Deviations between registered protocols and published systematic reviews in high-impact anesthesiology and pain medicine journals: a cross-sectional analysis
Authors' conclusion
Our study identified at least one deviation from the registered protocol in all of the 114 included systematic reviews published in high-impact anesthesiology journals.
Study context
- Population
- Systematic reviews published in 2025 in first-quartile anesthesiology journals (Journal Citation Reports)of 172 identified reviews
- Participants
- 114 reviews
- Exposure
- Registered protocols vs published systematic reviews
- Outcome
- Reviews with ≥1 protocol deviation
Methodological detailsmeta-research, two independent reviewers, standardized 22-item extraction form, PubMed searched July 2025
- Meta-research
- Two independent reviewers
- Standardized 22-item extraction form
- PubMed searched July 2025
Main finding
As reported in the abstract
Reviews with ≥1 protocol deviation
114
100%
Reviews providing justifications
18
16%
Observational data: associations, not effects.
Further findings
Types of deviation
- Authorship change (most frequent)
- 74%
- Additional authors without acknowledgement
- 317
- PICOS framework variations
- 65%
- Primary outcome changes
- 15%
- Primary outcome changes disclosed
- 2
- Search strategy deviations
- 28%
- Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessments added without prior registration
- 38%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Deviations between registered protocols and published systematic reviews in high-impact anesthesiology and pain medicine journals: a cross-sectional analysis. Can J Anaesth. Published 12 August 2026. doi:10.
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