Umbrella review: evidence-based practice for selecting and applying the best synthesis of evidence_Chinese Journal of Evidence-Based Medicine

Authors：

SUN Chongyang ¹ , ZHANG Haoran ² , LIU Xiaoyu ³ , SUN Chengyi ¹ ,  YAN Shiyan ^1,4

1. School of Acupuncture-Moxibustion and Tuina, Beijing University of CM, Beijing 100029, P. R. China;
2. Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;
3. School of Acupuncture-Moxibustion and Tuina, Tianjin University of CM, Tianjin 301617, P. R. China;
4. International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM, Beijing 100029, P. R. China;

Corresponding author：

YAN Shiyan, Email: ysy20200927@163.com

Keywords：

Umbrella review; Evidence based medicine; Systematic review; Clinical practice; Traditional Chinese medicine

DOI：

10.7507/1672-2531.202201021

Video：

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Umbrella review is a third study conducted through evidence synthesis method, based on the secondary studies including systematic reviews and meta-analyses. Although it has been widely used abroad, further understanding, recommendation and application of this type of method are still limited in China. We introduced the definition, objective, present application, the similarities and differences with systematic reviews or meta-analyses, indications, limitations, and research progress of umbrella review in the research area of traditional Chinese medicine (TCM), aiming to benefit future clinical research and treatment in practice.

Citation： SUN Chongyang, ZHANG Haoran, LIU Xiaoyu, SUN Chengyi, YAN Shiyan. Umbrella review: evidence-based practice for selecting and applying the best synthesis of evidence. Chinese Journal of Evidence-Based Medicine, 2022, 22(5): 609-614. doi: 10.7507/1672-2531.202201021 Copy

1.	Faulkner G, Fagan MJ, Lee J. Umbrella reviews (systematic review of reviews). Int Rev Sport Exerc Psychol, 2021. DOI:10.1080/1750984X.2021.1934888.
2.	Pollock M, Fernandes RM, Becker LA, et al. Chapter Ⅴ: overviews of reviews. In: Higgins JPT, Thomas J, Chandler J, et al (editors). Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration, 2021. Available at: http://www.cochrane-handbook.org.
3.	刘海霞, 胡德华, 尹怀琼. 伞形评价—一种新型循证医学分析方法. 中华流行病学杂志, 2020, 41(2): 261-266.
4.	Li M, Liu Y, Wang H, et al. The effects of acupuncture on pregnancy outcomes of recurrent implantation failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6661235.
5.	Xie ZY, Peng ZH, Yao B, et al. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC Complement Altern Med, 2019, 19(1): 131.
6.	Coyle ME, Stupans I, Abdel-Nour K, et al. Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis. Acupunct Med, 2021, 39(1): 20-29.
7.	Schwarze JE, Ceroni JP, Ortega-Hrepich C, et al. Does acupuncture the day of embryo transfer affect the clinical pregnancy rate. Systematic review and meta-analysis. JBRA Assist Reprod, 2018, 22(4): 363-368.
8.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.0.2). The Cochrane Collaboration, 2009. Available at: http://www.cochrane-handbook.org.
9.	Hartling L, Chisholm A, Thomson D, et al. A descriptive analysis of overviews of reviews published between 2000 and 2011. PLoS One, 2012, 7(11): e49667.
10.	刘雅莉, 袁金秋, 杨克虎, 等. 系统评价再评价的制作方法简介及相关资料分析. 中国循证儿科杂志, 2011, 6(1): 58-64.
11.	Zhu J, Yu X, Zheng Y, et al. Association of glucose-lowering medications with cardiovascular outcomes: an umbrella review and evidence map. Lancet Diabetes Endocrinol, 2020, 8(3): 192-205.
12.	Jin YH, Wang GH, Sun YR, et al. A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews. BMJ Open, 2016, 6(11): e011514.
13.	Hu C, Qin X, Ye R, et al. The role of traditional Chinese medicine nursing for stroke: an umbrella review. Evid Based Complement Alternat Med, 2021, 2021: 9918687.
14.	Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
15.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
16.	Theodoratou E, Tzoulaki I, Zgaga L, et al. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ, 2014, 348: g2035.
17.	Thomas J, Kneale D, McKenzie JE, et al. Chapter 2: Determining the scope of the review and the questions it will address. In: Higgins JPT, Thomas J, Chandler J, et al (editors). Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration, 2021. Available at: http://www.cochrane-handbook.org.
18.	Ortega A, Lopez-Briz E, Fraga-Fuentes MD. From qualitative reviews to umbrella reviews. In: Biondi-Zoccai G (editors). Umbrella reviews. Cham: Springer, 2016.
19.	Aromataris E, Fernandez R, Godfrey CM, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc, 2015, 13(3): 132-140.
20.	Neuenschwander M, Ballon A, Weber KS, et al. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies. BMJ, 2019, 366: l2368.
21.	Bi H, Gan Y, Yang C, et al. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr, 2015, 18(16): 3013-3019.
22.	Radua J, Ramella-Cravaro V, Ioannidis JPA, et al. What causes psychosis. An umbrella review of risk and protective factors. World Psychiatry, 2018, 17(1): 49-66.
23.	Poole R, Kennedy OJ, Roderick P, et al. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ, 2017, 359: j5024.
24.	O'Sullivan JW, Muntinga T, Grigg S, et al. Prevalence and outcomes of incidental imaging findings: umbrella review. BMJ, 2018, 361: k2387.
25.	Pieper D, Antoine SL, Mathes T, et al. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol, 2014, 67(4): 368-375.
26.	Howes OD, Whitehurst T, Shatalina E, et al. The clinical significance of duration of untreated psychosis: an umbrella review and random-effects meta-analysis. World Psychiatry, 2021, 20(1): 75-95.
27.	Fusar-Poli P, Radua J. Ten simple rules for conducting umbrella reviews. Evid Based Ment Health, 2018, 21(3): 95-100.

1. Faulkner G, Fagan MJ, Lee J. Umbrella reviews (systematic review of reviews). Int Rev Sport Exerc Psychol, 2021. DOI:10.1080/1750984X.2021.1934888.
2. Pollock M, Fernandes RM, Becker LA, et al. Chapter Ⅴ: overviews of reviews. In: Higgins JPT, Thomas J, Chandler J, et al (editors). Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration, 2021. Available at: http://www.cochrane-handbook.org.
3. 刘海霞, 胡德华, 尹怀琼. 伞形评价—一种新型循证医学分析方法. 中华流行病学杂志, 2020, 41(2): 261-266.
4. Li M, Liu Y, Wang H, et al. The effects of acupuncture on pregnancy outcomes of recurrent implantation failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6661235.
5. Xie ZY, Peng ZH, Yao B, et al. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC Complement Altern Med, 2019, 19(1): 131.
6. Coyle ME, Stupans I, Abdel-Nour K, et al. Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis. Acupunct Med, 2021, 39(1): 20-29.
7. Schwarze JE, Ceroni JP, Ortega-Hrepich C, et al. Does acupuncture the day of embryo transfer affect the clinical pregnancy rate. Systematic review and meta-analysis. JBRA Assist Reprod, 2018, 22(4): 363-368.
8. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.0.2). The Cochrane Collaboration, 2009. Available at: http://www.cochrane-handbook.org.
9. Hartling L, Chisholm A, Thomson D, et al. A descriptive analysis of overviews of reviews published between 2000 and 2011. PLoS One, 2012, 7(11): e49667.
10. 刘雅莉, 袁金秋, 杨克虎, 等. 系统评价再评价的制作方法简介及相关资料分析. 中国循证儿科杂志, 2011, 6(1): 58-64.
11. Zhu J, Yu X, Zheng Y, et al. Association of glucose-lowering medications with cardiovascular outcomes: an umbrella review and evidence map. Lancet Diabetes Endocrinol, 2020, 8(3): 192-205.
12. Jin YH, Wang GH, Sun YR, et al. A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews. BMJ Open, 2016, 6(11): e011514.
13. Hu C, Qin X, Ye R, et al. The role of traditional Chinese medicine nursing for stroke: an umbrella review. Evid Based Complement Alternat Med, 2021, 2021: 9918687.
14. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
15. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
16. Theodoratou E, Tzoulaki I, Zgaga L, et al. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ, 2014, 348: g2035.
17. Thomas J, Kneale D, McKenzie JE, et al. Chapter 2: Determining the scope of the review and the questions it will address. In: Higgins JPT, Thomas J, Chandler J, et al (editors). Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration, 2021. Available at: http://www.cochrane-handbook.org.
18. Ortega A, Lopez-Briz E, Fraga-Fuentes MD. From qualitative reviews to umbrella reviews. In: Biondi-Zoccai G (editors). Umbrella reviews. Cham: Springer, 2016.
19. Aromataris E, Fernandez R, Godfrey CM, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc, 2015, 13(3): 132-140.
20. Neuenschwander M, Ballon A, Weber KS, et al. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies. BMJ, 2019, 366: l2368.
21. Bi H, Gan Y, Yang C, et al. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr, 2015, 18(16): 3013-3019.
22. Radua J, Ramella-Cravaro V, Ioannidis JPA, et al. What causes psychosis. An umbrella review of risk and protective factors. World Psychiatry, 2018, 17(1): 49-66.
23. Poole R, Kennedy OJ, Roderick P, et al. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ, 2017, 359: j5024.
24. O'Sullivan JW, Muntinga T, Grigg S, et al. Prevalence and outcomes of incidental imaging findings: umbrella review. BMJ, 2018, 361: k2387.
25. Pieper D, Antoine SL, Mathes T, et al. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol, 2014, 67(4): 368-375.
26. Howes OD, Whitehurst T, Shatalina E, et al. The clinical significance of duration of untreated psychosis: an umbrella review and random-effects meta-analysis. World Psychiatry, 2021, 20(1): 75-95.
27. Fusar-Poli P, Radua J. Ten simple rules for conducting umbrella reviews. Evid Based Ment Health, 2018, 21(3): 95-100.

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