How to make a PRISMA 2020 flow diagram
Short answer
Pick the PRISMA 2020 template that matches your review (new or updated, databases and registers only or other sources too), then fill in the counts in three phases: identification, screening and included. Count records at identification and screening, reports at retrieval and full-text eligibility, and studies at inclusion, and give reasons for every full-text exclusion.
Step by step
- 1
Choose the right template
PRISMA 2020 provides flow diagram templates for new and for updated reviews, each in a version for searches of databases and registers only and a version that also includes other methods, such as citation searching or websites. Use the one that matches what you actually searched.
- 2
Identification: records found and removed
Report the number of records identified from each database and register (ideally per source), then the records removed before screening: duplicates, records marked as ineligible by automation tools, and records removed for other reasons.
- 3
Screening: records screened and excluded
Report how many records were screened by title and abstract and how many were excluded at that stage. The records screened should equal the records identified minus those removed before screening.
- 4
Retrieval and eligibility: reports
Report how many reports were sought for retrieval, how many could not be retrieved, how many were assessed for eligibility at full text, and how many were excluded, with the number excluded for each reason.
- 5
Included: studies and reports
Report the number of studies included in the review and the number of reports of those included studies. These can differ, because one study may be described in several reports.
- 6
Check that the arithmetic adds up
Each box should follow from the one before it. Reviewers and editors check the numbers, and a mismatch is one of the most common reasons for revision requests.
Records, reports and studies
PRISMA 2020 uses three distinct terms. A record is a title or abstract indexed in a database or register. A report is a document that supplies information about a study, such as a journal article, preprint, conference abstract or trial registry entry. A study is the investigation itself, which may have several reports. Using these words consistently is the easiest way to keep the diagram correct.
How Prolytiq does this step
Prolytiq keeps track of what happens to every record as it moves through import, deduplication, screening and full-text review, and builds the project's PRISMA flow from those decisions rather than from numbers typed in by hand. You can check the counts at each stage against your own records before exporting the diagram.
See the workflow →Frequently asked questions
What changed from PRISMA 2009 to PRISMA 2020?
Among other changes, the 2020 diagram separates records from reports and studies, adds boxes for records removed by automation tools and for reports not retrieved, and offers templates for updated reviews and for searches of other sources.
Do I have to give reasons for records excluded at title and abstract screening?
No. Reasons are required for reports excluded at the full-text eligibility stage.
Methodological sources
- Page MJ et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021
- Page MJ et al. PRISMA 2020 explanation and elaboration. BMJ 2021
- PRISMA 2020 flow diagram templates, published on the PRISMA statement website
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