Finding diamonds in the rough: evaluating the quality of meta-analyses in chronic pain – an infographic

Abstract

There is an increasing number of meta-analyses (MAs) investigating spinal cord stimulation (SCS) for the treatment of pain; however, the quality of these has not previously been appraised. Kleppel et al1 evaluate the methodological and statistical characteristics of MAs concerning SCS as a treatment for chronic pain syndromes. This study identified 25 MAs, with only 3 deemed ‘high’ quality, 3 labeled ‘low’ quality, and the majority (19) categorized as ‘critically low’ quality according to A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) criteria. While there was no significant association between publication year, effect size, and overall quality, higher-impact factor journals were associated with higher-quality MAs. Additionally, the study revealed that only a fraction of the analyzed studies (20%) were adequately powered, indicating a need for more robust methodologies in future research. These findings underscore the importance of improved study quality of future MAs, advocating for the adoption of AMSTAR-2 checklist items to enhance methodological rigor and validity.