. 2022 Aug 9:378:e070849.

doi: 10.1136/bmj-2022-070849.

Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement

Michelle Gates¹, Allison Gates¹, Dawid Pieper², Ricardo M Fernandes³, Andrea C Tricco^{4

5

6}, David Moher⁷, Sue E Brennan⁸, Tianjing Li⁹, Michelle Pollock¹⁰, Carole Lunny⁴, Dino Sepúlveda^{11

12}, Joanne E McKenzie⁸, Shannon D Scott¹³, Karen A Robinson¹⁴, Katja Matthias¹⁵, Konstantinos I Bougioukas¹⁶, Paolo Fusar-Poli^{17

18

19

20}, Penny Whiting²¹, Stephana J Moss²², Lisa Hartling²³

Affiliations

¹ Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany.
³ Clinical Pharmacology Unit, Faculty of Medicine and Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal.
⁴ Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
⁵ Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁶ Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, ON, Canada.
⁷ Clinical Epidemiology Program, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
⁸ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁹ Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
¹⁰ Institute of Health Economics, Edmonton, AB, Canada.
¹¹ Department of Health Technology Assessment and Evidence Based Healthcare, Ministry of Health, Chile.
¹² School of Medicine, Autonomous University of Chile, Santiago, Chile.
¹³ Faculty of Nursing, University of Alberta, Edmonton, Canada.
¹⁴ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁵ Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany.
¹⁶ Department of Hygiene, Social-Preventive Medicine, and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁷ Early Psychosis: Interventions and Clinical-detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's Collect London, London, UK.
¹⁸ OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.
¹⁹ Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
²⁰ National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
²¹ Bristol Medical School, University of Bristol, Bristol, UK.
²² Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
²³ Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada hartling@ualberta.ca.

PMID: 35944924
PMCID: PMC9361065
DOI: 10.1136/bmj-2022-070849

Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement

Michelle Gates et al. BMJ. 2022.

. 2022 Aug 9:378:e070849.

doi: 10.1136/bmj-2022-070849.

Authors

Affiliations

¹ Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany.
³ Clinical Pharmacology Unit, Faculty of Medicine and Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal.
⁴ Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
⁵ Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁶ Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, ON, Canada.
⁷ Clinical Epidemiology Program, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
⁸ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁹ Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
¹⁰ Institute of Health Economics, Edmonton, AB, Canada.
¹¹ Department of Health Technology Assessment and Evidence Based Healthcare, Ministry of Health, Chile.
¹² School of Medicine, Autonomous University of Chile, Santiago, Chile.
¹³ Faculty of Nursing, University of Alberta, Edmonton, Canada.
¹⁴ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁵ Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany.
¹⁶ Department of Hygiene, Social-Preventive Medicine, and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁷ Early Psychosis: Interventions and Clinical-detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's Collect London, London, UK.
¹⁸ OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.
¹⁹ Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
²⁰ National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
²¹ Bristol Medical School, University of Bristol, Bristol, UK.
²² Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
²³ Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada hartling@ualberta.ca.

PMID: 35944924
PMCID: PMC9361065
DOI: 10.1136/bmj-2022-070849

Abstract

Objective: To develop a reporting guideline for overviews of reviews of healthcare interventions.

Design: Development of the preferred reporting items for overviews of reviews (PRIOR) statement.

Participants: Core team (seven individuals) led day-to-day operations, and an expert advisory group (three individuals) provided methodological advice. A panel of 100 experts (authors, editors, readers including members of the public or patients) was invited to participate in a modified Delphi exercise. 11 expert panellists (chosen on the basis of expertise, and representing relevant stakeholder groups) were invited to take part in a virtual face-to-face meeting to reach agreement (≥70%) on final checklist items. 21 authors of recently published overviews were invited to pilot test the checklist.

Setting: International consensus.

Intervention: Four stage process established by the EQUATOR Network for developing reporting guidelines in health research: project launch (establish a core team and expert advisory group, register intent), evidence reviews (systematic review of published overviews to describe reporting quality, scoping review of methodological guidance and author reported challenges related to undertaking overviews of reviews), modified Delphi exercise (two online Delphi surveys to reach agreement (≥70%) on relevant reporting items followed by a virtual face-to-face meeting), and development of the reporting guideline.

Results: From the evidence reviews, we drafted an initial list of 47 potentially relevant reporting items. An international group of 52 experts participated in the first Delphi survey (52% participation rate); agreement was reached for inclusion of 43 (91%) items. 44 experts (85% retention rate) completed the second Delphi survey, which included the four items lacking agreement from the first survey and five new items based on respondent comments. During the second round, agreement was not reached for the inclusion or exclusion of the nine remaining items. 19 individuals (6 core team and 3 expert advisory group members, and 10 expert panellists) attended the virtual face-to-face meeting. Among the nine items discussed, high agreement was reached for the inclusion of three and exclusion of six. Six authors participated in pilot testing, resulting in minor wording changes. The final checklist includes 27 main items (with 19 sub-items) across all stages of an overview of reviews.

Conclusions: PRIOR fills an important gap in reporting guidance for overviews of reviews of healthcare interventions. The checklist, along with rationale and example for each item, provides guidance for authors that will facilitate complete and transparent reporting. This will allow readers to assess the methods used in overviews of reviews of healthcare interventions and understand the trustworthiness and applicability of their findings.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: no support from any organisation for the submitted work; AG and MG are employees of the Canadian Agency for Drugs and Technologies in Health (CADTH); the current work was unrelated to their employment at CADTH and CADTH had no role in the funding, design, or oversight of the work; ACT is an author of PRISMA 2020 and lead author of the PRISMA extension to scoping reviews; DM is co-lead of PRISMA 2020, coauthor of the PRISMA extension to scoping reviews, corresponding author of the EQUATOR guidance of how to develop reporting guidelines, and chair of the EQUATOR Network; SEB and PW are authors of PRISMA 2020; JEM is co-lead of PRISMA 2020; LH is co-author of the PRISMA extension to scoping reviews; all other authors have no competing interests to disclose.

Figures

**Fig 1**
Flow diagram of development process of PRIOR statement (preferred reporting items for overviews of reviews)

**Fig 2**
PRIOR flow diagram (in relation to preferred reporting items for overviews of reviews). *Appendix 6 in the supplementary materials includes the contextual information used to complete the flow diagram

See this image and copyright information in PMC

Comment in

Viewpoints on the PRIOR statement-a reporting guideline for overviews of reviews.
Yang N, Liu H, Zhang K, Chen Y, Estill J. Yang N, et al. Ann Transl Med. 2023 Mar 15;11(5):230. doi: 10.21037/atm-22-5724. Epub 2023 Jan 6. Ann Transl Med. 2023. PMID: 37007563 Free PMC article. No abstract available.

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Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement

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Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement

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