Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot

Fan Huang; Mingwang Qiu; Siyi Zhao; Lin Dai; Yanpeng Xu; Yunying Yang; Liming Lu; Rusong Guo; Qiang Tian; Zhiyong Fan; Shan Wu

doi:10.2147/JPR.S254234

Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot

J Pain Res. 2020 Oct 19:13:2633-2652. doi: 10.2147/JPR.S254234. eCollection 2020.

Authors

Fan Huang^#¹, Mingwang Qiu^#², Siyi Zhao^#¹, Lin Dai², Yanpeng Xu², Yunying Yang², Liming Lu², Rusong Guo^{1

3}, Qiang Tian^{1

3}, Zhiyong Fan^{1

3}, Shan Wu^{1

3}

Affiliations

¹ The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.
² Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, People's Republic of China.
³ Guangdong Province Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China.

^# Contributed equally.

Abstract

Objective: To evaluate systematic reviews (SRs) of acupuncture for low back pain (LBP) in terms of characteristics, reporting and methodological quality using a Veritas plot and to explore factors that may be associated with methodological quality and reporting quality.

Study design and setting: We searched 8 electronic bibliographic databases to find all SRs, and we evaluated the SRs' quality in 6 dimensions, including publication year, design type, homogeneity, risk of publication bias, methodological quality by Assessment of Multiple Systematic Reviews (AMSTAR) 2 and reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Excel 2010 and Adobe Illustrator CC were used to draw and optimize Veritas plots. Exploratory analysis was done using SPSS software version 23.0 to explore factors related to AMSTAR-2 and PRISMA scores. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence quality evaluation tool was used to grade all the outcome indicators in the included literature.

Results: We included 19 SRs in the analysis. Literature quality rank scores ranged from 9.67 to 17.00, with an average score of 13.18 ± 2.35. The average score of AMSTAR-2 was 7.47, and the average score of PRISMA was 18.47. Overall, the main issues were research strategies, inclusion and exclusion criteria, publication bias, and registration in PROSPERO. The results of exploratory analysis showed that duplication of literature selected and appropriate tools to assess the risk of bias were related to the AMSTAR-2 score, and the summary of evidence was related to the PRISMA score. The GRADE quality evaluation results showed mainly low quality.

Conclusion: The quality of SRs on acupuncture for low back pain should be improved, mainly by strengthening the methodological quality and reporting quality. The Veritas plot is an effective graphical evaluation method that is worth popularizing.

Keywords: AMSTAR-2; PRISMA; low back pain; methodological quality; reporting quality; systematic review.

Grants and funding

This work was supported by (1) National Natural Science Foundation of China (Grant No. 81874511); (2) Guangdong Provincial Department of Finance Project [Grant (2016) No. 387]; (3) Innovation and Entrepreneurship Program for College Students of Guangzhou University of Chinese Medicine (Grant No. 201910572001; 201910572245; 202010572048; 202010572176).