BJUI Systematic Review and Meta-analysis Guidelines
In order to assure the highest quality articles, please apply the following guidance:
1. A priori design: Please prospectively register your topic on the PROSPERO website
(http://www.crd.york.ac.uk/PROSPERO). We’d ask you to put particular emphasis on the
selection of the main outcomes of the review, which should be patient-important rather
than surrogate outcomes. Please also predefine any subgroup analyses you plan to do.
Ultimately, the actual analysis performed and the protocol should correspond as to
support the validity of your review findings.
2. Literature search: We strongly encourage you to include a team member with dedicated
expertise in literature searches. You should search multiple databases (for example:
MEDLINE, EMBASE, CENTRAL and others depending on the topic). Study inclusion and
exclusion criteria should correspond to those predefined in your PROSPERO protocol.
3. Inclusion of unpublished studies: To avoid publication bias, please describe your
searches for unpublished studies, such as abstract proceeding from urological meetings
(i.e. BAUS, EAU, AUA, ASCO etc.). Also consider searching dedicated databases for the
so-called grey literature. We also encourage you to include studies in other languages
than English alone.
4. Provide a list of included and excluded studies: Please provide a PRISMA flow diagram to
outline your literature search. This should provide reference numbers for the number of
references identified through the search (1), the number of references included after
title/abstract screening (2), the number of studies included after full text screening (3)
and the number of studies ultimately included (4). Please map multiple references for a
single study to a unique study ID. Please provide references for references that reach
stages (3) and (4).
5. Study Selection and Data Abstraction: Two independent members of the research team
should perform these steps in duplicate. Please pilot test your data abstraction form in
advance.
6. Characteristics of included studies: It is important that you provide the readers with
sufficient information about the included studies to put the results into perspective, e.g.
patient mean age, gender distribution, disease stage, drug dose etc. This is best
accomplished in the form of a table.
7. Assessment of scientific quality: Please use a contemporary system such as GRADE
(http://www.gradeworkinggroup.org/) to assess the quality of evidence. This should
include an assessment of study limitations (risk of bias), for example by using the
Cochrane risk of bias tool as well as other domains such as indirectness, imprecision,
inconsistency and publication bias. These assessments should be made on an outcomespecific basis. We encourage you to provide a summary of findings/evidence profile.
8. Using quality of evidence ratings in formulating conclusions: Please make sure that your
quality of evidence ratings for various outcomes finds explicit reference in our
discussion and conclusion. If intervention A is better than intervention B based on high
quality evidence, your interpretation should read differently than if it was based on very
low quality evidence.
9. Use of appropriate methods to pool study results: For result pooled in a meta-analysis, a
test should be done to ensure the studies were combinable, to assess their
homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists a
random effects model should be used and/or the clinical appropriateness of combining
should be taken into consideration (i.e., is it sensible to combine?). If your study
includes randomized controlled and observational studies, it is advisable to analyze
these separately first and pool them only if the results are similar.
10. Assess the likelihood of publication bias: If the number of studies included is sufficient
(usually > 10), please report an assessment of publication bias using graphical aids (e.g.,
funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test,
Hedges-Olken)
11. Conflict of interest reporting: Please abstract information on who funded the individual
studies included in your systematic review and report your own potential financial
conflicts of interests according to BJU International reporting guidelines.
As you report the results of your systematic review, please apply relevant reporting guidelines
as found on the website of the EQUATOR Network (http://www.equator-network.org/). These
include the PRISMA guidelines for systematic reviews of randomised controlled trials and
MOOSE guidelines for observational studies.