Methodological Quality of Systematic Reviews on Treatments for Liver Cancer: A Cross-sectional Study

Systematic reviews (SRs) are indispensable for presenting reliable evidence of the effectiveness of treatments. However, methodological flaws can affect their reliability and validity.

This cross-sectional study aimed to evaluate the methodological quality of SRs on liver cancer (LC) treatments and identify potential factors affecting their reliability.

A comprehensive literature search was carried out on four databases to identify eligible SRs published between January 2014 and October 2023. We appraised the methodological quality of included SRs by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) tool. Multivariable regression analysis was employed to investigate the factors influencing the methodological quality.

A total of 119 SRs were included and appraised. Only one SR (0.8%) was rated as high overall quality. One (0.8%), nine (7.6%), and 108 (90.8%) were appraised as moderate, low, and critical low quality, respectively. SRs published more recently, with higher journal impact factors, or with corresponding author from Europe have better performance.

The methodological quality of SRs on LC treatments was unsatisfactory. Future SR authors should improve quality of SRs through registering an a priori protocol, providing explanation for selection of study designs, using a comprehensive literature search strategy, listing all excluded studies and justifying their reasons, describing the included studies in adequate detail, and reporting funding resources of primary studies.