Low Methodological Quality of Systematic Reviews Published in the Urological Literature (2016-2018)

Objective: To investigate the methodological quality of systematic reviews (SRs) published in the urological literature. Methods: PubMed was systematically searched for SRs related to questions of prevention and therapy published in 5 major urology journals (January, 2016 to December, 2018). Two reviewers followed a written a priori protocol to independently screen references in Rayyan and abstract data using a piloted form based on the 16 domains of AMSTAR-2. We performed preplanned statistical hypothesis testing by journal of publication in SPSS version 24.0. Results: Our search identified 260 relevant references, 144 of which ultimately met inclusion criteria. The largest contributors by journal of publication were European Urology (53; 36.8%) followed by Urology (36; 25.0%), and BJU International (24; 16.6%). The most common clinical topics were oncology (64; 44.4%) and voiding dysfunction (32; 22.2%) followed by stones/endourology (14; 9.7%). Just over one-third (52; 36.2%) of reviews had a registered protocol. Nearly all studies (139; 96.5%) searched at least 2 databases. Less than one-third (46; 31.9%) also searched trial registries and one-fifth (30; 20.8%) consulted experts for additional trials. Few studies (14; 10.4%) provided a list of potentially relevant but excluded studies. Only 6 (4.2%) studies met all AMSTAR-2 critical domains as a prerequisite for high-quality reviews. Conclusion: A large number of SRs are published in the urological literature each year, yet their quality is suboptimal. There is a need for educating authors, peer reviewers, and editors alike on established standards for high-quality SRs to ensure improvement in the future.