Failure to define clinically meaningful outcomes

Systematic reviews should assess outcomes that are likely to be meaningful to clinicians, patients, consumers, the general public, and decision makers. Authors should specify in advance what outcomes would be clinically meaningful for the target population, rather than being led by outcomes measured in the included primary studies. Some medical conditions even have dedicated core outcome sets which aim to promote consistent measurement between studies. Treatment effect sizes should be defined so that clinically meaningful differences, not merely statistically significant differences are detected and reported by systematic reviews.

Articles that support this problem:

Multiple overlapping systematic reviews facilitate the origin of disputes: the case of thrombolytic therapy for pulmonary embolism

2018 : Journal of clinical epidemiology

Strong heterogeneity of outcome reporting in systematic reviews

2016 : Journal of clinical epidemiology

Bias due to changes in specified outcomes during the systematic review process

2010 : Plos one

Survey of new 2007 and 2011 Cochrane reviews found 37% of prespecified outcomes not reported

2015 : Journal of clinical epidemiology

Potential impact of missing outcome data on treatment effects in systematic reviews: imputation study

2020 : Bmj

Authors seldom report the most patient-important outcomes and absolute effect measures in systematic review abstracts

2017 : Journal of clinical epidemiology

Trust, but verify. The errors and misinterpretations in the Cochrane analysis by O. J. Storebo and colleagues on the efficacy and safety of methylphenidate for the treatment of children and adolescents with ADHD

2016 : Zeitschrift fur kinder-und jugendpsychiatrie und psychotherapie

Some problems with Cochrane reviews of diet and chronic disease

2005 : European journal of clinical nutrition

Systematic review of spinal manipulation: A biased report

2006 : Journal of the royal society of medicine

Systematic reviews of surgical procedures in children: quantity, coverage and quality

2013 : Journal of paediatrics and child health

Can a core outcome set improve the quality of systematic reviews?–a survey of the Co-ordinating Editors of Cochrane Review Groups

2013 : Trials

Characteristics and quality of systematic reviews of acupuncture, herbal medicines, and homeopathy

2003 : Complementary medicine research

Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews

2021 : Social science & medicine

Methodological issues in meta-analyses of observational studies: the need for attention to the details

2022 : British journal of anaesthesia

Industry effects on evidence: a case study of long-acting injectable antipsychotics

2024 : Accountability in research

Concerns Regarding Strength of Conclusions in Systematic Review and Meta-Analysis of Neuroradiological Abnormalities in First-Episode Psychosis

2024 : Jama psychiatry

Concerns Regarding Strength of Conclusions in Systematic Review and Meta-Analysis of Neuroradiological Abnormalities in First-Episode Psychosis

2024 : Jama psychiatry