Prevalence Systematic Reviews
Addressing critical methodological challenges
An editorial published in the latest issue of JBI Evidence Synthesis highlights the methodological issues researchers are challenged with when conducting systematic reviews of disease and condition prevalence. The editorial also offers guidance for improving the quality and interpretation of this type of systematic review.
The editorial, authored by members of the Prevalence Estimates Reviews – Systematic Review Methodology Group (PERSyst), outlines how standard systematic review methods developed primarily for randomised controlled trials often fail when applied to prevalence studies without the necessary adaptation.
Key challenges identified in the editorial are:
- Risk of Bias assessment
- Publication bias and funnel plots
- Heterogeneity interpretation
- Meta-analysis methods
These challenges are explained in the editorial.
PERSyst is working to address these challenges through several initiatives. The group is developing methods and guidance covering within-study and across-studies biases, heterogeneity assessment, and applicability considerations. This work will inform how GRADE domains should be applied when evaluating certainty of evidence in prevalence reviews.
Additionally, PERSyst is nearing completion of an extension to the PRISMA reporting guidelines specifically tailored for systematic reviews of prevalence, which aims to provide practical guidance for researchers in this field.
The editorial emphasises that while a generic systematic review toolkit is broadly applicable to prevalence questions, careful tailoring is required. As these reviews increasingly inform health policy, service planning, resource allocation, and economic modelling, methodological rigour becomes paramount.
Researchers conducting or planning prevalence systematic reviews are encouraged to visit PERSyst for additional resources and updates on emerging guidance from this methodology group.
The PERSyst Methodology Group is an academic, collaborative group, with the aim to develop and to disseminate methods for systematic reviews of prevalence and cumulative incidence.
To prevent redundant work, research duplication and waste, JBI does not provide methodological guidance for systematic reviews of prevalence and incidence. PERSyst methodology has been endorsed for adoption by the JBI Scientific Committee to conduct systematic reviews of prevalence and incidence.
Although this is an external methodology, JBI’s synthesis software, JBI SUMARI, can support reviews of this nature. This means that while JBI recognises and adopts the methodological expertise developed elsewhere, we ensure our existing infrastructure and tools remain compatible and useful for researchers following these external guidelines. In addition, the journal, JBI Evidence Synthesis, welcomes submissions for systematic reviews of prevalence and incidence that use PERSyst methodology.
This approach reflects JBI's broader philosophy of being part of an interconnected evidence ecosystem rather than operating in isolation, allowing us to focus their resources on areas where we have unique methodological strengths while leveraging excellence developed by other specialist groups.
Read the editorial, Systematic reviews of prevalence: challenges and future steps, to learn more.