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Methodological Rigor and Integrity of Systematic Reviews and Meta-Analyses From Nursing-Affiliated Institutions in
Nassima Bouzar1, Aya Ikhelk1, Abdelmounaim Manoussi1
1Faculty of Medical Sciences, UM6P Hospitals University Mohammed VI Polytechnic Ben Guerir Morocco.
Background And Objective:
Systematic reviews (SRs) and meta-analyses (MAs) are central to evidence-based practice (EBP). Despite their growing volume in low- and middle-income countries, especially those produced by nursing-affiliated institutions in North Africa (NA), no empirical meta-research has systematically assessed their methodological quality, reporting practices, and research integrity indicators. This study investigated methodological quality, reporting practices, and scientific integrity of SRs and MAs conducted in this context over the past decade.
Methods:
We conducted a meta-research synthesis of SRs and MAs in nursing sciences published between 2015 and 2025 using the PubMed database. Eligible reviews used explicit SR/MA methods, had a first or last author affiliated with a NA institution, and were identified through structured searches. Methodological and reporting quality were assessed using PRISMA and MOOSE guidelines, complemented by an exploratory 10-point composite quality score. Associations between review characteristics and quality indicators were examined.
Results:
We included 38 SRs/MAs, of which 15 included quantitative synthesis. Only 50% reported PROSPERO registration, with several registrations being retrospective or inaccurate. While eligibility criteria, database searches, and quality appraisal were commonly reported, dual data extraction and gray-literature searches were less common. Validated appraisal tools were inconsistently applied, and reporting guidelines were sometimes inappropriately used. The composite score indicated overall modest methodological quality; with PROSPERO registration was the only factor associated with higher quality scores (p = 0.008). Heterogeneity was usually reported, whereas sensitivity analyses and publication-bias assessments were inconsistently conducted.
Conclusions:
This study highlights important methodological and integrity-related deficiencies in SRs and MAs in NA. Strengthening methodological expertise in this central field of clinical practice is critical.
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