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Int J Equity Health. 2015 Oct 8;14:92. doi: 10.1186/s12939-015-0219-2.

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

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Bruyere Research Institute, 43 Bruyère St, Annex E, room 304, Ottawa, K1N 5C8, Ontario, Canada.
LSHTM, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Research Associate, 43 Bruyère St, Annex E, room 304, Ottawa, K1N 5C8, Ontario, Canada.
Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, Centre for Practice Changing Research Building 501 Smyth Road, PO BOX 201B, Ottawa, Ontario, K1H 8L6, Canada.
School of Population and Global Health, University of Melbourne, Level 5, 207 Bouverie Street, Victoria, 3010, Australia.
International Initiative for Impact Evaluation (3ie), Global Development Network, Post Box No. 7510, Vasant Kunj PO, New Delhi, India.
Department of Medicine, University of Ottawa, 43 Bruyère St, Annex E, room 304, Ottawa, K1N 5C8, Ontario, 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 synthesise evidence on equity in systematic reviews.


In this explanation and elaboration paper we provide the rationale for each extension item. These items are additions or modifications to the existing PRISMA Statement items, in order 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 judgement of applicability by policy makers which may result in more appropriate policies and programs and may contribute to reductions in health inequities. To encourage wide dissemination of this article it is accessible on the International Journal for Equity in Health, Journal of Clinical Epidemiology, and Journal of Development Effectiveness web sites.

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