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Strengthening the Evidence Base in Suicide Prevention

Systematic Reviews and Registered Reports

Article in review: Pirkis, J. (2020). Editorial- Strengthening the Evidence Base in Suicide Prevention – Systematic Reviews and Registered Reports. Crisis,



A recent editorial in Crisis has outlined the reasons for systematic reviews and registered reports being added to accepted article formats. Systematic reviews and registered reports can both give us new ways of looking at and thinking about suicide prevention research.

Opportunities for suicide prevention research

This editorial begins with an acknowledgement that although there has been significant progress in our understanding of suicide prevention, there is still much that we don’t know, and there is a great deal of room for improvement in research on the topic. We have long been aware that the suicide prevention research methods used may be suboptimal. We often see issues with transparency and validity in replication, and there are opportunities for improvement in the systemising of evidence when it is drawn from multiple sources and studies.

Benefits of Systematic Reviews in suicide research

Systematic reviews are designed to appraise, synthesise and report on multiple studies investigating the same topic or phenomenon. The benefit of considering systemic reviews in the field of suicide research is that they cohesively bring together findings from multiple studies to help reveal a bigger picture. Systematic reviews can teach us more by the nature of their range and scale than can individual studies in isolation.

Systematic reviews tend to consider interventions across the total body of evidence, delivering results on what can be best practice from among the considered interventions. Systematic reviews can also work to consolidate evidence from descriptive and analytic types or research. In other systematic reviews, authors pool data from multiple studies to create a meta-analysis that allows the overall effectiveness of interventions to be reported on. A meta-analysis can also provide consolidated estimates of the prevalence of phenomena or risk factors.

Benefits to Registered Reports in suicide research

A registered report is a newer form of research article intended to show reproducibility and transparency. Registered reports can play an important part in combating questionable research.

It is not just within suicide prevention research that research issues have been noted. Problematic research is found across all academic fields. Such problematic potential research issues include:
• Hypothesising after the results are known (HARKing)
• Conducting multiple analyses and only reporting on those that reach significance (p-hacking)
• An increased focus on and bias towards articles that present positive findings, which is exacerbated by the reward systems of universities and funders

Registered reports help to eliminate these research risks by focusing on the quality and process of research, rather than the ultimate results. A registered report gives priority to rational, hypotheses, study design and methods. Analyses are predefined and calculation methods are stated at the beginning. As a result registered reports have the potential to overcome some of these issues by being open about the direction of findings, as they are developed and shaped by independent advisors at certain specific points along the search timeline.

This approach is critical in research on suicide prevention because it is so important to understand what doesn’t work, as well as what does work. Reports with null findings are given as much weight as those with positive findings.

How Registered Reports in suicide research are prepared
The article by Pirkis (2020) explains the way in which registered reports are prepared and submitted for publication to Crisis magazine.

In Stage One:

• Authors submit a manuscript with an introduction, rationale and methodology for proposed analyses in enough detail they could be replicated
• Manuscripts undergo a peer review process, with reviewers recommending acceptance, revisions or rejection. This can be considered akin to application to an ethics committee or review board but has the advantage of committing the authors to the stated research methodology.

Research cannot begin until an acceptance is granted.

In Stage Two:

• All research must adhere strictly to the methods indicated in the accepted manuscript
• Data collection and analysis occurs
• The initial manuscript is extended, with the results and discussion added to the work initially done
• Peer review occurs to ensure what was proposed has been completed
• The manuscript is automatically accepted because it has been accepted in Stage One

The acceptance of systematic reviews and registered reports by publications like Crisis shows the interest of the academic community in suicide prevention to look at research in formats that will help expand our understanding of the field.

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