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
[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"
[1-2 sentences on context and why the review was done]
[Research question(s), ideally structured as PICOS]
[Databases searched and dates of last search]
[Eligibility criteria in brief]
[Methods used for data extraction, risk of bias, and synthesis]
[Number of studies included, key findings, effect estimates with CIs, certainty of evidence]
[Key limitations of the evidence and/or the review process]
[General interpretation and implications]
[Protocol registration number and repository]
Keywords: [3-5 keywords]
[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 - Why is this review needed (e.g., no existing review, existing review outdated, conflicting evidence)?
[Provide an explicit statement of the question(s) using PICOS:]
| 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] |
[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] |
[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.]
[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
[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)
[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 |
[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
[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 |
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]
[Methods to assess publication bias:] - Funnel plot (visual inspection) - Statistical test: [Egger's / Peter's / trim-and-fill] - Comparison of protocol to published reports
[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
┌─────────────────────────────────────────────────────┐
│ 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.]
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) | ... | ... | ... | ... | ... | ... | ... | ... |
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]
Table: Individual Study Results
| Study | Outcome | Effect Estimate | 95% CI | p-value | Weight |
|---|---|---|---|---|---|
| Author1 (Year) | [outcome] | [estimate] | [lower, upper] | [p] | [%] |
| Author2 (Year) | ... | ... | ... | ... | ... |
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]
[Repeat structure above for each secondary outcome]
[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]
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] |
[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
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]
For practice: - [What practitioners should do based on these findings]
For research: - [Gaps identified, recommended future study designs]
For policy: - [Policy implications, if applicable]
[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]
[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]
[Declare competing interests of all authors]
[Report availability of:] - [ ] Data extraction forms - [ ] Extracted data from included studies - [ ] Analysis code - [ ] List of excluded studies with reasons - [ ] PRISMA checklist (completed)
[Complete search strategies for all databases]
| Study | Reason for Exclusion |
|---|---|
| [citation] | [reason] |
[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] |