# README > Important! The raw survey data referenced in the text below had to be removed from the repo eventually following the request from the original data owner. The reason stated was additional reidentification concern raised upon review. > > The summary of these data is available in a [PRISMA 2020 preprint supplement](https://osf.io/eqrhj/). > Deviations from protocol? > – Yes ❌ (Please note below) This is the study published initially as a protocol on OSF ([DOI 10.17605/OSF.IO/MKCB5](https://doi.org/10.17605/OSF.IO/MKCB5)). Later in the research process, this document was modified to eventually represent the study report, while the version history is available from OSF. Specifically, I had it modified in a local [Git](https://git-scm.com) repository, then posted these updates here on OSF; this was not specified in the protocol. The reporting format is based off of the [PRISMA-P 2015 checklist](https://doi.org/10.1136/bmj.g7647). Although this is not a systematic review protocol, while the PRISMA-P 2015 checklist was designed for reporting systematic review protocols, I have found its format enjoyable to use for this study. This document is licensed under [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). # PRISMA-P 2015 checklist notice > Deviations from protocol? > – Not Applicable ♻️ It is strongly recommended that this checklist be read in conjunction with the PRISMA-P Explanation and Elaboration (cite when available) for important clarification on the items. Amendments to a review protocol should be tracked and dated. The copyright for PRISMA-P (including checklist) is held by the PRISMA-P Group and is distributed under a Creative Commons Attribution Licence 4.0. # ADMINISTRATIVE INFORMATION ## 1 Title ### 1a Identification: Identify the report as a protocol of a systematic review > Deviations from protocol? > – Yes ❌ (Please note below) PRISMA 2020 update: A prospective piloting case study. In contrast to the protocol version of the title, the word `prospective` was added to better reflect the study design. ### 1b Update: If the protocol is for an update of a previous systematic review, identify as such > Deviations from protocol? > – Not Applicable ♻️ This is not an update but an original study. ## 2 Registration: If registered, provide the name of the registry (such as PROSPERO) and registration number > Deviations from protocol? > – No ✅ The study protocol was registered a priori at OSF Registries as planned: [DOI 10.17605/OSF.IO/HF4JB](https://doi.org/10.17605/OSF.IO/HF4JB). ## 3 Authors ### 3a Contact: Provide name, institutional affiliation, e-mail address of all protocol authors; provide physical mailing address of corresponding author > Deviations from protocol? > – No ✅ Pavel Zhelnov, MD. He has no institutional affiliation doing this study as an independent researcher based in St. Petersburg, Russia. E-mail: [pzhelnov@p1m.org](mailto:pzhelnov@p1m.org) Telegram: [@drzhelnov](https://t.me/drzhelnov) Pavel is the only and corresponding author and will be available for electronical correspondence only. COI Statement: > I am involved in some research at [Pavlov University](http://en.1spbgmu.ru), being a PhD student there. I am also part-time self-employed as a freelance research assistant; the list of parties with whom I collaborated is publicly available from [my hiring webpage (in Russian)](https://hire.p1m.org). I am independently collaborating on a project by [QR.Bio LLC](http://qrbio.net). I do not have any other possible conflict of interest to disclose. ### 3b Contributions: Describe contributions of protocol authors and identify the guarantor of the review > Deviations from protocol? > – No ✅ Pavel is the only contributor to the protocol and is the guarantor of the study. I would like to also acknowledge with deep gratitude the contributions by [Matthew James Page](https://osf.io/dnzw2/) who gave helpful comments on the study, though having declined authorship. ## 4 Amendments: If the protocol represents an amendment of a previously completed or published protocol, identify as such and list changes; otherwise, state plan for documenting important protocol amendments > Deviations from protocol? > – Yes ❌ (Please note below) The protocol itself was not materially amended compared to the registration version ([Version 25 ot the wiki page](https://osf.io/hf4jb/wiki/home/) & [Version 6 ot the PDF](https://osf.io/52mzp/)), apart from a couple of changes (wiki Versions 26 & 27): * Added the registration DOI (Version 26); * Cleared one typo/misunderstanding (Version 27): `I will narratively review all the suggestions made in the course of the study.` Was reworded as: `I will narratively review all my suggestions made in the course of the study.` All the deviations _from_ the protocol that occured in the course of the study are to be listed on per-item basis throughout this document. ## 5 Support ### 5a Sources: Indicate sources of financial or other support for the review > Deviations from protocol? > – No ✅ No financial or other support sought or received for this study. ### 5b Sponsor: Provide name for the review funder and/or sponsor > Deviations from protocol? > – No ✅ No funding or sponsorship sought or received for this study. ### 5c Role of sponsor or funder: Describe roles of funder(s), sponsor(s), and/or institution(s), if any, in developing the protocol > Deviations from protocol? > – No ✅ This study is independent research. No institution had any role in developing the protocol. # INTRODUCTION ## 6 Rationale: Describe the rationale for the review in the context of what is already known > Deviations from protocol? > – Not Applicable ♻️ ### Conception of the study On April 14, 2020, I, as a member of the PRISMA 2020 Update Group, received an electronic copy of the draft checklist and a link to the electronic survey inviting to provide piloting feedback; hence the conception of this study. ### PRISMA 2020 Update Group It is worth noting that the PRISMA 2020 Update Group is not synonymous with the the PRISMA 2020 Update Core Group with the latter actually leading the update process and the former additionally involving international contributors to participate in the surveys and piloting. The Core Group members were listed in the [PRISMA 2020 protocol](https://osf.io/p75zc/) as follows: * Matthew J Page * Joanne E McKenzie * Patrick M Bossuyt * Isabelle Boutron * Tammy Hoffmann * Cynthia D Mulrow * Larissa Shamseer * David Moher ### Update process The piloting process has been specified in the protocol, which involved five steps of the update process that predate finalizing the checklist: 1. A systematic scoping literature review to inform the update process. 2. The first round of the Delphi survey to preliminarily decide on the items to modify, remove from, or add to the checklist. 220 persons were invited and 110 responded. The results of this round were to be discussed by the Core Group via teleconference. Apparently, the survey results later published in (and then—for licensing concerns, as personally clarified to me by Matthew J. Page—removed from) the [OSF file repository for the project](https://osf.io/p93ge/files/) represented these very results. 3. The second round of the survey to complete the Delphi process and review the items that had met consensus (66% agreement) in the first round as well as those that had not. Likewise, the results of the second round were to be discussed by the Core Group members via teleconference. 4. An in-person consensus meeting to discuss the results of the Delphi process and formulate the first draft of the updated checklist. The meeting was held on September 13–14, 2018 and involved the Core members as well as other members of the Update Group (21 attendees overall). 5. _The piloting (see below)._ Incidentally, I did not participate in the Delphi surveys nor did I attend the meeting because I was not a part of the team at that time. Some information on the update progress has been published by this moment as the [Cochrane Colloquium 2019 presentation slides](https://osf.io/qbyjg/), which I also used for this section. ### Piloting The objective of the piloting was formulated in the protocol as follows: > We will ask those who pilot the checklist whether the wording of items is ambiguous or difficult to interpret. In the preamble of the email I received, the objective of the piloting was formulated more vaguely, inviting the respondent to _share thoughts_ and _provide feedback_. It was also noted that anonymity of the response would be preserved by default, and the responses would be deidentified and collated before publication. To prepare for the piloting, I reviewed the [update protocol](https://osf.io/p75zc/) and the [associated literature review](https://doi.org/10.1016/j.jclinepi.2019.11.010) as well as the contents of the corresponding [OSF repository](https://doi.org/10.17605/OSF.IO/P93GE). Also, I have recorded this process live and [published it on YouTube](https://www.youtube.com/watch?v=RtEl-LXD6mg). ## 7 Objectives: Provide an explicit statement of the question(s) the review will address with reference to participants, interventions, comparators, and outcomes (PICO) > Deviations from protocol? > – No ✅ Comment on the proposed items of the draft PRISMA 2020 checklist while suggesting to remove, amend, or leave them as is as well as formulate and elaborate on any new items or more general ideas about the PRISMA 2020 update. # METHODS ## 8 Eligibility criteria: Specify the study characteristics (such as PICO, study design, setting, time frame) and report characteristics (such as years considered, language, publication status) to be used as criteria for eligibility for the review > Deviations from protocol? > – Yes ❌ (Please note below) I used the following basic information sources for this study as specified in the protocol (listing the PRISMA 2009 checklist as done in the protocol was later found redundant because one of the other list items had already contained all the PRISMA 2009 checklist items; see below): 1. The draft PRISMA 2020 checklist sent to me (undisclosable at the moment; however, it is already known from the [Cochrane Colloquium presentation](https://osf.io/qbyjg/) to contain 27 items, like its predecessor). 1. The [Table S4 of the Appendix]( https://osf.io/kbj6v/) containing verbatim copies of all 349 reporting items relevant to systematic reviews or meta-analyses of interventions that have been identified in the [systematic scoping review by the PRISMA 2020 Update Core Group](https://doi.org/10.1016/j.jclinepi.2019.11.010) (the first step in the PRISMA 2020 update process as referenced above in the _Rationale_). Also, this table contains all the PRISMA 2009 items. 1. The [results of the first round of the PRISMA 2020 Delphi survey](https://osf.io/eq95b/), which, as of June 3, 2020, are no longer available from the project OSF repository for licensing concerns, as personally clarified to me by Matthew J. Page; however, they are still legitimately available from this fork, which I had made earlier. Also, I deemed it necessary to make use of the following sources: 1. [QUORUM Statement & Checklist (1999)](https://doi.org/10.1016/s0140-6736(99)04149-5); and selected references. 1. [PRISMA 2009 Statement](https://doi.org/10.1371/journal.pmed.1000097); and selected references. 1. [PRISMA 2009 E&E](https://doi.org/10.1371/journal.pmed.1000100). 1. [PRISMA for Abstracts Statement & Checklist (2013)](https://doi.org/10.1371/journal.pmed.1001419). 1. [PRISMA-S Statement & Checklist (Mar 2, 2020 Preprint)](https://doi.org/10.31219/osf.io/sfc38). I have not had any set of sources to screen, so no eligibility criteria were applicable. ## 10 Search strategy: Present draft of search strategy to be used for at least one electronic database, including planned limits, such that it could be repeated > Deviations from protocol? > – No ✅ ### Consideration As no search was planned as part of this study, while the first and the third sources of information I was going to use required no additional explanation, I had summarized the process of the [systematic scoping review by the PRISMA 2020 Update Core Group](https://doi.org/10.1016/j.jclinepi.2019.11.010) that led to the identification of the 349 reporting items I used as the second source of information for this study. ### Item sources * All done solo by Matthew James Page. * PRISMA 2009 and all extensions. * All guidance on EQUATOR Network up to May 31, 2019. * Four major manuals for systematic reviewers by Cochrane (2011), IoM (2011), AHRQ (2014), and JBI (2017). * Other relevant methodological literature known to the authors. Per protocol, also planned a systematic search for methodologic literature adapting a strategy from [McGrath 2017](https://doi.org/10.1186/s13643-017-0590-8), but eventually did not do it because of the very low precision (>46,000 references). * A ‘systematic search for published comments on, or suggested revisions to, the PRISMA 2009 statement’ in Ovid MEDLINE up to July 31, 2017. Translated into PubMed syntax, the search query reads as follows: `("Preferred Reporting Items for Systematic reviews and Meta-analyses" [TIAB] OR (PRISMA [TIAB]))`. The search ‘yielded 5,001 citations. After screening each title and abstract, the full text of 170 articles was retrieved, and 43 met the inclusion criteria…However, none of the 43 articles contained any additional relevant reporting items…so are not discussed further.’ * Full list of sources available from Tables S1 & S2 of the [Appendix](https://osf.io/kbj6v/) (60 sources overall). ### Data charting * All done solo by Matthew James Page. * The authors ‘extracted all guidance that they deemed potentially relevant to the reporting of SRs and meta-analyses of interventions.’ * No _conduct_ guidance was extracted; ‘did not extract items that apply only to specific types or aspects of SRs.’ * ‘Reporting guidance was extracted verbatim from both the checklist and “explanation and elaboration” paper (where available) for each included reporting guideline.’ * ‘Reporting items were extracted into a table created in Microsoft Word, with one column for the reporting item and another for the source of the text extracted; each row in the table represented a single reporting item. The table was populated initially with each of the PRISMA 2009 checklist items and any corresponding reporting guidance found in the PRISMA 2009 “explanation and elaboration” paper. This resulted in an initial list of 46 reporting items (19 of the 27 PRISMA 2009 checklist items had additional reporting guidance in the “explanation and elaboration” paper whereas the following eight items did not: 2, 4, 15, 18, 19, 24, 25 and 26). The table was then populated by recording from other sources all relevant reporting guidance that differed in any way from what was previously extracted.’ * ‘After reviewing all sources, each source was reviewed a second time in the same order…to minimise the chance of missing relevant items.’ * The resulting ‘table created in Microsoft Word’ apparently reported as Table S4 in the [Appendix](https://osf.io/kbj6v/) (349 reporting items overall), which will be in fact used in this study. * ‘Once all sources had been reviewed twice, one author (MJP) read the reporting guidance extracted from all sources and compiled a list of unique reporting items. This was done by comparing and contrasting the text extracted and removing any guidance deemed redundant (i.e. covering the same conceptual or methodological issue).’ * ‘For some of the items presented in the list of unique reporting items, we changed the wording from the original source to make it more applicable to SRs of interventions, or broke a comprehensive item into multiple sub-items to facilitate clarity.’ * The resulting collated ‘list of unique reporting items’ apparently reported as Table S3 in the [Appendix](https://osf.io/kbj6v/) (221 unique reporting items overall). * Apparently, these 221 items were the ones used in the subsequent update process. In this study, I have not used this derivative list because the original list was available and seemed more robust to use. ## 11 Study records ### 11a Data management: Describe the mechanism(s) that will be used to manage records and data throughout the review > Deviations from protocol? > – Yes ❌ (Please note below) ### #1 PRISMA 2020 checklist * The PRISMA 2020 file sent to me were used for reference. * The PRISMA 2009 DOC file that was, too, specified in the protocol, was not eventually used because all its items were found to be present within the Table S4 (see below). ### #2 Table S4 of the literature review Appendix The original PDF file was used for reference. ### #3 Results of the first round of the Delphi survey * These data were originally reported as a single massive CSV file problematic to work with. * So I had reformatted the data to allow for comfortable item-by-item review. No data were changed—just the format. * As the process of transformation was solely technical in nature, I had not elaborated much on it but rather summed up its main stages: * Upload the CSV data into a [FormTools](https://formtools.org) form mirroring the structure of the CSV file (156 main data fields + accessory fields). * Set up the form to show a separate view for each survey item: 1 view for each of the 27 PRISMA items + 12 views for the PART B items of the survey + 3 views for the PART C items of the survey = 42 views overall * Debug some encoding glitches present (see [UTF-8 Character Debug Tool](https://www.i18nqa.com/debug/utf8-debug.html) for more info). * Export each view as a separate XLSX file and upload all the 42 files into the `Survey_data` directory in the [file repository of this fork](https://osf.io/mkcb5/files/). * Though specified in the protocol, I did not review the 15 of 42 files related to the parts B & C of the survey because, at last, I deemed it impractical. So only the 27 of 42 files that were related to each original PRISMA 2009 item were reviewed. * As a result, comfortable item-by-item review was possible with these files, so these were the files that have been used in this study. * No changes were required to these data structures given the contents of the new PRISMA 2020 checklist, because these data were used for reference only. ### The other five sources I used electronic full-text publications. ### 11b Selection process: State the process that will be used for selecting studies (such as two independent reviewers) through each phase of the review (that is, screening, eligibility and inclusion in meta-analysis) > Deviations from protocol? > – No ✅ No set of records to screen, so not applicable. ### 11c Data collection process: Describe planned method of extracting data from reports (such as piloting forms, done independently, in duplicate), any processes for obtaining and confirming data from investigators > Deviations from protocol? > – Yes ❌ (Please note below) * For a regular PRISMA 2020 checklist item, I have reviewed: * All available PRISMA E&E relatable to this item; this was not specified in the protocol. * All the reporting items from the Table S4 that were related to this item. * All the 110 survey responses related to this item. * As there was no one-to-one correspondence between the PRISMA 2009 & 2020 items, strict comparisons as specified in the protocol were not possible, so the reference data related to the most relevant items of the older checklist were used. * I cannot explicitly disclose these mappings because the permission to publish the draft 2020 checklist has not been issued by the PRISMA Update Core Group yet; however, I did record these mappings, so they are amenable to publishing when appropriate. * It must be noted that I did not follow the regular procedure for some of the items because it seemed irrelevant given the considerations I had regarding them and the specific features of the items under review. That also means that for some of the items, I did not review some or all of the information sources: When I did review all in full, I used structured comments, otherwise (when no full review was conducted) I used simple comments. The details on this will be available as soon as the results of this study should be published (see below). * Eventually, I have documented my suggestion to remove, amend, or leave the PRISMA 2020 checklist item under review and any free-text comment thereon (_Table #1_). * The structure of the _Table #1_ has been considerably reworked compared to the version presented in the protocol to reflect the changes of the 2020 checklist. These are not disclosable at the moment but are amenable to disclosure in the future at the discretion of the PRISMA Update Core Group. * Whenever I felt a new item was required, I should have documented this new item as well as the rationale in a separate table (_Table #2_). However, I did not elect to suggest any new items, so this table remained unused eventually. * Lastly, whenever I felt a general suggestion on updating PRISMA was warranted, I documented this suggestion. However, I have not used a separate table (_Table #3_) for this as specified in the protocol but have documented these suggestions under the Item #15d of this document (please see this item for the data and the detailed explanation). * In addition to the tables reported in the protocol, two more tables needed to be instantiated given the contents of the 2020 checklist (_Tables #1a & #1b_). These related to the changes introduced in the newer checklist (again, undisclosable at the moment). However, _Table #1a_ did not come to be useful eventually and was unused (again, reasons undisclosable at the moment). * Overall, two tables were populated using [FormTools](https://formtools.org) (_Tables #1 & #1b_). * **Override: A [PRISMA 2020 preprint](https://doi.org/10.31222/osf.io/v7gm2) has been published, so safely see the [interim piloting report](https://osf.io/bct56/). The full report is pending but will become available soon as part of the preparation of a manuscript to be submitted to _J Clin Epidemiol_, which is in the works.** As such, I cannot report any of these results at the moment as specified in the protocol because their publication will in turn invoke the undue publication of the draft 2020 checklist, so this will need to be held. But eventually, these tables are to be reported in the `Piloting_data` directory in the [file repository of this fork](https://osf.io/mkcb5/files/) as specified in the protocol. * However, I must note I am definitely sharing these results (in an appropriate format) with the PRISMA Update Core Group using the private feedback Google Form they provided. Before doing it, I have completed the study and have reviewed this document for mistakes. Also, I have added read-only views to the _Tables #1 & #1b_ in [FormTools](https://formtools.org) and have set them active by default; I have done this to prevent changing the contents of the forms by mistake while copying the text to the survey form provided by the Core Group. The version of this document used at the feedback stage is available from the file repository as the [pre feedback report](https://osf.io/kxhjr/); **the current version is the [interim piloting report](https://osf.io/bct56/)**. * It should also be noted that I worked on this study following a tight schedule, so this alone could be responsible for some deviations from the protocol described throughout this document. ## 12 Data items: List and define all variables for which data will be sought (such as PICO items, funding sources), any pre-planned data assumptions and simplifications > Deviations from protocol? > – Yes ❌ (Please note below) * From the PRISMA 2020 checklist and the Table S4, the reporting items were reviewed. I did also look at the additional `Administrative information` and `Data availability` sections of the Table S4 after I have finished reviewing all of the PRISMA items; however, no new information was generated after I looked. * From the survey responses tables, the responses were reviewed. It is worth noting I extracted not the distribution of the responses but mostly free-text information; that was not prespecified in the protocol. To be more specific, I opened my XLSX files from the `Survey_data` directory of the [file repository](https://osf.io/mkcb5/files/) using a desktop spreadsheet editor; then read the Core Group’s consideration regarding the item; then scrolled through all the responses related to the checklist; then scrolled through all the responses related to the elaboration as well as general comments (the four- to five-column format of the table made it difficult to read in whole lines). ## 13 Outcomes and prioritization: List and define all outcomes for which data will be sought, including prioritization of main and additional outcomes, with rationale > Deviations from protocol? > – No ✅ My personal suggestions on updating the PRISMA guidance with regard to (1) modifications of or removals from the draft 2020 checklist, (2) adding new items to the checklist, and (3) general considerations about PRISMA were the primary and only outcomes. ## 14 Risk of bias in individual studies: Describe anticipated methods for assessing risk of bias of individual studies, including whether this will be done at the outcome or study level, or both; state how this information will be used in data synthesis > Deviations from protocol? > – No ✅ As the risk of bias is preferably assessed at an outcome level (https://www.riskofbias.info), and the outcomes of this study are a personal opinion, the matter of risk of bias assessment in this study is disputable at best. Therefore, no risk of bias assessment was conducted because the outcomes were a personal opinion. ## 15 Data synthesis ### 15a Describe criteria under which study data will be quantitatively synthesised > Deviations from protocol? > – No ✅ No quantitative synthesis was conducted. ### 15b If data are appropriate for quantitative synthesis, describe planned summary measures, methods of handling data and methods of combining data from studies, including any planned exploration of consistency (such as I2, Kendall’s τ) > Deviations from protocol? > – Not Applicable ♻️ Not applicable. ### 15c Describe any proposed additional analyses (such as sensitivity or subgroup analyses, meta-regression) > Deviations from protocol? > – No ✅ None planned. ### 15d If quantitative synthesis is not appropriate, describe the type of summary planned > Deviations from protocol? > – Yes ❌ (Please note below) * **A [PRISMA 2020 preprint](https://doi.org/10.31222/osf.io/v7gm2) has been published, so safely see the [interim piloting report](https://osf.io/bct56/). The full report is pending but will become available soon as part of the preparation of a manuscript to be submitted to _J Clin Epidemiol_, which is in the works.** * I will narratively review all the suggestions I made in the course of the study and will save the text locally; as I am not allowed to publish it at the moment because it ‘spoils’ the 2020 checklist heavily (see similar comments above), I will do that later when preparing a publication. * When acceptable to publish, I will also copy and paste my narrative review in this section of this wiki page. * Once again, I must note some narrative will be shared (in an appropriate format) with the PRISMA Update Core Group using the private feedback Google Form they provided. * However, my general notes on this PRISMA Update (_Table #3_ in the protocol), arguably, can be shared, which is more sensibly done right here, in this document, rather than in a separate single-column table as specified in the protocol. * So I am removing the unused _Table #3_ files from the [file repository](https://osf.io/mkcb5/files/); please find my general PRISMA 2020 comment reported as the blockquote below: > * This update seems, by all means, absolutely needed. As far as I know, the 2020 PRISMA will be the first version of the systematic review reporting guidance (superseding the 1999 QUOROM & 2009 PRISMA statements) to be developed from an _a priori_ published protocol. Also, the previous methodologies to develop the checklist were reportedly less rigorous in that less input from the community and fewer iterations of the checklist development were available. Specifically: (1) no specially-tailored systematic review to inform the development of the checklist was reported for the previous versions of the guidance; (2) no pre-meeting two-stage Delphi exercise with its raw results published online in full was previously reported; (3) no post-meeting piloting of the checklist was previously reported. And to reiterate, most importantly, no _a priori_ published protocol was available for review for either QUOROM or PRISMA 2009. > * However, one is neither to overestimate possible benefits of updating the guidance, especially when any attempts subsequent (to the current) are considered, nor to oversee its potential harms. The notion that the guidance itself should be evidence-based when possible is by no means new and has been stated explicitly since the emergence of the 1999 QUOROM document. Fortunately, meta-epidemiologic evidence concerning various aspects of knowledge synthesis reporting guidelines is massive to date; but is there any high-certainty evidence that _updating_ the guidance should significantly alter the primary endpoints, that is, arguably, true reproducibility of the reviews (as opposed to the _surrogate_ endpoints such as guidance adherence or expert-reported quality profiles), while also avoiding important harms such as wasted research efforts or cognitive overload? To my knowledge, even if such evidence does exist, it is not the primary target of systematic review reporting guidelines research. Thus, I suggest such _primary_ research is urgently needed (preferably designed as randomized trials); but at first and at the very least, a scoping review is required to summarize available evidence. > * Also, an exhaustive and current (updated live) list of evidence supporting each feature of the guidance is, surely, a publication I am sadly missing. > * The upcoming PRISMA content update will, of course, refresh the guidance, directing newer methodologic currents into it. But at the same time, has the guidance presentation changed since 2009 (1999)? Not really if you think of it: What we have now is a [rather outdated website](http://www.prisma-statement.org) with almost no interactive features and noncurrent content, noninteractive checklist and E&E tools, and a dozen extensions that still need to be manually fit together when used in research; there is, too, this [EQUATOR Network page](https://www.equator-network.org/reporting-guidelines/prisma/) that does not seem to help much. In my opinion, it is crucial that the appropriate funding be secured and the PRISMA infrastructure be updated to represent a single web portal (mobile application) accumulating all the current checklists, statements, E&E documents, extensions, and evidence summaries in an interactive and cohesive manner. It is also probably prudent to run it as a bigger project incorporating all major reporting guidance branches (e.g. CONSORT, STROBE, AGREE, etc.), it probably being operational at the EQUATOR Network platform. > * The whole `Results` section of the guidance requires a separate comment. In short, I do not believe this section is at all justified in the guidance. In my opinion, it could be safely reduced to one item suggesting that authors report the results using the exact same framework they set up in the `Methods` section. I believe emphasizing the need for the results to mirror their respective methods could never be overstated. Thus, I suggest to convert the `Results` section into an item as follows, though exact wording is amenable for a change: > > ‘Describe the results generated while executing the “Methods” section of the review.’ ## 16 Meta-bias(es): Specify any planned assessment of meta-bias(es) (such as publication bias across studies, selective reporting within studies) > Deviations from protocol? > – No ✅ No risk of bias assessment was conducted because the outcomes were a personal opinion. ## 17 Confidence in cumulative evidence: Describe how the strength of the body of evidence will be assessed (such as GRADE) > Deviations from protocol? > – No ✅ No certainty of evidence assessment was conducted because the outcomes were a personal opinion and were not meant for extrapolation.