Reporting and Methodological Quality of Systematic Reviews and Meta-Analyses of Nursing Interventions in Patients With Alzheimer's Disease: General Implications of the Findings.

OBJECTIVE: The aim of this study was to evaluate the reporting characteristics as well as the methodological quality of systematic reviews (SRs) and meta-analyses (MAs) of nursing interventions in patients with Alzheimer's disease and determine potential factors for high quality.

METHODS: Following the inclusion and exclusion criteria, we searched the databases PubMed, EMBASE, and The Cochrane Library from inception through October 1, 2017. Two reviewers independently selected articles and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and Assessment of Multiple Systematic Reviews (AMSTAR) checklist were adopted to evaluate reporting and methodological quality, respectively.

RESULTS: A total of 64 eligible articles, published from 2001 to 2017, were included. The mean PRISMA and AMSTAR scores were 19.310 ± 4.167 and 6.390 ± 2.208, respectively. For the PRISMA checklist, the following characteristics had less than 50% compliance: protocol or registration, full electronic search strategy, summary measures, risk for bias across studies, and synthesis of results. For the AMSTAR checklist, the following characteristics had less than 50% compliance: a priori study design, comprehensive literature search, status of publication used as inclusion criteria, scientific quality, publication bias, and conflicts of interest stated. Logistic regression analyses indicated that systematic reviews including meta-analyses that followed PRISMA guidelines, had a protocol or registration, and had funding support were related to higher reporting quality; systematic reviews including meta-analyses that had a protocol or registration were related to higher methodological quality.

CONCLUSIONS: The reporting and methodological quality of systematic reviews and meta-analyses of nursing interventions in patients with Alzheimer's disease were suboptimal, with some areas needing further improvement. More endorsement by journals of the reporting guidelines for SRs and MAs may improve article quality and the dissemination of reliable evidence to nurses. We recommend that authors, readers, reviewers, and editors become better acquainted with and adhere more strictly to the PRISMA and AMSTAR checklists.