Extension of the Composite Quality Score (CQS) as an appraisal tool for prospective, controlled clinical therapy trials-A systematic review of meta-epidemiological evidence

PLoS One. 2022 Dec 30;17(12):e0279645. doi: 10.1371/journal.pone.0279645. eCollection 2022.

Abstract

Aim: To conduct a survey of current meta-epidemiological studies to identify additional trial design characteristics that may be associated with significant over- or underestimation of the treatment effect and to use such identified characteristics as a basis for the formulation of new CQS appraisal criteria.

Materials and methods: We retrieved eligible studies from two systematic reviews on this topic (latest search May 2015) and searched the databases PubMed and Embase for further studies from June 2015 -March 2022. All data were extracted by one author and verified by another. Sufficiently homogeneous estimates from single studies were pooled using random-effects meta-analysis. Trial design characteristics associated with statistically significant estimates from single datasets (which could not be pooled) and meta-analyses were used as a basis to formulate new or amend existing CQS criteria.

Results: A total of 38 meta-epidemiological studies were identified. From these, seven trial design characteristics associated with statistically significant over- or underestimation of the true therapeutic effect were found.

Conclusion: One new criterion concerning double-blinding was added to the CQS, and the original criteria for concealing the random allocation sequence and for minimum sample size were amended.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Epidemiologic Studies
  • Prospective Studies*
  • PubMed

Grants and funding

The authors received no specific funding for this work.