The number of published systematic reviews has increased over the last years, with a non-negligible proportion displaying methodological concerns. We aimed to develop and evaluate a tool to assess the reported methodological quality of medical systematic reviews. The developed tool (ReMarQ) consists of 26 dichotomous items. We applied an item response theory model to assess the difficulty and discrimination of the items and decision tree models to identify those items more capable of identifying systematic reviews with higher reported methodological quality. ReMarQ was applied to a representative sample of medical systematic reviews (excluding those published in the Cochrane Database of Systematic Reviews) to describe their methodological quality and identify associated factors. We assessed 400 systematic reviews published between 2010 and 2020, of which 196 (49.0%) included meta-analysis. The most discriminative items were (i) conducting a risk of bias assessment, (ii) having a published protocol and (iii) reporting methods for solving disagreements. More recent systematic reviews (adjusted yearly RR=1.03; 95%CI=1.02 −1.04, p<0.001) and those with meta-analysis (adjusted RR=1.34; 95%CI=1.25 −1.43, p<0.001) were associated with higher reported methodological quality. Such an association was not observed with the journal impact factor. The items most frequently fulfilled were (i) reporting search dates, (ii) reporting bibliographic sources and (iii) searching multiple electronic bibliographic databases. ReMarQ, consisting of dichotomous items and whose application does not require subject content expertise, may be important (i) in supporting an efficient quality assessment of systematic reviews and (ii) as the basis of automated processes to support that assessment.

Studies have demonstrated that the quality and transparency of reporting Clinical Practice Guidelines (CPGs) in healthcare are low. This meta-research aimed to evaluate the adherence of nutrition CPGs for critically ill adults to the reporting RIGHT checklist and its association with the methodological quality assessed by AGREE II, along with other potential publication-related factors. A systematic search for CPGs until December 2024 was conducted. RIGHT and AGREE II were applied. Reporting completeness score was created using the data from the evaluations of whether each broken-down item of the RIGHT. Eleven CPGs were identified, none demonstrated adherence greater than 60% to the RIGHT checklist, and the mean of RIGHT score was 33.5±15.5%. There was a strong correlation between the RIGHT score and AGREE II (r=0.886). A development CPGs team including methodologist and/or statistician was associated with a higher RIGHT score (48.9±4.5 versus 27.2±11.0) and it was higher in CPGs recommended or recommended with modifications by AGREE II in comparison to those not recommended (50.1±4.6 versus 37.7±8.1 versus 17.0±6.8), and in those with acceptable and moderate compared to those with low methodological quality (50.1±4.6 versus 32.2±14.5 versus 19.3±6.2). It was also related to the language of publication, being higher in those published in English. The reporting completeness in CPGs for critically ill adults was low, with a strong correlation with the methodological quality. High values of reporting completeness scores were observed between CPGs recommended by AGREE II (with moderate or acceptable quality) and in those including a methodologist/statistician in the development team.

A number of studies have examined the effects of reading interventions for younger readers; however, there does not appear to be any existing syntheses examining the effect of reading interventions on students in Years 7–12. The purpose of this study was to establish whether such a synthesis is feasible by reviewing the methodological quality of randomised controlled trial studies examining the effect of reading interventions for secondary students, using the Council for Exceptional Children (CEC) standards. A total of 17 studies were identified and reviewed. Overall, only two studies met all eight CEC quality indicators. All studies met the quality indicators for intervention agent, and context and settings. Findings, limitations and recommendations for future directions of study are discussed.

Objectives: The methodological quality of an economic evaluation performed alongside a clinical trial can be underestimated if the paper does not report key methodological features. This study discusses methodological assessment issues on the example of a systematic review on cost-effectiveness of physiotherapy for knee osteoarthritis.

Methods: Six economic evaluation studies included in the systematic review and related clinical trials were assessed using the 10-question check-list by Drummond and the Physiotherapy Evidence Database (PEDro) scale.

Results: All economic evaluations were performed alongside a clinical trial but the studied interventions were too heterogeneous to be synthesized. Methodological quality of the economic evaluations reported in the papers was not free of drawbacks, and in some cases, it improved when information from the related clinical trial was taken into account.

Conclusions: Economic evaluation papers dedicate little space to methodological features of related clinical trials; therefore, the methodological quality can be underestimated if evaluated separately from the trials. Future economic evaluations should follow more strictly the recommendations about methodology and the authors should pay special attention to the quality of reporting.

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.

Objectives: Case series constitute a weak form of evidence for effectiveness of health technologies. However, for a variety of reasons, such studies may be included in health technology assessments. There are no clear criteria for assessing the quality of case series. We carried out an empirical investigation of the association between outcome frequency and methodological characteristics in a sample of health technology assessments.

Methods: Systematic reviews of functional endoscopic sinus surgery for nasal polyps, spinal cord stimulation for chronic back pain, and percutaneous transluminal coronary angioplasty and coronary artery bypass grafting for chronic stable angina were identified as containing more than forty case series. Data were extracted by one reviewer and checked by a second on population characteristics, outcomes, and the following methodological features: sample size, prospective/retrospective approach, consecutive recruitment, multi- or single-center organization, length of follow-up, independence of outcome measurement, and date of publication. Association between methodological features and outcome were explored in univariate and multivariate analyses using parametric and nonparametric tests and robust regression or analysis of variance/analysis of covariance, as appropriate.

Results: Included reviews contained between forty-two and seventy-six case series studies, involving 5 to 172,283 participants. Reporting of methodological features was poor and limited the analyses. In general, we found little evidence of any association between methodological characteristics and outcome. Sample size is used as an inclusion criterion in many reviews of case series but was consistently shown to have no relationship to outcome in all analyses. A prospective approach was not associated with outcome. Insufficient data were available to explore consecutive recruitment. Mixed results were shown for length of follow-up, independence of outcome measurement, and publication date.

Conclusion: We found little evidence to support the use of many of the factors included in tools used for quality assessment of case series. Importantly, we found no relationship between study size and outcome across the four examples studied. Isolated examples of a potentially important relationship between other methodological factors and outcome were shown, for example, blinding of outcome measurement, but these examples were not shown consistently across the small number of examples studied. Further research into the determinants of quality in case series studies is required to support health technology assessment.