Schematex
flowchart·PRISMA 2020 (Page et al., BMJ 2021)·healthcare, research, biotech·complexity 3/3

PRISMA 2020 systematic review flow

Canonical PRISMA 2020 flow diagram for a systematic review — records identified across databases, screened, assessed for eligibility, and included in synthesis.

For the systematic-review author or research librarian

Open in Playground →
flowchart·§ —
↘ preview
100%
Flowchart Flowchart with 18 nodes and 17 edges. "Identification" "Screening" "Eligibility" pubmed → dedup embase → dedup cochrane → dedup registers → dedup dedup → titles titles → excl_titles: excluded excluded titles → fulltext: kept kept fulltext → retrieved fulltext → not_retrieved: paywall / no response paywall / no response retrieved → assessed assessed → excl_reasons: excluded with reasons excluded with reasons excl_reasons → r1 excl_reasons → r2 excl_reasons → r3 excl_reasons → r4 assessed → included: met inclusion criteria met inclusion criteria included → meta PubMed (n = 482) PubMed (n = 482) Embase (n = 314) Embase (n = 314) Cochrane (n = 91) Cochrane (n = 91) Trial registers (n = 38) Trial registers (n = 38) After duplicates removed (n = 712) After duplicates removed (n = 712) Title and abstract screened (n = 712) Title and abstract screened (n = 712) Records excluded (n = 598) Records excluded (n = 598) Full-text sought (n = 114) Full-text sought (n = 114) Assessed for eligibility (n = 109) Assessed for eligibility (n = 109) Not retrieved (n = 5) Not retrieved (n = 5) Full-text articles assessed (n = 109) Full-text articles assessed (n = 109) Studies in qualitative synthesis (n = 49) Studies in qualitative synthesis (n = 49) Excluded with reasons (n = 60) Excluded with reasons (n = 60) Studies in meta-analysis (n = 31) Studies in meta-analysis (n = 31) Wrong population (n = 18) Wrong population (n = 18) Wrong intervention (n = 22) Wrong intervention (n = 22) Wrong outcome (n = 11) Wrong outcome (n = 11) Conference abstract only (n = 9) Conference abstract only (n = 9)
UTF-8 · LF · 50 lines · 1533 chars✓ parsed·11.5 ms·17.2 KB SVG

Scenario

A research librarian working with a clinical team produces the PRISMA 2020 flow diagram for an upcoming Cochrane review submission. The journal requires the diagram in this exact four-phase structure (Identification → Screening → Eligibility → Included), with the count (n = …) shown explicitly in every box and the excluded-with-reasons box itemizing rejection reasons. Authoring this in a DSL (rather than redrawing in Word or BioRender) means the counts can be regenerated as the screening team updates the search.

Annotation key

How to read

Top to bottom, the four phases mirror the PRISMA 2020 template exactly:

  1. Identification — every database and register the team searched, with raw record counts before deduplication.
  2. Screening — after deduplication, records pass through title/abstract screening (most are excluded here), then eligible records advance to full-text retrieval. Records lost at retrieval (paywall, no response from authors) are split into a separate "not retrieved" box per PRISMA 2020 reporting requirements.
  3. Eligibility — full-text articles are assessed against inclusion/exclusion criteria. Exclusions must be itemized with reasons — this is the box reviewers most often flag if missing.
  4. Included — final study count for the qualitative synthesis, with a sub-count for studies that contributed to the meta-analysis (not all included studies always do).

Standard reference

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. The flow-diagram template lives at prisma-statement.org/prisma-2020-flow-diagram.

Flowchart syntax →