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 Publishing protocols of systematic reviews: comparing what was done to what was  planned Silagy CA; Middleton P; Hopewell SJAMA  2002[Jun]; 287 (21): 2831-4CONTEXT: Publication of research protocols minimizes bias by explicitly stating a  priori hypotheses and methods without prior knowledge of results. METHODS: We  conducted a retrospective comparative study to assess the extent to which the  content of published Cochrane reviews had changed compared with their previously  published protocols and to assess any potential impact these changes may have had  in introducing bias to the study. We identified previously published protocols  for new Cochrane reviews appearing in The Cochrane Library; 2000, issue 3. The  texts of published protocols and completed reviews were compared. Two raters  independently identified changes to the different sections of the protocol and  classified the changes as none, minor, or major. RESULTS: Of the 66 new Cochrane  reviews, we identified a previously published protocol for 47 reviews. Of these,  43 reviews had at least 1 section that had undergone a major change compared with  the most recently published protocol. The greatest variation between protocols  and reviews was in the methods section, in which 68% of reviews (n = 32) had  undergone a major change. Changes made in other sections that may have resulted  in the introduction of bias included narrowing of objectives, addition of  comparisons or new outcome measures, broadening of criteria for the types of  study design included, and narrowing of types of participants included.  CONCLUSIONS: Research protocols, even if published, are likely to remain, at  least to some extent, iterative documents. We found that a large number of  changes were made to Cochrane reviews, some of which could be prone to influence  by prior knowledge of results. Even if many of the changes between protocol and  review improve the overall study, the reasons for making these should be clearly  identified and documented within the final review.|*Evidence-Based Medicine[MESH]|*Review Literature as Topic[MESH]|Publication Bias[MESH]|Publishing/*standards[MESH]|Retrospective Studies[MESH]
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