Were the systematic review and meta-analysis performed according to an explicitly defined protocol? |
Were the research questions well formulated, and would their answers be clinically useful? |
Did the authors clearly define the eligibility criteria for studies to be included? Eligibility criteria should clearly define all of the following: - Study design (eg, randomized controlled trial versus observational study)
- Population of interest
- Treatment(s) and comparison(s) of interest
- Outcome(s) of interest
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Were the eligibility criteria appropriate to capture all relevant studies? - Were the population, treatment(s), comparison(s), and outcome(s) relevant to clinical practice?
- Were the study designs of included studies appropriate for addressing the key questions?
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Was the search for relevant studies comprehensive/exhaustive? - Was the search strategy reported in sufficient detail that it could be reproduced?
- Were all important concepts included in the search strategy?
- Were the selection and assessment of studies reproducible (ie, done independently by 2 or more separate reviewers)?
- Were adequate explanations given for exclusion of studies?
- Were important sources of unpublished data (ie, "grey" literature) included?
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Were the characteristics of the individual studies listed with sufficient detail to allow an assessment of the appropriateness of their inclusion? |
Were the individual studies assessed for their methodologic quality (ie, risk of bias assessment)? |
Was publication bias considered? |
Were the statistical methods for combining results (meta-analysis) described? |
Was the reporting of results clear? - Were the pooled effect estimates presented with corresponding confidence intervals (rather than p values)?
- Were primary results for each individual study also included?
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Was between-study heterogeneity assessed? - Did the review attempt to explain between-study heterogeneity (eg, by performing subgroup, meta-regression, or sensitivity analyses)?
- If subgroup or meta-regression analyses were performed, were the factors selected appropriate, specified a priori, and limited to only a few?
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Did the authors clearly explain their conclusions, and did they address the overall certainty of effect estimates? - Did they rate the certainty (or quality) of evidence for each outcome (eg, in a summary of findings table)?
- Was the methodologic quality (risk of bias) of the individual studies considered in formulating the overall certainty ratings?
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Were limitations of the meta-analysis discussed? |