Enhancing the Integrity of Evidence-Based Medicine: A Literature Review on Reporting Quality in Systematic Reviews and Randomised Controlled Trials
DOI:
https://doi.org/10.12775/QS.2025.44.62873Keywords
Evidence-Based Medicine, Systematic Reviews, Randomised Controlled Trials, Reporting Guidelines, PRISMA, CONSORT, Research Integrity, Methodological Quality, Evidence Synthesis, Publication BiasAbstract
This literature review synthesises evidence on reporting quality and integrity in evidence-based medicine (EBM). It critically examines challenges undermining the trustworthiness of systematic reviews (SRs) and randomised controlled trials (RCTs) and explores solutions and frameworks to address these issues. Based on 22 selected academic articles, including reviews, guidelines, studies, and opinions, the analysis highlights themes like reporting standards (PRISMA, CONSORT, SPIRIT), appraisal tools (GRADE, AMSTAR), technology (AI, telehealth, electronic data), and expert collaboration. Findings show a gap between reporting guidelines and practice, causing a “trustworthiness crisis”. Despite guideline adoption, poor reporting, data issues, and bias persist. Key solutions include involving information science experts to refine searches, using AI and automation to boost efficiency and spot integrity issues, adopting new tools like Evidence Gap Maps (EGMs), and improving trial design with Decentralised Clinical Trials (DCTs). Strengthening EBM’s integrity needs more than guideline compliance: it demands a cultural shift towards transparency, combined with methodological rigour, technology, and interdisciplinary collaboration. Only this integrated approach ensures that clinical and policy decisions rest on the most robust and credible evidence possible.
References
Belle. B, A., & Zhao, Y. (2023). Evidence-based decision-making: Using systematic cases to check the compliance of reviews with reporting guidelines such as PRISMA 2020. Expert Systems with Applications, 217, 119569. https://doi.org/10.1016/j.eswa.2023.119569
Butt, F. A., Fawzy, M., Wattar, A., Bueno-Cavanillas, A., Khan, K. S., & Khalaf, Y. (2024). The randomised clinical trial trustworthiness crisis. Middle East Fertility Society Journal, 29(1). https://doi.org/10.1186/s43043-023-00161-7
Butt, F. A., Nunez-Nunez, M., Juhász, B., Bueno-Cavanillas, A., & Khan, K. S. (2025). The quality and reporting of recommendation documents to enhance the integrity of clinical trials: A systematic review and critical appraisal. Medicina de Familia. SEMERGEN, 51(2), 102333. https://doi.org/10.1016/j.semerg.2024.102333
Clyne, B., Boland, F., Murphy, N., Murphy, E., Moriarty, F., Barry, A., Wallace, E., Devine, T., Smith, S. M., Devane, D., Murphy, A., & Fahey, T. (2020). Quality, scope, and reporting standards of randomised controlled trials in Irish Health Research: an observational study. Trials, 21(1). https://doi.org/10.1186/s13063-020-04396-x
Dermody, G., Whitehead, L., Wilson, G., & Glass, C. (2020). The role of virtual reality in improving health outcomes for community-dwelling older adults: systematic review. Journal of Medical Internet Research, 22(6), e17331–e17331. https://doi.org/10.2196/17331
Drewry, M. B., Yanguela, J., Khanna, A., O’Brien, S., Phillips, E., Bevel, M. S., McKinley, M. W., Corbie, G., & Dave, G. (2023). A systematic review of electronic community resource referral systems. American Journal of Preventive Medicine, 65(6), 1142–1152. https://doi.org/10.1016/j.amepre.2023.06.001
Goodson, N., Wiltrout, C., Warren, J., Reis, S., & Massart, M. (2025). The research visit of the future: An academic-industry model for telehealth, electronic clinical outcomes assessments, and Decentralised Clinical Trials (DCTs). Trials, 26(1). https://doi.org/10.1186/s13063-025-08886-8
Hamilton, D. G., Hong, K., Fraser, H., Rowhani-Farid, A., Fidler, F., & Page, M. J. (2023). Prevalence and predictors of data and code sharing in the medical and health sciences: Systematic review with meta-analysis of individual participant data. BMJ, e075767–e075767. https://doi.org/10.1136/bmj-2023-075767
Han, R., Acosta, J. N., Shakeri, Z., Ioannidis, J. P. A., Topol, E. J., & Rajpurkar, P. (2024). Randomised controlled trials evaluating artificial intelligence in clinical practice: a scoping review. The Lancet Digital Health, 6(5), e367–e373. https://doi.org/10.1016/s2589-7500(24)00047-5
Jafari, A., & Sahebkar, A. (2025). Can ginger improve cardiovascular health indices? A protocol for a GRADE-assessed systematic review and planned dose-response meta-analysis of randomised controlled trials. Systematic Reviews, 14(1). https://doi.org/10.1186/s13643-025-02867-3
Lighterness, A., Adcock, M., Scanlon, L. A., & Price, G. (2024). Data Quality–Driven Improvement in Health Care: Systematic Literature Review. Journal of Medical Internet Research, 26, e57615. https://doi.org/10.2196/57615
Mancin. S., Sguanci, M., Andreoli, D., Soekeland, F., Anastasi, G., Michela Piredda, & Grazia, M. (2023). Systematic review of clinical practice guidelines and systematic reviews: A method for conducting comprehensive analysis. MethodsX, 12, 102532–102532. https://doi.org/10.1016/j.mex.2023.102532
Muka, T., Li, J. J., Farahani, S. J., & Ioannidis, J. P. (2023). An umbrella review of systematic reviews on the impact of the COVID-19 pandemic on cancer prevention and management, as well as patient needs. ELife, 12. https://doi.org/10.7554/elife.85679
Nawijn. F., Ham, W., Houwert, R. M., Rolf, Hietbrink, F., & Diederik P. J. Smeeing. (2019). Quality of reporting of systematic reviews and meta-analyses in emergency medicine based on the PRISMA statement. BMC Emergency Medicine, 19(1). https://doi.org/10.1186/s12873-019-0233-6
Núñez-Núñez. M., Cano-Ibáñez, N., Zamora, J., Bueno-Cavanillas, A., & Khan, K. S. (2023). Assessing the Integrity of Clinical Trials Included in Evidence Syntheses. International Journal of Environmental Research and Public Health, 20(12), 6138–6138. https://doi.org/10.3390/ijerph20126138
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Asbjørn Hróbjartsson, L., M. M., L., T., L., E. W., M.-W., E., M., S., & McGuinness, L. A. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, n71–n71. https://doi.org/10.1136/bmj.n71
Platz, T. (2021). Methods for the Development of Healthcare Practice Recommendations Using Systematic Reviews and Meta-analyses. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.699968
Randles, R., & Finnegan, A. (2023). Guidelines for writing a systematic review. Nurse Education Today, 125, 105803–105803. https://doi.org/10.1016/j.nedt.2023.105803
Sablerolles, R. S. G., Rietdijk, W. J. R., Goorhuis, A., Postma, D. F., Visser, L. G., Geers, D., Schmitz, K. S., Garcia Garrido, H. M., Koopmans, M. P. G., Dalm, V. A. S. H., Kootstra, N. A., Huckriede, A. L. W., Lafeber, M., van Baarle, D., GeurtsvanKessel, C. H., de Vries, R. D., & van der Kuy, P. H. M. (2022). Immunogenicity and Reactogenicity of Vaccine Boosters after Ad26.COV2.S Priming. New England Journal of Medicine, 386(10), 951–963. https://doi.org/10.1056/nejmoa2116747
Shaheen, N., Shaheen, A., Ramadan, A., Mahmoud Tarek Hefnawy, Ramadan, A., Ibrahim, I. A., Hassanein, M. E., Ashour, M. E., & Flouty, O. (2023). Appraising systematic reviews: A comprehensive guide to ensuring validity and reliability. Frontiers in Research Metrics and Analytics, 8. https://doi.org/10.3389/frma.2023.1268045
Stevens, E. R., & Laynor, G. (2024). Enhancing the quality and efficiency of regulatory science literature reviews through innovation and collaboration with library and information science experts. Frontiers in Medicine, 11. https://doi.org/10.3389/fmed.2024.1434427
Zhang, D., Li, C., Tian, X., Miao, G., Shi, W., Lu, H., Qu, Y., Cai, M., Tang, Y., Shen, H., & Gao, B. (2025). Evidence map of nutrient interventions for major depression: A systematic review protocol. Systematic Reviews, 14(1), 1–12. https://doi.org/10.1186/s13643-025-02868-2
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