators of disease burden have their respective scopes of application and limitations. It is necessary to continue strengthening the construction of a comprehensive evaluation index system for disease burden, so that it is comparable and reliable, can adapt to local calculation weights, and covers both family burden and social burden.