Abstract
BACKGROUND: Systematic reviews (SRs) with thorough reporting and rigorous methodology lead to less biased outcomes. The Priority Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was developed to enhance SRs and meta-analysis reporting. While it was updated to PRISMA 2020, the impact on emergency medicine remains unexplored. Therefore, we aimed to investigate whether using PRISMA 2020 improves the reporting quality of SRs in the emergency medicine field. METHODS: This study is a cross-sectional meta-epidemiological analysis of SRs published in emergency medicine journals between 2021 and 2023. We selected SRs with pairwise meta-analyses of health interventions included in MEDLINE. We evaluated adherence to PRISMA 2020 items with and without the use of the PRISMA 2020 statement. RESULTS: A total of 695 articles were analyzed, ultimately including 31 that used PRISMA 2020 and 100 that did not. Adherence rates to PRISMA 2020 items were higher in papers using PRISMA 2020 (925/1270, 72.8%, odds ratio: 1.24, 95% confidence interval: 1.08-1.43) than in papers not using it (2758/4034, 68.4%). No SRs met all of the PRISMA 2020 criteria. Adherence to PRISMA 2020 for Abstracts was slightly higher in the group that used the PRISMA 2020 (182/372, 48.9%, odds ratio: 1.17, 95% confidence interval: 0.92-1.47), compared to those that had not (541/1200, 45.1%). Adherence was highest in the introduction and lowest in the methods section. Agreement between the first author and other reviewers' ratings averaged 89.6% (4815/5371). CONCLUSION: Implementing PRISMA 2020 significantly improved the reporting quality of SRs in emergency medicine-related journals. Declaring the use of PRISMA 2020 is insufficient, and researchers must strictly adhere to each item. REGISTRATION: The study protocol was registered in the Open Science Framework on September 22, 2023 (https://doi.org/10.17605/OSF.IO/DQ5W6).