Priority Setting Exercise

Priority reviews: 2021 & 2022

Following completion of Cochrane Gynaecology and Fertility’s (CGF) priority-setting exercise, the reviews we will prioritise for update/completion over 2021 & 2022, are as follows:




Hormonal treatment for uterine adenomyosis

Protocol - unpublished

Medical management of uterine fibroids


Non-surgical interventions for the management of chronic pelvic pain


Selective serotonin reuptake inhibitors for premenstrual syndrome


Uterine artery embolization for symptomatic uterine fibroids




Assisted reproductive technologies for male subfertility


Culture media for human pre-implantation embryos in assisted reproductive technology cycles


Depot versus daily administration of gonadotrophin-releasing hormone agonist protocols for pituitary down regulation in assisted reproduction cycles


Immune therapies for women with history of unsuccessful implantation undergoing IVF/ICSI treatment


Interventions for improving reproductive outcomes in women with recurrent implantation failure undergoing assisted reproductive techniques

These titles will be published as Cochrane priority reviews; the list will also be shared with our stakeholders.

We also intend to focus on updating/completing all reviews in these topic areas:

  1. Endometriosis
  2. Menopause
  3. Uterine Fibroids

Priority Setting Methodology

Cochrane Gynaecology and Fertility (CGF) has conducted a priority-setting exercise to identify a list of ten priority topics of interest to our stakeholders, namely those people who require interventions, and for those medical professionals who are tasked with providing such interventions, for conditions within the CGF scope. These conditions relate to:




Gynaecology, other than endometriosis and menopause

The focus of our priority setting process was to update and prioritise topics from the existing CGF portfolio.  We did not consider generating new systematic review questions as there are few new interventions for conditions within the CRG that are not covered by existing reviews.

1.       Governance

The CGF Priority Setting Steering Group (Steering Group) consisted of:

  • Angela Beros, Assistant Managing Editor
  • Dr Elena Kostova, Managing Editor
  • Helen Nagels, Managing Editor
  • Professor Cindy Farquhar, Co-ordinating Editor
  • Dr Madelon van Wely, Co-ordinating Editor

2.       Stakeholders

The Steering Group engaged the following stakeholders:

3.       Scope

The Steering Group’s scope was limited to fertility and gynaecology topics where the evidence was out of date (or likely to go out of date), namely:

- reviews where the last publication was earlier than 1 January 2018

- unpublished reviews where the protocol was published earlier than 1 January 2018

- reviews and protocols, which in the opinion of the Managing Editors, were not progressing satisfactorily, including reviews and protocols with no author teams (i.e. reviews unlikely to be published in the next 6 months)

Due to limited resources, the Steering Group excluded up to date reviews as these tend to have dedicated author teams who are active in keeping those reviews current.

The Steering Group excluded all topics relating to menopause and endometriosis, as all titles for these topics have already been targeted for update – both topics being planned for Cochrane Special Collections to be launched in time for their respective World Awareness Days.

4.       Timescale

The priority setting process was undertaken during the year 1 November 2020 to 31 October 2021. The Steering Group plans to have active author teams for the ten priority reviews by 1 March 2022 with a view to having those reviews published by 1 March 2023.

The CRG plans to repeat this process every five years.

5.       Methods

The priority process consisted of two data gathering stages and two implementation stages, as follows:

5.1.    Data Gathering 

5.1.1. Determining which reviews were out of date (or were likely to go out of date)

The Steering Group determined which topics were out of date (or were likely to go out of date) by checking the publication date of each protocol and review. The Steering Group also checked notes held on reviews and protocols to ascertain which reviews and protocols did not (or were likely to not) have author teams or which were not progressing satisfactorily. 

Once the Steering Group had determined which reviews were out of date, the reviews were split into two groups – gynaecology and fertility.

5.1.2. Usage of existing CRG reviews

The Steering Group separately ranked the gynaecology and fertility reviews based on their usage.  Metrics were collected on the following:

1.       Full text downloads – how often a review was downloaded from the Cochrane library in 2019

2.       Google Scholar citations – the number of times the review was cited in another paper according to Google Scholar

3.       The Altmetric Score – the Altmetric score for the review as set out in the Cochrane library

4.       Guideline citations -  the number of guideline citations for the review as set out in the Cochrane library

For both gynaecology and fertility topics, the Steering Group ranked the reviews based on each metric.  The Steering Group then took an average of each metric to rank each published review from highest to lowest usage.

5.2.    Implementation

5.2.1. Ranking by CGF Editors

The Steering Group emailed the CGF Editors a list of the gynaecology and fertility reviews together with the usage metrics.  Those reviews that had been published appeared in order according to usage. The CGF Editors were asked to rank the topics high, medium or low priority and were invited to give additional feedback including their opinion as to which reviews should take priority.  The Steering Group collated the CGF Editors’ rankings and feedback, calculated the average rankings from the CGF Editor rankings and ranked the reviews from highest to lowest priority based on those rankings.

For the gynaecology reviews, it became apparent from the CGF Editor feedback, and the number of uterine fibroid reviews on the gynaecology list, that uterine fibroids are a high priority area for the CRG – not only are nearly all reviews on uterine fibroids out of date, but the reviews for hormonal treatments are split between several reviews, rather than contained in one comprehensive review. Some of the clinical CGF Editors, as well as other clinical authors within the CRG, have advised that uterine fibroids affect many women and are a condition that can impact significantly on quality of life.  The Steering Group has therefore identified that a new review should be undertaken Hormonal treatments for uterine fibroids and that this is a priority review for the CRG, particularly as two of the CRG Editors have advised this review will be used to formulate Guidelines for treatment of uterine fibroids in England.

5.2.2. Ranking by senior clinicians (from RANZCOG)

The Steering Group took the top ten gynaecology and top ten fertility reviews as ranked by the CGF Editors.  For the gynaecology reviews, the Steering Group removed the two hormonal reviews pertaining to uterine fibroids (as these will form part of the new priority review on uterine fibroids) and added in the next two highest ranking reviews.

The Steering Group sent both of these ranked review lists to three senior clinicians from RANZCOG, who are not CGF Editors, and asked them to rank the reviews in each list from one to ten.  The Steering Group then took an average of those rankings.  The CRG’s ten priority reviews comprised the top four gynaecology reviews, together with Hormonal treatments for uterine fibroids and the top five fertility reviews.