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Management of haemorrhoids: protocol of an umbrella review of systematic reviews and meta-analyses
  1. Min Chen1,
  2. Tai-Chun Tang1,
  3. Tao-Hong He1,
  4. Yong-Jun Du1,
  5. Di Qin2,
  6. Hui Zheng2
  1. 1Colorectal disease department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
  2. 2The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
  1. Correspondence to Professor Hui Zheng; zhenghui{at}


Introduction The prevalence of haemorrhoidal diseases was high in general population, and many treatments are proposed for the management of haemorrhoids. The treatments include conservative and surgical interventions; the credibility and strength of current evidence of their effectiveness are not comprehensively evaluated. We aim to evaluate the credibility of systematic reviews and meta-analyses that assess the effectiveness of the treatments for haemorrhoidal diseases through an umbrella review.

Methods and analysis We will search Ovid Medline, Embase, Cochrane library and Web of Science from inception to March 2020 without any language restriction. We will include meta-analyses that examine the effectiveness of treatments in the management of haemorrhoids. Two reviewers will independently screen the titles and abstracts of retrieved articles, and they will extract data from the included meta-analyses. For each meta-analysis, we will estimate the effect size of a treatment through the random-effect model and the fixed-effect model, and we will evaluate between-study heterogeneity (Cochrane’s Q and I2 statistics) and small-study effect (Egger’s test); we will also estimate the evidence of excess significance bias. Evidence of each treatment will be graded according to prespecified criteria. Methodological quality of each meta-analysis will be evaluated by using Assessment of Multiple Systematic Reviews 2. The corrected cover area method will be used to assess the impact of overlap in reviews on the findings of the umbrella review.

Ethics and dissemination We will present the results of the umbrella review at conferences and publish the final report in a peer-reviewed journal. The umbrella review does not require ethical approval.

PROSPERO registration number CRD42019140702.

  • gastroenterology
  • general medicine (see internal medicine)
  • primary care
  • surgery

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors MC and HZ designed the study and will perform data analysis. DQ developed the search strategy. MC and T-CT will perform literature search and screen the eligibility of the retrieved articles. T-HH and DQ will evaluate the quality of the retrieved meta-analyses. Y-JD and T-HH will extract information from the eligible studies and prepare the information for data analysis. MC wrote the first draft of the protocol, and all authors read the article and approve it for publication.

  • Funding The review is financially supported by the National Natural Science Foundation of China (nos. 81774321 and 81473777).

  • Disclaimer Funders and sponsors have no role in the design of this protocol.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

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

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