Methodological overview of systematic reviews to establish the evidence base for emergency general surgery

Jelena Savović, Natalie Blencowe, Sean Strong, Noah Howes, Katy Chalmers, James Chrichton, Laura Gould, Sanjeeva Kariyawasam, John Mason, Victoria Pegna, Sarah Richards, Ceri Rowlands, Daniel Stevens, Katie Whale, Jane Blazeby

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)
464 Downloads (Pure)

Abstract

Background: The evidence for treatment decision-making in emergency general surgery has not been summarized previously. The aim of this overview was to review the quantity and quality of systematic review evidence for the most common emergency surgical conditions.
Methods: Systematic reviews of the most common conditions requiring unplanned admission and treat-ment managed by general surgeons were eligible for inclusion. The Centre for Reviews and D issemi-nation databases were searched to April 2014. The number and type (randomized or non-randomized) of included studies and patients were extracted and summarized. The total number of unique stud-ies was recorded for each condition. The nature of the interventions (surgical, non-surgical invasive ornon-invasive) was documented. The quality of reviews was assessed using the AMSTAR checklist.
Results: The 106 included reviews focused mainly on bowel conditions (42), appendicitis (40) andgallstone disease (17). Fifty-one (48⋅1 per cent) included RCTs alone, 79 (74⋅5 per cent) included at least one RCT and 25 (23⋅6 per cent) summarized non-randomized evidence alone. Reviews included727 unique studies, of which 30⋅3 per cent were RCTs. Sixty-ve reviews compared different types of surgical intervention and 27 summarized trials of surgical versus non-surgical interventions. Fifty-seven reviews (53⋅8 per cent) were rated as low risk of bias.
Conclusion: This overview of reviews highlights the need for more and better research in this field.
Original languageEnglish
Pages (from-to)513-524
Number of pages12
JournalBritish Journal of Surgery
Volume104
Issue number5
DOIs
Publication statusPublished - 14 Mar 2017

Structured keywords

  • Centre for Surgical Research

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