PRISMA Extensions Explained: Which One Applies to Your Review

PRISMA-ScR: scoping reviews

The scoping review extension adds reporting items reflecting scoping methodology's distinct structure -- the population-concept-context framework in place of PICO, expectations around the charting process rather than data extraction and synthesis, and accommodation for the more flexible, less risk-of-bias-focused nature of scoping review conclusions. Any scoping review reported against standard PRISMA 2020 rather than PRISMA-ScR is missing reporting elements specific to its actual methodology.

PRISMA-NMA: network meta-analysis

The network meta-analysis extension adds items specific to this methodology's added complexity, most notably an expectation for a network diagram showing which interventions have been directly compared, explicit reporting of the transitivity assumption underlying your indirect comparisons, and reporting of consistency checking between direct and indirect evidence where both exist for the same comparison.

PRISMA-DTA: diagnostic test accuracy

Systematic reviews evaluating a diagnostic test's accuracy, rather than an intervention's effectiveness, follow a genuinely different methodology, typically reporting sensitivity and specificity rather than a risk ratio or mean difference, and using QUADAS-2 rather than RoB 2 for quality assessment. PRISMA-DTA reflects these differences in its specific reporting items.

PRISMA-P: protocols

While not a reporting extension for a completed review, PRISMA-P provides a structured checklist specifically for systematic review protocols, distinct from the checklist for the completed review itself, and is worth following explicitly when drafting a protocol for PROSPERO registration or journal pre-registration.

ENTREQ: qualitative evidence synthesis

Though not technically part of the PRISMA family, ENTREQ serves the equivalent reporting function for qualitative evidence synthesis, with items reflecting thematic synthesis, meta-ethnography, or framework synthesis methodology rather than quantitative pooling.

PRIOR: overviews of reviews

For umbrella reviews specifically, PRIOR provides reporting guidance addressing this methodology's distinct concerns, including overlap management between included systematic reviews and quality appraisal of those included reviews using AMSTAR-2 or an equivalent tool -- items the standard PRISMA checklist, built around primary study synthesis, does not address.

PRISMA-S: search reporting

A more specialized extension focused specifically on search strategy reporting, PRISMA-S provides detailed guidance for documenting search strategies with enough precision for genuine reproducibility, useful as a supplementary reference even for reviews primarily following standard PRISMA 2020.

Choosing the right extension

Identifying which extension applies is usually straightforward once you're clear on your actual review type -- a scoping review uses PRISMA-ScR, a network meta-analysis uses PRISMA-NMA, and so on. The more common error isn't confusion about which extension exists, but simply not knowing an extension exists at all and defaulting to standard PRISMA 2020 for a review type that genuinely needs different reporting items.

What to do if your review combines methodologies

Some reviews combine elements -- a network meta-analysis that's also a diagnostic accuracy review, for instance -- and in these cases, following the relevant items from multiple extensions, clearly noting which items come from which guideline, is the appropriate approach. This should be stated explicitly in your methods section rather than left for a reader to infer, since combining extensions without disclosure can read as an inconsistent or incomplete reporting approach even when the underlying methodology is genuinely sound.

Extensions still in development

The PRISMA family continues to grow, with extensions for equity-focused reviews, for reviews of reviews, and for other specialized methodologies at various stages of development and adoption. Checking the current EQUATOR Network reporting guidelines library before finalizing your methods section is worth doing specifically because a relevant extension may exist, or may have been updated, since your training or your last review project.

What happens if no extension quite fits

Some reviews use a genuinely novel or hybrid methodology that doesn't map cleanly onto any existing extension. In this situation, the reasonable approach is following standard PRISMA 2020 as your base, explicitly noting in your methods section which specific items were adapted or added to address your review's particular methodology, and being transparent about the reasoning rather than either forcing an ill-fitting extension or omitting relevant reporting detail entirely. Reviewers are generally receptive to well-justified, clearly explained adaptations; what draws objections is an unexplained gap between what your review actually did and what any recognized reporting standard would have expected you to report.

Checking your manuscript against your chosen extension before submission

Whichever PRISMA extension applies to your review, working through it item by item against your actual drafted manuscript, not from memory of what you believe you included, is the single most reliable way to catch a missing reporting element before a reviewer does. Treating this as a mechanical, line-by-line check late in your drafting process, rather than something you assume you've covered along the way, consistently catches gaps that a more casual self-review misses. Building this check into your standard pre-submission workflow, rather than treating it as an occasional extra step, is a small habit that measurably reduces revision requests from methods-focused reviewers. Over time, teams that build this checklist-verification step into their standard drafting process tend to see a noticeably smoother path through peer review, since so many of the most common revision requests trace back to exactly the kind of gap a careful item-by-item check would have caught before submission. Over enough projects, this single habit tends to save considerably more cumulative time across a research career than it costs on any individual manuscript, simply by reducing how often a review cycles back through avoidable revision requests. It costs relatively little time against the manuscript as a whole, and consistently returns far more than it costs across a full publication cycle. Treat it as a standard, non-negotiable step rather than an optional extra squeezed in only when time genuinely permits it, and revisit the current EQUATOR library specifically at the start of each new review project rather than relying on what you remember from the last one.