Editorial comment to accompany BJA Open 100250
Philip M. Hopkins
Abstract
Genes, proteins, chemicals, diseases, species, mutations and cell lines named across the full text — each resolved to its canonical identifier and authoritative record.
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TopicsMeta-analysis and systematic reviews · Health and Medical Research Impacts
It is the normal policy of BJA Open to require all systematic reviews (with or without accompanying meta-analysis) to have been prospectively registered with the PROSPERO database. As with the registration of clinical trials in a clinical trials registry, prospective registration of systematic reviews and meta-analyses is intended to improve transparency and minimise bias. Bias may arise, for example, if a protocol is changed after the start of a project: registries enable authors to record changes in the protocol along with a justification for doing so. This enables journal reviewers and editors, and ultimately readers, to evaluate changes in the protocol and form a judgment as to their impact on the rigour of the data presented and their interpretation.
The paper published in BJA Open by Booth and colleagues1 is a systematic review and meta-analysis of the airway management of adult epiglottitis that was not registered in PROSPERO. The history of this work is that it was originally formulated as a narrative review and submitted to our sister journal, the British Journal of Anaesthesia. This manuscript was not accepted for publication but there was a recommendation arising from the peer review process that there might be greater merit if the work was redone as a systematic review. This advice was acted upon by Booth and colleagues but, as they describe,1 they found that they were unable to register their systematic review and meta-analysis with PROSPERO because they had already initiated a large part of their search protocol in preparing the prior narrative review.
In accepting this work for publication, and considering the comments of peer reviewers, I have made a value judgment that it makes a useful contribution to the body of knowledge and the evidence base that may benefit clinicians dealing with the life-threatening emergency of adult epiglottitis. Throughout the process I have been struck by the openness of the authors and their efforts to minimise bias. By inclusion of a description of the evolution of this article in the Methods section of the paper and inclusion of the original protocol and subsequent amendments in the supplementary materials, I invite readers to form their own judgments as to the value of the data presented by Booth and colleagues1 and how it might impact their clinical practice.
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