In this editorial space of the previous issue of the Journal, I offered some thoughts relative to the history of and the need for a higher level of research synthesis to advance nursing science (
Swartz, 2010
). The need for more sophisticated and uniform standards regarding the development of integrated literature or systematic reviews was particularly noted.Systematic reviews in the literature have become more important as a means of keeping clinicians up to date on advances in the field and as a method of developing clinical practice guidelines. Systematic reviews are also important in identifying research questions and in justifying to granting agencies that further research in a specific area is needed.
In response to the need to elevate the quality of systematic reviews in numerous disciplines, in 1996 an international group released the Quality of Reporting of Meta-Analyses (QUORUM) Statement, a set of guidelines that provided standards for reporting meta-analyses of randomized controlled trials (
Moher et al., 1999
). This set of guidelines recently has been revised to include additional standards for systematic reviews as well as meta-analyses and has been renamed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The updated PRISMA statement is based on the conceptual and practical advances that have been made in the science of systematic reviews. PRISMA also has adopted the definition used by the Cochrane Collaboration: “a systematic review is a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research and to collect and analyze data from the studies that are included in the review” (Moher et al., 2009
, p. 264).The complete PRISMA statement consists of a 27-item checklist, along with a flow diagram, which can be found at www.prisma-statement.org. This Web site also contains links to an accompanying explanatory document that provides examples from published works that address each of the items on the list. Although the checklist is not intended to be a quality assessment instrument, it is a valuable template for authors to utilize when reporting systematic reviews, particularly evaluations of interventions (
Moher et al., 2009
). Specifically, the checklist provides guidelines for:- •writing a substantive abstract (which is important for increasing the likelihood that reported research may be included in a subsequent systematic review);
- •stating the explicit question that a review addresses using the PICO reporting system (which describes the participants, interventions, comparisons and outcomes);
- •noting the quality of reported studies;
- •describing any assessments of risk of bias in the included studies; and
- •providing information on sources of funding for the systematic review.
The overall goal of the PRISMA statement is to improve the transparency and the scientific merit of a reported systematic review or meta-analysis. Many journals have endorsed the statement and reference it in their guidelines for authors. For nursing, attention to these guidelines by researchers, clinicians, authors, and reviewers will serve to elevate the level of nursing science and also will improve nursing practice by enhancing the quality of the evidence.
References
- Improving the quality of reports of meta-analyses of randomised controlled trials: The QUOROM statement.Lancet. 1999; 354: 1896-1900
- Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement.Annals of Internal Medicine. 2009; 151: 264-269
- A look back at research synthesis.Journal of Pediatric Health Care. 2010; 24: 355
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© 2011 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
