Article Text

Download PDFPDF

From living systematic reviews to meta-analytical research domains
  1. Pim Cuijpers1,2,
  2. Clara Miguel1,
  3. Davide Papola3,
  4. Mathias Harrer4,5,
  5. Eirini Karyotaki1
  1. 1 Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
  2. 2 Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
  3. 3 WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  4. 4 Department of Clinical Psychology & Psychotherapy, Friedrich-Alexander-University Erlangen, Nuremberg, Germany
  5. 5 Psychology & Digital Mental Health Care, Department of Health Sciences, Technical University Munich, Munich, Germany
  1. Correspondence to Professor Pim Cuijpers, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, Netherlands; p.cuijpers{at}


Because of the rapidly increasing number of randomised controlled trials (RCTs) and meta-analyses in many fields, there is an urgent need to step up from meta-analyses to higher levels of aggregation of outcomes of RCTs. Network meta-analyses and umbrella reviews allow higher levels of aggregation of RCT outcomes, but cannot adequately cover the evidence for a whole field. The ‘Meta-Analytic Research Domain’ (MARD) may be a new methodology to aggregate RCT data of a whole field. A MARD is a living systematic review of a research domain that cannot be covered by one PICO. For example, a MARD of psychotherapy for depression covers all RCTs comparing the effects of all types of psychotherapy to control conditions, to each other, to pharmacotherapy and combined treatment. It also covers all RCTs comparing treatment formats, the effects in different target groups, subtypes of depression and secondary outcomes. Although the time and resources needed to build a MARD are considerable, they offer many advantages, including a comprehensive and consistent overview of a research field and important meta-analytic studies that cannot be conducted with conventional methods. MARDs are a promising method to step up the aggregation of RCTs to a next level and it is highly relevant to work out the methods of this approach in a more detailed way.

  • adult psychiatry
  • depression & mood disorders

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors PC and EK had the idea for this paper. PC wrote the first draft. The content was generated in discussions among all authors. All authors read and approved the final version of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.