You can build a PRISMA flow diagram by hand in Microsoft Word, PowerPoint, or Excel using their built-in shapes and connectors, and many researchers do because the software is already on their machine. The trade-off is that manual drawing is slow to edit: every time a screening count changes, you reposition boxes and retype numbers by hand. This guide shows how to construct the diagram in each Office application and where each one helps or hinders, then explains why exporting from our free PRISMA 2020 flow diagram generator often produces a cleaner figure in a fraction of the time. The boxes and the top-to-bottom logic are identical whichever route you take.
The reason this question comes up so often is familiarity. Word and PowerPoint are universal, so the instinct is to draw the figure there. That works, but it is worth knowing the limits before you invest an afternoon in dragging text boxes into alignment.
When Building It in Office Makes Sense
Manual construction in Office is reasonable when your counts are final, your review is small, and you want full control over every label and color. Because nothing recalculates, a hand-drawn figure is only practical once screening is genuinely complete; redrawing it after a reviewer asks you to add a database is tedious. If your numbers are still moving, a tool that regenerates the figure from a data entry form will save far more time, a trade-off our comparison of the best PRISMA flow diagram tools weighs across the main options.
Building the Diagram in PowerPoint
PowerPoint is the most comfortable Office application for this because its canvas is designed for shapes and connectors. The workflow is:
- Insert a rectangle for each PRISMA box and stack them vertically in the four phases.
- Use connector arrows that anchor to the shapes, so the arrows follow when you nudge a box.
- Add a second column of boxes to the right for the excluded counts at each stage.
- Type the labels and numbers directly, keeping records, reports, and studies in the correct boxes.
- Group everything and export the slide as an image or PDF for your manuscript.
PowerPoint's advantage is the connector behavior; its disadvantage is that alignment is fiddly and the output is only as sharp as your export settings.
Before you start dragging boxes, settle which of the four PRISMA 2020 layouts your review needs, because that decision dictates how many columns and stacked boxes you draw. A new review searching databases only has a simpler structure than an updated review that also used citation searching, so picking the correct four-phase template before you start drawing saves you from rebuilding the slide once you realise a column is missing.
Building the Diagram in Word
Word can produce the same figure but is less forgiving because text reflow fights with floating shapes. The cleanest approach is to insert a drawing canvas first, then place all boxes and arrows inside it so they move as a unit and do not jump when you edit surrounding text. SmartArt offers a process-flow layout that some authors adapt, though it rarely matches the exact PRISMA structure and usually needs manual boxes anyway. Build inside the canvas, keep the four phases stacked, and the figure will hold together.
Using Excel for the Counts, Not the Drawing
Excel is poorly suited to drawing the figure, but it is excellent for the step that comes before: tracking your screening counts. Use a worksheet to log records per database, duplicates removed, records screened and excluded, reports sought and assessed, and exclusions by reason, with formulas that subtract automatically so you can see at a glance whether the chain reconciles. Then transfer the final, verified numbers into whatever tool draws the figure. Keeping the arithmetic in Excel and the drawing elsewhere plays to each tool's strength, and it catches reconciliation errors before they reach the figure.
Why a Generator Usually Wins for the Final Figure
The fundamental limitation of every Office route is that the diagram does not know your numbers. You position and type everything manually, and you redo that work on every revision. A dedicated generator inverts this: you enter the counts in a form, the figure draws itself in the correct PRISMA 2020 structure, and editing a number redraws the diagram instantly. It also exports clean vector output suitable for journals, which a hand-aligned PowerPoint slide struggles to match. Our step-by-step guide to creating a PRISMA flow diagram covers the data-entry workflow, and the guide on export formats explains why an SVG or PDF from a generator stays sharp where a pasted Office image can blur.
Frequently Asked Questions
Can I make a PRISMA flow diagram in Word?
Yes. Insert a drawing canvas and place rectangles and connector arrows inside it, stacking the four PRISMA phases vertically with a side column for exclusions. Building inside a canvas keeps the shapes from shifting as you edit surrounding text, though the figure must be redrawn by hand whenever a count changes.
Is there a PRISMA flow diagram template for PowerPoint?
You can construct one with PowerPoint shapes and connectors, which handle arrows more gracefully than Word. The limitation is that nothing recalculates, so any change to your screening numbers means repositioning and retyping. A generator that draws the figure from entered counts avoids that manual rework.
Should I use Excel to make a PRISMA diagram?
Excel is not suited to drawing the figure, but it is ideal for tracking the counts beforehand. Use formulas to log records, duplicates, exclusions, and inclusions so the arithmetic reconciles automatically, then move the verified numbers into a drawing tool.
Is it better to draw the diagram by hand or use a generator?
Drawing by hand in Office gives full control but is slow to revise because nothing updates automatically. A generator is faster for any review whose numbers might change and produces cleaner vector output for journal submission. Many researchers track counts in Excel and generate the final figure with a dedicated tool.
How do I get a sharp PRISMA figure for journal submission?
Export a vector format such as SVG or PDF rather than pasting a screenshot. A generator produces vector output directly; an Office drawing should be exported at high resolution or saved as a PDF rather than copied as a low-resolution image.