Rapid Identification of Low-quality Meta-analyses in Plastic Surgery Using the Meta-analysis Critique (MAC) Tool

Area of Science:

• Plastic Surgery
• Evidence-Based Medicine
• Research Methodology

Background:

• Meta-analyses represent the highest level of evidence in health literature.
• Assessing the quality and bias of meta-analyses is crucial but challenging.
• Existing tools for methodological assessment are often time-consuming and complex for clinicians.

Purpose of the Study:

• To develop and validate a simple screening instrument, the Meta-Analysis Critique (MAC) Tool, for appraising the quality of plastic surgery meta-analyses.
• To analyze temporal trends in the quality of plastic surgery meta-analyses.
• To assess the correlation between the novel MAC Tool and the established AMSTAR 2 tool.

Main Methods:

• A systematic search of MEDLINE and EMBASE for plastic surgery meta-analyses published between 2011 and 2023.
• Independent assessment of 283 identified meta-analyses using both the AMSTAR 2 and the MAC Tool by two reviewers.
• Statistical analysis to evaluate temporal trends and the correlation between MAC Tool scores and AMSTAR 2 results.

Main Results:

• The volume of plastic surgery meta-analyses increased significantly from 2011-2023, but the proportion of high-quality studies did not improve.
• The MAC Tool demonstrated high specificity when compared to AMSTAR 2 in assessing research question (100%), statistical analysis appropriateness (96.23%), and risk of bias (98.97%).
• A high correlation was observed between the MAC Tool and AMSTAR 2.

Conclusions:

• The Meta-Analysis Critique (MAC) Tool is a simple, effective screening instrument for quickly appraising the quality of plastic surgery meta-analyses.
• The MAC Tool shows high correlation with the gold-standard AMSTAR 2, aiding in the identification of potentially low-quality studies.
• Further validation of the MAC Tool in other specialties is recommended.