{
  "abstract": "Background: 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. Objective: 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. Methods: 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 “Adequate” (High/Moderate) versus “Inadequate” (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. Results: 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. Conclusion: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China",
    "Bazhong Hospital of Traditional Chinese Medicine, Bazhong, Sichuan, China"
  ],
  "article_type": "Study Protocol",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
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        0
      ],
      "name": "Maoyi Yang"
    },
    {
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        1
      ],
      "name": "Qifan Cao"
    },
    {
      "name": "Delin Chen"
    },
    {
      "name": "Zhaoxin Yang"
    },
    {
      "name": "Zhipeng Hu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2ghw17jtnytrn.bib",
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  "doi": "10.1371/journal.pone.0359531",
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    "1932-6203"
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  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "1804|Meta-analysis and systematic reviews"
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      "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Rheumatoid arthritis"
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      "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Rheumatoid arthritis"
    ],
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      "/Medicine and health sciences/Pharmaceutics/Drug therapy"
    ],
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      "plos",
      "/Medicine and health sciences/Rheumatology/Arthritis/Rheumatoid arthritis"
    ],
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      "/Physical sciences/Mathematics/Statistics/Statistical methods/Metaanalysis"
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      "/Physical sciences/Mathematics/Statistics/Statistical methods/Regression analysis"
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      "/Research and analysis methods/Database and informatics methods/Database searching"
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      "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Metaanalysis"
    ],
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      "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Regression analysis"
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      "/Research and analysis methods/Research assessment/Research reporting guidelines"
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      "/Research and analysis methods/Research assessment/Systematic reviews"
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      "/Social sciences/Psychology/Cognitive psychology/Decision making"
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  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359531&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-06",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/2ghw17jtnytrn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
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      "url": "https://doi.org/10.1371/journal.pone.0359531"
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
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    {
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      "origin": "plos:neuroscience",
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  "title": "Methodological quality of systematic reviews and meta-analyses of rheumatoid arthritis pharmacotherapy: A protocol for a meta-epidemiological study using AMSTAR 2",
  "title_text": "Methodological quality of systematic reviews and meta-analyses of rheumatoid arthritis pharmacotherapy: A protocol for a meta-epidemiological study using AMSTAR 2",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/2ghw17jtnytrn",
  "venue": "PLOS One",
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