Evaluating the methodology of studies conducted during the global COVID-19 pandemic:A systematic rev

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Background:The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019 (COVID-19).Evaluating the quality of therapeutic data collected during this most recent pandemic is important for improving future clinical research under sim-ilar circumstances.Objective:To assess the methodological quality and variability in implementation of randomized con-trolled trials (RCTs) for treating COVID-19,and to analyze the support that should be provided to improve data collected during an urgent pandemic situation.Search strategy:PubMed,Excerpta Medica Database,China National Knowledge Infrastructure,Wanfang,and Chongqing VIP.and the preprint repositories including Social Science Research Network and MedRxiv were systematically searched,up to September 30,2020,using the keywords “coronavirus disease 2019(COVID-19),” “2019 novel coronavirus (2019-nCoV),” “severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2),” “novel coronavirus pneumonia (NCP),” “randomized controlled trial(RCT)” and “random.”Inclusion criteria:RCTs studying the treatment of COVID-19 were eligible for inclusion.Data extraction and analysis:Screening of published RCrs for inclusion and data extraction were each conducted by two researchers.Analysis of general information on COVID-19 RCTs was done using descriptive statistics.Methodological quality was assessed using the risk-of-bias tools in the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0).Variability in implementation was assessed by comparing consistency between RCT reports and registration information.Results:A total of 5886 COVID-19 RCTs were identified.Eighty-one RCTs were finally included,of which,45 had registration information.Methodological quality of the RTCs was not optimal due to deficiencies in five main domains:allocation concealment,blinding of participants and personnel,blinding of out-come assessment,incomplete outcome data,and selective reporting.Comparisons of consistency between published protocols and registration information showed that the 45 RCTs with registration information had common deviations in seven items:inclusion and exclusion criteria,sample size,out-comes,research sites of recruitment,interventions,and blinding.Conclusion:The methodological quality of COVID-19 RCTs conducted in early to mid 2020 was consis-tently low and variability in implementation was common.More support for implementing high-quality methodology is needed to obtain the quality of therapeutic evidence needed to provide positive guidance for clinical care.We make an urgent appeal for accelerating the construction of a collaborative sharing platform and preparing multidisciplinary talent and professional teams to conduct excellentclinical research when faced with epidemic diseases of the future.Further,variability in RCT implemen-tation should be clearly reported and interpreted to improve the utility of data resulting from those trials.
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