PRISMA Systematic Review Writer

Systematic Literature Review — PRISMA 2020

Author: Chuah Kee Man | Based on: PRISMA 2020 (Page et al., 2021)

This skill walks a user through writing a systematic literature review (SLR) that follows the PRISMA 2020 reporting guideline. It produces a manuscript in strict journal article format as a Word document (.docx), generates an annotated PRISMA flow diagram, and enforces APA 7th Edition referencing throughout.

Before you begin

Read these reference files as needed:

• references/prisma-2020-checklist.md — The full 27-item PRISMA 2020 checklist. Consult this when drafting each section to make sure nothing is missed.
• references/flow-diagram.md — PRISMA flow diagram templates and guidance. Consult this when building the flow diagram.

Also read these skills before generating outputs:

• docx skill (/mnt/skills/public/docx/SKILL.md) — Critical rules for docx-js when generating the Word document.
• apa-referencing skill (/mnt/skills/user/apa-referencing/SKILL.md) — APA 7th Edition formatting rules. All citations and references in the manuscript must comply with APA 7th Edition. Consult references/apa7-formatting-rules.md within that skill for type-specific formatting.

If the user has a writing-style skill, apply it to all drafted prose (but note that academic writing conventions in the writing-style skill take precedence over informal style rules, e.g. no informal analogies in scholarly manuscripts).

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Phase 1: Interview

Before any drafting, gather the information needed to write the review. Offer the user two paths up front.

Path A: Upload existing documents

The user may already have a proposal, protocol, draft manuscript, PROSPERO registration, data extraction sheet, or search log. At the start of the interview, ask whether they have any documents to share. Common uploads include:

• Research proposal or protocol (often contains RQs, eligibility criteria, databases, and methods)
• PROSPERO registration form
• Draft or partial manuscript
• Search strategy export or search log
• Data extraction spreadsheet (e.g. from Excel, Google Sheets, or Rayyan/Covidence export)
• List of included/excluded studies
• Completed PRISMA checklist from a previous attempt
• Reference list or bibliography file

If the user uploads a document, read it using the appropriate skill (docx skill for .docx, file-reading skill for other formats, pdf-reading skill for PDFs, or xlsx skill for spreadsheets). Extract as much of the essential information (listed below) as possible from the document. Then present a summary of what was extracted and ask the user to confirm, correct, or fill in the gaps.

If the user uploads multiple documents, read them all and cross-reference the information. Flag any contradictions (e.g. different inclusion criteria in the proposal vs. the draft).

Path B: Conversational interview

If the user has no documents to share, or after extracting what is available from uploaded documents, gather the remaining information conversationally. Ask questions in a natural flow, not as a wall of text. Adapt to what the user already provides.

Essential information to collect

About the review itself:

• Working title
• Research question(s) or objective(s)
• Type of review (e.g. intervention effectiveness, diagnostic accuracy, qualitative, scoping turned systematic, mixed methods)
• Whether this is a new review or an update of a previous one
• Registration status (e.g. PROSPERO number, or not registered)
• Protocol status (published, unpublished, not prepared)
• Target journal (if known) — this affects formatting, word limits, and referencing conventions

About the search:

• Databases searched (e.g. Scopus, Web of Science, PubMed, ERIC, IEEE Xplore, ProQuest)
• Other sources (websites, grey literature, citation searching, hand-searching, expert consultation)
• Date range and date of last search
• Search terms and Boolean strategy (or enough detail to reconstruct one)
• Any filters or limits applied (language, date, document type)

About eligibility:

• Inclusion criteria (population, intervention/exposure, comparator, outcome, study design — or the relevant framework like PICo, PICO, SPIDER, etc.)
• Exclusion criteria
• How studies were grouped for synthesis

About screening and selection:

• Number of reviewers at each stage
• Whether reviewers worked independently
• How disagreements were resolved
• Any automation tools used (e.g. Rayyan, ASReview, Covidence)

About data extraction:

• What data items were extracted (outcomes, variables, study characteristics)
• Data extraction tool or form used
• Number of reviewers, independence, and conflict resolution

About quality appraisal:

• Risk of bias tool used (e.g. RoB 2, ROBINS-I, Newcastle-Ottawa Scale, CASP, JBI, MMAT)
• Number of reviewers and independence

About synthesis:

• Synthesis approach (narrative synthesis, thematic synthesis, framework synthesis, vote counting, harvest plots, etc.)
• How results will be presented (tables, figures, summary of findings)

About the numbers (for the flow diagram):

• Records identified per database/source
• Duplicates removed
• Records screened and excluded
• Full-text reports retrieved and not retrieved
• Full-text reports assessed and excluded (with reasons)
• Final number of included studies

If the user does not have all the numbers yet (common for students mid-process), note which are missing and use placeholder values (n = ?) in the flow diagram. The user can fill these in later.

About references:

• Ask whether the user has a reference list or bibliography already. If so, it should be uploaded for APA formatting and verification.
• Ask whether references should be verified using web search. (Default: yes, verify.)

How to run the interview

Start by asking the user whether they have any existing documents to share. If they do, read the documents first and extract what you can before asking follow-up questions.

If no documents are provided, or after processing uploads, work through the remaining gaps conversationally. Start with the big picture (title, RQ, databases) and work through the rest in 2–3 rounds of questions, grouping related items together. Use the ask_user_input tool where options are bounded (e.g. risk of bias tool choice, synthesis approach). Use open questions for things like research questions and search terms.

Once you have enough to begin, confirm the plan with the user before drafting.

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Phase 2: Section-by-section drafting (strict journal format)

The manuscript must follow strict journal article format. This means the document reads as a single, cohesive academic paper ready for submission, not a report or a student assignment. Every section must be written in formal academic prose, following the conventions of peer-reviewed journals.

Work through the manuscript one section at a time. After drafting each section, present it to the user and wait for feedback or approval before moving on.

Manuscript structure and PRISMA mapping

Draft sections in this order. The PRISMA item numbers in brackets show which checklist items each section addresses. This structure mirrors the standard journal article format used by most peer-reviewed journals publishing systematic reviews.

TITLE PAGE

1. Title [Item 1]
2. Author name(s) and affiliation(s)
3. Corresponding author contact details
4. ORCID iD(s) (if available)
5. Word count
6. Number of tables and figures

ABSTRACT [Item 2]

• Use the PRISMA 2020 for Abstracts structure
• For journals requiring structured abstracts, include these subheadings: Background, Objectives, Data Sources, Study Eligibility Criteria, Participants and Interventions, Study Appraisal and Synthesis Methods, Results, Limitations, Conclusions, Registration Number
• For journals requiring unstructured abstracts, cover the same content in paragraph form
• Typically 200–300 words (check target journal requirements)
• Include 4–6 keywords below the abstract

1. INTRODUCTION

• 1.1 Rationale [Item 3] — Situate the review within existing knowledge. Identify the gap. Cite prior reviews and explain why a new or updated review is needed.
• 1.2 Objectives [Item 4] — State the review's objective(s) or research question(s) explicitly. If using a framework (PICO, PICo, SPIDER), present it here.

2. METHODS

• 2.1 Protocol and registration [Items 24a–24c] — State registration number (e.g. PROSPERO CRD...) or declare unregistered. Note any amendments.
• 2.2 Eligibility criteria [Item 5] — Present inclusion and exclusion criteria explicitly, ideally in a table. Use the relevant framework (PICO, PICo, etc.).
• 2.3 Information sources [Item 6] — List all databases, registers, websites, and other sources. State the date of last search for each.
• 2.4 Search strategy [Item 7] — Present the full Boolean search string for at least the primary database. If the user provides keywords but not a Boolean string, help them construct one. State any filters or limits.
• 2.5 Selection process [Item 8] — Describe the screening procedure, number of reviewers, independence, disagreement resolution, and any automation tools.
• 2.6 Data collection process [Item 9] — Describe how data were extracted, by how many reviewers, and how conflicts were resolved.
• 2.7 Data items [Items 10a, 10b] — List all outcome variables and other data items sought.
• 2.8 Study risk of bias assessment [Item 11] — Name the tool (e.g. RoB 2, CASP, JBI, MMAT) and describe the assessment process.
• 2.9 Effect measures [Item 12] — Specify effect measures if applicable. Skip or mark "Not applicable" for purely qualitative reviews.
• 2.10 Synthesis methods [Items 13a–13f] — Describe the synthesis approach. For narrative synthesis, explain how studies were grouped, compared, and synthesised. Address each applicable sub-item (13a through 13f).
• 2.11 Reporting bias assessment [Item 14]
• 2.12 Certainty assessment [Item 15] — e.g. GRADE approach, if applicable.

3. RESULTS

• 3.1 Study selection [Items 16a, 16b] — Describe the selection process in narrative form AND include the PRISMA flow diagram (see Phase 3). Cite any studies that appear to meet inclusion criteria but were excluded, and explain why.
• 3.2 Study characteristics [Item 17] — Present a summary table of included studies (author/year, country, study design, population, intervention/exposure, outcome, key findings). This table is a standard feature of SLR journal articles.
• 3.3 Risk of bias in studies [Item 18] — Present risk of bias assessments, typically as a summary table or figure.
• 3.4 Results of individual studies [Item 19] — Present findings from each study.
• 3.5 Results of syntheses [Items 20a–20d] — Present the synthesis findings. Organise by theme, outcome, or research question as appropriate.
• 3.6 Reporting biases [Item 21]
• 3.7 Certainty of evidence [Item 22]

4. DISCUSSION

• 4.1 Summary of evidence [Item 23a] — Interpret the main findings in the context of other evidence.
• 4.2 Limitations [Items 23b, 23c] — Address limitations of the evidence (23b) and limitations of the review process (23c) separately.
• 4.3 Implications [Item 23d] — Discuss implications for practice, policy, and future research.

5. CONCLUSIONS

• A concise paragraph summarising the key findings and their significance. Some journals merge this into the Discussion; adapt to the target journal's convention.

DECLARATIONS

• Funding [Item 25]
• Competing interests [Item 26]
• Data availability [Item 27]
• Author contributions (if required by the target journal)
• Ethics approval (if applicable)
• Acknowledgements

REFERENCES

• All references must be formatted in APA 7th Edition style. See the "Referencing" section below for detailed rules.

APPENDICES (if needed)

• Full search strategies for each database
• Data extraction form
• Completed PRISMA 2020 checklist

Drafting conventions for journal format

These conventions apply throughout the manuscript:

• Academic register throughout. No conversational language, informal analogies, or hedging phrases like "it seems" or "it appears". Use precise disciplinary language.
• Third person and passive voice where appropriate. "Studies were screened by two reviewers" rather than "We screened the studies". (Some journals now accept first person; adapt if the user specifies.)
• Past tense for methods and results. "A systematic search was conducted..." / "Twenty-three studies met the inclusion criteria..."
• Present tense for established knowledge and discussion. "Evidence suggests that..." / "These findings are consistent with..."
• Every claim must be supported by a citation. Do not leave factual claims uncited in the Introduction or Discussion. Use APA 7th Edition in-text citations.
• Tables and figures are numbered sequentially. Table 1, Table 2, etc. Figure 1, Figure 2, etc. Each must have a title (above for tables, below for figures in APA style) and be referenced in the text.
• No bullet points in the body text. Journal manuscripts use continuous prose. The only exceptions are the eligibility criteria table and the PRISMA flow diagram. Bullet points may appear in Appendices if appropriate.
• Section numbering. Use numbered sections (1., 1.1, 1.2, 2., 2.1, etc.) unless the target journal prohibits it.

Tone calibration

For postgraduate students (first-time reviewers):

• Explain what each section needs to achieve before drafting it
• Flag common mistakes (e.g. writing eligibility criteria as vague narrative instead of explicit include/exclude lists)
• Offer brief rationale for why PRISMA requires certain details (transparency and reproducibility)

For experienced researchers:

• Skip the explanations and draft directly
• Focus on completeness and precision

When in doubt: briefly explain and offer to skip ("I can walk you through what this section needs, or just draft it directly. Your call.")

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Phase 3: PRISMA flow diagram

After drafting the Results section (specifically Item 16a), generate the PRISMA flow diagram. The flow diagram serves two purposes: it satisfies the PRISMA reporting requirement, and it gives readers an at-a-glance summary of the study selection process.

Step 1: Select the correct template

Read references/flow-diagram.md to determine which template applies:

Most student and first-time SLRs use Template A or Template B.

Step 2: Confirm the numbers

Before building the diagram, confirm every number with the user. Present a structured summary of what goes in each box so the user understands what to fill in. Use this annotated guide:

IDENTIFICATION phase — what goes here:

• Total records identified from each database (e.g. Scopus: 245, WoS: 189, PubMed: 112). This is the raw count before any deduplication.
• Records from registers, if any.
• If Template B/D: records from other methods (websites, citation searching, grey literature, expert consultation), listed by source.
• Records removed before screening: duplicate records, records marked ineligible by automation tools, records removed for other reasons (e.g. non-English, outside date range).

SCREENING phase — what goes here:

• Records screened (= total identified minus those removed before screening). This is typically title-and-abstract screening.
• Records excluded at screening (with or without reasons at this stage).
• Reports sought for retrieval (= records that passed screening). "Reports" means the full-text documents.
• Reports not retrieved (= full texts that could not be obtained, with reasons if possible).
• Reports assessed for eligibility (= full texts actually read and evaluated against inclusion criteria).
• Reports excluded at eligibility, with reasons. List each reason and its count, e.g. "Wrong population (n = 8), Wrong outcome (n = 5), Not empirical (n = 3)".

INCLUDED phase — what goes here:

• Studies included in the review (the final count).
• Reports of included studies (may differ from the study count if one study produced multiple publications, or one publication reports multiple studies).

If the user does not have all the numbers yet, use placeholder values (n = ?) and note which are missing.