A systematic review of the quality and impact of anxiety disorder meta-analyses

Meta-analyses are seen as representing the pinnacle of a hierarchy of evidence used to inform clinical practice. Therefore, the potential importance of differences in the rigor with which they are conducted and reported warrants consideration. In this review, we use standardized instruments to describe the scientific and reporting quality of meta-analyses of randomized controlled trials of the treatment of anxiety disorders. We also use traditional and novel metrics of article impact to assess the influence of meta-analyses across a range of research fields in the anxiety disorders. Overall, although the meta-analyses that we examined had some flaws, their quality of reporting was generally acceptable. Neither the scientific nor reporting quality of the meta-analyses was predicted by any of the impact metrics. The finding that treatment meta-analyses were cited less frequently than quantitative reviews of studies in current "hot spots" of research (ie, genetics, imaging) points to the multifactorial nature of citation patterns. A list of the meta-analyses included in this review is available on an evidence-based website of anxiety and trauma-related disorders.