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The methodological quality and clinical applicability of meta-analyses on probiotics in 2020: A cross-sectional study

Jakub Ruszkowski1, Katarzyna Majkutewicz2, Ewelina Rybka3

  • 1Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland; Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Poland.

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|August 16, 2021
PubMed

Insights

Most systematic reviews with meta-analyses (SR/MA) on probiotic efficacy lack methodological rigor, limiting their clinical applicability. Careful evaluation is needed before accepting SR/MA findings as high-level evidence.

Area of Science:

  • Microbiology and Clinical Research
  • Evidence-Based Medicine

Background:

  • Systematic reviews with meta-analyses (SR/MA) are crucial for evaluating probiotic efficacy.
  • High-quality SR/MA are essential for reliable clinical evidence.

Purpose of the Study:

  • To assess the methodological quality and clinical applicability of recent SR/MA on probiotic efficacy.
  • To identify factors associated with higher quality and applicability in these reviews.

Main Methods:

  • Systematic search of four databases for SR/MA on probiotic efficacy published in 2020.
  • Evaluation using the AMSTAR 2 tool for methodological quality and author-defined criteria for clinical applicability.
  • Appraisal of 114 SR/MA.

Main Results:

  • 77% of SR/MA had critically low confidence in their results.
  • Common flaws included lack of excluded studies lists, study protocols, and appropriate results combination.
  • Only 14 SR/MA offered clinically applicable results.
  • Higher journal impact factor and European author affiliation correlated with better quality.

Conclusions:

  • Many SR/MA on probiotic efficacy suffer from significant methodological flaws.
  • The clinical applicability of findings from these reviews is often limited.
  • SR/MA on probiotics require rigorous methodological assessment to be considered high-level evidence.
Keywords:
GRADEMicrobiomeOverview of systematic reviewsQuality of evidence

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