Record vs Report vs Study: Standard Terminology for the PRISMA Flow Diagrams in Systematic Reviews

Many reviewers are not familiar with the preferred terminology during the systematic reviewing process. They refer to the same or different concepts with confusing terms: article, paper, reference, citation, title, abstract, PDF, full text, trial, research, record, report, and study!

The confusion continues when the reviewers use these terms interchangeably throughout their review writing and in the PRISMA flow diagram. Fortunately, such details are embedded in the free PRISMA flow diagrams templates; however, reviewers may miss the details where the devil hides!

In this short blog, I am trying to explain why using Record, Report, and Study as three standard forms of three relevant concepts can solve this problem and why using the other terminology is not necessarily correct and causes confusion.

Use ‘Record’ instead of Article, Paper, Reference, Citation, Title, or Abstract.

The majority of the search results are coming from bibliographic databases. In data science and databases management, each one of these search results is called a ‘Record’. The collection of such records becomes a Database or a Library.

Using ‘Article’ or ‘Paper’ instead of ‘Record’ is confusing.

1. Article and Paper refer to items published in journals, magazines, and newspapers, while, in a systematic review, we have no limitations to the source of the search results. We usually have book chapters, conference abstracts, dissertations, clinical trial registry records and even web pages among the search results. Calling these items Article or Paper is confusing.
2. It is misleading because some reviewers think they should only include Articles and Papers (published in journals). So they exclude the rest of the relevant records by mistake just because they are not journal Articles or journal Papers.

Using ‘Reference’ or ‘Citation’ instead of ‘Record’ is confusing.

We use these terms in the academic writing context frequently and usually refer to either the bibliographic information at the end of academic works or in-text citations. What’s wrong is that Reference or Citation do not have Abstract, Medical Subject Headings, Notes, and many other fields. However, the search results have many more data points, including bibliographic information, abstract, subject headings, URL, IDs, URL, Address, Publisher, etc.

This confusion started when PubMed referred to its number of records as ‘Citations’, saying that PubMed has 30 million citations. On the other hand, employing the other search methods during the systematic reviews added to the terminology problem. We have methods called ‘Checking references of included studies’ and ‘Citation tracking’. Many reviewers think that because they check the reference lists of included papers or track citations to a report, the results should be called references/citations. In reality, what the reviewers have to check is not just the reference/citation but also the abstract or the full text of the paper.

Using Title or Abstract instead of ‘Record’ is confusing.

Each record in the database has several sub-sections that are called ‘Field’. The most known fields are title, abstract, authors, journal name, volume, page numbers, and DOI.

It happens that the reviewers write ‘we excluded X number of titles/abstracts’. I would ask did they only exclude titles or they also excluded authors and journal names and page numbers as well? For this apparent reason, please use ‘record’.

So as long as you are dealing with search results, de-duplication, and titles and abstracts screening during the systematic review, please call them Record. If it were to me, I would use Record Screening rather than Title and Abstract Screening, but it is too late; that ship sailed three decades ago!

Use ‘Report’ term instead of Full Text and PDF.

You will look for the full text of papers for eligibility assessment and data extraction, but it does not mean you should refer to them as Full Text or PDF because

1. Sometimes the record is a conference abstract and on its own, it is the full text and you don’t have to look for the full text. So, in this case, how would you resolve the confusion between ‘record’ and ‘full text’ while both are the same thing.
2. Sometimes, the retrieved full text is not PDF; it is in Word, Excel, Open Office, or Webpage formats. Oh, and sometimes they are in .jpg format because some conferences share the posters in this format!

So how we should refer to these items without confusion? It is suggested in PRISMA diagrams to use the term ‘Report’. These items are ‘reports’ of studies presented as PDF, full text, .jpg, web, or conference abstract.

Again if it were to me, I would call this stage ‘Report Screening’ rather than ‘Full-Text Screening’. However, Full-Text Screening is so widespread that if you start using Report Screening, journal editors will order you to stand corrected!

Use ‘Study’ after making an eligibility decision instead of ‘Trial’ or ‘Research’.

Researchers do not conduct papers or reports; they conduct ‘Studies’. Some of these studies may be trials but not all of them. It means using the term trial in PRISMA or systematic review context could be confusing. On the other hand, not all systematic reviews include ‘research’ papers; some of the systematic reviews include review papers. Such systematic reviews may be called Overview or Umbrella Review or Systematic Review of [Systematic] Reviews. So using the term ‘Research’ could be as confusing as using ‘Trial’.

Using a standard term of ‘Study’ could end these confusions.

The transition from ‘Report’ to ‘Study’ is not clear in the PRISMA flow diagram, so some reviewers have no idea what the difference is. While I already explained it in the post regarding ‘De-Duplication’, I repeat it briefly here.

A study may have more than one report. For example, the researchers may follow a protocol or a proposal. This proposal or protocol — published or unpublished — is a report of that study. Then the researchers may publish some of the preliminary findings in a journal which is another report of the same study. To disseminate the findings, the researchers may present the same or similar or different abstracts in the form of oral or poster presentations in several conferences; the conference abstracts, the posters, and the presented slides are the reports of the same study. Eventually, the researchers may publish the final result as a journal paper, another report of the same study. As you can see, one study can create many reports.

The PRISMA diagram asks to refer to both numbers of studies and reports separately in the last box to resolve this confusion.

Use ‘Record’ in your PRISMA flow diagram and writing as long as you are referring to search results, de-duplication, or title and abstract screening. Change to ‘Report’ when you are entering the full text screening and looking at the reports of the studies. Finally, use ‘study’ when you make final decision on eligibility of the studies. Again, this stage better be called Study Screening.

I hope you find this post useful and correctly use ‘Record’, ‘Report’, and ‘Study’ terms.

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