From Synthesis to Scrutiny: Evaluating the Quality of Anaesthesiology Meta-Analyses (2015-2022)

Introduction Meta-analyses (MAs) are useful for informing evidence-based clinical practice in constantly evolving fields such as anaesthesiology. This study aimed to assess the methodological quality of meta-analyses published in leading anaesthesiology journals from 2015 to 2022 and to evaluate trends in quality over time. Methods We utilised the Revised-A MeaSurement Tool to Assess systematic Reviews (R-AMSTAR) tool with in-depth binary sub-criterion scoring to evaluate the methodological rigour of a selection of meta-analyses identified in six prominent anaesthesiology journals between 2015 and 2022. For the purpose of this study, the journals selected for review were as follows: Anaesthesia, British Journal of Anaesthesia, Anesthesia & Analgesia, Anesthesiology, BMC Anesthesiology and Pain. PubMed and individual journals were manually searched for meta-analyses published within this timeframe, and a sample of papers was selected for full-text review and appraisal against the R-AMSTAR criteria. Areas on the R-AMSTAR tool that scored poorly were highlighted, and comparisons were made across journals and over time. Results Our study identified 455 meta-analyses published in leading anaesthesiology journals during the study period and found an increase in the number of meta-analyses published over time. In-depth R-AMSTAR analysis of 130 randomly selected papers found that, despite this increase, the overall methodological quality of these meta-analyses did not significantly improve over time, indicating a plateau in quality post-2014, in contrast to earlier reported trends. No statistically significant differences in methodological quality or sub-criterion level adherence were observed between the included journals. Consistent strengths were identified in reporting duplicate data extraction and descriptions of included studies. Conversely, persistent weaknesses were noted in research planning, the explicit statistical assessment of publication bias and the use of study quality to guide conclusions, as well as transparent reporting of excluded studies. Conclusion While the methodological quality of meta-analyses in anaesthesiology remained stable between 2015 and 2022, the anticipated trajectory of continued improvement has not materialised in recent years. Core methodological criteria, particularly regarding publication bias assessment, utilising study quality to inform conclusions and transparency in reporting excluded studies, continue to be under-implemented. Future efforts should focus on renewed editorial emphasis and targeted author training to enhance transparency and rigour in reporting practices to ensure the highest standards of scientific reliability.