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

Background: The Quality of Reporting of Meta-analyses (QUOROM) conference w as convened to address standards for improving the quality of reporting of meta-analyses of clinical randomised controlled trials (RCTs). Methods: The QUOROM group consisted of 30 clinical epidemiologists, clinicians, statist icians, editors, and researchers. In conference, the group was asked to ide ntify items they thought should be included in a checklist of standards. Wh enever possible, checklist items were guided by research evidence suggestin g that failure to adhere to the item proposed could lead to biased results. A modified Delphi technique was used in assessing candidate items. Finding s: The conference resulted in the QUOROM statement, a checklist, and a flow diagram. The checklist describes our preferred way to present the abstract , introduction, methods, results, and discussion sections of a report of a meta-analysis. It is organised into 21 headings and subheadings regarding s earches, selection, validity assessment, data abstraction, study characteri stics, and quantitative data synthesis, and in the results with "trial flow " study characteristics, and quantitative data synthesis; research document ation was identified for eight of the 18 items. The now diagram provides in formation about both the numbers of RCTs identified, included, and excluded and the reasons for exclusion of trials. Interpretation: We hope this repo rt will generate further thought about ways to improve the quality of repor ts of meta-analyses of RCTs and that interested readers, reviewers, re sear chers, and editors will use the QUOROM statement and generate ideas for its improvement.