Declining Quality of Systematic Reviews in Orthopaedic Sports Medicine: An Updated Systematic Review.

Purpose: To evaluate the quality and characteristics of systematic reviews, including meta-analyses, in the clinical orthopaedic sports medicine literature from 2015 to 2019 and to compare the results to previous findings from a similar analysis from 2009 to 2013.

Methods: All clinical orthopaedic sports medicine and meta-analyses published from 2015 to 2019 published in , , , , , and were reviewed. These were evaluated according to guidelines from Oxford Centre for Evidence-Based Medicine, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Assessment of Multiple Systematic Reviews tool. Results were compared to the quality of publications from 2009 to 2013.

Results: A total of 516 systematic reviews and meta-analyses were included in this study. Of these, 17.1% of studies included Level I or II evidence only, whereas 79.1% included Level IV or V studies. When compared to the previous study from 2009 to 2013, which demonstrated 32% of Level I or II evidence studies and 53% Level IV or V, there was a significant decrease in the level of evidence in the more recent study period ( < .001). The average Preferred Reporting Items for Systematic Reviews and Meta-Analyses scores were 81% and the average Assessment of Multiple Systematic Reviews scores 56%, which are declines from 87% and 73%, respectively ( < .001,  < .001).

Conclusions: There has been a significant increase in the volume of systematic reviews and meta-analyses published in orthopaedic sports medicine. This has coincided with significant declines in the level of evidence, as well as declines in methodologic and reporting quality.

Clinical Relevance: Clinicians increasingly use systematic reviews to drive their treatment decisions. Therefore, the quality of systematic reviews in orthopaedic sports medicine merits assessment.