The fate of urological systematic reviews registered in PROSPERO

  • Sari Khaleel
  • Brent Cleveland
  • Arveen Kalapara
  • Niranjan Sathianathen
  • Priyamvadha Balaji
  • Philipp DahmEmail author
Original Article



To identify urologic systematic reviews (SRs) registered to PROSPERO that resulted in a publication, and to evaluate their methodological quality and concordance with their stated a priori protocols.


We searched PubMed to identify urologic SR protocols registered in PROSPERO that resulted in a publication and assessed their methodological quality and protocols in relation to their stated a priori protocols in PROSPERO.


Of the 576 urologic SR protocols registered in PROSPERO up to December 2017, 201 (34.9%) resulted in a full SR publication, but only 40 (17.7%) updated their registration record accordingly. Publications were spread over 100 different journals, with a median time-to-publication of 29 months (95% CI 25.0–33.0). The most common topic by far was prostate cancer (59.7%), followed by voiding issues (15.3%), and renal transplantation (15.3%). Only little over half the reviews (52.74%) explicitly stated primary outcome(s) that matched the primary outcome of their corresponding PROSPERO protocol. Notable methodologic deviations from registered protocols included planned restriction on study design (33%), heterogeneity analysis (42%) and planned risk of bias analysis (65.2%).


SR authors in urology are increasingly using PROSPERO to register their titles, but our findings indicate that registration alone is not a guarantor of a high-quality SR product. There appears to be a critical need to raise the bar for review authors registering protocols in PROSPERO, with an emphasis on transparency in their publication status updates as well as deviations from their a priori protocols.


Systematic reviews Meta-analysis Evidence-based medicine Protocol PROSPERO 


Author contributions

SK: protocol/project development, data collection or management, data analysis, manuscript writing/editing; BC: data collection or management; AK: data collection or management, NS: data collection or management; PB: data collection or management; PD: protocol/project development, data analysis, manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Research involving human participants and/or animals

This research project did not involve any human participants and/or animals.

Informed consent

The research protocol did not involve human participants or animals and did not require informed consent.


  1. 1.
    Canfield SE, Dahm P (2011) Rating the quality of evidence and the strength of recommendations using GRADE. World J Urol 29:311–317. CrossRefPubMedGoogle Scholar
  2. 2.
    Corbyons K, Han J, Neuberger MM, Dahm P (2015) Methodological quality of systematic reviews published in the urological literature from 1998 to 2012. J Urol 194:1374–1379. CrossRefPubMedGoogle Scholar
  3. 3.
    Han JL, Gandhi S, Bockoven CG et al (2017) The landscape of systematic reviews in urology (1998 to 2015): an assessment of methodological quality. BJU Int 119:638–649. CrossRefPubMedGoogle Scholar
  4. 4.
    Ioannidis JPA (2016) The mass production of redundant, misleading, and conflicted systematic reviews and meta-analyses. Milbank Q 94:485–514. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Shea BJ, Grimshaw JM, Wells GA et al (2007) Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 7:10. CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Moher D, Booth A, Stewart L (2014) How to reduce unnecessary duplication: use PROSPERO. BJOG An Int J Obstet Gynaecol 121:784–786. CrossRefGoogle Scholar
  8. 8.
    Page MJ, Shamseer L, Tricco AC (2018) Registration of systematic reviews in PROSPERO: 30,000 records and counting. Syst Rev 7:32. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Booth A, Clarke M, Dooley G et al (2012) The nuts and bolts of PROSPERO: an international prospective register of systematic reviews. Syst Rev 1:2. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Khaleel S, Sathianathen N, Balaji P, Dahm P (2019) Quality of urological systematic reviews registered in PROSPERO. BJU Int. CrossRefPubMedGoogle Scholar
  12. 12.
    Borah R, Brown AW, Capers PL, Kaiser KA (2017) Analysis of the time and workers needed to conduct systematic reviews of medical interventions using data from the PROSPERO registry. BMJ Open. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Andrade R, Pereira R, Weir A et al (2017) Zombie reviews taking over the PROSPERO systematic review registry. It’s time to fight back! Br J Sports Med. CrossRefPubMedGoogle Scholar
  14. 14.
    Sideri S, Papageorgiou SN, Eliades T (2018) Registration in the international prospective register of systematic reviews (PROSPERO) of systematic review protocols was associated with increased review quality. J Clin Epidemiol. CrossRefPubMedGoogle Scholar

Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.Department of UrologyUniversity of MinnesotaMinneapolisUSA
  2. 2.Urology Section 112DMinneapolis VA Medical CenterMinneapolisUSA
  3. 3.Peter MacCallum Cancer InstituteRoyal Melbourne HospitalMelbourneAustralia

Personalised recommendations