博文
Systematic Review 系统化综述 （中英对照文本）
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系统综述和荟萃分析优先报告的条目：PRISMA声明
资料整理说明:
下面关于PRISMA综述指南的资料，整理自文献[1]（即中文译文, 下载地址为: http://www.cnki.net/kcms/detail/detail.aspx?QueryID=1&CurRec=1&DbCode=CJFQ&dbname=CJFDLAST2010&filename=XBZX200909021）和文献[2]（即英文原文, 下载地址为:http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000097）；译文[1]刊登于2009年的《中西医结合学报》。本文将中文英文对照在一起，并作了少量的标点修饰或修改。整理该资料的目的是让阅读者可以方便地对比参考；特别地，该指南不仅仅是医学相关领域的综述研究的准则，也可用于其他学科；许多杂志（例如PLOS）只接受符合PRISMA规范的综述而不接受其它类型的综述。
文献[1]的原编者按：
为了提高系统综述和荟萃分析文章报告的质量，2009年由国际著名专家组成的系统综述和荟萃分析优先报告的条目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA)小组在国际重要医学期刊包括《英国医学杂志》、《临床流行病学杂志》、《内科学年鉴》和美国《公共科学图书馆医学杂志》等同步发表了《系统综述与荟萃分析优先报告条目：PRISMA声明》。该标准的制定对于改进和提高系统综述和荟萃分析的报告质量将起到重要作用。该声明较以往制定的《随机对照试验荟萃分析报告质量》(Quality of Reporting of Meta-Analyses)，即(QUOROM声明)更加全面、完善。由于近年来国内外对系统综述的高度重视，发表的文章数量也越来越多，因此，有必要规范报告的标准，提高报告的质量。这份声明对系统综述和荟萃分析类文章报告的27个条目及流程图进行了定义和介绍，对相关条目进行了详细的解释和说明。及时向国内读者和临床试验研究人员介绍该声明具有重要的现实意义和学术价值。北京中医药大学循证医学中心刘建平等在第一时间内翻译了该声明，本刊希望通过介绍中文版《系统综述与荟萃分析优先报告的条目：PRISMA声明》，以进一步提高国内系统综述文章撰写和报告的质量，同时也有助于改进研究设计的方法学质量。
本文的英文原文“Preferred reporting items for systematic reviews and meta-analyses：the PRISMA statement”发表于PLoS Med 2009；6(7)：e1000097．doi：10．1371／journal．pmed．1000097。该文中文版本由北京中医药大学循证医学中心李迅、曹卉娟翻译，刘建平审校(Tel：010-64286760；E-mail：jianping_I@hotmail．corn)。中文译文的翻译出版由国家重点基础研究发展计划(973计划)项目资助(No．2006CB504602)。
Systematic reviews and meta-analyses have become increasingly important in health care. Clinicians read them to keep up to date with their field [1],[2], and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research [3], and some health care journals are moving in this direction[4]. As with all research, the value of a systematic review depends on what was done, what was found, and the clarity of reporting. As with other publications, the reporting quality of systematic reviews varies, limiting readers' ability to assess the strengths and weaknesses of those reviews.
系统综述和荟萃分析(又称meta分析)在医疗保健领域已变得越来越重要。临床医生通过阅渎它们来更新自己在该学科中所掌握的信息[1,2]，同时它们还常常成为制定临床实践指南的文献基础。出资机构在批准一项研究之前有可能要求先进行一个系统综述以确保其合理性[3]，同时一些医疗保健领域的期刊也有这样的倾向[4]。与所有的研究一样，系统综述价值的大小取决于已经存在的研究、研究的发现以及报告的明晰与否。与其他的发表形式一样，系统综述的报告质量千差万别，这会限制读者对综述文章优缺点的评估。
Several early studies evaluated the quality of review reports. In 1987, Mulrow examined 50 review articles published in four leading medical journals in 1985 and 1986 and found that none met all eight explicit scientific criteria, such as a quality assessment of included studies [5]. In 1987, Sacks and colleagues [6] evaluated the adequacy of reporting of 83 meta-analyses on 23 characteristics in six domains. Reporting was generally poor; between one and 14 characteristics were adequately reported (mean = 7.7; standard deviation = 2.7). A 1996 update of this study found little improvement[7].
先前已经有过一些文章评价综述报告的质量。1987年，Mulrow对4本当时处于领先水平的医学期刊在1985年与1986年发表的50篇综述文章进行了评估，发现没有一篇符合所有8项明确的科学规范，例如，对纳入研究的质量进行评估[5]。同年，Sacks及其同事[6]对83个meta分析进行了报告充分程度的评价，评价涉及6个领域23个特征。总体来说报告质量较低，83个meta分析只有1～14项条目被充分报告，均值(mean)为7．7，标准差(standard deviation)为2.7。1996年做了一次更新，10年过去了，这个情况几乎没有改善[7]。
In 1996, to address the suboptimal reporting of meta-analyses, an international group developed a guidance called the QUOROM Statement (QUality Of Reporting Of Meta-analyses), which focused on the reporting of meta-analyses of randomized controlled trials [8]. In this article, we summarize a revision of these guidelines, renamed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), which have been updated to address several conceptual and practical advances in the science of systematic reviews (Box 1).
1996年，为了使meta分析报告中这些不尽如人意的情况得到改善，一个国际性小组发布了一部名为meta分析报告的质量(Quality of Reportingof Meta-Analyses，QUOROM)的指南，该指南着重关注随机对照试验meta分析的报告[8]。本文对原有的指南进行修订并总结，同时将其更名为系统综述和meta分析优先报告的条目(Preferred ReportingItems for Systematic Reviews and Meta—Analyses，PRISMA)，有针对性地考虑了当前系统综述一些概念上和实际应用中的新发展。见框表1。
Box 1: Conceptual Issues in the Evolution from QUOROM to PRISMA 框表1：从QUOROM到PRISMA过程中的一些概念问题
完成一个系统综述是一个反复的过程
The conduct of a systematic review depends heavily on the scope and quality of included studies: thus systematic reviewers may need to modify their original review protocol during its conduct. Any systematic review reporting guideline should recommend that such changes can be reported and explained without suggesting that they are inappropriate. The PRISMA Statement (Items 5, 11, 16, and 23) acknowledges this iterative process. Aside from Cochrane reviews, all of which should have a protocol, only about 10% of systematic reviewers report working from a protocol [22]. Without a protocol that is publicly accessible, it is difficult to judge between appropriate and inappropriate modifications.
一项系统综述的实施与所纳入研究的规模和质量息息相关，因此在操作的过程中，有可能需要对原有的方案进行调整。系统综述报告指南则应该建议上述更改可以进行报告和解释，而不用认为它们是不合理的。《PRISMA声明》(条目5、11、16和23)体现了这个反复的过程。除Cochrane系统综述要求所有的综述都要首先提交方案外，其余的系统综述只有10％是从制定方案开始的[22]。如果没有公开发布的方案，将各种各样的修订在合理与不合理之间做出界定足十分困难的。
Conduct and Reporting Research Are Distinct Concepts实施和报告研究是两个不同的概念
This distinction is, however, less straightforward for systematic reviews than for assessments of the reporting of an individual study, because the reporting and conduct of systematic reviews are, by nature, closely intertwined. For example, the failure of a systematic review to report the assessment of the risk of bias in included studies may be seen as a marker of poor conduct, given the importance of this activity in the systematic review process [37].
说两者是不同的概念，对系统综述来说，其差异并不像单个研究报告的实施和报告之间的差异那么直接，这是因为系统综述的本质决定了其实施与报告必须是彼此紧密联系的。例如，系统综述未能报告对纳入的研究进行偏倚风险的评估，则意味着该系统综述的实施质量较差，表明对纳入研究的质量进行评估对系统综述过程来说十分重要一”。
Study-Level Versus Outcome-Level Assessment of Risk of Bias在研究层面以及结局层面对偏倚的风险作出评估
For studies included in a systematic review, a thorough assessment of the risk of bias requires both a “study-level” assessment (e.g., adequacy of allocation concealment) and, for some features, a newer approach called “outcome-level” assessment. An outcome-level assessment involves evaluating the reliability and validity of the data for each important outcome by determining the methods used to assess them in each individual study [38]. The quality of evidence may differ across outcomes, even within a study, such as between a primary efficacy outcome, which is likely to be very carefully and systematically measured, and the assessment of serious harms [39], which may rely on spontaneous reports by investigators. This information should be reported to allow an explicit assessment of the extent to which an estimate of effect is correct [38].
在一个系统综述中对纳入研究可能存在的偏倚进行深入的风险评估。不仅要求“研究层面”(study level)的评估(例如随机分配方案的隐藏是否充分)，针对某些特点，还需要一种新的方法，称为“结局层面”(outcome level)的评估。其过程涉及每一项单个研究中通过判断它们各自对重要结局的测量方法来评价这些重要结局相关数据的可靠性与真实性[38]。对于不同的结局，证据的质量也可能有所不同，甚至在同一个研究中也会如此。比如对一个主要疗效结局的评估和一个严重危害的评估[39]就有可能很不一样，因为前者的测量往往非常细致并且系统，后者却未必。这样的信息应该进行报告，从而对正确评价疗效的范围进行明确而详细的评估[38]。
Importance of Reporting Biases报告偏倚的重要性
Different types of reporting biases may hamper the conduct and interpretation of systematic reviews. Selective reporting of complete studies (e.g., publication bias) [28] as well as the more recently empirically demonstrated “outcome reporting bias” within individual studies [40],[41]should be considered by authors when conducting a systematic review and reporting its results. Though the implications of these biases on the conduct and reporting of systematic reviews themselves are unclear, some previous research has identified that selective outcome reporting may occur also in the context of systematic reviews [42].
不同类型的报告偏倚有可能削弱系统综述的实施和解读。当进行一项系统综述并报告结果时，研究者应该考虑到对于完整研究的选择性报告(例如发表偏倚)[28]以及新近基于经验得到验证的单个研究中的“结局报告偏倚”[40-41]。虽然这些偏倚对系统综述的实施和报告可能产生的影响还不清楚，先前的一些研究已经显示选择性结局报告同样有可能存在于系统综述中[42].
The terminology used to describe a systematic review and meta-analysis has evolved over time. One reason for changing the name from QUOROM to PRISMA was the desire to encompass both systematic reviews and meta-analyses. We have adopted the definitions used by the Cochrane Collaboration [9]. A systematic review is a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review. Statistical methods (meta-analysis) may or may not be used to analyze and summarize the results of the included studies. Meta-analysis refers to the use of statistical techniques in a systematic review to integrate the results of included studies.
随着时间的推移，用于描述系统综述和meta分析的术语渐渐演化出来（或译为：也在不断演进）。将QUOROM更名为PRISMA，其中一个原因就是考虑到我们不仅需要关注meta分析，同时还应该关注系统综述。对于术语，我们采用了Cochrane协作网的定义[9]。系统综述是指凭借清楚的格式化问题，运用系统和明确的方法对相关研究进行辨认、选择以及严格评价，对所纳入研究的数据进行收集和分析的综述（或译为：“系统综述”是对一个清晰表述的问题的综述，该综述使用系统的、明确的方法对相关研究进行识别、选择以及审慎评价，及对所纳入研究的数据进行收集和分析）。统计学方法(meta分析)可能用于也可能并不用于所纳入研究结果的分析和统计。Meta分析指在系统综述中运用统计学手段解读所纳入研究的结果的一种分析方法。
A three-day meeting was held in Ottawa, Canada, in June 2005 with 29 participants, including review authors, methodologists, clinicians, medical editors, and a consumer. The objective of the Ottawa meeting was to revise and expand the QUOROM checklist and flow diagram, as needed.
2005年6月，包括综述作者、方法学家、临床医生、医学编辑以及一位使用者在内的一共29名参与者在加拿大渥太华进行了为期3天的会议。会议的目的就是根据需要修订和扩展QUOROM清单和流程图。
The executive committee completed the following tasks, prior to the meeting: a systematic review of studies examining the quality of reporting of systematic reviews, and a comprehensive literature search to identify methodological and other articles that might inform the meeting, especially in relation to modifying checklist items. An international survey of review authors, consumers, and groups commissioning or using systematic reviews and meta-analyses was completed, including the International Network of Agencies for Health Technology Assessment (INAHTA) and the Guidelines International Network (GIN). The survey aimed to ascertain views of QUOROM, including the merits of the existing checklist items. The results of these activities were presented during the meeting and are summarized on the PRISMA Web site (http://www.prisma-statement.org/).
在会议之前，执行委员会完成了以下工作：一项关于评价系统综述报告质量研究的系统综述（或译为：完成一项关于“系统综述质量”的各项研究之系统综述），就可能对会议有帮助的方法学或其他类型文章，尤其是对与修改清单条目相关的文章进行全面的文献检索；对综述作者、消费者以及批准或者使用系统综述和meta分析的组织机构进行了一项国际性调查，受调查的组织机构包括国际卫生技术评估机构网络(International Network Agencies of Health Technology Assessment，INAHTA)和指南国际网(Guidelines International Network，GIN)；调查旨在确定公众对QUOROM的看法和评价，包括既有清单条目的优点。上述活动的结果在会议中进行展示，同时在PRISMA网站(http：//www.prisma-statement.org/)中附有总结。
Only items deemed essential were retained or added to the checklist. Some additional items are nevertheless desirable, and review authors should include these, if relevant [10]. For example, it is useful to indicate whether the systematic review is an update [11] of a previous review, and to describe any changes in procedures from those described in the original protocol.
只有确定非常重要的条目才能得到保留或者添加入新的清单，不过另有一些条目也是很可取的，综述作者自己的研究涉及这些相关方面时应该考虑[10]。比如说明某篇系统综述是否是在另一篇综述的基础上更新[11]，描述在原有方案基础上所作的更改也是很有用的。
Shortly after the meeting a draft of the PRISMA checklist was circulated to the group, including those invited to the meeting but unable to attend. A disposition file was created containing comments and revisions from each respondent, and the checklist was subsequently revised 11 times. The group approved the checklist, flow diagram, and this summary paper.
会议结束以后，迅速拟定出一份PRISMA清单的草稿在会议小组中传阅，只要是受到邀请的小组成员，包括无法出席的人员均同样有机会传阅该草稿。根据每位小组成员的评论和修改意见拟定一份目录文件，随后将清单修订为11个条目(应该译为：该清单经历了11次修改)，最后小组对清单、流程图以及本文达成一致意见。
Although no direct evidence was found to support retaining or adding some items, evidence from other domains was believed to be relevant. For example, Item 5 asks authors to provide registration information about the systematic review, including a registration number, if available. Although systematic review registration is not yet widely available [12],[13], the participating journals of the International Committee of Medical Journal Editors (ICMJE) [14] now require all clinical trials to be registered in an effort to increase transparency and accountability [15]. Those aspects are also likely to benefit systematic reviewers, possibly reducing the risk of an excessive number of reviews addressing the same question [16],[17] and providing greater transparency when updating systematic reviews.
尽管没有直接的证据支持一些条目的保留和添加，但还是能在其他领域找到相关的证据支持。例如，条目5要求作者提供系统综述注册的相关信息，如果存在注册号也需要报告。虽然系统综述的注册目前尚未普及[12,13]，但是国际医学期刊编辑委员会(International Committee of Medical Journal Editors，ICMJE)的成员期刊已经要求每个投稿的临床试验在开始之前进行注册[14]以确保研究的透明度和可信度[15]。而以上这些考虑同样很可能有利于系统综述，比如减少对于同一个问题进行过多系统综述的风险[16,17]，在对综述进行更新时，提高其透明度。
The PRISMA Statement consists of a 27-item checklist (Table 1; see also Text S1 for a downloadable Word template for researchers to re-use) and a four-phase flow diagram (Figure 1; see also Figure S1for a downloadable Word template for researchers to re-use). The aim of the PRISMA Statement is to help authors improve the reporting of systematic reviews and meta-analyses. We have focused on randomized trials, but PRISMA can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions. PRISMA may also be useful for critical appraisal of published systematic reviews. However, the PRISMA checklist is not a quality assessment instrument to gauge the quality of a systematic review.
《PRISMA声明》由27个条目组成的清单(见表1以及文本S1，后者为可下载的Word模板，供研究者重复使用)以及一个四阶段的流程图(见图1，也可见图S1，后者为可下载的word模板，供研究者重复使用)组成。本声明的目的在于帮助作者改进系统综述和meta分析的撰写和报告。我们主要针对的是随机对照试验的系统综述，但是PRISMA也适合作为其他类型研究系统综述报告的基础规范，尤其是对干预措施进行评价的研究。PRISMA也可以用于已发表系统综述的严格评价。然而，PRISMA清单并非测量系统综述质量的工具。
Figure 1. Flow of information through the different phases of a systematic review.
doi:10.1371/journal.pmed.1000097.g001
Table 1. Checklist of items to include when reporting a systematic
review or meta-analysis.
doi:10.1371/journal.pmed.1000097.t001
The new PRISMA checklist differs in several respects from the QUOROM checklist, and the substantive specific changes are highlighted in Table 2. Generally, the PRISMA checklist “decouples” several items present in the QUOROM checklist and, where applicable, several checklist items are linked to improve consistency across the systematic review report.
新的PRISMA清单与原来的QUOROM清单在很多方面都有所不同，实质性的改变在表2当中阐述。总的来说，PRISMA清单对QUOROM清单中一些条目带来的较为突兀和强硬的影响进行“减震”(或译为:对原有的某些项目进行了”去耦合”,即消除互相之间的关联)，同时对清单中的一些条目彼此间进行链接和联系，从而提高系统综述报告的连贯性。
Table 2. Substantive specific changes between the QUOROM checklist and the PRISMA checklist (a tick indicates the presence of the topic in QUOROM or PRISMA).
doi:10.1371/journal.pmed.1000097.t002
The flow diagram has also been modified. Before including studies and providing reasons for excluding others, the review team must first search the literature. This search results in records. Once these records have been screened and eligibility criteria applied, a smaller number of articles will remain. The number of included articles might be smaller (or larger) than the number of studies, because articles may report on multiple studies and results from a particular study may be published in several articles. To capture this information, the PRISMA flow diagram now requests information on these phases of the review process.
同时流程图也进行了调整。在对研究进行纳入，并且提供所排除研究的原因之前，综述小组必须首先进行文献检索，检索结果应进行记录。当根据选择标准对检索记录进行筛选后，就会留下数量更少的文章。纳入文章的数量有可能小于(或大于)研究的数量，这是因为有的文章可能同时报告多个研究，也可能某个研究在多篇文章中进行了报告。针对这个问题，PRISMA流程图要求在综述的相应阶段对报告进行改进以便捕捉和掌握相关信息。
The PRISMA Statement should replace the QUOROM Statement for those journals that have endorsed QUOROM. We hope that other journals will support PRISMA; they can do so by registering on the PRISMA Web site. To underscore to authors, and others, the importance of transparent reporting of systematic reviews, we encourage supporting journals to reference the PRISMA Statement and include the PRISMA Web address in their Instructions to Authors. We also invite editorial organizations to consider endorsing PRISMA and encourage authors to adhere to its principles.
对于已经接受和使用QUOROM的期刊，应将原来的《QUOROM声明》替换为《PRISMA声明》。同时我们希望其他期刊也能支持PRISMA，可以通过在PRISMA网页上注册的方式实现。为了向作者们以及其他人强调系统综述明晰报告的重要性，我们鼓励支持《PRISMA声明》的期刊在作者须知中引用该声明，并将PRISMA网站的网址加入期刊的作者须知中去。同时我们也邀请相关的编辑组织考虑对PRISMA的使用提供支持并鼓励投稿者严格遵守该声明的原则。
In addition to the PRISMA Statement, a supporting Explanation and Elaboration document has been produced [18] following the style used for other reporting guidelines [19]–[21]. The process of completing this document included developing a large database of exemplars to highlight how best to report each checklist item, and identifying a comprehensive evidence base to support the inclusion of each checklist item. The Explanation and Elaboration document was completed after several face to face meetings and numerous iterations among several meeting participants, after which it was shared with the whole group for additional revisions and final approval. Finally, the group formed a dissemination subcommittee to help disseminate and implement PRISMA.
作为PRIsMA的补充，制定了一份对其条目逐条解析的阐释性文件[18]，该文件的格式类似其他报告标准[19-21]。制定这份文件的过程包括形成和完善一个大规模的模板库来体现针对所制定的每一条目如何进行最佳的报告，并确认支持每一条目的全面广泛的证据。经过多名参与者多次面对面的商议和讨论，这份说明与详述文件才得以产生，并经过整个标准制定小组的共同修改和完善。最后，该小组专门成立了一个委员会负责PRISMA的推广与实施。
The quality of reporting of systematic reviews is still not optimal [22]–[27]. In a recent review of 300 systematic reviews, few authors reported assessing possible publication bias [22], even though there is overwhelming evidence both for its existence [28] and its impact on the results of systematic reviews [29]. Even when the possibility of publication bias is assessed, there is no guarantee that systematic reviewers have assessed or interpreted it appropriately [30]. Although the absence of reporting such an assessment does not necessarily indicate that it was not done, reporting an assessment of possible publication bias is likely to be a marker of the thoroughness of the conduct of the systematic review.
系统综述的报告质量还不是非常完善[22-27|。在最近的一篇纳入了300篇系统综述的综述中，只有少数作者报告评价了研究中可能存在的发表偏倚，尽管这些研究有明确证据表明不仅存在发表偏倚[28]，同时发表偏倚也影响到了该系统综述的结果[29]。即便是评价了发表偏倚的研究，也不能全都做到进一步分析阐释该可能存在的发表偏倚对系统综述结果可靠性的影响[30|。尽管没有报告这样一个评价并不能说明研究中这一评价步骤未被执行，但是对可能存在的发表偏倚是否进行分析是判断一个系统综述是否完善细致的标志之一。(附注:发表偏差: 有史以来，并非所有进行的研究都可以发表，往往那些认为干预措施与传统治疗有明显差别的研究（阳性结果的研究）很容易发表，而阴性结果的研究论文，即研究得出干预措施与传统治疗差异不大时，通常会被忽略，这种由研究结果的方向性和强度来决定研究论文是否被发表，就会导致发表性偏倚。对已发表的这类研究，所进行的SR将得出虚假的治疗效应，出现严重的偏倚. 摘自: http://www.daifumd.com/_daifumd/blog/html/194/article_41430.html)。
Several approaches have been developed to conduct systematic reviews on a broader array of questions. For example, systematic reviews are now conducted to investigate cost-effectiveness [31], diagnostic [32] or prognostic questions [33], genetic associations [34], and policy making [35]. The general concepts and topics covered by PRISMA are all relevant to any systematic review, not just those whose objective is to summarize the benefits and harms of a health care intervention. However, some modifications of the checklist items or flow diagram will be necessary in particular circumstances. For example, assessing the risk of bias is a key concept, but the items used to assess this in a diagnostic review are likely to focus on issues such as the spectrum of patients and the verification of disease status, which differ from reviews of interventions. The flow diagram will also need adjustments when reporting individual patient data meta-analysis [36].
许多方法被应用到系统综述中去探讨更大范围的研究问题(或译为：已经有一些工作将系统综述研究扩展到更大范围的问题上)。例如，目前系统综述可以被应用于研究成本-效果的问题[31]、诊断[32]或预后[33]、遗传相关性研究[34]以及政策制定方面的问题[35]上。PRISMA所覆盖的条目和方面可以适用于上述所有的系统综述，而并不仅仅足针对验证一个治疗干预措施疗效和安全性的研究。当然，在某些情况下对一些条目或图表作适当的修改是必要的。例如，对存在偏倚的风险进行评估是非常关键的，然而对于评估诊断性综述，该项条目往往倾向针对患者的代表性和疾病状态的核查等等，这与干预措施研究的综述不一样。流程图在用于单个样本数据的meta分析时也需要作适当调整[36].
We have developed an explanatory document [18] to increase the usefulness of PRISMA. For each checklist item, this document contains an example of good reporting, a rationale for its inclusion, and supporting evidence, including references, whenever possible. We believe this document will also serve as a useful resource for those teaching systematic review methodology. We encourage journals to include reference to the explanatory document in their Instructions to Authors.
我们也制定了一份说明性的文件[18]，目的是为了增加PRISMA的可应用性。对于每一个条目，这个文件都包含了一个规范的报告实例，说明需要报告该项目的基本原因、证据支持和参考文献。我们相信这份文件对于学习(或：教育)系统综述的方法学来说也是一份有价值的资源。我们也希望各大期刊能够在其作者须知中引用这份说明性的文件。
Like any evidence-based endeavor, PRISMA is a living document. To this end we invite readers to comment on the revised version, particularly the new checklist and flow diagram, through the PRISMA Web site. We will use such information to inform PRISMA's continued development.
像其他循证医学出版物（或：“像其他循证医学的尝试”）一样，PRISMA也将是随时更新的。我们欢迎各位使用者通过PRISMA的网站对这个修订版本提出意见，特别是对其中新的条目和图表。我们会收集这些信息，对PRISMA作进一步的完善。
Checklist of Systematic Review
Flow of information through the different phases of a systematic review (downloadable template document for researchers to re-use).
(0.08 MB DOC)
图S1为系统综述不同阶段的信息收集流程，是可下载的Word模板(0．08 MB DOC)，供研究者重复使用，可用doi:10.1371/journal/.pmed.1000097.s001找到。
Checklist of items to include when reporting a systematic review or meta-analysis (downloadable template document for researchers to re-use).
(0.04 MB DOC)
文本S1为报告系统综述和meta分析的条目清单，是可下载的Word模板(O．04 MB DOC)，供研究者重复使用，可用doi:10.1371/journal.pmed.1000097.s002找到。
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参考文献
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