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In their recent commentary Takkouche and Norman1 seriously misrepresent the PRISMA guideline for reporting systematic reviews and meta-analyses. They state that PRISMA “demands the prior registration of the protocol of any systematic review and meta-analysis, requiring that this protocol should be made accessible before any hands-on work is done.” No such demands are made in PRISMA. Item 5 of the checklist asks authors to “Indicate if a review protocol exists, if and where it can be accessed (such as Web address), and, if available, provide registration information including registration number.” 2 The rationale for this request is:“registration may reduce unnecessary duplication of the same review question, particularly in jurisdictions with limited budgets; minimize study publication bias and selective reporting bias; and provide important information for those involved in updating systematic reviews.” That …