literature review in research types

Types of Literature Review

There are many types of literature review. The choice of a specific type depends on your research approach and design. The following types of literature review are the most popular in business studies:

Narrative literature review , also referred to as traditional literature review, critiques literature and summarizes the body of a literature. Narrative review also draws conclusions about the topic and identifies gaps or inconsistencies in a body of knowledge. You need to have a sufficiently focused research question to conduct a narrative literature review

Systematic literature review requires more rigorous and well-defined approach compared to most other types of literature review. Systematic literature review is comprehensive and details the timeframe within which the literature was selected. Systematic literature review can be divided into two categories: meta-analysis and meta-synthesis.

When you conduct meta-analysis you take findings from several studies on the same subject and analyze these using standardized statistical procedures. In meta-analysis patterns and relationships are detected and conclusions are drawn. Meta-analysis is associated with deductive research approach.

Meta-synthesis, on the other hand, is based on non-statistical techniques. This technique integrates, evaluates and interprets findings of multiple qualitative research studies. Meta-synthesis literature review is conducted usually when following inductive research approach.

Scoping literature review , as implied by its name is used to identify the scope or coverage of a body of literature on a given topic. It has been noted that “scoping reviews are useful for examining emerging evidence when it is still unclear what other, more specific questions can be posed and valuably addressed by a more precise systematic review.” [1] The main difference between systematic and scoping types of literature review is that, systematic literature review is conducted to find answer to more specific research questions, whereas scoping literature review is conducted to explore more general research question.

Argumentative literature review , as the name implies, examines literature selectively in order to support or refute an argument, deeply imbedded assumption, or philosophical problem already established in the literature. It should be noted that a potential for bias is a major shortcoming associated with argumentative literature review.

Integrative literature review reviews , critiques, and synthesizes secondary data about research topic in an integrated way such that new frameworks and perspectives on the topic are generated. If your research does not involve primary data collection and data analysis, then using integrative literature review will be your only option.

Theoretical literature review focuses on a pool of theory that has accumulated in regard to an issue, concept, theory, phenomena. Theoretical literature reviews play an instrumental role in establishing what theories already exist, the relationships between them, to what degree existing theories have been investigated, and to develop new hypotheses to be tested.

At the earlier parts of the literature review chapter, you need to specify the type of your literature review your chose and justify your choice. Your choice of a specific type of literature review should be based upon your research area, research problem and research methods.  Also, you can briefly discuss other most popular types of literature review mentioned above, to illustrate your awareness of them.

[1] Munn, A. et. al. (2018) “Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach” BMC Medical Research Methodology

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Choosing a Literature Review Methodology

Growing interest in evidence-based practice has driven an increase in review methodologies. Your choice of review methodology (or literature review type) will be informed by the intent (purpose, function) of your research project and the time and resources of your team. 

• Decision Tree (What Type of Review is Right for You?) Developed by Cornell University Library staff, this "decision-tree" guides the user to a handful of review guides given time and intent.

Types of Evidence Synthesis*

Critical Review - Aims to demonstrate writer has extensively researched literature and critically evaluated its quality. Goes beyond mere description to include degree of analysis and conceptual innovation. Typically results in hypothesis or model.

Mapping Review (Systematic Map) - Map out and categorize existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature.

Meta-Analysis - Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results.

Mixed Studies Review (Mixed Methods Review) - Refers to any combination of methods where one significant component is a literature review (usually systematic). Within a review context it refers to a combination of review approaches for example combining quantitative with qualitative research or outcome with process studies.

Narrative (Literature) Review - Generic term: published materials that provide examination of recent or current literature. Can cover wide range of subjects at various levels of completeness and comprehensiveness.

Overview - Generic term: summary of the [medical] literature that attempts to survey the literature and describe its characteristics.

Qualitative Systematic Review or Qualitative Evidence Synthesis - Method for integrating or comparing the findings from qualitative studies. It looks for ‘themes’ or ‘constructs’ that lie in or across individual qualitative studies.

Rapid Review - Assessment of what is already known about a policy or practice issue, by using systematic review methods to search and critically appraise existing research.

Scoping Review or Evidence Map - Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research.

State-of-the-art Review - Tend to address more current matters in contrast to other combined retrospective and current approaches. May offer new perspectives on issue or point out area for further research.

Systematic Review - Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review. (An emerging subset includes Living Reviews or Living Systematic Reviews - A [review or] systematic review which is continually updated, incorporating relevant new evidence as it becomes available.)

Systematic Search and Review - Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce ‘best evidence synthesis.’

Umbrella Review - Specifically refers to review compiling evidence from multiple reviews into one accessible and usable document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address these interventions and their results.

*These definitions are in Grant & Booth's "A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies."

Literature Review Types/Typologies, Taxonomies

Grant, M. J., and A. Booth. "A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies."  Health Information and Libraries Journal  26.2 (2009): 91-108.  DOI: 10.1111/j.1471-1842.2009.00848.x  Link

Munn, Zachary, et al. “Systematic Review or Scoping Review? Guidance for Authors When Choosing between a Systematic or Scoping Review Approach.” BMC Medical Research Methodology , vol. 18, no. 1, Nov. 2018, p. 143. DOI: 10.1186/s12874-018-0611-x. Link

Sutton, A., et al. "Meeting the Review Family: Exploring Review Types and Associated Information Retrieval Requirements."  Health Information and Libraries Journal  36.3 (2019): 202-22.  DOI: 10.1111/hir.12276  Link

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Reproduced from Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91–108. doi:10.1111/j.1471-1842.2009.00848.x

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

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

For each publication, ask yourself:

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

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

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

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

As you write, make sure to follow these tips:

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

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

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

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

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

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

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

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

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

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

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What are Literature Reviews?

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

Goals of Literature Reviews

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

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

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

What kinds of sources require a Literature Review?

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

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

Types of Literature Reviews

What kinds of literature reviews are written?

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

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

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

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

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

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

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

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

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
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Literature Reviews within a Scholarly Work

Literature reviews as a scholarly work.

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Literature reviews summarize and analyze what has been written on a particular topic and identify gaps or disagreements in the scholarly work on that topic.

Within a scholarly work, the literature review situates the current work within the larger scholarly conversation and emphasizes how that particular scholarly work contributes to the conversation on the topic. The literature review portion may be as brief as a few paragraphs focusing on a narrow topic area.

When writing this type of literature review, it's helpful to start by identifying sources most relevant to your research question. A citation tracking database such as Web of Science can also help you locate seminal articles on a topic and find out who has more recently cited them. See "Your Literature Search" for more details.

A literature review may itself be a scholarly publication and provide an analysis of what has been written on a particular topic without contributing original research. These types of literature reviews can serve to help keep people updated on a field as well as helping scholars choose a research topic to fill gaps in the knowledge on that topic. Common types include:

Systematic Review

Systematic literature reviews follow specific procedures in some ways similar to setting up an experiment to ensure that future scholars can replicate the same steps. They are also helpful for evaluating data published over multiple studies. Thus, these are common in the medical field and may be used by healthcare providers to help guide diagnosis and treatment decisions. Cochrane Reviews are one example of this type of literature review.

Semi-Systematic Review

When a systematic review is not feasible, a semi-systematic review can help synthesize research on a topic or how a topic has been studied in different fields (Snyder 2019). Rather than focusing on quantitative data, this review type identifies themes, theoretical perspectives, and other qualitative information related to the topic. These types of reviews can be particularly helpful for a historical topic overview, for developing a theoretical model, and for creating a research agenda for a field (Snyder 2019). As with systematic reviews, a search strategy must be developed before conducting the review.

Integrative Review

An integrative review is less systematic and can be helpful for developing a theoretical model or to reconceptualize a topic. As Synder (2019) notes, " This type of review often re quires a more creative collection of data, as the purpose is usually not to cover all articles ever published on the topic but rather to combine perspectives and insights from di ff erent fi elds or research traditions" (p. 336).

Source: Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104. 333-339. doi: 10.1016/j.jbusres.2019.07.039

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Literature Review: Types of literature reviews

• Traditional or narrative literature reviews
• Scoping Reviews
• Systematic literature reviews
• Annotated bibliography
• Keeping up to date with literature
• Finding a thesis
• Evaluating sources and critical appraisal of literature
• Managing and analysing your literature
• Further reading and resources

Types of literature reviews

The type of literature review you write will depend on your discipline and whether you are a researcher writing your PhD, publishing a study in a journal or completing an assessment task in your undergraduate study.

A literature review for a subject in an undergraduate degree will not be as comprehensive as the literature review required for a PhD thesis.

An undergraduate literature review may be in the form of an annotated bibliography or a narrative review of a small selection of literature, for example ten relevant articles. If you are asked to write a literature review, and you are an undergraduate student, be guided by your subject coordinator or lecturer.

The common types of literature reviews will be explained in the pages of this section.

• Narrative or traditional literature reviews
• Critically Appraised Topic (CAT)
• Scoping reviews
• Annotated bibliographies

These are not the only types of reviews of literature that can be conducted. Often the term "review" and "literature" can be confusing and used in the wrong context. Grant and Booth (2009) attempt to clear up this confusion by discussing 14 review types and the associated methodology, and advantages and disadvantages associated with each review.

Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies . Health Information & Libraries Journal, 26 , 91–108. doi:10.1111/j.1471-1842.2009.00848.x

What's the difference between reviews?

Researchers, academics, and librarians all use various terms to describe different types of literature reviews, and there is often inconsistency in the ways the types are discussed. Here are a couple of simple explanations.

• The image below describes common review types in terms of speed, detail, risk of bias, and comprehensiveness:

"Schematic of the main differences between the types of literature review" by Brennan, M. L., Arlt, S. P., Belshaw, Z., Buckley, L., Corah, L., Doit, H., Fajt, V. R., Grindlay, D., Moberly, H. K., Morrow, L. D., Stavisky, J., & White, C. (2020). Critically Appraised Topics (CATs) in veterinary medicine: Applying evidence in clinical practice. Frontiers in Veterinary Science, 7 , 314. https://doi.org/10.3389/fvets.2020.00314 is licensed under CC BY 3.0

• The table below lists four of the most common types of review , as adapted from a widely used typology of fourteen types of reviews (Grant & Booth, 2009).  

Grant, M.J. & Booth, A. (2009).  A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26 (2), 91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x

See also the Library's  Literature Review guide.

Critical Appraised Topic (CAT)

For information on conducting a Critically Appraised Topic or CAT

Callander, J., Anstey, A. V., Ingram, J. R., Limpens, J., Flohr, C., & Spuls, P. I. (2017).  How to write a Critically Appraised Topic: evidence to underpin routine clinical practice.  British Journal of Dermatology (1951), 177(4), 1007-1013. https://doi.org/10.1111/bjd.15873 

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Systematic Reviews: Types of literature review, methods, & resources

• Types of literature review, methods, & resources
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Analytical reviews

GUIDELINES FOR HOW TO CARRY OUT AN ANALYTICAL REVIEW OF QUANTITATIVE RESEARCH

Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network. (Tracking and listing over 550 reporting guidelines for various different study types including Randomised trials, Systematic reviews, Study protocols, Diagnostic/prognostic studies, Case reports, Clinical practice guidelines, Animal pre-clinical studies, etc). http://www.equator-network.org/resource-centre/library-of-health-research-reporting/

When comparing therapies :

PRISMA (Guideline on how to perform and write-up a systematic review and/or meta-analysis of the outcomes reported in multiple clinical trials of therapeutic interventions. PRISMA  replaces the previous QUORUM statement guidelines ):  Liberati, A,, Altman, D,, Moher, D, et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.  Plos Medicine, 6 (7):e1000100. doi:10.1371/journal.pmed.1000100 

When comparing diagnostic methods :

Checklist for Artificial Intelligence in Medical Imaging (CLAIM). CLAIM is modeled after the STARD guideline and has been extended to address applications of AI in medical imaging that include classification, image reconstruction, text analysis, and workflow optimization. The elements described here should be viewed as a “best practice” to guide authors in presenting their research. Reported in Mongan, J., Moy, L., & Kahn, C. E., Jr (2020). Checklist for Artificial Intelligence in Medical Imaging (CLAIM): A Guide for Authors and Reviewers.  Radiology. Artificial intelligence ,  2 (2), e200029. https://doi.org/10.1148/ryai.2020200029

STAndards for the Reporting of Diagnostic accuracy studies (STARD) Statement. (Reporting guidelines for writing up a study comparing the accuracy of competing diagnostic methods)  http://www.stard-statement.org/

When evaluating clinical practice guidelines :

AGREE Research Trust (ART) (2013).  Appraisal of Guidelines for Research & Evaluation (AGREE-II) . (A 23-item instrument for as sessing th e quality of Clinical Practice Guidelines. Used internationally for evaluating or deciding which guidelines could be recommended for use in practice or to inform health policy decisions.)

National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument (2019). (A 15-item instrument using scales of 1-5 to evaluate a guideline's adherence to the Institute of Medicine's standard for trustworthy guidelines. It has good external validity among guideline developers and good interrater reliability across trained reviewers.)

When reviewing genetics studies

Human genetics review reporting guidelines.  Little J, Higgins JPT (eds.). The HuGENet™ HuGE Review Handbook, version 1.0 . 

When you need to re-analyze individual participant data

If you wish to collect, check, and re-analyze individual participant data (IPD) from clinical trials addressing a particular research question, you should follow the  PRISMA-IPD  guidelines as reported in  Stewart, L.A., Clarke, M., Rovers, M., et al. (2015). Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data: The PRISMA-IPD Statement. JAMA, 313(16):1657-1665. doi:10.1001/jama.2015.3656 .

When comparing Randomized studies involving animals, livestock, or food:

O’Connor AM, et al. (2010).  The REFLECT statement: methods and processes of creating reporting guidelines for randomized controlled trials for livestock and food safety by modifying the CONSORT statement.  Zoonoses Public Health. 57(2):95-104. Epub 2010/01/15. doi: 10.1111/j.1863-2378.2009.01311.x. PubMed PMID: 20070653.

Sargeant JM, et al. (2010).  The REFLECT Statement: Reporting Guidelines for Randomized Controlled Trials in Livestock and Food Safety: Explanation and Elaboration.  Zoonoses Public Health. 57(2):105-36. Epub 2010/01/15. doi: JVB1312 [pii] 10.1111/j.1863-2378.2009.01312.x. PubMed PMID: 20070652.

GUIDELINES FOR HOW TO WRITE UP FOR PUBLICATION THE RESULTS OF ONE QUANTITATIVE CLINICAL TRIAL

When reporting the results of a Randomized Controlled Trial :

Consolidated Standards of Reporting Trials (CONSORT) Statement. (2010 reporting guideline for writing up a Randomized Controlled Clinical Trial).  http://www.consort-statement.org . Since updated in 2022, see Butcher, M. A., et al. (2022). Guidelines for Reporting Outcomes in Trial Reports: The CONSORT-Outcomes 2022 Extension . JAMA : the Journal of the American Medical Association, 328(22), 2252–2264. https://doi.org/10.1001/jama.2022.21022

Kilkenny, C., Browne, W. J., Cuthill, I. C., Emerson, M., & Altman, D. G. (2010). Improving bioscience research reporting: The ARRIVE guidelines for reporting animal research. PLoS Biology, 8(6), e1000412–e1000412. https://doi.org/10.1371/journal.pbio.1000412 (A 20-item checklist, following the CONSORT approach, listing the information that published articles reporting research using animals should include, such as the number and specific characteristics of animals used; details of housing and husbandry; and the experimental, statistical, and analytical methods used to reduce bias.)

Narrative reviews

GUIDELINES  FOR HOW TO CARRY OUT  A  NARRATIVE REVIEW / QUALITATIVE RESEARCH /  OBSERVATIONAL STUDIES

Campbell, M. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ, 368. doi: https://doi.org/10.1136/bmj.l6890  (guideline on how to analyse evidence for a narrative review, to provide a recommendation based on heterogenous study types).

Community Preventive Services Task Force (2021).  The Methods Manual for Community Guide Systematic Reviews . (Public Health Prevention systematic review guidelines)

Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network. (Tracking and listing over 550 reporting guidelines for various different study types including Observational studies, Qualitative research, Quality improvement studies, and Economic evaluations). http://www.equator-network.org/resource-centre/library-of-health-research-reporting/

Cochrane Qualitative & Implementation Methods Group. (2019). Training resources. Retrieved from  https://methods.cochrane.org/qi/training-resources . (Training materials for how to do a meta-synthesis, or qualitative evidence synthesis). 

Cornell University Library (2019). Planning worksheet for structured literature reviews. Retrieved 4/8/22 from  https://osf.io/tnfm7/  (offers a framework for a narrative literature review).

Green, B. N., Johnson, C. D., & Adams, A. (2006).  Writing narrative literature reviews for peer-reviewed journals: secrets of the trade . Journal of Chiropractic Medicine, 5(3): 101-117. DOI: 10.1016/ S0899-3467 (07)60142-6.  This is a very good article about what to take into consideration when writing any type of narrative review.

When reviewing observational studies/qualitative research :

STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. (Reporting guidelines for various types of health sciences observational studies).  http://www.strobe-statement.org 

Meta-analysis of Observational Studies in Epidemiology (MOOSE)  http://jama.jamanetwork.com/article.aspx?articleid=192614

RATS Qualitative research systematic review guidelines.  https://www.equator-network.org/reporting-guidelines/qualitative-research-review-guidelines-rats/

Methods/Guidance

Right Review , this decision support website provides an algorithm to help reviewers choose a review methodology from among 41 knowledge synthesis methods.

The Systematic Review Toolbox , an online catalogue of tools that support various tasks within the systematic review and wider evidence synthesis process. Maintained by the UK University of York Health Economics Consortium, Newcastle University NIHR Innovation Observatory, and University of Sheffield School of Health and Related Research.

Institute of Medicine. (2011).  Finding What Works in Health Care: Standards for Systematic Reviews . Washington, DC: National Academies  (Systematic review guidelines from the Health and Medicine Division (HMD) of the U.S. National Academies of Sciences, Engineering, and Medicine (formerly called the Institute of Medicine)).

International Committee of Medical Journal Editors (2022).  Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals . Guidance on how to prepare a manuscript for submission to a Medical journal.

Cochrane Handbook of Systematic Reviews of Interventions (International Cochrane Collaboration systematic review guidelines). The various Cochrane review groups comporise around 30,000 physicians around the world working in the disciplines on reviews of interventions with very detailed methods for verifying the validity of the research methods and analysis performed in screened-in Randmized Controlled Clinical Trials. Typically published Cochrane Reviews are the most exhaustive review of the evidence of effectiveness of a particular drug or intervention, and include a statistical meta-analysis. Similar to practice guidelines, Cochrane reviews are periodically revised and updated.

Joanna Briggs Institute (JBI) Manual of Evidence Synthesis . (International systematic review guidelines). Based at the University of Adelaide, South Australia, and collaborating with around 80 academic and medical entities around the world. Unlike Cochrane Reviews that strictly focus on efficacy of interventions, JBI offers a broader, inclusive approach to evidence, to accommodate a range of diverse questions and study designs. The JBI manual provides guidance on how to analyse and include both quantitative and qualitative research.

Cochrane Methods Support Unit, webinar recordings on methodological support questions 

Cochrane Qualitative & Implementation Methods Group. (2019). Training resources. Retrieved from https://methods.cochrane.org/qi/training-resources . (How to do a meta-synthesis, or qualitative evidence synthesis). 

Center for Reviews and Dissemination (University of York, England) (2009).  Systematic Reviews: CRD's guidance for undertaking systematic reviews in health care . (British systematic review guidelines). 

Agency for Health Research & Quality (AHRQ) (2013). Methods guide for effectiveness and comparative effectiveness reviews . (U.S. comparative effectiveness review guidelines)

Hunter, K. E., et al. (2022). Searching clinical trials registers: guide for systematic reviewers.  BMJ (Clinical research ed.) ,  377 , e068791. https://doi.org/10.1136/bmj-2021-068791

Patient-Centered Outcomes Research Institute (PCORI).  The PCORI Methodology Report . (A 47-item methodology checklist for U.S. patient-centered outcomes research. Established under the Patient Protection and Affordable Care Act, PCORI funds the development of guidance on the comparative effectivess of clinical healthcare, similar to the UK National Institute for Clinical Evidence but without reporting cost-effectiveness QALY metrics). 

Canadian Agency for Drugs and Technologies in Health (CADTH) (2019). Grey Matters: a practical tool for searching health-related grey literature. Retrieved from https://www.cadth.ca/resources/finding-evidence/grey-matters . A checklist of N American & international online databases and websites you can use to search for unpublished reports, posters, and policy briefs, on topics including general medicine and nursing, public and mental health, health technology assessment, drug and device regulatory, approvals, warnings, and advisories.

Hempel, S., Xenakis, L., & Danz, M. (2016). Systematic Reviews for Occupational Safety and Health Questions: Resources for Evidence Synthesis. Retrieved 8/15/16 from http://www.rand.org/pubs/research_reports/RR1463.html . NIOSH guidelines for how to carry out a systematic review in the occupational safety and health domain.

A good source for reporting guidelines is the  NLM's  Research Reporting Guidelines and Initiatives .

Grading of Recommendations Assessment, Development and Evaluation (GRADE). (An international group of academics/clinicians working to promote a common approach to grading the quality of evidence and strength of recommendations.) 

Phillips, B., Ball, C., Sackett, D., et al. (2009). Oxford Centre for Evidence Based Medicine: Levels of Evidence. Retrieved 3/20/17 from https://www.cebm.net/wp-content/uploads/2014/06/CEBM-Levels-of-Evidence-2.1.pdf . (Another commonly used criteria for grading the quality of evidence and strength of recommendations, developed in part by EBM guru David Sackett.) 

Systematic Reviews for Animals & Food  (guidelines including the REFLECT statement for carrying out a systematic review on animal health, animal welfare, food safety, livestock, and agriculture)

Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies . Health Information & Libraries Journal, 26(2), 91-108. doi:10.1111/j.1471-1842.2009.00848.x. (Describes 14 different types of literature and systematic review, useful for thinking at the outset about what sort of literature review you want to do.)

Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: exploring review types and associated information retrieval requirements . Health information and libraries journal, 36(3), 202–222. doi:10.1111/hir.12276  (An updated look at different types of literature review, expands on the Grant & Booth 2009 article listed above).

Garrard, J. (2007).  Health Sciences Literature Review Made Easy: The Matrix Method  (2nd Ed.).   Sudbury, MA:  Jones & Bartlett Publishers. (Textbook of health sciences literature search methods).

Zilberberg, M. (2012).  Between the lines: Finding the truth in medical literature . Goshen, MA: Evimed Research Press. (Concise book on foundational concepts of evidence-based medicine).

Lang, T. (2009). The Value of Systematic Reviews as Research Activities in Medical Education . In: Lang, T. How to write, publish, & present in the health sciences : a guide for clinicians & laboratory researchers. Philadelphia : American College of Physicians.  (This book chapter has a helpful bibliography on systematic review and meta-analysis methods)

Brown, S., Martin, E., Garcia, T., Winter, M., García, A., Brown, A., Cuevas H.,  & Sumlin, L. (2013). Managing complex research datasets using electronic tools: a meta-analysis exemplar . Computers, Informatics, Nursing: CIN, 31(6), 257-265. doi:10.1097/NXN.0b013e318295e69c. (This article advocates for the programming of electronic fillable forms in Adobe Acrobat Pro to feed data into Excel or SPSS for analysis, and to use cloud based file sharing systems such as Blackboard, RefWorks, or EverNote to facilitate sharing knowledge about the decision-making process and keep data secure. Of particular note are the flowchart describing this process, and their example screening form used for the initial screening of abstracts).

Brown, S., Upchurch, S., & Acton, G. (2003). A framework for developing a coding scheme for meta-analysis . Western Journal Of Nursing Research, 25(2), 205-222. (This article describes the process of how to design a coded data extraction form and codebook, Table 1 is an example of a coded data extraction form that can then be used to program a fillable form in Adobe Acrobat or Microsoft Access).

Elamin, M. B., Flynn, D. N., Bassler, D., Briel, M., Alonso-Coello, P., Karanicolas, P., & ... Montori, V. M. (2009). Choice of data extraction tools for systematic reviews depends on resources and review complexity .  Journal Of Clinical Epidemiology ,  62 (5), 506-510. doi:10.1016/j.jclinepi.2008.10.016  (This article offers advice on how to decide what tools to use to extract data for analytical systematic reviews).

Riegelman R.   Studying a Study and Testing a Test: Reading Evidence-based Health Research , 6th Edition.  Lippincott Williams & Wilkins, 2012. (Textbook of quantitative statistical methods used in health sciences research).

Rathbone, J., Hoffmann, T., & Glasziou, P. (2015). Faster title and abstract screening? Evaluating Abstrackr, a semi-automated online screening program for systematic reviewers. Systematic Reviews, 480. doi:10.1186/s13643-015-0067-6

Guyatt, G., Rennie, D., Meade, M., & Cook, D. (2015). Users' guides to the medical literature (3rd ed.). New York: McGraw-Hill Education Medical.  (This is a foundational textbook on evidence-based medicine and of particular use to the reviewer who wants to learn about the different types of published research article e.g. "what is a case report?" and to understand what types of study design best answer what types of clinical question).

Glanville, J., Duffy, S., Mccool, R., & Varley, D. (2014). Searching ClinicalTrials.gov and the International Clinical Trials Registry Platform to inform systematic reviews: what are the optimal search approaches? Journal of the Medical Library Association : JMLA, 102(3), 177–183. https://doi.org/10.3163/1536-5050.102.3.007

Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan a web and mobile app for systematic reviews.  Systematic Reviews, 5 : 210, DOI: 10.1186/s13643-016-0384-4. http://rdcu.be/nzDM

Kwon Y, Lemieux M, McTavish J, Wathen N. (2015). Identifying and removing duplicate records from systematic review searches. J Med Libr Assoc. 103 (4): 184-8. doi: 10.3163/1536-5050.103.4.004. https://www.ncbi.nlm.nih.gov/pubmed/26512216

Bramer WM, Giustini D, de Jonge GB, Holland L, Bekhuis T. (2016). De-duplication of database search results for systematic reviews in EndNote. J Med Libr Assoc. 104 (3):240-3. doi: 10.3163/1536-5050.104.3.014. Erratum in: J Med Libr Assoc. 2017 Jan;105(1):111. https://www.ncbi.nlm.nih.gov/pubmed/27366130

McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. J Clin Epidemiol. 2016;75:40–46. doi: 10.1016/j.jclinepi.2016.01.021 . PRESS is a guideline with a checklist for librarians to critically appraise the search strategy for a systematic review literature search.

Clark, JM, Sanders, S, Carter, M, Honeyman, D, Cleo, G, Auld, Y, Booth, D, Condron, P, Dalais, C, Bateup, S, Linthwaite, B, May, N, Munn, J, Ramsay, L, Rickett, K, Rutter, C, Smith, A, Sondergeld, P, Wallin, M, Jones, M & Beller, E 2020, 'Improving the translation of search strategies using the Polyglot Search Translator: a randomized controlled trial',  Journal of the Medical Library Association , vol. 108, no. 2, pp. 195-207.

Journal articles describing systematic review methods can be searched for in PubMed using this search string in the PubMed search box: sysrev_methods [sb] . 

Software tools for systematic reviews

• Covidence GW in 2019 has bought a subscription to this Cloud based tool for facilitating screening decisions, used by the Cochrane Collaboration. Register for an account.
• NVIVO for analysis of qualitative research NVIVO is used for coding interview data to identify common themes emerging from interviews with several participants. GW faculty, staff, and students may download NVIVO software.
• RedCAP RedCAP is software that can be used to create survey forms for research or data collection or data extraction. It has very detailed functionality to enable data exchange with Electronic Health Record Systems, and to integrate with study workflow such as scheduling follow up reminders for study participants.
• SRDR tool from AHRQ Free, web-based and has a training environment, tutorials, and example templates of systematic review data extraction forms
• RevMan 5 RevMan 5 is the desktop version of the software used by Cochrane systematic review teams. RevMan 5 is free for academic use and can be downloaded and configured to run as stand alone software that does not connect with the Cochrane server if you follow the instructions at https://training.cochrane.org/online-learning/core-software-cochrane-reviews/revman/revman-5-download/non-cochrane-reviews
• Rayyan Free, web-based tool for collecting and screening citations. It has options to screen with multiple people, masking each other.
• GradePro Free, web application to create, manage and share summaries of research evidence (called Evidence Profiles and Summary of Findings Tables) for reviews or guidelines, uses the GRADE criteria to evaluate each paper under review.
• DistillerSR Needs subscription. Create coded data extraction forms from templates.
• EPPI Reviewer Needs subscription. Like DistillerSR, tool for text mining, data clustering, classification and term extraction
• SUMARI Needs subscription. Qualitative data analysis.
• Dedoose Needs subscription. Qualitative data analysis, similar to NVIVO in that it can be used to code interview transcripts, identify word co-occurence, cloud based.
• Meta-analysis software for statistical analysis of data for quantitative reviews SPSS, SAS, and STATA are popular analytical statistical software that include macros for carrying out meta-analysis. Himmelfarb has SPSS on some 3rd floor computers, and GW affiliates may download SAS to your own laptop from the Division of IT website. To perform mathematical analysis of big data sets there are statistical analysis software libraries in the R programming language available through GitHub and RStudio, but this requires advanced knowledge of the R and Python computer languages and data wrangling/cleaning.
• PRISMA 2020 flow diagram generator The PRISMA Statement website has a page listing example flow diagram templates and a link to software for creating PRISMA 2020 flow diagrams using R software.

GW researchers may want to consider using Refworks to manage citations, and GW Box to store the full text PDF's of review articles. You can also use online survey forms such as Qualtrics, RedCAP, or Survey Monkey, to design and create your own coded fillable forms, and export the data to Excel or one of the qualitative analytical software tools listed above.

Forest Plot Generators

• RevMan 5 the desktop version of the software used by Cochrane systematic review teams. RevMan 5 is free for academic use and can be downloaded and configured to run as stand alone software that does not connect with the Cochrane server if you follow the instructions at https://training.cochrane.org/online-learning/core-software-cochrane-reviews/revman/revman-5-download/non-cochrane-reviews.
• Meta-Essentials a free set of workbooks designed for Microsoft Excel that, based on your input, automatically produce meta-analyses including Forest Plots. Produced for Erasmus University Rotterdam joint research institute.
• Neyeloff, Fuchs & Moreira Another set of Excel worksheets and instructions to generate a Forest Plot. Published as Neyeloff, J.L., Fuchs, S.C. & Moreira, L.B. Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes 5, 52 (2012). https://doi-org.proxygw.wrlc.org/10.1186/1756-0500-5-52
• For R programmers instructions are at https://cran.r-project.org/web/packages/forestplot/vignettes/forestplot.html and you can download the R code package from https://github.com/gforge/forestplot
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Home » Literature Review – Types Writing Guide and Examples

Literature Review – Types Writing Guide and Examples

Table of Contents

Literature Review

Definition:

A literature review is a comprehensive and critical analysis of the existing literature on a particular topic or research question. It involves identifying, evaluating, and synthesizing relevant literature, including scholarly articles, books, and other sources, to provide a summary and critical assessment of what is known about the topic.

Types of Literature Review

Types of Literature Review are as follows:

• Narrative literature review : This type of review involves a comprehensive summary and critical analysis of the available literature on a particular topic or research question. It is often used as an introductory section of a research paper.
• Systematic literature review: This is a rigorous and structured review that follows a pre-defined protocol to identify, evaluate, and synthesize all relevant studies on a specific research question. It is often used in evidence-based practice and systematic reviews.
• Meta-analysis: This is a quantitative review that uses statistical methods to combine data from multiple studies to derive a summary effect size. It provides a more precise estimate of the overall effect than any individual study.
• Scoping review: This is a preliminary review that aims to map the existing literature on a broad topic area to identify research gaps and areas for further investigation.
• Critical literature review : This type of review evaluates the strengths and weaknesses of the existing literature on a particular topic or research question. It aims to provide a critical analysis of the literature and identify areas where further research is needed.
• Conceptual literature review: This review synthesizes and integrates theories and concepts from multiple sources to provide a new perspective on a particular topic. It aims to provide a theoretical framework for understanding a particular research question.
• Rapid literature review: This is a quick review that provides a snapshot of the current state of knowledge on a specific research question or topic. It is often used when time and resources are limited.
• Thematic literature review : This review identifies and analyzes common themes and patterns across a body of literature on a particular topic. It aims to provide a comprehensive overview of the literature and identify key themes and concepts.
• Realist literature review: This review is often used in social science research and aims to identify how and why certain interventions work in certain contexts. It takes into account the context and complexities of real-world situations.
• State-of-the-art literature review : This type of review provides an overview of the current state of knowledge in a particular field, highlighting the most recent and relevant research. It is often used in fields where knowledge is rapidly evolving, such as technology or medicine.
• Integrative literature review: This type of review synthesizes and integrates findings from multiple studies on a particular topic to identify patterns, themes, and gaps in the literature. It aims to provide a comprehensive understanding of the current state of knowledge on a particular topic.
• Umbrella literature review : This review is used to provide a broad overview of a large and diverse body of literature on a particular topic. It aims to identify common themes and patterns across different areas of research.
• Historical literature review: This type of review examines the historical development of research on a particular topic or research question. It aims to provide a historical context for understanding the current state of knowledge on a particular topic.
• Problem-oriented literature review : This review focuses on a specific problem or issue and examines the literature to identify potential solutions or interventions. It aims to provide practical recommendations for addressing a particular problem or issue.
• Mixed-methods literature review : This type of review combines quantitative and qualitative methods to synthesize and analyze the available literature on a particular topic. It aims to provide a more comprehensive understanding of the research question by combining different types of evidence.

Parts of Literature Review

Parts of a literature review are as follows:

Introduction

The introduction of a literature review typically provides background information on the research topic and why it is important. It outlines the objectives of the review, the research question or hypothesis, and the scope of the review.

Literature Search

This section outlines the search strategy and databases used to identify relevant literature. The search terms used, inclusion and exclusion criteria, and any limitations of the search are described.

Literature Analysis

The literature analysis is the main body of the literature review. This section summarizes and synthesizes the literature that is relevant to the research question or hypothesis. The review should be organized thematically, chronologically, or by methodology, depending on the research objectives.

Critical Evaluation

Critical evaluation involves assessing the quality and validity of the literature. This includes evaluating the reliability and validity of the studies reviewed, the methodology used, and the strength of the evidence.

The conclusion of the literature review should summarize the main findings, identify any gaps in the literature, and suggest areas for future research. It should also reiterate the importance of the research question or hypothesis and the contribution of the literature review to the overall research project.

The references list includes all the sources cited in the literature review, and follows a specific referencing style (e.g., APA, MLA, Harvard).

How to write Literature Review

Here are some steps to follow when writing a literature review:

• Define your research question or topic : Before starting your literature review, it is essential to define your research question or topic. This will help you identify relevant literature and determine the scope of your review.
• Conduct a comprehensive search: Use databases and search engines to find relevant literature. Look for peer-reviewed articles, books, and other academic sources that are relevant to your research question or topic.
• Evaluate the sources: Once you have found potential sources, evaluate them critically to determine their relevance, credibility, and quality. Look for recent publications, reputable authors, and reliable sources of data and evidence.
• Organize your sources: Group the sources by theme, method, or research question. This will help you identify similarities and differences among the literature, and provide a structure for your literature review.
• Analyze and synthesize the literature : Analyze each source in depth, identifying the key findings, methodologies, and conclusions. Then, synthesize the information from the sources, identifying patterns and themes in the literature.
• Write the literature review : Start with an introduction that provides an overview of the topic and the purpose of the literature review. Then, organize the literature according to your chosen structure, and analyze and synthesize the sources. Finally, provide a conclusion that summarizes the key findings of the literature review, identifies gaps in knowledge, and suggests areas for future research.
• Edit and proofread: Once you have written your literature review, edit and proofread it carefully to ensure that it is well-organized, clear, and concise.

Examples of Literature Review

Here’s an example of how a literature review can be conducted for a thesis on the topic of “ The Impact of Social Media on Teenagers’ Mental Health”:

• Start by identifying the key terms related to your research topic. In this case, the key terms are “social media,” “teenagers,” and “mental health.”
• Use academic databases like Google Scholar, JSTOR, or PubMed to search for relevant articles, books, and other publications. Use these keywords in your search to narrow down your results.
• Evaluate the sources you find to determine if they are relevant to your research question. You may want to consider the publication date, author’s credentials, and the journal or book publisher.
• Begin reading and taking notes on each source, paying attention to key findings, methodologies used, and any gaps in the research.
• Organize your findings into themes or categories. For example, you might categorize your sources into those that examine the impact of social media on self-esteem, those that explore the effects of cyberbullying, and those that investigate the relationship between social media use and depression.
• Synthesize your findings by summarizing the key themes and highlighting any gaps or inconsistencies in the research. Identify areas where further research is needed.
• Use your literature review to inform your research questions and hypotheses for your thesis.

For example, after conducting a literature review on the impact of social media on teenagers’ mental health, a thesis might look like this:

“Using a mixed-methods approach, this study aims to investigate the relationship between social media use and mental health outcomes in teenagers. Specifically, the study will examine the effects of cyberbullying, social comparison, and excessive social media use on self-esteem, anxiety, and depression. Through an analysis of survey data and qualitative interviews with teenagers, the study will provide insight into the complex relationship between social media use and mental health outcomes, and identify strategies for promoting positive mental health outcomes in young people.”

Reference: Smith, J., Jones, M., & Lee, S. (2019). The effects of social media use on adolescent mental health: A systematic review. Journal of Adolescent Health, 65(2), 154-165. doi:10.1016/j.jadohealth.2019.03.024

Reference Example: Author, A. A., Author, B. B., & Author, C. C. (Year). Title of article. Title of Journal, volume number(issue number), page range. doi:0000000/000000000000 or URL

Applications of Literature Review

some applications of literature review in different fields:

• Social Sciences: In social sciences, literature reviews are used to identify gaps in existing research, to develop research questions, and to provide a theoretical framework for research. Literature reviews are commonly used in fields such as sociology, psychology, anthropology, and political science.
• Natural Sciences: In natural sciences, literature reviews are used to summarize and evaluate the current state of knowledge in a particular field or subfield. Literature reviews can help researchers identify areas where more research is needed and provide insights into the latest developments in a particular field. Fields such as biology, chemistry, and physics commonly use literature reviews.
• Health Sciences: In health sciences, literature reviews are used to evaluate the effectiveness of treatments, identify best practices, and determine areas where more research is needed. Literature reviews are commonly used in fields such as medicine, nursing, and public health.
• Humanities: In humanities, literature reviews are used to identify gaps in existing knowledge, develop new interpretations of texts or cultural artifacts, and provide a theoretical framework for research. Literature reviews are commonly used in fields such as history, literary studies, and philosophy.

Role of Literature Review in Research

Here are some applications of literature review in research:

• Identifying Research Gaps : Literature review helps researchers identify gaps in existing research and literature related to their research question. This allows them to develop new research questions and hypotheses to fill those gaps.
• Developing Theoretical Framework: Literature review helps researchers develop a theoretical framework for their research. By analyzing and synthesizing existing literature, researchers can identify the key concepts, theories, and models that are relevant to their research.
• Selecting Research Methods : Literature review helps researchers select appropriate research methods and techniques based on previous research. It also helps researchers to identify potential biases or limitations of certain methods and techniques.
• Data Collection and Analysis: Literature review helps researchers in data collection and analysis by providing a foundation for the development of data collection instruments and methods. It also helps researchers to identify relevant data sources and identify potential data analysis techniques.
• Communicating Results: Literature review helps researchers to communicate their results effectively by providing a context for their research. It also helps to justify the significance of their findings in relation to existing research and literature.

Purpose of Literature Review

Some of the specific purposes of a literature review are as follows:

• To provide context: A literature review helps to provide context for your research by situating it within the broader body of literature on the topic.
• To identify gaps and inconsistencies: A literature review helps to identify areas where further research is needed or where there are inconsistencies in the existing literature.
• To synthesize information: A literature review helps to synthesize the information from multiple sources and present a coherent and comprehensive picture of the current state of knowledge on the topic.
• To identify key concepts and theories : A literature review helps to identify key concepts and theories that are relevant to your research question and provide a theoretical framework for your study.
• To inform research design: A literature review can inform the design of your research study by identifying appropriate research methods, data sources, and research questions.

Characteristics of Literature Review

Some Characteristics of Literature Review are as follows:

• Identifying gaps in knowledge: A literature review helps to identify gaps in the existing knowledge and research on a specific topic or research question. By analyzing and synthesizing the literature, you can identify areas where further research is needed and where new insights can be gained.
• Establishing the significance of your research: A literature review helps to establish the significance of your own research by placing it in the context of existing research. By demonstrating the relevance of your research to the existing literature, you can establish its importance and value.
• Informing research design and methodology : A literature review helps to inform research design and methodology by identifying the most appropriate research methods, techniques, and instruments. By reviewing the literature, you can identify the strengths and limitations of different research methods and techniques, and select the most appropriate ones for your own research.
• Supporting arguments and claims: A literature review provides evidence to support arguments and claims made in academic writing. By citing and analyzing the literature, you can provide a solid foundation for your own arguments and claims.
• I dentifying potential collaborators and mentors: A literature review can help identify potential collaborators and mentors by identifying researchers and practitioners who are working on related topics or using similar methods. By building relationships with these individuals, you can gain valuable insights and support for your own research and practice.
• Keeping up-to-date with the latest research : A literature review helps to keep you up-to-date with the latest research on a specific topic or research question. By regularly reviewing the literature, you can stay informed about the latest findings and developments in your field.

Advantages of Literature Review

There are several advantages to conducting a literature review as part of a research project, including:

• Establishing the significance of the research : A literature review helps to establish the significance of the research by demonstrating the gap or problem in the existing literature that the study aims to address.
• Identifying key concepts and theories: A literature review can help to identify key concepts and theories that are relevant to the research question, and provide a theoretical framework for the study.
• Supporting the research methodology : A literature review can inform the research methodology by identifying appropriate research methods, data sources, and research questions.
• Providing a comprehensive overview of the literature : A literature review provides a comprehensive overview of the current state of knowledge on a topic, allowing the researcher to identify key themes, debates, and areas of agreement or disagreement.
• Identifying potential research questions: A literature review can help to identify potential research questions and areas for further investigation.
• Avoiding duplication of research: A literature review can help to avoid duplication of research by identifying what has already been done on a topic, and what remains to be done.
• Enhancing the credibility of the research : A literature review helps to enhance the credibility of the research by demonstrating the researcher’s knowledge of the existing literature and their ability to situate their research within a broader context.

Limitations of Literature Review

Limitations of Literature Review are as follows:

• Limited scope : Literature reviews can only cover the existing literature on a particular topic, which may be limited in scope or depth.
• Publication bias : Literature reviews may be influenced by publication bias, which occurs when researchers are more likely to publish positive results than negative ones. This can lead to an incomplete or biased picture of the literature.
• Quality of sources : The quality of the literature reviewed can vary widely, and not all sources may be reliable or valid.
• Time-limited: Literature reviews can become quickly outdated as new research is published, making it difficult to keep up with the latest developments in a field.
• Subjective interpretation : Literature reviews can be subjective, and the interpretation of the findings can vary depending on the researcher’s perspective or bias.
• Lack of original data : Literature reviews do not generate new data, but rather rely on the analysis of existing studies.
• Risk of plagiarism: It is important to ensure that literature reviews do not inadvertently contain plagiarism, which can occur when researchers use the work of others without proper attribution.

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Muhammad Hassan

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

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

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

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

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

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

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

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

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

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

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

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

9.2. Overview of the Literature Review Process and Steps

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

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

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

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

9.3. Types of Review Articles and Brief Illustrations

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

9.3.1. Narrative Reviews

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

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

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

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

9.3.2. Descriptive or Mapping Reviews

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

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

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

9.3.3. Scoping Reviews

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

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

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

9.3.4. Forms of Aggregative Reviews

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

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

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

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

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

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

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

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

9.3.5. Realist Reviews

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

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

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

9.3.6. Critical Reviews

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

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

9.4. Summary

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

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

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

9.5. Concluding Remarks

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

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

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

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• Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
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Organizing Your Social Sciences Research Paper

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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Writing a Literature Review

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

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

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

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

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

What are the parts of a lit review?

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

Introduction:

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

Conclusion:

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

How should I organize my lit review?

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

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

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

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

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

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

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

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

Literature Reviews

• Getting Started

Selecting a Review Type

Defining the scope of your review, four common types of reviews.

• Developing a Research Question
• Searching the Literature
• Searching Tips
• ChatGPT [beta]
• Documenting your Search
• Using Citation Managers
• Concept Mapping
• Writing the Review
• Further Resources

More Review Types

This article by Sutton & Booth (2019) explores 48 distinct types of Literature Reviews:

Which Review is Right for You?

The  Right Review tool  has questions about your lit review process and plans. It offers a qualitative and quantitative option. At completion, you are given a lit review type recommendation.

You'll want to think about the kind of review you are doing. Is it a selective or comprehensive review? Is the review part of a larger work or a stand-alone work ?

For example, if you're writing the Literature Review section of a journal article, that's a selective review which is part of a larger work. Alternatively, if you're writing a review article, that's a comprehensive review which is a stand-alone work. Thinking about this will help you develop the scope of the review.

This exercise will help define the scope of your Literature Review, setting the boundaries for which literature to include and which to exclude.

A FEW GENERAL CONSIDERATIONS WHEN DEFINING SCOPE

• Which populations to investigate — this can include gender, age, socio-economic status, race, geographic location, etc., if the research area includes humans.
• What years to include — if researching the legalization of medicinal cannabis, you might only look at the previous 20 years; but if researching dolphin mating practices, you might extend many more decades.
• Which subject areas — if researching artificial intelligence, subject areas could be computer science, robotics, or health sciences
• How many sources  — a selective review for a class assignment might only need ten, while a comprehensive review for a dissertation might include hundreds. There is no one right answer.
• There will be many other considerations that are more specific to your topic. 

Most databases will allow you to limit years and subject areas, so look for those tools while searching. See the Searching Tips tab for information on how use these tools.

LITERATURE REVIEW

• Often used as a generic term to describe any type of review
• More precise definition:  Published materials that provide an examination of published literature . Can cover wide range of subjects at various levels of comprehensiveness.
• Identifies gaps in research, explains importance of topic, hypothesizes future work, etc.
• Usually written as part of a larger work like a journal article or dissertation

SCOPING REVIEW

• Conducted to address broad research questions with the goal of understanding the extent of research that has been conducted.
• Provides a preliminary assessment of the potential size and scope of available research literature. It aims to identify the nature and extent of research evidence (usually including ongoing research) 
• Doesn't assess the quality of the literature gathered (i.e. presence of literature on a topic shouldn’t be conflated w/ the quality of that literature)
• " Preparing scoping reviews for publication using methodological guides and reporting standards " is a great article to read on Scoping Reviews

SYSTEMATIC REVIEW

• Common in the health sciences ( Taubman Health Sciences Library guide to Systematic Reviews )
• Goal: collect all literature that meets specific criteria (methodology, population, treatment, etc.) and then appraise its quality and synthesize it
• Follows strict protocol for literature collection, appraisal and synthesis
• Typically performed by research teams 
• Takes 12-18 months to complete
• Often written as a stand alone work

META-ANALYSIS

• Goes one step further than a systematic review by statistically combining the results of quantitative studies to provide a more precise effect of the results. 
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ON YOUR 1ST ORDER

Different Types of Literature Review: Which One Fits Your Research?

By Laura Brown on 13th October 2023

You might not have heard that there are multiple kinds of literature review. However, with the progress in your academic career you will learn these classifications and may need to use different types of them. However, there is nothing to worry if you aren’t aware of them now, as here we are going to discuss this topic in detail.

There are approximately 14 types of literature review on the basis of their specific objectives, methodologies, and the way they approach and analyse existing literature in academic research. Of those 14, there are 4 major types. But before we delve into the details of each one of them and how they are useful in academics, let’s first understand the basics of literature review.

What is Literature Review?

A literature review is a critical and systematic summary and evaluation of existing research. It is an essential component of academic and research work, providing an overview of the current state of knowledge in a particular field.

In easy words, a literature review is like making a big, organised summary of all the important research and smart books or articles about a particular topic or question. It’s something scholars and researchers do, and it helps everyone see what we already know about that topic. It’s kind of like taking a snapshot of what we understand right now in a certain field.

It serves with some specific purpose in the research.

• Provides a comprehensive understanding of existing research on a topic.
• Identifies gaps, trends, and inconsistencies in the literature.
• Contextualise your own research within the broader academic discourse.
• Supports the development of theoretical frameworks or research hypotheses.

4 Major Types Of Literature Review

The four major types include, Narrative Review, Systematic Review, Meta-Analysis, and Scoping Review. These are known as the major ones because they’re like the “go-to” methods for researchers in academic and research circles. Think of them as the classic tools in the researcher’s toolbox. They’ve earned their reputation because they have a unique style for literature review introduction , clear steps and specific qualities that make them super handy for different research needs.

1. Narrative Review

Narrative reviews present a well-structured narrative that reads like a cohesive story, providing a comprehensive overview of a specific topic. These reviews often incorporate historical context and offer a broad understanding of the subject matter, making them valuable for researchers looking to establish a foundational understanding of their area of interest. They are particularly useful when a historical perspective or a broad context is necessary to comprehend the current state of knowledge in a field.

2. Systematic Review

Systematic reviews are renowned for their methodological rigour. They involve a meticulously structured process that includes the systematic selection of relevant studies, comprehensive data extraction, and a critical synthesis of their findings. This systematic approach is designed to minimise bias and subjectivity, making systematic reviews highly reliable and objective. They are considered the gold standard for evidence-based research as they provide a clear and rigorous assessment of the available evidence on a specific research question.

3. Meta Analysis

Meta analysis is a powerful method for researchers who prefer a quantitative and statistical perspective. It involves the statistical synthesis of data from various studies, allowing researchers to draw more precise and generalisable conclusions by combining data from multiple sources. Meta analyses are especially valuable when the aim is to quantitatively measure the effect size or impact of a particular intervention, treatment, or phenomenon.

4. Scoping Review

Scoping reviews are invaluable tools, especially for researchers in the early stages of exploring a topic. These reviews aim to map the existing literature, identifying gaps and helping clarify research questions. Scoping reviews provide a panoramic view of the available research, which is particularly useful when researchers are embarking on exploratory studies or trying to understand the breadth and depth of a subject before conducting more focused research.

Different Types Of Literature review In Research

There are some more approaches to conduct literature review. Let’s explore these classifications quickly.

5. Critical Review

Critical reviews provide an in-depth evaluation of existing literature, scrutinising sources for their strengths, weaknesses, and relevance. They offer a critical perspective, often highlighting gaps in the research and areas for further investigation.

6. Theoretical Review

Theoretical reviews are centred around exploring and analysing the theoretical frameworks, concepts, and models present in the literature. They aim to contribute to the development and refinement of theoretical perspectives within a specific field.

7. Integrative Review

Integrative reviews synthesise a diverse range of studies, drawing connections between various research findings to create a comprehensive understanding of a topic. These reviews often bridge gaps between different perspectives and provide a holistic overview.

8. Historical Review

Historical reviews focus on the evolution of a topic over time, tracing its development through past research, events, and scholarly contributions. They offer valuable context for understanding the current state of research.

9. Methodological Review

Among the different kinds of literature reviews, methodological reviews delve into the research methods and methodologies employed in existing studies. Researchers assess these approaches for their effectiveness, validity, and relevance to the research question at hand.

10. Cross-Disciplinary Review

Cross-disciplinary reviews explore a topic from multiple academic disciplines, emphasising the diversity of perspectives and insights that each discipline brings. They are particularly useful for interdisciplinary research projects and uncovering connections between seemingly unrelated fields.

11. Descriptive Review

Descriptive reviews provide an organised summary of existing literature without extensive analysis. They offer a straightforward overview of key findings, research methods, and themes present in the reviewed studies.

12. Rapid Review

Rapid reviews expedite the literature review process, focusing on summarising relevant studies quickly. They are often used for time-sensitive projects where efficiency is a priority, without sacrificing quality.

13. Conceptual Review

Conceptual reviews concentrate on clarifying and developing theoretical concepts within a specific field. They address ambiguities or inconsistencies in existing theories, aiming to refine and expand conceptual frameworks.

14. Library Research

Library research reviews rely primarily on library and archival resources to gather and synthesise information. They are often employed in historical or archive-based research projects, utilising library collections and historical documents for in-depth analysis.

Each type of literature review serves distinct purposes and comes with its own set of strengths and weaknesses, allowing researchers to choose the one that best suits their research objectives and questions.

Choosing the Ideal Literature Review Approach in Academics

In order to conduct your research in the right manner, it is important that you choose the correct type of review for your literature. Here are 8 amazing tips we have sorted for you in regard to literature review help so that you can select the best-suited type for your research.

• Clarify Your Research Goals: Begin by defining your research objectives and what you aim to achieve with the literature review. Are you looking to summarise existing knowledge, identify gaps, or analyse specific data?
• Understand Different Review Types: Familiarise yourself with different kinds of literature reviews, including systematic reviews, narrative reviews, meta-analyses, scoping reviews, and integrative reviews. Each serves a different purpose.
• Consider Available Resources: Assess the resources at your disposal, including time, access to databases, and the volume of literature on your topic. Some review types may be more resource-intensive than others.
• Alignment with Research Question: Ensure that the chosen review type aligns with your research question or hypothesis. Some types are better suited for answering specific research questions than others.
• Scope and Depth: Determine the scope and depth of your review. For a broad overview, a narrative review might be suitable, while a systematic review is ideal for an in-depth analysis.
• Consult with Advisors: Seek guidance from your academic advisors or mentors. They can provide valuable insights into which review type best fits your research goals and resources.
• Consider Research Field Standards: Different academic fields have established standards and preferences for different forms of literature review. Familiarise yourself with what is common and accepted in your field.
• Pilot Review: Consider conducting a small-scale pilot review of the literature to test the feasibility and suitability of your chosen review type before committing to a larger project.

Bonus Tip: Crafting an Effective Literature Review

Now, since you have learned all the literature review types and have understood which one to prefer, here are some bonus tips for you to structure a literature review of a dissertation .

• Clearly Define Your Research Question: Start with a well-defined and focused research question to guide your literature review.
• Thorough Search Strategy: Develop a comprehensive search strategy to ensure you capture all relevant literature.
• Critical Evaluation: Assess the quality and credibility of the sources you include in your review.
• Synthesise and Organise: Summarise the key findings and organise the literature into themes or categories.
• Maintain a Systematic Approach: If conducting a systematic review, adhere to a predefined methodology and reporting guidelines.
• Engage in Continuous Review: Regularly update your literature review to incorporate new research and maintain relevance.

Some Useful Tools And Resources For You

Effective literature reviews demand a range of tools and resources to streamline the process.

• Reference management software like EndNote, Zotero, and Mendeley helps organise, store, and cite sources, saving time and ensuring accuracy.
• Academic databases such as PubMed, Google Scholar, and Web of Science provide access to a vast array of scholarly articles, with advanced search and citation tracking features.
• Research guides from universities and libraries offer tips and templates for structuring reviews.
• Research networks like ResearchGate and Academia.edu facilitate collaboration and access to publications. Literature review templates and research workshops provide additional support.

Some Common Mistakes To Avoid

Avoid these common mistakes when crafting literature reviews.

• Unclear research objectives result in unfocused reviews, so start with well-defined questions.
• Biased source selection can compromise objectivity, so include diverse perspectives.
• Never miss on referencing; proper citation and referencing are essential for academic integrity.
• Don’t overlook older literature, which provides foundational insights.
• Be mindful of scope creep, where the review drifts from the research question; stay disciplined to maintain focus and relevance.

While Summing Up On Various Types Of Literature Review

As we conclude this classification of fourteen distinct approaches to conduct literature reviews, it’s clear that the world of research offers a multitude of avenues for understanding, analysing, and contributing to existing knowledge.

Whether you’re a seasoned scholar or a student beginning your academic journey, the choice of review type should align with your research objectives and the nature of your topic. The versatility of these approaches empowers you to tailor your review to the demands of your project.

Remember, your research endeavours have the potential to shape the future of knowledge, so choose wisely and dive into the world of literature reviews with confidence and purpose. Happy reviewing!

Laura Brown, a senior content writer who writes actionable blogs at Crowd Writer.

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Basics of Systematic Reviews

• About Systematic Review

Types of Reviews

Literature review.

Collects key sources on a topic and discusses those sources in conversation with each other

• Standard for research articles in most disciplines
• Tells the reader what is known, or not known, about a particular issue, topic, or subject
• Demonstrates knowledge and understanding of a topic
• Establishes context or background for a case or argument
• Helps develop the author’s ideas and perspective

Rapid Review

Thorough methodology but with process limitations in place to expeditethe completion of a review.

• For questions that require timely answers
• 3-4 months vs. 12-24 months
• Limitations - scope, comprehensiveness bias, and quality of appraisal
• Discusses potential effects that the limited methods may have had on results

Scoping Review

Determine the scope or coverage of a body of literature on a given topic and give clear indication of the volume of literature and studies available as well as an overview of its focus.

• Identify types of available evidence in a given field
• Clarify key concepts/definitions in the literature
• Examine how research is conducted on a certain topic or field
• Identify key factors related to a concept
• Key difference is focus
• Identify and analyze knowledge gaps

Systematic Review

Attempts to identify, appraise, and summarize all empirical evidence that fits pre-specified eligibility criteria to answer a specific research question.

• clearly defined question with inclusion/exclusion criteria
• rigorous and systematic search of the literature
• thorough screening of results
• data extraction and management
• analysis and interpretation of results
• risk of bias assessment of included studies

Meta-Analysis

Used to systematically synthesize or merge the findings of single, independent studies, using statistical methods to calculate an overall or ‘absolute’ effect.

• Combines results from multiple empirical studies
• Requires systematic review first
• Use well recognized, systematic methods to account for differences in sample size, variability (heterogeneity) in study approach and findings (treatment effects)
• Test how sensitive their results are to their own systematic review protocol

For additional types of reviews please see these articles:

• Sutton, A., Clowes, M., Preston, L. and Booth, A. (2019), Meeting the review family: exploring review types and associated information retrieval requirements. Health Info Libr J, 36: 202-222. https://doi.org/10.1111/hir.12276
• Grant, M.J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
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Literature Reviews

• 1. Define your research question
• Getting started
• Types of reviews

Define topic

Brainstorming, limit scope, how ai can help, helpful resources.

• 2. Plan your search
• 3. Search the literature
• 4. Organize your results
• 5. Synthesize your findings
• 6. Write the review
• Artificial intelligence (AI) tools
• Thompson Writing Studio This link opens in a new window
• Need to write a systematic review? This link opens in a new window

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For example, the following research question is too broad.

Does social media affect mental health in college students?

A more focused research question could be:

Does social media play a role in the number of eating disorder diagnoses in college-aged women?

Need some guidance? Contact your subject librarian for a research consultation or reach out to [email protected] .

Start the brainstorming process:

• Begin by identifying a broad topic of research interest (the more you're personally interested in it, the better!). Write it down to clarify your focus.
• Narrow down your scope  by considering specific areas within this topic that you want to explore.
• Identify key themes and elements  related to these specific areas. These will be the building blocks of your investigation.
• Finally,  integrate these key areas and elements  into a well-crafted research question.

One way to brainstorm is to use a flowchart.

The scope of a topic  encompasses the boundaries and constraints you set for your research. The more precise your research question, the smoother the research process becomes.

Feeling stuck? Here are some ways you can narrow down your topic:

• geographic location
• time period
• discipline/field of study
• age group, etc.

You:  I need to conduct a literature review about social media, mental health, and college students. What are some example research questions within this topic?

ChatGPT: 

• How does the frequency and nature of social media use impact the mental health of college students?
• What role do specific social media platforms play in influencing the mental well-being of college students?
• How do online social interactions on platforms like Facebook, Instagram, or Twitter relate to the mental health outcomes of college students?
• Are there differences in the association between social media use and mental health outcomes based on demographic factors such as gender, age, or academic major among college students?
• What strategies do college students employ to cope with negative mental health effects associated with social media use?
• How does the perception of social support through online platforms affect the mental health of college students?
• To what extent does the comparison of oneself to others on social media contribute to mental health challenges among college students?
• What interventions or educational programs are effective in promoting positive mental health behaviors in the context of social media use for college students?
• How do social media literacy and awareness programs impact the mental health attitudes and behaviors of college students?
• What is the relationship between the use of social media for academic and social purposes and the mental health outcomes of college students?

Generative AI tools : ChatGPT , Google Gemini (formerly Bard) , Claude , Microsoft Copilot

For more information on how to incorporate AI tools into your research, check out the section on AI Tools .

• Developing Your Research Question
• Developing a Researchable Question
• Brainstorming tips from UNC Writing Center
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Cross-Education of Muscular Endurance: A Scoping Review

• Review Article
• Open access
• Published: 17 May 2024

Cite this article

You have full access to this open access article

• Jun Seob Song 1 ,
• Yujiro Yamada 1 ,
• Ryo Kataoka 1 ,
• William B. Hammert 1 ,
• Anna Kang 1 &
• Jeremy P. Loenneke 1  

7 Altmetric

It is well established that performing unilateral resistance training can increase muscle strength not only in the trained limb but also in the contralateral untrained limb, which is widely known as the cross-education of strength. However, less attention has been paid to the question of whether performing unilateral resistance training can induce cross-education of muscular endurance, despite its significant role in both athletic performance and activities of daily living.

The objectives of this scoping review were to provide an overview of the existing literature on cross-education of muscular endurance, as well as discuss its potential underlying mechanisms and offer considerations for future research.

A scoping review was conducted on the effects of unilateral resistance training on changes in muscular endurance in the contralateral untrained limb. This scoping review was conducted in PubMed, SPORTDiscus, and Scopus.

A total of 2000 articles were screened and 21 articles met the inclusion criteria. Among the 21 included studies, eight studies examined the cross-education of endurance via absolute ( n  = 6) or relative ( n  = 2) muscular endurance test, while five studies did not clearly indicate whether they examined absolute or relative muscular endurance. The remaining eight studies examined different types of muscular endurance measurements (e.g., time to task failure, total work, and fatigue index).

The current body of the literature does not provide sufficient evidence to draw clear conclusions on whether the cross-education of muscular endurance is present. The cross-education of muscular endurance (if it exists) may be potentially driven by neural adaptations (via bilateral access and/or cross-activation models that lead to cross-education of strength) and increased tolerance to exercise-induced discomfort. However, the limited number of available randomized controlled trials and the lack of understanding of underlying mechanisms provide a rationale for future research.

Avoid common mistakes on your manuscript.

1 Introduction

Resistance training leads to improvements in strength and muscular endurance [ 1 , 2 , 3 ]. When resistance training is performed on one side of the body only (i.e., unilateral resistance training), increased muscle strength has been observed not only in the trained limb but also in the contralateral untrained limb, which is widely known as the cross-education (or cross-transfer) of strength [ 4 , 5 ]. The cross-education of strength was first reported in the scientific literature as early as the late nineteenth century [ 6 ], and thereafter it has been studied and reviewed extensively over the years [ 4 , 5 , 7 , 8 , 9 ]. Although its underlying mechanisms are not entirely understood, there is a general consensus within the cross-education literature that the transfer of strength to the untrained limb is mediated primarily by neural mechanisms and likely not by mechanisms at the local muscle level (e.g., changes in muscle fiber type and cross-sectional area) as these changes appear to occur within the trained limb only [ 4 , 7 , 10 , 11 ]. In contrast to cross-education of strength, considerably less attention has been paid to the question of whether performing unilateral resistance training can increase muscular endurance in the contralateral untrained limb (i.e., cross-education of muscular endurance).

Muscular endurance refers to the ability of muscles to perform successive contractions at a submaximal load, and it is considered as an important physical fitness component not only for athletic performance in sports but also for activities of daily living that require repetitive work [ 12 ]. Muscular endurance can be further specified into absolute and relative muscular endurance [ 13 ]. Absolute muscular endurance involves performing a maximal number of repetitions with a given absolute load regardless of changes in maximal strength (e.g., using 60% of pretraining 1RM at pre- and posttesting) [ 14 ]. In contrast, relative muscular endurance involves an individual performing a maximal number of repetitions with a load corresponding to a specific relative intensity or percentage of the individual’s current 1RM (e.g., using 60% of pretraining and posttraining 1RM at pre- and posttesting, respectively) [ 14 ]. In addition, muscular endurance has been measured in several other ways when using different types of testing (e.g., isometric, isokinetic), such as time to task failure or total work during repeated isokinetic contractions [ 15 , 16 ]. There is evidence that resistance training can increase strength as well as induce positive mitochondrial and microvascular adaptations (e.g., mitochondrial respiratory capacity, capillary to fiber ratio), which may help explain muscular endurance adaptations in the trained limb [ 17 , 18 , 19 ]. However, it remains unclear whether these mechanisms can also explain the changes in muscular endurance in the contralateral untrained limb. Therefore, the purpose of this paper was to provide an overview of the existing literature on cross-education of muscular endurance following unilateral resistance training and to discuss its potential underlying mechanisms.

A scoping review was conducted to evaluate the cross-education of muscular endurance. The current study was conducted and reported in accordance with the Preferred Reporting for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) [ 20 ].

To identify relevant articles for the current scoping review, systematic literature searches were conducted from inception through April 2023, using PubMed, SPORTDiscus, and Scopus. Relevant studies were identified with the following search terms: “cross education” OR “cross transfer” OR “contralateral effect” OR “contralateral transfer” OR “interlimb transfer” OR “bilateral transfer” AND “endurance.” An additional search was carried out by examining the references of the included articles. Following the removal of duplicates, articles were screened first by title and abstract, followed by full text screening for eligibility. The study selection process is summarized using the PRISMA flow diagram (Fig.  1 ). In the present scoping review, broad inclusion criteria were used to provide an overview of the existing literature on cross-education of muscular endurance. To be included within the scoping review, studies were required to fulfill the following criteria: (1) original article was written in English language; (2) included a unilateral resistance exercise training intervention (regardless of strength training type and training load); (3) measured muscular endurance (e.g., number of repetitions at an absolute or relative load, time to task failure, total work) in the contralateral untrained limb at pre- and posttesting; and (4) was performed in humans with no restrictions on age and training status. One reviewer (JSS) completed literature searches and extraction of data. The following information was extracted: characteristics of participants, unilateral resistance training intervention (exercise type, sets, repetitions, load), frequency, duration, and main outcomes (cross-education of strength and muscular endurance). Two reviewers (JSS and JPL) checked the studies that only reported within-group changes (i.e., pre- to posttest) for each group, and back-calculated the p -value of between-group differences when possible.

Study selection process as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR)

3.1 Search Results

The systematic search provided 2000 articles (PubMed = 860, Scopus = 535, SPORTDiscus = 605), of which 377 were duplicates, leaving 1623 for screening. After title/abstract screening, 1516 articles were excluded and the remaining 107 articles were assessed for eligibility via full-text screening. Ninety-six articles were omitted following the full-text assessment, and 10 additional studies were included by reference checking. In total, 21 studies met the aforementioned criteria and were included in the review.

3.2 Study Characteristics

The present review included both randomized controlled trials and nonrandomized controlled trials. Of the 21 articles included in the review (Table  1 ), 10 studies were randomized controlled trials (including a nontraining control group) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] and 11 studies were nonrandomized controlled trials [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Of note, this review focused more on randomized controlled trials, as it allows determination of whether changes in muscular endurance in an untrained limb (i.e., cross-education of muscular endurance) are solely due to the training interventions.

Among the 21 included studies, nine studies employed unilateral exercise training in the lower body (3 randomized controlled trials and 6 nonrandomized controlled trials) [ 21 , 23 , 24 , 31 , 33 , 35 , 36 , 37 , 39 ], nine studies in the upper arm (7 randomized controlled trials and 2 nonrandomized controlled trials) [ 22 , 25 , 26 , 27 , 28 , 29 , 30 , 40 , 41 ], and three studies used handgrip (3 nonrandomized controlled trials) [ 32 , 34 , 38 ]. For the muscular endurance measurements, absolute muscular endurance (i.e., number of repetitions with the same given load at pre- and postintervention, regardless of changes in maximal strength) was assessed in six studies [ 21 , 22 , 25 , 30 , 39 , 41 ], and relative muscular endurance (i.e., number of repetitions with a load corresponding to a specific relative intensity or percentage of individual’s current 1RM) was measured in two studies [ 26 , 27 ]. Of note, five studies did not provide enough detail to determine whether absolute or relative muscular endurance was examined for testing [ 23 , 29 , 32 , 38 , 40 ]. The remaining eight studies used several different types of muscular endurance measurements including: time to task failure (using absolute or relative load) [ 28 , 31 , 34 , 36 , 37 ], total work performed [ 24 , 33 ], and fatigue index (e.g., difference in work between the first three reps and the last three reps) [ 35 ]. Among the 21 included studies, five studies were conducted in untrained individuals [ 23 , 24 , 31 , 33 , 38 ], whereas the remaining 16 studies did not clearly describe the training status of the participants (e.g., physically active, college students from physical education program) [ 21 , 22 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 35 , 36 , 37 , 39 , 40 , 41 ].

4 Discussion

4.1 findings from nonrandomized controlled trials.

Several nonrandomized controlled trials reported changes in muscular endurance in the untrained limb following unilateral exercise training interventions. For example, 3 weeks of unilateral knee extension training increased absolute muscular endurance (i.e., maximal number of repetitions using 8.2 kg) in the contralateral untrained leg from pre- to posttest [ 39 ]. Similarly, 12 weeks of unilateral leg press exercise training increased relative muscular endurance [i.e., time to task failure during sustained isometric knee extension at relative 50% maximum voluntary isometric contraction (MVIC)] in the untrained leg from pre- to posttest [ 31 ]. In addition, four studies observed an increased muscular endurance (i.e., maximal number of repetitions and time to task failure) in the untrained limb (i.e., pre- to posttest) following 4–6 weeks of unilateral handgrip exercise training [ 32 , 34 , 38 ] and 6 weeks of unilateral isometric leg press training [ 37 ]. In those studies, however, it was unclear whether they used an absolute or relative muscular endurance test [ 32 , 34 , 37 , 38 ]. In one study, an increase in total work (i.e., during 30 maximum isokinetic knee extension) from pre- to posttest was observed in the untrained leg following 4 weeks of unilateral isokinetic knee extension and flexion [ 33 ]. However, these findings were not consistent throughout the literature. For example, no changes (i.e., pre- to posttest) in muscular endurance (i.e., absolute and/or relative, fatigue index) were observed in the contralateral untrained limb following unilateral knee extension training interventions [ 35 , 36 ], or following unilateral elbow flexion training interventions [ 40 , 41 ]. Of note, however, these findings should be interpreted with caution as it is not possible to know whether the changes in muscular endurance are due to the exercise training intervention or other factors outside of the training intervention. In other words, to determine whether the cross-education of muscular endurance is solely due to the training interventions, a time-matched nontraining control group is required (i.e., randomized controlled trials).

4.2 Findings from Randomized Controlled Trials

Among ten randomized controlled trials [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], three studies reported a cross-education of muscular endurance [ 23 , 30 ]. In male children (aged 10–13 years), for example, 8 weeks of unilateral leg press training increased not only strength but also muscular endurance (i.e., number of unilateral leg press repetitions with 60% of 1RM until failure) of the contralateral untrained leg compared with a nontraining control group [ 23 ]. In that study, however, it was not clear whether 60% of pre- or posttraining 1RM was used at the posttesting (i.e., absolute or relative muscular endurance) [ 23 ]. In healthy young males, 3 weeks of unilateral elbow flexion exercise training increased absolute muscular endurance (i.e., maximal number of unilateral elbow flexion repetitions with 6.4 kg) in the contralateral untrained arm compared with a nontraining control group [ 30 ]. In five randomized controlled trials, only within-group changes (i.e., pre- to posttest) in muscular endurance were reported [ 24 , 25 , 26 , 27 , 29 ]. For example, increases in muscular endurance (i.e., total work performed during 25 maximal isokinetic contractions and work performed during the last 5 repetitions) were observed in the contralateral untrained leg from pre- to posttest in a group that performed 7 weeks of isokinetic and isometric knee extension training, whereas no within-group changes were observed in a time-matched nontraining control group [ 24 ]. Similarly, increases in absolute and relative [ 25 , 26 ] muscular endurance from pre- to posttest were observed in the untrained arm following 6 weeks of unilateral elbow flexion training, while no changes were observed in a nontraining control group. In contrast, one study found no within-group changes (pre- to posttest) in either the training (i.e., 4 weeks of unilateral elbow flexion training) group or the nontraining control group [ 29 ]. Although some studies reported increases in muscular endurance only in the training groups and not in the control groups, this does not indicate that there was cross-education of muscular endurance. To determine whether a cross-education of muscular endurance is present, the changes in muscular endurance of the training groups should be directly compared with those of the control group. In one study, although only within-group changes (i.e., pre- to posttest) were reported for training and control groups, we were able to directly compare those two groups by back-calculating the p -value of between-group differences [ 27 ]. The calculation showed that the changes in relative muscular endurance in the untrained arm following 6 weeks of unilateral elbow flexion training were significantly greater compared with a control group, indicating a cross-education of relative muscular endurance [ 27 ]. Three randomized controlled trials did not observe cross-education of muscular endurance [ 21 , 22 , 28 ]. For example, no changes in absolute muscular endurance were observed in the contralateral untrained limb following 5 weeks of unilateral knee extension training [ 21 ] and following 5 weeks of unilateral elbow flexion training [ 22 ] when compared with a nontraining control group. Similarly, no changes in time to failure (i.e., sustaining at 100% MVIC until force drop below 50% MVIC) were observed in the untrained arm following 6 weeks of unilateral isometric elbow flexion training when compared with a nontraining control group [ 28 ].

Taken together, there is very limited evidence to suggest that performing unilateral resistance training can increase muscular endurance in the contralateral untrained limb (i.e., cross-education of muscular endurance). For example, there have been only three randomized controlled studies (out of 10 studies) that demonstrated evidence for cross-education of muscular endurance. Among these three studies, one showed increased absolute muscular endurance, another showed increased relative muscular endurance, and the third study showed increased muscular endurance (unclear whether absolute or relative). In contrast, the remaining seven studies either did not find or could not provide supporting evidence. These discrepancies in the cross-education of muscular endurance may be due to the differences in training interventions (e.g., contraction type, intensity, duration) and/or muscular endurance measurements (e.g., maximal number of repetitions and time to task failure using absolute or relative load). The current body of literature does not provide sufficient evidence to draw a clear conclusion on whether cross-education of muscular endurance is present, and thus requires further investigation.

4.3 Potential Underlying Mechanisms

There have been several mechanisms proposed to explain the increase in muscular endurance in the trained limb following resistance training, such as increased muscle capillarity [ 17 ] and mitochondrial respiratory capacity/function [ 42 , 43 ]. Although these proposed mechanisms may explain training-induced increases in muscular endurance in the trained limb, these would be unlikely to explain the changes in the contralateral untrained limb. The following section will discuss potential mechanisms that might contribute to the cross-education of muscular endurance.

4.3.1 Increases in Muscle Strength (Cross-Education of Strength)

One potential adaptation that could improve absolute muscular endurance in the contralateral untrained limb following unilateral resistance training is increased strength in the untrained limb via cross-education (i.e., cross-education of strength). According to the size principle, motor units are recruited in an orderly manner from the smaller motor units (i.e., low threshold) to the larger motor units (i.e., high threshold) as required force increases or muscle fatigues [ 44 ]. Based on this, increases in strength following resistance training may require fewer motor units to lift an absolute submaximal load for the same number of repetitions, which may delay the involvement of larger motor units and reserve them to be recruited subsequently for sustaining the required force as fatigue develops [ 14 , 45 ]. This hypothesis is partially supported by Ploutz et al. [ 45 ] who showed that less muscle was recruited to lift the same submaximal load in the untrained leg following 9 weeks of unilateral knee extension training [ 45 ], which may reserve larger motor units to be recruited later on and consequently allow for better performance on the absolute muscular endurance test in the untrained limb. However, this should be interpreted with caution since there was no time-matched control group, which makes it difficult to know whether the changes in muscle recruitment in the untrained limb were due to the unilateral training or some other factor [ 45 ]. The potential role of changes in strength on absolute muscular endurance may be also partially supported by a secondary analysis that examined if the changes in 1RM strength mediate changes in absolute muscular endurance (i.e., maximal number of repetitions using 42.5% pretraining 1RM) following high-load (i.e., 70% 1RM) training compared with low-load training interventions (i.e., 15% 1RM with or without blood flow restriction) [ 18 ]. In that study, it was found that training-induced increases in strength mediated the changes in muscular endurance in the high-load training group relative to the low-load training groups, suggesting that the differences in muscular endurance between high-load and low-load training groups may be explained by changes in strength. However, it is of note that the mediation analysis in that study only compared between training groups and not with a time-matched control group, meaning that the results can only explain the differences between training groups (i.e., high load versus low load). To clearly demonstrate whether the change in strength is an underlying mechanism for changes in muscular endurance, it may be more appropriate to compare training groups to a nonexercise control group in the mediation analysis. Furthermore, that analysis was on the changes in the trained limb, and thus it remains unknown whether increased strength from cross-education can also be translated to improved absolute muscular endurance in the untrained limb. One of the included studies reported concurrent increases in strength and muscular endurance in the untrained limb [ 23 ], whereas other studies showed that the cross-education of strength is not always accompanied by the cross-education of absolute muscular endurance [ 21 , 22 ]. Of note, simply assessing whether there were concurrent cross-education of strength and absolute muscular endurance may not be an appropriate approach to determine whether cross-education of strength can be translated to cross-education of absolute muscular endurance. A more appropriate approach might be using a mediation analysis to examine if the increases in strength from cross-education mediate the changes in absolute muscular endurance in the untrained limb [ 46 , 47 ]. It is of note that some previous studies have shown that unilateral low-load (or low-intensity) training does not increase strength in the opposite untrained limb (i.e., no cross-education of strength) [ 48 , 49 ]. However, this does not necessarily mean that unilateral low-load (or low-intensity) exercise would not induce cross-education of muscular endurance. It is plausible that cross-education of muscular endurance can occur in the absence of strength gain via different mechanisms.

4.3.2 Bilateral Access and Cross-Activation Model

Cross-education of relative muscular endurance likely cannot be explained by increased strength in the contralateral limb as relative muscular endurance is scaled to current maximal strength. Two main theoretical models, which may not be mutually exclusive, have been proposed to explain the cross-education of strength and skills: “bilateral access” and “cross-activation” models [ 50 ]. Although speculative, these two models may also explain the cross-education of muscular endurance. The “bilateral access” model involves the development of a motor engram during unilateral resistance training, which can be accessed not only by the trained limb, but also by the untrained limb for the control and execution of movements [ 50 , 51 ]. A widely used example is the “callosal access” hypothesis, in which the motor engrams developed in the trained hemisphere may be accessed by the opposite untrained hemisphere via the corpus callosum during motor tasks in the untrained limb [ 50 , 51 ]. In this model, it has been hypothesized that performing unilateral resistance training may develop an effective muscle recruitment pattern for maximum force production (i.e., muscle strength), such as coordination of synergists and inhibition of antagonists, which can be stored in neural circuits and accessed by the untrained hemisphere [ 4 ]. Although speculative, this hypothetical model may also play a role in the cross-education of muscular endurance. In other words, performing unilateral resistance training may create a motor engram of the motor output necessary to effectively perform repeated submaximal contractions, leading to cross-education of muscular endurance. However, further research is needed to determine whether or not the “bilateral access” model plays a role in the cross-education of muscular endurance in a similar way as cross-education of strength. In the “cross-activation” model, it is proposed that performing unilateral resistance training could induce bilateral cortical activation, potentially leading to concurrent neural adaptations in both trained and untrained hemispheres [ 50 , 52 , 53 , 54 , 55 ]. For example, it was previously found that unilateral resistance training increased corticospinal excitability in both the trained and untrained primary motor cortex [ 55 ]. Furthermore, decreases in interhemispheric inhibition [ 56 ], short-interval intracortical inhibition [ 52 , 57 ], and cortical silent period [ 58 , 59 ] were also observed in both the trained and untrained side following unilateral resistance training. However, whether or not these neural adaptations can explain the cross-education of muscular endurance is currently not known, and further research is needed.

4.3.3 Increase in Tolerance to Exercise-Induced Discomfort

Increases in tolerance to exercise-induced discomfort may in part play a role in the cross-education of muscular endurance. For example, previous studies have suggested that the cross-education of muscular endurance may be due to repeated exposures to uncomfortable exertions during a training intervention, which allows individuals to accommodate greater exercise-induced discomfort, pain, and/or fatigue sensation [ 23 , 27 , 30 , 32 ]. Although it is not directly related to exercise-induced discomfort perception, previous cross-sectional studies have demonstrated that athletes typically have higher pain tolerance when compared with nonathlete control individuals [ 60 , 61 ]. In addition, increased pain tolerance has been observed following aerobic and combined (aerobic + resistance) exercise training in healthy young adults [ 62 ]. It has been proposed that the higher pain tolerance observed in trained individuals may be due to enhanced pain coping strategies, developed through repeated exposure to physical and psychological stress during exercise [ 60 , 63 ]. This is further supported by a previous study in which 6 weeks of high-intensity interval training increased not only ischemic pain tolerance but also exercise tolerance (i.e., time to exhaustion) when compared with volume-matched moderate-intensity continuous training [ 64 ]. In that study, it was suggested that the improvement in pain tolerance is likely due to repeated exposure to high metabolic stress and exercise-induced noxious stimuli, which might partly explain the improvement in exercise tolerance [ 64 ]. Based on these findings, it is possible that repeated exposure to discomfort from unilateral resistance training can lead to increased tolerance, resulting in increased muscular endurance in the contralateral untrained limb. This proposed mechanism is unlikely to play a role in the cross-education of muscular endurance if the training intervention only induces very low levels of discomfort or pain (e.g., low repetition with low load). However, since this proposed mechanism is based on a study that implemented aerobic training intervention, it needs to be further examined with resistance training intervention.

4.4 Future Considerations

There has been extensive work on the cross-education of strength, but far less attention has been paid to the cross-education of muscular endurance. For example, there is a lack of randomized controlled studies, which makes it difficult to draw clear conclusions on the cross-education of muscular endurance. The inclusion of a time-matched nonexercise control group allows researchers to confidently conclude that the increase in muscular endurance in the untrained limb is due to the unilateral resistance training and not to some other factor. Thus, time-matched control groups are always recommended for future studies. In addition, it is common to see studies reporting within-group changes (i.e., pre- to posttest) for each training and control group, and when significant changes are observed only in the training group and not in the control group, it is often concluded that there is cross-education of muscular endurance. However, this interpretation is problematic since the change scores are not directly compared between groups (e.g., intervention group versus control group). In other words, it is important to test the group × time interaction or directly compare the change scores between the groups if the goal is to examine whether the changes in muscular endurance in the untrained limb differ between the groups [ 65 , 66 , 67 ].

Several included studies in the present review did not clearly indicate how they measured the cross-education of muscular endurance. For example, a number of studies measured the maximal number of repetitions using a certain percentage of maximum strength (e.g., 30% of 1RM); however, they did not clearly indicate whether an absolute or relative load/intensity was utilized at posttesting. This lack of clarity makes it difficult to compare results across the literature and to replicate the data in future works. Therefore, future studies should clearly state within their methodology whether muscular endurance was measured via an absolute or relative muscular endurance test. In addition to absolute/relative muscular endurance, several other types of outcome variables have been also examined to test muscular endurance (e.g., total work during a certain number of repetitions, time to task failure). This discrepancy in methodology may partially explain the inconsistent findings observed in the existing literature. At present, it remains unclear which outcome variable is the most appropriate way to test an individual’s muscular endurance, and thus further research is warranted. Of note, in the cross-education of strength literature, it has been suggested that the changes in strength in the contralateral untrained limb are the greatest when it is tested with the same movement task performed by the trained limb (training specificity; e.g., test and train dynamically) [ 4 ]. Based on this, it may be reasonable to test the cross-education of muscular endurance with the same movement task used for the training intervention. However, the question of whether the cross-education of muscular endurance follows the principle of specificity requires further investigation.

Future studies might examine other markers of endurance capacity (e.g., mitochondrial density, muscle capillarization) to provide better support for the idea that the mechanism underlying cross-education of muscular endurance may not be local per se, but potentially via neural adaptations. A final consideration for future studies, especially for those attempting to address potential underlying mechanisms, may be the use of mediation analysis. In the present review, we suggested a number of potential underlying mechanisms including changes in strength in the untrained limb (for absolute muscular endurance). In one of the included studies, for example, concurrent increases in strength and muscular endurance were observed in the untrained limb (i.e., cross-education of strength and muscular endurance) [ 23 ]. However, because there was concurrent cross-education of strength and absolute muscular endurance, this does not necessarily indicate that the cross-education of muscular endurance was driven by the cross-education of strength. One statistical approach to understanding the potential role of strength changes in cross-education of muscular endurance may be using a mediation analysis [ 46 , 47 ]. Mediation analysis can quantify the effect of the third (mediating) variable (e.g., changes in strength in untrained limb) on the relationship between the independent variable (e.g., intervention groups) and dependent variable (e.g., changes in absolute muscular endurance in untrained limb). This approach may help future studies with identifying the potential underlying mechanisms that contribute to the cross-education of muscular endurance (if it exists).

5 Conclusions

Performing unilateral resistance training has been shown to increase strength not only in the trained limb but also in the contralateral untrained limb (i.e., cross-education of strength). However, less attention has been paid to the question of whether performing unilateral resistance training can also increase muscular endurance in the contralateral untrained limb (i.e., cross-education of muscular endurance). The current body of the literature does not provide sufficient evidence to draw clear conclusions on whether a cross-education of muscular endurance is present. Therefore, further research with a nonexercise control group (i.e., randomized controlled trials) is necessary to draw a strong conclusion. Furthermore, some potential underlying mechanisms (i.e., increased strength, bilateral access model, increased tolerance) are discussed in the present review; however, the proposed ideas currently lack experimental evidence and require further research.

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Sexual and reproductive health implementation research in humanitarian contexts: a scoping review

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Reproductive Health volume  21 , Article number:  64 ( 2024 ) Cite this article

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Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited.

A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included.

Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process.

This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

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Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

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Over the past few decades, the field of public health implementation research (IR) has grown as a means by which the real-world conditions affecting health improvement efforts can be better understood. Peters et al. put forward the following broad definition of IR for health: “IR is the scientific inquiry into questions concerning implementation – the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions)” [ 1 ].

As IR emphasizes real-world circumstances, the context within which a health intervention is delivered is a core consideration. However, much IR implemented to date has focused on higher-resource settings, with many proposed frameworks developed with particular utility for a higher-income setting [ 2 ]. In recognition of IR’s potential to increase evidence across a range of settings, there have been numerous reviews of the use of IR in lower-resource settings as well as calls for broader use [ 3 , 4 ]. There have also been more focused efforts to modify various approaches and frameworks to strengthen the relevance of IR to low- and middle-income country settings (LMICs), such as the work by Means et al. to adapt a specific IR framework for increased utility in LMICs [ 2 ].

Within LMIC settings, the centrality of context to a health intervention’s impact is of particular relevance in humanitarian settings, which present a set of distinct implementation challenges [ 5 ]. Humanitarian responses to crisis situations operate with limited resources, under potential security concerns, and often under pressure to relieve acute suffering and need [ 6 ]. Given these factors, successful implementation of a particular health intervention may require different qualities than those that optimize intervention impact under more stable circumstances [ 7 ]. Despite increasing recognition of the need for expanded evidence of health interventions in humanitarian settings, the evidence base remains limited [ 8 ]. Furthermore, despite its potential utility, there is not standardized guidance on IR in humanitarian settings, nor are there widely endorsed recommendations for the frameworks best suited to analyze implementation in these settings.

Sexual and reproductive health (SRH) is a core aspect of the health sector response in humanitarian settings [ 9 ]. Yet, progress in addressing SRH needs has lagged far behind other services because of challenges related to culture and ideology, financing constraints, lack of data and competing priorities [ 10 ]. The Minimum Initial Service Package (MISP) for SRH in Crisis Situations is the international standard for the minimum set of SRH services that should be implemented in all crisis situations [ 11 ]. However, as in other areas of health, there is need for expanded evidence for planning and implementation of SRH interventions in humanitarian settings. Recent systematic reviews of SRH in humanitarian settings have focused on the effectiveness of interventions and service delivery strategies, as well as factors affecting utilization, but have not detailed whether IR frameworks were used [ 12 , 13 , 14 , 15 ]. There have also been recent reviews examining IR frameworks used in various settings and research areas, but none have explicitly focused on humanitarian settings [ 2 , 16 ].

Given the need for an expanded evidence base for SRH interventions in humanitarian settings and the potential for IR to be used to expand the available evidence, a scoping review was undertaken. This scoping review sought to identify IR approaches that have been used in the last ten years to evaluate SRH interventions in humanitarian settings.

This review also sought to shed light on whether there is a need for a common framework to guide research design, analysis, and reporting for SRH interventions in humanitarian settings and if so, if there are any established frameworks already in use that would be fit-for-purpose or could be tailored to meet this need.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was utilized to guide the elements of this review [ 17 ]. The review protocol was retrospectively registered with the Open Science Framework ( https://osf.io/b5qtz ).

Search strategy

A two-fold search strategy was undertaken for this review, which covered the last 10 years (2013–2022). First, recent systematic reviews pertaining to research or evaluation of SRH interventions in humanitarian settings were identified through keyword searches on PubMed and Google Scholar. Four relevant systematic reviews were identified [ 12 , 13 , 14 , 15 ] Table 1 .

Second, a literature search mirroring these reviews was conducted to identify relevant papers published since the completion of searches for the most recent review (April 2017). Additional file 1 includes the search terms that were used in the literature search [see Additional file 1 ].

The literature search was conducted for papers published from April 2017 to December 2022 in the databases that were searched in one or more of the systematic reviews: PubMed, Embase, PsycInfo, CINAHL and Global Health. Searches were completed in January 2023 Table 2 .

Two reviewers screened each identified study for alignment with inclusion criteria. Studies in the four systematic reviews identified were considered potentially eligible if published during the last 10 years. These papers then underwent full-text review to confirm satisfaction of all inclusion criteria, as inclusion criteria were similar but not fully aligned across the four reviews.

Literature search results were exported into a citation manager (Covidence), duplicates were removed, and a step-wise screening process for inclusion was applied. First, all papers underwent title and abstract screening. The remaining papers after abstract screening then underwent full-text review to confirm satisfaction of all inclusion criteria. Title and abstract screening as well as full-text review was conducted independently by both authors; disagreements after full-text review were resolved by consensus.

Data extraction and synthesis

The following content areas were summarized in Microsoft Excel for each paper that met inclusion criteria: publication details including author, year, country, setting [rural, urban, camp, settlement], population [refugees, internally displaced persons, general crisis-affected], crisis type [armed conflict, natural disaster], crisis stage [acute, chronic], study design, research methods, SRH intervention, and intervention target population [specific beneficiaries of the intervention within the broader population]; the use of an IR framework; details regarding the IR framework, how it was used, and any rationale given for the framework used; factors cited as impacting SRH interventions, either positively or negatively; and other key findings deemed relevant to this review.

As the focus of this review was on the approach taken for SRH intervention research and evaluation, the quality of the studies themselves was not assessed.

Twenty papers underwent full-text review due to their inclusion in one or more of the four systematic reviews and meeting publication date inclusion criteria. The literature search identified 7,016 unique papers. After full-text screening, 69 met all inclusion criteria and were included in the review. Figure  1 illustrates the search strategy and screening process.

Flow chart of paper identification

Papers published in each of the 10 years of the review timeframe (2013–2022) were included. 29% of the papers originated from the first five years of the time frame considered for this review, with the remaining 71% papers coming from the second half. Characteristics of included publications, including geographic location, type of humanitarian crisis, and type of SRH intervention, are presented in Table  3 .

A wide range of study designs and methods were used across the papers, with both qualitative and quantitative studies well represented. Twenty-six papers were quantitative evaluations [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 17 were qualitative [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], and 26 used mixed methods [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. Within the quantitative evaluations, 15 were observational, while five were quasi-experimental, five were randomized controlled trials, and one was an economic evaluation. Study designs as classified by the authors of this review are summarized in Table  4 .

Six papers (9%) explicitly cited use of an IR framework. Three of these papers utilized the Consolidated Framework for Implementation Research (CFIR) [ 51 , 65 , 70 ]. The CFIR is a commonly used determinant framework that—in its originally proposed form in 2009—is comprised of five domains, each of which has constructs to further categorize factors that impact implementation. The CFIR domains were identified as core content areas influencing the effectiveness of implementation, and the constructs within each domain are intended to provide a range of options for researchers to select from to “guide diagnostic assessments of implementation context, evaluate implementation progress, and help explain findings.” [ 87 ] To allow for consistent terminology throughout this review, the original 2009 CFIR domains and constructs are used.

Guan et al. conducted a mixed methods study to assess the feasibility and effectiveness of a neonatal hepatitis B immunization program in a conflict-affected rural region of Myanmar. Guan et al. report mapping data onto the CFIR as a secondary analysis step. They describe that “CFIR was used as a comprehensive meta-theoretical framework to examine the implementation of the Hepatitis B Virus vaccination program,” and implementation themes from multiple study data sources (interviews, observations, examination of monitoring materials) were mapped onto CFIR constructs. They report their results in two phases – Pre-implementation training and community education, and Implementation – with both anchored in themes that they had mapped onto CFIR domains and constructs. All but six constructs were included in their analysis, with a majority summarized in a table and key themes explored further in the narrative text. They specify that most concerns were identified within the Outer Setting and Process domains, while elements identified within the Inner Setting domain provided strength to the intervention and helped mitigate against barriers [ 70 ].

Sarker et al. conducted a qualitative study to assess provision of maternal, newborn and child health services to Rohingya refugees residing in camps in Cox’s Bazar, Bangladesh. They cite using CFIR as a guide for thematic analysis, applying it after a process of inductive and deductive coding to index these codes into the CFIR domains. They utilized three of the five CFIR domains (Outer Setting, Inner Setting, and Process), stating that the remaining two domains (Intervention Characteristics and Characteristics of Individuals) were not relevant to their analysis. They then proposed two additional CFIR domains, Context and Security, for use in humanitarian contexts. In contrast to Guan et al., CFIR constructs are not used nor mentioned by Sarker et al., with content under each domain instead synthesized as challenges and potential solutions. Regarding the CFIR, Sarker et al. write, “The CFIR guided us for interpretative coding and creating the challenges and possible solutions into groups for further clarification of the issues related to program delivery in a humanitarian crisis setting.” [ 51 ]

Sami et al. conducted a mixed methods case study to assess the implementation of a package of neonatal interventions at health facilities within refugee and internally displaced persons camps in South Sudan. They reference use of the CFIR earlier in the study than Sarker et al., basing their guides for semi-structured focus group discussions on the CFIR framework. They similarly reference a general use of the CFIR framework as they conducted thematic analysis. Constructs are referenced once, but they do not specify whether their application of the CFIR framework included use of domains, constructs, or both. This may be in part because they then applied an additional framework, the World Health Organization (WHO) Health System Framework, to present their findings. They describe a nested approach to their use of these frameworks: “Exploring these [CFIR] constructs within the WHO Health Systems Framework can identify specific entry points to improve the implementation of newborn interventions at critical health system building blocks.” [ 65 ]

Three papers cite use of different IR frameworks. Bolan et al. utilized the Theoretical Domains Framework in their mixed methods feasibility study and pilot cluster randomized trial evaluating pilot use of the Safe Delivery App by maternal and newborn health workers providing basic emergency obstetric and newborn care in facilities in the conflict-affected Maniema province of the Democratic Republic of the Congo (DRC). They used the Theroetical Domains Framework in designing interview questions, and further used it as the coding framework for their analysis. Similar to the CFIR, the Theoretical Domains Framework is a determinant framework that consists of domains, each of which then includes constructs. Bolan et al. utilized the Theoretical Domains Framework at the construct level in interview question development and at the domain level in their analysis, mapping interview responses to eight of the 14 domains [ 83 ]. Berg et al. report using an “exploratory design guided by the principles of an evaluation framework” developed by the Medical Research Council to analyze the implementation process, mechanisms of impact, and outcomes of a three-pillar training intervention to improve maternal and neonatal healthcare in the conflict-affected South Kivu province of the DRC [ 67 , 88 ]. Select components of this evaluation framework were used to guide deductive analysis of focus group discussions and in-depth interviews [ 67 ]. In their study of health workers’ knowledge and attitudes toward newborn health interventions in South Sudan, before and after training and supply provision, Sami et al. report use of the Conceptual Framework of the Role of Attitudes in Evidence-Based Practice Implementation in their analysis process. The framework was used to group codes following initial inductive coding analysis of in-depth interviews [ 72 ].

Three other papers cite use of specific frameworks in their intervention evaluation [ 19 , 44 , 76 ]. As a characteristic of IR is the use of an explicit framework to guide the research, the use of the frameworks in these three papers meets the intention of IR and serves the purpose that an IR framework would have in strengthening the analytical rigor. Castle et al. cite use of their program’s theory of change as a framework for a mixed methods evaluation of the provision of family planning services and more specifically uptake of long-acting reversible contraception use in the DRC. They describe use of the theory of change to “enhance effectiveness of [long-acting reversible contraception] access and uptake.” [ 76 ] Thommesen et al. cite use of the AAAQ (Availability, Accessibility, Acceptability and Quality) framework in their qualitative study assessing midwifery services provided to pregnant women in Afghanistan. This framework is focused on the “underlying elements needed for attainment of optimum standard of health care,” but the authors used it in this paper to evaluate facilitators and barriers to women accessing midwifery services [ 44 ]. Jarrett et al. cite use of the Centers for Disease Control and Prevention’s (CDC) Guidelines for Evaluating Public Health Surveillance Systems to explore the characteristics of a population mobility, mortality and birth surveillance system in South Kivu, DRC. Use of these CDC guidelines is cited as one of four study objectives, and commentary is included in the Results section pertaining to each criteria within these guidelines, although more detail regarding use of these guidelines or the authors’ experience with their use in the study is not provided [ 19 ].

Overall, 22 of the 69 papers either explicitly or implicitly identified IR as relevant to their work. Nineteen papers include a focus on feasibility (seven of which did not otherwise identify the importance of exploring questions concerning implementation), touching on a common outcome of interest in implementation research [ 89 ].

While a majority of papers did not explicitly or implicitly use an IR framework to evaluate their SRH intervention of focus, most identified factors that facilitated implementation when they were present or served as a barrier when absent. Sixty cite factors that served as facilitators and 49 cite factors that served as barriers, with just three not citing either. Fifty-nine distinct factors were identified across the papers.

Three of the six studies that explicitly used an IR framework used the CFIR, and the CFIR is the only IR framework that was used by multiple studies. As previously mentioned, Means et al. put forth an adaptation of the CFIR to increase its relevance in LMIC settings, proposing a sixth domain (Characteristics of Systems) and 11 additional constructs [ 2 ]. Using the expanded domains and constructs as proposed by Means et al., the 59 factors cited by papers in this review were thematically grouped into the six domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Within each domain, alignment with CFIR constructs was assessed for, and alignment was found with 29 constructs: eight of Means et al.’s 11 constructs, and 21 of the 39 standard CFIR constructs. Three factors did not align with any construct (all fitting within the Outer Setting domain), and 14 aligned with a construct label but not the associated definition. Table 5 synthesizes the mapping of factors affecting SRH intervention implementation to CFIR domains and constructs, with the construct appearing in italics if it is considered to align with that factor by label but not by definition.

Table 6 lists the CFIR constructs that were not found to have alignment with any factor cited by the papers in this review.

This scoping review sought to assess how IR frameworks have been used to bolster the evidence base for SRH interventions in humanitarian settings, and it revealed that IR frameworks, or an explicit IR approach, are rarely used. All four of the systematic reviews identified with a focus on SRH in humanitarian settings articulate the need for more research examining the effectiveness of SRH interventions in humanitarian settings, with two specifically citing a need for implementation research/science [ 12 , 13 ]. The distribution of papers across the timeframe included in this review does suggest that more research on SRH interventions for crisis-affected populations is taking place, as a majority of relevant papers were published in the second half of the review period. The papers included a wide range of methodologies, which reflect the differing research questions and contexts being evaluated. However, it also invites the question of whether there should be more standardization of outcomes measured or frameworks used to guide analysis and to facilitate increased comparison, synthesis and application across settings.

Three of the six papers that used an IR framework utilized the CFIR. Guan et al. used the CFIR at both a domain and construct level, Sarker et al. used the CFIR at the domain level, and Sami et al. did not specify which CFIR elements were used in informing the focus group discussion guide [ 51 , 65 , 70 ]. It is challenging to draw strong conclusions about the applicability of CFIR in humanitarian settings based on the minimal use of CFIR and IR frameworks within the papers reviewed, although Guan et al. provides a helpful model for how analysis can be structured around CFIR domains and constructs. It is worth considering that the minimal use of IR frameworks, and more specifically CFIR constructs, could be in part because that level of prescriptive categorization does not allow for enough fluidity in humanitarian settings. It also raises questions about the appropriate degree of standardization to pursue for research done in these settings.

The mapping of factors affecting SRH intervention implementation provides an example of how a modified CFIR framework could be used for IR in humanitarian contexts. This mapping exercise found factors that mapped to all five of the original CFIR domains as well as the sixth domain proposed by Means et al. All factors fit well within the definition for the selected domain, indicating an appropriate degree of fit between these existing domains and the factors identified as impacting SRH interventions in humanitarian settings. On a construct level, however, the findings were more variable, with one-quarter of factors not fully aligning with any construct. Furthermore, over 40% of the CFIR constructs (including the additional constructs from Means et al.) were not found to align with any factors cited by the papers in this review, also demonstrating some disconnect between the parameters posed by the CFIR constructs and the factors cited as relevant in a humanitarian context.

It is worth noting that while the CFIR as proposed in 2009 was used in this assessment, as well as in the included papers which used the CFIR, an update was published in 2022. Following a review of CFIR use since its publication, the authors provide updates to construct names and definitions to “make the framework more applicable across a range of innovations and settings.” New constructs and subconstructs were also added, for a total of 48 constructs and 19 subconstructs across the five domains [ 90 ]. A CFIR Outcomes Addendum was also published in 2022, based on recommendations for the CFIR to add outcomes and intended to be used as a complement to the CFIR determinants framework [ 91 ]. These expansions to the CFIR framework may improve applicability of the CFIR in humanitarian settings. Several constructs added to the Outer Setting domain could be of particular utility – critical incidents, local attitudes, and local conditions, each of which could help account for unique challenges faced in contexts of crisis. Sub-constructs added within the Inner Setting domain that seek to clarify structural characteristics and available resources would also be of high utility based on mapping of the factors identified in this review to the original CFIR constructs. As outcomes were not formally included in the CFIR until the 2022 addendum, a separate assessment of implementation outcomes was not undertaken in this review. However, analysis of the factors cited by papers in this review as affecting implementation was derived from the full text of the papers and thus captures content relevant to implementation determinants that is contained within the outcomes.

Given the demonstrated need for additional flexibility within an IR framework for humanitarian contexts, while not a focus of this review, it is worth considering whether a different framework could provide a better fit than the CFIR. Other frameworks have differing points of emphasis that would create different opportunities for flexibility but that do not seem to resolve the challenges experienced in applying the CFIR to a humanitarian context. As one example, the EPIS (Exploration, Preparation, Implementation, Sustainment) Framework considers the impact of inner and outer context on each of four implementation phases; while the constructs within this framework are broader than the CFIR, an emphasis on the intervention characteristics is missing, a domain where stronger alignment within the CFIR is also needed [ 92 ]. Alternatively, the PRISM (Practical, Robust Implementation and Sustainability Model) framework is a determinant and evaluation framework that adds consideration of context factors to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes framework. It has a stronger emphasis on intervention aspects, with sub-domains to account for both organization and patient perspectives within the intervention. While PRISM does include aspects of context, external environment considerations are less robust and intentionally less comprehensive in scope, which would not provide the degree of alignment possible between the Characteristics of Systems and Outer Setting CFIR domains for the considerations unique to humanitarian environments [ 93 ].

Reflecting on their experience with the CFIR, Sarker et al. indicate that it can be a “great asset” in both evaluating current work and developing future interventions. They also encourage future research of humanitarian health interventions to utilize the CFIR [ 51 ]. The other papers that used the CFIR do not specifically reflect on their experience utilizing it, referring more generally to having felt that it was a useful tool [ 65 , 70 ]. On their use of an evaluation framework, Berg et al. reflected that it lent useful structure and helped to identify aspects affecting implementation that otherwise would have gone un-noticed [ 67 ]. The remaining studies that utilized an IR framework did not specifically comment on their experience with its use [ 72 , 83 ]. While a formal IR framework was not engaged by other studies, a number cite a desire for IR to contribute further detail to their findings [ 21 , 37 ].

In their recommendations for strengthening the evidence base for humanitarian health interventions, Ager et al. speak to the need for “methodologic innovation” to develop methodologies with particular applicability in humanitarian settings [ 7 ]. As IR is not yet routinized for SRH interventions, this could be opportune timing for the use of a standardized IR framework to gauge its utility. Using an IR framework to assess factors influencing implementation of the MISP in initial stages of a humanitarian response, and interventions to support more comprehensive SRH service delivery in protracted crises, could lend further rigor and standardization to SRH evaluations, as well as inform strategies to improve MISP implementation over time. Based on categorizing factors identified by these papers as relevant for intervention evaluation, there does seem to be utility to a modified CFIR approach. Given the paucity of formal IR framework use within SRH literature, it would be worth conducting similar scoping exercises to assess for explicit use of IR frameworks within the evidence base for other health service delivery areas in humanitarian settings. In the interim, the recommended approach from this review for future IR on humanitarian health interventions would be a modified CFIR approach with domain-level standardization and flexibility for constructs that may standardize over time with more use. This would enable use of a common analytical framework and vocabulary at the domain level for stakeholders to describe interventions and the factors influencing the effectiveness of implementation, with constructs available to use and customize as most appropriate for specific contexts and interventions.

This review had a number of limitations. As this was a scoping review and a two-part search strategy was used, the papers summarized here may not be comprehensive of those written pertaining to SRH interventions over the past 10 years. Papers from 2013 to 2017 that would have met this scoping review’s inclusion criteria may have been omitted due to being excluded from the systematic reviews. The review was limited to papers available in English. Furthermore, this review did not assess the quality of the papers included or seek to assess the methodology used beyond examination of the use of an IR framework. It does, however, serve as a first step in assessing the extent to which calls for implementation research have been addressed, and identify entry points for strengthening the science and practice of SRH research in humanitarian settings.

With one in 23 people worldwide in need of humanitarian assistance, and financing required for response plans at an all-time high, the need for evidence to guide resource allocation and programming for SRH in humanitarian settings is as important as ever [ 94 ]. Recent research agenda setting initiatives and strategies to advance health in humanitarian settings call for increased investment in implementation research—with priorities ranging from research on effective strategies for expanding access to a full range of contraceptive options to integrating mental health and psychosocial support into SRH programming to capturing accurate and actionable data on maternal and perinatal mortality in a wide range of acute and protracted emergency contexts [ 95 , 96 ]. To truly advance guidance in these areas, implementation research will need to be conducted across diverse humanitarian settings, with clear and consistent documentation of both intervention characteristics and outcomes, as well as contextual and programmatic factors affecting implementation.

Conclusions

Implementation research has potential to increase impact of health interventions particularly in crisis-affected settings where flexibility, adaptability and context-responsive approaches are highlighted as cornerstones of effective programming. There remains significant opportunity for standardization of research in the humanitarian space, with one such opportunity occurring through increased utilization of IR frameworks such as a modified CFIR approach. Investing in more robust sexual and reproductive health research in humanitarian contexts can enrich insights available to guide programming and increase transferability of learning across settings.

Availability of data and materials

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Availability, Accessibility, Acceptability and Quality

Centers for Disease Control and Prevention

Consolidated Framework for Implementation Research

Democratic Republic of the Congo

Exploration, Preparation, Implementation, Sustainment

• Implementation research

Low and middle income country

Minimum Initial Service Package

Practical, Robust Implementation and Sustainability Model

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Reach, Effectiveness, Adoption, Implementation, Maintenance

• Sexual and reproductive health

World Health Organization

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AN and HT designed the scoping review. AN conducted the literature search. AN and HT screened records for inclusion. AN extracted data from included studies. Both authors contributed to synthesis of results. AN drafted the manuscript and both authors contributed to editorial changes.

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. Literature search terms: Exact search terms used in literature search, with additional detail on the methodology to determine search terms and definitions used for each component of the search

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Norton, A., Tappis, H. Sexual and reproductive health implementation research in humanitarian contexts: a scoping review. Reprod Health 21 , 64 (2024). https://doi.org/10.1186/s12978-024-01793-2

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Received : 06 November 2023

Accepted : 12 April 2024

Published : 13 May 2024

DOI : https://doi.org/10.1186/s12978-024-01793-2

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