History & Development of PRISMA
Systematic reviews and meta-analyses have become increasingly important in health
care. Clinicians read them to keep up to date with their field [1,2], and they are often used as a starting point for
developing clinical practice guidelines. Granting agencies may require a systematic
review to ensure there is justification for further research , and some health care journals are moving in this direction
. As with all research,
the value of a systematic review depends on what was done, what was found, and the
clarity of reporting. As with other publications, the reporting quality of systematic
reviews varies, limiting readers’ ability to assess the strengths and weaknesses
of those reviews.
Several early studies evaluated the quality of review reports. In 1987, Mulrow examined
50 review articles published in four leading medical journals in 1985 and 1986 and
found that none met all eight explicit scientific criteria, such as a quality assessment
of included studies .
In 1987, Sacks and colleagues 
evaluated the adequacy of reporting of 83 meta-analyses on 23 characteristics in
six domains. Reporting was generally poor; between one and 14 characteristics were
adequately reported (mean = 7.7; standard deviation = 2.7). A 1996 update of this
study found little improvement .
In 1999, to address the suboptimal reporting of meta-analyses, an international
group developed a guidance called the QUOROM Statement (QUality Of Reporting Of
Meta-analyses), which focused on the reporting of meta-analyses of randomized controlled
In 2009, the guideline was updated to address several conceptual and practical advances
in the science of systematic reviews, and was renamed PRISMA (Preferred Reporting
Items of Systematic reviews and Meta-Analyses).
- Oxman AD, Cook DJ, Guyatt GH (1994) Users’ guides to the medical literature. VI.
How to use an overview. Evidence-Based Medicine Working Group. JAMA 272: 1367-1371.
- Swingler GH, Volmink J, Ioannidis JP (2003) Number of published systematic reviews
and global burden of disease: Database analysis. BMJ 327: 1083-1084.
- Canadian Institutes of Health Research (2006) Randomized controlled trials registration/application
checklist (12/2006). Available: http://www.cihr-irsc.gc.ca/e/documents/rct_reg_e.pdf.
Accessed 19 May 2009
- Young C, Horton R (2005) Putting clinical trials into context. Lancet 366: 107.
- Mulrow CD (1987) The medical review article: State of the science. Ann Intern Med
- Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers TC (1987) Meta-analysis
of randomized controlled trials. New Engl J Med 316: 450-455.
- Sacks HS, Reitman D, Pagano D, Kupelnick B (1996) Meta-analysis: An update. Mt Sinai
J Med 63: 216-224.
- Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, et al. for the QUOROM group (1999)
Improving the quality of reporting of meta-analysis of randomized controlled trials:
The QUOROM statement. Lancet 354: 1896-1900.