Redundancy, quality appraisal, and discordance in the results of systematic reviews of early mobilization of critically ill adults. A meta-research protocol

Introduction In adult patients in intensive care units (ICU), early mobilization is one of the central non-pharmacological interventions studied for recovery from critical illness. Several systematic reviews (SRs) have been conducted to determine the effect of this intervention on ICU-acquired weakness (ICU-AW) with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may be generating research waste that makes it difficult for clinicians to keep up to date with the best available evidence. Therefore, this meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilization in critically ill adult patients on different clinical outcomes. Methods A meta-research of early mobilization SRs in critically ill adult patients will be conducted. A sensitive search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos, and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction, and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the “Evidence-Based Research” framework. The methodological quality of the SRs will be assessed with the AMSTAR 2 tool and the quality of the reports through compliance with the PRISMA statement. To assess the potential reasons for discordance in the results of the SRs, only SRs that an MA has carried out will be analyzed, considering divergence in results and their interpretation. Expected results The analysis of this meta-research will assess the redundancy in the conducting of SR on the mobilization of critically ill adult patients, their methodological quality, and the quality of the reporting of their findings, as well as the causes of possible discrepancies between their results. These findings could guide the development of better and more timely SRs on the effectiveness of early mobilization of adult critically ill patients. The decrease in waste research could facilitate evidence-based decision-making by stakeholders. Registration number osf.io/kxwq9 ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: N/A I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.