Quality Assessment of Traditional Persian Medicine Observational Studies
,
Abstract
Background: Although observational studies are valuable sources of scientific evidence, they are prone to bias and confounding. This study aimed to assess the quality of observational studies in Traditional Persian medicine (TPM).
Methods: A systematic search was conducted in national and international databases up to the end of 2022 to identify observational studies on TPM. The quality of articles was evaluated using the STROBE checklist and CARE guidelines.
Results: Out of the 192 articles identified, 109 met the eligible criteria for quality assessment. Cross-sectional and case-control studies had a mean STROBE score of 1.2±0.51 out of 2, with the introduction section scoring highest and the results and methods sections scoring lowest. The worst reported items in the method section involved sensitivity analyses, bias control, and management of missing data. Case reports and case series had a mean score of 1.4±0.55 out of 2, with the section on therapeutic interventions scoring the highest. Other sections like keywords, follow-up and outcomes, diagnostic assessment, patient perspective, and informed consent scored below one.
Conclusion: Many reviewed articles did not adhere to the recommended formatting in the evaluation tools, making it challenging to assess their quality. Having said that, the quality of observational studies in the field of TPM is a point of concern.
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13. Thiese MS (2014). Observational and interventional study design types; an overview. Biochem Med (Zagreb), 24 (2): 199-210.
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16. von Elm E, Altman DG, Egger M, et al (2008). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. J Clin Epidemiol, 61(4):344-9.
17. Vandenbroucke JP, von Elm E, Altman DG, et al (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med, 147 (8): W163-94.
18. Gagnier JJ, Kienle G, Altman DG, et al(2013). The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep, 7:223.
19. Riley DS, Barber MS, Kienle GS, et al (2017). CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol, 89: 218-35.
20. Sharp MK, Utrobičić A, Gómez G, et al (2017). The STROBE extensions: protocol for a qualitative assessment of content and a survey of endorsement. BMJ Open, 7 (10): e019043.
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22. Choi SY, Choi SY (2020). Evaluation of the Quality of Case Reports from the Journal of Korean Medicine Based on the CARE guidelines. Journal of Korean Medicine, 41 (2): 122-36.
23. Tapia JC, Ruiz EF, Ponce OJ, et al (2015). Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru. Colomb Med (Cali), 46 (4): 168-75.
24. Jeelani A, Malik W, Haq I, et al (2014). Cross-sectional studies published in Indian journal of community medicine: evaluation of adherence to strengthening the reporting of observational studies in epidemiology statement. Ann Med Health Sci Res, 4 (6): 875-8.
25. Irani M, Bashtian MH, Khadivzadeh T, et al (2018). Weaknesses in the reporting of cross-sectional studies in accordance with the STROBE report (the case of congenital anomaly among infants in Iran): a review article. Iran J Public Health, 47 (12): 1796-1804.
26. Bastuji-Garin S, Sbidian E, Gaudy-Marqueste C, et al (2013). Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis. PLoS One, 8 (8): e64733.
27. Shaghaghian S, Astaneh B (2020). Adherence to the strengthening the reporting of observational studies in epidemiology statement in observational studies published in Iranian medical journals. Iran J Public Health, 49 (8): 1520-9.
28. Serrano M, Gonzalvo M, Sanchez-Pozo M, et al (2014). Adherence to reporting guidelines in observational studies concerning exposure to persistent organic pollutants and effects on semen parameters. Hum Reprod, 29 (6): 1122-33.
29. Bonvini M, Kennedy EH (2022). Sensitivity analysis via the proportion of unmeasured confounding. Journal of the American Statistical Association, 117 (539): 1540-50.
30. Hendriksma M, Joosten MH, Peters JP, et al (2017). Evaluation of the Quality of Reporting of Observational Studies in Otorhinolaryngology - Based on the STROBE Statement. PLoS One, 12 (1): e0169316.
31. Rodríguez Del Águila M, González-Ramírez A (2014). Sample size calculation. Allergol Immunopathol (Madr), 42 (5): 485-92.
32. Nagarajan VB, Bhide S, Kanase HR, et al (2018). Adherence of Observational Studies Published in Indian Journals to STRO BE Statement. J Assoc Physicians India, 66 (12): 39-42.
33. Rahmani N, Salehi A, Molavi Vardanjani H, et al (2020). Using STROBE checklist to assess the reporting quality of observational studies affiliated with Shiraz University of Medical Sciences, and its correlates: a scientometric study from Iran. Scientometrics, 122 (2): 989-1001.
34. Ramke J, Palagyi A, Jordan V, et al (2017). Using the STROBE statement to assess reporting in blindness prevalence surveys in low and middle income countries. PLoS One, 12 (5): e0176178.
35. Gagnier JJ, Kienle G, Altman DG, et al (2013). The CARE guidelines: consensus-based clinical case report guideline development. J Diet Suppl, 10 (4): 381-90.
36. Munk N, Shue S, Freeland E, et al (2016). Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014. Int J Ther Massage Bodywork, 9 (3): 3-14.
37. Moeini R, Gorji N, Ghods R, Mozaffarpur S (2017). Quantitative and qualitative assessment of Persian medicine articles indexed in PubMed by the end of 2015. Journal of Babol University of Medical Sciences, 19 (1): 21-6.
38. Duan Y, Xu Z, Deng J, et al (2020). A scoping review of cohort studies assessing traditional Chinese medicine interventions. BMC Complement Med Ther, 20 (2): 361.
39. Hemkens LG, Benchimol EI, Langan SM, et al (2016). The reporting of studies using routinely collected health data was often insufficient. J Clin Epidemiol, 79: 104-11.
40. Habibi A, Salehi A, Vardanjani HM (2020). Quality assessment of randomized controlled trials of Iranian traditional medicine: An eight-year study. European Journal of Integrative Medicinem, 33 (5): 101040.
41. Sarveravan P, Astaneh B, Shokrpour N (2017). Adherence to the CONSORT Statement in the reporting of randomized controlled trials on pharmacological interventions published in iranian medical journals. Iran J Med Sci, 42 (6): 532-543.
2. Shorofi SA, Arbon P (2017). Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Complement Ther Clin Pract, 27: 37-45.
3. Chung VC, Wong CH, Zhong CC, et al (2021). Traditional and complementary medicine for promoting healthy ageing in WHO Western Pacific Region: Policy implications from utilization patterns and current evidence. Integr Med Res, 10 (1): 100469.
4. World Health Organization (2019). WHO global report on traditional and complementary medicine 2019.
5. Zahedi Anaraki R, Hodhodinezhad N, Ashrafi Rizi H (2012). The scientific production and scientific mapping of Iranian researchers in traditional medicine during 1990-2011 in Web of Science. Health Information Management, 9 (4): 513-24.
6. Hoppe DJ, Schemitsch EH, Morshed S, et al (2009). Hierarchy of evidence: where observational studies fit in and why we need them. J Bone Joint Surg Am, 91 Suppl 3:2-9.
7. Blonde L, Khunti K, Harris SB, et al (2018). Interpretation and impact of real-world clinical data for the practicing clinician. Adv Ther, 35 (11): 1763-74.
8. Burns PB, Rohrich RJ, Chung KC (2011). The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg, 128 (1): 305-10.
9. Vandenbroucke JP (2001). In defense of case reports and case series. Ann Intern Med, 134(4): 330-4.
10. Andrews M, Areekal B, Rajesh K, et al (2020). First confirmed case of COVID-19 infection in India: A case report. Indian J Med Res, 151 (5): 490-2.
11. Metelli S, Chaimani A (2020). Challenges in meta-analyses with observational studies. Evid Based Ment Health, 23 (2): 83-7.
12. Hosseini A, Jackson AC, Bahramnezhad F (2022). Ethical Considerations in Interventional Studies: A Systematic Review Ethics and Interventional Study. Acta Medica Iranica, 60 (10): 609-14.
13. Thiese MS (2014). Observational and interventional study design types; an overview. Biochem Med (Zagreb), 24 (2): 199-210.
14. Von Elm E, Altman DG, Egger M, et al (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet, 370 (9596): 1453-7.
15. Mannocci A, Saulle R, Colamesta V, et al (2015). What is the impact of reporting guidelines on Public Health journals in Europe? The case of STROBE, CONSORT and PRISMA. J Public Health (Oxf), 37 (4): 737-40.
16. von Elm E, Altman DG, Egger M, et al (2008). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. J Clin Epidemiol, 61(4):344-9.
17. Vandenbroucke JP, von Elm E, Altman DG, et al (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med, 147 (8): W163-94.
18. Gagnier JJ, Kienle G, Altman DG, et al(2013). The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep, 7:223.
19. Riley DS, Barber MS, Kienle GS, et al (2017). CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol, 89: 218-35.
20. Sharp MK, Utrobičić A, Gómez G, et al (2017). The STROBE extensions: protocol for a qualitative assessment of content and a survey of endorsement. BMJ Open, 7 (10): e019043.
21. Sharp MK, Tokalić R, Gómez G, et al (2019). A cross-sectional bibliometric study showed suboptimal journal endorsement rates of STROBE and its extensions. J Clin Epidemiol, 107: 42-50.
22. Choi SY, Choi SY (2020). Evaluation of the Quality of Case Reports from the Journal of Korean Medicine Based on the CARE guidelines. Journal of Korean Medicine, 41 (2): 122-36.
23. Tapia JC, Ruiz EF, Ponce OJ, et al (2015). Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru. Colomb Med (Cali), 46 (4): 168-75.
24. Jeelani A, Malik W, Haq I, et al (2014). Cross-sectional studies published in Indian journal of community medicine: evaluation of adherence to strengthening the reporting of observational studies in epidemiology statement. Ann Med Health Sci Res, 4 (6): 875-8.
25. Irani M, Bashtian MH, Khadivzadeh T, et al (2018). Weaknesses in the reporting of cross-sectional studies in accordance with the STROBE report (the case of congenital anomaly among infants in Iran): a review article. Iran J Public Health, 47 (12): 1796-1804.
26. Bastuji-Garin S, Sbidian E, Gaudy-Marqueste C, et al (2013). Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis. PLoS One, 8 (8): e64733.
27. Shaghaghian S, Astaneh B (2020). Adherence to the strengthening the reporting of observational studies in epidemiology statement in observational studies published in Iranian medical journals. Iran J Public Health, 49 (8): 1520-9.
28. Serrano M, Gonzalvo M, Sanchez-Pozo M, et al (2014). Adherence to reporting guidelines in observational studies concerning exposure to persistent organic pollutants and effects on semen parameters. Hum Reprod, 29 (6): 1122-33.
29. Bonvini M, Kennedy EH (2022). Sensitivity analysis via the proportion of unmeasured confounding. Journal of the American Statistical Association, 117 (539): 1540-50.
30. Hendriksma M, Joosten MH, Peters JP, et al (2017). Evaluation of the Quality of Reporting of Observational Studies in Otorhinolaryngology - Based on the STROBE Statement. PLoS One, 12 (1): e0169316.
31. Rodríguez Del Águila M, González-Ramírez A (2014). Sample size calculation. Allergol Immunopathol (Madr), 42 (5): 485-92.
32. Nagarajan VB, Bhide S, Kanase HR, et al (2018). Adherence of Observational Studies Published in Indian Journals to STRO BE Statement. J Assoc Physicians India, 66 (12): 39-42.
33. Rahmani N, Salehi A, Molavi Vardanjani H, et al (2020). Using STROBE checklist to assess the reporting quality of observational studies affiliated with Shiraz University of Medical Sciences, and its correlates: a scientometric study from Iran. Scientometrics, 122 (2): 989-1001.
34. Ramke J, Palagyi A, Jordan V, et al (2017). Using the STROBE statement to assess reporting in blindness prevalence surveys in low and middle income countries. PLoS One, 12 (5): e0176178.
35. Gagnier JJ, Kienle G, Altman DG, et al (2013). The CARE guidelines: consensus-based clinical case report guideline development. J Diet Suppl, 10 (4): 381-90.
36. Munk N, Shue S, Freeland E, et al (2016). Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014. Int J Ther Massage Bodywork, 9 (3): 3-14.
37. Moeini R, Gorji N, Ghods R, Mozaffarpur S (2017). Quantitative and qualitative assessment of Persian medicine articles indexed in PubMed by the end of 2015. Journal of Babol University of Medical Sciences, 19 (1): 21-6.
38. Duan Y, Xu Z, Deng J, et al (2020). A scoping review of cohort studies assessing traditional Chinese medicine interventions. BMC Complement Med Ther, 20 (2): 361.
39. Hemkens LG, Benchimol EI, Langan SM, et al (2016). The reporting of studies using routinely collected health data was often insufficient. J Clin Epidemiol, 79: 104-11.
40. Habibi A, Salehi A, Vardanjani HM (2020). Quality assessment of randomized controlled trials of Iranian traditional medicine: An eight-year study. European Journal of Integrative Medicinem, 33 (5): 101040.
41. Sarveravan P, Astaneh B, Shokrpour N (2017). Adherence to the CONSORT Statement in the reporting of randomized controlled trials on pharmacological interventions published in iranian medical journals. Iran J Med Sci, 42 (6): 532-543.
| Files | ||
| Issue | Vol 53 No 7 (2024) | |
| Section | Review Article(s) | |
| Keywords | ||
| Quality assessment Observational studies Medicine Persian CARE guidelines | ||
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How to Cite
1.
Norouzi M, Haghdoost AA, Setayesh M. Quality Assessment of Traditional Persian Medicine Observational Studies. Iran J Public Health. 2024;53(7):1469-1481.
