Step 5 Screen literature and assess quality of studies

The final search results obtained via databases etc are screened for eligibility in accordance with the inclusion/exclusion criteria.

This should be done independently by 2 reviewers to avoid bias.

Firstly, titles and abstracts of all de-duplicated records are screened for eligibility. Results are compared and disagreements resolved among reviewers.

Secondly, the full text articles of the selected studies are then assessed for eligibility for inclusion in the review. 

Assess risk of bias in included studies.

Tools such as EndNote, Covidence and Rayyan can be used to store citations and manage the workflow of the screening process.

There are a number of Critical Appraisal Tools to assist in this process such as:

• CASP Appraisal Checklists
• JBI Critical Appraisal Tools
• CONSORT Statement an evidence-based, minimum set of recommendations for reporting randomised trials
• AMSTAR checklist A Measurement Tool to Assess the Methodological Quality of Systematic Reviews
• Cochrane Handbook: 14.2 Assessing the certainty or quality of a body of evidence
• MOOSE (Meta-analyses Of Observational Studies in Epidemiology) Checklist
• Cochrane Risk of Bias Tool to assess risk of bias for randomised controlled trials

A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) diagram is used to show the steps involved in the review process, recording the number of records identified and then excluded at each stage of the screening process.

You can also use the PRISMA Flow Diagram Generator to produce a detailed diagram in a number of output formats.

There are a number of tools that can assist with managing records during the screening process of a systematic review. See the list here for more detail.