How are systematic reviews of prevalence conducted? A methodological study
Open accessPublished version of a preprint
Abstract
Background: There is a notable lack of methodological and reporting guidance for systematic reviews of prevalence data. This information void has the potential to result in reviews that are inconsistent and inadequate to inform healthcare policy and decision making. The aim of this meta-epidemiological study is to describe the methodology of recently published prevalence systematic reviews. Methods: We searched MEDLINE (via PubMed) from February 2017 to February 2018 for systematic reviews of prevalence studies. We included systematic reviews assessing the prevalence of any clinical condition using patients as the unit of measurement and we summarized data related to reporting and methodology of the reviews. Results: A total of 235 systematic reviews of prevalence were analyzed. The median number of authors was 5 (interquartile range [IQR] 4–7), the median number of databases searched was 4 (3–6) and the median number of studies included in each review was 24 (IQR 15–41.5). Search strategies were presented for 68% of reviews. Forty five percent of reviews received external funding, and 24% did not provide funding information. Twenty three percent of included reviews had published or registered the systematic review protocol. Reporting guidelines were used in 72% of reviews. The quality of included studies was assessed in 80% of reviews. Nine reviews assessed the overall quality of evidence (4 using GRADE). Meta-analysis was conducted in 65% of reviews; 1% used Bayesian methods. Random effect meta-analysis was used in 94% of reviews; among them, 75% did not report the variance estimator used. Among the reviews with meta-analysis, 70% did not report how data was transformed; 59% percent conducted subgroup analysis, 38% conducted meta-regression and 2% estimated prediction interval; I 2 was estimated in 95% of analysis. Publication bias was examined in 48%. The most common software used was STATA (55%). Conclusions: Our results indicate that there are significant inconsistencies regarding how these reviews are conducted. Many of these differences arose in the assessment of methodological quality and the formal synthesis of comparable data. This variability indicates the need for clearer reporting standards and consensus on methodological guidance for systematic reviews of prevalence data.
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Written from the paper’s full text.
TL;DR
This meta-epidemiological study describes how 235 recently published systematic reviews of prevalence were conducted and reported. It finds substantial inconsistency in critical appraisal, data synthesis, and reporting, with limited use of formal guidance for prevalence reviews.
Key findings
- Across 235 reviews, the median number of authors was 5 (IQR 4–7), databases searched was 4 (IQR 3–6), and included studies was 24 (IQR 15–41.5); 68% presented a full search strategy for at least one database, 23% published or registered a protocol, and 72% used a reporting guideline.
- Methodological quality of included studies was assessed in 80% of reviews, but only 9 reviews (3.8%) assessed the quality of the body of evidence, with 4 (1.7%) using GRADE; 17% used quality assessment as an inclusion criterion.
- Meta-analysis was conducted in 152/235 reviews (64.7%); 93.4% used random-effects models, but among these 75.2% did not report the variance estimator, and among meta-analyses 70.4% did not report how data were transformed.
- Heterogeneity was assessed with I² in 94.7% of meta-analyses, and 76.1% of analyses had an I² estimate of 90% or more; publication bias was examined in 48%, prediction intervals were estimated in 2.0%, and STATA was the most common software (54.6%).
Methods
- Meta-epidemiological study searching MEDLINE via PubMed from February 2017 to February 2018 using “prevalence” and “systematic review” in the title.
- Included systematic reviews assessing prevalence of any clinical condition using patients as the unit of measurement; excluded primary studies, letters, narrative reviews, reviews of interventions or diagnostic accuracy, association reviews, non-patient-unit prevalence reviews, and non-English studies.
- Data were extracted with a standard piloted form by one author and independently checked by another; results were summarized with descriptive statistics.
Limitations
- The paper states it searched only MEDLINE over a 1-year period using a title-based search strategy, so reviews not indexed, not published, or not using those title terms may differ from those characterized.
- The paper states it included only recently published reviews because older reviews may not reflect current practice.
- Evident from the text: the study is limited to English-language reviews and does not itself formally assess the methodological quality of the included systematic reviews beyond extracting reported methods.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 30 cited sources checked · 0 supported · 0 flagged
- Findingown data
Two percent of the included systematic reviews of prevalence estimated a prediction interval.
“2% estimated prediction interval”
- Also stated in: § Statistical methods for meta-analysis · plain
“Prediction interval was estimated in 3 reviews (2.0%).”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
Among the included systematic reviews of prevalence with meta-analysis, 70% did not report how data was transformed.
“Among the reviews with meta-analysis, 70% did not report how data was transformed”
Quote in the paperSubstantial claim - Findingown data
A total of 235 systematic reviews of prevalence were analyzed.
“A total of 235 systematic reviews of prevalence were analyzed.”
- Also stated in: § Results · plain
“We assessed the full text of 251 and included 235 of them in our analysis.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
Fifty-nine percent of the included systematic reviews of prevalence conducted subgroup analysis.
“59% percent conducted subgroup analysis”
- Also stated in: § Statistical methods for meta-analysis · plain
“and subgroup analysis was performed in 89 studies (58.6%).”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
Random effect meta-analysis was used in 94% of the included systematic reviews of prevalence.
“Random effect meta-analysis was used in 94% of reviews”
- Also stated in: § Statistical methods for meta-analysis · plain
“The majority of studies pooled estimates using a random effects model (n = 141, 93.4%)”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
I2 was estimated in 95% of the analyses in the included systematic reviews of prevalence.
“I2 was estimated in 95% of analysis.”
- Also stated in: § Statistical methods for meta-analysis · plain
“Heterogeneity among studies was assessed with the I2 statistics in 114 studies (94.7%)”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
MOOSE was used as a reporting guideline in 27 (11.5%) of the included systematic reviews of prevalence.
“MOOSE (n = 27, 11.5%)”
Quote in the paperNot a substantial claim - Findingown data
Publication bias was examined in 48% of the included systematic reviews of prevalence.
“Publication bias was examined in 48%.”
Quote in the paperNot a substantial claim - Findingown data
The leading publication journals for the included systematic reviews of prevalence, with 5 or more published reviews, were PLoS One, BMJ Open, Lancet Global Health and Medicine.
“The leading publication journals (with 5 or more published reviews) were PLoS One, BMJ Open, Lancet Global Health and Medicine.”
Quote in the paperNot a substantial claim - Findingown data
The median number of authors in the included systematic reviews of prevalence was 5 (IQR 4-7).
“The median number of authors was 5 (interquartile range [IQR] 4–7)”
Quote in the paperNot a substantial claim - Findingown data
A PubMed search identified a more than ten-fold increase in the number of systematic reviews of prevalence published from 2007 to 2017.
“identified a more than ten-fold increase in the number of reviews published from 2007 to 2017.”
Quote in the paperNot a substantial claim - Findingown data
The number of systematic reviews of prevalence data has increased steadily over the last decade.
“The number of systematic reviews of prevalence data has increased steadily over the last decade”
Quote in the paperNot a substantial claim - Findingown data
Thirty-eight percent of the included systematic reviews of prevalence conducted meta-regression.
“38% conducted meta-regression”
- Also stated in: § Statistical methods for meta-analysis · plain
“meta-regression in 57 studies (37.5%)”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
Reporting guidelines were used in 72% of the included systematic reviews of prevalence.
“Reporting guidelines were used in 72% of reviews.”
- Also stated in: § Results · plain
“170 (72.3%) used a reporting guideline”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Twenty-four percent of the included systematic reviews of prevalence did not provide funding information.
“24% did not provide funding information.”
Quote in the paperNot a substantial claim - Findingown data
The quality of included studies was assessed in 80% of the included systematic reviews of prevalence.
“The quality of included studies was assessed in 80% of reviews.”
- Also stated in: § Results · plain
“One hundred and eighty-eight reviews (80.0%) assessed the methodological quality of included studies.”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Forty-five percent of the included systematic reviews of prevalence received external funding.
“Forty five percent of reviews received external funding”
Quote in the paperNot a substantial claim - Findingown data
The 235 included systematic reviews of prevalence were published in 85 different journals.
“These 235 articles were published in 85 different journals.”
Quote in the paperNot a substantial claim - Findingown data
Of the 235 included studies, 83 (35.3%) presented narrative synthesis without quantitative synthesis.
“Of 235 studies included, 83 (35.3%) presented narrative synthesis, without quantitative synthesis”
Quote in the paperSubstantial claim - Findingown data
Among the included systematic reviews of prevalence that used random effect meta-analysis, 75% did not report the variance estimator used.
“among them, 75% did not report the variance estimator used.”
- Also stated in: § Statistical methods for meta-analysis · plain
“However, 106 studies (75.2%) did not report the variance estimator used.”
Quote in the paperNot a substantial claim - Also stated in: § Statistical methods for meta-analysis · plain
- Findingown data
Twenty-three percent of the included systematic reviews of prevalence had published or registered the systematic review protocol.
“Twenty three percent of included reviews had published or registered the systematic review protocol.”
- Also stated in: § Results · plain
“Fifty-three studies (22.6%) published or registered a protocol”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Meta-analysis was conducted in 65% of the included systematic reviews of prevalence.
“Meta-analysis was conducted in 65% of reviews”
- Also stated in: § Results · plain
“while 152 (64.7%) performed meta-analysis”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
One percent of the included systematic reviews of prevalence used Bayesian methods.
“1% used Bayesian methods.”
Quote in the paperNot a substantial claim - Findingown data
The most common software used in the included systematic reviews of prevalence was STATA (55%).
“The most common software used was STATA (55%).”
Quote in the paperNot a substantial claim - Findingown data
The median number of studies included in each systematic review of prevalence was 24 (IQR 15-41.5).
“the median number of studies included in each review was 24 (IQR 15–41.5)”
Quote in the paperNot a substantial claim - Findingown data
Search strategies were presented for 68% of the included systematic reviews of prevalence.
“Search strategies were presented for 68% of reviews.”
Quote in the paperNot a substantial claim - Findingown data
PRISMA was used as a reporting guideline in 161 (68.5%) of the included systematic reviews of prevalence.
“including PRISMA (n = 161, 68.5%)”
Quote in the paperNot a substantial claim - Findingown data
The median number of databases searched in the included systematic reviews of prevalence was 4 (IQR 3-6).
“the median number of databases searched was 4 (3–6)”
Quote in the paperNot a substantial claim - Findingown data
Twenty-four included systematic reviews of prevalence (10.2%) developed new tools for critical appraisal.
“Twenty-four studies (10.2%) developed new tools”
Quote in the paperNot a substantial claim - Findingown data
One included systematic review of prevalence summarized the quality of evidence as the mean STROBE score of included studies.
“For instance, one study summarized the quality of evidence as the mean STROBE score of included studies.”
Quote in the paperNot a substantial claim - Findingnone given
This study collated and interrogated the largest dataset of systematic reviews of prevalence currently available.
“In this study, we have collated and interrogated the largest dataset of systematic reviews of prevalence currently available.”
Quote in the paperSubstantial claim - Findingown data
Fifteen included systematic reviews of prevalence (6.4%) used STROBE, a reporting guideline, to assess the methodological quality of included studies.
“Fifteen reviews (6.4%) used STROBE, a reporting guideline, to assess the methodological quality of included studies.”
Quote in the paperNot a substantial claim - Findingown data
Publication bias was assessed with Egger's test in 54 included systematic reviews of prevalence (35.5%).
“and Egger’s test (n = 54, 35.5%).”
Quote in the paperNot a substantial claim - Findingown data
Most analyses in the included systematic reviews of prevalence (n = 105, 76.1%) had an I2 estimate of 90% or more.
“Most analyses (n = 105, 76.1%) had an I2 estimate of 90% or more.”
Quote in the paperNot a substantial claim - Findingown data
Freeman-Tukey double arcsine transformation was used in 32 included systematic reviews of prevalence (21.1%).
“the most used methods were Freeman-Tukey double arcsine (n = 32, 21.1%)”
Quote in the paperNot a substantial claim - Findingown data
Both included systematic reviews of prevalence that used the quality model used non-validated methods to critically appraise included studies.
“However, both reviews used non-validated methods to critically appraise included studies.”
Quote in the paperNot a substantial claim - Findingown data
PubMed was used in 231 (98.3%) of the included systematic reviews of prevalence.
“231 studies (98.3%) used PubMed”
Quote in the paperNot a substantial claim - Findingown data
The vast majority of included systematic reviews of prevalence (n = 151, 99.3%) used classic methods instead of Bayesian approaches to pool prevalence estimates.
“The vast majority of studies (n = 151, 99.3%) used classic methods instead of Bayesian approaches to pool prevalence estimates.”
Quote in the paperSubstantial claim - Findingown data
Thirty-two included systematic reviews of prevalence (17.0%) used assessment of methodological quality as an inclusion criterion for the review.
“Thirty-two reviews (17.0%) used assessment of methodological quality as an inclusion criterion for the review.”
Quote in the paperNot a substantial claim - Findingown data
Sixty-nine included systematic reviews of prevalence (29.4%) reported the search strategy incompletely.
“although 69 (29.4) reported it incompletely”
Quote in the paperNot a substantial claim - Findingown data
The DerSimonian and Laird method was used in 30 included systematic reviews of prevalence (21.3%) for variance estimation.
“the DerSimonian and Laird method was used in 30 reviews (21.3%).”
Quote in the paperNot a substantial claim - Findingown data
Forty-five included systematic reviews of prevalence (29.6%) reported how they transformed the prevalence estimates.
“Forty-five studies (29.6%) reported how they transformed the prevalence estimates”
Quote in the paperNot a substantial claim - Findingown data
Twenty-four included systematic reviews of prevalence (10.2%) used non-validated tools from previous similar systematic reviews.
“and 24 (10.2%) used non-validated tools from previous similar systematic reviews.”
Quote in the paperNot a substantial claim - Findingown data
Web of Science was used in 93 (39.6%) of the included systematic reviews of prevalence.
“93 (39.6%) used Web of Science”
Quote in the paperNot a substantial claim - Findingown data
Embase was used in 146 (62.1%) of the included systematic reviews of prevalence.
“146 (62.1%) used Embase”
Quote in the paperNot a substantial claim - Findingown data
Among validated and specific tools to assess prevalence studies, the JBI prevalence critical appraisal tool was the most used (n = 21, 8.9%).
“the JBI prevalence critical appraisal tool was the most used (n = 21, 8.9%).”
Quote in the paperNot a substantial claim - Findingown data
The most adaptations to any one tool (n = 13, 5.5%) were made to the Newcastle Ottawa Scale.
“with the most adaptions to any one tool (n = 13, 5.5%) being made to the Newcastle Ottawa Scale.”
Quote in the paperNot a substantial claim - Findingown data
Cochrane CENTRAL was used in 70 (29.8%) of the included systematic reviews of prevalence.
“70 (29.8%) used Cochrane CENTRAL”
Quote in the paperNot a substantial claim - Findingown data
Multiple databases were often searched during the systematic review process in the included reviews.
“It was encouraging to see that multiple databases were often searched during the systematic review process”
Quote in the paperNot a substantial claim - Findingown data
Publication bias was assessed with funnel plots in 56 included systematic reviews of prevalence (36.8%).
“Publication bias was assessed with funnel plots (n = 56, 36.8%)”
Quote in the paperNot a substantial claim - Findingown data
One hundred and five included systematic reviews of prevalence (44.7%) reported that quality assessment was performed by at least two reviewers.
“One hundred and five (44.7%) reported that this assessment was performed by at least two reviewers.”
Quote in the paperNot a substantial claim - Findingown data
Two included systematic reviews of prevalence (1.3%) used the 'quality model', where the weight of each study was calculated based on a quality assessment.
“Two studies (1.3%) used the ‘quality model’, where the weight of each study was calculated based on a quality assessment.”
Quote in the paperNot a substantial claim - Findingown data
GATHER was used as a reporting guideline in 2 (0.9%) of the included systematic reviews of prevalence.
“GATHER (n = 2, 0.9%)”
Quote in the paperNot a substantial claim - Findingown data
Seven included systematic reviews of prevalence (4.6%) utilized the fixed effect model.
“and 7 studies (4.6%) utilized the fixed effect model.”
Quote in the paperNot a substantial claim - Findingown data
Most included systematic reviews of prevalence (n = 228, 97.0%) reported the search strategy used.
“Most reviews (n = 228, 97.0%) reported the search strategy used”
Quote in the paperNot a substantial claim - Interpretationown data
There are significant inconsistencies regarding how systematic reviews of prevalence are conducted.
“Our results indicate that there are significant inconsistencies regarding how these reviews are conducted.”
- Also stated in: § Discussion · plain
“Our investigations have found that across the included systematic reviews of prevalence, there are significant and important discrepancies in how these reviews consider searching, risk of bias and data synthesis.”
- Also stated in: § Conclusions · plain
“This meta-epidemiological review found that among this sample of published systematic reviews of prevalence, there are considerable discrepancies in terms of conduct, reporting, risk of bias assessment and data synthesis.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Premisecitation
There is a notable lack of methodological and reporting guidance for systematic reviews of prevalence data.
“There is a notable lack of methodological and reporting guidance for systematic reviews of prevalence data.”
- Also stated in: § Background · plain
“there remains little discourse on how these reviews should be conducted and reported”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Systematic reviews of prevalence and incidence. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer's. Manual: The Joanna Briggs Institute; 2017.
Not checked in the free run.
- Also stated in: § Background · plain
- Interpretationown data
Many of the differences among systematic reviews of prevalence arose in the assessment of methodological quality and the formal synthesis of comparable data.
“Many of these differences arose in the assessment of methodological quality and the formal synthesis of comparable data.”
Quote in the paperSubstantial claim - Premisecitation
Methodological guidance from the Joanna Briggs Institute (JBI) exists for systematic reviews of prevalence.
“Although methodological guidance from the Joanna Briggs Institute (JBI) exists for these review types”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Systematic reviews of prevalence and incidence. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer's. Manual: The Joanna Briggs Institute; 2017.
Not checked in the free run.
- Interpretationreasoning
Review authors following inadequate approaches, missing key steps or information sources, increases the potential for review authors to report inaccurate or misleading summarized estimates.
“review authors themselves following inadequate approaches, missing key steps or information sources, and importantly increasing the potential for review authors to report inaccurate or misleading summarized estimates”
Quote in the paperSubstantial claim - Interpretationreasoning
The variability among systematic reviews of prevalence is understandable given the limited amount of guidance in this field, the lack of a reporting standard and a widely accepted risk of bias or critical appraisal tool.
“This variability is understandable given the limited amount of guidance in this field, the lack of a reporting standard and a widely accepted risk of bias or critical appraisal tool.”
Quote in the paperNot a substantial claim - Premisenone given
There are no clearly established procedures on how to deal with unpublished prevalence information.
“However, there are no clearly established procedures on how to deal with this kind of information.”
Quote in the paperSubstantial claim - Interpretationown data
There is considerable variability in the choice of methods to transform prevalence estimates for proportional meta-analysis among the included systematic reviews of prevalence.
“considerable variability in the choice of methods to transform prevalence estimates for proportional meta-analysis.”
Quote in the paperSubstantial claim - Interpretationown data
There was great variability regarding the instruments used to critically appraise included studies in the systematic reviews of prevalence.
“There was a great variability regarding the instruments used to critically appraise included studies.”
Quote in the paperSubstantial claim - Interpretationreasoning
Although only a sample, the 235 included systematic reviews of prevalence are likely to be representative of all published prevalence systematic reviews.
“Although only a sample, it is likely to be representative of all published prevalence systematic reviews”
Quote in the paperSubstantial claim - Interpretationreasoning
The small number of identified systematic reviews of prevalence that included formal quality assessment of the entire body of evidence might be linked to the lack of formal guidance from the GRADE working group.
“The considerably small number of identified reviews that included formal quality assessment of the entire body of evidence might be linked to the lack of formal guidance from the GRADE working group.”
Quote in the paperSubstantial claim - Interpretationown data
Not all methods used to assess the quality of evidence in the included systematic reviews of prevalence were validated and appropriate.
“Not all methods used to assess the quality of evidence were validated and appropriate.”
Quote in the paperSubstantial claim - Premisecitation
The use of a random effects model is appropriate in systematic reviews of prevalence.
“The vast majority of meta-analyses used classic methods and a random effects model, which is appropriate in these types of reviews [17] [18].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [17] Saha S, Chant D, McGrath J. Meta-analyses of the incidence and prevalence of schizophrenia: conceptual and methodological issues. Int J Methods Psychiatr Res. 2008;17(1):55–61. source
Not checked in the free run.
- cites [18] Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53. source
Not checked in the free run.
- Interpretationreasoning
Poorly conducted and reported systematic reviews of prevalence may have limited or even detrimental impacts on the planning and provision of healthcare.
“these poorly conducted and reported reviews may have limited or even detrimental impacts on the planning and provision of healthcare.”
Quote in the paperSubstantial claim - Premisecitation
PRISMA was designed particularly for reviews of interventions of therapies.
“However, this reporting guideline was designed particularly for reviews of interventions of therapies.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700. source
Not checked in the free run.
- Interpretationcitation
Some tools utilized for critical appraisal in the included systematic reviews of prevalence were not appropriate for this assessment, such as the Newcastle Ottawa Scale (designed for cohort and case-control studies) or STROBE (a reporting standard).
“Some of the tools utilized were not appropriate for this assessment, such as the Newcastle Ottawa Scale (designed for cohort and case-control studies) [8] or STROBE (a reporting standard) [9].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [8] Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa (ON): Ottawa Hospital Research Institute; 2009. Available in March 2016.
Not checked in the free run.
- cites [9] Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573–7. source
Not checked in the free run.
- Interpretationreasoning
A lack of standardization across systematic reviews of prevalence limits the ability to streamline, automate or use artificial intelligence to assist systematic review production.
“a lack of standardization across reviews limits the ability to streamline, automate or use artificial intelligence to assist systematic review production”
Quote in the paperSubstantial claim - Interpretationreasoning
Using inadequate or inappropriate critical appraisal tools and using the results of these tools to decide upon inclusion in a systematic review could lead to the inappropriate exclusion of relevant studies, which can alter the final results and produce misleading estimates.
“The combination of (a) using inadequate or inappropriate critical appraisal tools and (b) using the results of these tools to decide upon inclusion in a systematic review could lead to the inappropriate exclusion of relevant studies, which can alter the final results and produce misleading estimates.”
Quote in the paperSubstantial claim
- May combine two claims. 17
- Classified as probably not a substantial claim. 25
May combine two claims.
Findingown dataNine included systematic reviews of prevalence assessed the overall quality of evidence, and four of these used GRADE.
“Nine reviews assessed the overall quality of evidence (4 using GRADE).”
- Also stated in: § Results · plain
“Nine studies (3.8%) assessed the quality of the body of evidence, with GRADE being the highest cited methodology (n = 4, 1.7%).”
Quote in the paperNot a substantial claim- Also stated in: § Results · plain
May combine two claims.
Findingown dataSome tools identified in the included systematic reviews of prevalence were designed specifically for studies reporting prevalence information, while others were adapted for this purpose.
“some of the tools identified were designed specifically for studies reporting prevalence information, whilst other tools were adapted for this purpose”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataLog transformation was used in 4 included systematic reviews of prevalence (2.6%).
“and log (n = 4, 2.6%).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataLogit transformation was used in 5 included systematic reviews of prevalence (3.3%).
“logit (n = 5, 3.3%)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
InterpretationreasoningThe lack of methodological and reporting guidance for systematic reviews of prevalence data has the potential to result in reviews that are inconsistent and inadequate to inform healthcare policy and decision making.
“This information void has the potential to result in reviews that are inconsistent and inadequate to inform healthcare policy and decision making.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningStandards and guidelines for traditional systematic reviews do not comprehend specific issues for systematic reviews of prevalence and have not been as readily adopted.
“Even though such standards and guidelines could be adapted for systematic reviews of prevalence, they do not comprehend specific issues for this type of study, and have not been as readily adopted.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationStandards of reporting and conduct for traditional systematic reviews of interventions are considered commonplace and are endorsed by journal editors.
“standards of reporting and conduct for traditional systematic reviews (i.e. systematic reviews of interventions) [6] are considered commonplace, and even endorsed by journal editors.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700. source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
PremisecitationThere is now general acceptance that there needs to be different types of approaches for systematic reviews looking at different types of evidence.
“there is now general acceptance that there needs to be different types of approaches for systematic reviews looking at different types of evidence [6–8].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [6] Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700. source
Not checked in the free run.
- cites [7] Hoffmann F, Eggers D, Pieper D, Zeeb H, Allers K. An observational study found large methodological heterogeneity in systematic reviews addressing prevalence and cumulative incidence. J Clin Epidemiol. 2020;119:92–9. source
Not checked in the free run.
- cites [8] Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa (ON): Ottawa Hospital Research Institute; 2009. Available in March 2016.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe JBI critical appraisal tool has been formally evaluated and is increasingly used across systematic reviews of prevalence.
“we urge reviewers to refer to the JBI critical appraisal tool, [4] which has been formally evaluated and is increasingly used across these types of reviews.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag. 2014;3(3):123–8. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenOne author extracted relevant data from each review and another author independently checked all data.
“one author extracted relevant data from each review and another author independently checked all data.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationThe GRADE approach was developed to assess issues related to interventions and diagnostic tests, however there are several extensions for its application.
“The GRADE approach was developed to assess issues related to interventions (using evidence either from interventional or observational studies) and for diagnostic tests, however there are several extensions for the application of GRADE methodology.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [24] Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThere is potential that systematic reviews of prevalence published in journals not indexed (or not published at all) are meaningfully different from those characterized in the results.
“There is potential that systematic reviews of prevalence published in journals not indexed (or not published at all) are meaningfully different from those characterized in our results.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationQuality assessment of the entire body of evidence considers other factors in addition to methodological assessment that may impact on the subsequent recommendations drawn from such evidence.
“Separate to critical appraisal, quality assessment of the entire body of evidence considers other factors in addition to methodological assessment that may impact on the subsequent recommendations drawn from such evidence [23].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck-Ytter Y, Schünemann HJ. What is “quality of evidence” and why is it important to clinicians? BMJ. 2008;336(7651):995. source
Not checked in the free run.
May combine two claims.
InterpretationreasoningPrediction intervals are a more conservative way to incorporate uncertainty in the analysis when true heterogeneity is expected, but they are still underused in meta-analysis of prevalence.
“This is a more conservative way to incorporate uncertainty in the analysis when true heterogeneity is expected; however, it is still underused in meta-analysis of prevalence.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationPrediction intervals include the expected range of true effects in similar studies.
“Prediction intervals include the expected range of true effects in similar studies [22].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] IntHout J, Ioannidis JPA, Rovers MM, Goeman JJ. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open. 2016;6(7):e010247-e. source
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningThe general confusion in end users, peer reviewers and readers of systematic reviews of prevalence as they are required to become accustomed to various ways of conducting these studies is a consequence of lack of standardization.
“the general confusion in end users, peer reviewers and readers of these reviews as they are required to become accustomed to various ways of conducting these studies”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationI2 provides a useful indication of statistical heterogeneity amongst studies included in a meta-analysis, but it can be misleading in cases where studies are providing large datasets with precise confidence intervals, such as in prevalence reviews.
“Although I2 provides a useful indication of statistical heterogeneity amongst studies included in a meta-analysis, it can be misleading in cases where studies are providing large datasets with precise confidence intervals (such as in prevalence reviews) [20].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [20] Rücker G, Schwarzer G, Carpenter JR, Schumacher M. Undue reliance on I 2 in assessing heterogeneity may mislead. BMC Med Res Methodol. 2008;8(1):79. source
Not checked in the free run.
May combine two claims.
PremisecitationWhile there is no formal guidance for GRADE in systematic reviews of prevalence, there is some guidance into the use of GRADE for baseline risk or overall prognosis which may be useful for these types of reviews.
“While there is no formal guidance for GRADE in systematic reviews of prevalence, there is some guidance into the use of GRADE for baseline risk or overall prognosis [25] which may be useful for these types of reviews.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25] Iorio A, Spencer FA, Falavigna M, Alba C, Lang E, Burnand B, et al. Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients. BMJ. 2015;350:h870. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationA recently published study assessed a random sample of 215 systematic reviews of prevalence and cumulative incidence and also found great heterogeneity among the methods used to conduct these reviews.
“a recently published study assessed a random sample of 215 systematic reviews of prevalence and cumulative incidence, and also found great heterogeneity among the methods used to conduct these reviews [7].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] Hoffmann F, Eggers D, Pieper D, Zeeb H, Allers K. An observational study found large methodological heterogeneity in systematic reviews addressing prevalence and cumulative incidence. J Clin Epidemiol. 2020;119:92–9. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThere has been debate regarding the appropriateness of meta-analysis within systematic reviews of prevalence.
“There has been debate regarding the appropriateness of meta-analysis within systematic reviews of prevalence, [14, 15] [16–18]”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [14] Rao SR, Graubard BI, Schmid CH, Morton SC, Louis TA, Zaslavsky AM, et al. Meta-analysis of survey data: application to health services research. Health Serv Outcome Res Methodol. 2008;8(2):98–114. source
Not checked in the free run.
- cites [15] Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67(11):974–8. source
Not checked in the free run.
- cites [16] Jablensky A. Schizophrenia: the epidemiological horizon. In: Hirsch S, Weinberger D, editors. Schizophrenia. Oxford: Black-well Science; 2003. p. 203–31. source
Not checked in the free run.
- cites [17] Saha S, Chant D, McGrath J. Meta-analyses of the incidence and prevalence of schizophrenia: conceptual and methodological issues. Int J Methods Psychiatr Res. 2008;17(1):55–61. source
Not checked in the free run.
- cites [18] Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe selection of studies was conducted in two phases by two independent reviewers.
“The selection of studies was conducted in two phases by two independent reviewers.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenOlder systematic reviews of prevalence may not reflect the current practice.
“we decided to include only reviews recently published because older reviews may not reflect the current practice.”
Quote in the paperNot a substantial claim- Rests on an assumption: Older systematic reviews of prevalence may not reflect the current practice.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone givenSearching multiple databases is a recommendation for all review types.
“which is a recommendation for all review types.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationThere have been multiple extensions to the original PRISMA statement for various review types, yet no extension has yet been considered for systematic reviews of prevalence data.
“there have been multiple extensions to the original PRISMA statement for various review types [10, 11], yet no extension has yet been considered for systematic reviews of prevalence data.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [10] Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. source
Not checked in the free run.
- cites [11] McInnes MD, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. Jama. 2018;319(4):388–96. source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningNovice reviewers searching for exemplar systematic reviews of prevalence may follow inadequate methods as they conduct these reviews.
“novice reviewers searching for exemplar reviews may follow inadequate methods as they conduct these reviews”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductnone givenThe study only searched MEDLINE over a period of 1 year using a search strategy that only retrieved studies with the terms "prevalence" and "systematic review" in the title.
“we only searched MEDLINE over a period of 1 year using a search strategy that only retrieved studies with the terms “prevalence” and “systematic review” in the title.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataDiscrepancies in data extraction were discussed and solved by consensus or by a third reviewer.
“Discrepancies were discussed and solved by consensus or by a third reviewer.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Freeman-Tukey double arcsine transformation has been recommended as the preferred method for transformation, although more recently it has come under question.
“This has been recommended as the preferred methods for transformation [15, 18], although more recently it has come under question [19].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [15] Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67(11):974–8. source
Not checked in the free run.
- cites [18] Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53. source
Not checked in the free run.
- cites [19] Schwarzer G, Chemaitelly H, Abu-Raddad LJ, Rücker G. Seriously misleading results using inverse of Freeman-Tukey double arcsine transformation in meta-analysis of single proportions. Res Syn Meth. 2019;10:476–83. source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationcitationOther assessments of heterogeneity, such as T2 and prediction intervals, may be more appropriate in systematic reviews of prevalence.
“Other assessments of heterogeneity, such as T2 and prediction intervals, may be more appropriate in these types of reviews [20, 21].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [20] Rücker G, Schwarzer G, Carpenter JR, Schumacher M. Undue reliance on I 2 in assessing heterogeneity may mislead. BMC Med Res Methodol. 2008;8(1):79. source
Not checked in the free run.
- cites [21] Borenstein M, Higgins JP, Hedges LV, Rothstein HR. Basics of meta-analysis: I2 is not an absolute measure of heterogeneity. Res Synth Methods. 2017;8(1):5–18. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataA standard and piloted form was used for data abstraction.
“Using a standard and piloted form”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningGiven that reviews indexed on MEDLINE are likely to be of higher quality than those not indexed, and given that substantial inconsistency was still identified, a broader search is unlikely to have altered the main conclusions significantly.
“given that reviews indexed on MEDLINE are (hypothetically) likely to be of higher quality than those not indexed, and given that we still identified substantial inconsistency, variability and potentially inappropriate practices in this sample, we doubt that a broader search will have altered our main conclusions significantly.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Reviews indexed on MEDLINE are likely to be of higher quality than those not indexed.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
InterpretationreasoningIt is reasonable to expect some differences in how systematic reviews of prevalence are conducted, as different author groups will rationally disagree regarding key issues.
“It is reasonable to expect some differences in how these types of reviews are conducted, as different authors groups will rationally disagree regarding key issues”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe wide inconsistency and variability noted in the included systematic reviews of prevalence are far beyond the range of what could be considered reasonable and are of considerable concern.
“However, the wide inconsistency and variability noted in our review are far beyond the range of what could be considered reasonable and is of considerable concern”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningMeta-analysis, when done appropriately and using correct methodology, can provide important information regarding the burden of disease, including identifying differences amongst populations and regions, changes over time, and a summarized estimate.
“However, meta-analysis, when done appropriately and using correct methodology, can provide important information regarding the burden of disease, including identifying differences amongst populations and regions, changes over time, and can provide a summarized estimate that can be used when calculating baseline risk, such as in GRADE summary of findings tables.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
InterpretationreasoningA lack of standardization across systematic reviews of prevalence may encourage unnecessary duplication of reviews as reviewers approach similar questions with their own preferred methods.
“this lack of standardization may encourage unnecessary duplication of reviews as reviewers approach similar questions with their own preferred methods”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationnone givenReviews that do not use the terms "prevalence" and "systematic review" in the title would have, overall, even more inappropriate methods.
“we believe that reviews that do not use the terms “prevalence” and “systematic review” in the title terms would have, overall, even more inappropriate methods.”
Quote in the paperNot a substantial claim- Rests on an assumption: Systematic reviews of prevalence that do not use the terms “prevalence” and “systematic review” in the title would have, overall, even more inappropriate methods.
The authors state this as an assumption.
Reviews indexed on MEDLINE are likely to be of higher quality than those not indexed.
“given that reviews indexed on MEDLINE are (hypothetically) likely to be of higher quality than those not indexed”
The paper relies on this without support.
Systematic reviews of prevalence that do not use the terms “prevalence” and “systematic review” in the title would have, overall, even more inappropriate methods.
“we believe that reviews that do not use the terms “prevalence” and “systematic review” in the title terms would have, overall, even more inappropriate methods.”
The paper relies on this without support.
Older systematic reviews of prevalence may not reflect the current practice.
“we decided to include only reviews recently published because older reviews may not reflect the current practice.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
While this represents considerable heterogeneity, previous meta-analyses of prevalence have reported similar results, mainly due to the variability of the results among studies.
“While this represents ‘considerable heterogeneity’, previous meta‐analyses of prevalence have reported similar results, 35 mainly due to the variability of the results among studies.”
From Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta‐analysis (2022) · cites this paper as [35]
Our meta-analysis still provides relevant information regarding the burden of sarcopenia, providing a summarized estimate that can be used to calculate baseline risk for the total population as well as by sex and region.
“our meta‐analysis still provides relevant information regarding the burden of sarcopenia, providing a summarized estimate that can be used to calculate baseline risk for the total population as well as by sex and region. 35”
From Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta‐analysis (2022) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Number assessing quality of the body of evidence differs from Table 1
MinorThe text says nine reviews assessed the quality of the body of evidence, but Table 1 lists 227 of 235 as not conducting that assessment, leaving eight. Its listed assessment methods also total eight reviews.
“Nine studies (3.8%) assessed the quality of the body of evidence”
“Quality of the body of evidence | Not conducted: 227 (96.6%)”
Funding nonreporting percentage is incorrect
MinorThe paper reports 235 included reviews, so 56 reviews without funding information represent 23.8%, not 45.1%. Table 1 also gives 23.8% for this count.
Reported 45.1 · recomputed 23.829787
“In 56 studies (45.1%) there was no reporting of funding.”
I2 count and percentage do not agree
MinorAmong 152 meta-analyses, 114 is 75.0%, not 94.7%. Table 2 instead reports 144 studies (94.7%), suggesting the count in the sentence is wrong.
Reported 94.7 · recomputed 75
“Heterogeneity among studies was assessed with the I2 statistics in 114 studies (94.7%)”
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GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
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“7%) followed the GRADE approach [24] which is now the commonplace methodology to reliably and sensibly rate the quality of the body of evidence.”
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Self-citationPlea for routinely presenting prediction intervals in meta-analysis.
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Basics of meta‐analysis: <i>I</i> <sup>2</sup> is not an absolute measure of heterogeneity
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“The subsequent synthesis of this information in the form of a rigorously conducted and transparently reported systematic review has significant potential to better inform social and healthcare professionals, policy makers and consumers to better manage and plan for this disease burden [3].”
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Self-citation
Flagged first, then by citations
Research works printed but not linked: 3
- Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag. 2014;3(3):123–8. · DOI · Paper page
- Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Systematic reviews of prevalence and incidence. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer's. Manual: The Joanna Briggs Institute; 2017.
- Munn Z, Moola S, Lisy K, Riitano D. The synthesis of prevalence and incidence data. Pearson a, editor. Philadelphia: Lippincott Williams & Wilkins; 2014.
Cited by
Sorted by citations
Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta‐analysis
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The prevalence of loneliness across 113 countries: systematic review and meta-analysis
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Toh, J. Z. K., Pan, X.-H., Tay, P. W. L., Ng, C. H., Yong, J. N., Xiao, J., Koh, J. H., Tan, E. Y., Tan, E. X. X., Dan, Y. Y., et al. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.09.021 · Cited by 130 · see citing works
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- Authors
- on behalf of the Prevalence Estimates Reviews – Systematic Review Methodology Group (PERSyst), Borges Migliavaca, C., Stein, C., Colpani, V., Barker, T. H., Munn, Z., & Falavigna, M.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Hospital Moinhos de Vento (BR)
- The University of Adelaide (AU)
- Venue
- BMC Medical Research Methodology
- Published
- 2020-04-26
- Volume
- 20
- Issue
- 1
- Pages
- 96-96
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC7184711
- OpenAlex
- W3020176834
- Semantic Scholar
- 4f0496b7a284587062ae1f09891801c7372508ad
- Cited by
- 359
- References
- 27
- Citations by year
- 2026: 49 · 2025: 62 · 2024: 72 · 2023: 55 · 2022: 65 · 2021: 51 · 2020: 5
- FWCI
- 9.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- prevalence, meta-epidemiology, reporting quality, methodological quality, search strategies, funding disclosure, reporting guidelines, meta-analysis methodology, subgroup analysis, meta-regression, heterogeneity, publication bias, data transformation, methodological recommendations
- MeSH terms
- Systematic Reviews as Topic, Bayes Theorem, Cross-Sectional Studies, Humans, Meta-Analysis as Topic, Prevalence, MEDLINE, Research Report
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 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
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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