PRISMA 2020 Checklist: A Practical Guide

PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is the reporting standard most journals now expect for systematic reviews. It's a 27-item checklist plus a flow diagram — not a methodology in itself, but a transparency standard for reporting the methodology you used.

What PRISMA 2020 actually checks

The checklist is organized around the sections of a typical review manuscript:

• Title & abstract — identifying the report as a systematic review and summarizing key methods and findings.
• Introduction — the rationale and explicit objectives, usually framed with PICO.
• Methods — eligibility criteria, information sources, search strategy, selection process, data collection, risk-of-bias assessment, and synthesis methods, reported in enough detail to be reproducible.
• Results — study selection numbers (supported by the flow diagram), study characteristics, risk-of-bias results, and synthesis results.
• Discussion — interpretation, limitations, and conclusions.
• Other information — registration and protocol details, funding, and competing interests.

The PRISMA flow diagram

The flow diagram tracks records through four stages: identification (records found across databases and other sources), screening (title/abstract review), eligibility (full-text assessment), and inclusion (studies in the final synthesis) — with the number of records excluded, and why, at each stage. Reviewers and readers use this diagram as a quick sanity check on your selection process, so it needs to be accurate to the number, not approximate.

Common mistakes that lead to desk rejection

• Reporting numbers in the flow diagram that don't match the numbers in the text.
• Vague search strategy reporting that couldn't be reproduced by another researcher.
• Skipping or under-reporting the risk-of-bias assessment for included studies.
• Missing protocol registration details when a protocol was, in fact, registered.

Do you need to follow every item?

Yes, if you want your review to be taken seriously by a journal editor or dissertation committee. PRISMA 2020 is now referenced directly in the author guidelines of most major health and social science journals, and its absence — or a checklist that doesn't line up with the manuscript — is one of the more common reasons reviews stall at the editorial stage rather than reaching peer review.