Do I need a PRISMA flow diagram for my systematic review?

For almost every submission, yes. Leading journals including The Lancet, BMJ, and JAMA mandate a PRISMA flow diagram alongside the manuscript. Cochrane and the EQUATOR Network both endorse it as a reporting standard. Even where a specific journal stops short of a hard requirement, including the diagram signals methodological rigor and helps reviewers trace your selection decisions without ambiguity.

Which PRISMA 2020 template should I use for my review?

Select among the four available templates based on your situation. Template 1 suits a new review that searched only databases and registers. Template 2 fits a new review that also drew on grey literature, citation searching, or expert contacts. Templates 3 and 4 mirror those two scenarios but apply to reviews that update a prior systematic review. If you searched only PubMed and Scopus without any supplementary source, Template 1 is the right choice.

How do I handle duplicate records in a PRISMA flow diagram?

Duplicates are removed during the Identification phase, before screening begins. Report the full count of records across all sources, then record the number of duplicates your reference-management tool flagged and eliminated. The figure that proceeds to the Screening phase equals the total records minus those duplicates. If you used automated deduplication software, note the tool and settings in your methods section to allow replication.

Can I use a PRISMA flow diagram for a scoping review?

Yes, though the PRISMA-ScR extension is the appropriate choice rather than the standard PRISMA 2020 template. PRISMA-ScR follows a comparable overall structure but replaces strict eligibility criteria with a charting stage suited to the broader, mapping purpose of scoping reviews. The final count reflects sources charted rather than studies synthesized. Our generator supports both the standard systematic-review format and the PRISMA-ScR scoping-review format.

What exclusion reasons should I include in my PRISMA flow diagram?

At the full-text eligibility stage, apply specific, non-overlapping categories so that every rejected paper appears under exactly one reason. Typical categories include: inappropriate study design, ineligible population, intervention or exposure outside scope, wrong comparator, outcome not measured, setting not applicable, duplicate publication, full text unavailable, and language restriction. Apply criteria in a fixed hierarchical order, checking study design before population, for instance, so each exclusion is counted once and the total aligns with the numbers entering and exiting the eligibility box.

For Systematic Reviews & Meta-Analyses

PRISMA Flow Diagram Generator AI-Powered

Enter your study counts and our AI will generate a PRISMA 2020-compliant flow diagram ready for submission. Supports systematic reviews, meta-analyses, and scoping reviews.

✓PRISMA 2020 Compliant✓Multiple Database Sources✓Publication-Ready Quality✓Customizable Review Types

PRISMA Flow Diagram Examples

Browse examples for different review types or generate your own above

Standard PRISMA 2020 Flow Diagram

A complete PRISMA 2020 flow diagram walking through every required phase: database record identification, title-and-abstract screening, full-text eligibility assessment, and final study inclusion.

prisma-2020systematic-reviewstandard

PRISMA with Multiple Databases

PRISMA 2020 flow diagram that breaks out individual record counts from several academic databases, then merges them after duplicate removal.

multiple-databasesprisma-2020academic

PRISMA for Scoping Review

PRISMA extension for Scoping Reviews (PRISMA-ScR) flow diagram tailored to the broader, exploratory nature of scoping methodology with a dedicated data-charting stage.

scoping-reviewprisma-scrmethodology

PRISMA with Grey Literature Sources

Full two-column PRISMA 2020 layout that captures grey literature pathways alongside database records, covering organizational websites, reference-list checks, and expert referrals.

grey-literaturetwo-columncomprehensive

PRISMA for Meta-Analysis

PRISMA flow diagram designed for meta-analyses, clearly separating the qualitative synthesis count from the quantitative pooling count and flagging planned subgroup and sensitivity analyses.

meta-analysisquantitativesynthesis

Simplified PRISMA Template

A clean, stripped-back PRISMA template with placeholder n= values in each phase, useful as a starting point for student projects or early-stage review planning.

templatesimplifiedstudent-friendly

Prompt templates you can copy

Start with one of these examples, then adapt the subject, labels, data, or layout for your own use.

Standard PRISMA 2020 Flow Diagram

A complete PRISMA 2020 flow diagram walking through every required phase: database record identification, title-and-abstract screening, full-text eligibility assessment, and final study inclusion.

PRISMA 2020 flow diagram for systematic review, four phases: Identification showing records from databases n=2450 and duplicates removed n=380, Screening showing records screened n=2070 and records excluded n=1800, Eligibility showing full-text articles assessed n=270 and excluded with reasons n=235, Included showing studies in qualitative synthesis n=35 and quantitative synthesis n=28, clean flowchart with boxes and arrows, professional academic style, white background

PRISMA with Multiple Databases

PRISMA 2020 flow diagram that breaks out individual record counts from several academic databases, then merges them after duplicate removal.

PRISMA 2020 flow diagram with multiple database sources at the top: PubMed n=1200, Scopus n=890, Web of Science n=760, CINAHL n=340, total records n=3190, duplicates removed n=620, screening phase with records screened n=2570 excluded n=2100, eligibility with full-text assessed n=470 excluded n=412, included studies n=58, two-column layout with databases on left and other sources on right, professional academic flowchart, clean lines, white background

PRISMA for Scoping Review

PRISMA extension for Scoping Reviews (PRISMA-ScR) flow diagram tailored to the broader, exploratory nature of scoping methodology with a dedicated data-charting stage.

PRISMA-ScR flow diagram for scoping review, Identification phase showing database search n=4200 and grey literature n=180, Screening showing title/abstract screening n=3850 and excluded n=3200, Eligibility showing full-text review n=650 and excluded with reasons n=520, Charting showing data extraction from n=130 sources, final map of n=130 studies charted, flowchart style with rounded boxes and directional arrows, scoping review methodology, academic style, white background

PRISMA with Grey Literature Sources

Full two-column PRISMA 2020 layout that captures grey literature pathways alongside database records, covering organizational websites, reference-list checks, and expert referrals.

PRISMA 2020 flow diagram with two-column identification, left column: databases and registers with PubMed Scopus Embase n=2800, right column: other methods including websites n=45 citation searching n=120 expert consultation n=15, both columns merge at screening phase, records screened n=2640 excluded n=2200, full-text assessed n=440 excluded n=385, included n=55 studies, two-column PRISMA 2020 layout, professional flowchart, white background

What is a PRISMA Flow Diagram?

A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram is a standardized chart that maps the journey of records through the study selection process. It covers four stages: locating records in databases and other sources, screening by title and abstract, assessing full-text eligibility, and counting the studies ultimately included. Most peer-reviewed journals treating systematic reviews as submissions now require this diagram because it makes the selection process transparent and reproducible.

PRISMA 2020 vs PRISMA 2009: Key Differences

The PRISMA 2020 update reshaped the flow diagram in meaningful ways. A two-column layout now separates records retrieved from databases and registers from those gathered through other routes such as citation searching, grey literature, and expert contacts. Four distinct diagram templates replaced the single 2009 version, each matching a specific scenario: new reviews, updated reviews, database-only searches, and searches that incorporate additional sources. The accompanying checklist kept 27 items but gained new sub-items covering synthesis methods, risk-of-bias appraisal, certainty-of-evidence grading, and the role of automation in screening.

Components of a PRISMA Flow Diagram

Identification: Captures the total records found across all sources, including the count of duplicates removed before any screening takes place

Screening: Records how many titles and abstracts were reviewed and how many were excluded at that initial pass

Eligibility: Shows how many full-text papers were retrieved and formally assessed against pre-defined criteria, with specific reasons for each rejection

Included: States the final number of studies entering qualitative synthesis and, where applicable, quantitative pooling

Other Sources (PRISMA 2020): A parallel column that tracks records from non-database routes such as websites, reference-list searches, and expert suggestions

Exclusion Reasons: Itemized boxes at the eligibility stage that list precise reasons for rejection, for example wrong study design, wrong population, or wrong outcome

How to Create a PRISMA Flow Diagram

Begin by logging the number of records returned by each database you searched. Record how many duplicates your reference-management software identified and removed. Count records that moved through title-and-abstract screening, noting those set aside at that stage. Document the full-text articles you retrieved and track every rejection with a labelled reason. Finish by reporting the total studies entering qualitative synthesis and any subset entering quantitative pooling. Our generator handles the visual side: supply your counts and selection criteria, pick the template that suits your review type, and receive a ready-to-submit PRISMA 2020 diagram within seconds.

PRISMA in Different Types of Reviews

Systematic Reviews: The core PRISMA 2020 flow diagram with all four phases, required by journals such as The Lancet, BMJ, and Cochrane Reviews

Meta-Analyses: An extended diagram that distinguishes studies entering qualitative synthesis from those pooled in a quantitative forest-plot analysis

Scoping Reviews: PRISMA-ScR adapts the layout for broader, question-mapping reviews by substituting a charting stage for strict eligibility criteria

Rapid Reviews: A condensed flow diagram that reflects expedited screening procedures, often noting single-reviewer stages where applicable

Living Systematic Reviews: Diagrams refreshed on a rolling basis as newly identified evidence is assessed and incorporated

Network Meta-Analyses: The PRISMA-NMA extension adds reporting elements for indirect treatment comparisons and network structure

Common PRISMA Mistakes to Avoid

Using the older 2009 template when many journals now specifically require the 2020 version

Reporting a single combined record count rather than individual counts per database before deduplication

Conflating records, reports, and studies without defining what each term covers in your review

Omitting the second identification column when grey literature or citation searching contributed records

Listing vague exclusion reasons at the eligibility stage instead of the specific, mutually exclusive categories applied

Presenting inconsistent numbers that do not reconcile across successive phases of the diagram

Frequently asked questions

PRISMA 2020 replaced the single 2009 template with four variants covering new and updated reviews and different source combinations. The flow diagram gained a two-column layout so that database records and records from other methods are tracked separately before merging at screening. The checklist added sub-items addressing synthesis approaches, risk-of-bias assessment, certainty of evidence, and the use of automation in the review workflow. The majority of journals now expect PRISMA 2020 compliance in systematic review manuscripts.

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