Nelson Systematic Reviews to Answer Healthcare, Questions, 2e

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Chapter 6 • Selecting Studies for Inclusion

Identification of studies via databases and registers

Identification of studies via other methods

Records removed before screening : Duplicate records removed (n = ) Records marked as ineligible by automation tools (n = ) Records removed for other reasons (n = )

Records identified from: Websites (n = ) Organisations (n = ) Citation searching (n = ) etc

Records identified from a :

Databases (n = ) Registers (n = )

Identification Screening Included

Records screened (n = )

Records excluded b (n = )

Reports sought for retrieval (n = )

Reports not retrieved (n = )

Reports sought for retrieval (n = )

Reports for retrieved (n = )

Reports assessed for eligibility (n = )

Reports excluded: Reason 1 (n = ) Reason 2 (n = ) Reason 3 (n = ) etc

Studies included in review (n = ) Reports of included studies (n = )

publications retrieved, and the number of full-text publications screened. For studies excluded at the full-text level, PRISMA additionally recommends that reviewers indicate the numbers of exclusions based on their prespecified PICOTS-relevant exclusion categories (ie, wrong pop ulation, intervention, comparator, etc). This can be efficiently accomplished when reviewers use a standardized method for coding exclusions, and reference management or other data base software to electronically manage their study selection process. Included publications are those meeting all inclusion criteria and contributing to the body of evidence in the system atic review. The number of studies that are included in the quantitative analysis is separately reported, if applicable. For systematic reviews that include a variety of populations, study designs, or other com ponents, it is also acceptable to stratify the reporting of the numbers of included studies by relevant categories. For example, in a systematic review about screening for osteoporosis, the selection of studies for research questions about the efficacy and harms of drugs to prevent osteoporotic fractures was uniquely different from a question about the diagnostic accuracy of dual-energy x-ray absorptiometry in detecting low bone mineral density. 24 Reporting the included studies by research question was a useful way to focus results for both the systematic reviewers and users. In addition to reporting the numbers of studies excluded by the reasons for exclusion in the PRISMA diagram, systematic review guidelines recommend providing a list of the individual studies excluded from the review and their reasons for exclusions. 10–12,25 Rather than a com plete accounting of all studies excluded at both the abstract and full-text levels, this list is most informative when it focuses on full-text studies reviewed that nearly fulfilled eligibility criteria and initially appeared relevant. ■■ FIGURE 6.1 PRISMA 2020 flow diagram for new systematic reviews that included searches of databases, registers, and other sources. a Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). b If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools. Source: Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ . 2021;372:n71.

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