Included RCTs in each systematic review.

BackgroundThe purpose of our study is to assess the methodology of overlapping systematic reviews related to cemented vs uncemented hip hemiarthroplasties for the treatment of femoral neck fractures to find the study with the best evidence. Also, we assess the gaps in methodology and information to help with direction of future studies.MethodsA systematic search was conducted in September 2022 using Pubmed, Embase, and Cochrane Library. Clinical outcome data and characteristics of each study were extracted to see which treatment had better favorability. The outcomes and characteristics extracted from each study includes, first author, search date, publication journal and date, number of studies included, databases, level of evidence, software used, subgroup analyses that were conducted, and heterogeneity with the use of I2 statistics Methodological quality information was extracted from each study using four different methodologic scores (Oxford Levels of Evidence; Assessment of Multiple Systematic Reviews (AMSTAR); Quality of reporting of meta-analyses (QUROM); Oxman and Guyatt. After that, the Jadad decision algorithm was used to identify which studies in our sample contained the best available evidence. Finally, overlap of each systematic review was assessed using Corrected Covered Area (CCA) to look at redundancy and research waste among the systematic reviews published on the topic.ResultsAfter screening, 12 studies were included in our sample. For the Oxford Levels of Evidence, we found that all the studies were Level I evidence. For the QUORUM assessment, we had 1 study with the highest score of 18. Additionally, we did the Oxman and Guyatt assessment, where we found 4 studies with a maximum score of 6. Finally, we did an AMSTAR assessment and found 2 studies with a score of 9. After conducting the methodological scores; the authors determined that Li. L et al 2021 had the highest quality. In addition, it was found that the CCA found among the primary studies in each systematic review calculated to .22. Any CCA above .15 is considered “very high overlap”.ConclusionsThe best available evidence suggests that Cemented HAs are better at preventing Prosthesis-related complications. Conversely, the best evidence also suggests that Cemented HA also results in longer operative time and increased intraoperative blood loss. When conducting future systematic reviews related to the topic, we ask that authors restrict conducting another systematic review until new evidence emerges so as not to confuse the clinical decision-making of physicians.研究背景：本研究旨在评估针对骨水泥型与非骨水泥型髋关节半髋关节置换术（hip hemiarthroplasties）治疗股骨颈骨折（femoral neck fractures）的重叠系统评价（systematic reviews）方法学，以筛选出证据等级最高的研究；同时梳理现有研究在方法学与信息层面的不足，为后续研究指明方向。 研究方法：本研究于2022年9月在PubMed、Embase及Cochrane Library数据库中开展系统性检索。提取各项研究的临床结局数据与特征，以对比两种治疗方案的优劣。提取的结局与研究特征包括：第一作者、检索日期、发表期刊与发表时间、纳入研究数量、检索数据库、证据等级、所用软件、开展的亚组分析，以及采用I²统计量计算的异质性。 本研究从每项研究中提取方法学质量信息，采用4种不同的方法学评分量表：牛津证据等级量表（Oxford Levels of Evidence）、多系统评价评价工具（Assessment of Multiple Systematic Reviews, AMSTAR）、Meta分析报告质量量表（Quality of reporting of meta-analyses, QUROM），以及奥克斯曼-盖亚特评分量表（Oxman and Guyatt）。随后采用贾德决策算法（Jadad decision algorithm）从样本中筛选出证据等级最高的研究。最后，使用校正覆盖面积（Corrected Covered Area, CCA）评估每项系统评价的重叠程度，以分析该主题已发表系统评价的冗余性与研究浪费情况。 研究结果：经筛选后，本研究共纳入12项研究。在牛津证据等级量表评分中，所有研究均为I级证据。在QUROM评分中，有1项研究获得最高分18分。此外，奥克斯曼-盖亚特评分量表评估结果显示，有4项研究获得最高分6分。AMSTAR评分结果显示，有2项研究获得最高分9分。通过上述方法学评分分析后，研究人员确定2021年Li L等人的研究质量最高。同时，本次计算得到的各系统评价纳入原始研究的校正覆盖面积为0.22，而当CCA值大于0.15时，即被认定为"极高重叠度"。 研究结论：现有最佳证据表明，骨水泥型半髋关节置换术（Cemented HAs）在预防假体相关并发症（Prosthesis-related complications）方面效果更优。但与此同时，现有最佳证据也显示，骨水泥型半髋关节置换术的手术时长更长，术中失血量也更高。针对该主题开展后续系统评价时，建议作者在新的证据出现前勿重复开展此类研究，以免混淆临床医师的决策判断。