Science and art of writing the title of systematic review and meta-analysis

Writing a title for a systematic review and meta-analysis is not only a science but also an art. A title should be precise, clear, and informative enough to attract the target audience and ensure accurate database indexing.1 On the contrary, if it lacks clarity, conciseness, and relevance, it can significantly diminish the impact of a well-conducted meta-analysis.2 A title serves as the first point of contact between the research and its potential readers.3 It can give a concise summary that captures the essence of the study and attracts the attention of researchers, clinicians, and journal editors. An appropriate title can ensure visibility, readability, and impact.4 This manuscript provides guidance on crafting effective titles for meta-analyses, including examples of good and poor titles, as well as a list of "dos and don'ts." Knowledge of common acronyms can enhance the quality and writing process of meta-analysis titles and content Figure 1. Key acronyms include the "PRISMA" (Preferred Reporting Items for Systematic Reviews and Meta-analyses), which provides a structured framework for reporting the research;5 the "PICOS" (Population, Intervention, Comparison, Outcome, and Study design), a helpful organisational tool for framing research questions and inclusion criteria; and the "GRADE" (Grading of Recommendations, Assessment, Development, and Evaluations) tool, which offers a systematic approach to evaluate the certainty of evidence and strength of recommendations.6 Furthermore, a few more familiar common acronyms, such as "AMSTAR" (A MeaSurement Tool to Assess systematic Reviews), provide the criteria for evaluating the methodological quality of systematic reviews.7 These standardised tools can be appropriately referenced and utilised in writing the title or manuscript, demonstrating rigour and familiarity with the methods and practices of systematic review and meta-analysis research, thereby increasing the credibility of the work.Figure 1: Common acronyms for meta-analysis reportingCareful selection of keywords enhances the visibility of meta-analysis.8 After using the PICOS framework, standardised Medical Subject Headings (MeSH) terms can be included to improve discoverability in databases such as PubMed.9 One needs to apply the basic search engine optimisation principles by using commonly searched terms while maintaining scientific accuracy. Excluding a few redundant words is essential. One has to be specific and descriptive and clearly convey the study's focus, disease type, intervention, and methodology. A review of previously published similar meta-analyses is very useful in identifying patterns of keywords and balancing technical precision. When crafting a title, consider different approaches that enhance clarity and engagement. The various types of titles for meta-analysis are presented in Table 1.Table 1: Different types of titles for meta-analysisA good meta-analysis title contains several key elements that work together effectively. The title must distinguish the meta-analysis from other research types.10 It should be informative about the specific disease, intervention, or population being studied. If appropriate, major findings or focus areas should be included in the title itself. A simple language works well, avoiding additional complex terminologies or abbreviations. The title should have precision regarding the study content instead of vague descriptions. If permissible, briefly mentioning key results or clinical relevance can capture the reader's attention.11 A title can thus be made to function as a summary that accurately represents the research while optimising discoverability. A strong title for a meta-analysis typically incorporates: 1. The Intervention/Exposure; 2. The Outcome (especially the primary outcome); 3. The Study Design (meta-analysis or network meta-analysis); 4. The Population (if applicable, for example, "in children," "in elderly patients"); 5. Clarity and Conciseness (avoiding jargon and unnecessary words). Generally, employing the methods mentioned above improves search visibility and is therefore considered useful.12 A few key steps should be followed when creating a strong title for a meta-analysis. We describe this using an example. Consider identifying four core elements for an illustrative example here: (i) Study population (e.g. patients with type II diabetes mellitus); (ii) Intervention or exposure studied (e.g. sodium-glucose co-transporter inhibitors); (iii) Outcome measured (e.g. cardiovascular events); (iv) Study design (meta-analysis). Next, the elements mentioned above should be arranged in a logical sequence, typically in the following format: Population + Intervention + Outcome + Study design.13 For instance, an author has to start a title with, for example, "Efficacy of Sodium Glucose Cotransporter-2 Inhibitors in Reducing Cardiovascular Outcomes in Patients with Type-2 Diabetes: A Meta-Analysis." The third step involves refining the title for brevity and impact by reducing redundant words. Thus, the title can be modified/refined as "Sodium Glucose Cotransporter-2 Inhibitors and Cardiovascular Outcomes in Type-2 Diabetes: A Meta-Analysis." Finally, the author needs to consider adding key findings when results are significant, making the title more compelling, such as "Sodium Glucose Cotransporter-2 Inhibitors Reduce Cardiovascular Mortality in Type-2 Diabetes: A Meta-Analysis."14 We believe such a methodical approach helps craft a title that effectively conveys research content to the reader. An effective title for a meta-analysis is concise, descriptive, and clearly indicates the study's focus and methodology.15,16 Examples of effective titles include: 1. Basic titles (e.g. The association between vitamin D supplementation and risk of fractures in older adults: a meta-analysis); 2. Title with key findings (e.g. Vitamin D supplementation reduces fracture risk in older adults by 20%: a meta-analysis); 3. Title with population and intervention focus (e.g. effectiveness of cognitive behavioural therapy for depression in adolescents: a systematic review and meta-analysis); 4. Title with broad scopes (e.g. Global prevalence of hypertension in adults: a meta-analysis of population-based studies). DOS AND DON'TS When crafting scientific titles for meta-analyses, certain principles can significantly enhance their effectiveness and impact. Below, we outline key recommendations and pitfalls to avoid during this critical process Figures 2 and 3.Figure 2: Dos: Science and art of writing the title of systematic review and meta-analysisFigure 3: Don't: Science and art of writing the title of systematic review and meta-analysisDO Do Be Specific and Mention the Study Design: Clearly define key study components such as "population," "intervention," and "outcome." Explicitly state "meta-analysis" or "systematic review and meta-analysis" in the title, mentioning the study type.1 Example: "Impact of Statin Therapy on LDL Cholesterol Levels in Patients with Coronary Artery Disease: A Meta-Analysis." Do Use Standard Medical Terminology: Use standard terminology for indexing and retrieval. Ensure the title is understandable to the target audience. Write the title with the intended audience in mind.9 Example: "Efficacy of Antiviral Therapies in Reducing Hospitalisation Rates for Influenza: A Meta-Analysis." Do Keep It Concise and Accurate: Aim for brevity without sacrificing clarity. Keep it concise yet informative. Avoid jargon and unnecessary words. Ensure the title accurately reflects the content of the study.10 Example: "Probiotics for Irritable Bowel Syndrome in elderly: A Meta-Analysis." Do Highlight Novelty or Significance (if applicable): Focus on the primary outcome and highlight the main finding of the meta-analysis. Emphasise unique findings or clinical implications.11 Example: "First-Line Immunotherapy Improves Survival in Advanced Non-Small Cell Lung Cancer: A Meta-Analysis." Do follow journal formatting guidelines: Adhere to the specific formatting requirements of your target journal, including word count limitations, punctuation preferences, and structural elements. Each journal has unique style conventions that must be respected. Example: For IJA submission – "Regional versus General Anaesthesia for Hip Fracture Surgery in Elderly Patients: A Meta-analysis, Meta-Regressions and Trial Sequential Analysis of Randomised Controlled Trials" (include the terms "meta-regression" and "trial sequential analysis" only if they are major components of the study). DON'T Don't Use Ambiguous or Non-Specific Terms: Avoid use of vague or generic terms such as "study," "research," or "investigation" without further specification. Avoid phrases such as "a study of" or "an investigation into" or "effects of a drug"… Poor title example: "A Study of Drug Effects on Patients…" Don't Overload the Title with Details: Avoid including too many variables or outcomes. Avoid using overly long titles and keep them easy to read. Most journals have character limits.8 Poor title example: "The Effects of Drug A, Drug B, and Drug C on Outcomes X, Y, and Z in Populations P, Q, and R: A Meta-Analysis." Don't Use Abbreviations or Jargon: Spell out terms unless the abbreviation is universally recognised. Poor title example: "SGLT2i and CV Outcomes in T2D: A Meta-Analysis." Don't Make Unsupported Claims: Avoid misleading statements, exaggerations, or overstated conclusions in the title. Ensure that the population and interventions studied are accurately specified. The title should accurately reflect the scope and limitations of meta-analysis, rather than promising more than the evidence supports. Poor title example: "Miracle Drug Cures Cancer: A Meta-Analysis." Don't Forget the Study Design: Failing to mention "meta-analysis" can mislead readers about the nature of the study. Poor title example: "The Role of Diet in Preventing Cardiovascular Disease." Don't Use Abbreviations: Avoid abbreviations unless they are widely recognised and essential.12 Poor title example: "RCTs of SSRIs vs SNRIs for MDD: A MA of AEs and QoL Outcomes" (Instead of: "Randomised Controlled Trials Comparing Selective Serotonin Reuptake Inhibitors versus Serotonin-Norepinephrine Reuptake Inhibitors for Major Depressive Disorder: A Meta-Analysis of Adverse Events and Quality of Life Outcomes") Don't Include Results in the Title: The title should describe the study, not its findings. Poor title example: "Vitamin D Supplementation Reduces Fracture Risk by 23% in Elderly Patients: A Meta-Analysis" (Instead of: "Effects of Vitamin D Supplementation on Fracture Risk in Elderly Patients: A Meta-Analysis") Don't Use Sensational Language: Avoid hype or exaggerated claims in the title. Poor title example: "Revolutionary Breakthrough: The Shocking Impact of Mindfulness on Anxiety Disorders Revealed in a Meta-Analysis" (Instead of: "Effectiveness of Mindfulness-Based Interventions for Anxiety Disorders: A Meta-Analysis") For a comprehensive understanding, readers may refer to the examples of exemplary and problematic titles provided in Table 2 and Figure 4, which illustrate these principles in practice.Figure 4: Different types of titles for meta-analysisTable 2: Examples of good and poor titles in meta-analysisTechnological advancements now offer new approaches to title crafting for systematic reviews. Artificial intelligence tools have emerged that can analyse highly cited articles and suggest optimal title structures. The use of search engines is now a consistent basis for title creation, and most researchers now utilise digital databases. These emerging technologies provide valuable supplementary methods to traditional title crafting approaches; however, one must exercise caution to maintain scientific accuracy and avoid unnecessary jargon when implementing such techniques. CONCLUSION Crafting a convincing title for a meta-analysis is a crucial step in disseminating research effectively. By adhering to these principles, authors can ensure their meta-analysis titles are both compelling and scientifically rigorous, paving the way for greater engagement and dissemination of their work. A well-structured title improves the visibility, credibility, and impact of a meta-analysis. Authors should aim for precision, clarity, and compliance with journal requirements to enhance discoverability and relevance. By following the guidelines mentioned above, researchers can create effective and captivating titles that accurately reflect their work. Authors have to remember to focus on the key elements of the study, avoid common pitfalls, and tailor the title to the target reader or researcher. Authors contributions TPT: Concept, review of literature, writing and approval. RG: Concept, review of literature, writing and approval. Disclosure of use of artificial intelligence (AI)-assistive or generative tools The AI tools or language models (LLM) have not been utilised in the manuscript, except that software has been used for grammar corrections. Declaration of use of permitted tools Nil. Presentation at conferences/CMEs and abstract publication None. Financial support and sponsorship None. Conflicts of interest Both the authors of this editorial are the editor of this journal. The authors declare that they have no conflicts of interest.