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01-02-2020 | Review

A novel tool to evaluate bias in literature on use of biologic mesh in abdominal wall hernia repair

Authors: J. Con, L. Zarain, S. Gogna, D. J. Samson, K. Prabhakaran, S. Gashi, E. Tilley, R. Latifi

Published in: Hernia | Issue 1/2020

Abstract

Purpose

Biologic meshes are being increasingly used for abdominal hernia repair in high-risk patients or patients with a previous history of wound infection, due to their infection-resistant properties. Several studies have been carried out to assess whether biologic mesh is superior to synthetic mesh, as well as to establish guidelines for their use. Unfortunately, most of these studies were not rigorously designed and were vulnerable to different types of bias. The systematic reviews that have been published so far on this topic contain the same biases and limitations of the primary articles that are analyzed. The lack of a literature review on the bias on the use of biological mesh prompted us to conduct the literature search, assessment and plan this article.

Methods

We performed a literature search in PubMed, Embase and Cochrane databases of systematic reviews on biologic mesh for ventral hernia repair. The literature review was conducted using the Population, Intervention, Comparisons, Outcomes and Design approach. We identified 40 studies that matched the stringent criteria we had set. We then created a 13-point instrument to assess for bias and applied it on the primary studies that we intended to analyze.

Results

Most primary studies are case series or case reports of patients undergoing abdominal hernia repair with biologic mesh, without any comparison group, and the inclusion of cases was only specified to be consecutive in 6 out of 40 cases. In terms of assessing outcomes, in none of the 40 articles were the outcome assessors blinded to the intervention or exposure status of participants.

Conclusion

The instrument that we created could allow to assess the risk of bias in different kind of studies. Our assessment of the studies based on the criteria that we had set up in the instrument clearly identified that further research needs to be done due to the lack of unbiased studies regarding the use of biologic meshes for abdominal hernia repair.

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Title: A novel tool to evaluate bias in literature on use of biologic mesh in abdominal wall hernia repair
Authors: J. Con
L. Zarain
S. Gogna
D. J. Samson
K. Prabhakaran
S. Gashi
E. Tilley
R. Latifi
Publication date: 01-02-2020
Publisher: Springer Paris
Published in: Hernia / Issue 1/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-01935-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A novel tool to evaluate bias in literature on use of biologic mesh in abdominal wall hernia repair

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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