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Methodological Rigor and Temporal Trends of Cardiovascular Medicine Meta-Analyses in Highest-Impact Journals
Dhruv Mahtta1, Ahmed Altibi2, Mohamed M Gad3
1Section of Cardiology Baylor College of Medicine Houston TX.
Insights
The proportion of cardiovascular meta-analyses in top journals declined from 2012-2018. While guideline adherence improved, overall quality compliance remains low, despite increased PROSPERO registration.
Area of Science:
- Cardiovascular Medicine
- Medical Research Methodology
- Evidence-Based Practice
Background:
- Meta-analyses are crucial in cardiovascular research.
- Limited data exist on the quality and trends of these publications.
- High-impact journals are key venues for disseminating cardiovascular research.
Purpose of the Study:
- To assess the methodological rigor and temporal trends of meta-analyses in cardiovascular medicine.
- To evaluate adherence to reporting guidelines and registration practices.
- To analyze publication trends in leading cardiovascular journals.
Main Methods:
- Systematic review and meta-analysis of cardiovascular articles published in top journals (NEJM, Lancet, JAMA, BMJ, Annals of Internal Medicine, Circulation, EHJ, JACC) from 2012-2018.
- Data extraction on adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines.
- Analysis of PROSPERO (International Prospective Register of Systematic Reviews) registration rates.
Main Results:
- Meta-analyses constituted 6.6% of publications, showing an annual decline (8.7% in 2012 to 4.6% in 2018).
- Over half of studies (51.9%) failed to incorporate PRISMA/MOOSE guidelines, though this decreased over time (60.2% in 2012 vs. 40.0% in 2018).
- PROSPERO registration increased significantly (2.4% in 2013 to 17.5% in 2018), but remained low overall.
Conclusions:
- The publication rate of cardiovascular meta-analyses in high-impact journals has decreased.
- Methodological quality, measured by guideline adherence, is improving but remains suboptimal.
- Increased prospective registration is a positive trend, yet overall compliance with best practices requires enhancement.
Abstract:
Background Well-conducted meta-analyses are considered to be at the top of the evidence-based hierarchy pyramid, with an expansion of these publications within the cardiovascular research arena. There are limited data evaluating the trends and quality of such publications. The objective of this study was to evaluate the methodological rigor and temporal trends of cardiovascular medicine-related meta-analyses published in the highest impact journals. Methods and Results Using the Medline database, we retrieved cardiovascular medicine-related systematic reviews and meta-analyses published in The New England Journal of Medicine, The Lancet, Journal of the American Medical Association, The British Medical Journal, Annals of Internal Medicine, Circulation, European Heart Journal, and Journal of American College of Cardiology between January 1, 2012 and December 31, 2018. Among 6406 original investigations published during the study period, meta-analyses represented 422 (6.6%) articles, with an annual decline in the proportion of published meta-analyses (8.7% in 2012 versus 4.6% in 2018, Ptrend=0.002). A substantial number of studies failed to incorporate elements of Preferred Reporting Items for Systematic Reviews and Meta-Analyses or Meta-Analysis of Observational Studies in Epidemiology guidelines (51.9%) and only a minority of studies (10.4%) were registered in PROSPERO (International Prospective Register of Systematic Reviews). Fewer manuscripts failed to incorporate the Preferred Reporting Items for Systematic Reviews and Meta-Analyses or Meta-Analysis of Observational Studies in Epidemiology elements over time (60.2% in 2012 versus 40.0% in 2018, Ptrend<0.001) whereas the number of meta-analyses registered at PROSPERO has increased (2.4% in 2013 versus 17.5% in 2018, Ptrend<0.001). Conclusions The proportion of cardiovascular medicine-related meta-analyses published in the highest impact journals has declined over time. Although there is an increasing trend in compliance with quality-based guidelines, the overall compliance remains low.
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