Evaluation of the replicability of systematic reviews with meta-analyses of the effects of health interventions

Systematic reviews are often characterized as being inherently replicable, but several studies have challenged this claim. The objective of the study was to investigate the variation in results following independent replication of literature searches and meta-analyses of systematic reviews. We included 10 systematic reviews of the effects of health interventions published in November 2020. Two information specialists repeated the original database search strategies. Two experienced review authors screened full-text articles, extracted data, and calculated the results for the first reported meta-analysis. All replicators were initially blinded to the results of the original review. A meta-analysis was considered not 'fully replicable' if the original and replicated summary estimate or confidence interval width differed by more than 10%, and meaningfully different if there was a difference in the direction or statistical significance. The difference between the number of records retrieved by the original reviewers and the information specialists exceeded 10% in 25/43 (58%) searches for the first replicator and 21/43 (49%) searches for the second. Eight meta-analyses (80%, 95% CI: 49-96) were initially classified as not fully replicable. After screening and data discrepancies were addressed, the number of meta-analyses classified as not fully replicable decreased to five (50%, 95% CI: 24-76). Differences were classified as meaningful in one blinded replication (10%, 95% CI: 1-40) and none of the unblinded replications (0%, 95% CI: 0-28). The results of systematic review processes were not always consistent when their reported methods were repeated. However, these inconsistencies seldom affected summary estimates from meta-analyses in a meaningful way.