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Quality Assessment and Risk of Bias of Systematic Reviews of Prophylactic Mesh for Parastomal Hernia Prevention Using AMSTAR and ROBIS Tools

World Journal of Surgery volume 43, pages 3003–3012 (2019)Cite this article

Abstract

Background

Systematic reviews play a crucial role in clinical decision making and resource allocation and are expected to be unbiased and consistent. The aim of this study is a review of systematic reviews on the use of prophylactic mesh to prevent parastomal hernia (PH) formation using ROBIS and AMSTAR tools to assess the risk of bias and methodological quality.

Methods

We included systematic reviews with or without meta-analysis of which the objective was to assess the use of a prophylactic mesh to prevent PH. A systematic search of the literature in five databases from inception until December 2017 was conducted. For each systematic review, methodologic quality and risk of bias were assessed using the AMSTAR and ROBIS tools, respectively. We estimated the inter-rater reliability for individual domains and for the overall methodological quality and risk of bias using Fleiss’ k.

Results

We identified 14 systematic reviews that met the inclusion criteria. Using the AMSTAR scale with a cutoff value, six reviews showed high methodologic quality and eight were of low quality. Using the ROBIS tool, the overall risk of bias was low in 50% of the reviews analyzed. In the remaining studies, the risk of bias was unclear.

Conclusions

The global evidence in favor of the use of a prophylactic mesh for preventing PH is not uniform regarding quality and risk of bias. Surgeons cannot be equally confident in the results of all systematic reviews published on this topic.

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Acknowledgements

The authors are grateful to Marta Pulido, MD, for editing the manuscript and editorial assistance.

Funding

No direct or indirect financial support was received.

Author information

Author notes

  1. Josep M. García-Alamino and Manuel López-Cano have contributed equally to this work.

Affiliations

  1. DPhil Programme in Evidence-Based Healthcare, University of Oxford, Oxford, UK

    Josep M. García-Alamino

  2. Abdominal Wall Surgery Unit and General and Digestive Surgery Research Group, Department of General Surgery, Institut de Recerca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Manuel López-Cano

  3. Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands

    Leonard Kroese

  4. Department of Gastrointestinal Surgery, Centre for Surgical Science, Zealand University Hospital, Køge, Denmark

    Frederik Helgstrand

  5. Department of Surgery, Maria Middelares Hospital, Ghent, Belgium

    Filip Muysoms

Authors
  1. Josep M. García-Alamino
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  2. Manuel López-Cano
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  3. Leonard Kroese
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  4. Frederik Helgstrand
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  5. Filip Muysoms
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Corresponding author

Correspondence to Manuel López-Cano.

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Conflict of interest

ML-C reports personal fees (consultancy, speaker) from B. Braun and Bard Davol outside the submitted work. FM reports grants and personal fees (consultancy, speaker, grants) from Medtronic, CMR Surgical, Intuitive Surgical, Dynamesh, Bard Davol outside the submitted work. JMG-A, LK, FH declare no competing interests.

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García-Alamino, J.M., López-Cano, M., Kroese, L. et al. Quality Assessment and Risk of Bias of Systematic Reviews of Prophylactic Mesh for Parastomal Hernia Prevention Using AMSTAR and ROBIS Tools. World J Surg 43, 3003–3012 (2019). https://doi.org/10.1007/s00268-019-05139-z

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