Extending the PRISMA statement to equity-focused systematic reviews (PRISMA-E 2012): explanation and elaboration

Abstract

Background: The promotion of health equity, the absence of avoidable and unfair differences in health outcomes, is a global imperative. Systematic reviews are an important source of evidence for health decision-makers, but have been found to lack assessments of the intervention effects on health equity. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) is a 27 item checklist intended to improve transparency and reporting of systematic reviews. We developed an equity extension for PRISMA (PRISMA-E 2012) to help systematic reviewers identify, extract, and synthesise evidence on equity in systematic reviews.

Methods and findings: In this explanation and elaboration paper we provide the rationale for each extension item. These items are additions or modifications to the existing PRISMA Statement items, in order to incorporate a focus on equity. An example of good reporting is provided for each item as well as the original PRISMA item.

Conclusions: This explanation and elaboration document is intended to accompany the PRISMA-E 2012 Statement and the PRISMA Statement to improve understanding of the reporting guideline for users. The PRISMA-E 2012 reporting guideline is intended to improve transparency and completeness of reporting of equity-focused systematic reviews. Improved reporting can lead to better judgement of applicability by policy makers which may result in more appropriate policies and programs and may contribute to reductions in health inequities. To encourage wide dissemination of this article it is accessible on the International Journal for Equity in Health, Journal of Clinical Epidemiology, and Journal of Development Effectiveness web sites.

Fig. 1

Item 3A, Example 1 – Analytic Framework. This is an example of a “funnel of attrition” [41, 42]

Fig. 2

Item 3A, Example 2 – Analytic Framework. This is an example of a logic model [43]

Fig. 3

Harvest Plot. The ‘harvest plot’ synthesizes and displays the evidence to support possible social gradients in the effects of the intervention [18]

Fig. 4

Absolute and Relative Gender Disparity in Stomach Cancer Mortality, 1930–2000 [78]