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Systematic Reviews: Step 8: Write the Review

Created by Health Science Librarians

About Step 8: Write the Review

It takes an average of 120 hours for a systematic review team to write the review

Click an item below to see how it applies to Step 8: Write the Review.

To write your review, you will need the data from your PRISMA flow diagram.  Review the PRISMA checklist to see which items you should report in your methods section.

When you screen in Covidence, it will record the numbers you need for your PRISMA flow diagram all the way from duplicate removal through inclusion of studies.  You may need to add additional information, such as the number of references from each database, citations you find through grey literature or other searching methods, or the number of studies found in your previous work if you are updating a systematic review.

 

A librarian can advise you on the process of organizing and writing up your systematic review, including: 

  • Applying the PRISMA reporting templates and the level of detail to include for each element
  • How to report a systematic review search strategy and your review methodology in the completed review
  • How to use prior published reviews to guide you in organizing your manuscript 

 

Write your review

Reporting standards & guidelines

Be sure to reference reporting standards when writing your review. This helps ensure that you communicate essential components of your methods, results, and conclusions. There are a number of tools that can be used to ensure compliance with reporting guidelines. A few review-writing resources are listed below.


Tools for writing your review


Templates

Report your review with PRISMA

The PRISMA checklist

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) is a 27-item checklist used to improve transparency in systematic reviews. These items cover all aspects of the manuscript, including title, abstract, introduction, methods, results, discussion, and funding. The PRISMA checklist can be downloaded in PDF or Word files.

The PRISMA flow diagram

The PRISMA Flow Diagram visually depicts the flow of studies through each phase of the review process. The PRISMA Flow Diagram can be downloaded in Word files.

Documenting grey literature and/or hand searches

If you have also searched additional sources, such as professional organization websites, cited or citing references, etc., document your grey literature search using the flow diagram template version 1 PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources or the version 2 PRISMA 2020 flow diagram for updated systematic reviews which included searches of databases, registers and other sources

Complete the boxes documenting your database searches,  Identification of studies via databases and registers, according to the PRISMA flow diagram instructions.  Complete the boxes documenting your grey literature and/or hand searches on the right side of the template, Identification of studies via other methods, using the steps below.

Need help completing the PRISMA flow diagram?

There are different PRISMA flow diagram templates for new and updated reviews, as well as different templates for reviews with and without grey literature searches. Be sure you download the correct template to match your review methods, then follow the steps below for each portion of the diagram you have available.

Step 1: Preparation Download the flow diagram template version 1 PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only or the version 2 PRISMA 2020 flow diagram for updated systematic reviews which included searches of databases and registers only

PRISMA Diagram: Step by Step

Step 2: Doing the Database Search Run the search for each
database individually, including ALL your search terms, any
MeSH or other subject headings, truncation (like hemipleg*),
and/or wildcards (like sul?ur). Apply all your limits (such as
years of search, English language only, and so on). Once all
search terms have been combined and you have applied all
relevant limits, you should have a final number of records or
articles for each database. Enter this information in the top
left box of the PRISMA flow chart. You should add the total
number of combined results from all databases (including
duplicates) after the equal sign where it says Databases (n=).
Many researchers also add notations in the box for the number
of results from each database search, for example, Pubmed
(n=335), Embase (n= 600), and so on.  If you search trial
registers, such as ClinicalTrials.gov, CENTRAL, ICTRP, or others,
you should enter that number after the equal sign in Registers (n=).

NOTE:Some citation managers automatically remove duplicates
with each file you import.  Be sure to capture the number of articles
from your database searches before any duplicates are removed.

 
Records identified from databases and registers

Step 3: Remove All Duplicates To avoid reviewing duplicate articles,
you need to remove any articles that appear more than once in your
results. You may want to export the entire list of articles from each
database to a citation manager such as EndNote, Sciwheel, Zotero,
or Mendeley (including both citation and abstract in your file) and
remove the duplicates there. If you are using Covidence for your
review, you should also add the duplicate articles identified in
Covidence to the citation manager number.  Enter the number of
records removed as duplicates in the second box on your PRISMA
template.  If you are using automation tools to help evaluate the
relevance of citations in your results, you would also enter that
number here.

NOTE: If you are using Covidence to screen your articles, you can
copy the numbers from the PRISMA diagram in your Covidence
review into the boxes mentioned below.  Covidence does not include
the number of results from each database, so you will need to keep
track of that  number yourself.

Records removed before screening: duplicate records, records marked as ineligible by automation tools, records removed for other reasons
Step 4: Records Screened- Title/Abstract Screening The next step
is to add the number of articles that you will screen. This should be
the number of records identified minus the number from the duplicates
removed box.
Records screened
Step 5: Records Excluded- Title/Abstract Screening You will need to
screen the titles and abstracts for articles which are relevant to your
research question. Any articles that appear to help you provide an
answer to your research question should be included. Record the
number of articles excluded through title/abstract screening in the box
to the right titled "Records excluded."  You can optionally add exclusion
reasons at this level, but they are not required until full text screening.
Records excluded
Step 6: Reports Sought for Retrieval This is the number of articles
you obtain in preparation for full text screening.  Subtract the number
of excluded records (Step 5) from the total number screened (Step 4)
and this will be your number sought for retrieval.
Reports sought for retrieval
Step 7: Reports Not Retrieved List the number of articles for which
you are unable to find the full text.  Remember to use Find@UNC
and Interlibrary Loan to request articles to see if we can order them
from other libraries before automatically excluding them.
Reports not retrieved
Step 8: Reports Assessed for Eligibility- Full Text Screening  This
should be the number of reports sought for retrieval (Step 6) minus
the number of reports not retrieved (Step 7). Review the full text for
these articles to assess their eligibility for inclusion in your systematic
review. 
Reports assessed for eligibility
Step 9: Reports Excluded After reviewing all articles in the full-text
screening stage for eligibility, enter the total number of articles you
exclude in the box titled "Reports excluded," and then list your reasons
for excluding the articles as well as the number of records excluded
for each reason.  Examples include wrong setting, wrong patient
population, wrong intervention, wrong dosage, etc.  You should only
count an excluded article once in your list even if if meets multiple
exclusion criteria.
Reports excluded, with reasons, and the number of articles per reason

Step 10: Included Studies The final step is to subtract the number
of records excluded during the eligibility review of full-texts (Step 9)
from the total number of articles reviewed for eligibility (Step 8). Enter
this number in the box labeled "Studies included in review,"
combining numbers with your grey literature search results in this
box if needed. 

You have now completed your PRISMA flow diagram, unless you
have also performed searches in non-database sources or are
performing a search update. If so, complete those portions of the template as well.

Number of studies included in review, number of reports of included studies

 

Step 1: Preparation Download the flow diagram template version 1 PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources or the version 2 PRISMA 2020 flow diagram for updated systematic reviews which included searches of databases, registers and other sources

PRISMA grey literature step-by-step
Step 2: Records Identified If you have identified articles through other
sources than databases (such as manual searches through reference
lists of articles you have found or search engines like Google Scholar),
enter the total number of records from each source type in the box on
the top right of the flow diagram.
Records identified from websites, organizations, citation searching
Step 3: Reports Sought for Retrieval This should be the total number
of reports you obtain from each grey literature source. 
Reports sought for retrieval
Step 4: Reports Not Retrieved List the number of documents for which
you are unable to find the full text.  Remember to use Find@UNC and
Interlibrary Loan to request items to see if we can order them from other
libraries before automatically excluding them.
Reports not retrieved
Step 5: Reports Assessed for Eligibility This should be the number of
grey literature reports sought for retrieval (Step 2) minus the number of
reports not retrieved (Step 3). Review the full text for these items to
assess their eligibility for inclusion in your systematic review. 
Reports assessed for eligibility
Step 6: Reports excluded After reviewing all items in the full-text
screening stage for eligibility, enter the total number of articles you
exclude in the box titled "Reports Excluded," and then list your reasons
for excluding the item as well as the number of items excluded for each
reason.  Examples include wrong setting, wrong patient population,
wrong intervention, wrong dosage, etc.  You should only count an
excluded item once in your list even if if meets multiple exclusion criteria.
Reports excluded, along with reasons and number of articles for each reason
Step 7: Included Studies The final step is to subtract the number of
excluded articles or records during the eligibility review of full-texts from
the total number of articles reviewed for eligibility. Enter this number in
the box labeled "Studies included in review," combining numbers with
your database search results in this box if needed.  You have now
completed your PRISMA flow diagram, which you can now include in
the results section of your article or assignment.
Number of studies included in review and number of reports of included studies

Step 1: Preparation Download the flow diagram template version 2 PRISMA 2020 flow diagram for updated systematic reviews which included searches of databases and registers only or the version 2 PRISMA 2020 flow diagram for updated systematic reviews which included searches of databases, registers and other sources

PRISMA review update step-by-step

Step 2: Studies Included in Previous Version of Review  In the Previous
Studies column on the left side of your PRISMA flow diagram review
update template, indicate the number of studies included in the previous
version of your systematic review and the number of reports of studies
included in the previous version of your review.

 

Studies included in previous version of review and reports of studies included in previous version of review

Step 3: Total Studies Included in Review At the bottom of the column,
Identification of studies via databases and registers, there will be a box
to indicate the number of new studies included in the review and the
number of reports of new included studies.  This box should contain the
number of any new items from your review update. 

There will also be a box for the total number of studies included in your
review update and the number of reports of total included studies.  This
box should contain the sum of studies and reports from your previous
systematic review and the studies and reports from your new review
update.

A box for new studies included in review and a box below it for total number of studies (new and old) included in review

 

Review sections

Sections of a Scientific Manuscript

Scientific articles often follow the IMRaD format: Introduction, Methods, Results, and Discussion.  You will also need a title and an abstract to summarize your research.

You can read more about scientific writing through the library guides below.

Sections of a Systematic Review Manuscript

Systematic reviews follow the same structure as original research articles, but you will need to report on your search instead of on details like the participants or sampling. Sections of your manuscript are shown as bold headings in the PRISMA checklist.

Title Describe your manuscript and state whether it is a systematic review, meta-analysis, or both.
Abstract Structure the abstract and include (as applicable): background, objectives, data sources, study eligibility criteria, participants, interventions, quality assessment and synthesis methods, results, limitations, conclusions, implications of key findings, and systematic review registration number.
Introduction Describe the rationale for the review and provide a statement of questions being addressed.
Methods Include details regarding the protocol, eligibility criteria, databases searched, full search strategy of at least one database (often reported in appendix), and the study selection process. Describe how data were extracted and analyzed. If a librarian is part of your research team, that person may be best suited to write this section. 
Results Report the numbers of articles screened at each stage using a PRISMA diagram. Include information about included study characteristics, risk of bias (quality assessment) within studies, and results across studies.
Discussion Summarize main findings, including the strength of evidence and limitations of the review. Provide a general interpretation of the results and implications for future research.
Funding Describe any sources of funding for the systematic review.
Appendix Include entire search strategy for at least one database in the appendix (include search strategies for all databases searched for more transparency). 

Refer to the PRISMA checklist for more information.