common types of literature review

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Types of Literature Review — A Guide for Researchers

Table of Contents

Researchers often face challenges when choosing the appropriate type of literature review for their study. Regardless of the type of research design and the topic of a research problem , they encounter numerous queries, including:

What is the right type of literature review my study demands?

• How do we gather the data?
• How to conduct one?
• How reliable are the review findings?
• How do we employ them in our research? And the list goes on.

If you’re also dealing with such a hefty questionnaire, this article is of help. Read through this piece of guide to get an exhaustive understanding of the different types of literature reviews and their step-by-step methodologies along with a dash of pros and cons discussed.

Heading from scratch!

What is a Literature Review?

A literature review provides a comprehensive overview of existing knowledge on a particular topic, which is quintessential to any research project. Researchers employ various literature reviews based on their research goals and methodologies. The review process involves assembling, critically evaluating, and synthesizing existing scientific publications relevant to the research question at hand. It serves multiple purposes, including identifying gaps in existing literature, providing theoretical background, and supporting the rationale for a research study.

What is the importance of a Literature review in research?

Literature review in research serves several key purposes, including:

• Background of the study: Provides proper context for the research. It helps researchers understand the historical development, theoretical perspectives, and key debates related to their research topic.
• Identification of research gaps: By reviewing existing literature, researchers can identify gaps or inconsistencies in knowledge, paving the way for new research questions and hypotheses relevant to their study.
• Theoretical framework development: Facilitates the development of theoretical frameworks by cultivating diverse perspectives and empirical findings. It helps researchers refine their conceptualizations and theoretical models.
• Methodological guidance: Offers methodological guidance by highlighting the documented research methods and techniques used in previous studies. It assists researchers in selecting appropriate research designs, data collection methods, and analytical tools.
• Quality assurance and upholding academic integrity: Conducting a thorough literature review demonstrates the rigor and scholarly integrity of the research. It ensures that researchers are aware of relevant studies and can accurately attribute ideas and findings to their original sources.

Types of Literature Review

Literature review plays a crucial role in guiding the research process , from providing the background of the study to research dissemination and contributing to the synthesis of the latest theoretical literature review findings in academia.

However, not all types of literature reviews are the same; they vary in terms of methodology, approach, and purpose. Let's have a look at the various types of literature reviews to gain a deeper understanding of their applications.

1. Narrative Literature Review

A narrative literature review, also known as a traditional literature review, involves analyzing and summarizing existing literature without adhering to a structured methodology. It typically provides a descriptive overview of key concepts, theories, and relevant findings of the research topic.

Unlike other types of literature reviews, narrative reviews reinforce a more traditional approach, emphasizing the interpretation and discussion of the research findings rather than strict adherence to methodological review criteria. It helps researchers explore diverse perspectives and insights based on the research topic and acts as preliminary work for further investigation.

Steps to Conduct a Narrative Literature Review

Source:- https://www.researchgate.net/figure/Steps-of-writing-a-narrative-review_fig1_354466408

Define the research question or topic:

The first step in conducting a narrative literature review is to clearly define the research question or topic of interest. Defining the scope and purpose of the review includes — What specific aspect of the topic do you want to explore? What are the main objectives of the research? Refine your research question based on the specific area you want to explore.

Conduct a thorough literature search

Once the research question is defined, you can conduct a comprehensive literature search. Explore and use relevant databases and search engines like SciSpace Discover to identify credible and pertinent, scholarly articles and publications.

Select relevant studies

Before choosing the right set of studies, it’s vital to determine inclusion (studies that should possess the required factors) and exclusion criteria for the literature and then carefully select papers. For example — Which studies or sources will be included based on relevance, quality, and publication date?

*Important (applies to all the reviews): Inclusion criteria are the factors a study must include (For example: Include only peer-reviewed articles published between 2022-2023, etc.). Exclusion criteria are the factors that wouldn’t be required for your search strategy (Example: exclude irrelevant papers, preprints, written in non-English, etc.)

Critically analyze the literature

Once the relevant studies are shortlisted, evaluate the methodology, findings, and limitations of each source and jot down key themes, patterns, and contradictions. You can use efficient AI tools to conduct a thorough literature review and analyze all the required information.

Synthesize and integrate the findings

Now, you can weave together the reviewed studies, underscoring significant findings such that new frameworks, contrasting viewpoints, and identifying knowledge gaps.

Discussion and conclusion

This is an important step before crafting a narrative review — summarize the main findings of the review and discuss their implications in the relevant field. For example — What are the practical implications for practitioners? What are the directions for future research for them?

Write a cohesive narrative review

Organize the review into coherent sections and structure your review logically, guiding the reader through the research landscape and offering valuable insights. Use clear and concise language to convey key points effectively.

Structure of Narrative Literature Review

A well-structured, narrative analysis or literature review typically includes the following components:

• Introduction: Provides an overview of the topic, objectives of the study, and rationale for the review.
• Background: Highlights relevant background information and establish the context for the review.
• Main Body: Indexes the literature into thematic sections or categories, discussing key findings, methodologies, and theoretical frameworks.
• Discussion: Analyze and synthesize the findings of the reviewed studies, stressing similarities, differences, and any gaps in the literature.
• Conclusion: Summarizes the main findings of the review, identifies implications for future research, and offers concluding remarks.

Pros and Cons of Narrative Literature Review

• Flexibility in methodology and doesn’t necessarily rely on structured methodologies
• Follows traditional approach and provides valuable and contextualized insights
• Suitable for exploring complex or interdisciplinary topics. For example — Climate change and human health, Cybersecurity and privacy in the digital age, and more
• Subjectivity in data selection and interpretation
• Potential for bias in the review process
• Lack of rigor compared to systematic reviews

Example of Well-Executed Narrative Literature Reviews

Paper title:  Examining Moral Injury in Clinical Practice: A Narrative Literature Review

Source: SciSpace

You can also chat with the papers using SciSpace ChatPDF to get a thorough understanding of the research papers.

While narrative reviews offer flexibility, academic integrity remains paramount. So, ensure proper citation of all sources and maintain a transparent and factual approach throughout your critical narrative review, itself.

2. Systematic Review

A systematic literature review is one of the comprehensive types of literature review that follows a structured approach to assembling, analyzing, and synthesizing existing research relevant to a particular topic or question. It involves clearly defined criteria for exploring and choosing studies, as well as rigorous methods for evaluating the quality of relevant studies.

It plays a prominent role in evidence-based practice and decision-making across various domains, including healthcare, social sciences, education, health sciences, and more. By systematically investigating available literature, researchers can identify gaps in knowledge, evaluate the strength of evidence, and report future research directions.

Steps to Conduct Systematic Reviews

Source:- https://www.researchgate.net/figure/Steps-of-Systematic-Literature-Review_fig1_321422320

Here are the key steps involved in conducting a systematic literature review

Formulate a clear and focused research question

Clearly define the research question or objective of the review. It helps to centralize the literature search strategy and determine inclusion criteria for relevant studies.

Develop a thorough literature search strategy

Design a comprehensive search strategy to identify relevant studies. It involves scrutinizing scientific databases and all relevant articles in journals. Plus, seek suggestions from domain experts and review reference lists of relevant review articles.

Screening and selecting studies

Employ predefined inclusion and exclusion criteria to systematically screen the identified studies. This screening process also typically involves multiple reviewers independently assessing the eligibility of each study.

Data extraction

Extract key information from selected studies using standardized forms or protocols. It includes study characteristics, methods, results, and conclusions.

Critical appraisal

Evaluate the methodological quality and potential biases of included studies. Various tools (BMC medical research methodology) and criteria can be implemented for critical evaluation depending on the study design and research quetions .

Data synthesis

Analyze and synthesize review findings from individual studies to draw encompassing conclusions or identify overarching patterns and explore heterogeneity among studies.

Interpretation and conclusion

Interpret the findings about the research question, considering the strengths and limitations of the research evidence. Draw conclusions and implications for further research.

The final step — Report writing

Craft a detailed report of the systematic literature review adhering to the established guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). This ensures transparency and reproducibility of the review process.

By following these steps, a systematic literature review aims to provide a comprehensive and unbiased summary of existing evidence, help make informed decisions, and advance knowledge in the respective domain or field.

Structure of a systematic literature review

A well-structured systematic literature review typically consists of the following sections:

• Introduction: Provides background information on the research topic, outlines the review objectives, and enunciates the scope of the study.
• Methodology: Describes the literature search strategy, selection criteria, data extraction process, and other methods used for data synthesis, extraction, or other data analysis..
• Results: Presents the review findings, including a summary of the incorporated studies and their key findings.
• Discussion: Interprets the findings in light of the review objectives, discusses their implications, and identifies limitations or promising areas for future research.
• Conclusion: Summarizes the main review findings and provides suggestions based on the evidence presented in depth meta analysis.

*Important (applies to all the reviews): Remember, the specific structure of your literature review may vary depending on your topic, research question, and intended audience. However, adhering to a clear and logical hierarchy ensures your review effectively analyses and synthesizes knowledge and contributes valuable insights for readers.

Pros and Cons of Systematic Literature Review

• Adopts rigorous and transparent methodology
• Minimizes bias and enhances the reliability of the study
• Provides evidence-based insights
• Time and resource-intensive
• High dependency on the quality of available literature (literature research strategy should be accurate)
• Potential for publication bias

Example of Well-Executed Systematic Literature Review

Paper title: Systematic Reviews: Understanding the Best Evidence For Clinical Decision-making in Health Care: Pros and Cons.

Read this detailed article on how to use AI tools to conduct a systematic review for your research!

3. Scoping Literature Review

A scoping literature review is a methodological review type of literature review that adopts an iterative approach to systematically map the existing literature on a particular topic or research area. It involves identifying, selecting, and synthesizing relevant papers to provide an overview of the size and scope of available evidence. Scoping reviews are broader in scope and include a diverse range of study designs and methodologies especially focused on health services research.

The main purpose of a scoping literature review is to examine the extent, range, and nature of existing studies on a topic, thereby identifying gaps in research, inconsistencies, and areas for further investigation. Additionally, scoping reviews can help researchers identify suitable methodologies and formulate clinical recommendations. They also act as the frameworks for future systematic reviews or primary research studies.

Scoping reviews are primarily focused on —

• Emerging or evolving topics — where the research landscape is still growing or budding. Example — Whole Systems Approaches to Diet and Healthy Weight: A Scoping Review of Reviews .
• Broad and complex topics : With a vast amount of existing literature.
• Scenarios where a systematic review is not feasible: Due to limited resources or time constraints.

Steps to Conduct a Scoping Literature Review

While Scoping reviews are not as rigorous as systematic reviews, however, they still follow a structured approach. Here are the steps:

Identify the research question: Define the broad topic you want to explore.

Identify Relevant Studies: Conduct a comprehensive search of relevant literature using appropriate databases, keywords, and search strategies.

Select studies to be included in the review: Based on the inclusion and exclusion criteria, determine the appropriate studies to be included in the review.

Data extraction and charting : Extract relevant information from selected studies, such as year, author, main results, study characteristics, key findings, and methodological approaches.  However, it varies depending on the research question.

Collate, summarize, and report the results: Analyze and summarize the extracted data to identify key themes and trends. Then, present the findings of the scoping review in a clear and structured manner, following established guidelines and frameworks .

Structure of a Scoping Literature Review

A scoping literature review typically follows a structured format similar to a systematic review. It includes the following sections:

• Introduction: Introduce the research topic and objectives of the review, providing the historical context, and rationale for the study.
• Methods : Describe the methods used to conduct the review, including search strategies, study selection criteria, and data extraction procedures.
• Results: Present the findings of the review, including key themes, concepts, and patterns identified in the literature review.
• Discussion: Examine the implications of the findings, including strengths, limitations, and areas for further examination.
• Conclusion: Recapitulate the main findings of the review and their implications for future research, policy, or practice.

Pros and Cons of Scoping Literature Review

• Provides a comprehensive overview of existing literature
• Helps to identify gaps and areas for further research
• Suitable for exploring broad or complex research questions
• Doesn’t provide the depth of analysis offered by systematic reviews
• Subject to researcher bias in study selection and data extraction
• Requires careful consideration of literature search strategies and inclusion criteria to ensure comprehensiveness and validity.

In short, a scoping review helps map the literature on developing or emerging topics and identifying gaps. It might be considered as a step before conducting another type of review, such as a systematic review. Basically, acts as a precursor for other literature reviews.

Example of a Well-Executed Scoping Literature Review

Paper title: Health Chatbots in Africa Literature: A Scoping Review

Check out the key differences between Systematic and Scoping reviews — Evaluating literature review: systematic vs. scoping reviews

4. Integrative Literature Review

Integrative Literature Review (ILR) is a type of literature review that proposes a distinctive way to analyze and synthesize existing literature on a specific topic, providing a thorough understanding of research and identifying potential gaps for future research.

Unlike a systematic review, which emphasizes quantitative studies and follows strict inclusion criteria, an ILR embraces a more pliable approach. It works beyond simply summarizing findings — it critically analyzes, integrates, and interprets research from various methodologies (qualitative, quantitative, mixed methods) to provide a deeper understanding of the research landscape. ILRs provide a holistic and systematic overview of existing research, integrating findings from various methodologies. ILRs are ideal for exploring intricate research issues, examining manifold perspectives, and developing new research questions.

Steps to Conduct an Integrative Literature Review

• Identify the research question: Clearly define the research question or topic of interest as formulating a clear and focused research question is critical to leading the entire review process.
• Literature search strategy: Employ systematic search techniques to locate relevant literature across various databases and sources.
• Evaluate the quality of the included studies : Critically assess the methodology, rigor, and validity of each study by applying inclusion and exclusion criteria to filter and select studies aligned with the research objectives.
• Data Extraction: Extract relevant data from selected studies using a structured approach.
• Synthesize the findings : Thoroughly analyze the selected literature, identify key themes, and synthesize findings to derive noteworthy insights.
• Critical appraisal: Critically evaluate the quality and validity of qualitative research and included studies by using BMC medical research methodology.
• Interpret and present your findings: Discuss the purpose and implications of your analysis, spotlighting key insights and limitations. Organize and present the findings coherently and systematically.

Structure of an Integrative Literature Review

• Introduction : Provide an overview of the research topic and the purpose of the integrative review.
• Methods: Describe the opted literature search strategy, selection criteria, and data extraction process.
• Results: Present the synthesized findings, including key themes, patterns, and contradictions.
• Discussion: Interpret the findings about the research question, emphasizing implications for theory, practice, and prospective research.
• Conclusion: Summarize the main findings, limitations, and contributions of the integrative review.

Pros and Cons of Integrative Literature Review

• Informs evidence-based practice and policy to the relevant stakeholders of the research.
• Contributes to theory development and methodological advancement, especially in the healthcare arena.
• Integrates diverse perspectives and findings
• Time-consuming process due to the extensive literature search and synthesis
• Requires advanced analytical and critical thinking skills
• Potential for bias in study selection and interpretation
• The quality of included studies may vary, affecting the validity of the review

Example of Integrative Literature Reviews

Paper Title: An Integrative Literature Review: The Dual Impact of Technological Tools on Health and Technostress Among Older Workers

5. Rapid Literature Review

A Rapid Literature Review (RLR) is the fastest type of literature review which makes use of a streamlined approach for synthesizing literature summaries, offering a quicker and more focused alternative to traditional systematic reviews. Despite employing identical research methods, it often simplifies or omits specific steps to expedite the process. It allows researchers to gain valuable insights into current research trends and identify key findings within a shorter timeframe, often ranging from a few days to a few weeks — unlike traditional literature reviews, which may take months or even years to complete.

When to Consider a Rapid Literature Review?

• When time impediments demand a swift summary of existing research
• For emerging topics where the latest literature requires quick evaluation
• To report pilot studies or preliminary research before embarking on a comprehensive systematic review

Steps to Conduct a Rapid Literature Review

• Define the research question or topic of interest. A well-defined question guides the search process and helps researchers focus on relevant studies.
• Determine key databases and sources of relevant literature to ensure comprehensive coverage.
• Develop literature search strategies using appropriate keywords and filters to fetch a pool of potential scientific articles.
• Screen search results based on predefined inclusion and exclusion criteria.
• Extract and summarize relevant information from the above-preferred studies.
• Synthesize findings to identify key themes, patterns, or gaps in the literature.
• Prepare a concise report or a summary of the RLR findings.

Structure of a Rapid Literature Review

An effective structure of an RLR typically includes the following sections:

• Introduction: Briefly introduce the research topic and objectives of the RLR.
• Methodology: Describe the search strategy, inclusion and exclusion criteria, and data extraction process.
• Results: Present a summary of the findings, including key themes or patterns identified.
• Discussion: Interpret the findings, discuss implications, and highlight any limitations or areas for further research
• Conclusion: Summarize the key findings and their implications for practice or future research

Pros and Cons of Rapid Literature Review

• RLRs can be completed quickly, authorizing timely decision-making
• RLRs are a cost-effective approach since they require fewer resources compared to traditional literature reviews
• Offers great accessibility as RLRs provide prompt access to synthesized evidence for stakeholders
• RLRs are flexible as they can be easily adapted for various research contexts and objectives
• RLR reports are limited and restricted, not as in-depth as systematic reviews, and do not provide comprehensive coverage of the literature compared to traditional reviews.
• Susceptible to bias because of the expedited nature of RLRs. It would increase the chance of overlooking relevant studies or biases in the selection process.
• Due to time constraints, RLR findings might not be robust enough as compared to systematic reviews.

Example of a Well-Executed Rapid Literature Review

Paper Title: What Is the Impact of ChatGPT on Education? A Rapid Review of the Literature

A Summary of Literature Review Types

Tools and Resources for Conducting Different Types of Literature Reviews

Online scientific databases.

Platforms such as SciSpace , PubMed , Scopus , Elsevier , and Web of Science provide access to a vast array of scholarly literature, facilitating the search and data retrieval process.

Reference management software

Tools like SciSpace Citation Generator , EndNote, Zotero , and Mendeley assist researchers in organizing, annotating, and citing relevant literature, streamlining the review process altogether.

Automate Literature Review with AI tools

Automate the literature review process by using tools like SciSpace literature review which helps you compare and contrast multiple papers all on one screen in an easy-to-read matrix format. You can effortlessly analyze and interpret the review findings tailored to your study. It also supports the review in 75+ languages, making it more manageable even for non-English speakers.

Goes without saying — literature review plays a pivotal role in academic research to identify the current trends and provide insights to pave the way for future research endeavors. Different types of literature review has their own strengths and limitations, making them suitable for different research designs and contexts. Whether conducting a narrative review, systematic review, scoping review, integrative review, or rapid literature review, researchers must cautiously consider the objectives, resources, and the nature of the research topic.

If you’re currently working on a literature review and still adopting a manual and traditional approach, switch to the automated AI literature review workspace and transform your traditional literature review into a rapid one by extracting all the latest and relevant data for your research!

There you go!

Frequently Asked Questions

Narrative reviews give a general overview of a topic based on the author's knowledge. They may lack clear criteria and can be biased. On the other hand, systematic reviews aim to answer specific research questions by following strict methods. They're thorough but time-consuming.

A systematic review collects and analyzes existing research to provide an overview of a topic, while a meta-analysis statistically combines data from multiple studies to draw conclusions about the overall effect of an intervention or relationship between variables.

A systematic review thoroughly analyzes existing research on a specific topic using strict methods. In contrast, a scoping review offers a broader overview of the literature without evaluating individual studies in depth.

A systematic review thoroughly examines existing research using a rigorous process, while a rapid review provides a quicker summary of evidence, often by simplifying some of the systematic review steps to meet shorter timelines.

A systematic review carefully examines many studies on a single topic using specific guidelines. Conversely, an integrative review blends various types of research to provide a more comprehensive understanding of the topic.

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Types of Literature Review

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

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

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

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

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

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

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

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

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

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

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

  John Dudovskiy

Literature Review: Types of literature reviews

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

Types of literature reviews

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

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

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

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

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

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

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

What's the difference between reviews?

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

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

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

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

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

See also the Library's  Literature Review guide.

Critical Appraised Topic (CAT)

For information on conducting a Critically Appraised Topic or CAT

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

Books on Literature Reviews

• << Previous: Home
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• Last Updated: Aug 11, 2024 4:07 PM
• URL: https://libguides.csu.edu.au/review

Charles Sturt University is an Australian University, TEQSA Provider Identification: PRV12018. CRICOS Provider: 00005F.

• University Libraries
• Research Guides
• Reviewing Research: Literature Reviews, Scoping Reviews, Systematic Reviews
• Differentiating the Three Review Types

Reviewing Research: Literature Reviews, Scoping Reviews, Systematic Reviews: Differentiating the Three Review Types

• Framework, Protocol, and Writing Steps
• Working with Keywords/Subject Headings
• Citing Research

The Differences in the Review Types

Grant, M.J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. H ealth Information & Libraries Journal , 26: 91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x   The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains.

• What Type of Review is Right for you (Cornell University)

Literature Reviews

Literature Review: it is a product and a process.

As a product , it is a carefully written examination, interpretation, evaluation, and synthesis of the published literature related to your topic. It focuses on what is known about your topic and what methodologies, models, theories, and concepts have been applied to it by others.

The process is what is involved in conducting a review of the literature.

• It is ongoing
• It is iterative (repetitive)
• It involves searching for and finding relevant literature.
• It includes keeping track of your references and preparing and formatting them for the bibliography of your thesis

• Literature Reviews (University of North Carolina at Chapel Hill) This handout will explain what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.

Scoping Reviews

Scoping reviews are a " preliminary assessment of potential size and scope of available research literature . Aims to identify nature and extent of research evidence (usually including ongoing research)." Grant and Booth (2009).

Scoping reviews are not mapping reviews: Scoping reviews are more topic based and mapping reviews are more question based.

• examining emerging evidence when specific questions are unclear - clarify definitions and conceptual boundaries
• identify and map the available evidence
• a scoping review is done prior to a systematic review
• to summarize and disseminate research findings in the research literature
• identify gaps with the intention of resolution by future publications

• Scoping review timeframe and limitations (Touro College of Pharmacy

Systematic Reviews

Many evidence-based disciplines use ‘systematic reviews," this type of review is a specific methodology that aims to comprehensively identify all relevant studies on a specific topic, and to select appropriate studies based on explicit criteria . ( https://cebma.org/faq/what-is-a-systematic-review/ )

• clearly defined search criteria
• an explicit reproducible methodology
• a systematic search of the literature with the defined criteria met
• assesses validity of the findings - no risk of bias
• a comprehensive report on the findings, apparent transparency in the results

• Better evidence for a better world Browsable collection of systematic reviews
• Systematic Reviews in the Health Sciences by Molly Maloney Last Updated Jul 26, 2024 882 views this year
• Next: Framework, Protocol, and Writing Steps >>

Literature Reviews

• Getting Started

Selecting a Review Type

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

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

More Review Types

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

Which Review is Right for You?

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

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

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

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

A FEW GENERAL CONSIDERATIONS WHEN DEFINING SCOPE

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

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

LITERATURE REVIEW

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

SCOPING REVIEW

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

SYSTEMATIC REVIEW

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

META-ANALYSIS

• Goes one step further than a systematic review by statistically combining the results of quantitative studies to provide a more precise effect of the results. 
• << Previous: Getting Started
• Next: Developing a Research Question >>
• Last Updated: May 9, 2024 11:44 AM
• URL: https://guides.lib.umich.edu/litreview

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

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

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

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

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

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

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

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

9.2. Overview of the Literature Review Process and Steps

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

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

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

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

9.3. Types of Review Articles and Brief Illustrations

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

9.3.1. Narrative Reviews

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

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

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

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

9.3.2. Descriptive or Mapping Reviews

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

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

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

9.3.3. Scoping Reviews

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

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

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

9.3.4. Forms of Aggregative Reviews

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

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

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

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

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

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

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

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

9.3.5. Realist Reviews

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

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

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

9.3.6. Critical Reviews

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

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

9.4. Summary

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

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

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

9.5. Concluding Remarks

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

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

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

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• Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
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• Introduction
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• Types of Review Articles and Brief Illustrations
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Reproduced from Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91–108. doi:10.1111/j.1471-1842.2009.00848.x

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• How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

You can also use boolean operators to help narrow down your search.

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

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

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

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

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

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

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

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

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

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

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

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

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

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

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

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

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

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

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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Methodological Approaches to Literature Review

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The literature review can serve various functions in the contexts of education and research. It aids in identifying knowledge gaps, informing research methodology, and developing a theoretical framework during the planning stages of a research study or project, as well as reporting of review findings in the context of the existing literature. This chapter discusses the methodological approaches to conducting a literature review and offers an overview of different types of reviews. There are various types of reviews, including narrative reviews, scoping reviews, and systematic reviews with reporting strategies such as meta-analysis and meta-synthesis. Review authors should consider the scope of the literature review when selecting a type and method. Being focused is essential for a successful review; however, this must be balanced against the relevance of the review to a broad audience.

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Thomas, D., Zairina, E., George, J. (2023). Methodological Approaches to Literature Review. In: Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy. Springer, Cham. https://doi.org/10.1007/978-3-030-50247-8_57-1

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Literature Reviews within a Scholarly Work

Literature reviews as a scholarly work.

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

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

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

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

Systematic Review

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

Semi-Systematic Review

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

Integrative Review

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

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

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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

By Laura Brown on 13th October 2023

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

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

What is Literature Review?

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

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

It serves with some specific purpose in the research.

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

4 Major Types Of Literature Review

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

1. Narrative Review

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

2. Systematic Review

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

3. Meta Analysis

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

4. Scoping Review

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

Different Types Of Literature review In Research

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

5. Critical Review

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

6. Theoretical Review

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

7. Integrative Review

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

8. Historical Review

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

9. Methodological Review

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

10. Cross-Disciplinary Review

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

11. Descriptive Review

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

12. Rapid Review

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

13. Conceptual Review

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

14. Library Research

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

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

Choosing the Ideal Literature Review Approach in Academics

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

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

Bonus Tip: Crafting an Effective Literature Review

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

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

Some Useful Tools And Resources For You

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

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

Some Common Mistakes To Avoid

Avoid these common mistakes when crafting literature reviews.

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

While Summing Up On Various Types Of Literature Review

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

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

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

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

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Literature Review – Types Writing Guide and Examples

Table of Contents

Literature Review

Definition:

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

Types of Literature Review

Types of Literature Review are as follows:

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

Parts of Literature Review

Parts of a literature review are as follows:

Introduction

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

Literature Search

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

Literature Analysis

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

Critical Evaluation

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

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

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

How to write Literature Review

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

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

Examples of Literature Review

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

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

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

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

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

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

Applications of Literature Review

some applications of literature review in different fields:

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

Role of Literature Review in Research

Here are some applications of literature review in research:

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

Purpose of Literature Review

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

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

Characteristics of Literature Review

Some Characteristics of Literature Review are as follows:

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

Advantages of Literature Review

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

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

Limitations of Literature Review

Limitations of Literature Review are as follows:

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

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Literature Reviews, Introduction to Different Types of

There are many different types of literature reviews, each with its own approach, analysis, and purpose. To confuse matters, these types aren't named consistently. The following are some of the more common types of literature reviews.

These are more rigorous, with some level of appraisal:

• The Systematic Review is important to health care and medical trials, and other subjects where methodology and data are important. Through rigorous review and analysis of literature that meets a specific criteria, the systematic review identifies and compares answers to health care related questions. The systematic review may include meta-analysis and meta-synthesis, which leads us to...
• The Quantitative or Qualitative Meta-analysis Review can both make up the whole or part of systematic review(s). Both are thorough and comprehensive in condensing and making sense of a large body of research. The quantitative meta-analysis reviews quantitative research, is objective, and includes statistical analysis. The qualitative meta-analysis reviews qualitative research, is subjective (or evaluative, or interpretive), and identifies new themes or concepts.

These don't always include a formal assessment or analysis:

• The Literature Review (see our Literature Review video) or Narrative Review often appears as a chapter in a thesis or dissertation. It describes what related research has already been conducted, how it informs the thesis, and how the thesis fits into the research in the field. (See https://student.unsw.edu.au/writing-critical-review for more information.)
• The Critical Review is like a literature review, but requires a more detailed examination of the literature, in order to compare and evaluate a number of perspectives.
• The Scoping Review is often used at the beginning of an article, dissertation or research proposal. It is conducted before the research begins, and sets the stage for this research by highlighting gaps in the literature, and explaining the need for the research about to be conducted, which is presented in the remainder of the article.
• The Conceptual Review groups articles according to concepts, or categories, or themes. It identifies the current 'understanding' of the given research topic, discusses how this understanding was reached, and attempts to determine whether a greater understanding can be suggested. It provides a snapshot of where things are with this particular field of research.
• The State-of-the-Art Review is conducted periodically, with a focus on the most recent research. It describes what is currently known, understood, or agreed upon regarding the research topic, and highlights where are there still disagreements.

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

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Which review is that? A guide to review types

• Which review is that?
• Review Comparison Chart
• Decision Tool
• Critical Review
• Integrative Review
• Narrative Review
• State of the Art Review
• Narrative Summary
• Systematic Review
• Meta-analysis
• Comparative Effectiveness Review
• Diagnostic Systematic Review
• Network Meta-analysis
• Prognostic Review
• Psychometric Review
• Review of Economic Evaluations
• Systematic Review of Epidemiology Studies
• Living Systematic Reviews
• Umbrella Review
• Review of Reviews
• Rapid Review
• Rapid Evidence Assessment
• Rapid Realist Review
• Qualitative Evidence Synthesis
• Qualitative Interpretive Meta-synthesis
• Qualitative Meta-synthesis
• Qualitative Research Synthesis
• Framework Synthesis - Best-fit Framework Synthesis
• Meta-aggregation
• Meta-ethnography
• Meta-interpretation
• Meta-narrative Review
• Meta-summary
• Thematic Synthesis
• Mixed Methods Synthesis
• Narrative Synthesis
• Bayesian Meta-analysis
• EPPI-Centre Review
• Critical Interpretive Synthesis
• Realist Synthesis - Realist Review
• Scoping Review
• Mapping Review
• Systematised Review
• Concept Synthesis
• Expert Opinion - Policy Review
• Technology Assessment Review
• Methodological Review
• Systematic Search and Review

This quick reference tool provides information on a wide range of literature review types that are available for research synthesis for publication and research purposes.  

Graphic and guide based on on the work of  Sutton et al., (2019) on 'Review Families'.

*Note to students undertaking a literature review as part of coursework:

It is recommended that students undertaking a literature review as part of their coursework follow the literature review guidelines provided within their subject as they may include selected elements of full literature reviews suitable to the learning task.

References Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: exploring review types and associated information retrieval requirements.  Health Information & Libraries Journal ,  36 (3), 202-222.  Full Text

Cite this guide

Birkic, V., Celeste, T., & Cochrane, L. (2020). Which review is that? A guide to review types, Available from https://unimelb.libguides.com/whichreview

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• Last Updated: Aug 19, 2024 1:08 PM
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Writing the Literature Review

Barry Mauer and John Venecek

• The Literature Review

What is the Purpose of the Review?

What is the scope of the review, strategies for getting started, types of literature reviews, composition guidelines, how to locate reviews by discipline, key takeaways.

We also provide the following activities:

Types of Literature Reviews [Refresher]

Writing the literature review [refresher], the literature review [1].

Conducting a literary studies research project involves time and effort, with much of it going towards the development of a literature review . A literature review might fill several pages of your research paper and usually appears soon after an introduction but before you present your detailed argument. A literature review provides your audience with an overview of the available research about your area(s) of study, including the literary work, your theory, and methodology. The literature review demonstrates how these scholarly discussions have changed over time, and it allows you to position your research in relation to research that has come before yours. Your aim is to present the discussion up to this point. Depending on the nature of the assignment, you may also include your critical commentary on prior research, noting among this material the weaker and stronger arguments, breakthroughs and dead ends, blind spots and opportunities, the invention of key terms and methods, mistakes as well as misreadings, and so on.

Once you have gathered the research materials you need for your literature review, you have another task: conducting an analysis on the research to see where your original contribution fits into the scholarly conversation. As the saying goes, “we are standing on the shoulders of giants.” Your job is to show a portrait of these giants to your audience, and to show how your work relates to the portrait. On many scholarly topics, literature reviews already exist. You may refer to such existing reviews within your own, indicating any materials might have been overlooked, new developments that have arisen since the publication of the existing literature review, and new perspectives or insights you have about the materials.

Some beginning researchers try to tear down the work of other researchers in an effort to make their own work look good by comparison. It rarely works. First, it tends to make your audience skeptical of your claims. Second, it ignores the fact that even the mistakes, blind spots, and failures of other researchers contribute something to our knowledge. Albert Einstein didn’t disrespect Sir Isaac Newton by saying Newton’s theory of space was wrong and terrible and that Einstein’s own theory was great by comparison. He built upon Newton’s work, showing how it could be improved. If, however, a researcher willfully set out to deceive or distort or to tear down the work of other scholars without good reason, then their work does not deserve such deference.

Most literature reviews appear after the introduction. It presents your reader with relevant information about the scholarly discussion up to now. Later in your paper, you discuss your contribution. Before you begin work on your literature review, let’s discuss what we mean by “literature”; understand the purpose and scope of the review; establish criteria for selecting, organizing, and interpreting your findings; and discuss how to connect your findings to your research question.

Many students seek to “find sources that agree with my claim or idea.” That approach is too narrow, in our view. If we use such an approach, we may get the following results:

• Because we can find sources that agree with almost any claim, readers will wonder whether your claims are weak and the sources are cherry picked.
• While literary scholars sometimes cite authorities to support their claims, they don’t rely only on authority. They respect authority, but not too much. Your own claims need to rely more on evidence (from the literary text, historical and biographical information), and your critical and creative reasoning skills.
• Scholarship is a conversation; thus, the goal is less about finding agreement and more about joining the conversation with the aim of making a valuable contribution to the discussion.

The literature review provides your reader with an overview of the existing research about your topic or problem. It provides the context necessary for your reader to catch up with the scholarly conversation and then to appreciate the value of your contribution to it. The literature review sharpens the focus of your research and demonstrates your knowledge and understanding of the scholarly conversation around your topic, which, in turn, helps establish your credibility as a researcher.

Creating the literature review involves more than gathering citations. It is a qualitative process through which you will discover what is already known about your topic, and identify the key authorities, methods, and theoretical foundations, so you can begin to position your contributions within the scholarly conversation.

Defining the scope of your review will also help you establish criteria to determine the relevance of the sources you are finding. At this stage, you are not reading in-depth; instead, you are skimming through what has already been published and identifying the major concepts, theories, methodologies, and methods present within these published works. You should also be identifying connections, tensions, and contradictions within the already published works of your topic or problem. This involves building on the knowledge of others and understanding what methods, measures, and models we have inherited from previous researchers in our field.

Literature Reviews: Common Errors Made When Conducting a Literature Review [12 min 22 sec]

Video provided courtesy of the Center for Quality Research (CQR)

A literature review helps your reader understand the relationship of your research project to the work of other scholars. It covers the existing knowledge about a problem, and allows you to show the relevance/significance of your contribution to the discussion. Your reader may or may not have read scholarly literature about the theories, methodologies, and literary works you are discussing. But they want to know that you have read it and have thought about it. Your literature review provides not only a summary of the existing scholarship for readers; it also offers your perspective on it.

Begin your work on the literature review by synthesizing the various sources in your annotated bibliography .

For advice on Synthesizing Sources, consider the following from The Purdue Online Writing Lab: [2]

Note that  synthesizing is not the same as summarizing .

• A summary restates the information in one or more sources without providing new insight or reaching new conclusions.
• A synthesis draws on multiple sources to reach a broader conclusion.
• Don’t force a relationship between sources if there isn’t one. Not all of your sources have to complement one another.
• Do your best to highlight the relationships between sources in very clear ways.
• Don’t ignore any outliers in your research. It’s important to take note of every perspective (even those that disagree with your broader conclusions).

Not all humanities research projects contain literature reviews, but many do. Keep in mind that the type of literature review you choose (see list below) pertains to the secondary research – other scholarly sources – and not to the primary literary work. For instance, a literature review about Kate Chopin’s writing will be your thoughts about the scholarship on Chopin and not about Chopin’s text itself. You are summarizing what you see in the scholarly literature about Chopin’s writing. The literature review puts you in the position of authority not just on Chopin’s writing but on the scholarship about her writing. You are seeking to understand what scholars have said about her work. Scholars might belong to different schools of thought (psychoanalytic, feminist, Marxist, etc.). They might make different arguments about Chopin. They might use different methodological approaches. 

If your research involves two or more theories, such as psychology and genre studies, you may need to create multiple literature reviews, one for each theory or methodology. If the theories overlap with each other significantly (i.e., Marxism and Cultural Studies), you may combine them. Your literature review need not include everything about the subject area – you would need to write a book to cover a single theory – but only those concepts and methods that are most relevant to your research problem.

Factors to Consider When Developing Your Literature Review

• Determine the Scope : How broad or narrow should your literature review be? You may want to focus on recent scholarship only, or on a particular school of thought in the literature. Your scope is determined by your purpose; what is it you aim to achieve with your research?
• Establish Criteria : We discussed the importance of defining the purpose and scope of your review on the previous page, but it’s worth reviewing here as well. This step will help you establish important criteria and focus your searching. For example, how many sources will you need? What types of sources (primary, secondary, statistics, media)? Is currency important? Do you know who the prominent authors or theorists are in your subject area? Take some time to map out these or other important factors before you begin searching journals and databases.
• Consider Your Audience : Unlike a work cited page or an annotated bibliography, both of which are lists of sources, a literature review is essayistic and can be considered a precursor to your final paper. Therefore, it should be written in your own voice, and it should be geared toward a specific audience. Considering audience during this early stage will help focus your final paper as well.
• Find Models : We’ll discuss the different types of literature reviews and how to locate examples in the section below. However, even if you’re undecided about what type of review will work best for you, you may want to review some example literature reviews to get a sense of what they look like before you begin your own.

One piece of advice before starting: look for existing literature reviews on your area of scholarship. You can build on the work that other scholars have put into reviewing the scholarly literature. There’s no need to completely “reinvent the wheel” if some of the work is already done.

Scholars sometimes publish “stand-alone” literature reviews that are not part of a larger work; such literature reviews are valuable contributions to the field, as they summarize the state of knowledge for other scholars.

Maria J. Grant and Andrew Booth’s “A Typology of Reviews” identifies 14 distinct types of literature reviews. Further, the UCLA library created a chart to complement the article and for easy comparison of those 14 types of reviews. This section provides a brief summary of the most common literature reviews. For a more complete analysis, please see the full article and the chart .

To choose the most appropriate structure, put yourself in your reader’s shoes and think through their need for information. The literature review is about providing context for your contribution. How much context do people need? Keep it to the minimum necessary; compressing a lot of information into a small amount of text is a must.

These structures are not meant to be straightjackets but tools to help you organize your research. If you find that the tool is working, then keep using it. If not, switch tools or modify the one you are using. Keep in mind that the types of literature reviews are just different ways of organizing information. So, you can discuss literary trends without organizing your review of secondary literature by trend; your discussion can be organized by theory or theme, for examples. In our literature reviews, we are not recounting other scholars’ arguments at length but merely providing key concepts so we can summarize the discussion so far and position our own claims. You don’t have to adhere strictly to one structure or another. They are just organizing tools that help you manage your material (and help your reader make sense of it).

Types of Reviews

• Traditional or narrative reviews : This approach will generate a comprehensive, critical analysis of the published research on your topic. However, rather than merely compiling as many sources as possible, use this approach to establish a theoretical framework for your paper, establish trends, and identify gaps in the research. This process should bring your research question into clearer focus and help define a thesis that you will argue for in your paper. This is perhaps the most common and general type of literature review. The examples listed below are all designed to serve a more specific purpose.
• Argumentative : The purpose of an argumentative literature review is to select sources for the purpose of supporting or refuting a specific claim. While this type of review can help the author make a strong case for or against an issue, they can also be prone to claims of bias. Later in this textbook, we will read about the distinction between warranted and unwarranted bias . One is ok and the other is not.
• Chronological : A chronological review is used when the author wants to demonstrate the progression of how a theory, methodology, or issue has progressed over time. This method is most effective when there is a clear chronological path to the research about a specific historical event or trend as opposed to a more recursive theoretical concept.
• By trend : This is similar to the chronological approach except it focuses on clearly-defined trends rather than date ranges. This would be most appropriate if you want to illustrate changing perspectives or attitudes about a given issue when specific date ranges are less important than the ebb and flow of the trend.
• Thematic : In this type of literature review, the author will select specific themes that he or she feels are important to understanding a larger topic or concept. Then, the author will organize the sources around those themes, which are often based on relevance or importance. The value of this method is that the process of organizing the review by theme is similar to constructing an argument. This can help the author see how resources connect to each other and determine how as well as why specific sources support their thesis.
• Theoretical : The goal of this type of review is to examine how theory has shaped the research on a given topic. It establishes existing theoretical models, their connections, and how extensively they have been developed in the published research. For example, Jada applied critical race theory to her analysis of Sonny’s Blues , but she might also consider conducting a more comprehensive review of other theoretical frameworks such as feminism, Marxism, or postmodernism. Doing so could provide insight into alternate readings, and help her identify theoretical gaps such as unexplored or under-developed approaches to Baldwin’s work.
• Methodological : The approach focuses on the various methodologies used by researchers in a specific area rather than an analysis of their findings. In this case, you would create a framework of approaches to data collection related to your topic or research question. This is perhaps more common in education or the social and hard sciences where published research often includes a methods section, but it is sometimes appropriate for the digital humanities as well.
• Scoping : The aim of a scoping review is to provide a comprehensive overview or map of the published research or evidence related to a research question. This might be considered a prelude to a systematic review that would take the scoping review one step further toward answering a clearly defined research question. See below for more details.
• Systematic : The systematic review is most appropriate when you have a clearly-defined research question and have established criteria for the types of sources you need. In this way, the systematic review is less exploratory than other types of reviews. Rather, it is comprehensive, strategic, and focused on answering a specific research question. For this reason, the systematic review is more common in the health and social sciences, where comprehensiveness is more important. Literature reviews in the Humanities are not usually exhaustive but tend to show only the most representative or salient developments in the scholarship.
• Meta-analysis : Does your research deal with statistics or large amounts of data? If so, then a meta-analysis might be best for you rather than providing a critical review, the meta-analysis will summarize and synthesize the results of numerous studies that involve statistics or data to provide a more comprehensive picture than would be possible from just one study.

An argumentative literature review presents and takes sides in scholarly arguments about the literary work. It makes arguments about other scholars’ work. It does not necessarily involve a claim that the literary work is itself making an argument. Likewise, a chronological literature review presents the scholarly literature in chronological order.

You don’t need to keep strictly to one type. Scholars often combine features from various types of literature reviews. A sample review that combines the follow types –

• Argumentative
• Theoretical
• Methodological

– is the excellent work of Eiranen, Reetta, Mari Hatavara, Ville Kivimäki, Maria Mäkelä & Raisa Maria Toivo (2022) “ Narrative and Experience: Interdisciplinary Methodologies between History and Narratology , ” Scandinavian Journal of History , 47:1, 1-15

When writing your literature review, please follow these pointers:

• Conduct systematic searches
• Use Evidence
• Be Selective
• Use Quotes Sparingly
• Summarize & Synthesize
• Use Caution when Paraphrasing
• Use Your Own Voice

Advice from James Mason University’s “Literature Reviews: An Overview”

A note on synthesizing : Don’t make the common mistake of summarizing individual studies or articles one after the other. The goal is to synthesize — that is, to make observations about groups of studies. Synthesis often uses language like this:

• Much of the literature on [topic x ] focuses on [major themes].
• In recent years, researchers have begun investigating [facets a , b , and c ] of [topic x ].
• The studies in this review of [topic x ] confirm / suggest / call into question / support [idea / practice / finding / method / theory / guideline y ].
• In the reviewed studies [variable x ] was generally associated with higher / lower rates of [outcome y ].
• A limitation of some / most / all of these studies is [ y ].

Please see this sample annotated literature review  from James Mason University.

Structure of a literature review [2]

• Problematization: The 2 to 3 pages of problematization are a distinct, iterative, step. It may take doing such a statement a few times before moving forward to writing the actual paper.
• Search: Write down your keyword sets, your updated keyword sets, and databases. It is perfectly within a reviewer’s rights to ask for these details.
• Summary: Really getting to know major themes requires some annotation of articles. You want to identify core papers and themes and write about them. This helps you really learn the material. [ChatGPT or Wikipedia are no substitute for deep engagement with a paper.]
• Argument: Either outline or create a slide deck that help you express the arguments in your paper. Read them out loud. Have friends look at them. Present them. [Every literature review has an argument. If not, it’s a summary. A summary does not merit publication in a top outlet.]
• Unpacking: Once you’ve nailed the short pitch, unpack the full argument. [ a) Take time in each major section to map out a) the argument, b) the supporting evidence, and the takeaway. b) Take those major sections, reconcile them, make sure they don’t overlap, then move on to writing. c) Sketch out the paper’s sections, tables, figures, and appendices.]
• Writing: Writing is the easy part. You can always put words to the screen. [Revising and improving is hard. Make time to write every day. Improving requires feedback. Find a writing partner to give feedback. Create your tables and figures. Write to them. Make sure the words in the paper align to the visuals.]
• Communicate: When the paper is done, go back and create a paper presentation. [I do this for the papers that I’m most serious about. The act of storyboarding helps me sort out the small pieces of the story that don’t fit together. If I really want it to succeed, I present it. The act of presenting helps me get it right. My best papers sometimes take seven or eight presentations to get it right. Then I return to the paper and fine tune it. Only then, does it have a shot at a top outlet.]

Literature reviews can be published as part of a scholarly article, often after the introduction and sometimes with a header, but they can also be published as a standalone essay. To find examples of what reviews look like in your discipline, choose an appropriate subject database (such as MLA for literary criticism) and conduct a keyword search with the term “Literature Review” added in quotes:

Not only do these examples demonstrate how to structure different types of literature reviews, but some offer insights into trends and directions for future research. In the next section, we’ll take a closer look at some reading strategies to help guide you through this process.

Since scholars already have produced literature reviews on various scholarly conversations, you don’t always need to “reinvent the wheel” (start a literature review from nothing). You can find a published literature review and update it or amend it; scholars do that all the time. However, you must properly cite work you incorporate from others.

• What types of literature review will you be using for your research project? Why did you make this selection over others? If you haven’t made a selection yet, which types are you considering?
• What specific challenges do you face in following a literature review structure?
• If there are any elements of your assignment that need clarification, please list them.
• What was the most important lesson you learned from this page? What point was confusing or difficult to understand?
• In the “Back Matter” of this book, you will find a page titled “Rubrics.” On that page, we provide a rubric for Creating a Literature Review ↵
• Richard West, Brigham Young University, amended by Jason Thatcher, Temple University - https://www.linkedin.com/posts/jason-thatcher-0329764_academicwriting-topten2023-activity-7146507675021766656-BB0O ↵

Writing the Literature Review Copyright © 2021 by Barry Mauer and John Venecek is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Literature review process.

• Introduction
• Video Tutorials
• Select a Topic

Select a Review Type

Narrative/traditional literature review, scoping review, systematic review, meta-analysis, books about literature reviews.

• Search the Literature
• Plan Before Reviewing
• Review the Literature
• Write the Review

Before you start a literature review, you must determine the type of review you need to conduct for your project. Your choice will be influenced by your discipline and the purpose of the review. This page introduces you to four types of literature reviews and recommends resources about and examples of the reviews. The rest of this literature review guide provides general information that applies to most kinds of reviews.

For overviews of all review types, see these readings:

• Typology of Literature Reviews A table from Chapter 9 of Handbook of eHealth Evaluation, 2017.
• A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies A 2009 article from Health Information and Libraries Journal by Grant and Booth.
• Writing integrative literature reviews: Using the past and present to explore the future A 2016 article describing characteristics that should be found in all good literature reviews, regardless of type. Authored by Richard J. Torraco and published in Human Resource Development Review.

Characteristics:

• Most common type of literature review and used in all disciplines; most frequently a section in a book/article/dissertation/thesis, but can also be a standalone review.
• A selective and critical review of the most important literature related to your research question or hypothesis; creates context for your work and identifies the gaps in knowledge where you can contribute to the scholarly conversation.
• Discussion of the literature may be thematic, methodological, or conceptual, but a chronological treatment is discouraged because it tends to become a summary rather than an evaluation of the literature. 
• Am I the Only One Struggling to Write a Lit Review? 11 minute video from Sage Research Methods.
• Literature Review Chapter 7 from Understanding and Evaluating Research: A Critical Guide by Sue L. T. McGregor, 2018.
• Fostering Research and Publication in Academic Libraries Example of a Literature Review section on p. 459; Sassen and Wahl, 2014, College and Research Libraries
• Radical Women in the Struggle: A Review of Recent Literature on the Civil Rights and Black Freedom Movements Example of a standalone review; Charon, 2013, Journal of Feminist Studies in Religion

• A review type mainly used in the social sciences and sciences; usually seen as a standalone review article.
• Conducted to determine the scope and coverage of literature on a topic; the methods and sources for gathering the literature are made transparent so that the review can be reproduced. 
• The review identifies definitions and concepts in a field, methods used, and gaps in knowledge; the results are often communicated through tables. 
• Scoping Studies: Towards a Methodological Framework The article that introduced the framework for conducting scoping reviews by Arksey and O'Malley, 2005, International Journal of Social Research Methodology
• Systematic Review or Scoping Review? Wondering which type of review to do? Read this 2018 article by Munn et al. from the journal, BMC Medical Research Methodology.
• African Immigrant Women’s Experience in Western Host Societies: A Scoping Review Okeke-Ihejirika et al., 2018, Journal of Gender Studies
• A Scoping Review of Mentoring Programs for Academic Librarians Lorenzetti and Powelson, 2015, Journal of Academic Librarianship

For much more information about systematic reviews, visit our Systematic Reviews guide .

• A review type that originated in medicine ( Cochrane Reviews ) and has since been adopted by other health sciences and social sciences ( Campbell Collaboration ); published as a standalone article.
• The review synthesizes knowledge from multiple studies concerning a focused research question and provides an evidence-based conclusion; considered one of the most reliable sources of evidence in medicine.
• Uses transparent criteria for including/excluding literature based on quality. 
• Disciplines have standardized guidelines for conducting and reporting reviews - see Resources.
• Often done by a team composed of experts from the field, information science, and statistics.
• Synthesizing Evidence: Systematic Reviews, Meta-Analysis and Preference Analysis Find an overview of systematic reviews and meta-analyses in Chapter 11 from Research Methods for Clinical and Health Psychology by Marks and Yancey, 2004. For further reading, see the Bibliography of this ebook.
• How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-Analyses, and Meta-Syntheses A 2019 article in Annual Review of Psychology by Siddaway et al.
• Cochrane Handbook for Systematic Reviews of Interventions, Second Edition The official handbook for conducting systematic reviews of interventions in the health sciences.
• PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Highly recommended guidelines for producing transparent systematic reviews and meta-analyses when evaluating randomized clinical trials and interventions; the PRISMA approach is required by some journals.
• Self-management interventions for reducing challenging behaviors among school-age students: A systematic review A 2022 article from Campbell Systematic Reviews by Smith et al.
• The characteristics of effective technology-enabled dementia education: a systematic review and mixed research synthesis A 2022 article by Muirhead et al. from BMC Systematic Reviews.
• Campbell Systematic Reviews See this open access journal from the Campbell Collaboration for examples of systematic reviews in the social sciences.
• Systematic Reviews, BioMed Central See this open access journal for examples of systematic reviews in health sciences.
• A review type that originated in medicine ( Cochrane Reviews ) and has since been adopted by other health sciences and social sciences ( Campbell Collaboration ); published as a standalone article or in combination with a systematic review (see box above).
• The review synthesizes the results of multiple studies using statistics to provide an evidence-based answer to a research question; considered one of the most reliable sources of evidence in medicine.
• Knowledge in application of statistics is required.
• Methods of Meta-analysis: Correcting Error and Bias in Research Findings A comprehensive ebook on meta-analyses by Schmidt and Hunter, 2015.
• Genetic Meta-analysis of Diagnosed Alzheimer's Disease Identifies New Risk Loci and Implicates A Beta, Tau, Immunity and Lipid Processing Kunkle et al., 2019, Nature Genetics
• Research on Religion/Spirituality and Forgiveness: A Meta-analytic Review Davis et al., 2013, Psychology of Religion and Spirituality
• Campbell Systematic Reviews See this open access journal from the Campbell Collaboration for examples of meta-analyses in the social sciences.
• Systematic Reviews, BioMed Central See this open access journal for examples of meta-analyses in health sciences.

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Literature Reviews

• Getting started

What is a literature review?

Why conduct a literature review, stages of a literature review, lit reviews: an overview (video), check out these books.

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

Guide Owner

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Definition: A literature review is a systematic examination and synthesis of existing scholarly research on a specific topic or subject.

Purpose: It serves to provide a comprehensive overview of the current state of knowledge within a particular field.

Analysis: Involves critically evaluating and summarizing key findings, methodologies, and debates found in academic literature.

Identifying Gaps: Aims to pinpoint areas where there is a lack of research or unresolved questions, highlighting opportunities for further investigation.

Contextualization: Enables researchers to understand how their work fits into the broader academic conversation and contributes to the existing body of knowledge.

tl;dr  A literature review critically examines and synthesizes existing scholarly research and publications on a specific topic to provide a comprehensive understanding of the current state of knowledge in the field.

What is a literature review NOT?

❌ An annotated bibliography

❌ Original research

❌ A summary

❌ Something to be conducted at the end of your research

❌ An opinion piece

❌ A chronological compilation of studies

The reason for conducting a literature review is to:

Literature Reviews: An Overview for Graduate Students

While this 9-minute video from NCSU is geared toward graduate students, it is useful for anyone conducting a literature review.

Writing the literature review: A practical guide

Available 3rd floor of Perkins

Writing literature reviews: A guide for students of the social and behavioral sciences

Available online!

So, you have to write a literature review: A guided workbook for engineers

Telling a research story: Writing a literature review

The literature review: Six steps to success

Systematic approaches to a successful literature review

Request from Duke Medical Center Library

Doing a systematic review: A student's guide

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• Tips for Searching for Articles

What is a literature review?

Conducting a literature review, organizing a literature review, writing a literature review, helpful book.

• Avoiding Plagiarism
• Google Scholar

A  literature review  is a compilation of the works published in a particular field of study or line of research, usually over a specific period of time, in the form of an in-depth, critical bibliographic essay or annotated list in which attention is drawn to the most significant works.

• Summarizes and analyzes previous research relevant to a topic
• Includes scholarly books and articles published in academic journals
• Can be an specific scholarly paper or a section in a research paper

The objective of a Literature Review is to find previous published scholarly works relevant to an specific topic

• Help gather ideas or information
• Keep up to date in current trends and findings
• Help develop new questions

A literature review is important because it:

• Explains the background of research on a topic
• Demonstrates why a topic is significant to a subject area
• Helps focus your own research questions or problems
• Discovers relationships between research studies/ideas
• Suggests unexplored ideas or populations
• Identifies major themes, concepts, and researchers on a topic
• Tests assumptions; may help counter preconceived ideas and remove unconscious bias
• Identifies critical gaps, points of disagreement, or potentially flawed methodology or theoretical approaches

Source: "What is a Literature Review?", Old Dominion University,  https://guides.lib.odu.edu/c.php?g=966167&p=6980532

1. Choose a topic. Define your research question. 

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

• Make sure your research question is not too broad or too narrow.
• Write down terms that are related to your question for they will be useful for searches later. 

2. Decide on the scope of your review. 

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

• This may depend on your assignment.
• Consider these things when planning your time for research. 

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

• By Research Guide 

4. Conduct your searches and find the literature. 

• Review the abstracts carefully - this will save you time!
• Many databases will have a search history tab for you to return to for later.
• Use bibliographies and references of research studies to locate others.
• Use citation management software such as Zotero to keep track of your research citations. 

5. Review the literature. 

Some questions to help you analyze the research: 

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

Source: "Literature Review", University of West Florida,  https://libguides.uwf.edu/c.php?g=215113&p=5139469

A literature review is not a summary of the sources but a synthesis of the sources. It is made up of the topics the sources are discussing. Each section of the review is focused on a topic, and the relevant sources are discussed within the context of that topic. 

1. Select the most relevant material from the sources

• Could be material that answers the question directly
• Extract as a direct quote or paraphrase 

2. Arrange that material so you can focus on it apart from the source text itself

• You are now working with fewer words/passages
• Material is all in one place

3. Group similar points, themes, or topics together and label them 

• The labels describe the points, themes, or topics that are the backbone of your paper’s structure

4. Order those points, themes, or topics as you will discuss them in the paper, and turn the labels into actual assertions

• A sentence that makes a point that is directly related to your research question or thesis 

This is now the outline for your literature review. 

Source: "Organizing a Review of the Literature – The Basics", George Mason University Writing Center,  https://writingcenter.gmu.edu/writing-resources/research-based-writing/organizing-literature-reviews-the-basics

• Literature Review Matrix Here is a template on how people tend to organize their thoughts. The matrix template is a good way to write out the key parts of each article and take notes. Downloads as an XLSX file.

The most common way that literature reviews are organized is by theme or author. Find a general pattern of structure for the review. When organizing the review, consider the following: 

• the methodology 
• the quality of the findings or conclusions
• major strengths and weaknesses
• any other important information

Writing Tips: 

• Be selective - Select only the most important points in each source to highlight in the review. It should directly relate to the review's focus.
• Use quotes sparingly.
• Keep your own voice - Your voice (the writer's) should remain front and center. .   
• Aim for one key figure/table per section to illustrate complex content, summarize a large body of relevant data, or describe the order of a process
• Legend below image/figure and above table and always refer to them in text 

Source: "Composing your Literature Review", Florida A&M University,  https://library.famu.edu/c.php?g=577356&p=3982811

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• Literature Review Guidelines

Making sense of what has been written on your topic.

Goals of a literature review:.

Before doing work in primary sources, historians must know what has been written on their topic.  They must be familiar with theories and arguments–as well as facts–that appear in secondary sources.

Before you proceed with your research project, you too must be familiar with the literature: you do not want to waste time on theories that others have disproved and you want to take full advantage of what others have argued.  You want to be able to discuss and analyze your topic.

Your literature review will demonstrate your familiarity with your topic’s secondary literature.

GUIDELINES FOR A LITERATURE REVIEW:

1) LENGTH:  8-10 pages of text for Senior Theses (485) (consult with your professor for other classes), with either footnotes or endnotes and with a works-consulted bibliography. [See also the  citation guide  on this site.]

2) NUMBER OF WORKS REVIEWED: Depends on the assignment, but for Senior Theses (485), at least ten is typical.

3) CHOOSING WORKS:

Your literature review must include enough works to provide evidence of both the breadth and the depth of the research on your topic or, at least, one important angle of it.  The number of works necessary to do this will depend on your topic. For most topics, AT LEAST TEN works (mostly books but also significant scholarly articles) are necessary, although you will not necessarily give all of them equal treatment in your paper (e.g., some might appear in notes rather than the essay). 4) ORGANIZING/ARRANGING THE LITERATURE:

As you uncover the literature (i.e., secondary writing) on your topic, you should determine how the various pieces relate to each other.  Your ability to do so will demonstrate your understanding of the evolution of literature.

You might determine that the literature makes sense when divided by time period, by methodology, by sources, by discipline, by thematic focus, by race, ethnicity, and/or gender of author, or by political ideology.  This list is not exhaustive.  You might also decide to subdivide categories based on other criteria.  There is no “rule” on divisions—historians wrote the literature without consulting each other and without regard to the goal of fitting into a neat, obvious organization useful to students.

The key step is to FIGURE OUT the most logical, clarifying angle.  Do not arbitrarily choose a categorization; use the one that the literature seems to fall into.  How do you do that?  For every source, you should note its thesis, date, author background, methodology, and sources.  Does a pattern appear when you consider such information from each of your sources?  If so, you have a possible thesis about the literature.  If not, you might still have a thesis.

Consider: Are there missing elements in the literature?  For example, no works published during a particular (usually fairly lengthy) time period?  Or do studies appear after long neglect of a topic?  Do interpretations change at some point?  Does the major methodology being used change?  Do interpretations vary based on sources used?

Follow these links for more help on analyzing  historiography  and  historical perspective .

5) CONTENTS OF LITERATURE REVIEW:

The literature review is a research paper with three ingredients:

a) A brief discussion of the issue (the person, event, idea). [While this section should be brief, it needs to set up the thesis and literature that follow.] b) Your thesis about the literature c) A clear argument, using the works on topic as evidence, i.e., you discuss the sources in relation to your thesis, not as a separate topic.

These ingredients must be presented in an essay with an introduction, body, and conclusion.

6) ARGUING YOUR THESIS:

The thesis of a literature review should not only describe how the literature has evolved, but also provide a clear evaluation of that literature.  You should assess the literature in terms of the quality of either individual works or categories of works.  For instance, you might argue that a certain approach (e.g. social history, cultural history, or another) is better because it deals with a more complex view of the issue or because they use a wider array of source materials more effectively. You should also ensure that you integrate that evaluation throughout your argument.  Doing so might include negative assessments of some works in order to reinforce your argument regarding the positive qualities of other works and approaches to the topic.

Within each group, you should provide essential information about each work: the author’s thesis, the work’s title and date, the author’s supporting arguments and major evidence.

In most cases, arranging the sources chronologically by publication date within each section makes the most sense because earlier works influenced later ones in one way or another.  Reference to publication date also indicates that you are aware of this significant historiographical element.

As you discuss each work, DO NOT FORGET WHY YOU ARE DISCUSSING IT.  YOU ARE PRESENTING AND SUPPORTING A THESIS ABOUT THE LITERATURE.

When discussing a particular work for the first time, you should refer to it by the author’s full name, the work’s title, and year of publication (either in parentheses after the title or worked into the sentence).

For example, “The field of slavery studies has recently been transformed by Ben Johnson’s The New Slave (2001)” and “Joe Doe argues in his 1997 study, Slavery in America, that . . . .”

Your paper should always note secondary sources’ relationship to each other, particularly in terms of your thesis about the literature (e.g., “Unlike Smith’s work, Mary Brown’s analysis reaches the conclusion that . . . .” and “Because of Anderson’s reliance on the president’s personal papers, his interpretation differs from Barry’s”). The various pieces of the literature are “related” to each other, so you need to indicate to the reader some of that relationship.  (It helps the reader follow your thesis, and it convinces the reader that you know what you are talking about.)

7) DOCUMENTATION:

Each source you discuss in your paper must be documented using footnotes/endnotes and a bibliography.  Providing author and title and date in the paper is not sufficient.  Use correct Turabian/Chicago Manual of Style form.  [See  Bibliography  and  Footnotes/Endnotes  pages.]

In addition, further supporting, but less significant, sources should be included in  content foot or endnotes .  (e.g., “For a similar argument to Ben Johnson’s, see John Terry, The Slave Who Was New (New York: W. W. Norton, 1985), 3-45.”)

8 ) CONCLUSION OF LITERATURE REVIEW:

Your conclusion should not only reiterate your argument (thesis), but also discuss questions that remain unanswered by the literature.  What has the literature accomplished?  What has not been studied?  What debates need to be settled?

Additional writing guidelines

History and American Studies

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Code of Ethics

You are here

*NEW* Thousands of you have since shared your ideas, needs, and feedback through surveys and focus groups. With that guidance, and led by extraordinary workgroups made up of Governing Board members, educators, faculty, researchers, partners, and advisors, we are honored to be able to launch a public comment period with draft versions of Code of Ethics for your review through November 15, 2024.  

English   Español

You are invited to engage in the process of collective revision with us. Here are three ways you can provide feedback during this time:   

1. Take a survey. NAEYC has prepared surveys for both statements, available in English and Spanish . In addition to offering general feedback opportunities, these surveys will help guide you towards some areas where we are seeking specific feedback on open or unresolved questions.   

English Survey   Encuesta en español

2. Email your reflections. NAEYC is committed to reading, and translating if needed, all comments that come our way, so feel free to send your thoughts, in your preferred language, directly to [email protected] .     

3. Participate in conferences and focus groups. NAEYC and many Affiliates and Interest Forums will be holding conferences, meetings, and focus groups exploring one or both of these position statement drafts this fall, providing you with opportunities to share feedback in person and/or virtually.   

Thank you for helping us shape these collective, shared resources that support early childhood educators, partnering with families, in creating joyful, equitable learning environments for all. 

Thank you to the workgroup members who have done tremendous heavy lifting in bringing us to this point. 

• Leah Austin, President and CEO, The National Black Child Development Institute 
• Raquel Diaz, Implementation Consultant for Triple P 
• Cynthia DiCarlo, Professor of Early Childhood Education, Louisiana State University 
• Christyn Dundorf, Co-director, Teaching Preschool Partners 
• Zeynep Isik-Ercan, President, National Association of Early Childhood Teacher Educators and Department Chair of Early Childhood, Rowan University 
• Benita Flores-Muñoz, Member of the NAEYC Commission on Early Childhood Higher Education Accreditation and Retired ECE faculty , Del Mar College 
• Robin Fox, Interim Provost, University of Wisconsin Whitewater 
• *Stacey French-Lee, NAEYC Governing Board Member, and Clinical Assistant Professor, Executive Director of the Campus Child Development Program, Early Childhood and Elementary Education, Georgia State University 
• Heidi Friedel, NAEYC Faith Based Interest Forum Facilitator, Early Childhood Consultant, and Staff Support Specialist for ECE Subhub 
• Eugene Geist, Associate Professor, Louisiana State University 
• Georgia Goldburn, Executive Director, Hope For New Haven and Co-founder,CERCLE 
• *Brian Johnson, NAEYC Governing Board Member, and Assistant Dean, James Madison College at Michigan State University 
• Sim Loh, Public Policy Specialist, First Up: Champions for Early Education 
• Andrea Maldonado, Director of Quality Assessment and Recognition, National Association for Family Child Care 
• Meir Muller, Associate Professor of Early Childhood Education,University of South Carolina 
• Ernesto Muñoz, Senior Project Manager of Curriculum Literacy, University of Texas 
• Richelle Patterson, Senior Policy Analyst,  National Education Association
• Anu Sachdev, President, ACCESS and Adjunct ECE Faculty, East Stroudsburg University 
• **Ian Schiefelbein, ECE Faculty, Central New Mexico Community College 
• Ashley Simpson, BIPOC Educator Recruitment and Retention Strategies Program Manager, Aurora Public School District 
• *Toni Sturdivant, NAEYC Governing Board Member, and Director of Early Learning, Mid-America Regional Council 
• Tracy Weston, GAEYC District 1 Representative and Co-Founder, Noah's Ark Preschool Academy of Terrell, Inc. 
• **Reginald Williams, Full Professor of Early Childhood Education, South Carolina State University 

*Current NAEYC Governing Board Members  **Former NAEYC Governing Board Members 

NAEYC is grateful to our funders and supporters who make this work possible, including those who have donated through the Marilyn M. Smith Applied Research Fund

*NUEVO* Miles de ustedes compartieron sus opiniones, necesidades y comentarios a través de encuestas y grupos de discusión. Con esa guía, y liderados por grupos de trabajo extraordinarios compuestos por miembros del Directorio, docentes, socios y asesores, nos honra poder lanzar un período abierto a comentarios del público con versiones borrador de El Código de Conducta Ética y Declaración de Compromiso revisada para su lectura.   

Inglés   Español

Están invitado a participar en el proceso de revisión colectiva con nosotros. Estas son tres maneras en las que puede enviar sus comentarios durante este período:   

1. Responda una encuesta: La NAEYC preparó encuestas para ambas declaraciones, disponibles en inglés y en español . Además de ofrecer oportunidades generales para hacer comentarios, estas encuestas sirven de ayuda para guiarlo hacia algunas áreas en las que buscamos recibir comentarios específicos o preguntas abiertas o sin respuesta.   

Encuesta en inglés   Encuesta en español

2. Envíe sus reflexiones por correo electrónico. La NAEYC asume el compromiso de leer, y traducir si es necesario, todos los comentarios que recibamos, de manera que puede enviar libremente sus ideas, en su idioma de preferencia, directamente a [email protected] .    

3. Participe en conferencias y grupos de discusión. La NAEYC y muchas Afiliadas y Foros de interés organizarán conferencias, reuniones y grupos de discusión y estudiarán uno o ambos borradores de esta declaración de posición durante este otoño y le ofrecerán oportunidades para compartir sus comentarios de manera presencial y/o virtual.

Gracias a ustedes por ayudarnos a dar forma a estos recursos colectivos y compartidos que apoyan a los docentes de educación inicial, en colaboración con las familias, para crear ambientes educativos, disfrutables e igualitarios para todos.  

Gracias a los miembros del grupo de trabajo que han hecho un tremendo trabajo para llegar a este punto. 

• Richelle Patterson, Senior Policy Analyst, National Education Association
• Anu Sachdev, President,  ACCESS and Adjunct ECE Faculty, East Stroudsburg University 

NAEYC agradece a nuestros financiadores y patrocinadores que hacen posible este trabajo, incluidos aquellos que han donado a través del Marilyn M. Smith Applied Research Fund.

Position Statements

(Reaffirmation and Updated, 2011)  

• NAEYC Code of Ethical Conduct Brochure

Supplements

More ethics resources.

Teaching the NAEYC Code of Ethical Conduct: A Resource Guide, Revised Edition

Ethics and the Early Childhood Educator: Using the NAEYC Code, Second Edition

Sample Activities from Teaching the NAEYC Code of Ethical Conduct: A Resource Guide, Revised Edition

Why naeyc has updated the ethics position statements.

In May 2011, the NAEYC Governing Board reaffirmed the 2005 Code and updated this position statement to reflect consistency with the “Supplement for Early Childhood Program Administrators,” which was initially approved in July 2006. Specifically, Section III-C of the Code (Ethical Responsibilities to Colleagues / Responsibilities to Employees) was deleted, as these Ideals and Principles are addressed in the Supplement. Other minor modifications were also made to ensure clarity and consistency. In addition, changes were made to Ideals and Principles that regard responsibilities to families to ensure alignment with current family engagement best practices in the field.

The “Supplement for Early Childhood Program Administrators” was also reaffirmed by the NAEYC Governing Board in May 2011, and changes were made to Ideals and Principles that regard responsibilities to families to ensure alignment with current family engagement best practices in the field. In addition, references to the Code of Ethical Conduct, Section III, Part C: Responsibilities to Employees were deleted, as Section III, Part C was deleted in the May 2011 update of the Code.

A Meta-Analysis of Self-Regulated Learning Interventions Studies on Learning Outcomes in Online and Blended Environments

• Mochamad Guntur Universitas Negeri Yogyakarta
• Yoppy Wahyu Purnomo Universitas Negeri Yogyakarta

Self-regulated learning intervention studies influence students’ learning outcomes in online and blended environments.  Reviewing the national literature about self-regulated learning strategies, studies have indicated both significant and insignificant effects on learning outcomes in online and blended environments. The aim of this study is to calculate the common effect size of empirical studies conducted out between 2017-2022 that investigated the effect of self-regulated learning strategies on learning outcomes in online and blended environments, and to determine whether the common effect size shows a significant difference in terms of course type, self-regulated learning strategy type, school level, and learning context. A meta-analytical review method was employed to combine the outcome of independent empirical studies. The studies included in this review were collected from Scopus, IEEE Explore, and ERIC databases.  A total of 15 studies included in this study. Cohen’s d coefficient was calculated for the effect size in this study. As the heterogeneity among the effect sizes of the studies was high ( Q > χ2, p < .05), the common effect size was calculated in accordance with the random effects model. As a result of the meta-analysis, it was determined that self-regulated learning strategies had a “moderate” effect ( Q = 0.65) on learning outcomes in online and blended environments. Moreover, the calculated common effect size showed no significant difference according to the type of self-regulated learning strategy, course type, school level, and learning context.

Author Biographies

Mochamad guntur, universitas negeri yogyakarta, yoppy wahyu purnomo, universitas negeri yogyakarta.

Copyright (c) 2024 Mochamad Guntur, Yoppy Wahyu Purnomo

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• Open access
• Published: 04 September 2024

Characteristics of equestrian accidents and injuries leading to permanent medical impairment

• Helena Stigson   ORCID: orcid.org/0000-0002-2409-1379 1 , 2 &
• Maria Klingegård   ORCID: orcid.org/0000-0002-1539-2006 1  

BMC Sports Science, Medicine and Rehabilitation volume  16 , Article number:  184 ( 2024 ) Cite this article

Metrics details

Equestrian sports, also referred to as equestrianism, is practiced all over the world and a popular leisure activity in Sweden. Equestrianism is the country’s second-largest youth sport, and previous studies indicate that accidents are common in equestrianism. However, few previous studies have examined acute equestrian injuries leading to permanent medical impairment (PMI).

By using nationwide insurance data comprising all injured equestrians registered in the Swedish Equestrian Federation, the aim was to analyse characteristics of equestrian accidents and particularly injuries leading to PMI, both in general and by age, gender, incident type, injury type and injured body region. Injury incidence and injuries leading to PMI were examined. All equestrians injured during 2017–2021 were included ( n  = 6,876), however, only injuries occurring in 2017 and 2018 were used to analyse the risk and the injury distribution of injuries leading to PMI. Injury incidence was calculated separately for males and females, as well as for different age groups, by dividing the number of insurance claims by the number of members multiplied by 1,000. Risk Ratio (RR) was calculated between gender. Pearson’s chi-squared test was used to analyse differences in distribution for categorical variables.

The majority of injuries affected females, correlating to approximately three times higher risk, compared to males. The age group 21–40 years were associated with the highest injury risk (14.26/1,000 registered riders). In total 12% of all injuries led to PMI. Injuries to the upper and lower extremities, along with fractures, had a higher risk of resulting in a PMI. The risk of injury leading to PMI was higher among riders over 20 years of age.

Conclusions

The fact that females face nearly three times the injury risk of males, and riders aged 21–40 had the highest injury risk while younger riders (Luke KL, McAdie T, Smith BP, Warren-Smith AK. New insights into ridden horse behaviour, horse welfare and horse-related safety. Appl Anim Behav Sci. 2022;246:105539.); (Havlik HS. Equestrian sport-related injuries: a review of current literature. Curr Sports Med Rep. 2010;9(5):299–302.); (Samuels K, Bettis A, Davenport DL, Bernard AC. Occupational vs. non-occupational equestrians: Differences in demographics and injury patterns. Injury. 2022;53(1):171–5.); (Gharooni A-A, Anwar F, Ramdeep R, Mee H. Severe equestrian injuries: A seven-year review of admissions to a UK major trauma centre. Trauma. 2023;25(1):41–7.); (Hasler RM, Gyssler L, Benneker L, Martinolli L, Schotzau A, Zimmermann H, et al. Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey. J Trauma Manag Outcomes. 2011;5:4.); (Meredith L, Brolin K, Ekman R, Thomson R. Analyses of injuries to equestrians in a Swedish district over a 16-year period. Translational Sports Med. 2019;2:270–8.) had a lower risk, indicates that preventive efforts should target both older and female riders. Injuries predominantly resulting in PMI involve upper and lower extremities, however, to prevent the most serious injuries significantly affecting a rider’s daily life, measures preventing head and spinal cord neck injuries, must be implemented. Head injures remain the most frequent, serious and most significant group of injuries to prevent and mitigate, within equestrian sports.

Peer Review reports

Equestrianism, a popular activity in Sweden since the mid-twentieth century [ 1 ], offers numerous physical [ 2 ] and psychological benefits [ 3 ]. It is enjoyed both recreationally and therapeutically, providing muscular exercise and improved balance for a healthier lifestyle. However, globally, horse riding is emerging as a significant public health concern, with statistics showing an alarming frequency of acute injuries and even fatalities linked to equestrian accidents [ 4 , 5 , 6 ]. Unlike many other sports, riding is a high risk sport due to the elevated position of riders on powerful horses, horse speed, and the unpredictability of horse behaviour [ 7 ], making it different to many other sports. Risk factors may be influenced by the higher number of female riders, especially at the recreational and amateur levels [ 8 , 9 , 10 , 11 ].

Previous studies on Swedish equestrian injuries show that accidents affect all ages [ 6 , 12 , 13 , 14 ], although the highest risk of injury is found among riders aged 21–40 years (8.83/1000 registered riders) [ 13 ]. On average, three fatal accidents occurred annually between the years 1997–2014 [ 14 ]. Several studies have shown that the rider is usually injured due to falling off the horse [ 6 , 10 , 13 , 15 ]. Other common causes of injury include the rider being bitten, kicked or trampled on. An overview by Meredith et al. [ 15 ] shows that the type and location of injury depend on the activity performed (e.g. riding and handling a horse). In addition, the injury pattern changes with the rider’s age [ 6 , 13 , 14 , 16 ]. For example, Franzén et al. [ 6 ] demonstrated that as age increases, the risk of upper extremity injuries decreases, while the risk of vertebral fractures and thoracic injuries rises. In general the head is the most frequently injured region [ 17 ] and equestrian sports have been identified as one of the predominant contributors to sports-related traumatic brain injury [ 18 ]. Furthermore, almost half of equestrian riders (44%) were subject to concussion during their career [ 19 ]. Equestrians are exposed to both acute injuries and overuse injuries. Meyer et al. [ 20 ] found that overuse injuries among German show jumpers are relatively infrequent and primarily affect the upper extremities. Additionally, a study of Swedish eventing athletes revealed that acute injuries are more common than overuse injuries [ 21 ].

Few studies have had the opportunity to study if long-term consequences arise from equestrian injuries. The existing studies primarily focus on serious injuries that have required hospital care often treated at a trauma centre. Hence, the percentage of injuries resulting in long-term consequences, is as high as up to 50% of all injuries (see for example [ 22 , 23 , 24 , 25 ]). The Swedish insurance company, Folksam Insurance Group (Folksam), has been the appointed insurer for all members of the Swedish Equestrian Federation since 2017, providing the possibility of verifying and following up on injuries leading to long-term consequences, denoted as permanent medical impairment (PMI). Since all members are included, the data set is suitable for evaluating incidence rates. Studies into equestrian injuries leading to PMI a currently lacking. Grading of medical impairment degree [ 19 ] principles, established in the early 20th century in consensus between physicians, are applied by Swedish insurance companies. PMI is assigned a percentage between 1 and 99, regardless of the individual’s occupation or hobbies. Examples of impairment degrees include: 7% for an unstable ankle joint, 5–20% for a shoulder with maximal flexion of 0-120°, 37% for loss of one hand, 68% for total blindness, and 99% for severe dementia. Previous studies have shown that PMI can be used to predict which injuries should be prioritised to prevent lifelong complications (see for example [ 26 , 27 ]). Hence, it is crucial to study the long-term consequences of rider injuries, being essential for riders’ overall well-being, the sustainability of sports careers, and the development of effective preventive actions.

The aim of this study was to analyse characteristics of equestrian accidents and particularly injuries leading to PMI, both in general and by age, gender, incident type, injury type and injured body region.

Materials and methods

Folksam offers comprehensive insurance coverage to all members of the Swedish Equestrian Federation, covering everyone from beginners to competitive athletes. The insurance covers every member during training, Swedish Equestrian Federation activities, as well as competitive riding. This five-year retrospective study includes all horse-related injuries among all members of the Swedish Equestrian Federation reported to Folksam between 1 January 2017 and 31 December 2021 ( n  = 6,876). From 2017 to 2021 the number of registered members has increased from 138,511 to 143,516. Both exposure on an individual level and injury data were used.

All eligible injuries, defined as an acute injury reported to the sport injury database of Folksam, occurring while participating in an activity with, or related, to horses. This definition comprises both horse riding and horse care activities, in conjunction with either training or competition. An acute injury is defined as an injury resulting from a specific identifiable event. Overuse injuries, resulting from repetitive microtrauma to tissues over time without sufficient recovery are not covered by the insurance, and therefore not included in the study. Injuries were reported by the rider, or a parent of minor riders, via telephone or online. In the present study, all riders undergoing a medical examination within one week of the accident, were included. Consequently, all injuries, regardless of severity or the healthcare they received, have been included. While the majority of injuries were diagnosed by physicians, some were diagnosed by other experts, such as physiotherapists. The injuries were categorised into different categories based on type of injury and body location. The injured body region was categorised into five groups: head and neck (including face), torso, upper extremities, lower extremities and unknown. The type of injury was based on the classification made by claims adjusters including the following seven groups: fracture, dislocation/rupture, sprain/strain, laceration/abrasion/contusion, concussion, and “multiple injury types”. The category “multiple injuries types” includes riders who have sustained multiple injuries simultaneously.

An acute injury can lead to a PMI, resulting in lifelong complications [ 28 ]. A total of 357 personal injuries resulted in PMI in the years 2017 to 2021. However, as determining whether an injury will result in permanent impairment takes at least two years, in some cases significantly longer, only injuries occurring in 2017 and 2018 were used to analyse the risk and injury distribution of injuries leading to PMI. The incidence of PMI was calculated as a proportion of all registered injuries during these two years. A preliminary degree may be assigned before establishing PMI due to the challenge of accurately predicting the long-term consequences of an injury, especially among young people or in cases of specific diagnosis such as brain injuries with long rehabilitation Therefore, both preliminary and permanent degrees are included in this study.

Data comprised information on age (0–6, 7–12, 13–20, 21–40, 41 years or older, predefined by the Swedish Equestrian Federation) gender, date of injury, nature of injury and injured body region. Additionally, claimants were required to provide a description of the injury event, which was then categorised into type of activity (horse riding, horse handling, mounting or dismounting or other) and incident type (caught in equipment, falls, kicks, trampled or “other” (including for example being bitten, crushed, and knocked by horse). The study has been approved by the Swedish Ethical Review Authority (Dnr 2018/711 − 31/5). Participant consent is governed by the insurance agreement, which includes a provision requiring their consent to contribute to research. As such, individual consent from each injured participant was not required.

Statistical analysis

Descriptive statistics, including frequencies and percentages, were conducted on all available variables using IBM SPSS Statistics version 28. The injury incidence was calculated separately for males and females, as well as for different age groups, by dividing the number of insurance claims by the total number of members and multiplying the result by 1,000. This is expressed as “the number of injuries per 1,000 members”. The Risk Ratio (RR) was calculated to compare the risk between gender, obtained by dividing the injury incidence in females by that in males [ 29 ]. Pearson’s chi-squared test was used to analyse differences in distributions for categorical variables. All analyses were two-sided, with a significance level set at p  < 0.05.

During the period 2017 and 2021, 6,876 riders made insurance claims to Folksam following an acute traumatic injury while participating in horse riding or horse care activities, Table  1 . Among the 6,876 equestrians involved in accidents, a total of 7,768 injuries were reported, resulting in an average of 1.1 injuries per individual. Within the study period, a total of three riders were fatally injured. In total, female riders predominated, with 97% of the injured equestrians being female. The average age of injured riders was 29 years, ranging from 3 to 80 years. The average age of men was higher compared to women. The average age for women was 29 years (ranging from 6 to 75 years), whereas for men it was 38 years (ranging from 3 to 80 years). The percentage of riders injured in the different age-groups compared with all registered members can be seen in Fig.  1 . The proportion of injuries was highest among older age groups.

Distribution of injuries and total number of insured riders per age category (average number of members in the years 2017 to 2021)

Incident type and type of activity

The predominant incident type was falls from horseback, making up 84% of incidents, followed by kicks at 4%, entanglement in equipment at 3%, and being trampled by a horse at 2%, Table  1 . Among riders with multiple injuries, a slightly higher proportion of featured incidents falling off the horseback while riding (88%). Falls were the primary cause of injuries during riding, whereas kicks usually occurred during horse-handling and mounting/dismounting activities. In total, 87% of the injuries occurred while riding, 9% during horse-handling and 2% while mounting/dismounting, Table  1 .

Body location

Aggregated data on body region shows that the most injured body region was the “head and neck” (44%) followed by “upper extremity” (28%), Table  2 .

Injury type

The most frequently seen injury types were soft tissue injuries such as laceration, abrasion, and contusion (34%) and fractures (32%), Fig.  2 . Concussion was also commonly occurring, accounting for 18% of all injuries. Fractures were higher among riders older than 20 years of age ( p  < 0.001). There was a higher proportion of concussion among female riders ( p  = 0.038), however, gender did not make a difference with regard to fractures.

Distribution of the different types of injuries based on all injuries 2017–2021

Injuries leading to PMI

In total, 12% of all injured riders sustained a PMI during the years 2017 and 2018. Of these, 42% involved an injury to the upper extremities, Table  2 . Fingers, followed by a shoulder, were the most common parts of the upper extremities affected. The highest risks of sustaining a PMI for an injury was found for the upper and lower extremities (19% and 18% respectively), Table  3 . However, head and neck injuries often resulted in a higher average degree of PMI than other injuries. The majority of riders who had sustained PMI of 10% or more, had suffered a brain injury or damage to the spine.

Fracture was the most common type of injury leading to PMI, Fig.  3 . The risk of a fracture resulting in PMI was higher compared to other injuries ( p  < 0.001). Furthermore, riders with multiple injuries had a higher risk of either of the injuries resulting in PMI, than riders with only one injury ( p  = 0.01). There was no difference between genders if an injury resulted in PMI. However, a higher risk of injury resulting in PMI was higher among riders older than 20 years of age ( p  < 0.001). The average age of a rider with an injury resulting in PMI was 37 years.

Distribution of different types of injuries showing injuries leading to PMI

The majority of injuries resulting in PMI occurred during riding activities (74%), primarily resulting from falls off a horse (93%). About 18% of PMI cases stemmed from horse handling, with kicks or entanglement in equipment being the primary causes. Irrespective of the activity, falls constituted the most common cause of injury (70%), followed by being kicked by the horse (7%) and getting caught in equipment (7%).

• Injury incidence

The overall injury incidence rate was 8.98 injuries per 1,000 registered riders per year, Table  4 . Females were associated with an almost three times higher risk of injury than males (RR = 2.71) in general, at an injury incidence of 9.47 compared with 3.49 for males and more than three times higher risk of an injury resulting in PMI (RR = 3.47, 2.08 for females and 0.6 for males). Riders aged 21–40 years were associated with the highest injury incidence (14.25/1,000 registered riders), while 0-6-year-olds had the lowest (1.51/1,000 registered riders). Riders aged 13–20 years or 21–40 years were associated with the highest incidence of concussions (2.27–2.33/1,000 registered riders), although the proportion of concussions were highest among riders younger than 21 years of age ( p  < 0.001).

In this retrospective cohort study evaluating injured members of the Swedish Equestrian Federation spanning all age groups, it was found that around 1,400 riders annually, had reported equestrian injuries via their insurance. This corresponds to approximately 26 injured riders per week. Notably, injures affect riders across all ages, with the average age of injury being 29 years. Although, it is often highlighted that younger riders sustain injuries [ 6 , 12 , 30 ], which holds true in terms of raw injury numbers, when injured riders are put in relation to the proportion of practitioners in each age group, the results from this study uncover a higher risk of injury among older riders.

In previous studies such as Meredith et al. [ 12 ] and Franzén et al. [ 6 ], who studied admissions to healthcare facilities in one region of Sweden and one hospital trauma registry, they showed that most injured people were aged 10 to 21 years. Furthermore, another Swedish study estimated that approximately 9,000 of riders, injured annually in equestrian activities, required visiting an Accident & Emergency department, and that the largest proportion of injured riders were found in the 11–17 age group [ 31 ]. The average age of injured riders was 24 years in Franzén et al. [ 6 ] and 27 years in Meredith et al. [ 14 ], with the highest number of injuries in the age group 0–18 years. It is important to consider that these studies are based on all individuals who sought medical care after a horse riding and/or handling accident and are not in relation to the number of individual’s practicing these activities on a regular basis. Furthermore, it remains unclear how many of these riders were injured due to activities within the Swedish Equestrian Federation. In the present study, the results are based on Folksam injury data, which only comprises members of the Swedish Equestrian Federation and cases the data was set in proportion to injuries in relation to the number of members.

However, there are some international studies showing that both the number of injuries and the risk of being injured differ for different riding ages [ 13 , 16 , 30 , 32 ]. Similar to the present study, Smartt and Chalmers [ 32 ] found comparable average ages and noted that females tended to be younger and more frequently injured than males. However, the incidence rates were based on general participation in equestrian activity and not membership of an equestrian federation. This difference presents a challenge when directly comparing these findings to the data in the present study. Acton et al. [ 33 ] demonstrate parallels with the present study in that most horse-related injuries were diagnosed as a fracture or soft tissue injury. Furthermore, similarities were also found when studying female riders, who were more likely to have sustained a head and neck injury as well as being diagnosed with a concussion, compared to male riders. Similarly, younger riders were more likely to sustained a head and neck injury or be diagnosed with concussion, than older riders. In the present study older riders had a higher risk of both injuries and injuries leading to PMI. This aligns with findings from a study using German data [ 17 ], emphasising the importance of considering older individuals as a target group in efforts aiming at preventing serious injuries. A literature study by Meredith et al. [ 15 ], however, shows few studies indicating that older, rather than younger riders, have a higher injury rate. This statistic is mainly due to more young riders being included in previous studies. Acton et al. [ 33 ] highlight the need for more studies including older riders. Therefore, it is recommended that further studies explore the increased injury risk among older riders and investigating other injury characteristics in further detail, which could provide deeper insight into effective preventive strategies.

Regarding equestrian injuries leading to long-term consequences, Ball et al. [ 25 ] showed that a high number of orthopaedic related injuries resulted in residual functional deficits, supporting the finding of the present study showing that fractures more often resulted in PMI compared to other injuries. In total 12% of all the injured riders during the years 2017 and 2018 sustained a PMI. While this figure might appear low in contrast to a previous study [ 25 ], it is important to note that the present study includes all injuries, irrespective of healthcare and injury severity. PMI was higher among riders older than 20 years of age, for several reasons. A medical impairment is considered permanent when no further improvement in physical and/or mental function is expected with additional treatment. Medical impairment injury is monitored until the permanent degree of medical impairment can be determined, which in some cases take several years and cannot always be established until adulthood. This might explain why young riders had a lower risk of an injury resulting in PMI. However, previous studies have shown that in general, the risk is higher for older individuals [ 34 , 35 ]. Compared to studies involving individuals from other sports federations, such as the Swedish Cycling Federation, the risk of an injury sustained in competitive cycling resulting in PMI was lower than that observed among equestrians (9% compared to 12%) [ 36 ]. As a rider, you sit approximately 3 m above the ground, on an animal that can easily weigh 500 kg or more. High speed combined with falling from a great height is a major risk factor for severe injuries, not found in many other sports and activities.

In similarity with several studies, the most common incident was falls from horseback [ 13 , 16 , 30 , 32 , 33 ]. Falls from horses also constitute the majority of accidents involving injuries leading to PMI. However, when studying injuries leading to PMI, the proportion of accidents occurring while handling a horse, with kicks or entanglement in equipment being primary causes, becomes more significant (18% compared to 9% of all injuries). Hence, it is crucial to also consider that handling a horse presents a notable risk of injury. This aspect has been highlighted by Krüger et al. [ 17 ] and should be included when devising injury prevention strategies. For instance, adopting safety measures like wearing helmets and body protectors during horse-handling could effectively minimise the risk of injuries.

One of the main strengths of this study is the use of high quality insurance register data, with exposure data for the total Swedish Equestrian Federation population coverage and follow-up over several years. As mentioned, at the earliest, the PMI is assessed by the insurance company two years following an injury, thus PMI has only been based on data for the years 2017 and 2018. If the policyholder has an agreement with more than one insurance company, all companies will compensate for the PMI but not for the acute injury. This might exaggerate the risk of injuries leading to PMI.

The protective effects of equestrian helmets for head and facial injuries have been confirmed [ 11 ]. In the present study, head and neck injuries accounted for 44% of all injuries and it could therefore be argued that current helmet designs are not efficient enough. However, one limitation with the present study includes not being able to investigate all accidents in which riders were wearing a helmet. The insurance data only allowed tracking of cases where compensation was claimed due to damaged helmets. Nonetheless, several studies have stated that the protective effect of helmets must be improved and should be designed specifically for the softer ground and impact surfaces typically seen in falls from horsebacks [ 37 , 38 , 39 ]. During Swedish Equestrian Federation events, riders are required to wear a helmet while riding, and the recommendation of wearing a helmet while on the ground, is becoming more common. This recommendation should be further encouraged and enforced.

In the present study, only acute injuries were included. To gain a comprehensive understanding of all injuries among equestrians, overuse injuries should also be studied [ 20 , 21 ]. Furthermore, it has not been feasible to examine acute injuries across the various disciplines of equestrian sport, which would benefit from being investigated in future studies.

This nationwide register study shows that annually, approximately 1,400 out of 155,000 members within the Swedish Equestrian Federation, made a claim following an acute traumatic injury while participating in a horse-related activity. Therefore, the incidence of being injured is nine injured riders per 1,000 insured. The majority of injuries affected females, correlating with an almost three times higher risk compared to males.

Younger riders are often highlighted as the most injury-prone group. However, this study highlights that riders aged 21–40 years were associated with the highest risk of injury, whereas young riders (7–12 years old) had a comparatively lower risk. Furthermore, the injury distribution differs by age group and injuries resulting in PMI is higher among older riders. Hence, preventive efforts should target older riders as well.

This study further confirms that falls from horses are the single most significant cause of equestrian accidents, however, handling a horse also presents a notable risk of injury. Approximately, 12% of injuries led to PMI. Injuries to the upper and lower extremities, along with fractures, had a higher risk of resulting in a PMI. However, to prevent the most serious injuries significantly affecting a rider’s daily life, measures to prevent head and spinal cord neck injuries should be implemented. Therefore, head injures remain the most frequent, serious and the most important injuries to prevent and mitigate within equestrian sports.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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HS and MK planned and designed the study as well as analysed the data. HS drafted the manuscript that was read and critically revised by MK. Both authors approved the final version.

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Stigson, H., Klingegård, M. Characteristics of equestrian accidents and injuries leading to permanent medical impairment. BMC Sports Sci Med Rehabil 16 , 184 (2024). https://doi.org/10.1186/s13102-024-00973-8

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Insights into research activities of senior dental students in the Middle East: A multicenter preliminary study

• Mohammad S. Alrashdan 1 , 2 ,
• Abubaker Qutieshat 3 , 4 ,
• Mohamed El-Kishawi 5 ,
• Abdulghani Alarabi 6 ,
• Lina Khasawneh 7 &
• Sausan Al Kawas 1  

BMC Medical Education volume  24 , Article number:  967 ( 2024 ) Cite this article

Metrics details

Despite the increasing recognition of the importance of research in undergraduate dental education, limited studies have explored the nature of undergraduate research activities in dental schools in the Middle East region. This study aimed to evaluate the research experience of final year dental students from three dental schools in the Middle East.

A descriptive, cross-sectional study was conducted among final-year dental students from three institutions, namely Jordan University of Science and Technology, University of Sharjah (UAE), and Oman Dental College. Participants were asked about the nature and scope of their research projects, the processes involved in the research, and their perceived benefits of engaging in research.

A total of 369 respondents completed the questionnaire.  Cross-sectional studies represented the most common research type  (50.4%), with public health (29.3%) and dental education (27.9%) being the predominant domains. More than half of research proposals were developed via discussions with instructors (55.0%), and literature reviews primarily utilized PubMed (70.2%) and Google Scholar (68.5%). Regarding statistical analysis, it was usually carried out with instructor’s assistance (45.2%) or using specialized software (45.5%). The students typically concluded their projects with a manuscript (58.4%), finding the discussion section most challenging to write (42.0%). The research activity was considered highly beneficial, especially in terms of teamwork and communication skills, as well as data interpretation skills, with 74.1% of students reporting a positive impact on their research perspectives.

Conclusions

The research experience was generally positive among surveyed dental students. However, there is a need for more diversity in research domains, especially in qualitative studies, greater focus on guiding students in research activities s, especially in manuscript writing and publication. The outcomes of this study could provide valuable insights for dental schools seeking to improve their undergraduate research activities.

Peer Review reports

Introduction

The importance of research training for undergraduate dental students cannot be overstressed and many reports have thoroughly discussed the necessity of incorporating research components in the dental curricula [ 1 , 2 , 3 , 4 ]. A structured research training is crucial to ensure that dental graduates will adhere to evidence-based practices and policies in their future career and are able to critically appraise the overwhelming amount of dental and relevant medical literature so that only rigorous scientific outcomes are adopted. Furthermore, a sound research background is imperative for dental graduates to overcome some of the reported barriers to scientific evidence uptake. This includes the lack of familiarity or uncertain applicability and the lack of agreement with available evidence [ 5 ]. There is even evidence that engagement in research activities can improve the academic achievements of students [ 6 ]. Importantly, many accreditation bodies around the globe require a distinct research component with clear learning outcomes to be present in the curriculum of the dental schools [ 1 ].

Research projects and courses have become fundamental elements of modern biomedical education worldwide. The integration of research training in biomedical academic programs has evolved over the years, reflecting the growing recognition of research as a cornerstone of evidence-based practice [ 7 ]. Notwithstanding the numerous opportunities presented by the inclusion of research training in biomedical programs, it poses significant challenges such as limited resources, varying levels of student preparedness, and the need for faculty development in research mentorship [ 8 , 9 ]. Addressing these challenges is essential to maximize the benefits of research training and to ensure that all students can engage meaningfully in research activities.

While there are different models for incorporating research training into biomedical programs, including dentistry, almost all models share the common goals of equipping students with basic research skills and techniques, critical thinking training and undertaking research projects either as an elective or a summer training course, or more commonly as a compulsory course required for graduation [ 2 , 4 , 10 ].

Dental colleges in the Middle East region are not an exception and most of these colleges are continuously striving to update their curricula to improve the undergraduate research component and cultivate a research-oriented academic teaching environment. Despite these efforts, there remains a significant gap in our understanding of the nature and scope of student-led research in these institutions, the challenges they face, and the perceived benefits of their research experiences. Furthermore, a common approach in most studies in this domain is to confine data collection to a single center from a single country, which in turn limits the value of the outcomes. Therefore, it is of utmost importance to conduct studies with representative samples and preferably multiple institutions in order to address the existing knowledge gaps, to provide valuable insights that can inform future curricular improvements and to support the development of more effective research training programs in dental education across the region. Accordingly, this study was designed and conducted to elucidate some of these knowledge gaps.

The faculty of dentistry at Jordan University of Science and Technology (JUST) is the biggest in Jordan and adopts a five-year bachelor’s program in dental surgery (BDS). The faculty is home to more than 1600 undergraduate and 75 postgraduate students. The college of dental medicine at the University of Sharjah (UoS) is also the biggest in the UAE, with both undergraduate and postgraduate programs, local and international accreditation and follows a (1 + 5) program structure, whereby students need to finish a foundation year and then qualify for the five-year BDS program. Furthermore, the UoS dental college applies an integrated stream-based curriculum. Finally, Oman Dental College (ODC) is the sole dental school in Oman and represents an independent college that does not belong to a university body.

The aim of this study was to evaluate the research experience of final year dental students from three major dental schools in the Middle East, namely JUST from Jordan, UoS from the UAE, and ODC from Oman. Furthermore, the hypothesis of this study was that research activities conducted at dental schools has no perceived benefit for final year dental students.

The rationale for selecting these three dental schools stems from the diversity in the dental curriculum and program structure as well as the fact that final year BDS students are required to conduct a research project as a prerequisite for graduation in the three schools. Furthermore, the authors from these dental schools have a strong scholarly record and have been collaborating in a variety of academic and research activities.

Materials and methods

The current study is a population-based descriptive cross-sectional observational study. The study was conducted using an online self-administered questionnaire and targeted final-year dental students at three dental schools in the Middle East region: JUST from Jordan, UoS from the UAE, and ODC from Oman. The study took place in the period from January to June 2023.

For inclusion in the study, participants should have been final-year dental students at the three participating schools, have finished their research project and agreed to participate. Exclusion criteria included any students not in their final year, those who have not conducted or finished their research projects and those who refused to participate.

The study was approved by the institutional review board of JUST (Reference: 724–2022), the research ethics committee of the UoS (Reference: REC-22-02-22-3) as well as ODC (Reference: ODC-MA-2022-166). The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines [ 11 ]. The checklist is available as a supplementary file.

Sample size determination was based on previous studies with a similar design and was further confirmed with a statistical formula. A close look at the relevant literature reveals that such studies were either targeting a single dental or medical school or multiple schools and the sample size generally ranged from 158 to 360 [ 4 , 8 , 9 , 10 , 12 ]. Furthermore, to confirm the sample size, the following 2-step formula for finite population sample size calculation was used [ 13 ]:

Wherein Z is the confidence level at 95% =1.96, P is the population proportion = 0.5, and E is the margin of error = 0.05. Based on this formula, the resultant initial sample size was 384.

Wherein n is the initial sample size = 384, N is the total population size (total number of final year dental students in the 3 schools) = 443. Based on this formula, the adjusted sample size was 206.

An online, self-administered questionnaire comprising 13 questions was designed to assess the research experience of final year dental students in the participating schools. The questionnaire was initially prepared by the first three authors and was then reviewed and approved by the other authors. The questionnaire was developed following an extensive review of relevant literature to identify the most critical aspects of research projects conducted at the dental or medical schools and the most common challenges experienced by students with regards to research project design, research components, attributes, analysis, interpretation, drafting, writing, and presentation of the final outcomes.

The questionnaire was then pretested for both face and content validity. Face validity was assessed by a pilot study that evaluated clarity, validity, and comprehensiveness in a small cohort of 30 students. Content validity was assessed by the authors, who are all experienced academics with remarkable research profiles and experience in supervising undergraduate and postgraduate research projects. The authors critically evaluated each item and made the necessary changes whenever required. Furthermore, Cronbach’s alpha was used to assess the internal consistency/ reliability of the questionnaire and the correlation between the questionnaire items was found to be 0.79. Thereafter, online invitations along with the questionnaire were sent out to a total of 443 students, 280 from JUST, 96 from UoS and 67 from ODC, which represented the total number of final year students at the three schools. A first reminder was sent 2 weeks later, and a second reminder was sent after another 2 weeks.

In addition to basic demographic details, the questionnaire comprised questions related to the type of study conducted, the scope of the research project, whether the research project was proposed by the students or the instructors or both, the literature review part of the project, the statistical analysis performed, the final presentation of the project, the writing up of the resultant manuscript if applicable, the perceived benefits of the research project and finally suggestions to improve the research component for future students.

The outcomes of the study were the students’ research experience in terms of research design, literature review, data collection, analysis, interpretation and presentation, students’ perceived benefits from research, students’ perspective towards research in their future career and students’ suggestions to improve their research experience.

The exposures were the educational and clinical experience of students, research supervision by mentors and faculty members, and participation in extracurricular activities, while the predictors were the academic performance of students, previous research experience and self-motivation.

The collected responses were entered into a Microsoft Excel spreadsheet and analyzed using SPSS Statistics software, version 20.0 (SPSS Inc., Chicago, IL, USA). Descriptive data were presented as frequencies and percentages. For this study, only descriptive statistics were carried out as the aim was not to compare and contrast the three schools but rather to provide an overview of the research activities at the participating dental schools.

The heatmap generated to represent the answers for question 11 (perceived benefits of the research activity) was created using Python programming language (Python 3.11) and the pandas, seaborn, and matplotlib libraries. The heatmap was customized to highlight the count and percentage of responses in each component, with the highest values shown in red and the lowest values shown in blue.

Potentially eligible participants in this study were all final year dental students at the three dental schools (443 students, 280 from JUST, 96 from UoS and 67 from ODC). All potentially eligible participants were confirmed to be eligible and were invited to participate in the study.

The total number of participants included in the study, i.e. the total number of students who completed the questionnaire and whose responses were analyzed, was 369 (223 from JUST, 80 from UoS and 66 from ODC). The overall response rate was 83.3% (79.6% from JUST, 83.3% from UoS and 98.5% from ODC).

The highest proportion of participants were from JUST ( n  = 223, 60.4%), followed by UoS ( n  = 80, 21.7%), and then ODC ( n  = 66, 17.9%). The majority of the participants were females ( n  = 296, 80.4%), while males represented a smaller proportion ( n  = 73, 19.6%). It is noteworthy that these proportions reflect the size of the cohorts in each college.

With regards to the type of study, half of final-year dental students in the 3 colleges participated in observational cross-sectional studies (i.e., population-based studies) ( n  = 186, 50.4%), while literature review projects were the second most common type ( n  = 83, 22.5%), followed by experimental studies ( n  = 55, 14.9%). Longitudinal studies randomized controlled trials, and other types of studies (e.g., qualitative studies, case reports) were less common, with ( n  = 5, 1.4%), ( n  = 10, 2.7%), and ( n  = 30, 8.1%) participation rates, respectively. Distribution of study types within each college is shown Fig.  1 .

Distribution in percent of study types within each college. JUST: Jordan University of Science and Technology, UOS: University of Sharjah, ODC: Oman Dental College

The most common scope of research projects among final-year dental students was in public health/health services ( n  = 108, 29.3%) followed by dental education/attitudes of students or faculty ( n  = 103, 27.9%) (Fig.  2 ). Biomaterials/dental materials ( n  = 62, 16.8%) and restorative dentistry ( n  = 41, 11.1%) were also popular research areas. Oral diagnostic sciences (oral medicine/oral pathology/oral radiology) ( n  = 28, 7.6%), oral surgery ( n  = 12, 3.2%) and other research areas ( n  = 15, 4.1%) were less common among the participants. Thirty-two students (8.7%) were engaged in more than one research project.

Percentages of the scope of research projects among final-year dental students. JUST: Jordan University of Science and Technology, UOS: University of Sharjah, ODC: Oman Dental College

The majority of research projects were proposed through a discussion and agreement between the students and the instructor (55.0%). Instructors proposed the topic for 36.6% of the research projects, while students proposed the topic for the remaining 8.4% of the projects.

Most dental students (79.1%) performed the literature review for their research projects using internet search engines. Material provided by the instructor was used for the literature review by 15.5% of the students, while 5.4% of the students did not perform a literature review. More than half of the students ( n  = 191, 51.7%) used multiple search engines in their literature search. The most popular search engines for literature review among dental students were PubMed (70.2% of cases) and Google Scholar (68.5% of cases). Scopus was used by 12.8% of students, while other search engines were used by 15.6% of students.

The majority of dental students ( n  = 276, 74.8%) did not utilize the university library to gain access to the required material for their research. In contrast, 93 students (25.2%) reported using the university library for this purpose.

Dental students performed statistical analysis in their projects primarily by receiving help from the instructor ( n  = 167, 45.2%) or using specialized software ( n  = 168, 45.5%). A smaller percentage of students ( n  = 34, 9.4%) consulted a professional statistician for assistance with statistical analysis. at the end of the research project, 58.4% of students ( n  = 215) presented their work in the form of a manuscript or scientific paper. Other methods of presenting the work included PowerPoint presentations ( n  = 80, 21.7%) and discussions with the instructor ( n  = 74, 19.8%).

For those students who prepared a manuscript at the conclusion of their project, the most difficult part of the writing-up was the discussion section ( n  = 155, 42.0%), followed by the methodology section ( n  = 120, 32.5%), a finding that was common across the three colleges. Fewer students found the introduction ( n  = 13, 3.6%) and conclusion ( n  = 10, 2.7%) sections to be challenging. Additionally, 71 students (19.2%) were not sure which part of the manuscript was the most difficult to prepare (Fig.  3 ).

Percentages of the most difficult part reported by dental students during the writing-up of their projects. JUST: Jordan University of Science and Technology, UOS: University of Sharjah, ODC: Oman Dental College

The dental students’ perceived benefits from the research activity were evaluated across seven components, including literature review skills, research design skills, data collection and interpretation, manuscript writing, publication, teamwork and effective communication, and engagement in continuing professional development.

The majority of students found the research activity to be beneficial or highly beneficial in most of the areas, with the highest ratings observed in teamwork and effective communication, where 33.5% rated it as beneficial and 32.7% rated it as highly beneficial. Similarly, in the area of data collection and interpretation, 33.0% rated it as beneficial and 27.5% rated it as highly beneficial. In the areas of literature review skills and research design skills, 28.6% and 34.0% of students rated the research activity as beneficial, while 25.3% and 22.7% rated it as highly beneficial, respectively. Students also perceived the research activity to be helpful for the manuscript writing, with 27.9% rating it as beneficial and 19.2% rating it as highly beneficial.

When it comes to publication, students’ perceptions were more variable, with 22.0% rating it as beneficial and 11.3% rating it as highly beneficial. A notable 29.9% rated it as neutral, and 17.9% reported no benefit. Finally, in terms of engaging in continuing professional development, 26.8% of students rated the research activity as beneficial and 26.2% rated it as highly beneficial (Fig.  4 ).

Heatmap of the dental students’ perceived benefits from the research activity

The research course’s impact on students’ perspectives towards being engaged in research activities or pursuing a research career after graduation was predominantly positive, wherein 274 students (74.1%) reported a positive impact on their research perspectives. However, 79 students (21.5%) felt that the course had no impact on their outlook towards research engagement or a research career. A small percentage of students ( n  = 16, 4.4%) indicated that the course had a negative impact on their perspective towards research activities or a research career after graduation.

Finally, when students were asked about their suggestions to improve research activities, they indicated the need for more training and orientation ( n  = 127, 34.6%) as well as to allow more time for students to finish their research projects ( n  = 87, 23.6%). Participation in competitions and more generous funding were believed to be less important factors to improve students` research experience ( n  = 78, 21.2% and n  = 63, 17.1%, respectively). Other factors such as external collaborations and engagement in research groups were even less important from the students` perspective (Fig.  5 ).

Precentages of dental students’ suggestions to improve research activities at their colleges

To the best of our knowledge, this report is the first to provide a comprehensive overview of the research experience of dental students from three leading dental colleges in the Middle East region, which is home to more than 50 dental schools according to the latest SCImago Institutions Ranking ® ( https://www.scimagoir.com ). The reasonable sample size and different curricular structure across the participating colleges enhanced the value of our findings not only for dental colleges in the Middle East, but also to any dental college seeking to improve and update its undergraduate research activities. However, it is noteworthy that since the study has included only three dental schools, the generalizability of the current findings would be limited, and the outcomes are preliminary in nature.

Cross-sectional (epidemiological) studies and literature reviews represented the most common types of research among our cohort of students, which can be attributed to the feasibility, shorter time and low cost required to conduct such research projects. On the contrary, longitudinal studies and randomized trials, both known to be time consuming and meticulous, were the least common types. These findings concur with previous reports, which demonstrated that epidemiological studies are popular among undergraduate research projects [ 4 , 10 ]. In a retrospective study, Nalliah et al. also demonstrated a remarkable increase in epidemiological research concurrent with a decline in the clinical research in dental students` projects over a period of 4 years [ 4 ]. However, literature reviews, whether systematic or scoping, were not as common in some dental schools as in our cohort. For instance, a report from Sweden showed that literature reviews accounted for less than 10% of total dental students` projects [ 14 ]. Overall, qualitative research was seldom performed among our cohort, which is in agreement with a general trend in dental research that has been linked to the low level of competence and experience of dental educators to train students in qualitative research, as this requires special training in social research [ 15 , 16 ].

In terms of the research topics, public health research, research in dental education and attitudinal research were the most prevalent among our respondents. In agreement with our results, research in health care appears common in dental students` projects [ 12 ]. In general, these research domains may reflect the underlying interests of the faculty supervisors, who, in our case, were actively engaged in the selection of the research topic for more than 90% of the projects. Other areas of research, such as clinical dentistry and basic dental research are also widely reported [ 4 , 10 , 14 , 17 ].

The selection of a research domain is a critical step in undergraduate research projects, and a systematic approach in identifying research gaps and selecting appropriate research topics is indispensable and should always be given an utmost attention by supervisors [ 18 ].

More than half of the projects in the current report were reasonably selected based on a discussion between the students and the supervisor, whereas 36% were selected by the supervisors. Otuyemi et al. reported that about half of undergraduate research topics in a Nigerian dental school were selected by students themselves, however, a significant proportion of these projects (20%) were subsequently modified by supervisors [ 19 ]. The autonomy in selecting the research topic was discussed in a Swedish report, which suggested that such approach can enhance the learning experience of students, their motivation and creativity [ 20 ]. Flexibility in selecting the research topic as well as the faculty supervisor, whenever feasible, should be offered to students in order to improve their research experience and gain better outcomes [ 12 ].

Pubmed and Google Scholar were the most widely used search engines for performing a literature review. This finding is consistent with recent reviews which classify these two search systems as the most commonly used ones in biomedical research despite some critical limitations [ 21 , 22 ]. It is noteworthy that students should be competent in critical appraisal of available literature to perform the literature review efficiently. Interestingly, only 25% of students used their respective university library`s access to the search engines, which means that most students retrieved only open access publications for their literature reviews, a finding that requires attention from faculty mentors to guide students to utilize the available library services to widen their accessibility to available literature.

Statistical analysis has classically been viewed as a perceived obstacle for undergraduate students to undertake research in general [ 23 , 24 ] and recent literature has highlighted the crucial need of biomedical students to develop necessary competencies in biostatistics during their studies [ 25 ]. One obvious advantage of conducting research in our cohort is that 45.5% of students used a specialized software to analyze their data, which means that they did have at least an overview of how data are processed and analyzed to reach their final results and inferences. Unfortunately, the remaining 54.5% of students were, partially or completely, dependent on the supervisor or a professional statistician for data analysis. It is noteworthy that the research projects were appropriately tailored to the undergraduate level, focusing on fundamental statistical analysis methods. Therefore, consulting a professional statistician for more complex analyses was done only if indicated, which explains the small percentage of students who consulted a professional statistician.

Over half of participating students (58.4%) prepared a manuscript at the end of their research projects and for these students, the discussion section was identified as the most challenging to prepare, followed by the methodology section. These findings can be explained by the students’ lack of knowledge and experience related to conducting and writing-up scientific research. The same was reported by Habib et al. who found dental students’ research knowledge to be less than that of medical students [ 26 ]. The skills of critical thinking and scientific writing are believed to be of paramount importance to biomedical students and several strategies have been proposed to enhance these skills especially for both English and non-English speaking students [ 27 , 28 , 29 ].

Dental students in the current study reported positive attitude towards research and found the research activity to be beneficial in several aspects of their education, with the most significant benefits in the areas of teamwork, effective communication, data collection and interpretation, literature review skills, and research design skills. Similar findings were reported by previous studies with most of participating students reporting a positive impact of their research experience [ 4 , 10 , 12 , 30 ]. Furthermore, 74% of students found that their research experience had a positive impact on their perspectives towards engagement in research in the future. This particular finding may be promising in resolving a general lack of interest in research by dental students, as shown in a previous report from one of the participating colleges in this study (JUST), which demonstrated that only 2% of students may consider a research career in the future [ 31 ].

Notably, only 11.3% of our students perceived their research experience as being highly beneficial with regards to publication. Students` attitudes towards publishing their research appear inconsistent in literature and ranges from highly positive rates in developed countries [ 4 ] to relatively low rates in developing countries [ 8 , 32 , 33 ]. This can be attributed to lack of motivation and poor training in scientific writing skills, a finding that has prompted researchers to propose strategies to tackle such a gap as mentioned in the previous section.

Finally, key suggestions by the students to improve the research experience were the provision of more training and orientation, more time to conduct the research, as well as participation in competitions and more funding opportunities. These findings are generally in agreement with previous studies which demonstrated that dental students perceived these factors as potential barriers to improving their research experience [ 8 , 10 , 17 , 30 , 34 ].

A major limitation of the current study is the inclusion of only three dental schools from the Middle East which my limit the generalizability and validity of the findings. Furthermore, the cross-sectional nature of the study would not allow definitive conclusions to be drawn as students’ perspectives were not evaluated before and after the research project. Potential confounders in the study include the socioeconomic status of the students, the teaching environment, previous research experience, and self-motivation. Moreover, potential sources of bias include variations in the available resources and funding to students’ projects and variations in the quality of supervision provided. Another potential source of bias is the non-response bias whereby students with low academic performance or those who were not motivated might not respond to the questionnaire. This potential source of bias was managed by sending multiple reminders to students and aiming for the highest response rate and largest sample size possible.

In conclusion, the current study evaluated the key aspects of dental students’ research experience at three dental colleges in the Middle East. While there were several perceived benefits, some aspects need further reinforcement and revision including the paucity of qualitative and clinical research, the need for more rigorous supervision from mentors with focus on scientific writing skills and research presentation opportunities. Within the limitations of the current study, these outcomes can help in designing future larger scale studies and provide valuable guidance for dental colleges to foster the research component in their curricula. Further studies with larger and more representative samples are required to validate these findings and to explore other relevant elements in undergraduate dental research activities.

Data availability

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

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Acknowledgements

The authors would like to acknowledge final year dental students at the three participating colleges for their time completing the questionnaire.

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Preventive and Restorative Dentistry Department, College of Dental Medicine, University of Sharjah, Sharjah, UAE

Mohamed El-Kishawi

Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, UAE

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M.A.: Conceptualization, data curation, project administration; supervision, validation, writing - original draft; writing - review and editing. A.Q: Conceptualization, data curation, project administration; writing - review and editing. M.E: Conceptualization, data curation, project administration; validation, writing - original draft; writing - review and editing. A.A.: data curation, writing - original draft; writing - review and editing. L.K.: Conceptualization, data curation, validation, writing - original draft; writing - review and editing. S.A: Conceptualization, writing - review and editing.

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Alrashdan, M.S., Qutieshat, A., El-Kishawi, M. et al. Insights into research activities of senior dental students in the Middle East: A multicenter preliminary study. BMC Med Educ 24 , 967 (2024). https://doi.org/10.1186/s12909-024-05955-5

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• Tadele Dana Darebo 3 &
• Yisihak Debodina Suga 2  

BMC Cancer volume  24 , Article number:  1102 ( 2024 ) Cite this article

Metrics details

According to GLOBOCAN 2020 Breast cancer is the most common cancer among women and the prevalence is increasing worldwide and in Ethiopia. This review assessed studies conducted in Ethiopia on the clinical features and epidemiology of breast cancer.

Data base search conducted PubMed, Google Scholar African Journals Online (AJOL), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Hinari without time restrictions. The search keywords included; prevalence and pattern, clinical presentation, histological and molecular subtypes, and management. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to identify, search, extract articles, and report this systematic review. The protocol was registered in PROSPERO, ID: CRD42023403320.

Twenty studies were included in the review with 33,369 participants and 3 were community-based and 17 were hospital-based. In all except two reviewed studies, breast cancer is the most common cancer among women of Ethiopia. The most frequent presenting symptom was a breast lump/mass and commonly affected side was right breast. Most patients presented at a late stage and they were premenopausal age group. The commonest histology type is ductal carcinoma, that the most prevalent receptor was estrogen receptor positive, and the most common molecular subtype was Luminal A in pathology samples. Surgery is main stay of treatment and the most common surgical technique practiced in Ethiopia is modified radical mastectomy.

Breast cancer incidence is rising, and it accounts for the major cancer burden in the country. There is a need for additional awareness-raising and health education because delayed presentation are critical problems throughout Ethiopia. For planning and monitoring cancer patterns, comprehensive demographic and clinical data from a population or facility-based registry are needed in the regions. The available treatment options are still limited in Ethiopia it needs infrastructural development.

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Introduction

The World Health Organization (WHO) report shows that in 2020, 2.3 million women were diagnosed with breast cancer, making it the most common cancer with 685,000 deaths worldwide. It continues to cause more disability-adjusted life years (DALYs) in women worldwide than any other cancer. Deaths from breast cancer are high in African countries due to poor health infrastructure, poor vital records, delayed health-seeking behavior, and low community awareness [ 1 ].

Breast cancer incidence and mortality rates in the world have increased over the last three decades. Study done on Breast cancer incidence and mortality from 1990 to 2016. In 60 out of 102 countries, the incidence of breast cancer has more than doubled, while the death rate has doubled in 43 out of 102 countries [ 2 ]. By 2030, it is predicted that there will be 2.7 million new cases worldwide each year and 0.87 million deaths from breast cancer [ 3 ].

A country assessment showed that breast cancer is the most common cancer illness in Ethiopia, accounting for 16,133 (20.9%) of all cancer cases and 9,061 (17.5%) of all cancer-related deaths [ 4 ]. Approximately 80% of breast cancer cases in sub-Saharan Africa are detected at late stages (stage III or IV), compared to 15% in high-income countries [ 5 ].

Breast cancer arises from the epithelium lining the milk ducts, known as invasive ductal carcinoma. This is the most common subgroup (50–80%), followed by the group arising from the glandular tissue of the breast lobules [ 6 ]. Based on mRNA gene expression levels, breast cancer can be classified into molecular subgroups. The four main intrinsic subtypes of breast cancer (Luminal A, Luminal B, HER2-enriched, and basal-like). Regarding Hormone status of breast cancers ER-positive tumors account for almost 70% of all breast cancers in Western populations [ 7 , 8 ]. The TNM system for cancer staging refers to the classification of a tumor based on a list of factors, including the degree of disease affecting the main tumor (Tis to T4), regional lymph node status (N0 to N3), and distant metastases (M0 or M1) (0 to IV) [ 9 ].

When choosing a treatment plan, the type of breast cancer and its stage are often considered. Patients with breast cancer are often given several types of treatment. The current choices are radiation therapy, surgery, chemotherapy, hormonal therapy, biological therapy, and chemotherapy [ 10 ]. According to studies from underdeveloped countries, stage I and stage II have five-year survival rates of 90% and 65%, respectively, while stage III and stage IV have rates of only 33% and 6%, respectively [ 11 ].

Until April 2022, the Tikur Anbesa Specialized Hospital (TASH) was the only center in the country that offered radiotherapy. As of April 2022, Ethiopia has two additional functional radiation therapy centers: Jimma University Medical Center (JUMC) in the southwest of the country and Hiwot Fana Specialized Hospital at Haramaya University in the eastern part of the country.

Rationale of the study

Based on a preliminary search, we couldn’t find compressive evidence at the country level regarding breast cancer patients’ epidemiology and clinical profile. Therefore, a thorough examination of the existing evidence on breast cancer would aid in understanding breast cancer epidemiology and clinical profile in the country. This review provides evidence for the development of future strategies that are especially suited to the Ethiopian population.

Study objective

This study aimed to generate country wide evidence on epidemiology and clinical characteristics of breast cancer in Ethiopia.

The PROSPERO international prospective register of systematic review database checked for already-done or ongoing systematic reviews with the same objective before the data collection process started. The protocol of this review is registered in ID: CRD42023403320. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to identify, search, extract articles, and report this systematic review [ 12 ].

Search strategy

The electronic databases and search engines PubMed, Google Scholar African Journals Online, Cumulative Index of Nursing and Allied Health Literature and Hinari were searched until June 20, 2023. The MeSH terms and key words were as follows: breast cancer, breast neoplasm, prevalence, epidemiology, Sign, Symptom Presentation, histology, molecular subtype, and management of breast cancer. The MeSH keywords were combined using Boolean operators (AND/OR), and Ethiopia’s name was appended at the end. To enhance the number of articles included and lower the number of missing articles, hand searching was done on the citations and references listed in the eligible articles ( Tables  1 and 2 ).

Eligibility criteria

Selection of study and extraction.

As shown in the PRISMA flowchart, all articles identified from the electronic database searches were imported into Zotero and Duplicates were removed. Further Exclusion of articles conducted using title and abstract screening. Articles with full text were assessed for eligibility and further full text exclusion done on those articles which do not have a clearly written result. FGD and BTT extracted data simultaneously and independently, and any disagreements were resolved after independent review by the TGD and YDS. Finally, we extracted relevant information from each literature using an Excel spreadsheet template to avoid missing important information when preparing the results of the review or for future cross-checking. The extracted data includes first author’s name, year of publication, study design, location, prevalence and pattern, Presenting Symptom, Stage at presentation, Histology findings, Molecular Features and Treatment.

PRISMA flowchart for article Search and Selection Process

Data analysis

The extracted data were further categorized into institution-based and community-based according to the setting in which the studies took place and further sorted according to the institution in which the studies were conducted. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [ 13 ].

Study selection and characteristics

A total of 352 articles were found from electronic data base searching on the search engines and databases. All of these search results exported to Zotero computer software, where 140 duplicate records were removed and 149 were removed after being screened based on title and abstract. Further 43 articles were removed based on an objective of the review. Finally, 20 eligible articles, which enrolled 33,369 participants, were included in the systematic review (Fig.  1 ).

Most of the studies were conducted in Tikur Anbesa specialized hospital (TASH)(6/20), which was only hospital with radiotherapy treatment in the country until April 2022. Articles based on the study setting: 3 (15%) articles were community-based, and 17 (85%) articles were hospital-based. Based on study design, 9 (45%) articles were cross-sectional, 10 (50%) retrospective chart reviews, and one retrospective cohort.

Prevalence and pattern

Five studies assessed the prevalence and pattern of breast cancer in the country. All hospital-based studies showed the prevalence of breast cancer compared to other cancers. Breast cancer accounts for 15.2–26% of all cancers [ 14 , 15 ] and from female cancer 29.3–37% [ 11 , 16 ].

A community-based study done using the Addis Ababa City Cancer Registry (AACCR) showed the incidence of breast cancer (2012–2013) to be 31.5% of all female cancers [ 17 ] and a study done during 2012–2015 from AACCR and six regions showed breast cancer constituted 33% of all cancers in women and 23% of all cancers [ 18 ].

According to a study done at Hawassa University Comprehensive Specialized Hospital (HUCSH) from 2013 to 2019, the number of women diagnosed with breast cancer in hospitals has increased from 69 (12.3%) In 2013, 106 (19%) in 2019 [ 19 ].

A study from Gondar University Comprehensive Specialized Hospital (GUCSH), showed breast cancer accounts for 76 (14.1%) of all cancers [ 15 ] and finding from TASH showed breast cancer accounts for 26% of female cancers [ 14 ].

A study conducted at St. Paul’s Hospital Millennium Medical College (SPHMMC), of all malignancies, breast cancer accounted for 587 (29.3%) in 2019, making it the second most common disease after cervical CA [ 16 ].

Presenting symptom

Fourteen studies reported Age at diagnosis. The median age ranges 38-55.8 years [ 19 , 20 ] and mean age ranges 42.1–47.5 years [ 16 , 21 ].

Premenopausal patients represent the majority of female breast cancer patients at the time of diagnosis, with the median age being between 40 and 46 years (14,15,17,19,23,2829). Breast lumps or masses were the most common presenting symptoms in all studies, followed by breast pain and ulceration [ 20 , 22 , 23 , 24 , 25 ]. A study conducted at the GUCSH, where 65 (79%) patients presented with breast mass and breast ulceration in 15 patients (18%) [ 26 ].

Similar findings from two university hospitals (Gondar and Felege Hiwot University Comprehensive Specialized Hospital) (GUCSH and FHCSH) revealed that breast lump or mass was the most common presentable symptom in 328 (88.4%), followed by painful wound in 161 (43.4%) [ 22 ].

A study at Dessie Referral Hospital (DRH) showed 117 (57.4%) patients presented with breast lumps, followed by breast pain in 70 (34.3%) [ 25 ]. A multicenter study in Addis Ababa showed that breast lumps were found in 344 (78.0%) patients, followed by pain in 53 (10.2%) patients [ 24 ].

Regarding lymph node involvement, the findings from GUCSH and FHCSH showed that (320, 86.3%) and DRH 30, (14.7%), had a lymph node involvement at presentation [ 22 , 25 ]. According to studies done at the GUCSH and TASH, breast CA commonly affects the right breast 48 (59%), and, 160 (38.4%) respectively ( 26 , 19 and 27 )and unlike others finding from HUCSH showed left breast in is commonly affected 302 (54%), and the upper outer quadrant was the most commonly involved according to the findings from TASH 154 (78.2%) ,40 (9.6%) [ 27 , 28 ].

Stage at presentation

Nine studies included stage at presentation. Eight studies showed most of the patients presented in late stages (stage III and stage IV), and the prevalence of advanced stages ranges from 57 to 71.2% in ( 22 , 19 , 29 , and 25 ). This was shown in a study conducted in GUCSH and FHCSH, in which 53 (14.3%) patients were diagnosed at stage IV and 211 (56.9%) patients were diagnosed at stage III [ 22 ]. According to HUCSH findings, 24 (12.2%) were diagnosed with stage IV disease, 113 (57.4%) with stage III disease, and 160 (30.4%) with early-stage disease [ 19 ].

Findings from DRH showed 82 (40.2%) and 53 (25.5%) were diagnosed with stage IV and stage III, and early stage presentation was 69 (33.8%) [ 27 ]. TASH stages at diagnosis: 74 (57%) were diagnosed at stages III and IV. Stage III: 63 (48.5%); Stage IV: 11 (8.5%) [ 29 ].

Unlike the previous papers, a finding from the TASH showed that the majority of patients 56(59%) of patients presented with early and late stages accounted for 40(41%) [ 30 ].

Histology findings

Nine studies included histologic findings and in all reviewed studies, ductal carcinoma is the most prevalent histology type. The prevalence of ductal carcinoma in studies done in SPHMMC, (GUCSH and FHCSH), GUCSH, and HUCSH studies was 479 (81.6%), 347 (93.5%), 61 (74%), and 156 (79.2), respectively [ 16 , 22 , 26 , 28 ]. Out of nine studies 5 studies were from TASH. Ductal carcinoma is the most common histology type in TASH, followed by lobular carcinoma, with a prevalence ranging from 55.3 to 83.7% [ 20 , 27 , 29 , 30 , 31 ].

Regarding the level of differentiation, studies conducted in TASH and HUCSH, showed that moderate differentiation carcinoma is the commonest type (177 (31.7%) and 91 (46.2%), followed by poor differentiation (155 (27.7%) and 72 (36.5%), respectively [ 28 , 31 ]. Unlike the previous study findings, those from northern Ethiopia (GUCSH and FHCSH) and GUCSH showed that poor differentiation was the most common among types 140 (45.6%) and 30 (37%), followed by moderate differentiation in patients 79 (40.7%) and 14 (17%), respectively [ 22 , 26 ].

Molecular features

Two studies from TASH looked at the prevalence of hormone receptors and molecular subtypes. Both papers showed that the most prevalent receptor was estrogen receptor positive, and the most common molecular subtype was Luminal A in pathology samples. In a study from TASH in 2018, the prevalence of estrogen receptor positivity was 74 (65%), progesterone receptor positivity was 49 (43%), and HER2 positivity was 26 (23%). Regarding molecular subtype, the prevalence of Luminal A (ER + and/or PR+, HER2-) was 45 (40%), Luminal B (ER + and/or PR+, HER2+) was 30 (26%), HER2-enriched (ER-, PR-, HER2+) was 11 (10%), and Triple Negative/Basal like (ER-, PR-, HER2-) was 26 (23%) [ 30 ]. In a similar study from the same institution (2017), 137 biopsies were found to be ER+ (65.5%), PR+ (58%), and HER2 positive (28%) in a study, and the prevalence of molecular subtypes was shown to be Luminal A (54%), Luminal B (22%), HER2-enriched (6%), and Triple 29 Negative/Basal-like (18%) [ 29 ].

Studies included in this review Reported modalities of treatment, including surgery, chemotherapy, radiotherapy, and hormonal therapy. Surgery remain the mainstay of management in many settings in Ethiopia, and the most prevalent surgical technique was modified radical mastectomy (MRM) [ 19 , 22 , 25 ].

Finding from GUCSH showed, surgery was done for all 82 patients of which 51 (62%) of patients underwent MRM, and 79 (96%) received chemotherapy. The commonest chemotherapy regimen is Adriamycin and Cyclophosphamide (AC). Hormonal treatment given to 60 (73%) and Tamoxifen 18 (22%) was the commonest type [ 26 ].

Surgery was performed in 357 (96.2%) patients by two university hospitals (GUCSH and FHCSH); chemotherapy was performed in 163 (43.9%); and hormone therapy was performed in 50 (13.5%) [ 22 ].

According to a study conducted at HUCSH, chemotherapy provided for all 559 (100%) patients and Doxorubicin, cyclophosphamide, and paclitaxel were the chemotherapy regiment was commonest. Hormonal therapy provided 168(30%) and Tamoxifen regiment was commonest hormonal therapy patients, and surgery (modified radical mastectomy) was done for 196 (35.1%) [ 19 ].

Chemotherapy was given for 275 (90.7) patients in TASH in 2019, with the most prevalent regimen being 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) in 66.9% of cases. Surgery was done for 257 (85%) , combination therapy (surgery, chemotherapy, and palliative care) delivered to 189 (55.8%) and Radiotherapy was provided for 107 (35%) [ 21 ].

A similar study from TASH on 2013 Surgery was done for 902 (87%), and the majority had a modified radical mastectomy of 880 (95%). The majority of patients 893 (83%) also received chemotherapy, mainly anthracycline-containing chemotherapy (FAC)782 (73%). Hormonal therapy provided for 864 (81%) [ 31 ].

According to a study conducted at ACSH, 121 (65.1%) patients had surgery and 33 (17.7%) had chemotherapy, while the rest had both surgery and chemotherapy [ 30 ]. In TASH(2017), 192 (74%) patients received surgical intervention, the commonest being mastectomy 126, (65.6%); radiotherapy was provided for 53 (20.5%); and chemotherapy was provided for 231 (89.2%) patients [ 29 ].

Breast cancer is the most common type of cancer in Ethiopia in most reviewed studies, where the prevalence ranges from 15.2 to 26% from all cancers [ 14 , 15 ] and from female cancer 29.3–37% [ 11 , 16 ]. The pattern of breast cancer is increasing in Ethiopia. A study from HUCSH showed the breast cancer rate in hospitals has increased from 69 (12.3%) in 2013 to 106 (19%) in 2019 [ 19 ] and Results from TASH showed changes in breast cancer between 1997 and 2012, with a prevalence in 2012 has increased by more than seven times compared 1997 [ 32 ].

finding from different studies support this review’s finding which shows incidence increased by 1.44% per year from 1990 to 2017 and as for regional changes in incidence, all regions of breast cancer had increased incidence except North America, and the Middle East and North Africa had the largest increase in overall incidence [ 33 ]. In a similar study conducted between 2000 and 2012, incidence rates of breast cancer increased in South Korea, China, and the United Kingdom while decreasing in the United States [ 34 ]. The breast cancer incidence in Africa continues to increase and is projected to double by 2050.

This review showed commonest age group was from 40 to 46 years ( 7 , 22 , 23 , 21 , 16 , 28 , and 20 ) which similar finding other African studies [ 35 , 36 , 37 ].

Regarding stage at presentation, most of the patients presented with late stages (stages 3 and 4), with a prevalence range of 57–71.2% [ 19 , 22 , 25 , 29 ]. which is supported by papers from Africa showed with 89.6% and 72.8% of breast patients in Kenya and Nigeria respectively presenting with advanced stage disease [ 38 , 39 , 40 ]. Studies in South Africa reported an advanced stage breast cancer incidence of 50 and 55% [ 40 ]. This review showed that early-stage (stages I and II) accounts for 15–35% [ 6 , 8 , 15 , 27 ]. Similar findings were found in other developing countries, where only 20–50% of patients in the majority of low- and middle-income countries were diagnosed in these earlier stages [ 39 ].

Breast lump or mass is the most common presenting symptom in all studies from various parts of the country, ranging from 57.4 to 88.4% [ 22 , 24 , 25 , 26 ].

Regarding histological findings of breast cancer in Ethiopia, the commonest histology is ductal carcinoma, followed by lobar carcinoma in all reviewed research and prevalence ranges (55.3–93.5%) [ 16 , 20 , 22 , 26 , 27 , 28 , 29 , 31 , 41 ].

The prevalence of hormone receptors and molecular subtypes is high; estrogen receptor positivity is the most common receptor and is found in more than 65% of breast cancer patients. In terms of molecular subtype, Luminal A (ER + and/or PR+, HER2-) is the most common finding in breast cancer biopsies, accounting for more than 40% of cases, while Triple Negative/Basal-like cases account for more than 15% of cases [ 20 , 29 ]. Similar finding from studies from south Africa showed Estrogen Receptor is the commonest hormone receptors [ 39 , 40 ].

This review showed surgery is the mainstay treatment for breast cancer in Ethiopia, and radiotherapy is only provided in the capital city on TASH. A similar study from Africa showed a mastectomy rate greater than 85% and a huge difference from Europe’s breast cancer mastectomy of 30% [ 41 ].

Limitations of the study

Only English language articles were included.

Conclusion and recommendation

This review summarized the epidemiology, clinical and histological characteristics, and treatment modalities of breast cancer in Ethiopia. Breast cancer incidence is rising, and it accounts for the major cancer burden in the country. There is a need for additional awareness-raising and health education because delayed presentation is a critical problem throughout Ethiopia. For planning and monitoring cancer patterns, comprehensive demographic and clinical data from a population- or facility-based registry are needed. Currently, only one exists in the capital, the Addis Ababa City Cancer Registry (AACCR). There is a need to establish and strengthen histologic and pathology labs, as most hospitals are doing surgeries without histologic, molecular, or receptor identification since it helps with targeted therapy, according to what current best practice suggests. The available treatment options are still limited in Ethiopia; it needs Expanding radiation facilities is a major step toward improving outcomes for breast cancer patients.

Data availability

All data generated or analysed during this study are included in supplementary file .

Abbreviations

Addis Ababa City Cancer Registry 

Ayder Comprehensive Specialized Hospital

• Breast Cancer

Dessie Referral Hospital

Ethiopian Public Health Institute

Estrogen Receptor

Felege Hiwot Comprehensive specialized hospitals

Gondar University Comprehensive Specialized Hospital

Human Epidermal Receptor

Hawassa University Comprehensive Specialized Hospital

Institutional Review Board

Jimma University Medical Center

Low- and Middle-Income Country

Medical Subjects Headings

Modified Radical Mastectomy  

Progesterone Receptor

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

St. Paul’s Hospital Millennium Medical Collage

Tikur Anbesa specialized hospital

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Comparison of operatively and nonoperatively treated isolated mason type II radial head fractures: a systematic review and meta-analysis

• Binzhi Zhao 1   na1 ,
• Hanzhou Wang 1   na1 ,
• Shuo Diao 1 ,
• Xiaopei Xu 1 ,
• Yulin Gao 1 ,
• Tianchao Lu 1 ,
• Junlin Zhou 1 &
• Yang Liu 1  

Journal of Orthopaedic Surgery and Research volume  19 , Article number:  540 ( 2024 ) Cite this article

Metrics details

Radial head fractures are the most common bony injury of the elbow in adults. The current literature does not agree on whether isolated stable type II radial head fractures should be treated operatively or nonoperatively. This review aims to determine the preferred treatment for Mason type II radial head fractures and compare the outcomes of conservative and surgical treatment.

Our study used PRISMA guidelines and conducted a thorough search of multiple electronic databases, including PubMed, Cochrane, Embase, Web of Science, CNKI, and Wanfang databases, initially identifying 545 relevant publications on surgical and conservative treatment of Mason type II radial head fractures. The final search date for this study is July 7, 2024.Through a comprehensive meta-analysis, we evaluated several outcomes, including functional scores (DASH, OES, and MEPS scores), clinical outcomes (elbow flexion, elbow extension deficit, elbow pronation, and elbow supination), and complication rate (total complications and elbow pain). The mean difference (MD) was compared for continuous outcomes, and the odds ratios (ORs) were compared for categorical outcomes.

A total of 271 patients from 4 studies met the inclusion criteria. Among them, 142 patients received surgical treatment and 129 patients received non-surgical treatment. The study found no statistically significant differences between surgical and non-surgical treatments in DASH, OES, MEPS, elbow flexion, elbow extension impairment, and elbow pain. Compared with surgical treatment, non-surgical treatment was associated with greater elbow pronation (OR = -3.10, 95% CI = [-4.96, -1.25], P  = 0.55, I 2  = 0%) and a lower complication rate (OR = 5.54, 95% CI = [1.79, 17.14], P  = 0.42, I 2  = 0%).

Based on the current evidence, conservative management of isolated Mason II radial head fractures yields favorable therapeutic outcomes with a low incidence of complications.

Introduction

Approximately one-third of elbow fractures in adults are radial head fractures [ 1 , 2 , 3 ]. The typical injury mechanism involves an axial load transmitted through an extended wrist and elbow to the lateral column, leading to different radial head fracture patterns based on forearm rotation [ 4 ]. The classification of radial head fractures follows the Mason system or its various modifications [ 5 , 6 , 7 , 8 , 9 , 10 ].In 1954, Mason initially identified type II fractures as marginal sector fractures with displacement [ 8 ]. This classification was further refined by Broberg and Morrey in 1986, who described these fractures as involving ≥ 30% of the articular surface with at least 2 mm displacement [ 5 ]. Hotchkiss, in 1997, added to the discourse by pointing out the significance of mechanical blockade in type II fractures, which is essential for informing treatment methods [ 6 ].

The consensus is that nonoperative management with early mobilization is sufficient for Mason type I fractures, as they do not present a mechanical block to forearm rotation [ 11 , 12 , 13 , 14 ]. On the other hand, for Mason type III fractures, especially those that are comminuted and beyond reconstruction, surgical approaches such as open reduction and internal fixation or arthroplasty are recommended [ 15 , 16 , 17 , 18 ]. For Mason type II radial head fractures without associated elbow dislocation or other fractures, the surgeon has not reached a consensus on the optimal treatment strategy. The choice between operative and nonoperative approaches remains particularly contentious when these fractures do not mechanically obstruct motion [ 19 , 20 ]. In 2012, Kaas et al. [ 21 ]. conducted a systematic review which revealed that operative treatment had significantly better outcomes compared to nonoperative methods. However, the authors stated that the heterogeneity between the included studies prevented them from making definitive recommendations regarding treatment.

The study aims to address this gap by conducting the first meta-analysis comparing the functional outcomes and complications of surgical versus nonsurgical treatments for isolated Mason type II radial head fractures.

Study selection

The present study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for reporting systematic reviews and meta-analyses [ 22 ]. We registered the review protocol in the PROSPERO database (CRD42024540601) [ 23 ].The last search date was April 7, 2024, and the PubMed, the Cochrane Library, CNKI, Embase and Web of Science databases were searched. The search procedure is based on the following keywords: (“radial head” OR “Mason type II” OR “Mason II”) AND (“Operative” OR “Open reduction and internal fixation” OR “ORIF”) AND (“conservative” OR “nonoperative”). Initially, we screened the title and abstract of each article to assess eligibility. This was followed by a full-text review of articles that met the criteria. Additionally, we conducted a comprehensive examination of the references cited in the included articles to ensure completeness.

Inclusion and exclusion criteria

This study included only comparative studies of surgical and nonsurgical treatments for adult patients with Mason type II isolated radial head fractures. Case reports, Biomechanical cadaveric studies, anatomical descriptive studies, and review articles were excluded. Radial head fractures with dislocation were also excluded. There were no language restrictions. The surgical group was designated as the experimental group, while the nonsurgical group served as the control group. Measured outcomes included the Disability of the Arm, Shoulder and Hand (DASH) scores, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), elbow flexion, elbow extension deficit, elbow pronation, elbow supination, total complications, and elbow pain.

Quality assessment

Two authors (B.Z.Z. and H.Z.W.) evaluated the quality of the included studies using the Cochrane Reviewer’s Handbook [ 24 ]. This study assessed the risk of bias in seven domains, which included random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other sources of bias. Each criterion was assessed for a low, unclear, or high degree of bias. Non-randomized controlled trials were evaluated according to the Newcastle-Ottawa Scale (NOS), which mainly includes selection, comparison, and outcome [ 25 ]. Research scoring seven or more points was considered to be of high quality. The assessments of the included studies were conducted independently by two reviewers (B.Z.Z. and H.Z.W.), and any disagreements were resolved by consulting a third reviewer (J.L.Z.).

Data extraction

Two reviewers independently extracted relevant information from the included literature, including the first author, publication date, sample size, patient age and gender, dominant hand affected, and follow-up time. The outcome measures were the DASH score, OES, MEPS, elbow flexion, elbow extension deficit, elbow pronation, elbow supination, total complications, and elbow pain. When standard deviations were missing from studies, we attempted to contact the authors of articles by email to obtain relevant metrics. Medians and ranges were converted without means and SDs, as Wan et al. recommended [ 26 ]. Disagreements during the extraction process were resolved through consultation with a third investigator (J.L.Z.).

Statistical analysis

Data were analyzed using Review Manager (RevMan 5.4.1, Nordic Cochrane Center, Copenhagen, Denmark) for this meta-analysis. Mean difference (MD) with 95% confidence intervals (95% CI) was used for continuous data analysis, while odds ratios (OR) with 95% CI were used for dichotomous data analysis. To determine heterogeneity, we used the I 2 tests. If I 2  > 50% and P  < 0.10, it indicates high heterogeneity. In cases of significant heterogeneity, we applied random-effect models. Conversely, we used fixed-effect models when heterogeneity was low.

The PRISMA flow diagram (Fig.  1 ) illustrates the literature search and selection process. We identified 545 relevant articles by searching electronic databases. Four articles with 271 patients were selected for this meta-analysis, all of which compared the effect of surgical and nonoperative treatment of isolated mason type II radial head fractures [ 27 , 28 , 29 , 30 ].

Flow diagram of screening the included studies in the meta-analysis

Study characteristics

These studies included one randomized controlled trial [ 28 ], and three retrospective cohort studies [ 27 , 29 , 30 ], with 271 patients (115 males and 156 females), of which 142 underwent operative treatment and 129 with nonoperative treatment (Table  1 ).

Risk-of-bias assessment

The risk of bias items for each included study is shown in Fig.  2 . Furthermore, the three retrospective cohort studies [ 27 , 29 , 30 ] were evaluated using the Newcastle-Ottawa Scale and were all rated as high quality, with scores ranging from 7 to 9, as shown in Table  2 .

Review authors’ judgments about each risk of bias item for each included study. (a) Risk of bias summary; (b) risk of bias graph presented as percentages

Functional outcomes

Postoperative DASH scores were reported in four studies [ 27 , 28 , 29 , 30 ] involving 142 patients who underwent surgical treatment; 129 patients received conservative treatment. The surgical and non-surgical groups had postoperative DASH scores of 12.6 and 12.5, respectively. There was no statistically significant difference between the two treatments (MD = -1.08, 95% CI = [-3.67, 1.51], P  = 0.41), with no heterogeneity ( P  = 0.58, I 2  = 0%). The forest plot of DASH scores is presented in Fig.  3 .

Postoperative OES scores were reported in two studies [ 27 , 28 ] involving 54 patients who underwent surgical treatment; 41 patients received conservative treatment. The surgical and non-surgical groups had postoperative OES scores of 44.2 and 42.4, respectively. There was no statistically significant difference between the two treatments (MD = 1.75, 95% CI = [-0.25, 3.75], P  = 0.09), with no heterogeneity ( P  = 0.66, I 2  = 0%). The forest plot of OES scores is presented in Fig.  4 .

Postoperative MEPS scores were reported in two studies [ 27 , 28 , 29 , 30 ] involving 142 patients who underwent surgical treatment; 129 patients received conservative treatment. The surgical and non-surgical groups had postoperative MEPS scores of 91.2 and 91, respectively. There was no statistically significant difference between the two treatments (MD = -2.12, 95% CI = [-11.33, 7.08], P  = 0.65), with high heterogeneity ( P  = 0.02, I 2  = 82%). The forest plot of MEPS scores is presented in Fig.  5 .

Elbow flexion

Elbow extension deficit

Elbow pronation

Clinical outcomes

Postoperative elbow flexion range were reported in three studies [ 27 , 28 , 29 ] involving 84 patients who underwent surgical treatment; 71 patients received conservative treatment. The surgical and non-surgical groups had postoperative flexion ranges of 134.8 and 132.7, respectively. There was no statistically significant difference between the two treatments (MD = 0.16, 95% CI = [-5.26, 5.58], P  = 0.95), with high heterogeneity ( P  = 0.09, I 2  = 59%). The forest plot of flexion ranges is presented in Fig.  6 .

Elbow supination

Extension deficit

Postoperative elbow extension deficit range were reported in three studies [ 27 , 28 , 29 ] involving 84 patients who underwent surgical treatment; 71 patients received conservative treatment. The surgical and non-surgical groups had postoperative extension deficit ranges of 4.9 and 4.4, respectively. There was no statistically significant difference between the two treatments (MD = 1.58, 95% CI = [-0.99, 4.16], P  = 0.23), with low heterogeneity ( P  = 0.31, I 2  = 15%). The forest plot of extension deficit ranges is presented in Fig.  7 .

Total complications

Postoperative elbow pronation range were reported in three studies [ 27 , 28 , 29 ] involving 84 patients who underwent surgical treatment; 71 patients received conservative treatment. The surgical and non-surgical groups had postoperative pronation ranges of 77.0 and 78.5, respectively. There was statistically significant difference between the two treatments (MD = -3.10, 95% CI = [-4.96, -1.25], P  = 0.001), with no heterogeneity ( P  = 0.55, I 2  = 0%). The forest plot of pronation ranges is presented in Fig.  8 .

Postoperative elbow supination range were reported in three studies [ 27 , 28 , 29 ] involving 84 patients who underwent surgical treatment; 71 patients received conservative treatment. The surgical and non-surgical groups had postoperative supination ranges of 76.9 and 77.3, respectively. There was no statistically significant difference between the two treatments (MD = -0.90, 95% CI = [-4.31, 2.50], P  = 0.60), with no heterogeneity ( P  = 0.84, I 2  = 0%). The forest plot of supination ranges is presented in Fig.  9 .

Postoperative complication rates were reported in four studies [ 27 , 28 , 29 , 30 ] involving 142 patients who underwent surgical treatment; 129 patients received conservative treatment. In the surgical group, complications included elbow pain, wound infection, improper screw positioning, removal of the implants, heterotopic ossification, and hardware failure. In the non-surgical group, complications were primarily elbow pain and heterotopic ossification. The surgical and non-surgical groups had postoperative complication rates of 25% and 5.6%, respectively. There was statistically significant difference between the two treatments (MD = 5.54, 95% CI = [1.79, 17.14], P  = 0.003), with no heterogeneity ( P  = 0.42, I 2  = 0%). The forest plot of complication rates is presented in Fig.  10 .

Postoperative complication rates of postoperative elbow pain were reported in four studies [ 27 , 28 , 29 , 30 ] involving 142 patients who underwent surgical treatment; 129 patients received conservative treatment. The surgical and non-surgical groups had postoperative complication rates of postoperative elbow pain 4.2% and 6.9%, respectively. There was no statistically significant difference between the two treatments (MD = 0.61, 95% CI = [0.22, 1.69], P  = 0.34), with no heterogeneity ( P  = 0.89, I 2  = 0%). The forest plot of complication rates of postoperative elbow pain is presented in Fig.  11 .

The findings of this meta-analysis indicate no significant distinction between the two treatments in terms of the DASH, OES, MEPS, elbow flexion, elbow extension deficit, elbow supination and elbow pain. While our results showed a statistically significant difference favoring conservative treatment over operative treatment regarding elbow pronation (77 versus 78.5 degrees), this difference is small and unlikely to be clinically relevant. However, conservative treatment was superior in reducing the overall complication rate.

Our meta-analysis reveals no significant differences in functional outcomes between operative and conservative treatments as assessed by the DASH, OES, and MEPS scores. Specifically, average scores for conservative treatment were 12.5 for DASH, 42.4 for OES, and 91 for MEPS. These findings align with a systematic review by Lanzerath et al. [ 31 ], which reported a mean MEPS of 90.6 for the non-surgical cohort over a mean follow-up of 39 months, a mean Broberg and Morrey score of 94.4, and a 95.1% treatment success rate. In a prospective analysis by Duckworth et al. [ 32 ]. , 43 patients with non-operatively managed Mason II radial head fractures achieved excellent or good results in 96% of cases, evidenced by average scores of 6.1 on the DASH and 45.5 on the OES. Despite these generally positive outcomes, one patient did require surgery due to continued limitations in forearm rotation. Guzzini et al. [ 33 ]. demonstrated that 92.31% of 52 patients with Mason II radial head fractures, displaced 2 to 5 mm, achieved excellent outcomes as measured by the DASH score following conservative treatment; highly active athletes effectively regained mobility after two weeks of elbow immobilization without permanent stiffness. This suggests that satisfactory results can be obtained without surgical intervention. Our analysis revealed no significant differences between surgical and conservative treatments in elbow flexion, extension deficit, and supination. Although a statistically significant difference was detected in elbow pronation, the minor difference in magnitude (77 versus 78.5 degrees) suggests it is not likely clinically meaningful. Additionally, the study showed that conservative treatment was more effective than surgical approaches in improving elbow joint pronation, a finding consistent with those reported by Mulders et al. [ 28 ]. The prognosis of radial head fractures is affected by several factors, including the patient’s age and socioeconomic status, the type and comminution of the fracture, and the choice of management—whether operative or conservative [ 18 , 34 , 35 , 36 ]. While it has traditionally been thought that surgical fixation is necessary for Mason type II fractures with displacements of 2 mm or greater, recent studies have shown that these displacements do not inevitably lead to poor outcomes in non-operative settings [ 37 ].

In our study, the surgical group had comparable scores with an average DASH of 12.6, OES of 44.2, and MEPS of 91.2. Lanzerath et al. [ 31 ] corroborated these results in their study focused on Mason II radial head fractures, reporting similar functional scores and treatment success rates in patients treated with operative treatment. Zarattini et al. [ 38 ]. observed excellent long-term outcomes in patients with isolated Mason Type II radial head fractures, reporting an average DASH score of 2.81 and a Broberg and Morrey score of 95.09 over an average follow-up period of 125 months post-ORIF, with only a single case of postoperative osteoarthritis. In contrast, Khalfayan et al. [ 39 ]. compared nonoperative treatment with operative treatment in patients with Mason Type II radial head fractures, finding that more patients in the operative group had good or excellent MEPS outcomes. The systematic review by Kaas et al. [ 21 ]. specifically focused on Mason Type II radial head fractures and suggested that surgical treatments are more successful than non-surgical approaches for this fracture type. However, this evidence is less convincing due to the heterogeneity and lower quality of the retrospective studies included. Thus, the choice between conservative and surgical treatment remains contested, hindered by a lack of definitive, high-quality evidence. Surgical treatment often leads to favorable functional outcomes, yet conservative management is still a practical alternative, mainly when there is no substantial displacement or instability. Some studies have suggested that the primary indication for opting for operative treatment in isolated Mason type II fractures is the presence of a mechanical block to forearm rotation [ 6 , 20 , 34 , 35 , 40 , 41 , 42 , 43 ].

Our results showed that surgical treatment had a higher complication rate than conservative treatment, with the most common complications in the surgical group including wound infection, improper screw positioning, removal of implants, heterotopic ossification, and hardware failure. In contrast, the conservative treatment group primarily experienced complications such as heterotopic ossification and elbow pain. However, there was no significant difference in the incidence of elbow pain at the final follow-up between the two treatments. In a systematic review, Lanzerath et al. [ 31 ]. reported total complication rates for surgical and conservative treatment at 12.3% and 13.9%, respectively. This is inconsistent with our findings, which showed complication rates of 25% for surgical treatment and 5.6% for conservative treatment. While the short-term complications are important to consider, the long-term outcomes, particularly in terms of degenerative changes in the elbow, also play a crucial role in evaluating the effectiveness of different treatment approaches for Mason II radial head fractures. In their retrospective analysis, Akesson et al. [ 40 ]. reported that 82% of conservatively treated patients with Mason II radial head fractures experienced degenerative changes in their injured elbows, compared to only 21% in uninjured elbows. Nonetheless, these patients reported satisfactory functional outcomes and did not suffer from elbow discomfort. In a long-term study by Herbertsson et al. [ 44 ]. , 100 patients with Mason II and III-type fractures underwent surgical or conservative treatment. Nineteen years later, radiological examinations revealed that 76% of the elbows had degenerative changes, though clinical symptoms were absent in 77% of these cases. The study concluded that radiological signs of degeneration in the elbow do not necessarily correlate with pain or restricted movement. Some retrospective studies have reported favorable outcomes with surgical intervention for displaced partial radial head fractures [ 38 , 39 , 45 , 46 ]. Lindenhovius et al. [ 41 ]. observed minor degenerative changes in only 2 of 16 patients with operatively managed Mason type II radial head fractures after a follow-up period averaging 22 years. Lanzerath et al. [ 31 ]. found that osteoarthritis developed post-treatment in 11.9% of patients treated non-surgically, in contrast to 5.9% who received surgical intervention. Our findings suggest that while surgical treatment is associated with a higher complication rate in the short term, it may offer better long-term outcomes for patients with Mason Type II radial head fractures, particularly in reducing the risk of degenerative changes in the elbow. This indicates that surgical intervention could be preferable in younger, more active patients who have higher functional demands and are at risk for long-term joint degeneration.

Our meta-analysis also had some limitations. First, our study only included one RCT and did not include more randomized controlled studies of higher methodological quality. The quality and quantity of the studies included in our analysis impose limitations on the potential value of our meta-analysis. The level of available evidence will limit the value of the statistical analysis performed. This study suggests the need for conducting randomized controlled trials in a multicenter setting to obtain more definitive conclusions. Second, the meta-analysis included studies with varying length follow-up periods, which introduces a potential source of heterogeneity. These factors may impact the reliability and stability of the conclusions drawn from our meta-analysis.

Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

We appreciate all co-authors for their contributions to this study and the writing of this manuscript.

The correspondence author Junlin Zhou discloses receipt of the following financial support for the research, authorship, and publication of this article: National Natural Science Foundation of China (82272469) and Beijing Key Clinical Specialty Project.

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Binzhi Zhao and Hanzhou Wang contributed equally to this work.

Authors and Affiliations

Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, P.R. China

Binzhi Zhao, Hanzhou Wang, Shuo Diao, Xiaopei Xu, Yulin Gao, Tianchao Lu, Junlin Zhou & Yang Liu

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All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Binzhi Zhao and Hanzhou Wang. The first draft of the manuscript was written by Binzhi Zhao and Hanzhou Wang. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Junlin Zhou or Yang Liu .

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Zhao, B., Wang, H., Diao, S. et al. Comparison of operatively and nonoperatively treated isolated mason type II radial head fractures: a systematic review and meta-analysis. J Orthop Surg Res 19 , 540 (2024). https://doi.org/10.1186/s13018-024-05039-6

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Received : 15 June 2024

Accepted : 27 August 2024

Published : 04 September 2024

DOI : https://doi.org/10.1186/s13018-024-05039-6

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• http://orcid.org/0000-0002-4901-8709 Kyle Wallace 1 ,
• Samantha E. Scarneo-Miller 2 ,
• Jennifer Monnin 3 ,
• Andrew E Lincoln 4 ,
• Omar Hraky 5 ,
• Griffith Gosnell 6 ,
• Suin Jeong 6 ,
• Wilson Skinner 6 ,
• Eliana Schaefer 7 ,
• Dharmi K Desai 8 ,
• http://orcid.org/0000-0002-8775-2971 Shane V Caswell 8 , 9
• 1 Department of Orthopaedic Surgery , The University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
• 2 Division of Athletic Training , West Virginia University , Morgantown , West Virginia , USA
• 3 Health Sciences Library , West Virginia University , Morgantown , West Virginia , USA
• 4 Special Olympics International , Washington , District of Columbia , USA
• 5 University of Maryland at College Park , College Park , Maryland , USA
• 6 Georgetown University Medical Center , Georgetown University School of Medicine , Washington , District of Columbia , USA
• 7 Department of Orthopaedic Surgery , MedStar Georgetown University Hospital , Washington , District of Columbia , USA
• 8 George Mason University , Fairfax , Virginia , USA
• 9 Sports Medicine Assessment, Research & Testing (SMART) Laboratory , George Mason University , Manassas , Virginia , USA
• Correspondence to Kyle Wallace; kylewallace1020{at}gmail.com

Objective The objective is to comprehensively classify the types, topics and populations represented in the published lacrosse literature.

Design Mapping review. Protocol registration at Open Science Framework ( https://osf.io/kz4e6 ).

Data sources 10 electronic databases were searched from inception to 31 March 2023.

Eligibility criteria Peer-reviewed studies in English that included lacrosse were eligible. Publications without participant demographic or lacrosse-specific data were excluded.

Results We identified 498 articles pertaining to lacrosse, with 270 (54.2%) focused on player safety, 128 (25.7%) on sport science and 74 (14.9%) on clinical care. Musculoskeletal injury was the focus of 179 studies (35.9%), and the most common study design was cross-sectional (n=162, 32.5%). Most (n=423, 84.9%) originated in the USA. Over half (n=254, 51.0%) were published since 2017. 216 articles (43.4%) included female and male athletes, while 112 (22.5%) and 142 (28.5%) focused solely on female and male athletes, respectively. Collegiate athletes were the most frequent study population (n=277, 55.6%), and traditional field lacrosse was the focus of 298 (59.8%) articles. We observed that 77.1% (27/35) of quasiexperimental, 91.3% (21/23) of randomised controlled trials and 62.1% (18/29) of systematic reviews had a high or moderate risk of bias.

Conclusion The vast majority of lacrosse research originates from the USA, is in collegiate athletes, with a focus on player safety, and has a high risk of bias. With the sport’s inclusion in the 2028 Olympics and growing global participation, higher quality research studies that are more inclusive and adaptable to diverse athletic groups and changing gameplay parameters are needed.

Data availability statement

Data are available in a public, open access repository. Appendices for this manuscript are available on Open Science Framework ( https://doi.org/10.17605/OSF.IO/KNS3E ) and are linked to our original a priori protocol. All included articles in this mapping review, with data coding, are available online (appendix 1). Unfilled JBI checklists are available online (appendix 2). Completed JBI checklists for all included articles are available online (appendix 3).

https://doi.org/10.1136/bjsports-2024-108298

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Contributors All authors were an integral part of planning, collecting data, designing, writing and reviewing this manuscript. KW, primary author, is the corresponding author and guarantor.

Funding Funding for this project was provided by USA Lacrosse and MedStar Health.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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

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