Literature Review: Traditional or narrative literature reviews
Traditional or narrative literature reviews.
- Scoping Reviews
- Systematic literature reviews
- Annotated bibliography
- Keeping up to date with literature
- Finding a thesis
- Evaluating sources and critical appraisal of literature
- Managing and analysing your literature
- Further reading and resources
A narrative or traditional literature review is a comprehensive, critical and objective analysis of the current knowledge on a topic. They are an essential part of the research process and help to establish a theoretical framework and focus or context for your research. A literature review will help you to identify patterns and trends in the literature so that you can identify gaps or inconsistencies in a body of knowledge. This should lead you to a sufficiently focused research question that justifies your research.
Onwuegbuzie and Frels (pp 24-25, 2016) define four common types of narrative reviews:
- General literature review that provides a review of the most important and critical aspects of the current knowledge of the topic. This general literature review forms the introduction to a thesis or dissertation and must be defined by the research objective, underlying hypothesis or problem or the reviewer's argumentative thesis.
- Theoretical literature review which examines how theory shapes or frames research
- Methodological literature review where the research methods and design are described. These methodological reviews outline the strengths and weaknesses of the methods used and provide future direction
- Historical literature review which 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.
References and additional resources
Baker, J. D. (2016) The purpose, process and methods of writing a literature review: Editorial . Association of Operating Room Nurses. AORN Journal, 103 (3), 265-269. doi:10.1016/j.aorn.2016.01.016
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Purpose of traditional literature reviews
Literature reviews come in many shapes and sizes, and may be placed in different areas in different theses. However, for most projects, the literature review usually has one overall purpose: to provide a rationale for your research in terms of what has gone before.
The purpose of a traditional literature review is to demonstrate a gap or problem in your field that your research seeks to address. The importance of addressing the gap for your field or discipline must not be assumed but persuasively demonstrated. Indeed, explaining why there is a need for filling the gap helps you to justify your work's value, originality and significance.
To establish your credibility as a scholar, your literature review will typically need to do at least some (if not all) of the following effectively.
- Demonstrate that your research is rigorous and up-to-date by enagaging with seminal and current work
- Summarise relevant bodies of work and evaluate their strengths and weaknesses to demonstrate your critical understanding of the literature.
- Point out gaps in the literature or identify problems / issues remaining to be solved.
- Justify the choice of topic/area of research, to establish the value of the research and the nature of the contribution you expect to make to the research field.
- Highlight key issues essential to your own research.
- Synthesise the main themes and arguments of a particular body of literature.
- Develop an argument in the process of reviewing the literature
- Produce a brief historical survey or other context information in order to situate your research.
The literature review helps you to establish the nature of your contribution to knoweldge. The type of contribution differs from project to project. The list below gives a variety of ways in which different projects can contribute to different fields. Does your project fit into any of these categories?
- Filling a significant gap in the research (could be almost anything).
- Challenging prevailing methodologies, theories or test procedures.
- Continuing an ongoing line of enquiry (common in the experimental sciences).
- Developing new experimental procedures or perhaps a model.
- Developing new products, software or technology (perhaps for industry).
- Using established techniques or approaches in a new context (common in area studies).
- Providing extensive new data (common in field research).
- Producing a portfolio of creative work with an accompanying exegesis.
- Presenting studio work or performance presentations, as in some arts.
- Writing a biography (perhaps in History or English).
- Setting up a comprehensive practical study for professional development purposes.
- Doing a comprehensive analysis of issues in new, and important, policy proposals.
- Documenting a language (perhaps in Linguistics).
Whichever type of contribution you're making, your literature review should establish the need for your contribution.
Placement of traditional literature reviews>>
Placement of traditional literature reviews
Structuring a literature review
Language of the literature review
Systematic literature reviews
Grounded theory literature reviews
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- The Right Review for You - Workshop Recording (YouTube) 27min video From UHN Libraries Recorded Nov 2021
- The Screening Phase for Reviews Tutorial This tutorial presents information on the screening process for systematic reviews or other knowledge syntheses, and contains a variety of resources for successfully preparing to complete this important research stage.
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How to Choose Your Review Method
TREAD* Lightly and Consider...
- Available T ime for conducting your review
- Any R esource constraints within which you must deliver your review
- Any requirements for specialist E xpertise in order to complete the review
- The requirements of the A udience for your review and its intended purpose
- The richness, thickness and availability of D ata within included studies
* Booth A, Sutton A, Papaioannou D. Systematic approaches to a successful literature review. 2nd edition. Los Angeles, CA: Sage, 2016. (p.36)
How do I write a Review Protocol?
- What is a Protocol? (UofT)
- Guidance on Registering a Review with PROSPERO
- Advice on Academic Writing (University of Toronto)
- How to write a great research paper using reporting guidelines (EQUATOR Network)
- Instructions to Authors in the Health Sciences
- Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals (ICMJE)
- Referencing and Writing Help (Michener Institute)
- Writing resources guide (BMC)
What is a Literature Review?
A literature review provides an overview of what's been written about a specific topic. It is a generic term. There are many different types of literature reviews which can cover a wide range of subjects at various levels of completeness and comprehensiveness. Choosing the type of review you wish to conduct will depend on the purpose of your review, and the time and resources you have available.
This page will provide definitions of some of the most common review types in the health sciences and links to relevant reporting guidelines or methodological papers.
Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies . Health Information & Libraries Journal . 2009 Jun 1;26(2):91-108.
- Summary of Five Types of Reviews Table summarizing the characteristics, guidelines etc. of 5 common types of review article.
Traditional (Narrative) Review
Traditional (narrative) literature reviews provide a broad overview of a research topic with no clear methodological approach. Information is collected and interpreted unsystematically with subjective summaries of findings. Authors aim to describe and discuss the literature from a contextual or theoretical point of view. Although the reviews may be conducted by topic experts, due to preconceived ideas or conclusions, they could be subject to bias. This sort of literature review can be appropriate if you have a broad topic area, are working on your own, or have time constraints.
Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade . Journal of Chiropractic Medicine . 2006;5(3):101-117. doi:10.1016/S0899-3467(07)60142-6.
Ferrari R. Writing narrative style literature reviews . Medical Writing. 2015 Dec 1;24(4):230-5.
Greenhalgh T, Thorne S, Malterud K. Time to challenge the spurious hierarchy of systematic over narrative reviews ? European journal of clinical investigation . 2018;48:e12931.
Literature reviews using systematic methods fall under the knowledge synthesis umbrella. Knowledge synthesis can be defined as “…the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods. It could take the form of a systematic review, follow the methods developed by the Cochrane Collaboration, result from a consensus conference or expert panel or synthesize qualitative or quantitative results. Realist syntheses, narrative syntheses, meta-analyses, meta-syntheses and practice guidelines are all forms of synthesis.” (Canadian Institutes of Health Research. (2016, July 28). Knowledge Translation. Retrieved April 26, 2018, from http://www.cihr-irsc.gc.ca/e/29418.htm l. )
Grimshaw J. A Guide to Knowledge Synthesis [Internet]. CIHR. Canadian Institutes of Health Research; 2010.
Canadian Institutes of Health Research. Synthesis Resources [Internet]. CIHR. Canadian Institutes of Health Research; 2013.
Booth A, Noyes J, Flemming K, Gerhardus A, Wahlster P, van der Wilt, Gert Jan, et al. Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches . Journal of clinical epidemiology. 2018;99:41-52.
Kastner M, Tricco AC, Soobiah C, et al. What is the most appropriate knowledge synthesis method to conduct a review? Protocol for a scoping review . BMC Medical Research Methodology . 2012;12:114. doi:10.1186/1471-2288-12-114.
Kastner M, Antony J, Soobiah C, Straus SE, Tricco AC. Conceptual recommendations for selecting the most appropriate knowledge synthesis method to answer research questions related to complex evidence . Journal of Clinical Epidemiology . 2016;73:43-49.
Knowledge Synthesis Services at UHN
Common Types of Knowledge Syntheses
- Systematic Reviews
- Scoping Reviews
- Rapid or Restricted Reviews
- Clinical Practice Guidelines
- Realist Reviews
- Mixed Methods Reviews
- Qualitative Synthesis
- Narrative Synthesis
A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making. (See Section 1.2 in the Cochrane Handbook for Systematic Reviews of Interventions .)
A systematic review is not the same as a traditional (narrative) review or a literature review. Unlike other kinds of reviews, systematic reviews must be as thorough and unbiased as possible, and must also make explicit how the search was conducted. Systematic reviews may or may not include a meta-analysis.
On average, a systematic review project takes a year. If your timelines are shorter, you may wish to consider other types of synthesis projects or a traditional (narrative) review. See suggested timelines for a Cochrane Review for reference.
Systematic Review Overview (UHN)
Systematic Review Overview workshop recording (UHN)
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
Greyson D, Rafferty E, Slater L, et al. Systematic review searches must be systematic, comprehensive, and transparent: a critique of Perman et al. BMC public health . 2019;19:153.
Ioannidis J. P. (2016). The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta-analyses . The Milbank quarterly , 94 (3), 485-514.
Yale University Library. Systematic Reviews and Evidence Synthesis: Review Types .
A subset of systematic reviews. Meta-analysis is a technique that statistically combines the results of quantitative studies to provide a more precise effect of the results.
"..a form of knowledge synthesis that addresses an exploratory research question aimed at mapping key concepts, types of evidence, and gaps in research related to a defined area or field by systematically searching, selecting and synthesizing existing knowledge." (Colquhoun, HL et al., 2014)
Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework . International Journal of Social Research Methodology: Theory and Practice , 8 (1), 19-32. doi:10.1080/1364557032000119616.
Levac, D., Colquhoun, H. & O'Brien, K.K. Scoping studies: advancing the methodology . Implementation Sci 5 , 69 (2010). https://doi.org/10.1186/1748-5908-5-69
Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., . . . Moher, D. (2014). Scoping reviews: Time for clarity in definition, methods, and reporting . Journal of Clinical Epidemiology , 67(12), 1291-1294. doi:10.1016/j.jclinepi.2014.03.013.
Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews . Int.J.Evid Based.Healthc . 2015 Sep;13(3):141-146.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis , JBI, 2020.
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation . Ann Intern Med . [Epub ahead of print ] doi: 10.7326/M18-0850.
“…a type of knowledge synthesis in which systematic review processes are accelerated and methods are streamlined to complete the review more quickly than is the case for typical systematic reviews. Rapid reviews take an average of 5–12 weeks to complete, thus providing evidence within a shorter time frame required for some health policy and systems decisions.” (Tricco AC et al., 2017)
Ganann R, Ciliska D, Thomas H. Expediting systematic reviews: methods and implications of rapid reviews . Implementation Science : IS . 2010;5:56. doi:10.1186/1748-5908-5-56.
Langlois EV, Straus SE, Antony J, King VJ, Tricco AC. Using rapid reviews to strengthen health policy and systems and progress towards universal health coverage . BMJ Global Health . 2019;4:e001178.
Tricco AC, Langlois EV, Straus SE, editors. Rapid reviews to strengthen health policy and systems: a practical guide . Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Watt A, Cameron A, Sturm L, Lathlean T , Babidge W, Blamey S, et al. Rapid reviews versus full systematic reviews: An inventory of current methods and practice in health technology assessment . International Journal of Technology Assessment in Health Care . 2008;24(2):133-9.
“Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.” Source: Institute of Medicine. (1990). Clinical Practice Guidelines: Directions for a New Program, M.J. Field and K.N. Lohr (eds.) Washington, DC: National Academy Press. Page 38.
–Disclosure of any author conflicts of interest
AGREE Reporting Checklist
Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., ... & Guyatt, G. H. (2016). GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines . BMJ , 353 , i2089.
Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review - a new method of systematic review designed for complex policy interventions . Journal of Health Services Research & Policy . 2005;10:21-34.
Rycroft-Malone J, McCormack B, Hutchinson AM, et al. Realist synthesis: illustrating the method for implementation research . Implementation science : IS . 2012;7:33.
Wong G, Greenhalgh T, Westhorp G, Pawson R. Realist methods in medical education research: what are they and what can they contribute? Medical Education . 2012;46(1):89-96.
"Mixed-methods systematic reviews can be defined as combining the findings of qualitative and quantitative studies within a single systematic review to address the same overlapping or complementary review questions." (Harden A, 2010)
Harden A. Mixed-Methods Systematic Reviews: Integrating quantitative and qualitative findings . NCDDR:FOCUS. 2010.
Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews . Annual review of public health . 2014;35:29-45.
Pearson A, White H, Bath-Hextall F, Salmond S, Apostolo J, Kirkpatrick P. A mixed-methods approach to systematic reviews . International journal of evidence-based healthcare . 2015;13:121-131.
The Joanna Briggs Institute 2014 Reviewers Manual: Methodology for JBI Mixed Methods Systematic Reviews .
There are various methods for integrating the results from qualitative studies. "Systematic reviews of qualitative research have an important role in informing the delivery of evidence-based healthcare. Qualitative systematic reviews have investigated the culture of communities, exploring how consumers experience, perceive and manage their health and journey through the health system, and can evaluate components and activities of health services such as health promotion and community development." (Lockwood C et al., 2015)
Booth A, Noyes J, Flemming K, Gerhardus A, Wahlster P, van der Wilt, Gert Jan, et al. Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches . Journal of clinical epidemiology. 2018;99:41-52.
Ring N, Jepson R, Ritchie K. Methods of synthesizing qualitative research studies for health technology assessment . International Journal of Technology Assessment in Health Care . 2011;27:384-390.
Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation . International journal of evidence-based healthcare . 2015;13:179-187.
France EF, Cunningham M, Ring N, et al. Improving reporting of meta-ethnography: The eMERGe reporting guidance . Journal of advanced nursing . 2019.
Seers K. Qualitative systematic reviews: their importance for our understanding of research relevant to pain . Br J Pain . 2015;9(1):36-40.
Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review . BMC Med Res Methodol . 2009;9:59. Published 2009 Aug 11. doi:10.1186/1471-2288-9-59.
Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews . BMC Med Res Methodol . 2008;8:45. Published 2008 Jul 10. doi:10.1186/1471-2288-8-45
Lewin S, Booth A, Glenton C, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series . Implementation science : IS . 2018;13:2.
"Narrative synthesis refers to an approach to the systematic review and synthesis of findings from multiple studies that relies primarily on the use of words and text to summarise and explain the findings of the synthesis. Whilst narrative synthesis can involve the manipulation of statistical data, the defining characteristic is that it adopts a textual approach to the process of synthesis to ‘tell the story’ of the findings from the included studies." (Popay J, 2006)
Tricco AC, Soobiah C, Antony J, et al. A scoping review identifies multiple emerging knowledge synthesis methods, but few studies operationalize the method . Journal of Clinical Epidemiology . 2016;73:19-28.
Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews . Lancaster: ESRC Research Methods Programme; 2006.
Snilstveit B, Oliver S, Vojtkova M. Narrative approaches to systematic review and synthesis of evidence for international development policy and practice . Journal of development effectiveness . 2012 Sep 1;4(3):409-29.
Lucas PJ, Baird J, Arai L, Law C, Roberts HM. Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews . BMC medical research methodology . 2007 Dec;7(1):4.
Ryan R. Cochrane Consumer sand Communication Review Group. Cochrane Consumers and Communication Review Group: data synthesis and analysis . June 2013.
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Traditional reviews vs. systematic reviews
Posted on 3rd February 2016 by Weyinmi Demeyin
Millions of articles are published yearly (1) , making it difficult for clinicians to keep abreast of the literature. Reviews of literature are necessary in order to provide clinicians with accurate, up to date information to ensure appropriate management of their patients. Reviews usually involve summaries and synthesis of primary research findings on a particular topic of interest and can be grouped into 2 main categories; the ‘traditional’ review and the ‘systematic’ review with major differences between them.
Traditional reviews provide a broad overview of a research topic with no clear methodological approach (2) . Information is collected and interpreted unsystematically with subjective summaries of findings. Authors aim to describe and discuss the literature from a contextual or theoretical point of view. Although the reviews may be conducted by topic experts, due to preconceived ideas or conclusions, they could be subject to bias.
Systematic reviews are overviews of the literature undertaken by identifying, critically appraising and synthesising results of primary research studies using an explicit, methodological approach(3). They aim to summarise the best available evidence on a particular research topic.
The main differences between traditional reviews and systematic reviews are summarised below in terms of the following characteristics: Authors, Study protocol, Research question, Search strategy, Sources of literature, Selection criteria, Critical appraisal, Synthesis, Conclusions, Reproducibility, and Update.
- Authors: One or more authors usually experts in the topic of interest
- Study protocol: No study protocol
- Research question: Broad to specific question, hypothesis not stated
- Search strategy: No detailed search strategy, search is probably conducted using keywords
- Sources of literature: Not usually stated and non-exhaustive, usually well-known articles. Prone to publication bias
- Selection criteria: No specific selection criteria, usually subjective. Prone to selection bias
- Critical appraisal: Variable evaluation of study quality or method
- Synthesis: Often qualitative synthesis of evidence
- Conclusions: Sometimes evidence based but can be influenced by author’s personal belief
- Reproducibility: Findings cannot be reproduced independently as conclusions may be subjective
- Update: Cannot be continuously updated
- Authors: Two or more authors are involved in good quality systematic reviews, may comprise experts in the different stages of the review
- Study protocol: Written study protocol which includes details of the methods to be used
- Research question: Specific question which may have all or some of PICO components (Population, Intervention, Comparator, and Outcome). Hypothesis is stated
- Search strategy: Detailed and comprehensive search strategy is developed
- Sources of literature: List of databases, websites and other sources of included studies are listed. Both published and unpublished literature are considered
- Selection criteria: Specific inclusion and exclusion criteria
- Critical appraisal: Rigorous appraisal of study quality
- Synthesis: Narrative, quantitative or qualitative synthesis
- Conclusions: Conclusions drawn are evidence based
- Reproducibility: Accurate documentation of method means results can be reproduced
- Update: Systematic reviews can be periodically updated to include new evidence
Decisions and health policies about patient care should be evidence based in order to provide the best treatment for patients. Systematic reviews provide a means of systematically identifying and synthesising the evidence, making it easier for policy makers and practitioners to assess such relevant information and hopefully improve patient outcomes.
- Fletcher RH, Fletcher SW. Evidence-Based Approach to the Medical Literature. Journal of General Internal Medicine. 1997; 12(Suppl 2):S5-S14. doi:10.1046/j.1525-1497.12.s2.1.x. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497222/
- Rother ET. Systematic literature review X narrative review. Acta paul. enferm. [Internet]. 2007 June [cited 2015 Dec 25]; 20(2): v-vi. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002007000200001&lng=en. http://dx.doi.org/10.1590/S0103-21002007000200001
- Khan KS, Ter Riet G, Glanville J, Sowden AJ, Kleijnen J. Undertaking systematic reviews of research on effectiveness: CRD’s guidance for carrying out or commissioning reviews. NHS Centre for Reviews and Dissemination; 2001.
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No Comments on Traditional reviews vs. systematic reviews
La revisión sistemática vale si hay solo un autor?
HI Alex, so sorry for the delay in replying to you. Yes, that is a very good point. I have copied a paragraph from the Cochrane Handbook, here, which does say that for a Cochrane Review, you should have more than one author.
“Cochrane Reviews should be undertaken by more than one person. In putting together a team, authors should consider the need for clinical and methodological expertise for the review, as well as the perspectives of stakeholders. Cochrane author teams are encouraged to seek and incorporate the views of users, including consumers, clinicians and those from varying regions and settings to develop protocols and reviews. Author teams for reviews relevant to particular settings (e.g. neglected tropical diseases) should involve contributors experienced in those settings”.
Thank you for the discussion point, much appreciated.
Hello, I’d like to ask you a question: what’s the difference between systematic review and systematized review? In addition, if the screening process of the review was made by only one author, is still a systematic or is a systematized review? Thanks
Hi. This article from Grant & Booth is a really good one to look at explaining different types of reviews: https://onlinelibrary.wiley.com/doi/10.1111/j.1471-1842.2009.00848.x It includes Systematic Reviews and Systematized Reviews. In answer to your second question, have a look at this Chapter from the Cochrane handbook. It covers the question about ‘Who should do a systematic review’. https://training.cochrane.org/handbook/current/chapter-01
A really relevant part of this chapter is this: “Systematic reviews should be undertaken by a team. Indeed, Cochrane will not publish a review that is proposed to be undertaken by a single person. Working as a team not only spreads the effort, but ensures that tasks such as the selection of studies for eligibility, data extraction and rating the certainty of the evidence will be performed by at least two people independently, minimizing the likelihood of errors.”
I hope this helps with the question. Best wishes. Emma.
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- Types of Literature Reviews
- Getting Started
Narrative or Traditional Literature Review
A Narrative or Traditional Literature Review is conducted as preliminary part of a research study. The purpose is to critique and to summarize the current literature that exists on the research topic. The literature review helps to understand the topic and can identify inconsistencies and gaps in the literature, helping to justify why the research question is worth studying.
To conduct a narrative or traditional literature review a researcher should "systematically search, critique and combine the literature to demonstrate a gap in the existing research base" while demonstrating "their understanding of both the research and the methods previously used to investigate the area" (Aveyard, 2010).
The purpose of a literature review may slightly differ depending on what kind of research is being conducted.
Purpose in Quantitative:
- helps to "direct the planning and execution of a study" (Grove, 2015, p.163)
- provides background and reasons why the question is worth studying
- conducted before the study AND sometimes again after the study in order to capture any literature published while study was being conducted. Additional sources may also help researchers interpret the research findings (Grove, 2015, p.163).
Purpose in Qualitative :
- provides background and reasons why the questions is worth studying
- may not be extensive, attempt to manage expectations and bias in data collection, analysis and interpretation of findings
- no additional review, post study (Why? There may not be a lot of literature on topics being studied as qualitative often looks at topics that little is is known) (Grove, 2015, p.164).
- length and depth of the review will also depend on the qualitative methodology being studied
Knowledge Syntheses are reviews that are research projects themselves. The literature search is done systematically, and seeks to "evaluate and interpret all available research evidence relevant to a particular question" (Glasziou, 2001).
Knowledge synthesis can be defined as “…the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods... Realist syntheses, narrative syntheses, meta-analyses, meta-syntheses and practice guidelines are all forms of synthesis.” (Canadian Institutes of Health Research. (2016, July 28). Knowledge Translation. Retrieved September 15, 2019 from http://www.cihr-irsc.gc.ca/e/29418.htm l. )
Types of Knowledge Syntheses
- research study design that draws conclusions by analyzing all the single studies conducted on a topic
- comprehensive - looks for all the published and unpublished studies related to the research question
- uses a rigorous and well-defined method for searching, evaluating and synthesizing studies
Example: systematic review
- similar to a systematic review but statistically combines the results of quantitative studies to provide a more precise effect of the results
- comprehensive - looks for all the published and unpublished studies related to the research question
- uses a rigorous and well-defined method for searching, evaluating and synthesizing studies
- "... addresses an exploratory research question aimed at mapping key concepts, types of evidence, and gaps in research related to a defined area or field by systematically searching, selecting and synthesizing existing knowledge." (Colquhoun, HL et al., 2014)
- often happens before another type of study such as a primary research study or a systematic review is conducted; informs further research
Example: scoping review
- "The integrative review method is an approach that allows for the inclusion of diverse methodologies (i.e. experimental and non-experimental research)" (Whittemore et al., 2005).
- "integrative reviews present the state of the science, contribute to theory development, and have direct applicability to practice and policy" (Whittemore et al, 2005).
Example: integrative review
Aveyard, H. (2010). Doing a literature review in health and social care: A practical guide (2nd ed.). Berkshire, Great Britain: Open University Press.
Canadian Institutes of Health Research. (2016, July 28). Knowledge Translation. Retrieved September 15, 2019 from http://www.cihr- irsc.gc.ca/e/29418.html.
Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., . . . Moher, D. (2014). Scoping reviews: Time for clarity in definition, methods, and reporting . Journal of Clinical Epidemiology, 67(12), 1291-1294. doi:10.1016/j.jclinepi.2014.03.013.
Glasziou, P. (2001). Systematic reviews in health care: A practical guide. New York, NY: Cambridge University Press.
Grove, S., Gray, J. & Burns, N. (2015). Understanding Nursing Research: Building an Evidence-Based Practice. St. Louis, Missouri: Elsevier Saunders.
Whittemore R. & Knaf K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing, 52(5). http://dx.doi.org/10.1111/j.1365-2648.2005.03621.x
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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].
Chapter 9 methods for literature reviews.
Guy Paré and Spyros Kitsiou .
Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).
Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).
The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).
When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.
The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.
9.2. Overview of the Literature Review Process and Steps
As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:
- formulating the research question(s) and objective(s),
- searching the extant literature,
- screening for inclusion,
- assessing the quality of primary studies,
- extracting data, and
- analyzing data.
Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).
Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).
9.3. Types of Review Articles and Brief Illustrations
EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.
9.3.1. Narrative Reviews
The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).
Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).
Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.
Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.
9.3.2. Descriptive or Mapping Reviews
The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).
In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.
An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).
9.3.3. Scoping Reviews
Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.
Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).
One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).
9.3.4. Forms of Aggregative Reviews
Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.
Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:
- Formulating a review question and developing a search strategy based on explicit inclusion criteria for the identification of eligible studies (usually described in the context of a detailed review protocol).
- Searching for eligible studies using multiple databases and information sources, including grey literature sources, without any language restrictions.
- Selecting studies, extracting data, and assessing risk of bias in a duplicate manner using two independent reviewers to avoid random or systematic errors in the process.
- Analyzing data using quantitative or qualitative methods.
- Presenting results in summary of findings tables.
- Interpreting results and drawing conclusions.
Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.
The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed independently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.
Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.
A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guidelines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.
In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).
9.3.5. Realist Reviews
Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).
To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).
The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.
9.3.6. Critical Reviews
Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).
Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.
Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.
Typology of Literature Reviews (adapted from Paré et al., 2015).
As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.
9.5. Concluding Remarks
In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.
We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.
To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.
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The Palgrave Handbook of Applied Linguistics Research Methodology pp 123–144 Cite as
Traditional Literature Review and Research Synthesis
- Shaofeng Li 5 , 6 &
- Hong Wang 7
The exponential growth of research and enormity of the body of knowledge that has been accumulated in applied linguistics make the need for quality and reliable synthesis of the available research more pressing than ever. Traditional reviews seek to critique existing research, provide an overview of the research, and/or contextualize a new study. Research syntheses aim at reaching conclusions by means of aggregating the totality of the empirical research that has been carried out on a certain topic. This chapter discusses the procedures and best practices of each of the two approaches and concludes by making a comparison between the two approaches and proposing ways to integrate them.
- Literature review
- Research synthesis
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Authors and affiliations.
Foreign and Second Language Education Program, School of Teacher Education, Florida State University, Tallahassee, Florida, USA
Center for Linguistics and Applied Linguistics, Guangdong University of Foreign Studies, Guangzhou, China
University of Auckland Library and Learning Services, The University of Auckland, Auckland, New Zealand
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Correspondence to Shaofeng Li .
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Sydney School of Education and Social Work, University of Sydney, Sydney, NSW, Australia
Department of Linguistics, Germanic, Slavic, Asian and African Languages, Michigan State University, East Lansing, MI, USA
Peter De Costa
Applied Linguistics, Northern Arizona University, Flagstaff, AZ, USA
School of Education, UNSW Sydney, Sydney, NSW, Australia
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Li, S., Wang, H. (2018). Traditional Literature Review and Research Synthesis. In: Phakiti, A., De Costa, P., Plonsky, L., Starfield, S. (eds) The Palgrave Handbook of Applied Linguistics Research Methodology. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-59900-1_6
DOI : https://doi.org/10.1057/978-1-137-59900-1_6
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Online ISBN : 978-1-137-59900-1
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