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. 2018 Aug;21(3):95-100.
doi: 10.1136/ebmental-2018-300014. Epub 2018 Jul 13.

Ten simple rules for conducting umbrella reviews

Paolo Fusar-Poli  1   2   3 , Joaquim Radua  1   4   5
Affiliations

Ten simple rules for conducting umbrella reviews

Paolo Fusar-Poli et al. Evid Based Ment Health. 2018 Aug.

Abstract

Objective: Evidence syntheses such as systematic reviews and meta-analyses provide a rigorous and transparent knowledge base for translating clinical research into decisions, and thus they represent the basic unit of knowledge in medicine. Umbrella reviews are reviews of previously published systematic reviews or meta-analyses. Therefore, they represent one of the highest levels of evidence synthesis currently available, and are becoming increasingly influential in biomedical literature. However, practical guidance on how to conduct umbrella reviews is relatively limited.

Methods: We present a critical educational review of published umbrella reviews, focusing on the essential practical steps required to produce robust umbrella reviews in the medical field.

Results: The current manuscript discusses 10 key points to consider for conducting robust umbrella reviews. The points are: ensure that the umbrella review is really needed, prespecify the protocol, clearly define the variables of interest, estimate a common effect size, report the heterogeneity and potential biases, perform a stratification of the evidence, conduct sensitivity analyses, report transparent results, use appropriate software and acknowledge the limitations. We illustrate these points through recent examples from umbrella reviews and suggest specific practical recommendations.

Conclusions: The current manuscript provides a practical guidance for conducting umbrella reviews in medical areas. Researchers, clinicians and policy makers might use the key points illustrated here to inform the planning, conduction and reporting of umbrella reviews in medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Hierarchy of evidence synthesis methods.
Figure 2
Figure 2
Web of Knowledge records containing ’umbrella review' in their title up to April 2018.
Figure 3
Figure 3
Focus of umbrella reviews published in Web of Knowledge (see figure 2—up to April 2018).
See this image and copyright information in PMC

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