Improving the quality of reports of meta-analyses of randomised controlledtrials: the QUOROM statement

Background The Quality of Reporting of Meta-analyses (QUOROM) conference wa s convened to address standards for improving the quality of reporting of m eta-analyses of clinical randomised controlled trials (RCTs). Methods The QUOROM group consisted of 30 clinical epidemiologists, clinicia ns, statisticians, editors, and researchers. In conference, the group was a sked to identify items they thought should be included in a checklist of st andards. Whenever possible, checklist items were guided by research evidenc e suggesting that failure to adhere to the item proposed could lead to bias ed results. A modified Delphi technique was used in assessing candidate ite ms. Findings The conference resulted in the QUOROM statement, a checklist, and a flow diagram. The checklist describes our preferred way to present the ab stract, introduction, methods, results, and discussion sections of a report of a metaanalysis. It is organised into 21 headings and subheadings regard ing searches, selection, validity assessment, data abstraction, study chara cteristics, and quantitative data synthesis, and in the results with "trial flow", study characteristics, and quantitative data synthesis; research do cumentation was identified for eight of the 18 items. The flow diagram prov ides information about both the numbers of RCTs identified, included, and e xcluded and the reasons for exclusion of trials. Interpretation We hope this report will generate further thought about ways to improve the quality of reports of meta-analyses of RCTs and that intere sted readers, reviewers, researchers, and editors will use the QUOROM state ment and generate ideas for its improvement.