How Blockchain Technology Can Transform the Systematic Review/Meta-analysis Process?

We propose a blockchain-based solution for rendering the systematic review/meta-analyses process open-access, auditable, and reproducible. 1 Agbo CC Mahmoud QH Eklund JM Blockchain technology in healthcare: a systematic review. Healthcare. 2019; 7: 56 Crossref Google Scholar ,2 Justinia T Blockchain technologies: opportunities for solving real-world problems in healthcare and biomedical sciences. Acta Inform Med. 2019; 27: 284-291 Crossref PubMed Scopus (7) Google Scholar Blockchain, with its ability to create a tamper-proof, time-stamped records of events, can strengthen the scientific rigor of systematic reviews/meta-analyses. The proposed platform would seamlessly create dependable records without providing additional complexity to the already intricate process of conducting a systematic review/meta-analysis. After choosing the keywords, the team creates a list of articles for consideration for inclusion in the systematic review. We propose that a blockchain is created with these articles being the nodes. This blockchain will become publicly available when the systematic review/meta-analysis is published, for manuscript reviewers or third-party reviewers to audit. The proposed blockchain-based system (Figure 1) aims to provide 4 advantages to the systematic review/meta-analysis process: •Crowd sourcing transactions: The primary author would initiate a smart contract outlining the inclusion and exclusion criteria for articles to be included in the review process. Multiple contributors can review the articles on the block chain and decide whether each article meets the criteria for inclusion in the systematic review/meta-analysis. When a decision is made, a “transaction” is made on the blockchain and this decision is irreversibly stored on the blockchain with a timestamp. The primary author can decide the number of transactions and the amount of effort expected from each of the contributors and can verify them in real time. •Credited upgrade path: Every time a new research study is published, an existing systematic review/meta-analysis on that topic becomes outdated. Sometimes, it becomes necessary to update the existing systematic reviews/meta-analysis to reflect this newly available evidence, and hence new systematic reviews or meta-analysis may be published. However, the authors of this new systematic review or meta-analysis face an advantage in that they can benefit from the reviews done by the authors of prior systematic reviews on this topic. The authors of the new systematic review will only need to review the newer evidence and they inherit from the work done by their priors on this topic. In the system we propose, every time a new systematic review needs to be performed, if a prior review already exists on the same, the authors of the new review can fork the blockchain of the prior review along with all of its transactions and update it to add the newer evidence. This way, the authors of the prior study are sufficiently credited, and their contributions live on as transactions on the blockchain forever. •Public auditability: During the in-depth review process, every time a member of the team decides to include an article in the systematic review or meta-analysis, a transaction will be made on the chain. Once a transaction is made on the blockchain, it is irreversible. To overrule a previous decision, a new transaction will have to be made. Hence, every new iteration of the analysis process can be captured. These transactions are time-stamped and auditable when the chain is made public, thereby providing a decision trail to the community, to ensure scientific rigor and adherence to the principles of a systematic review. •Conflict resolution: In a multireviewer process such as conducting a systematic review or meta-analysis where the contributors cross-verify each other's decisions, it is common to have one contributor's decision of an article's eligibility be overruled by another of the same team. In smart contracts, these conflicts can be resolved using a consensus algorithm. The ability to provide weightage to decisions, with tie-breaker ability to a third party are inherent properties of “smart contract.”