The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
Open accessAbstract
Background: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did and what they found. Over the last decade, there have been many advances in systematic review methodology and terminology, which have necessitated an update to the guideline.Objectives: To develop the PRISMA 2020 statement for reporting systematic reviews.Methods: We reviewed 60 documents with reporting guidance for systematic reviews to generate suggested modifications to the PRISMA 2009 statement. We sought feedback on the suggested modifications through an online survey of 110 systematic review methodologists and journal editors. The results of the review and survey were discussed at a 21-member in-person meeting. Following the meeting, drafts of the PRISMA 2020 checklist, abstract checklist, explanation and elaboration and flow diagram were generated and refined iteratively based on feedback from co-authors and a convenience sample of 15 systematic reviewers.Results: In this statement paper, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews. The checklist includes new reporting guidance that reflects advances in methods to identify, select, appraise and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. The PRISMA 2020 statement replaces the 2009 statement.Conclusions: The PRISMA 2020 statement is intended to facilitate transparent, complete and accurate reporting of systematic reviews. Improved reporting should benefit users of reviews, including guideline developers, policy makers, health care providers, patients and other stakeholders. In order to achieve this, we encourage authors, editors and peer-reviewers to adopt the guideline.
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Throughout the draft and revision process, several teleconferences were held with the lead of the PRISMA 2020 statement to ensure that the content on search methods was consistent between the PRISMA 2020 and PRISMA-S guidelines.
“Throughout the draft and revision process, several teleconferences were held with the lead of the PRISMA 2020 statement (M.J.P), as an update of the 2009 PRISMA statement was in development, to ensure that the content on search methods was consistent between the PRISMA 2020 and PRISMA-S guidelines [34, 35].”
From PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews (2021) · cites this paper as [35]
The Development of PRISMA 2020 section describes updating the 2009 statement and circulating drafts and revisions during 2019–2020. It does not report teleconferences with the PRISMA-S team or say that the two guidelines’ search-methods content was coordinated. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe.
“The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe.”
From mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe (2023) · cites this paper as [5]
The PRISMA 2020 checklist includes items for reporting search and study selection (Study selection 16a; Methods 7 Search strategy). But the Scope of the guideline says PRISMA 2020 is not intended to guide review conduct or assess methodological quality. The source therefore does not establish that following it ensured an unbiased comparison between sub-Saharan Africa and Europe. (LLM, conf=0.86)
Experimental — accuracy not yet measuredRecording the flow of citations through the systematic review process is a key component of the PRISMA Statement.
“Recording the flow of citations through the systematic review process is a key component of the PRISMA Statement [9, 35].”
From PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews (2021) · cites this paper as [35]
The review was organized following the PRISMA reporting guidelines.
“The review is organized following the reporting guidelines of the PRISMA statement (Page et al., 2021)”
From Effects of COVID-19-Related School Closures on Student Achievement-A Systematic Review (2021) · cites this paper as Page et al., 2021
The PRISMA Statement was meticulously followed in this research.
“Adhering to internationally recognized systematic review guidelines, the PRISMA Statement was meticulously followed in this research [14].”
From Online Child Sexual Exploitation and Abuse of Children and Adolescents with Disabilities: A Systematic Review (2024) · cites this paper as [14]
This review followed the PRISMA 2020 guidelines in conjunction with the PRISMA Extension for Scoping Reviews (PRISMA-ScR).
“This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines [9] in conjunction with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) [10].”
From Climate Change and Mental Health: A Scoping Review (2021) · cites this paper as [9]
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Climate Change and Mental Health: A Scoping Review
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Cohen, C., Pignata, S., Bezak, E., Tie, M., & Childs, J. (2023) · BMJ open · doi:10.1136/bmjopen-2022-071203 · Cited by 514 · see citing works
Effects of COVID-19-Related School Closures on Student Achievement-A Systematic Review
Hammerstein, S., König, C., Dreisörner, T., & Frey, A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.746289 · Cited by 461 · see citing works
Digital literacy as a new determinant of health: A scoping review
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Green Space Quality and Health: A Systematic Review
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The impact of wearable technologies in health research: scoping review
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Opportunities and Challenges for ChatGPT and Large Language Models in Biomedicine and Health
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The potential of immersive virtual reality to enhance learning: A meta-analysis
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Human-centred learning analytics and AI in education: A systematic literature review
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The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis.
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Automated Grading and Feedback Tools for Programming Education: A Systematic Review
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Impact of online learning on student's performance and engagement: a systematic review
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Exploring automation bias in human–AI collaboration: a review and implications for explainable AI
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Exploring the ethical considerations of using Chat GPT in university education
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The mental health impact of perinatal loss: A systematic review and meta-analysis
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Safety of higher doses of melatonin in adults: A systematic review and meta-analysis
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A systematic review on barriers and enablers toward circular procurement management
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Disclosure of suicidal ideation and behaviours: A systematic review and meta-analysis of prevalence
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The associations of adolescent problematic internet use with parenting: A meta-analysis
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Lean Healthcare Tools for Processes Evaluation: An Integrative Review.
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A rapid review on current and potential uses of large language models in nursing
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Risk of endometrial cancer in patients with polycystic ovarian syndrome: A meta‑analysis
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Weeda, E. R., Muraoka, A. K., Brock, M. D., & Cannon, J. M. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14060 · Cited by 73 · see citing works
Robinson, T., Ali, M. U., Easterbrook, B., Hall, W., Jutras-Aswad, D., & Fischer, B. (2023) · Psychological Medicine · doi:10.1017/s0033291722000502 · Cited by 68 · see citing works
Talwar, A., Estes, E., Aparasu, R., & Reddy, D. S. (2023) · Experimental Neurology · doi:10.1016/j.expneurol.2022.114238 · Cited by 66 · see citing works
Eze, P., Ilechukwu, S., & Lawani, L. O. (2023) · PLOS ONE · doi:10.1371/journal.pone.0287600 · Cited by 67 · see citing works
Hartmann, D., Wang, S. M., Pohlmann, L., & Berendt, B. (2025) · Journal of Computational Social Science · doi:10.1007/s42001-025-00381-z · Cited by 59 · see citing works
Groenewegen, K. L., Mooij, C. F., & van Trotsenburg, A. S. P. (2021) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2021.100101 · Cited by 49 · see citing works
Generative AI and L2 Written Feedback Studies: A Scoping Review
Crosthwaite, P., & Sun, S. (2026) · RELC Journal · doi:10.1177/00336882251386530 · Cited by 50 · see citing works
Kahale, L. A., Elkhoury, R., El Mikati, I., Pardo-Hernandez, H., Khamis, A. M., Schünemann, H. J., Haddaway, N. R., & Akl, E. A. (2022) · F1000Research · doi:10.12688/f1000research.51723.3 · Cited by 48 · see citing works
Self-citationA meta-analysis of the relation between dream content and memory consolidation
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Li, M., & Wilson, J. (2025) · Information · doi:10.3390/info16070519 · Cited by 49 · see citing works
Feng, J., Li, Z., Tian, L., Mu, P., Hu, Y., Xiong, F., & Ma, X. (2022) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-022-03740-9 · Cited by 33 · see citing works
Aboye, G. T., Vande Walle, M., Simegn, G. L., & Aerts, J.-M. (2023) · Digital Health · doi:10.1177/20552076231180972 · Cited by 31 · see citing works
Rapid maxillary expansion versus watchful waiting in pediatric OSA: A systematic review
Fernández-Barriales, M., Lafuente-Ibáñez de Mendoza, I., Alonso-Fernández Pacheco, J. J., & Aguirre-Urizar, J. M. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101609 · Cited by 33 · see citing works
Biomarkers of ketamine’s antidepressant effect: An umbrella review
Meshkat, S., Ho, R. C., Cao, B., Teopiz, K. M., Rosenblat, J. D., Rhee, T. G., Di Vincenzo, J. D., Ceban, F., Jawad, M. Y., & McIntyre, R. S. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.021 · Cited by 29 · see citing works
Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers
Hulsegge, G., Coenen, P., Gascon, G. M., Pahwa, M., Greiner, B., Bohane, C., Wong, I. S., Liira, J., Riera, R., & Pachito, D. V. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010639.pub2 · Cited by 31 · see citing works
Kamrul-Hasan, A. B. M., Alam, M. S., Dutta, D., Sasikanth, T., Aalpona, F. T. Z., & Nagendra, L. (2025) · Endocrinology and Metabolism · doi:10.3803/enm.2024.2164 · Cited by 27 · see citing works
Hunniford, V. T., Grudniewicz, A., Fergusson, D. A., Montroy, J., Grigor, E., Lansdell, C., Lalu, M. M., & On behalf of The Canadian Critical Care Translational Biology Group (2023) · eLife · doi:10.7554/elife.76300 · Cited by 26 · see citing works
Self-citationIs there a role for N1-N2 neutrophil phenotypes in bone regeneration? A systematic review
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Han, X., Chen, W., Gao, Z., Lv, X., Sun, Y., Yang, X., & Shan, H. (2021) · Annals of Palliative Medicine · doi:10.21037/apm-21-3626 · Cited by 24 · see citing works
Younis, H. A., Ruhaiyem, N. I. R., Badr, A. A., Abdul-Hassan, A. K., Alfadli, I. M., Binjumah, W. M., Altuwaijri, E. A., & Nasser, M. (2023) · Processes · doi:10.3390/pr11051488 · Cited by 21 · see citing works
Efficacy of online intervention for ADHD: a meta-analysis and systematic review
Shou, S., Xiu, S., Li, Y., Zhang, N., Yu, J., Ding, J., & Wang, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.854810 · Cited by 20 · see citing works
van Ewijk, R., Cleirec, M., Herold, N., le Deley, M.-C., van Eijkelenburg, N., Boudou-Rouquette, P., Risbourg, S., Strauss, S. J., Palmerini, E., Boye, K., et al. (2023) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2023.102625 · Cited by 19 · see citing works
Álvarez-Guerrero, G., Fry, D., Lu, M., & Gaitis, K. K. (2024) · Disabilities · doi:10.3390/disabilities4020017 · Cited by 20 · see citing works
Muneer, S., Santhosh, M., Parangusan, H., & Bhadra, J. (2026) · International Journal of Technology and Design Education · doi:10.1007/s10798-025-10005-2 · Cited by 14 · see citing works
Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review
Correa, E. J., Conti, D. M., Moreno-Luna, R., Sánchez-Gómez, S., & O'Connor Reina, C. (2024) · Sleep Science · doi:10.1055/s-0044-1782527 · Cited by 15 · see citing works
Media literacy education for parents: A systematic literature review
Haywood, A., & Sembiante, S. (2023) · Journal of Media Literacy Education · doi:10.23860/jmle-2023-15-3-7 · Cited by 12 · see citing works
Wang, B., Gould, R. L., Kumar, P., Pikett, L., Thompson, B., Gonzalez, S. C., & Bamiou, D.-E. (2022) · American Journal of Audiology · doi:10.1044/2022_aja-21-00162 · Cited by 10 · see citing works
Baeza-Velasco, C., Vergne, J., Poli, M., Kalisch, L., & Calati, R. (2025) · Autism · doi:10.1177/13623613251328059 · Cited by 10 · see citing works
Jötten, L., Steinkraus, K. C., Traub, B., Graf, S., Mihaljevic, A. L., Kornmann, M., Michalski, C. W., & Hüttner, F. J. (2022) · BJS Open · doi:10.1093/bjsopen/zrac139 · Cited by 10 · see citing works
Hernandez-Lucas, P., Leirós-Rodríguez, R., Lopez-Barreiro, J., & García-Soidán, J. L. (2024) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-230252 · Cited by 10 · see citing works
Huang, Y., Zhou, W., Liu, S., Zeng, D., & Zhou, W. (2024) · Gene · doi:10.1016/j.gene.2024.148397 · Cited by 8 · see citing works
Long-term neurological consequences following benzodiazepine exposure: A scoping review
Shade, K. N., Ritvo, A. D., Silvernail, B., Finlayson, A. J. R., Bressi, J. E., Foster, D. E., Martin, I. J., Piper, C., & Martin, P. R. (2025) · PLOS One · doi:10.1371/journal.pone.0330277 · Cited by 7 · see citing works
Evolution of DevSecOps and Its Influence on Application Security: A Systematic Literature Review
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Osborne, K.-L., Munasinghe, S., & Page, A. (2025) · Journal of Family Violence · doi:10.1007/s10896-025-00871-8 · Cited by 7 · see citing works
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A Scoping Review of Adopted Information Extraction Methods for RCTs.
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LLM-as-a-Judge in Healthcare: A Scoping Analysis of Applications, Methods, and Human Alignment
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- Authors
- Page, M. J., McKenzie, J., Bossuyt, P., Boutron, I., Hoffmann, T., mulrow, C., Shamseer, L., Tetzlaff, J., Akl, E., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Stewart, L., Thomas, J., Tricco, A., Welch, V. A., Whiting, P., & Moher, D.
- Affiliations
- Queen's University (CA)
- 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)
- McMaster University (CA)
- Oregon Health & Science University (US)
- University of Southern Denmark (DK)
- Johns Hopkins University (US)
- Brigham and Women's Hospital (US)
- Indiana University Bloomington (US)
- University of Bristol (GB)
- University College London (GB)
- St. Michael's Hospital (CA)
- Corresponding author
- Page, Matthew James
- ORCID
- Page, Matthew James
- McKenzie, Joanne
- Bossuyt, Patrick
- Boutron, Isabelle
- Hoffmann, Tammy
- Shamseer, Larissa
- Tetzlaff, Jennifer
- Akl, Elie
- Brennan, Sue E
- Chou, Roger
- Glanville, Julie
- Grimshaw, Jeremy
- Hróbjartsson, Asbjørn
- Lalu, Manoj Mathew
- Li, Tianjing
- Loder, Elizabeth
- Mayo-Wilson, Evan
- McDonald, Steve
- McGuinness, Luke A
- Stewart, Lesley
- Thomas, James
- Tricco, Andrea
- Welch, Vivian Andrea
- Whiting, Penny
- Moher, David
- Publisher
- Center for Open Science
- Published
- 2020-09-14
- OpenAlex
- W4236476849
- Cited by
- 5,177
- References
- 59
- Citations by year
- 2026: 295 · 2025: 694 · 2024: 1484 · 2023: 1465 · 2022: 906 · 2021: 300 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 3 · 2014: 4
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- MetArXiv (OSF Preprints) (submittedVersion)
- MetArXiv (OSF Preprints) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (DRF-2018-11-ST2-048)
- Ottawa Hospital Anesthesia Alternate Funds Association
- National Institutes of Health
- Medical Research Council
- Australian Research Council (DE200101618)
- National Health and Medical Research Council (1088535, 1154607, 1143429)
- National Eye Institute (UG1EY020522)
- 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, transparency in research reporting, flowcharts, meta-analysis reporting, peer review
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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