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Screening Annotations and Reconciliation

Screening decisions now include structured exclusion reasons, and screening disagreements have their own reconciliation workflow. When a reviewer excludes a study, they select specific reasons from the screening profile's criteria -- such as "Wrong Population", "Wrong Study Design", or "Not in English." This structured data feeds directly into PRISMA reporting.

Why Structured Exclusion Reasons Matter

The PRISMA 2020 flow diagram requires exclusion counts broken down by reason (e.g., "45 excluded for wrong population, 23 for wrong intervention, 12 for wrong study design"). Without structured exclusion reasons, producing these counts requires tedious manual data reconciliation.

Structured reasons also improve screening quality. When a reviewer must explicitly select which criterion a study fails, they are encouraged to apply criteria more consistently and thoughtfully.

Screening a Study

Navigate to a stage with screening enabled. For each study, you see the title, abstract, and any attached files (such as PDFs).

Including a Study

Click Include. The study passes this screening stage and proceeds to the next stage in the pipeline (based on Stage Filtering rules).

Excluding a Study

  1. Click Exclude.
  2. A structured form appears, showing the exclusion criteria defined in the stage's Screening Profile.
  3. Select the primary exclusion reason from the list. For example:
  4. "Wrong Population"
  5. "Wrong Intervention"
  6. "Wrong Study Design"
  7. "Review article"
  8. "Not in English"
  9. If sub-reasons are configured, additional questions appear based on your primary selection. For example, selecting "Wrong Population" might prompt: "Non-mammalian species?" or "Wrong age range?"
  10. Click Confirm Exclusion.

The screening decision and the exclusion reason are saved together as a single atomic record. This guarantees that every exclusion has a documented reason.

Example Screening Decision

Study: "Effects of aspirin on murine models of stroke"

Decision: Exclude

Primary reason: Wrong Population

Sub-reason: Non-mammalian species (the study used zebrafish, not mice as the title suggests)

Screening Reconciliation

When your project uses dual screening (two reviewers per study), disagreements are resolved through screening reconciliation. This follows the same principles as annotation reconciliation (see Reconciliation Workflow).

When Reconciliation is Triggered

Screening reconciliation is triggered when two reviewers disagree on a study's screening decision:

Reviewer A Reviewer B What Happens
Include Include Both agree -- study is included (resolved automatically or by bulk approve)
Exclude Exclude (same reason) Both agree -- study is excluded with that reason
Include Exclude Disagreement -- study enters the screening reconciliation pool
Exclude (reason X) Exclude (reason Y) Disagreement on reason -- study enters the screening reconciliation pool

The Reconciliation Workflow

  1. The study enters the screening reconciliation pool.
  2. The system randomly assigns it to a reconciler (a project member with the Reconcile permission).
  3. The reconciler sees the anonymised decisions side-by-side:
  4. "Reviewer A: Include" vs. "Reviewer B: Exclude -- Wrong Population"
  5. The reconciler records their own decision: Include or Exclude, with a reason if excluding.
  6. The reconciler's decision becomes the final screening outcome.

Important: Screening Before Annotation

Screening reconciliation must complete before annotation reconciliation can proceed on the same study. If a study is excluded during screening reconciliation, it is never reconciled for annotations -- this saves work and avoids meaningless reconciliation effort.

Bulk Operations

Bulk Approve

When all screeners agree on a study's decision (and reason, if excluding), the study can be approved in bulk:

  1. Navigate to the stage's Screening Reconciliation tab.
  2. The dashboard shows how many studies are eligible for bulk approval.
  3. Click Bulk Approve. The system creates authoritative screening outcomes for each unanimous study.

Bypass Criteria

Project administrators can configure rules to skip reconciliation for specific cases. For example, if both reviewers exclude a study but give different reasons, the administrator might configure the system to accept the exclusion without reconciling the reason (since the study is excluded regardless).

Understanding Screening Authority

Every screening decision records how the final outcome was determined:

Resolution Type Meaning
Single Reviewer One reviewer's decision was sufficient (single-reviewer agreement mode)
Reviewer Agreement Two reviewers agreed independently
Manual Reconciliation A reconciler resolved a disagreement

This resolution type appears in data exports and PRISMA reports, providing a complete audit trail of how each study's screening outcome was determined.

Optional Configuration

Structured exclusion reasons are optional. Teams that prefer the current simple include/exclude workflow are unaffected. The feature is configured per Screening Profile:

  • When exclusion reasons are enabled: The structured form appears whenever a reviewer clicks Exclude
  • When exclusion reasons are disabled: Clicking Exclude records a simple binary decision (the current behaviour)

Your project administrator chooses whether to require reasons when creating or configuring a Screening Profile.