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

doi:10.1002/bjs.10476

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

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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 language	English
Pages (from-to)	513-524
Number of pages	12
Journal	British Journal of Surgery
Volume	104
Issue number	5
DOIs	https://doi.org/10.1002/bjs.10476
Publication status	Published - 14 Mar 2017

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Centre for Surgical Research

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ConDuCT-II
Blazeby, J. (Principal Investigator)
1/04/14 → 31/03/19
Project: Research
NIHR CLAHRC - UHB
Donovan , J. L. (Principal Investigator)
1/01/14 → 30/09/19
Project: Research, Parent

Dr Jelena Savovic
- jelena.savovicbristol.acuk
- Bristol Medical School (PHS) - Associate Professor in Epidemiology and Evidence Synthesis.
- Bristol Population Health Science Institute
Person: Academic , Member

Cite this

Savović, J., Blencowe, N., Strong, S., Howes, N., Chalmers, K., Chrichton, J., Gould, L., Kariyawasam, S., Mason, J., Pegna, V., Richards, S., Rowlands, C., Stevens, D., Whale, K., & Blazeby, J. (2017). Methodological overview of systematic reviews to establish the evidence base for emergency general surgery. British Journal of Surgery, 104(5), 513-524. https://doi.org/10.1002/bjs.10476

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title = "Methodological overview of systematic reviews to establish the evidence base for emergency general surgery",

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.",

author = "Jelena Savovi{\'c} and Natalie Blencowe and Sean Strong and Noah Howes and Katy Chalmers and James Chrichton and Laura Gould and Sanjeeva Kariyawasam and John Mason and Victoria Pegna and Sarah Richards and Ceri Rowlands and Daniel Stevens and Katie Whale and Jane Blazeby",

year = "2017",

month = mar,

day = "14",

doi = "10.1002/bjs.10476",

language = "English",

volume = "104",

pages = "513--524",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "Wiley",

number = "5",

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Savović, J , Blencowe, N, Strong, S, Howes, N, Chalmers, K, Chrichton, J, Gould, L, Kariyawasam, S, Mason, J, Pegna, V, Richards, S, Rowlands, C, Stevens, D, Whale, K & Blazeby, J 2017, 'Methodological overview of systematic reviews to establish the evidence base for emergency general surgery', British Journal of Surgery, vol. 104, no. 5, pp. 513-524. https://doi.org/10.1002/bjs.10476

TY - JOUR

T1 - Methodological overview of systematic reviews to establish the evidence base for emergency general surgery

AU - Savović, Jelena

AU - Blencowe, Natalie

AU - Strong, Sean

AU - Howes, Noah

AU - Chalmers, Katy

AU - Chrichton, James

AU - Gould, Laura

AU - Kariyawasam, Sanjeeva

AU - Mason, John

AU - Pegna, Victoria

AU - Richards, Sarah

AU - Rowlands, Ceri

AU - Stevens, Daniel

AU - Whale, Katie

AU - Blazeby, Jane

PY - 2017/3/14

Y1 - 2017/3/14

N2 - 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.

AB - 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.

U2 - 10.1002/bjs.10476

DO - 10.1002/bjs.10476

M3 - Article (Academic Journal)

C2 - 28295254

SN - 0007-1323

VL - 104

SP - 513

EP - 524

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 5

ER -

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

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Dr Jelena Savovic

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