Note: PRISMA 2020 is now available. The Equator Network recommends using the new PRISMA 2020 checklist and flow diagram rather than the PRISMA 2009 resources.
Step 1: Preparation To complete the the PRISMA diagram print out a copy of the diagram to use alongside your searches. It can be downloaded from the PRISMA website. You will need to print a copy with totals from all the databases, but you may want to print out a copy for each database you search as well. If you are using this system for a more advanced assignment, ask your supervisor whether they would like you to follow this system, or to specify totals for each individual database in your final PRISMA diagram.
Step 2: Doing the database search For each database enter each key search term individually. This should include ALL your search terms, including MeSH or other subject headings, truncation [like hemipleg*], and/or wildcard [like sul?ur] search terms. Combine all the search terms in the different combinations using boolean operators like AND or OR as appropriate. Apply all your limits [such as years of search, English language only, and so on]. Once all search terms have been combined and you have applied all relevant limits, you should have a number of records or articles. Enter this in the top left box of the PRISMA flow chart for each database. If you have searched databases individually, add all the 'records identified' up and fill this total number in the PRISMA flow diagram which you will use for your coursework. Remember this process of adding up the number of records in individual database searches to a total will need to be repeatedat each stepif you search databases separately.
Step 3: Additional sources If you have identified articles through other sources than databases [like manual searches through reference lists of articles you have found or Search engines like Google Scholar], enter the total number of records in the box on the top right of the flow diagram.
Step 4: Remove all duplicates To avoid reviewing duplicate articles, you need to remove any articles that appear more than once. You will need to go through all the records or articles you have found in the database and manually remove any duplicates.This is not easy to do if you have a large number of articles at this point. In this case you may want to export the entire list of articles to a citation manager such as EndNote, Sciwheel, Mendeley, or Zotero [including both citation and abstract in your file] and remove the duplicates there. Enter the number of records left after you have removed the duplicate in the second box from the top.
Step 5: Screening articles The next step is to add in the number of articles that you have screened. This is the same number as you have entered in the duplicates removed box.
Step 6: Screening - Excluded articles You will now need to screen the titles and abstracts for articles which are relevant to your research question. Any articles that appear to help you provide an answer to your research question should be included. Record the number of articles excluded based on this screening process in the appropriate box [next to the total number of screened records] with a short reason for excluding these articles.
Step 7: Eligibility Subtract the number of excluded articles following the screening phase [step 6] from the total number of records screened [step 5] and enter this number in the box titled "Full-text articles assessed for eligibility". Get the full text for these articles to review for eligibility. You can request articles through Interlibrary Loan to ensure you get access to the most research.
Step 8: Eligibility - Records excluded Review all full-text articles for eligibility to be included in the final review. Take a note of the number of articles that you exclude at this point and enter this number in the correct box titled: Full text articles excluded, and then write in a short reason for excluding the articles [this may be the same reason used for the screening phase]. Examples include wrong setting, wrong patient population, wrong intervention, wrong dosage, etc.
Step 9: Included The final step is to subtract the number of excluded articles or records during the eligibility review of full-texts [step 8] from the total number of articles reviewed for eligibility [step 7]. Enter this number in the qualitative synthesis box. If you perform a meta-analysis, you would also list the number of studies in the quantitative synthesis box, You have now completed your PRISMA flow diagram which you can now include in the results section of your article or assignment.