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Table 11 Summary of elements to include when reporting a systematic review

From: An approach to addressing subpopulation considerations in systematic reviews: the experience of reviewers supporting the U.S. Preventive Services Task Force

Report section

Reporting elements

Abstract

- Report valid, a priori subgroup or subpopulation findings in the structured abstract.

- Report non-valid or insufficient evidence if it is a critical clinical or policy issue.

Introduction

- Summarize the rationale for specific subpopulation considerations, including disease burden and potential differences in expected harms or benefits from the clinical preventive service, based on previous research [18].

Methods

- Briefly summarize the approach used to identify important subpopulation considerations in the review (e.g., literature searches, clinical and content expert consultation, and public comments).

- Identify the a priori subpopulations the review addressed and the approaches taken for locating these data.

- Clearly report how subgroups were defined (e.g., by categorical predictors or continuous risk scores) [18].

- Describe methods for abstracting subgroup and related analyses and any quality control processes, such as dual reviewing extracted data from primary studies [18].

- Describe methods for assessing the credibility of subgroup analyses related to a priori subpopulations at the study level and for focusing the report on clinically meaningful subpopulation results in the body of evidence.

- Report methods used to explore heterogeneity of intervention effects [18]. Describe methods for additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if conducted, indicating those that were specified a priori [37].

Results

- Summarize qualitative heterogeneity of body of evidence at methodological and clinical levels.

- Report all proposed and actual investigations of clinical heterogeneity differentiating prespecified and post hoc, including all subgroups and outcomes analyzed [18, 19, 61].

- Summarize the frequency of subgroup analyses for a priori subgroups, the credibility of available subgroup analyses, and overall coherence of findings.

- Report whether within-study results showed statistical evidence of effect modification by baseline subpopulation or other important characteristics across studies [64].

- Report results of meta-regression or other pooled subpopulation analyses if conducted. Report judgments or findings of clinical, methodological, or statistical heterogeneity.

- Summarize results of subgroup analyses as absolute risk reductions and relative risk reductions.

- Report any subpopulation differences in rates of serious harms. Report any other factors strongly associated with these harms [65].

- Any reported results from post hoc subgroups or subpopulations should be labeled exploratory.

Discussion

Summary of evidence

- Summarize the main findings for the overall body of evidence and subpopulations of interest [37].

- Report on all a priori subgroups, whether reporting on the absence of data to evaluate, an absence of detected effect modification (for relative or absolute measures), or detectable effect modification (on which scale), and its clinical significance.

- Clearly report and distinguish between evidence of no effect, uncertain or incomplete evidence, or lack of evidence.

- Clearly state when evidence may warrant separate considerations of net benefit in subpopulations.

- Clearly indicate if caution is warranted in applying the average effect for some types of patients, even if evidence is unavailable or limited.

Limitations

- Summarize limitations of subgroup and subpopulation findings at the study, outcome, and review levels based on gaps in the evidence.

Future research

- Reference important exploratory findings from post hoc subgroups.

- Provide recommendations on how future research could proceed or build upon results vis-à-vis important subpopulations.

Conclusions

- Provide a general interpretation of any a priori subpopulation findings in the context of other evidence.