Systematic Reviews: Checklists for review articles

Preparing a review entails many judgments.The focus ofthe review must be decided.Studies that are relevant to the focus ofthe review must be identified, selected for inclusion and critically appraised.Infor- mation must be collected and synthesised from the relevant studies, and conclusions must be drawn.Checklists can help prevent important errors in this process.Reviewers, editors, content experts, and users of reviews all have a role to play in improving the quality of published reviews and promoting the appropriate use of reviews by decisionmakers.It is essential that both providers and users appraise the validity ofreview articles. Why checklists?When we think about flying, it is obvious why a checklist is used before take off.Airplanes are complex machines.Things can go wrong with them, and it is preferable that problems are discovered on the ground.However brilliant a pilot and crew might be, most of us would prefer that they use a checklist when preparing for take off, rather than relying on memory.The need for checklists for review articles is less obvious, but the rationale is much the same.Preparing a review is a complex process entailing many judgments.The focus of the review must be decided.Studies that are relevant to the focus of the review must be identified, selected for inclusion, and critically appraised.Information must be collected and synthesised from the relevant studies, and conclusions must be drawn.Many decisions must be made throughout this process.It is important to go through this process systematically to avoid errors.Explicitness about how decisions were made enables others to assess how well the process protected against errors.Checklists can help those doing and using reviews to avoid important errors.Problem formulation * Is the question clearly focused?Study identification * Is the search for relevant studies thorough?Study selection * Are the inclusion criteria appropriate?Appraisal of studies * Is the validity of included studies adequately assessed?Data collection * Is missing information obtained from investigators?Data synthesis * How sensitive are the results to changes in the way the review is done?Interpretation ofresults * Do the conclusions flow from the evidence that is reviewed?* Are recommendations linked to the strength of the evidence?* Are judgments about preferences.(values) explicit?* If there is "no evidence of effect" is caution taken not to interpret this as "evidence ofno effect"?* Are subgroup analyses interpreted cautiously?