BackgroundFollowing publication of the PRISMA statement, the UK Centre for Reviews and Dissemination (CRD) at the University of York in England began to develop an international prospective register of systematic reviews with health-related outcomes. The objectives were to reduce unplanned duplication of reviews and provide transparency in the review process, with the aim of minimizing reporting bias.MethodsAn international advisory group was formed and a consultation undertaken to establish the key items necessary for inclusion in the register and to gather views on various aspects of functionality. This article describes the development of the register, now called PROSPERO, and the process of registration.ResultsPROSPERO offers free registration and free public access to a unique prospective register of systematic reviews across all areas of health from all around the world. The dedicated web-based interface is electronically searchable and available to all prospective registrants. At the moment, inclusion in PROSPERO is restricted to systematic reviews of the effects of interventions and strategies to prevent, diagnose, treat, and monitor health conditions, for which there is a health-related outcome.Ideally, registration should take place before the researchers have started formal screening against inclusion criteria but reviews are eligible as long as they have not progressed beyond the point of completing data extraction.The required dataset captures the key attributes of review design as well as the administrative details necessary for registration.Submitted registration forms are checked against the scope for inclusion in PROSPERO and for clarity of content before being made publicly available on the register, rejected, or returned to the applicant for clarification.The public records include an audit trail of major changes to planned methods, details of when the review has been completed, and links to resulting publications when provided by the authors.ConclusionsThere has been international support and an enthusiastic response to the principle of prospective registration of protocols for systematic reviews and to the development of PROSPERO.In October 2011, PROSPERO contained 200 records of systematic reviews being undertaken in 26 countries around the world on a diverse range of interventions.

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Objectives: To determine the accuracy of single-reviewer screening in correctly classifying abstracts as relevant or irrelevant for literature reviews. Study Design and Setting: We conducted a crowd-based, parallel-group randomized controlled trial. Using the Cochrane Crowd platform, we randomly assigned eligible participants to 100 abstracts each of a pharmacological or a public health topic. After completing a training exercise, participants screened abstracts online based on predefined inclusion and exclusion criteria. We calculated sensitivities and specificities of single-and dual-reviewer screening using two published systematic reviews as reference standards. Results: Two hundred and eighty participants made 24,942 screening decisions on 2,000 randomly selected abstracts from the reference standard reviews. On average, each abstract was screened 12 times. Overall, single-reviewer abstract screening missed 13% of relevant studies (sensitivity: 86.6%; 95% confidence interval [CI], 80.6%e91.2%). By comparison, dual-reviewer abstract screening missed 3% of relevant studies (sensitivity: 97.5%; 95% CI, 95.1%e98.8%). The corresponding specificities were 79.2% (95% CI, 77.4%e80.9%) and 68.7% (95% CI, 66.4%e71.0%), respectively. Conclusions: Single-reviewer abstract screening does not appear to fulfill the high methodological standards that decisionmakers expect from systematic reviews. It may be a viable option for rapid reviews, which deliberately lower methodological standards to provide decision makers with accelerated evidence synthesis products.

BackgroundPROSPERO, an international prospective register of systematic review protocols in health and social care, was launched in February 2011. After one year of operation we describe access and use, explore user experience and identify areas for future improvement.MethodsWe collated administrative data and web statistics and conducted an online survey of users’ experiences.ResultsOn 21 February 2012, there were 1,076 registered users and 359 registration records published on PROSPERO. The database usage statistics demonstrate the international interest in PROSPERO with high access around the clock and around the world. Based on 232 responses from PROSPERO users (response rate 22%), almost all respondents found joining and navigation was easy or very easy (99%); turn round time was good or excellent (96%); and supporting materials provided were helpful or very helpful (80%). The registration fields were found by 80% to be relevant to their review; 99% rated their overall experience of registering with PROSPERO as good or excellent. Most respondents (81%) had a written protocol before completing the registration form and 19% did not. The majority, 136 (79%), indicated they completed the registration form in 60 minutes or less. Of those who expressed an opinion, 167 (87%) considered the time taken to be about right.ConclusionsThe first year of PROSPERO has shown that registration of systematic review protocols is feasible and not overly burdensome for those registering their reviews. The evaluation has demonstrated that, on the whole, survey respondents are satisfied and the system allows registration of protocol details in a straightforward and acceptable way. The findings have prompted some changes to improve user experience and identified some issues for future consideration.

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