Page and Moher Systematic Reviews (2017) 6:263

DOI 10.1186/s13643-017-0663-8

METHODOLOGY Open Access

Evaluations of the uptake and impact of

the Preferred Reporting Items for
Systematic reviews and Meta-Analyses
(PRISMA) Statement and extensions: a
scoping review
Matthew J. Page1* and David Moher2,3

Abstract
Background: The PRISMA Statement is a reporting guideline designed to improve transparency of systematic reviews
(SRs) and meta-analyses. Seven extensions to the PRISMA Statement have been published to address the reporting of
different types or aspects of SRs, and another eight are in development. We performed a scoping review to map the
research that has been conducted to evaluate the uptake and impact of the PRISMA Statement and extensions. We
also synthesised studies evaluating how well SRs published after the PRISMA Statement was disseminated adhere to its
recommendations.
Methods: We searched for meta-research studies indexed in MEDLINE® from inception to 31 July 2017, which investigated
some component of the PRISMA Statement or extensions (e.g. SR adherence to PRISMA, journal endorsement of PRISMA).
One author screened all records and classified the types of evidence available in the studies. We pooled data on SR
adherence to individual PRISMA items across all SRs in the included studies and across SRs published after 2009 (the
year PRISMA was disseminated).
Results: We included 100 meta-research studies. The most common type of evidence available was data on SR adherence
to the PRISMA Statement, which has been evaluated in 57 studies that have assessed 6487 SRs. The pooled results of these
studies suggest that reporting of many items in the PRISMA Statement is suboptimal, even in the 2382 SRs published after
2009 (where nine items were adhered to by fewer than 67% of SRs). Few meta-research studies have evaluated the
adherence of SRs to the PRISMA extensions or strategies to increase adherence to the PRISMA Statement and
extensions.
Conclusions: Many studies have evaluated how well SRs adhere to the PRISMA Statement, and the pooled result of
these suggest that reporting of many items is suboptimal. An update of the PRISMA Statement, along with a toolkit of
strategies to help journals endorse and implement the updated guideline, may improve the transparency of SRs.
Keywords: Reporting, Systematic reviews, Methodology, Quality

* Correspondence: [email protected]
1
School of Public Health and Preventive Medicine, Monash University, 553 St
Kilda Road, Melbourne, VIC 3004, Australia
Full list of author information is available at the end of the article

© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. 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.
Page and Moher Systematic Reviews (2017) 6:263 Page 2 of 14

Background guidelines. Reporting guidelines provide evidence-based

Systematic reviews (SRs) and meta-analyses are an es- recommendations for authors on how to report their
sential resource for healthcare decision-makers [1]. research methods and findings clearly [9]. In 1999, an
When conducted well, SRs can provide credible and international group of 30 epidemiologists, clinicians, stat-
timely data on a range of enquiries, such as which treat- isticians, editors and researchers developed a reporting
ments are effective, ineffective or harmful; which tests guideline for meta-analyses of randomised trials—the
accurately diagnose a condition and which exposures are QUOROM (QUality Of Reporting Of Meta-analyses)
associated with health outcomes. However, the value of Statement [10]. In 2005, a meeting was convened to up-
SRs depends on how well authors have reported what date QUOROM to address several conceptual and prac-
they did, and what they found. If such information is ab- tical advances in the methodology of SRs and to help
sent or ambiguous, readers cannot judge whether the re- overcome several shortcomings identified in an audit of
sults of the SR are robust to the methods used, cannot SRs [3]. The guideline was renamed the PRISMA (Pre-
attempt to reproduce the findings and cannot interpret ferred Reporting Items for Systematic reviews and Meta-
the findings accurately. This can contribute to the failure Analyses) Statement, and published in 2009 [11]. It was
to implement the findings of SRs into clinical practice accompanied by an explanation and elaboration docu-
[2]. Therefore, transparent reporting of SRs should be ment, which provided detailed guidance for each of the 27
considered critically important by authors of SRs [3, 4]. included items, and examples of exemplar reporting [12].
The transparency of SRs and meta-analyses of health re- According to citation data in Scopus®, the PRISMA State-
search has been called into question on many occasions ment has had a very high uptake from the biomedical re-
[5]. The first formal appraisal of SRs with a focus on medi- search community (Fig. 1). The checklist paper [11, 13–19]
cine was performed by Cynthia Mulrow, who identified has been cited 19,402 times as of 31 July 2017, and the ac-
several poor reporting practices in a sample of 50 medical companying explanation and elaboration document [12,
review articles published between June 1985 and June 20–23] received 5483 citations by this date. However, not
1986 [6]. For example, clearly specified methods of identi- all published SRs cite the guideline; for example, in a ran-
fying, selecting and appraising studies were available in dom sample of 119 non-Cochrane SRs of therapeutic inter-
one article only. Transparency was only slightly better in ventions indexed in MEDLINE® in February 2014, 42 (35%)
reviews published in 1996, with less than 25% of articles mentioned the use of the PRISMA Statement [8].
describing how evidence was identified, evaluated or syn- Since its publication, seven extensions to the PRISMA
thesised [7]. In the last decade, transparency of SRs has Statement have been developed to facilitate reporting of
certainly improved, yet a high amount of suboptimal different types or aspects of SRs (Table 1). These include
reporting persists [8]. the PRISMA-Equity extension [24–26], PRISMA for Ab-
Improvements in the transparency of SRs in recent stracts of SRs [27], PRISMA extension for reporting SRs
years may be attributed to the dissemination of reporting incorporating network meta-analysis [28], PRISMA for

Fig. 1 Cumulative number of citations of the PRISMA Statement. Data obtained from Scopus® on 31 July 2017. E&E explanation and elaboration
Page and Moher Systematic Reviews (2017) 6:263 Page 3 of 14

Table 1 Scope of the PRISMA Statement and published extensions

Reporting guideline Year Scope of reporting guideline
published
PRISMA 2009 Reports of systematic reviews and meta-analyses, primarily of randomised trials that evaluate health care
interventions [11–23].
PRISMA-Equity 2012 Reports of systematic reviews and meta-analyses with a focus on health equity, defined as the
absence of avoidable and unfair inequalities in health [24–26].
PRISMA-Abstracts 2013 Abstracts for all types of systematic reviews, but the emphasis is on systematic reviews of evaluations of
interventions where one or more meta-analyses are conducted [27].
PRISMA-Network Meta- 2015 Reports of systematic reviews that address networks of multiple treatment comparisons [28].
Analysis
PRISMA-Individual Participant 2015 Reports of systematic reviews and meta-analyses of individual participant data. Developed
Data primarily for reviews of randomised trials, but many items apply to other contexts, including
reviews of diagnosis and prognosis [29].
PRISMA-Protocols 2015 Protocols for systematic reviews and meta-analyses that summarise aggregate data from studies,
particularly those which evaluate the effects of interventions [30, 31].
PRISMA-Harms 2016 Reports of systematic reviews and meta-analyses assessing adverse events (as either a primary or
secondary outcome) that are reported in prospective interventional studies or observational studies
(with or without a comparison group) [32].
PRISMA-Complex 2017 Reports of systematic reviews and meta-analyses of complex interventions. Complex interventions
Interventions are defined as interventions that have ‘multiple components (intervention complexity) and
complicated/multiple causal pathways, feedback loops, synergies and/or mediators and
moderators of effect (pathway complexity)’ [33, 34].

SRs and meta-analyses of individual participant data that fewer SRs to which the extensions are applicable are
[29], PRISMA for SR protocols [30, 31], PRISMA harms published each year. The most cited extension is the
checklist [32] and PRISMA extension for SRs of com- checklist paper for PRISMA-P (for SR protocols) [30],
plex interventions [33, 34]. Citation counts for the which has received 683 citations since its publication in
PRISMA extensions are much lower than those of the January 2015.
PRISMA Statement, but they have not had the same There are also eight PRISMA extensions that are in
amount of time to accrue citations (Fig. 2). Also, one development (Table 2). These include extensions for SRs
should not expect the extensions to receive as many ci- of newborn and child health research and for protocols
tations, as they are more restricted in scope, meaning of such SRs, for SRs of diagnostic test accuracy studies,

Fig. 2 Cumulative number of citations of PRISMA extensions published before 2017. Data obtained from Scopus® on 31 July 2017. E&E explanation
and elaboration, IPD individual participant data, NMA network meta-analysis
Page and Moher Systematic Reviews (2017) 6:263 Page 4 of 14

Table 2 Scope of the PRISMA extensions in development

Reporting guideline Month Scope of reporting guideline
registered
PRISMA-Children Nov 2014 Reports of systematic reviews and meta-analyses of randomised trials or observational
studies of newborn and child health research [155].
PRISMA-Protocol for Nov 2014 Protocols for systematic reviews and meta-analyses of randomised trials or observational
Children studies of newborn and child health research [155].
PRISMA-Diagnostic Test Accuracy Nov 2015 Reports of systematic reviews and meta-analyses of diagnostic test accuracy studies
(i.e. studies of the ability of medical tests to detect a target condition) [156].
PRISMA-Rapid Reviews Nov 2015 Reports of rapid reviews, including those with analogous terminology (e.g. rapid
evidence synthesis, rapid knowledge synthesis) [157].
PRISMA-Scoping Reviews Dec 2015 Reports of scoping reviews, which are used to map the concepts underpinning a
research area and the main sources and types of evidence available [158].
PRISMA-Search Feb 2016 Reports of literature searches in systematic reviews [159].
PRISMA-Traditional Aug 2016 Reports of systematic reviews and meta-analyses of studies that evaluate Chinese
Chinese Medicine herb medicine or moxibustion [160].
PRISMA-In Vivo Animal To be registered Reports of systematic reviews and meta-analyses of in vivo animal studies
studies (Manoj M. Lalu, personal communication, June 2017)
Registered PRISMA extensions were identified in the library of reporting guidelines available at the Enhancing the QUAlity and Transparency Of health Research
(EQUATOR) Network website (http://www.equator-network.org/library/), on 24 July 2017

for rapid reviews, for scoping reviews, for SR search used the PRISMA Statement or one of the extensions
methods, for SRs of traditional Chinese medicine inter- for evaluative purposes (e.g. to assess how often SRs ad-
ventions and for SRs of in vivo animal studies. here to each PRISMA item). We included meta-research
It is important to evaluate whether the PRISMA State- studies regardless of language or year of publication. We
ment and extensions have achieved what they are de- excluded commentaries, editorials or letters to the
signed to do—improve the transparency of SRs. We are editor.
aware of two previous SRs that have investigated the ad- One author (MJP) searched for potentially relevant
herence of SRs to the PRISMA Statement (i.e. the extent studies indexed in MEDLINE® from inception to 31
to which SRs comply with each item in the statement) July 2017 (specifically, Ovid MEDLINE® Epub Ahead
[35, 36]. Another SR has examined whether transparency of Print, In-Process and Other Non-Indexed Citations;
is better in SRs published in journals that endorse the Ovid MEDLINE® Daily and Ovid MEDLINE and Ver-
PRISMA Statement (e.g. suggest its use in the journal sions®). The following search strategy was used to re-
instructions to authors or require that authors submit a trieve articles that included the term ‘PRISMA’
PRISMA checklist accompanying their SR) [37]. How- (abbreviated or spelled out in full) in the title or ab-
ever, to our knowledge, there has been no attempt to stract of the article:
map what other research on the uptake, and impact of
the PRISMA Statement and extensions has been done. 1. ‘Preferred Reporting Items for Systematic Reviews
Also, there has been no attempt to synthesise studies and Meta-analyses’.ti,ab.
evaluating adherence of SRs published after the PRISMA 2. PRISMA.ti,ab.
Statement was disseminated. Therefore, we aimed to ad- 3. 1 or 2.
dress these gaps by conducting a scoping review of
meta-research studies evaluating the PRISMA Statement One author (MJP) screened all titles and abstracts, and
and extensions. any full-text articles retrieved, to determine eligibility.
The same author recorded the types of evidence avail-
Methods able in the included meta-research studies. Types of evi-
We did not pre-register the methods of our scoping dence were classified as:
review, as we are unaware of any register for meth-
odological research of this nature.  data on SR adherence to the PRISMA Statement or
We considered articles to be eligible for inclusion if extensions;
they were an empirical study of any design (e.g. rando-  characteristics associated with SR adherence to
mised trial, cross-sectional analysis, before-after study), PRISMA (e.g. journal endorsement, year of
which investigated some component of the PRISMA publication);
Statement or extensions (e.g. how often PRISMA is re-  the frequency of journal instructions to authors
ferred to in journal instructions to authors) or which referring to the PRISMA Statement or extensions;
Page and Moher Systematic Reviews (2017) 6:263 Page 5 of 14

 other (e.g. frequency of SR authors who reported available in the published article (e.g. when study au-
using the PRISMA Statement to guide their thors reported only the mean number of items that SRs
reporting). adhered to).
We pooled data on SR adherence to individual
To determine the influence of the PRISMA Statement PRISMA items across all SRs in the included studies.
on the transparency of SRs, we pooled the findings of We noted items that fewer than two thirds (67%) of SRs
meta-research studies evaluating how often SRs adhere adhered to and those that are fewer than half of SRs ad-
to the PRISMA Statement. This updates a previous SR hered to. We also pooled data on SR adherence to indi-
which included adherence studies published up to Oc- vidual PRISMA items in a subset of studies that
tober 2014 [35]. One author (MJP) collected from each evaluated SRs published after the PRISMA Statement
meta-research study the following data about the SRs was disseminated. For this analysis, we analysed studies
evaluated: focus (e.g. therapeutic, diagnostic), clinical which included only SRs published in 2010 or later or
area, language, years of publication and frequencies of studies which reported data on a subgroup of SRs pub-
SRs adhering to each of the 27 PRISMA Statement lished in 2010 or later. We did not contact study authors
items. In some cases, authors of meta-research studies for this subgroup data. We conducted all analyses in
recorded if a particular PRISMA item was fully re- Microsoft Excel.
ported or partially reported in each of the SRs evalu-
ated. In such cases, we recorded only the number of Results
SRs that fully reported the PRISMA item. One author Scoping review of meta-research studies
(MJP) contacted study authors to request data on ad- The search of MEDLINE® yielded 5001 citations (Fig. 3).
herence to individual items if these data were not After screening each title and abstract, we retrieved the

Fig. 3 Flow diagram of identification, screening and inclusion of studies

Page and Moher Systematic Reviews (2017) 6:263 Page 6 of 14

full text of 170 articles. We excluded 70 of these articles, the PRISMA Statement or extensions in the instructions
most of which were editorials or commentaries (reasons to authors (n = 18/100 [18%]).
for exclusion are listed in Additional file 1: Table S1). Few studies have evaluated how well SRs adhere to the
One hundred meta-research studies met our inclusion PRISMA extensions; adherence to PRISMA for Ab-
criteria (listed in Additional file 2: Table S2). The studies stracts and PRISMA for Network Meta-Analyses has
were published between 2011 and 2017, and more than been examined in three studies and one study, respect-
half were published in 2015 or later (n = 59). All of the ively (Table 3). Further, few studies have investigated
studies were observational in design; there were 86 whether the endorsement of the PRISMA Statement by
cross-sectional analyses, six uncontrolled before-after journals was associated with adherence to PRISMA (n =
studies, four surveys of authors and four systematic re- 8/100 [8%]). We did not identify any studies that investi-
views of meta-research studies. gated whether journal endorsement of one of the
We recorded 20 different types of evidence available PRISMA extensions was associated with SR adherence
across the included meta-research studies (Table 3). The to the extension.
most common type of evidence available was data on SR
adherence to the PRISMA Statement, which was re- Evaluations of SR adherence to the PRISMA Statement
ported in 57/100 (57%) studies. Many of these 57 studies Of the 57 studies evaluating SR adherence to the
(n = 37 [65%]) also investigated characteristics associated PRISMA Statement [38–94], most were published be-
with SR adherence to the PRISMA Statement, such as tween 2015 and 2017 (33/57 [58%]), focused on SRs of
the type of journal, year of publication and article word therapeutic interventions only (45/57 [79%]), evaluated
count. The third most common type of evidence avail- non-Cochrane SRs only (34/57 [60%]) and evaluated SRs
able was data on the frequency of journals referring to written in English only (39/57 [68%]) (Table 4). A total

Table 3 Types of evidence available in meta-research studies (n = 100) evaluating the PRISMA Statement or extensions
Type of evidence available Frequency of
studies
SR adherence to the PRISMA Statement or extensions
Data on SR adherence to the PRISMA Statement [38–94] 57
Data on SR adherence to a particular item of the PRISMA Statement (e.g. searching item, risk of bias assessment item) [95–99] 5
Data on SR abstract adherence to the PRISMA-Abstracts extension [74, 100, 101] 3
Data on network meta-analysis adherence to the PRISMA-Network Meta-Analysis extension [102] 1
Data on rapid review adherence to the PRISMA Statement [103] 1
Data on SR adherence to draft versions of the PRISMA-Child and PRISMA-Protocols Child extensions [104] 1
Data on SR adherence to reporting standards derived from the PRISMA Statement [8, 105, 106] 3
Data on SR abstract adherence to items derived from the PRISMA Statement [107, 108] 2
Data on individual participant data meta-analysis adherence to items derived from the PRISMA Statement [109] 1
Characteristics associated with SR adherence to the PRISMA Statement
Association between journal endorsement of the PRISMA Statement and SR adherence to PRISMA [38, 39, 46, 71, 77, 81, 84, 94] 8
Association between factors other than journal endorsement (e.g. type of journal, word count, year of publication) and SR 37
adherence to PRISMA [38, 43, 44, 46–51, 54, 57–62, 64, 66, 68, 70, 71, 73–75, 77, 78, 80, 82–86, 88–90, 92, 94]
Mention of the PRISMA Statement or extensions in journal instructions
Frequency of journals referring to the PRISMA Statement or extensions in the instructions to authors [46, 71, 77, 81, 84, 110–122] 18
Frequency of journals referring to the PRISMA Statement or extensions in the instructions to peer reviewers [112, 123] 2
Other
Frequency of SR authors who reported using the PRISMA Statement to guide reporting [8, 71, 114, 115, 124] 5
Frequency of editors who are aware of the PRISMA Statement [111] 1
Frequency of inappropriate citation of the PRISMA Statement by authors [125] 1
Association between adherence to the PRISMA Statement and citation of SRs [126] 1
Authors’ perceived barriers and facilitators to use of the PRISMA-Equity extension [127] 1
Authors’ views on what items are most important to report in SRs [128–130] 3
Systematic reviews of meta-research studies evaluating some component of the PRISMA Statement or extensions [35–37, 131] 4
Page and Moher Systematic Reviews (2017) 6:263 Page 7 of 14

of 6487 SRs were evaluated across all studies; the me- of bias across studies), item 23 (results: additional ana-
dian (interquartile range) number of SRs evaluated per lyses) and item 27 (funding). There were six items that
study was 74 (44-144). The evaluated SRs were pub- fewer than 50% of SRs adhered to (items 5, 15, 16, 22,
lished between 1989 and 2016. 23 and 27).
All 57 studies assessed adherence to individual PRISMA adherence data for SRs published in 2010 or
PRISMA items, with relevant data provided on request later (i.e. after the PRISMA Statement was published)
by authors of ten studies [39, 42, 43, 45, 66, 67, 69, 77, were available in 27 studies [38, 39, 41, 42, 44, 46, 56,
79, 85]. By pooling the PRISMA adherence data across 60, 62, 68–79, 81–84, 92, 94], which evaluated 2382 SRs.
SRs in all 57 reports, we identified 11 items that fewer The characteristics of these studies (i.e. focus, clinical
than 67% of SRs adhered to (Fig. 4; numerical data avail- area, language of SRs) were similar to those of the total
able in Additional file 3: Table S3). These include item 2 set of studies. SR adherence to the PRISMA Statement
(structured summary), item 5 (methods: protocol and was higher for nearly all items in this subset of recent
registration), item 8 (methods: search), item 11 SRs, compared with the adherence data across all SRs
(methods: data items), item 12 (methods: risk of bias in (Fig. 4; numerical data available in Additional file 3:
individual studies), item 15 (methods: risk of bias across Table S3). There were 12 items that more than 80% of
studies), item 16 (methods: additional analyses), item 19 SRs adhered to (items 1, 3, 4, 6, 7, 14, 17, 18, 20, 21, 24
(results: risk of bias within studies), item 22 (results: risk and 26). However, lack of transparency remains an issue
for many SRs. There were nine items that fewer than
Table 4 Characteristics of 57 studies evaluating SR adherence 67% of SRs adhered to (items 5, 8, 12, 15, 16, 19, 22, 23
to the PRISMA Statement and 27), and one item was adhered to by 21% of SRs
Characteristic Summary data only (item 5, on whether a SR protocol or registration
Year of study publication number exists).
2011–2014 24 (42%)
2015–2017 33 (58%) Discussion
Focus of SRs evaluated
Our scoping review suggests that the PRISMA State-
ment and extensions have provided fertile ground for
Therapeutic interventions (treatment/prevention) 45 (79%)
meta-research. Twenty different types of evidence were
Diagnostic 4 (7%) available across 100 meta-research studies. The most
Mix (e.g. some therapeutic, some diagnostic) 6 (11%) common type of evidence was data on SR adherence to
Not specified 2 (4%) the PRISMA Statement, which has been evaluated in 57
Clinical area of SRs evaluated studies. The pooled results of these studies indicate that
Surgery 14 (25%)
reporting of many items of the PRISMA Statement is
suboptimal, even in those SRs published after its dissem-
General medicine 5 (9%)
ination in 2009. Very few meta-research studies have
Nursing 5 (9%) evaluated SR adherence to the PRISMA extensions, but
Complementary and alternative medicine 4 (7%) this is unsurprising given that most extensions were dis-
Other (specific clinical condition) 29 (51%) seminated in 2015 or later. Few studies have tested strat-
Median number of SRs evaluated 74 (44-144) egies to increase adherence to the PRISMA Statement
Median earliest year of publication of SRs evaluated 2005 (2001–2009)
and extensions.
Median latest year of publication of SRs evaluated 2013 (2011–2015)
Strengths and limitations
Journal of SRs evaluated There are several strengths of our research. To our
Non-Cochrane only 34 (60%) knowledge, this is the first attempt to systematically map
Both Cochrane and non-Cochrane 22 (39%) research conducted on the PRISMA Statement and ex-
Unclear 2 (11%) tensions. Most of the included studies assessing SR ad-
Language of SRs evaluated
herence to the PRISMA Statement focused on one
clinical area, so by pooling data across these studies, our
English only 39 (68%)
findings are more generalisable. Also, we managed to
Chinese only 9 (16%) obtain unpublished data from ten studies that had not
Portuguese only 1 (2%) reported data on adherence to each individual PRISMA
English and LOE (less than 10% LOE) 6 (11%) item [39, 42, 43, 45, 66, 67, 69, 77, 79, 85].
English and LOE (more than 40% LOE) 2 (4%) A few limitations must be acknowledged. We included
Data given as number (percent) or median (interquartile range)
only meta-research articles indexed in one bibliographic
LOE language other than English, SR systematic review database (MEDLINE®) and written in English. However,
Page and Moher Systematic Reviews (2017) 6:263 Page 8 of 14

Fig. 4 Summary percentage across reports of SRs adhering to the PRISMA Statement

we do not see any reason why our findings would differ unaware if some SRs appeared in more than one of the
had other databases and meta-research articles in lan- included meta-research studies. However, based on the
guages other than English been consulted. Screening of information regarding the types of SRs (e.g. Cochrane
records and collection of data from articles were per- or non-Cochrane), years of publication of SRs and clin-
formed by one author only. It is therefore possible that ical focus of SRs, we judged the number of overlapping
we may have missed some relevant meta-research stud- SRs to be low.
ies or made errors when recording the frequency of SRs We were unable to compare the reporting of SRs pub-
adhering to the PRISMA Statement. We have uploaded lished after PRISMA was disseminated in 2009 with that
all data collected to the Open Science Framework before 2009 because of how the included meta-research
(https://osf.io/7x2mp/) so that interested readers can studies were designed and reported. Most studies (43 of
verify our data and replicate our results. Most of the SRs 57) included some SRs published before 2009 and some
evaluated in the 57 studies investigating SR adherence to published after 2009, but most studies did not report the
the PRISMA Statement were written in English, and it is number of SRs in each category. There were 14 studies
possible that non-English language SRs may be less that included only SRs published after 2009, 13 studies
likely to adhere to PRISMA, if their authors were not which provided subgroup data on SRs published after
confident in English. Our classification of types of evi- 2009 (but not all of these studies provided correspond-
dence available in meta-research studies reflects what ing data for SRs published before 2009) and three stud-
was reported; we did not contact study authors to en- ies included only SRs published before 2009. Given the
quire whether they conducted other analyses yet chose data on PRISMA adherence in SRs published before
not to report the findings. We did not record the refer- 2009 was limited to a small subset of the included stud-
ences of SRs evaluated in each study investigating SR ies, we decided to restrict our analysis of PRISMA ad-
adherence to the PRISMA Statement and so are herence to all SRs (regardless of year of publication) and
Page and Moher Systematic Reviews (2017) 6:263 Page 9 of 14

SRs published after 2009. A formal before-after compari- journals that do not allow supplementary files). In
son was therefore not possible. addition, some items with low adherence may not be
We focused on the PRISMA Statement and exten- considered sufficiently important to report by a majority
sions, although we are aware of other reporting guide- of systematic reviewers and journal editors. It would be
lines for SRs. These include the Methodological useful to conduct surveys and interviews with systematic
Expectations of Cochrane Intervention Reviews reviewers to explore the contributions of these potential
(MECIR) reporting standards [132, 133], the American barriers and facilitators to complete SR reporting.
Psychological Association Meta-Analysis Reporting Stan- To our knowledge, there have been no prospectively
dards (MARS) [134], the ENTREQ Statement for syn- designed, controlled studies evaluating whether the
theses of qualitative research [135], the RAMESES PRISMA Statement or extensions are having their
publication standards for realist syntheses [136] and intended effect. This is surprising, and a different thresh-
meta-narrative reviews [137] and reporting guidance for old than that required to introduce a drug into the
describing interventions in SRs [138]. More research is marketplace. Instead, only a few cross-sectional or un-
needed to map the research conducted on these report- controlled before-after studies have evaluated the impact
ing guidelines. of journal endorsement of the PRISMA Statement on
reporting of SRs. Of these eight studies [38, 39, 46, 71,
Comparison with other studies 77, 81, 84, 94], six evaluated whether journals which
We are aware of two other syntheses of meta-research ‘recommend’ or ‘encourage’ use of the PRISMA State-
studies that have investigated the adherence of SRs to ment in the journal instructions to authors publish SRs
the PRISMA Statement [35, 36]. Samaan et al. [36] in- that are reported more completely. Two studies investi-
cluded three studies, and Pussegoda et al. [35] included gated whether reporting is clearer in journals that ask
13 studies, respectively. Both reached the same conclu- authors to submit a PRISMA checklist when submitting
sion as us, that adherence to the PRISMA Statement is an SR. Both are rather low-intensity interventions that
suboptimal; however, unlike our review, neither analysed may not have the desired effect. For example, a recom-
reporting of SRs published after the PRISMA Statement mendation in the instructions to authors can easily be
was published. Another SR by Stevens et al. [37] synthe- missed by authors (some of whom will not even check
sised the results of three studies exploring whether SR the instructions), while a submitted PRISMA checklist
adherence to the PRISMA Statement is higher in jour- may be ignored by peer reviewers and journal editors
nals which endorse the reporting guideline. We identi- who face competing pressures on their time.
fied in our scoping review an additional five studies that Researchers need to develop more efficient and inten-
could be added to an update of this review. To our sive interventions to implement reporting guidelines
knowledge, ours is the only review which has mapped such as the PRISMA Statement and extensions. We be-
research conducted on the PRISMA extensions. lieve technology can play a valuable role in this regard.
For example, StatReviewer software performs an auto-
Implications of the findings mated review of the statistical and reporting integrity of
There are several reasons why adherence is better for scientific manuscripts (http://www.statreviewer.com/).
some PRISMA items than others. It is possible that the Manuscripts can currently be checked against the fol-
less complex the item, the easier it is to report it. For ex- lowing reporting guidelines: CONSORT 2010 [139],
ample, most of the 12 PRISMA items that were adhered STROBE [140], STARD [141, 142], ARRIVE [143] and
to by more than 80% of SRs published in 2010 or later The Uniform Requirements for Medical Journals (http://
are relatively straightforward to report. These items in- www.icmje.org/recommendations/). StatReviewer is con-
clude identifying the report as a SR or meta-analysis in sidering including PRISMA in their suite of reporting
the title, providing a rationale and objectives, presenting guidelines (D. Moher, personal communication). We also
study characteristics and reporting conclusions. Several think rigorous evaluations, in the form of randomised
items in the PRISMA Statement comprise multiple com- trials, of StatReviewer are needed. Such evaluations
ponents, which some systematic reviewers may fail to could build upon the experiences of previous rando-
fully address (e.g. item 12 asks authors to ‘describe mised trials evaluating web-based reporting guideline
methods used for assessing risk of bias of individual tools (e.g. WebCONSORT [144], COBWEB [145]).
studies (including specification of whether this was done It is 12 years since the PRISMA group last met, and
at the study or outcome level), and how this information the PRISMA Statement has not been updated since its
is to be used in any data synthesis’). Also, reporting of publication 8 years ago. We believe that an update is ne-
some items may depend on whether the journal facili- cessary to address the poor adherence to the guideline.
tates reporting of that item (e.g. authors may be unable An updating process will provide the opportunity to dis-
to present a full electronic search strategy (item 8) in cuss how to rearrange the layout and rephrase the
Page and Moher Systematic Reviews (2017) 6:263 Page 10 of 14

checklist items to increase clarity. It will also allow for Funding

potential new items to be considered, based on recent There was no direct funding for this study. MJP is supported by an Australian
National Health and Medical Research Council (NHMRC) Early Career
methodological developments affecting SR conduct and Fellowship (1088535). DM is supported in part by a University Research Chair,
reporting. These developments include novel guidance University of Ottawa. The funders had no role in the study design, data
on how to: collection and analysis, decision to publish or preparation of the manuscript.

Availability of data and materials

 summarise findings when meta-analysis is not The data underlying this study are available on the Open Science
appropriate [146, 147]; Framework: https://osf.io/7x2mp/
 report and synthesise intervention characteristics of
Authors’ contributions
included studies [138, 148]; Both authors declare to meet the ICMJE conditions for authorship. MJP and
 use and interpret prediction intervals for random- DM conceived the study design. MJP collected the data and undertook the
effects meta-analyses [149, 150]; statistical analyses. MJP wrote the first draft of the article. DM contributed to
the revisions of the article. Both authors approved the final version of the
 enhance reproducibility of meta-analytic results and submitted article.
share data collected [151, 152] and
 report the methods and results of updated SRs [153] Ethics approval and consent to participate
Not applicable.
and living SRs [154].
Consent for publication
In addition, developing a comprehensive research Not applicable.
translation strategy to help journals endorse and imple-
Competing interests
ment the updated guideline may facilitate its use. Journal We have read the journal’s policy, and the authors of this manuscript have
editors and researchers should work together to develop the following competing interests: DM is co-Editor in Chief, and MJP is an
prospective (ideally randomised), controlled studies to Associate Editor for Systematic Reviews, but neither had involvement in the
peer review process or decision for publication. DM led the development of
provide robust evidence about the effect of the updated the PRISMA Statement. MJP and DM are leading the update of the PRISMA
guideline on the transparency of SRs. Statement. DM is an unpaid advisor to StatReviewer.

Publisher’s Note
Conclusions Springer Nature remains neutral with regard to jurisdictional claims in
Many studies have evaluated how well SRs adhere to the published maps and institutional affiliations.
PRISMA Statement, and the pooled result of these sug- Author details
gests that reporting of many items is suboptimal. Little 1
School of Public Health and Preventive Medicine, Monash University, 553 St
research has been done to design and test strategies to Kilda Road, Melbourne, VIC 3004, Australia. 2Centre for Journalology and
Canadian EQUATOR Centre, Clinical Epidemiology Program, Ottawa Hospital
increase adherence to the PRISMA Statement or exten- Research Institute, Ottawa K1H 8L6, Canada. 3School of Epidemiology and
sions. An update of the PRISMA Statement, followed by Public Health, Faculty of Medicine, University of Ottawa, Ottawa K1H 8M5,
a toolkit of strategies to help journals endorse and im- Canada.
plement the updated guideline, may improve the trans- Received: 2 October 2017 Accepted: 8 December 2017
parency of SRs.

References
Additional files 1. Agoritsas T, Vandvik PO, Neumann I, Rochwerg B, Jaeschke R, Hayward R, et
al. Chapter 5: finding current best evidence. In: Guyatt G, Rennie D, Meade
MO, Cook DJ, editors. Users’ guides to the medical literature: a manual for
Additional file 1: Tables of excluded papers. (DOCX 21 kb) evidence-based clinical practice. 3rd ed. New York: McGraw-Hill; 2015. p.
Additional file 2: List of included meta-research studies. (DOCX 25 kb) 29–50.
2. Glasziou P, Altman DG, Bossuyt P, Boutron I, Clarke M, Julious S, et al.
Additional file 3: Summary across reports of SRs adhering to the
Reducing waste from incomplete or unusable reports of biomedical
PRISMA Statement. (DOCX 17 kb)
research. Lancet. 2014;383(9913):267–76.
3. Moher D, Tetzlaff J, Tricco AC, Sampson M, Altman DG. Epidemiology and
reporting characteristics of systematic reviews. PLoS Med. 2007;4:e78.
Abbreviations 4. Page MJ, Moher D. Mass production of systematic reviews and meta-
CI: Confidence interval; E&E: Explanation and elaboration; analyses: an exercise in mega-silliness? Milbank Q. 2016;94(3):515–9.
EQUATOR: Enhancing the QUAlity and Transparency Of health Research; 5. Ioannidis JP. The mass production of redundant, misleading, and conflicted
IPD: Individual participant data; NMA: Network meta-analysis; systematic reviews and meta-analyses. Milbank Q. 2016;94(3):485–514.
PRISMA: Preferred Reporting Items for Systematic reviews and Meta-Analyses; 6. Mulrow CD. The medical review article: state of the science. Ann Intern
QUOROM: QUality Of Reporting Of Meta-analyses; SR: Systematic review Med. 1987;106(3):485–8.
7. McAlister FA, Clark HD, van Walraven C, Straus SE, Lawson FM, Moher D, et
al. The medical review article revisited: has the science improved? Ann
Acknowledgments Intern Med. 1999;131(12):947–51.
We thank the following study authors who provided us with unpublished 8. Page MJ, Shamseer L, Altman DG, Tetzlaff J, Sampson M, Tricco AC, et al.
data on SR adherence to PRISMA: Shayden Bryce, Jared Campbell, Alexander Epidemiology and reporting characteristics of systematic reviews of
Fowler, Richard McGee, Livia Puljak, Amanda Shen and Matt Vassar. biomedical research: a cross-sectional study. PLoS Med. 2016;13(5):e1002028.
Page and Moher Systematic Reviews (2017) 6:263 Page 11 of 14

9. Moher D, Schulz KF, Simera I, Altman DG. Guidance for developers of health individual participant data: the PRISMA-IPD statement. JAMA. 2015;313(16):
research reporting guidelines. PLoS Med. 2010;7(2):e1000217. 1657–65.
10. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the 30. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.
quality of reports of meta-analyses of randomised controlled trials: the Preferred reporting items for systematic review and meta-analysis protocols
QUOROM statement. Qual Reporting Meta-Analyses Lancet. 1999;354(9193): (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.
1896–900. 31. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.
11. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting Preferred reporting items for systematic review and meta-analysis protocols
items for systematic reviews and meta-analyses: the PRISMA statement. (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.
PLoS Med. 2009;6(7):e1000097. 32. Zorzela L, Loke YK, Ioannidis JP, Golder S, Santaguida P, Altman DG, et al.
12. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. PRISMA harms checklist: improving harms reporting in systematic reviews.
The PRISMA statement for reporting systematic reviews and meta-analyses BMJ. 2016;352:i157.
of studies that evaluate health care interventions: explanation and 33. Guise JM, Butler ME, Chang C, Viswanathan M, Pigott T, Tugwell P, et al.
elaboration. J Clin Epidemiol. 2009;62(10):e1–34. AHRQ series on complex intervention systematic reviews—paper 6: PRISMA-
13. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting CI extension statement and checklist. J Clin Epi. 2017;90:43-50.
items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 34. Guise JM, Butler M, Chang C, Viswanathan M, Pigott T, Tugwell P, et al.
2009;339:b2535. AHRQ series on complex intervention systematic reviews-paper 7: PRISMA-
14. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting CI elaboration and explanation. J Clin Epi. 2017;90:51-58.
items for systematic reviews and meta-analyses: the PRISMA statement. J 35. Pussegoda K, Turner L, Garritty C, Mayhew A, Skidmore B, Stevens A, et al.
Clin Epidemiol. 2009;62(10):1006–12. Systematic review adherence to methodological or reporting quality.
15. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting Systematic Reviews. 2017;6(1):131.
items for systematic reviews and meta-analyses: the PRISMA statement. Ann 36. Samaan Z, Mbuagbaw L, Kosa D, Borg Debono V, Dillenburg R, Zhang S, et
Intern Med. 2009;151(4):264–9. W64 al. A systematic scoping review of adherence to reporting guidelines in
16. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for health care literature. J Multidiscip Healthc. 2013;6:169–88.
systematic reviews and meta-analyses: the PRISMA Statement. Open 37. Stevens A, Shamseer L, Weinstein E, Yazdi F, Turner L, Thielman J, et
Medicine. 2009;3(3):e123–30. al. Relation of completeness of reporting of health research to
17. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Reprint—preferred journals’ endorsement of reporting guidelines: systematic review. BMJ.
reporting items for systematic reviews and meta-analyses: the PRISMA 2014;348:g3804.
statement. Phys Ther. 2009;89(9):873–80. 38. Adie S, Ma D, Harris IA, Naylor JM, Craig JC. Quality of conduct and
18. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. reporting of meta-analyses of surgical interventions. Ann Surg. 2015;261(4):
Preferred reporting items for systematic reviews and meta-analyses: the 685–94.
PRISMA statement (Chinese edition). J Chin Integrative Med. 2009;7(9): 39. Agha RA, Fowler AJ, Limb C, Whitehurst K, Coe R, Sagoo H, et al. Impact of
889–96. the mandatory implementation of reporting guidelines on reporting quality
19. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting in a surgical journal: a before and after study. Int J Surg. 2016;30:169–72.
items for systematic reviews and meta-analyses: the PRISMA statement. 40. Aguiar PM, Brito GD, Correr CJ, Lyra Junior DP, Storpirtis S. Exploring the
[erratum appears in Int J Surg. 2010;8(8):658]. Int J Surg. 2010;8(5):336–41. quality of systematic reviews on pharmacist interventions in patients with
20. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. diabetes: an overview. Ann Pharmacother. 2014;48(7):887–96.
The PRISMA statement for reporting systematic reviews and meta-analyses 41. Akhigbe T, Zolnourian A, Bulters D. Compliance of systematic reviews
of studies that evaluate healthcare interventions: explanation and articles in brain arteriovenous malformation with PRISMA statement
elaboration. BMJ. 2009;339:b2700. guidelines: review of literature. J Clin Neurosci. 2017;39:45–8.
21. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. 42. Bryce S, Sloan E, Lee S, Ponsford J, Rossell S. Cognitive remediation in
The PRISMA statement for reporting systematic reviews and meta-analyses schizophrenia: a methodological appraisal of systematic reviews and meta-
of studies that evaluate health care interventions: explanation and analyses. J Psychiatr Res. 2016;75:91–106.
elaboration. Ann Intern Med. 2009;151(4):W65–94. 43. Campbell JM, Kavanagh S, Kurmis R, Munn Z. Systematic reviews in burns
22. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. care: poor quality and getting worse. J Burn Care Res. 2017;38(2):e552–e67.
The PRISMA statement for reporting systematic reviews and meta-analyses 44. Chapman SJ, Drake TM, Bolton WS, Barnard J, Bhangu A. Longitudinal
of studies that evaluate health care interventions: explanation and analysis of reporting and quality of systematic reviews in high-impact
elaboration. PLoS Med. 2009;6(7):e1000100. surgical journals. Br J Surg. 2017;104(3):198–204.
23. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. 45. Chong AB, Taylor M, Schubert G, Vassar M. Interventional radiology clinical
The PRISMA statement for reporting systematic reviews and meta-analyses practice guideline recommendations for neurovascular disorders are not
of studies that evaluate health care interventions: explanation and based on high-quality systematic reviews. AJNR: Am J Neuroradiol. 2017;
elaboration. Ital J Public Health. 2009;6(4):354–91. 38(4):759–65.
24. Welch V, Petticrew M, Tugwell P, Moher D, O'Neill J, Waters E, et al. PRISMA- 46. Cullis PS, Gudlaugsdottir K, Andrews J. A systematic review of the quality of
Equity 2012 extension: reporting guidelines for systematic reviews with a conduct and reporting of systematic reviews and meta-analyses in
focus on health equity. PLoS Med. 2012;9(10):e1001333. paediatric surgery. PLoS One. 2017;12(4):e0175213.
25. Welch V, Petticrew M, Petkovic J, Moher D, Waters E, White H, et al. 47. DiSilvestro KJ, Tjoumakaris FP, Maltenfort MG, Spindler KP, Freedman KB.
Extending the PRISMA statement to equity-focused systematic reviews Systematic reviews in sports medicine. Am J Sports Med. 2016;44(2):533–8.
(PRISMA-E 2012): explanation and elaboration. Int J Equity Health. 2015; 48. Evaniew N, van der Watt L, Bhandari M, Ghert M, Aleem I, Drew B, et al.
14:92. Strategies to improve the credibility of meta-analyses in spine surgery: a
26. Welch V, Petticrew M, Petkovic J, Moher D, Waters E, White H, et al. systematic survey. Spine J. 2015;15(9):2066–76.
Extending the PRISMA statement to equity-focused systematic reviews 49. Fleming PS, Seehra J, Polychronopoulou A, Fedorowicz Z, Pandis N. A
(PRISMA-E 2012): explanation and elaboration. J Clin Epidemiol. 2016;70: PRISMA assessment of the reporting quality of systematic reviews in
68–89. orthodontics. Angle Orthod. 2013;83(1):158–63.
27. Beller EM, Glasziou PP, Altman DG, Hopewell S, Bastian H, Chalmers I, et al. 50. Gagnier JJ, Kellam PJ. Reporting and methodological quality of systematic
PRISMA for abstracts: reporting systematic reviews in journal and reviews in the orthopaedic literature. J Bone Joint Surg (Am Vol). 2013;95(11):
conference abstracts. PLoS Med. 2013;10:e1001419. e771–7.
28. Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. 51. Ge L, Wang JC, Li JL, Liang L, An N, Shi XT, et al. The assessment of the
The PRISMA extension statement for reporting of systematic reviews quality of reporting of systematic reviews/meta-analyses in diagnostic tests
incorporating network meta-analyses of health care interventions: checklist published by authors in China. PLoS One. 2014;9(1):e85908.
and explanations. Ann Intern Med. 2015;162(11):777–84. 52. Hammad TA, Neyarapally GA, Pinheiro SP, Iyasu S, Rochester G, Dal Pan G.
29. Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, et al. Reporting of meta-analyses of randomized controlled trials with a focus on
Preferred reporting items for systematic review and meta-analyses of drug safety: an empirical assessment. Clin Trials. 2013;10(3):389–97.
Page and Moher Systematic Reviews (2017) 6:263 Page 12 of 14

53. Jin YH, Ma ET, Gao WJ, Hua W, Dou HY. Reporting and methodological quality rectal cancer surgery between 2002 and 2012. Dis Colon Rectum. 2014;
of systematic reviews or meta-analyses in nursing field in China. Int J Nurs Pract. 57(8):983–92.
2014;20(1):70–8. 77. Riado Minguez D, Kowalski M, Vallve Odena M, Longin Pontzen D, Jelicic
54. Klimo P Jr, Thompson CJ, Ragel BT, Boop FA. Methodology and reporting of Kadic A, Jeric M, et al. Methodological and reporting quality of systematic
meta-analyses in the neurosurgical literature. J Neurosurg. 2014;120(4):796–810. reviews published in the highest ranking journals in the field of pain.
55. Kurz A, Evaniew N, Yeung M, Samuelsson K, Peterson D, Ayeni OR. Anesth Analg. 2017;
Credibility and quality of meta-analyses addressing graft choice in anterior 78. Rice DB, Kloda LA, Shrier I, Thombs BD. Reporting completeness and
cruciate ligament reconstruction: a systematic review. Knee Surg Sports transparency of meta-analyses of depression screening tool accuracy: a
Traumatol Arthrosc. 2017;25(2):538–51. comparison of meta-analyses published before and after the PRISMA
56. Lee SY, Sagoo H, Whitehurst K, Wellstead G, Fowler AJ, Agha RA, et al. statement. J Psychosom Res. 2016;87:57–69.
Compliance of systematic reviews in plastic surgery with the PRISMA 79. Scott J, Howard B, Sinnett P, Schiesel M, Baker J, Henderson P, et al. Variable
Statement. JAMA Facial Plastic Surgery. 2016;18(2):101–5. methodological quality and use found in systematic reviews referenced in
57. Li JL, Ge L, Ma JC, Zeng QL, Yao L, An N, et al. Quality of reporting of STEMI clinical practice guidelines. Am J Emerg Med. 2017;14:14.
systematic reviews published in “evidence-based” Chinese journals. Syst Rev. 80. Shi C, Zhu L, Wang X, Qin C, Xu Q, Tian J. Epidemiology, methodological
2014;3:58. and reporting characteristics of systematic reviews of nursing interventions
58. Li X, Wang R, Shi X, Su J, Pan Y, Tian J, et al. Reporting characteristics and quality published in China. Int J Nurs Pract. 2014;20(6):689–700.
of systematic reviews of acupuncture analgesia. Pain Pract. 2017;13:13. 81. Tam WW, Lo KK, Khalechelvam P. Endorsement of PRISMA statement and
59. Liu D, Jin J, Tian J, Yang K. Quality assessment and factor analysis of systematic quality of systematic reviews and meta-analyses published in nursing
reviews and meta-analyses of endoscopic ultrasound diagnosis. PLoS One. journals: a cross-sectional study. BMJ Open. 2017;7(2):e013905.
2015;10(4):e0120911. 82. Tan WK, Wigley J, Shantikumar S. The reporting quality of systematic
60. Liu P, Qiu Y, Qian Y, Chen X, Wang Y, Cui J, et al. Quality of meta-analyses in reviews and meta-analyses in vascular surgery needs improvement: a
major leading gastroenterology and hepatology journals: a systematic systematic review. Int J Surg. 2014;12(12):1262–5.
review. J Gastroenterol Hepatol. 2017;32(1):39–44. 83. Tian J, Zhang J, Ge L, Yang K, Song F. The methodological and reporting
61. Liu X, Kinzler M, Yuan J, He G, Zhang L. Low reporting quality of the meta- quality of systematic reviews from China and the USA are similar. J Clin Epi
analyses in diagnostic pathology. Arch Pathol Lab Med. 2017;141(3):423–30. .2017;85:50-58.
62. Liu Y, Zhang R, Huang J, Zhao X, Liu D, Sun W, et al. Reporting quality of 84. Tunis AS, McInnes MD, Hanna R, Esmail K. Association of study quality with
systematic reviews/meta-analyses of acupuncture. PLoS One. 2014;9(11):e113172. completeness of reporting: have completeness of reporting and quality of
63. Luo J, Xu H, Yang G, Qiu Y, Liu J, Chen K. Oral Chinese proprietary medicine systematic reviews and meta-analyses in major radiology journals changed
for angina pectoris: an overview of systematic reviews/meta-analyses. since publication of the PRISMA statement?.[erratum appears in radiology.
Complement Ther Med. 2014;22(4):787–800. 2014 Jul;272(1):304]. Radiology. 2013;269(2):413–26.
64. Ma B, Guo J, Qi G, Li H, Peng J, Zhang Y, et al. Epidemiology, quality and 85. Wasiak J, Shen AY, Ware R, O'Donohoe TJ, Faggion CM, Jr. Methodological
reporting characteristics of systematic reviews of traditional Chinese medicine quality and reporting of systematic reviews in hand and wrist pathology. J
interventions published in Chinese journals. PLoS One. 2011;6(5):e20185. Hand Surg Eur Vol 2017:1753193417712660.
65. Ma B, Qi GQ, Lin XT, Wang T, Chen ZM, Yang KH. Epidemiology, quality, and 86. Wasiak J, Tyack Z, Ware R, Goodwin N, Faggion CM Jr. Poor methodological
reporting characteristics of systematic reviews of acupuncture interventions quality and reporting standards of systematic reviews in burn care
published in Chinese journals. J Altern Complement Med. 2012;18(9):813–7. management. Int Wound J. 2016;18:18.
66. Martins DE, Astur N, Kanas M, Ferretti M, Lenza M, Wajchenberg M. Quality 87. Weir CR, Staggers N, Laukert T. Reviewing the impact of computerized
assessment of systematic reviews for surgical treatment of low back pain: provider order entry on clinical outcomes: the quality of systematic reviews.
an overview. Spine J. 2016;16(5):667–75. Internation J Med Inform. 2012;81(4):219–31.
67. McGee RG, Craig JC, Rogerson TE, Webster AC. Systematic reviews of 88. Willis BH, Quigley M. The assessment of the quality of reporting of meta-
surgical procedures in children: quantity, coverage and quality. J Paediatr analyses in diagnostic research: a systematic review. BMC Med Res
Child Health. 2013;49(4):319–24. Methodol. 2011;11:163.
68. Nicolau I, Ling D, Tian L, Lienhardt C, Pai M. Methodological and reporting quality 89. Xiao Z, Zhang Y, Wang Y, Xu F. Quality assessment for systematic review/
of systematic reviews on tuberculosis. Int J Tuberc Lung Dis. 2013;17(9):1160–9. meta-analysis on antidepressant therapy published in Chinese journals. Int J
69. Nissen T, Wayant C, Wahlstrom A, Sinnett P, Fugate C, Herrington J, et Pharmacol. 2012;8(7):614–20.
al. Methodological quality, completeness of reporting and use of 90. Yang M, Jiang L, Wang A, Xu G. Epidemiology characteristics, reporting
systematic reviews as evidence in clinical practice guidelines for characteristics, and methodological quality of systematic reviews and meta-
paediatric overweight and obesity. Clin Obesity. 2017;7(1):34–45. analyses on traditional Chinese medicine nursing interventions published in
70. Padula RS, Pires RS, Alouche SR, Chiavegato LD, Lopes AD, Costa LO. Chinese journals. Int J Nurs Pract. 2017;23(1)
Analysis of reporting of systematic reviews in physical therapy 91. Yang SL, Ying K, Wang F, Wang L, Ren XY, Yang QF. Methodological and
published in Portuguese. Rev Bras Fisioter. 2012;16(4):381–8. reporting quality assessment for Chinese systematic reviews and meta
71. Panic N, Leoncini E, de Belvis G, Ricciardi W, Boccia S. Evaluation of the analysis in oral medicine. Shanghai Kou Qiang Yi Xue/Shanghai J Stomatol.
endorsement of the preferred reporting items for systematic reviews and 2015;24(4):505–10.
meta-analysis (PRISMA) statement on the quality of published systematic 92. Zhang H, Han J, Zhu YB, Lau WY, Schwartz ME, Xie GQ, et al. Reporting and
review and meta-analyses. PLoS One. 2013;8(12):e83138. methodological qualities of published surgical meta-analyses. J Clin
72. Passon AM, Drabik A, Sawicki PT. Quality scores do not predict Epidemiol. 2016;70:4–16.
discrepant statistical significances among meta-analyses on different 93. Zhang J, Wang J, Han L, Zhang F, Cao J, Ma Y. Epidemiology, quality,
targets of glycemic control in type 2 diabetes. J Clin Epidemiol. 2013; and reporting characteristics of systematic reviews and meta-analyses of
66(12):1356–66. nursing interventions published in Chinese journals. Nurs Outlook. 2015;
73. Pastorino R, Milovanovic S, Stojanovic J, Efremov L, Amore R, Boccia S. 63(4):446–55. e4
Quality assessment of studies published in open access and subscription 94. Zhu Y, Fan L, Zhang H, Wang M, Mei X, Hou J, et al. Is the best evidence
journals: results of a systematic evaluation. PLoS One. 2016;11(5):e0154217. good enough: quality assessment and factor analysis of meta-analyses on
74. Peters JP, Hooft L, Grolman W, Stegeman I. Reporting quality of systematic depression. PLoS One. 2016;11(6):e0157808.
reviews and meta-analyses of otorhinolaryngologic articles based on the 95. Atakpo P, Vassar M. Publication bias in dermatology systematic reviews and
PRISMA Statement. PLoS One. 2015;10(8):e0136540. meta-analyses. J Dermatol Sci. 2016;82(2):69–74.
75. Pidgeon TE, Wellstead G, Sagoo H, Jafree DJ, Fowler AJ, Agha RA. An 96. Hedin RJ, Umberham BA, Detweiler BN, Kollmorgen L, Vassar M. Publication
assessment of the compliance of systematic review articles published in bias and nonreporting found in majority of systematic reviews and meta-
craniofacial surgery with the PRISMA statement guidelines: a systematic analyses in anesthesiology journals. Anesth Analg. 2016;123(4):1018–25.
review. Journal of craniomaxillofacial. Surgery. 2016;44(10):1522–30. 97. Fleming PS, Koletsi D, Seehra J, Pandis N. Systematic reviews published in
76. Pinzon MC, Hayden DM, Ariel D, Bartosiak KA, Chiodo MV, Kosmidis K, et al. higher impact clinical journals were of higher quality. J Clin Epidemiol. 2014;
Are our publications failing the inspection?: a review of the publications in 67(7):754–9.
Page and Moher Systematic Reviews (2017) 6:263 Page 13 of 14

98. Saltaji H, Ospina MB, Armijo-Olivo S, Agarwal S, Cummings GG, Amin M, et 120. Tao KM, Li XQ, Zhou QH, Moher D, Ling CQ, WF Y. From QUOROM to
al. Evaluation of risk of bias assessment of trials in systematic reviews of oral PRISMA: a survey of high-impact medical journals’ instructions to authors
health interventions, 1991–2014: a methodology study. J Am Dent Assoc. and a review of systematic reviews in anesthesia literature. PLoS One. 2011;
2016;147(9):720–8. e1 6(11):e27611.
99. Toews LC. Compliance of systematic reviews in veterinary journals with 121. Toews I, Binder N, Wolff RF, Toprak G, von Elm E, Meerpohl JJ. Guidance in
Preferred Reporting Items for Systematic Reviews and Meta-Analysis author instructions of hematology and oncology journals: a cross sectional
(PRISMA) literature search reporting guidelines. J Med Lib Assoc. 2017; and longitudinal study. PLoS One. 2017;12(4):e0176489.
105(3):233–9. 122. Wayant C, Smith C, Sims M, Vassar M. Hematology journals do not
100. Tsou AY, Treadwell JR. Quality and clarity in systematic review abstracts: an sufficiently adhere to reporting guidelines: a systematic review. J Thromb
empirical study. Research Synthesis Methods. 2016;7(4):447–58. Haemost. 2017;15(4):608–17.
101. Bigna JJ, Um LN, Nansseu JR. A comparison of quality of abstracts of 123. Hirst A, Altman DG. Are peer reviewers encouraged to use reporting
systematic reviews including meta-analysis of randomized controlled trials guidelines? A survey of 116 health research journals. PLoS One. 2012;7(4):
in high-impact general medicine journals before and after the publication e35621.
of PRISMA extension for abstracts: a systematic review and meta-analysis. 124. Tsujimoto Y, Tsujimoto H, Kataoka Y, Kimachi M, Shimizu S, Ikenoue T, et al.
Syst Rev. 2016;5(1):174. Majority of systematic reviews published in high-impact journals neglected
102. Ge L, Tian JH, Li XX, Song F, Li L, Zhang J, et al. Epidemiology characteristics, to register the protocols: a meta-epidemiological study. J Clin Epidemiol.
methodological assessment and reporting of statistical analysis of network 2017;84:54–60.
meta-analyses in the field of cancer. Sci Rep. 2016;6:37208. 125. Fleming PS, Koletsi D, Pandis N. Blinded by PRISMA: are systematic
103. Kelly SE, Moher D, Clifford TJ. Quality of conduct and reporting in rapid reviewers focusing on PRISMA and ignoring other guidelines? PLoS One.
reviews: an exploration of compliance with PRISMA and AMSTAR guidelines. 2014;9(5):e96407.
Syst Rev. 2016;5:79. 126. van der Pol CB, McInnes MD, Petrcich W, Tunis AS, Hanna RI. Quality and
104. Farid-Kapadia M, Joachim KC, Balasingham C, Clyburne-Sherin A, Offringa M. completeness of reporting of systematic reviews and meta-analyses
Are child-centric aspects in newborn and child health systematic review published in high impact radiology journals associated with citation rates?
and meta-analysis protocols and reports adequately reported?—two PLoS One. 2015;10(3):e0119892.
systematic reviews. Syst Rev. 2017;6(1):31. 127. Burford BJ, Welch V, Waters E, Tugwell P, Moher D, O'Neill J, et al. Testing
105. Turner L, Galipeau J, Garritty C, Manheimer E, Wieland LS, Yazdi F, et al. An the PRISMA-Equity 2012 reporting guideline: the perspectives of systematic
evaluation of epidemiological and reporting characteristics of review authors. PLoS One. 2013;8(10):e75122.
complementary and alternative medicine (CAM) systematic reviews (SRs). 128. Lee AW. Use of network meta-analysis in systematic reviews: a survey of
PLoS One 2013;8(1):e53536. authors. Syst Rev. 2016;5:8.
106. Gianola S, Gasparini M, Agostini M, Castellini G, Corbetta D, Gozzer P, et al. 129. Rader T, Mann M, Stansfield C, Cooper C, Sampson M. Methods for
Survey of the reporting characteristics of systematic reviews in documenting systematic review searches: a discussion of common issues.
rehabilitation. Phys Ther. 2013;93(11):1456–66. Research Synthesis Methods. 2014;5(2):98–115.
107. Kiriakou J, Pandis N, Fleming PS, Madianos P, Polychronopoulou A. 130. Shi X, Wang X, Liu Y, Li X, Wei D, Zhao X, et al. A survey of evidence users
Reporting quality of systematic review abstracts in leading oral about the information need of acupuncture clinical evidence. BMC
implantology journals. J Dent. 2013;41(12):1181–7. Complement Altern Med. 2016;16(1):455.
108. Seehra J, Fleming PS, Polychronopoulou A, Pandis N. Reporting 131. Pussegoda K, Turner L, Garritty C, Mayhew A, Skidmore B, Stevens A, et al.
completeness of abstracts of systematic reviews published in leading dental Identifying approaches for assessing methodological and reporting quality
specialty journals. Eur J Oral Sci. 2013;121(2):57–62. of systematic reviews: a descriptive study. Syst Rev. 2017;6(1):117.
109. Simmonds M, Stewart G, Stewart L. A decade of individual participant 132. Churchill R, Lasserson T, Chandler J, Tovey D, Higgins JPT. Standards for the
data meta-analyses: a review of current practice. Contemp Clin Trials. reporting of new Cochrane Intervention Reviews. In: Higgins JPT, Lasserson
2015;45(Pt A):76–83. T, Chandler J, Tovey D, Churchill R, editors. Methodological Expectations of
110. Glujovsky D, Boggino C, Riestra B, Coscia A, Sueldo CE, Ciapponi A. Quality Cochrane Intervention Reviews. London: Cochrane; 2016.
of reporting in infertility journals. Fertil Steril. 2015;103(1):236–41. 133. Chandler J, Lasserson T, Higgins JPT, Tovey D, Churchill R. Standards for the
111. Glujovsky D, Villanueva E, Reveiz L, Murasaki R. Adherence to research planning, conduct and reporting of updates of Cochrane Intervention
reporting guidelines in biomedical journals in Latin America and the Reviews. In: Higgins JPT, Lasserson T, Chandler J, Tovey D, Churchill R,
Caribbean. Pan Am J Public Health. 2014;36(4):232–7. editors. Methodological Expectations of Cochrane Irntervention Reviews.
112. Hua F, Walsh T, Glenny AM, Worthington H. Surveys on reporting guideline London: Cochrane; 2016.
usage in dental journals. J Dent Res. 2016;95(11):1207–13. 134. APA Publications and Communications Board Working Group on
113. Knuppel H, Metz C, Meerpohl JJ, Strech D. How psychiatry journals support Journal Article Reporting Standards. Reporting standards for research
the unbiased translation of clinical research. A cross-sectional study of in psychology: why do we need them? What might they be? Am
editorial policies. PLoS One. 2013;8(10):e75995. Psychol. 2008;63(9):839–51.
114. Koch M, Riss P, Umek W, Hanzal E. The explicit mentioning of reporting 135. Tong A, Flemming K, McInnes E, Oliver S, Craig J. Enhancing transparency in
guidelines in urogynecology journals in 2013: a bibliometric study. reporting the synthesis of qualitative research: ENTREQ. BMC Med Res
Neurourol Urodyn. 2016;35(3):412–6. Methodol. 2012;12:181.
115. Mannocci A, Saulle R, Colamesta V, D'Aguanno S, Giraldi G, Maffongelli E, et 136. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES
al. What is the impact of reporting guidelines on public health journals in publication standards: realist syntheses. BMC Med. 2013;11:21.
Europe? The case of STROBE, CONSORT and PRISMA. J Public Health. 2015; 137. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES
37(4):737–40. publication standards: meta-narrative reviews. BMC Med. 2013;11:20.
116. Meerpohl JJ, Wolff RF, Antes G, von Elm E. Are pediatric open access 138. Hoffmann TC, Oxman AD, Ioannidis JP, Moher D, Lasserson TJ, Tovey DI, et
journals promoting good publication practice? An analysis of author al. Enhancing the usability of systematic reviews by improving the
instructions. BMC Pediatr. 2011;11:27. consideration and description of interventions. BMJ. 2017;358:j2998.
117. Reveiz L, Villanueva E, Iko C, Simera I. Compliance with clinical trial 139. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated
registration and reporting guidelines by Latin American and Caribbean guidelines for reporting parallel group randomised trials. BMJ. 2010;
journals. Cad Saude Publica. 2013;29(6):1095–100. 340:c332.
118. Sims MT, Henning NM, Wayant CC, Vassar M. Do emergency medicine 140. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke
journals promote trial registration and adherence to reporting guidelines? A JP. Strengthening the Reporting of Observational studies in Epidemiology
survey of “instructions for authors”. Scand J Trauma Resusc Emerg Med. (STROBE) statement: guidelines for reporting observational studies. BMJ.
2016;24(1):137. 2007;335(7624):806–8.
119. Smith TA, Kulatilake P, Brown LJ, Wigley J, Hameed W, Shantikumar S. Do 141. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al.
surgery journals insist on reporting by CONSORT and PRISMA? A follow-up The STARD statement for reporting studies of diagnostic accuracy:
survey of ‘instructions to authors’. Ann Med Surg. 2015;4(1):17–21. explanation and elaboration. Ann Intern Med. 2003;138(1):W1–12.
Page and Moher Systematic Reviews (2017) 6:263 Page 14 of 14

142. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al.
STARD 2015: an updated list of essential items for reporting diagnostic
accuracy studies. BMJ. 2015;351:h5527.
143. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving
bioscience research reporting: the ARRIVE guidelines for reporting animal
research. PLoS Biol. 2010;8(6):e1000412.
144. Hopewell S, Boutron I, Altman DG, Barbour G, Moher D, Montori V, et al.
Impact of a web-based tool (WebCONSORT) to improve the reporting of
randomised trials: results of a randomised controlled trial. BMC Med 2016;
14(1):199.
145. Barnes C, Boutron I, Giraudeau B, Porcher R, Altman DG, Ravaud P.
Impact of an online writing aid tool for writing a randomized trial
report: the COBWEB (Consort-based WEB tool) randomized controlled
trial. BMC Med. 2015;13:221.
146. Thomson HJ, Thomas S. The effect direction plot: visual display of non-
standardised effects across multiple outcome domains. Research Synthesis
Methods. 2013;4(1):95–101.
147. Harrison S, Jones HE, Martin RM, Lewis SJ, Higgins JPT. The albatross plot: a
novel graphical tool for presenting results of diversely reported studies in a
systematic review. Research Synthesis Methods. 2017;8(3):281-289.
148. Glasziou PP, Chalmers I, Green S, Michie S. Intervention synthesis: a missing
link between a systematic review and practical treatment(s). PLoS Med.
2014;11(8):e1001690.
149. Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta-
analyses. BMJ. 2011;342:d549.
150. IntHout J, Ioannidis JP, Rovers MM, Goeman JJ. Plea for routinely presenting
prediction intervals in meta-analysis. BMJ Open. 2016;6(7):e010247.
151. Li T, Vedula SS, Hadar N, Parkin C, Lau J, Dickersin K. Innovations in data
collection, management, and archiving for systematic reviews. Ann Intern
Med. 2015;162(4):287–94.
152. Lakens D, Hilgard J, Staaks J. On the reproducibility of meta-analyses: six
practical recommendations. BMC Psycholol. 2016;4(1):24.
153. Garner P, Hopewell S, Chandler J, MacLehose H, Schunemann HJ, Akl EA, et
al. When and how to update systematic reviews: consensus and checklist.
BMJ. 2016;354:i3507.
154. Elliott JH, Turner T, Clavisi O, Thomas J, Higgins JP, Mavergames C, et al.
Living systematic reviews: an emerging opportunity to narrow the
evidence-practice gap. PLoS Med. 2014;11(2):e1001603.
155. Kapadia MZ, Askie L, Hartling L, Contopoulos-Ioannidis D, Bhutta ZA, Soll R,
et al. PRISMA-Children (C) and PRISMA-Protocol for Children (P-C)
extensions: a study protocol for the development of guidelines for the
conduct and reporting of systematic reviews and meta-analyses of
newborn and child health research. BMJ Open. 2016;6(4):e010270.
156. McInnes M, Moher D, Bossuyt P. PRISMA-DTA: checklist for reporting of
diagnostic test accuracy systematic reviews (registered 18 November 2015)
http://www.equator-network.org/library/reporting-guidelines-under-
development/#52 [Accessed 16 Aug 2017].
157. Stevens A. PRISMA-RR 2017: an extension to PRISMA for rapid reviews
(registered 4 November 2015) http://www.equator-network.org/library/
reporting-guidelines-under-development/#51 [Accessed 16 Aug 2018].
158. Tricco AC, Straus S, Moher D. Preferred Reporting Items for Systematic
Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR)
(registered 18 December 2015) http://www.equator-network.org/library/
reporting-guidelines-under-development/#55 [Accessed 16 Aug 2017].
159. Rethlefsen M, Koffel J, Kirtley S. PRISMA-Search: guidelines for reporting
systematic review literature searches (registered 17 February 2016) http://
www.equator-network.org/library/reporting-guidelines-under-development/
#57 [Accessed 16 Aug 2017]. Submit your next manuscript to BioMed Central
160. Bian Z. Preferred Reporting Items for Systematic Review and Meta-Analyses
of traditional Chinese medicine: the PRISMA-TCM Statement (registered 18 and we will help you at every step:
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