How can clinicians choose between conflicting and discordant systematic reviews? A replication study of the Jadad algorithm

Abstract

Highlights: This is the first empirical study to replicate Jadad algorithm assessments to evaluate discordance across systematic reviews. In 62% (13/21) of cases, we were unable to replicate the Jadad algorithm assessment and ultimately chose a different systematic review than the authors. When assessing systematic reviews using the Jadad algorithm, some steps of the Jadad algorithm were vague in description, making it difficult to operationalise, interpret, and use. The Jadad algorithm has several limitations as it does not account for the last literature search of the systematic review and publication recency of included trials. To assess discordance in the absence of an algorithm, we recommend decision makers consider relevance (objectives that most closely resemble their clinical question), recency (dates of search), comprehensiveness (most trials), and risk of bias (lowest risk of bias SR) when choosing one systematic review across multiple.

Keywords

• Discordance
• Overviews of reviews
• Overlapping
• Systematic reviews
• Meta-analyses
• Conflicting