.2021 Mar 29:372:n71.

doi: 10.1136/bmj.n71.

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J Page¹, Joanne E McKenzie², Patrick M Bossuyt³, Isabelle Boutron⁴, Tammy C Hoffmann⁵, Cynthia D Mulrow⁶, Larissa Shamseer⁷, Jennifer M Tetzlaff⁸, Elie A Akl⁹, Sue E Brennan², Roger Chou¹⁰, Julie Glanville¹¹, Jeremy M Grimshaw¹², Asbjørn Hróbjartsson¹³, Manoj M Lalu¹⁴, Tianjing Li¹⁵, Elizabeth W Loder¹⁶, Evan Mayo-Wilson¹⁷, Steve McDonald², Luke A McGuinness¹⁸, Lesley A Stewart¹⁹, James Thomas²⁰, Andrea C Tricco²¹, Vivian A Welch²², Penny Whiting¹⁸, David Moher²³

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia matthew.page@monash.edu.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands.
⁴ Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France.
⁵ Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
⁶ University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Annals of Internal Medicine.
⁷ Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
⁸ Evidence Partners, Ottawa, Canada.
⁹ Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
¹⁰ Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
¹¹ York Health Economics Consortium (YHEC Ltd), University of York, York, UK.
¹² Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada.
¹³ Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark.
¹⁴ Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada.
¹⁵ Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁶ Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Head of Research, The BMJ, London, UK.
¹⁷ Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.
¹⁸ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
¹⁹ Centre for Reviews and Dissemination, University of York, York, UK.
²⁰ EPPI-Centre, UCL Social Research Institute, University College London, London, UK.
²¹ Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada.
²² Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
²³ Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.

PMID:33782057
PMCID: PMC8005924
DOI: 10.1136/bmj.n71

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J Page et al. BMJ.2021.

.2021 Mar 29:372:n71.

doi: 10.1136/bmj.n71.

Authors

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia matthew.page@monash.edu.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands.
⁴ Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France.
⁵ Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
⁶ University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Annals of Internal Medicine.
⁷ Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
⁸ Evidence Partners, Ottawa, Canada.
⁹ Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
¹⁰ Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
¹¹ York Health Economics Consortium (YHEC Ltd), University of York, York, UK.
¹² Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada.
¹³ Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark.
¹⁴ Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada.
¹⁵ Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁶ Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Head of Research, The BMJ, London, UK.
¹⁷ Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.
¹⁸ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
¹⁹ Centre for Reviews and Dissemination, University of York, York, UK.
²⁰ EPPI-Centre, UCL Social Research Institute, University College London, London, UK.
²¹ Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada.
²² Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
²³ Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.

PMID:33782057
PMCID: PMC8005924
DOI: 10.1136/bmj.n71

Abstract

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 past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and 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. In this article, 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.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/conflicts-of-interest/ and declare: EL is head of research for the BMJ; MJP is an editorial board member for PLOS Medicine; ACT is an associate editor and MJP, TL, EMW, and DM are editorial board members for the Journal of Clinical Epidemiology; DM and LAS were editors in chief, LS, JMT, and ACT are associate editors, and JG is an editorial board member for Systematic Reviews. None of these authors were involved in the peer review process or decision to publish. TCH has received personal fees from Elsevier outside the submitted work. EMW has received personal fees from the American Journal for Public Health, for which he is the editor for systematic reviews. VW is editor in chief of the Campbell Collaboration, which produces systematic reviews, and co-convenor of the Campbell and Cochrane equity methods group. DM is chair of the EQUATOR Network, IB is adjunct director of the French EQUATOR Centre and TCH is co-director of the Australasian EQUATOR Centre, which advocates for the use of reporting guidelines to improve the quality of reporting in research articles. JMT received salary from Evidence Partners, creator of DistillerSR software for systematic reviews; Evidence Partners was not involved in the design or outcomes of the statement, and the views expressed solely represent those of the author.

Figures

**Fig 1**
PRISMA 2020 flow diagram template for systematic reviews. The new design is adapted from flow diagrams proposed by Boers, Mayo-Wilson et al. and Stovold et al. The boxes in grey should only be completed if applicable; otherwise they should be removed from the flow diagram. Note that a “report” could be a journal article, preprint, conference abstract, study register entry, clinical study report, dissertation, unpublished manuscript, government report or any other document providing relevant information.

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Comment in

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Tissue Sealants for Facial Rhytidectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Chien WY, Huang YL, Chiu WK, Kang YN, Chen C.Chien WY, et al.Facial Plast Surg Aesthet Med. 2023 Mar-Apr;25(2):90-96. doi: 10.1089/fpsam.2022.0160. Epub 2022 Oct 18.Facial Plast Surg Aesthet Med. 2023.PMID:36260353Review.
Efficacy and safety of galcanezumab as a treatment of refractory episodic and chronic cluster headache: Case series and narrative review.
Membrilla JA, Torres-Ferrus M, Alpuente A, Caronna E, Pozo-Rosich P.Membrilla JA, et al.Headache. 2022 Nov;62(10):1395-1405. doi: 10.1111/head.14404. Epub 2022 Nov 2.Headache. 2022.PMID:36321947Review.

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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

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