Background
Methods
Inclusion and exclusion criteria
Search strategy
Study selection and data extraction
AMSTAR Checklist | modified AMSTAR Checklist | “YES” N (%) | “NO” N (%) | “Cannot answer” N (%) |
---|---|---|---|---|
1. Was an ‘a priori’ design provided? | 6 (9.5) | 0 | 57 (90.5) | |
2. Was there duplicate study selection and data extraction? | 2.1 Were there at least two independent data extractors for study selection? | 45 (71.4) | 4 (6.3) | 14 (22.2) |
2.2 Was there a consensus procedure for disagreements in study selection? | 38 (60.3) | 5 (7.9) | 20 (31.7) | |
2.3 Were there at least two independent data extractors for data extraction? | 46 (73.0) | 3 (4.8) | 14 (22.2) | |
2.4 Was there a consensus procedure for disagreements in data extraction? | 39 (61.9) | 5 (7.9) | 20 (31.7) | |
3. Was a comprehensive literature search performed? | 3.1 Were there at least 2 electronic sources searched? | 62 (98.4) | 1 (1.6) | 0 |
3.2 Did the report include search years? | 61 (96.8) | 1 (1.6) | 1 (1.6) | |
3.3 Were key words and/or MESH terms stated and where feasible the search strategy provided? | 61 (96.8) | 2 (3.2) | 0 | |
3.4 Were there supplementary searches? | 49 (77.8) | 9 (14.2) | 5 (7.9) | |
4. Was the status of publication (i.e., gray literature) used as an inclusion criterion? | 4.1 Were there any restrictions for publication type? | 8 (13.0) | 36 (57.1) | 19 (29.7) |
4.2 Were there any restrictions for language? | 22 (34.4) | 25 (39.1) | 17 (30.2) | |
5. Was a list of studies provided? | 5.1 Was a list of included studies provided? | 63 (100) | 0 | 0 |
5.2 Was a list of excluded studies provided? | 4 (6.3) | 59 (93.7) | 0 | |
6. Were the characteristics of the included studies provided? | 6.1 Were the demographics of the participants provided? | 52 (82.5) | 11 (17.4) | 0 |
6.2 Were the characteristics of the interventions provided? | 59 (93.7) | 4 (6.4) | 0 | |
6.3 Were the characteristics of the outcomes provided? | 40 (63.5) | 23 (36.5) | 0 | |
7. Was the scientific quality of the included studies assessed and documented? | 7.1 Were there ‘a priori’ methods of assessment being provided? | 55 (87.3) | 8 (12.7) | 0 |
7.2 Was a “risk of bias” table shown in a graphic form? | 55 (87.3) | 8 (12.7) | 0 | |
8. Was the scientific quality of the included studies used appropriately in formulating conclusions? | 8.1 Were the results of the methodological rigor and scientific quality considered in the analysis of the review? | 35 (55.6) | 26 (41.7) | 2 (3.2) |
8.2 Were the results of the methodological rigor and scientific quality considered in the conclusions of the review? | 37 (58.7) | 22 (34.9) | 4 (6.3) | |
9. Were the methods used to combine the findings of studies appropriate? | 9.1 Was the homogeneity test (i.e., Chi-squared test for homogeneity, I2) conducted when pooling results? | 61 (96.8) | 2 (3.2) | 0 |
9.2 Was a random effects model used and/or the clinical appropriateness of combing taken into consideration when heterogeneity exists? | 61 (96.8) | 2 (3.2) | 0 | |
10. Was the likelihood of publication bias assessed? | 20 (31.7) | 42 (66.7) | 1 (1.6) | |
11. Was the conflict of interest stated? | 11.1 Were the sources of support for the SR reported? | 47 (74.6) | 16 (25.4) | 0 |
11.2 Were the sources of support for the included primary studies reported? | 1 (1.6) | 62 (98.4) | 0 |
Quality assessment
AMSTAR item | Total reviews marched the item (n = 63) | Reviews marched the item in Chinese journal (n = 15) | Reviews marched the item in English journal (n = 48) | P value |
---|---|---|---|---|
1 | 6 (9.5%) | 0 | 6 (12.5) | 0.181△ |
2.1 | 45 (71.4%) | 12 (80%) | 32 (66.7%) | 0.520△ |
2.2 | 38 (60.3%) | 11 (73.3%) | 26 (54.2%) | 0.188 |
2.3 | 46 (73.0%) | 7 (46.7%) | 39 (81.3%) | 0.017*△ |
2.4 | 39 (61.9%) | 5 (33.3%) | 34 (70.8%) | 0.009* |
3.1 | 62 (98.4%) | 15 (100%) | 47 (97.9%) | 1.000△ |
3.2 | 61 (96.8%) | 15 (100%) | 46 (95.8%) | 1.000△ |
3.3 | 61 (96.8%) | 15 (100%) | 46 (95.8%) | 1.000△ |
3.4 | 50 (79.4%) | 12 (80%) | 38 (79.2%) | 1.000△ |
4.1 | 9 (14.3%) | 0 | 8 (16.7%) | 0.181△ |
4.2 | 22 (34.9%) | 3 (20%) | 19 (39.6%) | 0.165 |
5.1 | 63 (100%) | 15 (100%) | 48 (100%) | – |
5.2 | 4 (6.3%) | 0 | 4 (8.3%) | 0.564△ |
6.1 | 52 (82.5%) | 13 (86.7%) | 39 (81.3%) | 1.000△ |
6.2 | 59 (93.7%) | 13 (86.7%) | 46 (95.8%) | 0.238△ |
6.3 | 40 (63.5%) | 9 (60%) | 31 (64.6%) | 0.748 |
7.1 | 56 (88.9%) | 14 (93.3%) | 42 (87.5%) | 1.000△ |
7.2 | 55 (87.3%) | 13 (86.7%) | 42 (87.5%) | 1.000△ |
8.1 | 35 (55.6%) | 8 (53.3%) | 27 (56.3%) | 0.843 |
8.2 | 37 (58.7%) | 12 (80%) | 25 (52.1%) | 0.055 |
9.1 | 61 (96.8%) | 15 (100%) | 46 (95.8%) | 1.000△ |
9.2 | 61 (96.8%) | 15 (100%) | 46 (95.8%) | 1.000△ |
10 | 21 (33.3%) | 5 (33.3%) | 16 (33.3%) | 1.000 |
11.1 | 47 (74.6%) | 5 (33.3%) | 42 (87.5) | 0.000*△ |
11.2 | 1 (1.6%) | 0 | 1 (2.1%) | 1.000△ |
Statistical analysis
Results
Search results
Methodological quality
Comparison between Chinese journals and English journals
Bibliographical characteristics and methodological quality
Bibliographical characteristics | Number (%) | AMSTAR score | Results |
---|---|---|---|
1、published year | |||
2014 | 30 (47.6%) | 6.40 ± 1.35 | P = 0.375 |
2015 | 33 (52.4%) | 6.32 ± 1.19 | |
2、surgical type | |||
THA | 25 (39.7%) | 6.08 (5.46–7.09)b | △P = 0.435 |
TKA | 37 (58.7%) | 6.42 (5.58–7.50)b | |
THA and TKA | 1 (1.59%) | – | |
3、language | |||
Chinese | 15 (23.8%) | 6.67 (5.17–6.08)b | △P = 0.052 |
English | 48 (76.2%) | 5.67 (5.67–7.50)b | |
4、location of the corresponding author | |||
Asia | 50 (79.4%) | 6.17 (5.5–7.19)b | △P = 0.098 |
America | 9 (14.3%) | 6.09 (4.34–7.84)b | |
Europe | 4 (6.3%) | 7.75 (6.37–9.5)b | |
5、Number of SRs that included a PRISMA-like flow | |||
Included a PRISMA-like flow | 53 (84.1%) | 6.48 ± 1.20 | P = 0.752 |
Did not include a PRISMA-like flow | 10 (15.9%) | 5.73 ± 1.45 | |
6、Was the SRs published in journal | |||
Number of SRs published in journal | 59 (93.7%) | 6.17 (5.50–7.50)b | △P = 0.903 |
Number of SRs not published in journal | 4 (6.3%) | 6.34 (5.62–7.29)b | |
7、Tools for assessing risk of bias of primary studies | |||
Cochrane | 35 (55.6%) | 6.67 (5.50–7.50)b | △P = 0.312 |
Jadad scale | 11 (17.5%) | 5.75 (5.67–6.75)b | |
The PEDro scale | 2 (3.2%) | 7.46 | |
Other single assessment tool | 7 (11.1%) | 6.00 (4.5–7.00)b | |
Two or more assessment tools | 6 (9.5%) | 7.00 (5.63–8.13)b | |
Not reported | 2 (3.2%) | 5.45 | |
Average(range) | |||
8、Total number of authors in SRs | 4.9 (1–8) | – | #Nonlinear relation |
9、Number of databases searched | 4.5 (1–12) | – | #Nonlinear relation |
10、Median impact factor of the journal for which the included study was published | 1.864 (0.293–5.228) | – | #P = 0.006* |