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PRISMA 2020 Is a Reporting Guideline for Systematic Reviews but Is Often Misused to Guide Review Content
Lasse Østengaard1,2, Christoffer Bruun Korfitsen1,2, Asbjørn Hróbjartsson1,2
1Cochrane Denmark and Centre for Evidence-Based Medicine Odense (CEBMO), Department of Clinical Research University of Southern Denmark Odense Denmark.
Cochrane Evidence Synthesis and Methods
|August 12, 2026
Summary
Over half of systematic reviews misuse the PRISMA 2020 guideline, applying it to conduct rather than reporting. Authors should use PRISMA 2020 for reporting to ensure transparency and accuracy in systematic reviews.
Area of Science:
- Medical Research Methodology
- Evidence Synthesis
- Scientific Publishing Standards
Background:
- The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 is a guideline for transparent and accurate reporting.
- PRISMA 2020 is intended for reporting, not for guiding the conduct of systematic reviews.
Purpose of the Study:
- To evaluate the extent to which authors use PRISMA 2020 outside its intended scope.
- To assess the adequacy of PRISMA 2020 application in published systematic reviews.
Main Methods:
- Random sampling of 200 systematic reviews citing PRISMA 2020.
- Extraction and independent assessment of sentences describing PRISMA 2020 usage.
- Categorization of usage as adequate (reporting), inconclusive, or inadequate (conduct).
Main Results:
- 55.5% of reviews inadequately used PRISMA 2020, primarily to guide review conduct.
- 24.0% of usages were categorized as inconclusive.
- Only 20.5% of reviews adequately used PRISMA 2020 as a reporting guideline.
Conclusions:
- A significant proportion of systematic reviews misapply PRISMA 2020 beyond its intended scope.
- Authors are encouraged to adhere to PRISMA 2020 for reporting purposes.
- Alternative resources exist for guiding the conduct of systematic reviews.
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