Equity reporting in systematic reviews and meta-analysis for geographic atrophy: a PROGRESS-Plus assessment

As systematic reviews and meta-analyses (SRMAs) are crucial for treatment development, they must provide guidelines that represent diverse patient demographics to promote equitable health care. As new research and treatment modalities are being developed for geographic atrophy (GA), establishing an equitable research foundation is becoming vitally important to physicians as they personalize their treatment plans.

This analysis aims to determine whether SRMAs pertaining to GA are reporting equity-related items utilizing the PROGRESS-Plus framework.

We conducted a cross-sectional analysis by searching databases for systematic reviews and meta-analyses concerning GA from the year 2000 to November 2023. From this search, 176 articles returned, but only 57 of them met all the inclusion criteria. After screening the articles for inclusion, data pertaining to PROGRESS-Plus items were extracted. All analyses were conducted in a masked and duplicative fashion. χ ² tests were employed to determine whether associations existed between the variables.

From the initial search, 176 articles returned, of which 119 were excluded due to duplication, data unrelated to GA, or because it was animal-based research. Of the remaining 57 studies, 26 (45.6 %) included zero PROGRESS-Plus items. Fewer articles from the US-reported equity items (31.3 %, 5/16) compared to other countries (63.4 %, 26/41), which held statistical significance (p=0.028).

The American Academy of Ophthalmology has created initiatives to increase diversity, equity, and inclusion within the subspecialty. By using the PROGRESS-Plus framework, this study concluded that the majority of the articles pertaining to GA do not meet equity item objectives. As these documents aid physicians in developing treatment plans, these findings are concerning as physicians may find it more difficult to individually tailor treatment plans according to each patient's holistic needs. Limitations in this study included unintentional omission or misclassification of research documents despite the comprehensive search string and double-blinded analysis. Furthermore, the results of this study cannot be generalized to other areas of research.