Nursing 561

The PRISMA Flow Chart is a process showing how you searched for and then filtered down your search results. This process is used when conducting a systematic review. Though this assignment is not as comprehensive or intense as a systematic review would be, it will give you the chance to use this process on a smaller scale. You will search for articles, and then document how you exclude articles from your final selection. The general process looks something like this:

1. Search for articles, and then remove any duplicates.
2. Looking at the articles titles and abstracts, exclude articles based on your screening criteria (you decide what this criteria is).
3. Retrieve the full text of your remaining records, and then review them using your exclusionary criteria again. 

For this particular assignment, we suggest using PRISMA 2009, as this is more simple and will be more applicable to a basic research assignment. You can download the template below.

So let's break down the flow chart, line by line.

 

For the Identification section, you will run your search using your search strategy (including any keywords, subject headings and synonyms)

BOX 1

• n = the number of records you found in your database search. 

BOX 2

• If you found articles not through a database search (i.e., you looked in a reference list, someone shared an article with you, etc.), you would document that here.

BOX 3

• Remove any duplicate records (if applicable). You can include a separate line (n = ) for each type of record. For example:
  • Database searching (n=29)
  • Other sources (n=1)
• If you are using a single database, there will not be duplicates. But if you are compiling a list from multiple databases or other sources, then you will need to review your list of articles and remove duplicates.
• Systematic review software generally does this for you, so you will need to find an alternative method such as exporting your results to an excel file, using Zotero to import your records and display / merge duplicates, or simply browsing the lists and removing any identifiable duplicates. For the purposes of this assignment, it is okay if you don't catch them all -- as you whittle down your list, you will have another opportunity to remove any duplicates you find.

 

For the Screening section, you will be digging further into the records to decide whether it is worth keeping. 

BOX 4

• This is the new total of records you are working with (add up the numbers in box 3).

BOX 5

• In the Records excluded step, you will now review the titles and abstracts of each citation and remove any articles from consideration that do not seem to fit your criteria, or any articles for which you cannot access the full text. 

 

For the Eligibility section, you will be finding and reviewing full-text articles

BOX 6

• Full text articles assessed for eligibility is your new total (records screened minus the records you excluded, or box 4 - box 5). This is your list of eligible studies, and you are looking at the full text for each of these articles.

BOX 7

• In this box, you will review the full text and utilize your exclusionary criteria to remove unwanted articles. Some examples of exclusionary criteria could include: studies that upon closer investigation are covering the wrong population, are outdated, not peer reviewed, are written in a foreign language, are not the correct study type or have a poor design, etc. These exclusionary factors are up to you to decide, and should be based on your specific research question. 
• In this section, you should describe why you chose to eliminate these articles, along with the number of articles excluded for this reason. You can choose the criteria for exclusion. Some examples might be:
  • Low level study type (n=5)
  • Not on topic (n=3)
  • Includes co-morbidities (n=2)
• This box will equal the number of articles that you remove from consideration.

 

The last section (Included) refers to the total number of articles you will be using.

BOX 8

• This box is the new number of articles you have chosen as eligible studies (Full text articles assessed minus Full text articles excluded). This is the final number of articles you have chosen to use for this assignment.