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Abstract
Objectives The main objective of this study was to assess the methodological and reporting quality of the systematic reviews (SRs) supporting the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) clinical practice guidelines (CPGs) recommendations for the management of patients with ventricular arrhythmias and sudden cardiac death (SCD). As a secondary objective, we sought to determine: (1) the proportion of Cochrane SRs were cited; and (2) whether Cochrane SRs scored higher on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) appraisals.
Design Cross-sectional analysis.
Main outcome measures We searched for CPGs published by the ESC and the ACC from 2010 to 2020. We selected the CPGs for ventricular arrhythmias and the prevention of SCD. The reference sections were searched for SRs. Two independent investigators evaluated eligible SR using the PRISMA checklist and the AMSTAR-2 assessment tool.
Results Two CPGs for ventricular arrhythmia and SCD were included in this study. Fifty-five SRs were included in our analysis. Across all SRs, the mean PRISMA score was 0.70. The lowest scoring PRISMA item related to the presence of a pre-published protocol (item 5, score 0.17). Overall, 40% of included SRs were found to have ‘critically low’ AMSTAR-2 ratings. One of the lowest scoring items for AMSTAR-2 was reporting of sources of funding (item 10). The 4 Cochrane SRs that were included scored higher on both assessment tools than non-Cochrane studies, specifically in PRISMA overall completion (88.7% vs 69.7%).
Conclusion Our study suggests the methodological and reporting quality of SRs used within ESC and ACC CPGs is insufficient, as demonstrated by the lack of adherence to both AMSTAR-2 and PRISMA checklists. Given the importance of CPGs on clinical decision making, and ultimately patient care, the methodological rigour and quality reporting within SRs used in CPGs should be held to the highest standard within the field of cardiology.
- Cardiology
- Ventricular Dysfunction
- Heart Arrest
- Arrhythmias, Cardiac
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. Protocol, pilot-test Google data extraction forms, and data are available online at https://osf.io/mbzgq/
Statistics from Altmetric.com
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. Protocol, pilot-test Google data extraction forms, and data are available online at https://osf.io/mbzgq/
Footnotes
Contributors MV conceptualised the study and provided manuscript oversight. TT was responsible for project design and provided AMSTAR-2 and PRISMA training. EPG, BH, CW, DS and JC participated in all writing. CW, TT and MV conducted all editing. RM and ML screened CPG reference lists for SRs. EPG and BH conducted all SR appraisals. BH and MH conducted all statistical analyses. EPG, BH, CW, DS, JC, TT, MH, RM, ML and MV are equally the guarantors of the study and integrity of the data.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests MH reports receiving funding from the National Institute of Justice for work unrelated to the current subject. MV reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences—all outside of the present work. All other authors have no conflicts of interest to report. All other authors have no conflicts to report.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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