Pascal Probst1, Felix J Hüttner2, Ömer Meydan3, Mohammed Abu Hilal4, Mustapha Adham5, Savio G Barreto6, Marc G Besselink7, Olivier R Busch8, Maximillian Bockhorn9, Marco Del Chiaro10, Kevin Conlon11, Carlos Fernandez-Del Castillo12, Helmut Friess13, Giuseppe Kito Fusai14, Luca Gianotti15, Thilo Hackert16, Christopher Halloran17, Jakob Izbicki18, Eva Kalkum3, Dezső Kelemen19, Hannes G Kenngott16, Rüdiger Kretschmer3, Vincent Landré3, Keith D Lillemoe12, Yi Miao20, Giovanni Marchegiani21, André Mihaljevic2, Dejan Radenkovic22, Roberto Salvia21, Marta Sandini16, Alejandro Serrablo23, Shailesh Shrikhande24, Parul J Shukla25, Ajith K Siriwardena26, Oliver Strobel16, Faik G Uzunoglu18, Charles Vollmer27, Jürgen Weitz28, Christopher L Wolfgang29, Alessandro Zerbi30, Claudio Bassi21, Christos Dervenis31, John Neoptolemos16, Markus W Büchler16, Markus K Diener32. 1. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany; The Study Center of the German Surgical Society (SDGC), University of Heidelberg, Germany. Electronic address: info@evidencemap.surgery. 2. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany; The Study Center of the German Surgical Society (SDGC), University of Heidelberg, Germany. 3. The Study Center of the German Surgical Society (SDGC), University of Heidelberg, Germany. 4. HPB Department, Southampton General Hospital, Southampton, United Kingdom. 5. Department of Surgery, Lyon Civil Hospital, France. 6. Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Adelaide, Australia; College of Medicine and Public Health, Flinders University, South Australia, Australia. 7. Department of Surgery, Cancer Center Amsterdam, University of Amsterdam, The Netherlands. 8. Department of Surgery, Amsterdam UMC, University of Amsterdam, The Netherlands. 9. Department of General and Visceral Surgery, University Medical Center Oldenburg, Germany. 10. Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO. 11. Hepato-Pancreatico-Biliary Unit, Department of General Surgery, Trinity College Dublin, Tallaght Hospital, Ireland. 12. Department of Surgery, Massachusetts General Hospital and the Harvard Medical School, Boston, MA. 13. Department of Hepato-Pancreato-Biliary Surgery, Klinikum rechts der Isar, Technische Universität München, Germany. 14. Institute for Liver and Digestive Health, University College London, United Kingdom. 15. Pancreatic Surgery Unit, School of Medicine and Surgery, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. 16. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany. 17. Department of Molecular and Clinical Cancer Medicine, University of Liverpool, United Kingdom. 18. University Medical Center Hamburg-Eppendorf, Germany. 19. Department of Surgery, Clinical Center, Medical School, University of Pécs, Hungary. 20. Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, China. 21. Department of Surgery, The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. 22. Department of Surgery, Clinical Center of Serbia and School of Medicine, University of Belgrade, Serbia. 23. Hepatobiliopancreatic Surgery Unit, General and Digestive Surgery Service, Hospital Miguel Servet, Zaragoza, Spain. 24. Pancreato-Biliary Unit, Tata Memorial Hospital, Mumbai, India. 25. Weill Cornell Medical College & New York Presbyterian Hospital, NY. 26. Department of Surgery, Regional Hepato-Pancreato-Biliary Unit, Manchester Royal Infirmary, United Kingdom. 27. Department of Surgery, Penn Medicine, University of Pennsylvania, Philadelphia, PA. 28. Department of General, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. 29. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD. 30. Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano (MI), Italy; Humanitas University, Pieve Emanuele (MI), Italy. 31. Department of Surgery, Metropolitan Hospital, Athens, Greece. 32. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany; The Study Center of the German Surgical Society (SDGC), University of Heidelberg, Germany. Electronic address: https://twitter.com/evidencemap.
Abstract
BACKGROUND: Pancreatic surgery is associated with considerable morbidity and, consequently, offers a large and complex field for research. To prioritize relevant future scientific projects, it is of utmost importance to identify existing evidence and uncover research gaps. Thus, the aim of this project was to create a systematic and living Evidence Map of Pancreatic Surgery. METHODS: PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for all randomized controlled trials and systematic reviews on pancreatic surgery. Outcomes from every existing randomized controlled trial were extracted, and trial quality was assessed. Systematic reviews were used to identify an absence of randomized controlled trials. Randomized controlled trials and systematic reviews on identical subjects were grouped according to research topics. A web-based evidence map modeled after a mind map was created to visualize existing evidence. Meta-analyses of specific outcomes of pancreatic surgery were performed for all research topics with more than 3 randomized controlled trials. For partial pancreatoduodenectomy and distal pancreatectomy, pooled benchmarks for outcomes were calculated with a 99% confidence interval. The evidence map undergoes regular updates. RESULTS: Out of 30,860 articles reviewed, 328 randomized controlled trials on 35,600 patients and 332 systematic reviews were included and grouped into 76 research topics. Most randomized controlled trials were from Europe (46%) and most systematic reviews were from Asia (51%). A living meta-analysis of 21 out of 76 research topics (28%) was performed and included in the web-based evidence map. Evidence gaps were identified in 11 out of 76 research topics (14%). The benchmark for mortality was 2% (99% confidence interval: 1%-2%) for partial pancreatoduodenectomy and <1% (99% confidence interval: 0%-1%) for distal pancreatectomy. The benchmark for overall complications was 53% (99%confidence interval: 46%-61%) for partial pancreatoduodenectomy and 59% (99% confidence interval: 44%-80%) for distal pancreatectomy. CONCLUSION: The International Study Group of Pancreatic Surgery Evidence Map of Pancreatic Surgery, which is freely accessible via www.evidencemap.surgery and as a mobile phone app, provides a regularly updated overview of the available literature displayed in an intuitive fashion. Clinical decision making and evidence-based patient information are supported by the primary data provided, as well as by living meta-analyses. Researchers can use the systematic literature search and processed data for their own projects, and funding bodies can base their research priorities on evidence gaps that the map uncovers.
BACKGROUND: Pancreatic surgery is associated with considerable morbidity and, consequently, offers a large and complex field for research. To prioritize relevant future scientific projects, it is of utmost importance to identify existing evidence and uncover research gaps. Thus, the aim of this project was to create a systematic and living Evidence Map of Pancreatic Surgery. METHODS: PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for all randomized controlled trials and systematic reviews on pancreatic surgery. Outcomes from every existing randomized controlled trial were extracted, and trial quality was assessed. Systematic reviews were used to identify an absence of randomized controlled trials. Randomized controlled trials and systematic reviews on identical subjects were grouped according to research topics. A web-based evidence map modeled after a mind map was created to visualize existing evidence. Meta-analyses of specific outcomes of pancreatic surgery were performed for all research topics with more than 3 randomized controlled trials. For partial pancreatoduodenectomy and distal pancreatectomy, pooled benchmarks for outcomes were calculated with a 99% confidence interval. The evidence map undergoes regular updates. RESULTS: Out of 30,860 articles reviewed, 328 randomized controlled trials on 35,600 patients and 332 systematic reviews were included and grouped into 76 research topics. Most randomized controlled trials were from Europe (46%) and most systematic reviews were from Asia (51%). A living meta-analysis of 21 out of 76 research topics (28%) was performed and included in the web-based evidence map. Evidence gaps were identified in 11 out of 76 research topics (14%). The benchmark for mortality was 2% (99% confidence interval: 1%-2%) for partial pancreatoduodenectomy and <1% (99% confidence interval: 0%-1%) for distal pancreatectomy. The benchmark for overall complications was 53% (99%confidence interval: 46%-61%) for partial pancreatoduodenectomy and 59% (99% confidence interval: 44%-80%) for distal pancreatectomy. CONCLUSION: The International Study Group of Pancreatic Surgery Evidence Map of Pancreatic Surgery, which is freely accessible via www.evidencemap.surgery and as a mobile phone app, provides a regularly updated overview of the available literature displayed in an intuitive fashion. Clinical decision making and evidence-based patient information are supported by the primary data provided, as well as by living meta-analyses. Researchers can use the systematic literature search and processed data for their own projects, and funding bodies can base their research priorities on evidence gaps that the map uncovers.
Authors: Fabian Schuh; Matthias A Fink; Manuel Feisst; Christoph Eckert; Colette Dörr-Harim; Phillip Knebel; Markus K Diener; Markus W Büchler; André L Mihaljevic; Pascal Probst Journal: BMJ Open Date: 2022-04-13 Impact factor: 3.006
Authors: J Busquets; S Martín; Ll Secanella; M Sorribas; N Cornellà; J Altet; N Peláez; M Bajen; T Carnaval; S Videla; J Fabregat Journal: Langenbecks Arch Surg Date: 2022-07-04 Impact factor: 2.895