Where can I get an editable PRISMA 2020 flow diagram template?

You can create and customize a PRISMA 2020 flow diagram directly in your browser using EvidenceFlow's free PRISMA 2020 Flow Diagram Generator, which exports high-resolution PNG, vector SVG, and PDF diagrams with no account required.

What is the difference between records, reports, and studies in PRISMA 2020?

A record is a bibliographic citation retrieved during your search (e.g., from PubMed). A report is the full-text publication or document retrieved for eligibility assessment. A study is the underlying investigation — one study may produce multiple reports (e.g., a protocol, an interim analysis, and a 5-year follow-up paper).

Can I use PowerPoint or Word to edit a PRISMA diagram?

Yes, many authors use Word or PowerPoint shape templates. However, manually adjusting box sizes and aligning arrows when counts change is time-consuming and error-prone. Browser generators that render the standard layout dynamically save hours of re-alignment.

Are reasons for exclusion required at the title and abstract stage?

No. PRISMA 2020 does not require specific reasons for exclusion during title and abstract screening. However, reporting specific, categorized exclusion reasons is strictly mandatory during full-text eligibility assessment.

PRISMA 2020 TEMPLATES

PRISMA 2020 Flow Diagram Word and PowerPoint Editable Templates

Creating a compliant PRISMA 2020 flow diagram shouldn't require wrestling with misaligned shape boxes in Microsoft Word or PowerPoint. This guide provides formatting rules, counting distinctions, and access to our free interactive PRISMA generator.

Published October 12, 2026

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1. The Four PRISMA 2020 Stages Explained

The updated PRISMA 2020 statement replaced the old 2009 flow diagram with a clearer structure distinguishing database searches from other retrieval methods (such as citation chasing and organization websites):

Stage	Left Box (Identification & Progress)	Right Box (Exclusions & Deduplication)
1. Identification	Records identified from databases, registers, and other sources (citation searching, websites).	Records removed before screening (duplicates, automation tools).
2. Screening	Records screened by title and abstract against eligibility criteria.	Records excluded at title/abstract (counts only; reasons optional).
3. Eligibility	Full-text reports sought for retrieval and reports assessed for eligibility.	Reports not retrieved, and reports excluded with specific cited reasons.
4. Included	Total studies and reports included in the qualitative synthesis and meta-analysis.	Distinguish total unique studies from total individual reports.

2. Records vs Reports vs Studies (The #1 Rejection Mistake)

Peer reviewers and journal editors frequently reject manuscripts because authors confuse records with studies:

Record: A bibliographic database citation (e.g., 2,500 records found across PubMed, Embase, and Cochrane).
Report: A full-text document (e.g., 85 PDF reports assessed for eligibility).
Study: An underlying clinical trial or investigation. If one trial produced 3 separate reports (a baseline paper, a biochemical follow-up, and a 10-year survival paper), it counts as 1 study across 3 reports.

3. How to Categorize Full-Text Exclusion Reasons

In the Eligibility box, PRISMA 2020 mandates listing explicit exclusion reasons with study counts. Common standardized categories include:

Wrong patient population (e.g., pediatric vs adult)
Ineligible intervention or comparator (e.g., uncontrolled dosage)
Ineligible study design (e.g., observational study instead of RCT)
No usable outcome data or endpoint missing

4. Why Automated Generators Beat Manual Office Templates

When you screen studies inside EvidenceFlow, every inclusion and exclusion decision updates your PRISMA numbers automatically. You never have to count rows in Excel or manually edit Word shapes before manuscript submission.

For one-off manuscripts, use our free browser utility: Free PRISMA 2020 Flow Diagram Generator.

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