Replication of systematic reviews: is it to the benefit or detriment of methodological quality?

To perform an overview of the overlap of systematic reviews (SRs) assessing direct oral anticoagulants and characterize these reviews in terms of bias and methodological quality (PROSPERO: CRD42022316273). A PubMed-indexed search was performed from inception to January 31, 2022 to identify SRs evaluating direct oral anticoagulants in patients treated for an acute venous thromboembolism. The risk of bias of these SRs was assessed according to the Risk Of Bias In Systematic reviews tool. Redundancy was defined as overlap in terms of the type of population considered, the interventions compared, and the studies included. A total of 144 SRs were evaluated, of which 26 (18.1%) were classified as original, 87 (60.4%) as conceptual replications, and 31 (21.5%) as excessive replications. The risk of bias was high in 19 (73.1%) of the original SRs, 65 (74.7%) of the conceptual replications, and 21 (67.7%) of the excessive replications. Compared to the original SRs, the overall methodological quality was not improved in either conceptual or excessive replications. A large number of SRs was classified as replications; a fifth constituted excessive replications. The replications showed no improvement in overall methodological quality compared to the original SRs.

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Déclaration de conflit d'intérêts

Declaration of competing interest Céline Chapelle, Edouard Ollier, Paul Bonjean, Clara Locher, and Paul Jacques Zufferey: none. Michel Cucherat has received personal fees from Bayer and BMS for consulting. Silvy Laporte has received personal fees from Bayer for consulting, personal fees continuing medical education lectures from Pfizer, and personal fees for continuing medical education lectures from Eli Lilly.