Does the systematic review address a focused question (PICO)?
Indicator The main question being addressed should be clearly stated Results of critical appraisal and use it to direct the search and select articles for inclusion? Indicator The inclusion or exclusion of studies in a systematic review should be clearly defined a priori. The eligibility criteria used should specify the patients, interventions or exposures and outcomes of interest Results of critical appraisal Did the search find all the relevant evidence? Indicator Literature search use major bibliographic databases (eg, MEDLINE, Cochrane, EMBASE) and also include a search of reference lists from relevant studies, use of Science Citation Index, and contact with experts, particularly to inquire about unpublished studies. Results of critical appraisal Have the studies been critically appraised? Indicator The article should describe how the quality of each study was assessed using predetermined quality criteria appropriate to the type of clinical question (eg, randomisation, blinding and completeness of follow-up for intervention questions). Results of critical appraisal and was the overall quality adequate? Indicator The studies should be assessed independently by at least 2 reviewers. Th e overall quality should be such that the results are unlikely to be attributable to biases such as poor randomisation or unblinded subjects. Results of critical appraisal Have the results been synthesised with appropriate summary tables and plots? Indicator The results of included studies should at least be presented in a summary table. If the results are similar, there may be a meta-analysis with the results presented as a forest plot. Ideally, this should also include a heterogeneity analysis. Results of critical appraisal and were the results similar between studies? Indicator Ideally, the results of the different studies should besimilar or homogeneous. If heterogeneity exists the authors may estimate whether the differences
aresignificant (Cochrane Q test). Possible reasons for the heterogeneity