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Systematic reviews on interventions for COVID-19 have rarely graded the certainty of the evidence

Ana Luiza Cabrera Martimbianco1, Rafael Leite Pacheco2, Carolina de Oliveira Cruz Latorraca3

  • 1PhD. Professor, Centro Universitário São Camilo, São Paulo (SP), Brazil; and Professor, Universidade Metropolitana de Santos (UNIMES), Santos (SP), Brazil.

Sao Paulo Medical Journal = Revista Paulista De Medicina
|August 11, 2021
PubMed
Abstract

Insights

Most COVID-19 systematic reviews lack evidence certainty assessment. Only 21% used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, impacting review reliability for coronavirus disease-19 treatments.

Area of Science:

  • Medical research methodology
  • Evidence-based medicine
  • Infectious disease epidemiology

Background:

  • Numerous systematic reviews on COVID-19 treatments exist.
  • Methodological quality of many reviews is questionable, potentially introducing bias.
  • Syntheses of primary studies on COVID-19 interventions need reliable assessment.

Purpose of the Study:

  • To determine the proportion of COVID-19 systematic reviews using the GRADE approach.
  • To assess the certainty of evidence in reviews of therapeutic or preventive options for COVID-19.
  • To highlight methodological gaps in COVID-19 evidence synthesis.

Main Methods:

  • Systematic search of MEDLINE (PubMed) for systematic reviews on COVID-19 interventions.
  • Inclusion of all systematic reviews assessing any intervention for COVID-19.
  • Examination of reviews for planned or actual use of the GRADE approach for evidence certainty.

Main Results:

  • 177 systematic reviews were included.
  • Only 37 reviews (21%) utilized the GRADE approach for evidence certainty.
  • Excluding Cochrane reviews, only 16.2% used GRADE, despite its mandatory nature in Cochrane reviews.

Conclusions:

  • A significant majority of COVID-19 systematic reviews omit crucial evidence certainty assessment.
  • The lack of GRADE methodology is a critical omission affecting review impact and usefulness.
  • Future COVID-19 research syntheses must incorporate GRADE for improved reliability and clinical utility.

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