PRISMA 2020 Methodology
The systematic review follows the PRISMA 2020 guidelines for transparent reporting.
Flow Diagram
┌─────────────────────────────────────────────────────────────┐
│ IDENTIFICATION │
├─────────────────────────────────────────────────────────────┤
│ Records from databases (n=847) │
│ ├── Web of Science: 312 │
│ ├── Scopus: 289 │
│ ├── PubMed: 156 │
│ └── IEEE Xplore: 90 │
│ │
│ Grey literature (n=45) │
│ ├── EU publications │
│ ├── WHO reports │
│ └── Policy documents │
└─────────────────────────────────────────────────────────────┘
│
▼
┌─────────────────────────────────────────────────────────────┐
│ SCREENING │
├─────────────────────────────────────────────────────────────┤
│ Duplicates removed (n=234) │
│ Records screened (n=658) │
│ Records excluded (n=523) │
│ ├── Not EHDS-focused: 312 │
│ ├── Wrong study type: 145 │
│ └── Not English: 66 │
└─────────────────────────────────────────────────────────────┘
│
▼
┌─────────────────────────────────────────────────────────────┐
│ ELIGIBILITY │
├─────────────────────────────────────────────────────────────┤
│ Full-text assessed (n=135) │
│ Excluded (n=83) │
│ ├── Insufficient EHDS focus: 45 │
│ ├── Duplicate content: 23 │
│ └── Quality concerns: 15 │
└─────────────────────────────────────────────────────────────┘
│
▼
┌─────────────────────────────────────────────────────────────┐
│ INCLUDED │
├─────────────────────────────────────────────────────────────┤
│ Studies in review (n=52) │
│ ├── Peer-reviewed articles: 46 │
│ └── Grey literature: 6 │
└─────────────────────────────────────────────────────────────┘
Search Strategy
Databases Searched
- Web of Science - Core Collection
- Scopus - All fields
- PubMed - Title/Abstract
- IEEE Xplore - Full text
Search Terms
("European Health Data Space" OR "EHDS" OR
"EU health data" OR "Regulation 2025/327")
AND
("implementation" OR "governance" OR "privacy" OR
"secondary use" OR "federated learning" OR "interoperability")
Date Range
January 2020 - May 2025
Language
English only
Eligibility Criteria
Inclusion Criteria
- Focus on EHDS or EU health data governance
- Published 2020-2025
- Peer-reviewed or official policy document
- Available in English
- Addresses implementation, governance, or technology aspects
Exclusion Criteria
- Editorial/commentary without original analysis
- Conference abstracts only
- Non-EU focused studies
- Technical specifications without policy analysis
Access PRISMA Data
from ehdslens.visualization import EHDSVisualizer
viz = EHDSVisualizer(analyzer.db)
prisma = viz.create_prisma_diagram_data()
print(f"Identified: {prisma['identification']['total_database']}")
print(f"Screened: {prisma['screening']['records_screened']}")
print(f"Included: {prisma['included']['total']}")
References
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.