Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies

PLOS ONE RESEARCH ARTICLE Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies Jane Andreasen ID1*, Birgitte Nørgaard2, Eva Draborg ID2, Carsten Bogh Juhl3, Jennifer Yost4, Klara Brunnhuber5, Karen A. Robinson6, Hans Lund ID7 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark and Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark, 2 Department of Public Health, University of Southern Denmark Odense, Denmark, 3 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark and Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark, 4 M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, United States of America, 5 Digital Content Services, Elsevier, London, United Kingdom, 6 Johns Hopkins University School of Medicine, Baltimore, MD, United States of America, 7 Department of Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway * OPEN ACCESS Citation: Andreasen J, Nørgaard B, Draborg E, Juhl CB, Yost J, Brunnhuber K, et al. (2022) Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies. PLoS ONE 17(10): e0276955. https://doi.org/10.1371/journal. pone.0276955 Editor: Andrzej Grzybowski, University of Warmia, POLAND Received: January 24, 2022 Accepted: October 18, 2022 Published: October 31, 2022 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0276955 Copyright: © 2022 Andreasen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background Redundancy is an unethical, unscientific, and costly challenge in clinical health research. There is a high risk of redundancy when existing evidence is not used to justify the research question when a new study is initiated. Therefore, the aim of this study was to synthesize meta-research studies evaluating if and how authors of clinical health research studies use systematic reviews when initiating a new study. Methods Seven electronic bibliographic databases were searched (final search June 2021). Metaresearch studies assessing the use of systematic reviews when justifying new clinical health studies were included. Screening and data extraction were performed by two reviewers independently. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. Results were synthesized narratively and quantitatively using a randomeffects meta-analysis. The protocol has been registered in Open Science Framework (https://osf.io/nw7ch/). Results Twenty-one meta-research studies were included, representing 3,621 original studies or protocols. Nineteen of the 21 studies were included in the meta-analysis. The included studies represented different disciplines and exhibited wide variability both in how the use of previous systematic reviews was assessed, and in how this was reported. The use of PLOS ONE | https://doi.org/10.1371/journal.pone.0276955 October 31, 2022 1 / 17 PLOS ONE Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Justification of research using systematic reviews—A systematic review of meta-research studies systematic reviews to justify new studies varied from 16% to 87%. The mean percentage of original studies using systematic reviews to justify their study was 42% (95% CI: 36% to 48%). Conclusion Justification of new studies in clinical health research using systematic reviews is highly variable, and fewer than half of new clinical studies in health science were justified using a systematic review. Research redundancy is a challenge for clinical health researchers, as well as for funders, ethics committees, and journals. Introduction Research redundancy in clinical health research is an unethical, unscientific, and costly challenge that can be minimized by using an evidence-based research approach. First introduced in 2009 and since endorsed and promoted by organizations and researchers worldwide [1–6], evidence-based research is an approach whereby researchers systematically and transparently take into account the existing evidence on a topic before embarking on a new study. The researcher thus strives to enter the project unbiased, or at least aware of the risk of knowledge redundancy bias. The key is an evidence synthesis using formal, explicit, and rigorous methods to bring together the findings of pre-existing research to synthesize the totality what is known [7]. Evidence syntheses provide the basis for an unbiased justification of the proposed research study to ensure that the enrolling of participants, resource allocation, and healthcare systems are supporting only relevant and justified research. Enormous numbers of research studies are conducted, funded, and published globally every year [8]. Thus, if earlier relevant research is not considered in a systematic and transparent way when justifying research, the foundation for a research question is not properly established, thereby increasing the risk of redundant studies being conducted, funded, and published resulting in a waste of resources, such as time and funding [1, 4]. Most importantly, when redundant research is initiated, participants unethically and unnecessarily receive placebos or receive suboptimal treatment. Previous meta-research, defined as the study of research itself including the methods, reporting, reproducibility, evaluation and incentives of the research [9] have shown that there is considerable variation and bias in the use of evidence syntheses to justify research studies [10–12]. To the best of our knowledge, a systematic review of previous meta-research studies assessing the use of systematic reviews to justify studies in clinical health research has not previously been conducted. Evaluating how evidence-based research is implemented in research practices across disciplines and specialties when justifying (...truncated)