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Methodological quality of systematic reviews of the local management of anogenital warts: a systematic review using AMSTAR II, ROBIS and PRISMA
  1. Anissa Desmoulin1,
  2. Elisa Joly1,
  3. Phuong Tran2,3,
  4. Christian Derancourt4,
  5. Antoine Bertolotti1,5
  1. 1 Maladies Infectieuses Dermatologie, Centre Hospitalier Universitaire de La Réunion Site Sud, Saint-Pierre, France
  2. 2 Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire de La Réunion Site Sud, Saint-Pierre, France
  3. 3 Centre d’Etudes Périnatales de l’Océan Indien, Centre Hospitalier Universitaire de La Réunion Site Sud, 97448 Saint Pierre Cedex, Saint-Pierre, France
  4. 4 Cabinet de Dermatologie, Tallard, France
  5. 5 CIC-EC Inserm 1410, Centre Hospitalier Universitaire de La Réunion Site Sud, Saint-Pierre, France
  1. Correspondence to Dr Antoine Bertolotti, Maladie infectieuse - dermatologie, CHU de La Réunion Sites Sud Saint-Pierre, 97448 Saint-Pierre, La Réunion, Réunion; antoine_bertolotti{at}


Introduction Anogenital warts (AGWs) are among the most common STDs. Many therapy options are available but are not codified. Systematic reviews (SRs) and meta-analyses (MAs) are helpful to elaborate recommendations on the management of AGWs. The objective of our study was to assess the quality and consistency of SRs for the local management of AGWs using three international tools.

Methods Seven electronic databases were searched from inception to 10 January 2022 for this SR. The intervention of interest was any local treatment of AGWs. There was no restriction on language and population. The methodological quality, reporting quality and risk of bias (ROB) of the included SRs for the local treatments of AGWs were assessed independently by two investigators with A Measurement Tool to Assess systematic Reviews version II (AMSTAR II), Risk of Bias in Systematic Reviews (ROBIS) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).

Results Twenty-two SRs/MAs met all inclusion criteria. According to the results of the AMSTAR II, nine included reviews were rated critically as being of low quality, and only five were of high quality. Based on the ROBIS tool, only nine SRs/MAs had a low ROB. The domain-assessed ‘study eligibility criteria’ were mostly rated at a low ROB, unlike the other domains. With PRISMA, the reporting checklist was relatively complete for ten SRs/MAs, but some reporting weaknesses remained in the topics of the abstract, protocol and registration, ROB and funding.

Discussion Several therapy options are available for the local management of AGWs and are widely studied. However, due to the many ROB and low quality of these SRs/MAs, only a few of them have the sufficient methodological quality to support guidelines.

PROSPERO registration number CRD42021265175.

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  • Handling editor Laith J Abu-Raddad

  • AD and EJ contributed equally.

  • Contributors AD, EJ and AB conceptualised and designed the study, and participated in the acquisition, analysis and interpretation of data. AD and EJ drafted the initial manuscript. AB, PT and CD critically reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.