Frequently Asked Questions About PRISMA Flow Diagrams

A PRISMA 2020 flow diagram is a standardized visual representation of the study selection process in a systematic review. It documents records identified, screened, assessed for eligibility, and included, following the PRISMA 2020 reporting guidelines by Page et al. (2021). The diagram provides a transparent audit trail of how studies were selected or excluded at each phase.

PRISMA 2020 updated the 2009 PRISMA statement with a revised 27-item checklist, new flow diagram templates that distinguish between databases/registers and other sources, and improved guidance. The 2020 version includes 4 template types (vs. 1 in 2009) and requires more granular reporting of exclusion reasons and record sources.

Choose based on two factors: (1) Is your review new or an update of a previous review? (2) Did you search only databases/registers, or also use other sources like citation searching, websites, or grey literature? This gives you one of 4 templates: new/databases only, new/databases+other, updated/databases only, or updated/databases+other.

Yes, completely free. You can create, customize, and preview your PRISMA flow diagram without any payment or mandatory signup. A free watermarked download is available instantly. Provide your email to download without the watermark.

Yes. The exported PNG is high-resolution (2x pixel ratio) and suitable for publication in peer-reviewed journals. The diagram follows the official PRISMA 2020 structure, which is the standard required by most journals for systematic review reporting.

The PRISMA 2020 flow diagram has three main phases: Identification (records found through searching), Screening (title/abstract review and retrieval), and Included (final studies meeting all criteria). Each phase shows the number of records processed and reasons for exclusion.

Exclusion reasons are reported at the eligibility phase (full-text assessment). List each reason with its count, such as "Wrong population (n = 45)" or "Wrong study design (n = 28)". Our tool provides dynamic fields to add as many exclusion reasons as needed.

In PRISMA 2020: "Records" are individual items returned by a search (e.g., a database entry). "Reports" are the full-text documents assessed. "Studies" are the research projects — one study may produce multiple reports. The flow diagram tracks all three separately.

Only if you searched beyond databases and registers. If you used citation searching, contacted organisations, searched websites, or used grey literature, select a template that includes "other sources." If you only searched databases like PubMed or Scopus, use the "databases only" template.

The AI Load Example button fills all form fields with realistic data from published systematic review scenarios. It helps you see how a completed PRISMA flow diagram looks and understand the expected data format before entering your own numbers.

Scoping reviews use PRISMA-ScR (PRISMA Extension for Scoping Reviews), which has a different flow diagram structure. Our tool is designed for standard systematic reviews using PRISMA 2020. However, the general structure is similar and can be adapted.

The official PRISMA 2020 checklist is published at prisma-statement.org. It contains 27 items covering title, abstract, introduction, methods, results, discussion, and other information. We also have a detailed guide explaining all 27 items.

Report three categories: duplicate records removed, records marked as ineligible by automation tools (if applicable), and records removed for other reasons. If you didn't use automation tools, enter 0 for that field.

Currently, you can download your PRISMA flow diagram as a high-resolution PNG image. PNG is the most widely accepted format for journal submissions and presentations.