Updating guidelines for reporting systematic reviews and meta-analyses: development of the PRISMA 2020 statement

Article type
Authors
Page MJ1, McKenzie JE1, Bossuyt PM2, Boutron I3, Hoffmann T4, Mulrow CD5, Shamseer L6, Moher D7
1School of Public Health and Preventive Medicine, Monash University
2Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam
3Paris Descartes University
4Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University
5University of Texas Health Science Center at San Antonio
6School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa
7Centre for Journalology and Canadian EQUATOR Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute
Abstract
Background: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement was published in 2009 and designed to help authors of systematic reviews (SRs) prepare a transparent report of what they did and what they found. Authors and journals have widely adopted PRISMA, as evidenced by its 60,000 citations and 200 journals and SR organisations endorsing its use. A decade old and in need of incorporating advances in SR methodology and terminology and to reflect changes to the publishing landscape, we set out to update the original PRISMA reporting guideline.

Objectives: To describe the processes used to update the PRISMA 2009 statement for reporting SRs and meta-analyses, and summarise changes made to the guideline.

Methods: We conducted a selective review of documents providing reporting guidance for SRs, to generate ideas for how to modify the PRISMA 2009 statement. We invited 220 SR methodologists, authors and journal editors to provide feedback via an online survey on suggested modifications to PRISMA that arose from the selective review. The results of these projects were discussed at a 21-member in-person meeting in September 2018. Following the meeting, we drafted the PRISMA 2020 statement and refined it based on feedback from co-authors, and sought examples that best illustrated the items.

Results: The review of 60 documents providing reporting guidance for SRs resulted in a bank of 221 unique reporting items, and revealed that all sections of PRISMA 2009 could be modified or supplemented with additional guidance. Of the 110 respondents to the survey, more than 66% recommended keeping six of the PRISMA 2009 checklist items as they were and modifying 15 of the checklist items using the wording suggested by us. Attendees of the in-person meeting supported the revised wording for several items but suggested rewording for others, and further refinements were made over four drafts of the checklist. The PRISMA 2020 statement now consists of updated guidance intended to facilitate transparent reporting of SRs, with or without meta-analysis. Nearly all PRISMA 2009 checklist items were modified in some way (e.g. disaggregated into multiple sub-items to facilitate clarity). The statement also includes new reporting guidance to reflect advances in methods to identify, select, appraise and synthesise studies, and to enhance the reproducibility of SRs.

Conclusions: We anticipate that the PRISMA 2020 statement will benefit researchers, editors, peer reviewers, guideline developers and policy makers involved in conducting or using SRs and meta-analyses. Ultimately, we hope that uptake of the guideline will lead to more transparent reporting of SRs, so facilitating decision-making in the development of evidence-based guidance for clinical practice and health policy.

Patient or healthcare consumer involvement: No patients or healthcare consumers were involved in this research