No stone unturned: rigour versus relevance in systematic reviews
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Abstract
INTRODUCTION Antioxidant micronutrients may help alleviate oxidative stress in cystic fibrosis (CF) lung disease. To determine treatment effect, systematic reviews (SR) synthesize available evidence. Cochrane SRs are known for being methodologically rigourous, however, may have limited generalizability.
OBJECTIVES To assess effectiveness of antioxidant micronutrients in CF lung disease using Cochrane and non-Cochrane SR methodology; to determine whether Cochrane SRs trade relevance for rigour
METHODS The first SR followed Cochrane-preferred methods, while the non-Cochrane SR employed a broader search strategy and nclusion criteria. Reviews were contrasted regarding yield of search, treatment effect (efficacy and safety) and risk of bias.
RESULTS Neither SR had enough data to support or refute efficacy or safety of antioxidant supplementation in CF lung disease. Compared to the Cochrane SR, the non-Cochrane SR had four more included studies, more precise estimates of efficacy, additional harms data and a similar risk of bias.
CONCLUSION Broader search strategies and inclusion criteria may improve relevance of Cochrane SRs without compromising rigour.