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  • How to Write a PRISMA Systematic Review Chapter for a Public Health Dissertation (2026)

    How to Write a PRISMA Systematic Review Chapter for a Public Health Dissertation (2026)

    The systematic review is the most procedural chapter you will ever write, and that is the good news. Unlike a discussion chapter, it has a defined output, a published reporting standard and a diagram that either adds up or does not. What sinks postgraduate reviews is almost never the writing — it is a question that cannot be searched, a search that was never recorded, or numbers in the flow diagram that do not reconcile at 11pm the night before submission.

    This is the procedure in order. Each step states what you should have in hand before moving on. Every institution’s requirements differ, so check your programme handbook against this and follow the handbook where they disagree.

    Step 1: Decide whether you are writing a systematic review at all

    Confirm which of three things your dissertation actually requires, because they have different standards and different workloads.

    1. A full systematic review as the dissertation. Common on public health masters programmes where primary data collection is impractical in the time available. PRISMA applies in full.
    2. A systematic review chapter within an empirical dissertation. Shorter, still PRISMA-reported, positioned to justify the primary study that follows.
    3. A narrative or scoping review. Different reporting standard entirely — a scoping review reports to PRISMA-ScR, and a narrative review is not held to PRISMA at all.

    Expected output: a one-line statement of review type, agreed with your supervisor in writing.

    Step 2: Build a question that can actually be searched

    Reviews fail here more than anywhere else. “The effect of physical activity interventions on health” is not a review question; it is a research field. A searchable question specifies each element tightly enough that the database returns a number you can screen in the time you have.

    Use a structured framework. PICO suits intervention questions; SPIDER handles qualitative evidence better; PEO works for exposure questions common in public health.

    Worked example. Take a vague starting point — “does exercise help older people’s mental health?” — and force it through PICO:

    • Population: community-dwelling adults aged 65 and over, without a diagnosis of dementia
    • Intervention: structured group exercise programmes of at least eight weeks’ duration
    • Comparator: usual activity or waiting-list control
    • Outcome: depressive symptoms measured on a validated scale

    That yields a stated question: In community-dwelling adults aged 65 and over, do structured group exercise programmes of at least eight weeks reduce depressive symptoms compared with usual activity? Every one of those qualifiers becomes an inclusion criterion, and every inclusion criterion becomes a screening decision you can defend.

    Expected output: one question in a single sentence, plus a PICO or PEO table.

    Step 3: Write the inclusion and exclusion criteria before you search

    Write them now, while you have no attachment to any particular paper. Criteria written after you have seen the results are criteria bent to fit the results, and examiners recognise the pattern.

    Cover, at minimum: study designs eligible, population limits, intervention and comparator definitions, outcome measures accepted, date range with a justification for the start date, language restrictions with an honest acknowledgement of the bias they introduce, and publication status — whether you include grey literature, preprints, theses and conference abstracts.

    Expected output: a criteria table with a stated rationale for each restriction.

    Step 4: Register the protocol

    Register on PROSPERO before screening begins. Registration is free, takes an afternoon once your criteria are written, and does three useful things: it timestamps your criteria, it tells you whether someone is already running your review, and it makes the eventual paper substantially more publishable.

    If your programme does not require registration, write the protocol anyway and date it. The protocol is where you commit to your analysis plan, which protects you against the accusation that you chose your synthesis method after seeing which studies you had.

    Expected output: a PROSPERO registration number, or a dated protocol document lodged with your supervisor.

    Step 5: Build and record the search strategy

    Search at least three databases. For public health that typically means MEDLINE, Embase and CINAHL, often with PsycINFO for mental health outcomes, Scopus or Web of Science for breadth, and the Cochrane Library for trials. Ask your subject librarian to review the strategy — this is the single highest-return hour available to you, and most university libraries offer it.

    Each concept gets a block combining controlled vocabulary with free-text terms, and the blocks are combined with AND. A recorded MEDLINE strategy looks like this:

    1. exp Exercise/ OR exp “Physical Activity”/
    2. (exercis* OR “physical activit*” OR “resistance train*”).ti,ab.
    3. 1 OR 2
    4. exp Aged/
    5. (“older adult*” OR elderly OR “aged 65”).ti,ab.
    6. 4 OR 5
    7. exp Depression/
    8. (depress* OR “low mood”).ti,ab.
    9. 7 OR 8
    10. 3 AND 6 AND 9

    Record the exact string, the database and interface, the date you ran it, and the number of records returned. You will need all four in your methods section, and you will need to rerun the search shortly before submission to catch new publications. Reference management discipline matters here more than anywhere else in the dissertation; if you have not settled on a tool, the comparison of Zotero, Mendeley and EndNote covers which survives a large review library.

    Expected output: a search log table with one row per database, reproducible by a stranger.

    Step 6: Screen in two stages, and count everything

    Deduplicate first, in your reference manager, and record how many duplicates were removed. Then screen titles and abstracts against your criteria, then screen full texts.

    Have a second reviewer independently screen a proportion — 10 to 20 per cent is a common expectation at masters level — and report the agreement. A supervisor or fellow student can do this. Record disagreements and how they were resolved.

    The rule that saves the flow diagram: every full text you exclude needs a recorded reason, and the reasons must be categorised. “Not relevant” is not a reason. “Wrong population”, “wrong comparator”, “no eligible outcome measure”, “conference abstract only” are reasons, and they are what the exclusion box in the diagram reports.

    Expected output: a screening spreadsheet where the numbers reconcile at every stage.

    Step 7: Draw the PRISMA flow diagram so it adds up

    The diagram is arithmetic, and examiners check it. Work through the chain: records identified through database searching, plus records identified through other sources such as citation chasing, minus duplicates removed, equals records screened. Records screened minus records excluded at title and abstract equals full texts assessed for eligibility. Full texts assessed minus full texts excluded, with reasons broken down by category, equals studies included in the synthesis.

    A worked chain: 2,847 records from four databases plus 18 from reference lists, giving 2,865. Removing 912 duplicates leaves 1,953 screened. Excluding 1,847 at title and abstract leaves 106 full texts assessed. Excluding 89 with reasons — 34 wrong population, 28 wrong intervention, 15 no eligible outcome, 12 not primary research — leaves 17 studies included.

    Every number in that paragraph must match your spreadsheet and your diagram. Build the diagram from the spreadsheet, never from memory.

    Expected output: a flow diagram that reconciles line by line.

    Step 8: Appraise quality with a tool that fits the designs

    Choose the appraisal tool by study design, and justify the choice. Randomised trials call for the Cochrane risk-of-bias approach. Observational studies commonly use the Newcastle-Ottawa Scale. Mixed-design reviews often use the Mixed Methods Appraisal Tool, and JBI and CASP checklists are widely accepted on taught programmes.

    Two things distinguish a strong appraisal from a weak one. First, appraisal must have consequences — if you rate four studies at high risk of bias and then treat all seventeen identically in the synthesis, the appraisal was decorative. Say explicitly how quality shaped your conclusions, ideally through a sensitivity analysis. Second, report appraisal per domain rather than as a single score, because a study can be strong on measurement and weak on confounding, and that distinction matters to your reader.

    Expected output: an appraisal table by study and domain, plus a paragraph on how quality affected interpretation.

    Step 9: Synthesise, and be honest about whether you can pool

    Meta-analysis is not the default and is not the goal. Pool only when studies are similar enough in population, intervention, comparator and outcome measure that a summary estimate means something. Combining a twelve-week resistance programme with a two-year walking scheme produces a number, not a finding.

    Where pooling is inappropriate, conduct a structured narrative synthesis — group studies by intervention type or outcome, tabulate direction and magnitude of effects, and explain heterogeneity rather than averaging it away. This is a legitimate and common outcome for masters reviews. If you do pool, the analysis is usually straightforward in R or Stata; the comparison of statistical software for postgraduate research covers which handles meta-analysis packages most easily.

    Sample size across the included studies is worth commenting on directly — a review of seventeen underpowered trials tells you something different from a review of three large ones, and sample size conventions in postgraduate health research gives you the benchmarks to make that judgement.

    Expected output: a synthesis section with a stated method and a characteristics-of-included-studies table.

    Step 10: Write the chapter in the order examiners read it

    The chapter follows the PRISMA reporting sections: rationale and objectives, then methods covering eligibility criteria, information sources, search strategy, selection process, data collection, quality assessment and synthesis method, then results opening with study selection and the flow diagram, then characteristics of included studies, then quality appraisal findings, then synthesis, then a limitations section.

    A worked opening for the methods section, which you can adapt:

    This review was conducted in accordance with the PRISMA 2020 statement and registered prospectively on PROSPERO (CRD42026XXXXXX). MEDLINE, Embase, CINAHL and PsycINFO were searched from January 2010 to March 2026, the start date reflecting the publication of the first national guidance on this intervention. Search terms combined controlled vocabulary and free-text terms across three concept blocks, and the full MEDLINE strategy is reproduced in Appendix A. Titles and abstracts were screened against pre-specified criteria by the author, with 20 per cent independently screened by a second reviewer; disagreements were resolved by discussion.

    Write limitations as analytic judgements, not apologies. “English-language restriction may have excluded relevant evidence from non-Anglophone health systems, which is a material limitation for an intervention delivered largely in community settings” is a doctoral-level limitation. “I only had a few months” is not. The same principle governs writing limitations in a discussion chapter.

    Expected output: a complete chapter, with the search appendix attached.

    Keep the review reproducible while you write it

    A systematic review generates more moving parts than any other chapter — search logs, screening decisions, appraisal ratings, extraction tables — and they all have to still agree with each other months later when you write the methods section. Tesify keeps your sources, extraction notes and drafts in one workspace so the chapter you write is anchored to the records you actually screened, and the numbers you cite are the numbers you have.

    Start your systematic review chapter with Tesify

    Frequently asked questions

    How many studies should a masters systematic review include?

    There is no target number — the answer is however many meet your criteria. Reviews including fewer than five studies are publishable if the question is important and the search was thorough. A review returning eighty included studies usually signals a question that was too broad for the time available.

    Can you do a systematic review on your own?

    For a dissertation, yes, provided you report it honestly. Best practice requires dual independent screening; masters programmes typically accept a single reviewer with a proportion double-screened by a supervisor or peer. State exactly what was done and treat single screening as a limitation.

    Do you need PROSPERO registration for a dissertation review?

    Not usually required by programmes, but strongly advisable. PROSPERO accepts student reviews with supervisor details. Registration timestamps your criteria and materially improves the chances of publishing the review afterwards.

    What is the difference between PRISMA 2009 and PRISMA 2020?

    PRISMA 2020 replaced the 2009 statement and expanded the checklist, with more detail required on search strategies, automation tools, and reporting of bias assessment. It also revised the flow diagram, including a version for reviews updating a previous review. Report to PRISMA 2020 and cite it.

    Should you include grey literature in a public health review?

    Often yes, because public health interventions are frequently evaluated in government and NGO reports that never reach journals. Excluding grey literature risks publication bias. If you exclude it, say so and name the bias; if you include it, specify which sources you searched.

    What do you do if your search returns 20,000 records?

    Narrow the question rather than the search quality. Tighten the population, restrict to specific study designs, or limit to a defensible date range with a stated rationale. Do not simply screen the first few hundred records — that is not a systematic review and examiners will identify it.

    Can you use AI tools to screen studies?

    Screening-assistance tools are increasingly accepted, but PRISMA 2020 requires you to report any automation used, and you remain responsible for every inclusion decision. Check your institution’s academic integrity policy before using any tool, and never present machine decisions as independent human screening.

    How long does a masters systematic review take?

    Plan on the search and screening consuming considerably more calendar time than the writing. Protocol and search development typically take several weeks, screening several more, and the rerun before submission needs its own slot. Reviews run late because screening is estimated as if it were reading.

    Does a narrative synthesis count as a weaker result?

    No. Choosing narrative synthesis because heterogeneity makes pooling invalid is a methodological judgement in your favour. Forcing a meta-analysis on incomparable studies is the weaker outcome, and a well-briefed examiner will say so.

  • What Does a DClinPsy Thesis Look Like? Structure, Word Counts and the Three-Paper Portfolio (2026)

    What Does a DClinPsy Thesis Look Like? Structure, Word Counts and the Three-Paper Portfolio (2026)

    A UK DClinPsy thesis is usually not a monograph. It is a portfolio of journal-ready papers — most commonly a systematic review, an empirical study and a critical appraisal — bound and examined together, under a word limit set by your own programme rather than by any national standard.

    That single structural fact explains most of what confuses trainees in their second year. You are not writing chapters that build toward a conclusion across 80,000 words. You are writing two or three self-contained documents, each of which has to survive being read on its own, plus a reflective piece that does the work a monograph would have done through its connective tissue. The skills transfer badly from an undergraduate or MSc dissertation, and the timetable is unforgiving because clinical placements do not pause while you collect data.

    How is a DClinPsy thesis different from a PhD thesis?

    The difference is architectural, not one of difficulty or of standard. A PhD thesis is examined as a single sustained argument that makes an original contribution to knowledge; the reader is expected to move through it in order. A DClinPsy thesis is examined as a set of outputs plus evidence of the reflective, clinically-informed reasoning that produced them.

    The consequence is that redundancy is designed in rather than penalised. Your systematic review and your empirical paper will both contain an introduction that sets up the same clinical problem, and both will cite an overlapping literature. In a monograph that would be a fault. In a portfolio it is the correct behaviour, because each paper must stand alone at submission to a journal. This is the same logic that governs an alternative-format doctorate, and it is worth reading how professional doctorates differ from a PhD before you assume any structural convention carries across.

    The second difference is the assessed relationship to practice. A PhD is judged on contribution to knowledge. A professional doctorate in clinical psychology is judged on contribution to knowledge and on your capacity to reason as a scientist-practitioner — which is precisely what the critical appraisal exists to evidence.

    How many words is a DClinPsy thesis?

    Considerably fewer than a PhD, and the number you are governed by is in your programme handbook, not in a sector-wide rule. Totals in the region of 25,000 to 30,000 words are common, but programmes express the limit in at least three incompatible ways.

    Some set a single total for the whole portfolio and let you distribute it. Some set a per-paper limit — often around 8,000 words for each of the review and empirical papers, with a shorter appraisal. Some set the limit by reference to the target journal’s own instructions to authors, which can bring an empirical paper down to 4,000 or 5,000 words and push the rest into appendices. One UK institution’s regulations set the DClinPsy at 14,000 words where the same institution sets the PhD at 100,000 — a difference that only makes sense once you know appendices are excluded and the journal format is doing the compression.

    Check three things in your handbook before you plan anything: whether the limit is per paper or total, whether abstracts, tables, reference lists and appendices count toward it, and what the tolerance is for exceeding it. These vary enough between programmes that borrowing a friend’s plan from another university is actively risky. If you are trying to work out where chapter or paper boundaries belong at all, the reasoning behind how doctoral theses divide into chapters applies to portfolio components too.

    What goes in the systematic review paper?

    A publishable synthesis answering a clearly bounded clinical question, conducted and reported to a recognised standard. In practice that means a PRISMA-compliant systematic review, and increasingly a meta-analysis where the literature supports pooling.

    The commonest failure is a question that is too broad to be searched systematically — “psychological interventions for anxiety” will return tens of thousands of records and no trainee has the time. The question needs population, intervention, comparator and outcome specified tightly enough that the search returns a screenable number. You will also need a protocol, ideally registered on PROSPERO before screening begins, and a second reviewer for at least a proportion of the screening and quality appraisal.

    Quality appraisal is where clinical psychology reviews are marked hardest, because the included studies are usually heterogeneous in design. Expect to justify your choice of appraisal tool rather than simply apply one. The full procedure, including the screening arithmetic and the flow diagram, is set out in our guide to writing a PRISMA systematic review chapter.

    What goes in the empirical paper?

    Your own study, written to the length and section structure of a named target journal. It is the component most constrained by circumstances outside your control: recruitment through NHS services, ethics timelines, and the fact that you are on placement.

    Design realism matters more here than ambition. Trainees routinely propose a randomised design and end up with a cross-sectional survey because recruitment through a service ran at a fraction of the projected rate. Build the sample size assumption explicitly and early, and know what your paper becomes if you reach only half of it — a pilot, a feasibility study, a qualitative design. Getting the sample size right in postgraduate health research is the single decision that most often determines whether the empirical paper is publishable.

    Qualitative empirical papers are entirely standard in clinical psychology and are not a lesser option. They carry their own requirements: a stated epistemological position, a defensible analytic approach, and reflexivity that is evidenced rather than asserted.

    What is the critical appraisal for?

    It is the component with no equivalent in a PhD, and the one trainees most often treat as an afterthought. The critical appraisal — sometimes called the reflective commentary, integration chapter or extended paper — asks you to stand outside the two papers and interrogate them.

    Done badly it is a diary: what went wrong, how stressful it was, what you would do differently. Done well it is an argument about the epistemology and clinical utility of your own work. Why this design and not the obvious alternative? What does the systematic review tell you that changes how the empirical findings should be read? What would a service actually do differently on Monday morning, and what is the honest strength of the evidence for doing it? Where did your position as a trainee inside the service shape recruitment, the interviews, or the analysis?

    Examiners use it to test whether you understand the limits of your own study, which is also the substance of much of the viva. The reasoning is close to that of a doctoral discussion chapter that handles limitations well — limitations stated as analytic judgements strengthen the work rather than undermining it.

    Why write in journal article format at all?

    Because the profession expects the research to reach practice, and because a portfolio written to journal specifications can be submitted within weeks of the viva rather than being rewritten from scratch a year later.

    The practical implication is that you choose target journals before you write, not after. The journal determines your word limit, your section headings, your reporting checklist, your reference style and whether you can include a figure at all. Writing 8,000 words and then discovering the journal caps research articles at 5,000 is a fortnight lost. Name a first-choice and a fallback journal for each paper, put their instructions to authors in front of you, and write to them. Our guide to turning doctoral work into a journal article covers the submission decisions that follow.

    What ethics and governance approval will you need?

    More than an MSc project, and on a timeline you must plan backwards from. If your study involves NHS patients, staff recruited through the NHS, or NHS data, you are looking at an IRAS application, HRA approval and in most cases a Research Ethics Committee review, plus local capacity and capability confirmation from each participating site.

    Treat the approval process as a research phase with its own duration rather than as paperwork. Committee meeting dates are fixed, responses to provisional opinions take time to draft, and site confirmations arrive at their own pace. Trainees who lose a thesis year almost always lose it here. If your design can answer a worthwhile question using existing data, a service evaluation route, or participants recruited outside the NHS, that is a legitimate and often wiser choice — but confirm with your programme’s research director that it satisfies the thesis requirement before committing.

    What does the DClinPsy viva assess?

    The same things a PhD viva assesses — that the work is yours, that you understand its limits, that you can defend your decisions — with an added strand on clinical and professional implications.

    Expect to be asked why you chose this question rather than an adjacent one, what you would do with another year and a larger sample, how the review and empirical paper speak to each other, and what a clinician should take from your findings. Expect at least one question that invites you to criticise your own study before the examiners do. Examiner composition follows the same internal-and-external convention as other UK doctorates; if that is unfamiliar, see who examines a doctoral thesis in the UK.

    What do trainees most often get wrong?

    Four things, in roughly this order of frequency. Starting the systematic review too late, on the assumption that it is the easy component — it is not, and second-reviewer screening takes calendar time you cannot compress. Designing an empirical study whose recruitment assumptions were never stress-tested. Writing the critical appraisal in the last fortnight, when it is the component that most differentiates a strong portfolio. And leaving the choice of target journal until after drafting, which guarantees a rewrite.

    The structural fix for all four is the same: decide the shape of all three components in your second year, including target journals and sample size logic, and treat each as a document with its own deadline rather than as a section of one large thing you will assemble later.

    Write the portfolio without losing the thread between papers

    The hardest part of a portfolio thesis is holding three documents in mind at once while a clinical placement consumes your week. Tesify keeps the review, the empirical paper and the appraisal in one workspace, with your sources, notes and drafts attached to the paper they belong to, so the argument in the appraisal can actually reach back into the other two. It supports your writing rather than replacing it — the reasoning stays yours, which is the only version examiners will accept.

    Start your thesis portfolio with Tesify

    Frequently asked questions

    Is a DClinPsy thesis a real doctorate?

    Yes. A DClinPsy is a doctoral award at the same level as a PhD, examined against doctoral criteria including an original contribution to knowledge. It differs in assessment architecture — a portfolio of papers plus clinical competence requirements rather than a single monograph — not in level.

    How many papers are in a DClinPsy thesis?

    Most UK programmes require three components: a systematic review, an empirical paper and a critical appraisal. Some require only the review and empirical paper with a shorter integrative statement, and a minority require an additional service-related project. Your programme handbook is the authority.

    Do appendices count toward the DClinPsy word limit?

    Usually not, which is why journal-format portfolios can be much shorter than a monograph. Interview schedules, ethics documentation, extended analyses and search strategies typically sit in appendices outside the count. Confirm this in your regulations, because a minority of programmes count them.

    Do you have to publish your DClinPsy papers to pass?

    No. Programmes require the papers to be written to publishable standard and formatted for a named journal, but acceptance by that journal is not normally a condition of the award. Submission usually happens after the viva and any corrections.

    Can a DClinPsy empirical paper be qualitative?

    Yes, and qualitative designs are common in clinical psychology. They require an explicit epistemological position, a justified analytic method, and evidenced reflexivity. They are not treated as a weaker option, though they carry different appraisal expectations than quantitative work.

    When should you register a systematic review protocol on PROSPERO?

    Before you begin screening. Registration after screening has started is possible but must be declared, and reviewers of the eventual paper will notice. Registration also protects you if another group publishes a similar review while yours is in progress.

    How long does HRA and ethics approval take for a DClinPsy project?

    It varies with study type and how quickly you respond to a provisional opinion, and it is measured in months rather than weeks once site confirmations are included. Plan backwards from your data collection window and treat committee dates as fixed constraints.

    What happens if recruitment fails on a DClinPsy empirical study?

    You reframe the study rather than abandon it — commonly as a feasibility or pilot study, or by shifting to a qualitative analysis of the participants you did recruit. Discuss the change with your supervisor early, and check whether an ethics amendment is required.

    Is the critical appraisal assessed separately?

    It is normally assessed as part of the whole portfolio rather than given an independent mark, but it carries disproportionate weight in examiners’ overall judgement because it evidences the scientist-practitioner reasoning that distinguishes a professional doctorate.

    Can you fail a DClinPsy viva?

    Outright failure is rare. The usual outcomes mirror other UK doctorates: pass with no corrections, minor corrections, major corrections, or referral for resubmission. Because clinical training and the research award are linked, check how your programme handles a referral alongside qualification.