On 2017 Mar 19, Mauro Podda commented:

Dear Sir/Madam. Many thanks for showing your interest in our manuscript. We can guarantee that our systematic review with meta-analysis of RCTs comparing antibiotic therapy and surgery for uncomplicated acute appendicitis has been performed accordingly with the instructions provided by the Cochrane handbook for systematic review of interventions, and the PRISMA statement has been used for reporting research in the systematic review. Probably, this should better clarified in the text. With regards to the search keys, this is the strategy: (((((appendicitis) AND antibiotic treatment) OR conservative management) OR nonoperative management) OR nonoperative treatment) AND appendectomy

On 2017 Mar 16, Michelle Fiander commented:

What is a Systematic Literature Search?

This review describes its literature search as "systematic" but provides no evidence to support the statement. Reproducible search strategies are not provided--per PRISMA 8, but two sets of keywords are. I created a PubMed search strategy (copied below) by making an educated guess as to how the authors combined the list of terms provided and in doing so, found over 3800 citations up to April 2016 (one month before the search date reported in the review). The review reports screening 938 citations so it is unclear how the evidence for this review were identified.

The authors say the meta-analysis was "performed in accordance with the recommendations from the...PRISMA Statement." PRISMA does not recommend methodological approaches to data analysis, it describes the data authors should provide in a systematic review manuscript. For recommendations on how to analyze data in a systematic review, sources such as The Cochrane Handbook should be consulted.

There has been recent research on the poor quality of published systematic reviews; journal editors should engage with methodologists conversant with systematic review methodology to ensure the reviews it publishes are rigorously reported.

PubMed: Search (antibiotic OR "nonoperative treatment" OR "conservative management" OR "nonoperative management" OR "medical treatment" OR appendectomy OR appendicectomy OR laparoscopy) AND ("acute appendicitis") AND Filters: Publication date to 2016/04/30

On 2017 Mar 16, Michelle Fiander commented:

What is a Systematic Literature Search?

This review describes its literature search as "systematic" but provides no evidence to support the statement. Reproducible search strategies are not provided--per PRISMA 8, but two sets of keywords are. I created a PubMed search strategy (copied below) by making an educated guess as to how the authors combined the list of terms provided and in doing so, found over 3800 citations up to April 2016 (one month before the search date reported in the review). The review reports screening 938 citations so it is unclear how the evidence for this review were identified.

The authors say the meta-analysis was "performed in accordance with the recommendations from the...PRISMA Statement." PRISMA does not recommend methodological approaches to data analysis, it describes the data authors should provide in a systematic review manuscript. For recommendations on how to analyze data in a systematic review, sources such as The Cochrane Handbook should be consulted.

There has been recent research on the poor quality of published systematic reviews; journal editors should engage with methodologists conversant with systematic review methodology to ensure the reviews it publishes are rigorously reported.

PubMed: Search (antibiotic OR "nonoperative treatment" OR "conservative management" OR "nonoperative management" OR "medical treatment" OR appendectomy OR appendicectomy OR laparoscopy) AND ("acute appendicitis") AND Filters: Publication date to 2016/04/30

On 2017 Mar 19, Mauro Podda commented:

Dear Sir/Madam. Many thanks for showing your interest in our manuscript. We can guarantee that our systematic review with meta-analysis of RCTs comparing antibiotic therapy and surgery for uncomplicated acute appendicitis has been performed accordingly with the instructions provided by the Cochrane handbook for systematic review of interventions, and the PRISMA statement has been used for reporting research in the systematic review. Probably, this should better clarified in the text. With regards to the search keys, this is the strategy: (((((appendicitis) AND antibiotic treatment) OR conservative management) OR nonoperative management) OR nonoperative treatment) AND appendectomy