Opposing systematic reviews: the effects of two quality rating instruments on evidence regarding t'ai chi and bone mineral density in postmenopausal women

Ref ID 281
First Author S. Y. Alperson
Journal JOURNAL OF ALTERNATIVE & COMPLEMENTARY MEDICINE
Year Of Publishing 2011
URL https://www.liebertpub.com/doi/10.1089/acm.2010.0175
Keywords • Risk of bias
• Complementary & Alternative
Problem(s) • Ignores setting or context of included studies which limits review applicability
• Flawed risk of bias undertaken
Article Type Empirical
Article Subtype Case study
First Author Country United States
Aim To assess two systematic reviews of t’ai chi interventions on bone mineral density in postmenopausal women which have starkly opposing conclusions and to examine how chosen quality rating instruments can impact systematic reviews
Level of Investigation Descriptive
Summary of Findings Two systematic reviews of t’ai chi interventions on bone mineral density in postmenopausal women were found to have starkly opposing conclusions due to the choice of quality appraisal tool. The authors conclude that the use of the Jadad scale in one review was not only inadequate but also inappropriate for reviewing t’ai chi studies, potentially misleading researchers, clinicians and policymakers.
Number of systematic reviews included 2
Number of eligible systematic reviews assessed 2
Treatment impacted Yes
Treatment impacted description
Interpretation impacted Yes
Interpretation impacted description The authors compared the scores from the two quality rating scales used in the discordant systematic reviews with three others. While one of the rating scales (Wayne et al.) showed an agreement of 78% to the other scales (75%, 77% and 85%), the Jadad scale only had a 40% rating. This demonstrates how different inclusion criteria affected the ratings of individual studies and thus which studies were included in the pool of quality studies. The inclusion criteria also ultimately affect the conclusions regarding the effectiveness of one study (Lee et al. 2008).