Tip #6: Using Covidence to track and report snowballed references for the PRISMA 2020 flow diagram

Coauthored by Michelle R. Demetres, MLIS (mrd2006@med.cornell.edu)

Update (October 18, 2022): This guidance is out of date, as bulk-tagging of large import sets in Covidence is currently not possible. Instead of importing references obtained by snowballing into the original Covidence project, we recommend creating a separate Covidence project for the new references and de-duplicating the already-screened references in EndNote prior to import.

If you conduct snowballing (AKA citation searching or reference chasing) as part of your systematic review process, the PRISMA 2020 flow diagram may be causing you headaches. In the new flow diagram, snowballed results are reported in the right hand side of the diagram, "Identification of studies via other methods." Michelle Demetres of the Samuel J. Wood Library at Weill Cornell Medicine has contributed this tip on how to track snowballed references in Covidence.

  1. The team must be completely finished with their first round of full text screening in Covidence. 
    1. Import snowballing references into title/abstract. 
    2. Click "All" at the top. This will select all your newly imported references. 
    3. Click "Tags" and type Snowballing, click create new. 
    4. You should now see all new references have been tagged with "Snowballing." 
  2. As usual, have the team let you know when they are ready for full text with this set. If nothing made it there, you're done! If not, make note in your documentation of HOW MANY. 
  3. Once the team is finished with full text screening, you'll need to run an export. 
    1. Click on "Export"
    2. In the left-most box "References," select "Excluded" for Stage and "CSV" for Format. 
    3. Once you open the downloaded file, you should be able to see if any "Snowballing" tagged studies were excluded and for what reason.
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Image description for screen reader users:

  • Citation searching = total number from snowballing 
  • Reports sought for retrieval = Total number from snowballing in full text
  • Reports not retrieved = Number for which you couldn't locate full text
  • Reports assessed for eligibility = Total number from snowballing for which full text was reviewed
  • Reports excluded = Exclusion reasons from Covidence export



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