Characteristics of the included SRs.

BackgroundThe role of pulmonary rehabilitation (PR) in idiopathic pulmonary fibrosis (IPF) has been studied in several systematic reviews (SRs), but no definitive conclusions have been drawn due to the wide variation in the quality and outcomes of the studies. And there are no studies to assess the quality of relevant published SRs. This overview aims to determine the effectiveness of PR in patients with IPF and to summarize and critically evaluate the risk of bias, methodological, and evidence quality of SRs on this related topic.MethodsWith no language restrictions, eight databases were searched from inception to March 10, 2023. The literature search, screening, and data extraction were carried out separately by two reviewers. We assessed the risk of bias using the ROBIS tool, the reporting quality using PRISMA statements, the methodological quality using AMSTAR-2, and the evidence quality using Grades of Recommendations, Assessment, Development, and Evaluation (GRADE).ResultsSeven SRs from 2018–2023 (including 1836 participants) on PR for the treatment of IPF were selected, all of which included patients with a definitive diagnosis of IPF. After strict evaluation by the ROBIS tool and AMSTAR-2 tool, 42.86% of the SRs had a high risk of bias and 85.71% of the SRs had critically low methodological quality in this overview. PR might be effective for patients with IPF on exercise capacity, quality of life, and pulmonary function-related outcomes, but we did not find high quality evidence to confirm the effectiveness.ConclusionPR may appear to be an effective and safe treatment for patients with IPF, but the results of this overview should be interpreted dialectically and with caution. Further high-quality, rigorous studies are urgently needed to draw definitive conclusions and provide scientific evidence.研究背景 肺康复（Pulmonary Rehabilitation, PR）在特发性肺纤维化（Idiopathic Pulmonary Fibrosis, IPF）中的作用已在多项系统评价（Systematic Reviews, SRs）中开展研究，但由于相关研究的质量与结局差异较大，目前尚未得出明确结论。且目前尚无研究对已发表的相关系统评价的质量进行评估。本概述旨在明确PR对IPF患者的疗效，并对该主题相关系统评价的偏倚风险、方法学质量与证据质量进行总结与严格评价。 研究方法 本研究无语言限制，检索了8个数据库自建库至2023年3月10日的文献。由2名研究者独立完成文献检索、筛选及数据提取工作。本研究采用偏倚风险评估工具（Risk Of Bias In Systematic Reviews, ROBIS）评价偏倚风险，采用系统评价与荟萃分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）评价报告质量，采用系统评价方法学质量评价工具第二版（A MeaSurement Tool to Assess systematic Reviews 2, AMSTAR-2）评价方法学质量，采用推荐分级、评估、制定与评价系统（Grades of Recommendations, Assessment, Development, and Evaluation, GRADE）评价证据质量。 研究结果 本概述共纳入2018年至2023年间发表的7项关于PR治疗IPF的系统评价，涉及1836名受试者，所有纳入研究的受试者均明确诊断为IPF。经ROBIS工具与AMSTAR-2工具严格评价后，本概述中42.86%的系统评价存在高偏倚风险，85.71%的系统评价方法学质量等级为极低。PR或可改善IPF患者的运动能力、生活质量及肺功能相关结局，但本研究未发现高质量证据证实其疗效。 研究结论 PR或可为IPF患者提供安全有效的治疗方案，但本概述的结果需辩证且审慎解读。亟需开展高质量、严谨的研究以得出明确结论并提供科学依据。