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Large language model enhanced framework for systematic reviews and meta-analyses

Shen J, Luo Z, Jia D, Wang S, Sun F, Wu J

BMJ digital health & AI, 2025

Abstract

Objective: To evaluate and synthesise current applications of large language models (LLMs) in systematic reviews and meta-analyses (SRMAs), identify key limitations and propose an enhanced theoretical framework to improve the efficiency, scalability and reliability of evidence synthesis.

Methods and analysis: We conducted a narrative review of recent studies applying LLMs across key SRMA stages. A total of 21 publications were analysed for model type, task application, accuracy metrics and workflow impact. Building on this evidence base, we designed a comprehensive LLM-enhanced SRMA framework that categorises LLM roles as consultants and assistants, integrates human-in-the-loop strategies and uses retrieval-augmented generation (RAG) and agent-based architectures to address critical challenges including hallucinations, bias and workflow inefficiency.

Results: The reviewed literature demonstrated that LLMs can support various SRMA tasks with reported accuracy ranging from 61% to 99%, showing particular promise in literature screening and data extraction. Our proposed framework conceptualises modular integration of LLMs across all six SRMA stages, with LLMs serving as consultants for research question formulation and search strategy development and as assistants for task automation including abstract screening and structured data extraction. The framework incorporates RAG technology to reduce hallucinations by grounding outputs in retrieved literature and employs agent-based…

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