WorkflowLibraries, Archives & Research Integrity

Systematic Review & Evidence Synthesis

Systematic review software that keeps the PRISMA flow live, with two blind votes on every record and every number tied to its page

Two blind votes on every record, a person on each conflict, every number tied to its page.

See one case, screen by screen ↓
demo4,981recordsscreened on title and abstract with two blind agent votes each, in the sample review
demo112conflictswhere the two Screener agents disagreed, each decided by a second reviewer, never by an agent
demo7mismatchesfound by the Checker agent re-deriving every sample and effect size, all resolved by a reviewer
target100%of extracted values pinned to a page and table, every effect size re-derived from the raw numbers
In short

What is Systematic Review & Evidence Synthesis?

Systematic Review & Evidence Synthesis is systematic review software for library evidence synthesis services and review teams. Agents capture the criteria from the registered protocol, re-run the saved searches monthly, vote blind on every title and abstract, extract data pinned to page and table, re-derive every effect size and draft the PRISMA 2020 flow and checklist. People decide every conflict, confirm every exclusion and value, and the principal investigator signs the flow before it exports.

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Updated

The problem

Why a review takes 67 weeks, even with systematic review software

Systematic review software is meant to carry a review from a registered protocol to a published PRISMA 2020 flow diagram, yet a systematic review still takes 67.3 weeks on average from registration to publication. A university library's evidence synthesis service turns the protocol into searches across bibliographic databases, removes duplicates, organizes dual title and abstract screening of thousands of records, chases full texts, extracts data, judges risk of bias and reports the whole journey in the flow and the 27-item checklist.

Today that work is spread over five or six tools, spreadsheets and email. Searches live in database histories and go stale before submission; counts live in spreadsheets, and the flow is redrawn by hand at the end, so its numbers often do not add up. A sample size copied from the abstract instead of the results table quietly changes a study's weight in the meta-analysis. And since the 2025 RAISE recommendations, any automated step that makes or suggests a judgment has to be reported, with how people oversaw it. Systematic Review & Evidence Synthesis puts the review on one living PRISMA flow, where agents propose, quote and cite, and people decide.

typical67.3weeksaverage from registration to publication of a systematic review
typical1,781recordsscreened on average per review, by a mean team of five
typical14.7hoursof librarian time per review, measured at one medical library service across 319 requests
Where a review's working weeks goestimated
By hand38 weeks
With the solution15.5 weeks
  • Running and re-running searches, removing duplicates4 → 1 wk
  • Dual title and abstract screening, and settling conflicts10 → 4 wk
  • Retrieving full texts and deciding exclusions with reasons8 → 4 wk
  • Extracting data and checking every value10 → 4 wk
  • Risk of bias assessment by two reviewers4 → 2 wk
  • Drawing the PRISMA flow, the checklist and the methods2 → 0.5 wk

Estimated split of the weeks a library team spends on the stages this solution supports, by hand and with the agents; the 'after' column keeps both human decisions on every record and is in line with the estimated 50–70% cut in screening and extraction time. Our arithmetic, kept modest; journal peer review is not included.

How it works

How a review moves

Nine agents search, screen blind in pairs, extract and re-check every number; reviewers decide every conflict and the investigator signs the flow.

What comes in
Records in6 sources · protocol, 5 databases and a register, library holdings
Agents at work
Protocol and Search agentscriteria cited · monthly re-run
Then
Screener Ablind vote
Screener Bblind vote
Then
Adjudicator agentquotes both, never decides
Then
Extraction and Checker agentspage and table · g re-derived
Bias and Report agentsquoted judgments · checklist
A person decides
Second reviewer and principal investigatordecide conflicts and exclusions · verify values · sign the flow
What comes out
Signed PRISMA flow
Journal pack
Repository deposit
One case, step by step

One living systematic review, from a monthly search to a signed PRISMA flow

"Effects of high-dosage tutoring on middle-school math achievement", protocol REG-2026-0318, registered March 2, 2026, is one of the reviews Halden State University's evidence synthesis service runs. Here is Wednesday, October 21, screen by screen, in the working solution.

  1. 01Morning

    The review opens on its PRISMA flow, drawn live

    Priya Natarajan · Evidence Synthesis Librarian

    Every box is a count Priya can open: 6,412 records identified, 1,431 duplicates removed, 4,981 screened, 4,542 excluded with 61 awaiting a person, 378 reports sought, 369 assessed. A chip between the screening boxes reads "112 conflicts · 3 open", and the rail beside the flow holds the review question and the six inclusion criteria, each cited to its protocol page.

    One next step: decide 3 screening conflicts, due October 26.

  2. 02October 1, 6:00 a.m.

    The saved searches re-run themselves, and the new records show

    Search agent

    The Search agent re-ran the six saved strategies across five bibliographic databases and one trials register and found 86 new records. It removed 19 duplicates; the Screener agents voted on the rest: 58 agreed exclusions, 6 to full text and 3 conflicts. The increment sits on the top box of the flow as "+86", so the review stays a living systematic review without a manual update cycle.

  3. 03Two blind votes

    A screening conflict, with both reasons quoted side by side

    Screener A, Screener B and the Adjudicator agent

    For Moreau & Tanaka 2025, Screener A votes include at 0.82, quoting "two to four sessions a week"; Screener B votes exclude at 0.84, quoting "mean attendance was 2.3 sessions a week". The two run on different models, and their votes were sealed until both were in. The Adjudicator names the criterion they disagree on, C3 dosage, cites protocol page 5, and routes it to Dr. Imani Rhodes, who decides with a reason.

    The Adjudicator has not decided any of them; they are yours.

  4. 04One batch

    Agreed exclusions count only after a person confirms them

    Daniel Ruiz · First screener

    The 58 records both agents excluded on October 1 wait as one batch, grouped by reason: 17 not a tutoring intervention, 15 outside grades 6–8, 10 below three sessions a week, 7 with no comparison group, 5 with another outcome, 4 of an ineligible design. Daniel reads a 10% random sample of six records in full before he confirms the batch.

  5. 059:41 a.m.

    A sample size that does not match, lit in both places

    Checker agent

    At full text, both Screener agents included Vellacott 2023, a randomized trial from the October 1 search. The Checker agent re-derives every sample and effect size from the raw numbers and finds the abstract reports 212 students on page 1 while Table 2 on page 6 sums to 198: 101 tutored and 97 in the comparison group. Both passages light up beside the extraction form, and the study stays out of the synthesis.

    The Extraction agent proposed 212. The Checker never overwrites a value; it flags.

  6. 06October 21

    The right value, recorded with a reason, and the count ticks to 41

    Dr. Imani Rhodes · Second reviewer

    Dr. Rhodes records 198 as the analytic sample: 212 were randomized and 14 left before the spring test, 6.6% overall with a 0.2-point difference between arms. The included box ticks from 40 to 41 with her initials, all 12 values on the form are verified, and the Checker's re-derived effect size, g = 0.27, matches the paper's Table 3.

  7. 07Two signatures

    No full-text exclusion without a reason and a second reviewer

    Dr. Imani Rhodes and Daniel Ruiz

    Kessler & Ahn 2024 offered tutoring twice a week. Dr. Rhodes picks the protocol reason, dosage below 3 sessions a week (C3), and the exclusion waits for Daniel Ruiz to confirm it. The person who picks a reason never confirms their own.

  8. 08Drafted, then confirmed

    Risk of bias assessment with the sentence behind each judgment

    Bias agent

    For Vellacott 2023 the Bias agent drafts the RoB 2 domains with quoted passages: a computer-generated sequence held by the district research office (page 4), 91% of sessions delivered (page 7), 14 of 212 missing, 7 per arm (page 6). The analysis plan was not publicly registered, so the overall draft is Some concerns. Two reviewers confirm, and either can change a judgment with a reason.

  9. 09Verified values only

    A meta-analysis that pools only what a reviewer verified

    Checker agent

    The forest plot pools 36 studies at g = 0.29 (95% CI 0.22 to 0.36, I² = 41%, random effects) on the sample data. Beside it, the Checker's findings across the included studies: 7 found and 7 resolved, among them a standard error entered as a standard deviation and a sign reversed.

  10. 104:12 p.m.

    The flow is signed, and only then does it export

    Dr. Samuel Okafor · Principal investigator

    Priya prepares the export and the counts balance from 6,412 to 41. Dr. Okafor signs the PRISMA 2020 flow; the 27-item checklist reads 27 of 27 reported, and the AI-use statement for the methods names each agent, its prompt version, the 300-record calibration and the 112 disagreements decided by a second reviewer. The flow, checklist, search log, statement and audit trail export together for the journal.

Who it’s for

Built for everyone who puts their name on a review.

The same review, seen by the people who carry it — what their day looked like, and what it looks like now.

PN
Priya NatarajanEvidence synthesis librarian · coordinates five reviews at once
Evidence Synthesis Librarian
Before
Builds the searches, chases full texts and keeps the PRISMA counts honest across spreadsheets: "I spend more time reconciling spreadsheets than searching."
Now
Sees each month's search land on the flow as a visible increment, decides the four duplicate pairs the agent was unsure of, and prepares an export whose counts already balance.
IR
Dr. Imani RhodesAssociate Professor of Education · second reviewer
Second reviewer
Before
Decides conflicts and checks extracted values from rows in a spreadsheet, hunting for the page each one came from.
Now
Sees both blind votes, the quoted passages and the page side by side: "Show me both reasons and the page. I'll decide."
SO
Dr. Samuel OkaforProfessor of Education Policy · principal investigator
Principal investigator
Before
Owns the protocol and signs a flow diagram redrawn by hand at the end: "I sign the flow. Every number in it has to be real."
Now
Approves each criteria version, then signs a flow where every box opens to its records, with the AI-use statement written from the record.
LB
Dr. Laura BrennanHead of Evidence Synthesis Services · about 45 reviews a year
Head of Evidence Synthesis Services
Before
Asks around to learn which reviews are stuck: "Which reviews are stuck, and on whom?"
Now
Sees every active review with its stage, who holds the next step and its SLA, and reassigns or re-runs searches in bulk.
DR
Daniel RuizDoctoral candidate in education · first screener
First screener
Before
Reads thousands of titles and abstracts one row at a time.
Now
Confirms agreed exclusions in batches grouped by reason, after reading a random sample in full: "Give me the batch grouped by reason, not 4,000 rows."
Built on the engine

9 agents. Each with one job, and hard limits.

Nine agents search, screen blind in pairs, extract and re-check every number; reviewers decide every conflict and the investigator signs the flow.

Protocol agent

Reads the registered protocol and captures the review question and the inclusion criteria, each cited to its page, and spots amendments.

  • Never changes criteria
  • An amendment waits for the principal investigator
Search agent

Re-runs the saved strategies monthly across five bibliographic databases and one register, removes duplicates and fetches full texts through the library link resolver, requesting interlibrary loan for gaps.

  • Never edits a saved strategy
  • Uncertain duplicate pairs go to the librarian
Screener A

Votes include or exclude on every title and abstract against the criteria, quoting the abstract and citing the criterion.

  • Never sees Screener B's vote
  • Below 0.80 confidence, the record goes to a person
Screener B

The second, independent vote on every record, on a different model so the two screeners do not share blind spots.

  • Never sees Screener A's vote
  • Below 0.80 confidence, the record goes to a person
Adjudicator agent

Quotes both rationales side by side, names the criterion they disagree on and routes the conflict to the second reviewer.

  • Never decides a conflict
  • Never routes a conflict to one of its screeners
Extraction agent

Fills the data extraction form with every value pinned to its page and table: sample, dosage, grade, outcome, means and standard deviations.

  • Never enters a value without a location
  • Low-confidence values are left blank and flagged
Checker agent

Re-derives every sample and effect size from the raw numbers and flags any mismatch, lighting both spots in the paper.

  • Never overwrites a value; it flags
  • Counts must match exactly; g within ±0.02
Bias agent

Drafts risk-of-bias judgments by domain, RoB 2 for randomized trials or ROBINS-I for non-randomized studies, with the quoted passage behind each.

  • Never confirms a judgment; two reviewers must
Report agent

Drafts the PRISMA 2020 checklist locations, the flow export and the AI-use statement for the methods section from the record.

  • Never exports before the principal investigator signs
Second reviewer and principal investigator

Decide, verify and sign. The agents propose; a named person decides.

Ask in plain words

Ask about any record, vote or count

Ask about any record, vote, value or count in the review. Every answer cites its source, and the assistant opens the screen where the answer lives.

Why did the screeners disagree on the 3 open conflicts?

All three came in with the October 1 search, and each disagreement sits on one criterion. Moreau 2025: Screener A read "two to four sessions a week"; Screener B read the mean of 2.3, and the protocol judges the mean delivered. Adeyemi 2024 reports grades 5–9 together, and the protocol needs grades 6–8 reported separately. Lindgren 2025 measures anxiety and course grades only. The Adjudicator has not decided any of them; they are yours.

Which studies have a number that does not match?

The Checker agent re-derived every sample and effect size across 41 studies and found 7 mismatches. Six are resolved, for example Harlan 2022, where a standard error was entered as a standard deviation. One is open: Vellacott 2023 reports 212 students in the abstract, but Table 2 sums to 198 (101 + 97). The study stays out of the meta-analysis until a reviewer records the right value.

Draft the AI-use statement for our methods section

Drafted from the record: two screening agents on different models voted blind on all 4,981 records; people confirmed every agreed exclusion and decided all 112 conflicts; every extracted value was verified by a reviewer and every effect size re-derived. It is on the Report screen, with model and prompt versions.

What did this month's search add?

On October 1 the Search agent re-ran the 6 saved searches and found 86 new records. It removed 19 duplicates; the screeners voted on 67: 58 agreed exclusions wait for a person's batch check, 6 went to full text, and 3 are conflicts. One of the six, Vellacott 2023, came from the trials register.

Every screen

The working solution, as it ships.

13 screens from the working solution, on its sample data. Pick one to see it large.

The review's PRISMA 2020 flow diagram, drawn live as the home screenA living systematic review opens on its PRISMA flow diagram: 6,412 records identified with "+86" from the October 1 search, 1,431 duplicates removed, 4,981 screened with two blind agent votes on every record, and a "112 conflicts · 3 open" chip between the screening boxes. Every box is a count you can open, and the one next step is the three conflicts that need a person.
Inclusion criteria captured from the registered protocol, each cited to its pageThe Protocol agent read the 11-page registered protocol and captured the question and six inclusion criteria. Selecting C3, dosage, highlights the passage on page 5 it came from; amendment v1.3, proposed by the librarian on October 14, waits for the principal investigator's approval.
Saved searches re-run every month, with what each run addedThe Search agent re-runs six saved search strategies on the 1st of every month. The October 1 run added 86 records, source by source, removed 19 duplicates and sent 6 records to full text before the rest flowed into screening.
Title and abstract screening: two blind votes side by sideWhen Screener A and Screener B disagree on a title and abstract, the conflict shows both votes, the passage each one quoted and the criterion they disagree on. The Adjudicator agent explains the disagreement and routes it to the second reviewer, who decides with a reason.
Agreed exclusions confirmed by a person, in batches grouped by reasonThe 58 exclusions both agents agreed on after the October 1 search count only after a person confirms the batch: grouped by protocol reason, with a 10% random sample read in full first.
Systematic review data extraction, checked against the raw numbersFor Vellacott 2023 the abstract reports 212 students while Table 2 on page 6 sums to 198. The Checker agent lights both passages beside the extraction form, where every value is pinned to its page, and the study stays out of the synthesis until a reviewer decides.
The reviewer records the right value, and the included count ticks to 41Dr. Imani Rhodes records the analytic sample of 198 with her reason; the study is included, the count ticks from 40 to 41 with her initials, and the Checker's re-derived effect size, g = 0.27, matches the paper's Table 3.
Full-text exclusions: one person picks the reason, a second confirms itNo study is excluded at full text until one reviewer picks the reason from the protocol's list and a second reviewer confirms it. Kessler & Ahn 2024 waits for the first screener to confirm "dosage below 3 sessions a week".
Risk of bias assessment drafted with the quoted passage behind each domainThe Bias agent drafts each RoB 2 or ROBINS-I domain with the sentence that supports it, and two reviewers confirm. Across the included studies: 17 low, 15 some concerns, 5 high, and 4 drafts waiting.
A meta-analysis built only from verified valuesThe forest plot pools only values a reviewer has verified and the Checker agent has re-derived: 36 studies, g = 0.29 on the sample data. The Checker's findings across all included studies sit beside it, 7 found and 7 resolved.
The signed PRISMA flow, the PRISMA 2020 checklist and the AI-use statementThe Report agent drafts the 27-item checklist and an AI-use statement for the methods from the record. The librarian prepares the export, the principal investigator signs the flow, and only then does it export with the search log and audit trail.
Every vote, change and reviewer on one audit trailThe audit trail records every agent vote and every person's decision with the reason and a link to the evidence. It filters by people, agents, decisions and refusals and exports for peer reviewers, the journal and the research integrity office.
The evidence synthesis service: every review, its next step and its SLAThe head of evidence synthesis services sees 23 active reviews with their stage, who holds the next step and the SLA, escalates late items and reassigns or re-runs searches in bulk.
Governance

Systematic review software you can report: blind, cited, signed.

Seven roles, separated by dutyA librarian coordinates; a first screener confirms batches; a second reviewer decides conflicts and confirms exclusions and values; the principal investigator approves criteria and signs the flow; the head of service assigns and escalates; an administrator handles settings and integrations only; an auditor reads and exports, changing nothing. A screener never decides their own conflict, and a refused step is logged.
A second person on every exclusion and every valueAgreed agent exclusions count only after a person confirms the batch; a full-text exclusion needs a reason picked by one reviewer and confirmed by another; a drafted email to study authors waits for the librarian; and nothing exports before the principal investigator signs.
Every vote and value cites its passageEach vote quotes the abstract and cites the criterion; each criterion cites its protocol page; each extracted value names its page and table, and a click opens the passage, highlighted.
Agents and models under version controlThe two screeners run on different models with a versioned prompt, and every change to a model, prompt or threshold needs a reason and creates a new version. Agents screen a review only after a 300-record calibration pilot, and any person can override an agent's vote or value with a reason code.
FERPA-aware handling of student-level dataStudent-level data from study authors is accepted de-identified only, with identifiers redacted before anyone opens it; restricted datasets are visible only to the named review team; decisions in a review never train a model; reviewer notes and votes are retained 7 years after publication.
A full audit trail, exported for the journalEvery blind agent vote and every person's decision, with the time, the reason and a link to the evidence — 10,423 events in the sample review. It filters by people, agents, decisions and refusals, and exports for peer reviewers, the journal and the research integrity office, watermarked with the reviewer's name.
Configuration

Your review protocol and service rules, not ours

The thresholds every vote and value is checked against are settings. A change needs a reason, creates a version and goes on the audit trail.

SettingDefaultChoose from
Screener confidence0.80Below it, a record goes to a person even if both agents agree
Auto-merge duplicates at0.97 similarityPairs from 0.85 to 0.97 go to the librarian
Checker toleranceCounts exact; g within ±0.02Changed only with a reason, versioned
Batch sample read in full10%Of each agreed-exclusion batch, before a person confirms it
Monthly search1st of the month, 6:00 a.m.Saved strategies, sources and schedule per review
Service levelsConflicts 5 business daysFull-text decisions 10; Checker flags 5; escalation 2 days past, to the head of service
Reviewer notes and votesRetained 7 years after publicationThen deleted, with a record of the deletion
Agents learn from this reviewOffDecisions in a review never train a model
Connections

Works with the systems a library already runs on

Bibliographic databases and trials registerswhere the saved search strategies run every month
Reference managertwo-way sync of records and tags
Library link resolver and full-text holdingsfull texts retrieved without retyping a citation
Interlibrary loanrequests for the full texts the library does not hold
Protocol registrythe registered protocol and its amendments
Institutional repositorywhere the signed flow, extraction data and search log are deposited
What it changes

The difference, in numbers.

Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.

estimated
50–70%
less screening and extraction time per review
Dual reading by hand9,962 reads
With agents≈ 112 conflicts + batches
target
2votes
blind, on every record, and a person on every conflict and exclusion
Conflicts decided by a person
112 of 112 in the demo review
target
100%
of extracted values pinned to page and table, every effect size re-derived
Studies checked
7 mismatches found, all resolved

Sources: Borah et al., BMJ Open 2017 (67.3 weeks on average from registration to publication; a mean of 1,781 records screened by a mean team of five) · Journal of the Medical Library Association, librarian time on systematic review services (14.7 hours per review across 319 requests) · PRISMA 2020 statement (flow diagram and 27-item checklist) · RAISE recommendations on reporting AI use in evidence synthesis (2025) · "target" = design goal, measured in the live solution · "demo" = seen in the working solution, on its sample data · "typical" = published figures · "estimated" = our arithmetic from published inputs. Halden State University, its review and the people named on this page are fictional — characters and sample data in the working solution; study names and results are sample data.

Questions

What evidence synthesis teams ask about systematic review software.

What is Systematic Review & Evidence Synthesis?

Systematic Review & Evidence Synthesis is systematic review software for library evidence synthesis services and review teams. Agents capture the criteria from the registered protocol, re-run the saved searches monthly, vote blind on every title and abstract, extract data pinned to page and table, re-derive every effect size and draft the PRISMA 2020 flow and checklist. People decide every conflict, confirm every exclusion and value, and the principal investigator signs the flow before it exports.

Can AI screen titles and abstracts for a systematic review?

Here, two Screener agents on different models vote on every title and abstract against the registered criteria, each quoting the abstract and citing the criterion, without seeing the other's vote. A vote below 0.80 confidence goes to a person, agreed exclusions count only after a person confirms the batch, and every disagreement goes to a second reviewer. The agents screen a review only after a 300-record calibration pilot.

What is a PRISMA flow diagram?

The PRISMA 2020 flow diagram reports how many records a review identified, removed as duplicates, screened, excluded and included, with the reasons for full-text exclusions. In this solution the flow is the home screen and is drawn live from the record, so every box opens to its records and the counts balance from identification to inclusion.

What is a living systematic review?

A living systematic review is kept current as new studies appear. The Search agent re-runs the saved strategies on the 1st of every month, removes duplicates and drops the new records into screening, and the increment shows on the top box of the flow, such as "+86" from an October search.

How do we report the use of AI in the review?

The Report agent drafts an AI-use statement for the methods section from the record: which agent did what, on which model and prompt version, the calibration result and the human checks. The 2025 RAISE recommendations ask reviews to report any automated step that makes or suggests judgments, and how people oversaw it; the statement exports with the signed flow.

Do people stay in control of the decisions?

Yes. The Adjudicator never decides a conflict, the Checker never overwrites a value and the Bias agent never confirms a judgment. A second reviewer decides every conflict, every full-text exclusion needs a reason picked by one reviewer and confirmed by another, any person can override an agent with a reason code, and the principal investigator signs the flow before anything exports.

How long does a systematic review take?

On average, 67.3 weeks from registration to publication. The estimate for this solution is 50–70% less screening and extraction time, while keeping two decisions on every record; it is measured in the live solution.

How long does it take to go live?

The Agentic Solution Engine builds and deploys it from your requirements and documents — a registered protocol and a past review's records and search log — and it goes live once every quality gate has passed. We will walk you through it on one of your own reviews first.

See it on
your next review.

We'll run Systematic Review & Evidence Synthesis on a protocol and a search export from your own service.