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H Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist 303
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304 FINDING WHAT WORKS IN HEALTH CARE TABLE H-1 Checklist of Items to Include When Reporting a Systematic Review or Meta-Analysis Selection/Topic # Checklist Item TITLE Title 1 Identify the report as a systematic review, meta- analysis, or both. ABSTRACT Structured 2 Provide a structured summary including, as summary applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number. INTRODUCTION Rationale 3 Describe the rationale for the review in the context of what is already known. Objectives 4 Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS). METHODS Protocol and 5 Indicate if a review protocol exists, if and where registration it can be accessed (e.g., web address), and, if available, provide registration information, including registration number. Eligibility 6 Specify study characteristics (e.g., PICOS, length criteria of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale. Information 7 Describe all information sources (e.g., databases sources with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched. Search 8 Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated. Study selection 9 State the process for selecting studies (i.e., screening, eligibility, included in systematic reviews, and, if applicable, included in the meta- analysis). Data collection 10 Describe method of data extraction from reports process (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators. Data items 11 List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
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305 APPENDIX H TABLE H-1 Continued Selection/Topic # Checklist Item Risk of bias in 12 Describe methods used for assessing risk of bias individual studies of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis. Summary 13 State the principal summary measures (e.g., risk measures ratio, difference in means). Synthesis of 14 Describe the methods of handling data and results combining results of studies, if done, including measures of consistency (e.g., I2) for each meta- analysis. Risk of bias across 15 Specify any assessment of risk of bias that may studies affect the cumulative evidence (e.g., publication bias, selective reporting within studies). Additional 16 Describe methods of additional analyses (e.g., analyses sensitivity or subgroup analyses, meta-regression), if done, indicating which were prespecified. RESULTS Study selection 17 Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram. Study 18 For each study, present characteristics for which characteristics data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations. Risk of bias within 19 Present data on risk of bias of each study and, if studies available, any outcome-level assessment (see Item 12). Results of 20 For all outcomes considered (benefits or harms), individual studies present, for each study: (a) simple summary data for each intervention group; and (b) effect estimates and confidence intervals, ideally with a forest plot. Synthesis of 21 Present results of each meta-analysis done, results including confidence intervals and measures of consistency. Risk of bias across 22 Present results of any assessment of risk of bias studies across studies (see Item 15). Additional 23 Give results of additional analyses, if done (e.g., analyses sensitivity or subgroup analyses, meta-regression [see Item 16]). continued
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306 FINDING WHAT WORKS IN HEALTH CARE TABLE H-1 Continued Selection/Topic # Checklist Item DISCUSSION Summary of 24 Summarize the main findings, including the evidence strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers). Limitations 25 Discuss limitations at a study and outcome level (e.g., risk of bias) and at review level (e.g., incomplete retrieval of identified research, reporting bias). Conclusions 26 Provide a general interpretation of the results in the context of other evidence and implications for future research. FUNDING Funding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data) and the role of funders for the systematic review. SOURCES: Liberati et al. (2009); Moher et al. (2009). REFERENCES Liberati, A., D. G. Altman, J. Tetzlaff, C. Mulrow, P. Gotzsche, J. P. Ioannidis, M. Clarke, P. J. Devereaux, J. Kleijnen, and D. Moher. 2009. The PRISMA State- ment for reporting systematic reviews and meta-analysis of studies that evalu - ate health care interventions: Explanation and elaboration. Annals of Internal Medicine 151(4):W11–W30. Moher, D., A. Liberati, J. Tetzlaff, and D. G. Altman. 2009. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medi- cine 6(7):1–6.