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Are Systematic Reviews Qualitative or Quantitative?

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A systematic review is designed to be transparent and replicable. Therefore, systematic reviews are considered reliable tools in scientific research and clinical practice. They synthesize the results using multiple primary studies by using strategies that minimize bias and random errors. Depending on the research question and the objectives of the research, the reviews can either be qualitative or quantitative. Qualitative reviews deal with understanding concepts, thoughts, or experiences. Quantitative reviews are employed when researchers want to test or confirm a hypothesis or theory. Let’s look at some of the differences between these two types of reviews.

To learn more about how long it takes to do a systematic review , you can check out the link to our full article on the topic.

Differences between Qualitative and Quantitative Reviews

The differences lie in the scope of the research, the methodology followed, and the type of questions they attempt to answer. Some of these differences include:

Research Questions

As mentioned earlier qualitative reviews attempt to answer open-ended research questions to understand or formulate hypotheses. This type of research is used to gather in-depth insights into new topics. Quantitative reviews, on the other hand, test or confirm existing hypotheses. This type of research is used to establish generalizable facts about a topic.

Type of Sample Data

The data collected for both types of research differ significantly. For qualitative research, data is collected as words using observations, interviews, and interactions with study subjects or from literature reviews. Quantitative studies collect data as numbers, usually from a larger sample size.

Data Collection Methods

To collect data as words for a qualitative study, researchers can employ tools such as interviews, recorded observations, focused groups, videos, or by collecting literature reviews on the same subject. For quantitative studies, data from primary sources is collected as numbers using rating scales and counting frequencies. The data for these studies can also be collected as measurements of variables from a well-designed experiment carried out under pre-defined, monitored conditions.

Data Analysis Methods

Data by itself cannot prove or demonstrate anything unless it is analyzed. Qualitative data is more challenging to analyze than quantitative data. A few different approaches to analyzing qualitative data include content analysis, thematic analysis, and discourse analysis. The goal of all of these approaches is to carefully analyze textual data to identify patterns, themes, and the meaning of words or phrases.

Quantitative data, since it is in the form of numbers, is analyzed using simple math or statistical methods. There are several software programs that can be used for mathematical and statistical analysis of numerical data.

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Final Takeaway – Qualitative or Quantitative?

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• Published: 15 December 2015

Qualitative and mixed methods in systematic reviews

• David Gough 1  

Systematic Reviews volume  4 , Article number:  181 ( 2015 ) Cite this article

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Expanding the range of methods of systematic review

The logic of systematic reviews is very simple. We use transparent rigorous approaches to undertake primary research, and so we should do the same in bringing together studies to describe what has been studied (a research map) or to integrate the findings of the different studies to answer a research question (a research synthesis). We should not really need to use the term ‘systematic’ as it should be assumed that researchers are using and reporting systematic methods in all of their research, whether primary or secondary. Despite the universality of this logic, systematic reviews (maps and syntheses) are much better known in health research and for answering questions of the effectiveness of interventions (what works). Systematic reviews addressing other sorts of questions have been around for many years, as in, for example, meta ethnography [ 1 ] and other forms of conceptual synthesis [ 2 ], but only recently has there been a major increase in the use of systematic review approaches to answer other sorts of research questions.

There are probably several reasons for this broadening of approach. One may be that the increased awareness of systematic reviews has made people consider the possibilities for all areas of research. A second related factor may be that more training and funding resources have become available and increased the capacity to undertake such varied review work.

A third reason could be that some of the initial anxieties about systematic reviews have subsided. Initially, there were concerns that their use was being promoted by a new managerialism where reviews, particularly effectiveness reviews, were being used to promote particular ideological and theoretical assumptions and to indirectly control research agendas. However, others like me believe that explicit methods should be used to enable transparency of perspectives driving research and to open up access to and participation in research agendas and priority setting [ 3 ] as illustrated, for example, by the James Lind Alliance (see http://www.jla.nihr.ac.uk/ ).

A fourth possible reason for the development of new approaches is that effectiveness reviews have themselves broadened. Some ‘what works’ reviews can be open to criticism for only testing a ‘black box’ hypothesis of what works with little theorizing or any logic model about why any such hypothesis should be true and the mechanisms involved in such processes. There is now more concern to develop theory and to test how variables combine and interact. In primary research, qualitative strategies are advised prior to undertaking experimental trials [ 4 , 5 ] and similar approaches are being advocated to address complexity in reviews [ 6 ], in order to ask questions and use methods that address theories and processes that enable an understanding of both impact and context.

This Special Issue of Systematic Reviews Journal is providing a focus for these new methods of review whether these use qualitative review methods on their own or mixed together with more quantitative approaches. We are linking together with the sister journal Trials for this Special Issue as there is a similar interest in what qualitative approaches can and should contribute to primary research using experimentally controlled trials (see Trials Special Issue editorial by Claire Snowdon).

Dimensions of difference in reviews

Developing the range of methods to address different questions for review creates a challenge in describing and understanding such methods. There are many names and brands for the new methods which may or may not withstand the changes of historical time, but another way to comprehend the changes and new developments is to consider the dimensions on which the approaches to review differ [ 7 , 8 ].

One important distinction is the research question being asked and the associated paradigm underlying the method used to address this question. Research assumes a particular theoretical position and then gathers data within this conceptual lens. In some cases, this is a very specific hypothesis that is then tested empirically, and sometimes, the research is more exploratory and iterative with concepts being emergent and constructed during the research process. This distinction is often labelled as quantitative or positivist versus qualitative or constructionist. However, this can be confusing as much research taking a ‘quantitative’ perspective does not have the necessary numeric data to analyse. Even if it does have such data, this might be explored for emergent properties. Similarly, research taking a ‘qualitative’ perspective may include implicit quantitative themes in terms of the extent of different qualitative findings reported by a study.

Sandelowski and colleagues’ solution is to consider the analytic activity and whether this aggregates (adds up) or configures (arranges) the data [ 9 ]. In a randomized controlled trial and an effectiveness review of such studies, the main analysis is the aggregation of data using a priori non-emergent strategies with little iteration. However, there may also be post hoc analysis that is more exploratory in arranging (configuring) data to identify patterns as in, for example, meta regression or qualitative comparative analysis aiming to identify the active ingredients of effective interventions [ 10 ]. Similarly, qualitative primary research or reviews of such research are predominantly exploring emergent patterns and developing concepts iteratively, yet there may be some aggregation of data to make statements of generalizations of extent.

Even where the analysis is predominantly configuration, there can be a wide variation in the dimensions of difference of iteration of theories and concepts. In thematic synthesis [ 11 ], there may be few presumptions about the concepts that will be configured. In meta ethnography which can be richer in theory, there may be theoretical assumptions underlying the review question framing the analysis. In framework synthesis, there is an explicit conceptual framework that is iteratively developed and changed through the review process [ 12 , 13 ].

In addition to the variation in question, degree of configuration, complexity of theory, and iteration are many other dimensions of difference between reviews. Some of these differences follow on from the research questions being asked and the research paradigm being used such as in the approach to searching (exhaustive or based on exploration or saturation) and the appraisal of the quality and relevance of included studies (based more on risk of bias or more on meaning). Others include the extent that reviews have a broad question, depth of analysis, and the extent of resultant ‘work done’ in terms of progressing a field of inquiry [ 7 , 8 ].

Mixed methods reviews

As one reason for the growth in qualitative synthesis is what they can add to quantitative reviews, it is not surprising that there is also growing interest in mixed methods reviews. This reflects similar developments in primary research in mixing methods to examine the relationship between theory and empirical data which is of course the cornerstone of much research. But, both primary and secondary mixed methods research also face similar challenges in examining complex questions at different levels of analysis and of combining research findings investigated in different ways and may be based on very different epistemological assumptions [ 14 , 15 ].

Some mixed methods approaches are convergent in that they integrate different data and methods of analysis together at the same time [ 16 , 17 ]. Convergent systematic reviews could be described as having broad inclusion criteria (or two or more different sets of criteria) for methods of primary studies and have special methods for the synthesis of the resultant variation in data. Other reviews (and also primary mixed methods studies) are sequences of sub-reviews in that one sub-study using one research paradigm is followed by another sub-study with a different research paradigm. In other words, a qualitative synthesis might be used to explore the findings of a prior quantitative synthesis or vice versa [ 16 , 17 ].

An example of a predominantly aggregative sub-review followed by a configuring sub-review is the EPPI-Centre’s mixed methods review of barriers to healthy eating [ 18 ]. A sub-review on the effectiveness of public health interventions showed a modest effect size. A configuring review of studies of children and young people’s understanding and views about eating provided evidence that the public health interventions did not take good account of such user views research, and that the interventions most closely aligned to the user views were the most effective. The already mentioned qualitative comparative analysis to identify the active ingredients within interventions leading to impact could also be considered a qualitative configuring investigation of an existing quantitative aggregative review [ 10 ].

An example of a predominantly configurative review followed by an aggregative review is realist synthesis. Realist reviews examine the evidence in support of mid-range theories [ 19 ] with a first stage of a configuring review of what is proposed by the theory or proposal (what would need to be in place and what casual pathways would have to be effective for the outcomes proposed by the theory to be supported?) and a second stage searching for empirical evidence to test for those necessary conditions and effectiveness of the pathways. The empirical testing does not however use a standard ‘what works’ a priori methods approach but rather a more iterative seeking out of evidence that confirms or undermines the theory being evaluated [ 20 ].

Although sequential mixed methods approaches are considered to be sub-parts of one larger study, they could be separate studies as part of a long-term strategic approach to studying an issue. We tend to see both primary studies and reviews as one-off events, yet reviews are a way of examining what we know and what more we want to know as a strategic approach to studying an issue over time. If we are in favour of mixing paradigms of research to enable multiple levels and perspectives and mixing of theory development and empirical evaluation, then we are really seeking mixed methods research strategies rather than simply mixed methods studies and reviews.

Noblit G. Hare RD: meta-ethnography: synthesizing qualitative studies. Newbury Park NY: Sage Publications; 1988.

Google Scholar  

Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9:59.

Article   PubMed   PubMed Central   Google Scholar  

Gough D, Elbourne D. Systematic research synthesis to inform policy, practice and democratic debate. Soc Pol Soc. 2002;2002:1.

Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance 2015. BMJ. 2015;350:h1258

Candy B, Jone L, King M, Oliver S. Using qualitative evidence to help understand complex palliative care interventions: a novel evidence synthesis approach. BMJ Support Palliat Care. 2014;4:Supp A41–A42.

Article   Google Scholar  

Noyes J, Gough D, Lewin S, Mayhew A, Michie S, Pantoja T, et al. A research and development agenda for systematic reviews that ask complex questions about complex interventions. J Clin Epidemiol. 2013;66:11.

Gough D, Oliver S, Thomas J. Introduction to systematic reviews. London: Sage; 2012.

Gough D, Thomas J, Oliver S. Clarifying differences between review designs and methods. Syst Rev. 2012;1:28.

Sandelowski M, Voils CJ, Leeman J, Crandlee JL. Mapping the mixed methods-mixed research synthesis terrain. J Mix Methods Res. 2012;6:4.

Thomas J, O’Mara-Eves A, Brunton G. Using qualitative comparative analysis (QCA) in systematic reviews of complex interventions: a worked example. Syst Rev. 2014;3:67.

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45.

Oliver S, Rees R, Clarke-Jones L, Milne R, Oakley AR, Gabbay J, et al. A multidimensional conceptual framework for analysing public involvement in health services research. Health Exp. 2008;11:72–84.

Booth A, Carroll C. How to build up the actionable knowledge base: the role of ‘best fit’ framework synthesis for studies of improvement in healthcare. BMJ Qual Saf. 2015. 2014-003642.

Brannen J. Mixed methods research: a discussion paper. NCRM Methods Review Papers, 2006. NCRM/005.

Creswell J. Mapping the developing landscape of mixed methods research. In: Teddlie C, Tashakkori A, editors. SAGE handbook of mixed methods in social & behavioral research. New York: Sage; 2011.

Morse JM. Principles of mixed method and multi-method research design. In: Teddlie C, Tashakkori A, editors. Handbook of mixed methods in social and behavioural research. London: Sage; 2003.

Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annu Rev Public Health. 2014;35:29–45.

Harden A, Thomas J. Mixed methods and systematic reviews: examples and emerging issues. In: Tashakkori A, Teddlie C, editors. Handbook of mixed methods in the social and behavioral sciences. 2nd ed. London: Sage; 2010. p. 749–74.

Chapter   Google Scholar  

Pawson R. Evidenced-based policy: a realist perspective. London: Sage; 2006.

Book   Google Scholar  

Gough D. Meta-narrative and realist reviews: guidance, rules, publication standards and quality appraisal. BMC Med. 2013;11:22.

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Gough, D. Qualitative and mixed methods in systematic reviews. Syst Rev 4 , 181 (2015). https://doi.org/10.1186/s13643-015-0151-y

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Systematic Reviews

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Annual Review of Psychology

Volume 70, 2019, review article, how to do a systematic review: a best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-syntheses.

• Andy P. Siddaway 1 , Alex M. Wood 2 , and Larry V. Hedges 3
• View Affiliations Hide Affiliations Affiliations: 1 Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling FK9 4LA, United Kingdom; email: [email protected] 2 Department of Psychological and Behavioural Science, London School of Economics and Political Science, London WC2A 2AE, United Kingdom 3 Department of Statistics, Northwestern University, Evanston, Illinois 60208, USA; email: [email protected]
• Vol. 70:747-770 (Volume publication date January 2019) https://doi.org/10.1146/annurev-psych-010418-102803
• First published as a Review in Advance on August 08, 2018
• Copyright © 2019 by Annual Reviews. All rights reserved

Systematic reviews are characterized by a methodical and replicable methodology and presentation. They involve a comprehensive search to locate all relevant published and unpublished work on a subject; a systematic integration of search results; and a critique of the extent, nature, and quality of evidence in relation to a particular research question. The best reviews synthesize studies to draw broad theoretical conclusions about what a literature means, linking theory to evidence and evidence to theory. This guide describes how to plan, conduct, organize, and present a systematic review of quantitative (meta-analysis) or qualitative (narrative review, meta-synthesis) information. We outline core standards and principles and describe commonly encountered problems. Although this guide targets psychological scientists, its high level of abstraction makes it potentially relevant to any subject area or discipline. We argue that systematic reviews are a key methodology for clarifying whether and how research findings replicate and for explaining possible inconsistencies, and we call for researchers to conduct systematic reviews to help elucidate whether there is a replication crisis.

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Literature Cited

• APA Publ. Commun. Board Work. Group J. Artic. Rep. Stand. 2008 . Reporting standards for research in psychology: Why do we need them? What might they be?. Am. Psychol . 63 : 848– 49 [Google Scholar]
• Baumeister RF 2013 . Writing a literature review. The Portable Mentor: Expert Guide to a Successful Career in Psychology MJ Prinstein, MD Patterson 119– 32 New York: Springer, 2nd ed.. [Google Scholar]
• Baumeister RF , Leary MR 1995 . The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol. Bull. 117 : 497– 529 [Google Scholar]
• Baumeister RF , Leary MR 1997 . Writing narrative literature reviews. Rev. Gen. Psychol. 3 : 311– 20 Presents a thorough and thoughtful guide to conducting narrative reviews. [Google Scholar]
• Bem DJ 1995 . Writing a review article for Psychological Bulletin. Psychol . Bull 118 : 172– 77 [Google Scholar]
• Borenstein M , Hedges LV , Higgins JPT , Rothstein HR 2009 . Introduction to Meta-Analysis New York: Wiley Presents a comprehensive introduction to meta-analysis. [Google Scholar]
• Borenstein M , Higgins JPT , Hedges LV , Rothstein HR 2017 . Basics of meta-analysis: I 2 is not an absolute measure of heterogeneity. Res. Synth. Methods 8 : 5– 18 [Google Scholar]
• Braver SL , Thoemmes FJ , Rosenthal R 2014 . Continuously cumulating meta-analysis and replicability. Perspect. Psychol. Sci. 9 : 333– 42 [Google Scholar]
• Bushman BJ 1994 . Vote-counting procedures. The Handbook of Research Synthesis H Cooper, LV Hedges 193– 214 New York: Russell Sage Found. [Google Scholar]
• Cesario J 2014 . Priming, replication, and the hardest science. Perspect. Psychol. Sci. 9 : 40– 48 [Google Scholar]
• Chalmers I 2007 . The lethal consequences of failing to make use of all relevant evidence about the effects of medical treatments: the importance of systematic reviews. Treating Individuals: From Randomised Trials to Personalised Medicine PM Rothwell 37– 58 London: Lancet [Google Scholar]
• Cochrane Collab. 2003 . Glossary Rep., Cochrane Collab. London: http://community.cochrane.org/glossary Presents a comprehensive glossary of terms relevant to systematic reviews. [Google Scholar]
• Cohn LD , Becker BJ 2003 . How meta-analysis increases statistical power. Psychol. Methods 8 : 243– 53 [Google Scholar]
• Cooper HM 2003 . Editorial. Psychol. Bull. 129 : 3– 9 [Google Scholar]
• Cooper HM 2016 . Research Synthesis and Meta-Analysis: A Step-by-Step Approach Thousand Oaks, CA: Sage, 5th ed.. Presents a comprehensive introduction to research synthesis and meta-analysis. [Google Scholar]
• Cooper HM , Hedges LV , Valentine JC 2009 . The Handbook of Research Synthesis and Meta-Analysis New York: Russell Sage Found, 2nd ed.. [Google Scholar]
• Cumming G 2014 . The new statistics: why and how. Psychol. Sci. 25 : 7– 29 Discusses the limitations of null hypothesis significance testing and viable alternative approaches. [Google Scholar]
• Earp BD , Trafimow D 2015 . Replication, falsification, and the crisis of confidence in social psychology. Front. Psychol. 6 : 621 [Google Scholar]
• Etz A , Vandekerckhove J 2016 . A Bayesian perspective on the reproducibility project: psychology. PLOS ONE 11 : e0149794 [Google Scholar]
• Ferguson CJ , Brannick MT 2012 . Publication bias in psychological science: prevalence, methods for identifying and controlling, and implications for the use of meta-analyses. Psychol. Methods 17 : 120– 28 [Google Scholar]
• Fleiss JL , Berlin JA 2009 . Effect sizes for dichotomous data. The Handbook of Research Synthesis and Meta-Analysis H Cooper, LV Hedges, JC Valentine 237– 53 New York: Russell Sage Found, 2nd ed.. [Google Scholar]
• Garside R 2014 . Should we appraise the quality of qualitative research reports for systematic reviews, and if so, how. Innovation 27 : 67– 79 [Google Scholar]
• Hedges LV , Olkin I 1980 . Vote count methods in research synthesis. Psychol. Bull. 88 : 359– 69 [Google Scholar]
• Hedges LV , Pigott TD 2001 . The power of statistical tests in meta-analysis. Psychol. Methods 6 : 203– 17 [Google Scholar]
• Higgins JPT , Green S 2011 . Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 London: Cochrane Collab. Presents comprehensive and regularly updated guidelines on systematic reviews. [Google Scholar]
• John LK , Loewenstein G , Prelec D 2012 . Measuring the prevalence of questionable research practices with incentives for truth telling. Psychol. Sci. 23 : 524– 32 [Google Scholar]
• Juni P , Witschi A , Bloch R , Egger M 1999 . The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282 : 1054– 60 [Google Scholar]
• Klein O , Doyen S , Leys C , Magalhães de Saldanha da Gama PA , Miller S et al. 2012 . Low hopes, high expectations: expectancy effects and the replicability of behavioral experiments. Perspect. Psychol. Sci. 7 : 6 572– 84 [Google Scholar]
• Lau J , Antman EM , Jimenez-Silva J , Kupelnick B , Mosteller F , Chalmers TC 1992 . Cumulative meta-analysis of therapeutic trials for myocardial infarction. N. Engl. J. Med. 327 : 248– 54 [Google Scholar]
• Light RJ , Smith PV 1971 . Accumulating evidence: procedures for resolving contradictions among different research studies. Harvard Educ. Rev. 41 : 429– 71 [Google Scholar]
• Lipsey MW , Wilson D 2001 . Practical Meta-Analysis London: Sage Comprehensive and clear explanation of meta-analysis. [Google Scholar]
• Matt GE , Cook TD 1994 . Threats to the validity of research synthesis. The Handbook of Research Synthesis H Cooper, LV Hedges 503– 20 New York: Russell Sage Found. [Google Scholar]
• Maxwell SE , Lau MY , Howard GS 2015 . Is psychology suffering from a replication crisis? What does “failure to replicate” really mean?. Am. Psychol. 70 : 487– 98 [Google Scholar]
• Moher D , Hopewell S , Schulz KF , Montori V , Gøtzsche PC et al. 2010 . CONSORT explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340 : c869 [Google Scholar]
• Moher D , Liberati A , Tetzlaff J , Altman DG PRISMA Group. 2009 . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339 : 332– 36 Comprehensive reporting guidelines for systematic reviews. [Google Scholar]
• Morrison A , Polisena J , Husereau D , Moulton K , Clark M et al. 2012 . The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies. Int. J. Technol. Assess. Health Care 28 : 138– 44 [Google Scholar]
• Nelson LD , Simmons J , Simonsohn U 2018 . Psychology's renaissance. Annu. Rev. Psychol. 69 : 511– 34 [Google Scholar]
• Noblit GW , Hare RD 1988 . Meta-Ethnography: Synthesizing Qualitative Studies Newbury Park, CA: Sage [Google Scholar]
• Olivo SA , Macedo LG , Gadotti IC , Fuentes J , Stanton T , Magee DJ 2008 . Scales to assess the quality of randomized controlled trials: a systematic review. Phys. Ther. 88 : 156– 75 [Google Scholar]
• Open Sci. Collab. 2015 . Estimating the reproducibility of psychological science. Science 349 : 943 [Google Scholar]
• Paterson BL , Thorne SE , Canam C , Jillings C 2001 . Meta-Study of Qualitative Health Research: A Practical Guide to Meta-Analysis and Meta-Synthesis Thousand Oaks, CA: Sage [Google Scholar]
• Patil P , Peng RD , Leek JT 2016 . What should researchers expect when they replicate studies? A statistical view of replicability in psychological science. Perspect. Psychol. Sci. 11 : 539– 44 [Google Scholar]
• Rosenthal R 1979 . The “file drawer problem” and tolerance for null results. Psychol. Bull. 86 : 638– 41 [Google Scholar]
• Rosnow RL , Rosenthal R 1989 . Statistical procedures and the justification of knowledge in psychological science. Am. Psychol. 44 : 1276– 84 [Google Scholar]
• Sanderson S , Tatt ID , Higgins JP 2007 . Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int. J. Epidemiol. 36 : 666– 76 [Google Scholar]
• Schreiber R , Crooks D , Stern PN 1997 . Qualitative meta-analysis. Completing a Qualitative Project: Details and Dialogue JM Morse 311– 26 Thousand Oaks, CA: Sage [Google Scholar]
• Shrout PE , Rodgers JL 2018 . Psychology, science, and knowledge construction: broadening perspectives from the replication crisis. Annu. Rev. Psychol. 69 : 487– 510 [Google Scholar]
• Stroebe W , Strack F 2014 . The alleged crisis and the illusion of exact replication. Perspect. Psychol. Sci. 9 : 59– 71 [Google Scholar]
• Stroup DF , Berlin JA , Morton SC , Olkin I , Williamson GD et al. 2000 . Meta-analysis of observational studies in epidemiology (MOOSE): a proposal for reporting. JAMA 283 : 2008– 12 [Google Scholar]
• Thorne S , Jensen L , Kearney MH , Noblit G , Sandelowski M 2004 . Qualitative meta-synthesis: reflections on methodological orientation and ideological agenda. Qual. Health Res. 14 : 1342– 65 [Google Scholar]
• Tong A , Flemming K , McInnes E , Oliver S , Craig J 2012 . Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med. Res. Methodol. 12 : 181– 88 [Google Scholar]
• Trickey D , Siddaway AP , Meiser-Stedman R , Serpell L , Field AP 2012 . A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin. Psychol. Rev. 32 : 122– 38 [Google Scholar]
• Valentine JC , Biglan A , Boruch RF , Castro FG , Collins LM et al. 2011 . Replication in prevention science. Prev. Sci. 12 : 103– 17 [Google Scholar]
• Article Type: Review Article

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• Systematic Review | Definition, Example, & Guide

Systematic Review | Definition, Example & Guide

Published on June 15, 2022 by Shaun Turney . Revised on November 20, 2023.

A systematic review is a type of review that uses repeatable methods to find, select, and synthesize all available evidence. It answers a clearly formulated research question and explicitly states the methods used to arrive at the answer.

They answered the question “What is the effectiveness of probiotics in reducing eczema symptoms and improving quality of life in patients with eczema?”

In this context, a probiotic is a health product that contains live microorganisms and is taken by mouth. Eczema is a common skin condition that causes red, itchy skin.

Table of contents

What is a systematic review, systematic review vs. meta-analysis, systematic review vs. literature review, systematic review vs. scoping review, when to conduct a systematic review, pros and cons of systematic reviews, step-by-step example of a systematic review, other interesting articles, frequently asked questions about systematic reviews.

A review is an overview of the research that’s already been completed on a topic.

What makes a systematic review different from other types of reviews is that the research methods are designed to reduce bias . The methods are repeatable, and the approach is formal and systematic:

• Formulate a research question
• Develop a protocol
• Search for all relevant studies
• Apply the selection criteria
• Extract the data
• Synthesize the data
• Write and publish a report

Although multiple sets of guidelines exist, the Cochrane Handbook for Systematic Reviews is among the most widely used. It provides detailed guidelines on how to complete each step of the systematic review process.

Systematic reviews are most commonly used in medical and public health research, but they can also be found in other disciplines.

Systematic reviews typically answer their research question by synthesizing all available evidence and evaluating the quality of the evidence. Synthesizing means bringing together different information to tell a single, cohesive story. The synthesis can be narrative ( qualitative ), quantitative , or both.

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Systematic reviews often quantitatively synthesize the evidence using a meta-analysis . A meta-analysis is a statistical analysis, not a type of review.

A meta-analysis is a technique to synthesize results from multiple studies. It’s a statistical analysis that combines the results of two or more studies, usually to estimate an effect size .

A literature review is a type of review that uses a less systematic and formal approach than a systematic review. Typically, an expert in a topic will qualitatively summarize and evaluate previous work, without using a formal, explicit method.

Although literature reviews are often less time-consuming and can be insightful or helpful, they have a higher risk of bias and are less transparent than systematic reviews.

Similar to a systematic review, a scoping review is a type of review that tries to minimize bias by using transparent and repeatable methods.

However, a scoping review isn’t a type of systematic review. The most important difference is the goal: rather than answering a specific question, a scoping review explores a topic. The researcher tries to identify the main concepts, theories, and evidence, as well as gaps in the current research.

Sometimes scoping reviews are an exploratory preparation step for a systematic review, and sometimes they are a standalone project.

A systematic review is a good choice of review if you want to answer a question about the effectiveness of an intervention , such as a medical treatment.

To conduct a systematic review, you’ll need the following:

• A precise question , usually about the effectiveness of an intervention. The question needs to be about a topic that’s previously been studied by multiple researchers. If there’s no previous research, there’s nothing to review.
• If you’re doing a systematic review on your own (e.g., for a research paper or thesis ), you should take appropriate measures to ensure the validity and reliability of your research.
• Access to databases and journal archives. Often, your educational institution provides you with access.
• Time. A professional systematic review is a time-consuming process: it will take the lead author about six months of full-time work. If you’re a student, you should narrow the scope of your systematic review and stick to a tight schedule.
• Bibliographic, word-processing, spreadsheet, and statistical software . For example, you could use EndNote, Microsoft Word, Excel, and SPSS.

A systematic review has many pros .

• They minimize research bias by considering all available evidence and evaluating each study for bias.
• Their methods are transparent , so they can be scrutinized by others.
• They’re thorough : they summarize all available evidence.
• They can be replicated and updated by others.

Systematic reviews also have a few cons .

• They’re time-consuming .
• They’re narrow in scope : they only answer the precise research question.

The 7 steps for conducting a systematic review are explained with an example.

Step 1: Formulate a research question

Formulating the research question is probably the most important step of a systematic review. A clear research question will:

• Allow you to more effectively communicate your research to other researchers and practitioners
• Guide your decisions as you plan and conduct your systematic review

A good research question for a systematic review has four components, which you can remember with the acronym PICO :

• Population(s) or problem(s)
• Intervention(s)
• Comparison(s)

You can rearrange these four components to write your research question:

• What is the effectiveness of I versus C for O in P ?

Sometimes, you may want to include a fifth component, the type of study design . In this case, the acronym is PICOT .

• Type of study design(s)
• The population of patients with eczema
• The intervention of probiotics
• In comparison to no treatment, placebo , or non-probiotic treatment
• The outcome of changes in participant-, parent-, and doctor-rated symptoms of eczema and quality of life
• Randomized control trials, a type of study design

Their research question was:

• What is the effectiveness of probiotics versus no treatment, a placebo, or a non-probiotic treatment for reducing eczema symptoms and improving quality of life in patients with eczema?

Step 2: Develop a protocol

A protocol is a document that contains your research plan for the systematic review. This is an important step because having a plan allows you to work more efficiently and reduces bias.

Your protocol should include the following components:

• Background information : Provide the context of the research question, including why it’s important.
• Research objective (s) : Rephrase your research question as an objective.
• Selection criteria: State how you’ll decide which studies to include or exclude from your review.
• Search strategy: Discuss your plan for finding studies.
• Analysis: Explain what information you’ll collect from the studies and how you’ll synthesize the data.

If you’re a professional seeking to publish your review, it’s a good idea to bring together an advisory committee . This is a group of about six people who have experience in the topic you’re researching. They can help you make decisions about your protocol.

It’s highly recommended to register your protocol. Registering your protocol means submitting it to a database such as PROSPERO or ClinicalTrials.gov .

Step 3: Search for all relevant studies

Searching for relevant studies is the most time-consuming step of a systematic review.

To reduce bias, it’s important to search for relevant studies very thoroughly. Your strategy will depend on your field and your research question, but sources generally fall into these four categories:

• Databases: Search multiple databases of peer-reviewed literature, such as PubMed or Scopus . Think carefully about how to phrase your search terms and include multiple synonyms of each word. Use Boolean operators if relevant.
• Handsearching: In addition to searching the primary sources using databases, you’ll also need to search manually. One strategy is to scan relevant journals or conference proceedings. Another strategy is to scan the reference lists of relevant studies.
• Gray literature: Gray literature includes documents produced by governments, universities, and other institutions that aren’t published by traditional publishers. Graduate student theses are an important type of gray literature, which you can search using the Networked Digital Library of Theses and Dissertations (NDLTD) . In medicine, clinical trial registries are another important type of gray literature.
• Experts: Contact experts in the field to ask if they have unpublished studies that should be included in your review.

At this stage of your review, you won’t read the articles yet. Simply save any potentially relevant citations using bibliographic software, such as Scribbr’s APA or MLA Generator .

• Databases: EMBASE, PsycINFO, AMED, LILACS, and ISI Web of Science
• Handsearch: Conference proceedings and reference lists of articles
• Gray literature: The Cochrane Library, the metaRegister of Controlled Trials, and the Ongoing Skin Trials Register
• Experts: Authors of unpublished registered trials, pharmaceutical companies, and manufacturers of probiotics

Step 4: Apply the selection criteria

Applying the selection criteria is a three-person job. Two of you will independently read the studies and decide which to include in your review based on the selection criteria you established in your protocol . The third person’s job is to break any ties.

To increase inter-rater reliability , ensure that everyone thoroughly understands the selection criteria before you begin.

If you’re writing a systematic review as a student for an assignment, you might not have a team. In this case, you’ll have to apply the selection criteria on your own; you can mention this as a limitation in your paper’s discussion.

You should apply the selection criteria in two phases:

• Based on the titles and abstracts : Decide whether each article potentially meets the selection criteria based on the information provided in the abstracts.
• Based on the full texts: Download the articles that weren’t excluded during the first phase. If an article isn’t available online or through your library, you may need to contact the authors to ask for a copy. Read the articles and decide which articles meet the selection criteria.

It’s very important to keep a meticulous record of why you included or excluded each article. When the selection process is complete, you can summarize what you did using a PRISMA flow diagram .

Next, Boyle and colleagues found the full texts for each of the remaining studies. Boyle and Tang read through the articles to decide if any more studies needed to be excluded based on the selection criteria.

When Boyle and Tang disagreed about whether a study should be excluded, they discussed it with Varigos until the three researchers came to an agreement.

Step 5: Extract the data

Extracting the data means collecting information from the selected studies in a systematic way. There are two types of information you need to collect from each study:

• Information about the study’s methods and results . The exact information will depend on your research question, but it might include the year, study design , sample size, context, research findings , and conclusions. If any data are missing, you’ll need to contact the study’s authors.
• Your judgment of the quality of the evidence, including risk of bias .

You should collect this information using forms. You can find sample forms in The Registry of Methods and Tools for Evidence-Informed Decision Making and the Grading of Recommendations, Assessment, Development and Evaluations Working Group .

Extracting the data is also a three-person job. Two people should do this step independently, and the third person will resolve any disagreements.

They also collected data about possible sources of bias, such as how the study participants were randomized into the control and treatment groups.

Step 6: Synthesize the data

Synthesizing the data means bringing together the information you collected into a single, cohesive story. There are two main approaches to synthesizing the data:

• Narrative ( qualitative ): Summarize the information in words. You’ll need to discuss the studies and assess their overall quality.
• Quantitative : Use statistical methods to summarize and compare data from different studies. The most common quantitative approach is a meta-analysis , which allows you to combine results from multiple studies into a summary result.

Generally, you should use both approaches together whenever possible. If you don’t have enough data, or the data from different studies aren’t comparable, then you can take just a narrative approach. However, you should justify why a quantitative approach wasn’t possible.

Boyle and colleagues also divided the studies into subgroups, such as studies about babies, children, and adults, and analyzed the effect sizes within each group.

Step 7: Write and publish a report

The purpose of writing a systematic review article is to share the answer to your research question and explain how you arrived at this answer.

Your article should include the following sections:

• Abstract : A summary of the review
• Introduction : Including the rationale and objectives
• Methods : Including the selection criteria, search method, data extraction method, and synthesis method
• Results : Including results of the search and selection process, study characteristics, risk of bias in the studies, and synthesis results
• Discussion : Including interpretation of the results and limitations of the review
• Conclusion : The answer to your research question and implications for practice, policy, or research

To verify that your report includes everything it needs, you can use the PRISMA checklist .

Once your report is written, you can publish it in a systematic review database, such as the Cochrane Database of Systematic Reviews , and/or in a peer-reviewed journal.

In their report, Boyle and colleagues concluded that probiotics cannot be recommended for reducing eczema symptoms or improving quality of life in patients with eczema. Note Generative AI tools like ChatGPT can be useful at various stages of the writing and research process and can help you to write your systematic review. However, we strongly advise against trying to pass AI-generated text off as your own work.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Student’s  t -distribution
• Normal distribution
• Null and Alternative Hypotheses
• Chi square tests
• Confidence interval
• Quartiles & Quantiles
• Cluster sampling
• Stratified sampling
• Data cleansing
• Reproducibility vs Replicability
• Peer review
• Prospective cohort study

Research bias

• Implicit bias
• Cognitive bias
• Placebo effect
• Hawthorne effect
• Hindsight bias
• Affect heuristic
• Social desirability bias

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.

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

A systematic review is secondary research because it uses existing research. You don’t collect new data yourself.

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Systematic Reviews

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What Makes a Systematic Review Different from Other Types of Reviews?

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Reproduced from Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91–108. doi:10.1111/j.1471-1842.2009.00848.x

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The power of a belief system: a systematic qualitative synthesis of spiritual care for patients with brain tumors.

1. Introduction

2. materials and methods, 2.1. literature search and methodology, 2.2. screening and data extraction, 2.3. data synthesis and analysis, search results, 4. discussion, 4.1. patient, 4.2. family or care givers, 4.3. provider, 4.4. future directions and limitations, 5. conclusions, author contributions, data availability statement, conflicts of interest.

• Ostrom, Q.T.; Cioffi, G.; Gittleman, H.; Patil, N.; Waite, K.; Kruchko, C.; Barnholtz-Sloan, J.S. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012–2016. Neuro. Oncol. 2019 , 21 , v1–v100. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Rouse, C.; Gittleman, H.; Ostrom, Q.T.; Kruchko, C.; Barnholtz-Sloan, J.S. Years of Potential Life Lost for Brain and CNS Tumors Relative to Other Cancers in Adults in the United States, 2010. Neuro. Oncol. 2016 , 18 , 70–77. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Butowski, N.A. Epidemiology and Diagnosis of Brain Tumors. Continuum 2015 , 21 , 301–313. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Ali, F.S.; Hussain, M.R.; Gutiérrez, C.; Demireva, P.; Ballester, L.Y.; Zhu, J.-J.; Blanco, A.; Esquenazi, Y. Cognitive Disability in Adult Patients with Brain Tumors. Cancer Treat. Rev. 2018 , 65 , 33–40. [ Google Scholar ] [ CrossRef ]
• Koekkoek, J.A.F.; van der Meer, P.B.; Pace, A.; Hertler, C.; Harrison, R.; Leeper, H.E.; Forst, D.A.; Jalali, R.; Oliver, K.; Philip, J.; et al. Palliative Care and End-of-Life Care in Adults with Malignant Brain Tumors. Neuro. Oncol. 2023 , 25 , 447–456. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• de Brito Sena, M.A.; Damiano, R.F.; Lucchetti, G.; Peres, M.F.P. Defining Spirituality in Healthcare: A Systematic Review and Conceptual Framework. Front. Psychol. 2021 , 12 , 756080. [ Google Scholar ] [ CrossRef ]
• Brady, M.J.; Peterman, A.H.; Fitchett, G.; Mo, M.; Cella, D. A Case for Including Spirituality in Quality of Life Measurement in Oncology. Psychooncology 1999 , 8 , 417–428. [ Google Scholar ] [ CrossRef ]
• Ownsworth, T.; Nash, K. Existential Well-Being and Meaning Making in the Context of Primary Brain Tumor: Conceptualization and Implications for Intervention. Front. Oncol. 2015 , 5 , 96. [ Google Scholar ] [ CrossRef ]
• Anderson-Shaw, L.; Baslet, G.; Villano, J.L. Brain Neoplasm and the Potential Impact on Self-Identity. AJOB Neurosci. 2010 , 1 , 3–7. [ Google Scholar ] [ CrossRef ]
• Pertz, M.; Schlegel, U.; Thoma, P. Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors. Cancers 2022 , 14 , 767. [ Google Scholar ] [ CrossRef ]
• Pelletier, G.; Verhoef, M.J.; Khatri, N.; Hagen, N. Quality of Life in Brain Tumor Patients: The Relative Contributions of Depression, Fatigue, Emotional Distress, and Existential Issues. J. Neurooncol. 2002 , 57 , 41–49. [ Google Scholar ] [ CrossRef ]
• Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. Syst. Rev. 2021 , 10 , 89. [ Google Scholar ] [ CrossRef ]
• Strang, S.; Strang, P. Spiritual Thoughts, Coping and ‘Sense of Coherence’ in Brain Tumour Patients and Their Spouses. Palliat. Med. 2001 , 15 , 127–134. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Brody, H.; Cardinal, J.L.; Foglio, J.P. Addressing Spiritual Concerns in Family Medicine: A Team Approach. J. Am. Board Fam. Med. 2004 , 17 , 201–206. [ Google Scholar ] [ CrossRef ]
• Lipsman, N.; Skanda, A.; Kimmelman, J.; Bernstein, M. The Attitudes of Brain Cancer Patients and Their Caregivers towards Death and Dying: A Qualitative Study. BMC Palliat. Care 2007 , 6 , 7. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Nixon, A.; Narayanasamy, A. The Spiritual Needs of Neuro-oncology Patients from Patients’ Perspective. J. Clin. Nurs. 2010 , 19 , 2259–2370. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Zelcer, S.; Cataudella, D.; Cairney, A.E.L.; Bannister, S.L. Palliative Care of Children with Brain Tumors. Arch. Pediatr. Adolesc. Med. 2010 , 164 , 225. [ Google Scholar ] [ CrossRef ]
• Cavers, D.; Hacking, B.; Erridge, S.E.; Kendall, M.; Morris, P.G.; Murray, S.A. Social, Psychological and Existential Well-Being in Patients with Glioma and Their Caregivers: A Qualitative Study. CMAJ 2012 , 184 , E373–E382. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Newberry, A.G.; Choi, C.-W.J.; Donovan, H.S.; Schulz, R.; Bender, C.; Given, B.; Sherwood, P. Exploring Spirituality in Family Caregivers of Patients with Primary Malignant Brain Tumors across the Disease Trajectory. Oncol. Nurs. Forum 2013 , 40 , E119–E125. [ Google Scholar ] [ CrossRef ]
• Nixon, A.V.; Narayanasamy, A.; Penny, V. An Investigation into the Spiritual Needs of Neuro-Oncology Patients from a Nurse Perspective. BMC Nurs. 2013 , 12 , 2. [ Google Scholar ] [ CrossRef ]
• Sizoo, E.M.; Dirven, L.; Reijneveld, J.C.; Postma, T.J.; Heimans, J.J.; Deliens, L.; Pasman, H.R.W.; Taphoorn, M.J.B. Measuring Health-Related Quality of Life in High-Grade Glioma Patients at the End of Life Using a Proxy-Reported Retrospective Questionnaire. J. Neurooncol. 2014 , 116 , 283–290. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Piderman, K.M.; Breitkopf, C.R.; Jenkins, S.M.; Lovejoy, L.A.; Dulohery, Y.M.; Marek, D.V.; Durland, H.L.; Head, D.L.; Swanson, S.W.; Hogg, J.T.; et al. The Feasibility and Educational Value of Hear My Voice, a Chaplain-Led Spiritual Life Review Process for Patients with Brain Cancers and Progressive Neurologic Conditions. J. Cancer Educ. 2015 , 30 , 209–212. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Strang, S.; Strang, P.; Ternestedt, B.-M. Existential Support in Brain Tumour Patients and Their Spouses. Support. Care Cancer 2001 , 9 , 625–633. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Piderman, K.M.; Radecki Breitkopf, C.; Jenkins, S.M.; Lapid, M.I.; Kwete, G.M.; Sytsma, T.T.; Lovejoy, L.A.; Yoder, T.J.; Jatoi, A. The Impact of a Spiritual Legacy Intervention in Patients with Brain Cancers and Other Neurologic Illnesses and Their Support Persons. Psychooncology 2017 , 26 , 346–353. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Piderman, K.M.; Egginton, J.S.; Ingram, C.; Dose, A.M.; Yoder, T.J.; Lovejoy, L.A.; Swanson, S.W.; Hogg, J.T.; Lapid, M.I.; Jatoi, A.; et al. I’m Still Me: Inspiration and Instruction from Individuals with Brain Cancer. J. Health Care Chaplain. 2017 , 23 , 15–33. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Cutillo, A.; Zimmerman, K.; Davies, S.; Madan-Swain, A.; Landier, W.; Arynchyna, A.; Rocque, B.G. Coping Strategies Used by Caregivers of Children with Newly Diagnosed Brain Tumors. J. Neurosurg. Pediatr. 2018 , 23 , 30–39. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Giovagnoli, A.R.; Paterlini, C.; Meneses, R.F.; Martins da Silva, A. Spirituality and Quality of Life in Epilepsy and Other Chronic Neurological Disorders. Epilepsy Behav. 2019 , 93 , 94–101. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Randazzo, D.M.; McSherry, F.; Herndon, J.E.; Affronti, M.L.; Lipp, E.S.; Flahiff, C.; Miller, E.; Woodring, S.; Boulton, S.; Desjardins, A.; et al. Complementary and Integrative Health Interventions and Their Association with Health-Related Quality of Life in the Primary Brain Tumor Population. Complement. Ther. Clin. Pract. 2019 , 36 , 43–48. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Hyer, J.M.; Paredes, A.Z.; Kelley, E.P.; Tsilimigras, D.; Meyer, B.; Newberry, H.; Pawlik, T.M. Characterizing Pastoral Care Utilization by Cancer Patients. Am. J. Hosp. Palliat. Care 2021 , 38 , 758–765. [ Google Scholar ] [ CrossRef ]
• Randazzo, D.M.; McSherry, F.; Herndon, J.E., II; Affronti, M.L.; Lipp, E.S.; Miller, E.S.; Woodring, S.; Healy, P.; Jackman, J.; Crouch, B.; et al. Spiritual Well-Being and Its Association with Health-Related Quality of Life in Primary Brain Tumor Patients. Neurooncol. Pract. 2021 , 8 , 299–309. [ Google Scholar ] [ CrossRef ]
• Baksi, A.; Arda Sürücü, H.; Genç, H. Psychological Hardiness and Spirituality in Patients with Primary Brain Tumors: A Comparative Study. J. Relig. Health 2021 , 60 , 2799–2809. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Sprik, P.J.; Tata, B.; Kelly, B.; Fitchett, G. Religious/Spiritual Concerns of Patients with Brain Cancer and Their Caregivers. Ann. Palliat. Med. 2021 , 10 , 964–969. [ Google Scholar ] [ CrossRef ]
• Applebaum, A.J.; Baser, R.E.; Roberts, K.E.; Lynch, K.; Gebert, R.; Breitbart, W.S.; Diamond, E.L. Meaning-Centered Psychotherapy for Cancer Caregivers: A Pilot Trial among Caregivers of Patients with Glioblastoma Multiforme. Transl. Behav. Med. 2022 , 12 , 841–852. [ Google Scholar ] [ CrossRef ]
• Maugans, T.A. The SPIRITual History. Arch. Fam. Med. 1996 , 5 , 11–16. [ Google Scholar ] [ CrossRef ]
• Puchalski, C.; Ferrell, B.; Virani, R.; Otis-Green, S.; Baird, P.; Bull, J.; Chochinov, H.; Handzo, G.; Nelson-Becker, H.; Prince-Paul, M.; et al. Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference. J. Palliat. Med. 2009 , 12 , 885–904. [ Google Scholar ] [ CrossRef ]
• Nolan, S.; Saltmarch, P.; Leget, C. Spiritual Care in Palliative Care: Working towards an EAPC Task Force. Eur. J. Pal. Care 2011 , 18 , 86–89. [ Google Scholar ]
• Puchalski, C.M.; Vitillo, R.; Hull, S.K.; Reller, N. Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus. J. Palliat. Med. 2014 , 17 , 642–656. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Gholamhosseini, M.; Dehghan, M.; Azzizadeh Forouzi, M.; Mangolian Shahrbabaki, P.; Roy, C. Effectiveness of Spiritual Counseling on the Enhancement of Hope in Iranian Muslim Patients with Myocardial Infarction: A Two-Month Follow-Up. J. Relig. Health 2022 , 61 , 3898–3908. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Kobasa, S.C. Stressful Life Events, Personality, and Health: An Inquiry into Hardiness. J. Pers. Soc. Psychol. 1979 , 37 , 1–11. [ Google Scholar ] [ CrossRef ]
• Korman, M.B.; Ellis, J.; Moore, J.; Bilodeau, D.; Dulmage, S.; Fitch, M.; Mueller, C.; Sahgal, A.; Moroney, C. Dignity Therapy for Patients with Brain Tumours: Qualitative Reports from Patients, Caregivers and Practitioners. Ann. Palliat. Med. 2021 , 10 , 838–845. [ Google Scholar ] [ CrossRef ]

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Share and Cite

Mehta, N.H.; Prajapati, M.; Aeleti, R.; Kinariwala, K.; Ohri, K.; McCabe, S.; Buller, Z.; Leskinen, S.; Nawabi, N.L.; Bhatt, V.; et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. J. Clin. Med. 2024 , 13 , 4871. https://doi.org/10.3390/jcm13164871

Mehta NH, Prajapati M, Aeleti R, Kinariwala K, Ohri K, McCabe S, Buller Z, Leskinen S, Nawabi NL, Bhatt V, et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. Journal of Clinical Medicine . 2024; 13(16):4871. https://doi.org/10.3390/jcm13164871

Mehta, Neel H., Megh Prajapati, Rishi Aeleti, Kush Kinariwala, Karina Ohri, Sean McCabe, Zachary Buller, Sandra Leskinen, Noah L. Nawabi, Vatsal Bhatt, and et al. 2024. "The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors" Journal of Clinical Medicine 13, no. 16: 4871. https://doi.org/10.3390/jcm13164871

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Open Access

Study Protocol

Adolescent HIV prevent and care framework: A global scoping review protocol- BSGH 006

Contributed equally to this work with: Gamji Rabiu Abu-Ba’are, Osman Wumpini Shamrock

Roles Conceptualization, Supervision, Writing – original draft, Writing – review & editing

Affiliations School of Nursing, University of Rochester, Rochester, New York, United States of America, Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, United States of America, Behavioral, Sexual, and Global Health Lab, Accra, Ghana, School of Nursing, Yale University, New Haven, Connecticut, United States of America, Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, United States of America, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States of America

* E-mail: [email protected]

Affiliations School of Nursing, University of Rochester, Rochester, New York, United States of America, Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, United States of America, Behavioral, Sexual, and Global Health Lab, Accra, Ghana

Roles Methodology, Writing – original draft, Writing – review & editing

Affiliation Edward G. Miner Library, University of Rochester Medical Center, Rochester, New York, United States of America

Roles Conceptualization, Writing – original draft, Writing – review & editing

Affiliation Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, United States of America

Affiliations Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, United States of America, Behavioral, Sexual, and Global Health Lab, Accra, Ghana, School of Nursing, Yale University, New Haven, Connecticut, United States of America, Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, United States of America

• Gamji Rabiu Abu-Ba’are, 
• Osman Wumpini Shamrock, 
• Darcey Rodriguez, 
• George Rudolph Kofi Agbemedu, 
• LaRon E. Nelson

• Published: August 19, 2024
• https://doi.org/10.1371/journal.pone.0289994
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Among adolescents, HIV/AIDs remains a significant cause of death globally [ 1 – 4 ]. Given the unique stages in human development, adolescents have been shown to fall within a sexually active phase. Combined with other social and structural factors in their immediate environments, HIV prevention and care among adolescents can be filled with challenges for intervention. This paper outlines this protocol to systematically review peer-reviewed literature in prevention and care among adolescents 10–19 years. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used to report this scoping review. The review will involve screening and extracting data using covidence as the primary tool. The review will encompass quantitative, qualitative, and mixed methods studies, utilizing a search strategy from electronic databases such as PubMed (NCBI), Web of Science Core Collection (Clarivate), Embase (Elsevier), and Scopus (Elsevier). Additionally, a search will be conducted for grey literature using Global Index Medicus (WHO), MedNar (Deep Web Technologies), and Central Register of Controlled Trials (Cochrane). Duplicate removal and selection of articles that meet the inclusion criteria for the study will be performed using Covidence. Once the screening process is complete, data will be extracted from the full-text screened articles in Covidence. We will pilot the extracted data in Covidence to ensure that all relevant information has been captured, making necessary changes if required. Data extraction will be carried out by at least two authors, with any conflicts resolved by the same authors. If a conflict cannot be resolved between the two, a third author will make a final determination. We aim to analyze data thematically by employing a grounded theory approach to generate codes pertinent to the research question. The team will review and discuss codes to create a cohesive set of codes that will be instrumental in identifying knowledge gaps and constructing themes that summarize the data. The proposed systematic review will be among the pioneering efforts to rigorously assess global data on HIV prevention and care, with a specific focus on adolescents 10–19 years. It will consider the diverse socio-economic factors and experiences shaping these adolescents’ lives in HIV prevention and care. We expect this review to yield critical insights into the present landscape of HIV prevention and care for individuals aged 10–19. These findings will also play a pivotal role in shaping the development of a global framework that researchers and stakeholders can readily adopt and implement across socio-economic contexts. This framework will aim to address the unique needs of all adolescents concerning HIV prevention and care.

Citation: Abu-Ba’are GR, Shamrock OW, Rodriguez D, Agbemedu GRK, Nelson LE (2024) Adolescent HIV prevent and care framework: A global scoping review protocol- BSGH 006. PLoS ONE 19(8): e0289994. https://doi.org/10.1371/journal.pone.0289994

Editor: Graeme Hoddinott, Stellenbosch University, SOUTH AFRICA

Received: August 17, 2023; Accepted: June 28, 2024; Published: August 19, 2024

Copyright: © 2024 Abu-Ba’are et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Deidentified research data will be made publicly available when the study is completed and published.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Globally, HIV remains one of the leading causes of death worldwide [ 5 ]. Controlling the spread of the virus has been a major challenge, posing significant problems in advancing preventative measures and providing continuous care to affected individuals [ 6 – 10 ]. The global prevalence of HIV has reduced in this decade, but significant regional variations in trends and modes of transmission exist [ 11 , 12 ]. The epidemiology of HIV among various key population groups, such as adolescents and socially marginalized groups, based on varying community perceptions about sex, has challenged the global efforts to control the spread of the virus [ 13 – 17 ]. Adolescents aged 10–19 years account for approximately 16% of the world’s population. In 2021, 1.7 million adolescents were living with HIV, comprising 5% of all people living with HIV globally, and accounted for 11% of all new infections among emerging adults [ 18 , 19 ].

Adolescent HIV/AIDS is a distinct epidemic that needs to be handled and managed differently from adult HIV [ 20 , 21 ]. Adolescent sexual and reproductive health remains a significant public health concern globally, especially in communities where child marriage and adolescent childbearing are high, with low exposure to modern contraceptives [ 22 ]. Several factors contribute to the high prevalence of HIV among adolescents, including vulnerability during their transitional stage in life and biological changes that can affect their social relationships, potentially leading to risky behaviors that increase the risk of HIV infections [ 19 , 23 – 25 ]. The severity of addressing HIV prevention and care in adolescence is crucial, as many adolescents with HIV are unaware of their status and fail to consistently use condoms in sexual encounters or face challenges when accessing preventive options due to alcohol-drug abuse, sex-HIV-age stigma and discrimination [ 26 – 27 ].

Adherence to HIV medication is a concern among adolescents diagnosed with HIV [ 28 – 32 ]. Accepting a positive HIV test result is challenging for adolescents due to the need for lifelong treatment and worries about their future goals regarding health, education, career and marriage, among other personal goals, producing a micro-level barrier to adolescents’ readiness for HIV care [ 21 , 33 ]. HIV stigma and sex stigma in some communities deter adolescents from accessing HIV care [ 33 , 34 ]. Additionally, the side effects of HIV medications can affect adherence as they can affect adolescents’ ability and willingness to consistently take their prescribed Antiretrovirals [ 35 – 37 ]. Determining appropriate antiretroviral (ART) dosages for sustained suppression in adolescents is challenging adolescent may experience growth spurt, particularly in under resourced health facilities [ 38 ]. Failure to take the correct dosage of antiretroviral can intensify side effects and result in poor adherence [ 39 – 41 ].

Although several preventative measures have been proposed to curb the incidence of HIV among adolescents, it has been recognized that no singular technique is enough to address the epidemic adequately, hence, an integrated approach that combines biomedical preventive techniques with behavioral and structural interventions is recommended as the ideal means of preventing HIV among adolescents [ 6 , 42 ]. The World Health Organization has also proposed using psychosocial techniques to support preventive measures for HIV among adolescents [ 43 ]. Considering that contextual factors significantly influence the effectiveness of interventions in HIV prevention and care among adolescents, it is important to pay attention to regional dynamics when proposing interventions for adolescents. Adolescent girls in 2021 accounted for 75% of all new HIV infections among adolescents. This percentage was even higher with adolescent girls in the 35 HIV-priority countries in UNICEF’s Strategic Plan, accounting for 80% of all new HIV infections among adolescents. In sub-Saharan Africa in the same year, about six times as many adolescent girls were newly infected with HIV than adolescent boys. Beyond the sub-Saharan Africa region, the highest numbers of HIV-positive adolescents are in Asia and Latin America. In East Asia and the Pacific, more boys are newly infected with HIV each year than girls in adolescence. This finding mirrors the various distinct risk behaviors in the respective regions, which suggests that interventions must be personalized to the specific nature and dynamic of the epidemic.

Moreover, there’s a lack of a universal framework that adequately encompasses the multifaceted dynamics of HIV among adolescents, particularly those between the ages of 10–19 years. It’s important to address the gaps in adolescent HIV prevention and care research. Failing to consider social differences, intersectionality, and political climates in different geographical areas could hinder the development of practical and universally applicable policy recommendations that cater to the needs of this population. Our review proposes to:

• Develop a comprehensive assessment of data by conducting a thorough evaluation of existing research on HIV prevention and care among adolescents aged 10–19, considering diverse social factors such as geography, race, sex, age, gender, education, religion, sexual orientation, occupation, nationality, marital status, socio-economic status, disability, and immigration status.
• Use data to develop a global framework based on theory, research and practice to capture the diverse dynamics inherent in adolescent HIV prevention and care. This framework will be adaptable to various economic contexts and provide a standardized measure to support intervention in adolescent HIV prevention and care.

Method and analysis

We will utilize the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) by Tricco et al. (2018) for reporting this scoping review. As outlined by Tricco et al. (2018), the first step in conducting a scoping review is to develop a protocol to clarify the purpose and methodology of the review. By documenting and sharing this protocol, we aim to ensure transparency in our process and prevent duplication of efforts in the field of adolescent HIV prevention and care [ 45 , 46 ].

Ethics and dissemination

Our scoping review findings will be published in a peer-reviewed journal, making them accessible to researchers, practitioners, and the public. We will also share these findings at relevant conferences and events on adolescent HIV prevention and care. Additionally, we aim to use the insights gained from this review to inform future research studies, addressing gaps in the scholarly literature on HIV among adolescents, particularly in prevention and care.

Patient and public involvement

This study does not involve human participants or data collection, so it does not require ethical approval. The research findings will be disseminated through various channels, including conferences, webinars, and peer-reviewed manuscripts. The insights gained from this study have the potential to inform and influence the policies and practices of government health agencies and healthcare facilities, fostering improvements in the field.

Criteria for study inclusion

Only articles addressing HIV prevention or care among adolescents aged 10–19 will be considered. Such articles must present empirical data on the topic and be published in English. We will limit the search inclusion to English for two reasons. The first is due to the unavailability of a multilingual reviewer in the research team and the cost of translation services. The second is connected to our researchers’ expertise and proficiencies in English to ensure an accurate and thorough review of selected studies, enhancing the reliability of data extraction and minimizing the possibility of misinterpretation. Only studies published after 2013 will be included to provide up-to-date information.

Criteria for study exclusion

The review will exclude all individuals aged below 10 and above 19 years. Studies that do not capture empirical data on the topic and are not published in English will be excluded. Studies published before 2013 will be excluded. This review will not include certain types of publications such as review papers (including scoping and systematic reviews), book chapters, reports, opinions, commentaries, conference abstracts, and articles published in languages other than English.

Types of studies

Our review will include quantitative, qualitative, and mixed methods studies. We will encompass both experimental and observational studies without excluding any based on methodological approaches. However, we will exclude articles that synthesize existing literature, such as reviews, in our analysis.

Search strategy

Identifying sources..

A medical librarian (DR) from the University of Rochester Medical Center will create the search strategy with input from other authors to help find any extra sources, such as grey literature, similar to what was done in other protocols [ 45 , 46 ].

Electronic database searching.

DR will conduct a literature search using PubMed (NCBI), Web of Science Core Collection (Clarivate), Embase (Elsevier), and Scopus (Elsevier). The search strategy will use a combination of index terms when available in each database and keywords including HIV, adolescent, care continuum, and anti-retroviral agents. See attached file for an example. The search will limit results to those published in the English language between 2013 to present.

Grey literature searching.

Grey literature will also be searched for using Global Index Medicus (WHO), MedNar (Deep Web Technologies), and Central Registry of Controlled Trials (Cochrane) to capture other relevant data that may not be included in other databases.

Data screening.

After the search process is complete, all articles will be exported to Covidence, and duplicate articles will be removed. Using the inclusion criteria set forth by the team, a two-step screening process will occur in Covidence. After de-duplication, the first process will include two reviewers screening the title and abstract of all remaining articles. After the title and abstract screening process, a team of two will independently review the full text of articles that have met the inclusion criteria. When the two reviewers complete the screening process, they will meet to resolve any conflicts. If the two reviewers cannot resolve, a third reviewer will make a final determination.

Data extraction

Data extraction will begin after all articles have undergone title, abstract, and full-text screening. Using Covidence, the data extraction form will identify publication details, including title, author, and year of publication. The form will also extract data on the methods, including study design, aim, and date. Participate data will include a description of the population, methods of recruitment, and number of participants.

To ensure that all the relevant data is captured as intended, the data extraction form in Covidence will be pilot-tested on a few studies. After pilot testing, modifications will be made, and the form will be used to collect data from eligible studies. The data extraction process will involve two authors working together to ensure accuracy. In the event of any conflicts, they will discuss and resolve the issues. If they are unable to reach an agreement, a third reviewer will be consulted to make a final determination. The review will adhere to the JBI guidelines when conducting the review.

Analysis and reporting.

The findings in the study will adhere to the guidelines outlined in PRISMA-ScR [ 44 ]. We will present a narrative summary of the results while utilizing tables to organize the data. The outcomes will be categorized, taking into account the number of studies, their designs, and methodology. Additionally, key findings from each study will be condensed and presented in tables. Although we will focus on screening experimental studies, we will not conduct quantitative data analysis. Instead, we will employ descriptive statistics such as frequency and range to elucidate the results. Our data will be thematically analyzed [ 45 , 46 ]. We will utilize grounded theory and establish a comprehensive list of codes relevant to the research question and outcomes. This code list will undergo a duplicate review by the research team involved in the data extraction process. A consensus will be reached on a unified set of codes through group discussion. These codes serve as the foundation for creating themes that capture the narrative synthesis of the extracted data and identify any existing knowledge gaps. The proposed framework will be guided by data derived from the systematic review and recommendations from researchers in the diverse research fields in HIV prevention and care among adolescents aged 10–19 years. We will use data derived to serve as a checklist and measure the extent to which the framework considers the social differences, intersectionality, and political climates of adolescents globally.

Outcome. The primary objective of this study is to gain a comprehensive understanding of the current state of HIV prevention and care research among adolescents aged 10–19 years. We will use this knowledge to create a global framework that can be easily used in various economic contexts and serve as a standardized intervention measure in adolescent HIV prevention and care. This framework proposes to enhance research, theory, practice, and policy efforts that consider the diverse experiences of adolescents in HIV prevention and care.

The prevention and care of HIV among adolescents pose significant global challenges due to various factors, including their transitional stage in life, vulnerability associated with their age groups, and the complex interplay of biological, structural, and social factors [ 23 , 24 , 47 ]. These factors individually and collectively may hinder efforts to reduce adolescent HIV-related deaths and transmission. The prevalence of HIV among adolescents is particularly concerning, with areas such as the sub-Saharan region experiencing higher burden of HIV-related deaths among this population group, exacerbated by risky behaviors associated with their transitional stage and a lack of awareness of HIV status [ 4 ]. Our review will aim to analyze global data on HIV prevention and care, focusing on adolescents aged 10–19 years. We will take into account various socio-economic factors and life experiences that affect how these adolescents engage with HIV prevention and care. The insights gained from this analysis will be invaluable in tailoring HIV prevention and care specifically for this age group. Additionally, we plan to use these findings to create a framework that researchers and stakeholders can easily adopt in different socio-economic contexts. This framework will cater to the unique needs of all adolescents in HIV prevention and care, ensuring inclusivity and effectiveness in diverse settings.

Strengths and limitations of this study

1. A notable strength of this study will be its rigorous approach to literature search conducted by a skilled librarian. The search strategy will be comprehensive, augmented by including grey literature sources. This meticulous process will thoroughly cover the existing literature, bolstering the study’s credibility and reliability.

2. Furthermore, this study will offer significant advantage by providing cutting-edge insights and valuable guidance for future research and interventions focused on enhancing awareness among adolescents in HIV prevention and care globally. By keeping abreast of the latest developments, this research will actively advance effective strategies and interventions in this critical area of HIV research.

3. The restriction to articles published exclusively in the English language may be one of the notable limitations of this study. While this ensures consistency and enables a comprehensive analysis within that language, it may inadvertently exclude valuable contributions from non-English sources.

4. Another anticipated limitation of this study will be its specific focus on adolescents (10–19) as the target population. While this emphasis allows for in-depth exploration and tailored insights, it may overlook valuable perspectives and findings relevant to other age groups or people affected by HIV prevention and care.

Supporting information

S1 checklist. prisma-p 2015 checklist..

https://doi.org/10.1371/journal.pone.0289994.s001

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• 4. UNICEF. Although strides have been made in the HIV response, children are still affected by the epidemic. Unicef Data. 2021;(July 2022).
• 5. WHO. The top 10 causes of death—Factsheet. WHO reports. 2020;(December 2020).

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The Acceptability, Engagement, and Feasibility of Mental Health Apps for Marginalized and Underserved Young People: Systematic Review and Qualitative Study

Bear ha., ayala nunes l., ramos g., manchanda t., fernandes b., chabursky s., walper s., watkins e., fazel m..

Background Smartphone apps may provide an opportunity to deliver mental health resources and interventions in a scalable and cost-effective manner. However, young people from marginalized and underserved groups face numerous and unique challenges to accessing, engaging with, and benefiting from these apps. Objective This study aims to better understand the acceptability (ie, perceived usefulness and satisfaction with an app) and feasibility (ie, the extent to which an app was successfully used) of mental health apps for underserved young people. A secondary aim was to establish whether adaptations can be made to increase the accessibility and inclusivity of apps for these groups. Methods We conducted 2 sequential studies, consisting of a systematic literature review of mental health apps for underserved populations followed by a qualitative study with underserved young male participants (n=20; age: mean 19). Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 5 databases was conducted in 2021. The search yielded 18,687 results, of which 14 articles met the eligibility criteria. Results The included studies comprised a range of groups, including those affected by homelessness, having physical health conditions, living in low- and middle-income countries, and those with sexual and gender minority identities. Establishing and maintaining user engagement was a pervasive challenge across mental health apps and populations, and dropout was a reported problem among nearly all the included studies. Positive subjective reports of usability, satisfaction, and acceptability were insufficient to determine users’ objective engagement. Conclusions Despite the significant amount of funding directed to the development of mental health apps, juxtaposed with only limited empirical evidence to support their effectiveness, few apps have been deliberately developed or adapted to meet the heterogeneous needs of marginalized and underserved young people. Before mental health apps are scaled up, a greater understanding is needed of the types of services that more at-risk young people and those in limited-resource settings prefer (eg, standard vs digital) followed by more rigorous and consistent demonstrations of acceptability, effectiveness, and cost-effectiveness. Adopting an iterative participatory approach by involving young people in the development and evaluation process is an essential step in enhancing the adoption of any intervention, including apps, in “real-world” settings and will support future implementation and sustainability efforts to ensure that marginalized and underserved groups are reached. Trial Registration PROSPERO CRD42021254241; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254241

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10.2196/48964

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Journal of Medical Internet Research

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Ten Simple Rules for Writing a Literature Review

Marco pautasso.

1 Centre for Functional and Evolutionary Ecology (CEFE), CNRS, Montpellier, France

2 Centre for Biodiversity Synthesis and Analysis (CESAB), FRB, Aix-en-Provence, France

Literature reviews are in great demand in most scientific fields. Their need stems from the ever-increasing output of scientific publications [1] . For example, compared to 1991, in 2008 three, eight, and forty times more papers were indexed in Web of Science on malaria, obesity, and biodiversity, respectively [2] . Given such mountains of papers, scientists cannot be expected to examine in detail every single new paper relevant to their interests [3] . Thus, it is both advantageous and necessary to rely on regular summaries of the recent literature. Although recognition for scientists mainly comes from primary research, timely literature reviews can lead to new synthetic insights and are often widely read [4] . For such summaries to be useful, however, they need to be compiled in a professional way [5] .

When starting from scratch, reviewing the literature can require a titanic amount of work. That is why researchers who have spent their career working on a certain research issue are in a perfect position to review that literature. Some graduate schools are now offering courses in reviewing the literature, given that most research students start their project by producing an overview of what has already been done on their research issue [6] . However, it is likely that most scientists have not thought in detail about how to approach and carry out a literature review.

Reviewing the literature requires the ability to juggle multiple tasks, from finding and evaluating relevant material to synthesising information from various sources, from critical thinking to paraphrasing, evaluating, and citation skills [7] . In this contribution, I share ten simple rules I learned working on about 25 literature reviews as a PhD and postdoctoral student. Ideas and insights also come from discussions with coauthors and colleagues, as well as feedback from reviewers and editors.

Rule 1: Define a Topic and Audience

How to choose which topic to review? There are so many issues in contemporary science that you could spend a lifetime of attending conferences and reading the literature just pondering what to review. On the one hand, if you take several years to choose, several other people may have had the same idea in the meantime. On the other hand, only a well-considered topic is likely to lead to a brilliant literature review [8] . The topic must at least be:

• interesting to you (ideally, you should have come across a series of recent papers related to your line of work that call for a critical summary),
• an important aspect of the field (so that many readers will be interested in the review and there will be enough material to write it), and
• a well-defined issue (otherwise you could potentially include thousands of publications, which would make the review unhelpful).

Ideas for potential reviews may come from papers providing lists of key research questions to be answered [9] , but also from serendipitous moments during desultory reading and discussions. In addition to choosing your topic, you should also select a target audience. In many cases, the topic (e.g., web services in computational biology) will automatically define an audience (e.g., computational biologists), but that same topic may also be of interest to neighbouring fields (e.g., computer science, biology, etc.).

Rule 2: Search and Re-search the Literature

After having chosen your topic and audience, start by checking the literature and downloading relevant papers. Five pieces of advice here:

• keep track of the search items you use (so that your search can be replicated [10] ),
• keep a list of papers whose pdfs you cannot access immediately (so as to retrieve them later with alternative strategies),
• use a paper management system (e.g., Mendeley, Papers, Qiqqa, Sente),
• define early in the process some criteria for exclusion of irrelevant papers (these criteria can then be described in the review to help define its scope), and
• do not just look for research papers in the area you wish to review, but also seek previous reviews.

The chances are high that someone will already have published a literature review ( Figure 1 ), if not exactly on the issue you are planning to tackle, at least on a related topic. If there are already a few or several reviews of the literature on your issue, my advice is not to give up, but to carry on with your own literature review,

The bottom-right situation (many literature reviews but few research papers) is not just a theoretical situation; it applies, for example, to the study of the impacts of climate change on plant diseases, where there appear to be more literature reviews than research studies [33] .

• discussing in your review the approaches, limitations, and conclusions of past reviews,
• trying to find a new angle that has not been covered adequately in the previous reviews, and
• incorporating new material that has inevitably accumulated since their appearance.

When searching the literature for pertinent papers and reviews, the usual rules apply:

• be thorough,
• use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and
• look at who has cited past relevant papers and book chapters.

Rule 3: Take Notes While Reading

If you read the papers first, and only afterwards start writing the review, you will need a very good memory to remember who wrote what, and what your impressions and associations were while reading each single paper. My advice is, while reading, to start writing down interesting pieces of information, insights about how to organize the review, and thoughts on what to write. This way, by the time you have read the literature you selected, you will already have a rough draft of the review.

Of course, this draft will still need much rewriting, restructuring, and rethinking to obtain a text with a coherent argument [11] , but you will have avoided the danger posed by staring at a blank document. Be careful when taking notes to use quotation marks if you are provisionally copying verbatim from the literature. It is advisable then to reformulate such quotes with your own words in the final draft. It is important to be careful in noting the references already at this stage, so as to avoid misattributions. Using referencing software from the very beginning of your endeavour will save you time.

Rule 4: Choose the Type of Review You Wish to Write

After having taken notes while reading the literature, you will have a rough idea of the amount of material available for the review. This is probably a good time to decide whether to go for a mini- or a full review. Some journals are now favouring the publication of rather short reviews focusing on the last few years, with a limit on the number of words and citations. A mini-review is not necessarily a minor review: it may well attract more attention from busy readers, although it will inevitably simplify some issues and leave out some relevant material due to space limitations. A full review will have the advantage of more freedom to cover in detail the complexities of a particular scientific development, but may then be left in the pile of the very important papers “to be read” by readers with little time to spare for major monographs.

There is probably a continuum between mini- and full reviews. The same point applies to the dichotomy of descriptive vs. integrative reviews. While descriptive reviews focus on the methodology, findings, and interpretation of each reviewed study, integrative reviews attempt to find common ideas and concepts from the reviewed material [12] . A similar distinction exists between narrative and systematic reviews: while narrative reviews are qualitative, systematic reviews attempt to test a hypothesis based on the published evidence, which is gathered using a predefined protocol to reduce bias [13] , [14] . When systematic reviews analyse quantitative results in a quantitative way, they become meta-analyses. The choice between different review types will have to be made on a case-by-case basis, depending not just on the nature of the material found and the preferences of the target journal(s), but also on the time available to write the review and the number of coauthors [15] .

Rule 5: Keep the Review Focused, but Make It of Broad Interest

Whether your plan is to write a mini- or a full review, it is good advice to keep it focused 16 , 17 . Including material just for the sake of it can easily lead to reviews that are trying to do too many things at once. The need to keep a review focused can be problematic for interdisciplinary reviews, where the aim is to bridge the gap between fields [18] . If you are writing a review on, for example, how epidemiological approaches are used in modelling the spread of ideas, you may be inclined to include material from both parent fields, epidemiology and the study of cultural diffusion. This may be necessary to some extent, but in this case a focused review would only deal in detail with those studies at the interface between epidemiology and the spread of ideas.

While focus is an important feature of a successful review, this requirement has to be balanced with the need to make the review relevant to a broad audience. This square may be circled by discussing the wider implications of the reviewed topic for other disciplines.

Rule 6: Be Critical and Consistent

Reviewing the literature is not stamp collecting. A good review does not just summarize the literature, but discusses it critically, identifies methodological problems, and points out research gaps [19] . After having read a review of the literature, a reader should have a rough idea of:

• the major achievements in the reviewed field,
• the main areas of debate, and
• the outstanding research questions.

It is challenging to achieve a successful review on all these fronts. A solution can be to involve a set of complementary coauthors: some people are excellent at mapping what has been achieved, some others are very good at identifying dark clouds on the horizon, and some have instead a knack at predicting where solutions are going to come from. If your journal club has exactly this sort of team, then you should definitely write a review of the literature! In addition to critical thinking, a literature review needs consistency, for example in the choice of passive vs. active voice and present vs. past tense.

Rule 7: Find a Logical Structure

Like a well-baked cake, a good review has a number of telling features: it is worth the reader's time, timely, systematic, well written, focused, and critical. It also needs a good structure. With reviews, the usual subdivision of research papers into introduction, methods, results, and discussion does not work or is rarely used. However, a general introduction of the context and, toward the end, a recapitulation of the main points covered and take-home messages make sense also in the case of reviews. For systematic reviews, there is a trend towards including information about how the literature was searched (database, keywords, time limits) [20] .

How can you organize the flow of the main body of the review so that the reader will be drawn into and guided through it? It is generally helpful to draw a conceptual scheme of the review, e.g., with mind-mapping techniques. Such diagrams can help recognize a logical way to order and link the various sections of a review [21] . This is the case not just at the writing stage, but also for readers if the diagram is included in the review as a figure. A careful selection of diagrams and figures relevant to the reviewed topic can be very helpful to structure the text too [22] .

Rule 8: Make Use of Feedback

Reviews of the literature are normally peer-reviewed in the same way as research papers, and rightly so [23] . As a rule, incorporating feedback from reviewers greatly helps improve a review draft. Having read the review with a fresh mind, reviewers may spot inaccuracies, inconsistencies, and ambiguities that had not been noticed by the writers due to rereading the typescript too many times. It is however advisable to reread the draft one more time before submission, as a last-minute correction of typos, leaps, and muddled sentences may enable the reviewers to focus on providing advice on the content rather than the form.

Feedback is vital to writing a good review, and should be sought from a variety of colleagues, so as to obtain a diversity of views on the draft. This may lead in some cases to conflicting views on the merits of the paper, and on how to improve it, but such a situation is better than the absence of feedback. A diversity of feedback perspectives on a literature review can help identify where the consensus view stands in the landscape of the current scientific understanding of an issue [24] .

Rule 9: Include Your Own Relevant Research, but Be Objective

In many cases, reviewers of the literature will have published studies relevant to the review they are writing. This could create a conflict of interest: how can reviewers report objectively on their own work [25] ? Some scientists may be overly enthusiastic about what they have published, and thus risk giving too much importance to their own findings in the review. However, bias could also occur in the other direction: some scientists may be unduly dismissive of their own achievements, so that they will tend to downplay their contribution (if any) to a field when reviewing it.

In general, a review of the literature should neither be a public relations brochure nor an exercise in competitive self-denial. If a reviewer is up to the job of producing a well-organized and methodical review, which flows well and provides a service to the readership, then it should be possible to be objective in reviewing one's own relevant findings. In reviews written by multiple authors, this may be achieved by assigning the review of the results of a coauthor to different coauthors.

Rule 10: Be Up-to-Date, but Do Not Forget Older Studies

Given the progressive acceleration in the publication of scientific papers, today's reviews of the literature need awareness not just of the overall direction and achievements of a field of inquiry, but also of the latest studies, so as not to become out-of-date before they have been published. Ideally, a literature review should not identify as a major research gap an issue that has just been addressed in a series of papers in press (the same applies, of course, to older, overlooked studies (“sleeping beauties” [26] )). This implies that literature reviewers would do well to keep an eye on electronic lists of papers in press, given that it can take months before these appear in scientific databases. Some reviews declare that they have scanned the literature up to a certain point in time, but given that peer review can be a rather lengthy process, a full search for newly appeared literature at the revision stage may be worthwhile. Assessing the contribution of papers that have just appeared is particularly challenging, because there is little perspective with which to gauge their significance and impact on further research and society.

Inevitably, new papers on the reviewed topic (including independently written literature reviews) will appear from all quarters after the review has been published, so that there may soon be the need for an updated review. But this is the nature of science [27] – [32] . I wish everybody good luck with writing a review of the literature.

Acknowledgments

Many thanks to M. Barbosa, K. Dehnen-Schmutz, T. Döring, D. Fontaneto, M. Garbelotto, O. Holdenrieder, M. Jeger, D. Lonsdale, A. MacLeod, P. Mills, M. Moslonka-Lefebvre, G. Stancanelli, P. Weisberg, and X. Xu for insights and discussions, and to P. Bourne, T. Matoni, and D. Smith for helpful comments on a previous draft.

Funding Statement

This work was funded by the French Foundation for Research on Biodiversity (FRB) through its Centre for Synthesis and Analysis of Biodiversity data (CESAB), as part of the NETSEED research project. The funders had no role in the preparation of the manuscript.

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Association of Hepatitis B Surface Antigen Levels With Long-Term Complications in Chronic Hepatitis B Virus Infection: A Systematic Literature Review

Affiliations.

• 1 Bridge Medical Consulting Ltd, London, UK.
• 2 Research and Development, GSK, Stevenage, Hertfordshire, UK.
• 3 Research and Development, GSK, Brentford, Middlesex, UK.
• PMID: 39150061
• DOI: 10.1111/jvh.13988

Chronic hepatitis B virus (HBV) infection is a global issue and can lead to cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B surface antigen (HBsAg) is an important marker of HBV infection and HBsAg quantification could be a useful tool in clinical practice. This systematic literature review aimed to explore the association between HBsAg titres and long-term disease outcomes and evaluate the relationship between HBsAg titres, or changes in HBsAg titres, and clinical and treatment characteristics in patients with chronic HBV infection. Structured searches were performed in MEDLINE and Embase (January 2000 to 31 March 2023). Eighty-two studies were included, comprising 51% retrospective cohort studies, mostly conducted in Asia (85%). HBsAg levels were shown to predict the long-term development of cirrhosis and HCC in patients who were untreated prior to and during follow-up; however, these data were inconclusive in mixed and treated populations. HBsAg titres were significantly associated with various virological markers including serum HBV DNA, HBcrAg, HBeAg, HBV RNA levels, intrahepatic covalently closed circular DNA (cccDNA) and intrahepatic HBsAg expression. HBsAg titres generally declined over time; this decline was more pronounced in early (HBeAg-positive) than later disease phases (HBeAg-negative). Higher decline in HBsAg levels was consistently associated with subsequent HBsAg seroclearance and a greater decline in total intrahepatic HBV DNA and cccDNA levels. In conclusion, this review showed that HBsAg levels and rates of decline could inform assessment, management and prediction of outcomes in chronic HBV infection. Further studies in broader, more diverse populations and treated patients are needed.

Keywords: chronic hepatitis B; cirrhosis; clinical relevance; hepatitis B surface antigen; hepatocellular carcinoma.

© 2024 GSK plc. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.

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