PRISMA Flow Diagram Generator

A PRISMA flow diagram generator automates the creation of the standardized figure that every systematic review requires to document study selection transparency. The PRISMA 2020 statement, published by Page et al. (2021) in The BMJ, introduced significant updates to the original 2009 flow diagram, adding distinct pathways for records identified from databases and registers versus other sources such as citation searching, grey literature, and organizational websites. This PRISMA 2020 template ensures that review teams capture the full scope of their identification process, including records removed before screening (e.g., duplicates removed by automation tools) and records excluded with reasons at each stage. The Cochrane Handbook for Systematic Reviews of Interventions (Higgins et al., 2023) explicitly recommends using the updated PRISMA 2020 flow diagram format to improve reporting completeness and allow readers to assess the thoroughness of a review's literature search. Systematic review management platforms such as Covidence, Rayyan, and EPPI-Reviewer can auto-generate much of the PRISMA flow data from their screening logs, though manual verification remains essential to ensure accuracy. The identification box in PRISMA 2020 also accommodates citation screening and backward/forward snowballing as distinct record sources, reflecting the growing recognition that database searching alone may miss relevant studies.

At its core, the PRISMA flow diagram represents a series of semantic triples that trace the fate of every record. Records identified from databases enter the identification phase, where duplicate citations are removed, a step you can streamline using our reference deduplication tool. The remaining unique records proceed to the screening phase, where title-and-abstract screening eliminates clearly irrelevant citations. Records that survive screening advance to the eligibility phase, where full-text assessment applies the pre-specified inclusion and exclusion criteria. You can formalize these with our inclusion and exclusion criteria builder. Grey literature sources, including OpenGrey, ProQuest Dissertations & Theses, and trial registries such as ClinicalTrials.gov, should be captured in the identification counts under the "other sources" pathway to reflect the full scope of the search. Finally, the included studies box reports how many studies (and reports) contribute to the qualitative synthesis and, if applicable, the quantitative meta-analysis. Each box in the diagram contains a count, and each arrow represents a decision pathway, creating an auditable chain from identification to inclusion.

Using a systematic review flowchart maker offers several methodological advantages over manual diagram creation. First, it enforces the correct PRISMA 2020 structure, preventing common errors such as omitting the "other sources" pathway or failing to separate database-identified records from register-identified records. Second, real-time preview capabilities allow review teams to iterate quickly as they finalize their screening counts, which is especially valuable during the manuscript revision process when journals request updated figures. Third, high-resolution PNG export produces publication-ready figures that meet the resolution requirements of journals indexed in PubMed, Scopus, and Web of Science. The JBI Manual for Evidence Synthesis (Aromataris & Munn, 2020) notes that clear, accurate flow diagrams are a hallmark of methodological rigor in both systematic reviews and scoping reviews. For living systematic reviews that are updated on a rolling basis, the flow diagram should incorporate update cycles showing new records identified and screened in each iteration, maintaining a cumulative audit trail of the evolving evidence base. PRISMA-P (for protocols) also recommends a preliminary flow diagram at the protocol stage to anticipate the expected volume of records and plan screening resources accordingly.

For researchers conducting scoping reviews, the PRISMA extension for Scoping Reviews (PRISMA-ScR) by Tricco et al. (2018) uses a slightly modified flow diagram, and you can verify your compliance using our PRISMA-ScR checklist tool. Regardless of review type, the flow diagram should be completed after finalizing your search strategy. If you are still developing your search, our search strategy builder helps construct comprehensive Boolean queries for PubMed and other databases, while the PICO framework builder helps structure your research question before you begin searching. Together, these tools cover the full upstream workflow that feeds into the PRISMA flow diagram, from question formulation through search execution to transparent reporting of study selection.