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Finding What Works in Health Care: Standards for Systematic Reviews
H
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist
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Finding What Works in Health Care: Standards for Systematic Reviews
TABLE H-1 Checklist of Items to Include When Reporting a Systematic Review or Meta-Analysis
Selection/Topic
#
Checklist Item
TITLE
Title
1
Identify the report as a systematic review, meta-analysis, or both.
ABSTRACT
Structured summary
2
Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
INTRODUCTION
Rationale
3
Describe the rationale for the review in the context of what is already known.
Objectives
4
Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
METHODS
Protocol and registration
5
Indicate if a review protocol exists, if and where it can be accessed (e.g., web address), and, if available, provide registration information, including registration number.
Eligibility criteria
6
Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Information sources
7
Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Search
8
Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Study selection
9
State the process for selecting studies (i.e., screening, eligibility, included in systematic reviews, and, if applicable, included in the meta-analysis).
Data collection process
10
Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Data items
11
List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
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Selection/Topic
#
Checklist Item
Risk of bias in individual studies
12
Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Summary measures
13
State the principal summary measures (e.g., risk ratio, difference in means).
Synthesis of results
14
Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Risk of bias across studies
15
Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Additional analyses
16
Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were prespecified.
RESULTS
Study selection
17
Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Study characteristics
18
For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Risk of bias within studies
19
Present data on risk of bias of each study and, if available, any outcome-level assessment (see Item 12).
Results of individual studies
20
For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group; and (b) effect estimates and confidence intervals, ideally with a forest plot.
Synthesis of results
21
Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Risk of bias across studies
22
Present results of any assessment of risk of bias across studies (see Item 15).
Additional analyses
23
Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16]).
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Selection/Topic
#
Checklist Item
DISCUSSION
Summary of evidence
24
Summarize the main findings, including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Limitations
25
Discuss limitations at a study and outcome level (e.g., risk of bias) and at review level (e.g., incomplete retrieval of identified research, reporting bias).
Conclusions
26
Provide a general interpretation of the results in the context of other evidence and implications for future research.
FUNDING
Funding
27
Describe sources of funding for the systematic review and other support (e.g., supply of data) and the role of funders for the systematic review.
SOURCES: Liberati et al. (2009); Moher et al. (2009).
REFERENCES
Liberati, A., D. G. Altman, J. Tetzlaff, C. Mulrow, P. Gotzsche, J. P. Ioannidis, M. Clarke, P. J. Devereaux, J. Kleijnen, and D. Moher. 2009. The PRISMA Statement for reporting systematic reviews and meta-analysis of studies that evaluate health care interventions: Explanation and elaboration. Annals of Internal Medicine 151(4):W11–W30.
Moher, D., A. Liberati, J. Tetzlaff, and D. G. Altman. 2009. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine 6(7):1–6.
