Current status of methodological and reporting quality of systematic reviews and meta-analyses in medicine and health science fields in Ethiopia: Leveraging quantity to improve quality

Introduction Despite the rise in the number of systematic reviews (SR) and meta-analyses (MA) in medicine and health science fields in Ethiopia, there is limited up-to-date evidence on their methodological and reporting quality for using them in decision-making. The aim of this study was to characterize epidemiological trends and evaluate the methodological and reporting quality of SR and MA in Ethiopia. Methods A retrospective observational overview study was conducted on SR and MA in medicine and health science fields in Ethiopia that were accessed through PubMed, PsycINFO, EMBASE, CINAHL databases and additional manual searching. SR and MA based on primary human studies associated with the Ethiopian population, irrespective of the place of publication and authors’ affiliation, and published until March 16, 2021, were included. Title/abstract and full-text screening were conducted in duplicate using EndNote and Covidence semi-automated reference management tools. Data extraction tool was developed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and second version of A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) guides. We summarized the data using frequencies and median. Two-tailed Chi-Square and Fisher’s Exact tests for categorical variables were used while Kruskal-Wallis test for quantitative variables at alpha level 0.05 to compare the differences in the background characteristics of SR and MA as well as across the publication years. All analyses were done using R version 4.0.2 for macOS. Results Of the total 3,125 records initially identified, 349 articles were included in our analyses. Of these, 48 (13.75%) were SR and 301 (86.25%) were MA. The publication rate was dramatically increased with nearly three-quarters (73.9%) of SR and MA published after 2018. Most of the SR and MA included observational studies (92.8%), and infectious disease was the most researched (20.9%) subject area. Number of authors, number of affiliations, publication year, protocol registration, number of primary studies, number of references, citation counts and journal quality were significantly different between SR and MA (p < 0.05). Both SR and MA had a low methodological and reporting quality even though there were improvements in registering protocols, searching databases, and transparently reporting search strategy. Conclusions The production of SR and MA in Ethiopia has been increased over time, especially during the last three years. There is a promising trend of improvement in methodological and reporting quality even though there is much more to do. This study provides an up-to-date overview of the landscape of SR and MA publication rate and quality leverage in Ethiopia. Authors should equally prioritize quality in addition to the fast-track publication. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors