Juan Ling1,2,3,4, Long Ge1,2,3,4,5, Ding-Hua Zhang6, Yong-Feng Wang7, Zhuo-Lin Xie8, Jin-Hui Tian1,2,3,4, Xiao-Hui Xiao9, Ke-Hu Yang10,11,12,13. 1. School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China. 2. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. 3. Chinese GRADE Center, Lanzhou University, Lanzhou, China. 4. WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China. 5. The First Clinical Medical College of Lanzhou University, Lanzhou, China. 6. Gansu University of Traditional Chinese Medicine, Lanzhou, China. 7. School of Basic Medical Sciences, Gansu University of Traditional Chinese Medicine, Lanzhou, China. 8. Department of Endocrinology, Gansu Province Hospital of Traditional Chinese Medicine, Lanzhou, China. 9. Gansu Provincial People's Hospital, Lanzhou, China. 42352868@qq.com. 10. School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China. kehuyangebm2006@126.com. 11. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. kehuyangebm2006@126.com. 12. Chinese GRADE Center, Lanzhou University, Lanzhou, China. kehuyangebm2006@126.com. 13. WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China. kehuyangebm2006@126.com.
Abstract
AIMS: To evaluate the methodological quality of systematic reviews (SRs), and summarize evidence of important outcomes from dipeptidyl peptidase-4 inhibitors (DPP4-I) in treating type 2 diabetes mellitus (T2DM). METHODS: We included SRs of DPP4-I for the treatment of T2DM until January, 2018 by searching the Cochrane Library, PubMed, EMBASE and three Chinese databases. We evaluated the methodological qualities with the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool and the GRADE (The Grading of Recommendations Assessment, Development and Evaluation) approach. RESULTS: Sixty-three SRs (a total of 2,603,140 participants) receiving DPP4-I for the treatment of T2DM were included. The results of AMSTAR showed that the lowest quality was "a list of studies (included and excluded) item" with only one (1.6%) study provided, followed by the "providing a priori design" item with only four (6.3%) studies conforming to this item, the next were "the status of publication (gray literature) used as an inclusion criterion item", with only 18 (28.9%) studies conforming to these items. Only seven (11.1%) studies scored more than nine points in AMSTAR, indicating high methodological quality. For GRADE, of the 128 outcomes, high quality evidence was provided in only 28 (21.9%), moderate in 70 (54.7%), low in 27 (21.1%), and very low in three (2.3%). CONCLUSIONS: The methodological quality of SRs of DPP4-I for type 2 diabetes mellitus is not high and there are common areas for improvement. Furthermore, the quality of evidence level is moderate and more high quality evidence is needed.
AIMS: To evaluate the methodological quality of systematic reviews (SRs), and summarize evidence of important outcomes from dipeptidyl peptidase-4 inhibitors (DPP4-I) in treating type 2 diabetes mellitus (T2DM). METHODS: We included SRs of DPP4-I for the treatment of T2DM until January, 2018 by searching the Cochrane Library, PubMed, EMBASE and three Chinese databases. We evaluated the methodological qualities with the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool and the GRADE (The Grading of Recommendations Assessment, Development and Evaluation) approach. RESULTS: Sixty-three SRs (a total of 2,603,140 participants) receiving DPP4-I for the treatment of T2DM were included. The results of AMSTAR showed that the lowest quality was "a list of studies (included and excluded) item" with only one (1.6%) study provided, followed by the "providing a priori design" item with only four (6.3%) studies conforming to this item, the next were "the status of publication (gray literature) used as an inclusion criterion item", with only 18 (28.9%) studies conforming to these items. Only seven (11.1%) studies scored more than nine points in AMSTAR, indicating high methodological quality. For GRADE, of the 128 outcomes, high quality evidence was provided in only 28 (21.9%), moderate in 70 (54.7%), low in 27 (21.1%), and very low in three (2.3%). CONCLUSIONS: The methodological quality of SRs of DPP4-I for type 2 diabetes mellitus is not high and there are common areas for improvement. Furthermore, the quality of evidence level is moderate and more high quality evidence is needed.