Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses

Objective Numerous meta-analyses have revealed the association between gastro-oesophageal reflux disease (GORD) and a range of diseases; however, the certainty of the evidence remains unclear. This study aimed to summarise and assess the certainty of evidence derived from meta-analyses.Methods Embas...

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Main Authors: Xue Liang, Chengning Yang, Yina Zhao, Ran Chen, Daogang Wang
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/12/e038450.full
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spelling doaj-33a6e66a432747d7a50ce1498eec208d2021-09-17T15:00:04ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-038450Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analysesXue Liang0Chengning Yang1Yina Zhao2Ran Chen3Daogang Wang42Merck Research Laboratories, Kenilworth, NJ, USADepartment of Gastroenterology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaObjective Numerous meta-analyses have revealed the association between gastro-oesophageal reflux disease (GORD) and a range of diseases; however, the certainty of the evidence remains unclear. This study aimed to summarise and assess the certainty of evidence derived from meta-analyses.Methods Embase, PubMed, Web of Science, Cochrane Databases of Systematic Reviews, CNKI and Wangfang databases from their inception to 22 February 2020 were queried for systematic reviews and meta-analyses on the association between GORD and various diseases. The methodological quality of the included studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Statistical analysis was conducted using Stata V.15.Results Ten publications with associations between GORD and different types of diseases were included. There was high heterogeneity (I2 >75%) among seven independent meta-analyses. Evidence for publication bias in two independent meta-analyses was also observed. According to the AMSTAR 2 approach, the methodological quality was high for 20% of meta-analyses, moderate for 10%, low for 40% and critically low for 30%. Based on GRADE approach, the certainty of evidence was high for the association between GORD and higher risk of chronic obstructive pulmonary disease (COPD) exacerbation (OR 5.37; 95% CI 2.71 to 10.64) and higher prevalence of oesophageal adenocarcinoma (OR 4.57; 95% CI 3.89 to 5.36), and it was moderate for the association between GORD and higher chronic rhinosinusitis prevalence (OR 2.16; 95% CI 1.37 to 3.48).Conclusion The association between GORD and a range of diseases was extensively studied, and our findings revealed a high certainty of evidence of the association between GORD and an increased risk of COPD exacerbation as well as increased prevalence of oesophageal adenocarcinoma. Further investigations using systematic reviews and meta-analyses of high methodological quality that include prospective large cohort studies and adjusted confounders are warranted.PROSPERO registration number CRD42019122264.https://bmjopen.bmj.com/content/10/12/e038450.full
collection DOAJ
language English
format Article
sources DOAJ
author Xue Liang
Chengning Yang
Yina Zhao
Ran Chen
Daogang Wang
spellingShingle Xue Liang
Chengning Yang
Yina Zhao
Ran Chen
Daogang Wang
Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
BMJ Open
author_facet Xue Liang
Chengning Yang
Yina Zhao
Ran Chen
Daogang Wang
author_sort Xue Liang
title Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
title_short Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
title_full Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
title_fullStr Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
title_full_unstemmed Associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
title_sort associations between gastro-oesophageal reflux disease and a range of diseases: an umbrella review of systematic reviews and meta-analyses
publisher BMJ Publishing Group
series BMJ Open
issn 2044-6055
publishDate 2020-12-01
description Objective Numerous meta-analyses have revealed the association between gastro-oesophageal reflux disease (GORD) and a range of diseases; however, the certainty of the evidence remains unclear. This study aimed to summarise and assess the certainty of evidence derived from meta-analyses.Methods Embase, PubMed, Web of Science, Cochrane Databases of Systematic Reviews, CNKI and Wangfang databases from their inception to 22 February 2020 were queried for systematic reviews and meta-analyses on the association between GORD and various diseases. The methodological quality of the included studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Statistical analysis was conducted using Stata V.15.Results Ten publications with associations between GORD and different types of diseases were included. There was high heterogeneity (I2 >75%) among seven independent meta-analyses. Evidence for publication bias in two independent meta-analyses was also observed. According to the AMSTAR 2 approach, the methodological quality was high for 20% of meta-analyses, moderate for 10%, low for 40% and critically low for 30%. Based on GRADE approach, the certainty of evidence was high for the association between GORD and higher risk of chronic obstructive pulmonary disease (COPD) exacerbation (OR 5.37; 95% CI 2.71 to 10.64) and higher prevalence of oesophageal adenocarcinoma (OR 4.57; 95% CI 3.89 to 5.36), and it was moderate for the association between GORD and higher chronic rhinosinusitis prevalence (OR 2.16; 95% CI 1.37 to 3.48).Conclusion The association between GORD and a range of diseases was extensively studied, and our findings revealed a high certainty of evidence of the association between GORD and an increased risk of COPD exacerbation as well as increased prevalence of oesophageal adenocarcinoma. Further investigations using systematic reviews and meta-analyses of high methodological quality that include prospective large cohort studies and adjusted confounders are warranted.PROSPERO registration number CRD42019122264.
url https://bmjopen.bmj.com/content/10/12/e038450.full
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