Biomedical and public health reviews and meta-analyses in Ethiopia had poor methodological quality: overview of evidence from 1970 to 2018

Abstract

OBJECTIVES: The aims of this overview are to assess the trend of narrative and systematic reviews in Ethiopia, examine their methodological quality, and suggest future directions for improvement. STUDY DESIGN AND SETTING: All narrative reviews and systematic reviews with or without a meta-analysis on topics associated with Ethiopia irrespective of the place of publication and authors' affiliation were included. The International Narrative Systematic Assessment for narrative reviews and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews with or without a meta-analysis were used for quality appraisal. Fisher's exact test at the P-value threshold of 0.05 was used to investigate associated factors of methodological quality. RESULTS: Of 106 articles reviewed, 54 (50.9%) were narrative reviews, 17 (16%) were systematic reviews, and 35 (33.1%) were systematic reviews with meta-analyses. Among 48 systematic reviews with or without meta-analysis, only five (10.4%) registered their protocol, four (8.3%) justified the selection of the study design for inclusion, and none of them reported sources of funding for the primary studies. Overall, 55.3% of narrative reviews and 75% of systematic reviews with or without meta-analysis had poor methodological quality. CONCLUSIONS: Although publication rate of narrative and systematic reviews has risen in Ethiopia, half of the narrative reviews and three-quarters of the systematic reviews had poor methodological quality.