Reporting standards specific to updates 

  Standard Rationale and elaboration Resources
UR1 Background Mandatory  
  Review and update background as necessary to reflect changes over time. Examples of changes that should be addressed include updated estimates of disease burden, new understanding of how people are affected by the disease or condition, new insights into mechanisms of action, or changes in policy or practice. Up-to-date references should be supplied to support this information. See Handbook Section IV.5
UR2 Changes to scope Mandatory  
  Explain any changes to questions, objectives or eligibility criteria. Motivations to amend review questions and objectives for the update (such as addition of new interventions, or concerns over adverse effects) should be explained in the Background, and changes to eligibility criteria should be explained, dated and justified as ‘Differences between the protocol and the review’.  
UR3 Search for studies Mandatory  
  Describe the update search.

Describe which sources of information were searched for the update, and how. If any of the sources originally searched were not searched for the update, this should be explained and justified. There are at least four possibilities for providing information about search methods in an updated review:

  1. An integrated approach is to describe all searches together, which may be most feasible if the same search was repeated.
  2. An incremental approach is to add information at each update to describe explicitly which searches were done for the update, retaining all information about previous searches.
  3. A replacement approach is to describe only the searches done for the update, using the previous review as one source of studies.
  4. A hybrid approach is to describe only the searches done for the update in the main text, using Appendices to provide information about previous searches.
See Handbook Section IV.5
UR4 Flow of studies Mandatory  
  Record the flow of studies.

Provide information on the flow of studies into the updated review, using a PRISMA type flow diagram. There are two broad options for providing information about how studies were identified that are included in the updated version of the review:

  1. The results of previous searches can be retained in the review and supplemented with information about studies identified in the update.
  2. Alternatively, only information about searches in the current update can be presented, with the previous version of the review serving as one particular source of studies.

Either approach is acceptable. If taking the latter approach, the flow diagram should show one box for the number of studies included in the original review or previous update and an additional box for the new studies retrieved for the current update. If multiple searches have been conducted for the current update, the results of all the searches should be added together.

See Handbook Section IV.5
UR5 "Summary of findings" tables Highly desirable  
  Present a ‘Summary of findings’ table according to recommendations described in the Handbook (version 5 or later). Specifically, include results for one clearly defined population group (with few exceptions).  Efforts should be made to incorporate information presented in ‘Summary of findings’ tables (such as absolute effects, GRADE certainty ratings and downgrading decisions) in other parts of the review including the Abstract, Plain language summary, Effects of interventions, Discussion and Authors’ conclusions.

See Handbook Chapter 14

Common issues in Summary of Findings tables

UR6 Integrating findings Mandatory  
  Present findings integrated across new and previously included studies and not just for the new studies (in the main text, Abstract, ‘Summary of findings’ tables and Plain language summary). The main findings should be presented for the totality of evidence: it is not helpful to a new reader to be told about incremental updates to the evidence base. However, the impact of new evidence on review findings may be useful to draw on when interpreting the results.  
UR7 What's new? Mandatory  
  Explain what’s new.

It is important that changes are explained to inform returning readers about what’s new. This should be achieved in several ways.

A comment should be inserted to explain that the review is an update of a previously published review. This might be placed at the beginning or end of the Background or the start of the section ‘Search methods for identification of studies’. It can be helpful to explain also whether the article describes the first, second, third and so on update of the review.

Changes in review questions, eligibility criteria and methods should be reported in the section ‘Differences between protocol and review’, making it clear that they are changes since the previous version.

Changes in findings must be reported and dated in the ‘What’s new’ section. This should include the numbers of new studies and participants in those studies; and the nature of any changes in assessments of the certainty of the evidence (e.g. using GRADE) and in the clinical implications of the findings. For particularly notable changes it is useful to comment on these within the text of the review.


See Handbook Section IV.5

Common issues in Summary of Findings tables

Section info
Describe change
UR4: Provide information on the flow of studies into the updated review, ideally using a PRISMA flow diagram. Changed to: Provide information on the flow of studies into the updated review, using a PRISMA type flow diagram.
UR5, column 3: quality -changed to- certainty
UR7, column 3: quality -changed to- certainty

UR1, UR3, UR4: See Handbook (version 6) Section IV.5 ADDED
UR5: Chapter 11 of DELETED
UR5: See Handbook (version 6) Chapter 14
UR7: See Handbook (version 6) Section IV.5 ADDED

18/03/2021: removed (version 6) from all references to the Handbook as all references are to the most current version of the Handbook
Change date
18 March 2021