Problems with Early Systematic Reviews: The Case of Coronavirus Disease 2019 (COVID-19) in Pregnancy
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Problems with Early Systematic Reviews: The Case of Coronavirus Disease 2019 (COVID‑19) in Pregnancy Xue Ling Ang1 · Sonali Prashant Chonkar2 · Monica Shi Qi Chua2 · Suzanna Sulaiman2 · Jill Cheng Sim Lee3 Accepted: 6 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Rapid dissemination of findings regarding the Coronavirus Disease 2019 (COVID-19) and its potential effects on pregnancy is crucial to support understanding and development of recommendations for optimization of obstetrics care. However, much of the current studies published are in the form of case reports or case series which can be prone to biases. Other factors also further complicate attempts to analyze data accurately. Hence, this evaluation hopes to highlight some of these problems and provide suggestions to help clinicians mitigate and make reasonable conclusions when reading the abundant yet limited body of evidence when furthering their research efforts. Methods Studies regarding COVID-19 and pregnancy were searched on databases such as PubMed, EMBASE, Scopus, the Cochrane Library. Manual search of references of select articles were also undertaken. Apart from summarizing study limitations identified by authors, the characteristics of current literature and systematic reviews were also evaluated to identify potential factors affecting accuracy of subsequent analysis. Results Factors such as innate biasness in study design of current literature, duplicate reporting, differing inclusion criteria of systematic reviews, scarce data, inadequate follow-up period and limitations of systematic reviews have been shown to hinder the ability for accurate data extrapolation. Discussion Unless additional studies are conducted in identified areas of data scarcity and a common list of factors affecting accuracy of data analysis are taken into account when developing recommendations, discrepancies will continue to arise and accurate data analysis and valid systematic reviews will be precluded. Keywords COVID-19 · Novel coronavirus 2019 · Pregnancy · Pandemic · Systematic reviews
Significance Statement Information regarding COVID-19 and pregnancy are rapidly disseminated. However, the additional quantity of evidence does not translate to a similar improvement in the quality of evidence for systematic reviews as current evidence may be at risk of bias. Discrepancies arise when data is scarce and when different factors affecting biasness are omitted in data interpretation. To our knowledge, no current studies have * Jill Cheng Sim Lee [email protected] 1
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
2
Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
3
Department of Urogynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
specifically addressed factors affecting the accuracy and value of data analysis. This paper identifies some of these factors in ord
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