CUI Lu 1,2,3 , XU Meng 4 , LIANG Cui 1,2,3 , HU Xiaoye 1,2,3 , WANG Hanbin 1,2,3 , HUANG Jiayi 1,2,3 , YANG Kehu 2,3 , LI Xiuxia 1,2,3
  • 1. Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
  • 2. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China;
  • 3. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, P. R. China;
  • 4. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, P. R. China;
YANG Kehu, Email: yangkh-ebm@lzu.edu.cn; LI Xiuxia, Email: lixiuxia@lzu.edu
Disease burden; Cost of illness; Systematic reviews; Meta-analysis; Methodology
10.7507/1672-2531.202409064
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Objective To 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. Methods A 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. Results A 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). Conclusion The 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.