Quality Assessment of Cochrane and Non-Cochrane Systematic Reviews in Neonatal Medicine: A Meta-Analysis

Objective To compare the methodological and reporting performance of Cochrane reviews (CR) and non-Cochrane reviews (NCR) of clinical trials evaluating neonatal interventions. Study design PubMed, Embase, the Cochrane database, and Web of Science were searched from January 2015 to December 2023 for pairwise meta-analyses and systematic reviews. Review quality was assessed using A Measurement Tool to Assess Systematic Reviews-2 and compared across covariate-matched cohorts of CR and NCR. Trends in quality over time and across journal quartiles were examined using the Jonckheere Terpstra test. Results A total of 453 systematic reviews were included (202 CR and 251 NCR). A significantly greater number of NCR were rated as critically low quality compared with CR (71% vs 8%; P < .001); significantly fewer NCR were rated high or moderate quality (5.5% vs 13%; P = .007). The performance of CR was significantly higher than NCR for review protocol establishment (100% vs 49%), comprehensiveness of literature search (100% vs 57%), justification of exclusions (99% vs 38%), and reporting of trial funding (23% vs 5%). Reporting of review protocol, literature search, study exclusions, and sensitivity analyses improved across NCR categories ordered by increasing impact factor ( P < .01 for trend). Over the 9-year period, a positive trend was observed in protocol reporting of NCR (from 23% to 71%) and reporting of trial funding in CR (from 9% to 72%). Conclusions The mmethodological quality of neonatal CR was significantly better than NCR. NCR published in high-impact journals were superior to those in low-impact journals. Methodology and reporting of both review categories improved consistently over a 9-year time frame.