{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:53:03Z","timestamp":1791309183637,"version":"4.3.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the exponential growth of systematic reviews and meta-analyses on RA pharmacotherapy, a comprehensive and up-to-date assessment of methodological quality is urgently needed to gauge the credibility of this evidence base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This protocol describes a meta-epidemiological study that will systematically appraise the methodological quality of published systematic reviews and meta-analyses of RA pharmacotherapy (csDMARDs, bDMARDs, and tsDMARDs) using the AMSTAR 2 instrument and explore study-level factors associated with methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We will systematically search PubMed, Embase, the Cochrane Library and three Chinese databases-China National Knowledge Infrastructure (CNKI), Wanfang Data and China Science and Technology Journal Database-from inception to June 1, 2026. Two independent reviewers will screen studies, extract data and assess methodological quality using the AMSTAR 2 instrument; an overall rating (high, moderate, low, critically low) will be derived for each review. Binary logistic regression comparing \u201cAdequate\u201d (High\/Moderate) versus \u201cInadequate\u201d (Low\/Critically Low) reviews will be used for the primary analysis, with ordinal logistic regression fitted as a pre-specified exploratory analysis; pre-specified sensitivity and robustness analyses (including penalized and Bayesian estimation for sparse categories) will test the stability of findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results will provide a descriptive overview of the methodological quality landscape, highlighting common strengths and critical weaknesses across published RA meta-analyses. The regression analysis will quantify the relationship between specific study characteristics and methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study will provide a comprehensive, cross-drug-class AMSTAR 2-based methodological assessment of the RA pharmacotherapy evidence-synthesis field, complementing prior appraisals limited to specific complementary or single-agent interventions. The findings will offer clinicians and guideline developers a graded framework for judging evidence credibility and will provide empirical, actionable guidance for researchers to enhance the design, conduct, and reporting of future systematic reviews in RA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0359531","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:24:26Z","timestamp":1791307466000},"page":"e0359531","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methodological quality of systematic reviews and meta-analyses of rheumatoid arthritis pharmacotherapy: A protocol for a meta-epidemiological study using AMSTAR 2"],"prefix":"10.1371","volume":"21","author":[{"given":"Maoyi","family":"Yang","sequence":"first","affiliation":[{"name":"Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, 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