Editorial: CORR® criteria for reporting meta-analyses.

Meta-analyses and systematic reviews provide ways of synthesizing literature to clarify issues on which there is controversy or to confirm generally held views. They are used increasingly in orthopaedic surgery and other fields: a PubMed search of orthopaedic meta-analyses using ‘‘(orthopaedic[ad] OR orthopedic[ad]) AND meta-analysis[ti]’’ yielded 145 articles, 104 of which were published since 2008. The quality of these reviews has varied greatly. Because of the varying quality of review articles, numerous groups have established criteria to aid standardized methods of reporting. In 1999, a working group of 30 clinicians, epidemiologists, statisticians, and other methodologists [2] proposed an approach to enhance meta-analyses based on randomized controlled trials. They suggested authors develop a flow diagram describing the methods of identifying and selecting articles, and then complete a checklist of 21 items from the individual studies that should be included in a meta-analysis. They referred to their process by the name, ‘‘Quality of Reporting of Meta-analyses’’ or ‘‘QUOROM.’’ A working group of 29 participants updated their suggestions in 2009 and renamed the standards, ‘‘Preferred Reporting Items for Systematic Reviews and Meta-analyses’’ or ‘‘PRISMA’’ [3]. Even given these guidelines, the quality of the selected studies for inclusion remains an obstacle to high-quality meta-analyses. Oxman and Guyatt [4] in 1991 were perhaps among the earliest to propose a method of judging the quality of articles using a 13-item questionnaire. In 2003 Whiting et al. [5] proposed a checklist of nine items that reflected the quality of a study to be included in a systematic review (‘‘quality assessment of studies of diagnostic accuracy’’ or ‘‘QUADAS’’), and in 2011 [6] this proposal was updated. These efforts to judge the value of a study are crucial to enhancing the quality of medical evidence through metaanalyses, but do not necessarily ensure the worth of such reports. Wright et al. [8] recently proposed criteria the Journal of Bone and Joint Surgery (JBJS), American volume, will use for considering meta-analyses or systematic reviews: