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How to: Create a PRISMA Flow Chart

Aug 19, 2025

Overview

This lecture explains how to create a PRISMA flow diagram using both Word templates and an online Shiny app, highlighting the advantages of each approach for documenting study selection in meta-analyses.

What is a PRISMA Flow Diagram?

  • PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagrams document the process of identifying and selecting studies for systematic reviews.
  • The diagram tracks sources searched, records found, duplicates removed, exclusions, and final studies included.

Creating PRISMA Diagrams: Methods

  • The PRISMA website offers downloadable Word templates where you manually enter study numbers for each stage.
  • Word templates require manual editing, especially if you use multiple databases or need to customize entries.
  • The Shiny app for PRISMA diagrams, available via Evidence Synthesis Hackathon, provides a user-friendly, point-and-click interface to build diagrams.
  • The app allows customization, such as adding/removing registers, individual databases, or other search sources.

Steps in the Shiny App

  • Access the Shiny app from the PRISMA or Evidence Synthesis Hackathon website.
  • Remove sections not relevant to your field (e.g., registers, other search sources).
  • Add and name individual databases searched and input the number of studies found per database.
  • Enter the count of duplicates removed, records excluded, and reasons for exclusions.
  • The app updates the diagram in real time as you enter data.
  • Diagrams can be downloaded in multiple formats, such as PDF.

Tool Advantages

  • The Shiny app is free, versatile, and easier to use than manual Word templates.
  • You can include previous studies, registers, or other searches as needed for your review.

Key Terms & Definitions

  • PRISMA Flow Diagram — Visual summary of study selection and screening process in systematic reviews.
  • Shiny App — An online tool with a graphical interface for generating PRISMA diagrams automatically.

Action Items / Next Steps

  • Try creating a PRISMA flow diagram for your project using either the Word template or the Shiny app.
  • Cite the Shiny app if you use it to generate your diagram.