ArticlePDF Available

Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement

Authors:

Abstract and Figures

Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
Content may be subject to copyright.
R E S E A R C H Open Access
Preferred reporting items for systematic review
and meta-analysis protocols (PRISMA-P) 2015
statement
David Moher
1*
, Larissa Shamseer
1
, Mike Clarke
2
, Davina Ghersi
3
, Alessandro Liberati
ˆ
, Mark Petticrew
4
,
Paul Shekelle
5
, Lesley A Stewart
6
and PRISMA-P Group
Abstract
Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the
review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding
and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in
completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for
Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist
intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those
commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant
protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the
completeness and transparency of a systematic review protocol submitted for publication in a journal or other
medium.
Background
Systematic reviews are the reference standard for syn-
thesizing evidence in health care because of their meth-
odological rigor. They are used to support the
development of clinical practice guidelines and inform
clinical decision-making. They are becoming increas-
ingly common; in 2010, 11 new reviews were estimated
to be published daily [1]. Ideally, systematic reviews are
based on pre-defined eligibility criteria and conducted
according to a pre-defined methodological approach as
outlined in an associated protocol.
The preparation of a protocol is an essential compo-
nent of the systematic review process; it ensures that a
systematic review is carefully planned and that what is
planned is explicitly documented before the review
starts, thus promoting consistent conduct by the review
team, accountability, research integrity, and transparency
of the eventual completed review. A protocol may also
reduce arbitrariness in decision-making when extracting
and using data from primary research, since planning
provides an opportunity for the review team to antici-
pate potential problems. When clearly reported proto-
cols are made available, they enable readers to identify
deviations from planned methods in completed reviews
and whether they bias the interpretation of a review re-
sults and conclusions. Bias related to the selective
reporting of outcomes has been characterized as a ser-
ious problem in clinical research, including systematic
reviews [2-7].
Until recently, systematic review protocols were gener-
ally available only through select organizations, such as
The Cochrane [8] and Campbell Collaborations and the
Joanna Briggs Institute, for which the preparation of a
protocol is mandatory. Outside of these organizations,
the existence of a protocol is infrequently reported in
completed reviews [9,10]. Fewer than half of 300 system-
atic reviews indexed on MEDLINE in November 2004
(most recent generalizable sample; 2014 update under-
way) report working from a protocol [10], 80% of which
are non-Cochrane affiliated. Of the non-Cochrane thera-
peutic reviews, only 11% mentioned the existence of a
protocol [10]. The majority of reviews in health care are
* Correspondence: dmoher@ohri.ca
ˆ
Deceased
1
Ottawa Hospital Research Institute and University of Ottawa, Ottawa,
Canada
Full list of author information is available at the end of the article
© 2015 Moher et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
Moher et al. Systematic Reviews 2015, 4:1
http://www.systematicreviewsjournal.com/content/4/1/1
conducted and published outside of Cochrane, however
[10]. The paucity of protocols may be due, in part, to the
authorslack of knowledge about how to write them and
what to include. Currently, little succinct guidance is
available for those preparing systematic review protocols,
although the recent Standards for Systematic Reviews
prepared by the Institute of Medicine (IOM) provide
some guidance toward addressing this gap [11].
Many groups have called for the widespread preparation
and registration of systematic review protocols in order
to increase the availability and accessibility of apriori
methods for systematic reviews [12-14]. Such an effort
may reduce the duplication of effort [15] and reduce
the publication bias of systematic reviews. This chal-
lenge has been taken up by the Centre for Reviews and
Dissemination, University of York, which has spearheaded
the establishment of an international registerPROS-
PERO (International Prospective Register of Ongoing
Systematic Reviews, http://www.crd.york.ac.uk/prospero)
[16,17]. The register, which enables the permanent docu-
mentation of 22 mandatory (and 18 optional) items about
the a priori design and conduct of a review, was launched
in February 2011. At the time of writing, >5,000 system-
atic review protocols from over 70 countries have been
registered since its inception. Starting in October 2013,
new Cochrane protocols were and continue to be auto-
matically added to PROSPERO.
Along with the improved accessibility of protocols
through registration comes the need for strengthened
transparency, accuracy, and completeness of the reports
of protocols intended for dissemination. A template to
aid in the preparation of systematic review protocols,
such as a reporting guideline, may help achieve this. Fur-
thermore, such guidance will enable authors to create a
clear and complete document of their a priori methods,
which may facilitate the registration of key information
into the PROSPERO database. Building on an estab-
lished guideline for systematic reviews and meta-
analyses of studies evaluating health care interventions
the Preferred Reporting Items for Systematic reviews
and Meta-Analyses (PRISMA, www.prisma-statement.
org) [12,13]we have developed PRISMA for Protocols
(PRISMA-P) 2014. Table 1 summarizes the difference
in intentions between PRISMA-P and PROSPERO.
The aim of PRISMA-P 2015 is to improve the quality
of systematic review protocols, similar to the impact
achieved by other reporting guidelines [18-20]. By help-
ing authors document an a priori road map of their sys-
tematic review, PRISMA-P also has the potential to
improve the conduct of systematic reviews, as has been
suggested of other reporting guidelines [21]. This State-
ment paper summarizes the development of the guide-
line and presents the PRISMA-P checklist.
Terminology
There is no standard definition for a systematic review
and meta-analysis protocol, and we note that some ter-
minology contained within these definitions may carry
different meanings for different readers (i.e., systematic
search). The terms systematic review,meta-analysis,
and protocolare defined in Table 2. The former two
terms are in accordance with the definitions reported in
the PRISMA Statement [13] and are in line with those
used by the Agency for Healthcare Research and Qual-
itys Evidence-based Practice Center (EPC) program [22],
The Cochrane Collaboration [23], and the 2011 guidance
from the Institute of Medicine [11]. The definition pro-
vided is a culmination of the terminology used by the
Standard Protocol Items: Recommendations for Inter-
ventional Trials (SPIRIT) 2013 initiative [24], the PROS-
PERO register, and the IOM Standards (Table 2).
Scope
The PRISMA-P checklist is intended primarily for the
preparation of protocols of systematic reviews and meta-
analyses that summarize aggregate data from studies,
Table 1 PROSPERO and PRISMA-P
Definition and objective
PROSPERO: International Prospective
Register of Systematic Reviews
An online portal through which to register the intention to conduct a systematic review, with health-related
outcomes, before it is initiated [16]. One of the main goals of PROSPERO is to make the intent of systematic
reviews known before they are conducted in order to reduce the unplanned duplication of systematic
reviews [15]. In addition, by requiring the documentation of a priori methods, the register facilitates
increased transparency in the review process by allowing readers of systematic reviews to compare
methods, outcomes, and analyses carried out with those planned in advance and judge whether such
changes impact the results of a review.
PRISMA-P: Preferred Reporting Items for
Systematic Review and Meta-Analysis
Protocols
A guideline to help authors prepare protocols for planned systematic reviews and meta-analyses that
provides them with a minimum set of items to be included in the protocol. A protocol is intended to
provide the rationale for the review and pre-planned methodological and analytic approach, prior to
embarking on a review. Investigators should prepare a review protocol in advance of registering it in
PROSPERO so that details requiring further consideration may be thought through in advance, avoiding
the need for multiple amendments to registration information. PRISMA-P items have been derived largely
from the PRISMA checklist and items of the PROSPERO register, in order to facilitate seamless registration.
Moher et al. Systematic Reviews 2015, 4:1 Page 2 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
particularly the evaluations of the effects of interven-
tions. There are many review types that are outside of
this scope. As such, given the general lack of protocol
guidance for other types of reviews, we encourage re-
viewers preparing any type of review protocol to make
use of PRISMA-P as applicable. Readers can also use the
checklist to assess the completeness of the reporting of
published protocols. However, it is not recommended to
use the checklist as an assessment tool to gauge the ap-
propriateness of the methods of a systematic review
protocol; it has not been validated for that purpose.
Development of PRISMA-P 2015
An international steering committee (MC, DG, AL, DM,
MP, PS, and LAS) comprising members with wide-ranging
experience in systematic review methodology, protocol
registry development, and reporting guideline development
led the development of PRISMA-P, coordinated by LS. The
process proposed by the Enhancing the Quality and Trans-
parency of Health Research (EQUATOR) Network was
used to guide PRISMA-P development [27]. The process
has 18 step-by-step recommendations grouped into five
main stages:
1. Initial steps (determine the need for a reporting
guideline);
2. Pre-meeting activities (identify contributors, conduct
Delphi exercise, generate a list of potential items,
and prepare for face-to-face meeting);
3. Face-to-face consensus meeting (present results of
pre-meeting activities and relevant evidence);
4. Post-meeting activities (develop guidance Statement,
Explanation and Elaboration document, and a
publication strategy);
5. Post-publication activities (encourage uptake of
guideline).
The first stage, Initial steps,was described above; de-
tails of the remaining four steps are below.
Pre-meeting activities
In developing the PRISMA-P checklist, the steering
committee compiled a list of items from various tools
relating to the preparation of systematic review proto-
cols for discussion at a consensus meeting of experts.
Specifically, we mapped items from a Delphi exercise
carried out during the development of PROSPERO [28],
PROSPERO register items, PRISMA checklist items [13],
SPIRIT 2013 checklist items [29], and items of IOM
Standard 2.6 [11] against each other to identify unique
and overlapping concepts. Lessons learned from the de-
velopment of the SPIRIT checklist with respect to the
concept and content of research protocols were used to
guide discussion and debate at the meeting.
PRISMA-P consensus meeting
Twenty-three international experts attended the
PRISMA-P consensus meeting on June 2324, 2011, in
Rockville, MD, USA to gain consensus on and reduce
the number of potential PRISMA-P items. Delegates in-
cluded journal editors, systematic review methodologists
(including directors and representatives from inter-
national Cochrane Centres, Agency for Healthcare Re-
search and Qualitys (AHRQs) Evidence-based Practice
Centres, and the UK National Institute for Health Re-
search), reporting guideline developers, information spe-
cialists, biostatisticians, and health research funders.
Through group discussion at the meeting, 38 potential
checklist items were reduced to 22.
Post-meeting activities
Following the meeting, the steering committee revised
the draft 22-item checklist and refined their wording
such that they accurately reflected meeting discussions.
The draft checklist was also presented to the PROS-
PERO group, at a scientific meeting of the Cochrane
Collaboration, for input and feedback and to AHRQs
Learning Network. After each of these reviews, the steer-
ing committee made minor amendments to the items.
Table 2 PRISMA-P terminology
Term Definition
Systematic
review
A systematic review attempts to collate all relevant evidences that fits pre-specified eligibility criteria to answer a specific research
question. It uses explicit, systematic methods to minimize bias in the identification, selection, synthesis, and summary of studies.
When done well, this provides reliable findings from which conclusions can be drawn and decisions made [25,26]. The key
characteristics of a systematic review are (a) a clearly stated set of objectives with an explicit, reproducible methodology; (b) a
systematic search that attempts to identify all studies that would meet the eligibility criteria; (c) an assessment of the validity of the
findings of the included studies (e.g., assessment of risk of bias and confidence in cumulative estimates); and (d) systematic
presentation, and synthesis, of the characteristics and findings of the included studies
Meta-analysis Meta-analysis is the use of statistical techniques to combine and summarize the results of multiple studies; they may or may be
contained within a systematic review. By combining data from several studies, meta-analyses can provide more precise estimates
of the effects of health care than those derived from the individual studies
Protocol In the context of systematic reviews and meta-analyses, a protocol is a document that presents an explicit plan for a systematic
review. The protocol details the rationale and a priori methodological and analytical approach of the review
Moher et al. Systematic Reviews 2015, 4:1 Page 3 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
The checklist was then circulated to all meeting invitees
for critical input.
The PRISMA-P 2015 checklist
The final PRISMA-P 2015 checklist contains 17 numbered
items (26 including sub-items) Items are categorized into
three main sections: administrative information, introduc-
tion, and methods (Table 3).
We made a conscious effort to harmonize the PRISMA-
P checklist items with the items of the PRISMA checklist
to facilitate authors in transitioning their protocol into
a report of a systematic review. Thirteen PRISMA-P
sub-items have existing PRISMA counterparts. Where
PRISMAwordingorcontentdidnotsufficientlyad-
dress protocol reporting, checklist items were modified.
Readers familiar with PRISMA will notice that PRISMA-
P does not contain a flow diagram documenting the flow
of studies throughout the systematic review process. Such
documentation is possible only after a review has been car-
ried out and remains an essential component to include in
the report of a completed systematic review or meta-
analysis; for further guidance, see the PRISMA Explanation
and Elaboration document [12].
We strongly recommend that the present document
and the accompanying PRISMA-P 2015 Explanation and
Elaboration document [30], which includes examples of
good reporting, rationale, and evidence (where available),
be read together with the PRISMA-P 2015 checklist.
PRISMA-P 2015 explanation and elaboration
Once the steering committee prepared the PRISMA-P
2015 Statement and checklist, they drafted the content
of an Explanation and Elaboration document, with as-
sistance from the larger PRISMA-P group. The explana-
tory text was derived largely from discussions at the
PRISMA-P meeting (recorded at the time) as well as the
PRISMA Explanation and Elaboration document [12].
Examples of well-reported PRISMA-P items came from
protocols registered in the PROSPERO database,
AHRQs EPC Program, and the Cochrane Database of
Systematic Reviews or those published elsewhere. After
the entire group had an opportunity to suggest addi-
tions, deletions, and changes, the steering committee
combined all amendments to create the PRISMA-P 2014
Explanation and Elaboration document [30].
Post-publication activities
The post-publication activities recommended by EQUA-
TOR include seeking and responding to criticism, encour-
aging the endorsement of and adherence to the guideline
from various stakeholders, translating the guideline into
other languages, evaluating its impact, ensuring website
development, and updating of the guideline. The
PRISMA-P 2015 checklist and related publications are
freely available on the websites of the PRISMA Group
(www.prisma-statement.org) and EQUATOR Network
(www.equator-network.org). The PROSPERO register
also contains a link to the guidance to encourage regis-
trants to prepare a complete documentation of their
protocol if they have not done so already.
We plan to develop an educational webinar about the
rationale, usefulness, and potential impact of PRISMA-P,
similar to what was done for PRISMA [31]. In addition,
the potential for PRISMA-P 2015 to be used as an educa-
tional tool for authors, peer reviewers, and editors will be
explored. Targeted implementation activities for PRISMA-
P will be developed in a systematic manner together with
experts in knowledge translation. The PRISMA website
and social media (@PRISMAStatement, www.twitter.
com/PRISMAStatement) will be used to make an-
nouncements about the launch of PRISMA-P and edu-
cational initiatives.
Endorsement
We encourage journals publishing systematic review prod-
ucts to modify their Instructions for Authorssection to
endorse PRISMA-P 2015 and to consider publishing sys-
tematic review protocols, if they do not do so already. We
plan to communicate with known endorsers of PRISMA
(http://prisma-statement.org/endorsers.htm) as well as to
other, relevant non-endorsing journals, to ask them to
consider extending their support to PRISMA-P.
To help ensure optimal uptake by systematic reviewers,
we propose a uniform endorsement policy across organi-
zations and journals involved in the development and
publication of systematic review protocols, demonstrated
by the adoption of the following statement:
[this organization/journal] requires a completed
PRISMA-P 2015 checklist as a condition of submission
of systematic review protocols. We recommend that,
while completing the PRISMA-P 2015 checklist, you
ensure your protocol addresses all items. Taking the
time to ensure that your protocol adheres to these
basic reporting elements will improve your manuscript
and potentially enhance its chances of eventual
acceptance.
Such a statement could be included in a journalsIn-
structions to Authors,or for funding agencies and those
commissioning systematic reviews, in their Application
Guidelines, recommending that applicants developing
the proposals of systematic reviews for funding use
PRISMA-P 2014. Peer reviewers and scientific commit-
tees can also use the checklist to gauge the extent to
which protocols include necessary information.
As has been done for previous reporting guidelines
[18,32] we plan to evaluate whether and to what degree
Moher et al. Systematic Reviews 2015, 4:1 Page 4 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
Table 3 PRISMA-P 2015 checklist: recommended items to include in a systematic review protocol
a
Section/topic Item # Checklist item
ADMINISTRATIVE INFORMATION
Title
Identification 1a Identify the report as a protocol of a systematic review
Update 1b If the protocol is for an update of a previous systematic review, identify as such
Registration 2 If registered, provide the name of the registry (e.g., PROSPERO) and registration number
Authors
Contact 3a Provide name, institutional affiliation, and e-mail address of all protocol authors; provide physical
mailing address of corresponding author
Contributions 3b Describe contributions of protocol authors and identify the guarantor of the review
Amendments 4 If the protocol represents an amendment of a previously completed or published protocol,
identify as such and list changes; otherwise, state plan for documenting important protocol
amendments
Support
Sources 5a Indicate sources of financial or other support for the review
Sponsor 5b Provide name for the review funder and/or sponsor
Role of sponsor/
funder
5c Describe roles of funder(s), sponsor(s), and/or institution(s), if any, in developing the protocol
INTRODUCTION
Rationale 6 Describe the rationale for the review in the context of what is already known
Objectives 7 Provide an explicit statement of the question(s) the review will address with reference to participants,
interventions, comparators, and outcomes (PICO)
METHODS
Eligibility criteria 8 Specify the study characteristics (e.g., PICO, study design, setting, time frame) and report characteristics
(e.g., years considered, language, publication status) to be used as criteria for eligibility for the review
Information sources 9 Describe all intended information sources (e.g., electronic databases, contact with study authors,
trial registers, or other grey literature sources) with planned dates of coverage
Search strategy 10 Present draft of search strategy to be used for at least one electronic database, including planned
limits, such that it could be repeated
Study records
Data management 11a Describe the mechanism(s) that will be used to manage records and data throughout the review
Selection process 11b State the process that will be used for selecting studies (e.g., two independent reviewers) through each
phase of the review (i.e., screening, eligibility, and inclusion in meta-analysis)
Data collection process 11c Describe planned method of extracting data from reports (e.g., piloting forms, done independently, in
duplicate), any processes for obtaining and confirming data from investigators
Data items 12 List and define all variables for which data will be sought (e.g., PICO items, funding sources), any
pre-planned data assumptions and simplifications
Outcomes and
prioritization
13 List and define all outcomes for which data will be sought, including prioritization of main and
additional outcomes, with rationale
Risk of bias in
individual studies
14 Describe anticipated methods for assessing risk of bias of individual studies, including whether this will
be done at the outcome or study level, or both; state how this information will be used in data synthesis
Data
Synthesis 15a Describe criteria under which study data will be quantitatively synthesized
15b If data are appropriate for quantitative synthesis, describe planned summary measures, methods of
handling data, and methods of combining data from studies, including any planned exploration of
consistency (e.g., I
2
, Kendalls tau)
15c Describe any proposed additional analyses (e.g., sensitivity or subgroup analyses, meta-regression)
15d If quantitative synthesis is not appropriate, describe the type of summary planned
Moher et al. Systematic Reviews 2015, 4:1 Page 5 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
endorsement of PRISMA-P 2015 by journals (and poten-
tially by other organizations) influences the complete-
ness of reported protocols. Such an evaluation will be
planned after allowing sufficient time for the wide dis-
semination of PRISMA-P 2015.
Implementation
The current system of implementing reporting guide-
lines is not optimal. At present, their primary mechan-
ism of uptake is through endorsement by journals at
their discretion, if at all. In journals that do endorse
Table 3 PRISMA-P 2015 checklist: recommended items to include in a systematic review protocol
a
(Continued)
Meta-bias(es) 16 Specify any planned assessment of meta-bias(es) (e.g., publication bias across studies, selective
reporting within studies)
Confidence in
cumulative evidence
17 Describe how the strength of the body of evidence will be assessed (e.g., GRADE)
PRISMA-P Preferred Reporting Items for Systematic review and Meta-Analysis Protocols.
a
It is strongly recommended that this checklist be read in conjunction with the PRISMA-P Explanation and Elaboration [30] for important clarification on the items.
Amendments to a review protocol should be tracked and dated. The copyright for PRISMA-P (including checklist) is held by the PRISMA-P Group and is distributed
under a Creative Commons Attribution License 4.0.
Table 4 Proposed stakeholders, actions, and potential benefits for supporting adherence to PRISMA-P
Stakeholder Proposed action Potential benefits
Funders Promote or mandate adherence to PRISMA-P or use PRISMA-P as
a template for systematic review proposals for grant applications
Improved quality, completeness, and consistency
of systematic review proposal submissions
Standardized protocol content will improve peer
review efficiency and investigator understanding
of requirements
Systematic review authors/
groups/organizations
Use/adhere to PRISMA-P during protocol development Improved quality, completeness, and consistency
of protocol content
Enables reviewers to anticipate and avoid future
changes to review methods (i.e., outcomes)
Increased awareness of minimum content for
protocol reporting
Improved completeness of reporting of
completed reviews
PROSPERO (and other
review registries)
Encourage the development of PRISMA-P-based protocols Improved quality of registry entries
Improved consistency across registry entries,
protocols, and systematic reviews
Practice guideline
developers
Use PRISMA-P to gauge the completeness of protocols and
facilitate detection of selective reporting when considering
reviews for guideline inclusion
Enables easy comparison across protocols, registry
entries, and completed systematic reviews
Policymakers Advocate use of PRISMA-P by those funding and carrying
out systematic reviews
May yield better quality, more complete, and more
consistent reviews to inform decision-making
Journal editors Encourage compliance to PRISMA-P for authors submitting
protocols for publication
Improved quality, completeness, and consistency
of protocols over those published in journals not
endorsing PRISMA-P
Offer PRISMA-P as a template to assist in protocol
writing for publication
Increased efficiency in protocol peer and
author understanding of journal requirements
Improved transparency and interpretation
of reviews by readers
Educators Use PRISMA-P as a training tool Simplified teaching and grading of protocols
Encourage adherence in students submitting protocols
for coursework
Improved quality, completeness, and
consistency of protocol content
Students Develop protocols for coursework or research using PRISMA-P Improved understanding of the minimum
protocol content
Well-trained systematic reviewer going
into the workforce
Moher et al. Systematic Reviews 2015, 4:1 Page 6 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
guidelines, language describing their support is often
vague, leaving authors unclear on what they are sup-
posed to do with a given reporting guideline during the
submission process [33]. Furthermore, policies around
how journal editors and peer reviewers should ensure
and/or enforce adherence to reporting checklists are
even less clear, if they exist at all [34]. Other barriers to
implementation may include a lack of awareness of the
guideline and perceived burden of using a reporting
guideline checklist during the editorial process [35].
Some well-known checklists, such as PRISMA, include
a column to the right of the main checklists in which
users report the page number on which a specific item is
reported. This was initially intended to help authors en-
sure each checklist item is addressed and to aid peer re-
viewers in locating reported text for each item within a
document. However, this system is not optimal. One
major problem is that peer reviewers still have to search
within a considerable body of text to locate the exact
text describing a checklist item. When multiple items
are listed separately but reported together or vice versa,
this problem is compounded, because exactly which
content pertains to each item may remain unclear.
The lack of implementation and adherence to report-
ing guidelines is systemic; additional authorities encoun-
tered early in the research process should promote a
clearer message about author adherence to reporting
standards if improvements in reporting are to be made.
In targeting protocols of systematic reviews, PRISMA-P
has a unique opportunity to not only affect the way in
which protocols are reported but to also impact the way
in which reviews are eventually conducted, perhaps
allowing for a more seamless transition into a com-
pletely reported systematic review.
To overcome known challenges with reporting guideline
uptake [36,37], we are developing a prospective imple-
mentation strategy for PRISMA-P 2015 using knowledge
translation principles involving theoretically derived inter-
ventions [37] which have demonstrated effectiveness in
the development of implementation interventions for clin-
ical practice guidelines [38,39]. An initial list of proposed
stakeholders who can assist in the implementation of
PRISMA-P, along with proposed actions and benefits, is
provided in Table 4.
Discussion
Studies comparing trial protocols to final reports have
widely documented both the presence and the extent of
reporting biases in publications of randomized trials
[2,40]. Protocols for systematic reviews are rarely available
for such comparisons, with the exception of select organi-
zations. Of 288 reviews with available protocols in a 2006/
2007 cohort, 64 (22%) were observed to have at least one
discrepant outcome with their completed reviews; only 4
described reasons for the change in the completed review
[3]. Discrepant outcomes added or upgraded from second-
ary to primary at the review stage were more likely to be
statistically significant than those outcomes that had not
changed. This practice (i.e., including, excluding, or chan-
ging outcomes in association with the strength or direc-
tion of findings) has the potential to bias the findings of
any meta-analysis and the reviews conclusions. As review
protocols are expected to become increasingly available
with the advent of PROSPERO, clear reporting will be-
come essential to facilitate the identification of discrepan-
cies between protocol and review by readers and help
them determine whether they need to be cautious in inter-
preting findings.
Reporting and publishing protocols is an important step
in increasing the transparency of the research process and
reliability of published papers. For example, some journals
require a copy of the protocol as part of the peer review
process of randomized trials. As of 1 March 2014, BioMed
Central has published 4,158 trial protocols across 66 of its
258 open-access journals, including 1,026 in Trials. Sys-
tematic Reviews, a BioMed Central journal launched in
February 2012, is committed to publishing systematic re-
view products, including protocols [41], and has published
142 protocols since inception (to 8 June 2014).
Journals, granting agencies, and systematic review or-
ganizations are encouraged to endorse PRISMA-P 2015
in their Instructions to Authorsand guidance for appli-
cants and to implement its use during their peer review
process of systematic review proposals. Reviewers are
encouraged to use the PRISMA-P checklist and Explan-
ation and Elaboration [30] document to guide them
through the documentation of a protocol. Doing so will
enhance the completeness of reporting of review proto-
cols, facilitate the assessment of potential in systematic
reviews, and hopefully strengthen the methodological
quality and reliability of completed systematic reviews.
Competing interests
The PRISMA-P 2015 initiative was supported by the AHRQ, USA (Contract No.
HHSA 290 2007 10059 I) and the Canadian Institutes for Health Research
(Reference No. 114369). This manuscript does not reflect the opinions of
either agency; one author, SC, is an employee of AHRQ. MC, DG, DM, MP,
and LAS are members of the Advisory Board for PROSPERO. DGA, SC, MC,
JG, MH, JM, and MP are members of the Editorial Board, and DM, PS, and
LAS are co-Editors in Chief of Systematic Reviews. None of the authors who
are editors of Systematic Reviews were involved in the handling of this
paper or the decision to publish it.
Authorscontributions
DM, LS, MC, DG, AL, MP, PS, and LAS conceived this paper. DM and LS
drafted the article, and all authors critically revised it for important
intellectual content. All authors approved the final version of this article. DM
is the guarantor of this work.
Acknowledgements
The PRISMA-P steering committee would like to thank the following staff
from the Ottawa Hospital Research Institute (OHRI): Jodi Peters for her efforts
organizing the PRISMA-P consensus meeting, Michael Zhao for his assistance
Moher et al. Systematic Reviews 2015, 4:1 Page 7 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
in preparing documents for the PRISMA-P meeting, Dr. Mohammed Ansari
for valuable input and feedback throughout the process, and Justin Thielman
for his assistance during the preparation of the PRISMA-P manuscripts.
Dedication
The PRISMA-P 2015 initiative is dedicated to our colleague Alessandro Liberati
(19542012) who passed away during the time in which PRISMA-P 2015 was
under development and whose contributions to this work were invaluable.
PRISMA-P group (listed alphabetically)
Douglas G Altman, DSc, Centre for Statistics in Medicine (CSM), University of
Oxford, (Oxford, UK); Alison Booth, Centre for Reviews and Dissemination (CRD),
University of York (York, UK); An-Wen Chan, Womens College Research
Institute, University of Toronto (Toronto, Canada); Stephanie Chang,
Agency for Healthcare Research and Quality (Rockville, USA); Mike Clarke,
Queens University of Belfast (Belfast, Ireland); Tammy Clifford, Canadian
Agency for Drugs and Technologies in Health (CADTH) (Ottawa, Canada);
Kay Dickersin, Johns Hopkins Bloomberg School of Public Health; Matthias
Egger, Institut für Sozial-und Präventivmedizin; Davina Ghersi, National
Health and Medical Research Council (Canberra, Australia); Peter C Gøtzsche,
Nordic Cochrane Centre (Copenhagen, Denmark); Jeremy M Grimshaw,
Canadian Cochrane Centre and OHRI (Ottawa, Canada); Trish Groves, The
BMJ (London, UK); Mark Helfand, AHRQ EPC Scientific Resource Center,
Portland VA Research Foundation (Portland, USA); Julian Higgins, School of
Social and Community Medicine (Bristol, UK); Toby Lasserson, Cochrane
Editorial Unit (London, UK); Joseph Lau, Center for Evidence-based Medicine,
Brown University (Providence, USA); Alessandro Liberati, University of Modena
(Modena, Italy); Kathleen Lohr, Research Triangle Institute-University of North
Carolina EPC (Research Triangle Park, USA); Jessie McGowan, University of
Ottawa (Ottawa, Canada); David Moher, Clinical Epidemiology Program, OHRI,
and University of Ottawa (Ottawa, Canada); Cynthia Mulrow, Annals of
Internal Medicine (San Antonio, USA); Melissa Norton, PLoS Medicine
(London, UK); Matthew Page, Monash University (Australia); Mark Petticrew,
London School of Hygiene and Tropical Medicine (London, UK); Margaret
Sampson, Childrens Hospital of Eastern Ontario (Ottawa; Canada); Holger
Schünemann, McMaster University (Hamilton, Canada); Larissa Shamseer, Clinical
Epidemiology Program, OHRI, and University of Ottawa (Ottawa; Canada);
Paul Shekelle, Southern California EPC, (Los Angeles, USA); Iveta Simera,
CSM, University of Oxford (Oxford, UK); Lesley A Stewart, CRD, University of
York (York, UK); William Summerskill, The Lancet (London, UK); Jennifer Tetzlaff,
Clinical Epidemiology Program, OHRI (Ottawa, Canada); Thomas A Trikalinos,
Center for Evidence-based Medicine, Brown University (Providence, USA); David
Tovey, The Cochrane Library (London, UK); Lucy Turner, Clinical Epidemiology
Program, OHRI (Ottawa Canada); Evelyn Whitlock, Kaiser Permanente Research
Affiliates EPC (Portland, USA).
Author details
1
Ottawa Hospital Research Institute and University of Ottawa, Ottawa,
Canada.
2
Queens University Belfast, Belfast, Ireland.
3
National Health and
Medical Research Council, Canberra, Australia.
4
London School of Hygiene
and Tropical Medicine, London, UK.
5
Southern California Evidence-based
Practice Center, Santa Monica, CA, USA.
6
Centre for Reviews and
Dissemination, University of York, York, UK.
Received: 27 August 2014 Accepted: 26 November 2014
Published: 1 January 2015
References
1. Bastian H, Glasziou P, Chalmers I: Seventy-five trials and eleven systematic
reviews a day: how will we ever keep up? PLoS Med 2010, 7(9):e1000326.
2. Chan AW, Hróbjartsson A, Haahr MT, Gøtzsche PC, Altman DG: Empirical
evidence for selective reporting of outcomes in randomized trials:
comparison of protocols to published articles. JAMA 2004,
291(20):24572465.
3. Kirkham JJ, Altman DG, Williamson PR: Bias due to changes in specified
outcomes during the systematic review process. PLoS ONE 2010,
5(3):e9810.
4. Kirkham JJ, Dwan KM, Altman DG, Gamble C, Dodd S, Smyth R, Williamson
PR: The impact of outcome reporting bias in randomised controlled trials
on a cohort of systematic reviews. BMJ 2010, 340:c365.
5. Dwan K, Gamble C, Williamson PR, Kirkham JJ, Reporting Bias Group:
Systematic review of the empirical evidence of study publication bias
and outcome reporting biasan updated review. PLoS ONE 2013,
8(7):e66844.
6. Norris SL, Holmer HK, Ogden LA, Fu R, Abou-Setta AM, Viswanathan MS,
McPheeters ML: Selective Outcome Reporting as a Source of Bias in Reviews of
Comparative Effectiveness (Prepared by the Oregon Evidence-Based Practice Center
Under Contract no. 290-2007-10057-I). Rockville: Agency for Healthcare Research
and Quality; 2012. Report No.: AHRQ Publication No. 12-EHC110-EF.
7. Page MJ, McKenzie JE, Kirkham J, Dwan K, Kramer S, Green S, Forbes A: Bias
due to selective inclusion and reporting of outcomes and analyses in
systematic reviews of randomised trials of healthcare interventions.
Cochrane Lib 2014, (10):Art No.:MR000035. doi:10.1002/14651858.MR000035.
pub2.
8. Higgins JPT, Green S (Eds): Cochrane Handbook for Systematic Reviews of
Interventions Version 5.1.0: updated March 2011. The Cochrane Collaboration;
2011. Available from [www.cochrane-handbook.org]
9. Ma B, Guo J, Qi G, Li H, Peng J, Zhang Y, Ding Y, Yang K: Epidemiology,
quality and reporting characteristics of systematic reviews of traditional
Chinese medicine interventions published in Chinese journals. PLoS ONE
2011, 6(5):e20185.
10. MoherD,TetzlaffJ,TriccoAC,SampsonM,AltmanDG:Epidemiology
and reporting characteristics of systematic reviews. PLoS Med 2007,
4(3):e78.
11. Institute of Medicine. In Finding What Works in Health Care: Standards for
Systematic Reviews. Edited by Eden J, Levit L, Berg A, Morton S. Washington,
DC: The National Academies Press; 2011.
12. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke
M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting
systematic reviews and meta-analyses of studies that evaluate health
care interventions: explanation and elaboration. PLoS Med 2009,
6(7):e1000100.
13. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group: Preferred
reporting items for systematic reviews and meta-analyses: the PRISMA
Statement. BMJ 2009, 339:b2535.
14. Straus S, Moher D: Registering systematic reviews. CMAJ 2010, 182(1):1314.
15. Moher D, Booth A, Stewart L: How to reduce unnecessary duplication: use
PROSPERO. BJOG 2014, 121:784786.
16. Booth A, Clarke M, Ghersi D, Moher D, Petticrew M, Stewart L: An
international registry of systematic-review protocols. Lancet 2011,
377(9760):108109.
17. Booth A, Clarke M, Dooley G, Ghersi D, Moher D, Petticrew M, Stewart L:
The nuts and bolts of PROSPERO: an international prospective register of
systematic reviews. Syst Rev 2012, 1:2.
18. Turner L, Shamseer L, Altman DG, Schulz KF, Moher D: Does use of the
CONSORT statement impact the completeness of reporting of
randomised controlled trials published in medical journals? A Cochrane
review. Syst Rev 2012, 1:60.
19. Smidt N, Rutjes AWS, Van der Windt D, Ostelo R, Bossuyt PM, Reitsma JB,
Bouter LM, de Vet HCW: The quality of diagnostic accuracy studies since
the STARD statement: has it improved? Neurology 2006, 67(5):792797.
20. Prady SL, Richmond SJ, Morton VM, MacPherson H: A systematic
evaluation of the impact of STRICTA and CONSORT recommendations
on quality of reporting for acupuncture trials. PLoS ONE 2008, 3(2):e1577.
21. Williams HC: Cars, CONSORT 2010, and clinical practice. Trials 2010, 11:33.
22. Methods Guide for Effectiveness and Comparative Effectiveness Reviews, AHRQ
Publication No. 10(14)-EHC063-EF. Rockville: Agency for Healthcare Research
and Quality; 2014. Chapters available at: www.effectivehealthcare.ahrq.gov.
23. Green S, Higgins JPT, Alderson P, Clarke M, Mulrow CD, Oxman AD: 1.2.2.
What is a systematic review? In Cochrane Handbook for Systematic Reviews
of Interventions Version 5.1.0: updated March 2011. Edited by Higgins JPT,
Green S. The Cochrane Collaboration; 2011 [www.cochrane-handbook.org]
24. Chan A, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-JerićK,
Hróbjartsson A, Mann H, Dickersin K, Berlin JA, Doré C, Parulekar WR,
Summerskill WSM, Groves T, Schulz KF, Sox HC, Rockhold FW, Rennie D,
Moher D: SPIRIT 2013 statement: defining standard protocol items for
clinical trials. Ann Intern Med 2013, 158(3):200207.
25. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC: Acomparisonof
results of meta-analyses of randomized control trials and recommendations
of clinical experts: treatments for myocardial infarction. JAMA 1992,
268(2):240248.
Moher et al. Systematic Reviews 2015, 4:1 Page 8 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
26. Oxman AD, Guyatt GH: The science of reviewing research. Ann N Y Acad
Sci 1993, 703:125,33. discussion 133134.
27. Moher D, Schulz KF, Simera I, Altman DG: Guidance for developers of
health research reporting guidelines. PLoS Med 2010, 7(2):e1000217.
28. Booth A, Clarke M, Ghersi D, Moher D, Petticrew M, Stewart L: Establishing
a minimum dataset for prospective registration of systematic reviews: an
international consultation. PLoS ONE 2011, 6(11):e27319.
29. Chan A, Tetzlaff JM, Gøtzsche PS, Altman DG, Mann H, Berlin JA, Dickersin K,
Hróbjartsson A, Schulz KF, Paruleka WR, Krleža-JerićK, Laupaucis A, Moher D:
SPIRIT 2013 explanation and elaboration: guidance for protocols of
clinical trials. BMJ 2013, 346:e7586.
30. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P,
Stewart LA, PRISMA-P Group: Preferred reporting items for systematic
review and meta-analysis protocols (PRISMA-P) 2015: elaboration &
explanation.BMJ 2015, 349:g7647.
31. Cochrane Canada: David Moher on crystal clear reporting of systematic
reviews and EQUATOR Network. In 2010 [https://www.youtube.com/
watch?v=TVFYenon1Jo]
32. Stevens A, Shamseer L, Weinstein E, Yazdi F, Turner L, Thielman J, Altman
DG, Hirst A, Hoey J, Palepu A, Schulz KF, Moher D: Relation of
completeness of reporting of health research to journalsendorsement
of reporting guidelines: systematic review. BMJ 2014, 348:g3804.
33. Hopewell S, Altman DG, Moher D, Schulz KF: Endorsement of the
CONSORT statement by high impact factor medical journals: a survey of
journal editors and journal Instructions to Authors.Trials 2008, 9:20.
34. Hirst A, Altman DG: Are peer reviewers encouraged to use reporting
guidelines? A survey of 116 health research journals. PLoS ONE 2012,
7(4):e35621.
35. Shamseer L, Weeks L, Turner L, Straus S, Grimshaw J, Moher D: Identifying
barriers to uptake and implementation of the CONSORT statement.In
The Seventh International Congress on Peer Review and Biomedical Publication:
810 Sept 2014: Chicago, USA.
36. Mills E, Wu P, Gagnier J, Heels-Ansdell D, Montori VM: An analysis of
general medical and specialist journals that endorse CONSORT found
that reporting was not enforced consistently. J Clin Epidemiol 2005,
58(7):662667.
37. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M:
Developing and evaluating complex interventions: the new medical
research council guidance. BMJ 2008, 337(0959535):a1655.
38. Davies P, Walker AE, Grimshaw JM: A systematic review of the use of
theory in the design of guideline dissemination and implementation
strategies and interpretation of the results of rigorous evaluations.
Implement Sci 2010, 5:14.
39. Carlsen B, Glenton C, Pope C: Thou shalt versus thou shalt not: a meta-
synthesis of GPsattitudes to clinical practice guidelines. Br J Gen Pract
2007, 57(545):971978.
40. Dwan K, Altman DG, Cresswell L, Blundell M, Gamble CL, Williamson PR:
Comparison of protocols and registry entries to published reports for
randomised controlled trials. Cochrane Database Syst Rev 2011,
1:MR000031.
41. Moher D, Stewart L, Shekelle P: Establishing a new journal for systematic
review products. Syst Rev 2012, 1:1.
doi:10.1186/2046-4053-4-1
Cite this article as: Moher et al.:Preferred reporting items for
systematic review and meta-analysis protocols (PRISMA-P) 2015
statement. Systematic Reviews 2015 4:1.
Submit your next manuscript to BioMed Central
and take full advantage of:
Convenient online submission
Thorough peer review
No space constraints or color figure charges
Immediate publication on acceptance
Inclusion in PubMed, CAS, Scopus and Google Scholar
Research which is freely available for redistribution
Submit your manuscript at
www.biomedcentral.com/submit
Moher et al. Systematic Reviews 2015, 4:1 Page 9 of 9
http://www.systematicreviewsjournal.com/content/4/1/1
... El presente estudio se realizó por medio de una revisión sistemática y se adhiere a los elementos de informe preferidos para protocolos de revisión sistemática y metaanálisis (PRISMA) (Moher et al., 2009;Page et al., 2021). ...
... Flujograma PRISMA Fuente:Moher et al. (2009) ...
Article
Full-text available
El objetivo de esta investigación fue realizar una revisión sistemática acerca de los efectos de las intervenciones basadas en yoga en niños con TEA para considerar si es recomendable o no su aplicación como tratamiento complementario en otras intervenciones. Para el estudio se realizó una revisión sistemática de la literatura por medio del modelo PRISMA, a cerca de los efectos de las intervenciones de yoga en el TEA. La búsqueda se llevó a cabo en los buscadores World Wide Science, Google Scholar, Pubmed, donde se aplicaron como criterio de inclusión; publicaciones de los 10 últimos años, en idioma español e inglés, estudiantes hasta los 16 años de ambos géneros y como criterio de exclusión; los artículos de otras revisiones sistemáticas, tesis y libros. Los resultados arrojaron 677 publicaciones, que luego de seguir con el protocolo de selección, la eliminación de duplicados y selección por título se llegó a la selección de ocho artículos que cumplieron con los criterios establecidos para una revisión profunda de su contenido. Las intervenciones con yoga presentaron efectos positivos en aspectos conductuales, sociales, emocionales y físicos. Debido a esto se sugiere implementar el yoga como modelo de intervención como práctica complementaria al TEA.
... The selection of eligible articles adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] [50,56] (see Fig. 1). Five researchers [the four authors and an independent researcher] critically and independently appraised the titles of articles that were retrieved and approved those meeting the selection criteria. ...
... From the results presented in Table 2, the study of Van der Wielen et al. [6] ranked first with a score of 88 (high quality), Van der Wielen et al. [7] and Salari et al. [15] in second with a score of 87 (high quality) and Van der Wielen et al. [25] in third with a score of 86 (high quality). The study of Baozhen et al. [56] ranked lowest in terms of methodological quality, with a score of 50 (low quality). Overall, these studies contained relevant information that addressed the study's objective. ...
Article
Full-text available
Background We conducted an integrative review in an attempt to methodically and systematically understand the individual (personal factors) that influence National Health Insurance Scheme [NHIS] enrolment among older adults aged 50 years and above. The study was premised on evidence pointing to a state of little or no change in the enrolment rates [especially among older adults], which contrasts with the initial euphoria that greeted the launch of the scheme - which culminated in high enrolment rates. Methods The integrative literature review was conducted to synthesise the available evidence on individual determinants of NHIS among older adults. The methodological approach of the integrative literature review follows a five-stage interdependent and interconnected procedure of problem identification, literature search, data evaluation, data analysis and results presentation. Studies that met the inclusion criteria were peer-reviewed articles published in the English Language, from January 2010 to July 2020 and have Ghana as its setting or study area. The Andersen's Behavioural Model was used to categorize the predictor variables. Results Predisposing factors [gender, age, level of education and marital status], enabling factors [income] and need factors [health conditions or health attributes of older adults] were identified as individual predictors of NHIS enrolment among older adults. The findings support argument of Andersen's Behavioural Model [where predisposing, enabling and need factors are considered as individual determinants of health behaviour]. Conclusions The findings call for policy reforms that take into account the aforementioned individual predictors of NHIS enrolment, especially among the aged.
... (((((((((((("Malocclusion"[Mesh] OR "Malocclusion, Angle Class III"[Mesh] OR "Malocclusion, Angle Class II"[Mesh] OR "Malocclusion, Angle Class I"[Mesh]) AND "Dental Caries"[Mesh]) AND "Periodontal Diseases"[Mesh]) AND "Oral and Maxillofacial Surgeons"[Mesh]) AND "Orthodontic Appliances, Fixed"[Mesh]) OR "Orthodontic Appliances"[Mesh]) AND ( "Child"[Mesh] OR "Dental Care for Children"[Mesh] OR "Child, Adopted"[Mesh] OR "Only Child"[Mesh] )) AND ( "Adult"[Mesh] OR "Young Adult"[Mesh] OR "Adult Children"[Mesh] )) AND "Porphyromonasgingivalis"[Mesh]) OR "fomA protein, Fusobacterium" [Supplementary Concept]) OR "Prevotella intermedia"[Mesh]) OR "Tannerella forsythia"[Mesh]) AND "Dental Plaque Index"[Mesh]) AND "Periodontal Index"[Mesh].This systematic review has been conducted on the basis of the key consideration of the PRISMA Statement-Preferred Reporting Items for the Systematic Review and Meta-analysis(16), and PICO strategy (Table1). plaque index, sulcus bleeding index, probing depth ...
Article
Background an aim:the aim of present Systematic Review and Meta-Analysis study was evaluate the effect of fixed orthodontic appliances in children. Method:From the electronic databases, PubMed, Embase, Cochrane Library have been used to perform a systematic literature until May 2021. For Data extraction, two reviewers blind and independently extracted data from abstract and full text of studies that included.Moreover mean difference with 95% confidence interval (CI), fixed effect model and invariance method were calculated. Random effects were used to deal with potential heterogeneity and I 2 showed heterogeneity. I 2 values above 50% signified moderate-to-high heterogeneity. The Meta analysis have been evaluated with the statistical software Stata/MP v.16 (The fastest version of Stata). Result: subgroup meta-analysis showed no statistically significant difference of Plaque index, Sulcus bleeding index and Probing depth between control group vs children group (MD, 0.07 95% CI-0.09, 0.23. P<0.05), (MD,-0.17 95% CI-0.30,-0.04. P>0.05), (MD,-0.01 95% CI-0.05, 0.03. P>0.05), Respectively. Conclusions: fixed orthodontic appliances may increase periodontal and microbiological statuses, both in children and adults.
... This research aimed to systematically evaluate the evidence-base for NET efficacy in alleviating PTSD and depression outcomes through a meta-analysis of RCTs. The data reported in this meta-analysis conforms to the PRISMA framework, which is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses (Moher et al., 2009) (Appendix F). ...
Article
The current understanding of domestic violence is largely nomothetic by design and does not adequately address the treatment and rehabilitation needs of survivors. This thesis aimed to gain a qualitative understanding of the culture-specific experiences of domestic violence in south Indian female survivors, with a focus on the treatment of posttraumatic stress disorder (PTSD), and comorbid psychopathology. An interpretative phenomenological analysis was undertaken with five south Indian women to investigate the in-depth, lived experiences of domestic violence and its mental health sequelae. Responses to, and appraisals of abuse were found to be heavily influenced by pre-abuse identity, interpersonal childhood experiences, societal perceptions of, and stigmatising attitudes towards survivors. These factors impact the experience of disclosure and help-seeking among survivors, with a clear preference for informal sources of support such as family and social care organisations. Further, the findings shed light on the experience of resisting and counteracting the abuse in this context, as well as the complex, non-linear and iterative process of leaving abusive relationships. This was found to be rooted in the sociocultural framework of Indian society, patriarchal ideologies of gender roles, and the systemic and structural disempowerment of women, perpetuating the perpetration and experience of abuse and violence. The treatment protocol examined in this thesis is Narrative Exposure Therapy (NET), which is a short-form psychotherapeutic technique originally developed for survivors of war and organised violence in low-resource contexts. The comprehensive and up-to-date meta-analysis of its current evidence base along with a quality appraisal of the trials included was conducted. The findings revealed low- to medium-quality evidence of NET efficacy for the alleviation of PTSD. High heterogeneity estimates and low powered trials significantly impact the interpretation of the pooled intervention effect estimates. This review also revealed an overreliance on randomised controlled trial findings and a paucity of idiographic research investigating change mechanisms through NET. In the final study, an inductive and deductive thematic analysis was undertaken to investigate the change mechanisms through NET for survivors of domestic violence. NET was administered to seven south Indian women and was well tolerated by the sample. Paired sample t-tests revealed a statistically significant improvement in PTSD and somatic symptoms at post-test. The raw testimony data was qualitative analysed, and a theoretically-informed framework of recovery was developed through thematic analysis to elucidate the specific processes that contribute to change and underlie improvement on symptom scores. There was evidence for several proposed mechanisms based on seminal PTSD theories, as well as some data-driven mechanisms such as positive memories and a focus on future aspirations that contributed to recovery in this sample. There are no published accounts of NET’s use or efficacy in India, and practice implications include culture-specific and stressor-specific applications of NET using the template from the recovery framework. These findings complement the limited RCT evidence of NET from an idiographic perspective. Importantly, the need to consider and explore culture- and context-specific change mechanisms is demonstrated through the framework, which found additional processes contributing to recovery in this sample. Recommendations for the adaptation of individual-focused, empirically supported treatments such as NET that are culturally sensitive and consider the complex socio-ecological milieu of the Indian context are discussed.
... Berikutnya adalah kelayakan, semua artikel itu diteliti dengan membaca judul, abstrak, metode, hasil dan diskusi untuk memastikan mereka memenuhi kriteria dan paralel dengan tujuan penelitian saat ini. Terakhir, Pemilihan sesuai kriteria inklusi di mana artikel dipilih hanya yang telah memenuhi persyaratan untuk dianalisis (Moher et al., 2009). ...
Article
Full-text available
Sociologists have long recognized the important role of teachers in education. Teachers have a great influence on shaping a student's personality, knowledge, values, and attitudes towards school. The teacher as a central figure, which in addition to the school climate, academic environment and discipline, is an important element of the school context. Good teachers contribute to the realization of good education. Assessment implies the basic question "What makes a person a good teacher?" The purpose of this study is to examine studies that examine good teachers using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method. This study focuses on what factors must be possessed to be able to make someone a good teacher. The review of the research literature proved to provide a broad view of the different approaches in terms of personality traits, teaching abilities, professionalism, social emotional abilities and the ability of teachers to realize good education.
... Data were collected through a systematic literature review using the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) (Moher et al. 2009). A search was conducted on July 15-20, 2020, using all databases of Clarivate Analytics-Web of Science. ...
Chapter
The development for sustainable smallholder farming is not a transparent and replicable procedure because the agricultural sector focuses primarily on productivity with minimum attention on lean management as a sustainability strategy. Currently, the requirement of achieving a 70% increase in production often ignores the complementary factor of reducing wastage and loss to achieve sustainable food security and nutrition. This paper examines integrating lean management concepts in smallholder farming as a catalyst for sustainable agriculture, food, and nutrition security. Several sources indicate that approximately 500 million smallholder farms worldwide cultivate on under 2 ha farm size without adequate land tenure. These farms are primarily in difficult soil conditions and environmentally risk-prone areas, reducing their resilience to changes in weather conditions. Although smallholders comprise 84% of all farms with approximately 30% of global food production, the participants and their dependents constitute almost 75% of the underprivileged, hungry, and undernourished people worldwide. These conditions are exacerbated by smallholder farms experiencing more post-harvest loss due to inadequate market and access to cold storage facilities. Additionally, smallholders have limited adaptive capacity in coping with changing environments due to inadequate scientific knowledge, low income, small farm size, limited technical assistance, and marketing opportunities. Despite these challenges, smallholders are touted as potentially the backbone to implement the United Nations’ Goal #2 for Sustainable Development in achieving zero-hunger by at least 2030. This research presents Ro-Crops Agrotec, a 1.5-ha agroecology family farm in central Trinidad, as a case study with over 26 years of successfully integrating strategic lean management. The management of Ro-Crops demonstrates that sustainable agriculture and food security are achievable through strategic planning, farm management, and innovative waste removal without the measures becoming an obsession. While lean management is associated initially with auto manufacturing, the concept is equally essential in agriculture due to losses in production, post-harvest, and food processing. At the retailing and consumer stages, the annual global wastage consists of almost one-third of consumer food, estimated at approximately 1.3 billion tons. Lean management reduces waste, maximizes efficiency, and increases economic value due to productivity, quality, and flexibility as the primary performance indicators. The lean concepts help in effectively reducing wastage by developing standardised processes and continuously improving the operations.
... Data were collected through a systematic literature review using the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) (Moher et al. 2009). A search was conducted on July 15-20, 2020, using all databases of Clarivate Analytics-Web of Science. ...
Chapter
Full-text available
Achieving Sustainable Development Goal 2 (abating hunger) involves various role players. However, the focus has been at the macro and meso-scales, neglecting the micro-household scale. Even at that household level, there is neglect of the household food security status and role-playing. The study assessed household role-playing in achieving food security through food utilisation, in a cross-sectional survey of 116 households in Raymond Mhlaba Local Municipality, South Africa. The study hypothesised that there are differences in role-playing regarding food utilization. Descriptive statistics were utilised in data analysis. Intra-household members’ differentiated roles were established, and association with food utilisation was determined. The study revealed that females were responsible for food preparation, buying and home garden responsibilities. Furthermore, in terms of the household role, most female members indicated they preferred purchasing fruit and milk products, while males said they preferred to buy tubers and meat. Regarding the food buying roles, females stated they preferred purchasing vegetables while males preferred producing cereal-based foods. Female respondents engaged in home gardening indicated they preferred to purchase vegetables while males responsible for gardens stated they preferred producing cereal foods. The chapter concludes that, based on role-playing, differentiated food utilisation exists within households. In terms of the different roles such as food preparation, purchasing and home gardening, there is need for the conscientisation of household members on the various nutritional sources.
... Study selection flowchart[18]. ...
Article
Full-text available
Supraglottic stenosis is a rare symptom, particularly in fibroinflammatory multifocal diseases, such as IgG4-related disease (IgG4-RD). There is still an inconsistency in the diagnosis of less-common locations of IgG4-RD, which causes a delay in the diagnosis and treatment. Our paper aims to analyze different aspects of IgG4-RD presenting as supraglottic stenosis, including the possible overlap with ANCA-associated vasculitis. We compare the usefulness of the recently revised ACR/EULAR and Comprehensive criteria and discuss treatment options. The review was performed according to PRISMA guidelines using the MEDLINE Pubmed and Scopus databases. The analysis includes nine papers describing supraglottic laryngeal stenosis in 13 patients. Furthermore, we present a case of a woman with ongoing supraglottic stenosis presenting with cough, temporary dyspnea and stridor as the symptoms of localized IgG4-RD. At the time of writing, the patient remains in remission while receiving treatment with cyclophosphamide and methylprednisolone. The symptoms of supraglottic localization of IgG4-RD may be severe; however, at that point, clinicians should suspect autoimmune etiology and attempt to modulate the autoimmune response instead of performing dilatation surgery—the effects of which may not result in extended intervals between interventions. The ACR/EULAR criteria show great specificity; however, when IgG4-RD is presumed, the specific treatment should be implemented.
... We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework of (Moher et al., 2014). We searched for articles in July of 2021 in five databases (SCOPUS, Jstor, Emerald, SciELO, Science Direct, IEEE) using the following terms: ("Telemedicine" OR "Telecare" OR "eHealth") AND ("COVID-19" OR "Coronavirus") AND ("Acceptance" OR "Adoption") AND DOCTYPE (ar) AND PUBYEAR>2019. ...
Preprint
Full-text available
The outbreak of COVID-19 caused a major international public health crisis and led to the imposition of social distancing measures to contain the spread of the virus. In this context, the use of telehealth skyrocketed as the only way to deliver healthcare to patients during a lockdown was remotely. The countries of Latin America and the Iberian Peninsula were severely hit by the pandemic and the prospects and challenges associated with widespread adoption of telehealth are unique. The goal of this systematic literature review is to explore how telehealth has been used during the pandemic to prevent, diagnose, treat and control diseases in Ibero-America. Thus, we sought to identify the main keywords, themes, theoretical frameworks and methodologies used by researchers in this area. We used several tools for bibliographic management like Rayyan, VOSViewer and NVIVO and followed the PRISMA protocol. Our analysis of themes showed the existence of 3 nodes within the literature: students, teachers and education. After searching in 6 databases, 1826 articles were found. After excluding the duplicates (231 articles), we screened and read the titles and abstracts of 1595 articles. Only 119 articles met the inclusion criteria. Finally, after a full-text analysis, a final sample of 106 articles was selected for analysis. Spain and Brazil are the countries who have produced the greatest volume of research in the region. The public sector is the largest funder of research on this topic.
Article
Full-text available
Disaster loss indicators compatible with DesInventar Sendai were delineated to facilitate reporting to the Sendai Framework for Disaster Risk Reduction (SFDRR), and enable monetary valuation of disaster impacts in Malaysia. A standard means of collecting disaggregated information to ensure compliance to SFDRR targets is a challenge for many governments. A systematic review of the literature facilitated the extraction of an array of disaster loss indicators, which were compared to four global disaster databases and three national datasets for compatibility. Suitable indicators, validated through focus group discussions, were used to develop a data collection template with embedded models, which enables rapid calculation of disaster loss after an event. The template will support the advancement of evidence-based policymaking and reporting to the SFDRR.
Article
Full-text available
: Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols.
Article
Full-text available
Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols-PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols. © BMJ Publishing Group Ltd 2014.
Article
Full-text available
Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
Article
Full-text available
Objective To assess whether the completeness of reporting of health research is related to journals’ endorsement of reporting guidelines. Design Systematic review. Data sources Reporting guidelines from a published systematic review and the EQUATOR Network (October 2011). Studies assessing the completeness of reporting by using an included reporting guideline (termed “evaluations”) (1990 to October 2011; addendum searches in January 2012) from searches of either Medline, Embase, and the Cochrane Methodology Register or Scopus, depending on reporting guideline name. Study selection English language reporting guidelines that provided explicit guidance for reporting, described the guidance development process, and indicated use of a consensus development process were included. The CONSORT statement was excluded, as evaluations of adherence to CONSORT had previously been reviewed. English or French language evaluations of included reporting guidelines were eligible if they assessed the completeness of reporting of studies as a primary intent and those included studies enabled the comparisons of interest (that is, after versus before journal endorsement and/or endorsing versus non-endorsing journals). Data extraction Potentially eligible evaluations of included guidelines were screened initially by title and abstract and then as full text reports. If eligibility was unclear, authors of evaluations were contacted; journals’ websites were consulted for endorsement information where needed. The completeness of reporting of reporting guidelines was analyzed in relation to endorsement by item and, where consistent with the authors’ analysis, a mean summed score. Results 101 reporting guidelines were included. Of 15 249 records retrieved from the search for evaluations, 26 evaluations that assessed completeness of reporting in relation to endorsement for nine reporting guidelines were identified. Of those, 13 evaluations assessing seven reporting guidelines (BMJ economic checklist, CONSORT for harms, PRISMA, QUOROM, STARD, STRICTA, and STROBE) could be analyzed. Reporting guideline items were assessed by few evaluations. Conclusions The completeness of reporting of only nine of 101 health research reporting guidelines (excluding CONSORT) has been evaluated in relation to journals’ endorsement. Items from seven reporting guidelines were quantitatively analyzed, by few evaluations each. Insufficient evidence exists to determine the relation between journals’ endorsement of reporting guidelines and the completeness of reporting of published health research reports. Journal editors and researchers should consider collaborative prospectively designed, controlled studies to provide more robust evidence. Systematic review registration Not registered; no known register currently accepts protocols for methodology systematic reviews.
Article
Background: Systematic reviews may be compromised by selective inclusion and reporting of outcomes and analyses. Selective inclusion occurs when there are multiple effect estimates in a trial report that could be included in a particular meta-analysis (e.g. from multiple measurement scales and time points) and the choice of effect estimate to include in the meta-analysis is based on the results (e.g. statistical significance, magnitude or direction of effect). Selective reporting occurs when the reporting of a subset of outcomes and analyses in the systematic review is based on the results (e.g. a protocol-defined outcome is omitted from the published systematic review). Objectives: To summarise the characteristics and synthesise the results of empirical studies that have investigated the prevalence of selective inclusion or reporting in systematic reviews of randomised controlled trials (RCTs), investigated the factors (e.g. statistical significance or direction of effect) associated with the prevalence and quantified the bias. Search methods: We searched the Cochrane Methodology Register (to July 2012), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO and ISI Web of Science (each up to May 2013), and the US Agency for Healthcare Research and Quality (AHRQ) Effective Healthcare Program's Scientific Resource Center (SRC) Methods Library (to June 2013). We also searched the abstract books of the 2011 and 2012 Cochrane Colloquia and the article alerts for methodological work in research synthesis published from 2009 to 2011 and compiled in Research Synthesis Methods. Selection criteria: We included both published and unpublished empirical studies that investigated the prevalence and factors associated with selective inclusion or reporting, or both, in systematic reviews of RCTs of healthcare interventions. We included empirical studies assessing any type of selective inclusion or reporting, such as investigations of how frequently RCT outcome data is selectively included in systematic reviews based on the results, outcomes and analyses are discrepant between protocol and published review or non-significant outcomes are partially reported in the full text or summary within systematic reviews. Data collection and analysis: Two review authors independently selected empirical studies for inclusion, extracted the data and performed a risk of bias assessment. A third review author resolved any disagreements about inclusion or exclusion of empirical studies, data extraction and risk of bias. We contacted authors of included studies for additional unpublished data. Primary outcomes included overall prevalence of selective inclusion or reporting, association between selective inclusion or reporting and the statistical significance of the effect estimate, and association between selective inclusion or reporting and the direction of the effect estimate. We combined prevalence estimates and risk ratios (RRs) using a random-effects meta-analysis model. Main results: Seven studies met the inclusion criteria. No studies had investigated selective inclusion of results in systematic reviews, or discrepancies in outcomes and analyses between systematic review registry entries and published systematic reviews. Based on a meta-analysis of four studies (including 485 Cochrane Reviews), 38% (95% confidence interval (CI) 23% to 54%) of systematic reviews added, omitted, upgraded or downgraded at least one outcome between the protocol and published systematic review. The association between statistical significance and discrepant outcome reporting between protocol and published systematic review was uncertain. The meta-analytic estimate suggested an increased risk of adding or upgrading (i.e. changing a secondary outcome to primary) when the outcome was statistically significant, although the 95% CI included no association and a decreased risk as plausible estimates (RR 1.43, 95% CI 0.71 to 2.85; two studies, n = 552 meta-analyses). Also, the meta-analytic estimate suggested an increased risk of downgrading (i.e. changing a primary outcome to secondary) when the outcome was statistically significant, although the 95% CI included no association and a decreased risk as plausible estimates (RR 1.26, 95% CI 0.60 to 2.62; two studies, n = 484 meta-analyses). None of the included studies had investigated whether the association between statistical significance and adding, upgrading or downgrading of outcomes was modified by the type of comparison, direction of effect or type of outcome; or whether there is an association between direction of the effect estimate and discrepant outcome reporting.Several secondary outcomes were reported in the included studies. Two studies found that reasons for discrepant outcome reporting were infrequently reported in published systematic reviews (6% in one study and 22% in the other). One study (including 62 Cochrane Reviews) found that 32% (95% CI 21% to 45%) of systematic reviews did not report all primary outcomes in the abstract. Another study (including 64 Cochrane and 118 non-Cochrane reviews) found that statistically significant primary outcomes were more likely to be completely reported in the systematic review abstract than non-significant primary outcomes (RR 2.66, 95% CI 1.81 to 3.90). None of the studies included systematic reviews published after 2009 when reporting standards for systematic reviews (Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, and Methodological Expectations of Cochrane Intervention Reviews (MECIR)) were disseminated, so the results might not be generalisable to more recent systematic reviews. Authors' conclusions: Discrepant outcome reporting between the protocol and published systematic review is fairly common, although the association between statistical significance and discrepant outcome reporting is uncertain. Complete reporting of outcomes in systematic review abstracts is associated with statistical significance of the results for those outcomes. Systematic review outcomes and analysis plans should be specified prior to seeing the results of included studies to minimise post-hoc decisions that may be based on the observed results. Modifications that occur once the review has commenced, along with their justification, should be clearly reported. Effect estimates and CIs should be reported for all systematic review outcomes regardless of the results. The lack of research on selective inclusion of results in systematic reviews needs to be addressed and studies that avoid the methodological weaknesses of existing research are also needed.