the objective of literature review

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The objective of a literature review

Questions to Consider

B. In some fields or contexts, a literature review is referred to as the introduction or the background; why is this true, and does it matter?

The elements of a literature review • The first step in scholarly research is determining the “state of the art” on a topic. This is accomplished by gathering academic research and making sense of it. • The academic literature can be found in scholarly books and journals; the goal is to discover recurring themes, find the latest data, and identify any missing pieces. • The resulting literature review organizes the research in such a way that tells a story about the topic or issue.

The literature review tells a story in which one well-paraphrased summary from a relevant source contributes to and connects with the next in a logical manner, developing and fulfilling the message of the author. It includes analysis of the arguments from the literature, as well as revealing consistent and inconsistent findings. How do varying author insights differ from or conform to previous arguments?

Language in Action

A. How are the terms “critique” and “review” used in everyday life? How are they used in an academic context?

In terms of content, a literature review is intended to:

• Set up a theoretical framework for further research • Show a clear understanding of the key concepts/studies/models related to the topic • Demonstrate knowledge about the history of the research area and any related controversies • Clarify significant definitions and terminology • Develop a space in the existing work for new research

The literature consists of the published works that document a scholarly conversation or progression on a problem or topic in a field of study. Among these are documents that explain the background and show the loose ends in the established research on which a proposed project is based. Although a literature review focuses on primary, peer -reviewed resources, it may begin with background subject information generally found in secondary and tertiary sources such as books and encyclopedias. Following that essential overview, the seminal literature of the field is explored. As a result, while a literature review may consist of research articles tightly focused on a topic with secondary and tertiary sources used more sparingly, all three types of information (primary, secondary, tertiary) are critical.

The literature review, often referred to as the Background or Introduction to a research paper that presents methods, materials, results and discussion, exists in every field and serves many functions in research writing.

Adapted from Frederiksen, L., & Phelps, S. F. (2017). Literature Reviews for Education and Nursing Graduate Students. Open Textbook Library

Review and Reinforce

Two common approaches are simply outlined here. Which seems more common? Which more productive? Why? A. Forward exploration 1. Sources on a topic or problem are gathered. 2. Salient themes are discovered. 3. Research gaps are considered for future research. B. Backward exploration 1. Sources pertaining to an existing research project are gathered. 2. The justification of the research project’s methods or materials are explained and supported based on previously documented research.

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• Writing Tips

What is the Purpose of a Literature Review?

4-minute read

• 23rd October 2023

If you’re writing a research paper or dissertation , then you’ll most likely need to include a comprehensive literature review . In this post, we’ll review the purpose of literature reviews, why they are so significant, and the specific elements to include in one. Literature reviews can:

1. Provide a foundation for current research.

2. Define key concepts and theories.

3. Demonstrate critical evaluation.

4. Show how research and methodologies have evolved.

5. Identify gaps in existing research.

6. Support your argument.

Keep reading to enter the exciting world of literature reviews!

What is a Literature Review?

A literature review is a critical summary and evaluation of the existing research (e.g., academic journal articles and books) on a specific topic. It is typically included as a separate section or chapter of a research paper or dissertation, serving as a contextual framework for a study. Literature reviews can vary in length depending on the subject and nature of the study, with most being about equal length to other sections or chapters included in the paper. Essentially, the literature review highlights previous studies in the context of your research and summarizes your insights in a structured, organized format. Next, let’s look at the overall purpose of a literature review.

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Literature reviews are considered an integral part of research across most academic subjects and fields. The primary purpose of a literature review in your study is to:

Provide a Foundation for Current Research

Since the literature review provides a comprehensive evaluation of the existing research, it serves as a solid foundation for your current study. It’s a way to contextualize your work and show how your research fits into the broader landscape of your specific area of study.  

Define Key Concepts and Theories

The literature review highlights the central theories and concepts that have arisen from previous research on your chosen topic. It gives your readers a more thorough understanding of the background of your study and why your research is particularly significant .

Demonstrate Critical Evaluation 

A comprehensive literature review shows your ability to critically analyze and evaluate a broad range of source material. And since you’re considering and acknowledging the contribution of key scholars alongside your own, it establishes your own credibility and knowledge.

Show How Research and Methodologies Have Evolved

Another purpose of literature reviews is to provide a historical perspective and demonstrate how research and methodologies have changed over time, especially as data collection methods and technology have advanced. And studying past methodologies allows you, as the researcher, to understand what did and did not work and apply that knowledge to your own research.  

Identify Gaps in Existing Research

Besides discussing current research and methodologies, the literature review should also address areas that are lacking in the existing literature. This helps further demonstrate the relevance of your own research by explaining why your study is necessary to fill the gaps.

Support Your Argument

A good literature review should provide evidence that supports your research questions and hypothesis. For example, your study may show that your research supports existing theories or builds on them in some way. Referencing previous related studies shows your work is grounded in established research and will ultimately be a contribution to the field.  

Literature Review Editing Services 

Ensure your literature review is polished and ready for submission by having it professionally proofread and edited by our expert team. Our literature review editing services will help your research stand out and make an impact. Not convinced yet? Send in your free sample today and see for yourself! 

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What is a literature review? [with examples]

What is a literature review?

The purpose of a literature review, how to write a literature review, the format of a literature review, general formatting rules, the length of a literature review, literature review examples, frequently asked questions about literature reviews, related articles.

A literature review is an assessment of the sources in a chosen topic of research.

In a literature review, you’re expected to report on the existing scholarly conversation, without adding new contributions.

If you are currently writing one, you've come to the right place. In the following paragraphs, we will explain:

• the objective of a literature review
• how to write a literature review
• the basic format of a literature review

Tip: It’s not always mandatory to add a literature review in a paper. Theses and dissertations often include them, whereas research papers may not. Make sure to consult with your instructor for exact requirements.

The four main objectives of a literature review are:

• Studying the references of your research area
• Summarizing the main arguments
• Identifying current gaps, stances, and issues
• Presenting all of the above in a text

Ultimately, the main goal of a literature review is to provide the researcher with sufficient knowledge about the topic in question so that they can eventually make an intervention.

The format of a literature review is fairly standard. It includes an:

• introduction that briefly introduces the main topic
• body that includes the main discussion of the key arguments
• conclusion that highlights the gaps and issues of the literature

➡️ Take a look at our guide on how to write a literature review to learn more about how to structure a literature review.

First of all, a literature review should have its own labeled section. You should indicate clearly in the table of contents where the literature can be found, and you should label this section as “Literature Review.”

➡️ For more information on writing a thesis, visit our guide on how to structure a thesis .

There is no set amount of words for a literature review, so the length depends on the research. If you are working with a large amount of sources, it will be long. If your paper does not depend entirely on references, it will be short.

Take a look at these three theses featuring great literature reviews:

• School-Based Speech-Language Pathologist's Perceptions of Sensory Food Aversions in Children [ PDF , see page 20]
• Who's Writing What We Read: Authorship in Criminological Research [ PDF , see page 4]
• A Phenomenological Study of the Lived Experience of Online Instructors of Theological Reflection at Christian Institutions Accredited by the Association of Theological Schools [ PDF , see page 56]

Literature reviews are most commonly found in theses and dissertations. However, you find them in research papers as well.

There is no set amount of words for a literature review, so the length depends on the research. If you are working with a large amount of sources, then it will be long. If your paper does not depend entirely on references, then it will be short.

No. A literature review should have its own independent section. You should indicate clearly in the table of contents where the literature review can be found, and label this section as “Literature Review.”

The main goal of a literature review is to provide the researcher with sufficient knowledge about the topic in question so that they can eventually make an intervention.

• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
• Last Updated: Sep 21, 2022 2:16 PM
• URL: https://guides.lib.uconn.edu/literaturereview

Frequently asked questions

What is the purpose of a literature review.

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

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

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

Frequently asked questions: Academic writing

A rhetorical tautology is the repetition of an idea of concept using different words.

Rhetorical tautologies occur when additional words are used to convey a meaning that has already been expressed or implied. For example, the phrase “armed gunman” is a tautology because a “gunman” is by definition “armed.”

A logical tautology is a statement that is always true because it includes all logical possibilities.

Logical tautologies often take the form of “either/or” statements (e.g., “It will rain, or it will not rain”) or employ circular reasoning (e.g., “she is untrustworthy because she can’t be trusted”).

You may have seen both “appendices” or “appendixes” as pluralizations of “ appendix .” Either spelling can be used, but “appendices” is more common (including in APA Style ). Consistency is key here: make sure you use the same spelling throughout your paper.

The purpose of a lab report is to demonstrate your understanding of the scientific method with a hands-on lab experiment. Course instructors will often provide you with an experimental design and procedure. Your task is to write up how you actually performed the experiment and evaluate the outcome.

In contrast, a research paper requires you to independently develop an original argument. It involves more in-depth research and interpretation of sources and data.

A lab report is usually shorter than a research paper.

The sections of a lab report can vary between scientific fields and course requirements, but it usually contains the following:

• Title: expresses the topic of your study
• Abstract: summarizes your research aims, methods, results, and conclusions
• Introduction: establishes the context needed to understand the topic
• Method: describes the materials and procedures used in the experiment
• Results: reports all descriptive and inferential statistical analyses
• Discussion: interprets and evaluates results and identifies limitations
• Conclusion: sums up the main findings of your experiment
• References: list of all sources cited using a specific style (e.g. APA)
• Appendices: contains lengthy materials, procedures, tables or figures

A lab report conveys the aim, methods, results, and conclusions of a scientific experiment . Lab reports are commonly assigned in science, technology, engineering, and mathematics (STEM) fields.

The abstract is the very last thing you write. You should only write it after your research is complete, so that you can accurately summarize the entirety of your thesis , dissertation or research paper .

If you’ve gone over the word limit set for your assignment, shorten your sentences and cut repetition and redundancy during the editing process. If you use a lot of long quotes , consider shortening them to just the essentials.

If you need to remove a lot of words, you may have to cut certain passages. Remember that everything in the text should be there to support your argument; look for any information that’s not essential to your point and remove it.

To make this process easier and faster, you can use a paraphrasing tool . With this tool, you can rewrite your text to make it simpler and shorter. If that’s not enough, you can copy-paste your paraphrased text into the summarizer . This tool will distill your text to its core message.

Revising, proofreading, and editing are different stages of the writing process .

• Revising is making structural and logical changes to your text—reformulating arguments and reordering information.
• Editing refers to making more local changes to things like sentence structure and phrasing to make sure your meaning is conveyed clearly and concisely.
• Proofreading involves looking at the text closely, line by line, to spot any typos and issues with consistency and correct them.

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

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

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

Avoid citing sources in your abstract . There are two reasons for this:

• The abstract should focus on your original research, not on the work of others.
• The abstract should be self-contained and fully understandable without reference to other sources.

There are some circumstances where you might need to mention other sources in an abstract: for example, if your research responds directly to another study or focuses on the work of a single theorist. In general, though, don’t include citations unless absolutely necessary.

An abstract is a concise summary of an academic text (such as a journal article or dissertation ). It serves two main purposes:

• To help potential readers determine the relevance of your paper for their own research.
• To communicate your key findings to those who don’t have time to read the whole paper.

Abstracts are often indexed along with keywords on academic databases, so they make your work more easily findable. Since the abstract is the first thing any reader sees, it’s important that it clearly and accurately summarizes the contents of your paper.

In a scientific paper, the methodology always comes after the introduction and before the results , discussion and conclusion . The same basic structure also applies to a thesis, dissertation , or research proposal .

Depending on the length and type of document, you might also include a literature review or theoretical framework before the methodology.

Whether you’re publishing a blog, submitting a research paper , or even just writing an important email, there are a few techniques you can use to make sure it’s error-free:

• Take a break : Set your work aside for at least a few hours so that you can look at it with fresh eyes.
• Proofread a printout : Staring at a screen for too long can cause fatigue – sit down with a pen and paper to check the final version.
• Use digital shortcuts : Take note of any recurring mistakes (for example, misspelling a particular word, switching between US and UK English , or inconsistently capitalizing a term), and use Find and Replace to fix it throughout the document.

If you want to be confident that an important text is error-free, it might be worth choosing a professional proofreading service instead.

Editing and proofreading are different steps in the process of revising a text.

Editing comes first, and can involve major changes to content, structure and language. The first stages of editing are often done by authors themselves, while a professional editor makes the final improvements to grammar and style (for example, by improving sentence structure and word choice ).

Proofreading is the final stage of checking a text before it is published or shared. It focuses on correcting minor errors and inconsistencies (for example, in punctuation and capitalization ). Proofreaders often also check for formatting issues, especially in print publishing.

The cost of proofreading depends on the type and length of text, the turnaround time, and the level of services required. Most proofreading companies charge per word or page, while freelancers sometimes charge an hourly rate.

For proofreading alone, which involves only basic corrections of typos and formatting mistakes, you might pay as little as $0.01 per word, but in many cases, your text will also require some level of editing , which costs slightly more.

It’s often possible to purchase combined proofreading and editing services and calculate the price in advance based on your requirements.

There are many different routes to becoming a professional proofreader or editor. The necessary qualifications depend on the field – to be an academic or scientific proofreader, for example, you will need at least a university degree in a relevant subject.

For most proofreading jobs, experience and demonstrated skills are more important than specific qualifications. Often your skills will be tested as part of the application process.

To learn practical proofreading skills, you can choose to take a course with a professional organization such as the Society for Editors and Proofreaders . Alternatively, you can apply to companies that offer specialized on-the-job training programmes, such as the Scribbr Academy .

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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

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

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

Download Word doc Download Google doc

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

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

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

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

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

Search for relevant sources

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

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

You can use boolean operators to help narrow down your search:

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

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

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

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

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

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

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

You can use our free APA Reference Generator for quick, correct, consistent citations.

Prevent plagiarism, run a free check.

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

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

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

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

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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

As you write, make sure to follow these tips:

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

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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

It is often written as part of a dissertation , thesis, research paper , or proposal .

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

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

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

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

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Literature review.

• What is a Literature Review?
• What is Its Purpose?
• 1. Select a Topic
• 2. Set the Topic in Context
• 3. Types of Information Sources
• 4. Use Information Sources
• 5. Get the Information
• 6. Organize / Manage the Information
• 7. Position the Literature Review
• 8. Write the Literature Review

A literature review is a comprehensive summary of previous research on a topic. The literature review surveys scholarly articles, books, and other sources relevant to a particular area of research.  The review should enumerate, describe, summarize, objectively evaluate and clarify this previous research.  It should give a theoretical base for the research and help you (the author) determine the nature of your research.  The literature review acknowledges the work of previous researchers, and in so doing, assures the reader that your work has been well conceived.  It is assumed that by mentioning a previous work in the field of study, that the author has read, evaluated, and assimiliated that work into the work at hand.

A literature review creates a "landscape" for the reader, giving her or him a full understanding of the developments in the field.  This landscape informs the reader that the author has indeed assimilated all (or the vast majority of) previous, significant works in the field into her or his research. 

 "In writing the literature review, the purpose is to convey to the reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. The literature review must be defined by a guiding concept (eg. your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries.( http://www.writing.utoronto.ca/advice/specific-types-of-writing/literature-review )

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Conducting a literature review: why do a literature review, why do a literature review.

• How To Find "The Literature"
• Found it -- Now What?

Besides the obvious reason for students -- because it is assigned! -- a literature review helps you explore the research that has come before you, to see how your research question has (or has not) already been addressed.

You identify:

• core research in the field
• experts in the subject area
• methodology you may want to use (or avoid)
• gaps in knowledge -- or where your research would fit in

It Also Helps You:

• Publish and share your findings
• Justify requests for grants and other funding
• Identify best practices to inform practice
• Set wider context for a program evaluation
• Compile information to support community organizing

Great brief overview, from NCSU

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• Last Updated: Apr 25, 2024 1:10 PM
• URL: https://guides.lib.berkeley.edu/litreview

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

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

Table of Contents

What is the purpose of literature review , a. habitat loss and species extinction: , b. range shifts and phenological changes: , c. ocean acidification and coral reefs: , d. adaptive strategies and conservation efforts: .

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

Frequently asked questions 

What is a literature review .

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

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

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

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

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

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

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

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

Literature review example 

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

Literature Review on Climate Change Impacts on Biodiversity:  

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

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

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

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

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

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How to write a good literature review 

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

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

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

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

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

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

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

Conducting a literature review 

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

Choose a Topic and Define the Research Question:  

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

Decide on the Scope of Your Review:  

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

Select Databases for Searches:  

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

Conduct Searches and Keep Track:  

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

Review the Literature:  

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

Organize and Write Your Literature Review:  

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

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How to write a literature review faster with Paperpal?  

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

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

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

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

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

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

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

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

References 

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

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What is a Literature Review?

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

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Literature Review - what is a Literature Review, why it is important and how it is done

What are literature reviews, goals of literature reviews, types of literature reviews, about this guide/licence.

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 What is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries. " - Quote from Taylor, D. (n.d) "The literature review: A few tips on conducting it"

Source NC State University Libraries. This video is published under a Creative Commons 3.0 BY-NC-SA US license.

What are the goals of creating a Literature Review?

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

- Baumeister, R.F. & Leary, M.R. (1997). "Writing narrative literature reviews," Review of General Psychology , 1(3), 311-320.

When do you need to write a Literature Review?

• When writing a prospectus or a thesis/dissertation
• When writing a research paper
• When writing a grant proposal

In all these cases you need to dedicate a chapter in these works to showcase what have been written about your research topic and to point out how your own research will shed a new light into these body of scholarship.

Literature reviews are also written as standalone articles as a way to survey a particular research topic in-depth. This type of literature reviews look at a topic from a historical perspective to see how the understanding of the topic have change through time.

What kinds of literature reviews are written?

• Narrative Review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.
• Book review essays/ Historiographical review essays : This is a type of review that focus on a small set of research books on a particular topic " to locate these books within current scholarship, critical methodologies, and approaches" in the field. - LARR
• Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L.K. (2013). Research in Communication Sciences and Disorders . San Diego, CA: Plural Publishing.
• Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M.C. & Ilardi, S.S. (2003). Handbook of Research Methods in Clinical Psychology . Malden, MA: Blackwell Pub.
• Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). "Qualitative meta-synthesis: A question of dialoguing with texts," Journal of Advanced Nursing , 53(3), 311-318.

Guide adapted from "Literature Review" , a guide developed by Marisol Ramos used under CC BY 4.0 /modified from original.

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Literature reviews, what is a literature review, learning more about how to do a literature review.

• Planning the Review
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A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the literature you have read. 

• Sage Research Methods Core This link opens in a new window SAGE Research Methods supports research at all levels by providing material to guide users through every step of the research process. SAGE Research Methods is the ultimate methods library with more than 1000 books, reference works, journal articles, and instructional videos by world-leading academics from across the social sciences, including the largest collection of qualitative methods books available online from any scholarly publisher. – Publisher

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Literature Review: The What, Why and How-to Guide: Literature Reviews?

• Literature Reviews?
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What is a Literature Review?

So, what is a literature review .

"A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available or a set of summaries." - Quote from Taylor, D. (n.d)."The Literature Review: A Few Tips on Conducting it".

• Citation: "The Literature Review: A Few Tips on Conducting it"

What kinds of literature reviews are written?

Each field has a particular way to do reviews for academic research literature. In the social sciences and humanities the most common are:

• Narrative Reviews: The purpose of this type of review is to describe the current state of the research on a specific research topic and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weaknesses, and gaps are identified. The review ends with a conclusion section that summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.
• Book review essays/ Historiographical review essays : A type of literature review typical in History and related fields, e.g., Latin American studies. For example, the Latin American Research Review explains that the purpose of this type of review is to “(1) to familiarize readers with the subject, approach, arguments, and conclusions found in a group of books whose common focus is a historical period; a country or region within Latin America; or a practice, development, or issue of interest to specialists and others; (2) to locate these books within current scholarship, critical methodologies, and approaches; and (3) to probe the relation of these new books to previous work on the subject, especially canonical texts. Unlike individual book reviews, the cluster reviews found in LARR seek to address the state of the field or discipline and not solely the works at issue.” - LARR

What are the Goals of Creating a Literature Review?

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 
• Baumeister, R.F. & Leary, M.R. (1997). "Writing narrative literature reviews," Review of General Psychology , 1(3), 311-320.

When do you need to write a Literature Review?

• When writing a prospectus or a thesis/dissertation
• When writing a research paper
• When writing a grant proposal

In all these cases you need to dedicate a chapter in these works to showcase what has been written about your research topic and to point out how your own research will shed new light into a body of scholarship.

Where I can find examples of Literature Reviews?

Note:  In the humanities, even if they don't use the term "literature review", they may have a dedicated  chapter that reviewed the "critical bibliography" or they incorporated that review in the introduction or first chapter of the dissertation, book, or article.

• UCSB electronic theses and dissertations In partnership with the Graduate Division, the UC Santa Barbara Library is making available theses and dissertations produced by UCSB students. Currently included in ADRL are theses and dissertations that were originally filed electronically, starting in 2011. In future phases of ADRL, all theses and dissertations created by UCSB students may be digitized and made available.

Where to Find Standalone Literature Reviews

Literature reviews are also written as standalone articles as a way to survey a particular research topic in-depth. This type of literature review looks at a topic from a historical perspective to see how the understanding of the topic has changed over time. 

• Find e-Journals for Standalone Literature Reviews The best way to get familiar with and to learn how to write literature reviews is by reading them. You can use our Journal Search option to find journals that specialize in publishing literature reviews from major disciplines like anthropology, sociology, etc. Usually these titles are called, "Annual Review of [discipline name] OR [Discipline name] Review. This option works best if you know the title of the publication you are looking for. Below are some examples of these journals! more... less... Journal Search can be found by hovering over the link for Research on the library website.

Social Sciences

• Annual Review of Anthropology
• Annual Review of Political Science
• Annual Review of Sociology
• Ethnic Studies Review

Hard science and health sciences:

• Annual Review of Biomedical Data Science
• Annual Review of Materials Science
• Systematic Review From journal site: "The journal Systematic Reviews encompasses all aspects of the design, conduct, and reporting of systematic reviews" in the health sciences.
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What Is A Literature Review?

A plain-language explainer (with examples).

By:  Derek Jansen (MBA) & Kerryn Warren (PhD) | June 2020 (Updated May 2023)

If you’re faced with writing a dissertation or thesis, chances are you’ve encountered the term “literature review” . If you’re on this page, you’re probably not 100% what the literature review is all about. The good news is that you’ve come to the right place.

Literature Review 101

• What (exactly) is a literature review
• What’s the purpose of the literature review chapter
• How to find high-quality resources
• How to structure your literature review chapter
• Example of an actual literature review

What is a literature review?

The word “literature review” can refer to two related things that are part of the broader literature review process. The first is the task of  reviewing the literature  – i.e. sourcing and reading through the existing research relating to your research topic. The second is the  actual chapter  that you write up in your dissertation, thesis or research project. Let’s look at each of them:

Reviewing the literature

The first step of any literature review is to hunt down and  read through the existing research  that’s relevant to your research topic. To do this, you’ll use a combination of tools (we’ll discuss some of these later) to find journal articles, books, ebooks, research reports, dissertations, theses and any other credible sources of information that relate to your topic. You’ll then  summarise and catalogue these  for easy reference when you write up your literature review chapter. 

The literature review chapter

The second step of the literature review is to write the actual literature review chapter (this is usually the second chapter in a typical dissertation or thesis structure ). At the simplest level, the literature review chapter is an  overview of the key literature  that’s relevant to your research topic. This chapter should provide a smooth-flowing discussion of what research has already been done, what is known, what is unknown and what is contested in relation to your research topic. So, you can think of it as an  integrated review of the state of knowledge  around your research topic. 

What’s the purpose of a literature review?

The literature review chapter has a few important functions within your dissertation, thesis or research project. Let’s take a look at these:

Purpose #1 – Demonstrate your topic knowledge

The first function of the literature review chapter is, quite simply, to show the reader (or marker) that you  know what you’re talking about . In other words, a good literature review chapter demonstrates that you’ve read the relevant existing research and understand what’s going on – who’s said what, what’s agreed upon, disagreed upon and so on. This needs to be  more than just a summary  of who said what – it needs to integrate the existing research to  show how it all fits together  and what’s missing (which leads us to purpose #2, next). 

Purpose #2 – Reveal the research gap that you’ll fill

The second function of the literature review chapter is to  show what’s currently missing  from the existing research, to lay the foundation for your own research topic. In other words, your literature review chapter needs to show that there are currently “missing pieces” in terms of the bigger puzzle, and that  your study will fill one of those research gaps . By doing this, you are showing that your research topic is original and will help contribute to the body of knowledge. In other words, the literature review helps justify your research topic.  

Purpose #3 – Lay the foundation for your conceptual framework

The third function of the literature review is to form the  basis for a conceptual framework . Not every research topic will necessarily have a conceptual framework, but if your topic does require one, it needs to be rooted in your literature review. 

For example, let’s say your research aims to identify the drivers of a certain outcome – the factors which contribute to burnout in office workers. In this case, you’d likely develop a conceptual framework which details the potential factors (e.g. long hours, excessive stress, etc), as well as the outcome (burnout). Those factors would need to emerge from the literature review chapter – they can’t just come from your gut! 

So, in this case, the literature review chapter would uncover each of the potential factors (based on previous studies about burnout), which would then be modelled into a framework. 

Purpose #4 – To inform your methodology

The fourth function of the literature review is to  inform the choice of methodology  for your own research. As we’ve  discussed on the Grad Coach blog , your choice of methodology will be heavily influenced by your research aims, objectives and questions . Given that you’ll be reviewing studies covering a topic close to yours, it makes sense that you could learn a lot from their (well-considered) methodologies.

So, when you’re reviewing the literature, you’ll need to  pay close attention to the research design , methodology and methods used in similar studies, and use these to inform your methodology. Quite often, you’ll be able to  “borrow” from previous studies . This is especially true for quantitative studies , as you can use previously tried and tested measures and scales. 

How do I find articles for my literature review?

Finding quality journal articles is essential to crafting a rock-solid literature review. As you probably already know, not all research is created equally, and so you need to make sure that your literature review is  built on credible research . 

We could write an entire post on how to find quality literature (actually, we have ), but a good starting point is Google Scholar . Google Scholar is essentially the academic equivalent of Google, using Google’s powerful search capabilities to find relevant journal articles and reports. It certainly doesn’t cover every possible resource, but it’s a very useful way to get started on your literature review journey, as it will very quickly give you a good indication of what the  most popular pieces of research  are in your field.

One downside of Google Scholar is that it’s merely a search engine – that is, it lists the articles, but oftentimes  it doesn’t host the articles . So you’ll often hit a paywall when clicking through to journal websites. 

Thankfully, your university should provide you with access to their library, so you can find the article titles using Google Scholar and then search for them by name in your university’s online library. Your university may also provide you with access to  ResearchGate , which is another great source for existing research. 

Remember, the correct search keywords will be super important to get the right information from the start. So, pay close attention to the keywords used in the journal articles you read and use those keywords to search for more articles. If you can’t find a spoon in the kitchen, you haven’t looked in the right drawer. 

Need a helping hand?

How should I structure my literature review?

Unfortunately, there’s no generic universal answer for this one. The structure of your literature review will depend largely on your topic area and your research aims and objectives.

You could potentially structure your literature review chapter according to theme, group, variables , chronologically or per concepts in your field of research. We explain the main approaches to structuring your literature review here . You can also download a copy of our free literature review template to help you establish an initial structure.

In general, it’s also a good idea to start wide (i.e. the big-picture-level) and then narrow down, ending your literature review close to your research questions . However, there’s no universal one “right way” to structure your literature review. The most important thing is not to discuss your sources one after the other like a list – as we touched on earlier, your literature review needs to synthesise the research , not summarise it .

Ultimately, you need to craft your literature review so that it conveys the most important information effectively – it needs to tell a logical story in a digestible way. It’s no use starting off with highly technical terms and then only explaining what these terms mean later. Always assume your reader is not a subject matter expert and hold their hand through a journe y of the literature while keeping the functions of the literature review chapter (which we discussed earlier) front of mind.

Example of a literature review

In the video below, we walk you through a high-quality literature review from a dissertation that earned full distinction. This will give you a clearer view of what a strong literature review looks like in practice and hopefully provide some inspiration for your own. 

Wrapping Up

In this post, we’ve (hopefully) answered the question, “ what is a literature review? “. We’ve also considered the purpose and functions of the literature review, as well as how to find literature and how to structure the literature review chapter. If you’re keen to learn more, check out the literature review section of the Grad Coach blog , as well as our detailed video post covering how to write a literature review . 

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

16 Comments

Thanks for this review. It narrates what’s not been taught as tutors are always in a early to finish their classes.

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Organizing and Creating Information

• Citation and Attribution

What Is a Literature Review?

Review the literature, write the literature review, further reading, learning objectives, attribution.

This guide is designed to:

• Identify the sections and purpose of a literature review in academic writing
• Review practical strategies and organizational methods for preparing a literature review

A literature review is a summary and synthesis of scholarly research on a specific topic. It should answer questions such as:

• What research has been done on the topic?
• Who are the key researchers and experts in the field?
• What are the common theories and methodologies?
• Are there challenges, controversies, and contradictions?
• Are there gaps in the research that your approach addresses?

The process of reviewing existing research allows you to fine-tune your research question and contextualize your own work. Preparing a literature review is a cyclical process. You may find that the research question you begin with evolves as you learn more about the topic.

Once you have defined your research question , focus on learning what other scholars have written on the topic.

In order to  do a thorough search of the literature  on the topic, define the basic criteria:

• Databases and journals: Look at the  subject guide  related to your topic for recommended databases. Review the  tutorial on finding articles  for tips. 
• Books: Search BruKnow, the Library's catalog. Steps to searching ebooks are covered in the  Finding Ebooks tutorial .
• What time period should it cover? Is currency important?
• Do I know of primary and secondary sources that I can use as a way to find other information?
• What should I be aware of when looking at popular, trade, and scholarly resources ? 

One strategy is to review bibliographies for sources that relate to your interest. For more on this technique, look at the tutorial on finding articles when you have a citation .

Tip: Use a Synthesis Matrix

As you read sources, themes will emerge that will help you to organize the review. You can use a simple Synthesis Matrix to track your notes as you read. From this work, a concept map emerges that provides an overview of the literature and ways in which it connects. Working with Zotero to capture the citations, you build the structure for writing your literature review.

How do I know when I am done?

A key indicator for knowing when you are done is running into the same articles and materials. With no new information being uncovered, you are likely exhausting your current search and should modify search terms or search different catalogs or databases. It is also possible that you have reached a point when you can start writing the literature review.

Tip: Manage Your Citations

These citation management tools also create citations, footnotes, and bibliographies with just a few clicks:

Zotero Tutorial

Endnote Tutorial

Your literature review should be focused on the topic defined in your research question. It should be written in a logical, structured way and maintain an objective perspective and use a formal voice.

Review the Summary Table you created for themes and connecting ideas. Use the following guidelines to prepare an outline of the main points you want to make. 

• Synthesize previous research on the topic.
• Aim to include both summary and synthesis.
• Include literature that supports your research question as well as that which offers a different perspective.
• Avoid relying on one author or publication too heavily.
• Select an organizational structure, such as chronological, methodological, and thematic.

The three elements of a literature review are introduction, body, and conclusion.

Introduction

• Define the topic of the literature review, including any terminology.
• Introduce the central theme and organization of the literature review.
• Summarize the state of research on the topic.
• Frame the literature review with your research question.
• Focus on ways to have the body of literature tell its own story. Do not add your own interpretations at this point.
• Look for patterns and find ways to tie the pieces together.
• Summarize instead of quote.
• Weave the points together rather than list summaries of each source.
• Include the most important sources, not everything you have read.
• Summarize the review of the literature.
• Identify areas of further research on the topic.
• Connect the review with your research.
• DeCarlo, M. (2018). 4.1 What is a literature review? In Scientific Inquiry in Social Work. Open Social Work Education. https://scientificinquiryinsocialwork.pressbooks.com/chapter/4-1-what-is-a-literature-review/
• Literature Reviews (n.d.) https://writingcenter.unc.edu/tips-and-tools/literature-reviews/ Accessed Nov. 10, 2021

This guide was designed to: 

• Identify the sections and purpose of a literature review in academic writing 
• Review practical strategies and organizational methods for preparing a literature review​

Content on this page adapted from: 

Frederiksen, L. and Phelps, S. (2017).   Literature Reviews for Education and Nursing Graduate Students.  Licensed CC BY 4.0

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Research Methods

• Getting Started
• Literature Review Research
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Literature Review

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

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

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

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

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

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

A literature review is important because it:

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

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

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

Not an essay 

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

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

A literature review serves several purposes. For example, it

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

As Kennedy (2007) notes*, it is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of field. In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews.

Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

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

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

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

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

Systematic Review      This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyse data from the studies that are included in the review. Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?"

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

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

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

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

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

Systematic review or meta-analysis?

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

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

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

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

Not all systematic reviews contain meta-analysis. 

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

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

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

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

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Literature Review: Purpose of a Literature Review

• Literature Review
• Purpose of a Literature Review
• Work in Progress
• Compiling & Writing
• Books, Articles, & Web Pages
• Types of Literature Reviews
• Departmental Differences
• Citation Styles & Plagiarism
• Know the Difference! Systematic Review vs. Literature Review

The purpose of a literature review is to:

• Provide a foundation of knowledge on a topic
• Identify areas of prior scholarship to prevent duplication and give credit to other researchers
• Identify inconstancies: gaps in research, conflicts in previous studies, open questions left from other research
• Identify the need for additional research (justifying your research)
• Identify the relationship of works in the context of their contribution to the topic and other works
• Place your own research within the context of existing literature, making a case for why further study is needed.

Videos & Tutorials

VIDEO: What is the role of a literature review in research? What's it mean to "review" the literature? Get the big picture of what to expect as part of the process. This video is published under a Creative Commons 3.0 BY-NC-SA US license. License, credits, and contact information can be found here: https://www.lib.ncsu.edu/tutorials/litreview/

Elements in a Literature Review

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How to Write a Literature Review

What is a literature review.

• What Is the Literature
• Writing the Review

A literature review is much more than an annotated bibliography or a list of separate reviews of articles and books. It is a critical, analytical summary and synthesis of the current knowledge of a topic. Thus it should compare and relate different theories, findings, etc, rather than just summarize them individually. In addition, it should have a particular focus or theme to organize the review. It does not have to be an exhaustive account of everything published on the topic, but it should discuss all the significant academic literature and other relevant sources important for that focus.

This is meant to be a general guide to writing a literature review: ways to structure one, what to include, how it supplements other research. For more specific help on writing a review, and especially for help on finding the literature to review, sign up for a Personal Research Session .

The specific organization of a literature review depends on the type and purpose of the review, as well as on the specific field or topic being reviewed. But in general, it is a relatively brief but thorough exploration of past and current work on a topic. Rather than a chronological listing of previous work, though, literature reviews are usually organized thematically, such as different theoretical approaches, methodologies, or specific issues or concepts involved in the topic. A thematic organization makes it much easier to examine contrasting perspectives, theoretical approaches, methodologies, findings, etc, and to analyze the strengths and weaknesses of, and point out any gaps in, previous research. And this is the heart of what a literature review is about. A literature review may offer new interpretations, theoretical approaches, or other ideas; if it is part of a research proposal or report it should demonstrate the relationship of the proposed or reported research to others' work; but whatever else it does, it must provide a critical overview of the current state of research efforts. 

Literature reviews are common and very important in the sciences and social sciences. They are less common and have a less important role in the humanities, but they do have a place, especially stand-alone reviews.

Types of Literature Reviews

There are different types of literature reviews, and different purposes for writing a review, but the most common are:

• Stand-alone literature review articles . These provide an overview and analysis of the current state of research on a topic or question. The goal is to evaluate and compare previous research on a topic to provide an analysis of what is currently known, and also to reveal controversies, weaknesses, and gaps in current work, thus pointing to directions for future research. You can find examples published in any number of academic journals, but there is a series of Annual Reviews of *Subject* which are specifically devoted to literature review articles. Writing a stand-alone review is often an effective way to get a good handle on a topic and to develop ideas for your own research program. For example, contrasting theoretical approaches or conflicting interpretations of findings can be the basis of your research project: can you find evidence supporting one interpretation against another, or can you propose an alternative interpretation that overcomes their limitations?
• Part of a research proposal . This could be a proposal for a PhD dissertation, a senior thesis, or a class project. It could also be a submission for a grant. The literature review, by pointing out the current issues and questions concerning a topic, is a crucial part of demonstrating how your proposed research will contribute to the field, and thus of convincing your thesis committee to allow you to pursue the topic of your interest or a funding agency to pay for your research efforts.
• Part of a research report . When you finish your research and write your thesis or paper to present your findings, it should include a literature review to provide the context to which your work is a contribution. Your report, in addition to detailing the methods, results, etc. of your research, should show how your work relates to others' work.

A literature review for a research report is often a revision of the review for a research proposal, which can be a revision of a stand-alone review. Each revision should be a fairly extensive revision. With the increased knowledge of and experience in the topic as you proceed, your understanding of the topic will increase. Thus, you will be in a better position to analyze and critique the literature. In addition, your focus will change as you proceed in your research. Some areas of the literature you initially reviewed will be marginal or irrelevant for your eventual research, and you will need to explore other areas more thoroughly. 

Examples of Literature Reviews

See the series of Annual Reviews of *Subject* which are specifically devoted to literature review articles to find many examples of stand-alone literature reviews in the biomedical, physical, and social sciences. 

Research report articles vary in how they are organized, but a common general structure is to have sections such as:

• Abstract - Brief summary of the contents of the article
• Introduction - A explanation of the purpose of the study, a statement of the research question(s) the study intends to address
• Literature review - A critical assessment of the work done so far on this topic, to show how the current study relates to what has already been done
• Methods - How the study was carried out (e.g. instruments or equipment, procedures, methods to gather and analyze data)
• Results - What was found in the course of the study
• Discussion - What do the results mean
• Conclusion - State the conclusions and implications of the results, and discuss how it relates to the work reviewed in the literature review; also, point to directions for further work in the area

Here are some articles that illustrate variations on this theme. There is no need to read the entire articles (unless the contents interest you); just quickly browse through to see the sections, and see how each section is introduced and what is contained in them.

The Determinants of Undergraduate Grade Point Average: The Relative Importance of Family Background, High School Resources, and Peer Group Effects , in The Journal of Human Resources , v. 34 no. 2 (Spring 1999), p. 268-293.

This article has a standard breakdown of sections:

• Introduction
• Literature Review
• Some discussion sections

First Encounters of the Bureaucratic Kind: Early Freshman Experiences with a Campus Bureaucracy , in The Journal of Higher Education , v. 67 no. 6 (Nov-Dec 1996), p. 660-691.

This one does not have a section specifically labeled as a "literature review" or "review of the literature," but the first few sections cite a long list of other sources discussing previous research in the area before the authors present their own study they are reporting.

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Approaching literature review for academic purposes: The Literature Review Checklist

Debora f.b. leite.

I Departamento de Ginecologia e Obstetricia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, BR

II Universidade Federal de Pernambuco, Pernambuco, PE, BR

III Hospital das Clinicas, Universidade Federal de Pernambuco, Pernambuco, PE, BR

Maria Auxiliadora Soares Padilha

Jose g. cecatti.

A sophisticated literature review (LR) can result in a robust dissertation/thesis by scrutinizing the main problem examined by the academic study; anticipating research hypotheses, methods and results; and maintaining the interest of the audience in how the dissertation/thesis will provide solutions for the current gaps in a particular field. Unfortunately, little guidance is available on elaborating LRs, and writing an LR chapter is not a linear process. An LR translates students’ abilities in information literacy, the language domain, and critical writing. Students in postgraduate programs should be systematically trained in these skills. Therefore, this paper discusses the purposes of LRs in dissertations and theses. Second, the paper considers five steps for developing a review: defining the main topic, searching the literature, analyzing the results, writing the review and reflecting on the writing. Ultimately, this study proposes a twelve-item LR checklist. By clearly stating the desired achievements, this checklist allows Masters and Ph.D. students to continuously assess their own progress in elaborating an LR. Institutions aiming to strengthen students’ necessary skills in critical academic writing should also use this tool.

INTRODUCTION

Writing the literature review (LR) is often viewed as a difficult task that can be a point of writer’s block and procrastination ( 1 ) in postgraduate life. Disagreements on the definitions or classifications of LRs ( 2 ) may confuse students about their purpose and scope, as well as how to perform an LR. Interestingly, at many universities, the LR is still an important element in any academic work, despite the more recent trend of producing scientific articles rather than classical theses.

The LR is not an isolated section of the thesis/dissertation or a copy of the background section of a research proposal. It identifies the state-of-the-art knowledge in a particular field, clarifies information that is already known, elucidates implications of the problem being analyzed, links theory and practice ( 3 - 5 ), highlights gaps in the current literature, and places the dissertation/thesis within the research agenda of that field. Additionally, by writing the LR, postgraduate students will comprehend the structure of the subject and elaborate on their cognitive connections ( 3 ) while analyzing and synthesizing data with increasing maturity.

At the same time, the LR transforms the student and hints at the contents of other chapters for the reader. First, the LR explains the research question; second, it supports the hypothesis, objectives, and methods of the research project; and finally, it facilitates a description of the student’s interpretation of the results and his/her conclusions. For scholars, the LR is an introductory chapter ( 6 ). If it is well written, it demonstrates the student’s understanding of and maturity in a particular topic. A sound and sophisticated LR can indicate a robust dissertation/thesis.

A consensus on the best method to elaborate a dissertation/thesis has not been achieved. The LR can be a distinct chapter or included in different sections; it can be part of the introduction chapter, part of each research topic, or part of each published paper ( 7 ). However, scholars view the LR as an integral part of the main body of an academic work because it is intrinsically connected to other sections ( Figure 1 ) and is frequently present. The structure of the LR depends on the conventions of a particular discipline, the rules of the department, and the student’s and supervisor’s areas of expertise, needs and interests.

Interestingly, many postgraduate students choose to submit their LR to peer-reviewed journals. As LRs are critical evaluations of current knowledge, they are indeed publishable material, even in the form of narrative or systematic reviews. However, systematic reviews have specific patterns 1 ( 8 ) that may not entirely fit with the questions posed in the dissertation/thesis. Additionally, the scope of a systematic review may be too narrow, and the strict criteria for study inclusion may omit important information from the dissertation/thesis. Therefore, this essay discusses the definition of an LR is and methods to develop an LR in the context of an academic dissertation/thesis. Finally, we suggest a checklist to evaluate an LR.

WHAT IS A LITERATURE REVIEW IN A THESIS?

Conducting research and writing a dissertation/thesis translates rational thinking and enthusiasm ( 9 ). While a strong body of literature that instructs students on research methodology, data analysis and writing scientific papers exists, little guidance on performing LRs is available. The LR is a unique opportunity to assess and contrast various arguments and theories, not just summarize them. The research results should not be discussed within the LR, but the postgraduate student tends to write a comprehensive LR while reflecting on his or her own findings ( 10 ).

Many people believe that writing an LR is a lonely and linear process. Supervisors or the institutions assume that the Ph.D. student has mastered the relevant techniques and vocabulary associated with his/her subject and conducts a self-reflection about previously published findings. Indeed, while elaborating the LR, the student should aggregate diverse skills, which mainly rely on his/her own commitment to mastering them. Thus, less supervision should be required ( 11 ). However, the parameters described above might not currently be the case for many students ( 11 , 12 ), and the lack of formal and systematic training on writing LRs is an important concern ( 11 ).

An institutional environment devoted to active learning will provide students the opportunity to continuously reflect on LRs, which will form a dialogue between the postgraduate student and the current literature in a particular field ( 13 ). Postgraduate students will be interpreting studies by other researchers, and, according to Hart (1998) ( 3 ), the outcomes of the LR in a dissertation/thesis include the following:

• To identify what research has been performed and what topics require further investigation in a particular field of knowledge;
• To determine the context of the problem;
• To recognize the main methodologies and techniques that have been used in the past;
• To place the current research project within the historical, methodological and theoretical context of a particular field;
• To identify significant aspects of the topic;
• To elucidate the implications of the topic;
• To offer an alternative perspective;
• To discern how the studied subject is structured;
• To improve the student’s subject vocabulary in a particular field; and
• To characterize the links between theory and practice.

A sound LR translates the postgraduate student’s expertise in academic and scientific writing: it expresses his/her level of comfort with synthesizing ideas ( 11 ). The LR reveals how well the postgraduate student has proceeded in three domains: an effective literature search, the language domain, and critical writing.

Effective literature search

All students should be trained in gathering appropriate data for specific purposes, and information literacy skills are a cornerstone. These skills are defined as “an individual’s ability to know when they need information, to identify information that can help them address the issue or problem at hand, and to locate, evaluate, and use that information effectively” ( 14 ). Librarian support is of vital importance in coaching the appropriate use of Boolean logic (AND, OR, NOT) and other tools for highly efficient literature searches (e.g., quotation marks and truncation), as is the appropriate management of electronic databases.

Language domain

Academic writing must be concise and precise: unnecessary words distract the reader from the essential content ( 15 ). In this context, reading about issues distant from the research topic ( 16 ) may increase students’ general vocabulary and familiarity with grammar. Ultimately, reading diverse materials facilitates and encourages the writing process itself.

Critical writing

Critical judgment includes critical reading, thinking and writing. It supposes a student’s analytical reflection about what he/she has read. The student should delineate the basic elements of the topic, characterize the most relevant claims, identify relationships, and finally contrast those relationships ( 17 ). Each scientific document highlights the perspective of the author, and students will become more confident in judging the supporting evidence and underlying premises of a study and constructing their own counterargument as they read more articles. A paucity of integration or contradictory perspectives indicates lower levels of cognitive complexity ( 12 ).

Thus, while elaborating an LR, the postgraduate student should achieve the highest category of Bloom’s cognitive skills: evaluation ( 12 ). The writer should not only summarize data and understand each topic but also be able to make judgments based on objective criteria, compare resources and findings, identify discrepancies due to methodology, and construct his/her own argument ( 12 ). As a result, the student will be sufficiently confident to show his/her own voice .

Writing a consistent LR is an intense and complex activity that reveals the training and long-lasting academic skills of a writer. It is not a lonely or linear process. However, students are unlikely to be prepared to write an LR if they have not mastered the aforementioned domains ( 10 ). An institutional environment that supports student learning is crucial.

Different institutions employ distinct methods to promote students’ learning processes. First, many universities propose modules to develop behind the scenes activities that enhance self-reflection about general skills (e.g., the skills we have mastered and the skills we need to develop further), behaviors that should be incorporated (e.g., self-criticism about one’s own thoughts), and each student’s role in the advancement of his/her field. Lectures or workshops about LRs themselves are useful because they describe the purposes of the LR and how it fits into the whole picture of a student’s work. These activities may explain what type of discussion an LR must involve, the importance of defining the correct scope, the reasons to include a particular resource, and the main role of critical reading.

Some pedagogic services that promote a continuous improvement in study and academic skills are equally important. Examples include workshops about time management, the accomplishment of personal objectives, active learning, and foreign languages for nonnative speakers. Additionally, opportunities to converse with other students promotes an awareness of others’ experiences and difficulties. Ultimately, the supervisor’s role in providing feedback and setting deadlines is crucial in developing students’ abilities and in strengthening students’ writing quality ( 12 ).

HOW SHOULD A LITERATURE REVIEW BE DEVELOPED?

A consensus on the appropriate method for elaborating an LR is not available, but four main steps are generally accepted: defining the main topic, searching the literature, analyzing the results, and writing ( 6 ). We suggest a fifth step: reflecting on the information that has been written in previous publications ( Figure 2 ).

First step: Defining the main topic

Planning an LR is directly linked to the research main question of the thesis and occurs in parallel to students’ training in the three domains discussed above. The planning stage helps organize ideas, delimit the scope of the LR ( 11 ), and avoid the wasting of time in the process. Planning includes the following steps:

• Reflecting on the scope of the LR: postgraduate students will have assumptions about what material must be addressed and what information is not essential to an LR ( 13 , 18 ). Cooper’s Taxonomy of Literature Reviews 2 systematizes the writing process through six characteristics and nonmutually exclusive categories. The focus refers to the reviewer’s most important points of interest, while the goals concern what students want to achieve with the LR. The perspective assumes answers to the student’s own view of the LR and how he/she presents a particular issue. The coverage defines how comprehensive the student is in presenting the literature, and the organization determines the sequence of arguments. The audience is defined as the group for whom the LR is written.
• Designating sections and subsections: Headings and subheadings should be specific, explanatory and have a coherent sequence throughout the text ( 4 ). They simulate an inverted pyramid, with an increasing level of reflection and depth of argument.
• Identifying keywords: The relevant keywords for each LR section should be listed to guide the literature search. This list should mirror what Hart (1998) ( 3 ) advocates as subject vocabulary . The keywords will also be useful when the student is writing the LR since they guide the reader through the text.
• Delineating the time interval and language of documents to be retrieved in the second step. The most recently published documents should be considered, but relevant texts published before a predefined cutoff year can be included if they are classic documents in that field. Extra care should be employed when translating documents.

Second step: Searching the literature

The ability to gather adequate information from the literature must be addressed in postgraduate programs. Librarian support is important, particularly for accessing difficult texts. This step comprises the following components:

• Searching the literature itself: This process consists of defining which databases (electronic or dissertation/thesis repositories), official documents, and books will be searched and then actively conducting the search. Information literacy skills have a central role in this stage. While searching electronic databases, controlled vocabulary (e.g., Medical Subject Headings, or MeSH, for the PubMed database) or specific standardized syntax rules may need to be applied.

In addition, two other approaches are suggested. First, a review of the reference list of each document might be useful for identifying relevant publications to be included and important opinions to be assessed. This step is also relevant for referencing the original studies and leading authors in that field. Moreover, students can directly contact the experts on a particular topic to consult with them regarding their experience or use them as a source of additional unpublished documents.

Before submitting a dissertation/thesis, the electronic search strategy should be repeated. This process will ensure that the most recently published papers will be considered in the LR.

• Selecting documents for inclusion: Generally, the most recent literature will be included in the form of published peer-reviewed papers. Assess books and unpublished material, such as conference abstracts, academic texts and government reports, are also important to assess since the gray literature also offers valuable information. However, since these materials are not peer-reviewed, we recommend that they are carefully added to the LR.

This task is an important exercise in time management. First, students should read the title and abstract to understand whether that document suits their purposes, addresses the research question, and helps develop the topic of interest. Then, they should scan the full text, determine how it is structured, group it with similar documents, and verify whether other arguments might be considered ( 5 ).

Third step: Analyzing the results

Critical reading and thinking skills are important in this step. This step consists of the following components:

• Reading documents: The student may read various texts in depth according to LR sections and subsections ( defining the main topic ), which is not a passive activity ( 1 ). Some questions should be asked to practice critical analysis skills, as listed below. Is the research question evident and articulated with previous knowledge? What are the authors’ research goals and theoretical orientations, and how do they interact? Are the authors’ claims related to other scholars’ research? Do the authors consider different perspectives? Was the research project designed and conducted properly? Are the results and discussion plausible, and are they consistent with the research objectives and methodology? What are the strengths and limitations of this work? How do the authors support their findings? How does this work contribute to the current research topic? ( 1 , 19 )
• Taking notes: Students who systematically take notes on each document are more readily able to establish similarities or differences with other documents and to highlight personal observations. This approach reinforces the student’s ideas about the next step and helps develop his/her own academic voice ( 1 , 13 ). Voice recognition software ( 16 ), mind maps ( 5 ), flowcharts, tables, spreadsheets, personal comments on the referenced texts, and note-taking apps are all available tools for managing these observations, and the student him/herself should use the tool that best improves his/her learning. Additionally, when a student is considering submitting an LR to a peer-reviewed journal, notes should be taken on the activities performed in all five steps to ensure that they are able to be replicated.

Fourth step: Writing

The recognition of when a student is able and ready to write after a sufficient period of reading and thinking is likely a difficult task. Some students can produce a review in a single long work session. However, as discussed above, writing is not a linear process, and students do not need to write LRs according to a specific sequence of sections. Writing an LR is a time-consuming task, and some scholars believe that a period of at least six months is sufficient ( 6 ). An LR, and academic writing in general, expresses the writer’s proper thoughts, conclusions about others’ work ( 6 , 10 , 13 , 16 ), and decisions about methods to progress in the chosen field of knowledge. Thus, each student is expected to present a different learning and writing trajectory.

In this step, writing methods should be considered; then, editing, citing and correct referencing should complete this stage, at least temporarily. Freewriting techniques may be a good starting point for brainstorming ideas and improving the understanding of the information that has been read ( 1 ). Students should consider the following parameters when creating an agenda for writing the LR: two-hour writing blocks (at minimum), with prespecified tasks that are possible to complete in one section; short (minutes) and long breaks (days or weeks) to allow sufficient time for mental rest and reflection; and short- and long-term goals to motivate the writing itself ( 20 ). With increasing experience, this scheme can vary widely, and it is not a straightforward rule. Importantly, each discipline has a different way of writing ( 1 ), and each department has its own preferred styles for citations and references.

Fifth step: Reflecting on the writing

In this step, the postgraduate student should ask him/herself the same questions as in the analyzing the results step, which can take more time than anticipated. Ambiguities, repeated ideas, and a lack of coherence may not be noted when the student is immersed in the writing task for long periods. The whole effort will likely be a work in progress, and continuous refinements in the written material will occur once the writing process has begun.

LITERATURE REVIEW CHECKLIST

In contrast to review papers, the LR of a dissertation/thesis should not be a standalone piece or work. Instead, it should present the student as a scholar and should maintain the interest of the audience in how that dissertation/thesis will provide solutions for the current gaps in a particular field.

A checklist for evaluating an LR is convenient for students’ continuous academic development and research transparency: it clearly states the desired achievements for the LR of a dissertation/thesis. Here, we present an LR checklist developed from an LR scoring rubric ( 11 ). For a critical analysis of an LR, we maintain the five categories but offer twelve criteria that are not scaled ( Figure 3 ). The criteria all have the same importance and are not mutually exclusive.

First category: Coverage

1. justified criteria exist for the inclusion and exclusion of literature in the review.

This criterion builds on the main topic and areas covered by the LR ( 18 ). While experts may be confident in retrieving and selecting literature, postgraduate students must convince their audience about the adequacy of their search strategy and their reasons for intentionally selecting what material to cover ( 11 ). References from different fields of knowledge provide distinct perspective, but narrowing the scope of coverage may be important in areas with a large body of existing knowledge.

Second category: Synthesis

2. a critical examination of the state of the field exists.

A critical examination is an assessment of distinct aspects in the field ( 1 ) along with a constructive argument. It is not a negative critique but an expression of the student’s understanding of how other scholars have added to the topic ( 1 ), and the student should analyze and contextualize contradictory statements. A writer’s personal bias (beliefs or political involvement) have been shown to influence the structure and writing of a document; therefore, the cultural and paradigmatic background guide how the theories are revised and presented ( 13 ). However, an honest judgment is important when considering different perspectives.

3. The topic or problem is clearly placed in the context of the broader scholarly literature

The broader scholarly literature should be related to the chosen main topic for the LR ( how to develop the literature review section). The LR can cover the literature from one or more disciplines, depending on its scope, but it should always offer a new perspective. In addition, students should be careful in citing and referencing previous publications. As a rule, original studies and primary references should generally be included. Systematic and narrative reviews present summarized data, and it may be important to cite them, particularly for issues that should be understood but do not require a detailed description. Similarly, quotations highlight the exact statement from another publication. However, excessive referencing may disclose lower levels of analysis and synthesis by the student.

4. The LR is critically placed in the historical context of the field

Situating the LR in its historical context shows the level of comfort of the student in addressing a particular topic. Instead of only presenting statements and theories in a temporal approach, which occasionally follows a linear timeline, the LR should authentically characterize the student’s academic work in the state-of-art techniques in their particular field of knowledge. Thus, the LR should reinforce why the dissertation/thesis represents original work in the chosen research field.

5. Ambiguities in definitions are considered and resolved

Distinct theories on the same topic may exist in different disciplines, and one discipline may consider multiple concepts to explain one topic. These misunderstandings should be addressed and contemplated. The LR should not synthesize all theories or concepts at the same time. Although this approach might demonstrate in-depth reading on a particular topic, it can reveal a student’s inability to comprehend and synthesize his/her research problem.

6. Important variables and phenomena relevant to the topic are articulated

The LR is a unique opportunity to articulate ideas and arguments and to purpose new relationships between them ( 10 , 11 ). More importantly, a sound LR will outline to the audience how these important variables and phenomena will be addressed in the current academic work. Indeed, the LR should build a bidirectional link with the remaining sections and ground the connections between all of the sections ( Figure 1 ).

7. A synthesized new perspective on the literature has been established

The LR is a ‘creative inquiry’ ( 13 ) in which the student elaborates his/her own discourse, builds on previous knowledge in the field, and describes his/her own perspective while interpreting others’ work ( 13 , 17 ). Thus, students should articulate the current knowledge, not accept the results at face value ( 11 , 13 , 17 ), and improve their own cognitive abilities ( 12 ).

Third category: Methodology

8. the main methodologies and research techniques that have been used in the field are identified and their advantages and disadvantages are discussed.

The LR is expected to distinguish the research that has been completed from investigations that remain to be performed, address the benefits and limitations of the main methods applied to date, and consider the strategies for addressing the expected limitations described above. While placing his/her research within the methodological context of a particular topic, the LR will justify the methodology of the study and substantiate the student’s interpretations.

9. Ideas and theories in the field are related to research methodologies

The audience expects the writer to analyze and synthesize methodological approaches in the field. The findings should be explained according to the strengths and limitations of previous research methods, and students must avoid interpretations that are not supported by the analyzed literature. This criterion translates to the student’s comprehension of the applicability and types of answers provided by different research methodologies, even those using a quantitative or qualitative research approach.

Fourth category: Significance

10. the scholarly significance of the research problem is rationalized.

The LR is an introductory section of a dissertation/thesis and will present the postgraduate student as a scholar in a particular field ( 11 ). Therefore, the LR should discuss how the research problem is currently addressed in the discipline being investigated or in different disciplines, depending on the scope of the LR. The LR explains the academic paradigms in the topic of interest ( 13 ) and methods to advance the field from these starting points. However, an excess number of personal citations—whether referencing the student’s research or studies by his/her research team—may reflect a narrow literature search and a lack of comprehensive synthesis of ideas and arguments.

11. The practical significance of the research problem is rationalized

The practical significance indicates a student’s comprehensive understanding of research terminology (e.g., risk versus associated factor), methodology (e.g., efficacy versus effectiveness) and plausible interpretations in the context of the field. Notably, the academic argument about a topic may not always reflect the debate in real life terms. For example, using a quantitative approach in epidemiology, statistically significant differences between groups do not explain all of the factors involved in a particular problem ( 21 ). Therefore, excessive faith in p -values may reflect lower levels of critical evaluation of the context and implications of a research problem by the student.

Fifth category: Rhetoric

12. the lr was written with a coherent, clear structure that supported the review.

This category strictly relates to the language domain: the text should be coherent and presented in a logical sequence, regardless of which organizational ( 18 ) approach is chosen. The beginning of each section/subsection should state what themes will be addressed, paragraphs should be carefully linked to each other ( 10 ), and the first sentence of each paragraph should generally summarize the content. Additionally, the student’s statements are clear, sound, and linked to other scholars’ works, and precise and concise language that follows standardized writing conventions (e.g., in terms of active/passive voice and verb tenses) is used. Attention to grammar, such as orthography and punctuation, indicates prudence and supports a robust dissertation/thesis. Ultimately, all of these strategies provide fluency and consistency for the text.

Although the scoring rubric was initially proposed for postgraduate programs in education research, we are convinced that this checklist is a valuable tool for all academic areas. It enables the monitoring of students’ learning curves and a concentrated effort on any criteria that are not yet achieved. For institutions, the checklist is a guide to support supervisors’ feedback, improve students’ writing skills, and highlight the learning goals of each program. These criteria do not form a linear sequence, but ideally, all twelve achievements should be perceived in the LR.

CONCLUSIONS

A single correct method to classify, evaluate and guide the elaboration of an LR has not been established. In this essay, we have suggested directions for planning, structuring and critically evaluating an LR. The planning of the scope of an LR and approaches to complete it is a valuable effort, and the five steps represent a rational starting point. An institutional environment devoted to active learning will support students in continuously reflecting on LRs, which will form a dialogue between the writer and the current literature in a particular field ( 13 ).

The completion of an LR is a challenging and necessary process for understanding one’s own field of expertise. Knowledge is always transitory, but our responsibility as scholars is to provide a critical contribution to our field, allowing others to think through our work. Good researchers are grounded in sophisticated LRs, which reveal a writer’s training and long-lasting academic skills. We recommend using the LR checklist as a tool for strengthening the skills necessary for critical academic writing.

AUTHOR CONTRIBUTIONS

Leite DFB has initially conceived the idea and has written the first draft of this review. Padilha MAS and Cecatti JG have supervised data interpretation and critically reviewed the manuscript. All authors have read the draft and agreed with this submission. Authors are responsible for all aspects of this academic piece.

ACKNOWLEDGMENTS

We are grateful to all of the professors of the ‘Getting Started with Graduate Research and Generic Skills’ module at University College Cork, Cork, Ireland, for suggesting and supporting this article. Funding: DFBL has granted scholarship from Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES) to take part of her Ph.D. studies in Ireland (process number 88881.134512/2016-01). There is no participation from sponsors on authors’ decision to write or to submit this manuscript.

No potential conflict of interest was reported.

1 The questions posed in systematic reviews usually follow the ‘PICOS’ acronym: Population, Intervention, Comparison, Outcomes, Study design.

2 In 1988, Cooper proposed a taxonomy that aims to facilitate students’ and institutions’ understanding of literature reviews. Six characteristics with specific categories are briefly described: Focus: research outcomes, research methodologies, theories, or practices and applications; Goals: integration (generalization, conflict resolution, and linguistic bridge-building), criticism, or identification of central issues; Perspective: neutral representation or espousal of a position; Coverage: exhaustive, exhaustive with selective citations, representative, central or pivotal; Organization: historical, conceptual, or methodological; and Audience: specialized scholars, general scholars, practitioners or policymakers, or the general public.

Literature Reviews

• What is a Literature Review?
• Steps for Creating a Literature Review
• Providing Evidence / Critical Analysis
• Challenges when writing a Literature Review
• Systematic Literature Reviews

Developing a Literature Review

1. Purpose and Scope

To help you develop a literature review, gather information on existing research, sub-topics, relevant research, and overlaps. Note initial thoughts on the topic - a mind map or list might be helpful - and avoid unfocused reading, collecting irrelevant content.  A literature review serves to place your research within the context of existing knowledge. It demonstrates your understanding of the field and identifies gaps that your research aims to fill. This helps in justifying the relevance and necessity of your study.

To avoid over-reading, set a target word count for each section and limit reading time. Plan backwards from the deadline and move on to other parts of the investigation. Read major texts and explore up-to-date research. Check reference lists and citation indexes for common standard texts. Be guided by research questions and refocus on your topic when needed. Stop reading if you find similar viewpoints or if you're going off topic.

You can use a "Synthesis Matrix" to keep track of your reading notes. This concept map helps you to provide a summary of the literature and its connections is produced as a result of this study. Utilizing referencing software like RefWorks to obtain citations, you can construct the framework for composing your literature evaluation.

2. Source Selection

Focus on searching for academically authoritative texts such as academic books, journals, research reports, and government publications. These sources are critical for ensuring the credibility and reliability of your review. 

• Academic Books: Provide comprehensive coverage of a topic.
• Journal Articles: Offer the most up-to-date research and are essential for a literature review.
• Research Reports: Detailed accounts of specific research projects.
• Government Publications: Official documents that provide reliable data and insights.

3. Thematic Analysis

Instead of merely summarizing sources, identify and discuss key themes that emerge from the literature. This involves interpreting and evaluating how different authors have tackled similar issues and how their findings relate to your research.

4. Critical Evaluation

Adopt a critical attitude towards the sources you review. Scrutinize, question, and dissect the material to ensure that your review is not just descriptive but analytical. This helps in highlighting the significance of various sources and their relevance to your research.

Each work's critical assessment should take into account:

Provenance:  What qualifications does the author have? Are the author's claims backed up by proof, such as first-hand accounts from history, case studies, stories, statistics, and current scientific discoveries? Methodology:  Were the strategies employed to locate, collect, and evaluate the data suitable for tackling the study question? Was the sample size suitable? Were the findings properly reported and interpreted? Objectivity : Is the author's viewpoint impartial or biased? Does the author's thesis get supported by evidence that refutes it, or does it ignore certain important facts? Persuasiveness:  Which of the author's arguments is the strongest or weakest in terms of persuasiveness? Value:  Are the author's claims and deductions believable? Does the study ultimately advance our understanding of the issue in any meaningful way?

5. Categorization

Organize your literature review by grouping sources into categories based on themes, relevance to research questions, theoretical paradigms, or chronology. This helps in presenting your findings in a structured manner.

6. Source Validity

Ensure that the sources you include are valid and reliable. Classic texts may retain their authority over time, but for fields that evolve rapidly, prioritize the most recent research. Always check the credibility of the authors and the impact of their work in the field.

7. Synthesis and Findings

Synthesize the information from various sources to draw conclusions about the current state of knowledge. Identify trends, controversies, and gaps in the literature. Relate your findings to your research questions and suggest future directions for research.

Practical Tips

• Use a variety of sources, including online databases, university libraries, and reference lists from relevant articles. This ensures a comprehensive coverage of the literature.
• Avoid listing sources without analysis. Use tables, bulk citations, and footnotes to manage references efficiently and make your review more readable.
• Writing a literature review is an ongoing process. Start writing early and revise as you read more. This iterative process helps in refining your arguments and identifying additional sources as needed.  

Brown University Library (2024) Organizing and Creating Information. Available at: https://libguides.brown.edu/organize/litreview (Accessed: 30 July 2024).

Pacheco-Vega, R. (2016) Synthesizing different bodies of work in your literature review: The Conceptual Synthesis Excel Dump (CSED) technique . Available at: http://www.raulpacheco.org/2016/06/synthesizing-different-bodies-of-work-in-your-literature-review-the-conceptual-synthesis-excel-dump-technique/ (Accessed: 30 July 2024).

Study Advice at the University of Reading (2024) Literature reviews . Available at: https://libguides.reading.ac.uk/literaturereview/developing (Accessed: 31 July 2024).

Further Reading

Frameworks for creating answerable (re)search questions  How to Guide

Literature Searching How to Guide

• << Previous: Steps for Creating a Literature Review
• Next: Providing Evidence / Critical Analysis >>
• Last Updated: Sep 3, 2024 1:20 PM
• URL: https://library.lsbu.ac.uk/literaturereviews

• DOI: 10.1108/jpmh-04-2024-0055
• Corpus ID: 272230078

Defining mental health literacy: a systematic literature review and educational inspiration

• Shengnan Zeng , Richard Bailey , +1 author Xiaohui Chen
• Published in Journal of Public Mental… 2 September 2024
• Psychology, Education

56 References

A systematic review of the limitations and associated opportunities of chatgpt, deductive qualitative analysis: evaluating, expanding, and refining theory, conceptualising and measuring positive mental health literacy: a systematic literature review, mental health education integration into the school curriculum needs to be implemented, review: school-based mental health literacy interventions to promote help-seeking - a systematic review., public opinion towards mental health (the case of the vologda region), quantifying the global burden of mental disorders and their economic value, mental health literacy: it is now time to put knowledge into practice, clarifying the concept of mental health literacy: protocol for a scoping review, positive mental health literacy: a concept analysis, related papers.

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This report describes a literature review to build a baseline of knowledge of what is known about implementing a victim-centered approach in addressing human trafficking, policies that may hinder or promote this approach, and training or programming to assist law enforcement. This knowledge can assist Department of Homeland Security personnel in recognizing the importance of this approach and understanding how to factor it into day-to-day duties.

Literature Review on a Victim-Centered Approach to Countering Human Trafficking

Melissa M. Labriola , Nastassia Reed , Anna White Hewitt

Research Published Sep 3, 2024

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The U.S. Department of Homeland Security (DHS) Secretary's directive on human trafficking and the agency's strategy for combating human trafficking outline ambitious goals to address the harms of this criminal activity on its victims and society. However, the logistics and tactics needed to properly implement a victim-centered approach in all facets of law enforcement can be complex. A first step in implementing a victim-centered approach to countering human trafficking is to understand what is already known, what policies may hinder or promote a victim-centered approach, and what training and programming can assist law enforcement. This knowledge can assist DHS's Center for Countering Human Trafficking in both recognizing the importance of a victim-centered approach and understanding how to factor it into day-to-day duties.

To address the challenges and outcomes stated above, the authors conducted a review of academic and gray literature to build out a baseline of knowledge. The authors also summarize applicable practices (external to DHS) that implement a victim-centered approach in the following key areas: victim identification and screening, training, and law enforcement operations.

Key Findings

There is limited research in peer-reviewed articles and gray literature on how to improve victim identification and screening for human trafficking in a law enforcement setting.

• Most victim identification screening tools are implemented in clinical settings by clinical providers or social workers.
• Understanding the risk factors, accepting how an individual's exposure to trauma affects cognition, and recognizing common symptoms of trauma can inform agents in their daily work.

Effective training programs can create a workplace with a common understanding of trauma

• Building a workforce capable of using trauma-informed and victim-centered approaches relies on effective training programs to build knowledge, capacity, and skills.
• Key skills to develop through training include avoiding retraumatization, building relationships with survivors, working with a diverse population, and conducting effective interviews with survivors.
• During training, alternatives to standard lectures can be valuable to encourage participation and skill retention.

Organizational change is needed to implement a victim-centered approach in law enforcement operations

• Implementation of a victim-centered approach requires organizational change and an overarching framework that affects every step and person within the system.
• A victim-centered approach is centered in a culture of continuous learning and collaboration.
• The depth of knowledge about human trafficking, including prevalence rates and successful intervention methods, points to the difficulties in operationalizing an evidence-based, victim-centered approach.
• According to the literature review, individual police agencies and service agencies are prioritizing some operations that can possibly be adopted and adapted to a federal law enforcement setting.

Recommendations

• DHS law enforcement's best course of action would be to take an informal approach to screening and prioritize identifying trauma symptoms during law enforcement’s brief interactions with potential victims.
• Law enforcement personnel should educate themselves on myths and stereotypes about victim behavior and the cultural backgrounds and unique challenges faced by trafficking victims from different communities, including cultural differences and language barriers.
• Cultural sensitivity; acknowledging cultural norms, beliefs, and languages; and rapport-building would support victims in sharing their stories.
• Forced Migration
• Police-Community Relations
• Posttraumatic Stress Disorder

Document Details

• Availability: Web-Only
• DOI: https://doi.org/10.7249/RRA2429-1
• Document Number: RR-A2429-1

Research conducted by

• RAND Homeland Security Research Division

This research was sponsored by the Center for Countering Human Trafficking and conducted in the Infrastructure, Immigration, & Security Operations Program of the RAND Homeland Security Research Division .

This publication is part of the RAND research report series. Research reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND research reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

The Impact of Artificial Intelligence in Digital Marketing: Literature Review

• First Online: 31 August 2024

Cite this chapter

• Bayan Aljazeeri 11 ,
• Allam Hamdan 9 , 12 &
• Mohammad Kanan 10  

Part of the book series: Studies in Systems, Decision and Control ((SSDC,volume 538))

The rapid advancement of artificial intelligence (AI) technology has revolutionized various industries, and digital marketing is no exception. The objective of this study is to conduct a comprehensive review of previous research focusing on the pivotal role of artificial intelligence (AI) in the domain of digital marketing. AI has emerged as a powerful tool capable of transforming numerous industries, marketing being one of them. By facilitating the analysis of vast quantities of data, recognizing patterns, and enabling informed decision-making, AI has fundamentally reshaped the way businesses interact with their online customers. The present study employed a library research approach, involving the review of 40 research papers relevant to the subject matter. The selected research papers encompassed a publication period spanning from 1955 to 2023. The primary finding indicates how businesses can leverage AI to elevate customer experiences, optimize advertising campaigns, and enhance overall marketing effectiveness. The paper extensively covered the diverse applications of AI in digital marketing, such as the creation of personalized content, implementation of chatbots for customer support, utilization of predictive analytics for targeting and segmentation, and deployment of recommendation engines for generating product ideas.

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Aljazeeri, B., Hamdan, A., Kanan, M. (2024). The Impact of Artificial Intelligence in Digital Marketing: Literature Review. In: Hamdan, A., Harraf, A. (eds) Business Development via AI and Digitalization. Studies in Systems, Decision and Control, vol 538. Springer, Cham. https://doi.org/10.1007/978-3-031-62102-4_13

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Evaluation of Digital Mental Health Technologies in the United States: Systematic Literature Review and Framework Synthesis

Authors of this article:

• Julianna Catania 1 , MPH   ; 
• Steph Beaver 1 , MChem   ; 
• Rakshitha S Kamath 1 , MS, MSL   ; 
• Emma Worthington 2 , MPH   ; 
• Minyi Lu 3 , PhD   ; 
• Hema Gandhi 3 , PhD   ; 
• Heidi C Waters 3 , PhD   ; 
• Daniel C Malone 4 , PhD  

1 Costello Medical, Boston, MA, United States

2 Costello Medical, Cambridge, United Kingdom

3 Otsuka Pharmaceutical Development & Commercialization Inc, Princeton, NJ, United States

4 Department of Pharmacotherapy, Skaggs College of Pharmacy, University of Utah, Salt Lake City, UT, United States

Corresponding Author:

Daniel C Malone, PhD

Department of Pharmacotherapy

Skaggs College of Pharmacy

University of Utah

30 S 2000 East

Salt Lake City, UT, 84112

United States

Phone: 1 801 581 6257

Email: [email protected]

Background: Digital mental health technologies (DMHTs) have the potential to enhance mental health care delivery. However, there is little information on how DMHTs are evaluated and what factors influence their use.

Objective: A systematic literature review was conducted to understand how DMHTs are valued in the United States from user, payer, and employer perspectives.

Methods: Articles published after 2017 were identified from MEDLINE, Embase, PsycINFO, Cochrane Library, the Health Technology Assessment Database, and digital and mental health congresses. Each article was evaluated by 2 independent reviewers to identify US studies reporting on factors considered in the evaluation of DMHTs targeting mental health, Alzheimer disease, epilepsy, autism spectrum disorder, or attention-deficit/hyperactivity disorder. Study quality was assessed using the Critical Appraisal Skills Program Qualitative and Cohort Studies Checklists. Studies were coded and indexed using the American Psychiatric Association’s Mental Health App Evaluation Framework to extract and synthesize relevant information, and novel themes were added iteratively as identified.

Results: Of the 4353 articles screened, data from 26 unique studies from patient, caregiver, and health care provider perspectives were included. Engagement style was the most reported theme (23/26, 88%), with users valuing DMHT usability, particularly alignment with therapeutic goals through features including anxiety management tools. Key barriers to DMHT use included limited internet access, poor technical literacy, and privacy concerns. Novel findings included the discreetness of DMHTs to avoid stigma.

Conclusions: Usability, cost, accessibility, technical considerations, and alignment with therapeutic goals are important to users, although DMHT valuation varies across individuals. DMHT apps should be developed and selected with specific user needs in mind.

Introduction

Digital health comprises a broad range of technologies, including mobile health, health information technology, wearable devices, and personalized medicine, which serve as tools to enhance health care delivery. Recently, several digital mental health (MH) therapeutics, a category of digital MH technologies (DMHTs), have received US Food and Drug Administration (FDA) approval to prevent, manage, or treat a medical disorder or disease based on evidence from superiority trials and compliance with technical guidelines [ 1 , 2 ]. However, most DMHTs, particularly apps, fall outside FDA jurisdiction because they are not intended to diagnose, treat, or prevent disease and because they are “low risk” in that they would not cause harm in the event of malfunction [ 3 ]. Due to this lack of regulatory framework, few DMHTs are supported by published efficacy studies. One study found that only 16% of MH apps recommended by college counseling centers were supported by efficacy studies published in peer-reviewed journals [ 4 ].

Nonetheless, many health care providers (HCPs) use MH apps in clinical practice. Up to 83% of behavioral health providers in a small study covering the Greater Boston area reported using apps as part of their clinical care, particularly mindfulness apps for patient anxiety management [ 5 ]. As many DMHTs are currently widely used in clinical practice without undergoing any formal assessment for quality or relevance, understanding how DMHTs should be assessed based on factors impacting their value from the perspective of key stakeholders, such as patients, caregivers, providers, payers, and employers, could improve the selection of DMHTs for use by patients, thereby increasing care quality and outcomes for those seeking MH support.

To address identified gaps, a systematic literature review (SLR) was conducted using a published framework to synthesize emerging themes from mixed methods evidence in order to understand how digital health solutions, encompassing both digital therapeutics and direct-to-consumer digital health technologies, are valued, with a focus on MH disorders, Alzheimer disease, epilepsy, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) in the United States.

The SLR was performed in accordance with a prespecified protocol and reported in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines [ 6 , 7 ]. The protocol was not registered.

Search Strategy

Electronic databases, encompassing MEDLINE (including MEDLINE In-Process, MEDLINE Daily, and MEDLINE Epub Ahead of Print); Embase; the Cochrane Library (including Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials); PsycINFO; and the Health Technology Assessment Database, were selected in alignment with this SLR’s target indications and were searched on June 17, 2022. The search terms included combinations of free-text and Medical Subject Heading or Emtree terms related to indications of interest, DMHTs, and relevant outcomes or assessment types (eg, technology assessments and cost; Tables S1-S5 in Multimedia Appendix 1 ). Searches were limited to studies performed in the United States and to those published from 2017 onward.

Manual hand searches of gray literature, namely, the bibliographies of relevant SLRs identified from the electronic database searches and key conference proceedings (2019-2022), were performed to identify additional studies of relevance (Table S6 in Multimedia Appendix 1 ). The FDA website was also searched to identify factors involved in the FDA’s appraisal of relevant MH apps, which could supplement the factors identified in this SLR (Table S7 in Multimedia Appendix 1 ).

Study Selection

Studies were included in the SLR if they met prespecified criteria defined using the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework, which is appropriate for mixed methods research questions. Eligible studies were published in the English language, were set in the United States, and reported quantitative or qualitative outcomes relating to the factors considered in the evaluation of DMHTs. Only studies published in 2017 or later were included because of the rapidly evolving research area. Eligible studies reported on MH, Alzheimer disease, epilepsy, ASD, or ADHD from user, payer, or employer perspectives (Table S8 in Multimedia Appendix 1 ). While the primary focus of the SLR was MH, neurological conditions were also of interest because their pathologies, symptoms, and treatment strategies can overlap with those of mental illnesses. Alzheimer disease, epilepsy, ASD, and ADHD were selected because they are highly researched and represent diverse types of neurological conditions.

The titles and abstracts of records were assessed for inclusion against these eligibility criteria by 2 independent reviewers, and discrepancies were resolved by consensus, with arbitration by a third reviewer if necessary. Full texts of potentially relevant articles were acquired and screened using the same methodology.

Study Prioritization

Due to the large volume of the evidence identified, additional eligibility criteria were applied to prioritize primary research on theoretical DMHT valuation factors. In line with the thematic framework synthesis objective, theoretical valuation factors were defined as user or DMHT attributes that impact interaction with or perception of DMHTs; therefore, studies that reported only efficacy outcomes, such as mental illness symptom improvement, were deprioritized for full-text review. Secondary research was also deprioritized for full-text review. Studies that reviewed a select app against a framework and studies that reported only the outcomes specific to a select app were deprioritized for data extraction. For example, a study reporting the usability of a specific app’s features would have been deprioritized, while a study reporting what types of features increase MH app usability in general would not.

Data Extraction

All relevant data were extracted into a prespecified Microsoft Excel grid, and a quality assessment was performed for each study. Studies that reported only qualitative data were assessed with the Critical Appraisal Skills Program Qualitative Studies Checklist. Studies that reported only quantitative data were evaluated with the Critical Appraisal Skills Program Cohort Study Checklist, and studies reporting both qualitative and quantitative data were evaluated with both checklists [ 8 ]. Data extractions and quality assessments were performed by a single individual for each study, with the information verified by a second independent individual. Discrepancies were resolved by consensus, with arbitration by a third individual if necessary.

Framework Synthesis

A framework synthesis approach was undertaken to synthesize qualitative and quantitative data identified from the SLR. In line with the “best fit” framework synthesis approach, data were indexed deductively against an existing framework where possible, and novel themes were added inductively as needed [ 9 , 10 ]. The American Psychiatric Association (APA) Mental Health App Evaluation framework was considered the most appropriate framework to address the research objectives of this SLR because its key valuation themes were developed using psychiatrist and patient input, are broadly shared by other evaluation frameworks, are widely acknowledged in the literature, and have been described as durable and adaptable [ 11 - 13 ].

The APA model follows a hierarchical and chronological order whereby the evaluator moves through the framework using prompting questions (eg, “Does the app work offline?”). For this SLR, these questions were either thematically grouped into subthemes or left as prompting questions, as appropriate. The framework was therefore ultimately adapted into 3 levels: themes, subthemes, and more granular valuation criteria. It should be emphasized that this SLR did not aim to formally develop an updated framework to be used in practice by HCPs and their patients but rather was used to form a theoretical basis for understanding DMHT valuation factors, for which novel themes were expected to emerge.

A data-based convergent approach was used to synthesize quantitative and qualitative data [ 14 ]. Data were initially indexed deductively against the prespecified themes within the data collection instrument and then further synthesized within Docear [ 15 ], a mind-map software used to organize and connect data and concepts. Indexing was performed by 1 reviewer and checked by a second independent reviewer. New themes and subthemes that emerged from the literature through inductive coding were added post hoc to the thematic framework, with all extracted data then considered against both the prespecified and novel themes. The evidence identified for each theme was synthesized narratively, taking into consideration the context and design of each study.

Included Studies

A total of 4974 records were retrieved from the electronic databases. Of the 3374 (67.83%) unique records identified following deduplication across the databases, 2891 (85.68%) were excluded based on the eligibility criteria, and an additional 456 (13.52%) were deprioritized because they were not directly related to the topic of interest for this SLR. Excluded and deprioritized full texts are listed in Tables S9 and S10 in Multimedia Appendix 1 , respectively. Therefore, 27 (0.54%) articles were included from the electronic database searches. In addition, 1 article reporting on the same study as an already-included conference abstract was identified during supporting targeted searches and included as a supplementary record, resulting in a total of 28 articles reporting on 26 unique studies (Figure S1 in Multimedia Appendix 1 ). No relevant FDA appraisals were identified in the supplementary search.

Of the 26 included studies, 8 (31%) were quantitative, 12 (46%) were qualitative, and 6 (23%) used a mixed methods approach. While 5 (19%) studies assessed prospective cohorts, 22 (85%) used a cross-sectional approach, including 1 (4%) study that contained both a prospective cohort and a cross-sectional cohort ( Table 1 ). All studies (26/26, 100%) investigated a user perspective, with none specifically investigating payer or employer perspectives. Only 1 (4%) study, which examined ingestible sensor pills and smart pill dispensers to track adherence, investigated a DMHT that was not an app [ 16 ].

a Only information relevant to this systematic literature review is reported in this table.

b MDD: major depressive disorder.

c BD: bipolar disorder.

d OCD: obsessive-compulsive disorder.

e MH: mental health.

f General users are participants who were not necessarily diagnosed with indications of interest.

g ASD: autism spectrum disorder.

h HCP: Health care provider.

i mHealth: mobile health.

j PTSD: posttraumatic stress disorder.

k VA: Veterans Affairs.

l ADHD: attention-deficit/hyperactivity disorder.

m PHQ-9: Personal Health Questionnaire-9.

n GAD-7: Generalized Anxiety Disorder-7.

o DMHT: digital mental health technology.

Most frequently, studies focused on indications for mood, anxiety, or psychotic disorders (15/26, 58%), with other indications of focus including ADHD (2/26, 8%), ASD (1/26, 4%), and epilepsy (1/26, 4%). No relevant studies focused on Alzheimer disease were identified.

A total of 8 (31%) studies assessed the perspectives toward DMHTs of general population participants who were not necessarily diagnosed with relevant conditions [ 19 , 28 , 29 , 33 - 37 ]. Of these populations, several were identified as having an increased risk of MH conditions, such as patients with cancer [ 28 ], college students [ 29 , 34 ], deaf or hard-of-hearing individuals [ 19 ], and people who were unemployed or furloughed during the COVID-19 pandemic [ 33 ]. In addition, 1 (4%) study included a mix of patients who were above and below the referral criteria for psychotherapy for depression [ 37 ].

Thematic Analysis

Evidence was identified for all 5 themes included in the APA framework: engagement style (23/26, 88%), background and accessibility (16/26, 62%), privacy and security (13/26, 50%), therapeutic goal (12/26, 46%), and clinical foundation (8/26, 31%; Table 2 ). Five novel criteria were identified and added to the framework post hoc, 1 each under engagement style (forgetting or feeling unmotivated to use DMHTs) and privacy and security (personal image and stigma) and 3 under background and accessibility (willingness to pay, insurance restrictions, and cost savings compared with professional care).

a Novel findings that emerged from this systematic literature review.

b These subthemes and criteria were included in the American Psychiatric Association’s framework but were not reported on by studies included in this systematic literature review.

c HCP: health care provider.

Theme 1: Engagement Style

Engagement style was the most reported theme, with evidence identified from 23 (88%) of the 26 studies. Engagement style encompasses how and why users do or do not interact with DMHTs. The long-term usability subtheme was reported by 96% (22/23) of studies, short-term usability by 12 (52%) studies, and customizability by 7 (30%) studies. Findings from short- and long-term usability subthemes were highly interconnected.

A total of 4 studies reported that ease of use promoted short-term DMHT engagement. In the study by Schueller et al [ 35 ], 89.6% of a general population of smartphone users reported ease of use for MH apps as “important” or “very important,” and users qualitatively reported dislike of “overwhelming,” difficult-to-navigate apps. In addition, users valued apps that were “simplistic” [ 34 ], fit into their daily schedules, and were available when needed (eg, during acute symptom experiences) [ 5 , 25 ]. Select supporting qualitative data are presented in Table 3 .

a ASD: autism spectrum disorder.

b MH: mental health.

c ADHD: attention-deficit/hyperactivity disorder

d BD: bipolar disorder.

e Novel criteria identified by this systematic literature review.

f CHA: Cambridge Health Alliance.

g EMR: electronic medical record.

h HCP: health care provider.

Users valued DMHT features that aligned with their needs and priorities, as reflected by findings within the long-term usability subtheme. Across 9 studies, quantitative and qualitative findings demonstrated high interest in anxiety management features such as relaxation tools, breathing exercises, and mindfulness or meditation activities, and 10 studies identified interest in mood, symptom, or sleep tracking ( Tables 3 and 4 ). While most studies (24/26, 92%) focused on MH, patients with epilepsy also reported high interest in features to record seizure dates and types [ 17 ]. Importantly, users in 2 studies emphasized the need for developers to tailor DMHTs to the needs and priorities of the target population ( Table 3 ) [ 28 , 31 ]. Relatedly, mixed attitudes were reported toward positive affirmations and words of encouragement, with many users expressing interest but others emphasizing the value of a human component to DMHTs or cautioning against blanket encouragement and automated messages that could feel insincere [ 19 , 25 , 31 ].

a A 5-point Likert scale (0-4) was used.

b Not available.

c A 5-point Likert scale (1-5) was used.

d MH: mental health.

e DMHT: digital mental health technology.

f MDD: major depressive disorder.

g PTSD: posttraumatic stress disorder.

Both patients and caregivers expressed interest in psychoeducational content that aligned with their needs and priorities. When surveyed, >60% of veterans with anxiety or major depressive disorder (MDD), patients with epilepsy, young adults with psychosis, and essential and furloughed workers during the COVID-19 pandemic expressed interest in relevant psychoeducational content [ 17 , 22 , 32 , 33 ]. In contrast, only 4% of college students in another study reported using an MH app for information about MH, although an MH diagnosis was not required for study participation [ 29 ].

Caregivers of young adults with psychosis, caregivers of children with ADHD, and spouses and partners of people with bipolar disorder (BD) were all interested in information related to caring for the individual with the given disorder, such as information on psychological and pharmacological treatments, symptoms and symptom changes, and the MH system [ 21 , 24 , 26 ]. Comparatively smaller, but still notable, proportions of caregivers of patients with psychosis were interested in caregiver-focused information; for instance, 62% to 69% were interested in relaxation exercises, stress and mood management, and community events for caregivers, while 85% to 90% were interested in the aforementioned patient-focused information [ 21 ].

Information delivery–style preference was captured under the short-term usability subtheme. One study in young adults with psychosis and another study with their caregivers revealed that delivering information in a variety of formats was important; when presented with nonmutually exclusive options, >50% of both populations were interested in text content, video content, audio content, and discussion boards [ 21 , 22 ].

Social interaction promoted long-term engagement. Qualitatively, 3 studies found that users valued learning about similar experiences from others via social media–like features, which normalized their experiences and could provide new symptom management strategies ( Table 3 ) [ 28 , 31 , 36 ]. Similarly, 67% of both young adults with psychosis and deaf or hard-of-hearing survey participants (N=9) reported interest in peer support via chat features [ 19 , 22 ]. However, a comparatively smaller proportion of veterans with anxiety or MDD (48.3% of the full cohort and 51.3% of the smartphone user subgroup) were interested in peer support [ 32 ].

Overall, users endorsed social features to support their MH. In the study by Casarez et al [ 24 ], spouses and partners of people with BD likewise desired features to communicate with other caregivers and also emphasized that DMHTs could facilitate conversation and understanding with patients, a sentiment echoed by peer support specialists by Storm et al [ 38 ] ( Table 3 ). However, one oncology HCP cautioned that similar to support groups, “very strict guidelines of what is said” should be implemented to manage potential risks from shared social media–like content, although little additional context was provided [ 28 ].

Spouses and partners of people with BD also suggested both in-app information on accessing professional resources and direct counseling for the patient at times when other support might be inaccessible [ 24 ]. More than half of all workers, employed or unemployed during the COVID-19 pandemic, likewise endorsed links to resources, counseling, and crisis support as DMHT features, and 81.6% of young adults with psychosis endorsed a feature to communicate with professional experts [ 22 , 33 ]. Importantly, compared with patients attending public clinics, patients attending private psychiatric clinics expressed a higher comfort level for in-app communication with HCPs, suggesting demographic differences in the valuation of access to professional support through DMHTs [ 39 ].

A total of 9 studies reported an interest in DMHT reminders and notifications. Across 3 studies, >70% of patients or caregivers were interested in appointment reminders [ 17 , 21 , 22 ]. In addition, 73% and 68% of patients with epilepsy reported interest in reminders for medication refills and adherence, respectively [ 17 ]. Beyond apps, caregivers of patients with MDD, BD, and schizophrenia preferred an ingestible pill sensor that tracked medication adherence, physical activity, mood, and rest 9.79 (95% CI 4.81-19.9), 7.47 (95% CI 3.81-14.65), and 6.71 (95% CI 3.29-13.69) times more than a nondigital pill organizer, respectively [ 16 ]. Qualitatively, patients and caregivers also appreciated reminders, especially if reasonably timed or delivered via text messages [ 27 , 31 ].

Short-term DMHT engagement was also supported by games and graphics, which could communicate information in an accessible way [ 24 ], provide tools for stress management [ 17 , 33 ], and be used therapeutically with children [ 20 , 30 ]. However, some HCPs and caregivers expressed concerns that graphics and games may be distracting for certain children ( Table 3 ) [ 20 ].

In a novel finding, 3 studies reported forgetfulness or lack of motivation as an influence on DMHT engagement. In some cases, disuse was related to stress, other MH symptoms, or poor technical literacy ( Table 3 ) [ 5 , 25 , 31 ]. In contrast, “forgetting to use” DMHTs and “lack of motivation” were perceived as relatively small barriers to use in the study by Stiles-Shields et al [ 37 ].

The third subtheme under engagement style was customizability, which was generally valued by users; 70.9% of a general population of smartphone users noted customization was an important factor [ 35 ]. Similarly, 9.4% of all surveyed veterans and 10.9% of those with smartphones reported disliking a prior DMHT due to a lack of personalization [ 32 ]. Users specifically wanted to be able to opt out of irrelevant features, customize audiovisual and design elements, add personal notes to tracked mood data, and provide ongoing feedback to facilitate personalization [ 20 , 24 , 28 , 31 , 34 ].

Theme 2: Background and Accessibility

A total of 16 (62%) studies reported findings related to DMHT background and accessibility, which considers the developer of the DMHT, as well as functionality and accessibility. Of these, 12 (75%) studies reported on the technical considerations subtheme, 9 (56%) on costs, and 2 (13%) on stability.

Under technical considerations, 9 studies assessed diverse accessibility concerns. Broadly, Storm et al [ 38 ] emphasized that DMHTs should be developed in consideration of patients’ social, cognitive, and environmental needs to avoid overwhelming users. Specifically, 2 studies reported language as a barrier. Deaf or hard-of-hearing participants recommended visual content presentation, such as videos and icons, alongside text and American Sign Language translations where possible [ 19 ]. Similarly, when discussing English-only apps, 1 provider stated as follows: “language is a barrier for some [patients]” [ 5 ]. Mobility issues related to MH symptoms or other conditions and technical literacy, such as difficulties remembering passwords and navigating smartphones or apps, created accessibility barriers as well ( Table 3 ) [ 5 , 25 , 27 , 28 ]. Additional concerns included apps that restricted use based on geographic location [ 19 ], user difficulty in finding relevant, useful apps [ 32 ], and limited mobile device memory for downloading apps [ 5 , 19 ].

Offline functionality, reported by 6 studies, was also captured under the technical considerations subtheme. A majority (5/9, 56%) of participants included in the study by Borghouts et al [ 19 ] expressed concern about their mobile data plans when using their devices. Correspondingly, “availability of Wi-Fi” was noted as a top barrier to the use of apps for depression by Stiles-Shields et al [ 37 ], and several veterans in another study reported that home Wi-Fi connectivity facilitated app use by eliminating cellular data fees [ 25 , 37 ]. Quotes from patients and HCPs echoed the concern about apps without offline functionality ( Table 3 ) [ 23 , 30 ].

Data fees were also captured under the costs subtheme, with hidden or additional costs described as a barrier to app use by 2 studies [ 26 , 37 ]. Parents of children with ADHD reported that difficulty paying phone bills could result in their phones being shut off, limiting DMHT use; one MH clinic administrator stated as follows: “We often encounter parents’ phones being shut off because they haven’t paid their bill...If the app were free or low cost, I imagine it could be very helpful” [ 26 ]. In addition to hidden costs, this quote identifies up-front app costs as a barrier. Quantitatively, more than half of a general population of surveyed college students expressed that cost was a top concern for the use of MH apps [ 34 ]. Qualitative findings from 2 additional studies likewise identified cost as a barrier to DMHT use [ 25 , 27 ].

Three novel cost attributes were identified by this SLR: willingness to pay, insurance restrictions, and cost savings compared with professional care. Four studies, 3 of which focused on apps, explored willingness to pay for DMHTs from a user perspective. Willingness to pay varied based on user preference; some surveyed college students and smartphone users among general populations valued free apps due to financial restrictions or uncertainty around app effectiveness, although 1 student commented that the quality of free trials might be inferior [ 34 , 35 ]. Some smartphone users also voiced a limit on how much they would be willing to spend for an app subscription ( Table 3 ) [ 35 ]. Forma et al [ 16 ] found that caregivers were willing to pay US $255.04 (95% CI US $123.21-US $386.86) more per month for a pill with an ingestible sensor that tracked medication adherence, physical activity, and rest and could connect to an app that also collected self-reported mood data. Moreover, the caregivers were willing to pay US $124.50 (95% CI US $48.18-US $200.81) more per month for an app-connected pill organizer alone than for a nondigital pill organizer [ 16 ]. In contrast, some veterans expressed total disinterest in paid apps, with 1 user citing poor technical literacy (“don’t have the knowledge”) in addition to cost as affecting willingness to pay [ 25 ].

In another novel finding, a speech-language pathologist working with children with ASD preferred a single app including multiple features over separate apps for particular features due to insurance restrictions: “I agree that teaching Apps should be an in-App feature versus their own app because sometimes insurance doesn’t allow us to open the iPads purchased through insurance” [ 20 ]. Although no further detail was provided for this finding, it suggests that there may be restrictions on the use of other apps on devices purchased under insurance, which may have implications for DMHT use in formal care settings due to the lack of financial support.

In a third novel cost-related finding, a small number of participants from a general population of students (3.6%) in one study preferred using an MH app to seeing an MH professional due to cost savings [ 29 ].

A total of 13% (2/16) of studies reported on the subtheme of app stability and technical difficulties, with crashes and poor display quality decreasing DMHT value [ 35 , 37 ]. Participants in the study by Schueller et al [ 35 ] reported that technical difficulties were often an issue for apps developed by medical institutions, which might be effective and safe but less usable than apps from other developers.

Theme 3: Privacy and Security

A total of 13 (50%) out of 26 studies reported findings related to the privacy and security theme, which covered the use and protection of user data by DMHTs. Subthemes were reported relatively equally: data collection and storage (5/13, 38%), personal health information (PHI; 5/13, 38%), privacy policies (4/13, 31%), general privacy (3/13, 23%), and security measures (3/13, 23%).

Quantitative and qualitative findings on general privacy (ie, evidence not categorized under any specific subtheme), the data collection and storage subtheme, and the privacy policies subtheme revealed heterogeneous concerns ( Table 3 ). A total of 74% of a general population of college students reported privacy as a top concern for MH apps, although further details on the specific area of concern were unclear [ 34 ]. In the study by Stiles-Shields et al [ 37 ], participants were highly concerned with data access but less so with general privacy. Echoing the concerns about data collection and storage, 59.1% of veterans with anxiety or MDD in 1 study were concerned about in-app PHI protection [ 32 ]; however, a qualitative study in veterans with posttraumatic stress disorder, alcohol use disorder, or MDD reported that a relatively small number of participants expressed privacy concerns. In the latter study, reasons for the concerns included distrust in Veterans Affairs, belief that digital data are inherently not confidential, and fear of phone hacking [ 25 ]. From an HCP perspective, none of the surveyed behavioral health HCPs agreed with the statement “My patients are concerned about data security,” despite multiple patients within the same study reporting privacy concerns [ 5 ].

Still, privacy policies were important overall, with 70.5% of smartphone MH app users rating having a privacy policy as “very important” or “important” [ 35 ]. Melcher et al [ 34 ] found that although users valued data protection, some reported a lack of awareness about data privacy, and others were concerned about obscure privacy policies and PHI use. As noted in the data collection and storage subtheme, veteran concerns about government use of PHI were heterogeneous [ 25 ].

A novel valuation factor not included in the APA framework related to user concern with PHI privacy and security regarding MH diagnoses and MH app use is a desire to upkeep their personal image or avoid stigma ( Table 3 ) [ 5 , 25 , 29 , 40 ]. For instance, 21.1% of a general college student population preferred MH app use to seeing an MH professional due to anonymity or reduced stigma [ 29 ]. One participant in a study of Veterans Affairs health service users described access to professional care via MH apps as convenient because they could avoid disclosing their use of MH services to explain leaving work early for an appointment [ 25 ].

In line with the overarching concern about PHI privacy and security, users valued app security measures. Schueller et al [ 35 ] reported that 74.2% of users rated data encryption as “important” or “very important.” Users in another study perceived the level of privacy protection as the highest for apps using a combination of a generic app name (ie, not reflecting the indicated MH disorder); easily hidden modules; and secure, user-authenticated web portals for making module changes [ 40 ]. Behavioral health clinic staff echoed the importance of discreet MH app names ( Table 3 ) [ 30 ].

Theme 4: Therapeutic Goal

There were 12 (46%) studies that reported on the factors relating to the integration of DMHTs with users’ therapeutic goals. The clinical actionability and therapeutic alliance subthemes were reported by 83% (10/12) and 58% (7/12) of studies, respectively.

A total of 9 studies reported the value of clinically actionable insights from apps where the users could acquire and practice new skills to make positive changes in their lives ( Table 3 ). For instance, patient and caregiver app users reported interests in “daily tips,” “new ideas,” and “solutions or recommendations” for symptom management [ 26 , 27 , 36 ]. Furthermore, an app that could serve as a resource for multiple management strategies was preferable [ 26 , 28 , 31 ]. Quantitatively, 4% of patients receiving acute treatment in a partial hospitalization program for MH conditions, including mood and psychotic disorders, reported that the primary purpose of their DMHT use was therapy skills practice [ 18 ]. HCPs similarly appreciated that DMHTs could facilitate patients practicing skills outside of formal treatment sessions [ 5 ]. In particular, clinicians from a youth behavioral health clinic noted that DMHTs might be especially beneficial for young users because they could be conveniently and discreetly incorporated into their daily lives [ 30 ].

Users valued easy data sharing with clinicians, particularly for mood- or symptom-tracking features, which could improve communication and the accuracy of symptom reporting during clinical visits [ 5 , 25 - 27 , 34 , 36 ]. For instance, 53% of a general college student population believed that the potential to share information with their clinician was “one of the top benefits” of using DMHTs [ 34 ]. In addition, many HCPs reported active use or interest in the use of DMHTs in clinical practice to facilitate asynchronous communication and increase patient engagement with treatments outside of formal appointments; however, some preferred traditional care strategies for their personalization and flexibility ( Table 3 ) [ 5 , 26 , 30 ].

Theme 5: Clinical Foundation

A total of 8 (31%) studies reported findings related to the clinical foundation of DMHTs, that is, their utility and appropriateness for patients. Clinical validity was the most reported subtheme, with evidence identified from 6 (75%) studies; 2 (25%) studies reported on the user feedback subtheme and 2 (25%) on the impressions of use subtheme, which captured users’ perceptions of app content as accurate and relevant.

Across subthemes, users valued evidence of DMHT benefit or efficacy from various sources. A total of 71.8% of surveyed veterans said that they would use a DMHT if they “saw proof that it worked” for their MH conditions [ 32 ]. Similarly, among the 811 general population participants surveyed, 69.5% ranked direct research evidence as “important” or “very important” for DMHT, and 66.8% ranked indirect research evidence the same [ 35 ]. Qualitative data identified recommendations from HCPs or academic institutions, as well as evidence of DMHT benefit from publications or research studies, as specific sources for clinically valid evidence of benefits ( Table 3 ) [ 27 , 34 , 35 ].

In addition to academic and professional support, the user feedback subtheme captured user interest in whether DMHTs were beneficial for peers or recommended by other trusted individuals. Patients with depression reported that other users’ experiences influenced their app use, with one user wanting to know “...if other people had success using it” [ 27 ]. Quantitatively, user ratings and user reviews were ranked as “important” or “very important” factors in DMHT use by 59.4% and 58.7% of the general population participants, respectively [ 35 ].

Quality Assessment

The risk of bias was overall moderate. Of the 14 studies including quantitative components, only 1 (7%) used relevant validated outcome measurement instruments [ 33 ]; all others used custom questionnaires. Of the 18 studies with qualitative components, 4 (22%) were at risk of selection bias due to participants being exclusively recruited using web-based postings and research registries [ 33 - 35 , 37 ], and only 1 (6%) considered the relationship between researcher and participant when interpreting the results [ 36 ]. Full quality assessments for qualitative and quantitative study components can be found in Tables S11 and S12 in Multimedia Appendix 1 , respectively.

Principal Findings

This SLR aimed to identify and synthesize qualitative and quantitative evidence on how DMHTs are valued by users, payers, and employers in the United States. Evidence from users with or without diagnosed relevant disorders, caregivers, and HCPs was captured across a wide range of demographics. No study reported evaluating an app from a payer or employer perspective. Furthermore, all but one included study focused on mobile apps.

No relevant appraisals of DMHTs were identified from the FDA website searches; however, 8 relevant FDA approval labels or notifications for MH apps or guidance documents for industry and FDA staff were identified. The content of these materials overlapped with some valuation factors identified in this SLR, including evidence of clinical efficacy and safety, app maintenance, and privacy and security.

Engagement style, although not covered by the FDA materials, was the most reported theme by the studies included in this SLR and was found to overlap heavily with other themes. Engagement may be a key consideration for app developers, as app user retention can be low: 1 study showed that >90% of users had abandoned free MH apps within 30 days of installation [ 41 ]. Engagement is also a key clinical concern in terms of DMHT efficacy; one meta-analysis of 25 studies showed that increased use of DMHT modules was significantly associated with positive outcomes regardless of the target MH condition [ 42 ]. The findings of this SLR may therefore be informative to both DMHT designers and HCPs who integrate DMHTs into clinical care by providing insight on DMHT valuation and thus how use and benefit can be improved. For instance, users valued DMHTs that were easy to use and aligned with their needs and priorities, particularly through features that supported their therapeutic goals. In addition, content presented through multiple delivery modes, such as both text and visuals, promoted engagement as well as accessibility.

However, engagement and feature preference varied across populations. For instance, DMHT valuation was affected by technical literacy, which may relate to user demographics; in this SLR, veterans repeatedly emphasized technical literacy as a barrier to DMHT use [ 25 ]. Similarly, offline functionality may be more important for some users. Although 85% of the total United States population owns smartphones, only 59% of Medicare beneficiaries have access to a smartphone with a wireless plan. Moreover, beneficiaries who are older, less educated, disabled, or Black or Hispanic have even lower digital access [ 43 , 44 ]. These findings emphasize the importance of customizability and suggest that app development and selection in the clinical setting should consider the demographics of the target population, particularly in relation to ease of use and offline functionality.

Background and accessibility findings also identified up-front and hidden costs as barriers to DMHT use, with the willingness to pay varying among individuals. This has important implications for app development, considering that many MH apps currently on the market are direct-to-consumer sales and require out-of-pocket payment. App developers often take this approach as it does not require the accumulation of formal evidence of clinical benefit for FDA approval [ 45 ], but it may present a financial barrier to use for consumers.

Privacy and security, reported by 13 (50%) out of 26 studies, was a prevalent theme, with users primarily concerned with data and PHI security within apps. This finding reflects wider research; a 2019 review of 116 depression-related apps retrieved from iTunes and Google Play stores in 2017 found that only 4% of the identified apps had acceptable transparency in privacy and security, with many completely lacking a privacy policy [ 46 ]. Similarly, 39% of MH apps recommended by college counseling centers had no privacy policy, and of those with a policy, 88% collected user data, and 49% shared that data with third parties [ 4 ]. Most evidence identified in this SLR under this theme, as well as findings previously published in the wider literature, focuses on these remote privacy risks. However, local privacy concerns are also important to users. In particular, inconspicuous naming and the ability to hide sensitive modules within MH apps were rated as highly important by both patients and HCPs to maintain user privacy. Users emphasized a desire to avoid the stigma associated with mental illness, which was also reflected by the findings in the engagement style theme: more young adults with psychosis were more interested in in-app messaging with other patients in psychosis recovery (67.1%) than a provider and family member together (47.3%) or their personal support network (59.8%) [ 22 ]. Similarly, youths were interested in apps that could be used discreetly in school or other public settings to avoid potential MH stigma. This is a key, novel finding of this SLR, considering that many app or DMHT components on the market are named after their target disorder.

The use of DMHTs to achieve therapeutic goals was discussed from patient, caregiver, and HCP perspectives, all of which valued DMHTs that had evidence of efficacy, presented clinically actionable information, and facilitated patient-clinician relationships. Of the 5 studies that explored how HCPs value DMHTs in clinical practice, 2 (40%) were restricted to the oncology or ASD settings and were not readily generalizable to wider MH settings [ 20 , 28 ]. In other studies, providers reported interest in using DMHTs to facilitate asynchronous communication with patients and their caregivers, promote patient skill practice, and improve care for children through the use of games and visuals [ 26 , 30 ]. However, while HCPs overall believed that DMHTs improved care, some believed that their clinical training allowed for care personalization beyond what DMHTs could provide. Feature customizability and receipt of input from HCPs and users during app development and testing may be a way to mitigate these concerns, as well as concerns about safety and efficacy, as many available apps do not appropriately address user health concerns [ 47 ].

Findings additionally suggested that training and resources on DMHTs would be beneficial to ensure that HCPs were equipped to integrate DMHTs into their practices [ 5 ]. Collaboration between DMHT specialists and HCPs, along with a shift from randomized controlled trials to effectiveness-implementation hybrid trials, may be a way to streamline the integration of DMHTs into clinical care and provide more training and resources for HCPs [ 30 , 48 ].

This review followed a prespecified protocol and used systematic methods in line with the York Centre for Reviews and Dissemination guidelines [ 49 ] to conduct an exhaustive search of the literature, identifying evidence relevant to the review objectives from multiple databases and supplementary sources. The framework synthesis approach allowed for the inclusion and analysis of both qualitative and quantitative data, providing a detailed picture of not only what DMHT features users value but why they value them, especially in areas where valuation varies across patient demographics. In addition, the APA framework is a robust model created with patient and HCP input that incorporates key valuation themes broadly shared by other frameworks and widely acknowledged in the literature [ 11 - 13 ].

Limitations

Methodological limitations should be considered when interpreting the findings of this SLR. Only publications in English and in United States populations were included. As perceptions of value are influenced by factors including cultures, laws, and health care settings, the findings of this SLR should not be generalized to other countries. For instance, trust in HCPs and rates of longstanding relationships between patients and primary care providers are lower in the United States than in many European nations [ 50 , 51 ], which could impact the type of support users want from DMHTs (ie, engagement style) or interest in DMHT integration with therapeutic goals.

In addition to the prespecified eligibility criteria, deprioritization strategies were implemented due to the large volume of the identified evidence, and this may have resulted in missing relevant articles. In particular, the deprioritization of secondary research and opinion pieces likely led to the exclusion of relevant discussion around payer perspectives and reimbursement, for which no evidence was included in this SLR. Furthermore, although unlikely, there may have been reporting biases in the included studies due to missing results, which this SLR was not able to assess.

This SLR identified no evidence for 3 subthemes included in the APA framework: business model (background and accessibility), which covers DMHT funding sources and potential sources of conflict, medical claims (background and accessibility), which examines whether DMHTs claim to be medical and the trustworthiness of their creators, and data ownership, access, and export (therapeutic goal), which includes sharing data with eHealth records or wellness devices (eg, Apple HealthKit [Apple Inc], Fitbit [Google LLC]). The valuation of these subthemes should be evaluated in future research.

Conclusions

In summary, app usability, cost, accessibility and other technical considerations, and alignment with therapeutic goals were the most reported valuation factors identified by this SLR. Many studies also reported user preference for apps that incorporated privacy and security features that provided protection from stigma. However, individual DMHTs and their features are valued differently across individuals based on demographics and personal preferences. MH apps should be developed and selected with these specific user needs in mind. Feature customizability and input from users and HCPs during development may improve app usability and clinical benefit.

Acknowledgments

The authors thank Max Lee, Costello Medical, US, for medical writing and editorial assistance based on the authors’ input and direction.

Conflicts of Interest

DCM is a consultant for Otsuka Pharmaceutical Development & Commercialization (OPDC) Inc for this project and has received consulting funds from Pear Therapeutics, Sanofi, Avidity, Sarepta, Novartis, and BioMarin. ML, HG, and HCW are employees of OPDC. JC, SB, RSK, and EW are employees of Costello Medical. This research was funded by OPDC.

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Abbreviations

Edited by J Torous; submitted 15.02.24; peer-reviewed by A Mathieu-Fritz, K Stawarz; comments to author 05.05.24; revised version received 20.06.24; accepted 21.06.24; published 30.08.24.

©Julianna Catania, Steph Beaver, Rakshitha S Kamath, Emma Worthington, Minyi Lu, Hema Gandhi, Heidi C Waters, Daniel C Malone. Originally published in JMIR Mental Health (https://mental.jmir.org), 30.08.2024.

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

• Open access
• Published: 31 August 2024

Incidence of post-extubation dysphagia among critical care patients undergoing orotracheal intubation: a systematic review and meta-analysis

• Weixia Yu 1   na1 ,
• Limi Dan 1   na1 ,
• Jianzheng Cai 1 ,
• Yuyu Wang 1 ,
• Qingling Wang 1 ,
• Yingying Zhang 1 &
• Xin Wang 1  

European Journal of Medical Research volume  29 , Article number:  444 ( 2024 ) Cite this article

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Post-extubation dysphagia (PED) emerges as a frequent complication following endotracheal intubation within the intensive care unit (ICU). PED has been strongly linked to adverse outcomes, including aspiration, pneumonia, malnutrition, heightened mortality rates, and prolonged hospitalization, resulting in escalated healthcare expenditures. Nevertheless, the reported incidence of PED varies substantially across the existing body of literature. Therefore, the principal objective of this review was to provide a comprehensive estimate of PED incidence in ICU patients undergoing orotracheal intubation.

We searched Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science, Technology Journal Database (VIP), and SinoMed databases from inception to August 2023. Two reviewers independently screened studies and extracted data. Subsequently, a random-effects model was employed for meta-statistical analysis utilizing the “meta prop” command within Stata SE version 15.0 to ascertain the incidence of PED. In addition, we performed subgroup analyses and meta-regression to elucidate potential sources of heterogeneity among the included studies.

Of 4144 studies, 30 studies were included in this review. The overall pooled incidence of PED was 36% (95% confidence interval [CI] 29–44%). Subgroup analyses unveiled that the pooled incidence of PED, stratified by assessment time (≤ 3 h, 4–6 h, ≤ 24 h, and ≤ 48 h), was as follows: 31.0% (95% CI 8.0–59.0%), 28% (95% CI 22.0–35.0%), 41% (95% CI 33.0–49.0%), and 49.0% (95% CI 34.0–63.0%), respectively. When sample size was 100 <  N  ≤ 300, the PED incidence was more close to the overall PED incidence. Meta-regression analysis highlighted that sample size, assessment time and mean intubation time constituted the source of heterogeneity among the included studies.

The incidence of PED was high among ICU patients who underwent orotracheal intubation. ICU professionals should raise awareness about PED. In the meantime, it is important to develop guidelines or consensus on the most appropriate PED assessment time and assessment tools to accurately assess the incidence of PED.

Graphical abstract

Introduction

Mechanical ventilation is the most common technological support, being required by 20–40% of adult in ICU [ 1 ]. Orotracheal intubation is the primary way of mechanical ventilation in ICU, which can increase the risk of post-extubation dysphagia (PED) [ 2 , 3 ]. PED is any form of swallowing dysfunction that arises subsequent to extubation following endotracheal intubation, affecting the passage of food from the entrance to the stomach. The occurrence rate of PED within the ICU setting demonstrates considerable variation among different countries [ 4 ]. The incidence varied among countries, including 13.3–61.8% in the United States [ 5 , 6 ], 25.3–43.5% in France, and 23.2–56% in China [ 7 , 8 ], and the incidence ranging from 7 to 80% [ 9 , 10 ]. Significantly, PED standing out as a prominent complication encountered in this particular context. For instance, See et al. have elucidated that patients afflicted with PED face an 11-fold higher risk of aspiration compared to those without PED [ 11 ]. McIntyre et al. have underscored that patients afflicted with PED endure double the length of stay in the ICU and the overall hospitalization period when compared to patients without PED [ 10 ]. Furthermore, it is essential to note that PED emerged as an independent predictor of 28-day and 90-day mortality [ 12 ]. This high incidence of PED places an immense burden not only on patients but also on the broader healthcare system. Therefore, a systematic review and meta-analysis is necessary to explore the incidence of PED in ICU patients. A systematic review and meta-analysis conducted by McIntyre et al. reported that the incidence of PED was 41%, but the main outcomes of their partly included studies was aspiration [ 12 ]. Although aspiration and PED are closely related, not all aspiration is caused by dysphagia. The incidence of aspiration was 8.80%-88.00% in ICU [ 13 , 14 ], so the incidence of PED in that study may be overestimated. Moreover, there has been increasing literature on PED of ICU patients, and a new systematic review and meta-analysis is needed to obtain a more precise estimate of its incidence.

The incidence of PED may indeed vary depending on various covariates, including assessment time, mean intubation time, age and other relevant factors. First, there is no standard time for swallowing function assessment, which spans a range of intervals, including 3 h [ 6 , 9 , 12 ], 4–6 h [ 15 , 16 ], 24 h [ 17 , 18 , 19 ], 48 h [ 20 ], 7 days [ 21 ], and discharge [ 22 ], and the incidence of PED was 80% [ 9 ], 22.62% [ 15 ], 56.06% [ 18 ], and 35.91% [ 20 ], 22.06% [ 21 ], and 28.78% [ 22 ], respectively. Second, the PED is closely tied to the time of orotracheal intubation. Skoretz et al. have demonstrated that the overall incidence of PED in the ICU ranges from 3 to 4%. However, upon re-analysis of patients subjected to orotracheal intubation for more than 48 h, the PED incidence can surge as high as 51% [ 23 ]. Third, the choice of assessment tool to evaluate PED in ICU patients plays a pivotal role. These assessment tools may include Video-fluoroscopic Swallowing Study (VFSS), Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Standardized Swallowing Assessment (SSA), Bedside Swallowing Evaluation (BSE), Gugging Swallowing Screen (GUSS), Post-Extubation Dysphagia Screening Tool (PEDS), Water Swallowing Test (WST) and other assessment tools. FEES and VFSS are considered the gold standards, with a detection rate of approximately 80% [ 9 ]. SSA and BSE exhibit detection rates of 22% and 62%, respectively [ 5 , 15 ]. Finally, age-related changes in laryngeal sensory and motor functions also influence PED risk [ 24 ]. Notably, there may not be a significant difference in the incidence of PED between elderly and young patients within the initial 48 h post-extubation. However, elderly patients exhibit a significantly slower rate of PED recovery compared to their younger counterparts over time (5.0 days vs 3.0 days; p  = 0.006) [ 5 ]. Therefore, it is necessary to explore the potential source of heterogeneity in the incidence of PED in ICU patients from such covariates.

The purpose of this study was to estimate the incidence of PED among ICU patients who underwent orotracheal intubation and investigate potential sources of heterogeneity through the application of subgroup analyses and meta-regression.

This systematic review and meta-analysis was conducted adhering to the guidelines outlined in the Joanna Briggs Institute (JBI) Reviewers’ Manual and followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement (PRISMA 2020) [ 25 ] (see Additional file 1: Table S1). In addition, it was registered with PROSPERO under the registration number CRD42022373300.

Eligibility criteria

The study’s eligibility criteria were established in accordance with the PICOS principle. Inclusion criteria as follows: population (P): adult patients (≥ 18 years old) admitted to the ICU who underwent orotracheal intubation. Exposure (E): undergoing orotracheal intubation. Outcome (O): PED. Study design (S): observational study (cohort, case–control, cross-sectional study). In studies where multiple articles were derived from the same sample, only the article providing the most detailed data was included. Patients at high risk of dysphagia (such as those with head and neck cancer, who have undergone head and neck surgery, patients receiving palliative care, esophageal dysfunction, stroke, esophageal cancer and Parkinson’s disease) were excluded. Studies were excluded if they exhibited incomplete original data or data that could not be extracted. Studied were also excluded if their sample sizes fell below 30 participants or the full text was inaccessible.

Data sources and search strategy

Our comprehensive search multiple databases, including Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and SinoMed, with the search period encompassing inception to August 18, 2023. Search language was Chinese and English. The limited number of studies retrieved initially, primarily attributed to the inclusion of the qualifier “ICU” in the initial search, prompted us to broaden the scope of our literature search. Consequently, we refined the search strategy by reducing the emphasis on “ICU” during the search process. After a series of preliminary searches, we finalized the search strategy, which combined subject headings and free-text terms while employing Boolean operators to enhance search precision. In addition, a manual hand-search of the reference lists of selected articles was carried out to identify any supplementary studies not originally identified through the electronic search. For a detailed presentation of our complete search strategies across all databases, please refer to Additional file 1: Table S2.

Quality evaluation

The evaluation of the risk of bias within the included studies was conducted by two trained investigators. Cross-sectional study was evaluated by the Agency for Healthcare Research and Quality (AHRQ) tool [ 26 ], which consisted of 11 items, resulting in a maximum score of 11. Scores falling within the ranges of 0–3, 4–7, and 8–11 corresponded to studies of poor, moderate, and high quality, respectively. Cohort study was evaluated by the Newcastle–Ottawa Scale (NOS) tool [ 27 ], which comprised three dimensions and eight items, allowing for a star rating ranging from 2 to 9 stars. In this case, 0–4, 5–6, and 7–9 stars were indicative of study of poor, moderate, and high quality, respectively. Any discrepancies or disagreements between the investigators were resolved through discussion, when necessary, consultation with a third expert specializing in evidence-based practice methodology.

Study selection and data extraction

Bibliographic records were systematically exported into the NoteExpress database to facilitate the screening process and the removal of duplicate citations. Initial screening, based on titles and abstracts, was conducted by two reviewers who possessed specialized training in evidence-based knowledge. To ascertain whether the studies satisfied the predefined inclusion and exclusion criteria, the full texts of potentially relevant articles were acquired. In the event of disagreements between the two reviewers, resolution was achieved through discussion or, when necessary, by enlisting the input of a third reviewer for arbitration.

After confirming the included studies, the two authors independently extracted data from the each paper, including the first author, year of publication, country, study design, ICU type, mean patient age, mean intubation time, assessment time, assessment tool, evaluator, sample size, and the PED event. Any disparities during the process of extracted data were addressed through thorough discussion and consensus-building among the reviewers.

The outcomes of this review were as follows: (1) incidence of PED in patients with orotracheal intubation in the ICU; (2) sources of heterogeneity of PED in patients with orotracheal intubation in ICU.

Statistical analyses

Meta-analysis was conducted using the ‘meta prop’ function from the meta package within STATA/SE (version 15.0, StataCorp, TX, USA). To approximate the normal distribution of the data, incidence estimates were transformed using the “Freeman-Tukey Double Arcsine Transformation”. Heterogeneity was assessed using the I 2 statistic, and pooled analyses of PED were executed employing a random-effects model in the presence of significant heterogeneity ( I 2  ≥ 50%), with fixed-effects models utilized when heterogeneity was non-significant. A significance level of P  < 0.05 was established for all analyses.

Subgroup analyses were undertaken to investigate the potential impact of various factors, including assessment tool (gold standard, SSA, GUSS, BSE, PEDS, WST, and other assessment tools), year of publication (2000–2010, 2011–2015, 2016–2020, 2021–2023), study design (cross-sectional study and cohort study), study quality (moderate quality and high quality), assessment time (≤ 3 h, 4–6 h, ≤ 24 h, ≤ 48 h, and after 48 h post-extubation), mean intubation time (≤ 24 h, 48 – 168 h, and > 168 h), mean patient age (≤ 44 years, 45–59 years, 60–74 years), evaluator (nurses, speech-language pathologist), ICU type (Trauma ICU, Cardiac surgery ICU, Mixed medical and surgical ICU), and sample size ( N  ≤ 100, 100 <  N  ≤ 200, 200 <  N  ≤ 300, N  > 300) on the pooled estimate. In instances where no source of heterogeneity was identified in the subgroup analyse, we conducted meta-regression to further pinpoint the origins of heterogeneity, focusing on assessment time, mean intubation time, mean age, assessment tool, sample size, evaluator, ICU type, study design, study quality and year of publication. Sensitivity analysis by the “leave-one-out method” was employed to evaluate the random-effects model’s stability of the pooled incidence of PED. Publication bias was assessed by funnel plot and “Trim and Full” method.

Certainty of the evidence

The level of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) [ 28 ]. This tool classifies the certainty of evidence into four levels: very low, low, moderate, and high. “High quality” suggests that the actual effect is approximate to the estimate of the effect. On the other hand, “Very low quality” suggests that there is very little confidence in the effect estimate and the reported estimate may be substantially different from what was measured. Two reviewers judged the following aspects: risk of bias, inconsistency, imprecision, indirect evidence, and publication bias. Disagreements were resolved by consensus with the third reviewer.

Study selection

Out of the 4144 studies initially identified, 1280 duplicate studies were removed, and an additional 2864 studies that were deemed irrelevant were excluded based on title and abstract screening. Subsequently, a thorough examination of the full text was conducted for the remaining 122 studies. A manual hand-search of the reference lists of selected articles was 5 studies. Finally, 30 studies were chosen as they met the predetermined inclusion criteria for this systematic review and meta-analysis. The study selection flowchart is shown in Fig.  1 .

Flowchart of study selection

General characteristics of the included studies

The characteristics of the included studies are shown in Table  1 . The total sample size across these studies amounted to 6,228 participants. The earliest study in this review was conducted in 2003 [ 29 ], while the most recent study was conducted in 2023 [ 15 ], with 14 studies published after 2020. The study with the largest sample size was conducted by Schefold et al. [ 12 ], comprising 933 participants, while the study with the smallest sample size was carried out by Yılmaz et al. [ 19 ], including 40 participants. The methods employed to assess the incidence of PED exhibited variability among the studies. Specifically, one study employed VFSS [ 30 ], and four studies relied on FEES [ 9 , 29 , 31 , 32 ], and seven studies utilized SSA assessment tools [ 7 , 15 , 16 , 33 , 34 , 35 , 36 ]. Furthermore, six studies utilized BSE [ 5 , 10 , 17 , 37 , 38 , 39 ], two studies employed WST [ 12 , 40 ], two studies adopted PEDS [ 8 , 18 ], two studies utilized GUSS [ 19 , 41 ], and six studies employed other assessment tools [ 6 , 20 , 21 , 22 , 43 ,, 42 , 43 ] such as ASHA, FOIS, SSQ200, NPS-PED, MASA, and YSP.

Among all the studies, 23 studies recorded the assessment time for PED. Specifically, three studies assessed PED within ≤ 3 h post-extubation [ 6 , 9 , 12 ], four studies conducted assessments at 4–6 h post-extubation [ 15 , 16 , 33 , 36 ], nine studies assessed PED within ≤ 24 h post-extubation [ 7 , 8 , 17 , 18 , 19 , 31 , 34 , 40 , 41 ], three studies assessed PED within ≤ 48 h post-extubation [ 5 , 20 , 37 ], and four studies evaluated PED at > 24 h post-extubation [ 21 , 22 , 29 , 38 ]. In terms of study quality, eight of the included studies were categorized as high quality, while the remainder were deemed of moderate quality (see Additional 1: Tables S3, S4).

Meta-analysis results

Utilizing the random-effects model, the pooled incidence of PED was estimated to be 36% (95% CI 29.0%–44.0%, I 2  = 97.06%, p  < 0.001; Fig.  2 ), indicating a substantial degree of heterogeneity. Despite conducting additional subgroup analyses, the source of this high heterogeneity remained elusive. However, the results of the meta-regression analysis revealed that sample size ( p  < 0.001), assessment time ( p  = 0.027) and mean intubation time ( p  = 0.045) emerged as the significant factor contributing to the heterogeneity.

Overall pooled incidence of PED in ICU

Subgroup analysis of incidence

The subgroup analyses yielded the following incidence rates of PED based on assessment time post-extubation: the incidence of PED within 3 h post-extubation was 31% (95% CI 8.0–59.0), 4–6 h was 28% (95% CI 22.0–35.0, I 2  = 78.56%, p  < 0.001), within 24 h was 41% (95% CI 33.0–49.0, I 2  = 88.99%, p  < 0.001), and within 48 h was 49%. In addition, the incidence of PED beyond 24 h post-extubation was 37% (95% CI 23.0–52.0, I 2  = 91.73%, p  < 0.001) (Additional file 1: Fig. S1). Furthermore, when analyzing studies based on sample size ( N ), the overall incidence of PED was found 51% (95% CI 39.0–63.0, I 2  = 87.11%, p  < 0.001) for studies with N  < 100 participants, 37% (95% CI 31.0–43.0, I 2  = 84.74%, p  < 0.001) for studies with 100 <  N  ≤ 200 participants, 32% (95% CI 20.0–46.0, I 2  = 97.16%, p  < 0.001) for studies with 200 <  N  ≤ 300 participants, and 16% (95% CI 8.0–26.0, I 2  = 97.07%, p  < 0.001) for studies with N  > 300 participants (see Additional file 1: Fig. S2). In addition, further analyses were conducted based on assessment tool, mean intubation time, mean age, ICU type, evaluator, publication year, study design and study quality (see Additional file 1: Figs. S3–S11).

Results of meta-regression analysis

In the meta-regression analysis, we examined PED assessment time, sample size, assessment tools, mean intubation time, mean age, ICU type, evaluator, publication year, study design and study quality as potential covariates to identify the source of heterogeneity (Table  2 ). The univariate meta-regression analysis revealed a statistically significant correlation between incidence and sample size, assessment time and mean intubation time. Bubble plots of meta-regression of covariates were shown in Additional (see Additional file 1: Figs. S12–S22).

Sensitivity analysis

Sensitivity analysis showed that the incidence of PED ranged from 29 to 44% (see Additional file 1: Fig. S23). The marginal variance between these results and the pooled incidence was minimal, suggesting that the result of the pooled incidence being stable and reliable.

Publication bias

In our study, publication bias was detected by the funnel plot (see Additional file 1: Fig. S24). We found that the adjusted effect size was similar to the original effect size ( p  < 0.01) (see Additional file 1: Fig. S25).

The certainty of evidence was very low for all comparisons performed according to the GRADE rating [ 28 ]. Thus, it can be considered that the certainty of the evidence regarding the incidence of PED in this review is very low (Table  3 ).

This systematic review and meta-analysis aimed to estimate the incidence of PED in ICU patients. The study revealed an overall incidence of PED in ICU patients who underwent orotracheal intubation to be 36.0%. This incidence rate was comparable to the incidence of dysphagia resulting from stroke (36.30%) [ 45 ] and aligned with the incidence of PED observed in ICU patients (36%) [ 46 ]. However, it was slightly lower than the 41% reported in the meta-analysis conducted by McIntyre et al. [ 4 ]. The incidence of PED among ICU patients who underwent orotracheal intubation was high, ICU medical professionals, especially nurses should raise awareness about PED. However, the included studies were characterized by diversity and heterogeneity in assessment time and assessment tools signaled the need for obtaining consensus on a range of issues, including assessment time and assessment tools appropriate for ICU.

Sample size

This review identified sample size as a significant source of heterogeneity ( p  < 0.001). Notably, the incidence of PED demonstrated a gradual decrease as the sample size of the studies increased. In larger scale studies, such as those conducted by McIntyre et al. and Schefold et al., simpler assessment tools are employed, allowing for quick completion [ 10 , 12 ]. However, the reliability and validity of some of these tools remain unverified. Conversely, certain studies are conducted by highly trained professionals using the gold standard for PED assessment [ 9 , 29 , 31 ], which, while more accurate, is also time-consuming and costly [ 47 ]. In addition, some ICU patients, due to their unstable conditions, are unable to complete the gold standard assessment, resulting in relatively smaller sample sizes for these studies.

In statistics, sample size is intricately linked to result stability, and the confidence intervals for subgroups with N  < 100 in this study exhibited a wider range, this might diminish the result precision and lead to larger deviations from the true value. However, as the sample size increased to 100 <  N  ≤ 300, the confidence intervals narrowed in comparison to other subgroups. Consequently, when sample size was 100 <  N  ≤ 300, the PED incidence rates were more close with the overall PED rate. According to the central limit theorem, if the sampling method remains consistent, results obtained from larger samples are more stable and closer to the true value [ 48 , 49 ]. It is worth noting that the confidence intervals for the subgroup with N  > 300 in this study were wider and demonstrated a larger divergence from the total PED incidence. Therefore, in future studies, careful consideration of the sample size, based on the detection rate of the assessment tool used, is advisable to ensure both the stability and reliability of the results.

Mean intubation time

This review identified mean intubation time as a significant source of heterogeneity ( p  = 0.045). Variances in mean intubation time among ICU patients undergoing orotracheal intubation can lead to differing degrees of mucosal damage in the oropharynx and larynx [ 2 , 50 ], thereby resulting in varying incidence rates of PED. For instance, Malandraki et al. have reported that prolonged intubation is associated with more than a 12-fold increased risk of moderate/severe dysphagia compared to shorter intubation durations, and this effect is particularly pronounced among elderly patients [ 51 ]. Moreover, studies have demonstrated that ICU patients with extended orotracheal intubation periods leading to PED also exhibit diminished tongue and lip strength, protracted oral food transportation, slower swallowing, and muscle weakness in swallowing-related muscles [ 24 , 46 ]. In view of these findings, ICU medical professionals should routinely evaluate the need for orotracheal intubation, strive to minimize the duration of mechanical ventilation.

PED assessment time

This review identified assessment time as a significant source of heterogeneity ( P  = 0.027). It is important to note that there are currently no established guidelines recommending the optimal timing for the initial assessment of PED in ICU patients who have undergone orotracheal intubation. Consequently, the assessment time varies widely across studies, resulting in PED incidence rates ranging from 28 to 49% among subgroups. Interestingly, the incidence of PED assessed within ≤ 3 h post-extubation appeared lower than that assessed within ≤ 24 h and ≤ 48 h post-extubation. This difference may be attributed to the study by Schefold et al., which featured a shorter intubation duration [ 12 ]. Therefore, the incidence of PED assessed within ≤ 3 h post-extubation in ICU patients with orotracheal intubation may be underestimated. Moreover, it is essential to highlight that some ICU patients, particularly those with severe illnesses and extended intubation time, may face challenges in complying with post-extubation instructions provided by healthcare personnel. Paradoxically, this group of patients is at a higher risk of developing PED, subsequently increasing their susceptibility to post-extubation pneumonia [ 11 ]. ICU professionals should evaluate swallowing function in patients post-extubation; early identification of patients at risk for PED to reduce complications. If PED is identified, nurses should follow-up assessments at multiple time to obtain a thorough comprehension of PED recovery trajectory among PED patients, which can serve as a foundation for determining the timing of clinical interventions accurately.

PED assessment tools

Despite the subgroup analyses and meta-regression results indicating that PED assessment tools did not contribute to the observed heterogeneity, it is important to acknowledge the wide array of assessment tools employed across the studies included in this review. The study’s findings revealed that the results of the GUSS and BSE assessments were most closely aligned with the gold standard screening results. In contrast, the PEDS assessment results tended to be higher than those derived from the gold standard assessment. Furthermore, the results of other assessment tools generally yielded lower incidence rates of PED, possibly attributable to variations in specificity or sensitivity. FEES and VFSS assessments are recognized for their meticulous scrutiny of patients’ swallowing processes, including the detection of food residue and aspiration, which may not be as comprehensively addressed by other assessment methods [ 51 ]. Assessment tools such as BSE, SSA, GUSS, WST, and other clinical methods do not provide direct visualization of the swallowing process. Instead, assessors rely on the observation of overt clinical symptoms during the patient’s initial food or water intake to judge the presence of PED. However, these methods may overlook occult aspiration in patients, potentially resulting in an underestimation of PED incidence. In contrast, PEDS, which primarily assesses patients based on their medical history and plumbing symptoms without screening for drinking or swallowing, may overestimate PED incidence. Considering the varying strengths and limitations of existing assessment tools, ICU professionals select appropriate PED assessment tool based on the characteristics of the critically ill patient. Early and rapid identification of PED, before the use of more complex and expensive assessment tools, minimizes the occurrence of complications in patients.

Strengths and weaknesses

In this study, we conducted a comprehensive analysis of the incidence of PED in ICU patients who underwent orotracheal intubation across various subgroups, revealing a notable degree of heterogeneity among the included studies. In our study, we have expanded the search as much as possible and included a total of 30 papers after screening, half of which were published after 2020. There are several limitations that should be considered when interpreting the results of this meta-analysis. First, there was varied heterogeneity between methodological of the study and estimates of prevalence that may question the appropriateness of calculating pooled prevalence estimates. However, in order to address this heterogeneity, we addressed the heterogeneity with applying a random-effect model and conducting subgroup analysis and meta-regression to explore three sources of heterogeneity. Second, the overall quality of evidence for the incidence of PED was rated as low according to GRADE. Higher quality original studies on the incidence of PED should be performed in the future. As a result, the findings should be interpreted with caution in such cases.

In conclusion, our systematic review and meta-analysis revealed a high incidence of PED among ICU patients who underwent orotracheal intubation. It is also worth noting that the incidence of PED in the ICU may be underestimated. It is expected to increase awareness about the issue of PED among ICU patients. It will be important to develop guidelines or consensus on the most appropriate PED assessment time and assessment tools to accurately assess the incidence of PED.

Relevance to clinical practice

Each year, a substantial number of critically ill patients, ranging from 13 to 20 million, necessitate endotracheal intubation to sustain their lives. Patients undergoing orotracheal intubation are at heightened risk of developing PED. PED has been linked to prolonged hospital and ICU length of stay, increased rates of pneumonia, and all-cause mortality. Early identification of high-risk patients by clinical nurses is critical for reduce patient burden and adverse outcomes.

Early and multiple times assessment: Future investigations should early assess PED in clinical practice, especially within 6 h post-extubation. Furthermore, we suggest for follow-up assessments at multiple time to obtain a thorough comprehension of PED incidence and the recovery trajectory among ICU patients who have undergone orotracheal intubation.

Assessment tool: Considering the varying strengths and limitations of existing assessment tools, ICU professionals should carefully evaluate the characteristics of critically ill patients and select appropriate assessment tools, before the use of more complex and expensive assessment tools.

Routinely evaluate the need for orotracheal intubation: Healthcare professionals should routinely evaluate the need for orotracheal intubation, strive to minimize the duration of mechanical ventilation.

Availability of data and materials

All data related to the present systematic review and meta-analysis are available from the original study corresponding author on reasonable request.

Abbreviations

Confidence interval

• Intensive care unit

Post-extubation dysphagia

Sydney Swallow Questionnaire 200

Water swallowing test

Post-Extubation Dysphagia Screening Tool

Bedside swallow evaluation

The Yale swallow protocol

Mann Assessment of Swallowing Ability

American Speech-Language-Hearing Association

Video Fluoroscopic Swallowing Study

Fiberoptic endoscopic evaluation of swallowing

Gugging swallowing screen

Standardized Swallowing Assessment

Functional Oral Intake Scale

Nurse-performed screening for post-extubation dysphagia

Speech-language pathologists

Events of PED

Preferred Reporting Items for Systematic Reviews and Meta-analyses

International Prospective Register of Systematic Reviews

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Weixia Yu, Limi Dan, Jianzheng Cai, Yuyu Wang, Qingling Wang, Yingying Zhang & Xin Wang

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Weixia Yu, Limi Dan, Jianzheng Cai, and Yuyu Wang developed the original concept of this systematic review and meta-analysis. Weixia Yu, Limi Dan, Jianzheng Cai and Yuyu Wang contributed to the screening of eligible studies, data extraction, and data synthesis. Weixia Yu, Limi Dan, Jianzheng Cai, Yuyu Wang and Qingling Wang drafted the first version of the manuscript. Yingying Zhang, Qingling Wang and Xin Wang prepared the tables and figures. All the authors have edited and contributed for intellectual content. All the authors read and approved the final manuscript and take public responsibility for it.

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Additional file 1: Table S1. PRISMA 2020 Checklist. Table S2. Search strategy. Table S3. Quality evaluation results of the cohort studies. Table S4. Quality evaluation results of the cross-sectional study. Fig. S1. Subgroup analysis of the incidence of PED by assessment time. Fig. S2. Subgroup analysis of the incidence of PED by sample size. Fig. S3. Incidence of PED by assessment tool. Fig. S4. Incidence of PED by mean intubation time. Fig. S5 Incidence of PED by mean age. Fig. S6. Incidence of PED by ICU type. Fig. S7. Incidence of PED by evaluator. Fig. S8. Incidence of PED by year of publication. Fig. S9. Incidence of PED by study design. Fig. S10. Incidence of PED by quality of cohort study. Fig. S11. Incidence of PED by quality of Cross-sectional study. Fig. S12. Bubble plot of meta-regression result for evaluate time as a covariate. Fig. S13. Bubble plot of meta-regression result for sample size as a covariate. Fig. S14. Bubble plot of meta-regression result for assessment tool as a covariate. Fig. S15. Bubble plot of meta-regression result for mean intubation time as a covariate. Fig. S16. Bubble plot of meta-regression result for mean age as a covariate. Fig. S17. Bubble plot of meta-regression result for ICU type as a covariate. Fig. S18. Bubble plot of meta-regression result for evaluator as a covariate. Fig. S19. Bubble plot of meta-regression result for year of publication as a covariate. Fig. S20. Bubble plot of meta-regression result for study design as a covariate. Fig. S21. Bubble plot of meta-regression result for quality of cohort study as a covariate. Fig. S22. Bubble plot of meta-regression result for quality of cross-sectional study as a covariate. Fig. S23. Sensitivity analysis of PED. Fig. S24. Publication bias assessment plot. Fig. S25. Publication bias assessment plot. “Trim and Full test” method.

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Yu, W., Dan, L., Cai, J. et al. Incidence of post-extubation dysphagia among critical care patients undergoing orotracheal intubation: a systematic review and meta-analysis. Eur J Med Res 29 , 444 (2024). https://doi.org/10.1186/s40001-024-02024-x

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Received : 19 December 2023

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Published : 31 August 2024

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Artificial intelligence in net-zero carbon emissions for sustainable building projects: a systematic literature and science mapping review.

1. Introduction

• Analyze the annual publication trends of published articles and select peer-reviewed journals on AI in NZCEs for sustainable building projects.
• Apply a science mapping approach to analyze influential keywords and document analyses of AI in NZCEs for sustainable building projects.
• Identify and discuss mainstream research topics related to AI in NZCEs for sustainable building projects.
• Develop a framework for depicting research gaps and future research directions on AI in NZCEs for sustainable building projects.

2. Research Methods

2.1. search strategy, 2.2. selection criteria, 2.3. science mapping analysis, 2.4. qualitative discussion, 3.1. annual publication trend, 3.2. selection of relevant peer-reviewed journals, 3.3. co-occurrence analysis of keywords.

• Building eco-friendly, efficient, and energy-efficient structures can significantly reduce the problems associated with excessive carbon emissions. It has been shown that quantifying and analyzing the carbon footprint of public buildings over their life cycle can reduce negative environmental impacts [ 73 ]. Tushar et al. [ 74 ] applied sensitivity analysis to reduce the carbon footprint, thus improving energy efficiency. Developing implicit databases is also a good way to reduce carbon emissions and can be combined with machine and deep learning algorithms to combat climate change and resource scarcity [ 75 ]. It has also been reported that embodied carbon can be used throughout the life cycle of a building to improve the safety and environmental impact of a building project [ 76 , 77 , 78 , 79 ]. Additionally, the heating and cooling aspects of buildings consume more energy; therefore, the development of intelligent control systems is necessary. To reduce emissions, scalability should be the focus [ 69 ].
• The use of AI to minimize carbon emissions in construction projects is the second cluster of research. AI can be used to create smart energy networks and reduce energy costs [ 80 ]. By applying AI techniques, building energy and carbon footprints can be used to predict energy consumption and CO 2 emissions [ 81 , 82 , 83 ]. Deep learning and ML are branches of AI techniques that are widely used as data analytics techniques for reducing NZCEs for sustainable building projects. For example, ANN has been used to quantify environmental costs in residential buildings and optimize commercial building design [ 84 , 85 ]. To achieve this goal, Palladino [ 86 ] studied the use of ANN in specific energy strategies in the Umbria Region. It has been reported that the application of ML can reduce the power consumption of buildings and help optimize building performance in the design and development of smart buildings [ 87 , 88 ].
• A multi-objective optimization technique is proposed to reduce residential construction carbon emissions, accomplishing the dual goals of economic development and environmental conservation, and conforming to the sustainable development principle [ 89 ]. Multi-objective optimization combined with AI technology, can contribute to the development of sustainable buildings in terms of building material selection, retrofitting energy systems, and decision-making in building construction [ 90 ]. For example, the combination of an ANN with a multi-objective genetic algorithm can optimize the design of residential buildings [ 91 , 92 ]. Clustering techniques are integrated with multi-objective optimization to identify urban structures based on their energy performance. This strategy can be replicated in other cities to increase energy efficiency and execute carbon-cutting initiatives [ 70 ]. Multiple goals can help sustainable buildings achieve NZCEs.
• Improving energy consumption efficiency and strengthening building energy management are critical for mitigating the greenhouse effect and global warming trend [ 93 ]. Reduced carbon emissions, green buildings, and sustainable development have emerged as major concerns worldwide [ 2 , 94 ]. On the one hand, renewable energy-driven building systems based on solar and wind resources can reduce environmental effects and costs [ 95 , 96 ]. Building carbon emissions must be minimized to achieve energy sustainability [ 97 ]. However, focusing on building carbon emissions throughout their life cycle, including the design, transportation, construction, and operation stages, and quantifying them as environmental and carbon costs, can contribute to the long-term development of the construction industry [ 98 ]. In summary, reducing energy consumption can contribute to economic benefits and achieve sustainable development [ 77 , 99 ].
• In the face of serious problems posed by climate change, efficient ways to minimize carbon emissions in the construction sector are receiving considerable attention. China is attempting to assess the feasibility of NZCEs, provide a path to reduce emissions, adjust and optimize the industrial structure, and achieve the policy goals of green development and carbon neutrality [ 1 , 100 ]. The prediction of carbon emission intensity in different countries can help policymakers devise environmental policies to address the adverse environmental effects of climate change [ 101 , 102 ]. Enhancing building management systems and promoting smart buildings will also help reduce the energy footprint and continuously optimize building performance [ 88 ]. Carbon capture and storage technologies currently play an essential role in lowering carbon dioxide emissions; however, they face problems such as high costs and regulatory issues, and related technologies still need to be developed [ 103 ].
• Consider a structural design scheme for upgrading a building based on the decision support system (DSS). Carbon capture and storage technologies have been demonstrated in previous studies [ 104 ]. On the other hand, environmental considerations can be evaluated to assess building sustainability. As a result, the entire decision-making process can be optimized [ 105 ]. Simultaneously, DSS, combined with the predictive capabilities of ML to investigate the proper concrete mix proportions, can aid in assessing the impact of a building over its full life cycle, both in terms of environmental and financial expenses [ 72 , 106 ].

3.4. Document Analysis

4. discussion, 4.1. mainstream research topics on ai in nzces for sustainable building projects, 4.1.1. life cycle assessment and carbon footprint, 4.1.2. practical applications of ai techniques in sustainable buildings, 4.1.3. multi-objective optimization, 4.1.4. energy management and energy efficiency, 4.1.5. carbon emissions from buildings, 4.1.6. decision support system (dss) and sustainability, 4.2. research gaps of ai in nzces for sustainable buildings, 4.2.1. existing problems of the life cycle assessment method, 4.2.2. opportunities and challenges faced by ai techniques in sustainable buildings, 4.2.3. scope of application of multi-objective modeling, 4.2.4. improvements in energy management and efficiency, 4.2.5. raise awareness of reducing carbon emissions, 4.2.6. sustainable development of buildings, 4.3. research trends of ai in nzces for sustainable building projects.

• Various factors, such as energy savings, emissions reduction, and the feasibility of financial costs, should be considered when adopting LCA methods.
• Improving the legal framework and international regulatory regime for the application of AI techniques to reduce carbon emissions.
• Balancing carbon emission reduction with other sustainability objectives in response to changes in building parameters.
• Empirical research on energy optimization strategies for different building scenarios.
• Construction industries and practitioners should actively implement carbon-neutral policies.
• Countries can share their experiences and work together to promote the development of sustainable buildings.
• Using DSS to provide data analyses and forecasts should incorporate more environmental parameters to enable decision-makers to make sustainable development decisions.
• Increased attention to decision-making processes and the implementation of program design to reduce carbon emissions.

5. Conclusions

5.1. study implications and contributions, 5.2. limitations and future research directions, author contributions, data availability statement, acknowledgments, conflicts of interest.

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Li, Y.; Antwi-Afari, M.F.; Anwer, S.; Mehmood, I.; Umer, W.; Mohandes, S.R.; Wuni, I.Y.; Abdul-Rahman, M.; Li, H. Artificial Intelligence in Net-Zero Carbon Emissions for Sustainable Building Projects: A Systematic Literature and Science Mapping Review. Buildings 2024 , 14 , 2752. https://doi.org/10.3390/buildings14092752

Li Y, Antwi-Afari MF, Anwer S, Mehmood I, Umer W, Mohandes SR, Wuni IY, Abdul-Rahman M, Li H. Artificial Intelligence in Net-Zero Carbon Emissions for Sustainable Building Projects: A Systematic Literature and Science Mapping Review. Buildings . 2024; 14(9):2752. https://doi.org/10.3390/buildings14092752

Li, Yanxue, Maxwell Fordjour Antwi-Afari, Shahnawaz Anwer, Imran Mehmood, Waleed Umer, Saeed Reza Mohandes, Ibrahim Yahaya Wuni, Mohammed Abdul-Rahman, and Heng Li. 2024. "Artificial Intelligence in Net-Zero Carbon Emissions for Sustainable Building Projects: A Systematic Literature and Science Mapping Review" Buildings 14, no. 9: 2752. https://doi.org/10.3390/buildings14092752

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