Background: There is little published methodology to inform the process of screening search results for systematic reviews. The Cochrane Handbook recommends the use of bibliographic or reference management software as tools for managing references and removing duplicate citations. The Handbook doesn t mention, and perhaps it is not generally realized, that this kind of software can accelerate and simplify the screening process in other ways. Objectives: To use the EndNote software to improve the efficiency of the screening process. Methods: In 2009, the Cochrane HIV/AIDS Group worked with the World Health Organization to develop rapid advice on several topics relevant to the prevention of mother-to-child HIV transmission (PMTCT). We performed one comprehensive set of searches for 4 separate reviews, incorporating a broad range of PMTCT terms, each relevant to at least one of the reviews. We merged the combined results into EndNote, and, using EndNote s tool, removed duplicates. We then used EndNote s Search references feature, which permits searches for up to nine terms at once, to eliminate those containing terms indicative of animal studies. We put these into a separate EndNote file of less-likely references. We repeated this procedure with numerous other irrelevant terms, in sets of nine, searching specifically in titles. We later reviewed the less-likely references to identify any that might yet be relevant. Results: The searches produced 13,945 references, of which 4,018 (29%) were duplicates. From the 9,927 remaining, we sequentially removed 6,592 (66%) additional references from the results, leaving 3,335 (24% of studies originally identified) studies to review. No studies that were excluded were found to be eligible on subsequent review. Conclusions: Citation management software can serve as a tool for screening search results. Careful and appropriate use of such software can greatly increase the efficiency of this stage of the systematic review process.