Strengthening systematic reviews in public health: guidance in the Cochrane Handbook for Systematic Reviews of Interventions , 2nd edition
Open accessAbstract
Aims: Decision makers in public health practice and policy rely on access to trustworthy, relevant, synthesized evidence. The second edition of the Cochrane Handbook for Systematic Reviews of Interventions (‘the Handbook’) reflects a major revision in guidance for authors of systematic reviews, incorporating a decade of methodological development and a number of significant changes to previous recommendations. This paper aims to highlight new guidance that addresses a number of key methodological challenges for authors of systematic reviews in public health. Results: The revised Handbook includes guidance on framing public health research questions for synthesis, considering equity, intervention complexity, risk of bias assessment and synthesis methods other than meta-analysis. Reviews of public health interventions frequently encounter the types of methodological complexity addressed in this new guidance. Conclusion: We hope that readers will find that the Cochrane Handbook includes detailed and thoughtful guidance on both conceptualizing and executing systematic reviews relevant to public health questions. Considering the available methods guidance will, we hope, provide support for authors of public health reviews to tackle the challenges they encounter, strengthen their analysis and provide useful answers to the important questions asked by stakeholders and users of public health evidence.
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Written from the paper’s full text.
TL;DR
This paper is a narrative overview of new and revised methodological guidance in the second edition of the Cochrane Handbook for Systematic Reviews of Interventions, aimed at authors of public health systematic reviews. It highlights Handbook guidance on framing review questions, equity, intervention complexity, risk of bias across diverse study designs, and synthesis methods other than meta-analysis.
Key findings
- The second edition of the Handbook represents a major revision incorporating a decade of methodological development, with new standalone guidance on equity (Chapter 16) and, for the first time, alternative statistical synthesis methods (Chapter 12).
- Reviews of public health interventions frequently encounter the methodological complexity addressed by this guidance, including interventions that vary in theoretical approach, components and implementation, and populations that differ in important ways.
- Around a third to half of all systematic reviews do not use meta-analysis at all, and more do not use meta-analysis for all outcomes (citing refs 23–24).
- Alternative synthesis methods presented in Chapter 12 include summary statistics describing the range of effect estimates, vote counting based on direction of effect, and combining P values, with companion visual displays such as box plots, harvest plots and albatross plots; these yield results "more limited for decision making in comparison to meta-analysis."
Methods
- Design: a narrative guidance/commentary paper highlighting selected areas of updated Cochrane guidance of particular relevance to public health reviews; it is not itself a systematic review.
- Data: no new data were generated or analysed (per the paper's data availability statement); illustrative examples are drawn from existing reviews (e.g. a school-based physical activity review and a rotavirus vaccine review).
- Content covers Handbook chapters on scope and eligibility (Chapters 2–3), equity (Chapter 16), intervention complexity (Chapter 17), bias (Chapters 7, 13), risk-of-bias tools RoB 2 (Chapter 8) and ROBINS-I (Chapter 25), and alternative synthesis (Chapter 12), plus PRISMA 2020 and SWiM reporting guidelines.
Limitations
- The paper states no formal limitations section; it is explicitly a selective highlight of "some areas" of updated guidance rather than a comprehensive account.
- Evident from the text: as a narrative overview without new data or empirical evaluation, it does not assess the uptake, impact or effectiveness of the guidance it describes, and its recommendations rest on the Handbook's methodological development rather than on primary research conducted here.
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Claims the paper makes
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- Classified as probably not a substantial claim. 21
- May combine two claims. 11
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
InterpretationreasoningReviews of public health interventions frequently encounter the types of methodological complexity addressed in this new guidance.
“Reviews of public health interventions frequently encounter the types of methodological complexity addressed in this new guidance.”
Quote in the paperNot a substantial claim- Rests on an assumption: It is common for reviews in public health to consider interventions that vary in theoretical approach, components and implementation among the included studies.
- Rests on an assumption: It is well known that public health interventions are often comprised of multiple components (what may be considered ‘complicated’ interventions).
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisenone givenAdditional complexity in interventions may also arise from interactions, between components, between interventions and participants, or with the context in which the intervention occurs.
“Additional complexity in interventions may also arise from interactions, between components, between interventions and participants, or with the context in which the intervention occurs.”
Quote in the paperNot a substantial claim- Rests on an assumption: It is well known that public health interventions are often comprised of multiple components (what may be considered ‘complicated’ interventions).
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAddressed for the first time in a standalone chapter, Chapter 16 of the Handbook presents strategies to consider and incorporate equity throughout the systematic review process.
“Addressed for the first time in a standalone chapter, Chapter 16 of the Handbook presents strategies to consider and incorporate equity throughout the systematic review process.13”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] Welch
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InterpretationcitationRecent examples of collaboration during the COVID-19 crisis, such as that between Cochrane, WHO and other policy agencies, highlight the potential impact of well-conducted systematic reviews that meet the needs of policy partners.
“Recent examples of collaboration during the COVID-19 crisis, such as that between Cochrane, WHO and other policy agencies, highlight the potential impact of well-conducted systematic reviews that meet the needs of policy partners.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Cochrane, 2021
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationChapter 7 of the updated Handbook outlines the theoretical underpinnings of bias, using evidence-based methods to identify risk factors associated with bias in results and discussing the role of conflict of interest.
“Chapter 7 of the updated Handbook outlines the theoretical underpinnings of bias, using evidence-based methods to identify risk factors associated with bias in results and discussing the role of conflict of interest.17”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Boutron, 2019
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Classified as probably not a substantial claim. May combine two claims.
PremisecitationThe revised Handbook includes guidance on framing public health research questions for synthesis, considering equity, intervention complexity, risk of bias assessment and synthesis methods other than meta-analysis.
“The revised Handbook includes guidance on framing public health research questions for synthesis, considering equity, intervention complexity, risk of bias assessment and synthesis methods other than meta-analysis.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Higgins, 2019 source
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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
PremisecitationLogic models and conceptual frameworks may help to think through the important concepts within the review.
“Logic models and conceptual frameworks may help to think through the important concepts within the review.7”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] Thomas, 2019
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Classified as probably not a substantial claim. May combine two claims.
PremisecitationThe second edition of the Cochrane Handbook represents a major revision of methodological guidance for authors of systematic reviews, reflecting a decade of methodological development and including a number of significant changes to previous recommendations.
“The second edition of the Cochrane Handbook for Systematic Reviews of Interventions (‘the Handbook’) reflects a major revision in guidance for authors of systematic reviews, incorporating a decade of methodological development and a number of significant changes to previous recommendations.”
- Also stated in: § Introduction · plain
“Updated at the end of 2019, the second edition of the Handbook6 represents a major revision of methodological guidance for authors of systematic reviews, reflecting a decade of methodological development and including a number of significant changes to previous recommendations.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Higgins, 2019 source
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- Also stated in: § Introduction · plain
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenAlthough not every variation can be predicted in advance, the fact that variation will be found is predictable.
“Although not every variation can be predicted in advance, the fact that variation will be found is predictable.”
Quote in the paperNot a substantial claim- Rests on an assumption: It is common for reviews in public health to consider interventions that vary in theoretical approach, components and implementation among the included studies.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationUndertaking a review with a systems perspective takes the consideration of complexity even further, considering an intervention as an event within a broader, adaptive system.
“Undertaking a review with a systems perspective takes the consideration of complexity even further, considering an intervention as an event within a broader, adaptive system.15”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [15] Thomas, 2019
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PremisecitationSystematic reviews are widely published on public health topics and routinely incorporated into guidelines.
“Systematic reviews are widely published on public health topics and routinely incorporated into guidelines.1–3”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [1] World Health Organization, 2018
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- cites [2] NICE, 2020
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- cites [3] National Health and Medical Research Council, 2021
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PremisecitationThe Cochrane Handbook incorporates practical guidance on conducting a systematic review from idea to publication and has been internationally recognized as a gold standard resource since its first print publication in 2008.
“The Cochrane Handbook for Systematic Reviews of Interventions (‘the Handbook’) incorporates practical guidance on conducting a systematic review from idea to publication and has been internationally recognized as a gold standard resource since its first print publication in 2008.5”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] Higgins, 2008 source
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PremisecitationChapter 25 details the Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I), which is designed to be applied to a wide range of study designs, including follow-up (cohort) studies, and controlled or uncontrolled before-after studies (including interrupted time series).
“Chapter 25 details the Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I), which is designed to be applied to a wide range of study designs, including follow-up (cohort) studies, and controlled or uncontrolled before–after studies (including interrupted time series).20”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] Sterne, 2019
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PremisecitationGuidance in the updated Handbook suggests that authors specify how population or intervention groups will be used in specific syntheses or comparisons within the review, in enough detail that the selection of studies for inclusion in a group or synthesis could be replicated.
“Guidance in the updated Handbook suggests that authors then specify how these groups will be used in specific syntheses or comparisons within the review, in enough detail that the selection of studies for inclusion in a group or synthesis could be replicated.8”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] McKenzie, 2019
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationFor the first time, Chapter 12 of the Handbook presents a number of alternative statistical synthesis methods for this scenario, including the use of summary statistics to describe the observed range of intervention effect estimates, vote counting based on the direction of effect, or combining P values.
“For the first time, Chapter 12 of the Handbook presents a number of alternative statistical synthesis methods for this scenario, including the use of summary statistics to describe the observed range of intervention effect estimates, vote counting based on the direction of effect, or combining P values.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] McKenzie, 2019
Not checked in the free run.
- Rests on an assumption: Reasons why meta-analysis may not be possible are varied, but one reason may be when the included primary studies do not provide the necessary data required for a meta-analysis.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCompanion visual displays for these synthesis methods are also described in the Handbook, including box plots, harvest plots and albatross plots.
“Companion visual displays for these synthesis methods are also described, including box plots, harvest plots and albatross plots.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] McKenzie, 2019
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PremisecitationBoth tools provide structured signalling questions to assist authors in thinking through each aspect to be considered as part of the assessment process.
“Both tools provide structured signalling questions to assist authors in thinking through each aspect to be considered as part of the assessment process.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [19] Higgins, 2019 source
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- cites [20] Sterne, 2019
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PremisecitationChapter 17 of the Handbook outlines in further detail how authors of systematic reviews can think through what kinds of complexity might apply to their review at the planning stages, and how they might address it in the most useful way.
“Chapter 17 of the Handbook outlines in further detail how authors of systematic reviews can think through what kinds of complexity might apply to their review at the planning stages, and how they might address it in the most useful way.15”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [15] Thomas, 2019
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PremisecitationChapters 2 and 3 of the Handbook provide practical guidance on a structured approach for thinking through the scope and eligibility for the review as well as possible groupings of population, intervention, outcomes and study designs.
“Chapters 2 and 3 of the Handbook provide practical guidance on a structured approach for thinking through the scope and eligibility for the review as well as possible groupings of population, intervention, outcomes and study designs.7,8”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [7] Thomas, 2019
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- cites [8] McKenzie, 2019
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationChapter 8 details version 2 of the Cochrane Risk of Bias tool for randomized trials (RoB 2), which incorporates considerably updated thinking about factors important to bias, including updated guidance on cluster randomized trials, such as those where schools, families or communities are randomized to receive different interventions.
“Chapter 8 details version 2 of the Cochrane Risk of Bias tool for randomized trials (RoB 2), which incorporates considerably updated thinking about factors important to bias, including updated guidance on cluster randomized trials, such as those where schools, families or communities are randomized to receive different interventions.19”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Higgins, 2019 source
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PremisecitationChapter 13 presents guidance on the risks of bias due to missing results (such as unpublished studies or unreported outcomes).
“Chapter 13 presents guidance on the risks of bias due to missing results (such as unpublished studies or unreported outcomes).18”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Page, 2019
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May combine two claims.
PremisecitationAround a third to half of all systematic reviews do not use meta-analysis at all, and more do not use meta-analysis for all outcomes.
“Around a third to half of all systematic reviews do not use meta-analysis at all,23,24 and more do not use meta-analysis for all outcomes.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [23] Campbell, 2019, Lack of transparency in reporting narrative synthesis of quantitative data: a methodological assessment of systematic reviews, J Clin Epidemiol source
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- cites [24] Page, 2016, Epidemiology and reporting characteristics of systematic reviews of biomedical research: a cross-sectional study, PLoS Med source
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The paper relies on this without support.
It is common for reviews in public health to consider interventions that vary in theoretical approach, components and implementation among the included studies.
“It is common for reviews in public health to consider interventions that vary in theoretical approach, components and implementation among the included studies.”
The paper relies on this without support.
Planning for complexity can minimize bias arising from post hoc selection while improving clarity for readers.
“Planning for complexity can minimize bias arising from post hoc selection while improving clarity for readers.”
The paper relies on this without support.
Presenting a clear definition of each group and a rationale for the groups chosen enables transparency and replicability of the decisions to group studies in particular ways and enhances understanding for readers and end users of the review’s findings.
“Presenting a clear definition of each group and a rationale for the groups chosen enables transparency and replicability of the decisions to group studies in particular ways and enhances understanding for readers and end users of the review’s findings.”
The paper relies on this without support.
Considering equity explicitly in systematic reviews from question formulation to interpretation adds value to the review’s findings, enabling end users to understand whether and how the findings of the review apply to different populations and settings, and ensuring that high-level, aggregated results do not obscure important differences in effects.
“Considering equity explicitly in systematic reviews from question formulation to interpretation adds value to the review’s findings, enabling end users to understand whether and how the findings of the review apply to different populations and settings, and ensuring that high-level, aggregated results do not obscure important differences in effects.”
The paper relies on this without support.
It is well known that public health interventions are often comprised of multiple components (what may be considered ‘complicated’ interventions).
“It is well known that public health interventions are often comprised of multiple components (what may be considered ‘complicated’ interventions).”
The paper relies on this without support.
Exhaustively listing intervention components may complicate analysis without adding meaningful understanding to the review’s findings.
“Exhaustively listing intervention components may complicate analysis without adding meaningful understanding to the review’s findings.”
The paper relies on this without support.
It may be that the most useful review would not aim to estimate a universal effect, but to explore why and how an intervention may have been successful in specific cases.
“It may be that the most useful review would not aim to estimate a universal effect, but to explore why and how an intervention may have been successful in specific cases.”
The paper relies on this without support.
Although many systematic reviews of public health interventions include randomized trials, there are others that cannot, where randomized trials may be unethical, infeasible, unaffordable or simply do not exist.
“Although many systematic reviews of public health interventions include randomized trials, there are others that cannot, where randomized trials may be unethical, infeasible, unaffordable or simply do not exist.”
The paper relies on this without support.
Reasons why meta-analysis may not be possible are varied, but one reason may be when the included primary studies do not provide the necessary data required for a meta-analysis.
“Reasons why meta-analysis may not be possible are varied, but one reason may be when the included primary studies do not provide the necessary data required for a meta-analysis.”
The paper relies on this without support.
In some cases, synthesis may be inappropriate, for example where the included studies are at a high risk of bias or there are concerns about missing evidence.
“In some cases, synthesis may be inappropriate, for example where the included studies are at a high risk of bias or there are concerns about missing evidence.”
The paper relies on this without support.
Although these alternative synthesis methods yield results that are more limited for decision making in comparison to meta-analysis, they provide additional options for review authors when the required data for meta-analysis are not available.
“Although these alternative synthesis methods yield results that are more limited for decision making in comparison to meta-analysis, they provide additional options for review authors when the required data for meta-analysis are not available.”
The paper relies on this without support.
These methods may enable authors to make the most of the available data and provide a structured approach where authors may have felt limited to text-based descriptions of the findings of individual studies, which can become rapidly unwieldy where large numbers of studies or complex interventions are involved.
“These methods may enable authors to make the most of the available data and provide a structured approach where authors may have felt limited to text-based descriptions of the findings of individual studies, which can become rapidly unwieldy where large numbers of studies or complex interventions are involved.”
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Cochrane Collaboration guidelines require a minimum of ten studies to execute a moderator analysis.
“According to Cochrane Collaboration guidelines (Cumpston et al. 2022), a minimum of ten studies is required to execute a moderator analysis”
From Examining Working Memory Training for Healthy Adults—A Second-Order Meta-Analysis (2024) · cites this paper as Cumpston et al. 2022
The 'Synthesis methods other than meta-analysis' section discusses alternatives when meta-analysis is not possible, but gives no minimum study count for moderator analysis. Searches for 'minimum of ten studies moderator analysis' and 'meta-regression subgroup analysis 10 studies minimum' found no passage establishing the claimed requirement. Page numbers were unavailable in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Cites
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Effect of low-frequency noise exposure on cognitive function: a systematic review and meta-analysis
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Effectiveness of virtual clinical learning in nursing education: a systematic review
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“[38, 39].”
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“The meta-analysis was performed following the Cochrane Handbook for Systematic Reviews and Meta-Analyses [ 14 ] , while also embracing the comprehensive guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [ 15 ] .”
Technological affordances in teachers' online professional learning communities: A systematic review
Jin, F., Song, Z., Cheung, W. M., Lin, C., & Liu, T. (2023) · Journal of Computer Assisted Learning · doi:10.1111/jcal.12935 · Cited by 33 · see citing works
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Bone density and fracture risk factors in ankylosing spondylitis: a meta-analysis
Yan, F., Wu, L., Lang, J., & Huang, Z. (2023) · Osteoporosis International · doi:10.1007/s00198-023-06925-1 · Cited by 29 · see citing works
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Iqbal, M., Kamarullah, W., Pranata, R., Putra, I. C. S., Karwiky, G., Achmad, C., & Kim, Y. (2024) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2024.05 · Cited by 26 · see citing works
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MethodMa, S., Dou, Y., Wang, W., Wei, A., Lan, M., Liu, J., Yang, L., & Yang, M. (2024) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2023.101241 · Cited by 25 · see citing works
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Sandoval, M. M., Ruvinsky, S., Palermo, M., Alconada, T., Brizuela, M. E., Wierzbicki, E. R., Cantos, J., Bardach, A., Ciapponi, A., & Gagetti, P. S. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1337276 · Cited by 24 · see citing works
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“[17, 18].”
Raine, A., & Brodrick, L. (2024) · Aggression and Violent Behavior · doi:10.1016/j.avb.2024.101956 · Cited by 23 · see citing works
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Silva, F. F. V. E., Caponio, V. C. A., Pérez‐Sayáns, M., Padín-Iruegas, E., Mascitti, M., Chamorro-Petronacci, C. M., Peñaranda, J. M. S., & Lorenzo‐Pouso, A. I. (2023) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2023.104202 · Cited by 23 · see citing works
Altheyab, A., Alqurashi, H., England, T. J., Phillips, B. E., & Piasecki, M. (2024) · Experimental Physiology · doi:10.1113/ep091881 · Cited by 20 · see citing works
“We adhered to the Preferred Reporting Items for Systematic Reviews andMeta-Analyses(PRISMA)statement(Pageetal.,2021),andutilised the Cochrane Handbook for Systematic Reviews of Interventions to guide the conduct of this review (Cumpston et al., 2022).”
Vakili, S. T., Haywood, D., Kirk, D., Abdou, A. M., Gopalakrishnan, R., Sadeghi, S., Guedes, H., Tan, C. J., Thamm, C., Bernard, R., et al. (2024) · JCO Clinical Cancer Informatics · doi:10.1200/cci.24.00119 · Cited by 23 · see citing works
Apaer, S., Aizezi, Z., Cao, X., et al. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07076-w · Cited by 20 · see citing works
Workplace nomophobia: a systematic literature review
Hessari, H., Daneshmandi, F., Busch, P., & Smith, S. (2024) · Current Psychology · doi:10.1007/s12144-024-06222-y · Cited by 19 · see citing works
“Conversely, the significance of the review highlights its potential contributions to advancing knowledge, informing decision-making, or improving outcomes (Cumpston et al., 2022; Khaw et al., 2023).”
Elmajnoun, H. K., Faris, M. E., Abdelrahim, D. N., Haris, P. I., & Abu-Median, A.-B. (2023) · Diabetes Therapy · doi:10.1007/s13300-022-01363-4 · Cited by 21 · see citing works
“These indicate that the variability in the studies included in the present meta-analysis did not occur by chance; it could be classified by Cochrane groups into clinical, methodological and statistical heterogeneity [39].”
BackgroundWu, Q., Niu, X., Zhang, Y., Song, J., & Chi, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042859 · Cited by 20 · see citing works
Effect of exercise intervention on lung function in asthmatic adults: a network meta-analysis
Xing, S., Feng, S., & Zeng, D. L. (2023) · Annals of Medicine · doi:10.1080/07853890.2023.2237031 · Cited by 20 · see citing works
Lü, W., Liu, F., Zhang, Y., He, X., Hu, Y., Xu, H., Yang, X., Li, J., & Kuang, W. (2024) · BMJ Mental Health · doi:10.1136/bmjment-2024-301019 · Cited by 19 · see citing works
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“The risk-of-bias tool recommended by the Cochrane Handbook [16, 17] was used for evaluating of risk of bias in each included study.”
MethodLiu, H., Chen, J., Shao, W., Yan, S., & Ding, S. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1004465 · Cited by 20 · see citing works
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“The Cochrane Collaboration’s tool for assessing the risk of bias [ 13] was used to assess bias of the studies that can affect cumulative evidence.”
MethodJiang, X., Zhou, J., Chen, Q., Xu, Q., Wang, S., Lin, Y., Zhang, D., Bi, H., & Li, H. (2023) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-220395 · Cited by 18 · see citing works
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Suen, M. H. P., Chow, A. Y. M., Woo, R. K. W., & Yuen, S. K. (2024) · Palliative & Supportive Care · doi:10.1017/s1478951524000464 · Cited by 21 · see citing works
“Data were extracted by 2 reviewers (MS, RW) using a standardized data extraction form to provide consistency, reduce bias, and increase the validity and reliability of the data extraction (Cumpston et al. 2022).”
MethodHuang, Z., Huang, S., Huang, Y., et al. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1273378 · Cited by 18 · see citing works
Kan, Z., Yan, W., Yang, M., et al. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1144419 · Cited by 16 · see citing works
Wang, X., Han, X., Liu, X., Yan, J., Chen, C., & Li, Y. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.131 · Cited by 22 · see citing works
Bimanual motor impairments in older adults: An updated systematic review and meta-analysis
Kang, N., Ko, D. K., & Cauraugh, J. H. (2022) · EXCLI journal · doi:10.17179/excli2022-5236 · Cited by 15 · see citing works
“According to the PICO suggestion (Cumpston et al., 2022), we set following inclusion criteria: (a) Population: healthy older adults, (b) Intervention: age ≥ 60 years old, (c) Comparator: healthy young adults, and (d) Outcome: quantitative variables indicating bimanual motor performances.”
MethodEfficacy and safety of carnitine supplementation on NAFLD: a systematic review and meta-analysis
Liu, A., Cai, Y., Yuan, Y., Liu, M., Zhang, Z., Xu, Y., & Jiao, P. (2023) · Systematic Reviews · doi:10.1186/s13643-023-02238-w · Cited by 19 · see citing works
Seo, S., Jung, H., Gyawali, C. P., Lee, H. A., Lim, H. S., Jeong, E. S., Kim, S. E., & Moon, C. M. (2024) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm24024 · Cited by 17 · see citing works
“32 This evaluation encompassed various biases, including selective outcome data (reporting bias), incomplete outcome data (attrition bias), blinding of outcome assessment (detection bias), blinding of participants and personnel (performance bias), allocation concealment (selection bias), and random…”
BackgroundShammi, S. A., Ghosh, P., Sutradhar, A., Shamrat, F. M. J. M., Moni, M. A., & de Oliveira, T. E. A. (2024) · IEEE Transactions on Computational Social Systems · doi:10.1109/tcss.2024.3449748 · Cited by 18 · see citing works
Vámos, O., Komora, P., Gede, N., Hegyi, P. J., Kelemen, K., Varga, G., Mikulás, K., Kerémi, B., & Kispélyi, B. (2024) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntae085 · Cited by 17 · see citing works
“Our systematic review and meta-analysis are reported in accordance with the recommendations of the PRISMA 2020 guideline, 16 while the Cochrane Handbook 17 has been followed.”
MethodZhang, Q., Gao, Y., Wang, W., Zhao, X., Yu, J., & Huang, H. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1393902 · Cited by 19 · see citing works
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“,e quality of the literature was evaluated using the guidelines published in Cochrane handbook [16, 17], in which the evaluation indicators included the following: (1) selection bias (whether the included literature belongs to RCT); (2) group hiding (whether the group adopts blinding method); (3) blind method of both…”
Putra, O. N., Yulistiani, Y., Soedarsono, S., et al. (2023) · International Journal of Mycobacteriology · doi:10.4103/ijmy.ijmy_217_22 · Cited by 16 · see citing works
Childhood and adolescence physical activity and multimorbidity later in life: A systematic review
Souilla, L., Larsen, A. T. S., Juhl, C. B., Skou, S. T., & Bricca, A. (2024) · Journal of Multimorbidity and Comorbidity · doi:10.1177/26335565241231403 · Cited by 16 · see citing works
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Platelet-rich plasma treatment for talar cartilage repair: a systematic review and meta-analysis
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Non-invasive brain stimulation for patient with autism: a systematic review and meta-analysis
Liu, A., Gong, C., Wang, B., Sun, J., & Jiang, Z. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1147327 · Cited by 12 · see citing works
“Two researchers assessed the bias risk of the included RCT according to the RCT bias risk assessment tool recommended by the Cochrane system and cross-checked the results (38).”
BackgroundMethodMeta-analysis of visual fatigue based on visual display terminals
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Chen, S., Wang, C., Ko, A., Garber, C. E., Giovannucci, E. L., Yang, Y., Stults‐Kolehmainen, M., & Yang, L. (2025) · Journal of Medical Internet Research · doi:10.2196/60889 · Cited by 13 · see citing works
Restarting pre-exposure prophylaxis (PrEP) for HIV: a systematic review and meta-analysis
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“19 The inclusion criteria were as follows: the p opulation consisted of participants who suffered a stroke (18 years or older, with no limitations on gender, type of stroke, stage of stroke, or onset of stroke); the i ntervention was the use of mirror therapy; the c omparison was conventional…”
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Clinical efficacy of multiple intra-articular injection for hip osteoarthritis
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Kang, S. J., Tae, C. H., Bang, C. S., Shin, C. M., Jeong, Y., Choi, M., Hwang, J. H., Saito, Y., Chiu, P. W. Y., Rerknimitr, R., et al. (2024) · Clinical Endoscopy · doi:10.5946/ce.2024.002 · Cited by 10 · see citing works
- Authors
- Cumpston, M. S., McKenzie, J. E., Welch, V. A., & Brennan, S. E.
- Affiliations
- University of Newcastle Australia (AU)
- Monash University (AU)
- University of Ottawa (CA)
- Corresponding author
- Cumpston, Miranda S
- Venue
- Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-03-28
- Volume
- 44
- Issue
- 4
- Pages
- e588-e592
- ISSN
- 0943-1853 (ISSN-L)
- 1741-3842
- 1741-3850
- PMC
- PMC9715291
- OpenAlex
- W4213435918
- Semantic Scholar
- 2d71db8c682696f6d419e48317010613d7d43d5c
- Cited by
- 464
- References
- 24
- Citations by year
- 2026: 114 · 2025: 133 · 2024: 147 · 2023: 54 · 2022: 15 · 2013: 1
- FWCI
- 28.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Public Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Australian National Health and Medical Research Council
- Career Development Fellowship (1143429)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- systematic reviews, public health interventions, research question formulation, equity, intervention complexity, risk of bias assessment, methodological recommendations, evidence synthesis
- MeSH terms
- Systematic Reviews as Topic, Humans, Public Health, Public Health Practice, Bias
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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