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Select a screening tool

There are a number of different tools you can use to help manage the screening process. These include: 

  • Covidence (recommended) – an web-based team workspace that is designed for systematic review projects. It can be used for screening references, data extraction, quality assessment and for keeping track of your work. Monash Health has a subscription to Covidence – see our user guide for more information.
  • EndNote – reference management software for storing, organising and citing references. All computers in the Monash Health libraries have EndNote desktop installed, and the library team provides EndNote support and training. Visit our EndNote guide for more information.
  • Excel – Microsoft Excel is another option for compiling and managing reference lists.
  • Additional options include Rayyan, Abstrackr, Eppi-Reviewer, or Revman

Organise who will screen results and resolve conflicts

At least two reviewers must be involved in the screening process, and at least one of these reviewers should be a topic expert. The reviewers independently screen each result with the exclusion and inclusion criteria in mind. They decide whether to exclude a result or include it in the next stage of the review. 

Conflicts are differences of opinion/votes between the two reviewers. Conflicts may also arise from uncertainty or 'maybe' votes during screening. These conflicts can be resolved by discussion between the two reviewers, or by a third reviewer who is a subject matter expert.

The plans for screening should be documented in your protocol.

Decide how to record the results of screening

It is important to decide how you will document the screening of results. The PRISMA Flow Diagram was first used to record the number of results from database searching and de-duplication. PRISMA also guides how to record the results of screening. If you are using software such as Covidence, the tool will track this for you. Results can be transcribed to the PRISMA diagram.

Test screen a small number of studies

It is recommended to test screen a small number of results with your team before commencing the actual screening.

You only need to test a small number of studies (approximately 8-10). All reviewers should be involved in the testing to ensure that all team members consistently apply the inclusion and exclusion criteria.

The first stage in screening involves scanning titles and abstracts of de-duplicated results from all searches. In this stage reviewers will vote on whether to move a result to the next stage (full text screening) or exclude the result because it does not meet the inclusion criteria.

Each result must be independently screened by two reviewers to avoid bias. Conflicts are then resolved by discussion or a third reviewer.

The steps you will take are:

  1. Add your de-duplicated results to your chosen software tool.
  2. Scan the title and abstract of each result.
  3. Vote to move a result to full text screening or exclude.
    Note: it is best to be over-inclusive at this stage. If you’re not certain, then vote yes to examine the full text in the next stage.
  4. Resolve conflicts according to the plans set out in your review protocol.
  5. Record screening results for your PRISMA diagram if your software does not do this for you.

The second screening step involves checking the full text of each result to determine whether it meets the inclusion criteria. As with title and abstract screening, two reviewers must work independently to vote on each article. This ensures blinded decision making, reducing bias.

The screeners may resolve conflicts by discussion, or this can be done by a third team member with subject matter expertise.

The steps are:

  1. Export the list of citations requiring full text. If you are using a screening tool such as Covidence open access articles will be sourced by the software, it may also be possible to find full text using EndNote.
  2. Retrieve the full text of remaining results from the library catalogue or request the articles from the library.
  3. Link studies together if multiple publications appear in your results on the same study.
  4. Examine the full text of each result to check for compliance with the inclusion criteria, assessing eligibility criteria in order of importance.
  5. Vote to include or exclude the result, documenting the reason for an exclusion. The reasons for exclusion should be pre-set by the review team.
  6. Contact study authors if information is missing from the articles (for example, methods or results) before deciding. Automatically excluding studies with missing information may introduce bias due to selective outcome reporting.
  7. Resolve conflicts with the second screener by discussion. If a conflict cannot be resolved, it may require arbitration by another person.
  8. Record ongoing trials which have not yet been reported as they will need to be added to an ongoing studies table.
  9. Record screening results for your PRISMA diagram if your software does not do this for you.

Monash Health acknowledges the Traditional Custodians of the land, the Wurundjeri and Boonwurrung peoples, and we pay our respects to them, their culture and their Elders past, present and future.

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