Development of the InSynQ checklist: A tool for planning and reporting
the synthesis questions in systematic reviews of interventions
Abstract
Introduction Methods guidance and appraisal tools for systematic reviews
require specification of the question and eligibility criteria for the
review (‘PICO for the review’). Less emphasis has been given to
specifying the question and criteria for each synthesis (‘PICO for each
synthesis’), yet decisions about which studies to include in each
synthesis can critically influence the utility and findings of a review.
This paper describes the rationale and methods for developing the InSynQ
(Intervention Synthesis Questions) tool for planning and reporting
synthesis questions in reviews of interventions. The aim is to provide
transparency about the basis of the tool and contribute to evidence on
methods for developing guidance for research conduct and reporting.
Methods Informed by EQUATOR Network methods, we (1) established a
project group; (2) examined reporting of the ‘PICO for each synthesis’
in published reviews; (3) reviewed existing reporting guidance and the
Cochrane Handbook for Systematic Reviews of Interventions; (4) drafted
items with elaboration, explanation and examples; (5) conducted
consultation meetings, an evaluation survey and pilot test; (6)
incorporated feedback. Results Existing reporting guidelines do not
distinguish the review and synthesis PICO, with limited coverage of the
elements needed to specify the PICO for each synthesis. Using the PRISMA
2020 format, the draft tool contained 10 items with essential and
additional reporting elements, explanation and examples. Revisions
arising from feedback (>30 people), included adding an
eleventh item on consumer and stakeholder involvement, a figure
explaining PICO for each synthesis, and integrating examples into
elements/explanations. All respondents to the evaluation survey (12
people) said the tool would help them plan or appraise synthesis
questions. InSynQ is available at https://InSynQ.info. Conclusion
Transparent reporting of the development process contributes to the
evidence-base for methods to develop guidance. It may improve uptake of
InSynQ, in turn enhancing the clarity of syntheses.