Systematic review, meta-analysis and randomized controlled trials in cytopathology

Evidence-based medicine (EBM) relies on systematic review (SR), meta-analysis (MA) and randomized controlled trials (RCTs). These EBM tools are more commonly used in clinical medicine than in laboratory medicine. The extent of their use in cytopathology is not clear. The purpose of this study was to investigate the frequency of SR, MA and RCTs in cytopathology compared to other laboratory and clinical medicine specialties.

A literature-based search for SRs, MAs and RCTs in cytopathology was performed. Several electronic databases were searched without date restrictions. Four journals in cytopathology, pathology and clinical medicine were also searched over 6 years.

Gynecology cytology utilized SRs, MAs and RCTs more frequently (83%) than nongynecology and fine needle aspiration cytology. Cytopathology, histopathology and laboratory medicine journals showed comparable rates of 0.5-1.1% in papers reporting SRs, MAs and RCTs. Specialty medical journals showed a higher rate of 5.6% and general medical journals showed a much higher rate of 30%.

SR, MA and RCTs are less frequently utilized in pathology than in clinical medicine. Cytopathologists should be more aware of the benefits of SR and MA in resolving uncertainties and improving the clinical applicability of level III diagnostic studies.