Abstract
Background: An increasing demand for evidence-based
healthcare is placing new
emphasis on the methodological quality of systematic reviews. The
Guide to Community
Preventive Services (the Community Guide) was developed to
conduct systematic
reviews evaluating the effectiveness of public health
interventions. Each intervention is
issued a finding from the Task Force on Community Preventive
Services (Task Force),
based on the strength of the evidence obtained in the review. These
findings and
recommendations are increasingly being implemented in public health
policies and
programs.
Objective: To determine the association between
methodological reporting quality in
Community Guide systematic reviews and the corresponding Task Force
finding. We
also sought to evaluate the effect that three covariates
(publication year, topic area, or
the type of intervention considered in the review) have on the
methodological reporting
quality.
Methods: Community Guide systematic reviews were selected
from five topic areas,
and from each review that satisfied the inclusion and exclusion
criteria, data were
extracted on descriptive information, quality of the included
studies, methodological
reporting quality (based on five selected methodological
characteristics), and the Task
Force finding. Associations between the methodological reporting
quality and the Task
Force finding, and the effects of the three covariates on the
methodological reporting
quality, were evaluated using logistic regression modeling
techniques.
Results: In the 72 systematic reviews included, the average
number of methodological
characteristics addressed was 1.72 out of a possible 5. A Task
Force finding of strong
evidence vs. insufficient evidence was significantly associated
with increased
methodological reporting score (OR=2.31) and increased study
quality score (OR=2.24).
Significant associations of similar magnitude were also observed
for the comparison of
sufficient vs. insufficient evidence. Reporting of the individual
methodological
characteristics was significantly different at varying values of
the three covariates
evaluated.
Conclusions: All findings are of importance in public
health, whether a
recommendation with strong evidence supports an intervention's
effectiveness, or a
finding of insufficient evidence suggests areas for future
research. For any finding,
thorough and transparent methodological reporting contributes to
the validity of the
systematic review, increasing its usefulness to public health
policy-makers and
professionals.
Table of Contents
Section
..............................................................................
Page
Chapter I: Literature Review
.................................................... 1
Chapter II: Manuscript
...........................................................
11
Abstract
..............................................................................
12
Introduction
.........................................................................
13
Methods
..............................................................................
16
Results
................................................................................
21
Discussion
............................................................................
27
References
...........................................................................
33
Tables
.................................................................................
38
Figures
................................................................................
47
Chapter III: Public Health Implications
....................................... 53
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