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Selahittin Çayan, Editorial Commentary on "Erectile Dysfunction: An Umbrella Review of Meta-Analyses of Risk Factors, Treatment, and Prevalence Outcomes", The Journal of Sexual Medicine, Volume 16, Issue 7, July 2019, Page 1118, https://doi.org/10.1016/j.jsxm.2019.04.006
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The authors attempted to synthesize 98 meta-analyses of results on risk factors, treatment, and prevalence of erectile dysfunction (ED). They investigated 37 risk factors and 28 treatments in a meta-synthesis. I do not think it is a good idea to make an umbrella review to investigate analyses of all things, including all treatment modalities, risk factors, and prevalence of ED in the same meta-synthesis.
Statistical analyses of the data obtained from the meta-analyses in this umbrella review did not change any conclusions, given from the published meta-analyses related to ED in the literature. Therefore, this umbrella review gives no implications for clinical practice, because it provides no contribution on the literature other than published meta-analyses in terms of treatment, risk factors, and prevalence of ED. Separation of the 3 major parameters (treatment, risk factors, and prevalence) would make the article more readable and understandable. For example, the authors mentioned that smoking cigarettes was associated with increased ED. We already have this information from the published meta-analyses. However, it would be better if the authors had given the exact odds ratio of ED occurring in men who smoke cigarette, obtained from all published meta-analyses, as given in different diseases.1 I would also expect to see the odds ratio of each risk factor to cause ED obtained from all meta-analyses.2
