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Critical Appraisal of Systematic Reviews Assessing Gut Microbiota and Effect of Probiotic Supplementation in Children
Sachin Agrawal1, Chandra Rath1, Shripada Rao2,3
1Neonatal Directorate, KEM Hospital for Women, Perth, WA 6008, Australia.
Insights
Systematic reviews on gut microbiota and probiotics in autism spectrum disorder (ASD) show critically low quality. Future research must improve methodology and reporting for reliable evidence in ASD.
Area of Science:
- Neuroscience
- Microbiology
- Pediatrics
Background:
- Gut microbiota plays a significant role in autism spectrum disorder (ASD).
- Systematic reviews (SRs) are crucial for synthesizing evidence on gut microbiota and probiotic interventions in ASD.
- Assessing the quality of existing SRs is vital for guiding future research.
Purpose of the Study:
- To evaluate the methodological quality of systematic reviews concerning gut microbiota and probiotic supplementation in children with ASD.
- To identify the strengths and weaknesses of current SRs in this field.
Main Methods:
- A comprehensive literature search was conducted across PubMed, EMBASE, PsycINFO, Medline, and Cochrane databases up to November 2024.
- Systematic reviews of randomized or non-randomized studies focusing on gut microbiota or probiotic effects in children with ASD were included.
- Quality assessment of the included SRs was performed.
Main Results:
- A total of 48 SRs were included: 21 on probiotics and 27 on gut microbiota.
- The majority of included SRs were assessed as having low to critically low methodological quality.
- Common quality deficits included inadequate reporting of prior registration, protocol deviations, and risk of bias assessments.
Conclusions:
- Existing systematic reviews on gut microbiota and probiotics in ASD are of poor quality.
- Significant improvements in methodology and reporting are necessary for future studies to generate robust and reliable evidence in this area.
- Enhanced research rigor is essential for advancing our understanding of gut microbiome's role in ASD and the efficacy of probiotic interventions.
Abstract:
Given the significance of gut microbiota in autism spectrum disorder (ASD), we aimed to assess the quality of systematic reviews (SRs) of studies assessing gut microbiota and effects of probiotic supplementation in children with ASD. PubMed, EMBASE, PsycINFO, Medline, and Cochrane databases were searched from inception to November 2024. We included SRs of randomised or non-randomized studies reporting on gut microbiota or effects of probiotics in children with ASD. A total of 48 SRs (probiotics: 21, gut microbiota: 27) were included. The median (IQR) number of studies and participants was 7 (5) and 328 (362), respectively, for SRs of probiotic intervention studies and 18 (18) and 1083 (1201), respectively, for SRs of gut microbiota studies in children with ASD. The quality of included SRs was low (probiotics: 12, gut microbiota: 14) to critically low (probiotics: 9, gut microbiota: 13) due to lack of reporting of critical items including prior registration, deviation from protocol, and risk of bias assessment of included studies. Assuring robust methodology and reporting of future studies is important for generating robust evidence in this field.
