DÄ internationalArchive4/2010Who Assesses the Quality of Systematic Reviews?
The authors have provided a checklist to assess the quality of systematic reviews. In our opinion, the importance of the question whether the relevant data have been correctly extracted from the original publications cannot be emphasized strongly enough. We have studied the results of different meta-analyses of stapled hemorrhoidopexy versus conventional hemorrhoidectomy. On first impressions, these studies would meet the criteria set out by Ressing et al. However, the careful selection of raw data from the publications is of the utmost importance. This becomes clear from the articles by Shao (1) and Laughlan (2): they include a publication in which a completely different surgical technique was used (linear stapling rather than circular stapling). Shao’s article (1) included a study that compared the stapling procedure with a non-surgical procedure. The articles of Shao (1), Laughlan (2), and Lan (3) included duplications: the authors had overlooked the fact that the studies in question were follow-up studies of the same groups of patients. One might argue that the authors did not have any detailed knowledge of the surgical technique or that they did not have access to the original publication.

Study protocols, a priori hypotheses, and the description of the literature search are essential, but reviewers would have to perform the entire search and study all the literature again in order to be able to assess whether the included studies should have been included or not.

So the following question arises: who assesses the quality of the systematic reviewand the meta-analysis, not only on the basis of the checklist used by Ressing et al, but with a view to the quality of the included studies?
DOI: 10.3238/arztebl.2010.0057a

Dr. med. Johannes Jongen
PD Dr. med. Volker Kahlke
Beselerallee 67
24105 Kiel, Germany
E-Mail: j.jongen@kielnet.net

PD Dr. med. Sven Petersen
Asklepiosklinik Altona
1. Chirurgische Abteilung
Paul-Ehrlich-Str. 1
22763 Hamburg, Germany
1.
Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ: Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 2008; 95: 147–60 MEDLINE
2.
Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G: Stapler haemorrhoidopexy compared to Milligan-Morgan and Ferguson haemorrhoidectomy: a systemic review. Int J Colorectal Dis 2009; 24: 335–44 MEDLINE
3.
Lan P, Wu X, Zhou X, Wang J, Zhang L: The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Dis 2006; 21: 172–8 MEDLINE
4.
Ressing M, Blettner M, Klug SJ: Systematic literature reviews and meta-analyses—Part 6 of a Series on Evaluation of scientific publications. [Systematische Übersichtsarbeiten und Metaanalysen – Teil 6 der Serie zur Bewertung wissenschaftlicher Publikationen]. Dtsch Artzebl Int 2009; 106: 456–63 VOLLTEXT
1. Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ: Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 2008; 95: 147–60 MEDLINE
2. Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G: Stapler haemorrhoidopexy compared to Milligan-Morgan and Ferguson haemorrhoidectomy: a systemic review. Int J Colorectal Dis 2009; 24: 335–44 MEDLINE
3. Lan P, Wu X, Zhou X, Wang J, Zhang L: The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Dis 2006; 21: 172–8 MEDLINE
4. Ressing M, Blettner M, Klug SJ: Systematic literature reviews and meta-analyses—Part 6 of a Series on Evaluation of scientific publications. [Systematische Übersichtsarbeiten und Metaanalysen – Teil 6 der Serie zur Bewertung wissenschaftlicher Publikationen]. Dtsch Artzebl Int 2009; 106: 456–63 VOLLTEXT