What a PRISMA flow diagram is
A PRISMA flow diagram is the standardized figure in a systematic review or meta-analysis that shows how records moved through your selection process — how many were identified, screened, excluded and finally included, with reasons at the full-text stage. The PRISMA 2020 statement defines four phases and draws records from databases separately from registers and other sources.
Reference: the PRISMA 2020 statement and its official templates ↗
The four phases and what each box records
| Phase | What the boxes record |
|---|---|
| Identification | Records identified from databases (e.g. PubMed, Embase) and from registers or other methods, plus duplicates removed before screening. |
| Screening | Records screened by title and abstract, and records excluded at that pass. |
| Eligibility | Full-text reports sought and assessed, and reports excluded — each with a reason. |
| Included | Studies included in the review, and reports of included studies. |
When a review needs one
- Systematic reviews and meta-analyses in medicine and life sciences — expected under PRISMA 2020 and required by most journals that publish them.
- Scoping reviews, using the adapted flow under PRISMA-ScR.
- Thesis chapters and grant proposals documenting a literature search and selection process.
- Methods teaching where the selection workflow is demonstrated.
Whether your article type requires the diagram, and which template version applies, is decided by the reporting guideline and the journal — not by the tool that draws it.
How to build the diagram
- Collect your counts first: records per source, duplicates removed, records screened, screening exclusions, reports assessed, full-text exclusions with reasons, and included studies.
- Choose the matching PRISMA 2020 template — the standard version covers database-and-register searches; a variant exists for reviews that also searched other methods.
- Place each count in its phase box and list full-text exclusion reasons.
- Verify the arithmetic reads top to bottom, then export for the manuscript.
Before you submit
A generated diagram gives you the correct structure — not verified numbers. Recheck every count and exclusion reason against your screening records, confirm the template matches your review type, and inspect the exported file. Labels in whole-image SVG may be outlines rather than editable text, and PPTX availability and object editability depend on the document type. Generating the diagram does not certify journal compliance; the PRISMA 2020 checklist and the journal’s current author instructions remain the source of truth.
Frequently asked questions
Is a PRISMA flow diagram required for every review?
Systematic reviews and meta-analyses are expected to report one under the PRISMA 2020 statement, and most journals publishing them ask for it. Scoping reviews follow PRISMA-ScR, which uses an adapted flow. For narrative reviews it is usually optional — check the target journal’s author instructions.
What are the four PRISMA 2020 phases?
Identification (records found in databases, registers and other sources), screening (records remaining after deduplication, then title/abstract exclusions), eligibility (full-text reports assessed, with reasons for exclusion), and included (studies and reports in the final review).
Which numbers go into each box?
From your own screening records: records identified per source, duplicates removed, records screened, records excluded at screening, reports sought and assessed for eligibility, reports excluded with reasons, and studies included. The diagram reports your counts — it does not compute them.
Does a generated diagram guarantee PRISMA compliance?
No. A generator lays out the standard structure with your numbers in place. Whether the counts are accurate, the exclusion reasons complete, and the template version appropriate for your review type is for the authors to verify against the PRISMA 2020 checklist and journal instructions.
Can the labels and counts be edited after generation?
Labels in whole-image SVG may be outlines rather than editable text. PPTX availability and object editability depend on the document type. Inspect the exported file before relying on text or object editing — and re-verify every count in the final file.