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Selecting an Appropriate Font for Writing a Literature Review

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The 12 Most Readable Fonts for Print, Hands Down

by Gatekeeper Press | May 24, 2021 | Blog

Table of Contents

Have you ever experienced a frustrating font fiasco? This unfortunate event occurs when you sit down to devour a much-anticipated new book, but within a few pages, find yourself exhausted. This may even be so irksome that you give up on the book altogether. Sadly, either an editor or a self-published author simply selected the wrong font when designing and formatting the book’s interior matter.

As droll a topic as fonts might appear initially, font selection is actually a critical decision that can have an outsized impact on the ultimate success of your book. The right font choice will not only make your book more consumable, but will also be better aligned with the genre, the book’s tone, and your audience. Continue reading to discover the most readable fonts for print.

What to Look for When Selecting a Font for Print

To even begin to understand the 32,000 fonts available, it helps to know how fonts are categorized. Fonts generally fall into one of four categories:

Serif. Serif fonts have nearly indecipherable little flourishes (serifs) on the letters that make them easy to read as they closely resemble handwriting.
Sans-Serif. “Sans” means without, so these fonts feature simplified, clean letters.
Script. Script fonts are exactly that — fonts that emulate cursive writing.
Display. Display fonts are highly artistic and stylized, perfect for headings or titles but not appropriate for large blocks of text.

Consider the following items when deciding on the best fonts for your self-published book:

Readability. The most readable fonts for print are those that look best in a large block of text. Selecting the easiest fonts to read leads to a much higher likelihood that your book will be read in its entirety and may even result in more positive reader reviews.
Audience. Some fonts are more familiar and comfortable among people of different generations. If you are older, but your target audience is millennials or Gen Y, then you will want to avoid fonts that are perceived as dated or even medieval.
Suitable to topic. Fonts have personalities. They can feel whimsical, dramatic, serious, or comedic in tone. Be sure to pair the font that best suits the genre or subject portrayed in your self-published book.
Visual aesthetics. While the aesthetic value desired for your book is highly subjective, it is wise to consider if your personal tastes are going to resonate well with your target audience. It might be a good idea to ask a few friends to weigh in on your top contender font choices before making the final selections.

There are plenty of factors that play into choosing the most readable fonts for print, so consider hiring font extraordinaires like the team at Gatekeeper Press for your printing needs.

The Best, Reader-Approved Fonts for Books

When you arrive at the formatting stage for your self-published book, take the time to properly explore the fonts or typeface that are best suited for it. Compare three or four fonts by printing out large blocks of text in each font. As you compare the samples, consider which of them are the most readable fonts for print.

Ask yourself if your eyes are pleased with the font and if the font exudes the right vibe for your self-published book and its target audience. Out of these runners up, pick your winner, plus a second complementary font for chapter titles, title page, and sub-texts. Ideally, your book will utilize one strong serif and one strong sans-serif for the majority of the interior matter.

The best fonts for books include:

Serif Fonts

Garamond. This graceful font was developed in France in the 16th century and has a classical feel.
Georgia. This elegant yet sturdy font was designed in 1993 and is also the best font for small print.
Palantino. This font, released in 1949, is reminiscent of the old-style typeface. Released in 1949.
Caslon. This font was designed by William Caslon in the 18th century and has a somewhat textured appearance.
Minion Pro. Considered some of the most readable fonts for print, the Renaissance-inspired font series from the Adobe family was designed in 1989.
Merriweather. This font has a strong, dependable feel and is easy to read.

Sans-Serif Fonts

Helvetica Neue. This bold font is an excellent choice for chapter titles.
Myriad. This versatile, humanist, and general-purpose font was developed in the 1990s for Adobe.
Open Sans. Although a sans-serif font, Open Sans pays homage to certain elements of serif styles.
Roboto. This clear and concise font is quite versatile.

For perfect font selection and formatting, hire the professional and experienced design team at Gatekeeper Press.

Trust the Design Team at Gatekeeper Press

If the sheer number of available fonts is enough to make your head spin, why not partner with the design team at Gatekeeper Press ? These publishing pros will select the perfect fonts for your book’s genre and audience, in addition to being the most readable fonts for print. Give Gatekeeper Press a call today!

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What font should I choose for my thesis?

This post is by DrJanene Carey, a freelance writer and editor based in Armidale NSW. She occasionally teaches academic writing at the University of New England and often edits academic theses, articles and reports. Her website is http://www.janenecarey.com

Arguably, this question is a classic time waster and the student who poses it should be told to just get on with writing up their research. But as someone who edits theses for a living, I think a bit of time spent on fonts is part of the process of buffing and polishing what is, after all, one of the most important documents you will ever produce. Just bear in mind that there is no need to immerse yourself so deeply in the topic that you start quibbling about whether it’s a font or a typeface that you are choosing .

Times New Roman is the standard choice for academic documents, and the thesis preparation guidelines of some universities stipulate its use. For many years, it was the default body text for Microsoft Word. With the release of Office 2007, the default became a sans serif typeface called Calibri. Lacking the little projecting bits (serifs) at the end of characters makes Calibri and its many friends, such as Arial, Helvetica and Verdana, look smoother and clearer on a screen, but generally makes them less readable than a serif typeface when used for printed text . The other problem with choosing a sans serif for your body text is that if you want passages in italics (for example, lengthy participant quotes) often this will be displayed as slanted letters, rather than as a true italic font.

You would like your examiners to feel as comfortable as possible while their eyes are traversing the many, many pages of your thesis, so maximising legibility and readability is a good idea. Times New Roman is ubiquitous and familiar, which means it is probably the safest option, but it does have a couple of drawbacks. Originally designed for The Times in London, its characters are slightly narrowed, so that more of them can be squished into a newspaper column. Secondly, some people intensely dislike TNR because they think it has been overused, and regard it as the font you choose when you are not choosing a font .

If you do have the luxury of choice (your university doesn’t insist you use Times New Roman, and you have defined document styles that are easy to modify, and there’s enough time left before the submission deadline) then I think it is worth considering what other typefaces might work well with your thesis. I’m not a typographical expert, but I have the following suggestions.

Don’t use Calibri, or any other sans serif font, for your body text, though it is fine for headings. Most people agree that dense chunks of printed text are easier to read if the font is serif, and examiners are likely to expect a typeface that doesn’t stray too far from the standard. To my eye, Calibri looks a little too casual for the body of a thesis.
Typefaces like Garamond, Palatino, Century Schoolbook, Georgia, Minion Pro, Cambria and Constantia are all perfectly acceptable, and they come with Microsoft Word. However, some of them (Georgia and Constantia, for example) feature non-lining numerals, which means that instead of all sitting neatly on the base line, some will stand higher or lower than others, just like letters do. This looks nice when they are integrated with the text, but it is probably not what you want for a tabular display.
Consider using a different typeface for your headings. It will make them more prominent, which enhances overall readability because the eye scanning the pages can quickly take in the hierarchy of ideas. The easiest way to get a good contrast with your serif body text is to have sans serif headings. Popular combinations are Garamond/Helvetica; Minion Pro/Myriad Pro; Times New Roman/Arial Narrow. But don’t create a dog’s breakfast by having more than two typefaces in your thesis – use point sizes, bold and italics for variety.

Of late, I’ve become quite fond of Constantia. It’s an attractive serif typeface that came out with Office 2007 at the same time as Calibri, and was specifically designed to look good in print and on screen. Increasingly, theses will be read in PDF rather than book format, so screen readability is an important consideration. Asked to review Microsoft’s six new ClearType fonts prior to their release, typographer Raph Levien said Constantia was likely to be everyone’s favourite, because ‘Even though it’s a highly readable Roman font departing only slightly from the classical model, it still manages to be fresh and new.’

By default, Constantia has non-lining numerals, but from Word 2010 onwards you can set them to be lining via the advanced font/number forms option, either throughout your document or in specific sections, such as within tables.

Here is an excerpt from a thesis, shown twice with different typefaces. The first excerpt features Calibri headings with Constantia body text, and the second has that old favourite, Times New Roman. As these examples have been rendered as screenshots, you will get a better idea of how the fonts actually look if you try them on your own computer and printer.

Should I get an editor for my thesis?

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The 24 Most Professional Fonts to Use

Selecting the right font is an important design choice that can enhance—or detract from—the professionalism of a document. With thousands of fonts to choose from, the possibilities may seem endless. However, not all fonts are well-suited for professional business communications and documents.

This comprehensive guide explores the 24 most professional fonts to create polished, credible business documents that leave a positive impression. We analyse characteristics like readability, legibility, clarity, formality, visual appeal, and versatility to determine which fonts will top for professional use cases in 2024.

A Serif Sensation: Traditional Serif Fonts Offer Readability & Polish

1. times new roman.

This quintessential serif font designed for the New York Times newspaper 1931 remains a staple choice to exude professionalism. The fluid serifs and sturdy letterforms allow Times New Roman to be readable in print. The versatile design also displays well digitally. This font suggests the competence and trustworthiness key for professional communications.

Designed by Matthew Carter in 1993, this serif typeface contains thick, bracketed serifs for enhanced readability. Slightly wider letter proportion compared to Times New Roman improves clarity while maintaining a highly legible 11-point font size. The chunky, semi-bold weight is warm and refined for formal business uses.

3. Bookman Old Style

This classic, versatile serif face echoes Old Style typefaces used in publishing from the mid-1500s into the 1900s. Designed in 1884 by Alexander Lawson for the Century Schoolbook , the slightly condensed letterforms offer a more compact footprint without compressing readability. The sturdy serifs, graceful curves and horizontal stress suggest Old World heritage, perfect for adding gravitas to professional communications.

Key Takeaway: Traditional serif fonts like Times New Roman, Georgia and Bookman Old Style offer proven readability and polish well-suited for formal business documents.

Distinctive & Dignified: Transitional Serifs Bridge Generations

4. baskerville.

This refined, stately serif face designed by John Baskerville in 1757 defined transitional serif styles, forging a bridge from Old Style to modern looks. The crisp edges offer exceptional clarity, while distinctive ball terminals on letter curves add flair. Baskerville brings heritage elegance to contemporary professional settings, from resumes to reports.

5. New Baskerville

Released in 1917, this refreshed Baskerville interpretation by designer George W. Jones is often preferred for clarity on screens and modern printing presses. The slightly thicker strokes offer a bolder definition without compromising legibility. Pair with Georgia for font contrast that delivers professional polish.

6. Times Ten

Photosetting provider Linotype released this updated take on Times New Roman in 1990 to improve output on low-resolution printers and poor-quality paper stock. Subtle changes like shortened ascenders and descenders optimise modern legibility without forfeiting professional persona. The economical proportions also save space.

Key Takeaway: Transitional serif typefaces like Baskerville, New Baskerville and Times Ten marry historical richness with sharp digital display for today’s professional contexts.

Modern Serifs Marry Heritage With Contemporary Flair

Created by renowned German typographer Jan Tschichold in 1964, Sabon draws inspiration from classic Garamond designs but optimises for modern requirements. The Roman letterforms offer exceptional clarity and even texture suitable for continuous business reading—an excellent choice to communicate expertise.

8. ITC Legacy Serif

This 1993 serif release from the International Typeface Corporation retains Times New Roman’s professional personality but exhibits tighter spacing and finer hairlines for improved modern display. The condensed proportions occupy less real estate, allowing more content presentation.

9. Merriweather

Designed by Eben Sorkin in 2010 for Google Web Fonts, this free serif selection exhibits classic proportions and styling adapted for optimal clarity across print, web and digital media. The understated design promotes continuous reading while conveying competence for various professional communications, from handouts to websites.

Key Takeaway: Modern serif font interpretations like Sabon, ITC Legacy Serif and Merriweather smartly evolve heritage styling for today's professional, multi-media business needs.

Sans Serif Fonts Signal Modernity For The Digital Era

Initially designed by Monotype in 1982 to offer Helvetica -style appeal more economically, this ubiquitous neo-grotesque sans serif font conveys professionalism and modernity. The comfortably spaced proportions ensure approachability while promoting exceptional on-screen readability.

11. Helvetica Neue

This seminal, globally recognised neo-grotesque face originated from the 1957 Helvetica release. Designer Max Meidinger evolved the styling in 1983 to enhance spacing and strokes for improved digital rendering. The Swiss heritage of architectural clarity and purity perseveres through this digitally-optimized typeface.

12. Calibri

As the default font for Microsoft Office programs and Windows since 2007, Calibri offers a humanist sans serif option deeply familiar to modern business professionals. The rounded contours ensure approachability while the reliable rendering remains professionally polished across documents, slides, forms and other uses.

Key Takeaway: Leading neo-grotesque sans serifs like Arial, Helvetica Neue, and Calibri adopt simplified styling that crisply conveys professional digital-age messaging.

Specialised Sans Serifs Target Professional Needs

13. clearviewhwy.

Specifically tailored for road signage by designer Don Meeker in 1998, this humanist sans serif face allows extraordinary readability for content viewed from a moving vehicle. Tested and proven across state transportation departments, Clearview denotes authority for wayfinding signage applications.

14. Frutiger

This Univers-inspired sans serif, designed by Adrian Frutiger in 1976, improves visual hierarchy through letter variation. Numerals and glyphs are easily distinguished from letters to enhance clarity for signage and labelling purposes. The streamlined Swiss styling also denotes modern efficiency.

15. FF Mark

Designed by Erik Spiekermann in 2009, FF Mark offers a simplified, dotless construction derived from industrial German engineering and architectural signage applications dating to the 19th century. The functional format, stripped of superfluous strokes, delivers clear communication of professional content.

Key Takeaway: Field-specific sans serifs like ClearviewHwy, Frutiger , and FF Mark provide optimised displays targeted for professional signage or technical applications.

Authoritative & Distinctive: Professional Slab Serifs

16. rockwell.

Designer Frank Hinman released this bold, sturdy slab serif font 1934 for the Inland Type Foundry. The thick, monolinear strokes offer substantial visual presence, while softened rectangles lend friendlier allure. Rockwell brings commanding gravitas yet approachable warmth simultaneously to business communications.

HCI editor Matthew Carter designed this efficient slab serif family in 2001 for media conglomerate Martha Stewart Living Omnimedia exclusive use. Structured, compact strokes ensure clarity even at small sizes on inferior printing presses, maximising professional polish for publishing at scale.

18. Roboto Slab

Christian Robertson expanded his 2013 Roboto humanist sans serif into serif and slab serif families as core Google Fonts selections. Roboto Slab’s modern appearance and responsiveness across digital platforms offer a distinctive professional personality deviating from traditional expressions.

Key Takeaway: Distinctive professional slab serifs like Rockwell, Archer and Roboto Slab couple commanding visual presence with sturdy legibility to elevate business content .

Specialist Display Fonts Grab Professional Attention

This imposing caps-only Roman square capital's face echoes the solid strokes displayed prominently on Trajan ’s Column monument erected circa 113 AD. The all-caps letterforms project monumentality, allowing this font to emphasise professional titles, logos, signage and headlines with gravitas.

Paul Renner’s 1927 milestone project encapsulated Modernist design with ideological efficiency through ordered, geometric strokes. Branding professionals leverage Futura to communicate focus and innovation, while design principals rely on minimal expression to emphasise information density.

Inspired by architectural signage, designer Tobias Frere-Jones crafted this bold, structural alphabet in 2000 to evoke steadfast New York heritage. Professional designers rely on Gotham’s straightforward style to communicate confidence through headlines, titles, and branding elements .

Key Takeaway: Columnar Trajan, modern Futura, and architectural Gotham offer scalable display fonts to attract professional interest to titles, branding and headlines.

Handwritten Fonts Convey Personal and Professional Approachability

22. dearsarah sf pro.

Software developers Balance Type Foundry crafted this stylish, contemporary handwritten face in 2021 to inject personal warmth into professional communications. Ligatures between specific letter pairs boost intimacy while practising restraint to sustain polish, befitting more formal contexts like event invitations or featured callouts.

23. Sf Handwriting Dakota

This casual handwritten font comes courtesy of the digital agency Design K to resonate authentically with personal correspondence for professional introductions or outreach touchpoints. Designed with multilingual support, the global accessibility remains professionally inclusive.

24. Homemade Apple

Independent type designer Sam Parrett delivers this distinctive, organic handwritten face that combines whimsical, retro warmth akin to scampering chalkboard renderings with the approachability of a trusted neighbour. Professional applications could include feature headers in reports or emphasis lines within newsletters to boost engagement.

Key Takeaway: Casual handwritten fonts like DearSarah SF Pro, SF Handwriting Dakota, and Homemade Apple humanise professional messaging through personalised execution.

Combining Complementary Fonts Creates Hierarchy & Contrast

When combining fonts for professional communications:

Align Serif & Sans Serif Faces – Pairing a serif such as Garamond or Times New Roman with a sans serif like Arial or Helvetica offers visual hierarchy through contrast.
Vary Weights For Emphasis – Mix heavy, light or condensed weights of compatible font families to make key content stand out.
Highlight Display vs Text – Blend sturdy display fonts like Impact or Gotham to accent readable text choices like Georgia or Calibri.
Maintain Consistent Typography – Limit professional font combinations to 2 or 3 compatible families and remain consistent across branded touchpoints.

Key Takeaway: Thoughtfully blending 2-3 complementary fonts into professional communications clarifies visual hierarchy through strategic contrast.

5 Key Criteria Define Great Professional Fonts

Readability – Strong letterforms deliver content consumption efficiently
Legibility – Distinct characters discern at small sizes
Clarity – Crisp definition promotes engagement
Compatibility – Adapts gracefully across media formats
Personality – Unique traits align with context

Key Takeaway: Professional font technical effectiveness must match appropriate contextual emotion and personality to achieve communications goals fully.

Most Professional Fonts – Recap At A Glance

Serif – Times New Roman, Sabon, Georgia, Merriweather
Sans Serif – Arial, Helvetica Neue, ClearviewHwy
Slab Serif – Archer, Roboto Slab, Rockwell
Display – Futura, Gotham, Trajan
Handwritten – DearSarah SF Pro, Homemade Apple

Conclusion: Apply Thoughtful Typography For Professional Results

This expansive guide highlights 24 exceptional font faces spanning common professional categories like Serif, Sans Serif, Slab Serif, Display and Handwritten. Each recommended font qualifies for business usage through optimal legibility, compatibility across modern media, and personality characteristics that strategically match professional communications goals.

While the highlighted selections represent esteemed options, designers must carefully contemplate additional criteria like industry context, audience demographics and branded guidelines when specifying fonts for professional documents or communications. Traditional selections like Times New Roman remain prudent choices that reliably convey professional expectations for specific formal uses like legal briefs or financial statements. More progressive companies may incorporate distinctive yet legible modern fonts like Helvetica Neue or Roboto Slab to signal forward-thinking, design-focused appeal.

Above all, professional font selections rely on thoughtful implementation aligned to the specifics of the intended communication and consumption formats. Suitable fonts effectively capture attention, sharpen hierarchy, strengthen retention and promote clarity to optimise audience engagement. As fine dining plates must be expertly paired to complemental courses, precision font selections elevate messaging while underscoring competence and care through thoughtful typographic presentation.

Review these 24 versatile professional fonts for your next communications project, effortlessly conveying your expertise through strategic typography optimised for business results.

Frequently Asked Questions (FAQ) About Professional Fonts

What are the top 5 most professional fonts.

The five most versatile and professionally appropriate fonts include Times New Roman (Serif), Arial (Sans Serif), Archer (Slab Serif), Futura (Display) and DearSarah SF (Script). Each reliably offers legibility, compatibility and polish for business uses.

What font does Google use?

Product Sans is the primary Google font applied in branding and communications. The custom-designed geometric sans serif offers friendly simplicity aligned with Google's accessible brand personality.

What is the most attractive font?

Beauty proves subjective; attractive fonts vary by audience and context. Classic serifs like Bodoni and Didot offer elegant, fashionable appeal. Friendlier picks like Brush Script and Great Vibes provide emotive warmth. Helvetica Neue and Futura convey sleek modernity.

What fonts do lawyers use?

Legal conventions rely on tradition, so most attorneys use customary fonts like Times New Roman, Arial and Courier New for contracts, rulings and communications upholding document integrity expectations. More progressive firms occasionally incorporate contemporary alternatives like Calibri and Georgia.

What font size is best for professional documents?

Content legibility proves essential for professional communications. Print documents should use at least 11pt font size. Digital presentations can scale down to 8pt font size. Headings should run 2-4pts larger to establish hierarchy. More essential documents may use 12-14pt for optimal clarity.

Stuart Crawford

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10 Brilliant Fonts for Your Book Layout

It’s easy to forget that the book fonts we see today are the results of hundreds of years of design evolution. From designs emulating handwriting to the crisp, clean serif designs you’ll find in most publications, modern fonts are the culmination of centuries of people combining form and function into something magnificent, but that its users barely even notice anymore. Of course, as an author, you can’t get away with this same indifference: font selection is an essential step to designing your book — both inside and out .

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What is a font?

Before we get started, let’s clear up a terminological detail. True typography experts will be quick to point out how the term ‘font’ is commonly misused in everyday, non-technical conversation.

For typographers, ‘typefaces’ are different lettering designs, like Times New Roman and Arial. ‘Fonts’, on the other hand, are size, weight and style variations on typefaces, like 12 pt Times New Roman bold and 14 pt Arial italic. However, for convenience’s sake, we’re going to be using the term ‘font’ to refer to both the overall styles of type and their variations.

How to choose a book font

Choosing the 'right' font to use for a book's body matter often comes down to individual taste. With the exception of a few universally reviled typefaces — cough cough, Comic Sans — almost any legible font can be considered. Having said that, there are a few things that any discerning book designer will want to keep in mind.

It needs to be readable

Imagine a beautiful chair . It may be the most gorgeous thing to look at, but if it’s uncomfortable to sit on, then what use is it really? The same goes for fonts. Though you obviously want your font to look nice on the page, it also needs to do its job and be easily readable so that readers can immerse themselves in your words without getting distracted or having to decipher what things say.

To serif or not to serif?

Supposedly, serifs lead the eye from one letter to the next, making the reading experience easier and less tiring — although there isn’t actually much scientific evidence in favor of this. But as a result of this theory, you'll commonly see serif fonts used for large bodies of text while 'sans serif' fonts — literally, without serifs — are usually reserved for shorter bits of text like chapter titles and headings.

All this said, humans are adaptable and your reader should be able to adjust to pretty much any font after a chapter or so. If there is a font choice that you think would really elevate or set your work apart, feel free to choose novelty over convention.

Style is still important

To draw your reader in, you’ll want a modern, stylish font that will appeal — but this is pretty subjective, so again, go with one that you like. Your font choice should also be influenced by the contents of your book. You can get a bit creative with titles and headings that capture the spirit or genre of your book a little better. Or even go all out and do something funky with the body text — as long as it makes sense for the layout of your book . Many of the so-called font rules can be broken if the situation really calls for it.

Use fonts to tell a story

For example, the novel Interior Chinatown tackles the idea of typecasting and stereotyping in the film industry. To give it the feel of a Hollywood movie, the book is written in screenplay format using Courier as the standard font.

Needless to say, this is an unusual choice for a novel — using a specific font that is often strongly advised against for book typesetting. But in the case of Interior Chinatown , Courier is a very intentional choice serving a particular purpose and contributing to the impact of the book itself. This is a prime instance in which typical font conventions can be eschewed in favor of effect.

Pro tip: Some sites such as MyFonts allow you to test samples of text in a particular font before you take the plunge and buy it. This is especially useful when choosing among very similar fonts, as you may not be able to pick up subtle differences until you see them in a larger block of text.

10 brilliant book fonts

1. garamond.

If this font were a character: Garamond, a 1920s detective lurking in the shadows of a New York alleyway, waiting for a corrupt district attorney to leave a mob-connected nightclub — right at home in a suspenseful thriller .

If this font were a character: Caslon, a no-nonsense bespectacled professor, who still gets visits from ex-students years down the line because they feel like they owe all their success to him. Clear and reliable, Caslon is great for nonfiction .

3. Baskerville

If this font were a character: Baskerville , lady of the manor, runs the house like a tight ship. Servants quiver under her iron gaze — but her icy exterior melts away when she sits down at her easel. Baskerville clips down the hallways of a transporting piece of historical fiction.

If this font were a character: Sabon, a shy hopeless romantic, steals a glance at the sweetheart who doesn’t know of her true feelings — before finally plucking up the courage to go and say ‘hello’. Hence springs a sweet and dreamy romance .

If this font were a character: Dante, a mischievous teen who just pressed the forbidden big red button in the control room. The spacecraft lurches. Dante dares to take you on a rollicking sci-fi adventure .

Speaking of which, want to take readers on an otherworldly adventure? Check out our post on how to write science fiction !

If this font were a character: Bembo, a wanderlusting photographer dining alone in the shade of a palm tree, a third helping of fried fish already on its way — but can it truly fill the chasm inside of him? Bembo is a great choice for some evocative literary fiction .

If this font were a character: Janson — a wise old soul who, after years living the fast life of a musician, has traded in the trumpet for a trowel, growing fruit and vegetables in abundance. Take a trip down memory lane with Janson in your memoir .

If this font were a character: Bison, a large and in-charge CEO, feet propped up on the desk, looking out across the city from the 90th floor. Bison brings a sleek and confident touch to headers and titles.

9. Captain Comic

If this font were a character: Captain Comic, a dauntless hero, scales a clocktower in the dead of night — aware of what danger could await at the top, but fearless nonetheless. Captain Comic reigns supreme in an action-packed graphic novel .

10. Pequena Pro

If this font were a character: Pequena Pro, a talking hippo, is on the lookout for food (as always) when she comes across a family of meerkats stuck on the bank, and offers to help them cross the river. Pequena Pro is delightful for a children’s book .

How to access book fonts

The simplest way to get your hands on the most suitable fonts for your book is to work with a professional typographer. They will have access to font libraries and many of these experts can even create bespoke typefaces , should your project call for it.

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But if you take the DIY approach to formatting your book , then you’ll need to get hold of fonts yourself. Here’s what to know if you’re taking this route:

You don't buy a font, you license it. If you're going to be printing physical copies as well as publishing ebooks, you need to confirm that the font can be used in print and not just in digital work (which some are).

Fonts come in bundles. Quick switch to typography terminology here — to use all fonts of a certain typeface (for example Caslon Regular, Caslon Bold, and Caslon Italic) you need to buy the whole family of Caslon fonts, either individually or as part of a bundle.

Free isn't always good. Free font download links can sometimes carry viruses. Also, bear in mind that the individual offering the free font might not actually have the right to distribute it — and there could be consequences for using them .

On that note, here some trustworthy sites that offer both free and paid fonts:

Google Fonts

⚠️ Whether you download your fonts for free or purchase them, make sure to read the Terms and Conditions carefully so that you understand exactly what you are and aren’t allowed to do with them.

All fonts have a time and a place — yes, even Comic Sans — but that place may not be in your book. As you undertake this critical selection process, make sure that you’re thinking about the specificities of your book and precisely what you want your font to achieve.

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35+ Best Fonts for Books (Cover, Titles, and Body Text)

Finding the right font is the most important part of book design. It not only plays a key role in improving readability but also helps make your book look more professional.

In this collection, we’re featuring some of the best fonts you can use to design books. It’s always good practice to use at least two different fonts for your titles and body text. Of course, the cover design requires an entirely different font as well.

We made sure to cover all these aspects in this collection by listing fonts for covers, titles, and body text.

Sans-serif fonts are proven to improve readability. It’s ideal to use a sans font for body text. For titles, you can use both serif and sans fonts. However, there are times you may want to mix and match. We’ll leave it up to you to decide.

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Morton – Condensed Title Font Family

Morton is another modern font family that comes with 9 different font weights. This font can be used as both a title font or for body text. It features a condensed and grotesque style of design that gives it a classic look and feel. The font is ideal for professional and non-fiction book designs.

RNS Sanz – Clean Sans-Serif Font Family

RNS Sanz is a clean and minimalist sans-serif font family you can use with business and corporate books and magazines. This font includes 7 different font weights ranging from light to bold and black. Making it a suitable choice for designing both titles and body text.

Martian B – Industrial Title Font Family

Remember that big blocky text you see on the signs in industrial zones and on the sides of large containers. This is a font inspired by those industrial fonts. It has a very geometric design and it’s perfect for crafting titles for many different types of books. The font features 9 weights and includes glyphs as well.

Addington CF – Elegant Serif Font for Books

Even though sans-serif fonts are perfect for all kinds of book designs, we can’t leave out the elegance of serif fonts. Addington CF is a professional serif font you can use with your business-related and non-fiction book designs. The font comes in 7 weights including italic sets.

Seb Neue – Free Bold Font Family

You can use this beautiful font for free with your various book design projects. It actually comes with a license that allows you to use it with commercial projects as well. The font includes 12 different weights featuring both uppercase and lowercase letters.

Landasans – Free Title Font For Books

Landasans is another free font you can use with your personal projects. This font comes with a tall and narrow design that makes it most suitable for book cover and title designs.

FLIX – Modern Book Cover Font

You can create a bold and stylish book cover and titles using this creative font. Flix is a modern display font that features a set of unique letters with rounded edges. This is an all-caps font so it can only be used to design titles and covers.

Ace Sans – Bold Sans-Serif Font Family

Ace Sans is a modern font family that comes with multiple styles. It includes 8 different weights with light to extra bold and black styles. This wide variety of font styles makes this a great choice for crafting both titles and body text for your book projects.

Orion Pro – Modern Fonts for Books

This is another modern font featuring a total of 12 fonts. Orion Pro is available in 6 different weights and each style has an italic version as well. The font design is inspired by Swiss fonts and it’s perfect for book body text design.

Sumo – Fun Book Typeface

Check out Sumo, a fun, and playful typeface perfect for kids’ books, and comics. It comes with 273 ligatures, standard uppercase, and lowercase characters, and seamless multilingual support. Do try this out for your upcoming book title.

Maxwell – Retro Book Font

Here we have Maxwell, a neat, condensed sans-serif font that will take you back to the 50s without a time machine. It can very well be used as a headline, or body text, and comes with a range of customization features to keep you busy.

Benja – Free Comic Book Typeface

Created with attention to detail, Benja is a dialogue font perfectly suited for comic books. It features a range of glyphs, international characters, and multilingual support. You can get your hands on Benja without having to spend a penny.

Anthera – Modern Condensed Sans Serif Font

Anthera is a bold and condensed font that has a perfect look for crafting attention-grabbing titles for book covers. It has a clean sans-serif design with tall and narrow spacing. It’s great for all types of books.

Panther – Modern Font for Book Covers

Pather is a clean sans-serif font that features a slightly rounded letter design. The clean-cut look of the letters makes it a perfect choice for horror and thriller book cover designs. As well as many other fiction and non-fiction books.

Landiva – Modern Condensed Font for Book Covers

Another tall and narrow font for designing book titles and covers. This font comes with a set of modern and letter letters that will make your titles look much clearer and easier to read. It’s available in OpenType and TrueType formats.

Venus Plant – Sci-Fi Font for Book Covers

If you’re working on a title design for a sci-fi novel, this font will fit perfectly for the cover design. It features a futuristic letter design with a cool sci-fi look and feel. A great choice for fiction novels.

Variera – Free Geometric Sans Serif Font

This free sans-serif font features a chunky letter design that will easily highlight your book covers and titles. You can use the free font with personal and commercial projects as well.

Ghina – Creative Font for Book Titles

Ghina is a creative font with a set of letters featuring an uncommon and unique style. It has slightly squared characters that add an attractive look to title designs. This font is ideal for both fiction and non-fiction book covers.

Sellia – Stylish Script Font For Book Titles

You can use this font to design beautiful titles for book covers related to novels and non-fiction books. It’s especially suitable for romantic novels and books on feminine topics.

Codename FX – Slab Serif Font for Books

This is a family of slab serif fonts that includes 22 different fonts for you to choose from. It’s most suitable for designing body text for books as well as covers. The font consists of ligatures, alternate characters, and outline styles too.

Kurdis – Tall Condensed Font For Book Covers

Kurdis is a unique condensed font with a geometric design. This font has a very tall and narrow letter design that’s ideal for crafting book covers. The font has multilingual support and features both uppercase and lowercase letters.

Kompeni – Free Font for Book Titles

This free font has a unique style of serif lettering with a creative look. It’s ideal for designing titles for non-fiction books. The free version of the font is only available for personal use.

Fonseca – Art Deco Font Family

Fonseca is a beautiful font family with a design inspired by classic art deco from the early 20th century. This font is simply perfect for designing book cover titles and headings. The font includes a total of 16 typefaces including 8 weights with obliques, alternates, and with more than 340 glyphs.

Frank – Bold Title Font for Books

If you’re looking for a big and bold font to design an attractive cover for a book or even design titles for pages, this font is perfect for you. Frank is a bold sans-serif font that comes in 5 different weights featuring each weight in 4 different styles including oblique and rough styles. It also has more than 300 glyphs as well.

Genera Sans – Free Title Font

A stylish and bold font that’s ideal for making titles and headings. This free version includes one font style from the font family. You can use it for free with your personal projects.

Houston Italic – Free Outline & Shadow Font

Just as the name suggests, this free font features a stylish italic letter design. You can use it to design titles and headings for books and magazines. The font is free to use with your personal projects.

Mriya Grotesk – Minimal Sans-Serif Font

The clean and minimal design of the letters makes this font quite attractive. If you aim to make your book easily readable, this font will help you achieve that goal. Mriya Grotesk features a total of 8 fonts including 4 font weights such as bold, regular, light, and heavy. As well as 4 italic versions.

Wensley – Modern Serif Font Family

Designing a cover for a non-fiction or business book? This font will come in handy. Wensley is an elegant and modern serif font that comes in multiple styles ranging from light to bold. It also includes multilingual support and both uppercase and lowercase letters.

Storytime – Kids Book Font

Storytime is a clean, and modern book font that will make the kids feel right at home. The readability is thoughtful, making the children engage with the content, and trust the story and message the book has to offer.

Christmas Heart – Free Book Font

If you are looking for a simple and sweet font for your book title, look no further than Christmas Heart. It has an adorable design that instantly catches the eye and comes packed with uppercase and lowercase letters, numbers, punctuation, symbols, and multilingual support.

Visby CF – Geometric Font Family

Visby is a beautiful and clean sans-serif font that features an elegant and rounded letter design. This font is perfect for designing body text in all kinds of books and magazines. The font comes in 8 different weights including obliques as well as both Latin and Cyrillic alphabets.

CA Texteron – Classic Serif Font

This font will come in handy for designers who prefer the old-school style of serif fonts. CA Texteron is a serif font featuring a classic design that you normally see on official documents and manuals. This font includes 6 different weights and includes italics as well.

Helios – Cover & Title Font for Books

Helios is a great font you can use to design titles for various fiction and non-fiction books. The futuristic look of the font makes it most suitable for designing covers for science fiction novels and magazines. It’s an all-caps font that includes many alternates.

Rozanova – Free Clean Geometric Font

A clean and modern font that can be used for both title and body text designs. This font has a minimal geometric design that stands out from the crowd. It’s free to use with personal projects.

Grifter Bold – Free Book Title Font

Grifter Bold is a thick and bold font that’s most suitable for crafting attention-grabbing titles for book covers. This font includes both uppercase and lowercase letters. And it’s free to use with personal and commercial projects.

Five Essential Tips for Choosing Fonts for Your Book

1. match the font to the book’s genre.

Different genres often have different conventions when it comes to font choice. A sci-fi novel might do well with a sleek, modern font, while a romance novel could benefit from a more traditional, elegant script. Take some time to research books within your genre to understand the common themes and stylistic choices, and choose a font that complements your genre effectively.

2. Consider Readability

While stylistic choices are important, readability is paramount. Ensure your chosen font is easy to read, both for the cover and the body text. For body text, it’s often recommended to use serif fonts (like Times New Roman) as they are considered easier on the eyes for long-form reading. The font on the cover should be legible even at a smaller scale, as your book may be displayed in smaller images online.

3. Pair Fonts Carefully

If you plan on using more than one font, ensure they complement each other well. A good rule of thumb is to pair a serif font with a sans-serif one to create a balance of styles. Avoid using fonts that are too similar to each other as this may create a jarring effect. Using fonts from the same family can help ensure a cohesive look.

4. Reflect the Book’s Tone

The chosen font should reflect the tone and mood of your book. Is it a serious work of non-fiction? Consider using a stately, authoritative serif font. Is it a fun children’s book? Try a playful, whimsical font. The font you choose can give potential readers a glimpse into the feel of the book before they even open the cover.

5. Test Different Sizes and Weights

Once you have selected potential fonts, try them out in different sizes and weights. This is particularly crucial for the cover, where your title and author name need to stand out. Bold or larger fonts can draw attention, but don’t overdo it. The key is achieving a balance that makes your cover intriguing and eye-catching, but still easy to read.

You may also want to check out our best title and headline fonts collection for more inspiration.

Dr. Mark Womack

What Font Should I Use?

The Modern Language Association (MLA) provides explicit, specific recommendations for the margins and spacing of academic papers. (See: Document Format .) But their advice on font selection is less precise: “Always choose an easily readable typeface (e.g. Times New Roman) in which the regular style contrasts clearly with the italic, and set it to a standard size (e.g. 12 point)” ( MLA Handbook , 7th ed., §4.2).

So which fonts are “easily readable” and have “clearly” contrasting italics? And what exactly is a “standard” size?

For academic papers, an “easily readable typeface” means a serif font, and a “standard” type size is between 10 and 12 point.

Use A Serif Font

Serifs are the tiny strokes at the end of a letter’s main strokes. Serif fonts have these extra strokes; sans serif fonts do not. ( Sans is French for “without.”) Serif fonts also vary the thickness of the letter strokes more than sans serifs, which have more uniform lines.

Books, newspapers, and magazines typically set their main text in a serif font because they make paragraphs and long stretches of text easier to read. Sans serifs (Arial, Calibri, Helvetica, Gill Sans, Verdana, and so on) work well for single lines of text, like headings or titles, but they rarely make a good choice for body text.

Moreover, most sans serifs don’t have a true italic style. Their “italics” are really just “obliques,” where the letters slant slightly to the right but keep the same shape and spacing. Most serifs, on the other hand, do have a true italic style, with distinctive letter forms and more compact spacing.

Since they’re more readable for long passages and have sharper contrast in their italics, you should always use a serif font for the text of an academic paper.

Use A Readable Type Size

The standard unit for measuring type size is the point . A point is 1 / 72 of an inch, roughly one pixel on a computer screen. The point size of a font tells you the size of the “em square” in which your computer displays each letter of the typeface. How tall or wide any given letter is depends on how the type designer drew it within the em square, thus a font’s height and width can vary greatly depending on the design of the typeface. That’s why if you set two fonts at the same point size, one usually looks bigger than the other.

Compare the following paragraphs, both set at 12 point but in different fonts:

For body text in academic papers, type sizes below 10 point are usually too small to read easily, while type sizes above 12 point tend to look oversized and bulky. So keep the text of your paper between 10 and 12 point .

Some teachers may require you to set your whole text at 12 point. Yet virtually every book, magazine, or newspaper ever printed for visually unimpaired grown-ups sets its body type smaller than 12 point. Newspapers use even smaller type sizes. The New York Times , for example, sets its body text in a perfectly legible 8.7 point font. So with proper spacing and margins, type sizes of 11 or 10 point can be quite comfortable to read.

Font Recommendations

I usually ask my students to use Century Schoolbook or Palatino for their papers. If your teacher requires you to submit your papers in a particular font, do so. (Unless they require you to use Arial , in which case drop the class.)

One thing to consider when choosing a font is how you submit your essay. When you submit a hard copy or a PDF, your reader will see the text in whatever typeface you use. Most electronic submission formats, on the other hand, can only use the fonts available on the reader’s computer. So if you submit the paper electronically, be sure to use a font your instructor has.

What follows is a list of some widely available, highly legible serif fonts well-suited for academic papers. I’ve divided them into four categories: Microsoft Word Fonts, Mac OS Fonts, Google Fonts, and Universal Fonts.

Microsoft Word Fonts

Microsoft Word comes with lots of fonts of varying quality. If your teacher asks you to submit your paper in Word format, you can safely assume they have Word and all the fonts that go with it.

Morris Fuller Benton designed Century Schoolbook in 1923 for elementary-school textbooks, so it’s a highly readable font. It’s one of the best fonts available with Microsoft Word. Because it’s so legible, U. S. Supreme Court Rule 33.1.b madates that all legal documents submitted to the Court be set in Century Schoolbook or a similar Century-style font.

Hermann Zapf designed Palatino in 1948 for titles and headings, but its elegant proportions make it a good font for body text. Named for Renaissance calligrapher Giambattista Palatino, this font has the beauty, harmony, and grace of fine handwriting. Palatino Linotype is the name of the font included with Microsoft Word; Mac OS includes a version of the same typeface called simply Palatino.

Microsoft Word includes several other fonts that can work well for academic essays: Bell MT , Californian FB , Calisto MT , Cambria , Garamond , and Goudy Old Style .

Mac OS Fonts

Apple has a well-deserved reputation for design excellence which extends to its font library. But you can’t count on any of these Mac OS fonts being on a computer that runs Windows.

Finding his inspiration in the typography of Pierre Simon Fournier, Matthew Carter designed Charter in 1987 to look good even on crappy mid-80s fax machines and printers. Its ability to hold up even in low resolution makes Charter work superbly well on screen. Bitstream released Charter under an open license, so you can add it to your font arsenal for free. You can download Charter here .

In 1991 Apple commissioned Jonathan Hoefler to design a font that could show off the Mac’s ability to handle complex typography. The result was Hoefler Text , included with every Mac since then. The bold weight of Hoefler Text on the Mac is excessively heavy, but otherwise it’s a remarkable font: compact without being cramped, formal without being stuffy, and distinctive without being obtrusive. If you have a Mac, start using it.

Other Mac OS fonts you might consider are Baskerville and Palatino .

Google Fonts

When you submit a paper using Google Docs, you can access Google’s vast library of free fonts knowing that anyone who opens it in Google Docs will have those same fonts. Unfortunately, most of those free fonts are worth exactly what you paid for them, so choose wisely.

IBM Plex is a super-family of typefaces designed by Mike Abbink and the Bold Monday type foundry for — you guessed it — IBM. Plex serif is a solid, legible font that borrows features from Janson and Bodoni in its design. Plex is, not surprisingly, a thoroughly corporate font that aims for and achieves a bland neutrality suitable for most research papers.

John Baskerville originally designed this typeface in the 1850s, employing new techniques to make sharper contrasts between thin and thick strokes in the letter forms. The crisp, elegant design has inspired dozens of subsequent versions. Libre Baskerville is based on the American Type Founder’s 1941 version, modified to make it better for on-screen reading.

Unfortunately. Google Fonts has few really good serif fonts. Some others you might consider are Crimson Pro and Spectral .

Universal Fonts

Anyone you send your document to will have these fonts because they’re built in to both Windows and Mac OS.

Matthew Carter designed Georgia in 1993 for maximum legibility on computer screens. Georgia looks very nice on web sites, but in print it can look a bit clunky, especially when set at 12 point. Like Times New Roman, it’s on every computer and is quite easy to read. The name “Georgia” comes from a tabloid headline: “Alien Heads Found in Georgia.”

Times New Roman is, for better or worse, the standard font for academic manuscripts. Many teachers require it because it’s a solid, legible, and universally available font. Stanley Morison designed it in 1931 for The Times newspaper of London, so it’s a very efficient font and legible even at very small sizes. Times New Roman is always a safe choice. But unless your instructor requires it, you should probably use something a bit less overworked.

Best Fonts for Books: The Only 5 Fonts You’ll Ever Need

As the saying goes—if it ain’t broke don’t fix it. books are a classic print format and, even with their transition into the ebook world, they still look their best when set in one of the following tried-and-tested typefaces. , we judged the legibility, beauty, simplicity and variety of weights available of a huge range of fonts, and whittled them down to these faithful five. they’ll never let your typesetting down, guaranteed., 1. for literary fiction: baskerville.

fonts for books typesetting novels literary fiction baskerville

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A ‘transitional’ serif typeface, which borrows from its old-style predecessors (like Caslon, see below), Baskerville brings together the best of two worlds—classic and modern.

Baskerville is unfailingly elegant and intellectual, but also highly readable when set at small size, which makes it the perfect choice for literary fiction.

Find out more about setting your book type at the right size with this helpful guide .

Download Baskerville Font

2. For Romantic Fiction: Sabon

fonts for books typesetting romantic fiction sabon

Whether it’s a classic Austen re-print or a contemporary teen romance, you want to find a typeface with femininity and elegance in abundance. Enter Sabon, a 1960s update on Claude Garamond’s design.

This serif is simple and clear, while retaining a definite touch of grown-up romance. You can’t go wrong with setting a romantic epic in Sabon.

Download Sabon Font

Title and headings: Cansu with Envato Elements

The Cansu font family is a clean, plated typeface with a minimalistic feel to it, working wonders when properly kerned and especially in all-caps. The clean and geometric aesthetic, complements Baskerville quite well.

3. For Thrillers and Airport Page-Turners: Garamond

fonts for books typesetting novels airport fiction thrillers garamond

Used across all kinds of can’t-put-down paperbacks, from Dan Brown to Gillian Flynn, Garamond is a versatile, easy-to-digest classic typeface, which has a neutrality and versatility that makes typesetting with it a breeze. Based on the Roman typefaces of Claude Garamond, the updated version of the typeface, Adobe Garamond Pro, offers six weights.

Team with more experimental sans serif chapter headings to add a modern flavour to thrillers and action fiction.

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Download Adobe Garamond Pro

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4. For Academic Non-Fiction: Caslon

fonts for books typesetting novels academic non-fiction caslon

The sight of this typeface may, for some, bring back painful memories of sweating over text books in Double Chem, but you can’t deny that Caslon is the perfect choice for academic non-fiction. Set journals, encyclopaedias, text books and articles in Caslon and its subtle seriousness will convince any reader of its intellectual weight.

Adobe’s update (Adobe Caslon Pro) adds a touch of modernity and improved digital adaptability, without compromising on the charm of the 18th Century original.

Download Adobe Caslon Pro

Title and headings: Modelica with Envato Elements

If you want a catchy headline properly decorating the cover of your book, the Modelica is a gorgeous geometric contrast to the classic and more conservative expression of Sabon.

5. For General Interest: Utopia

fonts for books typesetting general interest science utopia

For typesetting the newest Richard Dawkins or Jared Diamond, you’ll want a typeface with a broad, approachable appeal. Just as general interest books seek to present factual information or opinion in an accessible format, so your font should strike a balance—not too intellectual, but not too dumbed-down either.

Typesetting devotees will no doubt still turn to a loyal serif for the task, and Utopia strikes the balance perfectly.

Download Utopia

Title and headings: Bison with Envato Elements

Bison is a tall sans-serif typeface that many designers herald as the next Bebas Neue, and would look tremendously well paired with the classic that is Garamond.

Now you’ve got your fonts ready, you can get started with creating a book in InDesign , and work out the perfect font sizes for your design.

The Most Popular Standard Book Sizes in the US and UK

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The Best Fonts for Books

Ashley Holstrom

Ashley Holstrom helps make books at Sourcebooks. She lives near Chicago with her cat named after Hemingway and her bookshelves organized by color. Newsletter: Crooked Reads . Twitter: @alholstrom .

View All posts by Ashley Holstrom

Until I was doing it for my real-life grown-up job, I never put much thought to the art behind typesetting. Newspapers, magazines, books—I thought they all just came that way. But there are so many decisions to be made about the best fonts for books, from the typeface itself to the type size, the space between lines, the amount of lines per page, and so much more. Where do you even begin?

Book interiors are something you probably don’t think much about. Covers are the attention-grabbers . They’re the trendsetters . The interiors, where you spend the most time, are meant to be smooth and seamless. The job of the typesetter is to be invisible and create an immersive reading experience—you don’t want the reader getting ripped out of the story because of an unreadable font. That’s why choosing the right font for the body of your book is so important.

When choosing the best fonts for books, you most likely want to stick with a classic. Jason Tselentis, graphic design and typography teacher, shares the history of typography in his book Type, Form & Function: A Handbook on the Fundamentals of Typography and suggests you keep it simple if you’re laying out a book. “Classic typefaces such as Old Style fonts Caslon, Bembo, and Garamond work well for text type because they have not only stood the test of time, but were also invented for the purpose of uninterrupted reading.”

And that, in essence, is the goal of typesetting: uninterrupted reading. If a reader notices a font, there’s probably something off.

Book designer Ingrid Paulson, who does freelance book design alongside publishing classics at Gladstone Press , knows her fonts. She says she can sometimes recognize them in the wild, but “I just want to enjoy the book, so if I notice the font, it means something isn’t quite right.”

Paulson also teaches book design and said she focuses on getting her students to train their eyes to spot the subtle differences in fonts, and also to pay attention to legibility.

“They may think that Garamond or Baskerville are a bit boring or old-fashioned, but we try to steer them to those classics over using something harder to read such as Times or Bodoni,” Paulson said over email.

Paulson’s go-to fonts are serifs, and she has fun getting to know their individual quirks: How to get to the “sweet spot” of 66 characters per line, and how wide that line of text would have to be. Whether a typeface includes all the diacritics—accent marks, fractions, old style numerals—she needs for a book. How large certain characters, like quotation marks, are and how they will affect the final page count.

“I know it sounds odd, but those text typefaces do carry a certain personality, so I need to look in my toolbox and figure out what typeface would suit a business book, or a novel, or poetry,” Paulson said.

Basically, the best fonts for books are simple and classic. A flashy font works great as display type—that is, chapter headers, part openers, and any other large type—or a call-out like a pull quote, but is exhausting on the eyes to read for more than a few words at a time.

Vyki Hendy of Spine Magazine also prefers a classic like Garamond. “Serifs are definitely easier to read on the printed page. Personally, I have a fondness for Garamond Pro; it’s just so elegant,” she said.

The plus side: The classics are probably default fonts on your computer, so you don’t have to shell out wads of cash for them if you’re designing your own book. For example, Bembo, one of my favorite body fonts that isn’t standard on devices, is upward of $200 for the entire family, including bolds, semibolds, extra bolds, and italics.

Fonts have a lot of personality, and that comes into play when laying out a book. I like to set historical fiction in Caslon, because it’s an older style and has that older feel to it. For academic books, something small and elegant would suffice—Jenson is beautiful. For kids chapter books, go with something classic with pronounced edges—I like monospaced-esque fonts like Chaparral.

The Elephant in the Room

Which brings us to Comic Sans. I would be remiss if I didn’t talk about the font the internet loves to hate. Sure, it’s goofy and juvenile and simple. But that’s exactly why it’s necessary in any font library. It can be helpful for people with dyslexia, because each letterform is so pronounced. Hating on it is actually a form of ableism, according to The Cut . So be cool about it.

Creative Market did a deep dive into a study about if Comic Sans is helpful for dyslexia and wrote this one very profound line: “Never forget that typography is so much more than decoration. It’s a functional tool that you should wield with great care.”

The design blog analyzed information from a study to see what fonts are easier for people with dyslexia to read. The study focused on fixation time (how long a reader spends on passages), and concluded that italic fonts get a lot of fixation time, while sans serifs, roman fonts, and monospaced fonts (like Courier, or other fonts that look like they were created on a typewriter) get less.

Unfortunately, Comic Sans wasn’t one of the fonts sampled in this study. But the information from the study—the wider or roman fonts are more legible—alongside anecdotal data can suffice here, I think.

How to Find Out What Font a Book is Set In

If you find yourself in love with a certain book’s typeface, there are a few places to find that information. The first is on the copyright page, which might say “Set in Times LT Pro Roman and Digi Grotesk LT,” as in Hank Green’s An Absolutely Remarkable Thing . Some books have a colophon page at the very end of the book, giving more information about the typeface used throughout, along with other production information. Esmé Weijun Wang’s The Collected Schizophrenias has such a page, listing the font, book designer, and printer and paper information.

The Short Answer

The short answer to the question “what are the best fonts for books?” is Garamond. It’s classic, versatile, and likely came pre-installed on your machine. As with all art forms, start with the basics and once you know your way around those, you can move on to the fancier things. Like Zapf Dingbats. (Just kidding!)

Good luck on all your book designing endeavors, friends.

For more book anatomy deep dives, be sure to check out these posts:

Why are Books That Shape?
A History of Deckle Edges
The World’s First Novel is Older Than You Think
The History of Dust Jackets
Quiz: How Well Do You Know the Parts of a Book?

The Most Read Books on Goodreads This Week

5 fonts that add credibility and professionalism to scientific research

by ikumikayama | Apr 29, 2013 | Uncategorized | 14 comments

Choosing the right fonts can affect how your scientific research is received.

Note: This is part 2 of a 2-part blog series about choices in fonts. You can read part 1 here .

You are dressed in your best. You edited the manuscript with a fine-tooth comb…but are your figures and images wearing flip-flops?

Last time we talked about fonts that suck professionalism out of your scientific research . In this article, we’ll talk about fonts that actually add credibility and professionalism to your research. Dress your research in a custom-tailored suit by just using these fonts!

My friend and colleague, Cassio Lynm described how a good figure should be like a billboard found in many highways around the country. Anyone who sees the billboard will understand what they are advertising in a split second. If someone is confused or gets the wrong idea, the image is not very successful.

Similarly, the best professional fonts should be one that’s easy to read with very little “bells and whistles”. When writing prose of informational value such as scientific research, a reader should pay attention to what the text is describing, not how the text looks. A good professional font should be like air–we don’t really even pay attention to it most of the time.

Some of the fonts I’ll share with you today are considered “boring” and “overused” by some. These fonts are everywhere because they are champions of legibility and simplicity. Make your work professional and trustworthy by using a time-tested font.

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1. Arial- “All-Around Champion with IBM Roots”

According to fonts.com , Arial is one of the most used typefaces of the last 30 years. Its electronic origins go back to 1982 for IBM laser-xerographic printers by designers Robin Nicholas and Patricia Saunders. When it came out, it was supposed to compete with Helvetica, which was one of the core fonts in Apple Computers in the mid 1980’s.

Arial letters have more round shapes and the edges of letters do not end in a horizontal line. Instead, the edges are at an angle.

Arial is an easy-to-read font in small and large blocks of text. Nature requests that the figure text be in Arial or Helvetica. It’s especially nice for figure labels and legends. When using Arial as figure legends, keep the font size small ~8 points for best results.

2. Helvetica- “All-Around Champion with Apple Roots”

Helvetica is the most heavily-used font. Helvetica was originally designed by a Swiss designer named Max Miedinger in 1957. The font was designed to be an easy-to-read font. The name “Helvetica” comes from “Helvetia” – Latin name for Switzerland. Actually, the font received a facelift in 1983-the newer version is called, you guessed it, Neue Helvetica.

Helvetica even has its own movie . I haven’t seen it yet, but please comment in the section below if you have.

Besides its Hollywood (Indie) status, Helvetica is a font that looks great on both print and on screen. Nature , Science , and Cell request that their figure labels be in Helvetica. (If you need assistance setting up figures, I’m here to help). It looks great small as in figure labels, and it looks pretty good in large formats as posters. I lost count of how many figures I labeled using Helvetica, since that’s what one of the publishers used for their books.

3. Baskerville- “Tends to have positive influence on readers”

Baskerville’s history goes all the way back to 1757 when John Baskerville designed a typeface that works well in print and easy to read. Mr. Baskerville preferred his letters simple and refined. He was also a writing master, so he had some ornamental letters like the upper case Q.

There was an informal study (not official, but some experiments here and there) that showed using Baskerville font increased trustworthiness of the text compared to other fonts. In the same study, Comic Sans had the most negative influence on the readers.

Baskerville is a serif font, which means that there are “tails” at the edge of the letters. Generally, serif fonts are better suited for print. This font works best when used in long blocks of text. Try to keep this font between 8 and 14pts for best results. This font looks dignified, so use this for your important professional occasions-award ceremonies, recognitions, etc.

4. Caslon- “When in doubt, use Caslon”

Caslon is another font with a long history. William Cason I designed the typeface back in the early 1700’s. This font is considered as the first original typeface from England. This font was very popular in colonial America, and it was used for many historical documents including the US Declaration of Independence.

Caslon is a serif font (with tails), and is best used in blocks of text. Like Baskerville, try to keep this font between 8 and 14 points for best results. Using this in a report or an application would be a good places.

5. Garamond – “Second best font after Helvetica”

This font’s history also goes way back. The font was designed by Claude Garamond (or Jean Jannon), who was commissioned to make a typeface for King Francis I of France (1515-47) to be used in series of books. The modern, electric version was revived in 1989 by Robert Slimbach.

Because there are different sources available for Garamond, there are numbers of different variations of the font. Adobe Garamond is the most popular and widely-available version today.

Garamond is still used extensively by French publishers. They also insist that Garamond be printed in size 9. Some of the most famous publications in France are in Garamond such as Histoire de l’édition français. The publishers prefer this font “for its beauty, its richness and its legibility” combined with “an uncluttered graphic style that underscores the rigour of essays and analysis providing a radical critique of contemporary society”.

Garamond is a great font to be used in long proses such as textbooks, dissertations and theses. Keeping it at 9 point is optional. In fact, my master’s thesis was in Garamond.

So that’s the 5 fonts that add credibility and professionalism to your scientific research. Did you find your favorite fonts here? Do you have other favorites? Please share your thoughts in the comment section. Also, please feel free to send this article along to those who might benefit from this short article.

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Now that you know about great scientific fonts, learn more about: PowerPoint Tips for the Scientist

Sources and Further reading:

Arial vs Helvetica – fonts.com

Research on font trustworthiness: Baskerville vs. Comic Sans

Caslon typeface

History of Garamond

Cell Press Figure Guide

Nature -Guide to preparing final artwork

Science Magazine: Preparing your manuscript

14 Comments

I’d rather like to know which font was used to write that article – it’s simple and readable, better than all presented above.

And the font being used for that article is Helvetica, which is one of the fonts mentioned above 😀

Hi Ewa! Great point. The font used is called “Open Sans” by Steve Matteson. For my blog, I made the font color dark grey to make it easier on the eyes, and also made them slightly bigger than average for easier reading. Hope this helps!

Hollo there, i liked the article but none of this fonts looks like the one used in the papers i read, (Journals of the American Chemical Society), do you know which one they use?

Hi There! Thank you for the note! ACS suggests Arial and Helvetica for their journal figures, so that’s what I introduced in this article–for the text, they might very well have their own custom font they use for their publications. I’ll dig into this a little deeper–thank you again!

I’m sorry, but this article is full of misinformation. Part 1 is a reiteration of articles that have been around for years. Absolutely nothing new there, and honestly, is there anyone even considering the typefaces you name there for scientific articles? Is it conceivable that anyone would use Curlz for his essay?

But my real concern goes to the second part. Arial and Helvetica are absolutely not scientific typefaces. The notion that ACS suggests these typefaces doesn’t make them suitable for scientific works. I think you ought to do research as to WHY these typefaces came recommended. Helvetica has history, as it won out of contemporaries like Univers as Helvetica was very heavily marketed. As a side note, Helvetica is actually based on the Akzidenz Grotesk model. Arial was designed to have the same metrics as Helvetica so it could be used on the same printers without having to pay a license fee to use Helvetica. Arial is more legible while Helvetica is more neutral and clear, but neither is particularly great.

So I would say Helvetica and Arial haven’t been chosen because they’re perfect. They’ve been chosen because they’re popular, and Arial is on every Windows computer, so people don’t have to purchase any fonts. I would say neither Arial and Helvetica are known to be particularly good to read. I suspect typefaces like Proxima Nova and Avenir will fair better. To be clear, I don’t think Arial or Helvetica are bad choices for labels and such, but to suggest them as top 5 typefaces, that’s very clearly misinformation.

“When using Arial as figure legends, keep the font size small ~8 points for best results.” For best results? Not entirely. It’s probably a good estimate, but in actuality the pt size should depend on the layout. I would recommend always making a test print to see if the text looks good in print, if that’s what it is intended for. Sometimes 0.2pts more or less could make the difference.

“Helvetica is the most heavily-used font.” I don’t think so. First off, Helvetica is not a font. It’s a typeface. Helvetica Regular would be a font. Helvetica is the most heavily-used typeface in graphic design, and likely the most heavily-used sans typeface. It’s not the most heavily-used typeface. At least, I would be very surprised if it was. I suspect Times New Roman is the most heavily-used.

“The font was designed to be an easy-to-read font.” No, Helvetica was designed to steal the popularity of Akzidenz Grotesk away.

Also, follow this link to see some of the problems of Helvetica at small sizes, and what professionals in the field have to say about it: http://spiekermann.com/en/helvetica-sucks/

“Actually, the font received a facelift in 1983-the newer version is called, you guessed it, Neue Helvetica.” Who would guess that the prefix for the new Helvetica would be German though? Small detail… Anyway, if you like Helvetica but want a more professional typeface (because really, Max Miedinger was not a type designer and as far as I’m concerned that shows), I can recommend Neue Haas Grotesk (a typeface that is true to the original Helvetica, but improved) or Neue Haas Unica (a more fresh looking Helvetica that deviates from the original).

“Helvetica even has its own movie. I haven’t seen it yet, but please comment in the section below if you have.” I have seen it a few times now. It’s quite a pleasure to watch, but there’s a lot of propaganda involved as well. You have the likes of Massimo Vignelli drooling over how great Helvetica is. The man was a pretty great graphic designer (although insisting on always using Helvetica has little to do with graphic design, as one ought to select the perfect typeface for the job, not use one typeface for every job), but he had no insight in type design. On the other hand, you have Erik Spiekermann formulate perfectly what Helvetica stands for. I would say for a type designer the Helvetica documentary is quite pleasant to watch. For the layman I’m afraid the documentary amounts to propaganda. It gives the layman the feeling this is one of the best typefaces out there and it’s simply not, by far.

“Besides its Hollywood (Indie) status, Helvetica is a font that looks great on both print and on screen.” Absolutely not! On Windows computers, websites set in Helvetica tend to look horrendous. The problem is that Helvetica is not well hinted, and so rendering problems occur. Helvetica was obviously not designed for monitors. Neue Helvetica doesn’t have the rendering problem to the same extent I believe, but relatively few people have Neue Helvetica, so it wouldn’t be wise to use that on your website, unless you embed the fonts. For websites I highly recommend using Arial rather than Helvetica.

“Baskerville’s history goes all the way back to 1757 when John Baskerville designed a typeface that works well in print and easy to read.” Easy to read? Not particularly, though it’s not bad either. Baskerville is a transitional typeface, meaning the weight modulation is vertical and the contrast is high. This is the tradition of the Baroque, but it’s not the most pleasant to read. However, Baskerville does look quite academic. For typefaces that are more pleasant to read, I would look at the Garalde style. Garamond and Caslon belong to that classification. They have a diagonal weight modulation, which naturally leads the eyes to the next letters. Typefaces with vertical weight modulation and high contrast tend to feature a fence effect, which disturbs the reading experience. To see this effect well, look at Didone typefaces like Didot and Bodoni.

“This font works best when used in long blocks of text. Try to keep this font between 8 and 14pts for best results.” 14pt seems quite large. Try 9–12pt. This goes for any serif typeface to be used for body text that is intended for print (for the web try 10–14pt, also depending on which device it’s intended for). But again, it will depend on the layout, and always make test prints to make sure it’s pleasant to read.

“Garamond is a great font to be used in long proses such as textbooks, dissertations and theses. Keeping it at 9 point is optional. In fact, my master’s thesis was in Garamond.” I distinctly remember years ago I noticed my Harry Potter book was set in Garamond. Both Garamond and Caslon are still used extensively for books.

However, Garamond may be a bit much for scientific documents. It’s quite classical and it has a low x-height, which these days is not preferable. Caslon is a bit less expressive and has a taller x-height. I would say Caslon is probably better for scientific articles.

One group of typefaces that certainly seems to be missing here is Century. Typefaces like Century Roman and Century Schoolbook. They belong to the Clarendon classification and are reminiscent of typefaces like Baskerville. These typefaces have been popular since the late 19th century and are still used extensively in academic literature. But I suppose you should also make a consideration of whether your article should be about the most comfortable typefaces to read, or the best suitable for scientific work, because they most certainly don’t amount to the same thing, yet you seem to be equating the two in this article.

Hi Martin! Thank you so much for your in-depth note! I have to look over and digest all your excellent points. Would you be open to expanding your writing and be a guest author or send me a link to your website/blog so the readers can have more information about what types to use for their work?

THE quick brown fox jumps over the lazy dog!!!!!

Leelawadee is a bit underrated. It is easy on the eyes, and simple. It could use a bit of a TimesNewRoman-punch to it, though.

Where can I download Helvetica from? I couldn’t find it anywhere

Seriously? I don’t know what this smug guy does with typography, in which he seems to be well versed, but if he were to take up writing he would need to work on his grammar.

I’m not an expert on fonts, but I’m currently using Helvetica for headlines and other Sans text in my thesis and DejaVu for the main text. Feels pretty scientific to me 🙂

I enjoyed the historical aspect of this article. Thanks! PS. I see you use a sans serif font.

How i download these font types?

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Readable & Stylish: The 15 Best Fonts for Reading

BY Bogdan Sandu
24 December 2023

Imagine this: You’re cozily nestled in your favorite reading nook, but the words on the screen start to blur and dance. Frustrating, right? It’s not just you; it’s the font. Fonts can make or break your reading experience, especially in our digital world.

As a web designer, I’ve seen how the right font transforms content from mundane to magnetic. This article dives into the best fonts for reading . We’re not just talking pretty letters here.

It’s about legibility, the subtle art of making text comfortably readable. Think about it – when was the last time you noticed the font on your favorite blog? Probably never, because it was just that good.

You’ll learn the secrets behind choosing fonts that are easy on the eyes . From the classic charm of serif fonts like Georgia to the sleek simplicity of sans-serif options like Arial , each font has its own personality and purpose.

We’ll explore readable typefaces , dive into font legibility factors , and even touch on digital typography standards . Get ready to transform your reading experience with fonts that don’t just look good but feel good to read!

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Best Fonts for Reading: Top 10

Why is it essential to use easy-to-read fonts, what fonts are best for reading, what makes a font easy to read, best reading fonts.

Choosing the best font for reading is a challenge we face more often than it may seem. A readable font may be needed for large-scale projects, like creating a website, designing a book, or developing a mobile app. In the smaller, day-to-day aspects of life, the question of choosing the best reading font is likely to arise as well.

What font is the most convenient for reading? What makes the font easy to read? Which fonts are more suitable for reading books, and which ones are better for on-screen reading? In this article, we are focusing on answering these and several other questions.

Imagine sending off the product you’ve put so much effort into to a customer. You chose a beautiful package for it and promised to deliver it as soon as possible. Unfortunately, the delivery service is slow, and the item gets dropped and dirty on the way. The contents of the package stay the same, but the customer wastes time and patience waiting. Then, their initial good impression is entirely spoiled by looking at a dirty and beaten-up package that takes much effort to open. The customer is not likely to order anything from you anymore.

And a font in this analogy is the delivery service. It influences how easy and pleasant it will be for a user to perceive the information your text is conveying. Some fonts are convenient for fast reading, and others are difficult to read and distract users from the text’s meaning.

However, it doesn’t mean that some fonts are clearly good and others are clearly bad. It all boils down to where you use them: a perfect font for a banner may not be your first choice for a website, and the best font for layout design may not work as efficiently on a sign.

That’s why we will first determine what kinds of fonts suit specific purposes.

In terms of purpose, all fonts can be split into display and text.

Display fonts are vivid and expressive, unusual and a bit odd visually. They attract attention and are used to accentuate text or headlines, so they are often called headline fonts. These fonts make a bold impression in standalone large lettering; however, they aren’t convenient to use for entire text blocks as the eye focuses too much on individual letters, which impedes the understanding of what is written. Display fonts are often full of peculiar details that are fascinating to look at in a large point size. In smaller point sizes, these details become hardly visible. In addition, they may cause the letters to blur, making the text messy and hard to read. One of the key characteristics of display fonts is their high contrast, which makes them so expressive but, at the same time, still harder to read in smaller point sizes.

Text fonts , in turn, serve exactly for typing large text blocks. They are more neutral and calm, with simple designs, low contrast, and no abundance of details. All that makes them more legible in smaller point sizes and allows the eye to smoothly track across the line without getting distracted by the glyph shapes. Besides, text fonts are easy to read in small point sizes. So, this particular category of fonts is the focus of this article.

It is commonly believed that fonts without serifs are better for reading than the ones with serifs. This isn’t true: serif fonts, or Antiquas, can easily be used for texts, and serifs themselves can support text readability. Thus, it’s essential to understand what exactly influences the font readability.

Here, it’s essential to differentiate the concepts of legibility and readability.

When using the term legibility, we are referring to the definition and clarity of individual characters as well as the precision of their contours, which influences how easily different letters can be distinguished.

Readability is influenced by how characters interact with one another, meaning the appearance of the body text during typesetting. This characteristic signifies how comfortable it is to read a large text block.

To begin with, the font should be simple enough to be readable. The easiest-to-read font is simple and rather neutral. Excessive elements blur the characters in small point sizes, and an overly vibrant personality distracts attention and interferes with reading.

The optimal choice for reading fonts is those with rounded contours, as they are better perceived than squared ones. The contour contrast should be visible enough but not too much. An essential role is played by proportions: they must be neutral (when the width of the letter is similar to its height, with a subtle vertical emphasis).

The weight of the lines is also important, as fonts with standard weights are better for reading. That’s why the best option for typing is a Regular font style.

In terms of characters’ width, it influences readability directly as well, so an intermediate option is also recommended. Some of TypeType’s popular typefaces have several subfamilies. The characters in the Normal subfamily have average width, which is the most convenient for text perception. There are also Condensed, Compact, Normal, Expanded, and Mono subfamilies.

Another key role belongs to letter spacing. Intervals that are too big or too small will significantly impede reading.

If your text is made for reading on screens, the font must be high-quality and advanced. Make sure it scales well across multiple devices so the words stay well-defined and legible when adjusting the screen zoom level.

We selected our Top-10 fonts suitable for typing large text blocks from the TypeType collection. They are all equally suitable for electronic formats (be it a phone screen or an electronic book) and text that will be printed on paper.

TT Firs Text

Elegant geometric sans serif TT Firs Text was made for using in text blocks. The font’s design was based on our popular typeface, TT Firs Neue . TT Firs Text kept many of the traits of its reference while being adapted specifically for text typing: every detail is considered for enjoyable reading. Due to more standardized typesetting, the font remains easy to read in smaller point sizes. This minimalist font is perfectly suited for websites and book design.

TT Wellingtons

TT Wellingtons is a Humanist sans serif with shapes that allude to the movement of the wide-nib pen. It gives an aesthetic look to text blocks and can be used in the web industry and for printed materials.

TT Chocolates

Text sans serif TT Chocolates is a visually appealing font with well-balanced proportions and a dense typesetting. It has an aesthetic, friendly, and minimalist look. This makes TT Chocolates an excellent choice for printing, and due to the manual TrueType hinting, it’s also well-suited for web design.

TT Neoris

Neo-Grotesque TT Neoris is an ultra-modern functional font for a multitude of tasks, including text typing. It’s neutral and easy to read while looking fresh and unusual.

TT Interphases Pro

Convenient and modern Neo Grotesque TT Interphases Pro is the optimal choice for screens. This font was specially designed to excel in interfaces. Its static proportions make the text look smooth. The legibility of this font on screens is enhanced by adding height to lowercase characters. And due to its neutral mood and squared shapes of the round characters, it’s comfortable to read in small point sizes, so the font is also well-suited for printing.

TT Norms Pro

TT Norms Pro , an all-purpose functional sans serif, is one of the studio’s bestsellers with a vast use range. It’s user-friendly and equally convenient for web and printing. It includes a large number of characters, an impressive feature set, and supports numerous languages. This font is simple and aesthetic at the same time.

TT Norms Pro Serif

TT Norms Pro Serif is a functional serif with open apertures and low-contrast proportions created with TT Norms Pro as the foundation. Even small text typed in this font will look excellent and read well. The font can be used in website and printed material design as a standalone font or paired with its predecessor.

TT Livret

A modern serif TT Livret has three subfamilies: a high-contrast Display, a moderate-contrast Subhead, and a low-contrast Text. The name of the third subfamily speaks for itself: it suits perfectly for typing large text blocks. Also, TT Livret Text has static proportions and a calm personality. Oval characters, loose spacing, and open apertures—all these features make the font highly comfortable for reading on screens or paper.

TT Jenevers

A Dutch New-Style serif, TT Jenevers , is rather expressive and looks unusual. However, due to large semi-ovals of lowercase characters, letter spacing is smooth, making the font ideal for large text blocks. This font adds a touch of style to both printed and digital publications, all while ensuring an effortless reading experience.

TT Rationalist

TT Rationalist is a functional and captivating slab typeface with elegant rectangular serifs. It can be used in headlines as well as text blocks. This font looks especially aesthetic in printed materials and is equally suitable for electronic books and websites.

We see fonts all the time in a variety of places: on websites, in apps, books, and magazines, on packaging, TV screens, and banners. Regardless of your text’s placement, if readability is key, opt for high-quality and legible fonts. We hope our recommendations were helpful to you!

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PMC10248995

Guidance to best tools and practices for systematic reviews

Kat kolaski.

1 Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC USA

Lynne Romeiser Logan

2 Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY USA

John P. A. Ioannidis

3 Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA USA

Associated Data

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.

A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.

Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13643-023-02255-9.

Part 1. The state of evidence synthesis

Evidence syntheses are commonly regarded as the foundation of evidence-based medicine (EBM). They are widely accredited for providing reliable evidence and, as such, they have significantly influenced medical research and clinical practice. Despite their uptake throughout health care and ubiquity in contemporary medical literature, some important aspects of evidence syntheses are generally overlooked or not well recognized. Evidence syntheses are mostly retrospective exercises, they often depend on weak or irreparably flawed data, and they may use tools that have acknowledged or yet unrecognized limitations. They are complicated and time-consuming undertakings prone to bias and errors. Production of a good evidence synthesis requires careful preparation and high levels of organization in order to limit potential pitfalls [ 1 ]. Many authors do not recognize the complexity of such an endeavor and the many methodological challenges they may encounter. Failure to do so is likely to result in research and resource waste.

Given their potential impact on people’s lives, it is crucial for evidence syntheses to correctly report on the current knowledge base. In order to be perceived as trustworthy, reliable demonstration of the accuracy of evidence syntheses is equally imperative [ 2 ]. Concerns about the trustworthiness of evidence syntheses are not recent developments. From the early years when EBM first began to gain traction until recent times when thousands of systematic reviews are published monthly [ 3 ] the rigor of evidence syntheses has always varied. Many systematic reviews and meta-analyses had obvious deficiencies because original methods and processes had gaps, lacked precision, and/or were not widely known. The situation has improved with empirical research concerning which methods to use and standardization of appraisal tools. However, given the geometrical increase in the number of evidence syntheses being published, a relatively larger pool of unreliable evidence syntheses is being published today.

Publication of methodological studies that critically appraise the methods used in evidence syntheses is increasing at a fast pace. This reflects the availability of tools specifically developed for this purpose [ 4 – 6 ]. Yet many clinical specialties report that alarming numbers of evidence syntheses fail on these assessments. The syntheses identified report on a broad range of common conditions including, but not limited to, cancer, [ 7 ] chronic obstructive pulmonary disease, [ 8 ] osteoporosis, [ 9 ] stroke, [ 10 ] cerebral palsy, [ 11 ] chronic low back pain, [ 12 ] refractive error, [ 13 ] major depression, [ 14 ] pain, [ 15 ] and obesity [ 16 , 17 ]. The situation is even more concerning with regard to evidence syntheses included in clinical practice guidelines (CPGs) [ 18 – 20 ]. Astonishingly, in a sample of CPGs published in 2017–18, more than half did not apply even basic systematic methods in the evidence syntheses used to inform their recommendations [ 21 ].

These reports, while not widely acknowledged, suggest there are pervasive problems not limited to evidence syntheses that evaluate specific kinds of interventions or include primary research of a particular study design (eg, randomized versus non-randomized) [ 22 ]. Similar concerns about the reliability of evidence syntheses have been expressed by proponents of EBM in highly circulated medical journals [ 23 – 26 ]. These publications have also raised awareness about redundancy, inadequate input of statistical expertise, and deficient reporting. These issues plague primary research as well; however, there is heightened concern for the impact of these deficiencies given the critical role of evidence syntheses in policy and clinical decision-making.

Methods and guidance to produce a reliable evidence synthesis

Several international consortiums of EBM experts and national health care organizations currently provide detailed guidance (Table (Table1). 1 ). They draw criteria from the reporting and methodological standards of currently recommended appraisal tools, and regularly review and update their methods to reflect new information and changing needs. In addition, they endorse the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for rating the overall quality of a body of evidence [ 27 ]. These groups typically certify or commission systematic reviews that are published in exclusive databases (eg, Cochrane, JBI) or are used to develop government or agency sponsored guidelines or health technology assessments (eg, National Institute for Health and Care Excellence [NICE], Scottish Intercollegiate Guidelines Network [SIGN], Agency for Healthcare Research and Quality [AHRQ]). They offer developers of evidence syntheses various levels of methodological advice, technical and administrative support, and editorial assistance. Use of specific protocols and checklists are required for development teams within these groups, but their online methodological resources are accessible to any potential author.

Guidance for development of evidence syntheses

Notably, Cochrane is the largest single producer of evidence syntheses in biomedical research; however, these only account for 15% of the total [ 28 ]. The World Health Organization requires Cochrane standards be used to develop evidence syntheses that inform their CPGs [ 29 ]. Authors investigating questions of intervention effectiveness in syntheses developed for Cochrane follow the Methodological Expectations of Cochrane Intervention Reviews [ 30 ] and undergo multi-tiered peer review [ 31 , 32 ]. Several empirical evaluations have shown that Cochrane systematic reviews are of higher methodological quality compared with non-Cochrane reviews [ 4 , 7 , 9 , 11 , 14 , 32 – 35 ]. However, some of these assessments have biases: they may be conducted by Cochrane-affiliated authors, and they sometimes use scales and tools developed and used in the Cochrane environment and by its partners. In addition, evidence syntheses published in the Cochrane database are not subject to space or word restrictions, while non-Cochrane syntheses are often limited. As a result, information that may be relevant to the critical appraisal of non-Cochrane reviews is often removed or is relegated to online-only supplements that may not be readily or fully accessible [ 28 ].

Influences on the state of evidence synthesis

Many authors are familiar with the evidence syntheses produced by the leading EBM organizations but can be intimidated by the time and effort necessary to apply their standards. Instead of following their guidance, authors may employ methods that are discouraged or outdated 28]. Suboptimal methods described in in the literature may then be taken up by others. For example, the Newcastle–Ottawa Scale (NOS) is a commonly used tool for appraising non-randomized studies [ 36 ]. Many authors justify their selection of this tool with reference to a publication that describes the unreliability of the NOS and recommends against its use [ 37 ]. Obviously, the authors who cite this report for that purpose have not read it. Authors and peer reviewers have a responsibility to use reliable and accurate methods and not copycat previous citations or substandard work [ 38 , 39 ]. Similar cautions may potentially extend to automation tools. These have concentrated on evidence searching [ 40 ] and selection given how demanding it is for humans to maintain truly up-to-date evidence [ 2 , 41 ]. Cochrane has deployed machine learning to identify randomized controlled trials (RCTs) and studies related to COVID-19, [ 2 , 42 ] but such tools are not yet commonly used [ 43 ]. The routine integration of automation tools in the development of future evidence syntheses should not displace the interpretive part of the process.

Editorials about unreliable or misleading systematic reviews highlight several of the intertwining factors that may contribute to continued publication of unreliable evidence syntheses: shortcomings and inconsistencies of the peer review process, lack of endorsement of current standards on the part of journal editors, the incentive structure of academia, industry influences, publication bias, and the lure of “predatory” journals [ 44 – 48 ]. At this juncture, clarification of the extent to which each of these factors contribute remains speculative, but their impact is likely to be synergistic.

Over time, the generalized acceptance of the conclusions of systematic reviews as incontrovertible has affected trends in the dissemination and uptake of evidence. Reporting of the results of evidence syntheses and recommendations of CPGs has shifted beyond medical journals to press releases and news headlines and, more recently, to the realm of social media and influencers. The lay public and policy makers may depend on these outlets for interpreting evidence syntheses and CPGs. Unfortunately, communication to the general public often reflects intentional or non-intentional misrepresentation or “spin” of the research findings [ 49 – 52 ] News and social media outlets also tend to reduce conclusions on a body of evidence and recommendations for treatment to binary choices (eg, “do it” versus “don’t do it”) that may be assigned an actionable symbol (eg, red/green traffic lights, smiley/frowning face emoji).

Strategies for improvement

Many authors and peer reviewers are volunteer health care professionals or trainees who lack formal training in evidence synthesis [ 46 , 53 ]. Informing them about research methodology could increase the likelihood they will apply rigorous methods [ 25 , 33 , 45 ]. We tackle this challenge, from both a theoretical and a practical perspective, by offering guidance applicable to any specialty. It is based on recent methodological research that is extensively referenced to promote self-study. However, the information presented is not intended to be substitute for committed training in evidence synthesis methodology; instead, we hope to inspire our target audience to seek such training. We also hope to inform a broader audience of clinicians and guideline developers influenced by evidence syntheses. Notably, these communities often include the same members who serve in different capacities.

In the following sections, we highlight methodological concepts and practices that may be unfamiliar, problematic, confusing, or controversial. In Part 2, we consider various types of evidence syntheses and the types of research evidence summarized by them. In Part 3, we examine some widely used (and misused) tools for the critical appraisal of systematic reviews and reporting guidelines for evidence syntheses. In Part 4, we discuss how to meet methodological conduct standards applicable to key components of systematic reviews. In Part 5, we describe the merits and caveats of rating the overall certainty of a body of evidence. Finally, in Part 6, we summarize suggested terminology, methods, and tools for development and evaluation of evidence syntheses that reflect current best practices.

Part 2. Types of syntheses and research evidence

A good foundation for the development of evidence syntheses requires an appreciation of their various methodologies and the ability to correctly identify the types of research potentially available for inclusion in the synthesis.

Types of evidence syntheses

Systematic reviews have historically focused on the benefits and harms of interventions; over time, various types of systematic reviews have emerged to address the diverse information needs of clinicians, patients, and policy makers [ 54 ] Systematic reviews with traditional components have become defined by the different topics they assess (Table 2.1 ). In addition, other distinctive types of evidence syntheses have evolved, including overviews or umbrella reviews, scoping reviews, rapid reviews, and living reviews. The popularity of these has been increasing in recent years [ 55 – 58 ]. A summary of the development, methods, available guidance, and indications for these unique types of evidence syntheses is available in Additional File 2 A.

Types of traditional systematic reviews

Both Cochrane [ 30 , 59 ] and JBI [ 60 ] provide methodologies for many types of evidence syntheses; they describe these with different terminology, but there is obvious overlap (Table 2.2 ). The majority of evidence syntheses published by Cochrane (96%) and JBI (62%) are categorized as intervention reviews. This reflects the earlier development and dissemination of their intervention review methodologies; these remain well-established [ 30 , 59 , 61 ] as both organizations continue to focus on topics related to treatment efficacy and harms. In contrast, intervention reviews represent only about half of the total published in the general medical literature, and several non-intervention review types contribute to a significant proportion of the other half.

Evidence syntheses published by Cochrane and JBI

a Data from https://www.cochranelibrary.com/cdsr/reviews . Accessed 17 Sep 2022

b Data obtained via personal email communication on 18 Sep 2022 with Emilie Francis, editorial assistant, JBI Evidence Synthesis

c Includes the following categories: prevalence, scoping, mixed methods, and realist reviews

d This methodology is not supported in the current version of the JBI Manual for Evidence Synthesis

Types of research evidence

There is consensus on the importance of using multiple study designs in evidence syntheses; at the same time, there is a lack of agreement on methods to identify included study designs. Authors of evidence syntheses may use various taxonomies and associated algorithms to guide selection and/or classification of study designs. These tools differentiate categories of research and apply labels to individual study designs (eg, RCT, cross-sectional). A familiar example is the Design Tree endorsed by the Centre for Evidence-Based Medicine [ 70 ]. Such tools may not be helpful to authors of evidence syntheses for multiple reasons.

Suboptimal levels of agreement and accuracy even among trained methodologists reflect challenges with the application of such tools [ 71 , 72 ]. Problematic distinctions or decision points (eg, experimental or observational, controlled or uncontrolled, prospective or retrospective) and design labels (eg, cohort, case control, uncontrolled trial) have been reported [ 71 ]. The variable application of ambiguous study design labels to non-randomized studies is common, making them especially prone to misclassification [ 73 ]. In addition, study labels do not denote the unique design features that make different types of non-randomized studies susceptible to different biases, including those related to how the data are obtained (eg, clinical trials, disease registries, wearable devices). Given this limitation, it is important to be aware that design labels preclude the accurate assignment of non-randomized studies to a “level of evidence” in traditional hierarchies [ 74 ].

These concerns suggest that available tools and nomenclature used to distinguish types of research evidence may not uniformly apply to biomedical research and non-health fields that utilize evidence syntheses (eg, education, economics) [ 75 , 76 ]. Moreover, primary research reports often do not describe study design or do so incompletely or inaccurately; thus, indexing in PubMed and other databases does not address the potential for misclassification [ 77 ]. Yet proper identification of research evidence has implications for several key components of evidence syntheses. For example, search strategies limited by index terms using design labels or study selection based on labels applied by the authors of primary studies may cause inconsistent or unjustified study inclusions and/or exclusions [ 77 ]. In addition, because risk of bias (RoB) tools consider attributes specific to certain types of studies and study design features, results of these assessments may be invalidated if an inappropriate tool is used. Appropriate classification of studies is also relevant for the selection of a suitable method of synthesis and interpretation of those results.

An alternative to these tools and nomenclature involves application of a few fundamental distinctions that encompass a wide range of research designs and contexts. While these distinctions are not novel, we integrate them into a practical scheme (see Fig. Fig.1) 1 ) designed to guide authors of evidence syntheses in the basic identification of research evidence. The initial distinction is between primary and secondary studies. Primary studies are then further distinguished by: 1) the type of data reported (qualitative or quantitative); and 2) two defining design features (group or single-case and randomized or non-randomized). The different types of studies and study designs represented in the scheme are described in detail in Additional File 2 B. It is important to conceptualize their methods as complementary as opposed to contrasting or hierarchical [ 78 ]; each offers advantages and disadvantages that determine their appropriateness for answering different kinds of research questions in an evidence synthesis.

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Distinguishing types of research evidence

Application of these basic distinctions may avoid some of the potential difficulties associated with study design labels and taxonomies. Nevertheless, debatable methodological issues are raised when certain types of research identified in this scheme are included in an evidence synthesis. We briefly highlight those associated with inclusion of non-randomized studies, case reports and series, and a combination of primary and secondary studies.

Non-randomized studies

When investigating an intervention’s effectiveness, it is important for authors to recognize the uncertainty of observed effects reported by studies with high RoB. Results of statistical analyses that include such studies need to be interpreted with caution in order to avoid misleading conclusions [ 74 ]. Review authors may consider excluding randomized studies with high RoB from meta-analyses. Non-randomized studies of intervention (NRSI) are affected by a greater potential range of biases and thus vary more than RCTs in their ability to estimate a causal effect [ 79 ]. If data from NRSI are synthesized in meta-analyses, it is helpful to separately report their summary estimates [ 6 , 74 ].

Nonetheless, certain design features of NRSI (eg, which parts of the study were prospectively designed) may help to distinguish stronger from weaker ones. Cochrane recommends that authors of a review including NRSI focus on relevant study design features when determining eligibility criteria instead of relying on non-informative study design labels [ 79 , 80 ] This process is facilitated by a study design feature checklist; guidance on using the checklist is included with developers’ description of the tool [ 73 , 74 ]. Authors collect information about these design features during data extraction and then consider it when making final study selection decisions and when performing RoB assessments of the included NRSI.

Case reports and case series

Correctly identified case reports and case series can contribute evidence not well captured by other designs [ 81 ]; in addition, some topics may be limited to a body of evidence that consists primarily of uncontrolled clinical observations. Murad and colleagues offer a framework for how to include case reports and series in an evidence synthesis [ 82 ]. Distinguishing between cohort studies and case series in these syntheses is important, especially for those that rely on evidence from NRSI. Additional data obtained from studies misclassified as case series can potentially increase the confidence in effect estimates. Mathes and Pieper provide authors of evidence syntheses with specific guidance on distinguishing between cohort studies and case series, but emphasize the increased workload involved [ 77 ].

Primary and secondary studies

Synthesis of combined evidence from primary and secondary studies may provide a broad perspective on the entirety of available literature on a topic. This is, in fact, the recommended strategy for scoping reviews that may include a variety of sources of evidence (eg, CPGs, popular media). However, except for scoping reviews, the synthesis of data from primary and secondary studies is discouraged unless there are strong reasons to justify doing so.

Combining primary and secondary sources of evidence is challenging for authors of other types of evidence syntheses for several reasons [ 83 ]. Assessments of RoB for primary and secondary studies are derived from conceptually different tools, thus obfuscating the ability to make an overall RoB assessment of a combination of these study types. In addition, authors who include primary and secondary studies must devise non-standardized methods for synthesis. Note this contrasts with well-established methods available for updating existing evidence syntheses with additional data from new primary studies [ 84 – 86 ]. However, a new review that synthesizes data from primary and secondary studies raises questions of validity and may unintentionally support a biased conclusion because no existing methodological guidance is currently available [ 87 ].

Recommendations

We suggest that journal editors require authors to identify which type of evidence synthesis they are submitting and reference the specific methodology used for its development. This will clarify the research question and methods for peer reviewers and potentially simplify the editorial process. Editors should announce this practice and include it in the instructions to authors. To decrease bias and apply correct methods, authors must also accurately identify the types of research evidence included in their syntheses.

Part 3. Conduct and reporting

The need to develop criteria to assess the rigor of systematic reviews was recognized soon after the EBM movement began to gain international traction [ 88 , 89 ]. Systematic reviews rapidly became popular, but many were very poorly conceived, conducted, and reported. These problems remain highly prevalent [ 23 ] despite development of guidelines and tools to standardize and improve the performance and reporting of evidence syntheses [ 22 , 28 ]. Table 3.1 provides some historical perspective on the evolution of tools developed specifically for the evaluation of systematic reviews, with or without meta-analysis.

Tools specifying standards for systematic reviews with and without meta-analysis

a Currently recommended

b Validated tool for systematic reviews of interventions developed for use by authors of overviews or umbrella reviews

These tools are often interchangeably invoked when referring to the “quality” of an evidence synthesis. However, quality is a vague term that is frequently misused and misunderstood; more precisely, these tools specify different standards for evidence syntheses. Methodological standards address how well a systematic review was designed and performed [ 5 ]. RoB assessments refer to systematic flaws or limitations in the design, conduct, or analysis of research that distort the findings of the review [ 4 ]. Reporting standards help systematic review authors describe the methodology they used and the results of their synthesis in sufficient detail [ 92 ]. It is essential to distinguish between these evaluations: a systematic review may be biased, it may fail to report sufficient information on essential features, or it may exhibit both problems; a thoroughly reported systematic evidence synthesis review may still be biased and flawed while an otherwise unbiased one may suffer from deficient documentation.

We direct attention to the currently recommended tools listed in Table 3.1 but concentrate on AMSTAR-2 (update of AMSTAR [A Measurement Tool to Assess Systematic Reviews]) and ROBIS (Risk of Bias in Systematic Reviews), which evaluate methodological quality and RoB, respectively. For comparison and completeness, we include PRISMA 2020 (update of the 2009 Preferred Reporting Items for Systematic Reviews of Meta-Analyses statement), which offers guidance on reporting standards. The exclusive focus on these three tools is by design; it addresses concerns related to the considerable variability in tools used for the evaluation of systematic reviews [ 28 , 88 , 96 , 97 ]. We highlight the underlying constructs these tools were designed to assess, then describe their components and applications. Their known (or potential) uptake and impact and limitations are also discussed.

Evaluation of conduct

Development.

AMSTAR [ 5 ] was in use for a decade prior to the 2017 publication of AMSTAR-2; both provide a broad evaluation of methodological quality of intervention systematic reviews, including flaws arising through poor conduct of the review [ 6 ]. ROBIS, published in 2016, was developed to specifically assess RoB introduced by the conduct of the review; it is applicable to systematic reviews of interventions and several other types of reviews [ 4 ]. Both tools reflect a shift to a domain-based approach as opposed to generic quality checklists. There are a few items unique to each tool; however, similarities between items have been demonstrated [ 98 , 99 ]. AMSTAR-2 and ROBIS are recommended for use by: 1) authors of overviews or umbrella reviews and CPGs to evaluate systematic reviews considered as evidence; 2) authors of methodological research studies to appraise included systematic reviews; and 3) peer reviewers for appraisal of submitted systematic review manuscripts. For authors, these tools may function as teaching aids and inform conduct of their review during its development.

Description

Systematic reviews that include randomized and/or non-randomized studies as evidence can be appraised with AMSTAR-2 and ROBIS. Other characteristics of AMSTAR-2 and ROBIS are summarized in Table 3.2 . Both tools define categories for an overall rating; however, neither tool is intended to generate a total score by simply calculating the number of responses satisfying criteria for individual items [ 4 , 6 ]. AMSTAR-2 focuses on the rigor of a review’s methods irrespective of the specific subject matter. ROBIS places emphasis on a review’s results section— this suggests it may be optimally applied by appraisers with some knowledge of the review’s topic as they may be better equipped to determine if certain procedures (or lack thereof) would impact the validity of a review’s findings [ 98 , 100 ]. Reliability studies show AMSTAR-2 overall confidence ratings strongly correlate with the overall RoB ratings in ROBIS [ 100 , 101 ].

Comparison of AMSTAR-2 and ROBIS

a ROBIS includes an optional first phase to assess the applicability of the review to the research question of interest. The tool may be applicable to other review types in addition to the four specified, although modification of this initial phase will be needed (Personal Communication via email, Penny Whiting, 28 Jan 2022)

b AMSTAR-2 item #9 and #11 require separate responses for RCTs and NRSI

Interrater reliability has been shown to be acceptable for AMSTAR-2 [ 6 , 11 , 102 ] and ROBIS [ 4 , 98 , 103 ] but neither tool has been shown to be superior in this regard [ 100 , 101 , 104 , 105 ]. Overall, variability in reliability for both tools has been reported across items, between pairs of raters, and between centers [ 6 , 100 , 101 , 104 ]. The effects of appraiser experience on the results of AMSTAR-2 and ROBIS require further evaluation [ 101 , 105 ]. Updates to both tools should address items shown to be prone to individual appraisers’ subjective biases and opinions [ 11 , 100 ]; this may involve modifications of the current domains and signaling questions as well as incorporation of methods to make an appraiser’s judgments more explicit. Future revisions of these tools may also consider the addition of standards for aspects of systematic review development currently lacking (eg, rating overall certainty of evidence, [ 99 ] methods for synthesis without meta-analysis [ 105 ]) and removal of items that assess aspects of reporting that are thoroughly evaluated by PRISMA 2020.

Application

A good understanding of what is required to satisfy the standards of AMSTAR-2 and ROBIS involves study of the accompanying guidance documents written by the tools’ developers; these contain detailed descriptions of each item’s standards. In addition, accurate appraisal of a systematic review with either tool requires training. Most experts recommend independent assessment by at least two appraisers with a process for resolving discrepancies as well as procedures to establish interrater reliability, such as pilot testing, a calibration phase or exercise, and development of predefined decision rules [ 35 , 99 – 101 , 103 , 104 , 106 ]. These methods may, to some extent, address the challenges associated with the diversity in methodological training, subject matter expertise, and experience using the tools that are likely to exist among appraisers.

The standards of AMSTAR, AMSTAR-2, and ROBIS have been used in many methodological studies and epidemiological investigations. However, the increased publication of overviews or umbrella reviews and CPGs has likely been a greater influence on the widening acceptance of these tools. Critical appraisal of the secondary studies considered evidence is essential to the trustworthiness of both the recommendations of CPGs and the conclusions of overviews. Currently both Cochrane [ 55 ] and JBI [ 107 ] recommend AMSTAR-2 and ROBIS in their guidance for authors of overviews or umbrella reviews. However, ROBIS and AMSTAR-2 were released in 2016 and 2017, respectively; thus, to date, limited data have been reported about the uptake of these tools or which of the two may be preferred [ 21 , 106 ]. Currently, in relation to CPGs, AMSTAR-2 appears to be overwhelmingly popular compared to ROBIS. A Google Scholar search of this topic (search terms “AMSTAR 2 AND clinical practice guidelines,” “ROBIS AND clinical practice guidelines” 13 May 2022) found 12,700 hits for AMSTAR-2 and 1,280 for ROBIS. The apparent greater appeal of AMSTAR-2 may relate to its longer track record given the original version of the tool was in use for 10 years prior to its update in 2017.

Barriers to the uptake of AMSTAR-2 and ROBIS include the real or perceived time and resources necessary to complete the items they include and appraisers’ confidence in their own ratings [ 104 ]. Reports from comparative studies available to date indicate that appraisers find AMSTAR-2 questions, responses, and guidance to be clearer and simpler compared with ROBIS [ 11 , 101 , 104 , 105 ]. This suggests that for appraisal of intervention systematic reviews, AMSTAR-2 may be a more practical tool than ROBIS, especially for novice appraisers [ 101 , 103 – 105 ]. The unique characteristics of each tool, as well as their potential advantages and disadvantages, should be taken into consideration when deciding which tool should be used for an appraisal of a systematic review. In addition, the choice of one or the other may depend on how the results of an appraisal will be used; for example, a peer reviewer’s appraisal of a single manuscript versus an appraisal of multiple systematic reviews in an overview or umbrella review, CPG, or systematic methodological study.

Authors of overviews and CPGs report results of AMSTAR-2 and ROBIS appraisals for each of the systematic reviews they include as evidence. Ideally, an independent judgment of their appraisals can be made by the end users of overviews and CPGs; however, most stakeholders, including clinicians, are unlikely to have a sophisticated understanding of these tools. Nevertheless, they should at least be aware that AMSTAR-2 and ROBIS ratings reported in overviews and CPGs may be inaccurate because the tools are not applied as intended by their developers. This can result from inadequate training of the overview or CPG authors who perform the appraisals, or to modifications of the appraisal tools imposed by them. The potential variability in overall confidence and RoB ratings highlights why appraisers applying these tools need to support their judgments with explicit documentation; this allows readers to judge for themselves whether they agree with the criteria used by appraisers [ 4 , 108 ]. When these judgments are explicit, the underlying rationale used when applying these tools can be assessed [ 109 ].

Theoretically, we would expect an association of AMSTAR-2 with improved methodological rigor and an association of ROBIS with lower RoB in recent systematic reviews compared to those published before 2017. To our knowledge, this has not yet been demonstrated; however, like reports about the actual uptake of these tools, time will tell. Additional data on user experience is also needed to further elucidate the practical challenges and methodological nuances encountered with the application of these tools. This information could potentially inform the creation of unifying criteria to guide and standardize the appraisal of evidence syntheses [ 109 ].

Evaluation of reporting

Complete reporting is essential for users to establish the trustworthiness and applicability of a systematic review’s findings. Efforts to standardize and improve the reporting of systematic reviews resulted in the 2009 publication of the PRISMA statement [ 92 ] with its accompanying explanation and elaboration document [ 110 ]. This guideline was designed to help authors prepare a complete and transparent report of their systematic review. In addition, adherence to PRISMA is often used to evaluate the thoroughness of reporting of published systematic reviews [ 111 ]. The updated version, PRISMA 2020 [ 93 ], and its guidance document [ 112 ] were published in 2021. Items on the original and updated versions of PRISMA are organized by the six basic review components they address (title, abstract, introduction, methods, results, discussion). The PRISMA 2020 update is a considerably expanded version of the original; it includes standards and examples for the 27 original and 13 additional reporting items that capture methodological advances and may enhance the replicability of reviews [ 113 ].

The original PRISMA statement fostered the development of various PRISMA extensions (Table 3.3 ). These include reporting guidance for scoping reviews and reviews of diagnostic test accuracy and for intervention reviews that report on the following: harms outcomes, equity issues, the effects of acupuncture, the results of network meta-analyses and analyses of individual participant data. Detailed reporting guidance for specific systematic review components (abstracts, protocols, literature searches) is also available.

PRISMA extensions

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

a Note the abstract reporting checklist is now incorporated into PRISMA 2020 [ 93 ]

Uptake and impact

The 2009 PRISMA standards [ 92 ] for reporting have been widely endorsed by authors, journals, and EBM-related organizations. We anticipate the same for PRISMA 2020 [ 93 ] given its co-publication in multiple high-impact journals. However, to date, there is a lack of strong evidence for an association between improved systematic review reporting and endorsement of PRISMA 2009 standards [ 43 , 111 ]. Most journals require a PRISMA checklist accompany submissions of systematic review manuscripts. However, the accuracy of information presented on these self-reported checklists is not necessarily verified. It remains unclear which strategies (eg, authors’ self-report of checklists, peer reviewer checks) might improve adherence to the PRISMA reporting standards; in addition, the feasibility of any potentially effective strategies must be taken into consideration given the structure and limitations of current research and publication practices [ 124 ].

Pitfalls and limitations of PRISMA, AMSTAR-2, and ROBIS

Misunderstanding of the roles of these tools and their misapplication may be widespread problems. PRISMA 2020 is a reporting guideline that is most beneficial if consulted when developing a review as opposed to merely completing a checklist when submitting to a journal; at that point, the review is finished, with good or bad methodological choices. However, PRISMA checklists evaluate how completely an element of review conduct was reported, but do not evaluate the caliber of conduct or performance of a review. Thus, review authors and readers should not think that a rigorous systematic review can be produced by simply following the PRISMA 2020 guidelines. Similarly, it is important to recognize that AMSTAR-2 and ROBIS are tools to evaluate the conduct of a review but do not substitute for conceptual methodological guidance. In addition, they are not intended to be simple checklists. In fact, they have the potential for misuse or abuse if applied as such; for example, by calculating a total score to make a judgment about a review’s overall confidence or RoB. Proper selection of a response for the individual items on AMSTAR-2 and ROBIS requires training or at least reference to their accompanying guidance documents.

Not surprisingly, it has been shown that compliance with the PRISMA checklist is not necessarily associated with satisfying the standards of ROBIS [ 125 ]. AMSTAR-2 and ROBIS were not available when PRISMA 2009 was developed; however, they were considered in the development of PRISMA 2020 [ 113 ]. Therefore, future studies may show a positive relationship between fulfillment of PRISMA 2020 standards for reporting and meeting the standards of tools evaluating methodological quality and RoB.

Choice of an appropriate tool for the evaluation of a systematic review first involves identification of the underlying construct to be assessed. For systematic reviews of interventions, recommended tools include AMSTAR-2 and ROBIS for appraisal of conduct and PRISMA 2020 for completeness of reporting. All three tools were developed rigorously and provide easily accessible and detailed user guidance, which is necessary for their proper application and interpretation. When considering a manuscript for publication, training in these tools can sensitize peer reviewers and editors to major issues that may affect the review’s trustworthiness and completeness of reporting. Judgment of the overall certainty of a body of evidence and formulation of recommendations rely, in part, on AMSTAR-2 or ROBIS appraisals of systematic reviews. Therefore, training on the application of these tools is essential for authors of overviews and developers of CPGs. Peer reviewers and editors considering an overview or CPG for publication must hold their authors to a high standard of transparency regarding both the conduct and reporting of these appraisals.

Part 4. Meeting conduct standards

Many authors, peer reviewers, and editors erroneously equate fulfillment of the items on the PRISMA checklist with superior methodological rigor. For direction on methodology, we refer them to available resources that provide comprehensive conceptual guidance [ 59 , 60 ] as well as primers with basic step-by-step instructions [ 1 , 126 , 127 ]. This section is intended to complement study of such resources by facilitating use of AMSTAR-2 and ROBIS, tools specifically developed to evaluate methodological rigor of systematic reviews. These tools are widely accepted by methodologists; however, in the general medical literature, they are not uniformly selected for the critical appraisal of systematic reviews [ 88 , 96 ].

To enable their uptake, Table 4.1 links review components to the corresponding appraisal tool items. Expectations of AMSTAR-2 and ROBIS are concisely stated, and reasoning provided.

Systematic review components linked to appraisal with AMSTAR-2 and ROBIS a

CoI conflict of interest, MA meta-analysis, NA not addressed, PICO participant, intervention, comparison, outcome, PRISMA-P Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, RoB risk of bias

a Components shown in bold are chosen for elaboration in Part 4 for one (or both) of two reasons: 1) the component has been identified as potentially problematic for systematic review authors; and/or 2) the component is evaluated by standards of an AMSTAR-2 “critical” domain

b Critical domains of AMSTAR-2 are indicated by *

Issues involved in meeting the standards for seven review components (identified in bold in Table 4.1 ) are addressed in detail. These were chosen for elaboration for one (or both) of two reasons: 1) the component has been identified as potentially problematic for systematic review authors based on consistent reports of their frequent AMSTAR-2 or ROBIS deficiencies [ 9 , 11 , 15 , 88 , 128 , 129 ]; and/or 2) the review component is judged by standards of an AMSTAR-2 “critical” domain. These have the greatest implications for how a systematic review will be appraised: if standards for any one of these critical domains are not met, the review is rated as having “critically low confidence.”

Research question

Specific and unambiguous research questions may have more value for reviews that deal with hypothesis testing. Mnemonics for the various elements of research questions are suggested by JBI and Cochrane (Table 2.1 ). These prompt authors to consider the specialized methods involved for developing different types of systematic reviews; however, while inclusion of the suggested elements makes a review compliant with a particular review’s methods, it does not necessarily make a research question appropriate. Table 4.2 lists acronyms that may aid in developing the research question. They include overlapping concepts of importance in this time of proliferating reviews of uncertain value [ 130 ]. If these issues are not prospectively contemplated, systematic review authors may establish an overly broad scope, or develop runaway scope allowing them to stray from predefined choices relating to key comparisons and outcomes.

Research question development

a Cummings SR, Browner WS, Hulley SB. Conceiving the research question and developing the study plan. In: Hulley SB, Cummings SR, Browner WS, editors. Designing clinical research: an epidemiological approach; 4th edn. Lippincott Williams & Wilkins; 2007. p. 14–22

b Doran, GT. There’s a S.M.A.R.T. way to write management’s goals and objectives. Manage Rev. 1981;70:35-6.

c Johnson BT, Hennessy EA. Systematic reviews and meta-analyses in the health sciences: best practice methods for research syntheses. Soc Sci Med. 2019;233:237–51

Once a research question is established, searching on registry sites and databases for existing systematic reviews addressing the same or a similar topic is necessary in order to avoid contributing to research waste [ 131 ]. Repeating an existing systematic review must be justified, for example, if previous reviews are out of date or methodologically flawed. A full discussion on replication of intervention systematic reviews, including a consensus checklist, can be found in the work of Tugwell and colleagues [ 84 ].

Protocol development is considered a core component of systematic reviews [ 125 , 126 , 132 ]. Review protocols may allow researchers to plan and anticipate potential issues, assess validity of methods, prevent arbitrary decision-making, and minimize bias that can be introduced by the conduct of the review. Registration of a protocol that allows public access promotes transparency of the systematic review’s methods and processes and reduces the potential for duplication [ 132 ]. Thinking early and carefully about all the steps of a systematic review is pragmatic and logical and may mitigate the influence of the authors’ prior knowledge of the evidence [ 133 ]. In addition, the protocol stage is when the scope of the review can be carefully considered by authors, reviewers, and editors; this may help to avoid production of overly ambitious reviews that include excessive numbers of comparisons and outcomes or are undisciplined in their study selection.

An association with attainment of AMSTAR standards in systematic reviews with published prospective protocols has been reported [ 134 ]. However, completeness of reporting does not seem to be different in reviews with a protocol compared to those without one [ 135 ]. PRISMA-P [ 116 ] and its accompanying elaboration and explanation document [ 136 ] can be used to guide and assess the reporting of protocols. A final version of the review should fully describe any protocol deviations. Peer reviewers may compare the submitted manuscript with any available pre-registered protocol; this is required if AMSTAR-2 or ROBIS are used for critical appraisal.

There are multiple options for the recording of protocols (Table 4.3 ). Some journals will peer review and publish protocols. In addition, many online sites offer date-stamped and publicly accessible protocol registration. Some of these are exclusively for protocols of evidence syntheses; others are less restrictive and offer researchers the capacity for data storage, sharing, and other workflow features. These sites document protocol details to varying extents and have different requirements [ 137 ]. The most popular site for systematic reviews, the International Prospective Register of Systematic Reviews (PROSPERO), for example, only registers reviews that report on an outcome with direct relevance to human health. The PROSPERO record documents protocols for all types of reviews except literature and scoping reviews. Of note, PROSPERO requires authors register their review protocols prior to any data extraction [ 133 , 138 ]. The electronic records of most of these registry sites allow authors to update their protocols and facilitate transparent tracking of protocol changes, which are not unexpected during the progress of the review [ 139 ].

Options for protocol registration of evidence syntheses

a Authors are advised to contact their target journal regarding submission of systematic review protocols

b Registration is restricted to approved review projects

c The JBI registry lists review projects currently underway by JBI-affiliated entities. These records include a review’s title, primary author, research question, and PICO elements. JBI recommends that authors register eligible protocols with PROSPERO

d See Pieper and Rombey [ 137 ] for detailed characteristics of these five registries

e See Pieper and Rombey [ 137 ] for other systematic review data repository options

Study design inclusion

For most systematic reviews, broad inclusion of study designs is recommended [ 126 ]. This may allow comparison of results between contrasting study design types [ 126 ]. Certain study designs may be considered preferable depending on the type of review and nature of the research question. However, prevailing stereotypes about what each study design does best may not be accurate. For example, in systematic reviews of interventions, randomized designs are typically thought to answer highly specific questions while non-randomized designs often are expected to reveal greater information about harms or real-word evidence [ 126 , 140 , 141 ]. This may be a false distinction; randomized trials may be pragmatic [ 142 ], they may offer important (and more unbiased) information on harms [ 143 ], and data from non-randomized trials may not necessarily be more real-world-oriented [ 144 ].

Moreover, there may not be any available evidence reported by RCTs for certain research questions; in some cases, there may not be any RCTs or NRSI. When the available evidence is limited to case reports and case series, it is not possible to test hypotheses nor provide descriptive estimates or associations; however, a systematic review of these studies can still offer important insights [ 81 , 145 ]. When authors anticipate that limited evidence of any kind may be available to inform their research questions, a scoping review can be considered. Alternatively, decisions regarding inclusion of indirect as opposed to direct evidence can be addressed during protocol development [ 146 ]. Including indirect evidence at an early stage of intervention systematic review development allows authors to decide if such studies offer any additional and/or different understanding of treatment effects for their population or comparison of interest. Issues of indirectness of included studies are accounted for later in the process, during determination of the overall certainty of evidence (see Part 5 for details).

Evidence search

Both AMSTAR-2 and ROBIS require systematic and comprehensive searches for evidence. This is essential for any systematic review. Both tools discourage search restrictions based on language and publication source. Given increasing globalism in health care, the practice of including English-only literature should be avoided [ 126 ]. There are many examples in which language bias (different results in studies published in different languages) has been documented [ 147 , 148 ]. This does not mean that all literature, in all languages, is equally trustworthy [ 148 ]; however, the only way to formally probe for the potential of such biases is to consider all languages in the initial search. The gray literature and a search of trials may also reveal important details about topics that would otherwise be missed [ 149 – 151 ]. Again, inclusiveness will allow review authors to investigate whether results differ in gray literature and trials [ 41 , 151 – 153 ].

Authors should make every attempt to complete their review within one year as that is the likely viable life of a search. (1) If that is not possible, the search should be updated close to the time of completion [ 154 ]. Different research topics may warrant less of a delay, for example, in rapidly changing fields (as in the case of the COVID-19 pandemic), even one month may radically change the available evidence.

Excluded studies

AMSTAR-2 requires authors to provide references for any studies excluded at the full text phase of study selection along with reasons for exclusion; this allows readers to feel confident that all relevant literature has been considered for inclusion and that exclusions are defensible.

Risk of bias assessment of included studies

The design of the studies included in a systematic review (eg, RCT, cohort, case series) should not be equated with appraisal of its RoB. To meet AMSTAR-2 and ROBIS standards, systematic review authors must examine RoB issues specific to the design of each primary study they include as evidence. It is unlikely that a single RoB appraisal tool will be suitable for all research designs. In addition to tools for randomized and non-randomized studies, specific tools are available for evaluation of RoB in case reports and case series [ 82 ] and single-case experimental designs [ 155 , 156 ]. Note the RoB tools selected must meet the standards of the appraisal tool used to judge the conduct of the review. For example, AMSTAR-2 identifies four sources of bias specific to RCTs and NRSI that must be addressed by the RoB tool(s) chosen by the review authors. The Cochrane RoB-2 [ 157 ] tool for RCTs and ROBINS-I [ 158 ] for NRSI for RoB assessment meet the AMSTAR-2 standards. Appraisers on the review team should not modify any RoB tool without complete transparency and acknowledgment that they have invalidated the interpretation of the tool as intended by its developers [ 159 ]. Conduct of RoB assessments is not addressed AMSTAR-2; to meet ROBIS standards, two independent reviewers should complete RoB assessments of included primary studies.

Implications of the RoB assessments must be explicitly discussed and considered in the conclusions of the review. Discussion of the overall RoB of included studies may consider the weight of the studies at high RoB, the importance of the sources of bias in the studies being summarized, and if their importance differs in relationship to the outcomes reported. If a meta-analysis is performed, serious concerns for RoB of individual studies should be accounted for in these results as well. If the results of the meta-analysis for a specific outcome change when studies at high RoB are excluded, readers will have a more accurate understanding of this body of evidence. However, while investigating the potential impact of specific biases is a useful exercise, it is important to avoid over-interpretation, especially when there are sparse data.

Synthesis methods for quantitative data

Syntheses of quantitative data reported by primary studies are broadly categorized as one of two types: meta-analysis, and synthesis without meta-analysis (Table 4.4 ). Before deciding on one of these methods, authors should seek methodological advice about whether reported data can be transformed or used in other ways to provide a consistent effect measure across studies [ 160 , 161 ].

Common methods for quantitative synthesis

CI confidence interval (or credible interval, if analysis is done in Bayesian framework)

a See text for descriptions of the types of data combined in each of these approaches

b See Additional File 4 for guidance on the structure and presentation of forest plots

c General approach is similar to aggregate data meta-analysis but there are substantial differences relating to data collection and checking and analysis [ 162 ]. This approach to syntheses is applicable to intervention, diagnostic, and prognostic systematic reviews [ 163 ]

d Examples include meta-regression, hierarchical and multivariate approaches [ 164 ]

e In-depth guidance and illustrations of these methods are provided in Chapter 12 of the Cochrane Handbook [ 160 ]

Meta-analysis

Systematic reviews that employ meta-analysis should not be referred to simply as “meta-analyses.” The term meta-analysis strictly refers to a specific statistical technique used when study effect estimates and their variances are available, yielding a quantitative summary of results. In general, methods for meta-analysis involve use of a weighted average of effect estimates from two or more studies. If considered carefully, meta-analysis increases the precision of the estimated magnitude of effect and can offer useful insights about heterogeneity and estimates of effects. We refer to standard references for a thorough introduction and formal training [ 165 – 167 ].

There are three common approaches to meta-analysis in current health care–related systematic reviews (Table 4.4 ). Aggregate meta-analyses is the most familiar to authors of evidence syntheses and their end users. This standard meta-analysis combines data on effect estimates reported by studies that investigate similar research questions involving direct comparisons of an intervention and comparator. Results of these analyses provide a single summary intervention effect estimate. If the included studies in a systematic review measure an outcome differently, their reported results may be transformed to make them comparable [ 161 ]. Forest plots visually present essential information about the individual studies and the overall pooled analysis (see Additional File 4 for details).

Less familiar and more challenging meta-analytical approaches used in secondary research include individual participant data (IPD) and network meta-analyses (NMA); PRISMA extensions provide reporting guidelines for both [ 117 , 118 ]. In IPD, the raw data on each participant from each eligible study are re-analyzed as opposed to the study-level data analyzed in aggregate data meta-analyses [ 168 ]. This may offer advantages, including the potential for limiting concerns about bias and allowing more robust analyses [ 163 ]. As suggested by the description in Table 4.4 , NMA is a complex statistical approach. It combines aggregate data [ 169 ] or IPD [ 170 ] for effect estimates from direct and indirect comparisons reported in two or more studies of three or more interventions. This makes it a potentially powerful statistical tool; while multiple interventions are typically available to treat a condition, few have been evaluated in head-to-head trials [ 171 ]. Both IPD and NMA facilitate a broader scope, and potentially provide more reliable and/or detailed results; however, compared with standard aggregate data meta-analyses, their methods are more complicated, time-consuming, and resource-intensive, and they have their own biases, so one needs sufficient funding, technical expertise, and preparation to employ them successfully [ 41 , 172 , 173 ].

Several items in AMSTAR-2 and ROBIS address meta-analysis; thus, understanding the strengths, weaknesses, assumptions, and limitations of methods for meta-analyses is important. According to the standards of both tools, plans for a meta-analysis must be addressed in the review protocol, including reasoning, description of the type of quantitative data to be synthesized, and the methods planned for combining the data. This should not consist of stock statements describing conventional meta-analysis techniques; rather, authors are expected to anticipate issues specific to their research questions. Concern for the lack of training in meta-analysis methods among systematic review authors cannot be overstated. For those with training, the use of popular software (eg, RevMan [ 174 ], MetaXL [ 175 ], JBI SUMARI [ 176 ]) may facilitate exploration of these methods; however, such programs cannot substitute for the accurate interpretation of the results of meta-analyses, especially for more complex meta-analytical approaches.

Synthesis without meta-analysis

There are varied reasons a meta-analysis may not be appropriate or desirable [ 160 , 161 ]. Syntheses that informally use statistical methods other than meta-analysis are variably referred to as descriptive, narrative, or qualitative syntheses or summaries; these terms are also applied to syntheses that make no attempt to statistically combine data from individual studies. However, use of such imprecise terminology is discouraged; in order to fully explore the results of any type of synthesis, some narration or description is needed to supplement the data visually presented in tabular or graphic forms [ 63 , 177 ]. In addition, the term “qualitative synthesis” is easily confused with a synthesis of qualitative data in a qualitative or mixed methods review. “Synthesis without meta-analysis” is currently the preferred description of other ways to combine quantitative data from two or more studies. Use of this specific terminology when referring to these types of syntheses also implies the application of formal methods (Table 4.4 ).

Methods for syntheses without meta-analysis involve structured presentations of the data in any tables and plots. In comparison to narrative descriptions of each study, these are designed to more effectively and transparently show patterns and convey detailed information about the data; they also allow informal exploration of heterogeneity [ 178 ]. In addition, acceptable quantitative statistical methods (Table 4.4 ) are formally applied; however, it is important to recognize these methods have significant limitations for the interpretation of the effectiveness of an intervention [ 160 ]. Nevertheless, when meta-analysis is not possible, the application of these methods is less prone to bias compared with an unstructured narrative description of included studies [ 178 , 179 ].

Vote counting is commonly used in systematic reviews and involves a tally of studies reporting results that meet some threshold of importance applied by review authors. Until recently, it has not typically been identified as a method for synthesis without meta-analysis. Guidance on an acceptable vote counting method based on direction of effect is currently available [ 160 ] and should be used instead of narrative descriptions of such results (eg, “more than half the studies showed improvement”; “only a few studies reported adverse effects”; “7 out of 10 studies favored the intervention”). Unacceptable methods include vote counting by statistical significance or magnitude of effect or some subjective rule applied by the authors.

AMSTAR-2 and ROBIS standards do not explicitly address conduct of syntheses without meta-analysis, although AMSTAR-2 items 13 and 14 might be considered relevant. Guidance for the complete reporting of syntheses without meta-analysis for systematic reviews of interventions is available in the Synthesis without Meta-analysis (SWiM) guideline [ 180 ] and methodological guidance is available in the Cochrane Handbook [ 160 , 181 ].

Familiarity with AMSTAR-2 and ROBIS makes sense for authors of systematic reviews as these appraisal tools will be used to judge their work; however, training is necessary for authors to truly appreciate and apply methodological rigor. Moreover, judgment of the potential contribution of a systematic review to the current knowledge base goes beyond meeting the standards of AMSTAR-2 and ROBIS. These tools do not explicitly address some crucial concepts involved in the development of a systematic review; this further emphasizes the need for author training.

We recommend that systematic review authors incorporate specific practices or exercises when formulating a research question at the protocol stage, These should be designed to raise the review team’s awareness of how to prevent research and resource waste [ 84 , 130 ] and to stimulate careful contemplation of the scope of the review [ 30 ]. Authors’ training should also focus on justifiably choosing a formal method for the synthesis of quantitative and/or qualitative data from primary research; both types of data require specific expertise. For typical reviews that involve syntheses of quantitative data, statistical expertise is necessary, initially for decisions about appropriate methods, [ 160 , 161 ] and then to inform any meta-analyses [ 167 ] or other statistical methods applied [ 160 ].

Part 5. Rating overall certainty of evidence

Report of an overall certainty of evidence assessment in a systematic review is an important new reporting standard of the updated PRISMA 2020 guidelines [ 93 ]. Systematic review authors are well acquainted with assessing RoB in individual primary studies, but much less familiar with assessment of overall certainty across an entire body of evidence. Yet a reliable way to evaluate this broader concept is now recognized as a vital part of interpreting the evidence.

Historical systems for rating evidence are based on study design and usually involve hierarchical levels or classes of evidence that use numbers and/or letters to designate the level/class. These systems were endorsed by various EBM-related organizations. Professional societies and regulatory groups then widely adopted them, often with modifications for application to the available primary research base in specific clinical areas. In 2002, a report issued by the AHRQ identified 40 systems to rate quality of a body of evidence [ 182 ]. A critical appraisal of systems used by prominent health care organizations published in 2004 revealed limitations in sensibility, reproducibility, applicability to different questions, and usability to different end users [ 183 ]. Persistent use of hierarchical rating schemes to describe overall quality continues to complicate the interpretation of evidence. This is indicated by recent reports of poor interpretability of systematic review results by readers [ 184 – 186 ] and misleading interpretations of the evidence related to the “spin” systematic review authors may put on their conclusions [ 50 , 187 ].

Recognition of the shortcomings of hierarchical rating systems raised concerns that misleading clinical recommendations could result even if based on a rigorous systematic review. In addition, the number and variability of these systems were considered obstacles to quick and accurate interpretations of the evidence by clinicians, patients, and policymakers [ 183 ]. These issues contributed to the development of the GRADE approach. An international working group, that continues to actively evaluate and refine it, first introduced GRADE in 2004 [ 188 ]. Currently more than 110 organizations from 19 countries around the world have endorsed or are using GRADE [ 189 ].

GRADE approach to rating overall certainty

GRADE offers a consistent and sensible approach for two separate processes: rating the overall certainty of a body of evidence and the strength of recommendations. The former is the expected conclusion of a systematic review, while the latter is pertinent to the development of CPGs. As such, GRADE provides a mechanism to bridge the gap from evidence synthesis to application of the evidence for informed clinical decision-making [ 27 , 190 ]. We briefly examine the GRADE approach but only as it applies to rating overall certainty of evidence in systematic reviews.

In GRADE, use of “certainty” of a body of evidence is preferred over the term “quality.” [ 191 ] Certainty refers to the level of confidence systematic review authors have that, for each outcome, an effect estimate represents the true effect. The GRADE approach to rating confidence in estimates begins with identifying the study type (RCT or NRSI) and then systematically considers criteria to rate the certainty of evidence up or down (Table 5.1 ).

GRADE criteria for rating certainty of evidence

a Applies to randomized studies

b Applies to non-randomized studies

This process results in assignment of one of the four GRADE certainty ratings to each outcome; these are clearly conveyed with the use of basic interpretation symbols (Table 5.2 ) [ 192 ]. Notably, when multiple outcomes are reported in a systematic review, each outcome is assigned a unique certainty rating; thus different levels of certainty may exist in the body of evidence being examined.

GRADE certainty ratings and their interpretation symbols a

a From the GRADE Handbook [ 192 ]

GRADE’s developers acknowledge some subjectivity is involved in this process [ 193 ]. In addition, they emphasize that both the criteria for rating evidence up and down (Table 5.1 ) as well as the four overall certainty ratings (Table 5.2 ) reflect a continuum as opposed to discrete categories [ 194 ]. Consequently, deciding whether a study falls above or below the threshold for rating up or down may not be straightforward, and preliminary overall certainty ratings may be intermediate (eg, between low and moderate). Thus, the proper application of GRADE requires systematic review authors to take an overall view of the body of evidence and explicitly describe the rationale for their final ratings.

Advantages of GRADE

Outcomes important to the individuals who experience the problem of interest maintain a prominent role throughout the GRADE process [ 191 ]. These outcomes must inform the research questions (eg, PICO [population, intervention, comparator, outcome]) that are specified a priori in a systematic review protocol. Evidence for these outcomes is then investigated and each critical or important outcome is ultimately assigned a certainty of evidence as the end point of the review. Notably, limitations of the included studies have an impact at the outcome level. Ultimately, the certainty ratings for each outcome reported in a systematic review are considered by guideline panels. They use a different process to formulate recommendations that involves assessment of the evidence across outcomes [ 201 ]. It is beyond our scope to describe the GRADE process for formulating recommendations; however, it is critical to understand how these two outcome-centric concepts of certainty of evidence in the GRADE framework are related and distinguished. An in-depth illustration using examples from recently published evidence syntheses and CPGs is provided in Additional File 5 A (Table AF5A-1).

The GRADE approach is applicable irrespective of whether the certainty of the primary research evidence is high or very low; in some circumstances, indirect evidence of higher certainty may be considered if direct evidence is unavailable or of low certainty [ 27 ]. In fact, most interventions and outcomes in medicine have low or very low certainty of evidence based on GRADE and there seems to be no major improvement over time [ 202 , 203 ]. This is still a very important (even if sobering) realization for calibrating our understanding of medical evidence. A major appeal of the GRADE approach is that it offers a common framework that enables authors of evidence syntheses to make complex judgments about evidence certainty and to convey these with unambiguous terminology. This prevents some common mistakes made by review authors, including overstating results (or under-reporting harms) [ 187 ] and making recommendations for treatment. This is illustrated in Table AF5A-2 (Additional File 5 A), which compares the concluding statements made about overall certainty in a systematic review with and without application of the GRADE approach.

Theoretically, application of GRADE should improve consistency of judgments about certainty of evidence, both between authors and across systematic reviews. In one empirical evaluation conducted by the GRADE Working Group, interrater reliability of two individual raters assessing certainty of the evidence for a specific outcome increased from ~ 0.3 without using GRADE to ~ 0.7 by using GRADE [ 204 ]. However, others report variable agreement among those experienced in GRADE assessments of evidence certainty [ 190 ]. Like any other tool, GRADE requires training in order to be properly applied. The intricacies of the GRADE approach and the necessary subjectivity involved suggest that improving agreement may require strict rules for its application; alternatively, use of general guidance and consensus among review authors may result in less consistency but provide important information for the end user [ 190 ].

GRADE caveats

Simply invoking “the GRADE approach” does not automatically ensure GRADE methods were employed by authors of a systematic review (or developers of a CPG). Table 5.3 lists the criteria the GRADE working group has established for this purpose. These criteria highlight the specific terminology and methods that apply to rating the certainty of evidence for outcomes reported in a systematic review [ 191 ], which is different from rating overall certainty across outcomes considered in the formulation of recommendations [ 205 ]. Modifications of standard GRADE methods and terminology are discouraged as these may detract from GRADE’s objectives to minimize conceptual confusion and maximize clear communication [ 206 ].

Criteria for using GRADE in a systematic review a

a Adapted from the GRADE working group [ 206 ]; this list does not contain the additional criteria that apply to the development of a clinical practice guideline

Nevertheless, GRADE is prone to misapplications [ 207 , 208 ], which can distort a systematic review’s conclusions about the certainty of evidence. Systematic review authors without proper GRADE training are likely to misinterpret the terms “quality” and “grade” and to misunderstand the constructs assessed by GRADE versus other appraisal tools. For example, review authors may reference the standard GRADE certainty ratings (Table 5.2 ) to describe evidence for their outcome(s) of interest. However, these ratings are invalidated if authors omit or inadequately perform RoB evaluations of each included primary study. Such deficiencies in RoB assessments are unacceptable but not uncommon, as reported in methodological studies of systematic reviews and overviews [ 104 , 186 , 209 , 210 ]. GRADE ratings are also invalidated if review authors do not formally address and report on the other criteria (Table 5.1 ) necessary for a GRADE certainty rating.

Other caveats pertain to application of a GRADE certainty of evidence rating in various types of evidence syntheses. Current adaptations of GRADE are described in Additional File 5 B and included on Table 6.3 , which is introduced in the next section.

Concise Guide to best practices for evidence syntheses, version 1.0 a

AMSTAR A MeaSurement Tool to Assess Systematic Reviews, CASP Critical Appraisal Skills Programme, CERQual Confidence in the Evidence from Reviews of Qualitative research, ConQual Establishing Confidence in the output of Qualitative research synthesis, COSMIN COnsensus-based Standards for the selection of health Measurement Instruments, DTA diagnostic test accuracy, eMERGe meta-ethnography reporting guidance, ENTREQ enhancing transparency in reporting the synthesis of qualitative research, GRADE Grading of Recommendations Assessment, Development and Evaluation, MA meta-analysis, NRSI non-randomized studies of interventions, P protocol, PRIOR Preferred Reporting Items for Overviews of Reviews, PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PROBAST Prediction model Risk Of Bias ASsessment Tool, QUADAS quality assessment of studies of diagnostic accuracy included in systematic reviews, QUIPS Quality In Prognosis Studies, RCT randomized controlled trial, RoB risk of bias, ROBINS-I Risk Of Bias In Non-randomised Studies of Interventions, ROBIS Risk of Bias in Systematic Reviews, ScR scoping review, SWiM systematic review without meta-analysis

a Superscript numbers represent citations provided in the main reference list. Additional File 6 lists links to available online resources for the methods and tools included in the Concise Guide

b The MECIR manual [ 30 ] provides Cochrane’s specific standards for both reporting and conduct of intervention systematic reviews and protocols

c Editorial and peer reviewers can evaluate completeness of reporting in submitted manuscripts using these tools. Authors may be required to submit a self-reported checklist for the applicable tools

d The decision flowchart described by Flemming and colleagues [ 223 ] is recommended for guidance on how to choose the best approach to reporting for qualitative reviews

e SWiM was developed for intervention studies reporting quantitative data. However, if there is not a more directly relevant reporting guideline, SWiM may prompt reviewers to consider the important details to report. (Personal Communication via email, Mhairi Campbell, 14 Dec 2022)

f JBI recommends their own tools for the critical appraisal of various quantitative primary study designs included in systematic reviews of intervention effectiveness, prevalence and incidence, and etiology and risk as well as for the critical appraisal of systematic reviews included in umbrella reviews. However, except for the JBI Checklists for studies reporting prevalence data and qualitative research, the development, validity, and reliability of these tools are not well documented

g Studies that are not RCTs or NRSI require tools developed specifically to evaluate their design features. Examples include single case experimental design [ 155 , 156 ] and case reports and series [ 82 ]

h The evaluation of methodological quality of studies included in a synthesis of qualitative research is debatable [ 224 ]. Authors may select a tool appropriate for the type of qualitative synthesis methodology employed. The CASP Qualitative Checklist [ 218 ] is an example of a published, commonly used tool that focuses on assessment of the methodological strengths and limitations of qualitative studies. The JBI Critical Appraisal Checklist for Qualitative Research [ 219 ] is recommended for reviews using a meta-aggregative approach

i Consider including risk of bias assessment of included studies if this information is relevant to the research question; however, scoping reviews do not include an assessment of the overall certainty of a body of evidence

j Guidance available from the GRADE working group [ 225 , 226 ]; also recommend consultation with the Cochrane diagnostic methods group

k Guidance available from the GRADE working group [ 227 ]; also recommend consultation with Cochrane prognostic methods group

l Used for syntheses in reviews with a meta-aggregative approach [ 224 ]

m Chapter 5 in the JBI Manual offers guidance on how to adapt GRADE to prevalence and incidence reviews [ 69 ]

n Janiaud and colleagues suggest criteria for evaluating evidence certainty for meta-analyses of non-randomized studies evaluating risk factors [ 228 ]

o The COSMIN user manual provides details on how to apply GRADE in systematic reviews of measurement properties [ 229 ]

The expected culmination of a systematic review should be a rating of overall certainty of a body of evidence for each outcome reported. The GRADE approach is recommended for making these judgments for outcomes reported in systematic reviews of interventions and can be adapted for other types of reviews. This represents the initial step in the process of making recommendations based on evidence syntheses. Peer reviewers should ensure authors meet the minimal criteria for supporting the GRADE approach when reviewing any evidence synthesis that reports certainty ratings derived using GRADE. Authors and peer reviewers of evidence syntheses unfamiliar with GRADE are encouraged to seek formal training and take advantage of the resources available on the GRADE website [ 211 , 212 ].

Part 6. Concise Guide to best practices

Accumulating data in recent years suggest that many evidence syntheses (with or without meta-analysis) are not reliable. This relates in part to the fact that their authors, who are often clinicians, can be overwhelmed by the plethora of ways to evaluate evidence. They tend to resort to familiar but often inadequate, inappropriate, or obsolete methods and tools and, as a result, produce unreliable reviews. These manuscripts may not be recognized as such by peer reviewers and journal editors who may disregard current standards. When such a systematic review is published or included in a CPG, clinicians and stakeholders tend to believe that it is trustworthy. A vicious cycle in which inadequate methodology is rewarded and potentially misleading conclusions are accepted is thus supported. There is no quick or easy way to break this cycle; however, increasing awareness of best practices among all these stakeholder groups, who often have minimal (if any) training in methodology, may begin to mitigate it. This is the rationale for inclusion of Parts 2 through 5 in this guidance document. These sections present core concepts and important methodological developments that inform current standards and recommendations. We conclude by taking a direct and practical approach.

Inconsistent and imprecise terminology used in the context of development and evaluation of evidence syntheses is problematic for authors, peer reviewers and editors, and may lead to the application of inappropriate methods and tools. In response, we endorse use of the basic terms (Table 6.1 ) defined in the PRISMA 2020 statement [ 93 ]. In addition, we have identified several problematic expressions and nomenclature. In Table 6.2 , we compile suggestions for preferred terms less likely to be misinterpreted.

Terms relevant to the reporting of health care–related evidence syntheses a

a Reproduced from Page and colleagues [ 93 ]

Terminology suggestions for health care–related evidence syntheses

a For example, meta-aggregation, meta-ethnography, critical interpretative synthesis, realist synthesis

b This term may best apply to the synthesis in a mixed methods systematic review in which data from different types of evidence (eg, qualitative, quantitative, economic) are summarized [ 64 ]

We also propose a Concise Guide (Table 6.3 ) that summarizes the methods and tools recommended for the development and evaluation of nine types of evidence syntheses. Suggestions for specific tools are based on the rigor of their development as well as the availability of detailed guidance from their developers to ensure their proper application. The formatting of the Concise Guide addresses a well-known source of confusion by clearly distinguishing the underlying methodological constructs that these tools were designed to assess. Important clarifications and explanations follow in the guide’s footnotes; associated websites, if available, are listed in Additional File 6 .

To encourage uptake of best practices, journal editors may consider adopting or adapting the Concise Guide in their instructions to authors and peer reviewers of evidence syntheses. Given the evolving nature of evidence synthesis methodology, the suggested methods and tools are likely to require regular updates. Authors of evidence syntheses should monitor the literature to ensure they are employing current methods and tools. Some types of evidence syntheses (eg, rapid, economic, methodological) are not included in the Concise Guide; for these, authors are advised to obtain recommendations for acceptable methods by consulting with their target journal.

We encourage the appropriate and informed use of the methods and tools discussed throughout this commentary and summarized in the Concise Guide (Table 6.3 ). However, we caution against their application in a perfunctory or superficial fashion. This is a common pitfall among authors of evidence syntheses, especially as the standards of such tools become associated with acceptance of a manuscript by a journal. Consequently, published evidence syntheses may show improved adherence to the requirements of these tools without necessarily making genuine improvements in their performance.

In line with our main objective, the suggested tools in the Concise Guide address the reliability of evidence syntheses; however, we recognize that the utility of systematic reviews is an equally important concern. An unbiased and thoroughly reported evidence synthesis may still not be highly informative if the evidence itself that is summarized is sparse, weak and/or biased [ 24 ]. Many intervention systematic reviews, including those developed by Cochrane [ 203 ] and those applying GRADE [ 202 ], ultimately find no evidence, or find the evidence to be inconclusive (eg, “weak,” “mixed,” or of “low certainty”). This often reflects the primary research base; however, it is important to know what is known (or not known) about a topic when considering an intervention for patients and discussing treatment options with them.

Alternatively, the frequency of “empty” and inconclusive reviews published in the medical literature may relate to limitations of conventional methods that focus on hypothesis testing; these have emphasized the importance of statistical significance in primary research and effect sizes from aggregate meta-analyses [ 183 ]. It is becoming increasingly apparent that this approach may not be appropriate for all topics [ 130 ]. Development of the GRADE approach has facilitated a better understanding of significant factors (beyond effect size) that contribute to the overall certainty of evidence. Other notable responses include the development of integrative synthesis methods for the evaluation of complex interventions [ 230 , 231 ], the incorporation of crowdsourcing and machine learning into systematic review workflows (eg the Cochrane Evidence Pipeline) [ 2 ], the shift in paradigm to living systemic review and NMA platforms [ 232 , 233 ] and the proposal of a new evidence ecosystem that fosters bidirectional collaborations and interactions among a global network of evidence synthesis stakeholders [ 234 ]. These evolutions in data sources and methods may ultimately make evidence syntheses more streamlined, less duplicative, and more importantly, they may be more useful for timely policy and clinical decision-making; however, that will only be the case if they are rigorously reported and conducted.

We look forward to others’ ideas and proposals for the advancement of methods for evidence syntheses. For now, we encourage dissemination and uptake of the currently accepted best tools and practices for their development and evaluation; at the same time, we stress that uptake of appraisal tools, checklists, and software programs cannot substitute for proper education in the methodology of evidence syntheses and meta-analysis. Authors, peer reviewers, and editors must strive to make accurate and reliable contributions to the present evidence knowledge base; online alerts, upcoming technology, and accessible education may make this more feasible than ever before. Our intention is to improve the trustworthiness of evidence syntheses across disciplines, topics, and types of evidence syntheses. All of us must continue to study, teach, and act cooperatively for that to happen.

Acknowledgements

Michelle Oakman Hayes for her assistance with the graphics, Mike Clarke for his willingness to answer our seemingly arbitrary questions, and Bernard Dan for his encouragement of this project.

Authors’ contributions

All authors participated in the development of the ideas, writing, and review of this manuscript. The author(s) read and approved the final manuscript.

The work of John Ioannidis has been supported by an unrestricted gift from Sue and Bob O’Donnell to Stanford University.

Declarations

The authors declare no competing interests.

This article has been published simultaneously in BMC Systematic Reviews, Acta Anaesthesiologica Scandinavica, BMC Infectious Diseases, British Journal of Pharmacology, JBI Evidence Synthesis, the Journal of Bone and Joint Surgery Reviews , and the Journal of Pediatric Rehabilitation Medicine .

Publisher’ s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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WHAT IS LITERATURE REVIEW?

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Selecting an Appropriate Font for Writing a Literature Review
There are many accepted fonts for national and international dissertations, all of which provide a clear, coherent and concise appearance for a reader of your literature review. For dissertations written in a modern and present style, the recommended font is Arial. This font provides a smooth transition between letters, allowing the reader more ...
The 12 Most Readable Fonts for Print, Hands Down
Serif Fonts. Garamond. This graceful font was developed in France in the 16th century and has a classical feel. Georgia. This elegant yet sturdy font was designed in 1993 and is also the best font for small print. Palantino. This font, released in 1949, is reminiscent of the old-style typeface. Released in 1949. Caslon.
Academic Appeal: The 11 Best Fonts for Academic Papers
First up, Constantia. It's like the chameleon of fonts, equally at home on screen and paper. It's got this subtle elegance that makes your academic work look effortlessly chic yet totally approachable. Plus, your eyes will thank you after those long hours of reading and writing.
The Best Book Fonts for All Time: 10 Excellent Fonts for Typesetting
3. Neutrality. Display typeface. Font size. Best fonts for book printing and design. Text typefaces. Web and printing in typography are two different worlds. At least, they are often presented this way. In reality, many typefaces can be used in both domains.
What font should I choose for my thesis?
Times New Roman is the standard choice for academic documents, and the thesis preparation guidelines of some universities stipulate its use. For many years, it was the default body text for Microsoft Word. With the release of Office 2007, the default became a sans serif typeface called Calibri. Lacking the little projecting bits (serifs) at the ...
The 24 Most Professional Fonts To Use In April 2024
A Serif Sensation: Traditional Serif Fonts Offer Readability & Polish. 1. Times New Roman. This quintessential serif font designed for the New York Times newspaper 1931 remains a staple choice to exude professionalism. The fluid serifs and sturdy letterforms allow Times New Roman to be readable in print.
10 Brilliant Fonts for Your Book Layout
10 brilliant book fonts. 1. Garamond. Quick fact: Styled after the work of prominent 16th-century engraver Claude Garamond, this family of fonts rose to prominence as a standard option in Microsoft Word. If this font were a character: Garamond, a 1920s detective lurking in the shadows of a New York alleyway, waiting for a corrupt district ...
What is the standard/recommended font to use in papers?
20. If there's no template, then the choice is yours. However, you should make sure to pick a font that's easy to read. The usual standards in academia tend to be the Times, Helvetica/Arial, and Computer Modern families. This doesn't restrict you from using fonts like Book Antiqua, Myriad Pro, Goudy Old Style, or Garamond, but they're ...
PDF Instructions and Guidelines for Writing a Literature Review
1. On the cover page list your name + student number, the title of your literature review, the research group you're in, and the date on which your literature review is submitted; 2. Format of your literature review: Abstract, Body, Concluding Remarks, References; 3. Use font Times New Roman, font size 11 and a line spacing of 1.5; 4.
30+ Best Fonts for Books (Classic & Fresh Options)
Addington CF. Image Credit: Envato Elements. Addington CF comes to life with its personality and beautiful details. Complete with six weights, italics, and OpenType features, this font is ideal for both large and small text and is a great Times New Roman alternative. sponsored message.
35+ Best Fonts for Books (Cover, Titles, and Body Text)
Visby CF - Geometric Font Family. Visby is a beautiful and clean sans-serif font that features an elegant and rounded letter design. This font is perfect for designing body text in all kinds of books and magazines. The font comes in 8 different weights including obliques as well as both Latin and Cyrillic alphabets.
What Font Should I Use?
The Modern Language Association (MLA) provides explicit, specific recommendations for the margins and spacing of academic papers. (See: Document Format.)But their advice on font selection is less precise: "Always choose an easily readable typeface (e.g. Times New Roman) in which the regular style contrasts clearly with the italic, and set it to a standard size (e.g. 12 point)" (MLA ...
The Best Fonts for Books
Title and headings: Cansu with Envato Elements. The Cansu font family is a clean, plated typeface with a minimalistic feel to it, working wonders when properly kerned and especially in all-caps. The clean and geometric aesthetic, complements Baskerville quite well. 3. For Thrillers and Airport Page-Turners: Garamond.
Your Guide To The Best Fonts for Books
Basically, the best fonts for books are simple and classic. A flashy font works great as display type—that is, chapter headers, part openers, and any other large type—or a call-out like a pull quote, but is exhausting on the eyes to read for more than a few words at a time. Vyki Hendy of Spine Magazine also prefers a classic like Garamond.
How to 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.
Guidelines for writing a systematic review
Therefore, ensure the manuscript uses a consistent font and referencing style, is well-written and free from typographical errors, following any further formatting guidelines advocated by the journal. ... A nine-step pathway to conduct an umbrella review of literature. Nurse Author Ed., 32 (2) (2022), pp. 31-34, 10.1111/nae2.12039. Google ...
5 fonts that add credibility and professionalism to scientific research
This font works best when used in long blocks of text. Try to keep this font between 8 and 14pts for best results. This font looks dignified, so use this for your important professional occasions-award ceremonies, recognitions, etc. [bra_divider height='40'] 4. Caslon- "When in doubt, use Caslon".
An Easy Guide to the Best Fonts & Font Sizes for Your Book
The standard book font size is typically 12 points, but most nonfiction novels range between 10 and 14 points. The word spacing is ideal for comprehension at this size, and your book will look consistent with other works in the same genre. Some of the most recommended and best fonts for nonfiction books. Garamond. Baskerville.
The Best Fonts for Books
Other good font choices are: Garamond — Developed in the 16th Century by Parisian engraver Claude Garamond, it is a popular font for books. Jenson —A more recent addition to the world of fonts, Jenson was developed specially for Adobe Systems, but is based on a text face cut by Nicolas Jenson in Venice around 1470.
Readable & Stylish: The 15 Best Fonts for Reading
Georgia with a sans-serif for headings: Georgia brings that old-school charm, while a sans-serif like Helvetica for headings cuts in with a modern, clean look. It's a classic meets contemporary vibe. Merriweather with Montserrat or Open Sans: Merriweather is strong but approachable, perfect for extended reading.
Choosing a Font When Printing Manuscripts
In printed materials, computer users should avoid more difficult-to-read fonts, like Arial, or a novelty font like "Comic Book," even with headlines and such. We're writers, not designers. And ultimately, we're communicators, and we should use typefaces that communicate quickly and easily. Just because computers give us the ability to use all ...
Best Fonts for Online Reading and Books: The Most Easy-To-Read Fonts
TT Chocolates. Text sans serif TT Chocolates is a visually appealing font with well-balanced proportions and a dense typesetting. It has an aesthetic, friendly, and minimalist look. This makes TT Chocolates an excellent choice for printing, and due to the manual TrueType hinting, it's also well-suited for web design.
Guidance to best tools and practices for systematic reviews
Guise JM, Chang C, Butler M, Viswanathan M, Tugwell P. AHRQ series on complex intervention systematic reviews—paper 1: an introduction to a series of articles that provide guidance and tools for reviews of complex interventions. J Clin Epidemiol. 2017;90:6-10.

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Selecting an Appropriate Font for Writing a Literature Review

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The 12 Most Readable Fonts for Print, Hands Down

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A Serif Sensation: Traditional Serif Fonts Offer Readability & Polish

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