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• How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

You can also use boolean operators to help narrow down your search.

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

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

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

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

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

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

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

Prevent plagiarism. Run a free check.

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

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

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

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

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit 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.

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

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

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

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

A literature review is a survey of 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 .  

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

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

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

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

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

What are the parts of a lit review?

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

Introduction:

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

Conclusion:

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

How should I organize my lit review?

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

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

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

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

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

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

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

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

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How To Write A Literature Review - A Complete Guide

Table of Contents

A literature review is much more than just another section in your research paper. It forms the very foundation of your research. It is a formal piece of writing where you analyze the existing theoretical framework, principles, and assumptions and use that as a base to shape your approach to the research question.

Curating and drafting a solid literature review section not only lends more credibility to your research paper but also makes your research tighter and better focused. But, writing literature reviews is a difficult task. It requires extensive reading, plus you have to consider market trends and technological and political changes, which tend to change in the blink of an eye.

Now streamline your literature review process with the help of SciSpace Copilot. With this AI research assistant, you can efficiently synthesize and analyze a vast amount of information, identify key themes and trends, and uncover gaps in the existing research. Get real-time explanations, summaries, and answers to your questions for the paper you're reviewing, making navigating and understanding the complex literature landscape easier.

In this comprehensive guide, we will explore everything from the definition of a literature review, its appropriate length, various types of literature reviews, and how to write one.

What is a literature review?

A literature review is a collation of survey, research, critical evaluation, and assessment of the existing literature in a preferred domain.

Eminent researcher and academic Arlene Fink, in her book Conducting Research Literature Reviews , defines it as the following:

“A literature review surveys books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated.

Literature reviews are designed to provide an overview of sources you have explored while researching a particular topic, and to demonstrate to your readers how your research fits within a larger field of study.”

Simply put, a literature review can be defined as a critical discussion of relevant pre-existing research around your research question and carving out a definitive place for your study in the existing body of knowledge. Literature reviews can be presented in multiple ways: a section of an article, the whole research paper itself, or a chapter of your thesis.

A literature review does function as a summary of sources, but it also allows you to analyze further, interpret, and examine the stated theories, methods, viewpoints, and, of course, the gaps in the existing content.

As an author, you can discuss and interpret the research question and its various aspects and debate your adopted methods to support the claim.

What is the purpose of a literature review?

A literature review is meant to help your readers understand the relevance of your research question and where it fits within the existing body of knowledge. As a researcher, you should use it to set the context, build your argument, and establish the need for your study.

What is the importance of a literature review?

The literature review is a critical part of research papers because it helps you:

• Gain an in-depth understanding of your research question and the surrounding area
• Convey that you have a thorough understanding of your research area and are up-to-date with the latest changes and advancements
• Establish how your research is connected or builds on the existing body of knowledge and how it could contribute to further research
• Elaborate on the validity and suitability of your theoretical framework and research methodology
• Identify and highlight gaps and shortcomings in the existing body of knowledge and how things need to change
• Convey to readers how your study is different or how it contributes to the research area

How long should a literature review be?

Ideally, the literature review should take up 15%-40% of the total length of your manuscript. So, if you have a 10,000-word research paper, the minimum word count could be 1500.

Your literature review format depends heavily on the kind of manuscript you are writing — an entire chapter in case of doctoral theses, a part of the introductory section in a research article, to a full-fledged review article that examines the previously published research on a topic.

Another determining factor is the type of research you are doing. The literature review section tends to be longer for secondary research projects than primary research projects.

What are the different types of literature reviews?

All literature reviews are not the same. There are a variety of possible approaches that you can take. It all depends on the type of research you are pursuing.

Here are the different types of literature reviews:

Argumentative review

It is called an argumentative review when you carefully present literature that only supports or counters a specific argument or premise to establish a viewpoint.

Integrative review

It is a type of literature review focused on building a comprehensive understanding of a topic by combining available theoretical frameworks and empirical evidence.

Methodological review

This approach delves into the ''how'' and the ''what" of the research question —  you cannot look at the outcome in isolation; you should also review the methodology used.

Systematic review

This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research and collect, report, and analyze data from the studies included in the review.

Meta-analysis review

Meta-analysis uses statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects than those derived from the individual studies included within a review.

Historical review

Historical literature reviews focus on examining research throughout a period, often starting with the first time an issue, concept, theory, or phenomenon emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and identify future research's likely directions.

Theoretical Review

This form aims to examine the corpus of theory accumulated regarding an issue, concept, theory, and phenomenon. The theoretical literature review helps to establish what theories exist, the relationships between them, the degree the existing approaches have been investigated, and to develop new hypotheses to be tested.

Scoping Review

The Scoping Review is often used at the beginning of an article, dissertation, or research proposal. It is conducted before the research to highlight gaps in the existing body of knowledge and explains why the project should be greenlit.

State-of-the-Art Review

The State-of-the-Art review is conducted periodically, focusing on the most recent research. It describes what is currently known, understood, or agreed upon regarding the research topic and highlights where there are still disagreements.

Can you use the first person in a literature review?

When writing literature reviews, you should avoid the usage of first-person pronouns. It means that instead of "I argue that" or "we argue that," the appropriate expression would be "this research paper argues that."

Do you need an abstract for a literature review?

Ideally, yes. It is always good to have a condensed summary that is self-contained and independent of the rest of your review. As for how to draft one, you can follow the same fundamental idea when preparing an abstract for a literature review. It should also include:

• The research topic and your motivation behind selecting it
• A one-sentence thesis statement
• An explanation of the kinds of literature featured in the review
• Summary of what you've learned
• Conclusions you drew from the literature you reviewed
• Potential implications and future scope for research

Here's an example of the abstract of a literature review

Is a literature review written in the past tense?

Yes, the literature review should ideally be written in the past tense. You should not use the present or future tense when writing one. The exceptions are when you have statements describing events that happened earlier than the literature you are reviewing or events that are currently occurring; then, you can use the past perfect or present perfect tenses.

How many sources for a literature review?

There are multiple approaches to deciding how many sources to include in a literature review section. The first approach would be to look level you are at as a researcher. For instance, a doctoral thesis might need 60+ sources. In contrast, you might only need to refer to 5-15 sources at the undergraduate level.

The second approach is based on the kind of literature review you are doing — whether it is merely a chapter of your paper or if it is a self-contained paper in itself. When it is just a chapter, sources should equal the total number of pages in your article's body. In the second scenario, you need at least three times as many sources as there are pages in your work.

Quick tips on how to write a literature review

To know how to write a literature review, you must clearly understand its impact and role in establishing your work as substantive research material.

You need to follow the below-mentioned steps, to write a literature review:

• Outline the purpose behind the literature review
• Search relevant literature
• Examine and assess the relevant resources
• Discover connections by drawing deep insights from the resources
• Structure planning to write a good literature review

1. Outline and identify the purpose of  a literature review

As a first step on how to write a literature review, you must know what the research question or topic is and what shape you want your literature review to take. Ensure you understand the research topic inside out, or else seek clarifications. You must be able to the answer below questions before you start:

• How many sources do I need to include?
• What kind of sources should I analyze?
• How much should I critically evaluate each source?
• Should I summarize, synthesize or offer a critique of the sources?
• Do I need to include any background information or definitions?

Additionally, you should know that the narrower your research topic is, the swifter it will be for you to restrict the number of sources to be analyzed.

2. Search relevant literature

Dig deeper into search engines to discover what has already been published around your chosen topic. Make sure you thoroughly go through appropriate reference sources like books, reports, journal articles, government docs, and web-based resources.

You must prepare a list of keywords and their different variations. You can start your search from any library’s catalog, provided you are an active member of that institution. The exact keywords can be extended to widen your research over other databases and academic search engines like:

• Google Scholar
• Microsoft Academic
• Science.gov

Besides, it is not advisable to go through every resource word by word. Alternatively, what you can do is you can start by reading the abstract and then decide whether that source is relevant to your research or not.

Additionally, you must spend surplus time assessing the quality and relevance of resources. It would help if you tried preparing a list of citations to ensure that there lies no repetition of authors, publications, or articles in the literature review.

3. Examine and assess the sources

It is nearly impossible for you to go through every detail in the research article. So rather than trying to fetch every detail, you have to analyze and decide which research sources resemble closest and appear relevant to your chosen domain.

While analyzing the sources, you should look to find out answers to questions like:

• What question or problem has the author been describing and debating?
• What is the definition of critical aspects?
• How well the theories, approach, and methodology have been explained?
• Whether the research theory used some conventional or new innovative approach?
• How relevant are the key findings of the work?
• In what ways does it relate to other sources on the same topic?
• What challenges does this research paper pose to the existing theory
• What are the possible contributions or benefits it adds to the subject domain?

Be always mindful that you refer only to credible and authentic resources. It would be best if you always take references from different publications to validate your theory.

Always keep track of important information or data you can present in your literature review right from the beginning. It will help steer your path from any threats of plagiarism and also make it easier to curate an annotated bibliography or reference section.

4. Discover connections

At this stage, you must start deciding on the argument and structure of your literature review. To accomplish this, you must discover and identify the relations and connections between various resources while drafting your abstract.

A few aspects that you should be aware of while writing a literature review include:

• Rise to prominence: Theories and methods that have gained reputation and supporters over time.
• Constant scrutiny: Concepts or theories that repeatedly went under examination.
• Contradictions and conflicts: Theories, both the supporting and the contradictory ones, for the research topic.
• Knowledge gaps: What exactly does it fail to address, and how to bridge them with further research?
• Influential resources: Significant research projects available that have been upheld as milestones or perhaps, something that can modify the current trends

Once you join the dots between various past research works, it will be easier for you to draw a conclusion and identify your contribution to the existing knowledge base.

5. Structure planning to write a good literature review

There exist different ways towards planning and executing the structure of a literature review. The format of a literature review varies and depends upon the length of the research.

Like any other research paper, the literature review format must contain three sections: introduction, body, and conclusion. The goals and objectives of the research question determine what goes inside these three sections.

Nevertheless, a good literature review can be structured according to the chronological, thematic, methodological, or theoretical framework approach.

Literature review samples

1. Standalone

2. As a section of a research paper

How SciSpace Discover makes literature review a breeze?

SciSpace Discover is a one-stop solution to do an effective literature search and get barrier-free access to scientific knowledge. It is an excellent repository where you can find millions of only peer-reviewed articles and full-text PDF files. Here’s more on how you can use it:

Find the right information

Find what you want quickly and easily with comprehensive search filters that let you narrow down papers according to PDF availability, year of publishing, document type, and affiliated institution. Moreover, you can sort the results based on the publishing date, citation count, and relevance.

Assess credibility of papers quickly

When doing the literature review, it is critical to establish the quality of your sources. They form the foundation of your research. SciSpace Discover helps you assess the quality of a source by providing an overview of its references, citations, and performance metrics.

Get the complete picture in no time

SciSpace Discover’s personalized suggestion engine helps you stay on course and get the complete picture of the topic from one place. Every time you visit an article page, it provides you links to related papers. Besides that, it helps you understand what’s trending, who are the top authors, and who are the leading publishers on a topic.

Make referring sources super easy

To ensure you don't lose track of your sources, you must start noting down your references when doing the literature review. SciSpace Discover makes this step effortless. Click the 'cite' button on an article page, and you will receive preloaded citation text in multiple styles — all you've to do is copy-paste it into your manuscript.

Final tips on how to write a literature review

A massive chunk of time and effort is required to write a good literature review. But, if you go about it systematically, you'll be able to save a ton of time and build a solid foundation for your research.

We hope this guide has helped you answer several key questions you have about writing literature reviews.

Would you like to explore SciSpace Discover and kick off your literature search right away? You can get started here .

Frequently Asked Questions (FAQs)

1. how to start a literature review.

• What questions do you want to answer?

• What sources do you need to answer these questions?

• What information do these sources contain?

• How can you use this information to answer your questions?

2. What to include in a literature review?

• A brief background of the problem or issue

• What has previously been done to address the problem or issue

• A description of what you will do in your project

• How this study will contribute to research on the subject

3. Why literature review is important?

The literature review is an important part of any research project because it allows the writer to look at previous studies on a topic and determine existing gaps in the literature, as well as what has already been done. It will also help them to choose the most appropriate method for their own study.

4. How to cite a literature review in APA format?

To cite a literature review in APA style, you need to provide the author's name, the title of the article, and the year of publication. For example: Patel, A. B., & Stokes, G. S. (2012). The relationship between personality and intelligence: A meta-analysis of longitudinal research. Personality and Individual Differences, 53(1), 16-21

5. What are the components of a literature review?

• A brief introduction to the topic, including its background and context. The introduction should also include a rationale for why the study is being conducted and what it will accomplish.

• A description of the methodologies used in the study. This can include information about data collection methods, sample size, and statistical analyses.

• A presentation of the findings in an organized format that helps readers follow along with the author's conclusions.

6. What are common errors in writing literature review?

• Not spending enough time to critically evaluate the relevance of resources, observations and conclusions.

• Totally relying on secondary data while ignoring primary data.

• Letting your personal bias seep into your interpretation of existing literature.

• No detailed explanation of the procedure to discover and identify an appropriate literature review.

7. What are the 5 C's of writing literature review?

• Cite - the sources you utilized and referenced in your research.

• Compare - existing arguments, hypotheses, methodologies, and conclusions found in the knowledge base.

• Contrast - the arguments, topics, methodologies, approaches, and disputes that may be found in the literature.

• Critique - the literature and describe the ideas and opinions you find more convincing and why.

• Connect - the various studies you reviewed in your research.

8. How many sources should a literature review have?

When it is just a chapter, sources should equal the total number of pages in your article's body. if it is a self-contained paper in itself, you need at least three times as many sources as there are pages in your work.

9. Can literature review have diagrams?

• To represent an abstract idea or concept

• To explain the steps of a process or procedure

• To help readers understand the relationships between different concepts

10. How old should sources be in a literature review?

Sources for a literature review should be as current as possible or not older than ten years. The only exception to this rule is if you are reviewing a historical topic and need to use older sources.

11. What are the types of literature review?

• Argumentative review

• Integrative review

• Methodological review

• Systematic review

• Meta-analysis review

• Historical review

• Theoretical review

• Scoping review

• State-of-the-Art review

12. Is a literature review mandatory?

Yes. Literature review is a mandatory part of any research project. It is a critical step in the process that allows you to establish the scope of your research, and provide a background for the rest of your work.

But before you go,

• Six Online Tools for Easy Literature Review
• Evaluating literature review: systematic vs. scoping reviews
• Systematic Approaches to a Successful Literature Review
• Writing Integrative Literature Reviews: Guidelines and Examples

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Literature Review and Theoretical Framework: Understanding the Differences

Types of Essays in Academic Writing - Quick Guide (2024)

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

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

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

What are Literature Reviews?

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

Goals of Literature Reviews

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

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

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

What kinds of sources require a Literature Review?

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

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

Types of Literature Reviews

What kinds of literature reviews are written?

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

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

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

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

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

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

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

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

Literature Reviews in the Health Sciences

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

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

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Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

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Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

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

For each publication, ask yourself:

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

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

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

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

As you write, make sure to follow these tips:

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

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

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

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

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

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

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

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

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

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 24 June 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

Is this article helpful?

Shona McCombes

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

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

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

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

What is a literature review?

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

What is the purpose of literature review?

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

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

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

Find academic papers related to your research topic faster. Try Research on Paperpal  

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

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

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

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

Literature review example

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

Literature Review on Climate Change Impacts on Biodiversity:

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

a. Habitat Loss and Species Extinction:

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

b. Range Shifts and Phenological Changes:

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

c. Ocean Acidification and Coral Reefs:

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

d. Adaptive Strategies and Conservation Efforts:

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

Strengthen your literature review with factual insights. Try Research on Paperpal for free!    

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

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

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

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

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

Write and Cite as you go with Paperpal Research. Start now for free.   

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

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

Conducting a literature review

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

Choose a Topic and Define the Research Question:

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

Decide on the Scope of Your Review:

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

Select Databases for Searches:

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

Conduct Searches and Keep Track:

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

Review the Literature:

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

Organize and Write Your Literature Review:

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

Whether you’re exploring a new research field or finding new angles to develop an existing topic, sifting through hundreds of papers can take more time than you have to spare. But what if you could find science-backed insights with verified citations in seconds? That’s the power of Paperpal’s new Research feature!  

How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

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

Frequently asked questions

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

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

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

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

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

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

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

References 

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

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How to Write a Literature Review

What is a literature review.

• What Is the Literature
• Writing the Review

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

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

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

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

Types of Literature Reviews

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

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

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

Examples of Literature Reviews

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

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

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

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

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

This article has a standard breakdown of sections:

• Introduction
• Literature Review
• Some discussion sections

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

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

• Next: What Is the Literature >>
• Last Updated: Jan 11, 2024 9:48 AM
• URL: https://libguides.wesleyan.edu/litreview

How To Write An A-Grade Literature Review

3 straightforward steps (with examples) + free template.

By: Derek Jansen (MBA) | Expert Reviewed By: Dr. Eunice Rautenbach | October 2019

Quality research is about building onto the existing work of others , “standing on the shoulders of giants”, as Newton put it. The literature review chapter of your dissertation, thesis or research project is where you synthesise this prior work and lay the theoretical foundation for your own research.

Long story short, this chapter is a pretty big deal, which is why you want to make sure you get it right . In this post, I’ll show you exactly how to write a literature review in three straightforward steps, so you can conquer this vital chapter (the smart way).

Overview: The Literature Review Process

• Understanding the “ why “
• Finding the relevant literature
• Cataloguing and synthesising the information
• Outlining & writing up your literature review
• Example of a literature review

But first, the “why”…

Before we unpack how to write the literature review chapter, we’ve got to look at the why . To put it bluntly, if you don’t understand the function and purpose of the literature review process, there’s no way you can pull it off well. So, what exactly is the purpose of the literature review?

Well, there are (at least) four core functions:

• For you to gain an understanding (and demonstrate this understanding) of where the research is at currently, what the key arguments and disagreements are.
• For you to identify the gap(s) in the literature and then use this as justification for your own research topic.
• To help you build a conceptual framework for empirical testing (if applicable to your research topic).
• To inform your methodological choices and help you source tried and tested questionnaires (for interviews ) and measurement instruments (for surveys ).

Most students understand the first point but don’t give any thought to the rest. To get the most from the literature review process, you must keep all four points front of mind as you review the literature (more on this shortly), or you’ll land up with a wonky foundation.

Okay – with the why out the way, let’s move on to the how . As mentioned above, writing your literature review is a process, which I’ll break down into three steps:

• Finding the most suitable literature
• Understanding , distilling and organising the literature
• Planning and writing up your literature review chapter

Importantly, you must complete steps one and two before you start writing up your chapter. I know it’s very tempting, but don’t try to kill two birds with one stone and write as you read. You’ll invariably end up wasting huge amounts of time re-writing and re-shaping, or you’ll just land up with a disjointed, hard-to-digest mess . Instead, you need to read first and distil the information, then plan and execute the writing.

Step 1: Find the relevant literature

Naturally, the first step in the literature review journey is to hunt down the existing research that’s relevant to your topic. While you probably already have a decent base of this from your research proposal , you need to expand on this substantially in the dissertation or thesis itself.

Essentially, you need to be looking for any existing literature that potentially helps you answer your research question (or develop it, if that’s not yet pinned down). There are numerous ways to find relevant literature, but I’ll cover my top four tactics here. I’d suggest combining all four methods to ensure that nothing slips past you:

Method 1 – Google Scholar Scrubbing

Google’s academic search engine, Google Scholar , is a great starting point as it provides a good high-level view of the relevant journal articles for whatever keyword you throw at it. Most valuably, it tells you how many times each article has been cited, which gives you an idea of how credible (or at least, popular) it is. Some articles will be free to access, while others will require an account, which brings us to the next method.

Method 2 – University Database Scrounging

Generally, universities provide students with access to an online library, which provides access to many (but not all) of the major journals.

So, if you find an article using Google Scholar that requires paid access (which is quite likely), search for that article in your university’s database – if it’s listed there, you’ll have access. Note that, generally, the search engine capabilities of these databases are poor, so make sure you search for the exact article name, or you might not find it.

Method 3 – Journal Article Snowballing

At the end of every academic journal article, you’ll find a list of references. As with any academic writing, these references are the building blocks of the article, so if the article is relevant to your topic, there’s a good chance a portion of the referenced works will be too. Do a quick scan of the titles and see what seems relevant, then search for the relevant ones in your university’s database.

Method 4 – Dissertation Scavenging

Similar to Method 3 above, you can leverage other students’ dissertations. All you have to do is skim through literature review chapters of existing dissertations related to your topic and you’ll find a gold mine of potential literature. Usually, your university will provide you with access to previous students’ dissertations, but you can also find a much larger selection in the following databases:

• Open Access Theses & Dissertations
• Stanford SearchWorks

Keep in mind that dissertations and theses are not as academically sound as published, peer-reviewed journal articles (because they’re written by students, not professionals), so be sure to check the credibility of any sources you find using this method. You can do this by assessing the citation count of any given article in Google Scholar. If you need help with assessing the credibility of any article, or with finding relevant research in general, you can chat with one of our Research Specialists .

Alright – with a good base of literature firmly under your belt, it’s time to move onto the next step.

Need a helping hand?

Step 2: Log, catalogue and synthesise

Once you’ve built a little treasure trove of articles, it’s time to get reading and start digesting the information – what does it all mean?

While I present steps one and two (hunting and digesting) as sequential, in reality, it’s more of a back-and-forth tango – you’ll read a little , then have an idea, spot a new citation, or a new potential variable, and then go back to searching for articles. This is perfectly natural – through the reading process, your thoughts will develop , new avenues might crop up, and directional adjustments might arise. This is, after all, one of the main purposes of the literature review process (i.e. to familiarise yourself with the current state of research in your field).

As you’re working through your treasure chest, it’s essential that you simultaneously start organising the information. There are three aspects to this:

• Logging reference information
• Building an organised catalogue
• Distilling and synthesising the information

I’ll discuss each of these below:

2.1 – Log the reference information

As you read each article, you should add it to your reference management software. I usually recommend Mendeley for this purpose (see the Mendeley 101 video below), but you can use whichever software you’re comfortable with. Most importantly, make sure you load EVERY article you read into your reference manager, even if it doesn’t seem very relevant at the time.

2.2 – Build an organised catalogue

In the beginning, you might feel confident that you can remember who said what, where, and what their main arguments were. Trust me, you won’t. If you do a thorough review of the relevant literature (as you must!), you’re going to read many, many articles, and it’s simply impossible to remember who said what, when, and in what context . Also, without the bird’s eye view that a catalogue provides, you’ll miss connections between various articles, and have no view of how the research developed over time. Simply put, it’s essential to build your own catalogue of the literature.

I would suggest using Excel to build your catalogue, as it allows you to run filters, colour code and sort – all very useful when your list grows large (which it will). How you lay your spreadsheet out is up to you, but I’d suggest you have the following columns (at minimum):

• Author, date, title – Start with three columns containing this core information. This will make it easy for you to search for titles with certain words, order research by date, or group by author.
• Categories or keywords – You can either create multiple columns, one for each category/theme and then tick the relevant categories, or you can have one column with keywords.
• Key arguments/points – Use this column to succinctly convey the essence of the article, the key arguments and implications thereof for your research.
• Context – Note the socioeconomic context in which the research was undertaken. For example, US-based, respondents aged 25-35, lower- income, etc. This will be useful for making an argument about gaps in the research.
• Methodology – Note which methodology was used and why. Also, note any issues you feel arise due to the methodology. Again, you can use this to make an argument about gaps in the research.
• Quotations – Note down any quoteworthy lines you feel might be useful later.
• Notes – Make notes about anything not already covered. For example, linkages to or disagreements with other theories, questions raised but unanswered, shortcomings or limitations, and so forth.

If you’d like, you can try out our free catalog template here (see screenshot below).

2.3 – Digest and synthesise

Most importantly, as you work through the literature and build your catalogue, you need to synthesise all the information in your own mind – how does it all fit together? Look for links between the various articles and try to develop a bigger picture view of the state of the research. Some important questions to ask yourself are:

• What answers does the existing research provide to my own research questions ?
• Which points do the researchers agree (and disagree) on?
• How has the research developed over time?
• Where do the gaps in the current research lie?

To help you develop a big-picture view and synthesise all the information, you might find mind mapping software such as Freemind useful. Alternatively, if you’re a fan of physical note-taking, investing in a large whiteboard might work for you.

Step 3: Outline and write it up!

Once you’re satisfied that you have digested and distilled all the relevant literature in your mind, it’s time to put pen to paper (or rather, fingers to keyboard). There are two steps here – outlining and writing:

3.1 – Draw up your outline

Having spent so much time reading, it might be tempting to just start writing up without a clear structure in mind. However, it’s critically important to decide on your structure and develop a detailed outline before you write anything. Your literature review chapter needs to present a clear, logical and an easy to follow narrative – and that requires some planning. Don’t try to wing it!

Naturally, you won’t always follow the plan to the letter, but without a detailed outline, you’re more than likely going to end up with a disjointed pile of waffle , and then you’re going to spend a far greater amount of time re-writing, hacking and patching. The adage, “measure twice, cut once” is very suitable here.

In terms of structure, the first decision you’ll have to make is whether you’ll lay out your review thematically (into themes) or chronologically (by date/period). The right choice depends on your topic, research objectives and research questions, which we discuss in this article .

Once that’s decided, you need to draw up an outline of your entire chapter in bullet point format. Try to get as detailed as possible, so that you know exactly what you’ll cover where, how each section will connect to the next, and how your entire argument will develop throughout the chapter. Also, at this stage, it’s a good idea to allocate rough word count limits for each section, so that you can identify word count problems before you’ve spent weeks or months writing!

PS – check out our free literature review chapter template…

3.2 – Get writing

With a detailed outline at your side, it’s time to start writing up (finally!). At this stage, it’s common to feel a bit of writer’s block and find yourself procrastinating under the pressure of finally having to put something on paper. To help with this, remember that the objective of the first draft is not perfection – it’s simply to get your thoughts out of your head and onto paper, after which you can refine them. The structure might change a little, the word count allocations might shift and shuffle, and you might add or remove a section – that’s all okay. Don’t worry about all this on your first draft – just get your thoughts down on paper.

Once you’ve got a full first draft (however rough it may be), step away from it for a day or two (longer if you can) and then come back at it with fresh eyes. Pay particular attention to the flow and narrative – does it fall fit together and flow from one section to another smoothly? Now’s the time to try to improve the linkage from each section to the next, tighten up the writing to be more concise, trim down word count and sand it down into a more digestible read.

Once you’ve done that, give your writing to a friend or colleague who is not a subject matter expert and ask them if they understand the overall discussion. The best way to assess this is to ask them to explain the chapter back to you. This technique will give you a strong indication of which points were clearly communicated and which weren’t. If you’re working with Grad Coach, this is a good time to have your Research Specialist review your chapter.

Finally, tighten it up and send it off to your supervisor for comment. Some might argue that you should be sending your work to your supervisor sooner than this (indeed your university might formally require this), but in my experience, supervisors are extremely short on time (and often patience), so, the more refined your chapter is, the less time they’ll waste on addressing basic issues (which you know about already) and the more time they’ll spend on valuable feedback that will increase your mark-earning potential.

Literature Review Example

In the video below, we unpack an actual literature review so that you can see how all the core components come together in reality.

Let’s Recap

In this post, we’ve covered how to research and write up a high-quality literature review chapter. Let’s do a quick recap of the key takeaways:

• It is essential to understand the WHY of the literature review before you read or write anything. Make sure you understand the 4 core functions of the process.
• The first step is to hunt down the relevant literature . You can do this using Google Scholar, your university database, the snowballing technique and by reviewing other dissertations and theses.
• Next, you need to log all the articles in your reference manager , build your own catalogue of literature and synthesise all the research.
• Following that, you need to develop a detailed outline of your entire chapter – the more detail the better. Don’t start writing without a clear outline (on paper, not in your head!)
• Write up your first draft in rough form – don’t aim for perfection. Remember, done beats perfect.
• Refine your second draft and get a layman’s perspective on it . Then tighten it up and submit it to your supervisor.

Psst… there’s more!

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

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38 Comments

Thank you very much. This page is an eye opener and easy to comprehend.

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But all the same I’ll make use of this opportunity to the fullest.

Thank you for this good job.

Keep it up!

You’re welcome, Yinka. Thank you for the kind words. All the best writing your literature review.

Thank you for a very useful literature review session. Although I am doing most of the steps…it being my first masters an Mphil is a self study and one not sure you are on the right track. I have an amazing supervisor but one also knows they are super busy. So not wanting to bother on the minutae. Thank you.

You’re most welcome, Renee. Good luck with your literature review 🙂

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You’re welcome, Maithe. Good luck writing your literature review 🙂

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Libraries | Research Guides

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

• Planning the Review
• The Research Question
• Choosing Where to Search
• Organizing the Review
• Writing the Review

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

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

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• Last Updated: May 2, 2024 10:39 AM
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Literature Review: The What, Why and How-to Guide: Literature Reviews?

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What is a Literature Review?

So, what is a literature review .

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

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

What kinds of literature reviews are written?

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

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

What are the Goals of Creating a Literature Review?

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

When do you need to write a Literature Review?

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

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

Where I can find examples of Literature Reviews?

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

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

Where to Find Standalone Literature Reviews

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

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

Social Sciences

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

Hard science and health sciences:

• Annual Review of Biomedical Data Science
• Annual Review of Materials Science
• Systematic Review From journal site: "The journal Systematic Reviews encompasses all aspects of the design, conduct, and reporting of systematic reviews" in the health sciences.
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• Last Updated: Mar 5, 2024 11:44 AM
• URL: https://guides.library.ucsb.edu/litreview

• University of Texas Libraries

Literature Reviews

• What is a literature review?
• Steps in the Literature Review Process
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support
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What is a Literature Review?

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

Carolyn Cunningham : Human Development & Family Sciences, Psychology, Sociology

Larayne Dallas : Engineering

Janelle Hedstrom : Special Education, Curriculum & Instruction, Ed Leadership & Policy ​

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

For help in other subject areas, please see the guide to library specialists by subject .

Periodically, UT Libraries runs a workshop covering the basics and library support for literature reviews. While we try to offer these once per academic year, we find providing the recording to be helpful to community members who have missed the session. Following is the most recent recording of the workshop, Conducting a Literature Review. To view the recording, a UT login is required.

• October 26, 2022 recording
• Last Updated: Jun 18, 2024 1:00 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

• USC Libraries
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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
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• Theoretical Framework
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• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

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

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

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

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

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

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

NOTE: Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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• Introduction
• Conclusions
• Article Information

In some articles, the number of cases and/or sample sizes might not coincide with those provided in the original study owing to the R package, which recalculates the percentage. We were interested in keeping the estimate provided; therefore, we modified numbers accordingly. A1 indicates the question “Have you experienced tinnitus?”; A2, “Have you experienced tinnitus for more than 5 minutes?”; A3, “Have you experienced tinnitus during the last months”?; A4, “During the last months, have you experienced tinnitus which lasts for more than 5 minutes?”; A5, assessment of tinnitus through a specific scale; A6, assessment of tinnitus via other tinnitus definitions; BG, Bulgaria; DE, Germany; ES, Spain; FR, France; GR, Greece; IE, Ireland; IT, Italy; LV, Latvia; PL, Polonia; PT, Portugal; RO, Romania; THI, Tinnitus Handicap Inventory; TQ, Tinnitus Questionnaire; and TSCHQ, Tinnitus Sample Case History Questionnaire.

a This study had 2 populations; the second population is indicated by “b.”

In some articles, the number of cases and/or sample sizes might not coincide with those provided in the original study owing to the R package, which recalculates the percentage. We were interested in keeping the estimate provided; therefore, we modified numbers accordingly. BG indicates Bulgaria; DE, Germany; ES, Spain; FR, France; GR, Greece; IE, Ireland; IT, Italy; LV, Latvia; PL, Polonia; PT, Portugal; RO, Romania; S1, “Are you bothered by your tinnitus?”; S2, “How much are you bothered by your tinnitus?”; S3, “Does your tinnitus interfere with sleep and concentration?”; S4, assessment of tinnitus severity through a specific scale; S5, assessment of tinnitus severity via other definitions of tinnitus severity; THI, Tinnitus Handicap Inventory; and TQ, Tinnitus Questionnaire.

eFigure 1. Flow Chart of the Present Systematic Review

eFigure 2. Forest Plot of Tinnitus Prevalence in Children and Adolescents, by Different Definition Classes of Any Tinnitus

eFigure 3. Forest Plot of Any Tinnitus Prevalence, by Age Group

eFigure 4. Funnel Plot for Publication Bias

eFigure 5. Forest Plot of Incidence Rate per 100,000 Person-Years of Any Tinnitus in Adults (Both Sexes)

eTable 1. Search String Used for the Umbrella and the Traditional Reviews

eTable 2. List of Articles Excluded and Reasons of Exclusion

eTable 3. List of and Reason for Exclusion of the 24 Eligible Studies Excluded From the Meta-analysis

eTable 4. Definitions of Any, Severe, Chronic, and Diagnosed Tinnitus Used in the Systematic Review

eTable 5. Characteristics of the 89 Studies Included in the Meta-analysis

eTable 6. Prevalence of Any Tinnitus and Severe Tinnitus per Continent and Globally

eReferences.

• Error in Open Access Status JAMA Neurology Correction February 1, 2023

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Jarach CM , Lugo A , Scala M, et al. Global Prevalence and Incidence of Tinnitus : A Systematic Review and Meta-analysis . JAMA Neurol. 2022;79(9):888–900. doi:10.1001/jamaneurol.2022.2189

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Global Prevalence and Incidence of Tinnitus : A Systematic Review and Meta-analysis

• 1 Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
• 2 GROW–School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
• 3 Care and Public Health Research Institute–School for Public Health and Primary Care, Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
• 4 Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
• 5 National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
• 6 Division of Clinical Neuroscience, Hearing Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
• 7 School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
• 8 Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
• 9 School of Medicine and Surgery, Department of Otorhinolaryngology, University of Milan–Bicocca, Milan, Italy
• 10 Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
• Correction Error in Open Access Status JAMA Neurology

Question   What is the global prevalence and incidence of tinnitus?

Findings   This systematic review and meta-analysis estimated that the annual incidence of tinnitus is approximately 1%, with 14% of adults experiencing any tinnitus and 2% experiencing a severe form of it. The prevalence of tinnitus did not differ by sex, but increased prevalence was associated with increasing age, with any tinnitus being present in 10% of young adults, 14% of middle-aged adults, and 24% of older adults.

Meaning   This study suggests that the global burden of tinnitus is large, similar to migraine and pain, and the lack of effective treatment options justifies a major investment in research in this area.

Importance   To date, no systematic review has taken a meta-analytic approach to estimating the prevalence and incidence of tinnitus in the general population.

Objective   To provide frequency estimates of tinnitus worldwide.

Data Sources   An umbrella review followed by a traditional systematic review was performed by searching PubMed-MEDLINE and Embase from inception through November 19, 2021.

Study Selection   Research data from the general population were selected, and studies based on patients or on subgroups of the population with selected lifestyle habits were excluded. No restrictions were applied according to date, age, sex, and country.

Data Extraction and Synthesis   Relevant extracted information included type of study, time and location, end point, population characteristics, and tinnitus definition. The study followed the Meta-analysis of Observational Studies in Epidemiology ( MOOSE ) reporting guideline.

Main Outcomes and Measures   Pooled prevalence estimates of any tinnitus, severe tinnitus, chronic tinnitus, and diagnosed tinnitus as well as incidence of tinnitus were obtained using random-effects meta-analytic models; heterogeneity between studies was controlled using the χ 2 test, and inconsistency was measured using the I 2 statistic.

Results   Among 767 publications, 113 eligible articles published between 1972 and 2021 were identified, and prevalence estimates from 83 articles and incidence estimates from 12 articles were extracted. The pooled prevalence of any tinnitus among adults was 14.4% (95% CI, 12.6%-16.5%) and ranged from 4.1% (95% CI, 3.7%-4.4%) to 37.2% (95% CI, 34.6%-39.9%). Prevalence estimates did not significantly differ by sex (14.1% [95% CI, 11.6%-17.0%] among male individuals; 13.1% [95% CI, 10.5%-16.2%] among female individuals), but increased prevalence was associated with age (9.7% [95% CI, 7.4%-12.5%] among adults aged 18-44 years; 13.7% [95% CI, 11.0%-17.0%] among those aged 45-64 years; and 23.6% [95% CI, 19.4%-28.5%] among those aged ≥65 years; P  < .001 among age groups). The pooled prevalence of severe tinnitus was 2.3% (95% CI, 1.7%-3.1%), ranging from 0.5% (95% CI, 0.3%-0.7%) to 12.6% (95% CI, 11.1%-14.1%). The pooled prevalence of chronic tinnitus was 9.8% (95% CI, 4.7%-19.3%) and the pooled prevalence of diagnosed tinnitus was 3.4% (95% CI, 2.1%-5.5%). The pooled incidence rate of any tinnitus was 1164 per 100 000 person-years (95% CI, 479-2828 per 100 000 person-years).

Conclusions and Relevance   Despite the substantial heterogeneity among studies, this comprehensive systematic review on the prevalence and incidence of tinnitus suggests that tinnitus affects more than 740 million adults globally and is perceived as a major problem by more than 120 million people, mostly aged 65 years or older. Health policy makers should consider the global burden of tinnitus, and greater effort should be devoted to boost research on tinnitus.

The term tinnitus comes from the Latin word tinnire , which means “to ring.” Individuals experiencing tinnitus report an unspecified acoustic sound like ringing, but also buzzing, clicking, pulsations, and other noises. 1 Tinnitus is considered a symptom of an underlying condition, rather than a disease, and it refers to the perception of sounds in the head or ears when no corresponding external sounds are present. 2 , 3 A severe form of tinnitus is associated with hearing loss, thus impairing quality of life. 4 , 5

Today there is no globally accepted categorization of tinnitus, although different attempts have been made. 6 Moreover, evidence on the frequency (ie, prevalence and incidence) of tinnitus among the general population is still scant. The difficulties in obtaining adequate data are due to the multifactorial etiology of tinnitus, its associated disorders, the various characteristics of the symptoms, and the subjective nature of any assessment of tinnitus. 7

The very few longitudinal studies on tinnitus hamper any accurate estimate of its incidence. Moreover, the prevalence of tinnitus, which is estimated as either point prevalence, period prevalence, or lifetime prevalence, 8 ranges widely, partly because of the lack of standardization in its assessment, illustrated in a systematic review in which McCormack et al 3 attempted to identify and collect data on the global prevalence of tinnitus.

Since that last review on the prevalence of tinnitus, the literature on tinnitus has increased by at least 30%. An update of the evidence, which also includes pediatric tinnitus, is now necessary. We conducted a systematic review to identify the relevant publications in the scientific literature on the frequency of tinnitus at a global level, using an original search method. 9

This systematic review and meta-analysis is based on 2 subsequent literature searches on the prevalence and incidence of tinnitus. The first search was an umbrella review: a systematic review to identify published meta-analyses, pooled analyses, and systematic reviews providing data on the prevalence or incidence of tinnitus. The second search was a traditional review of original publications: a systematic review of all original articles on the prevalence or incidence of tinnitus to update the results identified in the umbrella review. A review protocol was registered in advance on PROSPERO (registration number: CRD42021283684). The study followed the Meta-analysis of Observational Studies in Epidemiology ( MOOSE ) reporting guideline.

We conducted an umbrella review to systematically collect existing evidence on the prevalence and incidence of tinnitus. We searched in PubMed-MEDLINE and Embase for all systematic reviews or meta-analyses published from inception through November 19, 2021, that had the word tinnitus in the title (eTable 1 in the Supplement ). We retrieved 310 reviews from PubMed and 346 from Embase. After checking for duplicates using EndNote, version X7 (Clarivate), we excluded protocols, scoping reviews, case studies or animal model studies, and articles that were not in English. After applying our inclusion criteria (ie, reporting data on the prevalence or incidence of tinnitus), we excluded 369 reviews as not relevant, ending up with 15 publications. We added 1 study that we were aware of that followed our eligibility criteria but was not identified by our search string because it was not classified as a review. From each of these 16 relevant systematic reviews, we extracted the citations of all the original articles providing data on the prevalence and incidence of tinnitus, collecting 284 original studies in total.

We included only articles in English, based on samples representative of the general population, and with estimates specifically of tinnitus. Reports, letters to the editor, book chapters, conference proceedings, dissertations, and theses were not considered. We excluded studies based on patients or on subgroups of the population with selected lifestyle habits or other characteristics (eg, musicians or people regularly exposed to noise). No restrictions were applied regarding the date of publication, age, sex, and country. Two researchers (C.M.J. and M.S.) independently checked for eligibility. Any disagreement was resolved by discussion; in case of disagreement, a third reviewer (A.L.) helped to reach consensus. The umbrella review yielded 93 eligible original articles.

We then conducted a traditional review to check any relevant articles in the literature that might not have been identified through the umbrella review. We searched articles in PubMed-MEDLINE and Embase published from inception through November 19, 2021, using a string that included a combination of the words tinnitus , prevalence , and incidence in the title. From 245 publications, we checked for duplicates and retrieved 154 unique references. After excluding articles identified in the umbrella review (n = 45), other duplicates (n = 15), and noneligible articles (n = 78), we obtained 16 new records. To these, we added 2 other references retrieved from other sources that we knew followed our eligibility criteria. All the articles excluded from both the umbrella and the traditional review, as well as the reasons for exclusion, are listed in eTable 2 in the Supplement .

We used a standardized form in Excel 2016 (Microsoft Corp) to extract data from each article identified. Relevant information included first author, year of publication, journal, type of study, time and location, end point (prevalence and/or incidence), other information (country and sample size), population characteristics (sex and age group), and tinnitus definition. Data were blindly extracted by 2 independent reviewers (C.M.J. and M.S.). Any disagreement was resolved by discussion, or with the help of a third reviewer (A.L.). Each prevalence estimate was extracted and classified by age group: children (≥17 years), young adults (18-44 years), middle-aged adults (45-64 years), older adults (≥65 years), and all adults (≥18 years).

If, while extracting, we came across summary tables that gave additional relevant citations, these were evaluated using the same inclusion and exclusion criteria. This evaluation led to 2 additional eligible articles, yielding a final total of 113 eligible articles. Among these, 24 articles were not included in the extraction for meta-analysis because their results were already included in other more complete or more recent articles (eTable 3 in the Supplement ). We extracted prevalence or incidence estimates from 89 articles.

The pooled prevalence and incidence of any tinnitus and severe tinnitus were calculated overall for children, adolescents, and adults and separately by tinnitus definition (eTable 4 in the Supplement ). For any tinnitus in adults, we identified 6 possible classes of definitions (A1-A6), and for severe tinnitus, we identified 5 possible classes (S1-S5). For children and adolescents, classes either had the word tinnitus in the question asked (any tinnitus or severe tinnitus) or had a phrase, such as “noises in your ears” (any noises or severe noises). Other possible definitions were chronic tinnitus or diagnosed tinnitus.

Pooled estimates were obtained using random-effects meta-analytic models to take account of the heterogeneity of the estimates. Heterogeneity among studies was controlled using the χ 2 test, and inconsistency was measured using the I 2 statistic, which represents the proportion of total variation associated with between-study variance, with higher values denoting a greater degree of heterogeneity. Stratified analyses by selected individual-level characteristics (eg, sex and age) and country-specific characteristics (eg, continent, gross domestic product [GDP], and latitude of the main city) were performed to detect possible sources of heterogeneity. The quality of the studies was not assessed because it was beyond the scope of meta-analyses on disease frequency. Because most prevalence and incidence estimates were provided without 95% CIs, we recalculated all the 95% CIs from the raw data given in the original articles. All P values were from 2-sided tests and results were deemed statistically significant at P  < .05.

All statistical analyses were performed using the R Studio software, version 1.4.1717 (R Group for Statistical Computing), particularly the “meta” and “metaphor” packages. To assess publication bias, we examined the funnel plots visually and applied the Egger test for funnel plot asymmetry.

Among 767 publications (384 reviews, 284 identified original publications, 94 articles from the traditional review, and 5 articles known by the authors), 113 eligible articles published between 1972 and 2021 were identified. We extracted prevalence estimates from 83 articles and incidence estimates from 12 articles. eFigure 1 in the Supplement shows the flowchart of study selection. Details on country, age group, and tinnitus definition in the 89 eligible articles included in meta-analyses are summarized in eTable 5 in the Supplement .

The pooled prevalence estimate of any tinnitus among adults ( Figure 1 ) 4 , 7 , 10 - 49 was 14.4% (95% CI, 12.6%-16.5%; 55 studies; I 2  = 100%). Among all studies, the estimates ranged from 4.1% (95% CI, 3.7%-4.4%) to 37.2% (95% CI, 34.6%-39.9%). The prevalence of any tinnitus did not differ according to the definitions (test for subgroup differences, χ 2 5  = 8.60; P  = .13 among strata): the prevalence of those who were asked “Have you experienced tinnitus?” (A1) was 17.5% (95% CI, 14.0%-21.8%; 12 studies; I 2  = 100%); for those who were asked if they had experienced tinnitus “for more than 5 minutes?” (A2), it was 13.7% (95% CI, 10.7%-17.4%; 9 studies; I 2  = 100%); for those who were asked “Have you experienced tinnitus during the last months?” (A3), it was 14.2% (95% CI, 10.0%-19.8%; 7 studies; I 2  = 100%); for those who were asked “During the last months, have you experienced tinnitus which lasts for more than 5 minutes?” (A4), it was 16.0% (95% CI, 13.1%-19.4%; 18 studies; I 2  = 99%); for those assessing tinnitus through a specific scale (A5), it was 9.3% (95% CI, 3.2%-24.1%; 3 studies; I 2  = 100%); and for those who were asked about other tinnitus definitions (A6), it was 9.6% (95% CI, 6.3%-14.3%; 6 studies; I 2  = 100%).

The pooled prevalence of any tinnitus among children and adolescents (eFigure 2 in the Supplement ) was 13.6% (95% CI, 8.5%-21.0%; 27 studies; I 2  = 100%). Among all studies, this prevalence ranged from 0.7% (95% CI, 0.6%-0.8%) to 66.9% (95% CI, 62.6%-71.0%). The prevalence of any tinnitus among children and adolescents was heterogeneous in strata of tinnitus definition classes ( P  = .01 among strata); for those who were in a study in which the word “tinnitus” was not present in the question (any noises), the prevalence was 20.4% (95% CI, 14.4%-28.0%; 18 studies; I 2  = 99%), and for those who were in a study in which it was present (any tinnitus), it was 5.6% (95% CI, 2.0%-14.8%; 9 studies; I 2  = 100%).

The pooled prevalence of any tinnitus was 9.7% (95% CI, 7.4%-12.5%; 22 studies; I 2  = 100%) among young adults, 13.7% (95% CI, 11.0%-17.0%; 30 studies; I 2  = 100%) among middle-aged adults, and 23.6% (95% CI, 19.4%-28.5%; 31 studies; I 2  = 99%) among older adults (eFigure 3 in the Supplement ). For adults, the pooled prevalence for any tinnitus was 14.1% (95% CI, 11.6%-17.0%; 32 studies; I 2  = 100%) among male individuals and 13.1% (95% CI, 10.5%-16.2%; 30 studies; I 2  = 100%) among female individuals ( P  = .62 between strata; Table 1 ).

Any tinnitus in adults significantly differed by continents, ranging from 5.2% (95% CI, 4.7%-5.7%; 1 study) in Africa to 21.9% (95% CI, 20.2%-23.8%; 1 study) in South America ( P  < .001 among strata; Table 1 ). The presence of tinnitus did not differ among per-capita GDP tertiles (<$4100, 14.3% [95% CI, 11.2%-18.0%]; $4100-$5200, 13.8% [95% CI, 11.0%-17.1%]; and >$5200, 15.6% [95% CI, 12.3%-19.5%]; P  = .74 among strata), but it differed according to latitude of the main city (<40°, 15.0% [95% CI, 11.5%-19.4%]; 40°-51°, 11.7% [95% CI, 9.4%-14.5%]; and ≥52°, 17.0% [95% CI, 14.4%-19.9%]; P  = .03 among strata).

The pooled prevalence of severe tinnitus among adults was 2.3% (95% CI, 1.7%-3.1%; 34 studies; I 2  = 99%) ( Figure 2 ). 4 , 7 , 10 - 13 , 16 , 17 , 21 , 25 , 28 - 30 , 32 , 33 , 36 , 37 , 40 , 43 , 44 , 46 , 49 Among all studies, the pooled prevelance ranged from 0.5% (95% CI, 0.3%-0.7%) to 12.6% (95% CI, 11.1%-14.1%). Severity of tinnitus among adults differed with the tinnitus definition classes ( P  < .001 among strata). For those who were asked “Are you bothered by your tinnitus?” (S1), the pooled prevalence of severe tinnitus was 6.4% (95% CI, 4.2%-9.6%; 7 studies; I 2  = 100%); for those who were asked “How much are you bothered by your tinnitus?” (S2), it was 1.3% (95% CI, 1.1%-1.7%; 21 studies; I 2  = 93%); for those who were asked “Does your tinnitus interfere with sleep and concentration?” (S3), the only study identified a prevalence of 3.0% (95% CI, 2.5%-3.6%); for those asked about tinnitus severity assessed on a validated scale (S4), the pooled prevalence was 2.9% (95% CI, 0.9%-9.2%; 3 studies; I 2  = 99%); and for those asked about other tinnitus severity definitions (S5), it was 7.3% (95% CI, 5.4%-9.9%; 2 studies; I 2  = 100%).

The pooled prevalence of severe tinnitus among children and adolescents was 2.7% (95% CI, 0.8%-8.4%; 10 studies; I 2  = 99%) ( Table 2 ). The pooled prevalence of severe tinnitus was 0.4% (95% CI, 0.3%-0.7%; 2 studies; I 2  = 0%) for young adults, 2.7% (95% CI, 1.6%-4.7%; 3 studies; I 2  = 97%) for middle-aged adults, and 6.9% (95% CI, 2.6%-17.4%; 4 studies; I 2  = 99%) for the older adults. The pooled prevalence of severe tinnitus was 2.3% (95% CI, 1.1%-4.6%; 8 studies; I 2  = 100%) for male individuals and 2.7% (95% CI, 1.7%-4.3%; 7 studies; I 2  = 99%) for female individuals ( P  = .66 among strata).

Severity among adults significantly differed by continent, ranging from 0.8% (95% CI, 0.6%-1.0%; 1 study) in Africa to 3.3% (95% CI, 1.2%-8.8%; 4 studies; I 2  = 99%) in North America ( P  < .001 among strata) ( Table 2 ). The prevalence of severe tinnitus did not differ significantly by per capita GDP tertile (1.7% [95% CI, 1.1%-2.7%] for <$4100; 2.7% [95% CI, 1.6%-4.3%] for $4100-$5200; and 3.0% [95% CI, 1.5%-5.9%] for >$5200; P  = .29 among strata) or by latitude (2.6% [95% CI, 1.5%-4.6%] for <40°; 1.9% [95% CI, 1.1%-3.1%] for 40°-51°; and 2.4% [95% CI, 1.4%-4.0%] for ≥52°; P  = .65 among strata). Pooled prevalence estimates of any tinnitus and severe tinnitus per continent are listed in eTable 6 in the Supplement .

Converting our pooled prevalence estimates to absolute numbers, we found that there were 749 million adults (95% CI, 655-858 million adults) worldwide with any tinnitus and 120 million adults (95% CI, 88-177 million adults) with severe tinnitus. Using continent-specific estimates, we found that the resulting numbers would not change substantially (any tinnitus: 746 million people [95% CI, 537-1039 million people]; severe tinnitus: 140 million people [95% CI, 92-237 million people]).

A possible publication bias emerged for the prevalence of any tinnitus and for the prevalence of severe tinnitus ( P  < .001 for the Egger test; eFigure 4 in the Supplement ). For adults, the pooled prevalence of diagnosed tinnitus was 3.4% (95% CI, 2.1%-5.5%; 3 studies; I 2  = 99%), and the pooled prevalence of chronic tinnitus, defined as tinnitus occurring most or all of the time or persisting for months, was 9.8% (95% CI, 4.7%-19.3%; 3 studies; I 2  = 99%).

Of 89 studies, 12 provided information on incidence estimates ( Table 3 ). 14 , 15 , 23 , 46 , 50 - 57 These longitudinal studies came from 7 countries (ie, Australia, Germany, Sweden, Switzerland, Taiwan, UK, and US) and were published from 2002 to 2019. Annual incidence rates ranged substantially from 54 to 3914 per 100 000 person-years. The pooled annual incidence rate of any tinnitus, based on the crude estimate of the 6 studies among adults (with both sexes combined), is 1164 per 100 000 person-years (95% CI, 479-2828 per 100 000 person-years) (eFigure 5 in the Supplement ).

To our knowledge, this systematic review provides the most comprehensive and up-to-date evidence on the prevalence and incidence of tinnitus worldwide among adults and children or adolescents, summarizing estimates from 89 original studies. For the first time, we provide pooled estimates of tinnitus; based on our data, approximately 14% of the world population have experienced tinnitus, and more than 2% have severe tinnitus. The prevalence of tinnitus is similar for both sexes, and increases in prevalence are associated with increasing age. Heterogeneous estimates have been reported by the few studies that provide data on the incidence of tinnitus. The pooled annual incidence rate approaches 1%.

The various cross-sectional studies providing data on the frequency of tinnitus used a wide variety of assessment methods. 3 , 58 , 59 We therefore classified the questions about any tinnitus into 6 groups and about severe tinnitus into 5 groups. Despite the substantial heterogeneity of estimates in the classes of any tinnitus, we did not find statistically significant differences in its prevalence across classes. This finding suggests that, at least for any tinnitus, not all the variability is explained by different definitions, and other factors might explain the prevalence of any tinnitus better at the population level.

Concomitantly, our findings suggest that data on tinnitus among children or adolescents are more prone to different interpretations of the question used to assess tinnitus. One possible reason could be that children are more frequently asked about tinnitus without specifically mentioning the name of the symptom. Other researchers have suggested that children might report the presence of noise to please the interviewers. 60 Despite the increasing number of studies on the subject, tinnitus remains an unrecognized problem that is inadequately assessed in the pediatric population. 61

We found differences in terms of any tinnitus and severe tinnitus in association with age, confirming the increasing prevalence of the symptom with age. 7 , 10 , 11 In particular, whereas the prevalence of any tinnitus among older adults was close to 2.5 times higher than among young adults, the prevalence of severe tinnitus among older adults was almost 20 times higher than among young adults. This finding suggests that tinnitus is a particular disorder of older people. 8

The literature is not unanimous about whether there is any association between sex and tinnitus. McCormack and colleagues 3 generally reported a higher prevalence of any tinnitus among men than women, whereas Biswas and colleagues 12 found a higher prevalence of bothersome tinnitus among women than men. The latter is consistent with previous findings of an association between severe tinnitus and suicidal attempts among women but not among men. 4 In our comprehensive review, pooling findings from a vast scientific literature, we did not find any significant difference according to sex for either any tinnitus or severe tinnitus.

As previously noted, 8 information is scant on the differences in tinnitus prevalence among countries, and we were only partially able to fill the gap. In fact, Africa, Oceania, and South America are not well represented. We found only 2 studies on the prevalence of any tinnitus and 2 studies on the prevalence of severe tinnitus from Africa and South America combined, covering more than 1.7 billion people. This finding may, to some extent, be due to the fact that, by protocol, we did not include articles that were not in English. Pooled estimates for any tinnitus from the other continents were somehow similar—between 13% and 15%—whereas differences were larger for pooled estimates for severe tinnitus—between 1.8% and 3.3%.

In addition to country-specific population characteristics, including lifestyle and dietary habits, 7 mental health conditions, 1 or ethnicity, 13 variations in the prevalence of tinnitus between countries and continents could be explained by different exposures and etiologies. Recently, it has been evidenced by means of genetic epidemiology studies 50 , 62 - 64 and genomic studies 65 , 66 that tinnitus is hereditary. Although common variants have been associated with broad tinnitus definitions, such as “any” tinnitus, it appears that rare variants are more associated with severe tinnitus. 65 , 66 Thus, differences in population genetics could be associated with the large discrepancies in the prevalence of severe tinnitus, as for instance in South America. However, more efforts are needed to investigate the association of genetics with any tinnitus or severe tinnitus across different countries and continents. In a European survey, Biswas et al 12 found that the prevalence of tinnitus was greater in countries from the eastern European region than in western Europe, with Bulgaria reaching a prevalence for any tinnitus of 28.3% and Romania with a prevalence for severe tinnitus peaking at 4.2%. This finding is consistent with a greater prevalence of hearing loss among individuals in these countries, according to the Global Burden of Disease study. 67 It is possible that less active work-related preventive measures against occupational noise exposure or limited access to rehabilitation for hearing loss by means of hearing aids may cause such disparities across Europe. In contrast, the low frequency of acoustic neuromas and head injuries and traumas among individuals with tinnitus is unlikely to explain such variety across countries and continents. 68 - 70 Other risk factors could also underlie such differences in prevalence. However, only a handful of case-control and longitudinal studies have investigated the potential causal relationship to tinnitus, most of which focus on hearing-related conditions. 14 , 15 Thus, a comprehensive picture of the association of nonauditory etiologies with any tinnitus or severe tinnitus is required.

Our results do indicate that differences arise when using multiple definitions to assess tinnitus. For future research, therefore, we recommend using a standardized questionnaire for assessing the prevalence of tinnitus, to make better comparisons between different surveys, identifying more solid estimates of tinnitus in various countries worldwide. We acknowledge, however, that no single question can address the multidimensional properties of tinnitus that are critical for its assessment (duration [acute or chronic], temporality [intermittent or constant], and severity [negligible or impactful]). Thus, our suggestion is to systematically use the questions given by a consortium of experts available in multiple languages. 58

For children specifically, a large difference was clear between questionnaires that mentioned the term tinnitus and those that did not; we conclude that future surveys addressing children and adolescents must state clearly the name of the disorder in their questions—with an explanation—as the high prevalence of tinnitus might be a result of the participants not recognizing the extraordinary nature of the symptom being investigated.

An association has been hypothesized between socioeconomic status and tinnitus. 16 , 54 Although with all the limitations of an ecological analysis, 71 , 72 we found no association between per-capita GDP and tinnitus prevalence.

Tinnitus has been reported to have a seasonal pattern, where it is worse in the winter than in the summer. 73 Thus, the hours of sunlight per day or certain temperatures might be associated with the onset or severity of tinnitus. Countries with their main city at an intermediate latitude (40°-51°) had the lowest prevalence and the lowest severity of tinnitus. Future analytical studies should investigate this issue in more detail.

In this meta-analysis, we defined as eligible only studies based on samples representative of the general population, excluding subgroups of the population exposed to selected risk factors, such as veterans and musicians. In these 2 particular populations, the prevalence of tinnitus was reported with a point estimate of 31% among veterans 74 and 26% among musicians, 75 much higher than among the general adult population. These 2 subpopulations might therefore be targeted for specific interventions to prevent or limit exposure to noise and, consequently, to reduce tinnitus and other hearing conditions.

There is a paucity of articles on the incidence of tinnitus: of 113 eligible articles, only 12 provided data on the incidence of tinnitus, although many cohorts were available with tinnitus assessed at follow-up. The incidence rates differed by up to 2 orders of magnitude in various studies. Although estimates stratified by sex are frequently provided, information is limited on incident cases by age group.

This study has some limitations, including the classification of tinnitus into 6 groups of questions for any tinnitus (A1-A6) and 5 groups for severe tinnitus (S1-S5). Although inspired by the 8 different categories for tinnitus identified by McCormack et al, 3 our classification has not been validated and is therefore subject to the interpretation of the researchers who used it. Moreover, we cannot exclude a possible publication bias regarding the prevalence of both any tinnitus and severe tinnitus.

The strengths of the study include the original method used to identify relevant articles, which involves an umbrella review as well as a traditional review. 9 This method has already been shown to be both effective and efficient in the identification of relevant articles in other recent systematic reviews. 76 - 78 Thus, we were able to include almost twice the number of articles included in the most comprehensive review of the literature published before the present one, 3 including, in our opinion, at least 11 articles that could have been retrieved by McCormack and colleagues 3 but were not in that review. Thus, to our knowledge, this is the most comprehensive review conducted to date because it considers a larger publication period (between 1972 and 2021) and is not limited to adults but also includes children and adolescents.

To our knowledge, this is the first meta-analysis on the frequency of tinnitus. Generalizing our estimates to the whole global population, one can infer that more than 740 million people experience tinnitus and more than 120 million people worldwide have a severe form of tinnitus. Such estimates place tinnitus at an order of magnitude similar to the leading causes of years lived with disability, namely, hearing loss, followed by migraine, low back pain, and neck pain. 67 Health authorities and research institutions, such as the Global Burden of Disease, should consider this prevalence and play a leading role in funding, ultimately to boost research on tinnitus and improve the care and the lives of patients with tinnitus.

Accepted for Publication: June 13, 2022.

Published Online: August 8, 2022. doi:10.1001/jamaneurol.2022.2189

Correction: This article was corrected on November 7, 2022, to update to CC-BY open access status.

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2022 Jarach CM et al. JAMA Neurology .

Corresponding Author: Silvano Gallus, PhD, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy ( [email protected] ).

Author Contributions: Ms Jarach and Dr Galllus had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Jarach, Lugo, Cederroth, Odone, Garavello, Schlee, Gallus.

Acquisition, analysis, or interpretation of data: Jarach, Scala, van den Brandt, Odone, Schlee, Langguth, Gallus.

Drafting of the manuscript: Jarach, Scala, Schlee, Gallus.

Critical revision of the manuscript for important intellectual content: Jarach, Lugo, van den Brandt, Cederroth, Odone, Garavello, Schlee, Langguth, Gallus.

Statistical analysis: Jarach, Scala.

Obtained funding: Cederroth, Schlee, Gallus.

Supervision: van den Brandt, Odone, Garavello, Schlee, Gallus.

Conflict of Interest Disclosures: Dr Cederroth reported being a member of the British Tinnitus Association’s Professional Advisers’ Committee and the American Tinnitus Association’s Scientific Advisory Board. Dr Schlee reported receiving grants from the European Union’s Horizon 2020 Research and Innovation Programme grant agreement during the conduct of the study. Dr Langguth reported receiving grants from European Union Unification of Treatments and Interventions for Tinnitus Patients during the conduct of the study; receiving personal fees from Neuromod and Schwabe outside the submitted work; and serving as chair of the Tinnitus Research Initiative, a nonprofit organization. No other disclosures were reported.

Funding/Support: The work of Drs Lugo, Langguth, and Gallus and Mr Scala, is partially supported by Unification of Treatments and Interventions for Tinnitus Patients–UNITI project, which has received funding from the European Union's Horizon 2020 Research and Innovation Programme (grant agreement 848261). The work of Ms Jarach and Drs Cederroth and Gallus is partially supported by Tinnitus Genetic and Environmental Risks–TIGER project, which has received funding from the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement GNP-182). The study is also supported by AIT ONLUS Associazione Italiana Tinnitus.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Information: Data and R scripts that support the findings of this study and materials are available from the corresponding author on request.

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• Case report
• Open access
• Published: 28 June 2024

Pseudomyxoma peritonei leading to “jelly belly” abdomen: a case report and review of the literature

• Priyanka Garg   ORCID: orcid.org/0000-0003-0336-4750 1 ,
• Nikhil Garg 2 ,
• Sameer Peer 3 ,
• Deepika Chholak 1 &
• Manjit Kaur 4  

Journal of Medical Case Reports volume  18 , Article number:  296 ( 2024 ) Cite this article

Metrics details

Pseudomyxoma peritonei is an infrequent condition with a global annual incidence of only one to two cases per million people. Mucinous neoplasms, widespread intraperitoneal implants, and mucinous ascites characterize it. Currently, most clinicians misdiagnose this condition, which leads to delayed management.

Case presentation

A 44-year-old North Indian female presented with a 1.5-month history of an abdominal lump. Physical examination revealed a sizeable abdominopelvic mass at 36 weeks. Contrast-enhanced computed tomography showed a massive multiloculated right ovarian cystic mass measuring 28 × 23 × 13 cm with mild ascites and elevated carcinoembryonic antigen levels (113.75 ng/ml). A provisional diagnosis of ovarian mucinous neoplasm was made, for which the patient underwent laparotomy. Intraoperatively, there were gross mucinous ascites, along with a large, circumscribed, ruptured right ovarian tumor filled with gelatinous material. The appendicular lump was also filled with mucinous material along with the omentum, ascending colon, right lateral aspect of the rectum, splenic surface, and small bowel mesentery. Cytoreductive surgery was performed along with an oncosurgeon, including total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy, right hemicolectomy, lower anterior resection, ileo-transverse stapled anastomosis with proximal ileal loop diversion stoma, excision of multiple peritoneal gelatinous implants, and peritoneal lavage. Histopathology and immunohistochemistry confirmed the presence of intestinal-type mucinous carcinoma. Postoperatively, the patient was given six cycles of chemotherapy. She tolerated it without any specific morbidity and had an uneventful recovery. Postoperative follow-up at 15 months revealed normal tumor marker levels and abdominal computed tomography findings and no signs suggestive of local recurrence or distal metastases.

Conclusions

Pseudomyxoma peritonei is a rare disease that is frequently misdiagnosed in the preoperative phase. Therefore, radiologists and clinicians should maintain a high index of suspicion for accurate diagnosis and multidisciplinary management.

Peer Review reports

Introduction

Pseudomyxoma peritonei (PMP) is a rare condition caused by primary mucinous tumors arising from different locations, usually the appendix or ovary; other rare sites include the gallbladder, stomach, colorectum, fallopian tube, urachus, lung, and breast. It is characterized by mucin production in the abdominal cavity and, if left untreated, can compress adjacent vital organs. The term “PMP” was first given by Werth in 1884, and the current incidence is estimated to be one to two cases per million per year [ 1 ]. With a mean incidence at the age of 53 years, PMP is more prevalent in women (male-to-female ratio, 9:11) [ 2 ]. The clinical features are often nonspecific and may manifest as an inexplicable increase in abdominal girth, abdominal pain, ascites, unilateral or bilateral ovarian tumors, bowel obstruction, or appendicitis-like symptoms. The initial diagnostic modality is ultrasonography (USG), followed by computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen/pelvis. Most of the time, however, the diagnosis is often missed during preoperative evaluation, and the tumor is discovered accidentally during surgery [ 3 ]. The serum tumor markers cancer antigen (CA) 19–9 and carcinoembryonic antigen (CEA) aid in diagnosis and have prognostic value [ 2 ]. The definitive management consists of complete cytoreductive surgery (CRS) to achieve macroscopic tumor removal, followed by intraperitoneal or systemic chemotherapy to treat microscopic residual disease [ 4 ]. However, no standard guidelines are available for the treatment of these patients. In March 2018, the National Comprehensive Cancer Network (NCCN) published a guideline stating that, in recent research, completion of CRS was associated with improving patients’ overall survival, while hyperthermic intraoperative peritoneal chemotherapy (HIPEC) did not [ 5 ]. Hence, long-term survival and complete cure have limited expectations [ 5 ]. Thus, more robust data need to be generated to provide a less harmful therapeutic approach in an individualized manner along with palliative therapy for those who are ineligible candidates for surgery. PMP should be managed with a multidisciplinary team approach involving a gynecologist, oncosurgeon, radiologist, pathologist, and medical oncologist. We present one such rare case of PMP in a female who was missed on imaging and diagnosed intraoperatively. She was successfully managed with surgical debulking plus chemotherapy. To the best of our knowledge, this is one of the few case reports published in India that has highlighted such surgeries and generated awareness in favor of them.

A 44-year-old North Indian (para 2, live 2) patient with a previous cesarean section came to the gynecology out-patient department (OPD) with complaints of a lump in the abdomen for the last 1.5 months. Initially, the size of the lump reached the umbilicus, which suddenly increased to the xiphisternum. There was associated abdominal discomfort but no nausea, vomiting, or fever. Her previous medical and family history was unremarkable. On general examination, the patient was, on average, built and afebrile, with no evidence of anemia, jaundice, cyanosis, lymphadenopathy, clubbing, or weight loss. She had normal bladder and bowel function. Her menstrual cycles were regular with normal flow. An abdominal examination revealed a large abdominopelvic mass corresponding to the epigastrium for up to 36 weeks. It was cystic in consistency with a smooth surface, non-tender, and slightly mobile in the transverse plane. The lack of shifting dullness negated the presence of ascites. A per-vaginal examination confirmed an abdominopelvic mass of 36 weeks in size with a normal external vulva and cervix. The uterus could not be appreciated separately. Ultrasound revealed a large abdominopelvic mass with internal septations reaching the epigastrium. The uterus was normal in size, with mild ascites and bilateral adnexa obscured by the mass. On further evaluation, contrast-enhanced computed tomography (CECT) was performed to characterize the mass, which showed a large multiloculated abdominopelvic cystic mass measuring 28 × 23 × 13 cm with the right ovary not seen separately, suggesting a right ovarian origin.

The uterus and left ovary were normal and displaced by the mass. Mild ascites was present. Multiple thick enhancing septa were also observed within the mass with no solid component ( Fig.  1 ). Her CA 125 and CA 19–9 levels were normal (35.4 U/ml and 18.85 U/ml, respectively). However, her CEA level was elevated to 113.75 ng/ml (normal range 0–3 ng/ml). A provisional diagnosis of a right ovarian mucinous tumor was made, and the patient underwent exploratory laparotomy after providing informed consent. Intraoperative findings revealed gelatinous material filling the entire abdominal cavity and pelvis. A large, circumscribed, ruptured tumor arose from the right ovary filled with gelatinous material.

Axial contrast-enhanced computed tomography images of the abdomen and pelvis. The arrows point toward ( A ) a multiseptated abdominopelvic mass lesion with enhancing septations and relatively hyperdense ascites surrounding the mass; B scalloping of the anterior margin of the liver (arrow) caused by the ascitic fluid; C displacement of the small bowel loops (arrow) by the abdominopelvic mass and ascitic fluid, suggesting a mass effect in coronal reconstruction; and D enhancing appendix engulfed within the abdominopelvic mass (arrow) in axial contrast-enhanced computed tomography

There were mucinous deposits on the anterior surface of the normal-sized uterus and left ovary. The appendicular lump was also filled with gelatinous material. Multiple gelatinous nodules were present on the omentum, along the ascending colon, right lateral aspect of the rectum, splenic surface, and small bowel mesentery. The oncosurgeon was called intraoperatively, and we performed CRS, including total abdominal hysterectomy with bilateral salpingoophorectomy, total omentectomy, right hemicolectomy, lower anterior resection, ileo-transverse stapled anastomosis with proximal ileal loop diversion stoma, excision of multifocal peritoneal mucinous implants, and peritoneal lavage (Fig.  2 ). Surgical specimens were subjected to histopathological and immunohistochemical (IHC) examination. Microscopically, the tumor cells were arranged as back-to-back glands, papillae, and cysts lined by mucinous columnar epithelium (intestinal type), with oval to elongated nuclei, a high nucleocytoplasmic ratio, and vesicular nuclei. Stromal infiltration by tumors was noted in the form of nests, irregularly shaped glands, and cords of tumor cells. Abundant extravasated mucin was also observed, revealing mucinous carcinoma of the intestinal type (Fig.  3 ). On IHC, the tumor cells were CK20+ , CDX2+ , and CK7−, which indicate mucinous neoplasms of the intestinal type. The patient was given six cycles of chemotherapy with carboplatin and paclitaxel. She had an uneventful recovery (as of publication) for 15 months following the operation, with normal tumor marker levels and abdominal CT findings and no signs of local recurrence or distal metastases.

A Postoperative images showing yellow gelatinous material and B total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy, and right hemicolectomy with lower anterior resection

Low-power view of a section of A ovary B , C omentum, and D colon showing mucin deposits containing tumor cells (hematoxylin and eosin, 10×)

PMP is a poorly understood clinical condition characterized by intra-abdominal mucin accumulation secondary to the proliferation of malignant mucin-secreting cells on the peritoneal surface. In contrast to most malignancies, it rarely spreads via the hematogenous or lymphatic system [ 6 ]. Hence, there is nowhere for extracellular mucin to drain, which accumulates significantly in the abdominal cavity and causes the so-called jelly belly abdomen. It was first described by Carl Von Rokitansky in 1842, but the term was used in 1884 in association with a mucinous carcinoma of the ovary [ 7 ]. Later, in 1901, Franckel described PMP as an appendiceal cystic tumor [ 8 ]. The origin of PMP is still debatable. Most authors agree that PMP develops mainly in the appendix in men, and mounting evidence supports a similar genesis in women. Worldwide, 30–50% of women have simultaneous ovarian and appendiceal mucinous tumors [ 9 ]. However, immunohistochemical and molecular genetic approaches support the concept that most ovarian tumors in women are metastatic to a perforated appendiceal mucinous tumor. This notion is supported by our case, in which histological examination of the oophorectomy specimen revealed a pattern consistent with intestinal/appendicular origin.

The diagnosis of PMP is often challenging for clinicians, as the majority of patients remain asymptomatic or present with nonspecific clinical features, such as pain in the abdomen, nausea, vomiting, abdominal distention (as seen in our case), or mass. Approximately one-third of female patients present with an ovarian tumor, as observed in our case [ 10 ]. The excessive accumulation of mucin in the peritoneal cavity can compress adjacent structures, leading to bowel obstruction and malnutrition. Touloumis Z et al . reported a case of PMP in a 71-year-old patient who presented with intermittent diarrhea without any other symptoms [ 6 ].

Imaging studies are also not very helpful in reaching the diagnosis. USG is the initial investigation that may show highly echogenic ascitic fluid with immobile echogenic septations and a marked laminated appearance (onion-skin effect), reflecting the concentric layering of mucin, typical of gelatinous material [ 4 ]. The gold standard for imaging is CECT. The usual appearance includes areas of low attenuation, with islands of more significant attenuation resulting from solid elements within the mucinous material. Classically, “scalloping” of visceral surfaces, particularly of the liver and spleen, distinguishes mucinous from fluid ascites [ 5 ]. However, most cases are discovered incidentally during laparoscopy or laparotomy [ 11 ]. Mathur S et al . reported the case of a 27-year-old patient who was incidentally diagnosed with disseminated PMP at the time of a cesarean section [ 3 ]. According to the study conducted by Jarvinen and Lepisto, only 28% of patients underwent primary surgery for suspected PMP. The most frequent preoperative diagnosis is appendicitis, gynecological cancer, or ovarian tumor, as in our case, where the diagnosis of PMP was missed on imaging [ 3 ].

Tumor markers such as CEA, CA 19–9, and CA-125 are associated with PMP. CEA is a beneficial prognostic marker during diagnosis and postoperative surveillance [ 2 ]. Preoperative elevation of serum markers indicates aggressive disease and a high chance of recurrence. Canbay et al . noted that preoperative CEA levels can predict disease severity, surgical success, and overall survival in patients treated with CRS and hyperthermic intraoperative peritoneal chemotherapy (HIPEC) [ 12 ].

The definitive diagnosis mandates the presence of a mucinous neoplastic cells/epithelium and diffuse intra-abdominal mucin [ 13 ]. Patients without epithelium were considered to have mucinous ascites. Epithelial glandular cells must be present in the mucin pool on histopathology to confirm the diagnosis of PMP. The biopsy of our patient concurred. The Peritoneal Surface Oncology Group International (PSOGI) pathologic categorization for PMP now uses distinct nomenclature for treatment selection, as presented in Table  1 .

Appendiceal adenocarcinomas are classified into three histological categories. The most frequent form, mucinous, produces a large amount of mucin. The less prevalent intestinal or colonic form (our case) closely resembles colon adenocarcinomas. Signet ring cell adenocarcinoma is a rare and aggressive cancer with a poor prognosis [ 2 , 15 ].

Traditionally, the management of PMP includes repeated drainage of gelatinous ascites or serial debulking surgeries involving the removal of the primary tumor and mucinous ascites. However, repeat surgical procedures have become increasingly difficult due to adhesions and fibrous scar tissue formation [ 16 ]. These patients eventually die due to severe malnutrition, intestinal obstruction, or surgical complications. Recent studies support the idea that combined cytoreductive surgery with intraperitoneal chemotherapy (IPEC) should be the standard of care because it has improved survival rates. The 5-year survival rate of patients with CRS and IPEC for low-grade disease is 60–100%, whereas for high-grade disease, it is 0–60% [ 16 ]. CRS aims to eliminate as many macroscopic illnesses as possible. Sugarbaker’s protocol is commonly used for peritonectomy procedures, which may include anterior parietal peritonectomy, total omentectomy, splenectomy, distal pancreatectomy, right and left subphrenic peritonectomy, Glisson’s capsule removal, pelvic peritonectomy, cholecystectomy, and visceral resections such as rectosigmoidectomy, right colectomy, total abdominal colectomy, and hysterectomy with bilateral salpingo-oophorectomy and small bowel resection [ 11 ]. This system is supplemented with IPEC, which targets microscopic residual disease and free neoplastic cells in the peritoneal cavity. Heated/hyperthermic IPEC (HIPEC) can be utilized intraoperatively or early postoperatively [early postoperative intraperitoneal chemotherapy (EPIC)], comparable to peritoneal dialysis. According to a study by Sorensen et al ., there appears to be no difference in survival rates between the two IPEC procedures [ 17 ]. The treatment plan for PMP should aim for full cytoreduction to avoid recurrence or progression. This method is currently being used in numerous centers worldwide, with encouraging results, and appears to be gaining traction compared with traditional serial debulking. However, not all situations are appropriate for this strategy; every center or surgeon is not equipped to perform IPEC, and sometimes, patients might be medically unfit to receive these treatments safely. A randomized study by Verwaal revealed that patients involved in six or more abdominal cavity regions achieved minimal improvement in survival following CRS and intraoperative HIPEC [ 18 ]. Therefore, debulking surgeries alone are still being performed and have an overall survival rate of approximately 50% [ 19 ]. Additionally, currently, there is no consensus regarding the role of CRS and HIPEC treatment for more aggressive histological variations in PMP. Consequently, they provide evidence favoring systemic chemotherapy as the standard of care for such patients [ 20 ]. Per the retrospective research by Shapiro J et al ., patients considered inadequate candidates for CRS and/or HIPEC therapy benefited from extended disease remission of 7.6 months with contemporary systemic chemotherapy [ 21 ]. In another published review of consensus statements and guidelines by the PSOGI expert panel, neoadjuvant or adjuvant systemic chemotherapy can be considered in patients with low-grade PMP and high-grade PMP with signet ring cells. When required, fluoropyrimidine in conjunction with an alkylating drug (such as oxaliplatin) is advised [ 22 ]. Currently, there is no standard systemic chemotherapy regimen, and we are unaware of any prospective clinical trials in this patient cohort that involve contemporary systemic chemotherapy and/or biologic therapy. The patient in the present study was treated with CRS, which consisted of hysterectomy with bilateral salpingo‑oophorectomy, omentectomy, right hemicolectomy, lower anterior resection, ileo-transverse stapled anastomosis with proximal ileal loop diversion stoma, excision of multiple peritoneal mucinous implants, and peritoneal lavage. Since HIPEC was not available in our center, the patient was given six cycles of postoperative systemic chemotherapy, and she has been tumor-free to date.

Finally, PMP may relapse despite CRS and chemotherapy (HIPEC, IPEC, or systemic), mainly if the disease is diagnosed at an advanced stage. Tumor marker assessment and routine postoperative CT scans should be utilized to monitor any recurrence.

PMP is a rare condition that causes significant morbidity and mortality if left untreated. The diagnosis is often missed, resulting in delayed management. Radiologists and clinicians should maintain a high index of suspicion for timely diagnosis and management. CRS plus IPEC is the standard of care for these patients and can significantly improve survival but is associated with considerable morbidity. Furthermore, it is crucial that the management of PMP be individualized because some patients may benefit more from debulking alone than from CRS combined with IPEC/systemic therapy or vice versa. Additional research into chemotherapy schedules and patient selection may shed light on other strategies to reduce morbidity and increase survival associated with this disease. More prospective trials should be conducted to formulate evidence-based guidelines for managing such patients.

Availability of data and materials

Not applicable.

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Priyanka Garg & Deepika Chholak

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Nikhil Garg

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Sameer Peer

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PG, NG, and DC treated the patient. PG was involved in writing the manuscript and obtaining consent from the patient. The SP was involved in the patient’s radiological imaging. MK was involved in the patient’s histopathological diagnosis. All the authors have read and approved the final manuscript.

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Garg, P., Garg, N., Peer, S. et al. Pseudomyxoma peritonei leading to “jelly belly” abdomen: a case report and review of the literature. J Med Case Reports 18 , 296 (2024). https://doi.org/10.1186/s13256-024-04612-1

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The Literature Review: A Foundation for High-Quality Medical Education Research

a  These are subscription resources. Researchers should check with their librarian to determine their access rights.

Despite a surge in published scholarship in medical education 1 and rapid growth in journals that publish educational research, manuscript acceptance rates continue to fall. 2 Failure to conduct a thorough, accurate, and up-to-date literature review identifying an important problem and placing the study in context is consistently identified as one of the top reasons for rejection. 3 , 4 The purpose of this editorial is to provide a road map and practical recommendations for planning a literature review. By understanding the goals of a literature review and following a few basic processes, authors can enhance both the quality of their educational research and the likelihood of publication in the Journal of Graduate Medical Education ( JGME ) and in other journals.

The Literature Review Defined

In medical education, no organization has articulated a formal definition of a literature review for a research paper; thus, a literature review can take a number of forms. Depending on the type of article, target journal, and specific topic, these forms will vary in methodology, rigor, and depth. Several organizations have published guidelines for conducting an intensive literature search intended for formal systematic reviews, both broadly (eg, PRISMA) 5 and within medical education, 6 and there are excellent commentaries to guide authors of systematic reviews. 7 , 8

• A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact.
• A literature review provides context, informs methodology, maximizes innovation, avoids duplicative research, and ensures that professional standards are met.
• Literature reviews take time, are iterative, and should continue throughout the research process.
• Researchers should maximize the use of human resources (librarians, colleagues), search tools (databases/search engines), and existing literature (related articles).
• Keeping organized is critical.

Such work is outside the scope of this article, which focuses on literature reviews to inform reports of original medical education research. We define such a literature review as a synthetic review and summary of what is known and unknown regarding the topic of a scholarly body of work, including the current work's place within the existing knowledge . While this type of literature review may not require the intensive search processes mandated by systematic reviews, it merits a thoughtful and rigorous approach.

Purpose and Importance of the Literature Review

An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the “journal-as-conversation” metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: “Imagine yourself joining a conversation at a social event. After you hang about eavesdropping to get the drift of what's being said (the conversational equivalent of the literature review), you join the conversation with a contribution that signals your shared interest in the topic, your knowledge of what's already been said, and your intention.” 9

The literature review helps any researcher “join the conversation” by providing context, informing methodology, identifying innovation, minimizing duplicative research, and ensuring that professional standards are met. Understanding the current literature also promotes scholarship, as proposed by Boyer, 10 by contributing to 5 of the 6 standards by which scholarly work should be evaluated. 11 Specifically, the review helps the researcher (1) articulate clear goals, (2) show evidence of adequate preparation, (3) select appropriate methods, (4) communicate relevant results, and (5) engage in reflective critique.

Failure to conduct a high-quality literature review is associated with several problems identified in the medical education literature, including studies that are repetitive, not grounded in theory, methodologically weak, and fail to expand knowledge beyond a single setting. 12 Indeed, medical education scholars complain that many studies repeat work already published and contribute little new knowledge—a likely cause of which is failure to conduct a proper literature review. 3 , 4

Likewise, studies that lack theoretical grounding or a conceptual framework make study design and interpretation difficult. 13 When theory is used in medical education studies, it is often invoked at a superficial level. As Norman 14 noted, when theory is used appropriately, it helps articulate variables that might be linked together and why, and it allows the researcher to make hypotheses and define a study's context and scope. Ultimately, a proper literature review is a first critical step toward identifying relevant conceptual frameworks.

Another problem is that many medical education studies are methodologically weak. 12 Good research requires trained investigators who can articulate relevant research questions, operationally define variables of interest, and choose the best method for specific research questions. Conducting a proper literature review helps both novice and experienced researchers select rigorous research methodologies.

Finally, many studies in medical education are “one-offs,” that is, single studies undertaken because the opportunity presented itself locally. Such studies frequently are not oriented toward progressive knowledge building and generalization to other settings. A firm grasp of the literature can encourage a programmatic approach to research.

Approaching the Literature Review

Considering these issues, journals have a responsibility to demand from authors a thoughtful synthesis of their study's position within the field, and it is the authors' responsibility to provide such a synthesis, based on a literature review. The aforementioned purposes of the literature review mandate that the review occurs throughout all phases of a study, from conception and design, to implementation and analysis, to manuscript preparation and submission.

Planning the literature review requires understanding of journal requirements, which vary greatly by journal ( table 1 ). Authors are advised to take note of common problems with reporting results of the literature review. Table 2 lists the most common problems that we have encountered as authors, reviewers, and editors.

Sample of Journals' Author Instructions for Literature Reviews Conducted as Part of Original Research Article a

Common Problem Areas for Reporting Literature Reviews in the Context of Scholarly Articles

Locating and Organizing the Literature

Three resources may facilitate identifying relevant literature: human resources, search tools, and related literature. As the process requires time, it is important to begin searching for literature early in the process (ie, the study design phase). Identifying and understanding relevant studies will increase the likelihood of designing a relevant, adaptable, generalizable, and novel study that is based on educational or learning theory and can maximize impact.

Human Resources

A medical librarian can help translate research interests into an effective search strategy, familiarize researchers with available information resources, provide information on organizing information, and introduce strategies for keeping current with emerging research. Often, librarians are also aware of research across their institutions and may be able to connect researchers with similar interests. Reaching out to colleagues for suggestions may help researchers quickly locate resources that would not otherwise be on their radar.

During this process, researchers will likely identify other researchers writing on aspects of their topic. Researchers should consider searching for the publications of these relevant researchers (see table 3 for search strategies). Additionally, institutional websites may include curriculum vitae of such relevant faculty with access to their entire publication record, including difficult to locate publications, such as book chapters, dissertations, and technical reports.

Strategies for Finding Related Researcher Publications in Databases and Search Engines

Search Tools and Related Literature

Researchers will locate the majority of needed information using databases and search engines. Excellent resources are available to guide researchers in the mechanics of literature searches. 15 , 16

Because medical education research draws on a variety of disciplines, researchers should include search tools with coverage beyond medicine (eg, psychology, nursing, education, and anthropology) and that cover several publication types, such as reports, standards, conference abstracts, and book chapters (see the box for several information resources). Many search tools include options for viewing citations of selected articles. Examining cited references provides additional articles for review and a sense of the influence of the selected article on its field.

Box Information Resources

• Web of Science a
• Education Resource Information Center (ERIC)
• Cumulative Index of Nursing & Allied Health (CINAHL) a
• Google Scholar

Once relevant articles are located, it is useful to mine those articles for additional citations. One strategy is to examine references of key articles, especially review articles, for relevant citations.

Getting Organized

As the aforementioned resources will likely provide a tremendous amount of information, organization is crucial. Researchers should determine which details are most important to their study (eg, participants, setting, methods, and outcomes) and generate a strategy for keeping those details organized and accessible. Increasingly, researchers utilize digital tools, such as Evernote, to capture such information, which enables accessibility across digital workspaces and search capabilities. Use of citation managers can also be helpful as they store citations and, in some cases, can generate bibliographies ( table 4 ).

Citation Managers

Knowing When to Say When

Researchers often ask how to know when they have located enough citations. Unfortunately, there is no magic or ideal number of citations to collect. One strategy for checking coverage of the literature is to inspect references of relevant articles. As researchers review references they will start noticing a repetition of the same articles with few new articles appearing. This can indicate that the researcher has covered the literature base on a particular topic.

Putting It All Together

In preparing to write a research paper, it is important to consider which citations to include and how they will inform the introduction and discussion sections. The “Instructions to Authors” for the targeted journal will often provide guidance on structuring the literature review (or introduction) and the number of total citations permitted for each article category. Reviewing articles of similar type published in the targeted journal can also provide guidance regarding structure and average lengths of the introduction and discussion sections.

When selecting references for the introduction consider those that illustrate core background theoretical and methodological concepts, as well as recent relevant studies. The introduction should be brief and present references not as a laundry list or narrative of available literature, but rather as a synthesized summary to provide context for the current study and to identify the gap in the literature that the study intends to fill. For the discussion, citations should be thoughtfully selected to compare and contrast the present study's findings with the current literature and to indicate how the present study moves the field forward.

To facilitate writing a literature review, journals are increasingly providing helpful features to guide authors. For example, the resources available through JGME include several articles on writing. 17 The journal Perspectives on Medical Education recently launched “The Writer's Craft,” which is intended to help medical educators improve their writing. Additionally, many institutions have writing centers that provide web-based materials on writing a literature review, and some even have writing coaches.

The literature review is a vital part of medical education research and should occur throughout the research process to help researchers design a strong study and effectively communicate study results and importance. To achieve these goals, researchers are advised to plan and execute the literature review carefully. The guidance in this editorial provides considerations and recommendations that may improve the quality of literature reviews.

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Wonder Confronts Certainty: Russian Writers on the Timeless Questions and Why Their Answers Matter

Gary Saul Morson is the world’s leading authority on Tolstoy and Dostoevsky. In his latest book, conceived as a stocktaking magnum opus, wonder confronts certainty and triumphs decisively. But is the contest fair?

Certainty is represented by the nineteenth-century Russian intelligentsia and its Bolshevik successors, wonder by the questions posed in Russian realist prose. Both are remarkable for their maximalism and urgency. As Ivan says to his brother Alyosha in Dostoevsky’s The Brothers Karamazov , “Russian boys do nothing but talk of the eternal questions. Isn’t it so?”

It is, says Morson. Beginning in the mid-nineteenth century, “the Russian tendency to take ideas to extremes magnified otherwise indiscernible implications.” Readers, writers, casual acquaintances, and literary characters began to argue feverishly, and sometimes murderously, “about what is most essentially human, about whether morality has any nonarbitrary basis, about the relation of abstract theory to lived experience, about life’s meaning, and other such topics.” Western readers stand to benefit, provided they are willing to have their complacency unsettled: “If, from our perspective, Russian debates seem exaggerated, then our assumptions, as Solzhenitsyn insisted, appear naïve in the light of Russian experience.”

Russian experience, Morson argues, with little regard for chronology, is both cause and consequence of the late-nineteenth-century outburst:

Russian writers and thinkers responded to their country’s experience, which, in its very extremity, did not invite euphemisms. Evil was evil, as no one in the Gulag could doubt; if ever there was goodness, it was amidst immense suffering.

Stalin’s Gulag was the natural outcome of the radical positions taken in the course of those feverish conversations. What experiences brought about those positions in the first place, Morson does not say.

The villain of the story is the “intelligentsia,” defined early in the book as a community of rootless radicals in pursuit, or jealous possession, of a revolutionary dogma. Originally composed of “people of various ranks” (mostly priests’ sons) who flooded into the universities and professions in the second half of the nineteenth century, it was, according to Morson, a protean group characterized by three main traits. The first was a refusal to identify with anyone outside its own sacred fraternity; for this reason “the intelligentsia was often compared to a monastic order” (“or religious sect,” if we are to complete the oft-quoted statement by the philosopher Nikolai Berdyaev). The second was a commitment to socialism, which Morson defines as “a utopian or millenarian vision of a world that had banished evil once and for all.” The third was distinctive dress and demeanor. The first generation of the Russian intelligentsia favored blue-tinted glasses, walking sticks, abrupt speech, studied untidiness, short hair for women, and long hair and untrimmed beards for men. A famous poem by the fictitious versifier Kozma Prutkov, * first published in 1884, describes the intelligentsia at a provincial funeral procession:

Next come the Nihilists and the Slavophiles, Their fingernails uncut and unfiled. For, while disagreeing on the relativity of consciousness, They resemble each other in slovenliness.

The violation of prevailing grooming norms is a common but by no means necessary corollary of political radicalism. By the turn of the twentieth century full beards had been reduced to goatees, which, through the efforts of Lenin, Trotsky, Yakov Sverdlov, Feliks Dzierżyński, Lev Kamenev, Aleksei Rykov, and Nikolai Bukharin, presided over the Bolshevik Revolution and founded the Soviet state. During the Communist Party’s struggle against left and right oppositions in the late 1920s the goatees were routed by the mustaches, led by Stalin and including his associates Sergo Ordzhonikidze, Lazar Kaganovich, Vyacheslav Molotov, Anastas Mikoyan, and Andrei Andreev. Stalin’s death doomed the remaining whiskers, but the radically bald Khrushchev was condemned as “harebrained.” His ouster in 1964 resulted in the compromise of “collective leadership” and the long reign of Brezhnev’s eyebrows, known as “Stalin’s mustache raised to a proper height.” Beards moved into opposition, favoring Slavophiles over nihilists until, half a century later, hipster globalists balanced things out.

In Morson’s account the October Revolution represented the victory of the most radical and dogmatic wing of the intelligentsia. The rest died at the hands of the Bolsheviks, were forced into exile, or, in Solzhenitsyn’s words, quoted by Morson, “let themselves be hypnotized” by the party’s promise of socialism. But hadn’t they, in his telling, been hypnotized by it half a century earlier? At the gates of the Gulag, Morson revises his definition of the “intelligentsia” to include his heroes Solzhenitsyn and Nadezhda Mandelstam and accommodate their disapproval of the old intelligentsia’s betrayal of its “humanistic values.” “The lure of certainty, the irresistible appeal of escaping from doubt, the comfort of joining in collective affirmation” now become symptoms of a flight from the intelligentsia, not fealty to it.

Morson does not seem to realize that his “change of landmarks” (to use a popular intelligentsia formula he does much to elucidate) may put in question the neatness of his dichotomy. He is not the first to associate the intelligentsia with both certainty and wonder. The Bolsheviks, who prided themselves on having escaped from doubt, admitted their origins in the truth-seeking intelligentsia while denouncing its flabbiness and timidity. Chekhov, celebrated by Morson for his humanism and often seen as the epitome of the intelligentsia, mocked its impotence as well as its rigidity. Morson, in his classification of “types of thinker” within the intelligentsia, portrays Hamlets as well as Don Quixotes. The Soviets had no use for either and adopted the term as a value-neutral description of all white-collar professionals. In the 1970s Solzhenitsyn and Nadezhda Mandelstam praised a few of them for reverting to the values that the old intelligentsia might or might not have had. “Humanists,” concludes Morson, “survived in some Soviet equivalent of the catacombs.”

The reason they survived, he argues, was realist literature, represented above all by Tolstoy, Dostoevsky, Turgenev, Chekhov, and, after the intelligentsia in the narrow sense took over the empire, Solzhenitsyn and Vasily Grossman. Their writings make up Russia’s sacred scripture, a fictional world that reveals “truths about life beyond any purported social science”—the “tradition” that stands up to the “radical counter-tradition.” Russian literature, according to Morson, “is perhaps best compared not to French or English literature, but to the Hebrew Bible when the canon was open and books could still be added.” Canonical texts were—and still are—treated like gospel: memorized, venerated, commemorated, and used to interpret and guide human behavior. Canonical authors are prophets, visionaries, and lawgivers. “Poets,” wrote Shelley, are “the unacknowledged legislators of the world.” In Russia, writes Morson, “they are acknowledged.” In eighteenth-century Europe, it became fashionable for readers to imitate literary characters (most famously when several young readers killed themselves after reading Goethe’s The Sorrows of Young Werther ); in novel-stricken Russia, as Morson, following Yuri Lotman and Irina Paperno, vividly demonstrates, literary characters imitated flesh-and-blood human beings who imitated revised literary characters who imitated reformed human beings in an unrelenting, ever-accelerating, head-spinning loop.

The core of Morson’s book is a story of how the quest for certainty drove the intelligentsia to terrorism, Bolshevism, and the Gulag, and how Russian prose writers preserved doubt and wonder for Russia and beyond. In his telling, Russian literature owes its extraordinary power to the accidental concentration of genius, the provocation provided by the intelligentsia, the moral intensity of the questions it posed, and the genre most of the best writers preferred and perfected. “The realist novel,” he writes, “speculates in categories of ignorance, makes its home in uncertainty, and dwells in the land of opinion.” When done right it assumes multiplicity, doubts self-confidence, restores “the open presentness of past moments,” and expects the same of the future. It is best viewed through the prism of “prosaics”—an approach that, unlike “poetics,” emphasizes the contingent, celebrates the ordinary, and “attends to distinctively novelistic qualities and devices.” Guns aren’t always fired, shoes may or may not drop, and miracles, including those that reveal ultimate meanings, are hidden in plain sight:

Realist novels represent views not as impersonal propositions but as emotionally charged thoughts in the consciousness of particular people. They give us not the objective view from nowhere, but a perspective from somewhere specific.

They oppose Bolshevism just by being read, and the Soviets kept reading, Party misinterpretations notwithstanding. Wonder foretold, frustrated, and outlived Bolshevik certainty.

Morson’s discussions of Dostoevsky’s and Tolstoy’s novels are perceptive and convincing, but “if this study has a hero,” he writes on the second-to-last page of the book, “it is Chekhov,” and Chekhov did not write novels. To become the paragon of uncertainty, he had to struggle against the constraints of genre (his plays “dramatize the falsity of living dramatically”; his short stories rival Tolstoy’s novels in embracing the ordinary) and, implicitly, against Morson’s novel-centered argument. Other writers who might have challenged his binary are accomplished prose writers who happened to be Bolshevik true believers. Aleksei Tolstoy, the “Red Count” famous for his cynicism, could be dismissed as insincere, and the pointedly unprosaic Isaac Babel and Andrei Platonov as nonrealists, but what about Mikhail Sholokhov and Leonid Leonov, whose major novels ( And Quiet Flows the Don and Road to Ocean , among others) have no difficulty living up to Morson’s requirements of “prosaic intelligence”? Did their wonder defeat their certainty? Could there be such a thing as a Bolshevik—and, by extension, a Catholic, Muslim, or nationalist—novel? Morson seems to presume a negative answer but provides no explanations.

These are minor qualms. Tolstoy, Turgenev, and Dostoevsky would have defeated the devil’s army with or without Chekhov and Sholokhov. So why rig the fight? The main problem with Morson’s setup is that most of his novelists’ antipodes, from the Grand Inquisitor to the silliest nihilist, are their own creations. Dostoevsky defeats Raskolnikov, Turgenev defeats Bazarov, and Tolstoy, the mightiest of them all, defeats Napoleon along with his Russian and German counterparts. The result is a one-sided, not to say circular, affair, with no suspense and few surprises. Morson provides some quotations from Lenin and a few other Bolsheviks, but most of what we know about the book’s main villains comes from Dostoevsky’s premonitions and Solzhenitsyn’s indictments. The result is a static picture that is the opposite of the open-endedness and presentness-in-the-past that Morson advocates, in novels and morals. Soviet life appears to him to have been entirely lifeless and, as such, unique (with the possible exception of Nazi Germany, which shows up unannounced on several occasions). “Soviet Russian writers,” Morson writes, “understood all too clearly that their totalitarian regime had no precedent.”

His guide to the Inferno, and the Soviet Russian writer par excellence, is Solzhenitsyn, who “described the key moral error behind the Soviets, Nazis, and similar regimes as the division of humanity into the evil and the good.” He also explained, to Morson’s satisfaction, that the Soviet system was “unique in world history” because “it demands of us total surrender of our souls.” In his unquestioning identification with Solzhenitsyn, Morson forgets about Christianity, Islam, and any number of other faiths that have made similar demands more consistently and successfully. Or rather he seems to believe, along with Solzhenitsyn and most Christians and Muslims, that surrender to virtue is no surrender at all (“Islam” means “submission”); the coincidence of one’s desires with God’s will is freedom, not slavery.

In The Brothers Karamazov , Ivan, whose unfettered thought may have led to murder, argues that people should not be punished for their wishes: “Who has not the right to wish?” This position, writes Morson, taking the side of the saintly brother, Alyosha, “directly contradicts the Sermon on the Mount, which deems not just bad actions but also unworthy desires sinful.” But was the scrutiny of unworthy desires not the main task of Stalin’s thought police? Where is certainty here, and where is wonder? It was not the Bolsheviks who invented the surrender of souls, the sacrament of confession, or the office of the Grand Inquisitor.

According to Morson, “Russian literature might almost be described as the literature of conversion,” but only conversion to liberalism, sometimes disguised here as Christianity. (Texts centered on conversion to Bolshevism are not “Russian literature” as Morson defines it.) The real nemesis of intelligentsia radicalism is the “Western” reader, subsumed in the authorial “we” and assumed to be a common-sense liberal. “Westerners,” he writes, “find it hard even to comprehend that in Soviet ethics compassion, pity, and kindness were vices, since they might lead one to spare a class enemy.” More to the point:

Westerners often refute an opponent’s defense of his actions by asking: what if the shoe were on the other foot? If the other party had done the same thing and offered the same defense, would you accept it? However natural this question might seem to us, many Russian revolutionaries not only dismissed it, but even, at times, seemed not to grasp it.

“We” are few. If one expels from the ranks of Westerners all those who oppose moral equivalence (on the assumption that “we” are not answerable to the same moral standard), who fight against ever-regenerating “evil empires,” or root for Jesus as he tramples the grapes of wrath, one is left with a fairly small group ably represented, in Morson’s account, by a chastened Doctor Zhivago, who regrets having once succumbed to youthful enthusiasm and fears the “perpetual vitality” of utopian imagination. Add to the expulsion list those who “manage to hold the social and political beliefs most convenient for them to hold” and who train themselves “to sincerely accept contradictory beliefs” (a “particular state of mind, characteristic of the Soviet period”), and the West becomes vanishingly tiny.

More surprisingly, the Russian literature Morson admires for its “forthright posing of ultimate questions, which polite French and English novels did not ask or, at best, left merely implicit,” ends up standing for “prosaics” in the most quotidian sense (don’t wish the impossible or the possibly wicked). The Russian books we read—according to Virginia Woolf, as quoted by Morson, “feverishly, wildly,…now submerged, now in a moment of vision understanding more than we have ever understood before, and receiving such revelations as we are wont to get only from the press of life at its fullest”—turn out to be warnings against the very maximalism and urgency that make them irresistible. Zhivago, for one, does not act in accordance with his newfound wisdom. Toward the end of the novel, he meets another questing hero, and “they talk as only Russians can talk, particularly as they talked then, desperate and frenzied.”

They have been at it ever since. Most members of the dissenting intelligentsia would have loved Morson’s book had it been published in the late Soviet or early post-Soviet years. They would have been pleased to recognize themselves in the story of humanists who had survived in Soviet catacombs by wrestling with the “eternal questions” that had made Russia’s plight universally relevant. They thought of Dostoevsky’s The Possessed as a prophecy of the Bolshevik Revolution; admired Vladimir Nabokov’s The Gift (his last Russian novel) for its merciless portrait of the radical journalist Nikolai Chernyshevsky (whose utopian novel, What Is to Be Done? , was one of Lenin’s favorites); and liked to recite David Samoilov’s 1965 poem “Pestel, the Poet, and Anna,” about the conversation between Pushkin and the would-be regicide Pavel Pestel in 1821. Pestel talks about tyranny; Pushkin can’t stop listening to Anna, who has been singing since morning. Pestel leaves, to be hanged five years later; Pushkin sits down to write a few words in his diary and suddenly stops: “Anna, dear God!”

Out marched Russian Brutus. The Russian genius, With quiet sadness, watched him disappear.

Samoilov, born in 1920, had converted from orthodox Bolshevism to literary humanism (by way of the war and the Khrushchev Thaw). Most of his elite contemporaries, especially those who, like him, came from Jewish families, had traveled the same road and thought of themselves as the heirs of the old intelligentsia (whom they saw as humanists, not dogmatists). That peculiar fraternity, which everyone recognized but no one could define, had been Russia’s winning entry in the race of late-nineteenth-century radicalisms. Some national contingents had done better than others; some failed to show up.

The societies in which successful reformations had coincided with the defeat of old regimes (Britain, Holland, the United States, and, in a more muted, introverted form, Lutheran Scandinavia) channeled most forms of radical creativity into Protestant sectarianism, official nationalism, and franchise extension, leaving little room for integral socialism. The societies in which an unreformed church was subordinated to an infidel foreign state (Poland, Ireland, Serbia, Bulgaria, Greece) fused Christian martyrdom with Romantic self-sacrifice to produce patriotism without iconoclasm. The societies in which revitalized Catholicism proved a match for new anticlerical elites (France, Italy, Portugal, Spain) went through a series of unresolved revolutions until both Christianity and communism ran out of ammunition. The most favorable environments for revolutionary ferment were unified Germany, where the new activist state had great difficulty managing a society split by the Reformation and fenced in by inherited borders, and Russia, where an uncompromising autocracy buttressed by a subservient church and repressive empire kept breeding would-be professionals for whom it had neither use nor respect. The more hopeless the clamor for reform, the more intense the millenarian expectations and the more eternal the questions.

Russian literature reflected the proliferating conspiracies and conversations in a way that does justice to their maximalism and urgency but does not lend itself to the stark distinction Morson makes between the “tradition” of the great books and the “counter-tradition” of millenarian radicals. In one of Chekhov’s canonical stories, “The House with the Mezzanine,” the narrator, a landscape painter with whom the author seems to identify, disapproves of a Protestant-style social activist, a young woman with a small mouth and loud voice who keeps busy setting up schools, pharmacies, and libraries for peasants. Small improvements, he argues, do nothing but add new links to the “great chain” of oppression; what people need is freedom from physical labor, so they can devote themselves to the arts, the sciences, and the “search for truth and the meaning of life.” Is Morson’s favorite writer on the side of tradition or countertradition, “prosaics” or utopia?

Either way, it is true that, as a national religion, Russian literature has overtaken Christianity, vanquished communism, and filled most of the “sacred space that never remains empty” (to paraphrase a Russian saying). One reason is state censorship: literature has become so dominant by trying to make up for whatever has been outlawed elsewhere. Another is the intelligentsia (in either of Morson’s definitions): the chosen people sanctify the books they choose to read. The third is Orthodoxy: reading was not an important part of religious practice in Russia; most people learned to read when they first went to school in the late nineteenth century, and some of the first books they read came from the recently established national canon. There were no family Bibles to compete with Pushkin and Tolstoy.

The prerevolutionary intelligentsia’s main pursuits were reading and talking, their main predicament existential loneliness. They were opposed to the state and divorced from the “people.” The state was to be avoided or destroyed, depending on which wing of the intelligentsia one belonged to; the people were to be worshiped, emulated, enlightened, or awakened. Morson describes the “going to the people” movement of the 1860s and 1870s, when guilt-ridden radicals moved into peasant villages in an attempt to do some of those things, but he does not dwell on its outcome. In fact, Romantic nationalism throughout Europe involved the discovery of the noble savage close to home—first in a variety of highlands (Scots leading the way) and eventually on the Russian plain, where the orphaned intelligentsia embraced “the people” as a matter of salvation and almost dissolved in disappointment when peasant virtue proved illusory. Some fugitives from populism found comfort in Marxism, which replaced the peasant with the proletarian and promised an imminent socialist revolution.

The prophecy came true, or so it appeared. The members of the radically elitist Marxist sect that took over the empire stopped calling themselves part of the intelligentsia, destroyed most of those who did not convert, and created a new professional and managerial elite by instituting a massive affirmative action program for workers, peasants, and national minorities (the most successful of which, Jews from the former Pale of Settlement, moved up without the benefit of preferential admissions and promotions). In the 1930s and 1940s the new students and scholars felt at one with the state and the people (and of course with comrade Stalin, who represented both) and thus were not “intelligentsia” by any recognizable definition, but they associated the term with high culture (centered on the mastery of the literary canon) and were happy to apply it to themselves.

By the 1970s this quasi intelligentsia became the real thing by turning against the state and discovering a widening gap between themselves and the “people.” Some Russians rushed back to the countryside, some Jews turned to Zionism, but most members of the metropolitan intelligentsia, Russian or Jewish, embraced what they understood to be “the West” in general and Western liberalism in particular. Nobody liked workers. For the first time in the history of the Russian intelligentsia the overwhelming majority of its members gave up on the “humiliated and insulted” (to use the title of one of Dostoevsky’s novels) in order to worship the proud and prosperous.

Meanwhile, in the West, post-Christian intellectual elites, cloistered and tenured on university campuses, had revised their view of the “wretched of the earth” (to use the phrase from the Internationale, aka the first Soviet anthem, borrowed by Frantz Fanon in the title of his classic book) and shifted from an agenda of charity and conversion to one of admiration and solidarity. The West had acquired its own semi-intelligentsia, which did not mind the state but did love the people, provided they were ethnically diverse enough. It was the opposite of nationalism, the first gasp of globalism. The late-Soviet intelligentsia members who knew about “the left” despised it, focused their love on the brazenly successful, attempted to build capitalism after the Soviet state’s collapse, and formed an even lower opinion of “the people” at the sight of their immiseration and apparent irreformability.

Putin’s return to bureaucratic authoritarianism and great power politics seemed to recreate the prerevolutionary mise-en-scène: by the 2020s Russia’s westernizing elite had again become a proper intelligentsia by virtue of being equally alienated from the state and the people. But their dreams were no longer transcendental. In fact, they no longer had any dreams: what they wanted was a market economy, liberal institutions, and—most fatefully and hopelessly—an alliance with the West at a time when the West was expanding its alliance against Russia. They had become what many of their nineteenth-century predecessors most despised—bourgeois. They started filing their fingernails, quit smoking, switched from vodka to wine, and embraced consumer connoisseurship. The one other thing they kept, besides the sense of caste isolation and the associated inner cohesion, was the passionate dedication to literature and the assiduously curated national canon.

The invasion of Ukraine put an end to this arrangement. As far as most members of the intelligentsia were concerned, the state had been shown to be irredeemable and any association with it toxic; the “people” were complicit and therefore contemptible. For the second time in a little more than a hundred years, a large proportion of Russia’s intellectual and cultural elite left the country. (World War II losses and the Jewish emigration of the 1970–1990s made their own significant contributions.) But if the postrevolutionary émigrés mourned the destruction of paradise, cultivated nostalgia, thought of themselves as exiles, and had little love for their new homes, the current ones tend to think of Russia as congenitally defective and of emigration as a long-postponed homecoming. Spiritual destinations range from Zionism to Ukrainian patriotism to pan-Westernism.

The question is: What to do with the Russian literary canon, the only value that connects most of the émigrés to one another, to their country of origin, and to their intelligentsia predecessors? The majority are unsure; some persist in the view that a love of Chekhov is compatible with a rejection of Russia; and a few have accepted collective responsibility for empire-building and pledged to “decolonize” themselves, one another, and the entire literary tradition. Morson enters the debate by ignoring it. His book, unabashed in its devotion to the canon, provides a much-needed landmark by advocating a wisdom that used to be conventional.

Agreeing to Our Harm

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‘Kalki 2898 AD’ Review: Lavish Tollywood Sci-Fi Epic Is an Unabashedly Derivative Spectacle

Telugu cinema superstar Prabhas swashbuckles as a Han Solo clone.

By Joe Leydon

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With “ Kalki 2898 AD ,” Telugu cinema filmmaker Nag Ashwin rifles through a century of sci-fi and fantasy extravaganzas to create a wildly uneven mashup of everything from Fritz Lang’s “Metropolis” to Marvel Comics movies, underpinned by elements from the Hindu epic poem “Mahabharata.” It’s billed, perhaps optimistically, as the first chapter of the Kalki Cinematic Universe franchise — which makes it part of a larger trend, since it launches the same weekend that Kevin Costner’s multi-film “Horizon” saga does in the U.S.

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Bhairava (Telugu superstar Prabhas ), a roguish bounty hunter who rolls in a tricked-out faux Batmobile equipped with a robotic co-pilot, yearns to earn enough “credits” to buy his way into the Complex, where he can crash the best parties, ride horses through open fields and avoid all the debt collectors hounding him in Kasi. He seizes on the opportunity to make his dreams come true when a colossal reward is posted for the capture of SUM-80 (Deepika Padukone), an escapee from the Complex’s Project K lab, where pregnant women are routinely incinerated after being drained of fluids that can ensure Yaskin’s longevity.

While on the run through a desert wasteland, en route to the rebel enclave known as Shambala, SUM-80 is renamed Sumati by newfound allies and, more important, protected by the now-ancient Ashwatthama (Amitabh Bachchan), who has evolved into an 8-foot-tall sage with superhuman strength, kinda-sorta like Obi-Wan Kenobi on steroids, and a sharp eye for any woman who might qualify as the Mother, the long-prophesized parent of — yes, you guessed it — Kalki.

Bhairava and his droid sidekick Bujji (voiced by Shambala Keerthy Suresh) follow in hot pursuit, and are in turn pursued by an army of storm troopers led by Commander Manas (Saswata Chatterjee), a cherubic-faced Yaskin factotum who always seems to be trying a shade too hard to exude intimidating, butch-level authority. Ashwatthama swats away the storm troopers and their flying vehicles like so many bothersome flies, and exerts only slightly more effort by warding off Bhairava and his high-tech weaponry. (Shoes that enable you to fly do qualify as weaponry, right?)

For his own part, Bhairava has a few magical powers of his own, though it’s never entirely clear what he can or cannot do with them. After a while, it’s tempting to simply assume that, in any given scene, the bounty hunter can do whatever the script requires him to do.

But never mind: He and Ashwatthama do their respective things excitingly well during the marathon of mortal combat that ensues when just about everybody (including Manas and his heavily armed goons) get ready to rumble in Shambala for the climactic clash.

All of which may make “Kalki 2898 AD” sound a great deal more coherent than it actually is. Truth to tell, this is a movie that can easily lead you at some point to just throw up your hands and go with the flow. Or enjoy the rollercoaster ride. And if this really is, as reported, the most expensive motion picture ever produced in India, at least it looks like every penny and more is right there up on the screen.

Reviewed at AMC Fountains 18, Houston, June 26, 2024. Running time: 181 MIN.

• Production: An AA Films release of a Vyjayanthi Movies production. Producer: C. Aswini Dutt.
• Crew: Director, writer: Nag Ashwin. Dialogue: Sai Madhav Burra. Camera: Djordje Stojiljkovic. Editor: Kotagiri Venkateswara Rao. Music: Santhosh Narayanan.
• With: Prabhas, Amitabh Bachchan, Deepika Padukone, Kamal Haasan, Disha Patani. (Telugu, English dialogue)

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The role of bim in integrating digital twin in building construction: a literature review.

1. Introduction

2. background, 2.1. concept of bim, 2.2. concept of digital twin, 2.3. advancement of bim to digital twin, 3. methodology, 4. literature review, 4.1. discussion on available research on digital twin with bim.

• Integration of BIM and DT: Douglas et al. [ 35 ] focused on using real time data from sensors and other sources to enhance the DT, as well as using data analytics and machine learning algorithms to analyze these data and make predictions about building performance;
• Real time data analysis: Opoku et al. [ 27 ] and Deng et al. [ 11 ] focused on using real time data from sensors and other sources to enhance the DT, as well as using data analytics and machine learning algorithms to analyze these data and make predictions about building performance;
• Simulation and visualization: there has been research on using simulation and visualization technologies to enhance the DT and improve decision-making in the construction and engineering industries [ 21 , 27 ];
• Cost and resource optimization: DT and BIM potentially reduce costs, improve resource allocation, and increase overall efficiency in the building construction process [ 33 , 40 ];
• BIM/DT in the context of sustainability: the integration of BIM and DT support sustainable design and construction practices by incorporating data on energy efficiency [ 21 ], material usage [ 26 ], and environmental impact [ 18 ]; it integrates real-time data from sensors and IoT devices [ 21 ], enabling continuous monitoring [ 5 ], analysis, and proactive maintenance [ 34 ] for sustainable practices.

4.2. Evolution of Digital Twin from BIM

4.3. current study to compare digital twin with bim.

• Concept Origin: technology’s origin is its history, goals, and principles. Understanding the concept helps researchers evaluate their strengths, weaknesses, and applications. The concept’s origin can also indicate which technological parts are more developed or need more research.
• Purpose: to define each technology’s scope and goals. This criterion helps determine their complementary roles and the best integration strategies to improve building design, construction, and operation.
• Application focus: It highlights each technology’s primary focus. It also shows each technology’s pros and cons to guide future improvements. It is crucial to choose the right technology for a project or application.
• Features: They are an essential aspect of the scientific comparison between BIM and DT, as they help understand each technology’s capabilities and limitations and their potential for integration and interoperability.
• Level of Details: We can assess the pros and cons of integrating these technologies into building projects.
• Scalability: allows for evaluating their ability to handle different types of projects and their potential limitations regarding resource requirements and integration with other technologies.
• Main Users: Identify each technology’s primary users and how it meets their needs. This information can help stakeholders choose technology based on project needs and team expertise.
• Interoperability: enables these technologies to be integrated with other systems and software, leading to greater efficiencies and improved outcomes in the building lifecycle management process.
• Application interface: evaluates the usability and effectiveness of the software for different users and applications.
• Building life cycle stage: compares BIM and DT in building construction, as it can help determine which technology is more suitable for a given project.

4.3.1. Concept Origin

4.3.2. purposes, 4.3.3. application focus, 4.3.4. features, 4.3.5. level of details (lod), 4.3.6. scalability, 4.3.7. main users, 4.3.8. interoperability, 4.3.9. application interface, 4.3.10. characteristics, 4.4. advancement of bim to improve digital twin in building construction.

• Increased interoperability: BIM technology has become more interoperable, allowing seamless data exchange between platforms and systems [ 7 ]. It makes creating and updating DT easier with real time data from sensors and other sources.
• Improved data accuracy: BIM technology can offer precise and comprehensive insights into a building’s blueprint, building process, and maintenance, all of which can contribute to developing a more precise DT [ 12 ].
• Increased collaboration: BIM enables collaboration among architects, engineers, and construction professionals, leading to better decision-making and improved overall outcomes [ 25 ]. When this collaboration is applied to creating a DT, it can result in a more comprehensive and effective virtual representation of the building.
• Better visualization: BIM technology has advanced to include more realistic and interactive visualizations [ 40 ], making it easier to understand and analyze the building’s performance through the DT [ 11 ].
• More advanced simulation: BIM has also advanced to include more advanced simulation capabilities, allowing for the simulation of complex systems and analyzing building performance in real time [ 40 ].

5. Result and Discussion

5.1. result and discussion, 5.2. limitation, 5.3. future study, 6. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Nguyen, T.D.; Adhikari, S. The Role of BIM in Integrating Digital Twin in Building Construction: A Literature Review. Sustainability 2023 , 15 , 10462. https://doi.org/10.3390/su151310462

Nguyen TD, Adhikari S. The Role of BIM in Integrating Digital Twin in Building Construction: A Literature Review. Sustainability . 2023; 15(13):10462. https://doi.org/10.3390/su151310462

Nguyen, Tran Duong, and Sanjeev Adhikari. 2023. "The Role of BIM in Integrating Digital Twin in Building Construction: A Literature Review" Sustainability 15, no. 13: 10462. https://doi.org/10.3390/su151310462

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• Published: 24 June 2024

Analysis of funding landscape for health policy and systems research in the Eastern Mediterranean Region: A scoping review of the literature over the past decade

• Racha Fadlallah 1 , 2 , 3 ,
• Fadi El-Jardali   ORCID: orcid.org/0000-0002-4084-6524 1 , 3 , 4 ,
• Nesrin Chidiac 3 ,
• Najla Daher 3 &
• Aya Harb 3  

Health Research Policy and Systems volume  22 , Article number:  70 ( 2024 ) Cite this article

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Health policy and systems research (HPSR) can strengthen health systems and improve population health outcomes. In the Eastern Mediterranean Region (EMR), there is limited recognition of the importance of HPSR and funding remains the main challenge. This study seeks to: (1) assess the reporting of funding in HPSR papers published between 2010 and 2022 in the EMR, (2) examine the source of funding in the published HPSR papers in the EMR and (3) explore variables influencing funding sources, including any difference in funding sources for coronavirus disease 2019 (COVID-19)-related articles.

We conducted a rapid scoping review of HPSR papers published between 2010 and 2022 (inclusively) in the EMR, addressing the following areas: reporting of funding in HPSR papers, source of funding in the published HPSR papers, authors’ affiliations and country of focus. We followed the Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews.

We also conducted univariate and bivariate analyses for all variables at 0.05 significance level.

Of 10,797 articles screened, 3408 were included (of which 9.3% were COVID-19-related). More than half of the included articles originated from three EMR countries: Iran ( n  = 1018, 29.9%), the Kingdom of Saudi Arabia ( n  = 595, 17.5%) and Pakistan ( n  = 360, 10.6%). Approximately 30% of the included articles did not report any details on study funding. Among articles that reported funding ( n  = 1346, 39.5%), analysis of funding sources across all country income groups revealed that the most prominent source was national (55.4%), followed by international (41.7%) and lastly regional sources (3%). Among the national funding sources, universities accounted for 76.8%, while governments accounted for 14.9%. Further analysis of funding sources by country income group showed that, in low-income and lower-middle-income countries, all or the majority of funding came from international sources, while in high-income and upper-middle-income countries, national funding sources, mainly universities, were the primary sources of funding. The majority of funded articles’ first authors were affiliated with academia/university, while a minority were affiliated with government, healthcare organizations or intergovernmental organizations. We identified the following characteristics to be significantly associated with the funding source: country income level, the focus of HPSR articles (within the EMR only, or extending beyond the EMR as part of international research consortia), and the first author’s affiliation. Similar funding patterns were observed for COVID-19-related HPSR articles, with national funding sources (78.95%), mainly universities, comprising the main source of funding. In contrast, international funding sources decreased to 15.8%.

This is the first study to address the reporting of funding and funding sources in published HPSR articles in the EMR. Approximately 30% of HPSR articles did not report on the funding source. Study findings revealed heavy reliance on universities and international funding sources with minimal role of national governments and regional entities in funding HPSR articles in the EMR. We provide implications for policy and practice to enhance the profile of HPSR in the region.

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Introduction

The coronavirus disease 2019 (COVID-19) pandemic has demonstrated how vulnerabilities in health systems can have profound implications for health, economic progress, trust in governments and social cohesion [ 1 , 2 , 3 ]. Strengthening the capacity of health systems to respond swiftly and effectively has become a priority for governments worldwide as they emerge from the pandemic [ 4 ]. Health policy and systems research (HPSR) can provide context-relevant knowledge to strengthen health systems and improve population health outcomes [ 5 , 6 , 7 ]. In spite of international calls to increase investments in HPSR, studies suggest that less than 2% of global health funding is being spent on health systems strengthening and HPSR. This lack of adequate funding is especially an issue in low- and middle-income countries (LMIC), where funding remains largely dependent on external sources [ 8 ]. This is further challenged by the near invisibility of domestic funding flow for HPSR on a national level [ 9 ].

In the Eastern Mediterranean Region (EMR), while much of the policy priorities are related to health systems, there is poor recognition of the importance of HPSR [ 10 , 11 , 12 ], and funding limitations remain the main challenge facing HPSR in the region [ 11 , 13 ]. Given that the advancement of HPSR is greatly dependent on the availability of adequate and reliable funding [ 14 , 15 ], it would be important to gain a better understanding of HPSR funding in the EMR. Previous studies have assessed funding for HPSR at the level of national government and from international donor perspectives [ 11 , 14 ]. Rabbat et al. assessed funding for HSPR in the EMR on a national level and found that none of the EMR countries have explicit national funding or a budget line for HPSR [ 11 ]. Grepin et al. analysed donor funding for HPSR in LMICs, including EMR, and found that such funding is heavily concentrated, with more than 93% coming from just 10 donors, and only represents approximately 2% of all donor funding for health and population projects. Moreover, countries in the sub-Saharan African region were the major recipients of HPSR funding, while countries in the EMR were the least recipients of such funding [ 14 ].

The current study adds to existing literature by analysing the sources of funding for published HPSR studies in countries of the EMR. Analysis of HPSR publications in countries from the region can be used to monitor progress and trends in the production of policy-relevant research and is a core requirement for strengthening health research systems to generate and use knowledge to improve health systems [ 8 , 16 ]. The specific objectives are to: (1) assess the reporting of funding in HPSR papers published between 2010 and 2022 in the EMR, (2) examine the source of funding in the published HPSR papers in the EMR and (3) explore variables influencing funding sources, including any difference in funding sources for COVID-19-related articles. Findings will enable a better understanding of the HPSR funding landscape in the EMR.

We conducted a rapid scoping review of HPSR papers published between 2010 and 2022 in the EMR, addressing the following broad areas: reporting of funding in HPSR papers, source of funding in the published HPSR papers, authors’ affiliations and country of focus. Scoping reviews are an ideal tool to convey the breadth and depth of a body of literature on a given topic and give clear indication of the volume of literature and studies available as well as an overview of its focus [ 17 ]. We followed standard methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for reporting scoping reviews (Supplementary file 1) [ 18 ].

Eligibility criteria

Study design: All study designs were included except for letters, correspondence, commentaries, dissertations, technical papers, handbooks, protocols and editorials. We restricted the search date to studies published in the last decade (that is, 2010–2022, inclusive).

Setting: Eastern Mediterranean Region. We included all countries established within the WHO’s Eastern Mediterranean Regional Office, namely Afghanistan, Bahrain, Djibouti, Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, the Occupied Palestinian Territories, Qatar, Saudi Arabia, Somalia, South Sudan, Sudan, Syrian Arab Republic, Tunisia, the United Arab Emirates and Yemen.

Population: We did not limit the search to any specific type of population.

Dimensions of interest: We considered studies to be eligible if they met the criteria of health systems topics developed by the McMaster Health Forum, including governance, financial and delivery arrangements, and implementation strategies. The selected coding framework has been previously implemented for coding health policy and systems topics in countries from the region [ 19 , 20 ].

We did not restrict the search to any language.

Literature search

We searched the following electronic databases in December 2022: PubMed, Web of Science, The Index Medicus for the Eastern Mediterranean Region (IMEMR) and Google Scholar. We used both index terms and free text words for the following two concepts (and their variations): (1) EMR countries and (2) HPSR. The search strategy was validated with the guidance of an information specialist. For the Web of Science, we limited the search to 72 journals listed under the “Health Policy and Services” (HPS) category in Web of Science between 2010 and 2022. A similar approach was previously adopted in a study examining the reporting of funding in HPSR [ 19 ]. We also screened the reference lists of all included articles.

Study selection and data extraction

Prior to proceeding with the selection process, we conducted a calibration exercise to enhance validity of the selection process. Two reviewers used the above eligibility criteria to screen the identified citations for potential eligibility. Half of the included studies were screened in duplicate and independently by teams of two reviewers, while the remaining were screened independently by each reviewer. We obtained the full text for citations judged as potentially eligible by at least one of the reviewers. To enhance validity of the process, all excluded studies were validated by a senior reviewer (who is the senior author). Any disagreement was resolved by discussion, and when needed, with the help of a third reviewer.

We developed a data extraction form. Prior to proceeding with the selection process, we conducted a calibration exercise to enhance validity of the selection process. Each of four reviewers independently abstracted data from a subset of articles assigned to them (collectively covering the full dataset), using a standardized and pilot-tested form. Throughout the process, all team members were consulted to validate coding decisions. Any disagreement was resolved by discussion, and when needed, with the help of a third reviewer. We revisited and considered data in the context of any newly emergent decision. Additionally, the coding sections related to reported source of funding and first authors’ affiliations were independently validated by a second reviewer.

The following information was abstracted from all included studies:

Study ID (author last name, title of study).

Date of publication.

Type of article.

Country subject of the paper: This refers to the geographical scope of the article, specifically the country where the research was conducted. Articles encompassing more than one country were categorized into two distinct groups: those focusing solely on the EMR (referred to as “more than one within the region”), and those extending beyond the EMR (referred to as “more than one beyond the region”) – maintaining a distinction from individual country analyses.

Country income group classification (first country) as per World Bank classification data for 2021–2022.

Reported affiliation(s) by the first author.

Reported affiliation(s) by the corresponding author.

Country of the institution to which the first author is affiliated.

Country of the institution to which the corresponding author is affiliated.

Reporting of study funding (not reported, reported as funded or reported as not funded).

Reported source(s) of funding.

Whether the study was COVID-19-related.

Statistical analysis

We conducted univariate and bivariate analyses for all variables collected for the included papers using IBM Statistical Package for Social Sciences (SPSS) Statistics v.25. We used the chi-square test at 0.05 significance level to compare categorical data and investigate the associations between reporting of funding by papers, type of funding and income groups. We also used the chi-square test to examine whether significant associations exist between funding sources and the following variables: country income level, country focus of the HPSR articles (that is, within the EMR only, or beyond the EMR as part of international research consortia), the first author’s country of affiliation and COVID-19-related studies.

Characteristics of included articles

Figure  1 shows the PRISMA flowchart for study selection. Of 10,797 articles screened, 3408 were included.

PRISMA flowchart

Figure  2 illustrates the distribution of HPSR articles by country focus. The top country focus was Iran ( n  = 1018, 29.9%), followed by Saudi Arabia ( n  = 595, 17.5%), Pakistan ( n  = 360, 10.6%), Jordan ( n  = 208, 6.1%) and Lebanon ( n  = 150, 4.4%). Notably, more than half of the included articles originated from only three EMR countries: Iran, the Kingdom of Saudi Arabia (KSA) and Pakistan. Countries where the fewest number of articles were conducted were Libya ( n  = 10, 0.3%), Bahrain ( n  = 12, 0.4%), Somalia ( n  = 13, 0.4%), Syria ( n  = 18, 0.5%), and Yemen ( n  = 18, 0.5%). No articles were found focusing on Djibouti only. Approximately 10% of the included articles were conducted in more than one EMR country. Of these, 5% focused on multiple countries within the EMR, while an additional 5% included at least one country beyond the EMR region (along with at least one within the EMR).

Distribution of HPSR articles by country of focus ( N  = 3408)

COVID-19-related articles accounted for 9.3% of the total HPSR studies published. Of these, the Kingdom of Saudi Arabia produced the highest number of publications ( n  = 93, 29.3%), followed by Iran ( n  = 68, 21.5%).

Figure  3 illustrates the increase in the production of HPSR articles in the EMR from 2010 to 2022. The number of HPSR articles in 2010 was approximately 37, increasing to 598 by 2022. Furthermore, HPSR articles nearly doubled after 2020.

Annual production of HPSR articles from 2010 to 2022

Reporting of funding and funding sources for HPSR articles across country income groups

Table  1  presents the reporting of funding and sources of funding in the 3408 HPSR articles retrieved. Approximately 40% ( n  = 1346) of the articles reported being funded, while 29% (or 1001) did not report any details on study funding. It is worth noting that, while the number of funded articles is 1346, when taking into account all funding sources within an article, the total number of funding sources increases to 1635.

Among the 1346 funded articles (with 1635 funding sources) in the EMR, analysis of funding sources across all country income groups revealed that the most common source was national ( n  = 905, 55.4%) followed by international (682, 41.7%) and lastly regional sources (41, 3%). Among the national funding sources, universities accounted for 76.8%, while governments accounted for 14.9% of the sources. Further analysis of funding sources by country income group showed that, in low-income and lower-middle-income countries (as classified by the World Bank at the time of data collection), all or the majority of funding came from international sources, while in high-income and upper-middle-income countries, national funding sources, mainly universities, were the primary sources. The majority of funded articles’ first authors were affiliated with academia/university distributed into public university ( n  = 959, 71.2%) and private ( n  = 204, 15.2%) while a minority were affiliated with government, private for-profit or intergovernmental organizations.

Of the COVID-19-related HPSR articles, 95 (or 30%) were funded, while 69 (or 21.8%) did not report any detail on the study funding. The most notable funding source was national (75, 78.95%), mainly universities (61.05%), with governments contributing to 10.53% of funding. International funding sources accounted for 15 (or 15.79%) of publications. Regarding the first authors’ affiliations of funded COVID-19-related articles, almost all authors are from the EMR and affiliated to public academic universities (80%).

Source of funding and first-author affiliation for HPSR articles, by EMR country (2010–2020)

A breakdown of the source of funding by country is provided in Table  3 .

All of the articles conducted in Somalia, Syria and Yemen and the majority of articles conducted in Afghanistan (76.27%), Egypt (62.39%), Iraq (66.5%), Lebanon (70.5%), Morocco (82.54%), Pakistan (80%), Palestine (95.8%), Sudan (80.6%) and Tunisia (89%) were funded by international sources. Articles conducted in the remaining EMR countries were largely funded by national sources; among those conducted in Iran (92.96%), Jordan (55.5%), the KSA (89%), Qatar (99.8%) and the United Arab Emirates (UAE; 68.2%), the majority were funded by universities, whereas in Libya (100%) and Kuwait (75%), the government was the main source of funder. Regarding Oman (46%), funding was equally distributed between national and international sources.

Concerning the first author’s affiliations, the majority of articles conducted in Egypt (71.1%), Iran (95.3%), Jordan (73.8%), the KSA (79.3%), Kuwait (70%), Morocco (63.2%), Oman (55.6%), Palestine (83.3%), Qatar (56.3%), Tunisia (66.7%), Somalia (100%), Syria (57.1%), the UAE (58.3%), Iraq (40%), and Yemen (100%) were affiliated with public academic institutions. In Lebanon (65.3%), Sudan (32%), and Pakistan (41.1%), the majority of the papers’ first authors were affiliated with private academia/university. In Afghanistan (27.8%), the papers’ first authors were equally affiliated with private university/academia and not-for-profit organizations. In Libya (100%), the first author of the only funded study was affiliated with intergovernmental organizations.

Across all income groups, the majority of the papers’ first authors were affiliated with academia/university. A minority of papers’ first authors was affiliated with private for-profit and intergovernmental organizations (Table 2 ).

Associations between variables of interest and sources of funding for HPSR articles

There was significant association between country income level and source of funding ( P  < 0.001; Table  3 ). Countries in the high-income and upper-middle income groups were significantly more likely to be funded by national sources (78.7% versus 77.1%, respectively), more specifically universities, while countries in the low-income groups were significantly more likely to be funded by international sources (87.2%).

Studies that included at least one country beyond the EMR (for example, as part of international research consortia) were significantly more likely to be funded by international sources (80.2%), while studies focusing on one or more country within the EMR only were significantly more likely to be funded by national sources (65.3%), mainly universities (52%; Table  4 ).

Regarding the first author’s country of affiliation, articles with first authors from the EMR were more likely to be funded by national sources (73.9%), mainly universities (61.7%) while articles were the first authors were from non-EMR countries were more likely to be funded by international sources (79.8%) These differences are statistically significant, with a P -value < 0.001 (Table  5 ).

Similar funding patterns were observed for COVID-19-related HPSR articles (compared to non-COVID-19-related HPSR articles), with national sources, mainly universities, comprising the main source of funding (78.95% versus 59%). In contrast, international funding sources decreased for COVID-19-related HPSR articles (15.8% versus 37.7%). This difference was statistically significant at P  < 0.001 (Table 6 ).

Summary and interpretation of findings

This is the first study to address the reporting of funding and funding sources in published HPSR articles in the EMR. More than half of the included articles originated from only three out of the 22 EMR countries, namely Iran, the KSA and Pakistan. When it comes to funding, approximately 30% of HPSR papers in the EMR did not report any details on study funding. Among the articles that reported being funded, analysis of funding sources across all country income groups revealed that the most common source was national, followed by international and lastly regional sources. Among the national sources, universities accounted for the majority of funding. Further analysis of funding sources by country income group showed that in low-income and lower-middle-income countries (as classified by the World Bank at the time of data collection), all or the majority of funding came from international sources, while in high-income and upper-middle-income countries, national funding sources, mainly universities, were the primary sources of funding. However, exceptions to this trend included Kuwait, Oman and Libya, where government funding took precedence.

The majority of funded papers’ first authors were affiliated with academia/university while a minority were affiliated with government, healthcare organizations or intergovernmental organizations.

When articles conducted in Iran, which accounted for the highest number of included papers (30%), were excluded from the entire analysis (and not only those related to upper-middle-income countries), a different overall funding pattern emerged. In this scenario, international funding sources took precedence (457, 54.7%), followed by national (336, 40.2%) and regional (40, 4.8%) sources. This is not unexpected, given that, in Iran, the main source of funding is national funding (94%), specifically universities (82.80%). Furthermore, international sanctions have reduced the willingness of international scholars to cooperate with Iranians scholars and students, while also making it difficult for Iranian researchers to receive health-related grants from foreign regional or international organizations [ 21 ].

We found the following characteristics to be significantly associated with the funding source: income level, focus of HPSR article (that is, EMR or as part of international research consortia) and first-author affiliation. The latter may be partially explained by the limited expertise in the EMR to generate solid proposals to compete for these grants, restricting HPSR’s access to worldwide competitive funding options [ 11 ].

While the COVID-19 pandemic had drastic consequences on health systems, highlighting the importance of HPSR for evidence-informed decision-making, our findings suggest that funding from government did not increase for COVID-19-related HPSR, while universities/academia took the lead in funding COVID-19-related HPSR articles in the EMR. In contrast, international funding for HPSR in the EMR decreased during the pandemic. According to Becerra-Posada et al., given a higher need for funds for medical care and vaccines for COVID-19, research funding may be a lesser priority in countries suffering budgetary restrictions [ 22 ]. Thus, the international funding may have been diverted from HPSR to health systems reforms, testing centres, and more health-related and clinical research.

Some potential limitations of the study are worth noting. Firstly, despite our attempts to enhance the comprehensiveness of our search by utilizing several databases, including IMEMR, which is specific to the EMR, it should be acknowledged that some researchers in the region may publish their research papers on websites or journals not indexed in the databases we searched or these publications might not be available online. We attempted to partially overcome this by searching Google Scholar and screening the reference lists of included as well as relevant articles. Furthermore, our search date for articles extended up to 2022; hence, it does not encompass studies that could have been published after this date. Nevertheless, it is unlikely that such studies would change the findings in a significant way. At the same time, we believe the 12-year review we conducted provides a good analysis of the funding landscape for HPSR in the EMR. Secondly, for articles encompassing multiple countries, we categorized them into two groups: “More than one beyond the region” and “More than one within the region”, maintaining a distinction from individual country analyses. While this categorization may overlook specific contributions from individual countries within these broader categories, the lack of specificity regarding the countries involved made it challenging to merge them accurately with respective national totals. Indeed, several articles referenced broader regions such as “EMR” or “Middle East” without specifying the countries included, potentially leading to inaccuracies if merged without clear delineation. Also, it is worth noting that articles focusing on more than one country contributed to only 10% of the total included articles, suggesting limited implications for our findings. Finally, the income classification for two countries – Iran and Jordan – changed since the completion of the data collection period for this study. However, this is not expected to significantly alter the results, as both countries are still considered middle-income countries, with variations between upper-middle and lower-middle income levels.

Comparison to other studies and trends

Iran’s leading position in HPSR production has been re-iterated in previous publications [ 11 ]. When it comes to reporting of funding for HPSR papers, our findings align with a cross-sectional survey of 400 HPSR studies (200 systematic reviews and 200 primary studies), which revealed that a third of sampled HPSR papers did not provide any information about funding [ 19 ]. This is in contrast to clinical papers whereby 89% of clinical trial reports published in 2015 included funding statements [ 23 ]. This is a reflection of both a suboptimal compliance by authors with the funding policies and a deficient enforcement by the journals [ 19 ].

As for the sources of funding for published HPSR papers, our findings align with reported funding sources for HPSR in LMICs, indicating notably low government spending on HPSR, whereby governments tend to give more consideration to basic science and clinical research over HPSR [ 24 ]. In these settings, funding for HPSR primarily originates from international and multilateral aid as well as contracts with larger research consortia, with limited contributions from national governments [ 25 , 26 , 27 ]. This funding pattern was particularly evident in low-income and lower-middle income countries of the EMR. Additionally, international funding sources predominated when Iran was excluded from the analysis.

Existing research indicates that the strong dependence of countries on international funding generally comes at the expense of addressing community needs and health system priorities where research topics dictated by funders and donors are prioritized [ 14 , 28 , 29 ]. This concern is further reinforced by another study on HPSR funding in LMIC, which revealed that these countries depend on a narrow array of donors, which puts them at risk of losing funding if the donors’ priorities shift away from HPSR [ 14 ]. In addition to that, the reliance on international funding impedes the national authorities from developing local, sustainable capacity to perform HPSR [ 25 ].

A number of factors have been identified as influencing investment in or funding for health research in general and HPSR in particular in the EMR. Health research in this region is fragmented and insufficient because of the absence of national policies and strategic plans that promote investment in health systems research [ 11 , 28 ]. Moreover, in the conflict-affected countries of the region, health systems research is not a top priority of the national and international investments and initiatives [ 28 ]. Bureaucratic bottlenecks such as corruption and lack of accountability and unstable government regimes further hamper the establishment and improvement of domestic HPSR funding [ 29 ]. Additionally, the weak institutional and infrastructural capacity and the absence of a critical mass, that is, an abundant number of qualified researchers with a uniquely varied skill mix in research institutions hinders HPSR national as well as international funding [ 8 , 11 , 25 , 27 ].

Implications for policy and practice

Study findings indicate limited interest and commitment of governments to HPSR funding in the EMR. We provide key implications for policy and practice moving forward. First and foremost, governments are urged to outline a national vision with clearly defined goals, objectives, policies and strategies for HPSR [ 30 , 31 ]. The WHO Global Ministerial Forum suggests institutionalizing HPSR and forming a separate institute or department for HPSR, whether as part of ministry of health or not [ 29 , 32 ]. This would allow for better governance of research, improved management for resources and consequently enhanced credibility and integrity [ 29 , 32 ]. Also, these institutions and departments can hold national health programs and work on integrating them with those of the external donors [ 25 , 29 ].

Second, increasing domestic funding for HPSR is needed to reduce reliance on external donors while improving HPSR’s focus on national priorities. To this end, governments in the EMR should establish explicit national funding or a budget line item for HPSR with sustainable and transparent processes in place for mobilizing and allocating funds for HPSR [ 11 ]. Additional strategies for increasing domestic funding of HPSR include the formation of advocacy coalitions and continuous advocacy to both public- and private-sector stakeholders. Moreover, the engagement of local stakeholders in research priority-setting exercises, in organizational-level capacity-building to improve the use of research evidence, in assessing the gains of previous funding, and in assigning a portion of international funds to local research teams all enhance demand and funding for HPSR at the national level [ 31 , 33 ]. Given that funding from international sources will continue to play a role in the region, strong governance to ensure coordinated efforts and alignment to country priorities will be key to attaining maximum return on investment [ 11 ]. It is also important to ensure that at least some of this external funding is used to strengthen national researcher capacity as well as sensitize decision-makers to the potential of HPSR to inform improved national policy. Initiatives to promote donor alignment and harmonization such as the International Health Partnership are also a promising option for governments to align their HPSR vision with the funder’s interests [ 25 ].

Third, given that increases in domestic funding commitments for HPSR are likely to be difficult to achieve without stronger policy-maker demand for HPSR, it would be important for EMR countries to invest in capacity-building and awareness raising for HPSR to improve the prevailing culture for research and evidence-informed decision-making. Individual-level capacity should be complemented by institutional mandates for policy-makers to use research evidence as input into the decision-making process as well as institutional structures and mechanisms to hold decision-makers accountable for their decisions. Furthermore, given that generating appropriate, trustworthy evidence depends on the existence of good research organizations, building and strengthening academic programs (master’s and PHDs) and institutions for HPSR and knowledge translation would enhance the technical capacities of all HPSR stakeholders and improve the integration of research findings into policy-making. Incentive mechanisms to support knowledge translation work and interdisciplinary research can further incentivize researchers to engage in HPSR and evidence-informed policy-making.

Fourth, considerations could be given to establish a regional strategy for HPSR which articulates the vision and goal for HPSR in the EMR as well as guides resource mobilization and allocation decisions for HPSR, including priority-setting exercises to shape HPSR research agenda in the region. A regional advocacy coalition can also be considered to raise regional funds for HPSR, which can be allocated in an informed manner to support national HPSR initiatives [ 5 , 12 ]. Moreover, a regional forum or network can be established for raising awareness, building capacity and creating demand for HPSR.

Finally, given that our study identified suboptimal reporting of funding information in HPSR papers, journals need to better enforce their funding policies.

This is the first study to address the reporting of funding and funding sources in HPSR articles in the EMR. Despite the majority of journals publishing on HPSR requiring the reporting of funding, approximately 30% of HPSR papers did not report on the funding source. Moreover, study findings revealed heavy reliance on universities and international funding sources in funding HPSR articles in the EMR, with a minimal role of national governments and regional entities. Study findings can guide researchers, policy-makers and funders to strengthen and improve the profile of HPSR funding in the EMR.

Availability of data and materials

All data generated or analysed during this study are included in this published article (and its supplementary information files).

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Acknowledgements

The authors wish to extend their thanks to the Alliance for Health Policy and Systems Research at the World Health Organization for their support and guidance. We also wish to acknowledge the Health Systems Global Society (HSG) for their overall support. We would also like to acknowledge Ms. Diana Jamal for her support with data analysis and Ms. Mathilda Jabbour and Ms. Nour Hemadeh for their support in study screening.

This research was supported as part of the work of the Health Systems Global’s (HSG) Regional Networks – Eastern Mediterranean.

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R.F. conceived the idea. R.F. and F.E.J. designed the study and the methodology. R.F. developed and ran the search strategy. R.F., N.D. and A.H. conducted title and abstract screening. R.F., N.C., N.D. and A.H. conducted full text screening. R.F., N.C. and N.D. abstracted key variables from included studies. F.E.J., R.F. and N.C. analysed and interpreted the findings. R.F. wrote the initial draft of the manuscript with input from F.E.J. and N.C. All authors read and approved the submitted version. All authors have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated and resolved, and the resolution documented in the literature.

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Supplementary Material 1. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.

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Fadlallah, R., El-Jardali, F., Chidiac, N. et al. Analysis of funding landscape for health policy and systems research in the Eastern Mediterranean Region: A scoping review of the literature over the past decade. Health Res Policy Sys 22 , 70 (2024). https://doi.org/10.1186/s12961-024-01161-3

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Received : 19 July 2023

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Published : 24 June 2024

DOI : https://doi.org/10.1186/s12961-024-01161-3

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