Centre for Reviews and Dissemination An overview of development and progress May 2013 PROSPERO...

Centre for Reviews and Dissemination

An overview of development and progressMay 2013

PROSPEROInternational prospective register of systematic reviews


Background: the need for registration

• Systematic reviews usually provide the evidence base upon which health and social care decisions are made so they should be robust and free from bias

• There is concern about publication and selective outcome reporting biases associated with systematic reviews

• Unplanned duplication of reviews is a waste of resource– No open register for review protocols (Cochrane and Campbell

Collaboration protocol registration limited to their own organisations)

• PRISMA 2009 Checklist: asks for protocol and registration details


Taking the initiative

• Following publication of the PRISMA statement CRD began to receive unsolicited requests to register systematic reviews

• CRD has an established IT platform and infrastructure for the DARE, NHS EED and HTA databases

• Set up an international advisory group

• Carried out an international consultation to establish a minimum dataset and raise awareness


Registration minimum dataset 22 required fields:

Administrative • Review title• Named contact(s)• Contact e-mail• Organisational affiliation• Funding source/sponsors• Conflict of interests• Anticipated or actual start date• Stage of review†

• Anticipated completion date• Review status†

† these fields are updated as the review progresses

Review design • Review question/objective• Condition/domain studied• Search details• Participants/population• Intervention/exposure• Comparator/control• Study types• Primary outcomes• Secondary outcomes• Risk of bias (quality) assessment• Strategy for data synthesis• Planned subgroup analyses


Registration dataset 18 optional fields:

Administrative

• Contact postal address• Contact phone number• Review team members & affiliations• Collaborators• Other registration details• Organisational reference number• Language• Country• Key words• Existing review by same authors• Any other information ‡

Review design

• Type of review• URL to search strategy• URL to full protocol‡

• Context• Data extraction methods• Dissemination plan• Link to final report/publication ‡ (added

over time)

‡ Fields included in response to Delphi comments


PROSPERO: International prospective register of systematic reviews

• Web based• Free to register• Free to search• Users create and update their own records• Minimum data set required• Record content is the responsibility of review lead• Administrators check for “sense” not peer review• A public audit trail of amendments is maintained


Eligibility for inclusion in PROSPERO

• Systematic reviews of the effects of interventions and strategies to prevent, diagnose, treat, and monitor health conditions, for which there is a health related outcome

• Reviews of methodological issues need to contain at least one outcome of direct patient or clinical relevance in order to be included in PROSPERO (included from November 2012)

• Systematic reviews of reviews with a health related outcome (included from November 2012)

• New Cochrane review protocols uploaded automatically (should not be registered individually) (included from Jan 2013)

• Registration should take place once the systematic review protocol is finalised, but ideally before screening studies for inclusion begins


Eligibility for inclusion in PROSPERO

• Exclusions:– Scoping reviews – reviews of animal studies – reviews of methods for which there is no direct

health related outcome • Reviews that have progressed beyond the

completion of data extraction are not accepted• Completed reviews are not accepted


The story so far…

PROSPERO opened for registration 22 February 2011

In April 2013:

• Registered reviews being undertaken in 57 different countries

• 1467 registrations published:

– 1245 are ongoing reviews– 167 are completed but not yet published– 62 are completed and published– 6 have been abandoned


Cumulative new registrations on PROSPERO

Feb-11

Mar-11

Apr-11

May-11

Jun-11Jul-1

1

Aug-11

Sep-11

Oct-11

Nov-11

Dec-11

Jan-12

Feb-12

Mar-12

Apr-12

May-12

Jun-12Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

Mar-13

Apr-13

0

200

400

600

800

1000

1200

1400

1600

0 11 25 4081 109 134

170 202240

285322

372423

472551

599680

738813

897974

1045

1155

1255

1365

1486


Supporters of the principle of registration and PROSPERO

• Organisations and networks

– NIHR, CIHR, Cochrane and Campbell Collaborations, Joanna Briggs Institute, INAHTA, Guidelines International Network, James Lind Alliance, ANZCTR, WHO Alliance for Health Policy and Systems Research, AZQ, Public Health Wales, HNODS

• Publishers

– PLoS journals, BMJ, BMJ Open, BioMed Central, BJOG: recommend registration in their instructions to authors

• Funders

– The UK NIHR have introduced mandatory registration for all the eligible systematic reviews they fund


Achieving aims

• Reduce unplanned duplication of reviews:– the NIHR HTA Programme decided not to

commission research on restricted elimination diet in Attention Deficit-Hyperactivity Disorder after finding on PROSPERO an overlapping research project already in progress

• Allow comparison of plans with final report:– PROSPERO registration number now appearing in

final reports in peer reviewed journals– Peer reviewers are contacting CRD with queries, in

particular about stage of review at time of acceptance


Evaluation of utility at one year

Administrative data and web statistics were collated and an online survey of users’ experiences undertaken: • Registration is feasible and not overly

burdensome• On the whole, survey respondents are satisfied -

the system allows registration in a straightforward and acceptable way

• Some changes introduced to improve user experience e.g. save draft as editable document


Future developments

• Encourage more supporters to help raise awareness of the value of prospective registration of systematic reviews

• Work with commissioning and funding organisations to help facilitate grant holder uptake and compliance

• Continue to broaden the inclusion criteria

• Promote the wide use of both the registration process and the search facility

• Conduct methodological research


www.crd.york.ac.uk/PROSPERO

The development and ongoing management of PROSPERO is supported by CRD’s core work programme which is funded by the National Institute for Health Research, England; the Department of Health, Public Health Agency, Northern Ireland and the National Institute for Social Care and Health Research, Welsh Government

The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR, Department of Health, or any of CRD’s funders

Centre for Reviews and Dissemination An overview of development and progress May 2013 PROSPERO...

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