areas of research in literature

Fields of Study

Research in English used to be categorized by traditional field designations such as Renaissance or Victorian, but Chicago's English faculty have always been more interested in critical inquiry (the journal Critical Inquiry was founded and lives here) than in working within categorical boxes. That exploratory ethos continues to unify us as a department and animate our research interests, which are otherwise various, even heterogeneous, and which are constantly evolving.

Research interests, however, may be defined in a variety of ways and at various degrees of specification. For instance, a scholar such as Ken Warren , who has written a book on Ralph Ellison, could be said to be working within the American field, but also within the fields of African American literature and literary history. Visitors to this site may also have many interests, at many levels. They may want to identify the subset of faculty who are working in a specific  historical period  such as the Renaissance, on a particular  object of study  such as the novel, or on a specialized  theoretical or methodological problem  such as gender and sexuality . See the lists and categories below to help guide your search.

Research Clusters

Cultural studies and global literatures.

• Black Studies 
• Caribbean Studies
• African-American Literature
• African Literature in English
• Asian American/Pacific Studies
• Global Anglophone
• Latinx/Indigenous/Comparative Americas
• American Literature
• Early American
• 20-21c American
• American Literature and Cultural Studies
• African-American
• British Literature
• Medieval and Early Renaissance
• Renaissance 
• 18th c British/ Romanticism
• 19th c British/British Empire
• 20-21c British
• British Culture

Critical Theory, Methodology, or Objects of Study

• Critical Theory/Cultural Studies
• Drama/Theater and Performance Studies
• Gender and Sexuality Studies
• Media Studies
• Poetry and Poetics
• Postcolonial/Decolonial

Common Areas of Academic Study

• 18th Century British/Romanticism
• 19th Century
• 20/21st Century British Literature
• 20th Century American Literature
• Black Studies
• Caribbean Studies
• Critical Theory and Objects of Study
• Global Literatures
• Renaissance

Research Areas

The English Faculty’s research embraces language and literature from the 7th-century to ‘global English’ today. While focusing especially on mainstream literary and textual research, it also takes in broadcast media, film and drama, language and linguistics, history of the book, women’s studies and American studies.

Research Seminars

Research Projects

Research Centres

Open Educational Resources

Chapter Four: Theory, Methodologies, Methods, and Evidence

Research Methods

You are viewing the first edition of this textbook. a second edition is available – please visit the latest edition for updated information..

This page discusses the following topics:

Research Goals

Research method types.

Before discussing research   methods , we need to distinguish them from  methodologies  and  research skills . Methodologies, linked to literary theories, are tools and lines of investigation: sets of practices and propositions about texts and the world. Researchers using Marxist literary criticism will adopt methodologies that look to material forces like labor, ownership, and technology to understand literature and its relationship to the world. They will also seek to understand authors not as inspired geniuses but as people whose lives and work are shaped by social forces.

Example: Critical Race Theory Methodologies

Critical Race Theory may use a variety of methodologies, including

• Interest convergence: investigating whether marginalized groups only achieve progress when dominant groups benefit as well
• Intersectional theory: investigating how multiple factors of advantage and disadvantage around race, gender, ethnicity, religion, etc. operate together in complex ways
• Radical critique of the law: investigating how the law has historically been used to marginalize particular groups, such as black people, while recognizing that legal efforts are important to achieve emancipation and civil rights
• Social constructivism: investigating how race is socially constructed (rather than biologically grounded)
• Standpoint epistemology: investigating how knowledge relates to social position
• Structural determinism: investigating how structures of thought and of organizations determine social outcomes

To identify appropriate methodologies, you will need to research your chosen theory and gather what methodologies are associated with it. For the most part, we can’t assume that there are “one size fits all” methodologies.

Research skills are about how you handle materials such as library search engines, citation management programs, special collections materials, and so on.

Research methods  are about where and how you get answers to your research questions. Are you conducting interviews? Visiting archives? Doing close readings? Reviewing scholarship? You will need to choose which methods are most appropriate to use in your research and you need to gain some knowledge about how to use these methods. In other words, you need to do some research into research methods!

Your choice of research method depends on the kind of questions you are asking. For example, if you want to understand how an author progressed through several drafts to arrive at a final manuscript, you may need to do archival research. If you want to understand why a particular literary work became a bestseller, you may need to do audience research. If you want to know why a contemporary author wrote a particular work, you may need to do interviews. Usually literary research involves a combination of methods such as  archival research ,  discourse analysis , and  qualitative research  methods.

Literary research methods tend to differ from research methods in the hard sciences (such as physics and chemistry). Science research must present results that are reproducible, while literary research rarely does (though it must still present evidence for its claims). Literary research often deals with questions of meaning, social conventions, representations of lived experience, and aesthetic effects; these are questions that reward dialogue and different perspectives rather than one great experiment that settles the issue. In literary research, we might get many valuable answers even though they are quite different from one another. Also in literary research, we usually have some room to speculate about answers, but our claims have to be plausible (believable) and our argument comprehensive (meaning we don’t overlook evidence that would alter our argument significantly if it were known).

A literary researcher might select the following:

Theory: Critical Race Theory

Methodology: Social Constructivism

Method: Scholarly

Skills: Search engines, citation management

Wendy Belcher, in  Writing Your Journal Article in 12 Weeks , identifies two main approaches to understanding literary works: looking at a text by itself (associated with New Criticism ) and looking at texts as they connect to society (associated with Cultural Studies ). The goal of New Criticism is to bring the reader further into the text. The goal of Cultural Studies is to bring the reader into the network of discourses that surround and pass through the text. Other approaches, such as Ecocriticism, relate literary texts to the Sciences (as well as to the Humanities).

The New Critics, starting in the 1940s,  focused on meaning within the text itself, using a method they called “ close reading .” The text itself becomes e vidence for a particular reading. Using this approach, you should summarize the literary work briefly and q uote particularly meaningful passages, being sure to introduce quotes and then interpret them (never let them stand alone). Make connections within the work; a sk  “why” and “how” the various parts of the text relate to each other.

Cultural Studies critics see all texts  as connected to society; the critic  therefore has to connect a text to at least one political or social issue. How and why does  the text reproduce particular knowledge systems (known as discourses) and how do these knowledge systems relate to issues of power within the society? Who speaks and when? Answering these questions helps your reader understand the text in context. Cultural contexts can include the treatment of gender (Feminist, Queer), class (Marxist), nationality, race, religion, or any other area of human society.

Other approaches, such as psychoanalytic literary criticism , look at literary texts to better understand human psychology. A psychoanalytic reading can focus on a character, the author, the reader, or on society in general. Ecocriticism  look at human understandings of nature in literary texts.

We select our research methods based on the kinds of things we want to know. For example, we may be studying the relationship between literature and society, between author and text, or the status of a work in the literary canon. We may want to know about a work’s form, genre, or thematics. We may want to know about the audience’s reading and reception, or about methods for teaching literature in schools.

Below are a few research methods and their descriptions. You may need to consult with your instructor about which ones are most appropriate for your project. The first list covers methods most students use in their work. The second list covers methods more commonly used by advanced researchers. Even if you will not be using methods from this second list in your research project, you may read about these research methods in the scholarship you find.

Most commonly used undergraduate research methods:

• Scholarship Methods:  Studies the body of scholarship written about a particular author, literary work, historical period, literary movement, genre, theme, theory, or method.
• Textual Analysis Methods:  Used for close readings of literary texts, these methods also rely on literary theory and background information to support the reading.
• Biographical Methods:  Used to study the life of the author to better understand their work and times, these methods involve reading biographies and autobiographies about the author, and may also include research into private papers, correspondence, and interviews.
• Discourse Analysis Methods:  Studies language patterns to reveal ideology and social relations of power. This research involves the study of institutions, social groups, and social movements to understand how people in various settings use language to represent the world to themselves and others. Literary works may present complex mixtures of discourses which the characters (and readers) have to navigate.
• Creative Writing Methods:  A literary re-working of another literary text, creative writing research is used to better understand a literary work by investigating its language, formal structures, composition methods, themes, and so on. For instance, a creative research project may retell a story from a minor character’s perspective to reveal an alternative reading of events. To qualify as research, a creative research project is usually combined with a piece of theoretical writing that explains and justifies the work.

Methods used more often by advanced researchers:

• Archival Methods: Usually involves trips to special collections where original papers are kept. In these archives are many unpublished materials such as diaries, letters, photographs, ledgers, and so on. These materials can offer us invaluable insight into the life of an author, the development of a literary work, or the society in which the author lived. There are at least three major archives of James Baldwin’s papers: The Smithsonian , Yale , and The New York Public Library . Descriptions of such materials are often available online, but the materials themselves are typically stored in boxes at the archive.
• Computational Methods:  Used for statistical analysis of texts such as studies of the popularity and meaning of particular words in literature over time.
• Ethnographic Methods:  Studies groups of people and their interactions with literary works, for instance in educational institutions, in reading groups (such as book clubs), and in fan networks. This approach may involve interviews and visits to places (including online communities) where people interact with literary works. Note: before you begin such work, you must have  Institutional Review Board (IRB)  approval “to protect the rights and welfare of human participants involved in research.”
• Visual Methods:  Studies the visual qualities of literary works. Some literary works, such as illuminated manuscripts, children’s literature, and graphic novels, present a complex interplay of text and image. Even works without illustrations can be studied for their use of typography, layout, and other visual features.

Regardless of the method(s) you choose, you will need to learn how to apply them to your work and how to carry them out successfully. For example, you should know that many archives do not allow you to bring pens (you can use pencils) and you may not be allowed to bring bags into the archives. You will need to keep a record of which documents you consult and their location (box number, etc.) in the archives. If you are unsure how to use a particular method, please consult a book about it. [1] Also, ask for the advice of trained researchers such as your instructor or a research librarian.

• What research method(s) will you be using for your paper? Why did you make this method selection over other methods? If you haven’t made a selection yet, which methods are you considering?
• What specific methodological approaches are you most interested in exploring in relation to the chosen literary work?
• What is your plan for researching your method(s) and its major approaches?
• What was the most important lesson you learned from this page? What point was confusing or difficult to understand?

Write your answers in a webcourse discussion page.

• Introduction to Research Methods: A Practical Guide for Anyone Undertaking a Research Project  by Catherine, Dr. Dawson
• Practical Research Methods: A User-Friendly Guide to Mastering Research Techniques and Projects  by Catherine Dawson
• Qualitative Inquiry and Research Design: Choosing Among Five Approaches  by John W. Creswell  Cheryl N. Poth
• Qualitative Research Evaluation Methods: Integrating Theory and Practice  by Michael Quinn Patton
• Research Design: Qualitative, Quantitative, and Mixed Methods Approaches  by John W. Creswell  J. David Creswell
• Research Methodology: A Step-by-Step Guide for Beginners  by Ranjit Kumar
• Research Methodology: Methods and Techniques  by C.R. Kothari

Strategies for Conducting Literary Research Copyright © 2021 by Barry Mauer & John Venecek is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Areas of expertise

Faculty members in Waterloo English have research expertise in a wide variety of fields that span literature, rhetoric, professional communication, and digital media.

Research Methods

• Getting Started
• Literature Review Research
• Research Design
• Research Design By Discipline
• SAGE Research Methods
• Teaching with SAGE Research Methods

Literature Review

• What is a Literature Review?
• What is NOT a Literature Review?
• Purposes of a Literature Review
• Types of Literature Reviews
• Literature Reviews vs. Systematic Reviews
• Systematic vs. Meta-Analysis

Literature Review  is a comprehensive survey 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.

Also, we can define a literature review as the collected body of scholarly works related to a topic:

• 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.
• Indicates potential directions for future research.

All content in this section is from Literature Review Research from Old Dominion University 

Keep in mind the following, a literature review is NOT:

Not an essay 

Not an annotated bibliography  in which you summarize each article that you have reviewed.  A literature review goes beyond basic summarizing to focus on the critical analysis of the reviewed works and their relationship to your research question.

Not a research paper   where you select resources to support one side of an issue versus another.  A lit review should explain and consider all sides of an argument in order to avoid bias, and areas of agreement and disagreement should be highlighted.

A literature review serves several purposes. For example, it

• provides thorough knowledge of previous studies; introduces seminal works.
• helps focus one’s own research topic.
• identifies a conceptual framework for one’s own research questions or problems; indicates potential directions for future research.
• suggests previously unused or underused methodologies, designs, quantitative and qualitative strategies.
• identifies gaps in previous studies; identifies flawed methodologies and/or theoretical approaches; avoids replication of mistakes.
• helps the researcher avoid repetition of earlier research.
• suggests unexplored populations.
• determines whether past studies agree or disagree; identifies controversy in the literature.
• tests assumptions; may help counter preconceived ideas and remove unconscious bias.

As Kennedy (2007) notes*, 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 original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of 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 several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

Argumentative Review      This form examines literature selectively in order to support or refute an argument, deeply imbedded 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 to make summary claims of the sort found in systematic reviews.

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. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication.

Historical Review      Few things rest in isolation from historical precedent. Historical reviews are focused 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 [content], but how they said it [method of analysis]. This approach provides a framework of understanding at different levels (i.e. those of theory, substantive fields, research approaches and data collection and analysis techniques), enables researchers to draw on 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, and helps highlight many ethical issues which we should be aware of and consider as we go through our 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 analyse data from the studies that are included in the review. 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?"

Theoretical Review      The purpose of this form is to concretely examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review help 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.

* Kennedy, Mary M. "Defining a Literature."  Educational Researcher  36 (April 2007): 139-147.

All content in this section is from The Literature Review created by Dr. Robert Larabee USC

Robinson, P. and Lowe, J. (2015),  Literature reviews vs systematic reviews.  Australian and New Zealand Journal of Public Health, 39: 103-103. doi: 10.1111/1753-6405.12393

What's in the name? The difference between a Systematic Review and a Literature Review, and why it matters . By Lynn Kysh from University of Southern California

Systematic review or meta-analysis?

A  systematic review  answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria.

A  meta-analysis  is the use of statistical methods to summarize the results of these studies.

Systematic reviews, just like other research articles, can be of varying quality. They are a significant piece of work (the Centre for Reviews and Dissemination at York estimates that a team will take 9-24 months), and to be useful to other researchers and practitioners they should have:

• clearly stated objectives with pre-defined eligibility criteria for studies
• explicit, reproducible methodology
• a systematic search that attempts to identify all studies
• assessment of the validity of the findings of the included studies (e.g. risk of bias)
• systematic presentation, and synthesis, of the characteristics and findings of the included studies

Not all systematic reviews contain meta-analysis. 

Meta-analysis is the use of statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects of health care than those derived from the individual studies included within a review.  More information on meta-analyses can be found in  Cochrane Handbook, Chapter 9 .

A meta-analysis goes beyond critique and integration and conducts secondary statistical analysis on the outcomes of similar studies.  It is a systematic review that uses quantitative methods to synthesize and summarize the results.

An advantage of a meta-analysis is the ability to be completely objective in evaluating research findings.  Not all topics, however, have sufficient research evidence to allow a meta-analysis to be conducted.  In that case, an integrative review is an appropriate strategy. 

Some of the content in this section is from Systematic reviews and meta-analyses: step by step guide created by Kate McAllister.

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Research Process :: Step by Step

• Introduction
• Select Topic
• Identify Keywords
• Background Information
• Develop Research Questions
• Refine Topic
• Search Strategy
• Popular Databases
• Evaluate Sources
• Types of Periodicals
• Reading Scholarly Articles
• Primary & Secondary Sources
• Organize / Take Notes
• Writing & Grammar Resources
• Annotated Bibliography
• Literature Review
• Citation Styles
• Paraphrasing
• Privacy / Confidentiality
• Research Process
• Selecting Your Topic
• Identifying Keywords
• Gathering Background Info
• Evaluating Sources

Organize the literature review into sections that present themes or identify trends, including relevant theory. You are not trying to list all the material published, but to synthesize and evaluate it according to the guiding concept of your thesis or research question.  

What is a literature review?

A literature review is an account of what has been published on a topic by accredited scholars and researchers. Occasionally you will be asked to write one as a separate assignment, but more often it is part of the introduction to an essay, research report, or thesis. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries

A literature review must do these things:

• be organized around and related directly to the thesis or research question you are developing
• synthesize results into a summary of what is and is not known
• identify areas of controversy in the literature
• formulate questions that need further research

Ask yourself questions like these:

• What is the specific thesis, problem, or research question that my literature review helps to define?
• What type of literature review am I conducting? Am I looking at issues of theory? methodology? policy? quantitative research (e.g. on the effectiveness of a new procedure)? qualitative research (e.g., studies of loneliness among migrant workers)?
• What is the scope of my literature review? What types of publications am I using (e.g., journals, books, government documents, popular media)? What discipline am I working in (e.g., nursing psychology, sociology, medicine)?
• How good was my information seeking? Has my search been wide enough to ensure I've found all the relevant material? Has it been narrow enough to exclude irrelevant material? Is the number of sources I've used appropriate for the length of my paper?
• Have I critically analyzed the literature I use? Do I follow through a set of concepts and questions, comparing items to each other in the ways they deal with them? Instead of just listing and summarizing items, do I assess them, discussing strengths and weaknesses?
• Have I cited and discussed studies contrary to my perspective?
• Will the reader find my literature review relevant, appropriate, and useful?

Ask yourself questions like these about each book or article you include:

• Has the author formulated a problem/issue?
• Is it clearly defined? Is its significance (scope, severity, relevance) clearly established?
• Could the problem have been approached more effectively from another perspective?
• What is the author's research orientation (e.g., interpretive, critical science, combination)?
• What is the author's theoretical framework (e.g., psychological, developmental, feminist)?
• What is the relationship between the theoretical and research perspectives?
• Has the author evaluated the literature relevant to the problem/issue? Does the author include literature taking positions she or he does not agree with?
• In a research study, how good are the basic components of the study design (e.g., population, intervention, outcome)? How accurate and valid are the measurements? Is the analysis of the data accurate and relevant to the research question? Are the conclusions validly based upon the data and analysis?
• In material written for a popular readership, does the author use appeals to emotion, one-sided examples, or rhetorically-charged language and tone? Is there an objective basis to the reasoning, or is the author merely "proving" what he or she already believes?
• How does the author structure the argument? Can you "deconstruct" the flow of the argument to see whether or where it breaks down logically (e.g., in establishing cause-effect relationships)?
• In what ways does this book or article contribute to our understanding of the problem under study, and in what ways is it useful for practice? What are the strengths and limitations?
• How does this book or article relate to the specific thesis or question I am developing?

Text written by Dena Taylor, Health Sciences Writing Centre, University of Toronto

http://www.writing.utoronto.ca/advice/specific-types-of-writing/literature-review

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English literature

English literature research

Explore our work in four areas of expertise within English literature

To explore English literature is to uncover the history of the English speaking world. Throughout history, literature has been a companion to the trials, tribulations, successes and achievements of our nation. Beyond entertainment, it has commented on corruption, taught lessons on love, war and justice, transported us to new worlds, and changed our views. English literature can change the way we think about the world. It can shape opinion on cultures, communities and people. It can give power to unrepresented and marginalised voices, or be used as a weapon to repress and control through propaganda. In an increasingly globalised world, where rapid change is the norm, it is important to study how English literature provides insight and understanding into the lives of other individuals, communities and cultures. For over a decade, the Centre for Studies in Literature  has been home to our English literature research. Our researchers have expertise in early modern writing, nineteenth-century literature and culture, and twentieth-century British and American literature. We bring together scholars from different fields within literary studies to promote academic research and innovation in literary studies, and wider engagement with research through collaboration and dissemination.

Interested in a PhD in English literature?

Explore our Literary Studies  postgraduate research degrees – including PhDs and MPhils.

Explore our English literature areas of expertise

Find out more about our English literature research – and learn more about our recent projects, the partners with whom we collaborate and the major funders who fund our work, in the areas of expertise below.

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Publication highlights

Brexit and the migrant voice: eu citizens in post-brexit literature and culture.

Berberich, C. (2022) "Brexit and the Migrant Voice: EU Citizens in post-Brexit Literature and Culture", Taylor and Francis Ltd

Poles in Britain, History, Culture and Literature, 1772 to the Present

Bowers, M., Dew, B. (2021) "Poles in Britain, History, Culture and Literature, 1772 to the Present", Palgrave Macmillan

Auratic encounters with posthumous literary celebrity in Henry James’s late Victorian tales: desiring the dead

Boyce, C. (2022) "Auratic encounters with posthumous literary celebrity in Henry James’s late Victorian tales: desiring the dead", Victoriographies

Reading Novels During the Covid-19 Pandemic

Davies, B., Lupton, C., Gormsen Schmidt, J. (2022) "Reading Novels During the Covid-19 Pandemic", Oxford University Press

Environment and Ecology in the Long Nineteenth Century Vol 1: Scientific and Professional Perspectives on Environment, 1780-1858

Frost, M. (2022) "Environment and Ecology in the Long Nineteenth Century Vol 1: Scientific and Professional Perspectives on Environment, 1780-1858", Routledge

“You’ll be the only Dickinson they talk about in two hundred years”: Queer Celebrity, Thomas Wentworth Higginson, A Quiet Passion, Wild Nights with Emily, and Apple TV+'s Dickinson

Finnerty, P. (2022) "“You’ll be the only Dickinson they talk about in two hundred years”: Queer Celebrity, Thomas Wentworth Higginson, A Quiet Passion, Wild Nights with Emily, and Apple TV+'s Dickinson", The Emily Dickinson Journal

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We're researching the relationship between literature and nineteenth-century culture.

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We're researching how culture and transnational identity is portrayed in twentieth and twenty-first century literature.

Research projects

Portsmouth literary map.

Explore Portsmouth's rich literary heritage and contemporary literature scene through an interactive map and blog

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This project researches reading habits during the COVID-19 pandemic through surveys, publisher data and interviews.

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Writing Literary Portsmouth , the blog of the Portsmouth Literary Map, is here to stimulate discussions about the city, its incredible literary history, and its thriving creative scene.

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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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What is a literature review?

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

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

Why is it important?

A literature review is important because it:

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

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

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

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

2. Decide on the scope of your review

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

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

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

Make a list of the databases you will search. 

Where to find databases:

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

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

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

Review the literature

Some questions to help you analyze the research:

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

Tips: 

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

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

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

Larayne Dallas : Engineering

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

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

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

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

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Literature Reviews

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• 2. Plan your search
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For example, the following research question is too broad.

Does social media affect mental health in college students?

A more focused research question could be:

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

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

Start the brainstorming process:

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

One way to brainstorm is to use a flowchart.

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

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

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

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

ChatGPT: 

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

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

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

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

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

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 
• Frequently asked questions 

What is a literature review?

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

What is the purpose of literature review?

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

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

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

Literature Review on Climate Change Impacts on Biodiversity:

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

a. Habitat Loss and Species Extinction:

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

b. Range Shifts and Phenological Changes:

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

c. Ocean Acidification and Coral Reefs:

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

d. Adaptive Strategies and Conservation Efforts:

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

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

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

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

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

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

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

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

Conducting a literature review

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

Choose a Topic and Define the Research Question:

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

Decide on the Scope of Your Review:

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

Select Databases for Searches:

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

Conduct Searches and Keep Track:

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

Review the Literature:

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

Organize and Write Your Literature Review:

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

Whether you’re exploring a new research field or finding new angles to develop an existing topic, sifting through hundreds of papers can take more time than you have to spare. But what if you could find science-backed insights with verified citations in seconds? That’s the power of Paperpal’s new Research feature!  

How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

Frequently asked questions

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

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

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

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

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

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

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

References 

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

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Chapter 2: Getting Started in Research

Reviewing the Research Literature

Learning Objectives

• Define the research literature in psychology and give examples of sources that are part of the research literature and sources that are not.
• Describe and use several methods for finding previous research on a particular research idea or question.

Reviewing the research literature means finding, reading, and summarizing the published research relevant to your question. An empirical research report written in American Psychological Association (APA) style always includes a written literature review, but it is important to review the literature early in the research process for several reasons.

• It can help you turn a research idea into an interesting research question.
• It can tell you if a research question has already been answered.
• It can help you evaluate the interestingness of a research question.
• It can give you ideas for how to conduct your own study.
• It can tell you how your study fits into the research literature.

What Is the Research Literature?

The  research literature  in any field is all the published research in that field. The research literature in psychology is enormous—including millions of scholarly articles and books dating to the beginning of the field—and it continues to grow. Although its boundaries are somewhat fuzzy, the research literature definitely does not include self-help and other pop psychology books, dictionary and encyclopedia entries, websites, and similar sources that are intended mainly for the general public. These are considered unreliable because they are not reviewed by other researchers and are often based on little more than common sense or personal experience. Wikipedia contains much valuable information, but the fact that its authors are anonymous and may not have any formal training or expertise in that subject area, and its content continually changes makes it unsuitable as a basis of sound scientific research. For our purposes, it helps to define the research literature as consisting almost entirely of two types of sources: articles in professional journals, and scholarly books in psychology and related fields.

Professional Journals

Professional journals  are periodicals that publish original research articles. There are thousands of professional journals that publish research in psychology and related fields. They are usually published monthly or quarterly in individual issues, each of which contains several articles. The issues are organized into volumes, which usually consist of all the issues for a calendar year. Some journals are published in hard copy only, others in both hard copy and electronic form, and still others in electronic form only.

Most articles in professional journals are one of two basic types: empirical research reports and review articles.  Empirical research reports  describe one or more new empirical studies conducted by the authors. They introduce a research question, explain why it is interesting, review previous research, describe their method and results, and draw their conclusions. Review articles  summarize previously published research on a topic and usually present new ways to organize or explain the results. When a review article is devoted primarily to presenting a new theory, it is often referred to as a theoretical article .

Most professional journals in psychology undergo a process of  double-blind peer review . Researchers who want to publish their work in the journal submit a manuscript to the editor—who is generally an established researcher too—who in turn sends it to two or three experts on the topic. Each reviewer reads the manuscript, writes a critical but constructive review, and sends the review back to the editor along with his or her recommendations. The editor then decides whether to accept the article for publication, ask the authors to make changes and resubmit it for further consideration, or reject it outright. In any case, the editor forwards the reviewers’ written comments to the researchers so that they can revise their manuscript accordingly. This entire process is double-blind, as the reviewers do not know the identity of the researcher(s), and vice versa. Double-blind peer review is helpful because it ensures that the work meets basic standards of the field before it can enter the research literature. However, in order to increase transparency and accountability some newer open access journals (e.g., Frontiers in Psychology) utilize an open peer review process wherein the identities of the reviewers (which remain concealed during the peer review process) are published alongside the journal article.

Scholarly Books

Scholarly books  are books written by researchers and practitioners mainly for use by other researchers and practitioners. A  monograph  is written by a single author or a small group of authors and usually gives a coherent presentation of a topic much like an extended review article.  Edited volumes have an editor or a small group of editors who recruit many authors to write separate chapters on different aspects of the same topic. Although edited volumes can also give a coherent presentation of the topic, it is not unusual for each chapter to take a different perspective or even for the authors of different chapters to openly disagree with each other. In general, scholarly books undergo a peer review process similar to that used by professional journals.

Literature Search Strategies

Using psycinfo and other databases.

The primary method used to search the research literature involves using one or more electronic databases. These include Academic Search Premier, JSTOR, and ProQuest for all academic disciplines, ERIC for education, and PubMed for medicine and related fields. The most important for our purposes, however, is PsycINFO, which is produced by the APA. PsycINFO is so comprehensive—covering thousands of professional journals and scholarly books going back more than 100 years—that for most purposes its content is synonymous with the research literature in psychology. Like most such databases, PsycINFO is usually available through your university library.

PsycINFO consists of individual records for each article, book chapter, or book in the database. Each record includes basic publication information, an abstract or summary of the work (like the one presented at the start of this chapter), and a list of other works cited by that work. A computer interface allows entering one or more search terms and returns any records that contain those search terms. (These interfaces are provided by different vendors and therefore can look somewhat different depending on the library you use.) Each record also contains lists of keywords that describe the content of the work and also a list of index terms. The index terms are especially helpful because they are standardized. Research on differences between women and men, for example, is always indexed under “Human Sex Differences.” Research on notetaking is always indexed under the term “Learning Strategies.” If you do not know the appropriate index terms, PsycINFO includes a thesaurus that can help you find them.

Given that there are nearly four million records in PsycINFO, you may have to try a variety of search terms in different combinations and at different levels of specificity before you find what you are looking for. Imagine, for example, that you are interested in the question of whether women and men differ in terms of their ability to recall experiences from when they were very young. If you were to enter “memory for early experiences” as your search term, PsycINFO would return only six records, most of which are not particularly relevant to your question. However, if you were to enter the search term “memory,” it would return 149,777 records—far too many to look through individually. This is where the thesaurus helps. Entering “memory” into the thesaurus provides several more specific index terms—one of which is “early memories.” While searching for “early memories” among the index terms returns 1,446 records—still too many too look through individually—combining it with “human sex differences” as a second search term returns 37 articles, many of which are highly relevant to the topic.

Depending on the vendor that provides the interface to PsycINFO, you may be able to save, print, or e-mail the relevant PsycINFO records. The records might even contain links to full-text copies of the works themselves. (PsycARTICLES is a database that provides full-text access to articles in all journals published by the APA.) If not, and you want a copy of the work, you will have to find out if your library carries the journal or has the book and the hard copy on the library shelves. Be sure to ask a librarian if you need help.

Using Other Search Techniques

In addition to entering search terms into PsycINFO and other databases, there are several other techniques you can use to search the research literature. First, if you have one good article or book chapter on your topic—a recent review article is best—you can look through the reference list of that article for other relevant articles, books, and book chapters. In fact, you should do this with any relevant article or book chapter you find. You can also start with a classic article or book chapter on your topic, find its record in PsycINFO (by entering the author’s name or article’s title as a search term), and link from there to a list of other works in PsycINFO that cite that classic article. This works because other researchers working on your topic are likely to be aware of the classic article and cite it in their own work. You can also do a general Internet search using search terms related to your topic or the name of a researcher who conducts research on your topic. This might lead you directly to works that are part of the research literature (e.g., articles in open-access journals or posted on researchers’ own websites). The search engine Google Scholar is especially useful for this purpose. A general Internet search might also lead you to websites that are not part of the research literature but might provide references to works that are. Finally, you can talk to people (e.g., your instructor or other faculty members in psychology) who know something about your topic and can suggest relevant articles and book chapters.

What to Search For

When you do a literature review, you need to be selective. Not every article, book chapter, and book that relates to your research idea or question will be worth obtaining, reading, and integrating into your review. Instead, you want to focus on sources that help you do four basic things: (a) refine your research question, (b) identify appropriate research methods, (c) place your research in the context of previous research, and (d) write an effective research report. Several basic principles can help you find the most useful sources.

First, it is best to focus on recent research, keeping in mind that what counts as recent depends on the topic. For newer topics that are actively being studied, “recent” might mean published in the past year or two. For older topics that are receiving less attention right now, “recent” might mean within the past 10 years. You will get a feel for what counts as recent for your topic when you start your literature search. A good general rule, however, is to start with sources published in the past five years. The main exception to this rule would be classic articles that turn up in the reference list of nearly every other source. If other researchers think that this work is important, even though it is old, then by all means you should include it in your review.

Second, you should look for review articles on your topic because they will provide a useful overview of it—often discussing important definitions, results, theories, trends, and controversies—giving you a good sense of where your own research fits into the literature. You should also look for empirical research reports addressing your question or similar questions, which can give you ideas about how to operationally define your variables and collect your data. As a general rule, it is good to use methods that others have already used successfully unless you have good reasons not to. Finally, you should look for sources that provide information that can help you argue for the interestingness of your research question. For a study on the effects of cell phone use on driving ability, for example, you might look for information about how widespread cell phone use is, how frequent and costly motor vehicle crashes are, and so on.

How many sources are enough for your literature review? This is a difficult question because it depends on how extensively your topic has been studied and also on your own goals. One study found that across a variety of professional journals in psychology, the average number of sources cited per article was about 50 (Adair & Vohra, 2003) [1] . This gives a rough idea of what professional researchers consider to be adequate. As a student, you might be assigned a much lower minimum number of references to use, but the principles for selecting the most useful ones remain the same.

Key Takeaways

• The research literature in psychology is all the published research in psychology, consisting primarily of articles in professional journals and scholarly books.
• Early in the research process, it is important to conduct a review of the research literature on your topic to refine your research question, identify appropriate research methods, place your question in the context of other research, and prepare to write an effective research report.
• There are several strategies for finding previous research on your topic. Among the best is using PsycINFO, a computer database that catalogs millions of articles, books, and book chapters in psychology and related fields.
• Practice: Use the techniques discussed in this section to find 10 journal articles and book chapters on one of the following research ideas: memory for smells, aggressive driving, the causes of narcissistic personality disorder, the functions of the intraparietal sulcus, or prejudice against the physically handicapped.
• Watch the following video clip produced by UBCiSchool about how to read an academic paper (without losing your mind):

Video Attributions

• “ Sample PsycINFO Search on EBSCOhost ” by APA Publishing Training . Standard YouTube Licence.
• “ Using Google Scholar (CLIP) ” by clipinfolit . CC BY (Attribution)
• “ How to Read an Academic Paper ” by UBCiSchool . CC BY (Attribution)
• Adair, J. G., & Vohra, N. (2003). The explosion of knowledge, references, and citations: Psychology’s unique response to a crisis. American Psychologist, 58 , 15–23. ↵

All the published research in a particular field.

Periodicals that publish original research articles.

A type of research article which describes one or more new empirical studies conducted by the authors.

A type of research article that summarizes previously published research on a topic and usually presents new ways to organize or explain the results.

A type of review article primarily devoted to presenting a new theory.

Books written by researchers and practitioners mainly for sue by other researchers and practitioners.

Type of scholarly book written by a single author or small group of authors, coherently presents a topic much like an extended review article.

A type of scholarly book in which an editor or small group of editors recruit many authors to write separate chapters on different aspects of the same topic.

An electronic database covering thousands of professional journals and scholarly books produced by the APA.

Research Methods in Psychology - 2nd Canadian Edition Copyright © 2015 by Paul C. Price, Rajiv Jhangiani, & I-Chant A. Chiang is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Rapid literature review: definition and methodology

Beata smela.

a Assignity, Cracow, Poland

Mondher Toumi

b Public Health Department, Aix-Marseille University, Marseille, France

Karolina Świerk

Clement francois, małgorzata biernikiewicz.

c Studio Slowa, Wroclaw, Poland

Emilie Clay

d Clever-Access, Paris, France

Laurent Boyer

Introduction: A rapid literature review (RLR) is an alternative to systematic literature review (SLR) that can speed up the analysis of newly published data. The objective was to identify and summarize available information regarding different approaches to defining RLR and the methodology applied to the conduct of such reviews.

Methods: The Medline and EMBASE databases, as well as the grey literature, were searched using the set of keywords and their combination related to the targeted and rapid review, as well as design, approach, and methodology. Of the 3,898 records retrieved, 12 articles were included.

Results: Specific definition of RLRs has only been developed in 2021. In terms of methodology, the RLR should be completed within shorter timeframes using simplified procedures in comparison to SLRs, while maintaining a similar level of transparency and minimizing bias. Inherent components of the RLR process should be a clear research question, search protocol, simplified process of study selection, data extraction, and quality assurance.

Conclusions: There is a lack of consensus on the formal definition of the RLR and the best approaches to perform it. The evidence-based supporting methods are evolving, and more work is needed to define the most robust approaches.

Introduction

A systematic literature review (SLR) summarizes the results of all available studies on a specific topic and provides a high level of evidence. Authors of the SLR have to follow an advanced plan that covers defining a priori information regarding the research question, sources they are going to search, inclusion criteria applied to choose studies answering the research question, and information regarding how they are going to summarize findings [ 1 ].

The rigor and transparency of SLRs make them the most reliable form of literature review [ 2 ], providing a comprehensive, objective summary of the evidence for a given topic [ 3 , 4 ]. On the other hand, the SLR process is usually very time-consuming and requires a lot of human resources. Taking into account a high increase of newly published data and a growing need to analyze information in the fastest possible way, rapid literature reviews (RLRs) often replace standard SLRs.

There are several guidelines on the methodology of RLRs [ 5–11 ]; however, only recently, one publication from 2021 attempted to construct a unified definition [ 11 ]. Generally, by RLRs, researchers understand evidence synthesis during which some of the components of the systematic approach are being used to facilitate answering a focused research question; however, scope restrictions and a narrower search strategy help to make the project manageable in a shorter time and to get the key conclusions faster [ 4 ].

The objective of this research was to collect and summarize available information on different approaches to the definition and methodology of RLRs. An RLR has been run to capture publications providing data that fit the project objective.

To find publications reporting information on the methodology of RLRs, searches were run in the Medline and EMBASE databases in November 2022. The following keywords were searched for in titles and abstracts: ‘targeted adj2 review’ OR ‘focused adj2 review’ OR ‘rapid adj2 review’, and ‘methodology’ OR ‘design’ OR ‘scheme’ OR ‘approach’. The grey literature was identified using Google Scholar with keywords including ‘targeted review methodology’ OR ‘focused review methodology’ OR ‘rapid review methodology’. Only publications in English were included, and the date of publication was restricted to year 2016 onward in order to identify the most up-to-date literature. The reference lists of each included article were searched manually to obtain the potentially eligible articles. Titles and abstracts of the retrieved records were first screened to exclude articles that were evidently irrelevant. The full texts of potentially relevant papers were further reviewed to examine their eligibility.

A pre-defined Excel grid was developed to extract the following information related to the methodology of RLR from guidelines:

• Definition,
• Research question and searches,
• Studies selection,
• Data extraction and quality assessment,
• Additional information.

There was no restriction on the study types to be analyzed; any study reporting on the methodology of RLRs could be included: reviews, practice guidelines, commentaries, and expert opinions on RLR relevant to healthcare policymakers or practitioners. The data extraction and evidence summary were conducted by one analyst and further examined by a senior analyst to ensure that relevant information was not omitted. Disagreements were resolved by discussion and consensus.

Studies selection

A total of 3,898 records (3,864 articles from a database search and 34 grey literature from Google Scholar) were retrieved. After removing duplicates, titles and abstracts of 3,813 articles were uploaded and screened. The full texts of 43 articles were analyzed resulting in 12 articles selected for this review, including 7 guidelines [ 5–11 ] on the methodology of RLRs, together with 2 papers summarizing the results of the Delphi consensus on the topic [ 12 , 13 ], and 3 publications analyzing and assessing different approaches to RLRs [ 4 , 14 , 15 ].

Overall, seven guidelines were identified: from the World Health Organization (WHO) [ 5 ], National Collaborating Centre for Methods and Tools (NCCMT) [ 7 ], the UK government [ 8 ], the Oxford Centre for Evidence Based Medicine [ 9 ], the Cochrane group [ 6 , 11 ], and one multi-national review [ 10 ]. Among the papers that did not describe the guidelines, Gordon et al. [ 4 ] proposed 12 tips for conducting a rapid review in the right settings and discussed why these reviews may be more beneficial in some circumstances. The objective of work conducted by Tricco et al. [ 13 ] and Pandor et al. [ 12 ] was to collect and compare perceptions of rapid reviews from stakeholders, including researchers, policymakers, industry, journal editors, and healthcare providers, and to reach a consensus outlining the domains to consider when deciding on approaches for RLRs. Haby et al. [ 14 ] run a rapid review of systematic reviews and primary studies to find out the best way to conduct an RLR in health policy and practice. In Tricco et al. (2022) [ 15 ], JBI position statement for RLRs is presented.

From all the seven identified guidelines information regarding definitions the authors used for RLRs, approach to the PICOS criteria and search strategy development, studies selection, data extractions, quality assessment, and reporting were extracted.

Cochrane Rapid Reviews Methods Group developed methods guidance based on scoping review of the underlying evidence, primary methods studies conducted, as well as surveys sent to Cochrane representative and discussion among those with expertise [ 11 ]. They analyzed over 300 RLRs or RLR method papers and based on the methodology of those studies, constructed a broad definition RLR, one that meets a minimum set of requirements identified in the thematic analysis: ‘ A rapid review is a form of knowledge synthesis that accelerates the process of conducting a traditional systematic review through streamlining or omitting a variety of methods to produce evidence in a resource-efficient manner .’ This interpretation aligns with more than 50% of RLRs identified in this study. The authors additionally provided several other definitions, depending on specific situations or requirements (e.g., when RLR is produced on stakeholder’s request). It was additionally underlined that RLRs should be driven by the need of timely evidence for decision-making purposes [ 11 ].

Rapid reviews vary in their objective, format, and methods used for evidence synthesis. This is a quite new area, and still no agreement on optimal methods can be found [ 5 ]. All of the definitions are highlighting that RLRs are completed within shorter timeframes than SLRs, and also lack of time is one of the main reasons they are conducted. It has been suggested that most rapid reviews are conducted within 12 weeks; however, some of the resources suggest time between a few weeks to no more than 6 months [ 5 , 6 ]. Some of the definitions are highlighting that RLRs follow the SLR process, but certain phases of the process are simplified or omitted to retrieve information in a time-saving way [ 6 , 7 ]. Different mechanisms are used to enhance the timeliness of reviews. They can be used independently or concurrently: increasing the intensity of work by intensifying the efforts of multiple analysts by parallelization of tasks, using review shortcuts whereby one or more systematic review steps may be reduced, automatizing review steps by using new technologies [ 5 ]. The UK government report [ 8 ] referred to two different RLRs: in the form of quick scoping reviews (QSR) or rapid evidence assessments (REA). While being less resource and time-consuming compared to standard SLRs, QSRs and REAs are designed to be similarly transparent and to minimize bias. QSRs can be applied to rather open-ended questions, e.g., ‘what do we know about something’ but both, QSRs and REAs, provide an understanding of the volume and characteristics of evidence on a specific topic, allowing answering questions by maximizing the use of existing data, and providing a clear picture of the adequacy of existing evidence [ 8 ].

Research questions and searches

The guidelines suggest creating a clear research question and search protocol at the beginning of the project. Additionally, to not duplicate RLRs, the Cochrane Rapid Reviews Methods Group encourages all people working on RLRs to consider registering their search protocol with PROSPERO, the international prospective register of reviews; however, so far they are not formally registered in most cases [ 5 , 6 ]. They also recommend involving key stakeholders (review users) to set and refine the review question, criteria, and outcomes, as well as consulting them through the entire process [ 11 ].

Regarding research questions, it is better to structure them in a neutral way rather than focus on a specific direction for the outcome. By doing so, the researcher is in a better position to identify all the relevant evidence [ 7 ]. Authors can add a second, supportive research question when needed [ 8 ]. It is encouraged to limit the number of interventions, comparators and outcomes, to focus on the ones that are most important for decision-making [ 11 ]. Useful could be also reviewing additional materials, e.g., SLRs on the topic, as well as conducting a quick literature search to better understand the topic before starting with RLRs [ 7 ]. In SLRs researchers usually do not need to care a lot about time spent on creating PICOS, they need to make sure that the scope is broad enough, and they cannot use many restrictions. When working on RLRs, a reviewer may spend more or less time defining each of the components of the study question, and the main step is making sure that PICOS addresses the needs of those who requested the rapid review, and at the same time, it is feasible within the required time frame [ 7 ]. Search protocol should contain an outline of how the following review steps are to be carried out, including selected search keywords and a full strategy, a list of data sources, precise inclusion and exclusion criteria, a strategy for data extraction and critical appraisal, and a plan of how the information will be synthesized [ 8 ].

In terms of searches running, in most cases, an exhaustive process will not be feasible. Researchers should make sure that the search is effective and efficient to produce results in a timely manner. Cochrane Rapid Reviews Methods Group recommends involving an information specialist and conducting peer review of at least one search strategy [ 11 ]. According to the rapid review guidebook by McMaster University [ 7 ], it is important that RLRs, especially those that support policy and program decisions, are being fed by the results of a body of literature, rather than single studies, when possible. It would result in more generalizable findings applied at the level of a population and serve more realistic findings for program decisions [ 7 ]. It is important to document the search strategy, together with a record of the date and any date limits of the search, so that it can easily be run again, modified, or updated. Furthermore, the information on the individual databases included in platform services should always be reported, as this depends on organizations’ subscriptions and must be included for transparency and repeatability [ 7 , 8 ]. Good solution for RLRs is narrowing the scope or searching a limited number of databases and other sources [ 7 ]. Often, the authors use the PubMed/MEDLINE, Cochrane Library, and Embase databases. In most reviews, two or more databases are searched, and common limits are language (usually restricted to English), date, study design, and geographical area. Some RLRs include searching of grey literature; however, contact with authors is rather uncommon [ 5 , 8 ]. According to the flexible framework for restricted systematic review published by the University of Oxford, the search should be run in at least one major scientific database such as PubMed, and one other source, e.g., Google Scholar [ 9 ]. Grey literature and unpublished evidence may be particularly needed and important for intervention questions. It is related to the fact that studies that do not report the effects of interventions are less likely to be published [ 8 ]. If there is any type of evidence that will not be considered by the RLRs, e.g., reviews or theoretical and conceptual studies, it should also be stated in the protocol together with justification [ 8 ]. Additionally, authors of a practical guide published by WHO suggest using a staged search to identify existing SLRs at the beginning, and then focusing on studies with other designs [ 5 ]. If a low number of citations have been retrieved, it is acceptable to expand searches, remove some of the limits, and add additional databases and sources [ 7 ].

Searching for RLRs is an iterative process, and revising the approach is usually needed [ 7 ]. Changes should be confirmed with stakeholders and should be tracked and reflected in the final report [ 5 ].

The next step in the rapid review is the selection of studies consisting of two phases: screening of titles and abstracts, and analysis of full texts. Prior to screening initiation, it is recommended to conduct a pilot exercise using the same 30–50 abstracts and 5–10 full-texts for the entire screening team in order to calibrate and test the review form [ 11 ]. In contrast to SLRs, it can be done by one reviewer with or without verification by a second one. If verification is performed, usually the second reviewer checks only a subset of records and compares them. Cochrane Group, in contrast, recommends a stricter approach: at least 20% of references should be double-screened at titles and abstracts stage, and while the rest of the references may be screened by one reviewer, the excluded items need to be re-examined by second reviewer; similar approach is used in full-text screening [ 11 ]. This helps to ensure that bias was reduced and that the PICOS criteria are applied in a relevant way [ 5 , 8 , 9 , 11 ]. During the analysis of titles and abstracts, there is no need to report reasons for exclusion; however, they should be tracked for all excluded full texts [ 7 ].

Data extraction and quality assessment

According to the WHO guide, the most common method for data extraction in RLRs is extraction done by a single reviewer with or without partial verification. The authors point out that a reasonable approach is to use a second reviewer to check a random sample of at least 10% of the extractions for accuracy. Dual performance is more necessary for the extraction of quantitative results than for descriptive study information. In contrast, Cochrane group recommends that second reviewer should check the correctness and completeness of all data [ 11 ]. When possible, extractions should be limited to key characteristics and outcomes of the study. The same approach to data extraction is also suggested for a quality assessment process within rapid reviews [ 5 , 9 , 11 ]. Authors of the guidebook from McMaster University highlight that data extraction should be done ideally by two reviewers independently and consensus on the discrepancies should always be reached [ 7 ]. The final decision on the approach to this important step of review should depend on the available time and should also reflect the complexity of the research question [ 9 ].

For screening, analysis of full texts, extractions, and quality assessments, researchers can use information technologies to support them by making these review steps more efficient [ 5 ].

Before data reporting, a reviewer should prepare a document with key message headings, executive summary, background related to the topic and status of the current knowledge, project question, synthesis of findings, conclusions, and recommendations. According to the McMaster University guidebook, a report should be structured in a 1:2:20 format, that is, one page for key messages, two pages for an executive summary, and a full report of up to 20 pages [ 7 ]. All the limitations of the RLRs should be analyzed, and conclusions should be drawn with caution [ 5 ]. The quality of the accumulated evidence and the strength of recommendations can be assessed using, e.g., the GRADE system [ 5 ]. When working on references quoting, researchers should remember to use a primary source, not secondary references [ 7 ]. It would be worth considering the support of some software tools to automate reporting steps. Additionally, any standardization of the process and the usage of templates can support report development and enhance the transparency of the review [ 5 ].

Ideally, all the review steps should be completed during RLRs; however, often some steps may need skipping or will not be completed as thoroughly as should because of time constraints. It is always crucial to decide which steps may be skipped, and which are the key ones, depending on the project [ 7 ]. Guidelines suggest that it may be helpful to invite researchers with experience in the operations of SLRs to participate in the rapid review development [ 5 , 9 ]. As some of the steps will be completed by one reviewer only, it is important to provide them with relevant training at the beginning of the process, as well as during the review, to minimize the risk of mistakes [ 5 ].

Additional information

Depending on the policy goal and available resources and deadlines, methodology of the RLRs may be modified. Wilson et al. [ 10 ] provided extensive guidelines for performing RLR within days (e.g., to inform urgent internal policy discussions and/or management decisions), weeks (e.g., to inform public debates), or months (e.g., to inform policy development cycles that have a longer timeline, but that cannot wait for a traditional full systematic review). These approaches vary in terms of data synthesis, types of considered evidence and project management considerations.

In shortest timeframes, focused questions and subquestions should be formulated, typically to conduct a policy analysis; the report should consist of tables along with a brief narrative summary. Evidence from SLRs is often considered, as well as key informant interviews may be conducted to identify additional literature and insights about the topic, while primary studies and other types of evidence are not typically feasible due to time restrictions. The review would be best conducted with 1–2 reviewers sharing the work, enabling rapid iterations of the review. As for RLRs with longer timeline (weeks), these may use a mix of policy, systems and political analysis. Structure of the review would be similar to shorter RLRs – tabular with short narrative summary, as the timeline does not allow for comprehensive synthesis of data. Besides SLRs, primary studies and other evidence may be feasible in this timeframe, if obtained using the targeted searches in the most relevant databases. The review team should be larger, and standardized procedures for reviewing of the results and data extraction should be applied. In contrast to previous timeframe, merit review process may be feasible. For both timeframes, brief consultations with small transdisciplinary team should be conducted at the beginning and in the final stage of the review to discuss important matters.

For RLRs spanning several months, more comprehensive methodology may be adapted in terms of data synthesis and types of evidence. However, authors advise that review may be best conducted with a small review team in order to allow for more in-depth interpretation and iteration.

Studies analyzing methodology

There have been two interesting publications summarizing the results of Delphi consensus on the RLR methodology identified and included in this review [ 12 , 13 ].

Tricco et al. [ 13 ] first conducted an international survey and scoping review to collect information on the possible approaches to the running of rapid reviews, based on which, they employed a modified Delphi method that included inputs from 113 stakeholders to explore the most optimized approach. Among the six most frequent rapid review approaches (not all detailed here) being evaluated, the approach that combines inclusion of published literature only, a search of more than one database and limitations by date and language, study selection by one analyst, data extraction, and quality assessment by one analyst and one verifier, was perceived as the most feasible approach (72%, 81/113 responses) with the potentially lowest risk of bias (12%, 12/103). The approach ranked as the first one when considering timelines assumes updating of the search from a previously published review, no additional limits on search, studies selection and data extraction done by one reviewer, and no quality assessment. Finally, based on the publication, the most comprehensive RLRs can be made by moving on with the following rules: searching more than one database and grey literature and using date restriction, and assigning one reviewer working on screening, data extraction, and risk of bias assessment ( Table 1 ). Pandor et al. [ 12 ] introduced a decision tool for SelecTing Approaches for Rapid Reviews (STARR) that were produced through the Delphi consensus of international experts through an iterative and rigorous process. Participants were asked to assess the importance of predefined items in four domains related to the rapid review process: interaction with commissioners, understanding the evidence base, data extraction and synthesis methods, and reporting of rapid review methods. All items assigned to four domains achieved > 70% of consensus, and in that way, the first consensus-driven tool has been created that supports authors of RLRs in planning and deciding on approaches.

Six most frequent approaches to RLRs (adapted from Tricco et al. [ 13 ]).

Haby et al. [ 14 ] run searches of 11 databases and two websites and developed a comprehensive overview of the methodology of RLRs. With five SLRs and one RCT being finally included, they identified the following approaches used in RLRs to make them faster than full SLRs: limiting the number and scope of questions, searching fewer databases, limited searching of grey literature, restrictions on language and date (e.g., English only, most recent publications), updating the existing SLRs, eliminating or limiting hand searches of reference lists, noniterative search strategies, eliminating consultation with experts, limiting dual study selection, data extraction and quality assessment, minimal data synthesis with short concise conclusions or recommendations. All the SLRs included in this review were consistent in stating that no agreed definition of rapid reviews is available, and there is still no final agreement on the best methodological rules to be followed.

Gordon et al. [ 4 ] explained the advantages of performing a focused review and provided 12 tips for its conduction. They define focused reviews as ‘a form of knowledge synthesis in which the components of the systematic process are applied to facilitate the analysis of a focused research question’. The first tip presented by the authors is related to deciding if a focused review is a right solution for the considered project. RLRs will suit emerging topics, approaches, or assessments where early synthesis can support doctors, policymakers, etc., but also can direct future research. The second, third, and fourth tips highlight the importance of running preliminary searches and considering narrowing the results by using reasonable constraints taking into account the local context, problems, efficiency perspectives, and available time. Further tips include creating a team of experienced reviewers working on the RLRs, thinking about the target journal from the beginning of work on the rapid review, registering the search protocol on the PROSPERO registry, and the need for contacting authors of papers when data available in publications are missing or incongruent. The last three tips are related to the choice of evidence synthesis method, using the visual presentation of data, and considering and describing all the limitations of the focused review.

Finally, a new publication by Tricco et al. from 2022, describing JBI position statement [ 15 ] underlined that for the time being, there is no specific tool for critical appraisal of the RLR’s methodological quality. Instead, reviewers may use available tools to assess the risk of bias or quality of SLRs, like ROBIS, the JBI critical appraisal tools, or the assessment of multiple systematic reviews (AMSTAR).

Inconsistency in the definitions and methodologies of RLR

Although RLR was broadly perceived as an approach to quicken the conduct of conventional SLR, there is a lack of consensus on the formal definition of the RLR, so as to the best approaches to perform it. Only in 2021, a study proposing unified definition was published; however, it is important to note that the most accurate definition was only matching slightly over 50% of papers analysed by the authors, which underlines the lack of homogeneity in the field [ 11 ]. The evidence-based supporting methods are evolving, and more evidence is needed to define the most robust approaches [ 5 ].

Diverse terms are used to describe the RLR, including ‘rapid review’, focused systematic review’, ‘quick scoping reviews’, and ‘rapid evidence assessments’. Although the general principles of conducting RLR are to accelerate the whole process, complexity was seen in the methodologies used for RLRs, as reflected in this study. Also, inconsistencies related to the scope of the questions, search strategies, inclusion criteria, study screening, full-text review, quality assessment, and evidence presentation were implied. All these factors may hamper decision-making about optimal methodologies for conducting rapid reviews, and as a result, the efficiency of RLR might be decreased. Additionally, researchers may tend to report the methodology of their reviews without a sufficient level of detail, making it difficult to appraise the quality and robustness of their work.

Advantages and weaknesses of RLR

Although RLR used simplified approaches for evidence synthesis compared with SLR, the methodologies for RLR should be replicable, rigorous, and transparent to the greatest extent [ 16 ]. When time and resources are limited, RLR could be a practical and efficient tool to provide the summary of evidence that is critical for making rapid clinical or policy-related decisions [ 5 ]. Focusing on specific questions that are of controversy or special interest could be powerful in reaffirming whether the existing recommendation statements are still appropriate [ 17 ].

The weakness of RLR should also be borne in mind, and the trade-off of using RLR should be carefully considered regarding the thoroughness of the search, breadth of a research question, and depth of analysis [ 18 ]. If allowed, SLR is preferred over RLR considering that some relevant studies might be omitted with narrowed search strategies and simplified screening process [ 14 ]. Additionally, omitting the quality assessment of included studies could result in an increased risk of bias, making the comprehensiveness of RLR compromised [ 13 ]. Furthermore, in situations that require high accuracy, for example, where a small relative difference in an intervention has great impacts, for the purpose of drafting clinical guidelines, or making licensing decisions, a comprehensive SLR may remain the priority [ 19 ]. Therefore, clear communications with policymakers are recommended to reach an agreement on whether an RLR is justified and whether the methodologies of RLR are acceptable to address the unanswered questions [ 18 ].

Disclosure statement

No potential conflict of interest was reported by the author(s).

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Home > Conferences and Events > Research Week > 2024 > Posters > 75

The Effects of Hop Stabilization Training on Athletes with Chronic Ankle Instability: A Critically Appraised Topic

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Michael Pells , Liberty University Follow

Poster - Theoretical Proposal

Description

This critically appraised topic analyzes the utilization of hop-stabilization training (also known as plyometric training) when applied to the rehabilitation of athletes dealing with chronic ankle instability (CAI). Chronic ankle instability (CAI) is increasingly common among athletes due to a high prevalence in ankle sprains causing joint/ligament laxity which leads to altered biomechanics in the lower extremities. Altered biomechanics and reoccurring sprains are the hallmark sign of CAI in athletes. Hop stabilization training tends to be common in ankle injury prevention, but current research literature is limited concerning how hop stabilization interventions can affect the altered biomechanics of athletes who suffer from CAI. The purpose of this CAT is to look at hop stabilization’s effectiveness in the rehabilitation of CAI in athletes. It was found through an thorough examination of current literature that only three articles detail the impact of hop-stabilization on jump-landing biomechanics, and this literature comes to the consensus that not only do biomechanical metrics. All three studies found significant improvements in ankle stability through measures such as feedforward and feedback neuromuscular control, patient-reported feedback, dynamic balance, and postural sway. In addition to this, it was found that plyometric training (hop stabilization) was a preferable rehabilitation method when compared to traditional ankle stability exercises (ASE), when examining certain biomechanical markers. This CAT provides clinical evidence that the inclusion of plyometric training can provide major performance benefits in the areas of shock absorption and joint stability when rehabbing athletes, however, more research can be done both in various athletic populations, as well as applying these training methods to the general population.

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Natural Disaster, Tax Avoidance, and Corporate Pollution Emissions: Evidence from China

• Original Paper
• Published: 23 May 2024

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• Rui Xu 1 , 2 &
• Liuyang Ren 1  

Our study explores how climate risk affects the tax behavior of governments and local firms, subsequently affecting corporate pollution emissions. Using data on Chinese non-state-owned industrial enterprises from 1998 to 2014, we empirically investigate the impact of natural disasters on corporate tax avoidance. The results indicate that companies in earthquake-damaged areas are less likely to avoid taxes than those in unaffected areas. Furthermore, companies that pay more taxes after a disaster can secure favorable government environmental policies, as indicated by a rise in pollution emissions. Moreover, this effect is more pronounced for less polluting firms and firms with higher financial constraints. Our study contributes to the literature on taxation and ESG from the perspective of favor-exchange in government–firm relationships.

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The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

The risk appears to be manifesting itself along several physical dimensions: a) earthquake risk, which can cause extensive damages in a relatively short period; b) hurricane risk, which has increased in intensity and frequency in different parts of the world; c) drought risk, occur in some particular regions; d) flood risk, affecting predominantly some regions; e) heat risk, which refers to increase in average temperatures over time.

Tax-sharing system gives Chinese local governments tax autonomy to control local corporate taxes.

See the Chinese National Earthquake Response Plan on this page https://www.gov.cn/yjgl/2012-09/21/content_ 2,230,337.htm. (Notice this page is in Chinese; Google Translate can be used to view the content.).

See Earthquake Response Plan in Huangshan City on this page https://www.huangshan.gov.cn/zwgk/public /6615714/10703207.htm. (Notice this page is in Chinese; Google Translate can be used to view the content.).

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Acknowledgements

This work was supported by the National Natural Science Foundation Project of China (Grant No.72302061), the Guangdong Office of Philosophy and Social Science (Project GD23YGL21) and Philosophy and Social Science Foundation of Guangzhou (Project 2023GZGJ58). The corresponding author is Liuyang Ren. All errors remain ours. All co-authors make equal contributions to the formation of this paper.

Guangdong Office of Philosophy and Social Science, GD23YGL21, Liuyang Ren, National Natural Science Foundation of China, 72302061, Liuyang Ren, Philosophy and Social Science Foundation of Guangzhou, 2023GZGJ58, Rui Xu.

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Targeted temperature control following traumatic brain injury: ESICM/NACCS best practice consensus recommendations

• Andrea Lavinio 1 , 2 ,
• Jonathan P. Coles 1 , 2 ,
• Chiara Robba 3 ,
• Marcel Aries 4 , 5 ,
• Pierre Bouzat 6 ,
• Dara Chean 7 ,
• Shirin Frisvold 8 , 9 ,
• Laura Galarza 10 ,
• Raimund Helbok 11 , 12 ,
• Jeroen Hermanides 13 ,
• Mathieu van der Jagt 14 ,
• David K. Menon 1 , 2 ,
• Geert Meyfroidt 15 ,
• Jean-Francois Payen 6 ,
• Daniele Poole 16 ,
• Frank Rasulo 17 ,
• Jonathan Rhodes 18 ,
• Emily Sidlow 19 ,
• Luzius A. Steiner 20 ,
• Fabio Silvio Taccone 21 , 22 &
• Riikka Takala 23 , 24  

Critical Care volume  28 , Article number:  170 ( 2024 ) Cite this article

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Aims and scope

The aim of this panel was to develop consensus recommendations on targeted temperature control (TTC) in patients with severe traumatic brain injury (TBI) and in patients with moderate TBI who deteriorate and require admission to the intensive care unit for intracranial pressure (ICP) management.

A group of 18 international neuro-intensive care experts in the acute management of TBI participated in a modified Delphi process. An online anonymised survey based on a systematic literature review was completed ahead of the meeting, before the group convened to explore the level of consensus on TTC following TBI. Outputs from the meeting were combined into a further anonymous online survey round to finalise recommendations. Thresholds of ≥ 16 out of 18 panel members in agreement (≥ 88%) for strong consensus and ≥ 14 out of 18 (≥ 78%) for moderate consensus were prospectively set for all statements.

Strong consensus was reached on TTC being essential for high-quality TBI care. It was recommended that temperature should be monitored continuously, and that fever should be promptly identified and managed in patients perceived to be at risk of secondary brain injury. Controlled normothermia (36.0–37.5 °C) was strongly recommended as a therapeutic option to be considered in tier 1 and 2 of the Seattle International Severe Traumatic Brain Injury Consensus Conference ICP management protocol. Temperature control targets should be individualised based on the perceived risk of secondary brain injury and fever aetiology.

Conclusions

Based on a modified Delphi expert consensus process, this report aims to inform on best practices for TTC delivery for patients following TBI, and to highlight areas of need for further research to improve clinical guidelines in this setting.

Introduction

Traumatic brain injury (TBI) is a complex and heterogeneous disease, and a major cause of death and disability globally [ 1 , 2 , 3 ]. Amongst other common neurological diseases, TBI is estimated to have the highest prevalence and incidence, impacting up to 60 million people worldwide annually and representing a substantial public health burden [ 4 ].

TBI is defined as an alteration in brain function or other evidence of brain pathology caused by an external force [ 5 ], and requires immediate and sustained management strategies to optimise clinical outcome. The injury processes that follow from a TBI are divided into two stages: primary and secondary [ 6 ], where primary injury refers to the damage caused by the original physical impact, which can trigger a pathophysiological cascade resulting in secondary injury with deleterious effects on neurological outcome and survival [ 7 , 8 ]. In order to prevent or mitigate secondary injury, immediate treatment following severe TBI focuses on the prevention of further brain damage. As the brain remains susceptible to secondary injury from processes that extend beyond the zone of primary injury such as ischaemia, oedema, herniation, seizures and altered metabolism [ 9 ], immediate treatment following severe TBI focuses on prevention or mitigation of such injury. This is achieved through the control of intracranial pressure (ICP), and prompt treatment of systemic insults such as hypoxia, hypercapnia, and systemic hypotension [ 10 ].

In the neuro-intensive care unit (NICU), fever is a prevalent occurrence with heterogenous underlying causes, and it may contribute to secondary injury. Across patients with TBI, subarachnoid haemorrhage and stroke [ 11 , 12 , 13 ], hyperthermia has been found to increase the risk of complications and is believed to be associated with unfavourable clinical outcome including death [ 9 , 11 , 14 , 15 ].

Targeted temperature control (TTC) is a complex intervention that aims to control body or brain temperature to prevent further brain injury and improve neurological outcome [ 9 ]. The term TTC may refer to different degrees of temperature control, from fever prevention, maintenance of normothermia to the induction of hypothermia, at different levels [ 9 , 16 ]. In TBI, TTC can be used to modulate a range of important physiological parameters such as cerebral metabolism and ICP. However, its role in improving long-term outcome, as well as the appropriate indications, targets and duration of TTC in severe or moderate TBI are currently unknown.

This work aims to utilise a Delphi approach to develop best-practice consensus recommendations from international experts for the real-world application of TTC in severe TBI with ICP guided treatments.

Review of the literature and evidence quality assessment

Statements and questions were informed by a systematic review of the literature, which identified observational studies, meta-analyses and randomised controlled trials (RCTs) relevant to the topics under discussion. This review search focused on evidence released since 2013. Following this first review, the methodology group of ESICM conducted an independent systematic review of the literature, considering only published RCTs regarding TTC in TBI patients with ICP monitoring. This review confirmed the paucity of RCTs and the substantial clinical heterogeneity between them, which precluded meta-analytical combination. The outputs from the reviews were shared with the expert panel members ahead of the Delphi process. A detailed reporting of the literature reviews is provided as Additional files 1 and 4 .

Participants

The 18 expert attendees for the Delphi process were chosen from members of three professional societies: the Neuro Anaesthesia and Critical Care Society (NACCS), the European Society of Intensive Care Medicine (ESICM), and the European Society of Anaesthesiology and Intensive Care (ESAIC). Selection was based on a documented history of publications in the fields of traumatic brain injury and/or targeted temperature management, as well as their established professional profiles and expertise as leading intensive care practitioners in teaching university hospitals. We endeavoured to ensure balanced representation, covering the geographic areas of the EU, Switzerland, and the UK.

Delphi rounds

A modified Delphi consensus method was employed, involving a combination of an online survey (Round 1), a face-to-face meeting (Round 2), an additional online survey containing the refined questions from the previous steps, (Round 3) and post-meeting reviews of the consensus results. The questions asked at Round 1 can be found in the Additional file 2 , and the results following Round 3 are shown in Table  1 . Round 1 was conducted via the SmartSurvey® online platform, and Round 2 was held as a hybrid meeting in London, UK, on Tuesday 10th October 2023. AL acted as Chair, with an independent facilitator (ES) moderating the meeting. After the results from the final survey of Round 3 were received, the recommendations and final manuscript were developed, with documents shared by e-mail and feedback collected independently from each participant by the facilitator. The predefined agreed cut-off for strong consensus was to have ≥ 16 out of 18 (≥ 88%) of panel members in agreement, and for moderate consensus was to have ≥ 14 out of 18 (≥ 78%) of panel members in agreement. The Delphi methodology and process was adopted from the manuscript published by Lavinio et al. [ 17 ]. In a Delphi process, conflicting opinions are addressed through a structured framework that promotes consensus-building among experts. Initially, participants are asked to provide their views anonymously, which are then summarised and shared with the group. This approach facilitates open and unbiased input, as the anonymity helps mitigate the influence of dominant personalities or hierarchical pressures. When conflicting opinions emerge, they are documented and presented back to the participants, along with any common ground that has been identified. In subsequent rounds, individuals are encouraged to reconsider their positions in light of the collective feedback, which often leads to a convergence of opinions. If discrepancies persist, these are explored through further iterative rounds, with an emphasis on clarifying rationale and seeking areas of agreement. The Delphi method's iterative nature, combined with the feedback mechanism, effectively manages conflicting opinions by fostering a gradual move towards consensus, or at least a clearer understanding of the points of divergence. The process for the Delphi panel and subsequent manuscript development is visualised in Fig.  1 . A detailed overview of the iterative Delphi process is provided in the Additional files 2 and 3 .

Summary of the Delphi process. ESAIC European Society of Anaesthesiology and Intensive Care, ESICM European Society of Intensive Care Medicine, NACCS Neuro Anaesthesia and Critical Care Society

Definitions

To guide discussions during the Delphi process, clinical terms were defined with the values as shown below.

Declarations and conflicts of interest

The face-to face meeting in London was supported by Becton, Dickinson and Company (“BD”) through the provision of travel costs, meeting space and refreshments. Representatives from BD were allowed to silently observe the conference, without any interaction with the panellists or the process. No donors or other outside parties influenced any portion of these recommendations. There was no industry input into recommendation development, and no panel member received honoraria for their involvement. Panellists completed conflict of interest forms relevant to TBI management. There were no conflicts mandating recusal of any participant. No funding was provided by the societies involved.

The results of the final consensus are presented in Table  1 . We highlight and expand upon statements in which consensus was reached in the discussion section. Some consideration is added to statements in which consensus was not reached, proposing them as potential areas for valuable future research.

To date, there is a lack of definitive evidence regarding the use of TTC with an automated feedback-controlled device for managing temperature in severe TBI. This underlines the importance of consensus discussion in identifying areas of uncertainty where evidence is lacking, and in encouraging harmonised care delivery across different settings.

Pathophysiology

Temperature measurement and control is an essential aspect of high-quality care in patients with severe TBI

In patients with impending cerebral herniation, temperature control is essential

As an introduction to the discussions, the group debated the recommendation for temperature measurement and control following severe TBI and, after extensive discussion, concluded that core temperature measurement and control is essential for the provision of high-quality care, especially in patients perceived to be at high risk of secondary brain injury. Noting the phrasing of ‘temperature control’ in the recent guidelines for temperature control following cardiac arrest [ 18 ], the group agreed that as an entry point into high-quality care following TBI, the notion of temperature measurement and control is key, opening the door to the full practice of targeted temperature management. This nuanced phrasing was intended to set the scene for the group’s work, with the specifics of the TTC process such as temperature ranges and duration of control being addressed throughout the remainder of the discussions.

Highlighting the wealth of physiological data available on the management of temperature in stroke and cardiac arrest, the group noted that the guidelines for temperature management in TBI are less specific. Fundamentally, the group agreed that high-quality TBI care does include monitoring temperature and implementing some form of temperature control, recognising its potential role in optimising outcome. The group highlighted the importance of treatment titration based on an individualised risk–benefit assessment and stratification. In particular, it was noted that in patients with exhausted intracranial compensatory reserve and at risk of cerebral herniation or ischaemia—there exists an extreme susceptibility to secondary brain injury precipitated by suboptimal temperature control.

Cerebral herniation is a life-threatening event that requires early diagnosis and prompt management in order to prevent irreversible pathological cascades that can lead to death [ 19 ]. Increases in brain temperature have been linked to a linear rise in ICP, with the relationships between temperature, ICP and cerebral perfusion pressure (CPP) becoming more apparent with rapid temperature changes. The impact of temperature on ICP supports the recommendation from the group that temperature control is an essential aspect of care in patients at risk of herniation [ 20 ]. The group agreed that while control of ICP and prevention of herniation were important reasons for TTC in TBI, benefits of TTC in the acute phase of TBI also extended to patients without intracranial hypertension.

During the discussions the group highlighted that different pathologies often dictate different patient management. For example, patients in whom fluctuations in ICP are well-tolerated (e.g., patients with high intracranial compliance) will be managed differently to patients with obliterated basal cisterns, obliterated cortical sulci, and midline shift (e.g., intracranial mass effect). In patients with exhausted intracranial volume-buffering reserve, strict control of physiological parameters such as CO 2 and temperature, is strongly recommended.

Continuous temperature monitoring is preferable over intermittent temperature measurements in patients with severe TBI.

Monitoring core temperature (e.g., bladder, oesophageal, brain) is strongly recommended over measuring or monitoring superficial temperature (e.g., skin, tympanic) in severe TBI.

When brain temperature monitoring is in place, it is advisable to assess an additional source of core temperature monitoring (i.e. oesophageal, bladder).

The group widely agreed, in line with supporting literature, that continuous temperature monitoring is preferable over intermittent temperature measurements with severe TBI. Intermittent monitoring and recording of temperature can result in large fluctuations in temperature being missed, as highlighted by supporting literature investigating the use of TTC following cardiac arrest, TBI and stroke [ 17 , 21 , 22 ].

Discussions amongst the group drew attention to the fact that inaccurately measured temperatures can negatively impact patient care and outcome. Several temperature monitoring sites are available for TTC, and the group widely agreed that core temperature measurements, i.e., bladder and oesophageal sites, are strongly preferred over superficial measurements such as those taken at skin and tympanic sites. Following acknowledgement of their limitations [ 23 ], bladder and oesophageal were singled out as favoured core temperature measurements. The group acknowledged the widespread use of oesophageal probes due to their relative ease of insertion and the challenges of finding MRI compatible bladder probes. Confirmation of preference between the two was acknowledged as being beyond the scope of the group due to these nuances. Rectal temperature monitoring was widely regarded as impractical for reasons such as the lag time and a high rate of dislocation [ 16 , 23 ]. Peripheral sites were unanimously deemed to be insufficiently accurate to guide temperature treatment [ 16 ].

Some panel members argued that monitoring target organ (i.e. brain) temperature could add a layer of clinical safety, improve pathophysiological understanding and allow selective and individualised titration of treatment (i.e. selective brain cooling). It was, however, agreed by the group that more research is needed into optimum methods for measuring brain temperature and its interpretation from both a clinical and resource-availability perspective. In particular, it was highlighted that temperature thresholds for harm are less well defined for brain temperature than core temperature. When brain temperature monitoring is available and in place, the group advised that core temperature should also be assessed with bladder or oesophageal probes since this is part of routine practice and has been studied to a greater extent than brain temperature. The group noted the importance of having a dual source of temperature monitoring when using automated TTC devices to reduce the risk of probe malfunction and subsequent over or undercooling [ 24 ].

After TBI, brain temperature has often been shown to be higher than systemic temperature and can vary independently, with literature noting a difference of as much as 2 °C depending on the individual characteristics of brain pathology and/or probe location, making a consistent and accurate link between the two challenging and possibly inaccurate [ 25 , 26 ]. The group highlighted that targeting brain temperature may allow precise titration of treatment dose, including titration of selective brain cooling with brain temperature management technologies, theoretically reducing side effects associated with systemic hypothermia, whilst delivering neuroprotection and brain temperature management. However, it was concluded that further research is needed in this regard and that not enough evidence exists to support practical recommendations.

ICP management

Temperature control is a key component of ICP management in severe TBI.

Controlled normothermia (i.e., target core temperature 36.0–37.5 °C) should be included as an addition to the Tier 1 and Tier 2 treatments defined within the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) 2019 guidelines.

Therapeutic hypothermia (i.e., target core temperature ≤ 36.0 °C) should be considered in cases where tier 1 and 2 treatments (as per SIBICC guidance) have failed to control ICP.

If hypothermia is considered to control ICP, target temperature should be managed as close to normothermia as possible.

ICP monitoring remains a critical component in the management of severe TBI [ 27 , 28 ]. The group unanimously agreed that temperature control is a key aspect of managing ICP, highlighting that an increase in temperature can lead to an increase in cerebral metabolism and augmented cerebral blood flow, and a simultaneous increase in cerebral blood volume. In cases of exhausted compensatory mechanisms, these factors can precipitate intracranial hypertension [ 20 ], which in turn can have a deleterious effect on overall outcome.

Because there is often no single pathophysiological pathway of ICP elevation, its management is complex. The most recent versions of the Brain Trauma Foundation TBI guidelines do not contain treatment protocols, in part due to a lack of solid evidence around the relative efficacy of available interventions [ 27 ]. To address this, the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) developed a consensus-based practical algorithm for tiered management of severe TBI guided by ICP measurements [ 28 ].

One of the most impactful outcomes from this consensus meeting was the acknowledgement of the essential role of temperature control for ICP management in severe TBI, and the recommendation that controlled normothermia (i.e., target core temperature 36.0–37.5 °C) should be considered in addition to Tier 1 and Tier 2 treatments. The group was keen to harmonise this output with SIBICC by suggesting a more aggressive and specific management with the addition of controlled normothermia in Tiers 1 and 2, adding a layer of clinical safety beyond merely the avoidance of fever over 38.0 °C in Tier 0, as shown in Fig.  2 . In cases when hypothermia is considered (i.e., SIBICC Tier 3), the group recommended that target temperature be managed as close to normothermia as possible, based on an individualised risk–benefit assessment [ 29 ].

Intracranial pressure management algorithm for severe TBI edited from SIBICC 2019 [ 28 ]. * Including TTC in tiers 1 and 2 is the suggested addition from the TTC-TBI group to the original SIBICC tiers (green bars). *When possible, the lowest tier should be used. It is not necessary to use all modalities in a previous tier before moving to the next tier. Consider repeat CT and surgical options for space occupying lesions. CPP cerebral perfusion pressure, CT computed tomography, EEG electroencephalography, Hb haemoglobin, kPa kilopascal, mmHg milimetre of mercury, PaCO 2 arterial partial pressure of carbon dioxide, SpO 2 arterial oxygen saturation

No consensus was reached on whether hypothermia was a viable temporising strategy in patients with impending cerebral herniation, in patients awaiting haematoma evacuation or decompression, or before consideration of barbiturate coma. Whilst the group acknowledged that therapeutic hypothermia can be effective in reducing ICP, there was no consensus on whether this could be induced rapidly enough in these circumstances, and it was felt that insufficient evidence was available to provide pragmatic recommendations on its indication in these extreme clinical circumstances.

Whilst the majority of experts indicated 35.0 °C as the lowest target temperature to be considered in these circumstances, no consensus was reached. The discussion highlighted that insufficient evidence exists to support practical recommendations and highlighted the importance of an individualised risk–benefit assessment. It was also noted that centres might have a varying degree of familiarity with different therapeutic options, including ease of access to neurosurgical options (i.e. ventricular drainage, decompression) and this may have an impact on clinician preference for hypothermia as a temporising therapeutic modality.

The group also discussed the indication of barbiturates in the context of ICP control following severe TBI, not reaching consensus on whether therapeutic hypothermia should be attempted before considering barbiturates. The group noted that both barbiturate-induced burst-suppression and therapeutic hypothermia have distinctive side effects and concluded that no recommendations for standard clinical practice could be made beyond what was already stated in SIBICC guidance.

Neurogenic fever (core temperature > 37.5 °C) driven by neurological dysregulation in the absence of sepsis or a clinically significant systemic inflammatory process is relatively common in TBI, and it should be promptly detected and treated (i.e., with controlled normothermia targeting 36.0 °C to 37.5 °C), irrespective of ICP level.

Controlled normothermia should be considered when pyrexia is secondary to sepsis or inflammatory processes, and when the patient is perceived to be at risk of secondary brain injury, especially in the acute phase of TBI.

Uncontrolled fever (neurogenic or secondary to inflammation or infection) can precipitate secondary brain injury in patients with severe TBI.

It was widely agreed that neurogenic fever, defined here as core temperature > 37.5 °C driven by neurological dysregulation in the absence of sepsis or a clinically significant inflammatory process is common in intensive care and it has been found to be associated with an increased risk of complications and unfavourable outcome [ 9 , 14 , 15 ]. In the setting of neurogenic fever developing in comatose patients with acute traumatic encephalopathies, controlled normothermia targeting 36.0–37.5 °C was recommended in tier 1 and 2 of the ICP management algorithm.

Correctly differentiating central fever against fever of infectious origin is both challenging and clinically important due to the impact of failing to identify a treatable condition, the negative consequences of antibiotic overuse, and the detrimental effect of hyperthermia on brain-injured patients [ 17 , 30 , 31 ]. However, the group noted that physiological processes such as brain metabolic rate of oxygen, CO 2 control, brain tissue oxygenation (P bt O 2 ) and ICP are directly related to temperature, and that the deleterious effects and likelihood of secondary injury may occur irrespective of whether temperature is raised due to infection or impaired thermoregulation. This therefore highlights the need for acute management of temperature regardless of the source of the pyrexia, although added focus must be placed on the management of nuanced patient characteristics such as those with severe TBI with impending herniation and/or obliterated basal cisterns, as opposed those with low ICP and preserved intracranial compliance.

In line with current research [ 9 , 11 , 32 ], it was agreed that the development of fever is common in TBI cases, and that it can precipitate secondary brain injury and adversely affect patient outcome. It is therefore of utmost importance to prevent or promptly treat fever when detected. The group agreed that while some degree of controlled pyrexia may be allowed during the subacute phase of disease, ‘uncontrolled’ fever requires urgent management in the acute phase as long as the patient is still perceived to be at significant risk of secondary brain injury.

Fever control is recommended in patients with severe TBI who have seizures or are perceived to be at high risk of seizures.

In patients with severe TBI who are sedated and ventilated, controlled normothermia, irrespective of ICP, should be initiated reactively when fever is detected.

When neurogenic fever is detected in TBI cases, controlled normothermia should be continued for as long as the brain remains at risk of secondary brain damage.

The group strongly recommended that fever control and controlled normothermia are of particular relevance in patients perceived to be at high risk of seizures and, more in general, secondary brain injury. The assessment of whether an individual patient should be considered ‘at risk of seizures’ or ‘at risk of secondary brain injury’ remains the responsibility of the managing physician. The group defined risk factors for seizures as a history of seizures, the presence of temporal contusions or depressed skull fractures. Features associated with a higher ‘risk of secondary brain injury’ included labile ICP, obliterated basal cisterns, midline shift or subfalcine herniation, and other signs of exhausted intracranial volume buffering reserve. While no consensus was reached on a specific temperature range to target during controlled normothermia, the group agreed that the reactive initiation of temperature control was important in sedated and ventilated TBI patients, with agreement on a pragmatic setting of a target core temperature range of 36.0–37.5 °C to accommodate expected fluctuations of ± 0.5 °C while avoiding spikes over 38.0 °C [ 28 ].

Hypothermic TTC induction

It is recommended that the rapid induction of hypothermia in traumatic brain injury cases should be achieved with automated feedback-controlled temperature management devices.

In line with current research [ 17 ], the group widely agreed on the reactive use of an automated feedback-controlled device for the application of optimal TTC. The TTC process can be divided into three phases: induction, maintenance, and rewarming [ 9 , 16 ]. As explained in existing literature, varying availability of devices and financial aspects may dictate choice, and while non-automated methods of temperature control are cheaper and easier to apply, the level of control offered is poor and their use should be limited to the induction phase, as adjuncts to automated devices. [ 17 , 33 ] Whilst antipyretics such as acetaminophen (paracetamol) or nonsteroidal anti-inflammatory drugs (NSAIDs) are widely acknowledged in intensive care unit (ICU) settings for their role in fever management, it is recognised that in the context of severe TBI, the efficacy of antipyretics in controlling fever and minimising temperature variability is limited. The application of therapeutic hypothermia requires constant monitoring of core body temperature in order to achieve an accurate target temperature during induction to prevent overcooling, to assess variations during the maintenance phase, and to ensure a steady, controlled rewarming phase [ 16 ].

There was no agreed recommendation from the group as to whether ICUs should stock readily available ice-cold NaCl solutions of different concentrations for the management of ICP crises, citing a lack of clear evidence to draw upon. The group did however highlight the fact that the rapid infusion of ice-cold saline is an inexpensive and readily available option for lowering core body temperature [ 9 ], with the rapidity of response to ice-cold infusions being regarded as a valuable aspect of TTC induction.

TTC maintenance

An automated feedback-controlled TTC device that enables precise temperature control is desirable for the initiation of TTC and maintenance at target temperature in patients with severe TBI.

The maximum temperature variation that a patient should experience during normothermia is less than or equal to +/− 0.5 °C per hour and ≤ 1 °C per 24-hperiod

When hypothermia is indicated, treatment should be continued for as long as the brain is considered to be at risk of secondary brain injury.

Automated feedback-controlled devices for TTC are powerful tools, encouraging the delivery of quality care and aiming to improve neurological outcome [ 13 , 17 ], minimising the chances of temperature variability. Temperature variability is the deviation of patient temperature outside of the goal, typically reported as mean deviation or percent of time outside of target [ 9 ]. The group noted that there is a level of pragmatism to be adopted in TTC maintenance, discussing that while more time spent in fever can negatively impact neurological outcome, fluctuations in temperature may also affect outcome [ 17 ], and consensus was reached on the importance of maintaining temperature at as consistent a level as possible with the group settling on a fluctuation range of less than or equal to ± 0.5 °C per hour and ≤ 1 °C per 24-h period. In instances where an automated feedback-controlled device is not available, the group noted the importance of increased staff awareness of patient status to ensure fluctuations outside of this range are appropriately managed. The group highlighted that a dedicated protocol for sedation, analgesia and shivering management might be helpful to ensure consistent application of optimal TTC.

The group agreed that when indicated, hypothermia should be continued for as long as the individual practitioner considers the brain to be at risk of secondary injury. These considerations were supported with a suggestion that it should be maintained for as short a time as possible.

Rewarming following hypothermic TTC

Obtaining an interval scan and/or an alternative assessment of intracranial compliance, in addition to the absolute number of ICP, is recommended before rewarming.

Rebound hyperthermia should be prevented whenever possible or promptly treated in cases when the brain is perceived to be at risk of secondary brain injury.

In cases in which the patient is being rewarmed from therapeutic hypothermia (core temperature lower than 36.0 °C), the group agreed that once ICP has been maintained within controlled limits and de-escalation of treatment intensity is considered, it is sensible to ensure the patient has sufficient intracranial volume buffering reserve through the use of an interval scan and/or an alternative measure of intracranial compliance, before commencing the rewarming process. The group also noted the high prevalence and potential risks associated with rebound hyperthermia when TTC is discontinued following therapeutic hypothermia, highlighting the importance of continued vigilance and careful temperature control in the rewarming phase.

Whilst no consensus was reached on recommended rewarming rates, the group agreed that controlled rewarming with an automated feedback-controlled device may reduce the risk of rapid temperature variations and rebound pyrexia that can precipitate secondary brain injury and compromise care [ 16 , 33 ]. The group highlighted how controlled rewarming may improve the ability of clinicians to more effectively control important inter-dependent clinical variables such as PaCO 2 , ventilation settings and depth of sedation.

TTC for shivering

It is important to assess, document and manage shivering in severe TBI patients.

Whenever ICP is labile and shivering is detected, neuromuscular blockers should be considered after ensuring appropriate depth of sedation.

In self-ventilating patients in the subacute phase of severe TBI, an individualised risk–benefit assessment should be undertaken regarding the strict indications of controlled normothermia.

Permissive hyperthermia should be considered in cases where risk of secondary brain injury resulting from pyrexia is thought to be low, and when shivering cannot be controlled with first line treatments such as NSAIDs, opiates, magnesium or counter warming.

In line with current literature, it was widely agreed that shivering should be managed in patients following severe TBI. Shivering can reduce brain tissue oxygenation leading to cerebral metabolic stress, which may therefore negate the neuroprotective benefits of TTC [ 9 , 34 , 35 , 36 ].

Titration of sedation and the use of neuromuscular blocking agents provides intensivists with readily available and effective options for shivering control in critically ill patients [ 37 ]. To ensure appropriate and effective use however, treating staff must be aware of the nuances of selecting the correct agent, monitoring the depth of neuromuscular blockade, and ensuring adequate skeletal muscle recovery once therapy with neuromuscular blockers has ceased. In cases of shivering when ICP is labile, the group agreed in line with current literature that ensuring depth of sedation before administering neuromuscular blockers is of utmost importance [ 37 , 38 ]. When using pharmacologic agents for shivering management, treating staff must consider potential pharmacokinetic and pharmacodynamic variation and monitor for efficacy (i.e. shivering control) and safety (i.e. adverse events and drug-drug interactions) [ 9 ].

The group agreed that in patients who are perceived to be at relatively lower risk of secondary brain injury (i.e. self-ventilating patients in the sub-acute phase of severe TBI), permissive hyperthermia may be considered over TTC, especially if the latter therapeutic option would require sedation or other invasive interventions. The group agreed that an individualised risk–benefit assessment should ultimately be undertaken before commencing controlled normothermia in such patients.

‘Time within target range’, ‘burden of fever’ and similar metrics can be considered as indicators of quality of temperature management.

‘Time within target range’ and ‘burden of fever’ were considered by the group to be appropriate metrics of quality temperature management. It was widely acknowledged that these metrics should be weighed by patient length of stay and/or duration of monitoring for appropriate statistical interpretation. The group was also careful to note that the administrative burden on physicians is already high and acknowledged the fact that some centres may not have access to electronic patient data management systems, so it was agreed that it was unrealistic for this group to issue prescriptive recommendations on auditing practices. In light of the high heterogeneity across centres [ 9 ], here the group were keen to clarify that wherever possible, documenting metrics such as ‘time within target range’ and ‘burden of fever’ may improve their ability to deliver data-driven service improvement and temperature control.

This consensus review was undertaken to evaluate current evidence on the application of TTC in the management of severe TBI in a critical care setting, and to develop a set of practical recommendations to address identified gaps in current published evidence.

As highlighted by the SIBICC 2020 group, the gap between published evidence and management protocols is bridged by expert opinion [ 39 ]. The optimal method for the provision of high-quality TTC remains unknown, and barriers to its consistent implementation include the lack of evidence-based treatment protocols, knowledge deficiencies, limited access to equipment, lack of financial resources and staff workload. This document aims to address key practice gaps and optimise patient care through multimodal assessment following TBI.

Strengths and limitations

The Delphi process has a number of strengths. Participants are able to reconsider their views in light of the evolving discussions, allowing for an element of reflection that isn’t regularly seen in other studies involving a single time point such as interviews or focus groups [ 40 ]. The element of anonymity offered to the panellists in the survey rounds avoids group conformity and promotes honesty, and the controlled and iterative discussions offer a flexible approach to gathering expert viewpoints on the set research questions. The Delphi method is an iterative process allowing the anonymous inclusion of a number of individuals across diverse locations and areas of expertise and avoiding dominance by any one individual. It uses a systematic progression of repeated rounds of voting and is an effective process for determining expert group consensus where there is little or no definitive evidence and where opinion is important [ 41 , 42 ]. The modified Delphi approach used here combined the early flow of structured information and submission of anonymous responses with the (hybrid) face-to-face discussion and further voting to gain consensus (or establish lack thereof) and expert insight into usual practice regarding non-pharmacological TTC with an automated feedback-controlled device. As cited in existing literature however [ 13 , 17 ], the Delphi process has limitations. The process is vulnerable to drop-outs and technical issues, with the online voting process during our meeting seeing some participants unable to cast their votes on a number of questions, leading to the need for a final anonymous survey round. The group opinions during the meeting may have been impacted by social bias, and the voices across the in-person and online participants may not have been equally heard, highlighting a potential need to ensure consistency in attendance in the same format in future panel meetings.

Our recommendations for the use of automated feedback-controlled TTC devices are based on expert consensus and theoretical benefits, such as precise temperature control and reduced temperature variability, which are thought to potentially improve outcomes in severe TBI management. We acknowledge the current evidence gap and strongly emphasise the need for rigorous research to evaluate the effectiveness of these devices, especially in diverse healthcare settings, including lower-income countries where resource limitations are critical. Future updates to these best-practice recommendations will incorporate emerging evidence to ensure relevance and applicability across different healthcare contexts, aiming for the highest standards of care within the constraints of available resources. While automated feedback-controlled TTC devices represent a significant advancement in the management of temperature in severe TBI patients, offering potential benefits in terms of precision and consistency, it is imperative to recognise the value and applicability of a wide range of temperature management approaches. These include both manual methods and simpler devices, which remain vital in many clinical settings around the world. Our guidelines advocate for the adaptation and implementation of TTC principles based on the specific resources, capabilities, and needs of each clinical setting.

This report has been developed by an expert panel comprised of specialists in neuro-critical care experienced in the management of severe TBI, therefore the recommendations focus on patients managed in a critical care environment. An individualised risk–benefit assessment should be undertaken for each domain to accommodate the high levels of heterogeneity seen across TBI patients, local practice settings, staff training and equipment availability [ 9 ].

TTC is a therapy that has a role in ICP management and may reduce secondary injury and improve long-term neurological outcome for victims of TBI [ 9 ]. Appropriate methods for the implementation of TTC across widely heterogenous clinical settings and patient populations are relatively understudied, and due to a lack of consistent and high-quality evidence, remain largely unknown. Areas of consensus emerging from the Delphi process included TTC being recognised as an essential aspect of high-quality TBI care. Controlled normothermia (36.0–37.5 °C) was strongly recommended as a therapeutic option to be considered in Tier 1 and 2 of the SIBICC ICP management protocol. Temperature management targets should be individualised based on the perceived risk of secondary brain injury and fever aetiology.

Availability of data and materials

All data generated or analysed during this study are included in this article and its supplementary information files.

Abbreviations

Cerebral perfusion pressure

Computed tomography

Electroencephalography

European Society of Anaesthesiology and Intensive Care

European Society of Intensive Care Medicine

Haemoglobin

• Intracranial pressure

Intensive care unit

Neuro Anaesthesia and Critical Care Society

Sodium chloride

Neuro-intensive care unit

Nonsteroidal anti-inflammatory drugs

Arterial partial pressure of carbon dioxide

Brain tissue oxygenation

Randomised controlled trial

Seattle International Severe Traumatic Brain Injury Consensus Conference

Arterial oxygen saturation

• Traumatic brain injury
• Targeted temperature control

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Acknowledgements

The group would like to acknowledge the support of Page & Page, London UK in facilitating the Delphi meeting.

The Delphi Panel meeting in October 2023 was facilitated (through the provision of travel costs, meeting space and refreshments) by Becton, Dickinson and Company. The development of these consensus recommendations was conducted with strict measures to ensure independence from its sponsor. The research team independently conducted all data analyses and drafted the manuscript. The role of BD was limited to providing logistical support for the Delphi panel meeting held in London, including travel costs, meeting space, and refreshments, without any influence over the study's content or conclusions. The Delphi voting process was conducted anonymously, ensuring that panel members could freely express their professional opinions without bias or influence from the sponsoring body or among panel members. The manuscript's drafting, review, and revision processes were carried out independently of BD. The sponsor had no editorial control, ensuring that the recommendations are based on the authors’ independent, professional expertise in targeted temperature management following traumatic brain injury. This article contains the personal and professional opinions of the individual authors and does not necessarily reflect the views and opinions of Becton, Dickinson and Company (“BD”) or any Business Unit or affiliate of BD. If drugs and/or medical devices are cited in the article, please consult package insert and instructions for use of them to know indications, contraindications, and any other more detailed safety information.

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Andrea Lavinio, Jonathan P. Coles & David K. Menon

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Chiara Robba

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Marcel Aries

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Supplementary Information

Additional file 1.

. Evaluation of five randomized controlled trials by the ESICM Methodology Group evaluates evulating cooling strategies against traditional interventions. The evaluation highlights methodological heterogeneities and evidential challenges.

Additional file 2

. Delphi questionnaire: Round 1.

Additional file 3

. Delphi questionnaire. Round 3.

Additional file 4

. Systematic review of the literature on targeted temperature control in traumatic brain injury, covering clinical studies from 2013 to 2023.

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Lavinio, A., Coles, J.P., Robba, C. et al. Targeted temperature control following traumatic brain injury: ESICM/NACCS best practice consensus recommendations. Crit Care 28 , 170 (2024). https://doi.org/10.1186/s13054-024-04951-x

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