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What is a literature review?

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

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

Why is it important?

A literature review is important because it:

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

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1. Choose a topic. Define your research question.

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

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

2. Decide on the scope of your review

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

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

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

Make a list of the databases you will search. 

Where to find databases:

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

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

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

Review the literature

Some questions to help you analyze the research:

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

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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Systematically Reviewing the Literature: Building the Evidence for Health Care Quality

Suzanne austin boren , phd, david moxley , mlis.

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Contact: [email protected]

Corresponding author.

There are important research and non-research reasons to systematically review the literature. This article describes a step-by-step process to systematically review the literature along with links to key resources. An example of a graduate program using systematic literature reviews to link research and quality improvement practices is also provided.

Introduction

Systematic reviews that summarize the available information on a topic are an important part of evidence-based health care. There are both research and non-research reasons for undertaking a literature review. It is important to systematically review the literature when one would like to justify the need for a study, to update personal knowledge and practice, to evaluate current practices, to develop and update guidelines for practice, and to develop work related policies. 1 A systematic review draws upon the best health services research principles and methods to address: What is the state of the evidence on the selected topic? The systematic process enables others to reproduce the methods and to make a rational determination of whether to accept the results of the review. An abundance of articles on systematic reviews exist focusing on different aspects of systematic reviews. 2 – 9 The purpose of this article is to describe a step by step process of systematically reviewing the health care literature and provide links to key resources.

Systematic Review Process: Six Key Steps

Six key steps to systematically review the literature are outlined in Table 1 and discussed here.

Systematic Review Steps

1. Formulate the Question and Refine the Topic

When preparing a topic to conduct a systematic review, it is important to ask at the outset, “What exactly am I looking for?” Hopefully it seems like an obvious step, but explicitly writing a one or two sentence statement of the topic before you begin to search is often overlooked. It is important for several reasons; in particular because, although we usually think we know what we are searching for, in truth our mental image of a topic is often quite fuzzy. The act of writing something concise and intelligible to a reader, even if you are the only one who will read it, clarifies your thoughts and can inspire you to ask key questions. In addition, in subsequent steps of the review process, when you begin to develop a strategy for searching the literature, your topic statement is the ready raw material from which you can extract the key concepts and terminology for your strategies. The medical and related health literature is massive, so the more precise and specific your understanding of your information need, the better your results will be when you search.

2. Search, Retrieve, and Select Relevant Articles

The retrieval tools chosen to search the literature should be determined by the purpose of the search. Questions to ask include: For what and by whom will the information be used? A topical expert or a novice? Am I looking for a simple fact? A comprehensive overview on the topic? Exploration of a new topic? A systematic review? For the purpose of a systematic review of journal research in the area of health care, PubMed or Medline is the most appropriate retrieval tool to start with, however other databases may be useful ( Table 2 ). In particular, Google Scholar allows one to search the same set of articles as PubMed/MEDLINE, in addition to some from other disciplines, but it lacks a number of key advanced search features that a skilled searcher can exploit in PubMed/MEDLINE.

Examples of Electronic Bibliographic Databases Specific to Health Care

Note: These databases may be available through university or hospital library systems.

An effective way to search the literature is to break the topic into different “building blocks.” The building blocks approach is the most systematic and works the best in periodical databases such as PubMed/MEDLINE. The “blocks” in a “building blocks” strategy consist of the key concepts in the search topic. For example, let’s say we are interested in researching about mobile phone-based interventions for monitoring of patient status or disease management. We could break the topic into the following concepts or blocks: 1. Mobile phones, 2. patient monitoring, and 3. Disease management. Gather synonyms and related terms to represent each concept and match to available subject headings in databases that offer them. Organize the resulting concepts into individual queries. Run the queries and examine your results to find relevant items and suggest query modifications to improve your results. Revise and re-run your strategy based on your observations. Repeat this process until you are satisfied or further modifications produce no improvements. For example in Medline, these terms would be used in this search and combined as follows: cellular phone AND (ambulatory monitoring OR disease management), where each of the key word phrases is an official subject heading in the MEDLINE vocabulary. Keep detailed notes on the literature search, as it will need to be reported in the methods section of the systematic review paper. Careful noting of search strategies also allows you to revisit a topic in the future and confidently replicate the same results, with the addition of those subsequently published on your topic.

3. Assess Quality

There is no consensus on the best way to assess study quality. Many quality assessment tools include issues such as: appropriateness of study design to the research objective, risk of bias, generalizability, statistical issues, quality of the intervention, and quality of reporting. Reporting guidelines for most literature types are available at the EQUATOR Network website ( http://www.equator-network.org/ ). These guidelines are a useful starting point; however they should not be used for assessing study quality.

4. Extract Data and Information

Extract information from each eligible article into a standardized format to permit the findings to be summarized. This will involve building one or more tables. When making tables each row should represent an article and each column a variable. Not all of the information that is extracted into the tables will end up in the paper. All of the information that is extracted from the eligible articles will help you obtain an overview of the topic, however you will want to reserve the use of tables in the literature review paper for the more complex information. All tables should be introduced and discussed in the narrative of the literature review. An example of an evidence summary table is presented in Table 3 .

Example of an evidence summary table

Notes: BP = blood pressure, HbA1c = Hemoglobin A1c, Hypo = hypoglycemic, I = Internet, NS = not significant, PDA = personal digital assistant, QOL = quality of life, SMBG = self-monitored blood glucose, SMS = short message service, V = voice

5. Analyze and Synthesize Data and information

The findings from individual studies are analyzed and synthesized so that the overall effectiveness of the intervention can be determined. It should also be observed at this time if the effect of an intervention is comparable in different studies, participants, and settings.

6. Write the Systematic Review

The PRISMA 12 and ENTREQ 13 checklists can be useful resources when writing a systematic review. These uniform reporting tools focus on how to write coherent and comprehensive reviews that facilitate readers and reviewers in evaluating the relative strengths and weaknesses. A systematic literature review has the same structure as an original research article:

TITLE : The systematic review title should indicate the content. The title should reflect the research question, however it should be a statement and not a question. The research question and the title should have similar key words.

STRUCTURED ABSTRACT: The structured abstract recaps the background, methods, results and conclusion in usually 250 words or less.

INTRODUCTION: The introduction summarizes the topic or problem and specifies the practical significance for the systematic review. The first paragraph or two of the paper should capture the attention of the reader. It might be dramatic, statistical, or descriptive, but above all, it should be interesting and very relevant to the research question. The topic or problem is linked with earlier research through previous attempts to solve the problem. Gaps in the literature regarding research and practice should also be noted. The final sentence of the introduction should clearly state the purpose of the systematic review.

METHODS: The methods provide a specification of the study protocol with enough information so that others can reproduce the results. It is important to include information on the:

Eligibility criteria for studies: Who are the patients or subjects? What are the study characteristics, interventions, and outcomes? Were there language restrictions?

Literature search: What databases were searched? Which key search terms were used? Which years were searched?

Study selection: What was the study selection method? Was the title screened first, followed by the abstract, and finally the full text of the article?

Data extraction: What data and information will be extracted from the articles?

Data analysis: What are the statistical methods for handling any quantitative data?

RESULTS: The results should also be well-organized. One way to approach the results is to include information on the:

Search results: What are the numbers of articles identified, excluded, and ultimately eligible?

Study characteristics: What are the type and number of subjects? What are the methodological features of the studies?

Study quality score: What is the overall quality of included studies? Does the quality of the included studies affect the outcome of the results?

Results of the study: What are the overall results and outcomes? Could the literature be divided into themes or categories?

DISCUSSION: The discussion begins with a nonnumeric summary of the results. Next, gaps in the literature as well as limitations of the included articles are discussed with respect to the impact that they have on the reliability of the results. The final paragraph provides conclusions as well as implications for future research and current practice. For example, questions for future research on this topic are revealed, as well as whether or not practice should change as a result of the review.

REFERENCES: A complete bibliographical list of all journal articles, reports, books, and other media referred to in the systematic review should be included at the end of the paper. Referencing software can facilitate the compilation of citations and is useful in terms of ensuring the reference list is accurate and complete.

The following resources may be helpful when writing a systematic review:

CEBM: Centre for Evidence-based Medicine. Dedicated to the practice, teaching and dissemination of high quality evidence based medicine to improve health care Available at: http://www.cebm.net/ .

CITING MEDICINE: The National Library of Medicine Style Guide for Authors, Editors, and Publishers. This resource provides guidance in compiling, revising, formatting, and setting reference standards. Available at http://www.ncbi.nlm.nih.gov/books/NBK7265/ .

EQUATOR NETWORK: Enhancing the QUAlity and Transparency Of health Research. The EQUATOR Network promotes the transparent and accurate reporting of research studies. Available at: http://www.equator-network.org/ .

ICMJE RECOMMENDATIONS: International Committee of Medical Journal Editors Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. The ICJME recommendations are followed by a large number of journals. Available at: http://www.icmje.org/about-icmje/faqs/icmje-recommendations/ .

PRISMA STATEMENT: Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Authors can utilize the PRISMA Statement checklist to improve the reporting of systematic reviews and meta-analyses. Available at: http://prisma-statement.org .

THE COCHRANE COLLABORATION: A reliable source for making evidence generated through research useful for informing decisions about health. Available at: http://www.cochrane.org/ .

Examples of Systematic Reviews To Link Research and Quality Improvement

Over the past 17 years more than 300 learners, including physicians, nurses, and health administrators have completed a course as part of a Master of Health Administration or a Master of Science in Health Informatics degree at the University of Missouri. An objective of the course is to educate health informatics and health administration professionals about how to utilize a systematic, scientific, and evidence-based approach to literature searching, appraisal, and synthesis. Learners in the course conduct a systematic review of the literature on a health care topic of their choosing that could suggest quality improvement in their organization. Students select topics that make sense in terms of their core educational competencies and are related to their work. The categories of topics include public health, leadership, information management, health information technology, electronic medical records, telehealth, patient/clinician safety, treatment/screening evaluation cost/finance, human resources, planning and marketing, supply chain, education/training, policies and regulations, access, and satisfaction. Some learners have published their systematic literature reviews 14 – 15 . Qualitative comments from the students indicate that the course is well received and the skills learned in the course are applicable to a variety of health care settings.

Undertaking a literature review includes identification of a topic of interest, searching and retrieving the appropriate literature, assessing quality, extracting data and information, analyzing and synthesizing the findings, and writing a report. A structured step-by-step approach facilitates the development of a complete and informed literature review.

Suzanne Austin Boren, PhD, MHA, (above) is Associate Professor and Director of Academic Programs, and David Moxley, MLIS, is Clinical Instructor and Associate Director of Executive Programs. Both are in the Department of Health Management and Informatics at the University of Missouri School of Medicine.

None reported.

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Understanding the importance of a literature review in research

• March 29, 2023

Gerald Naepi

When conducting research, a literature review plays a crucial role as it provides an overview of the existing literature related to a specific topic. Its main objective is to identify the gaps in the current knowledge and provide direction for future research. This article delves into the purpose and structure of a literature review, along with the various types of literature reviews typically employed in research. By familiarising themselves with the different types of literature reviews and their unique features, researchers can determine which review type would best suit their research question and help them achieve their desired results.

Purpose of a literature review in research

The primary goal of a literature review in research is to offer a comprehensive overview of the relevant research within a given area. A well-executed literature review should provide readers with a clear understanding of the theoretical and empirical contributions made in the field, while also highlighting areas that require further exploration or investigation. Additionally, literature reviews help researchers identify gaps in existing knowledge that can lead to new hypotheses or questions for future study.

When conducting a literature review, researchers should pay close attention to key themes and topics covered by previous studies, including the approaches used to answer specific questions or address particular issues. This ensures that any conclusions drawn by the researcher are supported by established evidence and build on prior work in the field. Moreover, when synthesising information from multiple studies, researchers should aim to identify conflicting opinions or discrepancies in the literature and draw implications for further study. Through this process, a comprehensive literature review can provide invaluable insights into the current state of research and inform future studies.

Literature review format

The format of a literature review in research typically consists of the following elements:

Introduction: The introduction is an important part of a literature review, as it gives the reader a sense of what to expect. It should start with a clear statement of the research question or objective, so that the reader understands what the review is trying to achieve. It’s also important to explain why the topic is important, so that the reader understands the relevance of the review. Finally, the introduction should give the reader an overview of the structure and organisation of the review, so that they can easily navigate through the rest of the content.

Search Strategy: The search strategy should be comprehensive, focused, and systematic. It involves selecting appropriate databases, developing effective search terms, and utilizing other sources to collect information. To begin, the researcher needs to determine the most relevant databases to search. Depending on the topic, discipline, and research question, different databases may be more suitable. Some commonly used databases are PubMed, Scopus, Web of Science, and Google Scholar. Once the databases are selected, the researcher can develop a set of search terms that accurately reflect the topic and research question. These search terms can be a combination of keywords and subject headings. Other sources of information may include reference lists, grey literature, conference proceedings, and experts in the field. These sources can provide additional insights and help to ensure a comprehensive search.

The search strategy should be documented in detail to enable replication and transparency. This documentation should include the databases searched, search terms used, search dates, and any filters or limits applied. By having a clear and systematic search strategy, the researcher can ensure that they have identified all relevant literature and that the research findings are reliable and valid.

Inclusion and Exclusion Criteria: Inclusion criteria refer to the characteristics that a study must have to be included in the review, while exclusion criteria refer to the characteristics that disqualify a study from being included. The inclusion and exclusion criteria may vary depending on the research question, but generally, they should be clearly defined and stated in the methods section of the review. Common criteria include study design, population, intervention or exposure, and outcome measures. For example, a systematic review on the effectiveness of a particular drug for a specific condition may include only randomized controlled trials (RCTs) with a minimum sample size of 50 participants, and exclude non-randomized studies or studies with a high risk of bias.

Defining clear inclusion and exclusion criteria is crucial in ensuring that the studies included in the review are relevant, appropriate, and of high quality. It also helps to minimize bias and enhance the validity of the review’s findings. Additionally, transparent reporting of inclusion and exclusion criteria allows readers to assess the rigor of the review process and the generalizability of the findings to their own context.

Methodology: The methodology section typically involves outlining the procedures and techniques employed to collect relevant data and information, including any data extraction forms that were used. Additionally, this section may also include information about the process of data extraction, such as how the data was collected, coded, and analysed. Furthermore, it is essential to include a description of the quality assessment process used to ensure that the extracted data was reliable and valid. This may involve explaining the criteria used to evaluate the quality of the studies, as well as any potential biases or limitations that were taken into consideration. By providing a thorough description of the methodology, readers will be able to assess the rigor of the research and better understand the context and implications of the findings.

Results: The results section summarises the main outcomes and findings of the review process, including the key themes, concepts, and trends identified in the literature. The results section provides a clear and concise description of the analysed data and should be presented in a logical and organized manner to make it easy for readers to understand. The results section of a literature review provides an overview of the evidence and information obtained from the analysed sources and explains how the findings support or challenge the research question or hypothesis. It is essential to ensure that the results are presented accurately, and any limitations or weaknesses of the study are acknowledged to provide a transparent and objective review of the literature.

Discussion: The discussion section of a literature review in research is an important component that provides a critical analysis of the literature reviewed in the study. This section allows the researcher to present their findings and interpretations of the literature, as well as to draw conclusions about the research question or problem being investigated. In the discussion section, the researcher will typically summarise the key findings of the literature review and then discuss these findings in relation to the research question or problem. The discussion section may also identify gaps in the literature and suggest areas for further research, as well as discuss the implications of the findings for theory, practice, or policy. Ultimately, the discussion section of a literature review should provide a comprehensive and insightful analysis of the literature reviewed, which contributes to the overall understanding of the research question or problem at hand.

Conclusion: The conclusion section in a literature review summarises the key findings and implications of the reviewed studies. It is the final part of the literature review that brings together all the main points and themes discussed in the previous sections. In this section, the researcher should provide a critical evaluation of the reviewed literature, highlighting the strengths and limitations of the studies, and how they relate to the research question or problem. The conclusion section should also address any gaps or inconsistencies in the existing literature and suggest future research directions. Furthermore, it should provide a clear and concise summary of the main findings and their significance for the field of study.

References: The reference section provides a comprehensive list of all the sources that have been cited in the literature review, including books, journal articles, reports, and other relevant materials. The purpose of the reference section is to give credit to the authors whose work has been used to support the arguments and ideas presented in the paper. Additionally, the reference section allows readers to locate and retrieve the sources that have been cited, which can help them further explore the topic or verify the accuracy of the information presented. The reference section is typically organized in alphabetical order by the last name of the first author of each source, and it includes all of the necessary bibliographic information such as the title of the work, the name of the journal or book, the date of publication, and the page numbers

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Types of literature review in research

Literature reviews in research can be conducted for a variety of reasons, including to gain a comprehensive understanding of a topic, to identify research gaps, or to support the development of research proposals.

Here are the different types of literature reviews in research:

• Narrative Literature Review: A narrative literature review is an overview of the literature on a specific topic or research question that does not follow a structured or systematic approach. It is a qualitative review that summarizes and synthesizes the findings from different studies.
• Systematic Literature Review: A systematic literature review is a rigorous and structured approach to reviewing literature that involves a comprehensive search strategy, inclusion/exclusion criteria, and critical appraisal of the quality of evidence. It involves a meta-analysis and quantitative synthesis of data from multiple studies.
• Meta-analysis: A meta-analysis is a quantitative review of the literature that involves statistical analysis of the data from multiple studies. It combines the results of different studies to produce an overall estimate of the effect size of a particular intervention or treatment.
• Scoping Review: A scoping review is a type of literature review that aims to map the existing literature on a topic, identify research gaps, and provide an overview of the evidence. It is useful when the research question is broad or unclear.
• Rapid Review: A rapid review is a type of systematic review that uses streamlined methods to quickly and efficiently review the literature. It is useful when there is a time constraint or when there is a need to update a previous review.
• Umbrella Review: An umbrella review is a type of systematic review that synthesizes the findings of multiple systematic reviews on a particular topic. It provides a higher level of evidence by combining the findings from multiple studies.
• Critical Review: A critical review involves the evaluation and analysis of the strengths and weaknesses of the literature on a particular topic. It assesses the quality, credibility, and relevance of the literature and identifies research gaps.

Literature review example:

A literature review can play a crucial role in connecting with qualitative talanoa research. Talanoa is a research approach that emphasises collaboration, dialogue, and relationships within Pacific communities. Conducting a thorough literature review can help researchers to identify existing knowledge and gaps in ta specific field. This can inform the design of Talanoa research that centers on community engagement and dialogue. By reviewing literature that focuses on Pacific cultures, histories, and knowledge systems, researchers can develop a deeper understanding of the context and values of the community they are working with. This can help to build trust and establish meaningful relationships between researchers and community members.

An example of a literature review is our social research on Pacific peoples’ concerns about COVID-19, titled “The $7 cabbage dilemma: Pacific peoples’ experiences and New Zealand’s COVID-19 response.pdf” The objective of our study was to investigate how the COVID-19 pandemic impacted the wellbeing of Pacific peoples in New Zealand. To accomplish this, we conducted a comprehensive literature review of existing research on Pacific peoples’ urban climate change, health, economy, and housing in New Zealand. Through our talanoa-based research, we discovered that many Pacific peoples were worried about the cost of living, access to healthcare, support for parents, and affordable healthy food options, which were all connected to the broader themes of urban climate change, health, economy, and housing that we had identified in our literature review.

In conclusion, a literature review is an essential component of research as it helps to identify gaps in existing knowledge, provide direction for future research and support or challenge research questions or hypotheses. The purpose of a literature review is to offer a comprehensive overview of the relevant research within a given area, identify key themes and topics, and synthesize information from multiple studies. Researchers need to pay attention to the different types of literature reviews and their unique features when conducting literature reviews to determine which review type would best suit their research question and help them achieve their desired results. A well-structured literature review should include an introduction, search strategy, inclusion and exclusion criteria, methodology and results sections. A well-executed literature review ensures that the research findings are reliable and valid and provides invaluable insights into the current state of research to inform future studies.

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By: Gerald Naepi

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