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• Critical Reviews

How to Write an Article Review (With Examples)

Last Updated: April 24, 2024 Fact Checked

Preparing to Write Your Review

Writing the article review, sample article reviews, expert q&a.

This article was co-authored by Jake Adams . Jake Adams is an academic tutor and the owner of Simplifi EDU, a Santa Monica, California based online tutoring business offering learning resources and online tutors for academic subjects K-College, SAT & ACT prep, and college admissions applications. With over 14 years of professional tutoring experience, Jake is dedicated to providing his clients the very best online tutoring experience and access to a network of excellent undergraduate and graduate-level tutors from top colleges all over the nation. Jake holds a BS in International Business and Marketing from Pepperdine University. There are 12 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 3,102,573 times.

An article review is both a summary and an evaluation of another writer's article. Teachers often assign article reviews to introduce students to the work of experts in the field. Experts also are often asked to review the work of other professionals. Understanding the main points and arguments of the article is essential for an accurate summation. Logical evaluation of the article's main theme, supporting arguments, and implications for further research is an important element of a review . Here are a few guidelines for writing an article review.

Education specialist Alexander Peterman recommends: "In the case of a review, your objective should be to reflect on the effectiveness of what has already been written, rather than writing to inform your audience about a subject."

Article Review 101

• Read the article very closely, and then take time to reflect on your evaluation. Consider whether the article effectively achieves what it set out to.
• Write out a full article review by completing your intro, summary, evaluation, and conclusion. Don't forget to add a title, too!
• Proofread your review for mistakes (like grammar and usage), while also cutting down on needless information.

• Article reviews present more than just an opinion. You will engage with the text to create a response to the scholarly writer's ideas. You will respond to and use ideas, theories, and research from your studies. Your critique of the article will be based on proof and your own thoughtful reasoning.
• An article review only responds to the author's research. It typically does not provide any new research. However, if you are correcting misleading or otherwise incorrect points, some new data may be presented.
• An article review both summarizes and evaluates the article.

• Summarize the article. Focus on the important points, claims, and information.
• Discuss the positive aspects of the article. Think about what the author does well, good points she makes, and insightful observations.
• Identify contradictions, gaps, and inconsistencies in the text. Determine if there is enough data or research included to support the author's claims. Find any unanswered questions left in the article.

• Make note of words or issues you don't understand and questions you have.
• Look up terms or concepts you are unfamiliar with, so you can fully understand the article. Read about concepts in-depth to make sure you understand their full context.

• Pay careful attention to the meaning of the article. Make sure you fully understand the article. The only way to write a good article review is to understand the article.

• With either method, make an outline of the main points made in the article and the supporting research or arguments. It is strictly a restatement of the main points of the article and does not include your opinions.
• After putting the article in your own words, decide which parts of the article you want to discuss in your review. You can focus on the theoretical approach, the content, the presentation or interpretation of evidence, or the style. You will always discuss the main issues of the article, but you can sometimes also focus on certain aspects. This comes in handy if you want to focus the review towards the content of a course.
• Review the summary outline to eliminate unnecessary items. Erase or cross out the less important arguments or supplemental information. Your revised summary can serve as the basis for the summary you provide at the beginning of your review.

• What does the article set out to do?
• What is the theoretical framework or assumptions?
• Are the central concepts clearly defined?
• How adequate is the evidence?
• How does the article fit into the literature and field?
• Does it advance the knowledge of the subject?
• How clear is the author's writing? Don't: include superficial opinions or your personal reaction. Do: pay attention to your biases, so you can overcome them.

• For example, in MLA , a citation may look like: Duvall, John N. "The (Super)Marketplace of Images: Television as Unmediated Mediation in DeLillo's White Noise ." Arizona Quarterly 50.3 (1994): 127-53. Print. [9] X Trustworthy Source Purdue Online Writing Lab Trusted resource for writing and citation guidelines Go to source

• For example: The article, "Condom use will increase the spread of AIDS," was written by Anthony Zimmerman, a Catholic priest.

• Your introduction should only be 10-25% of your review.
• End the introduction with your thesis. Your thesis should address the above issues. For example: Although the author has some good points, his article is biased and contains some misinterpretation of data from others’ analysis of the effectiveness of the condom.

• Use direct quotes from the author sparingly.
• Review the summary you have written. Read over your summary many times to ensure that your words are an accurate description of the author's article.

• Support your critique with evidence from the article or other texts.
• The summary portion is very important for your critique. You must make the author's argument clear in the summary section for your evaluation to make sense.
• Remember, this is not where you say if you liked the article or not. You are assessing the significance and relevance of the article.
• Use a topic sentence and supportive arguments for each opinion. For example, you might address a particular strength in the first sentence of the opinion section, followed by several sentences elaborating on the significance of the point.

• This should only be about 10% of your overall essay.
• For example: This critical review has evaluated the article "Condom use will increase the spread of AIDS" by Anthony Zimmerman. The arguments in the article show the presence of bias, prejudice, argumentative writing without supporting details, and misinformation. These points weaken the author’s arguments and reduce his credibility.

• Make sure you have identified and discussed the 3-4 key issues in the article.

You Might Also Like

• ↑ https://libguides.cmich.edu/writinghelp/articlereview
• ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548566/
• ↑ Jake Adams. Academic Tutor & Test Prep Specialist. Expert Interview. 24 July 2020.
• ↑ https://guides.library.queensu.ca/introduction-research/writing/critical
• ↑ https://www.iup.edu/writingcenter/writing-resources/organization-and-structure/creating-an-outline.html
• ↑ https://writing.umn.edu/sws/assets/pdf/quicktips/titles.pdf
• ↑ https://owl.purdue.edu/owl/research_and_citation/mla_style/mla_formatting_and_style_guide/mla_works_cited_periodicals.html
• ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548565/
• ↑ https://writingcenter.uconn.edu/wp-content/uploads/sites/593/2014/06/How_to_Summarize_a_Research_Article1.pdf
• ↑ https://www.uis.edu/learning-hub/writing-resources/handouts/learning-hub/how-to-review-a-journal-article
• ↑ https://writingcenter.unc.edu/tips-and-tools/editing-and-proofreading/

About This Article

If you have to write an article review, read through the original article closely, taking notes and highlighting important sections as you read. Next, rewrite the article in your own words, either in a long paragraph or as an outline. Open your article review by citing the article, then write an introduction which states the article’s thesis. Next, summarize the article, followed by your opinion about whether the article was clear, thorough, and useful. Finish with a paragraph that summarizes the main points of the article and your opinions. To learn more about what to include in your personal critique of the article, keep reading the article! Did this summary help you? Yes No

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• CAREER FEATURE
• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

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

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

Interviews have been edited for length and clarity.

Updates & Corrections

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

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

Article   Google Scholar  

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

Article   PubMed   Google Scholar  

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

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

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How to write a good scientific review article

Affiliation.

• 1 The FEBS Journal Editorial Office, Cambridge, UK.
• PMID: 35792782
• DOI: 10.1111/febs.16565

Literature reviews are valuable resources for the scientific community. With research accelerating at an unprecedented speed in recent years and more and more original papers being published, review articles have become increasingly important as a means to keep up to date with developments in a particular area of research. A good review article provides readers with an in-depth understanding of a field and highlights key gaps and challenges to address with future research. Writing a review article also helps to expand the writer's knowledge of their specialist area and to develop their analytical and communication skills, amongst other benefits. Thus, the importance of building review-writing into a scientific career cannot be overstated. In this instalment of The FEBS Journal's Words of Advice series, I provide detailed guidance on planning and writing an informative and engaging literature review.

© 2022 Federation of European Biochemical Societies.

Publication types

• Review Literature as Topic*

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College Textbooks Costs: Everything You Need to Know

What is an ahk file, keeping yourself safe in college: everything you need to know, myths about online high schools: everything you need to know, reasons you should study geography: everything you need to know, the vtoman jump 1800 portable power station: the best of the best, key roles of a school superintendent: everything you need to know, is earning a degree online worthwhile and beneficial, why learners cheat: everything you need to know, top issues in education: everything you need to know, how to write an article review (with sample reviews)  .

An article review is a critical evaluation of a scholarly or scientific piece, which aims to summarize its main ideas, assess its contributions, and provide constructive feedback. A well-written review not only benefits the author of the article under scrutiny but also serves as a valuable resource for fellow researchers and scholars. Follow these steps to create an effective and informative article review:

1. Understand the purpose: Before diving into the article, it is important to understand the intent of writing a review. This helps in focusing your thoughts, directing your analysis, and ensuring your review adds value to the academic community.

2. Read the article thoroughly: Carefully read the article multiple times to get a complete understanding of its content, arguments, and conclusions. As you read, take notes on key points, supporting evidence, and any areas that require further exploration or clarification.

3. Summarize the main ideas: In your review’s introduction, briefly outline the primary themes and arguments presented by the author(s). Keep it concise but sufficiently informative so that readers can quickly grasp the essence of the article.

4. Evaluate the strengths and weaknesses: In subsequent paragraphs, assess the strengths and limitations of the article based on factors such as methodology, quality of evidence presented, coherence of arguments, and alignment with existing literature in the field. Be fair and objective while providing your critique.

5. Discuss any implications: Deliberate on how this particular piece contributes to or challenges existing knowledge in its discipline. You may also discuss potential improvements for future research or explore real-world applications stemming from this study.

6. Provide recommendations: Finally, offer suggestions for both the author(s) and readers regarding how they can further build on this work or apply its findings in practice.

7. Proofread and revise: Once your initial draft is complete, go through it carefully for clarity, accuracy, and coherence. Revise as necessary, ensuring your review is both informative and engaging for readers.

Sample Review:

A Critical Review of “The Effects of Social Media on Mental Health”

Introduction:

“The Effects of Social Media on Mental Health” is a timely article which investigates the relationship between social media usage and psychological well-being. The authors present compelling evidence to support their argument that excessive use of social media can result in decreased self-esteem, increased anxiety, and a negative impact on interpersonal relationships.

Strengths and weaknesses:

One of the strengths of this article lies in its well-structured methodology utilizing a variety of sources, including quantitative surveys and qualitative interviews. This approach provides a comprehensive view of the topic, allowing for a more nuanced understanding of the effects of social media on mental health. However, it would have been beneficial if the authors included a larger sample size to increase the reliability of their conclusions. Additionally, exploring how different platforms may influence mental health differently could have added depth to the analysis.

Implications:

The findings in this article contribute significantly to ongoing debates surrounding the psychological implications of social media use. It highlights the potential dangers that excessive engagement with online platforms may pose to one’s mental well-being and encourages further research into interventions that could mitigate these risks. The study also offers an opportunity for educators and policy-makers to take note and develop strategies to foster healthier online behavior.

Recommendations:

Future researchers should consider investigating how specific social media platforms impact mental health outcomes, as this could lead to more targeted interventions. For practitioners, implementing educational programs aimed at promoting healthy online habits may be beneficial in mitigating the potential negative consequences associated with excessive social media use.

Conclusion:

Overall, “The Effects of Social Media on Mental Health” is an important and informative piece that raises awareness about a pressing issue in today’s digital age. Given its minor limitations, it provides valuable

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• Research Process

Writing a good review article

• 3 minute read
• 78.3K views

Table of Contents

As a young researcher, you might wonder how to start writing your first review article, and the extent of the information that it should contain. A review article is a comprehensive summary of the current understanding of a specific research topic and is based on previously published research. Unlike research papers, it does not contain new results, but can propose new inferences based on the combined findings of previous research.

Types of review articles

Review articles are typically of three types: literature reviews, systematic reviews, and meta-analyses.

A literature review is a general survey of the research topic and aims to provide a reliable and unbiased account of the current understanding of the topic.

A systematic review , in contrast, is more specific and attempts to address a highly focused research question. Its presentation is more detailed, with information on the search strategy used, the eligibility criteria for inclusion of studies, the methods utilized to review the collected information, and more.

A meta-analysis is similar to a systematic review in that both are systematically conducted with a properly defined research question. However, unlike the latter, a meta-analysis compares and evaluates a defined number of similar studies. It is quantitative in nature and can help assess contrasting study findings.

Tips for writing a good review article

Here are a few practices that can make the time-consuming process of writing a review article easier:

• Define your question: Take your time to identify the research question and carefully articulate the topic of your review paper. A good review should also add something new to the field in terms of a hypothesis, inference, or conclusion. A carefully defined scientific question will give you more clarity in determining the novelty of your inferences.
• Identify credible sources: Identify relevant as well as credible studies that you can base your review on, with the help of multiple databases or search engines. It is also a good idea to conduct another search once you have finished your article to avoid missing relevant studies published during the course of your writing.
• Take notes: A literature search involves extensive reading, which can make it difficult to recall relevant information subsequently. Therefore, make notes while conducting the literature search and note down the source references. This will ensure that you have sufficient information to start with when you finally get to writing.
• Describe the title, abstract, and introduction: A good starting point to begin structuring your review is by drafting the title, abstract, and introduction. Explicitly writing down what your review aims to address in the field will help shape the rest of your article.
• Be unbiased and critical: Evaluate every piece of evidence in a critical but unbiased manner. This will help you present a proper assessment and a critical discussion in your article.
• Include a good summary: End by stating the take-home message and identify the limitations of existing studies that need to be addressed through future studies.
• Ask for feedback: Ask a colleague to provide feedback on both the content and the language or tone of your article before you submit it.
• Check your journal’s guidelines: Some journals only publish reviews, while some only publish research articles. Further, all journals clearly indicate their aims and scope. Therefore, make sure to check the appropriateness of a journal before submitting your article.

Writing review articles, especially systematic reviews or meta-analyses, can seem like a daunting task. However, Elsevier Author Services can guide you by providing useful tips on how to write an impressive review article that stands out and gets published!

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How to Write an Article Review: Tips and Examples

Did you know that article reviews are not just academic exercises but also a valuable skill in today's information age? In a world inundated with content, being able to dissect and evaluate articles critically can help you separate the wheat from the chaff. Whether you're a student aiming to excel in your coursework or a professional looking to stay well-informed, mastering the art of writing article reviews is an invaluable skill.

Short Description

In this article, our research paper writing service experts will start by unraveling the concept of article reviews and discussing the various types. You'll also gain insights into the art of formatting your review effectively. To ensure you're well-prepared, we'll take you through the pre-writing process, offering tips on setting the stage for your review. But it doesn't stop there. You'll find a practical example of an article review to help you grasp the concepts in action. To complete your journey, we'll guide you through the post-writing process, equipping you with essential proofreading techniques to ensure your work shines with clarity and precision!

What Is an Article Review: Grasping the Concept 

A review article is a type of professional paper writing that demands a high level of in-depth analysis and a well-structured presentation of arguments. It is a critical, constructive evaluation of literature in a particular field through summary, classification, analysis, and comparison.

If you write a scientific review, you have to use database searches to portray the research. Your primary goal is to summarize everything and present a clear understanding of the topic you've been working on.

Writing Involves:

• Summarization, classification, analysis, critiques, and comparison.
• The analysis, evaluation, and comparison require the use of theories, ideas, and research relevant to the subject area of the article.
• It is also worth nothing if a review does not introduce new information, but instead presents a response to another writer's work.
• Check out other samples to gain a better understanding of how to review the article.

Types of Review

When it comes to article reviews, there's more than one way to approach the task. Understanding the various types of reviews is like having a versatile toolkit at your disposal. In this section, we'll walk you through the different dimensions of review types, each offering a unique perspective and purpose. Whether you're dissecting a scholarly article, critiquing a piece of literature, or evaluating a product, you'll discover the diverse landscape of article reviews and how to navigate it effectively.

Journal Article Review

Just like other types of reviews, a journal article review assesses the merits and shortcomings of a published work. To illustrate, consider a review of an academic paper on climate change, where the writer meticulously analyzes and interprets the article's significance within the context of environmental science.

Research Article Review

Distinguished by its focus on research methodologies, a research article review scrutinizes the techniques used in a study and evaluates them in light of the subsequent analysis and critique. For instance, when reviewing a research article on the effects of a new drug, the reviewer would delve into the methods employed to gather data and assess their reliability.

Science Article Review

In the realm of scientific literature, a science article review encompasses a wide array of subjects. Scientific publications often provide extensive background information, which can be instrumental in conducting a comprehensive analysis. For example, when reviewing an article about the latest breakthroughs in genetics, the reviewer may draw upon the background knowledge provided to facilitate a more in-depth evaluation of the publication.

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Address to Our Writers and Get Assistance in Any Questions!

Formatting an Article Review

The format of the article should always adhere to the citation style required by your professor. If you're not sure, seek clarification on the preferred format and ask him to clarify several other pointers to complete the formatting of an article review adequately.

How Many Publications Should You Review?

• In what format should you cite your articles (MLA, APA, ASA, Chicago, etc.)?
• What length should your review be?
• Should you include a summary, critique, or personal opinion in your assignment?
• Do you need to call attention to a theme or central idea within the articles?
• Does your instructor require background information?

When you know the answers to these questions, you may start writing your assignment. Below are examples of MLA and APA formats, as those are the two most common citation styles.

Using the APA Format

Articles appear most commonly in academic journals, newspapers, and websites. If you write an article review in the APA format, you will need to write bibliographical entries for the sources you use:

• Web : Author [last name], A.A [first and middle initial]. (Year, Month, Date of Publication). Title. Retrieved from {link}
• Journal : Author [last name], A.A [first and middle initial]. (Publication Year). Publication Title. Periodical Title, Volume(Issue), pp.-pp.
• Newspaper : Author [last name], A.A [first and middle initial]. (Year, Month, Date of Publication). Publication Title. Magazine Title, pp. xx-xx.

Using MLA Format

• Web : Last, First Middle Initial. “Publication Title.” Website Title. Website Publisher, Date Month Year Published. Web. Date Month Year Accessed.
• Newspaper : Last, First M. “Publication Title.” Newspaper Title [City] Date, Month, Year Published: Page(s). Print.
• Journal : Last, First M. “Publication Title.” Journal Title Series Volume. Issue (Year Published): Page(s). Database Name. Web. Date Month Year Accessed.

Enhance your writing effortlessly with EssayPro.com , where you can order an article review or any other writing task. Our team of expert writers specializes in various fields, ensuring your work is not just summarized, but deeply analyzed and professionally presented. Ideal for students and professionals alike, EssayPro offers top-notch writing assistance tailored to your needs. Elevate your writing today with our skilled team at your article review writing service !

The Pre-Writing Process

Facing this task for the first time can really get confusing and can leave you unsure of where to begin. To create a top-notch article review, start with a few preparatory steps. Here are the two main stages from our dissertation services to get you started:

Step 1: Define the right organization for your review. Knowing the future setup of your paper will help you define how you should read the article. Here are the steps to follow:

• Summarize the article — seek out the main points, ideas, claims, and general information presented in the article.
• Define the positive points — identify the strong aspects, ideas, and insightful observations the author has made.
• Find the gaps —- determine whether or not the author has any contradictions, gaps, or inconsistencies in the article and evaluate whether or not he or she used a sufficient amount of arguments and information to support his or her ideas.
• Identify unanswered questions — finally, identify if there are any questions left unanswered after reading the piece.

Step 2: Move on and review the article. Here is a small and simple guide to help you do it right:

• Start off by looking at and assessing the title of the piece, its abstract, introductory part, headings and subheadings, opening sentences in its paragraphs, and its conclusion.
• First, read only the beginning and the ending of the piece (introduction and conclusion). These are the parts where authors include all of their key arguments and points. Therefore, if you start with reading these parts, it will give you a good sense of the author's main points.
• Finally, read the article fully.

These three steps make up most of the prewriting process. After you are done with them, you can move on to writing your own review—and we are going to guide you through the writing process as well.

Outline and Template

As you progress with reading your article, organize your thoughts into coherent sections in an outline. As you read, jot down important facts, contributions, or contradictions. Identify the shortcomings and strengths of your publication. Begin to map your outline accordingly.

If your professor does not want a summary section or a personal critique section, then you must alleviate those parts from your writing. Much like other assignments, an article review must contain an introduction, a body, and a conclusion. Thus, you might consider dividing your outline according to these sections as well as subheadings within the body. If you find yourself troubled with the pre-writing and the brainstorming process for this assignment, seek out a sample outline.

Your custom essay must contain these constituent parts:

• Pre-Title Page - Before diving into your review, start with essential details: article type, publication title, and author names with affiliations (position, department, institution, location, and email). Include corresponding author info if needed.
• Running Head - In APA format, use a concise title (under 40 characters) to ensure consistent formatting.
• Summary Page - Optional but useful. Summarize the article in 800 words, covering background, purpose, results, and methodology, avoiding verbatim text or references.
• Title Page - Include the full title, a 250-word abstract, and 4-6 keywords for discoverability.
• Introduction - Set the stage with an engaging overview of the article.
• Body - Organize your analysis with headings and subheadings.
• Works Cited/References - Properly cite all sources used in your review.
• Optional Suggested Reading Page - If permitted, suggest further readings for in-depth exploration.
• Tables and Figure Legends (if instructed by the professor) - Include visuals when requested by your professor for clarity.

Example of an Article Review

You might wonder why we've dedicated a section of this article to discuss an article review sample. Not everyone may realize it, but examining multiple well-constructed examples of review articles is a crucial step in the writing process. In the following section, our essay writing service experts will explain why.

Looking through relevant article review examples can be beneficial for you in the following ways:

• To get you introduced to the key works of experts in your field.
• To help you identify the key people engaged in a particular field of science.
• To help you define what significant discoveries and advances were made in your field.
• To help you unveil the major gaps within the existing knowledge of your field—which contributes to finding fresh solutions.
• To help you find solid references and arguments for your own review.
• To help you generate some ideas about any further field of research.
• To help you gain a better understanding of the area and become an expert in this specific field.
• To get a clear idea of how to write a good review.

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Steps for Writing an Article Review

Here is a guide with critique paper format on how to write a review paper:

Step 1: Write the Title

First of all, you need to write a title that reflects the main focus of your work. Respectively, the title can be either interrogative, descriptive, or declarative.

Step 2: Cite the Article

Next, create a proper citation for the reviewed article and input it following the title. At this step, the most important thing to keep in mind is the style of citation specified by your instructor in the requirements for the paper. For example, an article citation in the MLA style should look as follows:

Author's last and first name. "The title of the article." Journal's title and issue(publication date): page(s). Print

Abraham John. "The World of Dreams." Virginia Quarterly 60.2(1991): 125-67. Print.

Step 3: Article Identification

After your citation, you need to include the identification of your reviewed article:

• Title of the article
• Title of the journal
• Year of publication

All of this information should be included in the first paragraph of your paper.

The report "Poverty increases school drop-outs" was written by Brian Faith – a Health officer – in 2000.

Step 4: Introduction

Your organization in an assignment like this is of the utmost importance. Before embarking on your writing process, you should outline your assignment or use an article review template to organize your thoughts coherently.

• If you are wondering how to start an article review, begin with an introduction that mentions the article and your thesis for the review.
• Follow up with a summary of the main points of the article.
• Highlight the positive aspects and facts presented in the publication.
• Critique the publication by identifying gaps, contradictions, disparities in the text, and unanswered questions.

Step 5: Summarize the Article

Make a summary of the article by revisiting what the author has written about. Note any relevant facts and findings from the article. Include the author's conclusions in this section.

Step 6: Critique It

Present the strengths and weaknesses you have found in the publication. Highlight the knowledge that the author has contributed to the field. Also, write about any gaps and/or contradictions you have found in the article. Take a standpoint of either supporting or not supporting the author's assertions, but back up your arguments with facts and relevant theories that are pertinent to that area of knowledge. Rubrics and templates can also be used to evaluate and grade the person who wrote the article.

Step 7: Craft a Conclusion

In this section, revisit the critical points of your piece, your findings in the article, and your critique. Also, write about the accuracy, validity, and relevance of the results of the article review. Present a way forward for future research in the field of study. Before submitting your article, keep these pointers in mind:

• As you read the article, highlight the key points. This will help you pinpoint the article's main argument and the evidence that they used to support that argument.
• While you write your review, use evidence from your sources to make a point. This is best done using direct quotations.
• Select quotes and supporting evidence adequately and use direct quotations sparingly. Take time to analyze the article adequately.
• Every time you reference a publication or use a direct quotation, use a parenthetical citation to avoid accidentally plagiarizing your article.
• Re-read your piece a day after you finish writing it. This will help you to spot grammar mistakes and to notice any flaws in your organization.
• Use a spell-checker and get a second opinion on your paper.

The Post-Writing Process: Proofread Your Work

Finally, when all of the parts of your article review are set and ready, you have one last thing to take care of — proofreading. Although students often neglect this step, proofreading is a vital part of the writing process and will help you polish your paper to ensure that there are no mistakes or inconsistencies.

To proofread your paper properly, start by reading it fully and checking the following points:

• Punctuation
• Other mistakes

Afterward, take a moment to check for any unnecessary information in your paper and, if found, consider removing it to streamline your content. Finally, double-check that you've covered at least 3-4 key points in your discussion.

And remember, if you ever need help with proofreading, rewriting your essay, or even want to buy essay , our friendly team is always here to assist you.

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What Is A Review Article?

How to write an article review, how to write an article review in apa format.

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How to Write an Article Review: Template & Examples

An article review is an academic assignment that invites you to study a piece of academic research closely. Then, you should present its summary and critically evaluate it using the knowledge you’ve gained in class and during your independent study. If you get such a task at college or university, you shouldn’t confuse it with a response paper, which is a distinct assignment with other purposes (we’ll talk about it in detail below).

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In this article, prepared by Custom-Writing experts, you’ll find:

• the intricacies of article review writing;
• the difference between an article review and similar assignments;
• a step-by-step algorithm for review composition;
• a couple of samples to guide you throughout the writing process.

So, if you wish to study our article review example and discover helpful writing tips, keep reading.

❓ What Is an Article Review?

• ✍️ Writing Steps

📑 Article Review Format

🔗 references.

An article review is an academic paper that summarizes and critically evaluates the information presented in your selected article.

The first thing you should note when approaching the task of an article review is that not every article is suitable for this assignment. Let’s have a look at the variety of articles to understand what you can choose from.

Popular Vs. Scholarly Articles

In most cases, you’ll be required to review a scholarly, peer-reviewed article – one composed in compliance with rigorous academic standards. Yet, the Web is also full of popular articles that don’t present original scientific value and shouldn’t be selected for a review.

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Not sure how to distinguish these two types? Here is a comparative table to help you out.

Article Review vs. Response Paper

Now, let’s consider the difference between an article review and a response paper:

• If you’re assigned to critique a scholarly article , you will need to compose an article review .
• If your subject of analysis is a popular article , you can respond to it with a well-crafted response paper .

The reason for such distinctions is the quality and structure of these two article types. Peer-reviewed, scholarly articles have clear-cut quality criteria, allowing you to conduct and present a structured assessment of the assigned material. Popular magazines have loose or non-existent quality criteria and don’t offer an opportunity for structured evaluation. So, they are only fit for a subjective response, in which you can summarize your reactions and emotions related to the reading material.

All in all, you can structure your response assignments as outlined in the tips below.

✍️ How to Write an Article Review: Step by Step

Here is a tried and tested algorithm for article review writing from our experts. We’ll consider only the critical review variety of this academic assignment. So, let’s get down to the stages you need to cover to get a stellar review.

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Read the Article

As with any reviews, reports, and critiques, you must first familiarize yourself with the assigned material. It’s impossible to review something you haven’t read, so set some time for close, careful reading of the article to identify:

• The author’s main points and message.
• The arguments they use to prove their points.
• The methodology they use to approach the subject.

In terms of research type , your article will usually belong to one of three types explained below.

Summarize the Article

Now that you’ve read the text and have a general impression of the content, it’s time to summarize it for your readers. Look into the article’s text closely to determine:

• The thesis statement , or general message of the author.
• Research question, purpose, and context of research.
• Supporting points for the author’s assumptions and claims.
• Major findings and supporting evidence.

As you study the article thoroughly, make notes on the margins or write these elements out on a sheet of paper. You can also apply a different technique: read the text section by section and formulate its gist in one phrase or sentence. Once you’re done, you’ll have a summary skeleton in front of you.

Evaluate the Article

The next step of review is content evaluation. Keep in mind that various research types will require a different set of review questions. Here is a complete list of evaluation points you can include.

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Write the Text

After completing the critical review stage, it’s time to compose your article review.

The format of this assignment is standard – you will have an introduction, a body, and a conclusion. The introduction should present your article and summarize its content. The body will contain a structured review according to all four dimensions covered in the previous section. The concluding part will typically recap all the main points you’ve identified during your assessment.

It is essential to note that an article review is, first of all, an academic assignment. Therefore, it should follow all rules and conventions of academic composition, such as:

• No contractions . Don’t use short forms, such as “don’t,” “can’t,” “I’ll,” etc. in academic writing. You need to spell out all those words.
• Formal language and style . Avoid conversational phrasing and words that you would naturally use in blog posts or informal communication. For example, don’t use words like “pretty,” “kind of,” and “like.”
• Third-person narrative . Academic reviews should be written from the third-person point of view, avoiding statements like “I think,” “in my opinion,” and so on.
• No conversational forms . You shouldn’t turn to your readers directly in the text by addressing them with the pronoun “you.” It’s vital to keep the narrative neutral and impersonal.
• Proper abbreviation use . Consult the list of correct abbreviations , like “e.g.” or “i.e.,” for use in your academic writing. If you use informal abbreviations like “FYA” or “f.i.,” your professor will reduce the grade.
• Complete sentences . Make sure your sentences contain the subject and the predicate; avoid shortened or sketch-form phrases suitable for a draft only.
• No conjunctions at the beginning of a sentence . Remember the FANBOYS rule – don’t start a sentence with words like “and” or “but.” They often seem the right way to build a coherent narrative, but academic writing rules disfavor such usage.
• No abbreviations or figures at the beginning of a sentence . Never start a sentence with a number — spell it out if you need to use it anyway. Besides, sentences should never begin with abbreviations like “e.g.”

Finally, a vital rule for an article review is properly formatting the citations. We’ll discuss the correct use of citation styles in the following section.

When composing an article review, keep these points in mind:

• Start with a full reference to the reviewed article so the reader can locate it quickly.
• Ensure correct formatting of in-text references.
• Provide a complete list of used external sources on the last page of the review – your bibliographical entries .

You’ll need to understand the rules of your chosen citation style to meet all these requirements. Below, we’ll discuss the two most common referencing styles – APA and MLA.

Article Review in APA

When you need to compose an article review in the APA format , here is the general bibliographical entry format you should use for journal articles on your reference page:

• Author’s last name, First initial. Middle initial. (Year of Publication). Name of the article. Name of the Journal, volume (number), pp. #-#. https://doi.org/xx.xxx/yyyy

Horigian, V. E., Schmidt, R. D., & Feaster, D. J. (2021). Loneliness, mental health, and substance use among US young adults during COVID-19. Journal of Psychoactive Drugs, 53 (1), pp. 1-9. https://doi.org/10.1080/02791072.2020.1836435

Your in-text citations should follow the author-date format like this:

• If you paraphrase the source and mention the author in the text: According to Horigian et al. (2021), young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic.
• If you paraphrase the source and don’t mention the author in the text: Young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (Horigian et al., 2021).
• If you quote the source: As Horigian et al. (2021) point out, there were “elevated levels of loneliness, depression, anxiety, alcohol use, and drug use among young adults during COVID-19” (p. 6).

Note that your in-text citations should include “et al.,” as in the examples above, if your article has 3 or more authors. If you have one or two authors, your in-text citations would look like this:

• One author: “According to Smith (2020), depression is…” or “Depression is … (Smith, 2020).”
• Two authors: “According to Smith and Brown (2020), anxiety means…” or “Anxiety means (Smith & Brown, 2020).”

Finally, in case you have to review a book or a website article, here are the general formats for citing these source types on your APA reference list.

Article Review in MLA

If your assignment requires MLA-format referencing, here’s the general format you should use for citing journal articles on your Works Cited page:

• Author’s last name, First name. “Title of an Article.” Title of the Journal , vol. #, no. #, year, pp. #-#.

Horigian, Viviana E., et al. “Loneliness, Mental Health, and Substance Use Among US Young Adults During COVID-19.” Journal of Psychoactive Drugs , vol. 53, no. 1, 2021, pp. 1-9.

In-text citations in the MLA format follow the author-page citation format and look like this:

• According to Horigian et al., young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (6).
• Young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (Horigian et al. 6).

Like in APA, the abbreviation “et al.” is only needed in MLA if your article has 3 or more authors.

If you need to cite a book or a website page, here are the general MLA formats for these types of sources.

✅ Article Review Template

Here is a handy, universal article review template to help you move on with any review assignment. We’ve tried to make it as generic as possible to guide you in the academic process.

📝 Article Review Examples

The theory is good, but practice is even better. Thus, we’ve created three brief examples to show you how to write an article review. You can study the full-text samples by following the links.

📃 Men, Women, & Money  

This article review examines a famous piece, “Men, Women & Money – How the Sexes Differ with Their Finances,” published by Amy Livingston in 2020. The author of this article claims that men generally spend more money than women. She makes this conclusion from a close analysis of gender-specific expenditures across five main categories: food, clothing, cars, entertainment, and general spending patterns. Livingston also looks at men’s approach to saving to argue that counter to the common perception of women’s light-hearted attitude to money, men are those who spend more on average.

📃 When and Why Nationalism Beats Globalism

This is a review of Jonathan Heidt’s 2016 article titled “When and Why Nationalism Beats Globalism,” written as an advocacy of right-wing populism rising in many Western states. The author illustrates the case with the election of Donald Trump as the US President and the rise of right-wing rhetoric in many Western countries. These examples show how nationalist sentiment represents a reaction to global immigration and a failure of globalization.

📃 Sleep Deprivation  

This is a review of the American Heart Association’s article titled “The Dangers of Sleep Deprivation.” It discusses how the national organization concerned with the American population’s cardiovascular health links the lack of high-quality sleep to far-reaching health consequences. The organization’s experts reveal how a consistent lack of sleep leads to Alzheimer’s disease development, obesity, type 2 diabetes, etc.

✏️ Article Review FAQ

A high-quality article review should summarize the assigned article’s content and offer data-backed reactions and evaluations of its quality in terms of the article’s purpose, methodology, and data used to argue the main points. It should be detailed, comprehensive, objective, and evidence-based.

The purpose of writing a review is to allow students to reflect on research quality and showcase their critical thinking and evaluation skills. Students should exhibit their mastery of close reading of research publications and their unbiased assessment.

The content of your article review will be the same in any format, with the only difference in the assignment’s formatting before submission. Ensure you have a separate title page made according to APA standards and cite sources using the parenthetical author-date referencing format.

You need to take a closer look at various dimensions of an assigned article to compose a valuable review. Study the author’s object of analysis, the purpose of their research, the chosen method, data, and findings. Evaluate all these dimensions critically to see whether the author has achieved the initial goals. Finally, offer improvement recommendations to add a critique aspect to your paper.

• Scientific Article Review: Duke University
• Book and Article Reviews: William & Mary, Writing Resources Center
• Sample Format for Reviewing a Journal Article: Boonshoft School of Medicine
• Research Paper Review – Structure and Format Guidelines: New Jersey Institute of Technology
• Article Review: University of Waterloo
• Article Review: University of South Australia
• How to Write a Journal Article Review: University of Newcastle Library Guides
• Writing Help: The Article Review: Central Michigan University Libraries
• Write a Critical Review of a Scientific Journal Article: McLaughlin Library
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How to Review a Journal Article

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For many kinds of assignments, like a  literature review , you may be asked to offer a critique or review of a journal article. This is an opportunity for you as a scholar to offer your  qualified opinion  and  evaluation  of how another scholar has composed their article, argument, and research. That means you will be expected to go beyond a simple  summary  of the article and evaluate it on a deeper level. As a college student, this might sound intimidating. However, as you engage with the research process, you are becoming immersed in a particular topic, and your insights about the way that topic is presented are valuable and can contribute to the overall conversation surrounding your topic.

IMPORTANT NOTE!!

Some disciplines, like Criminal Justice, may only want you to summarize the article without including your opinion or evaluation. If your assignment is to summarize the article only, please see our literature review handout.

Before getting started on the critique, it is important to review the article thoroughly and critically. To do this, we recommend take notes,  annotating , and reading the article several times before critiquing. As you read, be sure to note important items like the thesis, purpose, research questions, hypotheses, methods, evidence, key findings, major conclusions, tone, and publication information. Depending on your writing context, some of these items may not be applicable.

Questions to Consider

To evaluate a source, consider some of the following questions. They are broken down into different categories, but answering these questions will help you consider what areas to examine. With each category, we recommend identifying the strengths and weaknesses in each since that is a critical part of evaluation.

Evaluating Purpose and Argument

• How well is the purpose made clear in the introduction through background/context and thesis?
• How well does the abstract represent and summarize the article’s major points and argument?
• How well does the objective of the experiment or of the observation fill a need for the field?
• How well is the argument/purpose articulated and discussed throughout the body of the text?
• How well does the discussion maintain cohesion?

Evaluating the Presentation/Organization of Information

• How appropriate and clear is the title of the article?
• Where could the author have benefited from expanding, condensing, or omitting ideas?
• How clear are the author’s statements? Challenge ambiguous statements.
• What underlying assumptions does the author have, and how does this affect the credibility or clarity of their article?
• How objective is the author in his or her discussion of the topic?
• How well does the organization fit the article’s purpose and articulate key goals?

Evaluating Methods

• How appropriate are the study design and methods for the purposes of the study?
• How detailed are the methods being described? Is the author leaving out important steps or considerations?
• Have the procedures been presented in enough detail to enable the reader to duplicate them?

Evaluating Data

• Scan and spot-check calculations. Are the statistical methods appropriate?
• Do you find any content repeated or duplicated?
• How many errors of fact and interpretation does the author include? (You can check on this by looking up the references the author cites).
• What pertinent literature has the author cited, and have they used this literature appropriately?

Following, we have an example of a summary and an evaluation of a research article. Note that in most literature review contexts, the summary and evaluation would be much shorter. This extended example shows the different ways a student can critique and write about an article.

Chik, A. (2012). Digital gameplay for autonomous foreign language learning: Gamers’ and language teachers’ perspectives. In H. Reinders (ed.),  Digital games in language learning and teaching  (pp. 95-114). Eastbourne, UK: Palgrave Macmillan.

Be sure to include the full citation either in a reference page or near your evaluation if writing an  annotated bibliography .

In Chik’s article “Digital Gameplay for Autonomous Foreign Language Learning: Gamers’ and Teachers’ Perspectives”, she explores the ways in which “digital gamers manage gaming and gaming-related activities to assume autonomy in their foreign language learning,” (96) which is presented in contrast to how teachers view the “pedagogical potential” of gaming. The research was described as an “umbrella project” consisting of two parts. The first part examined 34 language teachers’ perspectives who had limited experience with gaming (only five stated they played games regularly) (99). Their data was recorded through a survey, class discussion, and a seven-day gaming trial done by six teachers who recorded their reflections through personal blog posts. The second part explored undergraduate gaming habits of ten Hong Kong students who were regular gamers. Their habits were recorded through language learning histories, videotaped gaming sessions, blog entries of gaming practices, group discussion sessions, stimulated recall sessions on gaming videos, interviews with other gamers, and posts from online discussion forums. The research shows that while students recognize the educational potential of games and have seen benefits of it in their lives, the instructors overall do not see the positive impacts of gaming on foreign language learning.

The summary includes the article’s purpose, methods, results, discussion, and citations when necessary.

This article did a good job representing the undergraduate gamers’ voices through extended quotes and stories. Particularly for the data collection of the undergraduate gamers, there were many opportunities for an in-depth examination of their gaming practices and histories. However, the representation of the teachers in this study was very uneven when compared to the students. Not only were teachers labeled as numbers while the students picked out their own pseudonyms, but also when viewing the data collection, the undergraduate students were more closely examined in comparison to the teachers in the study. While the students have fifteen extended quotes describing their experiences in their research section, the teachers only have two of these instances in their section, which shows just how imbalanced the study is when presenting instructor voices.

Some research methods, like the recorded gaming sessions, were only used with students whereas teachers were only asked to blog about their gaming experiences. This creates a richer narrative for the students while also failing to give instructors the chance to have more nuanced perspectives. This lack of nuance also stems from the emphasis of the non-gamer teachers over the gamer teachers. The non-gamer teachers’ perspectives provide a stark contrast to the undergraduate gamer experiences and fits neatly with the narrative of teachers not valuing gaming as an educational tool. However, the study mentioned five teachers that were regular gamers whose perspectives are left to a short section at the end of the presentation of the teachers’ results. This was an opportunity to give the teacher group a more complex story, and the opportunity was entirely missed.

Additionally, the context of this study was not entirely clear. The instructors were recruited through a master’s level course, but the content of the course and the institution’s background is not discussed. Understanding this context helps us understand the course’s purpose(s) and how those purposes may have influenced the ways in which these teachers interpreted and saw games. It was also unclear how Chik was connected to this masters’ class and to the students. Why these particular teachers and students were recruited was not explicitly defined and also has the potential to skew results in a particular direction.

Overall, I was inclined to agree with the idea that students can benefit from language acquisition through gaming while instructors may not see the instructional value, but I believe the way the research was conducted and portrayed in this article made it very difficult to support Chik’s specific findings.

Some professors like you to begin an evaluation with something positive but isn’t always necessary.

The evaluation is clearly organized and uses transitional phrases when moving to a new topic.

This evaluation includes a summative statement that gives the overall impression of the article at the end, but this can also be placed at the beginning of the evaluation.

This evaluation mainly discusses the representation of data and methods. However, other areas, like organization, are open to critique.

Review articles: purpose, process, and structure

• Published: 02 October 2017
• Volume 46 , pages 1–5, ( 2018 )

Cite this article

• Robert W. Palmatier 1 ,
• Mark B. Houston 2 &
• John Hulland 3  

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Many research disciplines feature high-impact journals that are dedicated outlets for review papers (or review–conceptual combinations) (e.g., Academy of Management Review , Psychology Bulletin , Medicinal Research Reviews ). The rationale for such outlets is the premise that research integration and synthesis provides an important, and possibly even a required, step in the scientific process. Review papers tend to include both quantitative (i.e., meta-analytic, systematic reviews) and narrative or more qualitative components; together, they provide platforms for new conceptual frameworks, reveal inconsistencies in the extant body of research, synthesize diverse results, and generally give other scholars a “state-of-the-art” snapshot of a domain, often written by topic experts (Bem 1995 ). Many premier marketing journals publish meta-analytic review papers too, though authors often must overcome reviewers’ concerns that their contributions are limited due to the absence of “new data.” Furthermore, relatively few non-meta-analysis review papers appear in marketing journals, probably due to researchers’ perceptions that such papers have limited publication opportunities or their beliefs that the field lacks a research tradition or “respect” for such papers. In many cases, an editor must provide strong support to help such review papers navigate the review process. Yet, once published, such papers tend to be widely cited, suggesting that members of the field find them useful (see Bettencourt and Houston 2001 ).

In this editorial, we seek to address three topics relevant to review papers. First, we outline a case for their importance to the scientific process, by describing the purpose of review papers . Second, we detail the review paper editorial initiative conducted over the past two years by the Journal of the Academy of Marketing Science ( JAMS ), focused on increasing the prevalence of review papers. Third, we describe a process and structure for systematic ( i.e. , non-meta-analytic) review papers , referring to Grewal et al. ( 2018 ) insights into parallel meta-analytic (effects estimation) review papers. (For some strong recent examples of marketing-related meta-analyses, see Knoll and Matthes 2017 ; Verma et al. 2016 ).

Purpose of review papers

In their most general form, review papers “are critical evaluations of material that has already been published,” some that include quantitative effects estimation (i.e., meta-analyses) and some that do not (i.e., systematic reviews) (Bem 1995 , p. 172). They carefully identify and synthesize relevant literature to evaluate a specific research question, substantive domain, theoretical approach, or methodology and thereby provide readers with a state-of-the-art understanding of the research topic. Many of these benefits are highlighted in Hanssens’ ( 2018 ) paper titled “The Value of Empirical Generalizations in Marketing,” published in this same issue of JAMS.

The purpose of and contributions associated with review papers can vary depending on their specific type and research question, but in general, they aim to

Resolve definitional ambiguities and outline the scope of the topic.

Provide an integrated, synthesized overview of the current state of knowledge.

Identify inconsistencies in prior results and potential explanations (e.g., moderators, mediators, measures, approaches).

Evaluate existing methodological approaches and unique insights.

Develop conceptual frameworks to reconcile and extend past research.

Describe research insights, existing gaps, and future research directions.

Not every review paper can offer all of these benefits, but this list represents their key contributions. To provide a sufficient contribution, a review paper needs to achieve three key standards. First, the research domain needs to be well suited for a review paper, such that a sufficient body of past research exists to make the integration and synthesis valuable—especially if extant research reveals theoretical inconsistences or heterogeneity in its effects. Second, the review paper must be well executed, with an appropriate literature collection and analysis techniques, sufficient breadth and depth of literature coverage, and a compelling writing style. Third, the manuscript must offer significant new insights based on its systematic comparison of multiple studies, rather than simply a “book report” that describes past research. This third, most critical standard is often the most difficult, especially for authors who have not “lived” with the research domain for many years, because achieving it requires drawing some non-obvious connections and insights from multiple studies and their many different aspects (e.g., context, method, measures). Typically, after the “review” portion of the paper has been completed, the authors must spend many more months identifying the connections to uncover incremental insights, each of which takes time to detail and explicate.

The increasing methodological rigor and technical sophistication of many marketing studies also means that they often focus on smaller problems with fewer constructs. By synthesizing these piecemeal findings, reconciling conflicting evidence, and drawing a “big picture,” meta-analyses and systematic review papers become indispensable to our comprehensive understanding of a phenomenon, among both academic and practitioner communities. Thus, good review papers provide a solid platform for future research, in the reviewed domain but also in other areas, in that researchers can use a good review paper to learn about and extend key insights to new areas.

This domain extension, outside of the core area being reviewed, is one of the key benefits of review papers that often gets overlooked. Yet it also is becoming ever more important with the expanding breadth of marketing (e.g., econometric modeling, finance, strategic management, applied psychology, sociology) and the increasing velocity in the accumulation of marketing knowledge (e.g., digital marketing, social media, big data). Against this backdrop, systematic review papers and meta-analyses help academics and interested managers keep track of research findings that fall outside their main area of specialization.

JAMS’ review paper editorial initiative

With a strong belief in the importance of review papers, the editorial team of JAMS has purposely sought out leading scholars to provide substantive review papers, both meta-analysis and systematic, for publication in JAMS . Many of the scholars approached have voiced concerns about the risk of such endeavors, due to the lack of alternative outlets for these types of papers. Therefore, we have instituted a unique process, in which the authors develop a detailed outline of their paper, key tables and figures, and a description of their literature review process. On the basis of this outline, we grant assurances that the contribution hurdle will not be an issue for publication in JAMS , as long as the authors execute the proposed outline as written. Each paper still goes through the normal review process and must meet all publication quality standards, of course. In many cases, an Area Editor takes an active role to help ensure that each paper provides sufficient insights, as required for a high-quality review paper. This process gives the author team confidence to invest effort in the process. An analysis of the marketing journals in the Financial Times (FT 50) journal list for the past five years (2012–2016) shows that JAMS has become the most common outlet for these papers, publishing 31% of all review papers that appeared in the top six marketing journals.

As a next step in positioning JAMS as a receptive marketing outlet for review papers, we are conducting a Thought Leaders Conference on Generalizations in Marketing: Systematic Reviews and Meta-Analyses , with a corresponding special issue (see www.springer.com/jams ). We will continue our process of seeking out review papers as an editorial strategy in areas that could be advanced by the integration and synthesis of extant research. We expect that, ultimately, such efforts will become unnecessary, as authors initiate review papers on topics of their own choosing to submit them to JAMS . In the past two years, JAMS already has increased the number of papers it publishes annually, from just over 40 to around 60 papers per year; this growth has provided “space” for 8–10 review papers per year, reflecting our editorial target.

Consistent with JAMS ’ overall focus on managerially relevant and strategy-focused topics, all review papers should reflect this emphasis. For example, the domains, theories, and methods reviewed need to have some application to past or emerging managerial research. A good rule of thumb is that the substantive domain, theory, or method should attract the attention of readers of JAMS .

The efforts of multiple editors and Area Editors in turn have generated a body of review papers that can serve as useful examples of the different types and approaches that JAMS has published.

Domain-based review papers

Domain-based review papers review, synthetize, and extend a body of literature in the same substantive domain. For example, in “The Role of Privacy in Marketing” (Martin and Murphy 2017 ), the authors identify and define various privacy-related constructs that have appeared in recent literature. Then they examine the different theoretical perspectives brought to bear on privacy topics related to consumers and organizations, including ethical and legal perspectives. These foundations lead in to their systematic review of privacy-related articles over a clearly defined date range, from which they extract key insights from each study. This exercise of synthesizing diverse perspectives allows these authors to describe state-of-the-art knowledge regarding privacy in marketing and identify useful paths for research. Similarly, a new paper by Cleeren et al. ( 2017 ), “Marketing Research on Product-Harm Crises: A Review, Managerial Implications, and an Agenda for Future Research,” provides a rich systematic review, synthesizes extant research, and points the way forward for scholars who are interested in issues related to defective or dangerous market offerings.

Theory-based review papers

Theory-based review papers review, synthetize, and extend a body of literature that uses the same underlying theory. For example, Rindfleisch and Heide’s ( 1997 ) classic review of research in marketing using transaction cost economics has been cited more than 2200 times, with a significant impact on applications of the theory to the discipline in the past 20 years. A recent paper in JAMS with similar intent, which could serve as a helpful model, focuses on “Resource-Based Theory in Marketing” (Kozlenkova et al. 2014 ). The article dives deeply into a description of the theory and its underlying assumptions, then organizes a systematic review of relevant literature according to various perspectives through which the theory has been applied in marketing. The authors conclude by identifying topical domains in marketing that might benefit from additional applications of the theory (e.g., marketing exchange), as well as related theories that could be integrated meaningfully with insights from the resource-based theory.

Method-based review papers

Method-based review papers review, synthetize, and extend a body of literature that uses the same underlying method. For example, in “Event Study Methodology in the Marketing Literature: An Overview” (Sorescu et al. 2017 ), the authors identify published studies in marketing that use an event study methodology. After a brief review of the theoretical foundations of event studies, they describe in detail the key design considerations associated with this method. The article then provides a roadmap for conducting event studies and compares this approach with a stock market returns analysis. The authors finish with a summary of the strengths and weaknesses of the event study method, which in turn suggests three main areas for further research. Similarly, “Discriminant Validity Testing in Marketing: An Analysis, Causes for Concern, and Proposed Remedies” (Voorhies et al. 2016 ) systematically reviews existing approaches for assessing discriminant validity in marketing contexts, then uses Monte Carlo simulation to determine which tests are most effective.

Our long-term editorial strategy is to make sure JAMS becomes and remains a well-recognized outlet for both meta-analysis and systematic managerial review papers in marketing. Ideally, review papers would come to represent 10%–20% of the papers published by the journal.

Process and structure for review papers

In this section, we review the process and typical structure of a systematic review paper, which lacks any long or established tradition in marketing research. The article by Grewal et al. ( 2018 ) provides a summary of effects-focused review papers (i.e., meta-analyses), so we do not discuss them in detail here.

Systematic literature review process

Some review papers submitted to journals take a “narrative” approach. They discuss current knowledge about a research domain, yet they often are flawed, in that they lack criteria for article inclusion (or, more accurately, article exclusion), fail to discuss the methodology used to evaluate included articles, and avoid critical assessment of the field (Barczak 2017 ). Such reviews tend to be purely descriptive, with little lasting impact.

In contrast, a systematic literature review aims to “comprehensively locate and synthesize research that bears on a particular question, using organized, transparent, and replicable procedures at each step in the process” (Littell et al. 2008 , p. 1). Littell et al. describe six key steps in the systematic review process. The extent to which each step is emphasized varies by paper, but all are important components of the review.

Topic formulation . The author sets out clear objectives for the review and articulates the specific research questions or hypotheses that will be investigated.

Study design . The author specifies relevant problems, populations, constructs, and settings of interest. The aim is to define explicit criteria that can be used to assess whether any particular study should be included in or excluded from the review. Furthermore, it is important to develop a protocol in advance that describes the procedures and methods to be used to evaluate published work.

Sampling . The aim in this third step is to identify all potentially relevant studies, including both published and unpublished research. To this end, the author must first define the sampling unit to be used in the review (e.g., individual, strategic business unit) and then develop an appropriate sampling plan.

Data collection . By retrieving the potentially relevant studies identified in the third step, the author can determine whether each study meets the eligibility requirements set out in the second step. For studies deemed acceptable, the data are extracted from each study and entered into standardized templates. These templates should be based on the protocols established in step 2.

Data analysis . The degree and nature of the analyses used to describe and examine the collected data vary widely by review. Purely descriptive analysis is useful as a starting point but rarely is sufficient on its own. The examination of trends, clusters of ideas, and multivariate relationships among constructs helps flesh out a deeper understanding of the domain. For example, both Hult ( 2015 ) and Huber et al. ( 2014 ) use bibliometric approaches (e.g., examine citation data using multidimensional scaling and cluster analysis techniques) to identify emerging versus declining themes in the broad field of marketing.

Reporting . Three key aspects of this final step are common across systematic reviews. First, the results from the fifth step need to be presented, clearly and compellingly, using narratives, tables, and figures. Second, core results that emerge from the review must be interpreted and discussed by the author. These revelatory insights should reflect a deeper understanding of the topic being investigated, not simply a regurgitation of well-established knowledge. Third, the author needs to describe the implications of these unique insights for both future research and managerial practice.

A new paper by Watson et al. ( 2017 ), “Harnessing Difference: A Capability-Based Framework for Stakeholder Engagement in Environmental Innovation,” provides a good example of a systematic review, starting with a cohesive conceptual framework that helps establish the boundaries of the review while also identifying core constructs and their relationships. The article then explicitly describes the procedures used to search for potentially relevant papers and clearly sets out criteria for study inclusion or exclusion. Next, a detailed discussion of core elements in the framework weaves published research findings into the exposition. The paper ends with a presentation of key implications and suggestions for the next steps. Similarly, “Marketing Survey Research Best Practices: Evidence and Recommendations from a Review of JAMS Articles” (Hulland et al. 2017 ) systematically reviews published marketing studies that use survey techniques, describes recent trends, and suggests best practices. In their review, Hulland et al. examine the entire population of survey papers published in JAMS over a ten-year span, relying on an extensive standardized data template to facilitate their subsequent data analysis.

Structure of systematic review papers

There is no cookie-cutter recipe for the exact structure of a useful systematic review paper; the final structure depends on the authors’ insights and intended points of emphasis. However, several key components are likely integral to a paper’s ability to contribute.

Depth and rigor

Systematic review papers must avoid falling in to two potential “ditches.” The first ditch threatens when the paper fails to demonstrate that a systematic approach was used for selecting articles for inclusion and capturing their insights. If a reader gets the impression that the author has cherry-picked only articles that fit some preset notion or failed to be thorough enough, without including articles that make significant contributions to the field, the paper will be consigned to the proverbial side of the road when it comes to the discipline’s attention.

Authors that fall into the other ditch present a thorough, complete overview that offers only a mind-numbing recitation, without evident organization, synthesis, or critical evaluation. Although comprehensive, such a paper is more of an index than a useful review. The reviewed articles must be grouped in a meaningful way to guide the reader toward a better understanding of the focal phenomenon and provide a foundation for insights about future research directions. Some scholars organize research by scholarly perspectives (e.g., the psychology of privacy, the economics of privacy; Martin and Murphy 2017 ); others classify the chosen articles by objective research aspects (e.g., empirical setting, research design, conceptual frameworks; Cleeren et al. 2017 ). The method of organization chosen must allow the author to capture the complexity of the underlying phenomenon (e.g., including temporal or evolutionary aspects, if relevant).

Replicability

Processes for the identification and inclusion of research articles should be described in sufficient detail, such that an interested reader could replicate the procedure. The procedures used to analyze chosen articles and extract their empirical findings and/or key takeaways should be described with similar specificity and detail.

We already have noted the potential usefulness of well-done review papers. Some scholars always are new to the field or domain in question, so review papers also need to help them gain foundational knowledge. Key constructs, definitions, assumptions, and theories should be laid out clearly (for which purpose summary tables are extremely helpful). An integrated conceptual model can be useful to organize cited works. Most scholars integrate the knowledge they gain from reading the review paper into their plans for future research, so it is also critical that review papers clearly lay out implications (and specific directions) for research. Ideally, readers will come away from a review article filled with enthusiasm about ways they might contribute to the ongoing development of the field.

Helpful format

Because such a large body of research is being synthesized in most review papers, simply reading through the list of included studies can be exhausting for readers. We cannot overstate the importance of tables and figures in review papers, used in conjunction with meaningful headings and subheadings. Vast literature review tables often are essential, but they must be organized in a way that makes their insights digestible to the reader; in some cases, a sequence of more focused tables may be better than a single, comprehensive table.

In summary, articles that review extant research in a domain (topic, theory, or method) can be incredibly useful to the scientific progress of our field. Whether integrating the insights from extant research through a meta-analysis or synthesizing them through a systematic assessment, the promised benefits are similar. Both formats provide readers with a useful overview of knowledge about the focal phenomenon, as well as insights on key dilemmas and conflicting findings that suggest future research directions. Thus, the editorial team at JAMS encourages scholars to continue to invest the time and effort to construct thoughtful review papers.

Barczak, G. (2017). From the editor: writing a review article. Journal of Product Innovation Management, 34 (2), 120–121.

Article   Google Scholar  

Bem, D. J. (1995). Writing a review article for psychological bulletin. Psychological Bulletin, 118 (2), 172–177.

Bettencourt, L. A., & Houston, M. B. (2001). Assessing the impact of article method type and subject area on citation frequency and reference diversity. Marketing Letters, 12 (4), 327–340.

Cleeren, K., Dekimpe, M. G., & van Heerde, H. J. (2017). Marketing research on product-harm crises: a review, managerial implications. Journal of the Academy of Marketing Science, 45 (5), 593–615.

Grewal, D., Puccinelli, N. M., & Monroe, K. B. (2018). Meta-analysis: error cancels and truth accrues. Journal of the Academy of Marketing Science, 46 (1).

Hanssens, D. M. (2018). The value of empirical generalizations in marketing. Journal of the Academy of Marketing Science, 46 (1).

Huber, J., Kamakura, W., & Mela, C. F. (2014). A topical history of JMR . Journal of Marketing Research, 51 (1), 84–91.

Hulland, J., Baumgartner, H., & Smith, K. M. (2017). Marketing survey research best practices: evidence and recommendations from a review of JAMS articles. Journal of the Academy of Marketing Science. https://doi.org/10.1007/s11747-017-0532-y .

Hult, G. T. M. (2015). JAMS 2010—2015: literature themes and intellectual structure. Journal of the Academy of Marketing Science, 43 (6), 663–669.

Knoll, J., & Matthes, J. (2017). The effectiveness of celebrity endorsements: a meta-analysis. Journal of the Academy of Marketing Science, 45 (1), 55–75.

Kozlenkova, I. V., Samaha, S. A., & Palmatier, R. W. (2014). Resource-based theory in marketing. Journal of the Academy of Marketing Science, 42 (1), 1–21.

Littell, J. H., Corcoran, J., & Pillai, V. (2008). Systematic reviews and meta-analysis . New York: Oxford University Press.

Book   Google Scholar  

Martin, K. D., & Murphy, P. E. (2017). The role of data privacy in marketing. Journal of the Academy of Marketing Science, 45 (2), 135–155.

Rindfleisch, A., & Heide, J. B. (1997). Transaction cost analysis: past, present, and future applications. Journal of Marketing, 61 (4), 30–54.

Sorescu, A., Warren, N. L., & Ertekin, L. (2017). Event study methodology in the marketing literature: an overview. Journal of the Academy of Marketing Science, 45 (2), 186–207.

Verma, V., Sharma, D., & Sheth, J. (2016). Does relationship marketing matter in online retailing? A meta-analytic approach. Journal of the Academy of Marketing Science, 44 (2), 206–217.

Voorhies, C. M., Brady, M. K., Calantone, R., & Ramirez, E. (2016). Discriminant validity testing in marketing: an analysis, causes for concern, and proposed remedies. Journal of the Academy of Marketing Science, 44 (1), 119–134.

Watson, R., Wilson, H. N., Smart, P., & Macdonald, E. K. (2017). Harnessing difference: a capability-based framework for stakeholder engagement in environmental innovation. Journal of Product Innovation Management. https://doi.org/10.1111/jpim.12394 .

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Palmatier, R.W., Houston, M.B. & Hulland, J. Review articles: purpose, process, and structure. J. of the Acad. Mark. Sci. 46 , 1–5 (2018). https://doi.org/10.1007/s11747-017-0563-4

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Published : 02 October 2017

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Published on 16.5.2024 in Vol 26 (2024)

Person-Generated Health Data in Women’s Health: Scoping Review

Authors of this article:

• Jalisa Lynn Karim 1 , BA, BMath   ; 
• Rachel Wan 1 , BSc, BSN, RN   ; 
• Rhea S Tabet 2 , BSc   ; 
• Derek S Chiu 3 , BSc, MSc   ; 
• Aline Talhouk 1 , BA, MSc, PhD  

1 Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada

2 Department of Pharmacology and Therapeutics, McGill University, Montréal, QC, Canada

3 Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada

Corresponding Author:

Aline Talhouk, BA, MSc, PhD

Department of Obstetrics and Gynaecology

University of British Columbia

593 - 828 West 10th Ave

Vancouver, BC, V5Z 1M9

Phone: 1 604 875 3111

Email: [email protected]

Background: The increased pervasiveness of digital health technology is producing large amounts of person-generated health data (PGHD). These data can empower people to monitor their health to promote prevention and management of disease. Women make up one of the largest groups of consumers of digital self-tracking technology.

Objective: In this scoping review, we aimed to (1) identify the different areas of women’s health monitored using PGHD from connected health devices, (2) explore personal metrics collected through these technologies, and (3) synthesize facilitators of and barriers to women’s adoption and use of connected health devices.

Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews, we searched 5 databases for articles published between January 1, 2015, and February 29, 2020. Papers were included if they targeted women or female individuals and incorporated digital health tools that collected PGHD outside a clinical setting.

Results: We included a total of 406 papers in this review. Articles on the use of PGHD for women steadily increased from 2015 to 2020. The health areas that the articles focused on spanned several topics, with pregnancy and the postpartum period being the most prevalent followed by cancer. Types of digital health used to collect PGHD included mobile apps, wearables, websites, the Internet of Things or smart devices, 2-way messaging, interactive voice response, and implantable devices. A thematic analysis of 41.4% (168/406) of the papers revealed 6 themes regarding facilitators of and barriers to women’s use of digital health technology for collecting PGHD: (1) accessibility and connectivity, (2) design and functionality, (3) accuracy and credibility, (4) audience and adoption, (5) impact on community and health service, and (6) impact on health and behavior.

Conclusions: Leading up to the COVID-19 pandemic, the adoption of digital health tools to address women’s health concerns was on a steady rise. The prominence of tools related to pregnancy and the postpartum period reflects the strong focus on reproductive health in women’s health research and highlights opportunities for digital technology development in other women’s health topics. Digital health technology was most acceptable when it was relevant to the target audience, was seen as user-friendly, and considered women’s personalization preferences while also ensuring accuracy of measurements and credibility of information. The integration of digital technologies into clinical care will continue to evolve, and factors such as liability and health care provider workload need to be considered. While acknowledging the diversity of individual needs, the use of PGHD can positively impact the self-care management of numerous women’s health journeys. The COVID-19 pandemic has ushered in increased adoption and acceptance of digital health technology. This study could serve as a baseline comparison for how this field has evolved as a result.

International Registered Report Identifier (IRRID): RR2-10.2196/26110

Introduction

The practice of keeping notes to monitor one’s health is not a recent phenomenon. Individuals have long recognized the benefits of tracking various health aspects, including the ability to be more active participants in managing their health, gaining a more complete picture of their health, and reducing the frequency of in-person appointments; however, this tracking was previously done through paper logs [ 1 ]. Today, with the proliferation of digital tools, self-tracking has significantly evolved and become more prevalent. The increasing pervasiveness of technology, particularly mobile phones, has seamlessly integrated it into our daily lives, making self-tracking more accessible and convenient than ever before [ 2 ]. Connected digital health technologies such as smartphones, wearables (eg, smartwatches), sensors, the Internet of Things (eg, internet-enabled weight scales), and web-based applications have permeated society and are increasingly adopted to collect and track health data. In 2021, a total of 87% of Canadians owned a smartphone, up by 73% from 2009 [ 3 ]. With >350,000 digital health apps accessible via these smartphones [ 4 ], approximately two-thirds of Canadians digitally track at least one aspect of their health [ 5 ]; similar statistics have been reported in the United States [ 6 ]. Moreover, since the introduction and popularization of fitness trackers in 2010, sensors and wearable devices have increasingly become part of daily life [ 2 ]. During the global COVID-19 pandemic, self-tracking took on even greater significance [ 7 , 8 ]. With the heightened awareness of health and the need for proactive measures, individuals have turned to self-tracking to monitor their well-being and make informed decisions. With this transformation, self-tracking has transcended its previous boundaries, offering individuals new opportunities to optimize their well-being and ushering in a new era of personalized health care [ 9 - 11 ].

Digital health tools have revolutionized the active and passive collection of health data through various applications and wearable devices. These various digital health tools collect and generate an unprecedented amount of data that can be used to glean insights into one’s health. Person-generated health data (PGHD), which are clinically relevant data captured outside traditional care settings [ 12 ], provide valuable insights that empower users to self-monitor and reflect on their health. PGHD can refer to any data collected from wearable and smart devices as well as self-input information into platforms such as mobile apps and websites. By leveraging digital technologies, individuals can collect and store their health data, enabling them to actively manage their own health and monitor chronic conditions. Furthermore, the integration of these data with research presents an opportunity to improve the patients’ experience and enhance personalized medicine. The recognition of this opportunity has started to take shape with patient-reported outcome measures and patient-reported experience measures being increasingly recognized as essential information to assess quality of care and prioritize patient-centered approaches and with mandatory assessment as part of clinical trials [ 13 ]. Seamlessly linking PGHD that are captured outside traditional care settings with clinical data and disease models can unlock new possibilities for tailored treatments and predictive informatics. The integration of digital health tools not only facilitates patient-provider communication but also offers opportunities for education, increased awareness, self-tracking, and self-monitoring without burdening health care resources. By focusing on the individual’s experience, personalization, and prevention, digital health tools contribute to a patient-centered care paradigm that aims to optimize health care outcomes and improve overall well-being while empowering patients to take charge of their health.

In recent years, the emergence of femtech, defined as technology-driven solutions specifically designed to address women’s health needs and concerns, has revolutionized the landscape of self-tracking and health care for women [ 14 ]. Femtech encompasses a wide range of digital tools, such as period-tracking apps, fertility monitors, pregnancy trackers, and menopause management platforms. These innovative solutions empower women to track and manage their reproductive health, menstrual cycles, and overall well-being with greater accuracy and ease. Femtech has not only provided women with personalized insights into their bodies but has also helped break taboos and encouraged open conversations about topics that were once stigmatized or ignored. The rapid growth of femtech has promoted access to women’s health information, greater autonomy in decision-making, and enhanced overall health care experiences for women worldwide. It has become an integral part of the self-tracking movement, demonstrating the transformative power of technology in promoting women’s health and well-being.

In this study, we reviewed the use of digital tools and PGHD in women’s health research, focusing on articles published between January 1, 2015, and February 29, 2020, before the COVID-19 pandemic. Our review encompassed various connected health devices, which included both passive data collection devices such as wearable sensors and active input devices such as smartphone apps and websites. This review sought to accomplish the following:

• Identify the different areas of women’s health and health-related behaviors monitored using PGHD from connected health devices.
• Explore personal metrics collected through these technologies.
• Synthesize facilitators and barriers that impact women’s adoption and use of connected health devices in managing their health.

This scoping review was conducted based on our previously published protocol [ 15 ]. We adopted the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines [ 16 ]. The completed checklist is provided in Multimedia Appendix 1 [ 16 ].

Search Strategy

The search strategy was designed in close collaboration with a reference librarian with input from the authors (JLK and AT). We searched a total of 5 databases: MEDLINE, Embase, APA PsycINFO, CINAHL Complete, and Web of Science Core Collection. Initial searches were completed in early March 2020. Searches were limited to articles published in 2015 or later because publications with the keyword “digital health” started to emerge in the literature around that time [ 17 ], and with the fast evolution of the field, previous articles may not be relevant to the current landscape. Keywords and subject headings were designed to search the literature for the intersection of the following 4 topics: women, health, digital devices, and tracking. The full search strategy, including a full list of search terms, was published with the protocol [ 15 ] and is available in Multimedia Appendix 2 .

Eligibility Criteria

We were interested in digital technologies and interventions targeting women and people assigned female at birth. To be included in the review, studies needed to specifically target women, focus on female-only health topics (eg, menstruation), or only include female participants. We included a variety of publication types but excluded conference abstracts and conference reviews, editorials, letters, and comments due to the limited details in such literature.

We excluded articles that presented digital health tools designed for health care providers as we were primarily interested in devices and apps that women can engage with outside a clinical setting. Articles only discussing the use of real-time consultations, whether through video, phone, or web-based chat, were excluded. We excluded articles that described digital health tools used solely for educational purposes; to maintain the focus of the review on tracking or monitoring one’s data for health, devices must have allowed users to input personal health data.

The complete inclusion and exclusion criteria are presented in Textbox 1 . We decided to retain the original inclusion end date of February 29, 2020, to maintain a focus on the literature before the COVID-19 pandemic and avoid potential complexities caused by pandemic-related disruptions in research and health care practices. Concentrating on prepandemic literature also established a clear baseline for future comparisons and allowed us to maintain feasibility of completion without compromising quality given the broad scope of the review.

Inclusion criteria

• Published between January 1, 2015, and February 29, 2020
• Refers to a health issue that pertains only to women or comprises only female participants of any age
• Includes the use of connected health tools for tracking or monitoring some aspect of health, which could include smartphone apps, wearable devices, the Internet of Things (eg, Bluetooth- or internet-enabled glucometers, blood pressure cuffs, and weight scales), and implantable devices
• Involves data collection from the user of the connected health tool (ie, the user either manually inputs data into the device or they are automatically uploaded)
• The user must be able to interact with the app or device on her own at home (outside a clinical setting)
• Available in English

Exclusion criteria

• Not available in English
• Conference abstracts, conference reviews, editorials, letters, or comments
• Study media releases and user reviews of specific applications
• Research conducted on animals
• Research involving male participants
• Tracking of infants and children unless tracking breastfeeding (because breastfeeding is directly related to the mother’s health and body)
• Devices or apps that are meant for health care provider use or use in a clinical setting only or cannot be used independently without a health care provider present
• Digital health tools that are only for educational or informational purposes and do not allow the user to enter or track her own data (ie, no information exchange)
• Telemedicine services (eg, live video consultations with health care providers)

Study Selection

We imported the results from the database searches to the Covidence systematic review software (Veritas Health Innovation). Covidence detected records believed to be duplicates, and these were manually checked before removing them. In addition, some articles were manually recognized as duplicates during the screening process and were subsequently tagged as duplicates and removed. Screening was conducted independently by at least 2 reviewers (JLK, RST, and AT) at both the abstract screening stage and the full-text screening stage. We attempted to contact the corresponding authors of articles that passed abstract screening when we were unable to locate the full text. Conflicts at either stage were discussed and agreed upon among the 3 authors involved in the screening process.

Data Charting and Deviations From the Protocol

The final list of data charting elements is provided in Textbox 2 . Data charting for all elements except for usability and acceptability was conducted using Google Sheets created by the study team. The categories for different data charting options were initially created based on a small subset of articles and were discussed among the authors involved in the charting process. The team met regularly throughout the data charting process to discuss and refine coding categories that best summarized the data. Starting with more granular categories and later combining them into broader concepts was necessary to summarize the number of articles included in this review. For each article included, data were charted by one reviewer (RW or RST) and verified for accuracy by a second reviewer (JLK). Data were summarized in bar graphs, maps, and tables (JLK, RST, and DSC), as presented in the following sections. For the locations, we recorded the countries from which the participants were recruited (if applicable). If an article did not describe recruiting participants, then the countries of the authors were recorded based on the authors’ affiliations.

Article information

• Year of first publication

Study characteristics

• Country or countries in which the research was conducted
• Research study type

Contexts for women’s connected health

• Health areas of focus

Digital device details

• Types of digital health
• Metrics collected by the devices

Usability and acceptability

• Facilitators of and barriers to the use of the technologies (coded into themes)

For the thematic analysis, articles that mentioned any aspect of usability, acceptability, facilitators, or barriers to the use of digital health tools were imported into NVivo (R1 2020; QSR International). Coding was done independently by 2 reviewers (JLK and RW) and then combined through discussions. As with the data charting process, we initially coded more granularly and then grouped the detailed codes together later in the analytic process. Decisions on how to group the codes into themes and subthemes were made through group consensus (JLK, RW, and AT).

In our protocol, we indicated that we would extract the name of the device or app used in each study. While we did complete this step in our data charting, we have not presented the results in this paper. Several articles either did not specify the brand name (eg, only specified that it was a mobile app) or had digital health tools named after the study, so we did not find this information useful to showcase in our results. There were no other deviations from the published protocol.

The searches identified 14,629 records that were imported into the Covidence software for deduplication and screening. After deduplication, a total of 9102 articles were screened for relevance, and 8545 (93.88%) were excluded based on title and abstract. From reading the full texts of the remaining 557 records, an additional 151 (27.1%) were excluded. The most common reasons for exclusion were the inability of study participants to enter or track their own data (58/151, 38.4%) or because the digital health technology was designed to be used by or with a health care provider (48/151, 31.8%). The remaining 406 publications were included in the scoping review. Some of the included publications reported on the same research project; in those cases, all of them were included. Our search did not encounter any articles that directly addressed or mentioned the inclusion of intersex, transgender, or nonbinary participants. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram detailing the full study selection process is shown in Figure 1 . The list of included articles sorted by health areas of focus can be found in Multimedia Appendix 3 [ 18 - 58 ].

Year and Country

There was an increasing trend in number of publications per year, with 10.1% (41/406) of the articles published in 2015, a total of 13.3% (54/406) of the articles published in 2016, a total of 18% (73/406) of the articles published in 2017, a total of 26.4% (107/406) of the articles published in 2018, and 29.6% (120/406) of the articles published in 2019. Only 2.7% (11/406) of the publications were from 2020 because our cutoff date for inclusion was February 29, 2020.

Articles included in the review covered worldwide research, including every continent except Antarctica ( Figure 2 ). As we only considered articles written in English, most of the articles were published in Western, English-speaking countries, primarily the United States (169/406, 41.6% of the articles), the United Kingdom (34/406, 8.4% of the articles), Australia (33/406, 8.1% of the articles), and Canada (19/406, 4.7% of the articles). Other countries where several included articles were published were China (13/406, 3.2% of the articles), the Netherlands (13/406, 3.2% of the articles), Spain (13/406, 3.2% of the articles), and Sweden (10/406, 2.5% of the articles).

Interestingly, of the 169 articles from the United States, 26 (15.4%) specifically focused on African American or Black, ethnic minority, or low-income women. One study from Singapore specifically included multiethnic women [ 18 ], and a study from Australia included Indigenous Australian women as their participants [ 19 ]. In addition, one review conducted by researchers in Australia looked specifically at studies with women from culturally and linguistically diverse backgrounds [ 20 ].

Study Types

The types of studies that used digital health tools in women’s health research are reported in Figure 3 by year of publication (note that the articles could fall into more than one study category). The most common study type encountered was feasibility or acceptability studies (197/406, 48.5% of the articles, including 9/197, 4.6% protocols), followed by effectiveness studies (146/406, 36% of the articles, including 36/146, 24.7% protocols) and publications reporting on digital tool prototypes (73/406, 18% of the articles). Effectiveness studies reported on outcome measures of an intervention, including randomized and nonrandomized trials with one or more study arms. Reviews (of published literature, apps, or wearables), viewpoints, manuals, case studies, or analytical methods (56/406, 13.8% of the articles combined) were also encountered. Observational or correlative studies (44/406, 10.8% of the articles, including 3/44, 7% protocols) were studies that observed the health behaviors of individuals through digital health technologies without assessing the effectiveness of an intervention or analyzed associations between variables (eg, associations between heart rate and loss-of-control eating) [ 21 ]. Finally, measurement studies (23/406, 5.7% of the articles) reported on the validity, reliability, or accuracy of a digital health tool.

Health Areas of Focus

The analysis of the reviewed articles highlighted research in several recurring women’s health areas of focus. A full breakdown of the health areas is reported in Table 1 (articles could fall into more than one health area). Pregnancy and the postpartum period emerged as the most prominent health area with 42.6% (173/406) of the articles. Within this category, there was a specific emphasis on general care and monitoring (45/173, 26% of the articles), physical activity and diet (34/173, 19.7% of the articles), and glucose monitoring (31/173, 17.9% of the articles). Cancer was identified as the second most common health area, with 19.5% (79/406) of the articles dedicated to its exploration. Specifically, a significant focus was observed on the relationship between cancer and cardiovascular health, with 47% (37/79) of the articles addressing this aspect. The impact of lifestyle on overall health and well-being was also addressed, with 14.3% (58/406) of the articles delving into physical activity, sedentary behavior, diet, weight, and obesity. Menstrual, sexual, and reproductive health were explored in 12.1% (49/406) of the articles to shed light on various aspects of women’s reproductive health and associated concerns, with 76% (37/49) focusing on menstrual cycle tracking or fertility monitoring. Furthermore, 9.9% (40/406) of the articles were dedicated to chronic conditions (such as urinary incontinence, osteoporosis, and diabetes) with the aim of enhancing understanding and developing interventions for individuals living with chronic health conditions. To accommodate articles that did not fit within the primary health areas, an Other category comprising 6.4% (26/406) of the articles was established. This category included articles on athlete monitoring (10/26, 38% of the articles), such as heart rate monitoring during sports tournaments; mental health and quality of life (9/26, 35% of the articles); gender-based violence (3/26, 12% of the articles); and more. Finally, a small subset of 0.5% (2/406) of the articles did not align with any specific health area; these included a publication reporting results from a survey on African American women’s willingness to participate in eHealth research [ 22 ] and a publication analyzing women’s interactions with digital health technologies [ 23 ]. These articles were included because, although they did not discuss a specific health area, they still focused on women’s use of digital health tools in general.

a PCOS: polycystic ovary syndrome.

b CVD: cardiovascular disease.

c COPD: chronic obstructive pulmonary disease.

d SLE: systemic lupus erythematosus.

e IC: interstitial cystitis.

f BPS: bladder pain syndrome.

g ABL: accidental bowel leakage.

Figure 4 shows how the health areas of focus for women’s use of digital health changed over the years that were included in the review (2015-2019 plus January 2020-February 2020). There was an increasing trend from 2015 to 2020 in the number of publications focusing on pregnancy and the postpartum period, as well as cancer and menstrual, sexual, and reproductive health. However, articles focused on women’s use of digital health for lifestyle-related topics and chronic conditions did not see a notable increase over those years.

Type of Digital Health and Metrics Collected

Within the articles reviewed, smartphone, mobile, or tablet apps emerged as the most prevalent type of digital health (295/406, 72.7% of the articles), followed by wearable devices (165/406, 40.6% of the articles) and websites or patient portals (93/406, 22.9% of the articles). Other types of technology were not investigated as much. For example, 13.5% (55/406) of the articles addressed smart devices or the Internet of Things (referring to objects with sensors that connect to a network, such as Bluetooth-enabled glucometers and blood pressure machines). Finally, 7.4% (30/406) of the articles reported on 2-way messaging, 1% (4/406) of the articles reported on interactive voice response telephone calls, and only 0.5% (2/406) of the articles reported on implantable devices. With respect to the metrics collected, we found >250 metrics, such as heart rate, number of steps, mood, ovulation test results, and days of menstruation. A full list of the metrics is reported in Multimedia Appendix 4 .

Thematic Analysis

Of the 406 articles included in this scoping review, 168 (41.4%) mentioned usability, acceptability, facilitators, or barriers to the use of digital health tools at least once. Our thematic analysis identified 6 themes: (1) accessibility and connectivity, (2) design and functionality, (3) accuracy and credibility, (4) audience and adoption, (5) impact on community and health service, and (6) impact on health and behavior. The themes are described in further detail in the following sections.

The thematic analysis detailed in the following sections is primarily based on the views of the participants in the studies we reviewed to provide a user perspective; however, one subsection in theme 5 focuses on the health care provider perspective.

Theme 1: Accessibility and Connectivity

The accessibility and connectivity of digital technologies emerged as an important theme with two subthemes: (1) cost and convenience and (2) connectivity, compatibility, and software issues.

Cost and Convenience

Our analysis revealed that the cost and convenience of digital tools collecting PGHD are important factors that can impact their adoption and use. On the one hand, digital health technologies can be seen as more affordable compared to traditional health care visits and more accessible to a wider range of people, including those of a lower socioeconomic status. On the other hand, they can also be perceived as too expensive and novelty items, and associated extra costs such as data plans can also be a barrier for some people. Because PGHD can be collected and entered throughout the day in real time, and because most people carry a phone around with them every day, these technologies offer greater convenience than traditional in-person health care encounters by providing anytime, anywhere virtual access and putting information at people’s fingertips through smartphones and web platforms. One user spoke about an in-app treatment program:

That was what was so good about this, I can do this at home myself, no need to book an appointment, find the time and suit others, and you know, that process of booking a time. [ 24 ]

Some inconvenient aspects of digital health technologies include uncomfortable wearables that are too bulky, difficulty of use, or not fitting into the users’ lifestyles, as noted in one article:

Women also mentioned that the comfort of the wearable sensors was a barrier. Comfort became a barrier for some women during exercise and hot weather. [ 25 ]

Devices with a short battery life and wearables that are not water resistant are also considered inconvenient as they require the user to frequently remember to charge the device or put the wearable back on after water-based activities. Certain restrictions, such as not being able to wear a device in a workplace, can also create inconvenient barriers for some users.

Connectivity, Compatibility, and Software Issues

Factors related to connectivity and other issues such as device synchronization, freezing, or disconnection can significantly impact the user experience and engagement with digital health tools. For example, the dependence on mobile and internet access can be a disadvantage. Cellphone and network coverage limitations can pose an important barrier in rural areas or during travel. Where mobile data or Wi-Fi connection are limited, people may struggle to use digital health tools that require internet connection; this can create disparities in access to health care resources, particularly for those of a lower socioeconomic status or living in remote communities with limited infrastructure. Incompatibility between operating systems such as Android and iOS, iPhone and iPad, or various browsers can also be an important barrier to accessing digital health technology.

Software issues can significantly impact the user experience of digital health technologies. Broken links can prevent users from accessing valuable information or features within apps or websites. App crashes can discourage users from engaging with the digital health tool altogether. In addition, slow loading times can negatively impact the user experience, making it challenging for users to access information or features quickly and efficiently.

Theme 2: Design and Functionality

The second theme centered on design and functionality and included four subthemes: (1) appearance and design; (2) functionality and features; (3) personalization; and (4) safety, privacy, and security.

Appearance and Design

Appearance and design play important roles in the success of connected health devices. In terms of app design, the color scheme and layout facilitate user-friendliness. Bad formatting can make it difficult for users to read or understand the content of an app or website. Font size that is too small can be challenging for those with visual impairments, and some color combinations can be difficult to read. The quality of the images used in digital health interventions can also impact user experience, with low-quality images potentially making it difficult for users to interpret the information being presented.

Apps that are visually appealing and easy to use are more likely to be successful. When it comes to wearables, women tend to prefer sleek, understated designs that are esthetically pleasing without being bulky. A sleek design can encourage use of the wearable. For example, some women consider their wearable to be a fashion item that sparks conversation, which encourages their continued use of the device, as illustrated in a participant quote:

Um, that it’s, like, kind of stylish, like, I feel, like, cool that I wear one. A lot of people ask me, they’re like, oh, which one is that, like, is that a Fitbit, is that an Apple watch? It has the interchangeable bands and stuff like that, so, you can, like, change the color of it and everything. It’s like a conversation piece. [ 26 ]

Other women prefer more discretion in the design of wearables and their size or in the app icon on their mobile device because they do not want to reveal the purpose of the device to others. People may feel self-conscious when wearing the device or using the app, especially if it reveals their medical condition. For example, the following quote is from a study that incorporated a sensor band worn on the wrist to help female undergraduate students with problematic drinking:

P310 noted that while in class, “my professor commented on it which made me feel awkward.” [ 27 ]

Functionality and Features

In terms of functionality, the availability of clinical interpretation of user data is deemed essential, and health warnings based on recorded PGHD are noted to be helpful. Moreover, notifications and reminders are also useful for improving adherence to self-tracking and maintaining goals, and users appreciate receiving automated SMS text messages and feedback on progress. Actionable advice is seen as very important, and women expressed a desire for more interaction and the ability to integrate with other apps. For example, users want the ability to access information from their health record and to be able to see graphical summaries of their data over time. Regarding the presentation of information, users appreciate concise information written in simple language. Choice of words is also perceived as especially important to ensure that the information is easy to understand. People enjoy the gamification of content, and the graphical presentation of results is found to be informative.

The ability to upload multimedia and the ability to customize the application’s displays and notifications are noted as features that improve user engagement and satisfaction. The ability to record voice notes and consultations within apps is noted as a desirable feature, as well as having the option to book appointments directly through apps. Women also want the option to sync their desktop or phone calendar with apps to remind them of medical appointments and prescription requests, as some researchers noted:

Women could see the potential usefulness of being reminded to order their next prescription through the electronic alerts system. They found managing the monthly prescription requests challenging long-term and found setting up the reminder easy with the alert popping up on their phone or tablet. [ 28 ]

The application also allows women to set appointment reminders to ensure she is not missing her appointments and developing gaps in her care [...] “It allows me to remain organized for my visits to my OB with concerns, questions, symptoms I have experienced since my last visit.” [ 29 ]

Issues that negatively impact user engagement and outcomes are the inability to edit information or unsubscribe from notifications, which are sometimes thought to be either inconvenient or intrusive, as well as the presence of advertisements within the app. Ease of use is essential as apps or websites that are difficult to navigate can discourage users from engaging with them. For example, a study including the use of a mobile phone app reported the following:

A hindrance and disliked aspect was the difficulty in navigating through the app (eg, no back button, clunkiness, and the inability of participants to edit their inputted daily goals) as well as a lack of color and visuals within the app, giving it a clinical appearance. [ 30 ]

Some women are not comfortable answering questions that they consider intrusive, such as those related to sexual health. They rely on applications to provide trusted information about their condition and want suggestions for additional resources such as website links and local information.

Personalization

Women generally expressed a desire for greater personalization across several features within digital health tools. Messages and notifications that are personalized to the user’s health and self-tracking history and goals are more motivational and less likely to be ignored or perceived as irritating. Even factors such as using a first name in messages from the app make women feel like the messages are more personal and supportive.

Users have individual preferences when it comes to the frequency and timing of notifications, and it is important for digital health apps to allow for the customization of these settings as they can greatly impact user engagement and adherence. Moreover, users expressed a desire for the ability to customize their goals and the metrics they tracked. For example, they may want to change their goals in an app when their life circumstances change (eg, moving, starting a new job, becoming pregnant, or sustaining an injury). The ability to customize the dashboard of an app or website according to the user’s goals was also expressed as a desired feature. The ability to make these customizations will improve their adherence in the long run as their goals evolve.

When it comes to wearables, their placement on the body influences users’ preference and adherence to their use. For example, some women may prefer a wrist-worn device, whereas others may prefer a chest strap, a ring, or a device worn on the waist or ankle. The type of activity being monitored may also influence placement preference. A wrist-worn device may be more appropriate for monitoring steps, whereas a chest strap may be better suited for monitoring heart rate during exercise. Furthermore, placement preference may also be influenced by factors such as comfort, convenience, and visibility. A user may prefer a wrist-worn device because it is more visible and easier to access, whereas another user may prefer a device worn on the waist because it is less obtrusive and more comfortable during exercise or sleep. For instance, one study found the following:

Eight of the participants (40%) reported at some point of the long study period that the smart wristbands were uncomfortable to wear, especially at night. The wristbands irritated the skin, possibly due to pregnancy-related swelling. [ 31 ]

Finally, users have different preferences for how they want information to be presented in an app or website. Some people prefer to read content that is written out with citations and links to external websites. Others enjoy learning content from videos or audio recordings. When looking at their trends and progress, some users like to look at detailed graphs showing their daily progress, whereas others prefer to look at the data occasionally and only receive high-level information. The challenges concerning personalization were articulated by several authors:

It’s a difficult one. Some women want the full picture to fully understand what they are taking. Others want a black and white sketch, but not the details. They just want to know enough. Others do not want to see the picture, they just want to get on with it without knowing too much. Catering for all is a challenge. [ 28 ]

Safety, Privacy, and Security

Women are sometimes concerned about the physical safety of certain devices. For example, some mothers worried about their wearable wristbands scratching their babies [ 31 ]. Others worried about the effects of wearable devices on their skin, as expressed by a participant:

It’s weird because it does have a little laser thing on it, and I wonder if that’s, like, harming my skin (laughing). Like, I’ll sleep in it, and when I wake up I’ll have a red spot on my arm, it’s itchy sometime or sensitive, and I think it’s because of the laser thing, but I don’t really know. [ 26 ]

Some women are concerned about the privacy and security of digital health technologies and expect appropriate safeguards to be implemented in the tools they use. However, privacy and data security are not a concern for all women:

As I said, I’m very critical about patient data in general, especially in terms of data security...If you have a free app, it really depends on what happens to the private data. As a matter of fact, usually the information is stored on the app itself, and so other apps might gain access to the data easily. [ 32 ]

The survey revealed a low level of concern about issues relating to privacy or security of personal data. This suggests that privacy concerns were secondary to the benefits offered by uploading personal details into apps to provide the type of customisation they seek. [ 33 ]

Researchers also shared that some users perceived there to be more privacy when using an app as compared to traditional ways of communicating:

Some participants perceived the storage of their glucose levels on the smartphone as more secure than their current registration in a booklet. [ 34 ]

Women, particularly those who worked outside of the home, also commented that they appreciated the added convenience and privacy of this [text-based] communication method over phone-based communication. [ 34 ]

Theme 3: Accuracy and Credibility

In theme 3, we identified accuracy and credibility as important factors for acceptability considerations in digital health technologies.

The accuracy of digital health can impact user trust and adoption. Digital health tools enable users to keep track of their health, symptoms, and behaviors over time without relying on memory recall, which can be inaccurate or incomplete. Many studies reported that digital tracking can lead to more accurate data collection compared to paper-based methods. For example, at-home measurements of blood pressure and other vital signs have been found to be more accurate than those taken in a hospital or clinic setting. In some cases, apps are even able to accurately predict users’ menstrual cycles and mood changes. In addition, food diaries and activity trackers are often found to be more accurate when tracked within the app compared to using traditional paper-based methods. As the following participant conveyed, digital health may also make it easier for patients to tell the truth about their habits or health concerns:

I like this principle because...I know exactly, that via tablet one would admit things you wouldn’t necessarily tell the doctor or nurse. So, for starters, you can state it in the application. Of course, a conversation shouldn’t be missed afterwards, but this might make it easier for you to overcome yourself. [ 32 ]

However, accuracy can still be an issue in digital health. Different devices can produce different measurements, and some devices may miscount steps, the intensity of workouts, or the quantity and quality of sleep. For example, some women reported devices not tracking their steps while pushing a grocery cart or stroller, whereas others found that their steps were overcounted due to arm movements while they were seated. In addition, some users reported that food tracking options in apps were limited and did not include foods from their culture. Therefore, users may perceive digital health tools as not being representative of their true activity, which may lead them to discontinue the use of the devices. The following participant quote refers to a wrist-worn activity tracker:

Out paddling and we’re huffing and puffing and barely breathing and this isn’t even triggering anything. So it shows [...] that our 150 minute goal is like 60 or half of that. But we’ve actually put in the effort and then you just give up after a while. Like there’s no way I can make this. [ 35 ]

Women often prefer evidence-based health information (eg, explanations of conditions and symptoms and health advice) from a trustworthy source, such as an app curated from up-to-date and evidence-based research, over general internet searches. Users reported that the information provided in some apps was incomplete or inaccurate, with gaps in content or contradictory information that diminished their trustworthiness. In such cases, users may still prefer to talk to a health professional for more trustworthy information. Some women may also find it challenging to trust information that does not disclose sources as they are unsure of its reliability. Devices that are endorsed by, cite, and link to trustworthy health sources are more appealing to users. When sharing results from a web-based survey, the authors of one study reported the following:

Some respondents were specific about from where such advice should come, stating that they wanted expert, credible and up-to-date advice while others noted that they would like to see more Australian-specific or locally-based information in apps or apps that were not linked to the manufacturers of pregnancy or baby products. [ 33 ]

Theme 4: Audience and Adoption

Our fourth theme concerns audience and adoption, which includes two subthemes: (1) demographics and inclusivity and (2) timing and circumstances.

Demographics and Inclusivity

One of the challenges with digital health is to avoid one-size-fits-all interventions and to strive to tailor interventions to address the specific needs of different populations. Digital health that targets specific demographic groups or specific health conditions may increase the adoption of digital tools in those populations. That said, even when targeting people with specific health conditions as the audience, attention must be paid to the language and content in apps and websites. Some researchers noted that women did not want to participate or continue in their study because they did not want to constantly be confronted with their disease. Too much of a focus on disease and ill health can deter women from engaging with the tools, as commented on by some authors:

All but one participant preferred text content that focused on health and physical activity rather than content explicit to cancer. [ 36 ]

The women emphasized that less attention should be paid to chronic disease management and medication as the only treatment option. [...] it was important to explain the implications of the result of the scan and the risk of fractures in a way that will not place the women in a sickness role unnecessarily. [...] The knowledge base of osteoporosis should focus on osteoporosis as a common condition instead of a chronic bone disease. [ 37 ]

Younger women are often more familiar with and more comfortable using digital technology and, therefore, are more likely to use and adhere to a digital health protocol. Users with low technology skills want more training on how to use the digital health tools properly. Little provision is made for those for whom English is not their primary language, which can limit the accessibility and usefulness of digital health interventions. Factors such as language barriers, cultural beliefs, or lack of access to technology may lead to less adoption by some people belonging to ethnic minority groups. The relevance and usefulness of digital health may also vary based on geographic location.

Digital health tools are negatively perceived by some users if not designed to be inclusive of attributes such as body type or gender. For example, users prefer applications that use pictures or models that represent a diverse range of body sizes. Digital health technologies may not be gender inclusive and can conflate sex and gender. It is important to consider the unique health needs and experiences of individuals across the gender spectrum, as several researchers reported:

Participants commented on an exercise demonstration video and recommended that the model should have an “everyday-look” (e.g. plain clothes, jewellery). Also a choice of models of different ages to engage a wider range of patients and help them to relate or identify with the model was proposed. [ 38 ]

[Participant quote]: Maybe the body image it presents...like on a lot of apps, the people doing it looked like they were athletes already. And maybe they should have more people that look normal. [ 39 ]

Two women commented on the gendered design of most FTAs. FTA092 commented that “I chose Clue because it’s the only app that wasn’t pink.” FTA051 also found the gendered design of her previous app insulting; “my last app had a pink flower and was called MyDays or something ...I felt like they were trying to lure me in with this kind of ‘women’s’ approach” (FTA051). She subsequently stopped using that app and downloaded Clue. [ 40 ]

Timing and Circumstances

Individuals are more motivated to use digital health tools during times of illness or when they have a specific health goal in mind. The introduction of technology at the appropriate time impacts the utility and effectiveness of digital health interventions, especially when they are integrated into existing health care systems and routines. Digital health apps need to account for existing medical conditions or medical history to ensure accurate and complete information. For example, technologies that do not provide an option to indicate current pregnancy are perceived as frustrating to users as the in-app goals or notifications can be irrelevant and inconsiderate of their current limitations. In a focus group, one mother shared the following:

I get frustrated with the Garmin [smartwatch] because I wear my watch during the night so it tracks my sleeping as well. Then it gives you like an insight—so a little note will pop up and you know whether your sleep has been really regular or you’ve had irregular sleep. I wish that there was a thing that during pregnancy where that I could put in and say I’m pregnant, because I got those notes that your sleep is really irregular, and I was like, “Because I’m pregnant!” [ 23 ]

Users who are not experiencing symptoms or who perceive their health to be good are less likely to adopt digital health tools as they may not perceive any benefit from using them. Moreover, those who are already tracking their health using other methods (eg, paper-based tracking) are less interested in trying a new digital health tool. Similarly, regarding wearables, some people may already have a wearable and be less interested in having an additional wearable device.

Theme 5: Impact on Community and Health Service

This theme considers the impact of PGHD on community and health service, with three subthemes: (1) communication and community support, (2) clinical integration, and (3) health care provider perspective.

Communication and Community Support

One of the many perceived benefits by users of digital health interventions is the sense of community that these platforms enable. Even though some women reported feeling uncomfortable sharing personal information with strangers in a virtual group, most found that the ability to connect with others who shared similar experiences provided a sense of belonging and support that was motivating and reassuring, as shared by one woman:

What I did love about the apps is the forums. So if you have a weird pain or, you know, you have cramp in your legs at three a.m., you can get on your phone straight away, and you can get support by the women who are going through the same thing. [ 41 ]

Discussion forums and social media platforms associated with digital health interventions are perceived as helpful for connecting with others, sharing personal stories, and receiving support. Digital health interventions can also help women elicit support from friends and family to stay motivated and achieve health goals. For example, researchers who reported on women’s experiences of an app for stress urinary incontinence shared that some participants found it easier to talk to friends about an app for pelvic floor muscle training rather than talk about incontinence [ 24 ]. This can enable increased accountability and further encourage adherence to the intervention. One woman spoke about how her family supported her engagement with a digital health intervention for physical activity maintenance among female cancer survivors:

My husband’s a good motivator. When I say I’m going for a walk, he’ll go with me...with my sister-in-law and her kids, it’s they want to go with me; so it’s how many steps have you got today? Or, are we going to go for a walk. That kind of thing. And with my husband and my daughter it’s, “how many steps did you get today, did you do your workout, let us get it going.” [ 36 ]

In addition to support from family, friends, and community members, these digital platforms can provide an alternative to speaking with a health care provider in person. Asynchronous communication with health care providers is helpful especially for those who may not have easy access to in-person visits or for those who are uncomfortable discussing sensitive information face-to-face. Records of PGHD can also improve the ability to gather and share details with health care providers about symptoms that are difficult to remember during an in-person visit.

Clinical Integration

Women are more willing to participate in digital health interventions if they perceive that they have a direct impact on their clinical care. They appreciate the idea that their health is being monitored and that someone is keeping an eye on their data. Furthermore, women want to see more integration of their clinical test results within their digital health apps and websites. This increases their motivation to adhere to the interventions prescribed through the digital health application.

It was noted that physicians and other health care providers play a crucial role in promoting the use of digital health interventions among patients. As noted in the following participant quote, women enjoy being able to communicate with a health care provider through digital health:

I like it because you can tell the doctor what’s going on and submit it to your doctor, that is the main reason I like it because you can talk directly to your doctor and tell them what is going on without going in or calling. [ 42 ]

Women are more likely to adopt and use technology if it is recommended by their health care providers, family members, or friends. Women reported that digital health interventions were more effective when they were supported by a health care team. For example, having access to a health coach or counselor or receiving feedback from a health care provider on their progress increases their motivation to adhere to the interventions. This support also provides reassurance that they are on the right track toward achieving their health goals. However, some patients become frustrated when they receive conflicting advice from the digital health tool and their health care provider.

Health Care Provider Perspective

Some articles included thoughts from health care providers on digital health tools collecting PGHD [ 20 , 37 , 43 - 55 ]. From the health care provider perspective, digital health can offer several benefits, including the ability to monitor patients’ adherence to treatment and interventions. This can be particularly helpful for patients with chronic conditions that require ongoing management. Providers can use digital health tools to track patients’ progress and identify any potential issues that may require further attention, which can lead to improved clinical outcomes and reduce unnecessary consultations. For instance, one provider learned about their patient’s anxiousness through a mobile health intervention:

I didn’t know my patient was feeling anxious...But when she wrote it down, we could talk about it... [ 43 ]

Some health care providers expressed that digital health tracking could give them a more accurate picture of their patients’ activities and adherence to treatments. In a study about perspectives on a sensor attached to pills that can send data such as date and time of ingestion, a provider commented the following:

A positive would be data and getting a better grip on compliance. (...) I’m making sure the patient is adhering - assuming that the patient is taking everything inside of that blister, you can have confirmation of that. [ 44 ]

In addition, digital health can improve the efficiency of care delivery by providing education and resources directly to patients. This can help patients better understand their condition, treatment options, and self-management strategies, which can lead to better health outcomes.

However, it was also noted that digital health interventions should not replace in-person visits but rather complement them. Some health care providers are concerned about overreliance on digital health tools as well as the potential for misinterpretation of the data they provide. There may be a lack of feedback on the correct use of interventions, such as interpretations of medical advice provided, and health care providers have raised concerns about the safety and trustworthiness of the medical advice generated by the digital health tools. Health care providers especially worry about medico-legal effects of having information from digital health tools taken out of context or without considering the full picture of the user’s history and health, as demonstrated in the following quotes:

As a health care professional, I’m just mindful that if there was a video of me up there talking, if that was taken out of context or shared with another person where that information was not appropriate, that’s a concern to me. [ 45 ]

One anesthesiologist raised, “Who has access to the responses that I provide? Because if a patient receives information from me which they hold onto and is taken out of context, in a medical–legal situation, then that’s a big issue as well.” [ 46 ]

Providers may also find that the abundance of information generated by digital health tools can be overwhelming and time-consuming to manage, adding to an already hectic workflow and blurring professional boundaries. Large volumes of alerts and notifications from digital health tools can be disruptive to health care providers, who expressed the need to set boundaries regarding how and when they engaged with digital health tools. In a study reporting on perspectives about digital health from key informants (health care providers and researchers), one participant shared their thoughts on the potential for digital health to increase workload and liability:

Sometimes the more information that we provide for them (doctors), the more work and liability we give them, right? So if they get so much information that becomes actionable but they are overwhelmed, now they would be obligated to do something with this patient, they are in a chain of distribution, a chain of liability. [ 44 ]

Theme 6: Impact on Health and Behavior

Finally, our sixth theme describes the impact of PGHD on health and health behaviors.

Several studies reported that digital health interventions helped users stay motivated and, in turn, improved their health habits and behaviors, such as adherence to medication, physical activity, and healthy eating. The ability of users to look back at their data helps them identify patterns in their health and behaviors, which increases their awareness of their health and habits. The awareness then allows them to be more mindful of their habits and encourages self-reflection, thus promoting a deeper understanding of their health and well-being. The tracking of patterns in their health, combined with the educational component of some digital health tools, helps users come up with better self-management strategies and feel more confident in their ability to reach their health goals, giving them a greater sense of self-efficacy and control over their health. In a digital health intervention aimed at treating lymphedema following breast cancer treatment, a participant spoke of changes in her awareness of symptoms and improvements:

It helped me realize that I had excess fluid. My arms got lighter each time I did the exercises. My arms began to feel less heavy. It noticed it in my clothes as well. [ 56 ]

Digital health interventions are often reported to positively impact the mental health and well-being of individuals. Women reported improvements in their mood, emotional state, and coping abilities. They also reported a reduction in stress and anxiety levels, which can lead to improvements in overall health outcomes. The digital health tools provide users with a sense of support and accountability as well as feelings of accomplishment when meeting their goals.

However, it is important to note that, while digital health interventions can have many benefits, they may not be suitable for everyone and may even have negative effects on some individuals. For example, some users reported increased anxiety due to excessive monitoring or notifications, and others reported negative effects on their thoughts or worsening of symptoms related to health conditions. Some users found that self-tracking made them more attached to their phones, less likely to engage in social activities, and more isolated overall. Care should be taken to ensure that users do not become obsessive about self-tracking as this can be counterproductive or even harmful. Being hyperfocused on their symptoms or health condition could be distressing and even detrimental to their overall well-being. Therefore, it is important to carefully monitor the use of digital health interventions and adjust them as needed to ensure the best possible outcomes for each individual. One woman spoke about her overreliance on an app used to track breastfeeding:

I stopped using it because um I thought I’m being too anal about this...being too concerned about it, I just need to stress less, and just go with the flow and just be a bit more relaxed about it...so, that’s why I stopped using it completely, and then I think the breastfeeding improved from there ’cause I was worrying about it less. [ 57 ]

Table 2 provides a summary of the thematic analysis grouped into barriers and facilitators. It is worth noting that many things are both a barrier and a facilitator (eg, cost) depending on the individual. In addition, the presence of a specific feature may be a facilitator, whereas the absence of it may be a barrier.

Principal Findings

In this scoping review, we summarized information from 406 articles on digital technologies collecting PGHD and how they have been used in women’s health research. We found a steady increase in articles meeting our inclusion criteria from 2015 to 2020, indicating an increasing trend in the uptake and use of digital health tools in women’s health research before the COVID-19 pandemic. Most included studies (310/406, 76.4%) were feasibility or acceptability studies, effectiveness studies, or reports of digital tool prototypes. Most studies (299/406, 73.6%) focused on tracking conditions related to pregnancy or the postpartum period, cancer survivorship, or menstrual, sexual, and reproductive health. Several types of digital health were represented, with the most common being apps, wearable devices, and websites or patient portals. Through our thematic analysis, we found several considerations of facilitators of and barriers to using digital health tools, including the accessibility and convenience of the tools, visual appearance, device functionality and ability to personalize the user experience, and accuracy of the algorithms and information provided. It is also important to consider the target audience to optimize the adoption of the tools. Engagement with digital health tools may help users improve their health and health-related behaviors and gather support from friends, family, and other digital health users. Women are more likely to use digital health if it is recommended by a health care provider, but there are both benefits and challenges that health care providers may face if considering integrating digital health technology into clinical practice.

A previously published scoping review focused on information and communications technologies as a tool for women’s empowerment [ 59 ]. They reported that the concept of empowerment appeared in various ways with no clear consensus on the definition, with some studies mentioning terms such as self-concept, self-esteem, self-worth, and self-efficacy. Our thematic analysis also found that some women’s use of digital health tools increases their self-efficacy in managing their health. Another systematic review of 13 digital health interventions for midlife women found that many interventions did not use a specific behavior change theory [ 60 ]. Our scoping review did not examine the effectiveness of the interventions described, but those designing digital health tools and interventions may want to carefully consider behavioral theories in the design to increase adoption and retention rates and adherence to interventions.

Overall, digital health technology to collect PGHD has gained popularity over the past several years. The integration of wearables, smartphones, and digital health technologies has enabled the integration of passive data collection. This wealth of data provides valuable insights into various aspects of health, enabling informed decisions and the adoption of proactive measures to improve well-being. The uptake of this technology will usher in a new era in how we manage our health and well-being. This transformation has changed how we engage with our health and shifted our perception of health and the approach we take toward maintaining it.

Femtech, as a subset of digital health technology, has grown in popularity. This was evidenced by the large increase in the number of articles published between 2015 and 2020 that used digital health tools to track metrics during pregnancy and the postpartum period as well as metrics related to menstrual, sexual, and reproductive health. These technologies empower women and people assigned female at birth to take charge of their health. This is particularly relevant for people with conditions that are not diseases or health concerns per se but are nevertheless part of managing their overall health and well-being. In this way, femtech can provide a greater sense of control over reproductive health and choices, which can be precarious in many settings worldwide. However, in a previous scoping review, researchers reported that many mobile health apps do not follow data privacy, sharing, and security standards [ 61 ]. Issues related to the privacy and security of personal health data may be especially important when it comes to tracking reproductive health in settings where sexual and reproductive health rights are not guaranteed. This focus on pregnancy and reproductive health is consistent with the fact that women’s health research has largely focused on reproductive health topics [ 62 ]. Researchers and digital health developers must address gaps in women’s health regarding areas that are not strictly related to reproductive health. Women’s health encompasses much more than obstetrics and gynecology; even for health conditions that affect men and women, there may be sex or gender differences in disease presentation, personal experiences, and treatment plans. While using gendered language and design in femtech has the potential to reinforce stereotypes regarding femininity that could cause harm [ 63 ], there is a need for apps to provide content relevant to female populations while being gender inclusive and conscious of biases in the language and advice presented.

When analyzing themes related to acceptability, personalization emerged as a key aspect influencing the adoption and sustained use of digital health tools. People respond positively and want to engage with tools that cater to their unique needs and preferences. The ability to customize elements such as the frequency of notifications, specific health measures tracked and displayed, goal-setting options, and the amount of health information provided enhanced user engagement and motivation. However, offering too many personalization options might overwhelm users, making apps or devices cumbersome to use and navigate. Simplicity and ease of use should not be compromised in the pursuit of personalization. Creating personalized experiences that are intuitive and user-friendly while integrating multiple functionalities into a given device is an important consideration. Recognizing that a “one-size-fits-all” approach is inadequate, digital intervention designers need to define their target audience clearly. Apps that cater to specific groups, such as those with certain chronic health conditions, may inherently provide a sense of personalization by addressing their unique requirements. We have also learned the importance of ensuring that the design is inclusive and accessible to everyone within the target audience. Our findings that some tools are not sensitive to certain circumstances such as pregnancy are consistent with those of a systematic review of digital health interventions for postpartum women, in which the authors reported that barriers related to postpartum status could make it more difficult to engage with the interventions [ 58 ]. Tools designed with these circumstances in mind may be more engaging for women during pregnancy and the postpartum period, leading to greater adoption and quality of the technologies. Attrition can be high among users of digital health interventions [ 64 , 65 ], but most participants were willing to self-track when motivated by a specific health condition.

An important finding of this review was the growing demand and expectation that PGHD are integrated with clinical care. As digital health continues evolving, patients seek more seamless interactions between digital health data and health care providers. Moreover, services delivered through digital health technologies were not expected to replace the role of health care professionals but rather to be a useful tool to support health care management. Maintaining the human touch during communication for health care delivery was seen as important, with technology complementing clinical care to enhance the overall experience for patients and providers.

One of the critical considerations in clinical integration is the accuracy of PGHD collected from digital health tools. Ensuring the reliability and validity of the data is essential for effective clinical decision-making. Striking a balance between patient empowerment and health care provider oversight is crucial to achieving the best possible outcomes. In general, it is important for health care providers to actively propose digital health during patient visits and encourage its use. While challenges and concerns associated with the use of digital health are noted from health care providers’ perspective, such as concerns about medico-legal effects, maintaining professional boundaries, and not adding an abundance of work, the benefits of these tools in supporting patient care and improving outcomes are perceived as important.

Strengths, Limitations, and Future Directions

There are some limitations to this scoping review. Our inclusion criteria did not cover conference abstracts, conference reviews, editorials, letters, comments, or gray literature. Our review also did not include articles written in languages other than English. Therefore, there may be other uses of PGHD in women’s health that were not captured in this review. The assessments of the quality of included articles, the effectiveness of the interventions, or the accuracy in validating PGHD were outside this review’s scope and were not performed. Our aim was to provide a broad overview of PGHD in published women’s health research literature rather than evaluating the quality of the digital technologies or intervention effectiveness. Another limitation is the rapid growth of digital health and femtech, especially during the COVID-19 pandemic. It is important to note that this scoping review only captures the use of PGHD in women’s health before the emergence of the pandemic. We suggest that this review may provide a baseline for comparison in a future scoping review that captures articles published in March 2020 or later. The strengths of this review include the large number of publications analyzed and the data charting process conducted in duplicate by 2 reviewers. The broad scope of this review also helps provide an overall picture of digital health for women and highlights gaps in the research literature.

Future endeavors in this space should consider digital health tools for women for nonreproductive topics such as chronic health conditions that primarily affect women or conditions that have sex or gender differences in presentation and treatment. Within reproductive health, there was a large focus on pregnancy, but there is an unmet need for research and digital health tools appropriate for women in perimenopause and menopause. A previous literature review found <5 articles published between 2010 and 2020 about digital health technologies that meet the psychosocial needs of women experiencing menopause [ 66 ]. There may also be further opportunities for digital health tools geared toward specific racial or ethnic groups that are culturally sensitive and available in multiple languages. A systematic review found that barriers to the use of digital health among culturally and linguistically diverse populations include lower literacy levels and the use of complex medical terminology in some apps, lack of recognition of cultural concerns, stereotypes, and inaccurate portrayals of cultural groups [ 67 ]. Previous scoping reviews in the space of women’s digital health have identified the need for femtech to pay more attention to cultural appropriateness and consider cultural contexts in their design [ 68 , 69 ].

Conclusions

In conclusion, the integration of wearables, smartphones, and other forms of digital health has revolutionized how we approach and engage with our health. Personalization, inclusivity, and integration with clinical care are vital aspects of developing effective digital health solutions. By understanding the needs of the target audience, providing meaningful personalization, and ensuring data accuracy, digital health can truly transform health care and empower individuals to take charge of their well-being while maintaining a collaborative relationship with health care professionals.

Acknowledgments

Thank you to Shannon Cheng, reference librarian, for her work in developing the search strategy and conducting the database searches. A big thank you to Dr Beth Payne for reviewing the manuscript draft and providing helpful feedback. AT is funded by a Michael Smith Health Research British Columbia Scholar award.

Data Availability

The data sets generated during this study are available in the OSF repository [ 70 ].

Authors' Contributions

JLK and AT conceived the study and designed the study protocol. JLK, RST, and AT conducted the article screening. JLK, RW, and RST conducted the data charting. JLK, RST, and DSC created the visualizations and tables of the charted data. The thematic analysis coding was conducted by JLK and RW, with additional discussions with AT in refining the themes. JLK, RST, and AT wrote the draft of the manuscript. All authors reviewed the manuscript before submission.

Conflicts of Interest

None declared.

PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.

Full search strategy.

List of included articles by health area.

Metrics collected in the included studies.

• Conceptualizing a data infrastructure for the capture, use, and sharing of patient-generated health data in care delivery and research through 2024. The Office of the National Coordinator for Health Information Technology. Jan 2018. URL: https://www.healthit.gov/sites/default/files/onc_pghd_final_white_paper.pdf [accessed 2024-05-03]
• DeSilva J, Prensky-Pomeranz R, Zweig M. Digital health consumer adoption report 2020. RockHealth. Feb 26, 2021. URL: https://rockhealth.com/insights/digital-health-consumer-adoption-report-2020 [accessed 2024-05-03]
• Taylor P. Penetration of mobile devices in Canada as share of the population from 2009 to 2021. Statista. URL: https://www.statista.com/statistics/462386/mobile-device-penetration-canada [accessed 2024-05-03]
• Olsen E. Digital health apps balloon to more than 350,000 available on the market, according to IQVIA report. MobiHealthNews. Aug 4, 2021. URL: https:/​/www.​mobihealthnews.com/​news/​digital-health-apps-balloon-more-350000-available-market-according-iqvia-report [accessed 2024-05-03]
• Paré G, Leaver C, Bourget C. Diffusion of the digital health self-tracking movement in Canada: results of a national survey. J Med Internet Res. May 02, 2018;20(5):e177. [ CrossRef ] [ Medline ]
• Fox S, Duggan M. Tracking for health. Pew Research Center. Jan 28, 2013. URL: https:/​/www.​pewresearch.org/​internet/​wp-content/​uploads/​sites/​9/​media/​Files/​Reports/​2013/​PIP_TrackingforHealth-with-appendix.​pdf [accessed 2024-05-03]
• Peek N, Sujan M, Scott P. Digital health and care in pandemic times: impact of COVID-19. BMJ Health Care Inform. Jun 2020;27(1):e100166. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Budd J, Miller BS, Manning EM, Lampos V, Zhuang M, Edelstein M, et al. Digital technologies in the public-health response to COVID-19. Nat Med. Aug 2020;26(8):1183-1192. [ CrossRef ] [ Medline ]
• Bruining N. The post-pandemic legacy: the breakthrough of digital health and telemedicine. Cardiovasc Res. Jul 27, 2021;117(9):e118-e119. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Meskó B. COVID-19's impact on digital health adoption: the growing gap between a technological and a cultural transformation. JMIR Hum Factors. Sep 19, 2022;9(3):e38926. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kim KK, Jalil S, Ngo V. Improving self-management and care coordination with person-generated health data and mobile health. In: Edmunds M, Hass C, Holve E, editors. Consumer Informatics and Digital Health. Cham, Switzerland. Springer; Jan 18, 2019.
• Shapiro M, Johnston D, Wald J, Mon D. Patient-generated health data. White paper. RTI International. 2012. URL: https://www.rti.org/publication/patient-generated-health-data-white-paper [accessed 2024-05-03]
• Vodicka E, Kim K, Devine EB, Gnanasakthy A, Scoggins JF, Patrick DL. Inclusion of patient-reported outcome measures in registered clinical trials: evidence from ClinicalTrials.gov (2007-2013). Contemp Clin Trials. Jul 2015;43:1-9. [ CrossRef ] [ Medline ]
• Femtech—time for a digital revolution in the women’s health market. Frost & Sullivan. Jan 31, 2018. URL: https://www.frost.com/frost-perspectives/femtechtime-digital-revolution-womens-health-market [accessed 2024-05-03]
• Karim JL, Talhouk A. Person-generated health data in women's health: protocol for a scoping review. JMIR Res Protoc. May 28, 2021;10(5):e26110. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. Oct 02, 2018;169(7):467-473. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ahmadvand A, Kavanagh D, Clark M, Drennan J, Nissen L. Trends and visibility of "digital health" as a keyword in articles by JMIR publications in the new millennium: bibliographic-bibliometric analysis. J Med Internet Res. Dec 19, 2019;21(12):e10477. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lau Y, Cheng LJ, Chi C, Tsai C, Ong KW, Ho-Lim SS, et al. Development of a healthy lifestyle mobile app for overweight pregnant women: qualitative study. JMIR Mhealth Uhealth. Apr 23, 2018;6(4):e91. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Maxwell H, O’Shea M, Stronach M, Pearce S. Empowerment through digital health trackers: an exploration of Indigenous Australian women and physical activity in leisure settings. Ann Leis Res. Oct 04, 2019;24(1):150-167. [ CrossRef ]
• Hughson JP, Daly JO, Woodward-Kron R, Hajek J, Story D. The rise of pregnancy apps and the implications for culturally and linguistically diverse women: narrative review. JMIR Mhealth Uhealth. Nov 16, 2018;6(11):e189. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ranzenhofer LM, Engel SG, Crosby RD, Haigney M, Anderson M, McCaffery JM, et al. Real-time assessment of heart rate variability and loss of control eating in adolescent girls: a pilot study. Int J Eat Disord. Feb 2016;49(2):197-201. [ FREE Full text ] [ CrossRef ] [ Medline ]
• James DC, Harville C2, Whitehead N, Stellefson M, Dodani S, Sears C. Willingness of African American women to participate in e-Health/m-Health research. Telemed J E Health. Mar 2016;22(3):191-197. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lupton D, Maslen S. The more-than-human sensorium: sensory engagements with digital self-tracking technologies. Senses Soc. Jul 25, 2018;13(2):190-202. [ CrossRef ]
• Asklund I, Samuelsson E, Hamberg K, Umefjord G, Sjöström M. User experience of an app-based treatment for stress urinary incontinence: qualitative interview study. J Med Internet Res. Mar 14, 2019;21(3):e11296. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huberty J, Ehlers DK, Kurka J, Ainsworth B, Buman M. Feasibility of three wearable sensors for 24 hour monitoring in middle-aged women. BMC Womens Health. Jul 30, 2015;15:55. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Haney AC. Young female college millennials' intent for behavior change with wearable fitness technology. Walden University. 2018. URL: https://scholarworks.waldenu.edu/dissertations/5197/ [accessed 2020-04-11]
• Leonard NR, Silverman M, Sherpa DP, Naegle MA, Kim H, Coffman DL, et al. Mobile health technology using a wearable sensorband for female college students with problem drinking: an acceptability and feasibility study. JMIR Mhealth Uhealth. Jul 07, 2017;5(7):e90. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Brett J, Boulton M, Watson E. Development of an e-health app to support women prescribed adjuvant endocrine therapy after treatment for breast cancer. Patient Prefer Adherence. Dec 11, 2018;12:2639-2647. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Chaudhry BM. Expecting great expectations when expecting. Mhealth. Jan 10, 2018;4:2. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Mann D, Riddell L, Lim K, Byrne LK, Nowson C, Rigo M, et al. Mobile phone app aimed at improving iron intake and bioavailability in premenopausal women: a qualitative evaluation. JMIR Mhealth Uhealth. Sep 28, 2015;3(3):e92. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Grym K, Niela-Vilén H, Ekholm E, Hamari L, Azimi I, Rahmani A, et al. Feasibility of smart wristbands for continuous monitoring during pregnancy and one month after birth. BMC Pregnancy Childbirth. Jan 17, 2019;19(1):34. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Goetz M, Müller M, Matthies LM, Hansen J, Doster A, Szabo A, et al. Perceptions of patient engagement applications during pregnancy: a qualitative assessment of the patient's perspective. JMIR Mhealth Uhealth. May 26, 2017;5(5):e73. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lupton D, Pedersen S. An Australian survey of women's use of pregnancy and parenting apps. Women Birth. Aug 2016;29(4):368-375. [ CrossRef ] [ Medline ]
• de Mooij MJ, Hodny RL, O'Neil DA, Gardner MR, Beaver M, Brown AT, et al. OB nest: reimagining low-risk prenatal care. Mayo Clin Proc. Apr 2018;93(4):458-466. [ CrossRef ] [ Medline ]
• Kokts-Porietis RL, Stone CR, Friedenreich CM, Froese A, McDonough M, McNeil J. Breast cancer survivors' perspectives on a home-based physical activity intervention utilizing wearable technology. Support Care Cancer. Aug 2019;27(8):2885-2892. [ CrossRef ] [ Medline ]
• Gell NM, Tursi A, Grover KW, Dittus K. Female cancer survivor perspectives on remote intervention components to support physical activity maintenance. Support Care Cancer. May 2020;28(5):2185-2194. [ CrossRef ] [ Medline ]
• Ravn Jakobsen P, Hermann AP, Søndergaard J, Wiil UK, Clemensen J. Development of an mHealth application for women newly diagnosed with osteoporosis without preceding fractures: a participatory design approach. Int J Environ Res Public Health. Feb 13, 2018;15(2):330. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Harder H, Holroyd P, Burkinshaw L, Watten P, Zammit C, Harris PR, et al. A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment. J Cancer Surviv. Dec 2017;11(6):732-742. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Depper A, Howe PD. Are we fit yet? English adolescent girls’ experiences of health and fitness apps. Health Sociol Rev. Jul 04, 2016;26(1):98-112. [ CrossRef ]
• Gambier-Ross K, McLernon DJ, Morgan HM. A mixed methods exploratory study of women's relationships with and uses of fertility tracking apps. Digit Health. Jul 25, 2018;4:2055207618785077. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lupton D. ‘It just gives me a bit of peace of mind’: Australian women’s use of digital media for pregnancy and early motherhood. Societies. Sep 15, 2017;7(3):25. [ CrossRef ]
• Logsdon MC, Lauf A, Stikes R, Revels A, Vickers-Smith R. Partnering with new mothers to develop a smart phone app to prevent maternal mortality after hospital discharge: a pilot study. J Adv Nurs. Jan 2020;76(1):324-327. [ CrossRef ] [ Medline ]
• Wright AA, Raman N, Staples P, Schonholz S, Cronin A, Carlson K, et al. The HOPE pilot study: harnessing patient-reported outcomes and biometric data to enhance cancer care. JCO Clin Cancer Inform. Dec 2018;2:1-12. [ FREE Full text ] [ CrossRef ] [ Medline ]
• de Mendoza AH, Cabling ML, Dilawari A, Turner JW, Fernández N, Henderson A, et al. Providers' perspectives on adherence to hormonal therapy in breast cancer survivors. Is there a role for the digital health feedback system? Health Technol (Berl). Mar 2019;9(2):175-184. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Willcox JC, van der Pligt P, Ball K, Wilkinson SA, Lappas M, McCarthy EA, et al. Views of women and health professionals on mHealth lifestyle interventions in pregnancy: a qualitative investigation. JMIR Mhealth Uhealth. Oct 28, 2015;3(4):e99. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ke JX, George RB, Wozney L, Chorney JL. Patient-centred perioperative mobile application in Cesarean delivery: needs assessment and development. Can J Anaesth. Oct 2019;66(10):1194-1201. [ CrossRef ] [ Medline ]
• Firet L, de Bree C, Verhoeks CM, Teunissen DA, Lagro-Janssen AL. Mixed feelings: general practitioners' attitudes towards eHealth for stress urinary incontinence - a qualitative study. BMC Fam Pract. Jan 26, 2019;20(1):21. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Garnweidner-Holme LM, Borgen I, Garitano I, Noll J, Lukasse M. Designing and developing a mobile smartphone application for women with gestational diabetes mellitus followed-up at diabetes outpatient clinics in Norway. Healthcare (Basel). May 21, 2015;3(2):310-323. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Grassl N, Nees J, Schramm K, Spratte J, Sohn C, Schott TC, et al. A web-based survey assessing the attitudes of health care professionals in Germany toward the use of telemedicine in pregnancy monitoring: cross-sectional study. JMIR Mhealth Uhealth. Aug 08, 2018;6(8):e10063. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Pais S, Parry D, Petrova K, Rowan J. Acceptance of using an ecosystem of mobile apps for use in diabetes clinic for self-management of gestational diabetes mellitus. Stud Health Technol Inform. 2017;245:188-192. [ Medline ]
• Ragavan MI, Ferre V, Bair-Merritt M. Thrive: a novel health education mobile application for mothers who have experienced intimate partner violence. Health Promot Pract. Mar 2020;21(2):160-164. [ CrossRef ] [ Medline ]
• Runkle J, Sugg M, Boase D, Galvin SL, C Coulson C. Use of wearable sensors for pregnancy health and environmental monitoring: descriptive findings from the perspective of patients and providers. Digit Health. Feb 06, 2019;5:2055207619828220. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sadigursky A. Move my mood: development and evaluation of a mobile mental health self-help app using behavioral activation for women with postpartum depression. Alliant International University. 2018. URL: https://books.google.co.in/books/about/Move_My_Mood.html?id=dYtP0AEACAAJ&redir_esc=y [accessed 2020-03-30]
• Scherr CL, Feuston JL, Nixon DM, Cohen SA. A two-phase approach to developing SNAP: an iPhone application to support appointment scheduling and management for women with a BRCA mutation. J Genet Couns. Apr 2018;27(2):439-445. [ CrossRef ] [ Medline ]
• Tommasone G, Bazzani M, Solinas V, Serafini P. Midwifery e-health: from design to validation of “mammastyle — Gravidanza Fisiologica”. In: Proceedings of the IEEE 18th International Conference on e-Health Networking, Applications and Services (Healthcom). 2016. Presented at: Healthcom 2016; September 14-16, 2016; Munich, Germany. [ CrossRef ]
• Fu MR, Axelrod D, Guth AA, Wang Y, Scagliola J, Hiotis K, et al. Usability and feasibility of health IT interventions to enhance Self-Care for Lymphedema Symptom Management in breast cancer survivors. Internet Interv. Sep 2016;5:56-64. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Dienelt K, Moores CJ, Miller J, Mehta K. An investigation into the use of infant feeding tracker apps by breastfeeding mothers. Health Informatics J. Sep 2020;26(3):1672-1683. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lim S, Tan A, Madden S, Hill B. Health professionals' and postpartum women's perspectives on digital health interventions for lifestyle management in the postpartum period: a systematic review of qualitative studies. Front Endocrinol (Lausanne). Nov 8, 2019;10:767. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Mackey A, Petrucka P. Technology as the key to women's empowerment: a scoping review. BMC Womens Health. Feb 23, 2021;21(1):78. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sediva H, Cartwright T, Robertson C, Deb SK. Behavior change techniques in digital health interventions for midlife women: systematic review. JMIR Mhealth Uhealth. Nov 09, 2022;10(11):e37234. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Alfawzan N, Christen M, Spitale G, Biller-Andorno N. Privacy, data sharing, and data security policies of women's mHealth apps: scoping review and content analysis. JMIR Mhealth Uhealth. May 06, 2022;10(5):e33735. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hallam L, Vassallo A, Pinho-Gomes AC, Carcel C, Woodward M. Does journal content in the field of women's health represent women's burden of disease? A review of publications in 2010 and 2020. J Womens Health (Larchmt). May 2022;31(5):611-619. [ CrossRef ] [ Medline ]
• Figueroa CA, Luo T, Aguilera A, Lyles CR. The need for feminist intersectionality in digital health. Lancet Digit Health. Aug 2021;3(8):e526-e533. [ CrossRef ]
• Jabir AI, Lin X, Martinengo L, Sharp G, Theng YL, Tudor Car L. Attrition in conversational agent-delivered mental health interventions: systematic review and meta-analysis. J Med Internet Res. Feb 27, 2024;26:e48168. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Meyerowitz-Katz G, Ravi S, Arnolda L, Feng X, Maberly G, Astell-Burt T. Rates of attrition and dropout in app-based interventions for chronic disease: systematic review and meta-analysis. J Med Internet Res. Sep 29, 2020;22(9):e20283. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Cronin C, Hungerford C, Wilson RL. Using digital health technologies to manage the psychosocial symptoms of menopause in the workplace: a narrative literature review. Issues Ment Health Nurs. Jun 2021;42(6):541-548. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Whitehead L, Talevski J, Fatehi F, Beauchamp A. Barriers to and facilitators of digital health among culturally and linguistically diverse populations: qualitative systematic review. J Med Internet Res. Feb 28, 2023;25:e42719. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Birati Y, Yefet E, Perlitz Y, Shehadeh N, Spitzer S. Cultural and digital health literacy appropriateness of app- and web-based systems designed for pregnant women with gestational diabetes mellitus: scoping review. J Med Internet Res. Oct 14, 2022;24(10):e37844. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Woodley SJ, Moller B, Clark AR, Bussey MD, Sangelaji B, Perry M, et al. Digital technologies for women's pelvic floor muscle training to manage urinary incontinence across their life course: scoping review. JMIR Mhealth Uhealth. Jul 05, 2023;11:e44929. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Person-generated health data in women’s health: scoping review. OSF Home. Mar 7, 2024. URL: https://osf.io/3eync/ [accessed 2024-05-07]

Abbreviations

Edited by T de Azevedo Cardoso; submitted 04.10.23; peer-reviewed by D Liu, M Herron; comments to author 23.02.24; revised version received 15.03.24; accepted 26.03.24; published 16.05.24.

©Jalisa Lynn Karim, Rachel Wan, Rhea S Tabet, Derek S Chiu, Aline Talhouk. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.05.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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Writing, reading, and critiquing reviews

Écrire, lire et revue critique, douglas archibald.

1 University of Ottawa, Ontario, Canada;

Maria Athina Martimianakis

2 University of Toronto, Ontario, Canada

Why reviews matter

What do all authors of the CMEJ have in common? For that matter what do all health professions education scholars have in common? We all engage with literature. When you have an idea or question the first thing you do is find out what has been published on the topic of interest. Literature reviews are foundational to any study. They describe what is known about given topic and lead us to identify a knowledge gap to study. All reviews require authors to be able accurately summarize, synthesize, interpret and even critique the research literature. 1 , 2 In fact, for this editorial we have had to review the literature on reviews . Knowledge and evidence are expanding in our field of health professions education at an ever increasing rate and so to help keep pace, well written reviews are essential. Though reviews may be difficult to write, they will always be read. In this editorial we survey the various forms review articles can take. As well we want to provide authors and reviewers at CMEJ with some guidance and resources to be able write and/or review a review article.

What are the types of reviews conducted in Health Professions Education?

Health professions education attracts scholars from across disciplines and professions. For this reason, there are numerous ways to conduct reviews and it is important to familiarize oneself with these different forms to be able to effectively situate your work and write a compelling rationale for choosing your review methodology. 1 , 2 To do this, authors must contend with an ever-increasing lexicon of review type articles. In 2009 Grant and colleagues conducted a typology of reviews to aid readers makes sense of the different review types, listing fourteen different ways of conducting reviews, not all of which are mutually exclusive. 3 Interestingly, in their typology they did not include narrative reviews which are often used by authors in health professions education. In Table 1 , we offer a short description of three common types of review articles submitted to CMEJ.

Three common types of review articles submitted to CMEJ

More recently, authors such as Greenhalgh 4 have drawn attention to the perceived hierarchy of systematic reviews over scoping and narrative reviews. Like Greenhalgh, 4 we argue that systematic reviews are not to be seen as the gold standard of all reviews. Instead, it is important to align the method of review to what the authors hope to achieve, and pursue the review rigorously, according to the tenets of the chosen review type. Sometimes it is helpful to read part of the literature on your topic before deciding on a methodology for organizing and assessing its usefulness. Importantly, whether you are conducting a review or reading reviews, appreciating the differences between different types of reviews can also help you weigh the author’s interpretation of their findings.

In the next section we summarize some general tips for conducting successful reviews.

How to write and review a review article

In 2016 David Cook wrote an editorial for Medical Education on tips for a great review article. 13 These tips are excellent suggestions for all types of articles you are considering to submit to the CMEJ. First, start with a clear question: focused or more general depending on the type of review you are conducting. Systematic reviews tend to address very focused questions often summarizing the evidence of your topic. Other types of reviews tend to have broader questions and are more exploratory in nature.

Following your question, choose an approach and plan your methods to match your question…just like you would for a research study. Fortunately, there are guidelines for many types of reviews. As Cook points out the most important consideration is to be sure that the methods you follow lead to a defensible answer to your review question. To help you prepare for a defensible answer there are many guides available. For systematic reviews consult PRISMA guidelines ; 13 for scoping reviews PRISMA-ScR ; 14 and SANRA 15 for narrative reviews. It is also important to explain to readers why you have chosen to conduct a review. You may be introducing a new way for addressing an old problem, drawing links across literatures, filling in gaps in our knowledge about a phenomenon or educational practice. Cook refers to this as setting the stage. Linking back to the literature is important. In systematic reviews for example, you must be clear in explaining how your review builds on existing literature and previous reviews. This is your opportunity to be critical. What are the gaps and limitations of previous reviews? So, how will your systematic review resolve the shortcomings of previous work? In other types of reviews, such as narrative reviews, its less about filling a specific knowledge gap, and more about generating new research topic areas, exposing blind spots in our thinking, or making creative new links across issues. Whatever, type of review paper you are working on, the next steps are ones that can be applied to any scholarly writing. Be clear and offer insight. What is your main message? A review is more than just listing studies or referencing literature on your topic. Lead your readers to a convincing message. Provide commentary and interpretation for the studies in your review that will help you to inform your conclusions. For systematic reviews, Cook’s final tip is most likely the most important– report completely. You need to explain all your methods and report enough detail that readers can verify the main findings of each study you review. The most common reasons CMEJ reviewers recommend to decline a review article is because authors do not follow these last tips. In these instances authors do not provide the readers with enough detail to substantiate their interpretations or the message is not clear. Our recommendation for writing a great review is to ensure you have followed the previous tips and to have colleagues read over your paper to ensure you have provided a clear, detailed description and interpretation.

Finally, we leave you with some resources to guide your review writing. 3 , 7 , 8 , 10 , 11 , 16 , 17 We look forward to seeing your future work. One thing is certain, a better appreciation of what different reviews provide to the field will contribute to more purposeful exploration of the literature and better manuscript writing in general.

In this issue we present many interesting and worthwhile papers, two of which are, in fact, reviews.

Major Contributions

A chance for reform: the environmental impact of travel for general surgery residency interviews by Fung et al. 18 estimated the CO 2 emissions associated with traveling for residency position interviews. Due to the high emissions levels (mean 1.82 tonnes per applicant), they called for the consideration of alternative options such as videoconference interviews.

Understanding community family medicine preceptors’ involvement in educational scholarship: perceptions, influencing factors and promising areas for action by Ward and team 19 identified barriers, enablers, and opportunities to grow educational scholarship at community-based teaching sites. They discovered a growing interest in educational scholarship among community-based family medicine preceptors and hope the identification of successful processes will be beneficial for other community-based Family Medicine preceptors.

Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners by Allison Brown and team 20 studied the impact of COVID-19 on medical learners around the world. There were different concerns depending on the levels of training, such as residents’ concerns with career timeline compared to trainees’ concerns with the quality of learning. Overall, the learners negatively perceived the disruption at all levels and geographic regions.

The impact of local health professions education grants: is it worth the investment? by Susan Humphrey-Murto and co-authors 21 considered factors that lead to the publication of studies supported by local medical education grants. They identified several factors associated with publication success, including previous oral or poster presentations. They hope their results will be valuable for Canadian centres with local grant programs.

Exploring the impact of the COVID-19 pandemic on medical learner wellness: a needs assessment for the development of learner wellness interventions by Stephana Cherak and team 22 studied learner-wellness in various training environments disrupted by the pandemic. They reported a negative impact on learner wellness at all stages of training. Their results can benefit the development of future wellness interventions.

Program directors’ reflections on national policy change in medical education: insights on decision-making, accreditation, and the CanMEDS framework by Dore, Bogie, et al. 23 invited program directors to reflect on the introduction of the CanMEDS framework into Canadian postgraduate medical education programs. Their survey revealed that while program directors (PDs) recognized the necessity of the accreditation process, they did not feel they had a voice when the change occurred. The authors concluded that collaborations with PDs would lead to more successful outcomes.

Experiential learning, collaboration and reflection: key ingredients in longitudinal faculty development by Laura Farrell and team 24 stressed several elements for effective longitudinal faculty development (LFD) initiatives. They found that participants benefited from a supportive and collaborative environment while trying to learn a new skill or concept.

Brief Reports

The effect of COVID-19 on medical students’ education and wellbeing: a cross-sectional survey by Stephanie Thibaudeau and team 25 assessed the impact of COVID-19 on medical students. They reported an overall perceived negative impact, including increased depressive symptoms, increased anxiety, and reduced quality of education.

In Do PGY-1 residents in Emergency Medicine have enough experiences in resuscitations and other clinical procedures to meet the requirements of a Competence by Design curriculum? Meshkat and co-authors 26 recorded the number of adult medical resuscitations and clinical procedures completed by PGY1 Fellow of the Royal College of Physicians in Emergency Medicine residents to compare them to the Competence by Design requirements. Their study underscored the importance of monitoring collection against pre-set targets. They concluded that residency program curricula should be regularly reviewed to allow for adequate clinical experiences.

Rehearsal simulation for antenatal consults by Anita Cheng and team 27 studied whether rehearsal simulation for antenatal consults helped residents prepare for difficult conversations with parents expecting complications with their baby before birth. They found that while rehearsal simulation improved residents’ confidence and communication techniques, it did not prepare them for unexpected parent responses.

Review Papers and Meta-Analyses

Peer support programs in the fields of medicine and nursing: a systematic search and narrative review by Haykal and co-authors 28 described and evaluated peer support programs in the medical field published in the literature. They found numerous diverse programs and concluded that including a variety of delivery methods to meet the needs of all participants is a key aspect for future peer-support initiatives.

Towards competency-based medical education in addictions psychiatry: a systematic review by Bahji et al. 6 identified addiction interventions to build competency for psychiatry residents and fellows. They found that current psychiatry entrustable professional activities need to be better identified and evaluated to ensure sustained competence in addictions.

Six ways to get a grip on leveraging the expertise of Instructional Design and Technology professionals by Chen and Kleinheksel 29 provided ways to improve technology implementation by clarifying the role that Instructional Design and Technology professionals can play in technology initiatives and technology-enhanced learning. They concluded that a strong collaboration is to the benefit of both the learners and their future patients.

In his article, Seven ways to get a grip on running a successful promotions process, 30 Simon Field provided guidelines for maximizing opportunities for successful promotion experiences. His seven tips included creating a rubric for both self-assessment of likeliness of success and adjudication by the committee.

Six ways to get a grip on your first health education leadership role by Stasiuk and Scott 31 provided tips for considering a health education leadership position. They advised readers to be intentional and methodical in accepting or rejecting positions.

Re-examining the value proposition for Competency-Based Medical Education by Dagnone and team 32 described the excitement and controversy surrounding the implementation of competency-based medical education (CBME) by Canadian postgraduate training programs. They proposed observing which elements of CBME had a positive impact on various outcomes.

You Should Try This

In their work, Interprofessional culinary education workshops at the University of Saskatchewan, Lieffers et al. 33 described the implementation of interprofessional culinary education workshops that were designed to provide health professions students with an experiential and cooperative learning experience while learning about important topics in nutrition. They reported an enthusiastic response and cooperation among students from different health professional programs.

In their article, Physiotherapist-led musculoskeletal education: an innovative approach to teach medical students musculoskeletal assessment techniques, Boulila and team 34 described the implementation of physiotherapist-led workshops, whether the workshops increased medical students’ musculoskeletal knowledge, and if they increased confidence in assessment techniques.

Instagram as a virtual art display for medical students by Karly Pippitt and team 35 used social media as a platform for showcasing artwork done by first-year medical students. They described this shift to online learning due to COVID-19. Using Instagram was cost-saving and widely accessible. They intend to continue with both online and in-person displays in the future.

Adapting clinical skills volunteer patient recruitment and retention during COVID-19 by Nazerali-Maitland et al. 36 proposed a SLIM-COVID framework as a solution to the problem of dwindling volunteer patients due to COVID-19. Their framework is intended to provide actionable solutions to recruit and engage volunteers in a challenging environment.

In Quick Response codes for virtual learner evaluation of teaching and attendance monitoring, Roxana Mo and co-authors 37 used Quick Response (QR) codes to monitor attendance and obtain evaluations for virtual teaching sessions. They found QR codes valuable for quick and simple feedback that could be used for many educational applications.

In Creation and implementation of the Ottawa Handbook of Emergency Medicine Kaitlin Endres and team 38 described the creation of a handbook they made as an academic resource for medical students as they shift to clerkship. It includes relevant content encountered in Emergency Medicine. While they intended it for medical students, they also see its value for nurses, paramedics, and other medical professionals.

Commentary and Opinions

The alarming situation of medical student mental health by D’Eon and team 39 appealed to medical education leaders to respond to the high numbers of mental health concerns among medical students. They urged leaders to address the underlying problems, such as the excessive demands of the curriculum.

In the shadows: medical student clinical observerships and career exploration in the face of COVID-19 by Law and co-authors 40 offered potential solutions to replace in-person shadowing that has been disrupted due to the COVID-19 pandemic. They hope the alternatives such as virtual shadowing will close the gap in learning caused by the pandemic.

Letters to the Editor

Canadian Federation of Medical Students' response to “ The alarming situation of medical student mental health” King et al. 41 on behalf of the Canadian Federation of Medical Students (CFMS) responded to the commentary by D’Eon and team 39 on medical students' mental health. King called upon the medical education community to join the CFMS in its commitment to improving medical student wellbeing.

Re: “Development of a medical education podcast in obstetrics and gynecology” 42 was written by Kirubarajan in response to the article by Development of a medical education podcast in obstetrics and gynecology by Black and team. 43 Kirubarajan applauded the development of the podcast to meet a need in medical education, and suggested potential future topics such as interventions to prevent learner burnout.

Response to “First year medical student experiences with a clinical skills seminar emphasizing sexual and gender minority population complexity” by Kumar and Hassan 44 acknowledged the previously published article by Biro et al. 45 that explored limitations in medical training for the LGBTQ2S community. However, Kumar and Hassen advocated for further progress and reform for medical training to address the health requirements for sexual and gender minorities.

In her letter, Journey to the unknown: road closed!, 46 Rosemary Pawliuk responded to the article, Journey into the unknown: considering the international medical graduate perspective on the road to Canadian residency during the COVID-19 pandemic, by Gutman et al. 47 Pawliuk agreed that international medical students (IMGs) do not have adequate formal representation when it comes to residency training decisions. Therefore, Pawliuk challenged health organizations to make changes to give a voice in decision-making to the organizations representing IMGs.

In Connections, 48 Sara Guzman created a digital painting to portray her approach to learning. Her image of a hand touching a neuron showed her desire to physically see and touch an active neuron in order to further understand the brain and its connections.

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How to Thrive as You Age

Got tinnitus a device that tickles the tongue helps this musician find relief.

Allison Aubrey

After using the Lenire device for an hour each day for 12 weeks, Victoria Banks says her tinnitus is "barely noticeable." David Petrelli/Victoria Banks hide caption

After using the Lenire device for an hour each day for 12 weeks, Victoria Banks says her tinnitus is "barely noticeable."

Imagine if every moment is filled with a high-pitched buzz or ring that you can't turn off.

More than 25 million adults in the U.S., have a condition called tinnitus, according to the American Tinnitus Association. It can be stressful, even panic-inducing and difficult to manage. Dozens of factors can contribute to the onset of tinnitus, including hearing loss, exposure to loud noise or a viral illness.

There's no cure, but there are a range of strategies to reduce the symptoms and make it less bothersome, including hearing aids, mindfulness therapy , and one newer option – a device approved by the FDA to treat tinnitus using electrical stimulation of the tongue.

The device has helped Victoria Banks, a singer and songwriter in Nashville, Tenn., who developed tinnitus about three years ago.

"The noise in my head felt like a bunch of cicadas," Banks says. "It was terrifying." The buzz made it difficult for her to sing and listen to music. "It can be absolutely debilitating," she says.

Shots - Health News

Tinnitus bothers millions of americans. here's how to turn down the noise.

Banks tried taking dietary supplements , but those didn't help. She also stepped up exercise, but that didn't bring relief either. Then she read about a device called Lenire, which was approved by the FDA in March 2023. It includes a plastic mouthpiece with stainless steel electrodes that electrically stimulate the tongue. It is the first device of its kind to be approved for tinnitus.

"This had worked for other people, and I thought I'm willing to try anything at this point," Banks recalls.

She sought out audiologist Brian Fligor, who treats severe cases of tinnitus in the Boston area. Fligor was impressed by the results of a clinical trial that found 84% of participants who tried Lenire experienced a significant reduction in symptoms. He became one of the first providers in the U.S. to use the device with his patients. Fligor also served on an advisory panel assembled by the company who developed it.

"A good candidate for this device is somebody who's had tinnitus for at least three months," Fligor says, emphasizing that people should be evaluated first to make sure there's not an underlying medical issue.

Tinnitus often accompanies hearing loss, but Victoria Banks' hearing was fine and she had no other medical issue, so she was a good candidate.

Banks used the device for an hour each day for 12 weeks. During the hour-long sessions, the electrical stimulation "tickles" the tongue, she says. In addition, the device includes a set of headphones that play a series of tones and ocean-wave sounds.

The device works, in part, by shifting the brain's attention away from the buzz. We're wired to focus on important information coming into our brains, Fligor says. Think of it as a spotlight at a show pointed at the most important thing on the stage. "When you have tinnitus and you're frustrated or angry or scared by it, that spotlight gets really strong and focused on the tinnitus," Fligor says.

"It's the combination of what you're feeling through the nerves in your tongue and what you're hearing through your ears happening in synchrony that causes the spotlight in your brain to not be so stuck on the tinnitus," Fligor explains.

A clinical trial found 84% of people who used the device experienced a significant reduction in symptoms. Brian Fligor hide caption

A clinical trial found 84% of people who used the device experienced a significant reduction in symptoms.

"It unsticks your spotlight" and helps desensitize people to the perceived noise that their tinnitus creates, he says.

Banks says the ringing in her ears did not completely disappear, but now it's barely noticeable on most days.

"It's kind of like if I lived near a waterfall and the waterfall was constantly going," she says. Over time, the waterfall sound fades out of consciousness.

"My brain is now focusing on other things," and the buzz is no longer so distracting. She's back to listening to music, writing music, and performing music." I'm doing all of those things," she says.

When the buzz comes back into focus, Banks says a refresher session with the device helps.

A clinical trial found that 84% of people who tried Lenire , saw significant improvements in their condition. To measure changes, the participants took a questionnaire that asked them to rate how much tinnitus was impacting their sleep, sense of control, feelings of well-being and quality of life. After 12 weeks of using the device, participants improved by an average of 14 points.

"Where this device fits into the big picture, is that it's not a cure-all, but it's quickly become my go-to," for people who do not respond to other ways of managing tinnitus, Fligor says.

One down-side is the cost. Banks paid about $4,000 for the Lenire device, and insurance doesn't cover it. She put the expense on her credit card and paid it off gradually.

Fligor hopes that as the evidence of its effectiveness accumulates, insurers will begin to cover it. Despite the cost, more than 80% of participants in the clinical trial said they would recommend the device to a friend with tinnitus.

But, it's unclear how long the benefits last. Clinical trials have only evaluated Lenire over a 1-year period. "How durable are the effects? We don't really know yet," says audiologist Marc Fagelson, the scientific advisory committee chair of the American Tinnitus Association. He says research is promising but there's still more to learn.

Fagelson says the first step he takes with his patients is an evaluation for hearing loss. Research shows that hearing aids can be an effective treatment for tinnitus among people who have both tinnitus and hearing loss, which is much more common among older adults. An estimated one-third of adults 65 years of age and older who have hearing loss, also have tinnitus.

"We do see a lot of patients, even with very mild loss, who benefit from hearing aids," Fagelson says, but in his experience it's about 50-50 in terms of improving tinnitus. Often, he says people with tinnitus need to explore options beyond hearing aids.

Bruce Freeman , a scientist at the University of Pittsburgh Medical Center, says he's benefitted from both hearing aids and Lenire. He was fitted for the device in Ireland where it was developed, before it was available in the U.S.

Freeman agrees that the ringing never truly disappears, but the device has helped him manage the condition. He describes the sounds that play through the device headphones as very calming and "almost hypnotic" and combined with the tongue vibration, it's helped desensitize him to the ring.

Freeman – who is a research scientist – says he's impressed with the results of research, including a study published in Nature, Scientific Reports that points to significant improvements among clinical trial participants with tinnitus.

Freeman experienced a return of his symptoms when he stopped using the device. "Without it the tinnitus got worse," he says. Then, when he resumed use, it improved.

Freeman believes his long-term exposure to noisy instruments in his research laboratory may have played a role in his condition, and also a neck injury from a bicycle accident that fractured his vertebra. "All of those things converged," he says.

Freeman has developed several habits that help keep the high-pitched ring out of his consciousness and maintain good health. "One thing that does wonders is swimming," he says, pointing to the swooshing sound of water in his ears. "That's a form of mindfulness," he explains.

When it comes to the ring of tinnitus, "it comes and goes," Freeman says. For now, it has subsided into the background, he told me with a sense of relief. "The last two years have been great," he says – a combination of the device, hearing aids and the mindfulness that comes from a swim.

This story was edited by Jane Greenhalgh

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Google helped make an exquisitely detailed map of a tiny piece of the human brain

A small brain sample was sliced into 5,000 pieces, and machine learning helped stitch it back together.

• Cassandra Willyard archive page

A team led by scientists from Harvard and Google has created a 3D, nanoscale-resolution map of a single cubic millimeter of the human brain. Although the map covers just a fraction of the organ—a whole brain is a million times larger—that piece contains roughly 57,000 cells, about 230 millimeters of blood vessels, and nearly 150 million synapses. It is currently the highest-resolution picture of the human brain ever created.

To make a map this finely detailed, the team had to cut the tissue sample into 5,000 slices and scan them with a high-speed electron microscope. Then they used a machine-learning model to help electronically stitch the slices back together and label the features. The raw data set alone took up 1.4 petabytes. “It’s probably the most computer-intensive work in all of neuroscience,” says Michael Hawrylycz, a computational neuroscientist at the Allen Institute for Brain Science, who was not involved in the research. “There is a Herculean amount of work involved.”

Many other brain atlases exist, but most provide much lower-resolution data. At the nanoscale, researchers can trace the brain’s wiring one neuron at a time to the synapses, the places where they connect. “To really understand how the human brain works, how it processes information, how it stores memories, we will ultimately need a map that’s at that resolution,” says Viren Jain, a senior research scientist at Google and coauthor on the paper, published in Science on May 9 . The data set itself and a preprint version of this paper were released in 2021 .

Brain atlases come in many forms. Some reveal how the cells are organized. Others cover gene expression. This one focuses on connections between cells, a field called “connectomics.” The outermost layer of the brain contains roughly 16 billion neurons that link up with each other to form trillions of connections. A single neuron might receive information from hundreds or even thousands of other neurons and send information to a similar number. That makes tracing these connections an exceedingly complex task, even in just a small piece of the brain..  

To create this map, the team faced a number of hurdles. The first problem was finding a sample of brain tissue. The brain deteriorates quickly after death, so cadaver tissue doesn’t work. Instead, the team used a piece of tissue removed from a woman with epilepsy during brain surgery that was meant to help control her seizures.

Once the researchers had the sample, they had to carefully preserve it in resin so that it could be cut into slices, each about a thousandth the thickness of a human hair. Then they imaged the sections using a high-speed electron microscope designed specifically for this project. 

Next came the computational challenge. “You have all of these wires traversing everywhere in three dimensions, making all kinds of different connections,” Jain says. The team at Google used a machine-learning model to stitch the slices back together, align each one with the next, color-code the wiring, and find the connections. This is harder than it might seem. “If you make a single mistake, then all of the connections attached to that wire are now incorrect,” Jain says. 

“The ability to get this deep a reconstruction of any human brain sample is an important advance,” says Seth Ament, a neuroscientist at the University of Maryland. The map is “the closest to the  ground truth that we can get right now.” But he also cautions that it’s a single brain specimen taken from a single individual. 

The map, which is freely available at a web platform called Neuroglancer , is meant to be a resource other researchers can use to make their own discoveries. “Now anybody who’s interested in studying the human cortex in this level of detail can go into the data themselves. They can proofread certain structures to make sure everything is correct, and then publish their own findings,” Jain says. (The preprint has already been cited at least 136 times .) 

The team has already identified some surprises. For example, some of the long tendrils that carry signals from one neuron to the next formed “whorls,” spots where they twirled around themselves. Axons typically form a single synapse to transmit information to the next cell. The team identified single axons that formed repeated connections—in some cases, 50 separate synapses. Why that might be isn’t yet clear, but the strong bonds could help facilitate very quick or strong reactions to certain stimuli, Jain says. “It’s a very simple finding about the organization of the human cortex,” he says. But “we didn’t know this before because we didn’t have maps at this resolution.”

The data set was full of surprises, says Jeff Lichtman, a neuroscientist at Harvard University who helped lead the research. “There were just so many things in it that were incompatible with what you would read in a textbook.” The researchers may not have explanations for what they’re seeing, but they have plenty of new questions: “That’s the way science moves forward.” 

Biotechnology and health

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SYSTEMATIC REVIEW article

Research of visual attention networks in deaf individuals: a systematic review.

• 1 Department of Psychology, University of Almería, Almería, Spain
• 2 CIBIS Research Center, University of Almería, Almería, Spain
• 3 Growing Brains, Washington, DC, United States

The impact of deafness on visual attention has been widely discussed in previous research. It has been noted that deficiencies and strengths of previous research can be attributed to temporal or spatial aspects of attention, as well as variations in development and clinical characteristics. Visual attention is categorized into three networks: orienting (exogenous and endogenous), alerting (phasic and tonic), and executive control. This study aims to contribute new neuroscientific evidence supporting this hypothesis. This paper presents a systematic review of the international literature from the past 15 years focused on visual attention in the deaf population. The final review included 24 articles. The function of the orienting network is found to be enhanced in deaf adults and children, primarily observed in native signers without cochlear implants, while endogenous orienting is observed only in the context of gaze cues in children, with no differences found in adults. Results regarding alerting and executive function vary depending on clinical characteristics and paradigms used. Implications for future research on visual attention in the deaf population are discussed.

1 Introduction

1.1 background.

Early auditory deprivation is recognized as a factor influencing the development of visual attention in deaf individuals ( Colmenero et al., 2004 ; Bavelier et al., 2006 ; Stevens and Neville, 2006 ). However, existing evidence on the nature of this effect is conflicting and, crucially for the present review, unclear concerning the temporal versus spatial distribution of visual attention. Historically, research on this topic has been centered on two seemingly opposing hypotheses: the deficiency hypothesis, positing that early profound deafness leads to visual attention deficits, and the enhancement hypothesis, suggesting compensatory changes to visual attention processes ( Dye and Bavelier, 2010 ).

According to the deficiency hypothesis , integrating information from different senses is essential for the normal development of attention functioning within each sensory modality. Consequently, the absence of auditory input results in underdeveloped selective attention capacities. For deaf individuals, the lack of audition impairs the development of multisensory integration, thereby impeding the typical development of visual attention skills. Put simply, while hearing people can selectively attend to a narrow visual field and still monitor the broader environment through sounds, deaf individuals must use vision to accomplish both specific tasks and monitor the broader environment ( Smith et al., 1998 ).

This view has been primarily supported by studies examining sustained visual attention or vigilance using the Continuous Performance Test or “CPT.” For example, using the Gordon Diagnostic System (GDS), a widely used CPT, the participant is presented with digits and must respond when a “1” is followed by a “9” for around 10 min ( Dye and Hauser, 2014 ). These studies have found consistent underperformance in CPTs among the deaf population, indicating that auditory input plays a role in organizing visual attention. These results are consistent with a deficit view of cross-modal reorganization stemming from early sensory deprivation ( Mitchell and Quittner, 1996 ; Smith et al., 1998 ; Quittner et al., 2004 ).

Although CPTs have been widely used to assess sustained visual attention, these tasks are sensitive to certain additional cognitive factors ( Parasnis et al., 2003 ). Specifically, CPTs require sustained attention and the ability to hold information about the target sequence in working memory, and performance is negatively affected by the inability to inhibit responses to non-target stimuli.

In contrast to the deficiency hypothesis, the enhancement hypothesis or compensation view is based on the common assumption that deficits in one sensory modality lead to heightened sensitivities in the remaining modalities ( Bavelier et al., 2006 ). In the case of early deafness, this perspective posits that the visual system is reorganized to compensate for the lack of auditory input. Consequently, visual skills assume the functional roles previously performed by audition in the typically developing child, such as monitoring the environment or discriminating temporally complex stimuli ( Bottari et al., 2014 ; Benetti et al., 2017 ; Bola et al., 2017 ; Seymour et al., 2017 ).

The enhancement or compensation hypothesis has primarily received support from studies measuring the allocation of attention across space. The results of these studies suggest that in deaf individuals, there is a spatial redistribution of visual attention toward the periphery, allowing them to better monitor their peripheral environment based on visual rather than auditory cues ( Loke and Song, 1991 ; Sladen et al., 2005 ). For example, deaf individuals can be faster than hearing controls in detecting the onset of peripheral visual targets ( Chen et al., 2006 ; Bottari et al., 2010 ; Codina et al., 2011 , 2017 ) or in discriminating the direction of visual motion with attention to peripheral locations ( Neville and Lawson, 1987 ; Bavelier et al., 2001 ).

This redistribution of visual attention can alter the trade-off in the responses of deaf people to the periphery versus the centre. Specifically, in situations where central and peripheral static stimuli compete for selective attention resources, deaf participants are more likely to orient visual attention toward peripheral than central locations ( Sladen et al., 2005 ; Chen et al., 2006 ). Consistent with these findings, Proksch and Bavelier (2002) observed that deaf individuals are more distracted by irrelevant peripheral information, whereas hearing individuals are more distracted by irrelevant central information. However, while deaf individuals have been shown to possess a field of view that extends further toward the periphery than hearing controls ( Sladen et al., 2005 ), no differences between deaf individuals and hearing controls have been documented when processing targets presented toward the centre of the visual field ( Neville and Lawson, 1987 ; Loke and Song, 1991 ).

In an initial review conducted by Tharpe et al. (2008) to examine evidence-based literature on visual attention and deafness, various paradigms were explored, including the CPT, the letter cancellation task, and conflict tasks. No conclusive evidence was found to support general enhancement or deficits in visual attention or enhanced fundamental visual sensory abilities ( Tharpe et al., 2002 ). Rather, the authors propose that the variability in performance across these paradigms could be explained by the extensive allocation of attentional resources across the visual field, driven by increased monitoring demands. This hypothesis explains why deaf individuals tend to show poorer performance on tasks requiring sustained attention to central stimuli over time compared to those involving the detection of peripheral stimuli. This idea has been supported by results found using a modified flanker paradigm incorporating several degrees of distance between distractor and target ( Sladen et al., 2005 ).

Functional brain studies have also revealed significant differences between deaf and hearing individuals that support the compensation view. These differences are related to alterations in the visual areas and the activation of visual and attention-related brain networks. For instance, Bavelier et al. (2001) found that the absence of auditory input and sign language use in the deaf population was associated with greater activation of visual cortex areas when processing peripheral and moving stimuli. Furthermore, Mayberry et al. (2011) reported that deaf individuals exhibited greater activation of visual and attention-related brain networks during peripheral visual tasks.

An area of the cortex that has been extensively studied in the context of deafness is the middle temporal (MT) or medial superior temporal (MST) area. MT/MST areas play a key role in detecting and analyzing movement and activity in these areas is modulated by attentional processes ( O’Craven et al., 1997 ). When observing unattended moving stimuli, both deaf and hearing participants show similar recruitment of the MT/MST cortex. However, when required to attend to peripheral movement and ignore concurrent central motion, enhanced recruitment of the MT/MST is observed in deaf individuals relative to hearing controls ( Bavelier et al., 2001 ; Fine et al., 2005 ). This pattern echoes a general trend in the literature, where the most significant population differences have been reported for motion stimuli in the visual periphery under conditions that engage selective attention, such as when the location or time of arrival of the stimulus is unknown or when the stimulus must be selected from distractors ( Bavelier et al., 2006 ). These findings suggest that deafness is associated with alterations in visual attention, resulting in changes in the recruitment of brain networks involved in the processing of visual information.

These apparently contradictory hypotheses highlight the necessity of organising previous research within a recognized model of attention. This review aims to respond to this need by systematically analysing the tasks employed to measure various aspects of attention in each study.

1.2 The integrative hypothesis

The contradictory results mentioned previously prompted an integrative review published by Dye and Bavelier (2010) . These authors proposed that while the deficiency hypothesis and enhancement hypothesis may appear to be mutually exclusive, the conflicting evidence concerning the impact of deafness on visual attention could arise from measuring different aspects of visual attention. Consequently, the deficit view is predominantly supported by studies focused on the allocation of attention over time, whereas the compensation view is backed by studies measuring the allocation of attention across space. Therefore, when considering different aspects of visual attention, a striking pattern of attentional enhancements and deficits emerges as a consequence of early deafness.

In addition, these two perspectives consider groups of different ages and backgrounds. Individuals in the deaf and hard of hearing population are quite diverse regarding their preferred mode of communication (sign language versus oral language), the age of acquisition of their native language, the hearing status of their parents, the aetiology of hearing loss (e.g., genetic, infection), and the implantation of cochlear implants [CI—a small electronic device that is surgically implanted into the inner ear to help provide a sense of sound to individuals with severe to profound hearing loss ( Wilson and Dorman, 2008 )]. Most of the research suggesting that deaf children have problems with visual attention has focused on deaf children learning spoken language, examining changes in sustained visual attention after restoration of auditory input through a CI ( Mitchell and Quittner, 1996 ; Smith et al., 1998 ; Quittner et al., 2004 ). In contrast, studies suggesting that the visual system compensates for the lack of auditory input by enhancing the monitoring of the peripheral visual field have primarily involved deaf adults. Specifically, these studies have focused on culturally deaf individuals born to Deaf parents, acquiring American Sign Language (ASL) as their first language and lacking CI. This group is compared to those who received oral speech therapy and have CI ( Bavelier et al., 2006 ; Dye et al., 2009 ).

Dye and Bavelier (2010) suggested that the deficiency and compensatory views were not necessarily contradictory but complementary in explaining the cross-modal reorganization of visual attention after early deafness. They propose an integrative view in which early auditory deprivation does not have an overall positive or negative impact on visual attention, but rather, selected aspects of visual attention are modified in various ways throughout the developmental trajectory.

However, this division of visual attention in temporal and spatial aspects is very broad, and the paradigms used to test these hypotheses have certain shortcomings. Studies examining the impact on temporal attention used measures from the Rapid Serial Visual Presentation Paradigms and the Attentional Blink; however, consistent results were not observed across different experiments ( Dye and Bavelier, 2010 ; Dye, 2014 ; Thakur et al., 2019 ). Concerning spatial attention, the Useful Field Of View (UFOV) task has been employed. However, this complex dual task requires following two instructions — to both detect and locate a target while ignoring several distractors. Consequently, working memory, inhibition, orienting, and divided attention can all be deployed in this task, giving rise to what is referred to as the task impurity problem ( Miyake et al., 2000 ).

1.3 The attention networks model

Understanding the potential deficits and enhancements in visual attention among deaf individuals requires recognizing that visual attention is not a unitary entity. From this perspective, based on behavioral and neuroscientific studies, Posner and colleagues have suggested a model that divides the human attentional system into three functionally and anatomically independent networks responsible for alerting, orienting, and executive attention ( Fan et al., 2002 , 2005 ; Posner and Rothbart, 2007 ; Petersen and Posner, 2012 ). As already mentioned, previous hypotheses suggest that various aspects of visual attention can be affected differently in deaf individuals due to compensatory changes. The attentional networks model offers a framework to measure these different changes by separating attention into several functions.

The alerting network is responsible for achieving and maintaining a state of elevated sensitivity to incoming information. Alertness can be further subdivided into tonic and phasic alertness (for a review, see Sturm and Willmes, 2001 ). Tonic alertness (also called vigilance or sustained attention) is a state of general wakefulness or vigilance and refers to the ability to sustain attention over a period of time. Phasic alertness is a more transient alert state, modulated by a warning that precedes a target stimulus and prepares the individual for a fast reaction. Performance within this network has been measured using tasks where the appearance of the target is preceded by an anticipatory alerting cue, provoking a phasic change in alertness. This transition involves a shift from a resting state to a prepared state, ready to detect and respond to an expected event ( Marrocco and Davidson, 1998 ; Beane and Marrocco, 2004 ). Tonic alertness, on the other hand, is typically evaluated through lengthy and repetitive tasks requiring participants to identify and respond to infrequently occurring targets, the most frequent example being CPTs ( Petersen and Posner, 2012 ).

The orienting network is responsible for the movement of attention throughout space, allowing the selection of specific information from numerous sensory inputs. In this regard, orienting can be reflexive ( exogenous ), such as when a sudden target event draws attention to its location, or it can be voluntary ( endogenous ), such as when a person searches the visual field looking for a target ( Jonides, 1981 ). Although overt orienting is often associated with head or eye movements toward the target, it can also enhance target processing by covertly orienting attention ( Posner, 1980 , 2016 ). Spatial orientation has traditionally been studied with tasks based on the “spatial orienting paradigm” or “cost and benefits paradigm.” In these tasks, the participants are presented with a fixation point and placeholders (the location where the target appears) at both sides of a fixation point. Following the onset of the fixation point, an attentional cue is presented, followed by the target to which participants must respond. Trials are categorized as cued/valid if the target appears at cued locations, uncued/invalid when it appears opposite to the cue, or neutral when the cue appears at the centre or both locations. In typical measures of exogenous orienting, a change occurs in the placeholder location to elicit an involuntary orienting response (such as the illumination of the locations). Conversely, in measures of endogenous orienting, a central cue is presented to prompt a voluntary orienting response toward a specific location or object ( Uncapher et al., 2011 ; Chica et al., 2014 ).

Finally, the executive attention network involves more complex mental operations to detect and resolve the conflict between expectation, stimulus, and response. While this network shares some overlap with executive functions, it specifically involves processes related to planning and executing goal-directed actions. However, executive functions are a more general domain that includes working memory, mental flexibility, conflict monitoring, and, in close association with executive attention, inhibitory control ( Botvinick et al., 2001 ; Matsumoto and Tanaka, 2004 ). Assessment of the executive attention network typically involves “resolution of conflict” paradigms, which require the suppression of either processing or responding to information that elicits incorrect or inappropriate responses ( Posner and DiGirolamo, 1998 ). Examples of such paradigms include the flanker ( Fan et al., 2002 ), Stroop ( Fan et al., 2003 ), or Simon tasks ( Simon and Craft, 1970 ).

One commonly used task specifically designed to measure most of these networks is the attention network test (ANT), which is based on two paradigms — the flanker task and the cost and benefits paradigm. The ANT enables the evaluation of three attentional networks in children and adults: phasic alerting, exogenous orienting, and executive attention ( Fan et al., 2002 ).

The main task is based on the flanker paradigm where the participant must press two keys indicating the direction (left or right) of a central arrow surrounded by congruent, incongruent, or neutral flankers. The difference in reaction times or accuracy between the congruent and incongruent conditions provides a measure of the executive attention network. The efficiency of the alerting network is examined by changes in performance resulting from a warning signal preceding the target, compared to trials without any previous cue. The efficiency of the orienting network is measured by comparing the performance benefits associated with a spatial cue predicting the location of the stimulus array (above or below fixation) with a central cue.

The integrative hypothesis proposed by Dye and Bavelier (2010) predicts that the strengths and weaknesses in visual attention resulting from early auditory deprivation are also linked to the abilities of orienting, alerting, and executive functions within the visual attention networks model developed by Petersen and Posner (2012) . Consequently, it is important to identify the tasks used to measure attention in deaf individuals and their possible interpretation according to the attention networks model. Understanding the weaknesses and strengths of visual attention networks related to early auditory deprivation aids in characterizing the developmental trajectory of these attentional functions during middle childhood (from 6 to 12 years old) since this is an important developmental stage for visual attention ( Rueda et al., 2004 ) and marks the beginning of formal schooling.

1.4 Objectives

To our knowledge, no systematic review has included evidence regarding the integrative hypothesis proposed by Dye and Bavelier (2010) . Furthermore, since the publication of the 2008 review by Tharpe and colleagues, no comprehensive review has been conducted to gather research findings enabling the identification of visual attention functions that could be diminished or enhanced in individuals with early auditory deprivation.

We conducted a systematic review of studies published between 2008 and 2023 focusing on deaf populations (from middle childhood through adulthood). The objective was to analyse investigations exploring one or more visual attention functions described in the attentional networks model. More specifically, our systematic review aims to:

1. Determine the most frequently studied functions of alerting, orienting, and executive attention in deaf individuals, along with the task paradigms employed to investigate such functions.

2. Identify the main strengths and impairments observed in the functioning of attentional networks in deaf adults and explore whether differences are found depending on the use of different communication systems, cochlear implants, and age of cochlear implant acquisition.

3. Examine the key developmental changes observed in the functioning of attention networks in deaf children during middle childhood (ages 6–12) and identify the main differences compared to typical hearing children of the same age.

2.1 Search strategy

We conducted a search on October 9th, 2023, of the peer-reviewed literature published in English between 2008 and 2023. The search was carried out on the Web of Science, Medline, Scielo, and Psycinfo databases, focusing on experimental studies of deaf populations aged 6–50 years. Using performance tasks to measure visual attention. The search utilized specific terms with relevant connectors to target visual attention measures and the population of interest. The search terms included: (deaf* OR “auditory deprivation” OR “hearing impairment”) AND (“orient*” OR “alert*” OR “spatial attention” OR “attention network” OR “visual selective attention” OR “visual attention” OR “sustained attention” OR “altered attention” OR “divided attention” OR “visuospatial attention” OR “executive attention”). Data extraction adhered to the recommendations provided by the Cochrane group ( Higgins and Green, 2011 ) and the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol (PRISMA; Moher et al., 2009 ).

2.2 Selection criteria

We use the PICOS strategy to define inclusion criteria (Participants, Intervention, Comparisons, Results, and Studies). This review includes studies with the following characteristics: (P) participants without a psychiatric history and typical neurodevelopment with mild, severe, or profound bilateral deafness aged between 6 and 50 year; (I) measures of some of the specific functions of the attention networks, including alerting orienting and executive attention. No specific intervention is considered in this review; (C) Transversal studies comparing performance between the deaf and typical hearing population, studies that compare the deaf population across different clinical variables such as CI and system of communication, and longitudinal studies within the deaf population assessing the development of visual attention; (O) studies are included where at least some of the attention networks can be separately measured through performance-based tasks based on the previously mentioned paradigms; and (S) Single case studies, doctoral theses, conference presentations, and papers without peer review are excluded.

2.3 Data extraction and quality evaluation

The initial search yielded 2,603 articles. After excluding duplicates between databases, 1,349 articles were removed. After applying the exclusion criteria, the studies were filtered by title and abstract, resulting in 86 remaining papers by the first author. The full texts of these 86 articles were then read and analysed by all authors. Most articles were excluded due to the inclusion of populations with other deficits, non-performance-based measures, or tasks that measured other aspects of visual attention not included in the attention networks model. In total, 24 articles met our inclusion criteria in agreement with all authors (see Figure 1 ).

Figure 1 . Flow chart of the identification, screening, eligibility, and selection of studies.

Based on our research objective, the articles were classified according to the age of the participants: individuals aged 18 to 60 were categorized as adults, while those aged 6 to 12 were considered children. After some deliberation among the authors, studies involving participants up to 14 years old were included in the children category, along with a study by Kronenberger et al. (2013) which encompassed individuals aged 7–25 years. Significant statistical differences between deaf or hard of hearing and fully hearing individuals in measures assessing attention network efficiency were used as an indication of specific outcomes for each study.

The risk of bias was assessed for all articles using the Newcastle-Ottawa scale (NOS; Wells et al., 2021 , adapted from Herzog et al., 2013 ) to evaluate the quality of the studies. In this version, the quality scores were based on the selection of sample, comparability between groups, and the measurement of results. For cross-sectional studies, a maximum score of 10 can be obtained, with a score above 6 considered a satisfactory methodology score ( Orton et al., 2014 ). In this systematic review, none of the studies included in the final analysis scored <7 (see Table 1 ).

Table 1 . Risk of bias scores adapted from the Newcastle-Ottawa scale.

3.1 Frequency of studies and tasks used

The initial objective of the study was to determine the most frequently studied aspects of attention. Of the 24 included studies, 23 adopted a cross-sectional experimental design and one was a longitudinal study. Additionally, 15 studies focused solely on adult samples, eight studies exclusively involved children, and one study included both adult and child participants. Not all studies investigated a single attention network (see Table 2 ).

Table 2 . Studies included in the review by group of age sample and function measured.

3.1.1 The alerting network

The alerting network was studied in 8 of 24 articles. Among these studies, five exclusively involved children aged between 6 and 12 years, two studies focused on adults aged between 19 and 57, and one study used a mixed sample of adults and children aged between 7 and 25. Except for two of the 11 studies ( Daza and Phillips-Silver, 2013 ; Bharadwaj et al., 2020 ), the rest compared the deaf group with their hearing peers. Six of the 11 studied the tonic alerting network using CPTs, while one studied phasic alerting using the ANT (see Table 3 ).

Table 3 . Paradigms used in the studies included in the review.

As mentioned above, CPTs are frequently used to measure visual attention in deaf individuals. Depending on the paradigm used, several interpretations are possible regarding the specific function measured. Following the previously described example of the GDS, commission errors due to responding to “9” when no “1” appeared are considered impulsive, lack of response or omission errors are considered distraction/inattention, and the most commonly used “ d ’” combines commission and omission errors to obtain a measure of sensitivity and is considered to show vigilance, which is why it has been classified as a tonic alerting measure ( Baijot et al., 2013 ).

3.1.2 The orienting network

The orienting network was studied in 12 of the 24 articles. Only two studies focused on children, one involving a sample aged between 6 and 14 years and another involving both children and adults aged between 10 and 58. The majority of studies (seven out of 12) were conducted exclusively with adults aged between 18 and 57. In eight out of 12 articles, exogenous orienting was studied, using spatial orienting paradigms, including the ANT. Four articles investigated endogenous orienting using spatial orienting paradigms. A visual search paradigm designed by Heimler et al. (2015a) allows for obtaining a measure of exogenous and endogenous orienting and was included in both categories (see Table 3 ).

As mentioned previously, the orienting paradigms facilitate the measurement of exogenous and endogenous orienting by manipulating cues before the appearance of targets. These paradigms provide various measures of the orienting process, the most common being the facilitation of a valid cue toward the target. Additionally, they can be used to measure the disengagement of attention following an invalid cue. In cases where eye movements are considered, overt orienting of attention is measured instead of covert attention. Four of the nine studies focusing on exogenous attention with orienting paradigms measured saccadic eye movements (overt attention), while the remaining five used only manual responses (covert attention). Heimler et al. (2015a) designed a visual search paradigm in which participants must search for a target (tilted line) among a visual field full of similar distractors (straight lines) while ignoring a salient distractor (line tilted opposite direction). The salience of the target and distractor was manipulated trial by trial by changing their colors. This approach was driven by the idea that the salient stimulus attracts exogenous attention while the target requires an endogenous search across the visual field. Through this method, they were able to obtain a measure of endogenous orienting and exogenous orienting.

3.1.3 The executive attention network

The executive attention network was studied in 7 of 24 articles. Four studies involved a sample of children aged between 6 and 13 (see Figure 2 ), while three focused exclusively on adults aged between 18 and 58 (see Figure 3 ). Three of the 7 used conflict tasks with several modifications, three used the ANT, and the remainder employed the modified CPT developed by Dye and Hauser (2014) (see Table 3 ).

Figure 2 . Number of studies with deaf children in each attention network function and the general findings in comparison to full hearing children. *Deficits in executive attention found with younger children [2, 74].

Figure 3 . Number of studies with deaf adults in each attention network function and the general findings in comparison to full hearing adults. *Enhancements found in overt orienting but not in covert orienting and deficits with executive attention found only during specific conditions.

Regarding measures of executive attention, paradigms classified as conflict tasks were included. These tasks require participants to ignore distractors while attending to a central target. Notably, the study conducted by Dye and Hauser (2014) used a CPT but compared the execution of a CPT with and without distractors in the same sample, thereby measuring executive attention.

3.2 Comparisons between deaf and hearing adults

Our second objective was to compile the differences found between deaf and full hearing adults. We note that all studies involving adults employed a cross-sectional design (see Figure 2 ). The two studies that measured tonic alerting in deaf adults revealed poorer performance compared to hearing peers when using CPTs as a measure ( Kronenberger et al., 2013 ; Bharadwaj et al., 2020 ). Specifically, Kronenberger et al. (2013) used the Test of Variables of Attention (TOVA), indicating poorer performance by deaf individuals across all measures. Similarly, Bharadwaj et al. (2020) used the Integrated Visual and Auditory Continuous Performance Test (IVA plus CPT), demonstrating that deaf individuals commit more omission errors and have slower reaction times.

The only study that measured phasic alerting with alerting cues found an advantage in deaf adults ( Prasad et al., 2022 ). Deaf adults also seem to have advantages in covert exogenous orienting ( Xingjuan et al., 2011 ; Brazão et al., 2021 ; Li et al., 2022 ; Prasad et al., 2022 ). However, studies that measured overt attention with saccadic movement found no facilitation of exogenous orienting with this measure ( Bottari et al., 2012 ; Prasad et al., 2015 ; Heimler et al., 2015a ; Jayaraman et al., 2016 ). The five studies that measured endogenous orienting found no differences between deaf and full-hearing adults ( Bottari et al., 2008 ; Heimler et al., 2015a , b ; Bonmassar et al., 2021 ; Li et al., 2022 ).

Regarding executive attention, no differences were found between deaf adults and their hearing peers in a typical flanker task ( Holmer et al., 2020 ). Chen et al. (2010) used a paradigm with three conditions: congruency, the distance of the distractor (central or peripheral), and screen proximity (typical computer screen or projected onto a wall) and found that deaf adults showed greater interference from peripheral distractors compared to central cues. This effect was reversed when the display was projected onto a wall. Hauthal et al. (2012) designed a paradigm where participants had to discern the gender of a central target while faces appeared as distractors at the flanks. The faces could either match or differ in gender from the target, creating interference. The study revealed that with a high volume of distractors, adult deaf signers without CI still showed interference effects while hearing adults did not.

Regarding our secondary objective, to explore any differences observed among deaf individuals in relation to variables concerning hearing loss history, device use and mode of communication, very few studies examined adults with CI (see Table 4 ), possibly due to the relative novelty of the technology ( Wilson and Dorman, 2008 ). The few studies that included adults with CI did not find any effect of implantation in tonic alerting ( Kronenberger et al., 2013 ; Bharadwaj et al., 2020 ). The rest of the findings will be discussed below along with the results of studies in children.

Table 4 . Basic deaf related variables regarding auditory access and system of communication.

3.3 Development of attention networks and comparison between deaf and full hearing children

With respect to our third and final objective, we found one longitudinal study and four studies that either compared groups across different ages or treated age as a continuous independent variable. In deaf individuals, tonic alerting was observed to develop between 6 and 13 years of age ( Dye and Hauser, 2014 ; Dye and Terhune-Cotter, 2023 ). With exogenous orienting, the only result found was that the fundamental operations of moving and engaging develop from 6 to 7 years of age ( Daza and Phillips-Silver, 2013 ). Lastly, executive attention appears to develop around 8 years of age in deaf individuals ( Dye and Hauser, 2014 ). As mentioned before, comparisons between differences between individuals with and without CIs and different systems of communication were almost exclusive to studies with children. When comparing deaf and typical hearing children, greater challenges in tonic alertness were evident in speaking deaf children with CI ( Yucel and Derim, 2008 ; Hoffman et al., 2018 ), but not in deaf signers without CI ( Dye and Hauser, 2014 ). Regarding phasic alertness, Daza and Phillips-Silver (2013) found a greater alerting effect in the ANT when comparing oral deaf children with CI and deaf signers without CI. Daza and Phillips-Silver (2013) also found faster movement and engagement in a spatial orienting paradigm when comparing deaf signers without CI to oral deaf children with CI. However, in endogenous orienting, an advantage was found in deaf children (independent of the system of communication) when a social central cue was employed ( Pavani et al., 2019 ). When measuring executive attention with a flanker task, no differences were found between deaf children (mostly speaking with CI) and hearing children ( Daza and Phillips-Silver, 2013 ; Daza González et al., 2021 ) except for Merchán et al. (2022) who observed poorer performance in deaf children. Dye and Hauser (2014) , examining the effect of distractors on a central target with a focus on the difference in performance on two CPTs, found that deaf signers without CI showed poorer performance than their full hearing counterparts.

4 Discussion

4.1 current frequency of studies and tasks used.

As observed, there exist notable gaps in our understanding of the visual attention network in deaf individuals, with research focusing on different functions depending on the age of the participants. While tonic alerting has been extensively researched in both adult and youth deaf populations, primarily through CPTs, the exploration of phasic alerting remains scarce in both groups. Notably, only one study in adults has investigated phasic alerting, emerging as an unexpected result from a cost and benefit paradigm measuring orienting behavior ( Prasad et al., 2022 ).

Similarly, concerning the orienting network, while there is a wide range of research on exogenous orienting in deaf adults, few studies have tested these differences in deaf children ( Daza and Phillips-Silver, 2013 ). Moreover, endogenous attention has been underexplored in both age groups.

Regarding executive attention, there appears to be a more balanced interest across developmental stages, primarily through flanker tasks in children and a broader range of conflict tasks in deaf adults. This is likely due to the fact that flanker tasks have been previously studied in deaf adults prior to the scope of this review ( Sladen et al., 2005 ; Dye et al., 2009 ).

From these observations, it becomes evident that there is a critical need to delve deeper into the exploration of phasic alerting and endogenous orienting of attention, particularly in deaf and hard of hearing children. This need arises from the potential existence of adaptive developmental aspects in visual attention that warrant further investigation.

4.2 Results of comparisons between deaf and hearing adults

The results in deaf adults seem to indicate a deficit in the tonic alerting network, which can be explained by several hypotheses. One possibility is that deaf individuals have difficulties in sustaining attention over time, possibly due to a more rapid depletion of attentional resources. To test this hypothesis, investigating how performance changes over the course of a task could provide insights into whether there is a faster decline in performance or a general difficulty in executing the task. While Hoffman et al. (2018) attempted to analyse this aspect, they focused exclusively on children, which will be discussed below. Another hypothesis emerges from the division of labor perspective, which supports the deficit view. According to this notion, the observed results may be due to the need for deaf individuals to rely on vision to simultaneously monitor their environment and focus on a specific task. This dual demand on attentional resources might limit the resources available for performing visual tasks such as the CPT ( Smith et al., 1998 ; Quittner et al., 2004 ).

Normally, phasic alerting is primarily dependent on the auditory system. Therefore, in adults, it would be reasonable to expect that adaptive mechanisms could lead to a heightened state of alert generated by visual cues, as demonstrated in the experiment conducted by Prasad et al. (2022) .

The overall advantage observed in spatial exogenous orienting in deaf adults appears to be attributable to covert orienting rather than overt orienting/ eye movements ( Prasad et al., 2015 ; Brazão et al., 2021 ; Prasad et al., 2022 ). This supports the notion of an adaptive alteration in the visual attention system in deaf individuals. This adaptation enables them to monitor the environment since they are able to efficiently shift their attentional focus across the visual field towards important stimuli and also disengage from them more rapidly.

The mechanisms governing orienting of attention or eye movements have been shown to be more dependent on endogenous attention, which could explain why the differences between deaf and full hearing individuals do not extend to the results of these tasks ( Zangrossi et al., 2021 ; Celli et al., 2022 ). Endogenous orienting does not differ between deaf and typical hearing adults, whether measured by visual search ( Heimler et al., 2015a ) or spatial orienting paradigms using central cues ( Heimler et al., 2015b ; Bonmassar et al., 2021 ; Li et al., 2022 ). One explanation for this result is that endogenous orienting of attention requires voluntary control of attention (top-down), while exogenous attention is an involuntary mechanism (bottom-up), as some results indicated that deaf individuals could have worse executive control, possibly explaining the lack of differences in these tasks ( Li et al., 2022 ). However, as we have found in this review, deficits in executive control are not common in adults or native signers, contrary to the results found in orienting. Another possible explanation for this discrepancy is that this function does not show differences since it is not inherently adaptative. In contrast, the improvements observed in exogenous orienting could stem from the need to monitor environmental changes using only the visual system, without the support of the auditory system. On the other hand, attention shifts due to endogenous attention could be distracting for deaf individuals required to maintain a strong focus on hands and facial expressions during conversations.

Regarding executive function, no differences were found in a typical flanker task ( Holmer et al., 2020 ). However, when distractors were placed in the periphery instead of the centre, deaf individuals showed poorer performance compared to their hearing peers ( Chen et al., 2010 ). These contradictory results seem to support the hypothesis that the observed performance deficits in conflict tasks with central targets may not necessarily be due to deficits in executive attention. Instead, these findings could be due to the further allocation of attentional resources towards distractors in comparison to hearing individuals. This explanation is further supported when these results are compared to those of the UFOV tasks, where both targets and distractors are located in the periphery. In these tasks, deaf individuals tend to have an advantage ( Dye et al., 2016 ; Samar and Berger, 2017 ). However, the findings of Hauthal et al. (2012) could indicate an adaptive change specifically in the processing of faces. These results suggest that the performance of signers without CI in executive attention tasks depends on the position of the target, which can be explained by the further allocation of attention towards the periphery. An alternative interpretation of these findings is that deaf adults may develop an advantage in the ventral attention network (VAN). The VAN is responsible for reflexive bottom-up attentional mechanisms and has been associated with exogenous orienting and phasic alerting This could potentially explain the observed benefits in both functions among deaf adults. In contrast, the dorsal attention network (DAN) governs voluntary or top-down attentional mechanisms and has been linked to endogenous orienting, tonic alerting, and executive functioning ( Corbetta and Shulman, 2002 ; Rueda et al., 2023 ). Apart from tonic alerting, it appears that deaf adults may not experience performance deficits relative to typical hearing controls in this pathway.

4.3 Findings of comparisons between deaf and hearing children

In children, the differences between deaf and typical hearing individuals vary according to age, suggesting that middle childhood is an important period of development for visual attention. Our review found that deaf children show worse scores in CPTs, which is argued as being indicative of a deficit in tonic alerting. However, contrary to this notion, Hoffman et al. (2018) found no differences in performance block by block between deaf and hearing children. This suggests that tonic alerting or vigilance may not be affected, but the difference in performance is due to the division of labor, as mentioned previously. Furthermore, the poor performance during these tasks was characterized by high commission errors ( Yucel and Derim, 2008 ; Hoffman et al., 2018 ), which could be interpreted as poor inhibition or impulsivity. These findings have been replicated with other paradigms that measure response inhibition, such as the Go/No Go or Simon tasks ( Figueras et al., 2008 ; Botting et al., 2017 ; Hall et al., 2018 ).

The results reported by Daza and Phillips-Silver (2013) , indicating higher phasic alerting and faster exogenous orienting, could potentially suggest a benefit due to the lack of auditory stimulation. However, these results have not been directly compared with those of hearing children. We must also consider that the differences in endogenous attention found by Pavani et al. (2019) can only be interpreted in the context of gaze cues, since there is evidence that other (non-gaze) directional cues rely on different processes ( Heimler et al., 2015b ). Consequently, there is insufficient experimental data on orienting in deaf children in comparison to their hearing counterparts, which prevents us from drawing any firm conclusions in this regard.

Concerning executive attention, discrepancies between the results of Dye and Hauser (2014) and Merchán et al. (2022) and those of Daza González et al. (2021) could be due to differences in the sample, specifically in terms of age, since the latter study focused on children aged 9 to 10 years. As observed in adults, deaf children show no difference in UFOV task performance between the ages of 7 and 10 years. In fact, their performance surpasses that of their hearing peers between the ages of 11 and 17 ( Dye et al., 2009 ; Dye and Bavelier, 2010 ). This discrepancy in performance might manifest as a reduced ability to ignore distractors when they are at the periphery and the target is in the centre of the visual field. Notably, this difference disappears when the target is also positioned in the periphery, supporting the hypothesis that attentional resources are allocated toward the periphery.

In general, we can conclude that, as expected, the findings have revealed improved performance of deaf individuals in tasks related to covert exogenous orienting, with limited impact on endogenous orienting in adults. However, deaf individuals show poorer execution of tasks involving tonic alertness and executive attention, except when the target is presented peripherally. These results are consistent with much of the clinical literature in deaf individuals ( Barker et al., 2009 ) and support the integrative hypothesis suggesting a deficiency in the temporal distribution of attention and an enhancement in spatial distribution ( Dye and Bavelier, 2010 ). Finally, from the perspective of the attention network model, our study highlights the need to further explore phasic alerting. Currently, there is a gap in research exploring differences in exogenous and endogenous orienting between deaf and full hearing children and a lack of studies investigating the endogenous orienting network in deaf adults.

4.4 Development of attention network functions in deaf children

Regarding our objective of characterizing the development of attentional networks in middle childhood within the deaf population, several conclusions can be drawn. However, we must consider the need for further research in this area, particularly through longitudinal studies.

Our findings indicate that tonic alertness continues to develop from ages 6 to 13 in both deaf and typical hearing children ( Dye and Hauser, 2014 ; Dye and Terhune-Cotter, 2023 ). This aligns with previous research on typical hearing children using the same task, which showed a specific development ceiling at 10 years old ( Betts et al., 2006 ). However, it appears that deaf individuals do not reach the levels observed in typical hearing adults, at least those who are not native signers ( Bharadwaj et al., 2020 ).

The elemental operations of moving and engaging improve between the ages of 6 and 7 in deaf children ( Daza and Phillips-Silver, 2013 ). In comparison to hearing children, our results suggest that orienting networks continue to develop during middle childhood in deaf individuals, whereas in their hearing counterparts, this development tends to plateau at around 6 years old ( Rueda et al., 2004 ; Pozuelos et al., 2014 ; Federico et al., 2017 ). Notably, this development in deaf individuals appears to extend into adulthood, providing them with an advantage over typical hearing adults. Interestingly, when measuring electrophysiological brain activity through evoked potentials, improvements in visual attention related to saliency processing and orienting of attention have been observed as early as 3 years of age. These measures demonstrate improvement during the early years in deaf children, indicating early and differential development of these components of attention ( Campbell and Sharma, 2016 ; de Schonen et al., 2018 ; Gabr et al., 2022 ; Corina et al., 2024 ).

Finally, executive attention seems to improve between 7 and 9 years of age in deaf children. Dye and Hauser (2014) found that deaf signers without CI reach the same levels of performance between 9 and 13 years old. However, Daza González et al. (2021) found no differences among children aged 9–10, while Merchán et al. (2022) observed worse performance in a sample of 7–10 years old. These findings are consistent with those reported in studies of typical hearing children, suggesting that difficulties found in this aspect of the attention network cannot be solely attributed to late development ( Rueda et al., 2004 ; Pozuelos et al., 2014 ; Federico et al., 2017 ). When comparing deaf and hearing adults, it is plausible that deaf individuals continue to show development in exogenous orienting during early childhood, eventually achieving better performance than their hearing counterparts ( Bottari et al., 2012 ; Prasad et al., 2015 ). In adulthood, deaf signers without CI reach similar levels in executive attention when central targets are present ( Chen et al., 2010 ; Holmer et al., 2020 ). However, differences in tonic alertness may persist into adulthood ( Parasnis et al., 2003 ; Kronenberger et al., 2013 ).

4.5 Effects of the communication system and the use of cochlear implants

In most studies, the use of sign language is associated with the absence of a CI. It is important to recognize the clear distinction between culturally deaf people who communicate mainly in sign language within deaf communities and those who have received CI along with speech therapy. The latter group has experienced some level of auditory input and uses a language that is less reliant on visual cues.

In adults, there are no studies on tonic alertness involving deaf signers without CI. However, age at CI implantation does not seem to have an impact on CPT performance ( Kronenberger et al., 2013 ; Bharadwaj et al., 2020 ). While no differences were observed between deaf signers without CI and full hearing children ( Dye and Hauser, 2014 ), differences have been found in oral-speaking deaf children with CI ( Yucel and Derim, 2008 ; Hoffman et al., 2018 ). Additionally, Daza and Phillips-Silver (2013) found differences in tonic alertness between oral speaking deaf children with CI and deaf signers without CI in favor of the former. Dye and Terhune-Cotter (2023) found that while the English language was a strong predictor of better sustained attention, ASL proficiency was a more accurate predictor of response inhibition.

Generally speaking, these findings suggest a consistent trend toward poorer performance on tonic alerting tasks in oral speaking deaf individuals. Notably, the lack of an effect of age of implantation in adults raises the possibility that early language acquisition does not influence these outcomes. Regarding exogenous orienting, it is evident that elementary operations of orienting such as moving and engaging are enhanced in deaf signers without CI compared to oral speaking deaf individuals with CI ( Daza and Phillips-Silver, 2013 ). Additionally, the advantage observed in executive attention towards peripheral targets in adults appears to be more prevalent among deaf signers without CI ( Samar and Berger, 2017 ), while in children these improvements have also been found in deaf signers without CI ( Dye et al., 2009 ).

These findings align with the main hypothesis put forward to explain differences in performance on tasks that measure different executive functions in deaf people and could also be applied to these results, that is, worse performance can be attributed to late acquisition of language ( Hall et al., 2017 , 2018 ; Merchán et al., 2022 ). This explanation has commonly been invoked when attempting to explain performance on executive function tasks, but as observed in this review, tonic alertness also appears to be affected. However, an adaptive form of development is evident when executive attention is directed toward the periphery in deaf signers without CI who lack auditory stimulation and have delayed acquisition of language ( Dye et al., 2009 ; Samar and Berger, 2017 ). Unfortunately, there is insufficient evidence to conclusively establish the impact of these variables on phasic alertness, endogenous orienting, and executive attention.

5 Conclusion

In summary, there are notable gaps in the literature regarding the functions of visual attention networks, specifically in the alerting network functions in adults, phasic alerting, and both orienting networks in children. Current evidence suggests that deaf adults show poorer performance during CPTs, but this might not necessarily be attributed to deficits in tonic alerting. Phasic alerting, on the other hand, appears to confer advantages in deaf adults. Exogenous orienting shows enhancements, whereas endogenous orienting does not. Additionally, differences in executive attention are evident, particularly depending on the peripheral placement of the distractors. In children, the evidence reveals similar patterns of results, with the exception that difficulties in executive attention are observed before the ages of 9 or 10.

Regarding individual differences in language delay and the use of CI, it seems that benefits in exogenous orienting are more frequent in deaf individuals without CI and users of sign language while language abilities appear to be a good predictor of difficulties in executive attention. This understanding contributes to the growing body of knowledge in the field, emphasizing the need for further research to bridge the identified gaps and refine our comprehension of the intricate development of visual attention networks in the deaf population.

Data availability statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

Author contributions

NG: Writing – original draft, Methodology, Investigation. JP-S: Supervision, Conceptualization, Writing – review & editing. MD: Writing – original draft, Supervision, Writing – review & editing, Funding acquisition, Conceptualization.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by a grant PID2019-111454RB-I00/AEI/10.13039/501100011033 from Spanish Ministry of Science and Innovation—Spanish State Research Agency, to the last author.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

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Baijot, S., Deconinck, N., Slama, H., Massat, I., and Colin, C. (2013). Behavioral and neurophysiological study of attentional and inhibitory processes in ADHD-combined and control children. Acta Neurol. Belg. 113, 477–485. doi: 10.1007/s13760-013-0219-1

Crossref Full Text | Google Scholar

Barker, D. H., Quittner, A. L., Fink, N. E., Eisenberg, L. S., Tobey, E. A., Niparko, J. K., et al. (2009). Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev. Psychopathol. 21, 373–392. doi: 10.1017/S0954579409000212

Bavelier, D., Brozinsky, C., Tomann, A., Mitchell, T., Neville, H., and Liu, G. (2001). Impact of early deafness and early exposure to sign language on the cerebral organization for motion processing. J. Neurosci. 21, 8931–8942. doi: 10.1523/JNEUROSCI.21-22-08931.2001

Bavelier, D., Dye, M. W., and Hauser, P. C. (2006). Do deaf individuals see better? Trends Cogn. Sci. 10, 512–518. doi: 10.1016/j.tics.2006.09.006

Beane, M., and Marrocco, R. (2004). “Cholinergic and noradrenergic inputs to the posterior parietal cortex modulate the components of exogenous attention” in Cognitive Neuroscience of Attention . ed. M. I. Posner (New York, NY, USA: The Guilford Press), 313–325.

Google Scholar

Benetti, S., Van Ackeren, M. J., Rabini, G., Zonca, J., Foa, V., Baruffaldi, F., et al. (2017). Functional selectivity for face processing in the temporal voice area of early deaf individuals. Proc. Natl. Acad. Sci. USA 114, E6437–E6446. doi: 10.1073/pnas.1618287114

Betts, J., McKay, J., Maruff, P., and Anderson, V. (2006). The development of sustained attention in children: the effect of age and task load. Child Neuropsychol. 12, 205–221. doi: 10.1080/09297040500488522

Bharadwaj, S. V., Matzke, P. L., and Maricle, D. (2020). Effects of longstanding degraded auditory signal on visuospatial, visuomotor, and visual attention skills in adults with hearing loss. Cochlear Implants Int. 22, 17–28. doi: 10.1080/14670100.2020.1799151

Bola, Ł., Zimmermann, M., Mostowski, P., Jednoróg, K., Marchewka, A., Rutkowski, P., et al. (2017). Task-specific reorganization of the auditory cortex in deaf humans. Proc. Natl. Acad. Sci. USA 114, E600–E609. doi: 10.1073/pnas.1609000114

Bonmassar, C., Pavani, F., Di Renzo, A., Caselli, M. C., and van Zoest, W. (2021). Eye-movement patterns to social and non-social cues in early deaf adults. Q. J. Exp. Psychol. 74, 1021–1036. doi: 10.1177/1747021821998511

Bottari, D., Heimler, B., Caclin, A., Dalmolin, A., Giard, M. H., and Pavani, F. (2014). Visual change detection recruits auditory cortices in early deafness. NeuroImage 94, 172–184. doi: 10.1016/j.neuroimage.2014.02.031

Bottari, D., Nava, E., Ley, P., and Pavani, F. (2010). Enhanced reactivity to visual stimuli in deaf individuals. Restor. Neurol. Neurosci. 28, 167–179. doi: 10.3233/RNN-2010-0502

Bottari, D., Turatto, M., Bonfioli, F., Abbadessa, C., Selmi, S., Beltrame, M. A., et al. (2008). Change blindness in profoundly deaf individuals and cochlear implant recipients. Brain Res. 1242, 209–218. doi: 10.1016/j.brainres.2008.05.041

Bottari, D., Valsecchi, M., and Pavani, F. (2012). Prominent reflexive eye-movement orienting associated with deafness. Cogn. Neurosci. 3, 8–13. doi: 10.1080/17588928.2011.578209

Botting, N., Jones, A., Marshall, C., Denmark, T., Atkinson, J., and Morgan, G. (2017). Nonverbal executive function is mediated by language: a study of deaf and hearing children. Child Dev. 88, 1689–1700. doi: 10.1111/cdev.12659

Botvinick, M. M., Braver, T. S., Barch, D. M., Carter, C. S., and Cohen, J. D. (2001). Conflict monitoring and cognitive control. Psychol. Rev. 108, 624–652. doi: 10.1037/0033-295X.108.3.624

Brazão, P., Ribeiro, F., Castro-Caldas, A., Nunes, V., and Mineiro, A. (2021). Exogenous orientation of attention in congenitally deaf individuals. Psychol. Neurosci. 14, 173–182. doi: 10.1037/pne0000232

Campbell, J., and Sharma, A. (2016). Visual cross-modal re-organization in children with cochlear implants. PLoS One 11:e0147793. doi: 10.1371/journal.pone.0147793

Celli, M., Mazzonetto, I., Zangrossi, A., Bertoldo, A., Cona, G., and Corbetta, M. (2022). One-year-later spontaneous EEG features predict visual exploratory human phenotypes. Commun Biol 5:1361. doi: 10.1038/s42003-022-04294-9

PubMed Abstract | Crossref Full Text | Google Scholar

Chen, Q., He, G., Chen, K., Jin, Z., and Mo, L. (2010). Altered spatial distribution of visual attention in near and far space after early deafness. Neuropsychologia 48, 2693–2698. doi: 10.1016/j.neuropsychologia.2010.05.016

Chen, Q., Zhang, M., and Zhou, X. (2006). Spatial and nonspatial peripheral auditory processing in congenitally blind people. Neuroreport 17, 1449–1452. doi: 10.1097/01.wnr.0000233103.51149.52

Chica, A. B., Martín-Arévalo, E., Botta, F., and Lupiáñez, J. (2014). The Spatial Orienting paradigm: how to design and interpret spatial attention experiments. Neurosci. Biobehav. Rev. 40, 35–51. doi: 10.1016/j.neubiorev.2014.01.002

Codina, C., Buckley, D., Port, M., and Pascalis, O. (2011). Deaf and hearing children: a comparison of peripheral vision development. Dev. Sci. 14, 725–737. doi: 10.1111/j.1467-7687.2010.01017.x

Codina, C. J., Pascalis, O., Baseler, H. A., Levine, A. T., and Buckley, D. (2017). Peripheral visual reaction time is faster in deaf adults and British Sign Language interpreters than in hearing adults. Front. Psychol. 8:50. doi: 10.3389/fpsyg.2017.00050

Colmenero, J. M., Catena, A., Fuentes, L. J., and Ramos, M. M. (2004). Mechanisms of visuospatial orienting in deafness. Eur. J. Cogn. Psychol. 16, 791–805. doi: 10.1080/09541440340000312

Corbetta, M., and Shulman, G. L. (2002). Control of goal-directed and stimulus-driven attention in the brain. Nat. Rev. Neurosci. 3, 201–215. doi: 10.1038/nrn755

Corina, D. P., Coffey-Corina, S., Pierotti, E., Mankel, K., and Miller, L. M. (2024). Electrophysiological study of visual processing in children with cochlear implants. Neuropsychologia 194:108774. doi: 10.1016/j.neuropsychologia.2023.108774

Daza González, M. T., Phillips-Silver, J., López Liria, R., Gioiosa Maurno, N., Fernández García, L., and Ruiz-Castañeda, P. (2021). Inattention, Impulsivity, and Hyperactivity in Deaf Children Are Not Due to Deficits in Inhibitory Control, but May Reflect an Adaptive Strategy. Front. Psychol. 12, 1–10. doi: 10.3389/fpsyg.2021.629032

Daza, M. T., and Phillips-Silver, J. (2013). Development of attention networks in deaf children: Support for the integrative hypothesis. Res. Dev. Disabil. 34, 2661–2668. doi: 10.1016/j.ridd.2013.05.012

de Schonen, S., Bertoncini, J., Petroff, N., Couloigner, V., and Van Den Abbeele, T. (2018). Visual cortical activity before and after cochlear implantation: A follow up ERP prospective study in deaf children. Int. J. Psychophysiol. 123, 88–102. doi: 10.1016/j.ijpsycho.2017.10.009

Dye, M. W. G. (2014). Temporal entrainment of visual attention in children: Effects of age and deafness. Vis. Res. 105, 29–36. doi: 10.1016/j.visres.2014.09.001

Dye, M. W. G., and Bavelier, D. (2010). Attentional enhancements and deficits in deaf populations: an integrative review. Restor. Neurol. Neurosci. 28, 181–192. doi: 10.3233/RNN-2010-0501

Dye, M. W. G., and Hauser, P. C. (2014). Sustained attention, selective attention and cognitive control in deaf and hearing children. Hear. Res. 309, 94–102. doi: 10.1016/j.heares.2013.12.001

Dye, M. W. G., Hauser, P. C., and Bavelier, D. (2009). Is visual selective attention in deaf individuals enhanced or deficient? The case of the useful field of view. PLoS One 4:5640. doi: 10.1371/journal.pone.0005640

Dye, M. W. G., Seymour, J. L., and Hauser, P. C. (2016). Response bias reveals enhanced attention to inferior visual field in signers of American Sign Language. Exp. Brain Res. 234, 1067–1076. doi: 10.1007/s00221-015-4530-3

Dye, M. W. G., and Terhune-Cotter, B. (2023). Development of visual sustained selective attention and response inhibition in deaf children. Mem. Cogn. 51, 509–525. doi: 10.3758/s13421-022-01330-1

Fan, J., McCandliss, B. D., Fossella, J., Flombaum, J. I., and Posner, M. I. (2005). The activation of attentional networks. NeuroImage 26, 471–479. doi: 10.1016/j.neuroimage.2005.02.004

Fan, J., McCandliss, B. D., Sommer, T., Raz, A., and Posner, M. I. (2002). Testing the efficiency and independence of attentional networks. J. Cogn. Neurosci. 14, 340–347. doi: 10.1162/089892902317361886

Fan, J., Raz, A., and Posner, M. I. (2003). “Attentional mechanisms” in Encyclopedia of Neurological Sciences . eds. M. J. Aminoff and R. B. Daroff (New York: Elsevier Science), 92–299.

Federico, F., Marotta, A., Martella, D., and Casagrande, M. (2017). Development in attention functions and social processing: Evidence from the Attention Network Test. Br. J. Dev. Psychol. 35, 169–185. doi: 10.1111/bjdp.12154

Figueras, B., Edwards, L., and Langdon, D. (2008). Executive function and language in deaf children. J. Deaf. Stud. Deaf. Educ. 13, 362–377. doi: 10.1093/deafed/enm067

Fine, I., Finney, E. M., Boynton, G. M., and Dobkins, K. R. (2005). Comparing the effects of auditory deprivation and sign language within the auditory and visual cortex. J. Cogn. Neurosci. 17, 1621–1637. doi: 10.1162/089892905774597173

Gabr, T., Eldessouki, T., Hashem, A., Elgamal, S., and Zeinhom, M. (2022). Cochlear implants: visual evoked potentials study. Int. J. Pediatr. Otorhinolaryngol. 161:111250. doi: 10.1016/j.ijporl.2022.111250

Hall, M. L., Eigsti, I. M., Bortfeld, H., and Lillo-Martin, D. (2017). Auditory deprivation does not impair executive function, but language deprivation might: evidence from a parent-report measure in deaf native signing children. J. Deaf. Stud. Deaf. Educ. 22, 9–21. doi: 10.1093/deafed/enw054

Hall, M. L., Eigsti, I. M., Bortfeld, H., and Lillo-Martin, D. (2018). Executive function in deaf children: Auditory access and language access. J. Speech Lang. Hear. Res. 61, 1970–1988. doi: 10.1044/2018_JSLHR-L-17-0281

Hauthal, N., Neumann, M. F., and Schweinberger, S. R. (2012). Attentional spread in deaf and hearing participants: face and object distractor processing under perceptual load. Atten. Percept. Psychophys. 74, 1312–1320. doi: 10.3758/s13414-012-0320-1

Heimler, B., van Zoest, W., Baruffaldi, F., Donk, M., Rinaldi, P., Caselli, M. C., et al. (2015a). Finding the balance between capture and control: Oculomotor selection in early deaf adults. Brain Cogn. 96, 12–27. doi: 10.1016/j.bandc.2015.03.001

Heimler, B., van Zoest, W., Baruffaldi, F., Rinaldi, P., Caselli, M. C., and Pavani, F. (2015b). Attentional orienting to social and nonsocial cues in early deaf adults. J. Exp. Psychol. Hum. Percept. Perform. 41, 1758–1771. doi: 10.1037/xhp0000099

Herzog, R., Álvarez-Pasquin, M. J., Díaz, C., Del Barrio, J. L., Estrada, J. M., and Gil, Á. (2013). Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health 13:154. doi: 10.1186/1471-2458-13-154

Higgins, J. P. T., and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration. Available at: http://handbook-5-1.cochrane.org (Accessed April 30, 2024).

Hoffman, M., Tiddens, E., and Quittner, A. L. (2018). Comparisons of visual attention in school-age children with cochlear implants versus hearing peers and normative data. Hear. Res. 359, 91–100. doi: 10.1016/j.heares.2018.01.002

Holmer, E., Rudner, M., Schönström, K., and Andin, J. (2020). Evidence of an effect of gaming experience on visuospatial attention in deaf but not in hearing individuals. Front. Psychol. 11:534741. doi: 10.3389/fpsyg.2020.534741

Jayaraman, S., Klein, R. M., Hilchey, M. D., Patil, G. S., and Mishra, R. K. (2016). Spatial gradients of oculomotor inhibition of return in deaf and normal adults. Exp. Brain Res. 234, 323–330. doi: 10.1007/s00221-015-4439-x

Jonides, J. (1981). “Voluntary versus automatic control over the mind’s eye’s movement” in Attention and Performance XI . eds. J. Long and A. Baddeley (Hillsdale, NJ: Lawrence Erlbaum), 187–283.

Kronenberger, W. G., Pisoni, D. B., Henning, S. C., and Colson, B. G. (2013). Executive functioning skills in long-term users of cochlear implants: A case control study. J. Pediatr. Psychol. 38, 902–914. doi: 10.1093/jpepsy/jst034

Li, Y., Luo, M., Zhang, X., and Wang, S. (2022). Effects of exogenous and endogenous cues on attentional orienting in deaf adults. Front. Psychol. 13:1038468. doi: 10.3389/fpsyg.2022.1038468

Loke, W. H., and Song, S. (1991). Central and peripheral visual processing in hearing and non-hearing individuals. Bull. Psychon. Soc. 29, 437–440. doi: 10.3758/BF03333964

Marrocco, R. T., and Davidson, M. C. (1998). “Neurochemistry of attention” in The Attentive Brain . ed. R. Parasuraman (Cambridge, MA, USA: The MIT Press), 35–50.

Matsumoto, K., and Tanaka, K. (2004). Conflict and Cognitive Control. Science 303, 969–970. doi: 10.1126/science.1094733

Mayberry, R. I., Chen, J. K., Witcher, P., and Klein, D. (2011). Age of acquisition effects on the functional organization of language in the adult brain. Brain Lang. 119, 16–29. doi: 10.1016/j.bandl.2011.05.007

Merchán, A., Fernández García, L., Gioiosa Maurno, N., Ruiz Castañeda, P., and Daza González, M. T. (2022). Executive functions in deaf and hearing children: The mediating role of language skills in inhibitory control. J. Exp. Child Psychol. 218:105374. doi: 10.1016/j.jecp.2022.105374

Mitchell, T. V., and Quittner, A. L. (1996). Multimethod study of attention and behavior problems in hearing-impaired children. J. Clin. Child Psychol. 25, 83–96. doi: 10.1207/s15374424jccp2501_10

Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., and Howerter, A. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. Cogn. Psychol. 41, 49–100. doi: 10.1006/cogp.1999.0734

Moher, D., Liberati, A., Tetzlaff, J., and Altman, D. G. PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6:e1000097. doi: 10.1371/journal.pmed.1000097

Neville, H. J., and Lawson, D. (1987). Attention to central and peripheral visual space in a movement detection task. III. Separate effects of auditory deprivation and acquisition of a visual language. Brain Res. 405, 253–294. doi: 10.1016/0006-8993(87)90297-6

O’Craven, K. M., Rosen, B. R., Kwong, K. K., Treisman, A., and Savoy, R. L. (1997). Voluntary attention modulates fMRI activity in human MT-MST. Neuron 18, 591–598. doi: 10.1016/s0896-6273(00)80300-1

Orton, S., Jones, L. L., Cooper, S., Lewis, S., and Coleman, T. (2014). Predictors of children’s secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence. PLoS One 9:e112690. doi: 10.1371/journal.pone.0112690

Parasnis, I., Samar, V. J., and Berent, G. P. (2003). Deaf adults without attention deficit hyperactivity disorder display reduced perceptual sensitivity and elevated impulsivity on the Test of Variables of Attention (T.O.V.A.). J. Speech Lang. Hearing Res. 46, 1166–1183. doi: 10.1044/1092-4388(2003/091)

Pavani, F., Venturini, M., Baruffaldi, F., Caselli, M. C., and van Zoest, W. (2019). Environmental learning of social cues: evidence from enhanced gaze cueing in deaf children. Child Dev. 90, 1525–1534. doi: 10.1111/cdev.13284

Petersen, S. E., and Posner, M. I. (2012). The attention system of the human brain: 20 years after. Annu. Rev. Neurosci. 35, 73–89. doi: 10.1146/annurev-neuro-062111-150525

Posner, M. I. (1980). Orienting of attention. Q. J. Exp. Psychol. 32, 3–25. doi: 10.1080/00335558008248231

Posner, M. I. (2016). Orienting of attention: then and now. Q. J. Exp. Psychol. 69, 1864–1875. doi: 10.1080/17470218.2014.937446

Posner, M. I., and DiGirolamo, G. J. (1998). “Executive attention: conflict, target detection, and cognitive control” in The Attentive Brain . ed. R. Parasuraman (Cambridge, MA: MIT Press).

Posner, M. I., and Rothbart, M. K. (2007). Research on attention networks as a model for the integration of psychological science. Annu. Rev. Psychol. 58, 1–23. doi: 10.1146/annurev.psych.58.110405.085516

Pozuelos, J. P., Paz-Alonso, P. M., Castillo, A., Fuentes, L. J., and Rueda, M. R. (2014). Development of attention networks and their interactions in childhood. Dev. Psychol. 50, 2405–2415. doi: 10.1037/a0037469

Prasad, S. G., Patil, G. S., and Mishra, R. K. (2015). Effect of exogenous cues on covert spatial orienting in deaf and normal hearing individuals. PLoS One 10:e0141324. doi: 10.1371/journal.pone.0141324

Prasad, S., Patil, G. S., Somashekarappa, V., and Mishra, R. K. (2022). Attention capture by brief abrupt-onset cues in deaf individuals. Neuropsychologia 167:108157. doi: 10.1016/j.neuropsychologia.2022.108157

Proksch, J., and Bavelier, D. (2002). Changes in the spatial distribution of visual attention after early deafness. J. Cogn. Neurosci. 14, 687–701. doi: 10.1162/08989290260138591

Quittner, A. L., Leibach, P., and Marciel, K. (2004). The impact of cochlear implants on young deaf children. Arch. Otolaryngol. Head Neck Surg. 130:547. doi: 10.1001/archotol.130.5.547

Rueda, M. R., Fan, J., McCandliss, B. D., Halparin, J. D., Gruber, D. B., Lercari, L. P., et al. (2004). Development of attentional networks in childhood. Neuropsychologia 42, 1029–1040. doi: 10.1016/j.neuropsychologia.2003.12.012

Rueda, M. R., Moyano, S., and Rico-Picó, J. (2023). Attention: The grounds of self-regulated cognition. Wiley interdisciplinary reviews. Cogn. Sci. 14:e1582. doi: 10.1002/wcs.1582

Samar, V. J., and Berger, L. (2017). Does a flatter general gradient of visual attention explain peripheral advantages and central deficits in deaf adults? Front. Psychol. 8:713. doi: 10.3389/fpsyg.2017.00713

Seymour, J. L., Low, K. A., Maclin, E. L., Chiarelli, A. M., Mathewson, K. E., Fabiani, M., et al. (2017). Reorganization of neural systems mediating peripheral visual selective attention in the deaf: an optical imaging study. Hear. Res. 343, 162–175. doi: 10.1016/j.heares.2016.09.007

Simon, J. R., and Craft, J. L. (1970). Effects of altered display-control relationships on information processing from a visual display. J. Appl. Psychol. 54, 253–257. doi: 10.1037/h0029083

Sladen, D. P., Tharpe, A. M., Ashmead, D. H., Wesley Grantham, D., and Chun, M. M. (2005). Visual attention in deaf and typical hearing adults: effects of stimulus compatibility. J. Speech Lang. Hearing Res. 48, 1529–1537. doi: 10.1044/1092-4388(2005/106)

Smith, L. B., Quittner, A. L., Osberger, M. J., and Miyamoto, R. (1998). Audition and visual attention: the developmental trajectory in deaf and hearing populations. Dev. Psychol. 34, 840–850. doi: 10.1037//0012-1649.34.5.840

Stevens, C., and Neville, H. (2006). Neuroplasticity as a double-edged sword: Deaf enhancements and dyslexic deficits in motion processing. J. Cogn. Neurosci. 18, 701–714. doi: 10.1162/jocn.2006.18.5.701

Sturm, W., and Willmes, K. (2001). On the functional neuroanatomy of intrinsic and phasic alertness. NeuroImage 14, S76–S84. doi: 10.1006/nimg.2001.0839

Thakur, R., Jayakumar, J., and Pant, S. (2019). Visual defects in hearing-challenged schoolchildren from Ludhiana, Punjab. Indian J. Otol. 25, 18–21. doi: 10.4103/indianjotol.INDIANJOTOL_95_18

Tharpe, A. M., Ashmead, D. H., and Rothpletz, A. M. (2002). Visual attention in children with typical hearing, children with hearing aids, and children with cochlear implants. J. Speech Lang. Hear. Res. 45, 403–413. doi: 10.1044/1092-4388(2002/032)

Tharpe, A. M., Ashmead, D., Sladen, D. P., Ryan, H. A. M., and Rothpletz, A. M. (2008). Visual attention and hearing loss: past and current perspectives. J. Am. Acad. Audiol. 19, 741–747. doi: 10.3766/jaaa.19.10.2

Uncapher, M. R., Hutchinson, J. B., and Wagner, A. D. (2011). Dissociable effects of top-down and bottom-up attention during episodic encoding. J. Neurosci. 31:12613 LP – 12628. doi: 10.1523/JNEUROSCI.0152-11.2011

Wells, G., Shea, B., O’Connell, D., Peterson, J., Welch, V., Losos, M., et al. (2021). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses . Ottawa: The Ottawa Hospital Research Institute.

Wilson, B. S., and Dorman, M. F. (2008). Cochlear implants: a remarkable past and a brilliant future. Hear. Res. 242, 3–21. doi: 10.1016/j.heares.2008.06.005

Xingjuan, L., Yang, Z., and Ming, Z. (2011). Location-based inhibition of return of the congenitally deaf people in detection tasks. Psychol. Sci. (China) 34, 558–564.

Yucel, E., and Derim, D. (2008). The effect of implantation age on visual attention skills. Int. J. Pediatr. Otorhinolaryngol. 72, 869–877. doi: 10.1016/j.ijporl.2008.02.017

Zangrossi, A., Cona, G., Celli, M., Zorzi, M., and Corbetta, M. (2021). Visual exploration dynamics are low-dimensional and driven by intrinsic factors. Commun Biol 4:1100. doi: 10.1038/s42003-021-02608-x

Keywords: deaf, children, attention, hearing, orienting, review methodology, investigation

Citation: Gioiosa Maurno N, Phillips-Silver J and Daza González MT (2024) Research of visual attention networks in deaf individuals: a systematic review. Front. Psychol . 15:1369941. doi: 10.3389/fpsyg.2024.1369941

Received: 13 January 2024; Accepted: 22 April 2024; Published: 09 May 2024.

Reviewed by:

Copyright © 2024 Gioiosa Maurno, Phillips-Silver and Daza González. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: María Teresa Daza González, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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New treatment could reverse hair loss caused by an autoimmune skin disease

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Researchers at MIT, Brigham and Women’s Hospital, and Harvard Medical School have developed a potential new treatment for alopecia areata, an autoimmune disorder that causes hair loss and affects people of all ages, including children.

For most patients with this type of hair loss, there is no effective treatment. The team developed a microneedle patch that can be painlessly applied to the scalp and releases drugs that help to rebalance the immune response at the site, halting the autoimmune attack.

In a study of mice, the researchers found that this treatment allowed hair to regrow and dramatically reduced inflammation at the treatment site, while avoiding systemic immune effects elsewhere in the body. This strategy could also be adapted to treat other autoimmune skin diseases such as vitiligo, atopic dermatitis, and psoriasis, the researchers say.

“This innovative approach marks a paradigm shift. Rather than suppressing the immune system, we’re now focusing on regulating it precisely at the site of antigen encounter to generate immune tolerance,” says Natalie Artzi, a principal research scientist in MIT’s Institute for Medical Engineering and Science, an associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, and an associate faculty member at the Wyss Institute of Harvard University.

Artzi and Jamil R. Azzi, an associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, are the senior authors of the new study , which appears in the journal Advanced Materials . Nour Younis, a Brigham and Women’s postdoc, and Nuria Puigmal, a Brigham and Women’s postdoc and former MIT research affiliate, are the lead authors of the paper.

The researchers are now working on launching a company to further develop the technology, led by Puigmal, who was recently awarded a Harvard Business School Blavatnik Fellowship.

Direct delivery

Alopecia areata, which affects more than 6 million Americans, occurs when the body’s own T cells attack hair follicles, leading the hair to fall out. The only treatment available to most patients — injections of immunosuppressant steroids into the scalp — is painful and patients often can’t tolerate it.

Some patients with alopecia areata and other autoimmune skin diseases can also be treated with immunosuppressant drugs that are given orally, but these drugs lead to widespread suppression of the immune system, which can have adverse side effects.

“This approach silences the entire immune system, offering relief from inflammation symptoms but leading to frequent recurrences. Moreover, it increases susceptibility to infections, cardiovascular diseases, and cancer,” Artzi says.

A few years ago, at a working group meeting in Washington, Artzi happened to be seated next to Azzi (the seating was alphabetical), an immunologist and transplant physican who was seeking new ways to deliver drugs directly to the skin to treat skin-related diseases.

Their conversation led to a new collaboration, and the two labs joined forces to work on a microneedle patch to deliver drugs to the skin. In 2021, they reported that such a patch can be used to prevent rejection following skin transplant. In the new study, they began applying this approach to autoimmune skin disorders.

“The skin is the only organ in our body that we can see and touch, and yet when it comes to drug delivery to the skin, we revert to systemic administration. We saw great potential in utilizing the microneedle patch to reprogram the immune system locally,” Azzi says.

The microneedle patches used in this study are made from hyaluronic acid crosslinked with polyethylene glycol (PEG), both of which are biocompatible and commonly used in medical applications. With this delivery method, drugs can pass through the tough outer layer of the epidermis, which can’t be penetrated by creams applied to the skin.

“This polymer formulation allows us to create highly durable needles capable of effectively penetrating the skin. Additionally, it gives us the flexibility to incorporate any desired drug,” Artzi says. For this study, the researchers loaded the patches with a combination of the cytokines IL-2 and CCL-22. Together, these immune molecules help to recruit regulatory T cells, which proliferate and help to tamp down inflammation. These cells also help the immune system learn to recognize that hair follicles are not foreign antigens, so that it will stop attacking them.

Hair regrowth

The researchers found that mice treated with this patch every other day for three weeks had many more regulatory T cells present at the site, along with a reduction in inflammation. Hair was able to regrow at those sites, and this growth was maintained for several weeks after the treatment ended. In these mice, there were no changes in the levels of regulatory T cells in the spleen or lymph nodes, suggesting that the treatment affected only the site where the patch was applied.

In another set of experiments, the researchers grafted human skin onto mice with a humanized immune system. In these mice, the microneedle treatment also induced proliferation of regulatory T cells and a reduction in inflammation.

The researchers designed the microneedle patches so that after releasing their drug payload, they can also collect samples that could be used to monitor the progress of the treatment. Hyaluronic acid causes the needles to swell about tenfold after entering the skin, which allows them to absorb interstitial fluid containing biomolecules and immune cells from the skin.

Following patch removal, researchers can analyze samples to measure levels of regulatory T cells and inflammation markers. This could prove valuable for monitoring future patients who may undergo this treatment.

The researchers now plan to further develop this approach for treating alopecia, and to expand into other autoimmune skin diseases.

The research was funded by the Ignite Fund and Shark Tank Fund awards from the Department of Medicine at Brigham and Women’s Hospital.

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MIT researchers have developed microneedle patches that are capable of restoring hair growth in alopecia areata patients, reports Ernie Mundell for HealthDay . The team’s approach includes a, “patch containing myriad microneedles that is applied to the scalp,” writes Mundell. “It releases drugs to reset the immune system so it stops attacking follicles.” 

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Research: What Companies Don’t Know About How Workers Use AI

• Jeremie Brecheisen

Three Gallup studies shed light on when and why AI is being used at work — and how employees and customers really feel about it.

Leaders who are exploring how AI might fit into their business operations must not only navigate a vast and ever-changing landscape of tools, but they must also facilitate a significant cultural shift within their organizations. But research shows that leaders do not fully understand their employees’ use of, and readiness for, AI. In addition, a significant number of Americans do not trust business’ use of AI. This article offers three recommendations for leaders to find the right balance of control and trust around AI, including measuring how their employees currently use AI, cultivating trust by empowering managers, and adopting a purpose-led AI strategy that is driven by the company’s purpose instead of a rules-heavy strategy that is driven by fear.

If you’re a leader who wants to shift your workforce toward using AI, you need to do more than manage the implementation of new technologies. You need to initiate a profound cultural shift. At the heart of this cultural shift is trust. Whether the use case for AI is brief and experimental or sweeping and significant, a level of trust must exist between leaders and employees for the initiative to have any hope of success.

• Jeremie Brecheisen is a partner and managing director of The Gallup CHRO Roundtable.

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Vegetarian and vegan diets linked to lower risk of heart disease, cancer and death, large review finds

A plant-based diet is associated with a reduced risk of heart disease, cancer and death, according to a large-scale review published Wednesday. 

The research , which appears in the journal PLOS ONE, analyzed the results of nearly 50 studies published from 2000 to 2023.

The studies examined the health effects of either vegetarian diets or vegan regimens, which restrict any food derived from animals, including dairy.

A clear consensus emerged: Both eating patterns were associated with a lower risk of cancer and ischemic heart disease (heart problems caused by narrowed arteries). In particular, the diets seemed to reduce the risk of prostate cancer and gastrointestinal cancers like colon cancer. Vegetarian diets were also linked to a lower risk of dying from cardiovascular disease.

In addition, plant-based diets were associated with a reduction in risk factors for heart disease and cancer, including high body weight, inflammation and LDL or “bad” cholesterol. 

“This research shows, in general, that a plant-based diet can be beneficial, and taking small steps in that direction can make a difference,” said Matthew Landry, one of the review’s authors and an assistant professor of population health and disease prevention at the University of California, Irvine.

“You don’t have to go completely vegan to see some of these benefits,” he added. “Even reducing a day or two per week of animal-based consumption can have benefits over time.”

However, Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, pointed out that not everyone who follows a plant-based diet eats the same foods, so levels of healthiness still vary.

“A vegetarian diet could be based primarily on refined starches and sugar, which we see to be the worst dietary pattern,” Willett, who was not involved in the new research, said in an email. 

A healthy plant-based diet, he said, should consist mostly of whole grains, fruits, vegetables, nuts, soy, beans and non-hydrogenated plant oils. 

Why are plant-based diets so healthy?

Researchers are still investigating the mechanisms through which plant-based diets lower the risk of disease. 

Some of it may have to do with preventing obesity, which is linked to heart disease and certain cancers . But the benefits likely extend beyond that, Landry said. 

“Some of it is independent of weight. Even when weight is maintained or doesn’t change, we still see reductions in some of these other clinical health outcomes, especially when it relates to cardiovascular disease,” he said.

One possible reason is that many fruits and vegetables are high in anti-inflammatory nutrients and antioxidants, which can reduce plaque buildup in the arteries.

Plant-based diets also tend to be high in fiber, which helps lower bad cholesterol, said Brie Turner-McGrievy, a professor of health promotion, education and behavior at the University of South Carolina. She published a study in 2014 which found that plant-based diets can reduce risk factors for heart disease, stroke and Type 2 diabetes. The research was included in the new review.

“Soluble fiber that’s found in things like beans and oats is really a powerful tool to help lower LDL cholesterol levels,” she said.

Turner-McGrievy noted, though, that much of that benefit can only be achieved through eating whole foods: “It’s not like you can take a fiber supplement and hope to have these same outcomes.”

Another benefit of a plant-based diet may come simply from the absence of meat, she said. People who are vegan tend to consume less saturated fat than meat eaters. 

“It’s just really hard to lower your saturated fat intake if you’re consuming animal-based foods,” Turner-McGrievy said. “Cheese, for example, is the No. 1 source of saturated fat in the diet.”

Processed meat products such as bacon or salami are also known to raise the risk of cancer , according to the World Health Organization. The agency considers red meat in general to be a “probable human carcinogen.”

Is a vegan or vegetarian diet right for everyone?

According to the Academy of Nutrition and Dietetics, vegetarian and vegan diets are adequate and healthy at all stages of life , including pregnancy, childhood and older adulthood. 

But the new review stopped short of recommending plant-based diets for everyone. 

“During pregnancy, it’s not recommended based on the data that we have to use a strict vegetarian diet,” said Dr. Federica Guaraldi, one of the review’s authors and an endocrinologist at the IRCCS Institute of Neurological Sciences of Bologna in Italy. 

Guaraldi and her co-authors found that the plant-based regimens studied didn’t lower the risk of gestational diabetes or hypertension in pregnant women. One study included in the review suggested that pregnant women who followed a vegetarian diet had lower levels of zinc — which is important for children's growth, development and immune function — than those who ate meat. Another study in the review found that vegetarian mothers had an increased risk of delivering babies with low birthweights. 

The review's authors also cautioned that plant-based diets might lead to vitamin B12 deficiencies in the general population. Landry said that can be addressed by taking a B12 supplement.  

“From my perspective as a dietitian, a healthy plant-based diet — either vegetarian or vegan — can really meet just about all your vitamin and mineral needs,” he said. 

Aria Bendix is the breaking health reporter for NBC News Digital.