Evidence map of pancreatic surgery - living systematic review and meta-analysis

Background Pancreatic surgery offers a large and complex field for research. To prioritize relevant future scientific projects, it is of utmost importance to identify existing evidence and uncover research gaps. Thus the aim of this project was to create a systematic and living Evidence Map of Pancreatic Surgery.

Methods PubMed, CENTRAL, and WoS were systematically searched for all randomized controlled trials (RCT) and systematic reviews (SR) on pancreatic surgery. Outcomes from every existing RCT were extracted and trial quality was assessed. RCTs and SRs on identical subjects were grouped according to research topics. A web-based evidence map modeled after a mind map was created to visualize existing evidence. A meta-analysis of specific outcomes of pancreatic surgery was performed for all research topics with more than three RCTs. For partial pancreatoduodenectomy and distal pancreatectomy, pooled benchmarks for outcomes were calculated with a 99% confidence interval. The evidence map undergoes regular updates.

Results Out of 22,496 articles reviewed, 292 RCTs on 30,218 patients and 255 SRs were included and grouped into 74 research topics. Most RCTs were from Europe (46%) and most SRs were from Asia (50%). A living meta-analysis for 21 out of 74 research topics (28%) was performed and included in the web-based evidence map. Evidence gaps were identified in 12 out of 74 research topics (16%). The benchmark for mortality was 1% (99%-CI: 1% to 2%) for partial pancreatoduodenectomy and 1% (99%-CI: 0% to 1%) for distal pancreatectomy. The benchmark for overall morbidity was 54% (99%-CI: 45% to 65%) for partial pancreatoduodenectomy and 57% (99%-CI: 38% to 88%) for distal pancreatectomy.

Conclusion The Evidence Map of Pancreatic Surgery, which is freely accessible via www.evidencemap.surgery, provides a regularly updated overview of the available literature displayed in an intuitive fashion. Clinical decision-making and evidence-based patient information are supported by the primary data provided, as well as living meta-analyses. Researchers can use the systematic literature search and processed data for their own projects and funding bodies can base their research priorities on evidence gaps that the map uncovers.

Publication History

Article published online:
08 September 2020