Dear editor
We have reviewed the systematic review and meta-analysis conducted by Dian et al.1 which assessed the efficacy and safety of tebentafusp in patients with metastatic uveal melanoma. The results indicate that tebentafusp shows promising treatment outcomes for metastatic uveal melanoma (mUM) patients. However, several methodological concerns need addressing to enhance the reliability and applicability of the findings.
Firstly, evaluating the quality of included studies is crucial for understanding the robustness of the results. A quality assessment was not included in this systematic review. While a sensitivity analysis was conducted using a leave-one-out approach, conducting quality assessments and performing sensitivity analyses by omitting low-quality studies would help elucidate the impact of potential bias on the pooled estimates. Additionally, the inclusion of a Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) analysis could offer a structured approach to rating the quality of evidence in systematic reviews and meta-analyses.2
Secondly, the authors assessed heterogeneity using I2 statistics, a commonly used metric. However, applying prediction intervals in the analysis would be beneficial, especially for translating the findings into real-world settings.3 Prediction intervals provide a range within which the results of future studies are expected to fall, offering practical insights for healthcare researchers and policymakers regarding the variability of outcomes across different contexts.
Furthermore, the authors used funnel plots to assess publication bias, even though only a few studies were available. Employing Doi plots and the Luis Furuya-Kanamori (LFK) index could enhance the evaluation for the meta-analysis of proportions.4 These tools help quantify asymmetry in a less subjective manner, potentially indicating the presence of publication bias.
As systematic reviews and meta-analyses represent the pinnacle of evidence synthesis, it is crucial that they adhere to the highest methodological standards to provide reliable evidence for clinical decision-making.
Biography
Hashem Abu Serhan is an Ophthalmology Resident at Hamad Medical Corporation in Doha, Qatar. He has a strong research background, with a particular interest in the intersection of Ophthalmology and Evidence synthesis. Dr. Abu Serhan has served as an invited reviewer for several prestigious journals, including the International Ophthalmology, American Journal of Ophthalmology, and the British Journal of Ophthalmology. His research contributions span various areas of ophthalmology, including retinal diseases, cataract surgery, and uveitis. Dr. Abu Serhan has co-authored multiple peer-reviewed articles, showcasing his expertise in both clinical practice and academic research. In addition to his clinical and research roles, he is actively involved in academic collaborations, aiming to advance the field of ophthalmology through innovative approaches and interdisciplinary partnerships. His work has been recognized for its impact on improving patient outcomes and advancing the understanding of complex ophthalmic conditions. Dr. Abu Serhan holds a Bachelor of Medicine from Yarmouk University and continues to contribute to the global ophthalmology community through his research and clinical practice.
Funding Statement
The author(s) reported there is no funding associated with the work featured in this article.
Disclosure statement
No potential conflict of interest was reported by the author(s).
References
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