Top

Systematic Reviews

Published in:

Open Access 01-12-2019 | Research

Reporting quality of Cochrane systematic reviews with Chinese herbal medicines

Authors: Xuan Zhang, Qi-Ying Aixinjueluo, Si-Yao Li, Lisa-L Song, Chung-Tai Lau, Ran Tan, Zhao-Xiang Bian

Published in: Systematic Reviews | Issue 1/2019

Abstract

Background

Chinese herbal medicines (CHMs) are the major interventions of traditional Chinese medicine (TCM), which are typically administered as either single herbs or formulas. The Cochrane systematic reviews (SRs) of CHMs are essential references for evaluating the efficacy and safety of CHMs interventions; they are expected to be accurate and reliable. This study aimed to assess the reporting quality of these SRs, particularly whether necessary information related to CHM was adequately reported.

Methods

The Cochrane Database was systematically searched for all SRs of CHM that were published up to 31 December 2017. The primary analysis was to assess their reporting quality based on 27-item of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and 9-item of CHM-related information designed according to TCM theory. Descriptive statistics were additionally used to analyze their baseline characteristics.

Results

A total of 109 Cochrane SRs of CHM were identified from 1999 to 2017. For 27-item of PRISMA, 26 had the reporting compliances higher than 50%, of which 11 were fully reporting (100%). However, for CHM-related information, 65 (59.6%) SRs did not report the specific name of the CHM in the title, 42 (38.5%) lacked TCM-related rationales in the introduction, 62 (56.9%) did not include CHM-related characteristics in the additional analyses, and 77 (70.6%) did not analyze CHM results in terms of TCM-related theories in the discussion. Of 97 SRs that included clinical trials, 38 (39.2%) did not provide the details of composition and dosage of CHMs, 85 (87.6%) did not report the CHM sources, 13 (13.4%) did not provide the dosage form, 95 (97.9%) lacked CHM quality control information, and 57 (58.8%) did not describe details of the controls. For 62 (72.9%) of 85 SRs that included meta-analysis, it was impossible to assess whether meta-analysis had been properly conducted due to inadequate reporting of CHM interventions.

Conclusion

Although the Cochrane SRs of CHM showed reporting compliance with PRISMA checklist, their reporting quality needs improvement, especially about full reporting of CHM interventions and of TCM-related rationales. Reporting guideline of “PRISMA extension for CHM interventions” should be developed thus to improve their quality.

Available only for authorised users

Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997;126(5):376–80. https://doi.org/10.7326/0003-4819-126-5-199703010-00006.CrossRefPubMed

Villar J, Carroli G, Belizán JM. Predictive ability of meta-analyses of randomised controlled trials. Lancet. 1995;345(8952):772–6. https://doi.org/10.1016/S0140-6736(95)90646-0.CrossRefPubMed

Mulrow CD, Cook DJ, Davidoff F. Systematic reviews: critical links in the great chain of evidence. Ann Intern Med. 1997;126(5):389–91. https://doi.org/10.7326/0003-4819-126-5-199703010-00008.CrossRefPubMed

Moher D, Simera L, Schulz KF, Hoey J, Altman DG. Helping editors, peer reviewers and authors improve the clarity, completeness and transparency of reporting health research. BMC Med. 2008;6:13. https://doi.org/10.1186/1741-7015-6-13.CrossRefPubMedPubMedCentral

Dixon E, Hameed M, Sutherland F, Cook DJ, Doig C. Evaluating meta-analyses in the general surgical literature: a critical appraisal. Ann Surg. 2005;241(3):450–9. https://doi.org/10.1097/01.sla.0000154258.30305.df.CrossRefPubMedPubMedCentral

Moher D, Tetzlaff J, Tricco AC, Sampson M, Altman DG. Epidemiology and reporting characteristics of systematic reviews. PLoS Med. 2007;4(3):e78. https://doi.org/10.1371/journal.pmed.0040078.CrossRefPubMedPubMedCentral

Wen J, Ren Y, Wang L, Li YP, Liu Y, Zhou M, et al. The reporting quality of meta-analyses improves: a random sampling study. J Clin Epidemiol. 2008;61(8):770–5. https://doi.org/10.1016/j.jclinepi.2007.10.008.CrossRefPubMed

Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999;354(9193):1896–900. https://doi.org/10.1016/S0140-6736(99)04149-5.PubMed

Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral

10.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100. https://doi.org/10.1371/journal.pmed.1000100.CrossRefPubMedPubMedCentral

11.

Fleming PS, Seehra J, Polychronopoulou A, Fedorowicz Z, Pandis N. A PRISMA assessment of the reporting quality of systematic reviews in orthodontics. Angle Orthod. 2013;83(1):158–63. https://doi.org/10.2319/032612-251.1.CrossRefPubMed

12.

Tan WK, Wigley J, Shantikumar S. The reporting quality of systematic reviews and meta-analyses in vascular surgery needs improvement: a systematic review. Int J Surg. 2014;12(12):1262–5. https://doi.org/10.1016/j.ijsu.2014.10.015.CrossRefPubMed

13.

Li JL, Ge L, Ma JC, Zeng QL, Yao L, An N, et al. Quality of reporting of systematic reviews published in “evidence-based” Chinese journals. Syst Rev. 2014;3:58. https://doi.org/10.1186/2046-4053-3-58.CrossRefPubMedPubMedCentral

14.

Tian JH, Zhang J, Ge L, Yang K, Song F. The methodological and reporting quality of systematic reviews from China and the USA are similar. J Clin Epidemiol. 2017;85:50–8. https://doi.org/10.1016/j.jclinepi.2016.12.004.CrossRefPubMed

15.

Green S, Higgins JP, Alderson P, Clarke M, Mulrow CD, Oxman AD. Cochrane Handbook Version 5.0.2: The Cochrane Collaboration; 2008.

16.

Jadad AR, Cook DJ, Jones A, Klassen TP, Tugwell P, Moher M, et al. Methodology and reports of systematic reviews and meta-analyses: a comparison of Cochrane reviews with articles published in paper-based journals. JAMA. 1998;280(3):278–80. https://doi.org/10.1001/jama.280.3.278.CrossRefPubMed

17.

Petticrew M, Wilson P, Wright K, Song FJ. Quality of Cochrane reviews. Quality of Cochrane reviews is better than that of non-Cochrane reviews. BMJ. 2002;324(7336):545.CrossRefPubMedPubMedCentral

18.

Handoll H, Madhok R. Another study found that most Cochrane reviews are of a good standard. BMJ. 2002;324(7336):545.CrossRefPubMedPubMedCentral

19.

Fleming PS, Seehra J, Polychronopoulou A, Fedorowicz Z, Pandis N. Cochrane and non-Cochrane systematic reviews in leading orthodontic journals: a quality paradigm? Eur J Orthod. 2013;35(2):244–8. https://doi.org/10.1093/ejo/cjs016.CrossRefPubMed

20.

Xiong XJ, Yang XC, Liu YM, Zhang Y, Wang PQ, Wang J. Chinese herbal formulas for treating hypertension in traditional Chinese medicine: perspective of modern science. Hypertens Res. 2013;36(7):570–9. https://doi.org/10.1038/hr.2013.18.CrossRefPubMedPubMedCentral

21.

Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. Revised edition. Seattle: Eastland Press, 1993.

22.

He YT, Hou J. Using meta-analysis on secondary prevention of esophageal. Chin J Prevention Control of Chron Dis. 1997;5(3):33–4. [Article in Chinese]. https://doi.org/10.16386/j.cjpccd.issn.1004-6194.1997.03.017.CrossRef

23.

Wang JY, Wang JF, Cheng SQ, Tian GH, Wang YP, Shang HC, et al. Analysis of 19 years development and present situation of Chinese medicine systematic review/meta-analysis. J Tradit Chin Med. 2017;58(11):919–25. [Article in Chinese]. https://doi.org/10.13288/j.11-2166/r.2017.11.006.CrossRef

24.

Chen M, He J, Xiao Y, Huang R, Zhou ZF, Chen CY, et al. Status quo analysis on TCM systematic reviews/meta-analyses published in Chinese journals. Chin J Evid-based Med. 2012;12(12):1526–30 [Article in Chinese].

25.

Ma B, Guo JW, Qi GQ, Li HM, Peng JY, Zhang YL, et al. Epidemiology, quality and reporting characteristics of systematic reviews of traditional Chinese medicine interventions published in Chinese journals. PLoS One. 2011;6(5):e20185. https://doi.org/10.1371/journal.pone.0020185.CrossRefPubMedPubMedCentral

26.

Zhang JH, Shang HC, Gao XM, Zhang BL, Xiang YZ, Cao HB, et al. Methodology and reporting quality of systematic review/meta-analysis of traditional Chinese medicine. J Altern Complement Med. 2007;13(8):797–805. https://doi.org/10.1089/acm.2007.7195.CrossRef

27.

Li Q, Xia Y, Mou YJ, Wang YY, Liu JP. Reevaluation on quality of TCM systematic reviews and Meta-analyses documents published in domestic Chinese journals. Mod Chin Clin Med. 2012;19(3):28–33 [Article in Chinese].

28.

Li TQ, Liu XM, Zhang MM, Ma JX, Du L, Zhou YD, et al. Assessment of systematic reviews and meta-analyses on traditional Chinese medicine published in Chinese journals. Chin J Evid-based Med. 2007;7(3):180–8 [Article in Chinese].

29.

Hu D, Kang DY, Wu YX, Wang JL. Methodological quality assessment of systematic reviews correlated to traditional Chinese medicine published in China. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011;31(3):402–6 [Article in Chinese].PubMed

30.

Hu J, Zhang JH, Zhao W, Zhang YL, Zhang L, Shang HC. Cochrane systematic reviews of Chinese herbal medicines: an overview. PLOS One. 2011;6(12):e28696. https://doi.org/10.1371/journal.pone.0028696.CrossRefPubMedPubMedCentral

31.

Leung KS, Bian ZX, Moher D, Dagenais S, Li YP, Liu L, et al. Improving the quality of randomized controlled trials in Chinese herbal medicine, part III: quality control of Chinese herbal medicine used in randomized controlled trials. Chin J Integr Med. 2006;4(3):225–32.CrossRef

32.

Ma B, Qi GQ, Lin XT, Wang T, Chen ZM, Yang KH. Epidemiology, quality, and reporting characteristics of systematic reviews of acupuncture interventions published in Chinese journals. J Altern Complement Med. 2012;18(9):813–7. https://doi.org/10.1089/acm.2011.0274.CrossRefPubMed

33.

Wang X, Chen Y, Liu Y, Yao L, Estill J, Bian Z, et al. Reporting items for systematic reviews and meta-analyses of acupuncture: the PRISMA for acupuncture checklist. BMC Complement Altern Med. 2019;19(1):208. https://doi.org/10.1186/s12906-019-2624-3.CrossRefPubMedPubMedCentral

34.

Wu TT, Zhang SQ, Guo SW, Gu YZ, Dou LP, Wang YY, et al. Correspondence analysis between traditional Chinese medicine (TCM) syndrome differentiation and histopathology in colorectal cancer. Eur J Integr Med. 2015;7(4):342–7. https://doi.org/10.1016/j.eujim.2015.07.003.CrossRef

35.

Wu TX, Li YP, Bian ZX, Li TQ, Li J, Dagenais S, et al. Consolidated standards for reporting trials of traditional Chinese medicine (CONSORT for TCM) (For solicitation of comments). Chin J Evid-based Med 2007;7(8): 601-605. [Article in Chinese]

36.

Cheng CW, Wu TX, Shang HC, Li YP, Altman DG, Moher D, et al. CONSORT extension for Chinese herbal medicine formulas 2017: recommendations, explanation and elaboration. Ann Intern Med. 2017;167(2):112–21. https://doi.org/10.7326/M16-2977.CrossRefPubMed

37.

Guo XF, Lai SL. Key methodological and institutional issues on how to promote the evidence based traditional Chinese medicine. Chin J Evid-based Med 2008;8(1):10-12. [Article in Chinese]

38.

Moher D, Tsertsvadze A. Systematic reviews: when is an update an update? Lancet, DOI. 2006;367(9514):881–3 https://doi.org/10.1016/S0140-6736(06)68358-X.CrossRef

39.

Hu D, Kang DY, Hong Q. Heterogeneity analysis of systematic reviews on traditional Chinese medicine. Chin J Evid-based Med 2010;10(4):488-491. [Article in Chinese]

40.

Wang G, Mao B, Xiong ZY, Fan T, Chen XD, Wang L, et al. CONSORT Group for traditional Chinese medicine. The quality of reporting of randomized controlled trials of traditional Chinese medicine: a survey of 13 randomly selected journals from mainland China. Clin Ther. 2007;29(7):1456–67. https://doi.org/10.1016/j.clinthera.2007.07.023.CrossRefPubMed

41.

Han M, Wang YY, Mu YJ, Liu ZJ, Li Q, Li XX, et al. Reporting specification of systematic reviews on Chinese medicine and methodological evaluation. Zhongguo Zhong Xi Yi Jie He Za Zhi 2012;32(7):872-874. [Article in Chinese]

42.

Xiong J, Du YH, Li B, Shi L, Xu YY, Liu Q, et al. Assessment of methodology and reporting quality of systematic evaluation and Meta-analysis of acupuncture-moxibustion in China. Zhongguo Zhen Jiu 2009;29(9):763-768. [Article in Chinese]

43.

Ferreira AS, Lopes AJ. Chinese medicine pattern differentiation and its implications for clinical practice. Chin J Integr Med. 2011;17(11):818–23. https://doi.org/10.1007/s11655-011-0892-y.CrossRefPubMed

44.

Yang GY, Luo H, Liu JP. Reporting parts of discussion and conclusion in systematic reviews. Modern Chin Clin Med 2012;19(5):30-32. [Article in Chinese]

45.

Cheng CW, Zhang L, Zhao C, Zhong LL, Shi LJ, Dai L, et al. Whether syndrome differentiation affects treatment result: study protocol of MaZiRenWan for functional constipation in a randomized controlled trial. Chin J Integr Med, DOI. 2019;25(3):175–81 https://doi.org/10.1007/s11655-018-2848-y.CrossRefPubMed

46.

Liu JP, Han M, Li XX, Mu YJ, Lewith G, Wang YY, et al. Prospective registration, bias risk and outcome-reporting bias in randomised clinical trials of traditional Chinese medicine: an empirical methodological study. BMJ Open. 2013;3(7):e002968. https://doi.org/10.1136/bmjopen-2013-002968.CrossRefPubMedPubMedCentral

47.

Wu TX, Liu GJ, Li J. Some risks of affecting the quality of published systematic reviews in China. Chin J Evid-based Med 2005;5(1):51-58. [Article in Chinese]

48.

Ma B, Chen ZM, Xu JK, Wang YN, Chen KY, Ke FY, et al. Do the CONSORT and STRICTA checklists improve the reporting quality of acupuncture and moxibustion randomized controlled trials published in Chinese journals? a systematic review and analysis of trends. PLoS One. 2016;11(1):e0147244. https://doi.org/10.1371/journal.pone.0147244.CrossRefPubMedPubMedCentral

49.

Hoffmann T, Glasziou P, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ, DOI. 2014;348:g1687 https://doi.org/10.1136/bmj.g1687.CrossRefPubMed

50.

Liu Y, Zhang R, Huang J, Zhao X, Liu D, Sun W, et al. Reporting quality of systematic reviews/meta-analyses of acupuncture. PLoS One. 2014;9(11):e113172. https://doi.org/10.1371/journal.pone.0113172.CrossRefPubMedPubMedCentral

51.

Enhancing the QUAlity and Transparency Of health Research (EQUAOR) Network. http://www.equator-network.org/library/reporting-guidelines-under-development/#38 Accessed 26 May 2018.

Title: Reporting quality of Cochrane systematic reviews with Chinese herbal medicines
Authors: Xuan Zhang
Qi-Ying Aixinjueluo
Si-Yao Li
Lisa-L Song
Chung-Tai Lau
Ran Tan
Zhao-Xiang Bian
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-019-1218-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reporting quality of Cochrane systematic reviews with Chinese herbal medicines

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

A systematic review of experimental methods to manipulate secondary hyperalgesia in humans: protocol

How should systematic reviewers handle conference abstracts? A view from the trenches

Strategies for incorporating patient-reported outcomes in the care of people with chronic kidney disease (PRO kidney): a protocol for a realist synthesis

Effect of mobile text message reminders on routine childhood vaccination: a systematic review and meta-analysis

The association of telomere length with substance use disorders: systematic review and meta-analysis protocol

Acceptance and commitment therapy for chronic pain: protocol of a systematic review and individual participant data meta-analysis