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

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          Abstract

          David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses

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          Most cited references23

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          Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses.

          The Quality of Reporting of Meta-analyses (QUOROM) conference was convened to address standards for improving the quality of reporting of meta-analyses of clinical randomised controlled trials (RCTs). The QUOROM group consisted of 30 clinical epidemiologists, clinicians, statisticians, editors, and researchers. In conference, the group was asked to identify items they thought should be included in a checklist of standards. Whenever possible, checklist items were guided by research evidence suggesting that failure to adhere to the item proposed could lead to biased results. A modified Delphi technique was used in assessing candidate items. The conference resulted in the QUOROM statement, a checklist, and a flow diagram. The checklist describes our preferred way to present the abstract, introduction, methods, results, and discussion sections of a report of a meta-analysis. It is organised into 21 headings and subheadings regarding searches, selection, validity assessment, data abstraction, study characteristics, and quantitative data synthesis, and in the results with "trial flow", study characteristics, and quantitative data synthesis; research documentation was identified for eight of the 18 items. The flow diagram provides information about both the numbers of RCTs identified, included, and excluded and the reasons for exclusion of trials. We hope this report will generate further thought about ways to improve the quality of reports of meta-analyses of RCTs and that interested readers, reviewers, researchers, and editors will use the QUOROM statement and generate ideas for its improvement.
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            Systematic reviews in health care: Systematic reviews of evaluations of diagnostic and screening tests.

            J J Deeks (2001)
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              Meta-analyses of randomized controlled trials.

              A new type of research, termed meta-analysis, attempts to analyze and combine the results of previous reports. We found 86 meta-analyses of reports of randomized controlled trials in the English-language literature. We evaluated the quality of these meta-analyses, using a scoring method that considered 23 items in six major areas--study design, combinability, control of bias, statistical analysis, sensitivity analysis, and application of results. Only 24 meta-analyses (28 percent) addressed all six areas, 31 (36 percent) addressed five, 25 (29 percent) addressed four, 5 (6 percent) addressed three, and 1 (1 percent) addressed two. Of the 23 individual items, between 1 and 14 were addressed satisfactorily (mean +/- SD, 7.7 +/- 2.7). We conclude that an urgent need exists for improved methods in literature searching, quality evaluation of trials, and synthesizing of the results.
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                Author and article information

                Journal
                BMJ
                bmj
                BMJ : British Medical Journal
                BMJ Publishing Group Ltd.
                0959-8138
                1468-5833
                2009
                2009
                21 July 2009
                : 339
                : b2535
                Affiliations
                [1 ]Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
                [2 ]Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
                [3 ]Università di Modena e Reggio Emilia, Modena, Italy
                [4 ]Centro Cochrane Italiano, Istituto Ricerche Farmacologiche Mario Negri, Milan, Italy
                [5 ]Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
                Author notes
                Correspondence to: dmoher@ 123456ohri.ca
                Article
                mohd626499
                10.1136/bmj.b2535
                2714657
                19622551
                25f4ba85-6123-4530-b1a2-788891e93f81
                © Moher et al 2009

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 June 2009
                Categories
                Research Methods & Reporting
                Clinical trials (epidemiology)
                Guidelines

                Medicine
                Medicine

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