Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement
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Abstract
Objectives To describe the processes used to update the PRISMA 2009 statement for reporting systematic reviews, present results of a survey conducted to inform the update, summarize decisions made at the PRISMA update meeting, and describe and justify changes made to the guideline.Methods We reviewed 60 documents with reporting guidance for systematic reviews to generate suggested modifications to the PRISMA 2009 statement. We invited 220 systematic review methodologists and journal editors to complete a survey about the suggested modifications. The results of these projects were discussed at a 21-member in-person meeting. Following the meeting, we drafted the PRISMA 2020 statement and refined it based on feedback from co-authors and a convenience sample of 15 systematic reviewers.Results The review of 60 documents revealed that all topics addressed by the PRISMA 2009 statement could be modified. Of the 110 survey respondents, more than 66% recommended keeping six of the original checklist items as they were and modifying 15 of them using wording suggested by us. Attendees at the in-person meeting supported the revised wording for several items but suggested rewording for most to enhance clarity, and further refinements were made over six drafts of the guideline.Conclusions The PRISMA 2020 statement consists of updated reporting guidance for systematic reviews. We hope that providing this detailed description of the development process will enhance the acceptance and uptake of the guideline and assist those developing and updating future reporting guidelines.
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PRISMA 2020 is published as a suite of three papers: a statement paper, a development paper, and this explanation and elaboration paper.
“PRISMA 2020 is published as a suite of three papers: a statement paper (consisting of the 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagram23); a development paper (which outlines the steps taken to update the PRISMA 2009 statement and provides rationale for modifications to the original”
From PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews (2021) · cites this paper as [24]
Experimental — accuracy not yet measuredThis umbrella review was conducted following PRISMA 2020 guidelines.
“This umbrella review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 [21] guidelines to ensure a rigorous and transparent approach.”
From The Role of AI in Nursing Education and Practice: Umbrella Review (2025) · cites this paper as [21]
The systematic review was preregistered (PROSPERO CRD42022313034) and reported according to the PRISMA checklist.
“This preregistered systematic review with meta-analysis (International prospective register of systematic reviews [PROSPERO], no.CRD42022313034) was reported in accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist ( 16).”
From Optimal Dose and Type of Physical Activity to Improve Glycemic Control in People Diagnosed With Type 2 Diabetes: A Systematic Review and Meta-analysis (2024) · cites this paper as [16]
The development of PRISMA 2020 included surveying systematic review methodologists and journal editors for their views on how to revise the original PRISMA statement.
“surveyed systematic review methodologists and journal editors for their views on how to revise the original PRISMA statement [35]”
From The PRISMA 2020 statement: an updated guideline for reporting systematic reviews (2021) · cites this paper as [35]
The systematic review was conducted in accordance with the PRISMA 2020 statement.
“This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement55.”
From Systematic review of cost effectiveness and budget impact of artificial intelligence in healthcare (2025) · cites this paper as [55]
The study was conducted in accordance with PRISMA guidelines.
“Following PRISMA guidelines”
The review followed the most current PRISMA guidelines.
“The most current version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting systematic reviews was followed throughout the review process (Page et al., 2021).”
From Camouflaging in autism: A systematic review (2021) · cites this paper as Page et al., 2021
The meta-analysis was conducted in accordance with PRISMA 2020 guidelines.
“The meta-analysis was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [38].”
From Comparison of weightlifting, traditional resistance training and plyometrics on strength, power and speed: a systematic review with meta-analysis. (2022) · cites this paper as [38]
The authors surveyed expert methodologists in systematic reviews and journal editors to learn their views on how to revise the original PRISMA statement.
“encuestaron a metodo ´ logos expertos en revisiones sistema ´ticas y editores de revistas para conocer sus puntos de vista sobre co ´ mo revisar la declaracio ´ n original PRISMA 34 ,”
From Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas (2021) · cites this paper as [34]
This review followed the PRISMA systematic review methodology.
“This review follows the PRISMA systematic review methodology and synthesizes the results of 85 studies that were selected from an initial pool of 818 records across several databases.”
From Leveraging AI in E-Learning: Personalized Learning and Adaptive Assessment through Cognitive Neuropsychology—A Systematic Analysis (2024) · cites this paper as [127]
This integrative review adheres to PRISMA 2020 guidelines.
“This integrative review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to ensure comprehensive and transparent reporting (23).”
From Artificial intelligence in nursing: an integrative review of clinical and operational impacts (2025) · cites this paper as [23]
This review followed the PRISMA guidelines for reporting a systematic review.
“This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for authors reporting a systematic review.”
From Interoperability of heterogeneous health information systems: a systematic literature review (2023) · cites this paper as [11]
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Self-citationDeclaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas
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Self-citationCamouflaging in autism: A systematic review
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A Scoping Review of Empirical Evidence on (Digital) Public Services Co-Creation
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Vegetation-based ecosystem service delivery in urban landscapes: A systematic review
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Suicide and suicide attempts in the Pacific Islands: A Systematic Literature Review.
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- Authors
- Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., & Moher, D.
- Affiliations
- Monash University (AU)
- Amsterdam University Medical Centers (NL)
- Inserm (FR)
- Bond University (AU)
- The University of Texas at San Antonio Health Science Center (US)
- University of Ottawa (CA)
- Corresponding author
- Page, Matthew J
- ORCID
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 134
- Pages
- 103-112
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W3126226315
- Cited by
- 3,490
- References
- 52
- Citations by year
- 2026: 683 · 2025: 831 · 2024: 718 · 2023: 552 · 2022: 463 · 2021: 233 · 2020: 4 · 2012: 2
- FWCI
- 19.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Bond University Research Portal (Bond University) (acceptedVersion, cc-by-nc-nd)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- HAL (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- MetArXiv (OSF Preprints) (submittedVersion)
- MetArXiv (OSF Preprints) (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council (1088535, 1143429, 1154607)
- Australian Research Council (DE200101618)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- PRISMA 2020, reporting guidelines, systematic reviews, reporting checklist, guideline development
- MeSH terms
- Systematic Reviews as Topic, Humans, Surveys and Questionnaires, Guidelines as Topic, Evidence-Based Medicine, Guideline Adherence, Consensus, Research Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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