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. 2024 Mar-Apr;99(2):223-232.
doi: 10.1016/j.abd.2023.06.003. Epub 2023 Nov 18.

Quality of systematic reviews on the treatment of vesiculobullous skin diseases. A meta-epidemiological study

Kamilla Mayr Martins Sá  1 , Juliana Cavaleiro Rodrigues  2 , Lígia Borges da Silva  2 , Giovanna Marcılio Santos  2 , Mileny Esbravatti Stephano Colovati  3 , Ana Luiza Cabrera Martimbianco  4
Affiliations

Quality of systematic reviews on the treatment of vesiculobullous skin diseases. A meta-epidemiological study

Kamilla Mayr Martins Sá et al. An Bras Dermatol. 2024 Mar-Apr.

Abstract

Background: Systematic reviews of Randomized Controlled Trials (RCTs) are considered high-level evidence to support a decision on therapeutic interventions, and their methodological quality is essential to provide reliable and applicable results.

Objective: This meta-epidemiological study aimed to map and critically appraise systematic reviews assessing treatments for vesiculobullous skin diseases.

Methods: We conducted a comprehensive search strategy on MEDLINE (via Pubmed) in December 2022 without restrictions to find systematic reviews evaluating pharmacological interventions for vesiculobullous skin diseases. The methodological quality was assessed using the AMSTAR-2 tool, and additional information was extracted. We identified nine systematic reviews published between 2002 and 2021, seven assessing pemphigus.

Results: According to the AMSTAR-2 tool, 55.6% were classified as critically low quality, 22.2% as moderate quality, 11.1% as low and 11.1% as high quality. No review assessed the certainty of the evidence (GRADE); 86% of pemphigus reviews had at least two overlapping RCTs. There were some limitations regarding methodological flaws and the AMSTAR-2 tool use CONCLUSIONS: These findings reveal a frail methodological quality of systematic reviews about vesiculobullous diseases treatment that may impact the results. Therefore, methodological rigor is mandatory for future systematic reviews to avoid duplication of effort and increase the certainty of the evidence supporting decision-making.

Keywords: Bias; Evidence-based medicine; Skin diseases, vesiculobullous; Systematic reviews as a topic.

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Figures

Figure 1
Figure 1
Flowchart of the study selection process.
Figure 2
Figure 2
Methodological quality assessment through AMSTAR-2.
Figure 3
Figure 3
Additional analysis on search strategies of the included systematic reviews.
See this image and copyright information in PMC

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