History and 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
[3], and some health care journals are moving in this direction [4]. 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 [5]. In 1987, Sacks and colleagues [6] 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 [7].

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 trials [8].

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). The PRISMA statement was published in
multiple journals [9,10,11,12,13,14,15] and accompanied by an
Explanation and Elaboration paper [16,17,18,19,20].

To ensure its currency and relevance, in 2017 an international group

set out to update the PRISMA 2009 statement by incorporating
advances in systematic review methodology and terminology
occurring in the last decade. The PRISMA 2020 statement was posted
as a preprint on MetaArXiv in September 2020 [21] and published in
March 2021 [22,23,24,25,26]. A detailed description of the methods
used to update the PRISMA statement is available in Page et al. [27].
References

1. 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.
2. Swingler GH, Volmink J, Ioannidis JP (2003) Number of
published systematic reviews and global burden of disease:
Database analysis. BMJ 327: 1083-1084.
3. Canadian Institutes of Health Research (2006) Randomized
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19 May 2009
4. Young C, Horton R (2005) Putting clinical trials into context.
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5. Mulrow CD (1987) The medical review article: State of the
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6. Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers
TC (1987) Meta-analysis of randomized controlled trials. New
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7. Sacks HS, Reitman D, Pagano D, Kupelnick B (1996) Meta-
analysis: An update. Mt Sinai J Med 63: 216-224.
8. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, et al. for the
QUOROM group (1999) Improving the quality of reporting of
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statement. Lancet 354: 1896-1900
9. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group.
Preferred reporting items for systematic reviews and meta-
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21. Page MJ, McKenzie JE, Bossuyt PM, Boutron I,
Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement:
an updated guideline for reporting systematic reviews.
MetaArXiv, 14 Sept 2020. doi: 10.31222/osf.io/v7gm2
22. Page MJ, McKenzie JE, Bossuyt PM, Boutron I,
Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement:
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23. Page MJ, McKenzie JE, Bossuyt PM, Boutron I,
Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement:
an updated guideline for reporting systematic reviews. PLOS
Medicine 2021;18(3):e1003583. doi:
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24. Page MJ, McKenzie JE, Bossuyt PM, Boutron I,
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