SynthesisBMC medical research methodology2022
How can clinicians choose between conflicting and discordant systematic reviews? A replication study of the Jadad algorithm.
Synthesis in BMC medical research methodology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 6 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Effect of compound kushen injection on immune function in patients with primary liver cancer: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Flexible exoskeleton-assisted training enhances lower limb motor function after stroke: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- StandardizedFrontiers in pharmacology · 2025Pooled it
- Pooled it
- The effect of metformin in clinical studies on knee osteoarthritis: an updated systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Effects ofFrontiers in pharmacology · 2024Pooled it
- Polyphenols and Cardiovascular Health: Emerging Relevance for Blueberries, Grapes, and Red-Fleshed Table Grapes.Nutrients · 2026Review
- Impact of matrix-construction assumptions on quantitative overlap assessment in overviews: A meta-research study.Research synthesis methods · 2026Article
- Effects of standing Baduanjin exercise on cardiac function and quality of life in patients with chronic heart failure: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Article
- Article
- Overview of systematic reviews comparing endovascular to best medical treatment for large-vessel occlusion acute ischaemic stroke: an umbrella review.Therapeutic advances in neurological disorders · 2024Review
- Article
- Effectiveness of physical rehabilitation interventions in critically ill patients-A protocol for an overview of systematic reviews.PloS one · 2023Article
- A new taxonomy was developed for overlap across 'overviews of systematic reviews': A meta-research study of research waste.Research synthesis methods · 2022Article
- Comparison of percutaneous transforaminal endoscopic discectomy and open lumbar discectomy for lumbar disc herniations: A systematic review and meta-analysis.Frontiers in surgery · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 10 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe exponential growth of published systematic reviews (SRs) presents challenges for decision makers seeking to answer clinical, public health or policy questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple. Our study aims to replicate author assessments using the Jadad algorithm to determine: (i) if we chose the same SR as the authors; and (ii) if we reach the same results.
methodsWe searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation.
resultsWe identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR.
conclusionsOur results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. number of included RCTs), and at the lowest risk of bias.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.