Making the Most of Systematic Reviews and Meta-analyses in Spine Surgery: A Primer for the Practicing Spine Surgeon

Spine (Phila Pa 1976). 2020 Jul 1;45(13):E808-E812. doi: 10.1097/BRS.0000000000003429.

Abstract

Study design: Review.

Objective: To provide practicing spine surgeons a primer with key insights for reading, interpreting, and clinically integrating systematic reviews and meta-analyses.

Summary of background data: Evidence-based medicine (EBM) refers to a family of standardized techniques for critical appraisal of clinical research. Within the contemporary spine literature, EBM is most commonly encountered in the form of systematic reviews and meta-analyses. Although these analytic techniques are potentially useful when appropriately applied to well-formulated questions with adequate primary data in the literature, the rapid and somewhat indiscriminate increase in volume of systematic reviews and meta-analyses published may be associated with an overall dilution in their quality, as well as misperceptions regarding the applicability of particular EBM studies to spine surgery in general.

Methods: The collective experience of spine specialists with vested interests in advancing EBM and its utility was summarized into a primer.

Results: We emphasize components that are pertinent methodologically (search strategy, study number, meta-analysis, bias, and certainty), and pertinent clinically (outcomes) to interpreting, and clinically integrating systematic reviews and meta-analyses into spine surgery practice.

Conclusions: Armed with these insights into these five perspectives, we anticipate that practicing spine surgeons will be better equipped to interpret systematic reviews and meta-analyses in a fashion that will meaningfully impact their patient care.

Level of evidence: 2.

MeSH terms

  • Bias
  • Evidence-Based Medicine
  • Humans
  • Meta-Analysis as Topic*
  • Spine / surgery*
  • Systematic Reviews as Topic*