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J Clin Epidemiol. 2016 Feb;70:68-89. doi: 10.1016/j.jclinepi.2015.09.001. Epub 2015 Sep 5.

Extending the PRISMA statement to equity-focused systematic reviews (PRISMA-E 2012): explanation and elaboration.

Author information

  • 1Bruyere Research Institute, University of Ottawa, 43 Bruyère Street, Annex E, Room 304, Ottawa, Ontario K1N 5C8, Canada. Electronic address:
  • 2Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine (LSHTM), 15-17 Tavistock Place, London WC1H 9SH, UK.
  • 3Bruyere Research Institute, University of Ottawa, 43 Bruyère Street, Annex E, Room 304, Ottawa, Ontario K1N 5C8, Canada.
  • 4Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, Centre for Practice Changing Research Building, 501 Smyth Road, Post Box No. 208, Ottawa, Ontario K1H 8L6, Canada.
  • 5Jack Brockhoff Child Health and Wellbeing Program, School of Population and Global Health, University of Melbourne, Level 5, 207 Bouverie Street, Victoria 3010, Australia.
  • 6International Initiative for Impact Evaluation (3ie), Global Development Network, Post Box No. 7510, Vasant Kunj PO, New Delhi, India.
  • 7Department of Medicine, University of Ottawa, 43 Bruyère Street, Annex E, Room 304, Ottawa, Ontario K1N 5C8, Canada.



The promotion of health equity, the absence of avoidable and unfair differences in health outcomes, is a global imperative. Systematic reviews are an important source of evidence for health decision makers but have been found to lack assessments of the intervention effects on health equity. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) is a 27-item checklist intended to improve transparency and reporting of systematic reviews. We developed an equity extension for PRISMA (PRISMA-E 2012) to help systematic reviewers identify, extract, and synthesize evidence on equity in systematic reviews.


In this explanation and elaboration article, we provide the rationale for each extension item. These items are additions or modifications to the existing PRISMA statement items, to incorporate a focus on equity. An example of good reporting is provided for each item as well as the original PRISMA item.


This explanation and elaboration document is intended to accompany the PRISMA-E 2012 statement and the PRISMA statement to improve understanding of the reporting guideline for users. The PRISMA-E 2012 reporting guideline is intended to improve transparency and completeness of reporting of equity-focused systematic reviews. Improved reporting can lead to better judgment of applicability by policy makers which may result in more appropriate policies and programs and may contribute to reductions in health inequities.


Health equity; Reporting guidelines; Research methodology; Systematic reviews

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