AI evidence extraction

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

David Moher, A. Liberati, Jennifer Tetzlaff, Douglas G. Altman · BMJ · 2009

AI-generated evidence extraction, verified across multiple analytical personas. Not a substitute for the peer-reviewed original.

6/10

Relevance

3/4

Quality (LMQS)

Evidence

83,271

Citations

634.05

FWCI

Top 10%

Impact

This is an AI analysis. Read the peer-reviewed original at the publisher: https://doi.org/10.1136/bmj.b2535

Methodology & findings

Study design

Consensus development process: A three-day meeting held in Ottawa, Canada, in June 2005 with 29 participants including review authors, methodologists, clinicians, medical editors, and a consumer.

Sample

N = 29, 3 groups

Primary method

Qualitative consensus development methodology. Descriptive analysis of prior studies on reporting quality (e.g., Mulrow 1987 found "none [of 50 review articles] met all eight explicit scientific criteria"; Sacks 1987 found "between one and 14 characteristics were adequately reported [of meta-analyses on 23 characteristics], mean 7.7, standard deviation 2.7"). Systematic review and literature search conducted to identify methodological evidence.

Main result

The PRISMA statement provides an updated framework for reporting systematic reviews and meta-analyses. The authors note that "the quality of reporting of systematic reviews is still not optimal" and document that "in a recent review of 300 systematic reviews, few authors reported assessing possible publication bias, even though there is overwhelming evidence for its existence and its impact on the results of systematic reviews." The statement consists of "a 27 item checklist and a four phase flow diagram" designed to improve transparency and reporting quality.

Reports effect sizes.

Research paradigm

Methodological guidance and standardization

Author conclusions

"PRISMA is a living document. To this end we invite readers to comment on the revised version, particularly the new checklist and flow diagram, through the PRISMA website. We will use such information to inform PRISMA's continued development." The authors further state: "The aim of the PRISMA statement is to help authors improve the reporting of systematic reviews and meta-analyses." They conclude that "the PRISMA statement should replace the QUOROM statement for those journals that have endorsed QUOROM" and encourage journals to reference PRISMA in their instructions to authors.

Risk of bias

Consensus-based development may reflect biases of the 29 participating experts; International survey methodology not detailed; potential selection bias in survey respondents; Limited empirical evidence for some checklist items; reliance on evidence from other domains; Funding from pharmaceutical industry (GlaxoSmithKline) could introduce bias, though authors state "None of the sponsors had any involvement in the planning, execution, or writing of the PRISMA documents"; Predominant focus on randomized controlled trials may not generalize to other systematic review types; Potential selection bias in the 29 participants chosen for the Ottawa meeting - composition skewed toward established methodologists and journal editors; Possible confirmation bias in evidence gathering - selective literature search may favor existing practices; Funding from pharmaceutical company (GlaxoSmithKline Canada) could influence recommendations, though authors state funders had no involvement in planning or execution; Expert consensus bias (29 participants may not represent all perspectives); Publication bias in evidence base informing checklist items; Selection bias in survey of systematic review authors; Selection bias in scope of PRISMA - focused on randomised trials but extended to other research types; Potential bias in checklist item selection - some items retained without direct evidence; Geographic and disciplinary representation of the 29 meeting participants may not be comprehensive; Publication bias in systematic reviews not consistently reported; Outcome reporting bias within individual studies; Selective reporting of complete studies; Potential conflict of interest: GlaxoSmithKline Canada was a funder

Limitations

The authors acknowledge that "some modifications of the checklist items or flow diagram will be necessary in particular circumstances
For example, assessing the risk of bias is a key concept, but the items used to assess this in a diagnostic review are likely to focus on issues such as the spectrum of patients and the verification of disease status, which differ from reviews of interventions
The flow diagram will also need adjustments when reporting meta-analysis of individual patient data." Additionally, "although no direct evidence was found to support retaining or adding some items, evidence from other domains was believed to be relevant."

Open questions raised

The paper implicitly identifies a gap in standardized reporting practices for systematic reviews and meta-analyses, addressing inconsistencies in how these syntheses were previously reported.
Optimal reporting of systematic reviews remains a gap; authors note "the quality of reporting of systematic reviews is still not optimal"
Assessment and interpretation of publication bias needs improvement; "even when the possibility of publication bias is assessed, there is no guarantee that systematic reviewers have assessed or interpreted it appropriately"
Systematic reviews beyond intervention evaluation (e.g., cost-effectiveness, diagnostic, prognostic, genetic associations, policy-making) need further guidance on checklist modifications
Meta-analysis of individual patient data requires adjustment to the flow diagram
Need for continued development and refinement of PRISMA as a living document with ongoing community feedback

Data: No datasets are analyzed in this paper. The PRISMA statement itself is made freely available: "In order to encourage dissemination of the PRISMA statement, this article is freely accessible on bmj.com and will also be published in PLoS Medicine, Annals of Internal Medicine, Journal of Clinical Epidemiology, and Open Medicine." The PRISMA website (www.prisma-statement.org/) contains supplementary materials and exemplars.Code: None mentioned.Extracted from: pdfAgreement 45%

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