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PRISMA 2020 — Systematic Review Report Template

Purpose

Template for writing a systematic review report following PRISMA 2020 (Page et al., 2021). All 27 PRISMA items are mapped to their corresponding sections. Use alongside references/systematic_review_toolkit.md for detailed guidance.

Reference: Page et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71


Title [PRISMA Item 1]

[Full title identifying the report as a systematic review, meta-analysis, or both]

Example: "The Effect of [Intervention] on [Outcome] in [Population]: A Systematic Review and Meta-Analysis"


Abstract [PRISMA Item 2]

Background

[1-2 sentences on context and why the review was done]

Objectives

[Research question(s), ideally structured as PICOS]

Data Sources

[Databases searched and dates of last search]

Study Selection

[Eligibility criteria in brief]

Data Extraction and Synthesis

[Methods used for data extraction, risk of bias, and synthesis]

Results

[Number of studies included, key findings, effect estimates with CIs, certainty of evidence]

Limitations

[Key limitations of the evidence and/or the review process]

Conclusions

[General interpretation and implications]

Registration

[Protocol registration number and repository]

Keywords: [3-5 keywords]


1. Introduction

1.1 Rationale [PRISMA Item 3]

[Describe the rationale for the review in the context of existing knowledge. Address:]

  • What is the problem or question?
  • What is already known (with references to existing reviews)?
  • Why is this review needed (e.g., no existing review, existing review outdated, conflicting evidence)?

1.2 Objectives [PRISMA Item 4]

[Provide an explicit statement of the question(s) using PICOS:]

  • Population: [target population]
  • Intervention/Exposure: [intervention or exposure of interest]
  • Comparator: [comparison group]
  • Outcome(s): [primary and secondary outcomes]
  • Study Design: [eligible study designs]

2. Methods

2.1 Eligibility Criteria [PRISMA Item 5]

Criterion Include Exclude
Study design [e.g., RCTs, quasi-experimental] [e.g., case reports, editorials]
Population [describe] [describe]
Intervention [describe] [describe]
Comparator [describe] [describe]
Outcome [describe] [describe]
Time frame [e.g., published 2014-2024] [before cutoff]
Language [e.g., English] [other]
Setting [describe] [describe]

2.2 Information Sources [PRISMA Item 6]

[List all databases and other sources searched, with dates of coverage and last search date:]

Source Date Range Last Searched
[Database 1] [start]-[end] [date]
[Database 2] [start]-[end] [date]
[Other sources: reference lists, expert contact, grey literature] [date]

2.3 Search Strategy [PRISMA Item 7]

[Present the complete search strategy for at least one database. Include all search terms, Boolean operators, and any filters applied.]

[Database Name] Search Strategy:

#1 [search block 1 - Population terms]
#2 [search block 2 - Intervention terms]
#3 [search block 3 - Outcome terms]
#4 #1 AND #2 AND #3
#5 #4 with filters: [date, language, document type]

[Search strategies for other databases are available in Appendix A.]

2.4 Selection Process [PRISMA Item 8]

[Describe the study selection process:]

  • Number of reviewers at each stage
  • How independence was maintained
  • How disagreements were resolved
  • Software used (e.g., Covidence, Rayyan)
  • Pilot testing of screening criteria

2.5 Data Collection Process [PRISMA Item 9]

[Describe methods for extracting data from reports:]

  • Data extraction form (developed, piloted)
  • Number of extractors and independence
  • Process for resolving discrepancies
  • How missing data were handled (e.g., contacted authors)

2.6 Data Items [PRISMA Item 10]

[List all variables for which data were sought:]

Category Variables
Study-level Authors, year, country, design, setting, funding
Participants N, age, gender, diagnosis/condition, attrition
Intervention Type, duration, frequency, fidelity
Outcomes Definition, measurement tool, time points
Results Effect sizes, CIs, p-values, raw data

2.7 Study Risk of Bias Assessment [PRISMA Item 11]

[Describe the risk of bias assessment:]

  • Tool(s) used: [RoB 2 for RCTs / ROBINS-I for non-randomized / other]
  • Domains assessed
  • Number of assessors and independence
  • How results were used in the synthesis

2.8 Effect Measures [PRISMA Item 12]

[Specify the effect measure(s) for each outcome:]

Outcome Type Effect Measure Justification
[Outcome 1] Continuous SMD (Hedges' g) Different scales across studies
[Outcome 2] Binary RR Incidence data

2.9 Synthesis Methods [PRISMA Items 13a-13f]

13a. Eligibility for synthesis: [Criteria for grouping studies into each synthesis]

13b. Data preparation: [Methods to prepare data, e.g., converting SE to SD, handling multi-arm studies]

13c. Tabulation/visualization: [Methods for displaying individual study and synthesis results, e.g., forest plots, summary tables]

13d. Synthesis approach: [Statistical model and software]

  • Model: [Fixed-effect / Random-effects (DerSimonian-Laird / REML)]
  • Software: [R metafor / RevMan / Stata]
  • OR if narrative: [SWiM approach, vote counting, effect direction plot]

13e. Heterogeneity exploration: [Methods used]

  • Subgroup analyses: [pre-specified subgroups and rationale]
  • Meta-regression: [covariates tested, if applicable]

13f. Sensitivity analyses: [Planned sensitivity analyses]

  1. Leave-one-out analysis
  2. Excluding high risk of bias studies
  3. Fixed-effect vs. random-effects comparison
  4. [Other analyses]

2.10 Reporting Bias Assessment [PRISMA Item 14]

[Methods to assess publication bias:]

  • Funnel plot (visual inspection)
  • Statistical test: [Egger's / Peter's / trim-and-fill]
  • Comparison of protocol to published reports

2.11 Certainty Assessment [PRISMA Item 15]

[Framework used to assess certainty of evidence:]

  • GRADE approach
  • Factors assessed: risk of bias, inconsistency, indirectness, imprecision, publication bias
  • Rating up factors (for observational studies): large effect, dose-response, plausible confounding

3. Results

3.1 Study Selection [PRISMA Item 16a, 16b]

PRISMA Flow Diagram

 ┌─────────────────────────────────────────────────────┐
 │                 IDENTIFICATION                      │
 ├─────────────────────────────────────────────────────┤
 │ Records identified from databases (n = )            │
 │   Database 1 (n = )                                 │
 │   Database 2 (n = )                                 │
 │   Database 3 (n = )                                 │
 │ Records identified from other sources (n = )        │
 │   Reference lists (n = )                            │
 │   Expert recommendations (n = )                     │
 └──────────────────────┬──────────────────────────────┘
                        │
 ┌──────────────────────▼──────────────────────────────┐
 │ Records removed before screening:                   │
 │   Duplicate records (n = )                          │
 │   Records marked ineligible by automation (n = )    │
 │   Records removed for other reasons (n = )          │
 └──────────────────────┬──────────────────────────────┘
                        │
 ┌──────────────────────▼──────────────────────────────┐
 │                  SCREENING                          │
 ├─────────────────────────────────────────────────────┤
 │ Records screened (n = )                             │
 │ Records excluded (n = )                             │
 └──────────────────────┬──────────────────────────────┘
                        │
 ┌──────────────────────▼──────────────────────────────┐
 │ Reports sought for retrieval (n = )                 │
 │ Reports not retrieved (n = )                        │
 └──────────────────────┬──────────────────────────────┘
                        │
 ┌──────────────────────▼──────────────────────────────┐
 │ Reports assessed for eligibility (n = )             │
 │ Reports excluded, with reasons (n = )               │
 │   Reason 1 (n = )                                   │
 │   Reason 2 (n = )                                   │
 │   Reason 3 (n = )                                   │
 └──────────────────────┬──────────────────────────────┘
                        │
 ┌──────────────────────▼──────────────────────────────┐
 │                  INCLUDED                           │
 ├─────────────────────────────────────────────────────┤
 │ Studies included in review (n = )                   │
 │ Reports of included studies (n = )                  │
 │ Studies in quantitative synthesis (n = )             │
 └─────────────────────────────────────────────────────┘

[PRISMA Item 16b: Cite studies that appeared to meet inclusion criteria but were excluded, with reasons.]

3.2 Study Characteristics [PRISMA Item 17]

Table: Characteristics of Included Studies

Study Country Design Population (N) Intervention Comparator Outcome(s) Follow-up Funding
Author1 (Year) [country] [design] [N] [intervention] [comparator] [outcomes] [duration] [source]
Author2 (Year) ... ... ... ... ... ... ... ...

3.3 Risk of Bias in Studies [PRISMA Item 18]

Table: Risk of Bias Summary (Traffic-Light)

Study D1 D2 D3 D4 D5 Overall
Author1 (Year) [L/S/H] [L/S/H] [L/S/H] [L/S/H] [L/S/H] [L/S/H]
Author2 (Year) ... ... ... ... ... ...

L = Low risk, S = Some concerns, H = High risk

[Narrative summary of risk of bias findings across studies]

3.4 Results of Individual Studies [PRISMA Item 19]

Table: Individual Study Results

Study Outcome Effect Estimate 95% CI p-value Weight
Author1 (Year) [outcome] [estimate] [lower, upper] [p] [%]
Author2 (Year) ... ... ... ... ...

3.5 Results of Syntheses [PRISMA Items 20a-20d]

Primary Outcome: [Name]

20a. Study characteristics: [Brief summary of contributing studies' characteristics and risk of bias]

20b. Pooled result:

  • Pooled effect: [estimate] (95% CI: [lower, upper])
  • Statistical significance: Z = [value], p = [value]
  • Heterogeneity: I² = [value]% (95% CI: [lower, upper]), Q = [value] (df = [n], p = [value]), tau² = [value]
  • Prediction interval: [lower, upper]

Forest Plot: [Insert or reference forest plot]

20c. Heterogeneity investigation:

  • Subgroup analyses: [results]
  • Meta-regression: [results, if conducted]

20d. Sensitivity analyses:

  1. Leave-one-out: [results — did any single study substantially change the estimate?]
  2. Excluding high-risk studies: [revised estimate]
  3. Fixed vs. random effects: [comparison]

Secondary Outcome(s): [Name]

[Repeat structure above for each secondary outcome]

3.6 Reporting Biases [PRISMA Item 21]

[Report assessments of publication bias:]

  • Funnel plot: [description of symmetry/asymmetry]
  • Statistical test: [result]
  • Trim-and-fill: [adjusted estimate, if applicable]
  • Other assessments: [protocol-outcome comparison]

3.7 Certainty of Evidence [PRISMA Item 22]

GRADE Summary of Findings Table

Outcome Studies (n) Participants (N) Effect (95% CI) Certainty Rationale
[Outcome 1] [n] [N] [estimate (CI)] [High/Moderate/Low/Very Low] [Reasons for up/downgrading]
[Outcome 2] [n] [N] [estimate (CI)] [level] [reasons]

4. Discussion [PRISMA Item 23]

4.1 Summary of Evidence

[Provide a general interpretation of the results in the context of other evidence. Address:]

  • Main findings for each outcome
  • How findings compare to previous reviews
  • Consistency of findings across studies

4.2 Limitations

Limitations of the evidence:

  • [e.g., risk of bias across studies, inconsistency, indirectness, imprecision]

Limitations of the review process:

  • [e.g., language restrictions, database coverage, inability to contact authors]

4.3 Implications

For practice:

  • [What practitioners should do based on these findings]

For research:

  • [Gaps identified, recommended future study designs]

For policy:

  • [Policy implications, if applicable]

5. Other Information

5.1 Registration and Protocol [PRISMA Item 24]

[Provide registration information and link to protocol:]

  • Registry: [e.g., PROSPERO]
  • Registration number: [number]
  • Protocol URL: [link]
  • Deviations from protocol: [describe any deviations and rationale]

5.2 Support [PRISMA Item 25]

[Describe sources of support:]

  • Financial: [funding sources and grant numbers]
  • Non-financial: [e.g., institutional support, access to databases]
  • Role of funder: [describe any role of funders in the review]

5.3 Competing Interests [PRISMA Item 26]

[Declare competing interests of all authors]

5.4 Availability of Data and Materials [PRISMA Item 27]

[Report availability of:]

  • Data extraction forms
  • Extracted data from included studies
  • Analysis code
  • List of excluded studies with reasons
  • PRISMA checklist (completed)

Appendices

Appendix A: Full Search Strategies

[Complete search strategies for all databases]

Appendix B: Excluded Studies with Reasons

Study Reason for Exclusion
[citation] [reason]

Appendix C: PRISMA 2020 Checklist

[Completed PRISMA 2020 checklist with page/section numbers for each item]

Item # Checklist Item Reported on Page/Section
1 Title [page]
2 Abstract [page]
... ... ...
27 Availability [page]