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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

When you write a dissertation or thesis, you will have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list if you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can use boolean operators to help narrow down your search:

Read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models and methods? Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible, and make sure you read any landmark studies and major theories in your field of research.

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

You can use our free APA Reference Generator for quick, correct, consistent citations.

To begin organising your literature review’s argument and structure, you need to understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly-visual platforms like Instagram and Snapchat – this is a gap that you could address in your own research.

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarising sources in order.

Try to analyse patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organise your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text, your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, discussing the significance of findings in relation to the literature as a whole.
• Critically evaluate: mention the strengths and weaknesses of your sources.
• Write in well-structured paragraphs: use transitions and topic sentences to draw connections, comparisons and contrasts.

In the conclusion, you should summarise the key findings you have taken from the literature and emphasise their significance.

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a dissertation , thesis, research paper , or proposal .

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarise yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
• Last Updated: Sep 21, 2022 2:16 PM
• URL: https://guides.lib.uconn.edu/literaturereview

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

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Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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Literature review

How to write a literature review in 6 steps

How do you write a good literature review? This step-by-step guide on how to write an excellent literature review covers all aspects of planning and writing literature reviews for academic papers and theses.

How to write a systematic literature review [9 steps]

How do you write a systematic literature review? What types of systematic literature reviews exist and where do you use them? Learn everything you need to know about a systematic literature review in this guide

What is a literature review? [with examples]

Not sure what a literature review is? This guide covers the definition, purpose, and format of a literature review.

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Conducting a literature review: why do a literature review, why do a literature review.

• How To Find "The Literature"
• Found it -- Now What?

Besides the obvious reason for students -- because it is assigned! -- a literature review helps you explore the research that has come before you, to see how your research question has (or has not) already been addressed.

You identify:

• core research in the field
• experts in the subject area
• methodology you may want to use (or avoid)
• gaps in knowledge -- or where your research would fit in

It Also Helps You:

• Publish and share your findings
• Justify requests for grants and other funding
• Identify best practices to inform practice
• Set wider context for a program evaluation
• Compile information to support community organizing

Great brief overview, from NCSU

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• URL: https://guides.lib.berkeley.edu/litreview

• USC Libraries
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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
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• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
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• Primary Sources
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• Scholarly vs. Popular Publications
• Qualitative Methods
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• Using Non-Textual Elements
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• Common Grammar Mistakes
• Writing Concisely
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• Footnotes or Endnotes?
• Further Readings
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• Bibliography

A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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Literature Reviews

• What is a literature review?
• Steps in the Literature Review Process
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support

What is a Literature Review?

A literature or narrative review is a comprehensive review and analysis of the published literature on a specific topic or research question. The literature that is reviewed contains: books, articles, academic articles, conference proceedings, association papers, and dissertations. It contains the most pertinent studies and points to important past and current research and practices. It provides background and context, and shows how your research will contribute to the field. 

A literature review should: 

• Provide a comprehensive and updated review of the literature;
• Explain why this review has taken place;
• Articulate a position or hypothesis;
• Acknowledge and account for conflicting and corroborating points of view

From  S age Research Methods

Purpose of a Literature Review

A literature review can be written as an introduction to a study to:

• Demonstrate how a study fills a gap in research
• Compare a study with other research that's been done

Or it can be a separate work (a research article on its own) which:

• Organizes or describes a topic
• Describes variables within a particular issue/problem

Limitations of a Literature Review

Some of the limitations of a literature review are:

• It's a snapshot in time. Unlike other reviews, this one has beginning, a middle and an end. There may be future developments that could make your work less relevant.
• It may be too focused. Some niche studies may miss the bigger picture.
• It can be difficult to be comprehensive. There is no way to make sure all the literature on a topic was considered.
• It is easy to be biased if you stick to top tier journals. There may be other places where people are publishing exemplary research. Look to open access publications and conferences to reflect a more inclusive collection. Also, make sure to include opposing views (and not just supporting evidence).

Source: Grant, Maria J., and Andrew Booth. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal, vol. 26, no. 2, June 2009, pp. 91–108. Wiley Online Library, doi:10.1111/j.1471-1842.2009.00848.x.

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

Carolyn Cunningham : Human Development & Family Sciences, Psychology, Sociology

Larayne Dallas : Engineering

Janelle Hedstrom : Special Education, Curriculum & Instruction, Ed Leadership & Policy ​

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

For help in other subject areas, please see the guide to library specialists by subject .

Periodically, UT Libraries runs a workshop covering the basics and library support for literature reviews. While we try to offer these once per academic year, we find providing the recording to be helpful to community members who have missed the session. Following is the most recent recording of the workshop, Conducting a Literature Review. To view the recording, a UT login is required.

• October 26, 2022 recording
• Last Updated: Oct 26, 2022 2:49 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

Literature Reviews

What this handout is about.

This handout will explain what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.

Introduction

OK. You’ve got to write a literature review. You dust off a novel and a book of poetry, settle down in your chair, and get ready to issue a “thumbs up” or “thumbs down” as you leaf through the pages. “Literature review” done. Right?

Wrong! The “literature” of a literature review refers to any collection of materials on a topic, not necessarily the great literary texts of the world. “Literature” could be anything from a set of government pamphlets on British colonial methods in Africa to scholarly articles on the treatment of a torn ACL. And a review does not necessarily mean that your reader wants you to give your personal opinion on whether or not you liked these sources.

What is a literature review, then?

A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period.

A literature review can be just a simple summary of the sources, but it usually has an organizational pattern and combines both summary and synthesis. A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information. It might give a new interpretation of old material or combine new with old interpretations. Or it might trace the intellectual progression of the field, including major debates. And depending on the situation, the literature review may evaluate the sources and advise the reader on the most pertinent or relevant.

But how is a literature review different from an academic research paper?

The main focus of an academic research paper is to develop a new argument, and a research paper is likely to contain a literature review as one of its parts. In a research paper, you use the literature as a foundation and as support for a new insight that you contribute. The focus of a literature review, however, is to summarize and synthesize the arguments and ideas of others without adding new contributions.

Why do we write literature reviews?

Literature reviews provide you with a handy guide to a particular topic. If you have limited time to conduct research, literature reviews can give you an overview or act as a stepping stone. For professionals, they are useful reports that keep them up to date with what is current in the field. For scholars, the depth and breadth of the literature review emphasizes the credibility of the writer in his or her field. Literature reviews also provide a solid background for a research paper’s investigation. Comprehensive knowledge of the literature of the field is essential to most research papers.

Who writes these things, anyway?

Literature reviews are written occasionally in the humanities, but mostly in the sciences and social sciences; in experiment and lab reports, they constitute a section of the paper. Sometimes a literature review is written as a paper in itself.

Let’s get to it! What should I do before writing the literature review?

If your assignment is not very specific, seek clarification from your instructor:

• Roughly how many sources should you include?
• What types of sources (books, journal articles, websites)?
• Should you summarize, synthesize, or critique your sources by discussing a common theme or issue?
• Should you evaluate your sources?
• Should you provide subheadings and other background information, such as definitions and/or a history?

Find models

Look for other literature reviews in your area of interest or in the discipline and read them to get a sense of the types of themes you might want to look for in your own research or ways to organize your final review. You can simply put the word “review” in your search engine along with your other topic terms to find articles of this type on the Internet or in an electronic database. The bibliography or reference section of sources you’ve already read are also excellent entry points into your own research.

Narrow your topic

There are hundreds or even thousands of articles and books on most areas of study. The narrower your topic, the easier it will be to limit the number of sources you need to read in order to get a good survey of the material. Your instructor will probably not expect you to read everything that’s out there on the topic, but you’ll make your job easier if you first limit your scope.

Keep in mind that UNC Libraries have research guides and to databases relevant to many fields of study. You can reach out to the subject librarian for a consultation: https://library.unc.edu/support/consultations/ .

And don’t forget to tap into your professor’s (or other professors’) knowledge in the field. Ask your professor questions such as: “If you had to read only one book from the 90’s on topic X, what would it be?” Questions such as this help you to find and determine quickly the most seminal pieces in the field.

Consider whether your sources are current

Some disciplines require that you use information that is as current as possible. In the sciences, for instance, treatments for medical problems are constantly changing according to the latest studies. Information even two years old could be obsolete. However, if you are writing a review in the humanities, history, or social sciences, a survey of the history of the literature may be what is needed, because what is important is how perspectives have changed through the years or within a certain time period. Try sorting through some other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to consider what is currently of interest to scholars in this field and what is not.

Strategies for writing the literature review

Find a focus.

A literature review, like a term paper, is usually organized around ideas, not the sources themselves as an annotated bibliography would be organized. This means that you will not just simply list your sources and go into detail about each one of them, one at a time. No. As you read widely but selectively in your topic area, consider instead what themes or issues connect your sources together. Do they present one or different solutions? Is there an aspect of the field that is missing? How well do they present the material and do they portray it according to an appropriate theory? Do they reveal a trend in the field? A raging debate? Pick one of these themes to focus the organization of your review.

Convey it to your reader

A literature review may not have a traditional thesis statement (one that makes an argument), but you do need to tell readers what to expect. Try writing a simple statement that lets the reader know what is your main organizing principle. Here are a couple of examples:

The current trend in treatment for congestive heart failure combines surgery and medicine. More and more cultural studies scholars are accepting popular media as a subject worthy of academic consideration.

Consider organization

You’ve got a focus, and you’ve stated it clearly and directly. Now what is the most effective way of presenting the information? What are the most important topics, subtopics, etc., that your review needs to include? And in what order should you present them? Develop an organization for your review at both a global and local level:

First, cover the basic categories

Just like most academic papers, literature reviews also must contain at least three basic elements: an introduction or background information section; the body of the review containing the discussion of sources; and, finally, a conclusion and/or recommendations section to end the paper. The following provides a brief description of the content of each:

• Introduction: Gives a quick idea of the topic of the literature review, such as the central theme or organizational pattern.
• Body: Contains your discussion of sources and is organized either chronologically, thematically, or methodologically (see below for more information on each).
• Conclusions/Recommendations: Discuss what you have drawn from reviewing literature so far. Where might the discussion proceed?

Organizing the body

Once you have the basic categories in place, then you must consider how you will present the sources themselves within the body of your paper. Create an organizational method to focus this section even further.

To help you come up with an overall organizational framework for your review, consider the following scenario:

You’ve decided to focus your literature review on materials dealing with sperm whales. This is because you’ve just finished reading Moby Dick, and you wonder if that whale’s portrayal is really real. You start with some articles about the physiology of sperm whales in biology journals written in the 1980’s. But these articles refer to some British biological studies performed on whales in the early 18th century. So you check those out. Then you look up a book written in 1968 with information on how sperm whales have been portrayed in other forms of art, such as in Alaskan poetry, in French painting, or on whale bone, as the whale hunters in the late 19th century used to do. This makes you wonder about American whaling methods during the time portrayed in Moby Dick, so you find some academic articles published in the last five years on how accurately Herman Melville portrayed the whaling scene in his novel.

Now consider some typical ways of organizing the sources into a review:

• Chronological: If your review follows the chronological method, you could write about the materials above according to when they were published. For instance, first you would talk about the British biological studies of the 18th century, then about Moby Dick, published in 1851, then the book on sperm whales in other art (1968), and finally the biology articles (1980s) and the recent articles on American whaling of the 19th century. But there is relatively no continuity among subjects here. And notice that even though the sources on sperm whales in other art and on American whaling are written recently, they are about other subjects/objects that were created much earlier. Thus, the review loses its chronological focus.
• By publication: Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on biological studies of sperm whales if the progression revealed a change in dissection practices of the researchers who wrote and/or conducted the studies.
• By trend: A better way to organize the above sources chronologically is to examine the sources under another trend, such as the history of whaling. Then your review would have subsections according to eras within this period. For instance, the review might examine whaling from pre-1600-1699, 1700-1799, and 1800-1899. Under this method, you would combine the recent studies on American whaling in the 19th century with Moby Dick itself in the 1800-1899 category, even though the authors wrote a century apart.
• Thematic: Thematic reviews of literature are organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in a thematic review. For instance, the sperm whale review could focus on the development of the harpoon for whale hunting. While the study focuses on one topic, harpoon technology, it will still be organized chronologically. The only difference here between a “chronological” and a “thematic” approach is what is emphasized the most: the development of the harpoon or the harpoon technology.But more authentic thematic reviews tend to break away from chronological order. For instance, a thematic review of material on sperm whales might examine how they are portrayed as “evil” in cultural documents. The subsections might include how they are personified, how their proportions are exaggerated, and their behaviors misunderstood. A review organized in this manner would shift between time periods within each section according to the point made.
• Methodological: A methodological approach differs from the two above in that the focusing factor usually does not have to do with the content of the material. Instead, it focuses on the “methods” of the researcher or writer. For the sperm whale project, one methodological approach would be to look at cultural differences between the portrayal of whales in American, British, and French art work. Or the review might focus on the economic impact of whaling on a community. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed. Once you’ve decided on the organizational method for the body of the review, the sections you need to include in the paper should be easy to figure out. They should arise out of your organizational strategy. In other words, a chronological review would have subsections for each vital time period. A thematic review would have subtopics based upon factors that relate to the theme or issue.

Sometimes, though, you might need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. Put in only what is necessary. Here are a few other sections you might want to consider:

• Current Situation: Information necessary to understand the topic or focus of the literature review.
• History: The chronological progression of the field, the literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Methods and/or Standards: The criteria you used to select the sources in your literature review or the way in which you present your information. For instance, you might explain that your review includes only peer-reviewed articles and journals.

Questions for Further Research: What questions about the field has the review sparked? How will you further your research as a result of the review?

Begin composing

Once you’ve settled on a general pattern of organization, you’re ready to write each section. There are a few guidelines you should follow during the writing stage as well. Here is a sample paragraph from a literature review about sexism and language to illuminate the following discussion:

However, other studies have shown that even gender-neutral antecedents are more likely to produce masculine images than feminine ones (Gastil, 1990). Hamilton (1988) asked students to complete sentences that required them to fill in pronouns that agreed with gender-neutral antecedents such as “writer,” “pedestrian,” and “persons.” The students were asked to describe any image they had when writing the sentence. Hamilton found that people imagined 3.3 men to each woman in the masculine “generic” condition and 1.5 men per woman in the unbiased condition. Thus, while ambient sexism accounted for some of the masculine bias, sexist language amplified the effect. (Source: Erika Falk and Jordan Mills, “Why Sexist Language Affects Persuasion: The Role of Homophily, Intended Audience, and Offense,” Women and Language19:2).

Use evidence

In the example above, the writers refer to several other sources when making their point. A literature review in this sense is just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence to show that what you are saying is valid.

Be selective

Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the review’s focus, whether it is thematic, methodological, or chronological.

Use quotes sparingly

Falk and Mills do not use any direct quotes. That is because the survey nature of the literature review does not allow for in-depth discussion or detailed quotes from the text. Some short quotes here and there are okay, though, if you want to emphasize a point, or if what the author said just cannot be rewritten in your own words. Notice that Falk and Mills do quote certain terms that were coined by the author, not common knowledge, or taken directly from the study. But if you find yourself wanting to put in more quotes, check with your instructor.

Summarize and synthesize

Remember to summarize and synthesize your sources within each paragraph as well as throughout the review. The authors here recapitulate important features of Hamilton’s study, but then synthesize it by rephrasing the study’s significance and relating it to their own work.

Keep your own voice

While the literature review presents others’ ideas, your voice (the writer’s) should remain front and center. Notice that Falk and Mills weave references to other sources into their own text, but they still maintain their own voice by starting and ending the paragraph with their own ideas and their own words. The sources support what Falk and Mills are saying.

Use caution when paraphrasing

When paraphrasing a source that is not your own, be sure to represent the author’s information or opinions accurately and in your own words. In the preceding example, Falk and Mills either directly refer in the text to the author of their source, such as Hamilton, or they provide ample notation in the text when the ideas they are mentioning are not their own, for example, Gastil’s. For more information, please see our handout on plagiarism .

Revise, revise, revise

Draft in hand? Now you’re ready to revise. Spending a lot of time revising is a wise idea, because your main objective is to present the material, not the argument. So check over your review again to make sure it follows the assignment and/or your outline. Then, just as you would for most other academic forms of writing, rewrite or rework the language of your review so that you’ve presented your information in the most concise manner possible. Be sure to use terminology familiar to your audience; get rid of unnecessary jargon or slang. Finally, double check that you’ve documented your sources and formatted the review appropriately for your discipline. For tips on the revising and editing process, see our handout on revising drafts .

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Anson, Chris M., and Robert A. Schwegler. 2010. The Longman Handbook for Writers and Readers , 6th ed. New York: Longman.

Jones, Robert, Patrick Bizzaro, and Cynthia Selfe. 1997. The Harcourt Brace Guide to Writing in the Disciplines . New York: Harcourt Brace.

Lamb, Sandra E. 1998. How to Write It: A Complete Guide to Everything You’ll Ever Write . Berkeley: Ten Speed Press.

Rosen, Leonard J., and Laurence Behrens. 2003. The Allyn & Bacon Handbook , 5th ed. New York: Longman.

Troyka, Lynn Quittman, and Doug Hesse. 2016. Simon and Schuster Handbook for Writers , 11th ed. London: Pearson.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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Libraries | Research Guides

Literature reviews, what is a literature review, learning more about how to do a literature review.

• Planning the Review
• The Research Question
• Choosing Where to Search
• Organizing the Review
• Writing the Review

A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the literature you have read. 

• Sage Research Methods Core Collection This link opens in a new window SAGE Research Methods supports research at all levels by providing material to guide users through every step of the research process. SAGE Research Methods is the ultimate methods library with more than 1000 books, reference works, journal articles, and instructional videos by world-leading academics from across the social sciences, including the largest collection of qualitative methods books available online from any scholarly publisher. – Publisher

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What Is A Literature Review?

A plain-language explainer (with examples).

By:  Derek Jansen (MBA) & Kerryn Warren (PhD) | June 2020 (Updated May 2023)

If you’re faced with writing a dissertation or thesis, chances are you’ve encountered the term “literature review” . If you’re on this page, you’re probably not 100% what the literature review is all about. The good news is that you’ve come to the right place.

Literature Review 101

• What (exactly) is a literature review
• What’s the purpose of the literature review chapter
• How to find high-quality resources
• How to structure your literature review chapter
• Example of an actual literature review

What is a literature review?

The word “literature review” can refer to two related things that are part of the broader literature review process. The first is the task of  reviewing the literature  – i.e. sourcing and reading through the existing research relating to your research topic. The second is the  actual chapter  that you write up in your dissertation, thesis or research project. Let’s look at each of them:

Reviewing the literature

The first step of any literature review is to hunt down and  read through the existing research  that’s relevant to your research topic. To do this, you’ll use a combination of tools (we’ll discuss some of these later) to find journal articles, books, ebooks, research reports, dissertations, theses and any other credible sources of information that relate to your topic. You’ll then  summarise and catalogue these  for easy reference when you write up your literature review chapter. 

The literature review chapter

The second step of the literature review is to write the actual literature review chapter (this is usually the second chapter in a typical dissertation or thesis structure ). At the simplest level, the literature review chapter is an  overview of the key literature  that’s relevant to your research topic. This chapter should provide a smooth-flowing discussion of what research has already been done, what is known, what is unknown and what is contested in relation to your research topic. So, you can think of it as an  integrated review of the state of knowledge  around your research topic. 

What’s the purpose of a literature review?

The literature review chapter has a few important functions within your dissertation, thesis or research project. Let’s take a look at these:

Purpose #1 – Demonstrate your topic knowledge

The first function of the literature review chapter is, quite simply, to show the reader (or marker) that you  know what you’re talking about . In other words, a good literature review chapter demonstrates that you’ve read the relevant existing research and understand what’s going on – who’s said what, what’s agreed upon, disagreed upon and so on. This needs to be  more than just a summary  of who said what – it needs to integrate the existing research to  show how it all fits together  and what’s missing (which leads us to purpose #2, next). 

Purpose #2 – Reveal the research gap that you’ll fill

The second function of the literature review chapter is to  show what’s currently missing  from the existing research, to lay the foundation for your own research topic. In other words, your literature review chapter needs to show that there are currently “missing pieces” in terms of the bigger puzzle, and that  your study will fill one of those research gaps . By doing this, you are showing that your research topic is original and will help contribute to the body of knowledge. In other words, the literature review helps justify your research topic.  

Purpose #3 – Lay the foundation for your conceptual framework

The third function of the literature review is to form the  basis for a conceptual framework . Not every research topic will necessarily have a conceptual framework, but if your topic does require one, it needs to be rooted in your literature review. 

For example, let’s say your research aims to identify the drivers of a certain outcome – the factors which contribute to burnout in office workers. In this case, you’d likely develop a conceptual framework which details the potential factors (e.g. long hours, excessive stress, etc), as well as the outcome (burnout). Those factors would need to emerge from the literature review chapter – they can’t just come from your gut! 

So, in this case, the literature review chapter would uncover each of the potential factors (based on previous studies about burnout), which would then be modelled into a framework. 

Purpose #4 – To inform your methodology

The fourth function of the literature review is to  inform the choice of methodology  for your own research. As we’ve  discussed on the Grad Coach blog , your choice of methodology will be heavily influenced by your research aims, objectives and questions . Given that you’ll be reviewing studies covering a topic close to yours, it makes sense that you could learn a lot from their (well-considered) methodologies.

So, when you’re reviewing the literature, you’ll need to  pay close attention to the research design , methodology and methods used in similar studies, and use these to inform your methodology. Quite often, you’ll be able to  “borrow” from previous studies . This is especially true for quantitative studies , as you can use previously tried and tested measures and scales. 

How do I find articles for my literature review?

Finding quality journal articles is essential to crafting a rock-solid literature review. As you probably already know, not all research is created equally, and so you need to make sure that your literature review is  built on credible research . 

We could write an entire post on how to find quality literature (actually, we have ), but a good starting point is Google Scholar . Google Scholar is essentially the academic equivalent of Google, using Google’s powerful search capabilities to find relevant journal articles and reports. It certainly doesn’t cover every possible resource, but it’s a very useful way to get started on your literature review journey, as it will very quickly give you a good indication of what the  most popular pieces of research  are in your field.

One downside of Google Scholar is that it’s merely a search engine – that is, it lists the articles, but oftentimes  it doesn’t host the articles . So you’ll often hit a paywall when clicking through to journal websites. 

Thankfully, your university should provide you with access to their library, so you can find the article titles using Google Scholar and then search for them by name in your university’s online library. Your university may also provide you with access to  ResearchGate , which is another great source for existing research. 

Remember, the correct search keywords will be super important to get the right information from the start. So, pay close attention to the keywords used in the journal articles you read and use those keywords to search for more articles. If you can’t find a spoon in the kitchen, you haven’t looked in the right drawer. 

Need a helping hand?

How should I structure my literature review?

Unfortunately, there’s no generic universal answer for this one. The structure of your literature review will depend largely on your topic area and your research aims and objectives.

You could potentially structure your literature review chapter according to theme, group, variables , chronologically or per concepts in your field of research. We explain the main approaches to structuring your literature review here . You can also download a copy of our free literature review template to help you establish an initial structure.

In general, it’s also a good idea to start wide (i.e. the big-picture-level) and then narrow down, ending your literature review close to your research questions . However, there’s no universal one “right way” to structure your literature review. The most important thing is not to discuss your sources one after the other like a list – as we touched on earlier, your literature review needs to synthesise the research , not summarise it .

Ultimately, you need to craft your literature review so that it conveys the most important information effectively – it needs to tell a logical story in a digestible way. It’s no use starting off with highly technical terms and then only explaining what these terms mean later. Always assume your reader is not a subject matter expert and hold their hand through a journe y of the literature while keeping the functions of the literature review chapter (which we discussed earlier) front of mind.

Example of a literature review

In the video below, we walk you through a high-quality literature review from a dissertation that earned full distinction. This will give you a clearer view of what a strong literature review looks like in practice and hopefully provide some inspiration for your own. 

Wrapping Up

In this post, we’ve (hopefully) answered the question, “ what is a literature review? “. We’ve also considered the purpose and functions of the literature review, as well as how to find literature and how to structure the literature review chapter. If you’re keen to learn more, check out the literature review section of the Grad Coach blog , as well as our detailed video post covering how to write a literature review . 

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

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16 Comments

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 
• How to write a good literature review 
• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

• Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 
• Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 
• Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 
• Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 
• Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 
• Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

How to write a good literature review

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. 

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.

Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).

Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).

The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).

When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.

The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.

9.2. Overview of the Literature Review Process and Steps

As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:

• formulating the research question(s) and objective(s),
• searching the extant literature,
• screening for inclusion,
• assessing the quality of primary studies,
• extracting data, and
• analyzing data.

Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).

Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).

9.3. Types of Review Articles and Brief Illustrations

EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.

9.3.1. Narrative Reviews

The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).

Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).

Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.

Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.

9.3.2. Descriptive or Mapping Reviews

The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).

In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.

An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).

9.3.3. Scoping Reviews

Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.

Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).

One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).

9.3.4. Forms of Aggregative Reviews

Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.

Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:

• Formulating a review question and developing a search strategy based on explicit inclusion criteria for the identification of eligible studies (usually described in the context of a detailed review protocol).
• Searching for eligible studies using multiple databases and information sources, including grey literature sources, without any language restrictions.
• Selecting studies, extracting data, and assessing risk of bias in a duplicate manner using two independent reviewers to avoid random or systematic errors in the process.
• Analyzing data using quantitative or qualitative methods.
• Presenting results in summary of findings tables.
• Interpreting results and drawing conclusions.

Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.

The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed inde­­pen­dently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.

Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.

A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guide­lines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.

In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).

9.3.5. Realist Reviews

Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).

To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).

The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.

9.3.6. Critical Reviews

Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).

Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.

9.4. Summary

Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.

Typology of Literature Reviews (adapted from Paré et al., 2015).

As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.

9.5. Concluding Remarks

In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.

We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.

To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.

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• Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
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Special Education Teacher Training to Address Challenging Behaviors for Students with ASD in the Classroom Setting: A Systematic Review of the Literature

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• Chelsea Marelle   ORCID: orcid.org/0000-0002-7988-3824 1 ,
• Emily Tanner 2 &
• Claire Donehower Paul 2  

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As the number of children diagnosed with autism spectrum disorder (ASD) increases, the need for well trained teachers who can implement behavior interventions also increases. The current study examines the available research to determine which methods of training are most effective in increasing teacher fidelity to implement behavior interventions. The method of training and the teacher fidelity post training were examined. Electronic database searches of Education Resources Information Center (ERIC), APA PyschINFO, and hand searches were conducted. Results revealed varying training methods and combinations of those methods can be deemed effective in increasing teacher fidelity. A system was created and implemented to categorize the results of teacher fidelity for each study. Directions for future research and practice are discussed.

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Marelle, C., Tanner, E. & Paul, C.D. Special Education Teacher Training to Address Challenging Behaviors for Students with ASD in the Classroom Setting: A Systematic Review of the Literature. Rev J Autism Dev Disord (2023). https://doi.org/10.1007/s40489-023-00404-3

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• Volume 10, Issue 1
• Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review
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• http://orcid.org/0000-0001-9784-416X Rikisha Shah Gupta 1 , 2 ,
• Ardita Koteci 3 , 4 ,
• Ann Morgan 3 , 4 ,
• Peter M George 5 and
• Jennifer K Quint 1 , 3
• 1 National Heart and Lung Institute , Imperial College London , London , UK
• 2 Real-World Evidence , Gilead Sciences , Foster City , CA , USA
• 3 Imperial College London , London , UK
• 4 NIHR Imperial Biomedical Research Centre , London , UK
• 5 Royal Brompton and Harefield NHS Foundation Trust , London , UK
• Correspondence to Rikisha Shah Gupta; r.shah20{at}imperial.ac.uk

Interstitial lung disease (ILD) is a collective term representing a diverse group of pulmonary fibrotic and inflammatory conditions. Due to the diversity of ILD conditions, paucity of guidance and updates to diagnostic criteria over time, it has been challenging to precisely determine ILD incidence and prevalence. This systematic review provides a synthesis of published data at a global level and highlights gaps in the current knowledge base. Medline and Embase databases were searched systematically for studies reporting incidence and prevalence of various ILDs. Randomised controlled trials, case reports and conference abstracts were excluded. 80 studies were included, the most described subgroup was autoimmune-related ILD, and the most studied conditions were rheumatoid arthritis (RA)-associated ILD, systemic sclerosis associated (SSc) ILD and idiopathic pulmonary fibrosis (IPF). The prevalence of IPF was mostly established using healthcare datasets, whereas the prevalence of autoimmune ILD tended to be reported in smaller autoimmune cohorts. The prevalence of IPF ranged from 7 to 1650 per 100 000 persons. Prevalence of SSc ILD and RA ILD ranged from 26.1% to 88.1% and 0.6% to 63.7%, respectively. Significant heterogeneity was observed in the reported incidence of various ILD subtypes. This review demonstrates the challenges in establishing trends over time across regions and highlights a need to standardise ILD diagnostic criteria.PROSPERO registration number: CRD42020203035.

• Asbestos Induced Lung Disease
• Clinical Epidemiology
• Interstitial Fibrosis
• Systemic disease and lungs

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Introduction

Interstitial lung disease (ILD) is a collective term representing a diverse group of lung conditions characterised by the presence of non-infective infiltrates, most commonly in the pulmonary interstitium and alveoli, which in certain cases manifest as architectural distortion and irreversible fibrosis. These conditions vary in their aetiology, clinical pathways, severity and prognosis. 1 Some conditions resolve completely without pharmacological intervention, whereas others, such as idiopathic pulmonary fibrosis (IPF) and non-IPF progressive fibrosing (PF) ILDs, inexorably progress to respiratory failure and premature mortality despite treatment.

Given its universally progressive nature and poor prognosis, IPF has attracted the most research attention and the current literature suggests a wide variation in disease distribution across Europe and USA. IPF prevalence varies between 0.63 and 7.6 per 100 000 persons in the USA and Europe 2 3 with a sharp increase with age.

More recently, there have been several studies investigating the incidence and prevalence of non-IPF ILDs, mainly autoimmune ILDs. Most of these reviews included studies drawn from single centres. Epidemiological data for non-IPF ILDs is inconsistent which makes it challenging to fully appreciate the ILD landscape. A recent review reported the prevalence of ILD in myositis conditions ranged from 23% in America to 50% in Asia. 4 Sambataro et al 5 reported about 20% of primary Sjogren’s syndrome patients were diagnosed with ILD. Additionally, there have been a few studies evaluating the incidence of drug induced ILD (DILD). 6–8 Guo et al 9 reported ILD incidence ranged from 4.6 to 31.5 per 100 000 persons in Europe and North America. A recent study using Global Burden of Disease data indicated the global ILD incidence in the past 10 years has risen by 51% (313.2 cases in 1990 to 207.2 per 1 00 000 cases in 2019). 10 These published estimates highlight a discernible variation in the ILD epidemiology across countries. It is unclear whether this is an ‘actual’ difference in the numbers across regions or whether the heterogeneity is driven by lack of guidelines and inconsistencies in ILD diagnostic pathways and standards of care. Likewise, while evidence suggests that the incidence of ILD has been rising over time, 9 whether this increase reflects a true increase in the disease burden, possibly related to an ageing population or whether this is due to improvements in detection, increased availability of cross-sectional imaging or coding practices over time is unknown.

This systematic review appraises the published literature on the incidence and prevalence of various ILDs over the last 6 years. We aimed to provide a comprehensive understanding of global incidence and prevalence. Specifically, we sought to identify areas where data are robust, to better appreciate the burden of ILD conditions and to comprehend the implications on healthcare utilisation and resources. We also set out to highlight areas where there remains a need for further study.

Study registration

This protocol has been drafted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines 11 and registered with the International Prospective Register of Systematic Reviews, PROSPERO ( CRD42020203035 ). Please refer to the online supplemental material for the full study protocol.

Supplemental material

Search strategy and selection criteria.

A systematic search of Medline and Embase was carried out in September 2021 to identify relevant studies investigating the incidence and prevalence of various ILDs. The search criteria were developed with support of librarian ( online supplemental figure E1 ). Due to the high volume of papers, we restricted this study period to papers published in the past 6 years. This search was limited to human studies written in English that were published between 2015 and 2021. The full search strategy and data sources included are described in online supplemental material .

Study population

Inclusion criteria included observational studies reporting the incidence and/or prevalence of individual ILDs, with study participants aged over 18 years old. Randomised controlled trials, case reports, reviews and conference abstracts were excluded. Studies which referred to DILD only were excluded because (1) there were many abstracts reporting on DILD, therefore this could be a standalone review and (2) epidemiology of DILD was a subject of a recent systematic review. 12 The first author (RG) screened all records by title and abstract; to begin with, the second reviewer (AK) independently screened 10% of all records. If there was a disagreement between RG and AK, an additional 15% were screened by AK. All studies identified as eligible for full text review were reviewed by RG, with AK reviewing 50% of eligible studies. Any disagreement was resolved through discussion with other authors, including an ILD expert. Reference of included studies were searched for additional literature.

Following full text review, RG carried out data extraction for eligible studies. AK independently extracted data for 25% of studies using the same template. RG assessed the quality for all included studies, reporting incidence and/or prevalence using a modified Newcastle Ottawa Scale (NOS). There were two NOS modified scales, one each for studies reporting prevalence and/incidence. AK independently assessed the quality of 25% of included studies. If there was a discrepancy between the data extraction and/or quality assessment conducted by RG and AK, then additional 15% were extracted and/or reviewed by AK.

It was noted that for IPF, many authors adopted what they termed ‘broad’ and ‘narrow’ case definitions. For example, Raghu et al 2 defined patients with International Classification of Disease, Ninth Revision (ICD-9) code 516.3 as a broadly defined case of IPF, and those who had this ICD-9 code alongside a claim for a surgical lung biopsy, transbronchial lung biopsy, or CT thorax as a narrowly defined case. We summarised the data using various reported case definitions. If multiple estimates were reported in a study, only the most recent estimate was included in this review.

There were two common themes around the reporting of prevalence. Studies drawn from the general population (reported prevalence per 100 000 persons) and studies drawn from multicentre or single centres (reported prevalence as the proportion of patients with ILD in the study cohort).

For this review, we have classified ILDs based on aetiology, grouped by conditions linked to environmental or occupational exposures, conditions typified by granulomatous inflammation, autoimmune ILDs and ILDs with no known cause ( online supplemental figure E2 ). 1

Evidence synthesis

The initial plan for this review was to conduct meta-analysis. However, due to high heterogeneity, we were unable to meta-analyse. Therefore, we have proceeded with data synthesis across the ILD subgroups.

Total number of included studies

The literature search yielded a total of 12 924 studies, of which 80 were included in this review. Online supplemental figure E3 demonstrates the selection process for all studies and highlights reasons for exclusion at each stage.

Although 80 unique publications were included, some papers explored the epidemiology of more than one ILD, the total count of reported estimates is 88. Half of the included publications explored autoimmune-related ILDs (n=44/88)( online supplemental figure E4 ).

Geographically, ILD publications represented all major world regions, but were predominantly from Asia (n=30, 34.1%) and Europe (n=23, 26.1%) ( figure 1 ).

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Geographical distribution of publications included.

Studies reporting prevalence

Eight studies reported the prevalence of IPF in general population. Prevalence of IPF was commonly reported applying ‘primary’, ‘broad’, ‘intermediate’ and/or ‘narrow’ case definitions. In the general population, the prevalence of IPF ranged from 7 to 1650 per 100 000 persons ( table 1 ). When explored within various case definitions, the prevalence for ‘broad’ cases ranged from 11 (USA, 2010) 2 to 1160 (USA, 2021) 16 ; for ‘narrow’ cases, this ranged from 7 (USA, 2010) 2 to 725 (USA, 2019). 16 There was only one study that reported IPF prevalence of 8.6% using a multicentre study setting. 19

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Studies reporting IPF prevalence per 100 000 persons by various case definitions

Twelve studies reported estimates for non-IPF ILDs in the general population ( online supplemental figure E5 ), with most of these conducted in the USA. The prevalence of systemic sclerosis (SSc) ILD in the general population ranged from 2.3 (Canada, 2018) 20 to 19 (USA, 2017) 21 per 100 000 persons. The highest SSc-ILD prevalence was reported in Medicare data which included patients aged 65 years and above. 21 22 For rheumatoid arthritis (RA) ILD, prevalence in an RA Medicare cohort was 2%. 23

Forty-six studies reported the prevalence of autoimmune-related ILD in cohorts of patients with an autoimmune condition or occupational ILD in workers with specific exposures. These studies primarily reported prevalence as a proportion, with the denominator representing patients with an autoimmune disorder or people working at a factory with exposure to certain agents, such as silica or asbestosis ( figure 2 ). Most of these estimates were drawn from cohorts at single or multiple tertiary centres, disease registries or a factory in the case of occupational ILD. Significant heterogeneity was noted in the reported prevalence of ILD associated with SSc, RA and Sjogren’s ( figure 2 ). The prevalence of ILD in SSc ranged from 26.1% (Australia, 2015) 36 to 88.1% (India, 2013). 44 Similarly, Sjogren’s ILD ranged from 1% (Sweden, 2011) 55 to 87.8% (Saudi Arabia, 2021). 56 In addition to dissimilarities in the prevalence across various regions, we also observed variation within region-specific estimates. For example, the 4 studies 47 50–52 which reported Sjogren’s ILD prevalence within China, estimated a 4-fold variation in magnitude (18.6% in 2011 47 to 78.6% in 2014). 52 Likewise, for RA ILD, there was substantial variation in the reported prevalence in Egypt (0.8% vs 63.7%). 31 32 Among the occupational-related ILDs ( figure 2 ), silicosis was the most explored condition (n=8)). Among these eight studies, there was a considerable variation in the reported prevalence of silicosis. Souza et al 61 reported an approximately 7-fold higher estimate of silicosis prevalence than that reported by Siribaddana et al (37% vs 5.6%, respectively). 65

Studies reporting non-IPF prevalence as percentage of study population. DM, dermatomyositis; HP, hypersensitivity pneumonitis; IIP, idiopathic interstitial pneumonia; ILD, interstitial lung disease; LAM, lymphangioleiomyomatosis; MCTD, mixed connective tissue disorder; multiC, multicentre; PLCH, pulmonary langerhans cell histiocytosis; PM, polymyositis; RA, rheumatoid arthritis; reg, registry; single, single centre; SSc, systemic sclerosis. Details on the study population, sample size and ILD diagnosis methods are summarised in online supplemental tables E1–E31 .

Studies reporting incidence

Significant discrepancies were observed in reported ILD incidence across subgroups and individual conditions, mainly due to differences in the study setting. Depending on the study setting and type of data source used, some authors reported an incidence rate (per 100 000 person-years), while others reported incidence proportion. Table 2 lists IPF incidence by case classification and country, and figure 3 provides a list of studies reporting incidence of non-IPF ILDs.

Published estimates of IPF incidence, stratified by various case definitions

Studies reporting ILD incidence, grouped by ILD subgroups. ICD-9-CM, International Classification of Disease, Ninth Revision, Clinical Modification; ILD, interstitial lung disease; py, person-years; RA, rheumatoid arthritis; SSc, systemic sclerosis. Ɨ Narrow silicosis definition used: Medicare beneficiaries with any claim that included ICD-9-CM code 502, pneumoconiosis due to other silica or silicates, listed in any position during 1999–2014, with at least one inpatient, skilled nursing or home health agency claim, or at least two outpatient provider claims within 365 days of each other and cases with a chest X-ray or CT scan 30 days before or 30 days after a silicosis claim. Details on the study population, sample size and ILD diagnosis methods are summarised in online supplemental tables E1–E31 .

In this review, we synthesised the evidence for the incidence and prevalence of ILDs from studies published between 2015 and 2021. Considering the changing ILD nomenclature and the desire to reflect more current estimates, in this review, we decided to restrict the study period to past 6 years. We took this conscious effort with the aim to limit the heterogeneity across reported estimates. We evaluated 39 incidence and 78 prevalence estimates for individual ILD disorders that were distributed globally. We noted an increase in the number of studies investigating non-IPF ILDs and more specifically autoimmune ILDs in recent years. There was a 6-fold rise in the autoimmune ILDs studies, in 2021 when compared with 2015 (18 vs 3 studies, respectively). This increase in non-IPF ILD studies may be related to the emergence of antifibrotic therapies for non-IPF fibrosing lung diseases. 91–93 Interestingly, the publication trend for IPF has remained unchanged.

This review revealed considerable inconsistencies in the incidence and prevalence estimated of the main ILD subgroups. The reported prevalence of IPF ranged from 7 to 1650 per 100 000 persons, 2 16 an approximately 800-fold difference across case definitions, despite most studies reporting IPF prevalence in the general population. The incidence and prevalence estimates reported by Zhang et al 16 were a notable outlier; this study was based on the USA veterans’ healthcare database which included mostly White patients aged over 70 years—the demographic in which IPF is most common. Aside from this study, the majority of studies reported a prevalence of IPF ranging from 7 to 42 per 100 000 persons across different case definitions. 2 17

Unlike prevalence, we found considerable inconsistencies in how the incidence of IPF is reported. An important factor is the lack of uniformity in reporting units. Half of the studies reported incidence using person-years, whereas others reported per 100 000 person-years. We were, therefore, unable to compare incidence estimates in a similar fashion to prevalence. It is also important to note that changes in diagnostic guidelines for IPF over the years may have made it more challenging to accurately estimate its burden and temporal trends. 94–96

For non-IPF subgroups, such as autoimmune ILDs, there were wide variations in prevalence estimates between countries and within different healthcare settings in the same country. Overall, the variation in prevalence and incidence estimates was even greater for non-IPF ILDs than IPF. This can be attributed to several factors. First, in clinical practice, it is common for the clinical presentation and serological autoantibody profiles to result in overlap syndromes. Autoimmune conditions can coexist and patients with occupational ILDs may also have autoimmune conditions. Such fluidity of diagnoses at a clinical level reflects the challenges in estimating non-IPF ILDs. Second, the denominator more frequently differs for non-IPF ILDs, resulting in lack of standardised reporting. Unlike IPF, for which there are published validated algorithms to identify ‘true’ cases in the general population. 18 24 97 For non-IPF ILDs, studies relied on disease registries or were conducted at single/multispecialist clinics.

Majority of the autoimmune-related ILD estimates were in RA and SSc ILD. When assessing SSc ILD prevalence, we observed a wide range (26.1% to 88.1%) 37 44 in reported estimates, but when studies were dichotomised into single-centre studies and multicentre studies, it became clear that the highest variability was contributed by single centre studies (SSc prevalence, 31.2%–88.1%). 43–46 Owing to a smaller number of studies reporting incidence, we were unable to observe whether the same challenge existed.

The prevalence of silicosis ranged from 5.6% 65 to 37% 61 in workers exposed to silica. Occupational ILD studies were conducted at a factory, in a neighbourhood with proximity to industries, a registry or multicentre settings. Therefore, lack of generalisability and applicability of findings only to certain populations contributed largely to the wide variabilities of these reported estimates. The geographical distribution of occupational ILD papers alludes to dominance of exposure related ILDs in low-income and middle-income countries in Asia and South America (42.8% were in Asia).

While historical diagnostic classification has been founded on underlying aetiology or clinical pathways, there is now a growing emphasis on disease behaviour. 98 99 Attention has focused on a subgroup of ILD patients who go on to develop a PF phenotype. IPF is the archetypal PF ILD but other ILDs such as chronic hypersensitivity pneumonitis (HP), SSc ILD can exhibit ‘IPF-like’ behaviour, including rapid decline in lung function and early mortality. 100 The epidemiology of PF ILD is particularly challenging to examine as accepted guidelines on definition and diagnosis have yet to be published The reported prevalence of PF ILDs (per 100 000 persons) was 19.4 in France and 57.8 in the USA. 88 89 The future direction of research will likely focus on PF ILD as a phenotype which transcends previously adhered-to diagnostic labels and is associated with poorer outcomes and increased mortality. 100 101

Among the 39 studies reporting ILD incidence ( online supplemental figure E6 ), most studies were categorised as medium risk (n=25/39, 64.1%). Two studies were categorised as high-risk primarily because of lack of information on ILD diagnosis and poor quality of reporting estimates (ie, descriptive statistics were not reported, were incomplete or did not include proper measures of dispersion).

Similarly, there were 78 prevalence assessments ( online supplemental figure E7 ) of which approximately 18% (n=14/78) were categorised as high risk, 64.1% (n=50/78) as medium risk and 18% (n=14/76) as low risk. Most studies assessed as high risk were studies reporting autoimmune ILDs, mainly because of ILD diagnosis, single-centre studies or small sample size. Most of the studies reporting prevalence based on large healthcare datasets or disease registries were classified as low risk.

There are several strengths of this systematic review. We have provided an assessment of the incidence and prevalence of several ILD conditions globally and have grouped ILDs based on their aetiology to allow the appraisal of incidence and/prevalence at a disease level with as much granularity as possible. This review underlines the need for standardisation of diagnostic classifications for non-IPF ILDs—the narrower estimates for IPF provide the evidence that clear and consistent diagnostic guidelines are of great clinical utility. Guidelines have recently emerged for the diagnosis of HP 102 103 which we envisage will further improve the epidemiological reporting of this important condition, although incorporation of guidelines into routine clinical practice and then into epidemiological estimates takes time. Cross-specialty guideline groups will undoubtedly improve standardisation of reporting for autoimmune driven ILDs.

It is possible that genetic differences between individuals from different ethnic backgrounds may play a role in the global variability in incidence and prevalence. For example, the MUC5B promoter polymorphism (rs35705950) is the dominant risk factor for IPF 104 and is also a key risk factor for other ILDs such as RA. 105 This gain of function polymorphism is frequent in those of European decent but almost completely absent in those of African ancestry. 106 As more research is performed unravelling the complex interplay between genetics and environment in the development of ILD, it is likely that genetic variability will be found to play an important role in the global variability of ILD.

Despite the strengths, there are limitations to this systematic review. The certainty of the ILD case definition varied across studies. It was not always possible to be sure of how reliable the ascertainment method was. However, we attempted to reflect the differences in the ILD diagnostic methods in our risk of bias quality assessment. Along with the uncertainty in the diagnosis of ILD, there were different disease definitions used across studies. Therefore, in this review due to high heterogeneity, in how ILD was defined, we were unable to perform a meta-analysis. In this review, we have only included studies reporting ILD estimates in general populations, registries or populations with a specific disorder of interest. For single-centre studies reporting incidence and/or prevalence of autoimmune or exposure ILDs, the estimates were not generalisable and this has been reflected in the risk of bias quality assessment score. This review is limited to English publications only. However, due to high volume of papers found with the study period, we are confident it has a minimal effect on the overall conclusion. 107

This review highlights the lack of uniformity in the published estimates of incidence and prevalence of ILD conditions. In addition, there is a dissimilarity in disease definitions across the studies and geographical regions. Owing to these discrepancies, we were unable to derive estimates for the global incidence and prevalence of ILD and moreover unable to confirm whether there has been a ‘true’ increase in ILD incidence over time. Revisions to diagnostic criteria have augmented the challenges of estimating incidence and prevalence of individual ILD conditions and determining the drivers for temporal trends in incidence. Improving our estimates of the burden of fibrosing lung conditions is essential for future health service planning, a need that has been heightened by the development of new antifibrotic treatments. Guidelines have recently emerged for non-IPF ILDs, we envisage this may improve the epidemiological reporting for future research. There is a fundamental need to standardise ILD diagnosis, disease definitions and reporting in order to provide the data which will drive the provision of a consistently high level of care for these patients across the globe. 108

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Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1

Twitter @DrPeter_George

Contributors RG, AM, PMG and JKQ developed the research question. RG, AM, PMG and JKQ developed the study protocol. RG developed the search strategy with input from AM and JKQ. RG screened the studies for inclusion, extracted the data from included studies and carried out quality assessment of the data. AK was the secondary reviewer for screening, data extraction and quality assessment. PMG supported with the understanding of various ILD diseases and their clinical pathways. All authors interpreted the review results. RG drafted the manuscript. All authors read, commented on and approved the manuscript.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Map disclaimer The inclusion of any map (including the depiction of any boundaries therein), or of any geographic or locational reference, does not imply the expression of any opinion whatsoever on the part of BMJ concerning the legal status of any country, territory, jurisdiction or area or of its authorities. Any such expression remains solely that of the relevant source and is not endorsed by BMJ. Maps are provided without any warranty of any kind, either express or implied.

Competing interests RG is a current employee of Gilead Sciences, outside the submitted work. JKQ has received grants from The Health Foundation, MRC, GSK, Bayer, BI, British Lung Foundation, IQVIA, Chiesi AZ, Insmed and Asthma UK. JKQ has received personal fees for advisory board participation or speaking fees from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Bayer and Insmed. PMG has received grants from the MRC, Boehringer Ingelheim and Roche Pharmaceuticals and personal fees from Boehringer Ingelheim, Roche Pharmaceuticals, Teva, Cippla, AZ and Brainomix. AK and AM have nothing to disclose.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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• Published: 10 November 2023

A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum?

• Mahé Arexis 1 , 2 ,
• Gilles Feron 1 ,
• Marie-Claude Brindisi 1 , 3 ,
• Pierre-Édouard Billot 2 &
• Stéphanie Chambaron 1  

Journal of Eating Disorders volume  11 , Article number:  197 ( 2023 ) Cite this article

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Emotional eating is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation and inhibition. Previous research has suggested the existence of an “eating continuum” that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between emotional eating and BED and to observe whether deficits in emotion regulation and inhibition follow this continuum in terms of severity. The other aims were to hopefully clarify the ill-defined concept of overeating, to question the potential role of positive emotions and to identify potential knowledge gaps.

A systematic scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two databases (PubMed/Medline and PsycINFO) were examined in complete accordance with the beforehand sharply defined eligibility and exclusion criteria. The main criteria included adults (≥ 18) with emotional eating, BED or overeating and emotion regulation and inhibition as exposure criteria.

Thirty-two studies were included in this scoping review. If the results showed a link between emotional eating and BED, with the presence of inhibition and emotion regulation deficits in both eating behaviors, no mention of a continuum between emotional eating and BED was found.

In the absence of research directly comparing emotional eating and BED in the same studies and testing the potential increase in severity of emotion regulation and inhibition deficits along this continuum, there is currently no certainty that a continuum exists between emotional eating and BED. In the end, the idea of a continuum in terms of increased severity of overeating and in terms of emotion regulation and inhibition deficits between emotional eating and BED appears to be a gap in knowledge in the literature. This scoping review highlights the need for further research to identify knowledge gaps.

Plain English summary

Emotional eating (EE) is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation (ER) and inhibition. Previous research has suggested the existence of an “eating continuum” that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between EE and BED and to observe whether deficits in ER and inhibition follow this continuum in terms of severity. A systematic scoping review was conducted, and thirty-two studies were included in this review. If the results showed a link between EE and BED, with the presence of inhibition and ER deficits in both eating behaviors, no mention of a continuum between EE and BED, or in relation to a continuum, was found. Thus, in the absence of research directly comparing EE and BED in the same studies and testing the potential increase in severity of ER and inhibition deficits along this continuum, there is currently no certainty about the existence or absence of such a continuum.

Introduction

Our scoping review mainly focused on emotional eating (EE) and binge-eating disorder (BED). EE is an eating behavior that can be defined as “the tendency to overeat in response to negative emotions […]” ([ 1 ], p. 106) but in a nonpathological way. It differs from BED, which was formally indexed in 2013 in the DSM-5 as a discrete eating disorder. BED symptoms include recurrent binge-eating episodes (i.e., eating a larger amount of food than most people do during a discrete period of time, with at least one episode per week for three months), “a sense of lack of control over eating during the episode” and “marked distress regarding binge eating”, but without compensatory behaviors as in anorexia nervosa or bulimia nervosa [ 2 ].

Although different, both EE and BED appear to be affected by deficits in emotion regulation (ER) and inhibition [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Indeed, both individuals with EE and BED present with overeating behaviors caused by emotion regulation difficulties and a lack of inhibition/greater impulsivity. For example, it has been shown that negative emotions act as a trigger for binge-eating episodes in BED [ 7 , 11 , 12 ], and some data also suggest that positive emotions may increase food consumption [ 7 ]. Binge eating can be seen as a way to regulate negative emotions (but it is yet uncertain if this strategy successfully improves mood, see Leehr et al. and Stein et al. [ 7 , 13 ]), and BED patients are more prone to use maladaptive strategies such as suppression or rumination [ 4 ].

Davis [ 14 ] suggested the existence of an “(over) eating continuum”: in some way, on one end of the continuum are nonpathological overeating behaviors and at the other end is BED, which is a pathological and extreme state of overeating. The evolution on this continuum, therefore, reflects the “increased severity and compulsiveness” of overeating behaviors. It is also important to emphasize that this idea of a continuum in severity and compulsiveness between those eating behaviors is also reported by clinicians and physicians. It is therefore reasonable to think that the severity of ER and inhibition deficits could increase along this continuum between EE and BED, as shown in Fig.  1 . Taken together, this information is a starting point to lead a systematic screening of the literature. Since our main goals are to clarify the concept of continuum and to identify knowledge gaps, we chose to conduct a scoping review following the guidelines of PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) [ 15 ].

Schematic view of increased emotion regulation and inhibition deficits along a continuum between nonpathological emotional eating and binge-eating disorder (BED)

The present scoping review aimed (1) to address the possible existence of a continuum between EE and BED; (2) to address the possibility of an increase in the severity of deficits in emotion regulation and inhibition; and (3) to address the ill-defined concept of overeating. Indeed, is overeating (OE) a symptom, an eating behavior, a synonymous concept of EE, or a synonym for binge eating? (4) The final aim was to potentially investigate whether positive emotions can, like negative emotions, trigger emotional eating episodes associated with emotion regulation and/or inhibition difficulties. Finally, this scoping review also aimed to identify gaps in knowledge.

The scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines [ 15 ].

The review protocol can be accessed at HAL ( https://hal.science/hal-03643357v1 —HAL Id/Registration number: hal-03643357) [ 16 ].

Eligibility criteria

Studies were selected based on the following criteria:

The PICOS framework was used to highlight the main criteria. PICOS criteria: Populations : People (adult human subjects ≥ 18) with binge-eating disorder (BED) (and meeting the full DSM-IV-TR or DSM-5 criteria for BED) or subthreshold BED and people (adult human subjects, 18 +) presenting with emotional eating (EE) or emotional overeating (EO). Interventions/Exposures : Our review focused on the impact of “emotion regulation” and “inhibitory control” on BED and EE. Comparisons : Our review did not focus on studies with specific comparisons. Outcomes : Our review considered all types of outcomes related to emotion regulation and inhibitory control in BED, EE, and EO ( e.g. , deficit, level of attention, response impairment, and degree of compulsivity). Studies : All types of journal articles published in peer-reviewed scientific journals, either written in English or in French. The exclusion criteria were all types of reviews, book chapters, abstracts, preprints, theses, and articles focusing on therapies/treatments.

Only papers published between January 2009 and January 2022 were eligible for consideration. Although the MeSH (Medical Subject Headings) terms for binge-eating disorder were not introduced until 2010, the year 2009 was chosen because it was a “transition year” between the previous indexing of binge-eating disorder as bulimia nervosa and the introduction of the MeSH term BED in 2010.

Information sources and search

Two electronic bibliographic databases, PubMed/Medline and PsycINFO, were searched to identify references related to the scoping review topic. The search focused on articles published between January 2009 and January 2022. The following search equation was used in both databases: ("Binge-Eating Disorder"[Mesh] OR BED OR Binge eater OR Emotional Eating OR Emotional Overeating OR Overeater OR Emotional eater OR Overeating) AND ("Emotional Regulation"[Mesh] OR Emotion regulation OR Reappraisal OR Rumination OR Attentional deployment OR Mood regulation OR "Inhibition, Psychological"[Mesh] OR Inhibitory control).

This database search stage was conducted by one of the authors, M. A. No additional references were added from other sources at this stage.

Selection of sources of evidence

Duplicates were removed, and all references were imported into Rayyan, an online application for systematic reviews [ 17 ]. Figure  2 shows the flowchart of the literature search and screening/study selection process. During the successive screening stages, at least 2 authors (M. A., and P.-E. B. or S. C., up to 4 authors, M. A., P.-E. B., S. C. and M.-C. B.) screened each record. Disagreements regarding study selection were resolved by a third or even a fourth investigator, and discussions took place between the authors. In the first screening step, for each article, the inclusion criteria described in Sect. " Eligibility criteria " were applied to both titles and abstracts. In the second screening step (eligibility), for each article, the inclusion criteria described in Sect. " Eligibility criteria " were applied to the entire article (i.e., a complete reading of the article). Note that at this stage, we screened the bibliographic references of the included articles to identify potential new references. At the end of this screening, no new articles were included.

Flowchart of the literature search and screening/study selection process

Data charting process and data items

Three investigators (authors M. A., P.-E. B., and S. C.) developed a data charting form to extract the relevant data from each of the 32 included studies. For each study, author M. A. extracted the data according to the following variables of the chart: authors, title, year of publication, country of the study, journal of publication, type of study, method/study design, participants and sample sizes, type of interventions, comparisons, and outcomes/results. Table 1 shows the final version of the chart with the main characteristics of the studies included in the scoping review. We did not include in Table 1 the journal of publication or type of study variables of the chart, as they were deemed irrelevant for this table. Note that we added in Table 1 a new column “Outcomes/Results highlight” with a simplified overview of the results, as well as a “Limitations” column.

Critical analysis

Two authors (M. A. and P.-E. B.) listed the possible limitations of each study. The limitations identified by both authors were retained, and the others were either eliminated or retained after discussion. A third author (S. C.) checked this list, and her comments were considered. The limitations are summarized in the "Limitations" column of Table 1 and are discussed in Sect. " Critical analysis ".

Synthesis of results

Data were analyzed qualitatively. We first grouped the studies by the types of eating behaviors (emotional eating (EE), overeating (OE), and binge-eating disorder (BED)). Then, we addressed each of the topics formulated in our questions/hypotheses.

The source search in the electronic bibliographic databases retrieved 2596 records (2130 on PubMed/Medline and 466 on PsycINFO) (see Fig.  2 ). After removing 301 duplicate records, 2295 records were screened in the first screening step. During this first screening step, for each of the 2295 articles, the inclusion criteria described in the Eligibility criteria section of the Methods section were applied to both titles and abstracts, resulting in 110 records to be assessed for eligibility in the next step. Thus, in the second screening step (eligibility), for each of the 110 articles, the same inclusion criteria were applied to the entire article (i.e., a complete reading of the article). At the end of this second stage, 32 studies were selected to be included in the review. Table 1 shows the main characteristics of the 32 studies included in the scoping review, according to the variables described in Sect. " Data charting process and data items ".

Regarding the types of populations (cf. PICOS criteria), 9 studies out of 32 focused on emotional eating (EE), 21 studies out of 32 focused on binge-eating disorder (BED), and 2 out of 32 focused on overeating (OE). Regarding the types of intervention/exposure (cf. PICOS criteria), namely, ER and inhibition/impulsivity, 19 studies out of 32 focused on emotion regulation (ER), 18 studies out of 32 focused on inhibition/impulsivity, and 5 out of 32 focused on both ER and inhibition/impulsivity. More than a third of the included studies (11 studies out of 32, ≈ 34%) were conducted in Germany. Moreover, more than half of the studies (17 studies out of 32, ≈ 53%) were conducted in Germany or in countries bordering Germany (i.e., France, Switzerland, Belgium and Poland).

Summary of findings

Emotional eating and emotion regulation.

Studies confirm the existence of a link between ER and EE, including the fact that ER difficulties predict EE. For example, Stapleton and Whitehead [ 18 ] highlighted that “Emotion regulation difficulties was the greatest predictor of emotional eating, suggesting that individuals who have difficulty regulating their emotions are more likely to engage in emotional eating behavior”. Similarly, Crockett et al. [ 3 ] concluded that “In every model we tested, difficulties in emotion regulation predicted emotional eating”. Sultson and Akkermann [ 19 ] concluded that "Higher level of ER difficulties among obese and normal weight individuals with EE also lend further support for the assumption that emotion dysregulation might underlie EE". Kornacka et al. [ 20 ] highlighted the “[…] crucial role of ruminative thinking in the occurrence of emotional eating […]”. Regarding avoidance, Deroost and Cserjési [ 21 ] showed “[…] that people with a high degree of EM use avoidance as a primary coping strategy" and added that "avoidance coping also significantly predicted the level of EM” (EM = emotional eating).

Future studies focusing on EE and ER should separately test other specific types of emotional eating (e.g., EE in response to depression, to anxiety…). Indeed, Braden et al. [ 22 ] explained that “exploratory analyses suggest possible unique relationships between types of emotional eating and specific facets of emotion regulation”. The authors added that “[…] findings suggest that certain emotion regulation strategies may be more closely linked to various types of emotional eating”.

Emotional eating and inhibition

The studies included in this scoping review dealing with EE and inhibition/impulsivity confirmed the existence of an association between EE and some inhibition difficulties and impulsivity. For example, Wolz et al. [ 23 ] showed that “[…] emotional eating was not related to general inhibitory control deficits, but was associated with higher behavioral inhibitory control difficulties only while suppressing negative emotions. They added that “[…] the difficulty to inhibit behavioral responses while regulating negative emotions may contribute to disinhibited food intake while experiencing negative emotions”. Stapleton and Whitehead [ 18 ] revealed that emotional eating was related to high impulsivity and that impulsivity was the second greatest predictor of EE after emotion regulation difficulties. Regarding self-control, Wood et al. [ 24 ] showed “[…] an increase in activation across brain regions related to self-control and urges in response to high-calorie food associated with both emotional eating and routine restraint". Taken together, these findings confirm that emotional eaters are prone to inhibition impairments. Moreover, Wolz et al. [ 23 ] suggest that deficits in inhibition only appear when participants are regulating their emotions, highlighting an interesting link between ER and inhibition in EE.

BED and emotion regulation

Concerning BED and emotion regulation, most of the studies confirm the ER difficulties in BED. Leehr et al. [ 25 ] showed that individuals with BED have lower ER capacities. Limited access to ER strategies is also one of the ER difficulties met in BED [ 26 , 27 ], as well as nonacceptance of emotional responses [ 27 ] and lack of emotional clarity [ 26 , 27 ].

BED and inhibition

Overall, studies focusing on BED indicated a deficit in inhibition and increased impulsivity. Leehr et al. [ 25 ] concluded that “Overall, results support the assumption of inhibitory control deficiencies in BED on a behavioral level”. Grant and Chamberlain [ 28 ] underlined that “Binge-eating disorder was associated with impaired response inhibition and executive planning”. Schag et al. [ 29 ] said that “[…] BED represents a neurobehavioural phenotype of obesity that is characterized by increased impulsivity”, and Leehr et al. [ 30 ] showed that “the BED + sample showed higher trait and behavioural impulsivity”. Moreover, according to Aloi et al. [ 31 ], “[…] impaired self-monitoring metacognition and difficulties in impulse control are the central nodes in the psychopathological network of BED […]”.

Overeating and emotion regulation

One of the objectives of this scoping review was to clarify the ill-defined concept of overeating . In the eating disorders literature, overeating sometimes refers to a symptom of an eating disorder or as an eating behavior or is sometimes used as a synonym for emotional eating or binge eating.

Unfortunately, only two of the studies included in this scoping review focused on overeating [ 32 , 33 ], so we could not address this specific question. Nevertheless, similar to EE and BED, those studies highlighted the links between overeating and emotion regulation.

Positive emotions and emotional eating

We questioned the possibility of positive emotions causing emotional eating episodes associated with emotion regulation and/or inhibition difficulties (in the same way as negative emotions). Based on the studies included in our review, opinions differ regarding this point. Indeed, while an article highlights that “[…] positive EE was associated with elevated levels of ER difficulties, suggesting that overeating in response to positive emotions might also include some features of emotion dysregulation” [ 19 ], another article concludes, on the contrary, that “[…] eating in response to positive emotions was not significantly related to poorer psychological well-being, greater eating disorder symptoms, or emotion dysregulation” [ 22 ]. Since there is yet no consensus on the subject, further research on emotional eating needs to be conducted to separately test and dissociate positive and negative emotions.

Positive emotions and BED

We wondered about positive emotions as a possible cause of emotional eating episodes associated with emotion regulation and/or inhibition difficulties. We checked whether the BED studies included in this scoping review addressed the question of positive emotions/affect/mood. Loeber et al. [ 34 ] showed that “[…] restrained eating and mood are factors that moderate response inhibition to food-associated stimuli in obese patients with BED” and that “[…] apart from negative mood, positive mood might as well be a trigger for loss of control over eating behaviour”.

Finally, it is worth mentioning that one study showed that negative and positive mood levels are different during binge days, with an increasing negative mood and a decreasing positive mood at the first binge-eating episode (see Munsch et al. [ 35 ]).

Emotional eating and weight profiles

Studies included in this scoping review tended to show that the relationships between EE and emotion dysregulation (and anxiety, depression, and rumination) might be different according to the weight profile (i.e., normal weight, overweight, and with moderate or severe obesity) (see, for example, Willem et al. [ 36 ] or Kornacka et al. [ 20 ]). Willem et al. [ 36 ] highlighted that “emotion dysregulation, anxiety and depression have different impacts on emotional eating (EE) depending on obesity severity", while Kornacka et al. [ 20 ] underlined that “the role of emotional eating in the link between rumination and uncontrolled eating is different in overweight vs. healthy individuals”.

Emotional eating, BED and rumination

According to three of the studies included in this scoping review, rumination, a maladaptive emotion regulation strategy, is encountered in both EE and BED. Indeed, in EE, Kornacka et al. [ 20 ] highlight that rumination is a predictor of EE (“[…] the results of the two studies confirm the crucial role of ruminative thinking in the occurrence of emotional eating […]”. Similarly, people with BED are more inclined than healthy people to use rumination as a negative emotion regulation strategy [ 27 ]. Wang et al. [ 37 ] also highlighted that “[…] rumination is an important cognitive process associated with severity of eating-disorder psychopathology”.

The idea of a possible continuum

We hypothesized that there would be a continuum between EE (nonpathological eating behavior) and BED (pathological eating behavior). Three studies focusing on BED mentioned this idea of a continuum in the severity of eating disorders. Leehr et al. [ 25 ] stated that “From a clinical perspective eating behavior of the three groups can be seen on a continuum from normal eating behavior, to overeating, to binge eating”. Mobbs et al. [ 38 ] highlighted that “[…] these cognitive deficits are more severe in obese patients with binge eating disorder, which indicates that there is a continuum of increasing inhibition and cognitive problems with increasingly disordered eating”. Moreover, Svaldi et al. [ 39 ] underlined that “[…] the magnitude of the inhibitory deficit was found to be related to the reported severity of eating pathology”, which is compatible with the idea of a continuum.

However, none of the reviewed studies directly compared EE to BED regarding ER or inhibition performances, neither in a longitudinal nor cross-sectional design. Thus, a gap can clearly be identified in this specific field since there is a complete lack of experimental data about an increased severity in ER and inhibition deficit between EE and BED.

We identified some limitations between studies, and some of them were quite redundant in our corpus. First, half of the included studies recorded only self-reported data using scales, questionnaires, or interviews. These declarative measures often suffer from memory bias or social desirability concerns [ 40 ]. Moreover, these measures are often carried out for a particular purpose, and this purpose may differ from study to study, depending on the research question being asked [ 40 ]. Strikingly, 88.9% of papers addressing ER gathered only self-report measures (but only 11.8% for inhibition). Thus, there is a lack of experimental data to address the issue of ER in BED and EE.

Second, 43.8% of the articles with self-report measures only appeared to have rather small sample sizes and/or unbalanced groups and were therefore underpowered. Sample size is a critical issue for quantitative analysis. This sample size must be large enough to achieve the appropriate level of measurement precision. [ 41 ].

Third, most of the participants enrolled in these studies were women, compromising the generalizability to the global population (81.3% of studies had only women participants or an unbalanced sex ratio toward women). Eating disorders are more frequent among women, and for BED, the ratio varies between 1:2 and 1:6 [ 42 ]. Thus, while the lack of men in BED studies is understandable, future studies should consider recruiting more men to properly balance the experimental groups.

Finally, a recurring limitation emphasized by many authors of the included studies is that their research was cross-sectional. Indeed, given the short duration of these types of studies, it was impossible to reveal some causal links between different phenomena (e.g., between BED and impulsivity). However, in our opinion, this is not a limitation per se, as cross-sectional and longitudinal studies are two very different types of research. Therefore, we did not report this limitation in Table 1 .

The main objectives of this scoping review were to explore the idea of a continuum between EE and BED as well as explore the idea of a gradation in emotion regulation and inhibition deficits along this continuum. This hypothesis is supported by some authors and is widely discussed in Davis [ 14 ]. He developed the concept of an “eating continuum”, ranging from homeostatic eating (energy balance) to food addiction, with different levels of “overeating”, including BED-like symptoms and diagnosed BED. It should also be noted that this idea of a continuum is shared by many physicians in their daily clinical practice and that this idea needs to be verified.

The most striking result of our scoping review is that there are strong similarities between EE and BED, with emotional eaters and BED patients sharing the same difficulties in emotion regulation and inhibition. Some of the included studies seem to be compatible with the idea of a gradation of ER and inhibition deficits following this continuum. For instance, Mobbs et al.’s [ 38 ] conclusions strengthened the idea of a continuum of inhibition impairment, with BED patients living with obesity having more difficulties inhibiting their responses compared to controls living with obesity. Indeed, the authors concluded that “[…] these cognitive deficits are more severe in obese patients with binge eating disorder, which indicates that there is a continuum of increasing inhibition and cognitive problems with increasingly disordered eating”. Concerning EE, the results of Sultson and Akkermann [ 19 ] showed that participants with EE have more binge eating behaviors than participants without EE but do not meet all the DSM-5 criteria to be diagnosed with BED. These results suggest that EE could lead to BED and thus support the idea of a continuum. It is, however, crucial to remember that none of the articles included in this review directly compared EE and BED in the same study, neither in a longitudinal nor cross-sectional design. To ascertain the existence of a continuum between EE and BED, the increased severity of ER and inhibition deficits between EE and BED still need to be proven. One of the main goals of this scoping review was also to identify knowledge gaps, and indeed, we found a gap in the literature regarding the increased severity in ER and inhibition impairments from EE to BED. Such a lack of experimental work is truly surprising given the feelings shared by many caregivers in the field of eating disorders as well as the thoughts shared by some authors [ 14 , 25 , 38 , 39 ].

Among the thirty-two articles reviewed, only one focused on the relationship between ER and inhibition in EE. Indeed, Wolz et al. [ 23 ] showed that EE was associated with higher behavioral inhibitory control difficulties only while participants were suppressing negative emotions. This outcome should be taken into account in further studies, since ER and inhibition deficits are often studied separately [ 7 , 43 , 44 ]. Indeed, the direct relationship between ER and inhibition remains poorly studied in BED, as well as in EE, but is an important question to explore the idea of a continuum.

The third objective of this scoping review was to address the ill-defined concept of overeating. Unfortunately, only two studies focused on overeating [ 32 , 33 ], and it is thus difficult to clearly define this concept. For both authors, overeating is not an eating disorder per se since participants were healthy volunteers with no prior diagnosis of an eating disorder. However, in both studies, overeating is measured with questionnaires widely used in medical contexts to assess eating disorders, such as the Eating Disorder Examination-Questionnaire (EDE-Q) or the Binge Eating Scale (BES). Thus, overeating may be seen as pathological eating. Moreover, Racine and Horvath [ 33 ] used the Eating Disorder Diagnostic Scale and the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) to determine experimental groups. Women included in the “overeating” group reported consuming an “unusually large amount of food unaccompanied by loss of control over the past 3 months” on both questionnaires. Thus, this inclusion criterion could be a suitable definition of the concept of overeating, but it must be emphasized that there is too little information to properly define this concept.

The fourth aim of this review was to determine whether positive emotions could trigger emotional eating or binge eating episodes associated with emotion regulation and/or inhibition difficulties. Most of the studies only measured EE and binge eating episodes in response to negative emotions. However, few articles specifically focused on positive mood or emotions. Due to a lack of consensus among studies, it was impossible to strongly conclude that positive emotions can affect eating behaviors. Indeed, some data support this idea [ 19 , 34 ], and others are less affirmative [ 22 , 35 ].

Last, concerning the weight profile, it was not one of the aims of this scoping review, but our results showed that emotion regulation deficits were more severe in obese participants than in normal weight or overweight volunteers. Thus, the weight profile seems to be an important parameter when addressing the question of an increased severity in ER deficits between EE and BED.

Limitations

This scoping review presents some limitations. First, regarding the selection phase, not all relevant studies may have been indexed in the two searched databases (PsycINFO and PubMed/Medline). Second, the examination was based on a list of terms describing emotional eating, binge-eating disorder, emotion regulation and inhibition. The possibility that additional articles would have been identified by adding other terms cannot be completely excluded, although the search was intended to be as extensive as possible. Third, a possible limitation of our scoping review is that we did not mention explicitly in our search equation the terms “positive emotions”. Indeed, given that one of our questions was about the possibility that positive emotions can, like negative emotions, trigger emotional eating episodes, we could have perhaps included it in our search equation. Nevertheless, given that we used the inclusive terms “Emotional Regulation”[Mesh]” and “Emotion regulation”, it is likely that we did not miss some interesting records focusing on positive emotions. Finally, in this review, only studies in French or English were included, which did not allow us to be exhaustive in our conclusions.

Conclusion and further directions

In conclusion, this scoping review fully confirmed the presence of inhibition and emotion regulation deficits in both EE and BED, showing strong similarities between these two eating behaviors. However, the lack of experimental data coming from direct comparisons between EE and BED did not make it possible either to confirm the existence or the absence of a possible continuum between EE and BED or an increased severity in ER and inhibition deficits between EE and BED. Thus, this scoping review helped to identify a knowledge gap, and the question of the existence of a continuum still needs to be addressed in further research.

If such a continuum exists, we think it could greatly impact the clinical care of eating disorders. Indeed, if EE can become BED, early care of emotional eaters becomes essential, and early diagnoses could be made. Additionally, prevention could be improved in emotional eaters and even in the general population to avoid progression to an eating disorder (i.e., subthreshold BED and BED) and could also reduce the risk of developing obesity and its comorbidities often associated with BED. Given the variety of symptoms (psychological and physical), monitoring of emotional eaters could be performed by a multidisciplinary medical team, especially for children and adolescents.

The existence of a continuum between EE and BED could also have implications for eating disorder research. In our view, this could lead to further research to develop more specific screening instruments, such as scales and questionnaires. Such instruments might indeed be helpful to classify emotional eater participants into more relevant experimental groups that take into account the severity of EE. To go even further, one could imagine a new scale that would assess the level of eating behaviors across the entire continuum. Moreover, regarding data analysis, data could be analyzed in a discrete way in addition to group comparisons between EE and BED. Last, if such a continuum was verified, it could guide the focus on future research, especially studies on the etiology of BED, and help to better define the concept of “emotional overeating”.

Moreover, to test the idea of a continuum from a different angle, it could be interesting to see if there is an evolution of some other markers between EE and BED, such as biomarkers. Some of them are well known in BED but remain rather poorly studied in EE. Several fMRI studies have shown that brain activation patterns are different in BED patients, especially in the reward system, which explains why this eating disorder is often associated with food addiction [ 14 ]. For example, the ventral striatum and the medial prefrontal cortex seem to be underactivated during a rewarding task. Moreover, the ventral putamen, orbitofrontal cortex, amygdala, and insula respond less in BED patients than in controls [ 8 ]. EEG studies have also provided a valuable understanding of neurophysiological markers. In their narrative review, Berchio et al. [ 45 ] found that behavioral traits of BED and bulimia nervosa, such as loss of control over eating and emotional eating, are associated with an increased attentional reactivity (P300 wave) to visual food stimuli. Finally, animal studies allow us to better understand the functioning of some molecules. For example, the role of dopamine, oxytocin, and opiate in eating disorders is well understood [ 46 ], and this could be an interesting focus to measure the gradation between EE and BED.

Availability of data and materials

Two electronic bibliographic databases, PubMed/Medline and PsycINFO, were searched to identify references related to the scoping review topic. The search focused on articles published between January 2009 and January 2022. Original records (before screening) can be found using the search equation that was used in both databases: ("Binge-Eating Disorder"[Mesh] OR BED OR Binge eater OR Emotional Eating OR Emotional Overeating OR Overeater OR Emotional eater OR Overeating) AND ("Emotional Regulation"[Mesh] OR Emotion regulation OR Reappraisal OR Rumination OR Attentional deployment OR Mood regulation OR "Inhibition, Psychological"[Mesh] OR Inhibitory control). The 32 articles included after the screening steps are listed in the References section.

Abbreviations

• Emotional eating
• Binge-eating disorder
• Emotion regulation

Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews

Populations, interventions, comparisons, outcomes, studies

Diagnostic and statistical manual of mental disorders Text Revision, or 5th edition

Electroencephalography

Magnetoencephalography

Normal weight controls

Food stroop task

Body mass index

Barratt impulsiveness scale

Ecological momentary assessment

Bulimia nervosa

Healthy controls

Eating disorders

Difficulties in emotion regulation scale

People living with BED (or subthreshold BED, depending on the studies)

People living without BED (or subthreshold BED, depending on the studies)

Loss of control

Objective binge episode

Late positive potential

Stop signal task

Stop signal reaction time

Functional magnetic resonance imaging

Healthy volunteers

Go-trial reaction time

Normal-weight people living with BED

Overweight people living with BED

Executive functioning

Non-BED obese individuals

Lean comparison

Ventromedial prefrontal cortex

Inferior frontal gyrus

Anorexia nervosa-restricting type

Anorexia nervosa–binge/purge type

Eating disorder, not otherwise specified

Emotional eating/eaters (depending on the studies)

Exogenous cueing task

Network analysis

Emotional overeating

Medical subject headings

Emotional eating (used in some of the included articles)

Eating disorder examination-questionnaire (EDE-Q)

Binge eating scale

Eating disorder diagnostic scale and the questionnaire on eating and weight patterns-5

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Acknowledgements

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This scoping review was supported by grants from the French National Research Agency [Agence Nationale de la Recherche (ANR): ImplicEAT project ANR-17-CE21-0001].

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Contributions

All authors participated in the conception of the study. Three investigators (authors MA, P-EB, and SC) developed a data charting form to extract the relevant data from each of the 32 included studies. For each study, author MA extracted the data according to the following variables of the chart: authors, title, year of publication, country of the study, journal of publication, type of study, method/study design, participants and sample sizes, type of interventions, comparisons, and outcomes/results. Two authors (MA and P-EB) listed the possible limitations of each study. The limitations identified by both authors were retained, and the others were either eliminated or retained after discussion. Two authors (SC and M-CB) checked this list, and their comments were considered. MA wrote the first draft of the article and MA, P-EB, SC and M-CB contributed to the final version. All authors proofread the final version.

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Correspondence to Pierre-Édouard Billot .

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This scoping review did not involve animals or human participants, and we did not use personal information. All data used in this review were extracted from published articles.

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This scoping review did not involve human participants, and we did not use personal information. Thus, consent for publication was unnecessary for this scoping review.

Competing interests

The authors declare that they have no competing interests.

The review protocol can be accessed at HAL ( https://hal.science/hal-03643357v1 —HAL Id/Registration number: hal-03643357). Protocol reference: Arexis, M., Feron, G., Brindisi, M.-C., Billot, P.-E., & Chambaron, S. (2022). Impacts of emotional regulation and inhibition on Emotional Eating (EE) and Binge Eating Disorder (BED): Protocol for a scoping review. Hal-03643357 .

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Arexis, M., Feron, G., Brindisi, MC. et al. A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum?. J Eat Disord 11 , 197 (2023). https://doi.org/10.1186/s40337-023-00916-7

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Received : 24 February 2023

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DOI : https://doi.org/10.1186/s40337-023-00916-7

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