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TLDR This helps you summarize any piece of text into concise, easy to digest content so you can free yourself from information overload.

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In the sheer amount of information that bombards Internet users from all sides, hardly anyone wants to devote their valuable time to reading long texts. TLDR This's clever AI analyzes any piece of text and summarizes it automatically, in a way that makes it easy for you to read, understand and act on.

Article Metadata Extraction

TLDR This, the online article summarizer tool, not only condenses lengthy articles into shorter, digestible content, but it also automatically extracts essential metadata such as author and date information, related images, and the title. Additionally, it estimates the reading time for news articles and blog posts, ensuring you have all the necessary information consolidated in one place for efficient reading.

• Automated author-date extraction
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As an efficient article summarizer tool, TLDR This meticulously eliminates ads, popups, graphics, and other online distractions, providing you with a clean, uncluttered reading experience. Moreover, it enhances your focus and comprehension by presenting the essential content in a concise and straightforward manner, thus transforming the way you consume information online.

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TLDR This smartly selects the most relevant points from a text, filtering out weak arguments and baseless speculation. It allows for quick comprehension of the essence, without needing to sift through all paragraphs. By focusing on core substance and disregarding fluff, it enhances efficiency in consuming information, freeing more time for valuable content.

• Filters weak arguments and speculation
• Highlights most relevant points
• Saves time by eliminating fluff

Who is TLDR This for?

TLDR This is a summarizing tool designed for students, writers, teachers, institutions, journalists, and any internet user who needs to quickly understand the essence of lengthy content.

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TLDR This is for anyone who just needs to get the gist of a long article. You can read this summary, then go read the original article if you want to.

TLDR This is for students studying for exams, who are overwhelmed by information overload. This tool will help them summarize information into a concise, easy to digest piece of text.

TLDR This is for anyone who writes frequently, and wants to quickly summarize their articles for easier writing and easier reading.

TLDR This is for teachers who want to summarize a long document or chapter for their students.

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TLDR This is for corporations and institutions who want to condense a piece of content into a summary that is easy to digest for their employees/students.

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TLDR This is for journalists who need to summarize a long article for their newspaper or magazine.

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LITERATURE REVIEW SOFTWARE FOR BETTER RESEARCH

“Litmaps is a game changer for finding novel literature... it has been invaluable for my productivity.... I also got my PhD student to use it and they also found it invaluable, finding several gaps they missed”

Varun Venkatesh

Austin Health, Australia

As a full-time researcher, Litmaps has become an indispensable tool in my arsenal. The Seed Maps and Discover features of Litmaps have transformed my literature review process, streamlining the identification of key citations while revealing previously overlooked relevant literature, ensuring no crucial connection goes unnoticed. A true game-changer indeed!

Ritwik Pandey

Doctoral Research Scholar – Sri Sathya Sai Institute of Higher Learning

Using Litmaps for my research papers has significantly improved my workflow. Typically, I start with a single paper related to my topic. Whenever I find an interesting work, I add it to my search. From there, I can quickly cover my entire Related Work section.

David Fischer

Research Associate – University of Applied Sciences Kempten

“It's nice to get a quick overview of related literature. Really easy to use, and it helps getting on top of the often complicated structures of referencing”

Christoph Ludwig

Technische Universität Dresden, Germany

“This has helped me so much in researching the literature. Currently, I am beginning to investigate new fields and this has helped me hugely”

Aran Warren

Canterbury University, NZ

“I can’t live without you anymore! I also recommend you to my students.”

Professor at The Chinese University of Hong Kong

“Seeing my literature list as a network enhances my thinking process!”

Katholieke Universiteit Leuven, Belgium

“Incredibly useful tool to get to know more literature, and to gain insight in existing research”

KU Leuven, Belgium

“As a student just venturing into the world of lit reviews, this is a tool that is outstanding and helping me find deeper results for my work.”

Franklin Jeffers

South Oregon University, USA

“Any researcher could use it! The paper recommendations are great for anyone and everyone”

Swansea University, Wales

“This tool really helped me to create good bibtex references for my research papers”

Ali Mohammed-Djafari

Director of Research at LSS-CNRS, France

“Litmaps is extremely helpful with my research. It helps me organize each one of my projects and see how they relate to each other, as well as to keep up to date on publications done in my field”

Daniel Fuller

Clarkson University, USA

As a person who is an early researcher and identifies as dyslexic, I can say that having research articles laid out in the date vs cite graph format is much more approachable than looking at a standard database interface. I feel that the maps Litmaps offers lower the barrier of entry for researchers by giving them the connections between articles spaced out visually. This helps me orientate where a paper is in the history of a field. Thus, new researchers can look at one of Litmap's "seed maps" and have the same information as hours of digging through a database.

Baylor Fain

Postdoctoral Associate – University of Florida

Our Course: Learn and Teach with Litmaps

RAxter is now Enago Read! Enjoy the same licensing and pricing with enhanced capabilities. No action required for existing customers.

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From Surface-Level Exploration to Critical Reading - All in one Place!

Fine-tune your literature search.

Our AI-powered reading assistant saves time spent on the exploration of relevant resources and allows you to focus more on reading.

Select phrases or specific sections and explore more research papers related to the core aspects of your selections. Pin the useful ones for future references.

Our platform brings you the latest research related to your and project work.

Speed up your literature review

Quickly generate a summary of key sections of any paper with our summarizer.

Make informed decisions about which papers are relevant, and where to invest your time in further reading.

Get key insights from the paper, quickly comprehend the paper’s unique approach, and recall the key points.

Bring order to your research projects

Organize your reading lists into different projects and maintain the context of your research.

Quickly sort items into collections and tag or filter them according to keywords and color codes.

Experience the power of sharing by finding all the shared literature at one place.

Decode papers effortlessly for faster comprehension

Highlight what is important so that you can retrieve it faster next time.

Select any text in the paper and ask Copilot to explain it to help you get a deeper understanding.

Ask questions and follow-ups from AI-powered Copilot.

Collaborate to read with your team, professors, or students

Share and discuss literature and drafts with your study group, colleagues, experts, and advisors. Recommend valuable resources and help each other for better understanding.

Work in shared projects efficiently and improve visibility within your study group or lab members.

Keep track of your team's progress by being constantly connected and engaging in active knowledge transfer by requesting full access to relevant papers and drafts.

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Everything you add or create on Enago Read is private by default. It is visible if and when you share it with other users.

You can put Creative Commons license on original drafts to protect your IP. For shared files, Enago Read always maintains a copy in case of deletion by collaborators or revoked access.

We use state-of-the-art security protocols and algorithms including MD5 Encryption, SSL, and HTTPS to secure your data.

Your all in one AI-powered Reading Assistant

A Reading Space to Ideate, Create Knowledge, & Collaborate on Your Research

• Smartly organize your research
• Receive recommendations that can not be ignored
• Collaborate with your team to read, discuss, and share knowledge

From Surface-Level Exploration to Critical Reading - All at One Place!

Fine-tune your literature search.

Our AI-powered reading assistant saves time spent on the exploration of relevant resources and allows you to focus more on reading.

Select phrases or specific sections and explore more research papers related to the core aspects of your selections. Pin the useful ones for future references.

Our platform brings you the latest research news, online courses, and articles from magazines/blogs related to your research interests and project work.

Speed up your literature review

Quickly generate a summary of key sections of any paper with our summarizer.

Make informed decisions about which papers are relevant, and where to invest your time in further reading.

Get key insights from the paper, quickly comprehend the paper’s unique approach, and recall the key points.

Bring order to your research projects

Organize your reading lists into different projects and maintain the context of your research.

Quickly sort items into collections and tag or filter them according to keywords and color codes.

Experience the power of sharing by finding all the shared literature at one place

Decode papers effortlessly for faster comprehension

Highlight what is important so that you can retrieve it faster next time

Find Wikipedia explanations for any selected word or phrase

Save time in finding similar ideas across your projects

Collaborate to read with your team, professors, or students

Share and discuss literature and drafts with your study group, colleagues, experts, and advisors. Recommend valuable resources and help each other for better understanding.

Work in shared projects efficiently and improve visibility within your study group or lab members.

Keep track of your team's progress by being constantly connected and engaging in active knowledge transfer by requesting full access to relevant papers and drafts.

Find Papers From Across the World's Largest Repositories

Testimonials

Privacy and security of your research data are integral to our mission..

Everything you add or create on Enago Read is private by default. It is visible only if and when you share it with other users.

You can put Creative Commons license on original drafts to protect your IP. For shared files, Enago Read always maintains a copy in case of deletion by collaborators or revoked access.

We use state-of-the-art security protocols and algorithms including MD5 Encryption, SSL, and HTTPS to secure your data.

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Go to the main ideas in your texts, summarize them « relevantly » in 1 Click

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Identify the important ideas and facts

To help you summarize and analyze your argumentative texts , your articles, your scientific texts, your history texts as well as your well-structured analyses work of art, Resoomer provides you with a "Summary text tool" : an educational tool that identifies and summarizes the important ideas and facts of your documents. Summarize in 1-Click, go to the main idea or skim through so that you can then interpret your texts quickly and develop your syntheses .

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College students.

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Surf online and save time when reading on internet ! Resoomer summarizes your articles in 500 words so that you can go to the main idea of your text.

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AI Literature Review Generator

Generate high-quality literature reviews fast with ai.

• Academic Research: Create a literature review for your thesis, dissertation, or research paper.
• Professional Research: Conduct a literature review for a project, report, or proposal at work.
• Content Creation: Write a literature review for a blog post, article, or book.
• Personal Research: Conduct a literature review to deepen your understanding of a topic of interest.

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All-in-one Literature Review Software

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MAXQDA The All-in-one Literature Review Software

MAXQDA is the best choice for a comprehensive literature review. It works with a wide range of data types and offers powerful tools for literature review, such as reference management, qualitative, vocabulary, text analysis tools, and more.

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Your analysis.

As your all-in-one literature review software, MAXQDA can be used to manage your entire research project. Easily import data from texts, interviews, focus groups, PDFs, web pages, spreadsheets, articles, e-books, and even social media data. Connect the reference management system of your choice with MAXQDA to easily import bibliographic data. Organize your data in groups, link relevant quotes to each other, keep track of your literature summaries, and share and compare work with your team members. Your project file stays flexible and you can expand and refine your category system as you go to suit your research.

Developed by and for researchers – since 1989

Having used several qualitative data analysis software programs, there is no doubt in my mind that MAXQDA has advantages over all the others. In addition to its remarkable analytical features for harnessing data, MAXQDA’s stellar customer service, online tutorials, and global learning community make it a user friendly and top-notch product.

Sally S. Cohen – NYU Rory Meyers College of Nursing

Literature Review is Faster and Smarter with MAXQDA

Easily import your literature review data

With a literature review software like MAXQDA, you can easily import bibliographic data from reference management programs for your literature review. MAXQDA can work with all reference management programs that can export their databases in RIS-format which is a standard format for bibliographic information. Like MAXQDA, these reference managers use project files, containing all collected bibliographic information, such as author, title, links to websites, keywords, abstracts, and other information. In addition, you can easily import the corresponding full texts. Upon import, all documents will be automatically pre-coded to facilitate your literature review at a later stage.

Capture your ideas while analyzing your literature

Great ideas will often occur to you while you’re doing your literature review. Using MAXQDA as your literature review software, you can create memos to store your ideas, such as research questions and objectives, or you can use memos for paraphrasing passages into your own words. By attaching memos like post-it notes to text passages, texts, document groups, images, audio/video clips, and of course codes, you can easily retrieve them at a later stage. Particularly useful for literature reviews are free memos written during the course of work from which passages can be copied and inserted into the final text.

Find concepts important to your generated literature review

When generating a literature review you might need to analyze a large amount of text. Luckily MAXQDA as the #1 literature review software offers Text Search tools that allow you to explore your documents without reading or coding them first. Automatically search for keywords (or dictionaries of keywords), such as important concepts for your literature review, and automatically code them with just a few clicks. Document variables that were automatically created during the import of your bibliographic information can be used for searching and retrieving certain text segments. MAXQDA’s powerful Coding Query allows you to analyze the combination of activated codes in different ways.

Aggregate your literature review

When conducting a literature review you can easily get lost. But with MAXQDA as your literature review software, you will never lose track of the bigger picture. Among other tools, MAXQDA’s overview and summary tables are especially useful for aggregating your literature review results. MAXQDA offers overview tables for almost everything, codes, memos, coded segments, links, and so on. With MAXQDA literature review tools you can create compressed summaries of sources that can be effectively compared and represented, and with just one click you can easily export your overview and summary tables and integrate them into your literature review report.

Powerful and easy-to-use literature review tools

Quantitative aspects can also be relevant when conducting a literature review analysis. Using MAXQDA as your literature review software enables you to employ a vast range of procedures for the quantitative evaluation of your material. You can sort sources according to document variables, compare amounts with frequency tables and charts, and much more. Make sure you don’t miss the word frequency tools of MAXQDA’s add-on module for quantitative content analysis. Included are tools for visual text exploration, content analysis, vocabulary analysis, dictionary-based analysis, and more that facilitate the quantitative analysis of terms and their semantic contexts.

Visualize your literature review

As an all-in-one literature review software, MAXQDA offers a variety of visual tools that are tailor-made for qualitative research and literature reviews. Create stunning visualizations to analyze your material. Of course, you can export your visualizations in various formats to enrich your literature review analysis report. Work with word clouds to explore the central themes of a text and key terms that are used, create charts to easily compare the occurrences of concepts and important keywords, or make use of the graphical representation possibilities of MAXMaps, which in particular permit the creation of concept maps. Thanks to the interactive connection between your visualizations with your MAXQDA data, you’ll never lose sight of the big picture.

AI Assist: literature review software meets AI

AI Assist – your virtual research assistant – supports your literature review with various tools. AI Assist simplifies your work by automatically analyzing and summarizing elements of your research project and by generating suggestions for subcodes. No matter which AI tool you use – you can customize your results to suit your needs.

Free tutorials and guides on literature review

MAXQDA offers a variety of free learning resources for literature review, making it easy for both beginners and advanced users to learn how to use the software. From free video tutorials and webinars to step-by-step guides and sample projects, these resources provide a wealth of information to help you understand the features and functionality of MAXQDA for literature review. For beginners, the software’s user-friendly interface and comprehensive help center make it easy to get started with your data analysis, while advanced users will appreciate the detailed guides and tutorials that cover more complex features and techniques. Whether you’re just starting out or are an experienced researcher, MAXQDA’s free learning resources will help you get the most out of your literature review.

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Get your maxqda license, compare the features of maxqda and maxqda analytics pro, faq: literature review software.

Literature review software is a tool designed to help researchers efficiently manage and analyze the existing body of literature relevant to their research topic. MAXQDA, a versatile qualitative data analysis tool, can be instrumental in this process.

Literature review software, like MAXQDA, typically includes features such as data import and organization, coding and categorization, advanced search capabilities, data visualization tools, and collaboration features. These features facilitate the systematic review and analysis of relevant literature.

Literature review software, including MAXQDA, can assist in qualitative data interpretation by enabling researchers to organize, code, and categorize relevant literature. This organized data can then be analyzed to identify trends, patterns, and themes, helping researchers draw meaningful insights from the literature they’ve reviewed.

Yes, literature review software like MAXQDA is suitable for researchers of all levels of experience. It offers user-friendly interfaces and extensive support resources, making it accessible to beginners while providing advanced features that cater to the needs of experienced researchers.

Getting started with literature review software, such as MAXQDA, typically involves downloading and installing the software, importing your relevant literature, and exploring the available features. Many software providers offer tutorials and documentation to help users get started quickly.

For students, MAXQDA can be an excellent literature review software choice. Its user-friendly interface, comprehensive feature set, and educational discounts make it a valuable tool for students conducting literature reviews as part of their academic research.

MAXQDA is available for both Windows and Mac users, making it a suitable choice for Mac users looking for literature review software. It offers a consistent and feature-rich experience on Mac operating systems.

When it comes to literature review software, MAXQDA is widely regarded as one of the best choices. Its robust feature set, user-friendly interface, and versatility make it a top pick for researchers conducting literature reviews.

Yes, literature reviews can be conducted without software. However, using literature review software like MAXQDA can significantly streamline and enhance the process by providing tools for efficient data management, analysis, and visualization.

The Sheridan Libraries

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Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
• << Previous: Summarize
• Next: Integrate >>
• Last Updated: Sep 26, 2023 10:25 AM
• URL: https://guides.library.jhu.edu/lit-review

• USC Libraries
• Research Guides

Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

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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Computer Science > Cryptography and Security

Title: large language models for cyber security: a systematic literature review.

Abstract: The rapid advancement of Large Language Models (LLMs) has opened up new opportunities for leveraging artificial intelligence in various domains, including cybersecurity. As the volume and sophistication of cyber threats continue to grow, there is an increasing need for intelligent systems that can automatically detect vulnerabilities, analyze malware, and respond to attacks. In this survey, we conduct a comprehensive review of the literature on the application of LLMs in cybersecurity (LLM4Security). By comprehensively collecting over 30K relevant papers and systematically analyzing 127 papers from top security and software engineering venues, we aim to provide a holistic view of how LLMs are being used to solve diverse problems across the cybersecurity domain. Through our analysis, we identify several key findings. First, we observe that LLMs are being applied to a wide range of cybersecurity tasks, including vulnerability detection, malware analysis, network intrusion detection, and phishing detection. Second, we find that the datasets used for training and evaluating LLMs in these tasks are often limited in size and diversity, highlighting the need for more comprehensive and representative datasets. Third, we identify several promising techniques for adapting LLMs to specific cybersecurity domains, such as fine-tuning, transfer learning, and domain-specific pre-training. Finally, we discuss the main challenges and opportunities for future research in LLM4Security, including the need for more interpretable and explainable models, the importance of addressing data privacy and security concerns, and the potential for leveraging LLMs for proactive defense and threat hunting. Overall, our survey provides a comprehensive overview of the current state-of-the-art in LLM4Security and identifies several promising directions for future research.

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SWE Magazine Publishes 2023 Engineering Literature Review

• May 13, 2024
• Member News

A review of 372 peer-reviewed journal articles and conference proceedings that relate to girls and women in engineering and STEM found that systemic injustices were still prevalent and negatively impact many women seeking to make a contribution to the profession.

The findings are part of an annual issue of the SWE Magazine review of published research on women in engineering and STEM. You can read the literature review online .

The issue was edited by co-authored by Ari Hock , research assistant at the University of Washington (UW) Center for Evaluation & Research for STEM Equity (CERSE) and a Ph.D. candidate in the UW College of Education; Erin Carll , Ph.D., associate director of CERSE, where she conducts program evaluation and research into efforts to improve diversity, equity, and inclusion in STEM; and Aryaa Rajouria , research assistant at CERSE and a Ph.D. student in the UW Department of Sociology.

The literature review focuses on eight main areas:

• Gender and intersectionality
• Damage-based vs. desire-based research
• Individual-level and systems-level factors
• International perspectives
• Stereotypes and biases
• Support networks, mentors, and role models
• Recruitment
• Retention and advancement

The authors noted that while the 2022 literature review included significant research on how COVID-19 pandemic affected women in the engineering workforce, the 2023 review featured significantly fewer studies on COVID-19.

“This year’s literature review included over 370 peer-reviewed articles and publications ― the highest we’ve analyzed since SWE started conducting this annual review more than 20 years ago,” said Roberta Rincon , director of research and impact for SWE. “While we have seen many changes over the years in the issues of interest among researchers, gender equity in STEM continues to be a complex field of study. Covering barriers to the recruitment and retention of diverse STEM talent in education and career, from individual struggles to systemic challenges, and considering intersecting identities and international perspectives, our review highlights the multifaceted journey women across the globe.”

Read the 2023 Literature Review

About  SWE Magazine

SWE Magazine , the magazine of the Society of Women Engineers, is published five times per year. Reaching more than 40,000 members, stakeholders, and supporters, the magazine provides authoritative information on women’s status and challenges in engineering.

SWE Magazine celebrates the accomplishments of women engineers past and present; explores career development topics; examines broad, cross-disciplinary technical themes; and discusses public policy issues important to women in engineering and STEM.

SWE Blog provides up-to-date information and news about the Society and how our members are making a difference every day. You’ll find stories about SWE members, engineering, technology, and other STEM-related topics.

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ABOUT ALL TOGETHER

All Together  is the blog of the Society of Women Engineers . Find stories about SWE members, engineering, technology, and other STEM related topics. It’s up-to-date information and news about the Society and how our members are making a difference everyday.

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Delays Occurred in Some Veterans’ Benefits Claims While Awaiting Decision

Report information.

Issue Date May 8, 2024 Report Number 22-03463-60 VA Office Veterans Benefits Administration (VBA) Report Author Office of Audits and Evaluations Report Type Review Report Topic Claims and Appeals Major Management Challenges Benefits for Veterans Recommendations 2 Questioned Costs $0 Better Use of Funds $0 Congressionally Mandated No

The National Work Queue (NWQ) division generally uses the NWQ tool and ranking rules to prioritize and distribute claims across VBA’s regional offices for processing. The OIG conducted this review after discovering some claims at the NWQ division had been awaiting decisions for one year or longer. The team identified 10,541 claims aged 365 days or older that, on August 1, 2022, were at the NWQ division awaiting decision and were not distributed to a regional office. Most of these claims had been at the NWQ division for at least six months, and over 99 percent required routing to specialized teams that process special mission herbicide-related claims. Office of Field Operations (OFO) leaders limited staffing for these teams to control quality for these complex claims and balance workloads, and they generally expected the delays. However, the OIG team reviewed VBA’s oldest pending claims and identified instances in which the NWQ division’s ranking rules unintentionally contributed to delays. Additionally, by comparing the ranking scores that the NWQ tool assigned with the NWQ division’s ranking rules, the OIG team found instances in which the NWQ tool incorrectly ranked some claims, which may have affected whether those claims were distributed to regional offices. Stronger monitoring could have allowed the NWQ division to identify these issues earlier and make adjustments to ensure claims were appropriately prioritized. The team also found that OFO’s FY 2022 internal controls assessment did not evaluate claims prioritization and distribution and did not mention the NWQ division or tool. To reduce delays in claims processing, the OIG recommended strengthening the NWQ division’s monitoring of claims awaiting decision to ensure its rules are operating as intended and ensuring OFO includes the NWQ division’s functioning in its annual internal controls assessment. The recommendations have been closed based on documentation provided.

Recommendations (2)

Implement a plan to strengthen the National Work Queue division’s monitoring of claims awaiting decision at its own location to ensure its rules are operating as intended and make adjustments as needed.

Ensure the Office of Field Operations includes the National Work Queue division’s functioning in its annual internal controls assessment and statement of assurance.

2024 Subaru WRX RS Is Both A Parent-Friendly Daily Driver And A Fantastic Track Tool

Are you a parent, not exactly rich, but still looking for a sports car to bring to a track event over the weekend? The Subaru WRX RS has you covered.

• A smooth turbo engine makes the WRX exhilarating to drive.
• Exceptional grip and track performance.
• An affordable, practical, and enthusiast-friendly package.

At this point, it's a given that the Subaru WRX kicks ass. When it was brought to our market from Japan in the early 2000s, it brought with it Subaru's rally-racing heritage , sports compact car fun, and near endless levels of tunability. It felt like the automotive gods had just finally answered all the prayers of automotive enthusiasts alike.

While some contenders did try to take a stab at Subaru's turbocharged, all-wheel drive sedan , almost none of them have survived up to this day.

Sure, the WRX has evolved over time, but it's still essentially the same excellent recipe as it was two decades ago. And now, Subaru just added an all-new, track-ready version to the lineup called the RS. Or should I say, the TR ? That all depends on which side of the US/Canada border you live. Don't worry, though, because both of them rock.

2024 Subaru WRX RS

The WRX RS is Canada's way of calling it the TR. It's essentially a track package that receives different suspension and steering tuning, as well as larger, more powerful brakes. All RS/TRs also come standard with model-specific 19-inch wheels wrapped around Bridgestone Potenza S007 high-performance tires. Sports Recaro seats are also unique to the RS/TR, as well as the absence of a sunroof, so you can fit in the car when wearing a helmet.  

• Smooth and rev-happy turbo engine.
• Grip for days.
• Affordable, practical and easy to live with.
• Questionable looks.
• Intrusive EyeSight driving aid technology.
• Smallish cargo space.

The 2024 Subaru WRX RS pictured here was driven on the track and on the road during a private one-day event held by Subaru. I did not live with the car during an entire week like I normally do. For detailed insight into testing procedures and data collection, please review our methodology policy .

2024 Subaru WRX RS First Impressions

The RS moniker is really just a name play from Subaru Canada to underline how different its lineup hierarchy and pricing is to its US neighbors. But I'll get back to all that in a bit.

What you essentially get from the RS/TR package is a WRX that's even more enthusiast-ready than the already enthusiast-ready base car. It was designed for someone who enjoys the daily driveability of a WRX, but would also like to take part in some weekend track activities without ruining their budget.

Subaru answers to this type of consumer by equipping the WRX with a set of larger (+24 mm front/+36 mm rear) brake rotors as well as 6-piston front, 2-piston rear calipers supplied by Brembo. The RS also gets new suspension tuning by way of different springs, revised damping, as well as a reprogrammed electric power steering unit.

Model-specific 19-inch wheels are also part of the package. They're wrapped in Bridgestone Potenza S007 high-performance tires. Recaro sports bucket seats are also unique to the RS/TR. This model can only be paired to a six-speed manual transmission, and can't be equipped with a sunroof. Why? So you, the driver, can fit easily in the cockpit when wearing a helmet.

While I have a ton of respect for this car, I don't like the way the current WRX looks.

In RS form, the wheel and brake package helps a bit , but I still find the WRX's styling direction has no character. It's a blob with an air scoop in the front. The plastic cladding on the wheel arches also looks incredibly goofy.

Exterior Dimensions

2024 subaru wrx rs: differences between the us and canadian markets.

The obvious main difference between both markets is the name: RS for Canada and TR for the US. But also, in Canada, the RS is positioned lower within the lineup, costing - when factoring in the exchange rate - considerably less and therefore representing a much better value.

In the US, Subaru offers one extra version equipped with the Subaru Performance Transmission (SPT), which is a fancy way for the carmaker to call it a continuously variable transmission (CVT). From a mechanical standpoint, the car is identical in both markets.

Driving Impressions And Performance

My time with the WRX RS/TR was mostly spent on the track, at Canada's Shannonville Motorsport Park where Subaru hosted journalists and content creators to hoon its latest sport compact cars as we saw fit. I did, however, do a quick road test with the RS/TR, just to get a feel of its everyday livability. I had already driven the WRX more than once, so I already knew what to expect.

Pushing the WRX RS/TR at the limits of its capabilities really allowed me to realize that Subaru understands track days.

If you've ever been on a closed circuit with your car before, you know how rough it can be on brakes and tires. The fact that the RS/TR basically upgrades these components from the factory shows that Subaru understands this struggle. It also meant that I could have even more fun, for a longer period of time, and, perhaps of more importance, not have to change the brake pads at the end of the day.

I was also grateful for the fact that the RS/TR has no sunroof, because at the top of my six foot tall body, my helmet-wearing bobblehead was able to fit inside the cockpit.

The WRX's turbocharged 2.4-liter flat four never runs out of puff, even when it's held up there close to its 6,000 RPM redline. Some may argue that 271 horsepower and 258 lb-ft of torque is not enough, and that the old STI's 2.5-liter unit offered more (305 hp/290 lb-ft). But the idea behind this new 2.4-liter was to offer the driver more engine, and less boost. And that's precisely how this WRX feels.

Contrary to the previous WRX's 2.0-liter engine which ran out of puff once the turbo stopped spooling, the 2.4-liter actually likes to rev, and doesn't mind staying up there in the stratosphere of the rev counter, presenting very little harshness or vibrations during the process.

It's all very smooth, unusual for a Boxer engine . This characteristic also proved handy on a small track like Shannonville where I was mostly staying in third gear, only occasionally shifting up to fourth. I could therefore hang on to third gear, with some power left on tap even when I was approaching the rev limiter.

Of course, traction, thanks to Subaru's famed all-wheel drive system, was never an issue, both on the track and on public roads. The WRX will catapult itself out of a corner like a slingshot, allowing it to set frankly quick lap times.

But it was mostly out there in the wild that its suspension damping really showed me why the Subaru WRX is the ideal daily driveable sports car.

You can take on potholes and road imperfections at blistering speeds with this thing, and it'll just eat them up in one bite.

Meanwhile, I was having a blast rowing its exquisite manual shift lever from one short cog to the next. My only real gripe with the on-road experience had to do with the intrusiveness of Subaru's EyeSight driving aid technology. It just keeps beeping at you, constantly afraid you'll hit the car in front.

Performance Specifications

2024 Subaru WRX RS Fuel Consumption

Since the RS/TR doesn't change anything underneath the WRX's hood and driveline, the fuel consumption ratings are essentially the same as the standard car. According to the EPA , although the current WRX's engine has gone up in displacement, it's good for 21 MPG combined. That's a solid improvement over the previous car's 18 MPG .

Unfortunately, since my time with the car was brief and mostly spent on a track going all out, I wasn't able to properly test out its real-world fuel consumption. I'll get back inside a press unit for a full week later this summer. I'll therefore be able to live with the car and adequately evaluate it.

EPA And As Tested Fuel Consumption Ratings

Interior Design And Comfort

Except for the Recaro seats I mentioned earlier, the interior of an RS/TR is identical to that of a standard WRX. There's really nothing fancy here, as it's basically the same cabin as in all of Subaru's latest products. While not particularly attractive due to a lack of substantial design, it is a well put together interior.

The level of ergonomics is also superb in the sense that everything is precisely where you'd expect it to be. Those Recaro seats are great for people of larger stature like yours truly, holding you well in place, but also not bolstered too aggressively as to uncomfortably squeeze your dad bod's love handles. That all being said, the WRX's cabin remains loud, especially at high speeds where wind, tire and engine noise pierce annoyingly through the cabin.

Not many sports cars can brag about being able to also carry around important merchandise such as kids, pets or a set of groceries, but the WRX can. Its rear seat area is a little tight due to the overall size of the car, but it's spacious enough back there to comfortably install a rear-facing child's seat.

Interior Dimensions

Technology and ease of use.

There's not that much technology inside a Subaru WRX, and that's what mostly constitutes its charm. It still relies on an analog gauge cluster and a physical handbrake. And while its main infotainment system is a large tablet, it's still relatively small compared to everything else currently on there.

Subaru's Starlink multimedia interface does certain things really well, but also comes with its share of frustrations. For starters, it looks good, displays its information clearly thanks to large, colorful icons and, most of the time, responds quickly. Subaru also stays away from the "customize your own ride" direction that most carmakers are now taking these days, and I'm totally OK with this. You basically get what Subaru gives you.

But I do wish basic climate control settings had been left on physical buttons. Well, they are, at least, the temperature control buttons are physical, but if you want something specific, like change the direction of the airflow for instance, you'll need to fiddle with some menus, and that's annoying. It's the same story for the EyeSight features. Yes, you can turn them all off, but you'll need to dig inside the system each time you turn on the car to do so, because the car saves nothing once you turn it off. These are minor irritants, but irritants nevertheless.

Cargo And Storage Space

Like its tight rear seat, the Subaru WRX doesn't have a very big trunk. But the fact that it even has one at all is already a huge deal considering the amount of performance you are getting for the price. Yes, it's possible to lower the rear seats for added volume, but when they're in place, the WRX offers less cargo space than a Honda Civic sedan (14.8 cu-ft). Even the already small Toyota Corolla (13.1 cu-ft) has a larger trunk.

How The 2024 Subaru WRX Compares To Its Competition

With the Mitsubishi Lancer Evolution now long gone, the Subaru WRX is sort of alone on its rock as the affordable, turbocharged, all-wheel drive sports sedan available with a manual transmission. It does, however, face some solid contenders in the sports compact car segment.

As far as fun, compact sedans with turbocharged engines go, there's the Honda Civic Si, the Hyundai Elantra N, the Volkswagen Jetta GLI, and the Acura Integra Type S. But they're all front-wheel drive. If you're looking for all-wheel drive as well, then your choice has pretty much narrowed down to the Audi S3 .

2024 Subaru WRX Versus 2024 Audi S3

Audi has already launched the 2025 S3 in Europe, but we'll need to wait until the fall until we get it in US and Canadian showrooms. We'll therefore focus on the 2024 model for this comparison.

2022 Audi S3 Sedan

Interestingly enough, while the S3 is technically a luxury product sold at a higher starting MSRP than the Subaru WRX, when you compare its base price to the RS/TR model, they're both sitting in similar territory. For reference, a 2024 Audi S3 will cost you $47,400 before piling on options, or about $6,000 more than the Subaru.

For that extra money, you will be getting a tad more performance from the S3's turbocharged 2.0-liter four-cylinder engine. Horsepower and torque are rated at 306 hp and 295 lb-ft. The Audi cannot be paired to a manual transmission, but its seven-speed dual-clutch automatic setup allows it to shift faster, but also take off quicker thanks to a launch control system. This gives the S3 an advantage in the 0-60 MPH time, which it completes in 4.3 seconds versus 5.4 seconds in the Subaru. The Audi is a downright faster car.

But it's also considerably smaller than the WRX. Rear legroom is not as generous (35.2 in. vs 36.5 in.), neither is cargo space (8.3 cu-ft vs 12.5 cu-ft). So, while the Audi S3 is a superior sports compact car from a performance standpoint, the WRX RS/TR is still getting you more car for your hard-earned dollar.

The Quintessential All-Wheel Drive Sports Compact Car Lives On

I tell you, it feels awesome to see Subaru still making a big deal out of the WRX. As a father myself who now needs to worry about parent-related things like a child seat, a stroller and everything that goes around these items, I love the idea of using this car as a sensible compact sedan during the week, and chase some purpose-built sports cars on the track over the weekend.

Like what the MX-5 Miata is to Mazda or the 911 is to Porsche, the WRX has become Subaru's trademark sports car. It's the model that defines the brand. And with versions like this RS/TR, Subaru is taking the time to remind us that we, driving enthusiasts, still matter. As for me, I'm already looking forward to booking the press car, so I can repeat the experience all over again.

• Open access
• Published: 03 May 2024

PRECIS-2 analysis of pragmatic acupuncture trials: a systematic review

• Jinwoong Lim 1   na1 ,
• Hyeonhoon Lee 2 , 3   na1 &
• Yong-Suk Kim 4  

BMC Complementary Medicine and Therapies volume  24 , Article number:  181 ( 2024 ) Cite this article

272 Accesses

Metrics details

Pragmatic acupuncture trials (PATs) are a research tool for assessing the effectiveness of acupuncture treatments in a real-world setting. This study aimed to provide a comprehensive methodological analysis of PATs using the PRECIS-2(PRagmatic Explanatory Continuum Indicator Summary-2) tool to determine their pragmatism.

The MEDLINE, EMBASE, Cochrane Central Register for Controlled Trials, CINAHL, Allied and Complementary Medicine Database, China National Knowledge Infrastructure, VIP, WANFANG, Taiwan Periodical Literature Database, KoreaMed, KMbase, Research Information Service System, Oriental Medicine Advanced Searching Integrated System, CiNii and ClinicalTrials.gov were searched. The search included randomised controlled trials (RCTs) and protocols of RCTs that investigated all types of acupuncture and used self-declared pragmatic design. Two authors independently collected the basic information and characteristics of the studies and assessed their pragmatism using the nine PRECIS-2 domains and the additional domain of control.

A total of 93 studies were included. The means of eligibility, recruitment, organisation, primary outcome, primary analysis, and control domains were statistically larger than three and were shown to be pragmatic. The means of setting, flexibility:delivery, and follow-up domains were not greater than three and were shown to be non-pragmatic. For flexibility:adherence domain was inappropriate for assessment owing to insufficient information in the studies.

Conclusions

PATs were pragmatic in the domain of eligibility, recruitment, organisation, primary outcome, primary analysis, and control and were not pragmatic in the domain of setting, flexibility:delivery, and follow-up. Future PATs need to strengthen the pragmatism in the setting, flexibility:delivery, and follow-up domains and to describe the flexibility:adherence domain in more detail.

Trial registration

CRD42021236975.

Peer Review reports

Acupuncture has been practiced for thousands of years with acupuncture research beginning in the eighteenth century [ 1 ]. However, owing to the large disjunction between the histories of clinical practice and clinical trials, acupuncture trials have continuously been controversial regarding the disharmony between real-world practice and experimental interpretation [ 2 ]. For instance, acupuncture’s placebo effect has thus far not been clearly described, yet it is a crucial factor for identifying the exact efficacy of this treatment in randomised controlled trials (RCTs) [ 3 ].

The term pragmatic trial refers to a trial conducted in a realistic simulated practice setting that focuses on the effectiveness of treatments as opposed to an explanatory trial [ 4 ]. The trial method has been proposed as a superior way to assess the clinical benefit of acupuncture [ 5 , 6 , 7 , 8 ]. Recently, some acupuncture trials have been conducted with a pragmatic-oriented direction; however, there are unanswered questions regarding whether these trials have been conducted with real-world settings or have provided an accurate assessment of acupuncture treatment.

PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) is a tool for designing pragmatic trials and is developed by Loudon et al. [ 9 ]. It includes the following nine domains: eligibility, recruitment, setting, organisation, flexibility:delivery, flexibility:adherence, follow-up, primary outcome, and primary analysis. Zwarenstein et al. have reported the retrospective use of the PRECIS-2 tool in published RCTs [ 10 ]. Since acupuncture trials must employ a pragmatic design to show the effectiveness of acupuncture, it is necessary to analyse how pragmatically they are designed before assessing acupuncture’s effectiveness in a pragmatic setting. However, no comprehensive methodological analysis of the pragmatic acupuncture trials (PATs) has yet been reported. Therefore, we conducted a systematic review of PATs and assessed the pragmatism of the trials using the PRECIS-2 tool to inform a proper direction for future PATs.

The present study has been registered in the PROSPERO (CRD42021236975); however, the protocol has been revised before the publication and some parts of the methods have been altered from the first registration. The method of the present study was based on the previously published protocol [ 11 ].

Literature search strategy

We searched fifteen electronic databases (MEDLINE, EMBASE, the Cochrane Central Register for Controlled Trials, CINAHL, Allied and Complementary Medicine Database, China National Knowledge Infrastructure, VIP, WANFANG, Taiwan Periodical Literature Database, KoreaMed, KMbase, Research Information Service System, Oriental Medicine Advanced Searching Integrated System, CiNii and ClinicalTrials.gov for registered trials). The search terms for the databases are provided in the previous protocol [ 11 ]. Appropriate articles were manually retrieved when necessary. This study was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines [ 12 ]. (see Additional file 1 ).

Eligibility criteria

We reviewed RCTs and RCT protocols published before March 2022 that investigated or planned to investigate any type of acupuncture including manual acupuncture, electroacupuncture, microsystem acupuncture such as auricular acupuncture, and acupoint acupressure. The inclusion criteria were as follows: 1) RCTs and RCT protocols that mentioned pragmatic trial design or pragmatic treatment in the title, abstract, or manuscript, and 2) RCTs and RCT protocols for interventions that included acupuncture treatment. The exclusion criteria were as follows: 1) protocols of published RCTs, 2) secondary analyses of published RCTs, and 3) studies that used the word ‘pragmatic’ not in a methodological manner. Two researchers independently screened the articles based on the inclusion and exclusion criteria.

Study selection

After excluding duplicates, two independent researchers selected the studies based on the criteria. A discussion was held with the third party if there was inconsistency.

Data extraction and analysis

Two independent researchers extracted the bibliographical and basic information from the selected studies. To assess the pragmatism of the included studies, they scored the nine domains of the PRECIS-2 tool for each study and experimentally added the additional domain of control. This domain is currently not included in the PRECIS-2 tool; however, Zwarenstein et al. recommend a control-related domain to clarify whether a control group has been pragmatically designed when retrospectively assessing trials [ 10 ]. Scoring criteria were based on Loudon et al. [ 9 ] and the exact criteria suitable for the characteristics of acupuncture trials were further discussed. The control domain was assigned a score of five when the control group was a usual care group without any restrictions on treatments and scored one when the control group was a sham-controlled group as Zwarenstein et al. suggested [ 10 ]. We attempted to find any additional available information for protocols or other related articles of included RCTs to score the domains; however, if there was insufficient information, the scores were left blank as suggested by Loudon et al. [ 9 ]. Two researchers independently scored the studies and discussed the scores. If there was inconsistency, a discussion was held with a third researcher. If inconsistency remained following the discussion, the mean scores of the first two researchers were used. To obtain consistency, a conference for understanding the criteria of the PRECIS-2 tool and the characteristics of the acupuncture trial and discussing the score was held once a week for six months. First, 10% of the included studies were scored, and three authors established the detailed criteria for acupuncture trials. Then after scoring all the studies, two reviewers independently re-checked the score and rationale and finally confirmed the scores. When there were discrepancies regarding data extractions and analysis, we engaged a third reviewer to resolve the issues ensuring our results were accurate and reliable. All the authors were specialists in acupuncture and moxibustion certified by the Ministry of Health and Welfare of the Republic of Korea and have more than five years of experience in acupuncture trials and clinical practice.

Statistical analysis

The descriptive statistics of the PRECIS-2 scores were investigated with mean and standard deviation calculations. Based on the bibliographical characteristics, the scores were assessed by subgroup analysis. According to Loudon et al., [ 9 ] for the domains of flexibility:delivery, flexibility:adherence, and control, if there were more than two groups, each group could be scored separately. However, when it came to statistical analysis, we used the score of the acupuncture-related group, and if all groups were related to acupuncture, we used the highest score to reflect the potential pragmatism of the trial. A one-sample t-test was used to investigate whether the score was greater than three (equally pragmatic and explanatory), and p  < 0.05 was considered statistically significant.

In total, 1,740 studies were found after searching and excluding duplicates. Based on the titles and abstracts, 1,647 studies were excluded, and 93 studies were finally included in the review. Two studies [ 13 , 14 ] were considered to be the same trial; however, they reported different outcomes. Hence, we reviewed both articles. The flow chart [ 12 ] of this study is shown in Fig.  1 .

Flow chart of the study

Sixteen studies were published until 2009 when PRECIS was first presented, [ 15 ] and 27 more were published between 2010 and 2015 when PRECIS-2 was presented. Thirty-eight studies in European countries (14 in the UK; 10 in Germany; 3 in Norway; 2 each in Denmark, Italy, Spain, and Sweden; 1 each in France, Greece, and the Netherlands), 35 studies in East Asian countries (21 in China; 9 in Korea; 3 in Japan; 1 each in Singapore and Hong Kong), 9 studies in the United States, 5 studies in Australia, 3 studies in Brazil, and 1 study each in Canada, Israel, and New Zealand was conducted. Three of the studies were written in Korean, Chinese, and German, and one was written in Japanese. Twenty-seven were protocol articles, 18 studies were pilot or feasibility trials, and one study was an interim analysis. The bibliographic characteristics of these studies are summarised in the Additional file 1 .

PRECIS-2 scores

Overall results.

The mean ± standard deviation (p-value) values of 10 domains (eligibility, recruitment, setting, organisation, flexibility:delivery, flexibility:adherence, follow-up, primary outcome, primary analysis, and control) were 3.49 ± 1.08 ( p  < 0.01), 3.48 ± 1.47 ( p  < 0.01), 3.26 ± 1.37( p  = 0.06), 3.61 ± 1.43 ( p  < 0.01), 2.84 ± 1.50 ( p  = 0.83), 2.29 ± 0.83 ( p  = 0.99), 3.20 ± 1.24 ( p  = 0.07), 3.82 ± 1.22 ( p  < 0.01), 3.78 ± 1.73 ( p  < 0.01) and 3.76 ± 1.18 ( p  < 0.01) respectively (Fig.  2 ). The mean ± standard deviation ( p -value) of the average score of nine domains in each study was 3.41 ± 0.64 ( p  < 0.01). The key factors of scoring in each RCT were summarised in Table  1 . Individual scores of the studies and the scores of nine domains divided by subgroups [publication years before 2009, between 2010 and 2015, and after 2015; countries where five or more studies were reported (China, the United Kingdom, Germany, Korea, the United States of America, and Australia); type of study (pilot or feasibility trial and original RCT)] are shown in the Additional file 2 .

PRECIS-2 score of included studies

Eligibility

We assessed whether inclusion or exclusion criteria unnecessarily narrowed the number of possible participants compared to usual care. Contraindications to acupuncture and usual diagnostic criteria were not considered during scoring.

Fifteen studies that stated loose criteria without specific limitations were scored as five. Thirty-six studies with strict criteria, such as excluding common diseases or comorbidities, were considered pragmatic (scored as four). One study was scored as 3.5 since the study included patients with rather severe conditions. Twenty-one studies were scored as three, and the reasons for this included requiring laboratory results, setting a specific cut-off, or excluding common comorbidities, medication, low education level, and other diseases that could have affected the results of the intervention. One study was scored as 2.5 since it required specific inclusion criteria and excluded patients with common conditions and acupuncture experience. Twelve studies were scored as two, and these studies stated stricter criteria that required laboratory results, questionnaire scores, and daily diaries before enrolment, and excluded common conditions and medication that could have affected the results of the intervention. One study that required endoscopic results and excluded common comorbidities was scored as 1.5. Four studies were scored as one as they required extensive data before enrolment and exclusion of various conditions and diseases. Two studies did not properly state the inclusion/exclusion criteria, and thus the score was left blank.

Recruitment

In the recruitment domain, we assessed whether additional strategies rather than the usual setting were used as part of the recruitment method.

Twenty-six studies were scored as five as they recruited participants only through referrals. They contacted eligible persons who visited a clinic or were admitted or mailed eligible patients after searching a local database or registry (achievable in the usual setting) [ 9 ]. Eight studies were scored as four since they advertised the trial only to patients who visited clinics or searched specialised hospital registries. Five studies were scored as three because they recruited participants as in the usual setting and additionally advertised the trial. One study that used massive advertisements and contacted possible patients through an outpatient clinic scored as 2.5. Nineteen studies were scored as two because they used advertisements in centres or newspapers or mailed to extensive groups of people who may have been ineligible from a database. Five studies were scored as one as some recruited participants from one specific unit, used massive advertisements, or compensated participants.Twenty-nine studies did not properly report their recruitment methods, and the score was left blank.

We assessed the appropriateness of study centres for managing patient conditions and research on the delivery of acupuncture or other interventions as well as the number of study centres.

Nineteen studies were scored as five as they were conducted in more than two general practices (GPs) or hospitals according to the disease or condition they investigated. Six studies were scored as four because they included two GPs or two specialised hospitals appropriately in accordance with participant conditions. Thirty-two studies were scored as three as they had conducted single-centre trials appropriately in accordance with participant conditions. Thirteen studies were scored as one because they conducted single-centre trials of specialised or tertiary hospitals on diseases or conditions which are usually treated by GPs. Twenty-three studies were scored as blank since they either failed to mention where the study was conducted and treatment delivered or reported that they conducted a multicentre trial, but the types of centres or clinics were not clearly identified.

Organisation

We assessed the experience level of the acupuncture practitioners and the level of equipments used in the included studies.

Thirty-seven studies were scored as five as they required a minimum qualification that was required to practise acupuncture in each country without additional training. Six studies were scored as four because they included acupuncture practitioners with 10 years of experience. Twelve studies were scored as three since they required moderate additional training to perform acupuncture. One study was scored as 2.5 as it included two types of professionals without extensive training. Twenty studies were scored as two since they required extensive additional training, various kinds of professionals, or an academic degree. Five studies were scored as one as they required highly experienced and trained practitioners with an academic degree and additional professionals. Twelve studies either did not report or insufficiently reported the practitioner’s information and thus were scored as blank.

Flexibility: delivery

We also assessed how much acupuncture treatments were individualised or based on the discretion of practitioners.

Seventeen studies were scored as five as acupuncture point selection and treatment were highly individualised and flexible at the discretion of practitioners. One study was scored as 4.5 since the delivery was highly flexible, but a protocol was suggested. Fifteen studies were scored as four as acupuncture prescriptions were generally individualised and flexible based on the practitioner’s discretion; however, other treatment regimens such as the number of treatment sessions or co-intervention were minimally fixed. Fifteen studies were scored as three since they showed semi-individualised (flexible within certain standard treatment procedures) acupuncture treatments, fixed treatment sessions, and cointerventions. Sixteen studies were scored as two as their acupuncture treatments were standardised and defined strictly as treatment sessions and cointervention with adherence management of practitioners. Twenty-four studies were scored as one since they thoroughly investigated standardised acupuncture treatments within a strict discipline. Five studies did not report sufficient information on the delivery of the intervention and thus were scored blank.

Flexibility: adherence

Any specific method used to manage the adherence of participants to intervention was assessed.

Two studies were scored as four since they attempted to maintain adherence as in usual care by allowing non-attendance of participants or sending messages for upcoming sessions. One study was scored as three because the study fixed minimum treatment sessions prior to inclusion. Ten studies were scored as two because they excluded poor compliance from trials or measured various outcomes to promote adherence. One study was scored as one as it compensated participants at each follow-up visit. Seventy-nine studies either did not sufficiently report any methods regarding adherence or were not applicable.

The frequency and duration of follow-ups, additional data collection, or any other methods regarding follow-up management were also measured. Typically, acupuncture treatments consist of several sessions, and therefore follow-up outcome assessments during treatment sessions were considered pragmatic unless they were more extensive than usual care.

Thirteen studies were scored as five since either participants were not followed up after the end of the treatment session or medical records were used for follow-up assessments. Thirty studies were scored as four because they carried out follow-up assessments, but they were not extensive in terms of frequency and duration. Twenty-three studies were scored as three because their follow-up assessments were considered quite intense in terms of frequency and duration. Fourteen studies were scored as two since the follow-ups were intense as compared with usual care and quite intense with extensive outcome measurements or excessive reminders used. Twelve studies were scored as one since the follow-ups were intense in terms of frequency and duration, and extensive outcome measurements were collected with participants either individually contacted to turn in outcome measurements or compensated on each follow-up and at the end of the study. One study did not properly state the follow-up strategy and was scored as a blank.

Primary outcome

We additionally measured whether the primary outcome was patient-centred and available in usual care. If there were many outcomes like in the pilot study, the outcome used to calculate the sample size was considered the primary outcome.

Thirty-three studies used pragmatic measurements such as the visual analogue scale or objective outcomes using medical records and were scored as five. Thirty studies were scored as four as most of them used questionnaires related to the disease or condition, and this was regarded as pragmatic. Five studies were scored as three because they employed questionnaires that were less commonly used in usual care. Two studies were scored as 2.5 since they used questionnaires that were unrelated to the disease or condition. Sixteen studies were scored as two because they used unrelated outcome measurements or outcome measurements requiring intense data collection such as daily diaries or additionally trained assessors. Three studies were scored as one because they used various outcomes as primary outcomes and required additional professionals and equipment. Four studies did not determine the primary outcome and measured various outcomes without sample calculation, and the score for these was left blank.

Primary analysis

We also assessed the statistical methods such as the intention-to-treat (ITT) and per-protocol analysis.

Fifty studies analysed all the participants at randomisation and were scored as five. Twelve studies were scored as four since they used a full analysis set or modified ITT (for instance, including participants who received at least one treatment session) even though they used ITT analysis. Twenty-three studies were scored as one since they used the per-protocol analysis or excluded missing data and poor compliance despite the fact that they used ITT analysis. Eight studies did not report the analysis methods, and these scores were left blank.

We also measured which interventions were used in control groups. Studies that provided usual care without any discipline to their control groups were scored as five; thus, 27 studies that used usual care without specific restrictions as the control group were scored as five. Eighteen studies were scored as four since there was a restriction placed on usual care in the control group. Twenty-six studies were scored as three since they used fixed treatments available in usual care as the control group. One study was scored as two since the study used physical touch in the control group that tended to function as sham acupuncture. Six studies used sham-acupuncture treatment in the control groups and were scored as one. Fifteen studies that did either not report the extent to which usual care or sham treatment was applied in the control group or had no available control group (for instance, all groups were using acupuncture treatment for experimental purposes) were left blank in this domain.

As Dal-Ré et al. have previously reported, some self-labelled pragmatic trials have not been properly pragmatically designed, [ 16 ] and this tendency is observed among PATs. In this study, we assessed the pragmatism of PATs and aimed to suggest an appropriate direction for future PATs.

As Ian Ford et al. have stated, few trials are pragmatic in all domains of the PRECIS-2 tool, and most trials show pragmatism in certain domains [ 17 ]. In the same manner, acupuncture trials may be designed pragmatically in one or two domains; however, self-labelled PATs need to strengthen their pragmatic methods and report them in detail for each domain of the PRECIS-2 tool with rationale considering the results of this systematic review.

The eligibility, recruitment, organisation, primary outcome, and primary analysis domains were shown to be pragmatic (with a mean value greater than three) for the studies in this analysis. These results are encouraging as acupuncture intervention is commonly used to treat daily life conditions and needs no additional training or qualifications to the institutional qualification needed in each country. For these domains, it would be desirable for researchers to embed a real-world setting in future PATs.

Setting, flexibility:delivery, and follow-up domains were not shown to be pragmatic. Several issues need to be addressed for these domains. For setting, the factors reducing the score in this domain included the conduction of some trials in hospitals or specialised centres when the diseases or conditions are usually treated in GPs in real life. Delivering acupuncture itself usually does not require a high degree of a clinical setting. So the location in which the condition or disease that the trial aims to investigate is treated in usual care settings needs to be considered more in PATs. Additionally, as Zwarenstein et al. [ 10 ] argued, single centres were not considered completely explanatory in this review; however, the number of centres needs to be expanded to apply the results generally in real-world practice settings. For flexibility:delivery, this domain may be considered the most important factor in PATs; however, the mean was below three and did not show pragmatism in the t-test. The main reasons for this were strict acupuncture delivery protocols that limited the acupuncture points, treatment sessions, cointerventions, and interactions between practitioners and patients. Of course, the specific acupuncture point and treatment sessions can be suggested through cumulative evidence such as the point pericardium 6 for postoperative nausea and vomiting [ 18 ]. However, a primary characteristic of acupuncture is individualised and complex treatment [ 19 , 20 ] and is commonly emphasised in the usual care setting. Even in the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA), [ 21 ] descriptions of individualised and pragmatic acupuncture protocols and a certain degree of flexibility are allowed. Future researchers conducting PATs need to consider this domain. The follow-up domain was not pragmatic; the principal reason for this was the extensive data collection at follow-up periods as well as the frequency and duration of follow-ups. As acupuncture treatment usually deals with the usual day-to-day conditions, follow-ups need to be simplified. Although the primary outcomes were pragmatic in the studies, various secondary outcomes occasionally requiring special equipment and additional assessors reduced the score in this domain. The primary purpose of clinical trials is significant; however, extensive outcome measurements and follow-up procedures could potentially compromise the practical applicability of acupuncture trials in real-world settings. The flexibility:adherence domain could not be appropriately assessed in this review because of insufficient information in the studies. Along with the recruitment domain for which 31.2% of the studies were left blank, the rate of the score ‘blank’ indicating a lack of sufficient information provided in the studies to assess the domain was 84.9% and relatively higher than other domains, and this tendency was shown in a previous study assessing integrative medicine research [ 22 ]. In the real-world setting, methods such as sending messages or making phone calls for upcoming appointments may plausibly be used; however, attendance would not be compulsorily forced. Future PATs should explore this issue in more detail.

The control groups in the studies were experimentally scored and shown to be pragmatic. This serves as evidence that the control group is a feature in pragmatic trials; conversely, as Zwarenstein et al.[ 10 ] argued, the placebo-controlled group could be pragmatic in some circumstances, so that the rationale for choosing the sham-controlled group as a control group needs to be further described in future pragmatic acupuncture studies.

We have summarised overall score of the PRECIS-2 domain in countries where more than 5 studies were published, (Additional file 2 ) and the average scores were 2.89, 2.84, 3.75, 3.31, 3.66 and 3.61 for China, Korea, UK, USA, Germany and Australia, respectively. Surprisingly, RCTs conducted in two East Asian countries that have used acupuncture for thousand years tended to be less pragmatic, and the tendency needs further investigations in future studies. For the analysis based on the publication year, (Additional file 2 ) the average scores were 3.73, 3.24 and 3.24 for before 2009, between 2010–2015, and after 2015 respectively. The more recent studies showed less pragmatic findings; however, the scores indicate minimal differences across the year.

The strengths of this systematic review are that it was, to the best of our knowledge, the first study to conduct a comprehensive review of PATs and assess the pragmatism of the trials. In particular, we highlighted the insufficient features of the trials which must be further improved and described in future PATs to help decision-makers such as doctors, patients, and policymakers to efficiently utilise the results of future PATs.

The limitations of the review are as follows: 1) Assessment was based on published articles. So if trials were conducted more pragmatically or differently from the articles, the score was able to be changed. This issue will be improved when future articles report more detailed pragmatic methods as well as how real trials are performed according to the extended version of the Consolidated Standards of Reporting Trials statement[ 23 ] and in acupuncture the Standards for Reporting Interventions in Clinical Trials of Acupuncture statement [ 21 ]; 2) When scoring PRECIS-2 domains, it is unreasonable to recognise that the one-point difference in the domains reflects an exact one-degree difference in pragmatism of the trial. Since this study quantitatively utilised the score from the qualitative information from the studies for descriptive analysis and understanding the status of PATs and used statistical analysis as little as possible, the pragmatism of the individual studies should be interpreted with caution.

Eligibility, recruitment, organisation, primary outcome, and primary analysis domains of the PRECIS-2 tool were shown to be quite pragmatic in PATs, and other domains such as setting, flexibility:delivery, and follow-up were not shown to be pragmatic. The flexibility:adherence domain was insufficient to be assessed, and more description is needed in future PATs for this domain as well as the recruitment domain. East Asian countries tended to conduct less pragmatic trials, and there was minimal difference observed across publication years.

Availability of data and materials

All the data analysed/generated in this study is involved in this published article.

Abbreviations

Pragmatic acupuncture trials

PRagmatic Explanatory Continuum Indicator Summary-2

Allied and Complementary Medicine Database

Randomised controlled trial

General practice

Intention-to-treat

Standards for Reporting Interventions in Clinical Trials of Acupuncture

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Acknowledgements

Not applicable.

This study did not receive any grant from funding agencies.

Author information

Jinwoong Lim and Hyeonhoon Lee contributed equally to this work.

Authors and Affiliations

Department of Acupuncture and Moxibustion, Wonkwang University Gwangju Korean Medicine Hospital, Gwangju, Republic of Korea

Jinwoong Lim

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea

Hyeonhoon Lee

Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea

Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyunghee Dae-Ro, Dongdaemun-Gu, Seoul, 02447, Republic of Korea

Yong-Suk Kim

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JL, HL, and YSK conceived and designed the study. JL and HL screened, summarised, assessed the articles, and wrote the draft of this manuscript. YSK supervised the study and arbitrated the disagreements. All authors revised the manuscript and approved the final version of the manuscript. YSK is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Correspondence to Yong-Suk Kim .

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Lim, J., Lee, H. & Kim, YS. PRECIS-2 analysis of pragmatic acupuncture trials: a systematic review. BMC Complement Med Ther 24 , 181 (2024). https://doi.org/10.1186/s12906-024-04473-7

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Received : 21 August 2023

Accepted : 12 April 2024

Published : 03 May 2024

DOI : https://doi.org/10.1186/s12906-024-04473-7

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