phrases to use in literature reviews

17 strong academic phrases to write your literature review (+ real examples)

A well-written academic literature review not only builds upon existing knowledge and publications but also involves critical reflection, comparison, contrast, and identifying research gaps. The following 17 strong academic key phrases can assist you in writing a critical and reflective literature review.

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Academic key phrases to present existing knowledge in a literature review

Academic key phrases to contrast and compare findings in a literature review, academic key phrases to highlight research gaps in a literature review, the topic has received significant interest within the wider literature..

Example: “ The topic of big data and its integration with AI has received significant interest within the wider literature .” ( Dwivedi et al. 2021, p. 4 )

The topic gained considerable attention in the academic literature in…

Example:  “ The relationship between BITs and FDI gained considerable attention in the academic literature in the last two decades .” ( Amendolagine and Prota, 2021, p. 173 )

Studies have identified…

Example: “ Studies have identified the complexities of implementing AI based systems within government and the public sector .” ( Dwivedi et al. 2021, p. 6 )

Researchers have discussed…

Example: “ Researchers have discussed the ethical dimensions of AI and implications for greater use of the technology. ” ( Dwivedi et al. 2021, p. 6)

Recent work demonstrated that…

Example: “Recent work demonstrated that dune grasses with similar morphological traits can build contrasting landscapes due to differences in their spatial shoot organization.” ( Van de Ven, 2022 et al., p. 1339 )

Existing research frequently attributes…

Example:  “Existing research frequently attributes these challenges to AI’s technical complexity, demand for data, and unpredictable interactions.” ( Yang et al., 2020, p. 174 )

Prior research has hypothesized that…

Example:  “Prior research has hypothesized that racial and ethnic disparities may be mitigated if the patient and provider share the same race due to improved communication and increased trust” ( Otte, 2022, p. 1 )

Prior studies have found that…

Example:  “ Prior studies have found that court-referred individuals are more likely to complete relationship violence intervention programs (RVIP) than self-referred individuals. ” ( Evans et al. 2022, p. 1 )

You may also like: 26 powerful academic phrases to write your introduction (+ real examples)

While some scholars…, others…

Example: “On the sustainable development of microcredit, some scholars emphasize the effect of its poverty alleviation, while some scholars emphasize the factors such as institutional innovation and government support.” ( Huang et al., 2021, p. 2117 )

The findings of Scholar A showcase that… . Scholar B , on the other hand, found…

Example: “ The findings of Arinto (2016) call for administrators concerning the design of faculty development programs, provision of faculty support, and strategic planning for online distance learning implementation across the institution. Francisco and Nuqui (2020) on the other hand found that the new normal leadership is an adaptive one while staying strong on their commitment. ” ( Asio and Bayucca, 2021, p. 20 )

Interestingly, all the arguments refer to…

Example:  “Interestingly, all the arguments above refer to daily role transitions—more specifically: role transitions on teleworking days—as an important explanatory mechanism for both the possible conflict-reducing effect and the potential conflict enhancing effects of telework.”  ( Delanoeije et al., 2019, p. 1845 )

This argument is similar to…

Example: “The third argument against physician involvement in lethal injection is that physicians are prohibited from deliberately harming patients or the argument from nonmaleficence. This argument is similar to the argument from healing but has different implications and must therefore be considered independently.” ( Sawicki, 2022, p. 22 )

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Yet, it remains unknown how…

Example: “Yet, it remains unknown how findings from aeolian landscapes translate to aquatic systems and how young clonally expanding plants in hydrodynamically exposed conditions overcome these establishment thresholds by optimizing shoot placement.” ( Van de Ven, 2022 et al., p. 1339 )

There is, however, still little research on…

Example:  “There is, however, still little research on what integrated STEM approaches require from schools and teachers, and on the potential obstacles that may prevent teachers from running this kind of teaching.”  ( Bungum and Mogstad, 2022, p. 2 )

Existing studies have failed to address…

Example: “ University–industry relations (UIR) are usually analysed by the knowledge transfer channels, but existing studies have failed to address what knowledge content is being transferred – impacting the technology output aimed by the partnership.”  (Dalmarco et al. 2019, p. 1314 )

Several scholars have recommended to move away…

Example: “Several scholars have recommended to move away from such a stable-level approach (i.e. using a global judgment of work-home conflict) to a dynamic episodes approach ” ( Delanoeije et al., 2019, p. 1847 )

New approaches are needed to address…

Example:  “ Accurate computational approaches are needed to address this gap and to enable large-scale structural bioinformatics. ” ( Jumper et al. 2021,p. 583 )

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Academic Phrasebank

Referring to sources.

• GENERAL LANGUAGE FUNCTIONS
• Being cautious
• Being critical
• Classifying and listing
• Compare and contrast
• Defining terms
• Describing trends
• Describing quantities
• Explaining causality
• Giving examples
• Signalling transition
• Writing about the past

One of the distinguishing features of academic writing is that it is informed by what is already known, what work has been done before, and/or what ideas and models have already been developed. Thus, in academic texts, writers frequently make reference to other studies and to the work of other authors. It is important that writers guide their readers through this literature. This section of  Academic Phrasebank  lists some of the phrases that writers may use for this purpose.

A note on the literature review: It is the purpose of the literature review section of a paper or dissertation to show the reader, in a systematic way, what is already known about the research topic as a whole, and to outline the key ideas and theories that help us to understand this. As well as being systematic, the review should be evaluative and critical of the studies or ideas which are relevant to the current work. For example, you may think a particular study did not investigate some important aspect of the area you are researching, that the author(s) failed to notice a weakness in their methods, or that their conclusion is not well-supported (refer to  Being Critical ).

A note on referencing style: The way a writer refers to other sources varies somewhat across different disciplines. In some cases, where the individual author is important, the author’s name will be the main subject of the sentence; in other cases, the author’s name may only be mentioned in brackets ( … ) or via a number notation system (e.g. footnotes and endnotes). The ‘author as subject’ style is less common in the empirical disciplines (sciences) and more commonly used in the humanities. Different referencing systems are used in different disciplines. In the majority of the examples given here, the Harvard in-text referencing system has been used.

A note on verb tenses: For general reference to the literature, the present perfect tense (have/has + verb participle) tends to be used. For reference to specific studies carried out in the past, the simple past tense is most commonly used. This is normally the case where a specific date or point in time in the past forms a part of the sentence. When referring to the words or ideas of writers, the present tense is often used if the ideas are still relevant, even if the author is no longer alive. The examples given below reflect these general patterns, but these are by no means rigid.

General comments on the relevant literature

The literature on X has highlighted several … Different theories exist in the literature regarding … More recent attention has focused on the provision of … There are relatively few historical studies in the area of … A large and growing body of literature has investigated … Much of the literature since the mid-1990s emphasises the … Much of the current literature on X pays particular attention to … There is a large volume of published studies describing the role of … The existing literature on X is extensive and focuses particularly on … There is a relatively small body of literature that is concerned with … The generalisability of much published research on this issue is problematic. A considerable amount of literature has been published on X. These studies … The academic literature on X has revealed the emergence of several contrasting themes. Previous research findings into X have been inconsistent and contradictory (Smith, 1996; …).

Previous research: a historical perspective

Research into X has a long history. For many years, this phenomenon was surprisingly neglected by … Only in the past ten years have studies of X directly addressed how … Prior to the work of Smith (1983), the role of X was largely unknown. Over the past decade, most research in X has emphasized the use of … In recent years, there has been an increasing amount of literature on … Early examples of research into X include … (Smith, 1962; Jones, 1974). During the past 30 years, much more information has become available on … The first serious discussions and analyses of X emerged during the 1970s with … Over the past two decades, major advances in molecular biology have allowed … Historically, research investigating the factors associated with X has focused on … It is only since the work of Smith (2001) that the study of X has gained momentum. The construct of X was first articulated by Smith (1977) and popularised in his book: … Around the early 1960s, small-scale research and case studies began to emerge linking … It was not until the late 1960s that historians considered X worthy of scholarly attention. Awareness of X is not recent, having possibly first been described in the 5th century BCE by …

Previous research: methodological approaches taken

Most research on X has been carried out in … Most researchers investigating X have utilised … Using this approach, researchers have been able to … Several systematic reviews of X have been undertaken. The vast majority of studies on X have been quantitative. What we know about X is largely based on observational studies. There are a number of large cross-sectional studies which suggest … Much of the previous research on X has been exploratory in nature. Much of the X research has focused on identifying and evaluating the … What we know about X is largely based upon empirical studies that investigate … Publications that concentrate on X more frequently adopt a historical or chronological approach …

Previous research: area investigated

To date, several studies have investigated … A number of studies have begun to examine … Various studies have assessed the efficacy of … Researchers attempted to evaluate the impact of … A great deal of previous research into X has focused on … Several studies have used longitudinal data to examine … Previous studies have explored the relationships between X and Y. Twenty cohort study analyses have examined the relationship between … A number of authors have considered the effects of … (Smith, 2003; Jones, 2004). At least 120 case-control studies worldwide have examined the relationship between … Numerous studies have attempted to explain … (for example, Smith, 1996; Jones, 1998; …).

Previous research: what has been established or proposed

Several lines of evidence suggest that … Previous research has established that … Data from several studies suggest that … Recent evidence suggests that … (Smith, 2020; …). It is now well established from a variety of studies that … New findings amongst X provides further evidence that …

A number of studies have postulated a convergence between … Recently, considerable evidence has accumulated to show that … Surveys such as that conducted by Smith (2015) have shown that … Many recent studies (e.g. Smith, 2019; Jones, 2020) have shown that … Traditionally, it has been argued that … (e.g. Smith, 1960; Jones, 1972). Several biographies of Brown have been published. Smith (2016) presents …

In previous studies on X, different variables have been found to be related to … Many historians have argued that … (e.g. Jones, 1997; Brown, 1999; Smith, 2019). There is a consensus among social scientists that … (e.g. Smith, 2019; Jones, 2020; … Data from several sources have identified the increased X and Y associated with obesity. Recently, in vitro studies have shown that X can … (Smith et al. , 2018; Jones et al. , 2021). It has been demonstrated that a high intake of X results in damage to … (Smith, 2015; …).

Stating what is currently known about the topic

X increases when … (Smith, 2015) X is able to affect Y (Smith, 2015; Jones, 2020). X is positively related to Y (Smith, 2015; Jones, 2020). X is proportional to Y as expressed by the… (Smith, 2015). X is one of the most important … (Smith, 2015; Jones, 2020). X is one of the most intense reactions following Y (Jones, 2020). A relationship exists between X and Y (Smith, 2015; Jones, 2020). X is a principal determining factor of Y (Smith, 2015; Jones, 2020). There is an unambiguous relationship between X and Y (Smith, 2015). X is significantly reduced during the first months of … (Smith, 2015; Jones, 2020). X has been found to oppose the anti-inflammatory actions of Y on Z (Smith, 2020).

Reference to a previous investigation: researcher prominent

Smith’s comparative study (2017) found that … Jones’s comprehensive review concluded that … Brown’s (1998) model of X assumes three main … Smith’s cross-country analysis (2017) showed that … Jones’s (2010) review of the literature concluded that … Brown’s (2022) recent analysis of X provides a strong critique of …

Reference to a previous investigation: time prominent

In 1959, a seminal article was published entitled … Following this period, Smith actively searched for X. In the 1950s, Smith pointed to some of the ways in which … Thirty years later, Smith (1974) reported three cases of X which … Almost 20 years ago, Jones (1995) formulated his X theory, centred around …

Reference to a previous investigation: investigation prominent

One longitudinal study found that … A seminal study in this area is the work of … One study by Smith (2014) examined the trend in … A recent study by Smith and Jones (2012) involved … A qualitative study by Smith (2003) described how … A recent systematic literature review concluded that … Preliminary work on X was undertaken by Jones (1992). A longitudinal study of X by Smith (2012) reports that … A key study comparing X and Y is that of Smith (2010), in which … The first systematic study of X was reported by Smith  et al.  in 1986. Detailed examination of X by Smith and Jones (1961) showed that … Analysis of the genes involved in X was first carried out by Smith  et al.  (1983). A significant analysis and discussion on the subject was presented by Smith (1988). The study of the structural behaviour of X was first carried out by Jones  et al.  (1986). A small scale study by Smith (2015) reached different conclusions, finding no increase in … The study by Jones (1990) offers probably the most comprehensive empirical analysis of …

Reference to a previous investigation: topic prominent

To determine the effects of X, Jones  et al . (2005) compared … X was originally isolated from Y in a soil sample from … (Jones  et al. , 1952). The electronic spectroscopy of X was first studied by Smith and Jones in 1970. X formed the central focus of a study by Smith (2002) in which the author found … To better understand the mechanisms of X and its effects, Jones (2013) analysed the … X was first demonstrated experimentally by Pavlov (Smith, 2002). In his seminal study … The acid-catalyzed condensation reaction between X and Y was first reported by Smith in 1872. The way in which X is regulated was studied extensively by Smith and colleagues (Smith  et al.  1995 and 1998).

Reference to what other writers do in their published work

In Chapter 2, Smith provides us with a number of important … In the subsequent chapter, Smith examines the extent to which … By drawing on the concept of X, Smith has been able to show that … Some analysts (e.g. Smith, 2015) have attempted to draw fine distinctions between … Drawing on an extensive range of sources, the authors set out the different ways in which … Other authors (see Smith, 2010; Jones, 2014) question the usefulness of such an approach.  

Reference to another writer's idea or position

As noted by Smith (2003) X is far more cost effective, and therefore … According to Smith (2003), preventative medicine is far more cost effective, and therefore … 

Synthesising material: supporting evidence or ideas

Similarly, Jones (2015) found that X … This is consistent with the data obtained by … Smith (1995) makes a similar point in his study of X … In the same vein, Smith (1995) in his book XYZ notes This view is supported by Jones (2015) who writes that Along the same lines, Smith (1995) subsequently argued that … Smith argues that her data support Jones’s (1995) view that Jones’s (1986) work on X is complemented by Smith’s (2009) study of Almost every paper that has been written on X includes a section relating to A broadly similar point has also recently been made by Johnson (2019), who …

Synthesising material: contrasting evidence or ideas

Other writers have argued that … Other studies have concluded that … Unlike Smith, Jones (2013) argues that In contrast to Smith, Jones (2013) argues that Smith (2010) presents an X account, whilst Jones (2011) While Smith (2008) focuses on X, Jones (2009) is more concerned with A broader perspective has been adopted by Smith (213) who argues that Contrary to previously published studies, Jones et al. demonstrated the efficacy of… This result conflicts with Smith’s (1965) previously mentioned study which found that … Conversely, Smith (2010) reported no significant difference in mortality between X and Y.

Some ways of introducing quotations

Commenting on X, Smith (2003) argues: ‘… …’ As Smith (2004: 215) states: ‘there are many good reasons to be sceptical’. As Smith argues: ‘In the past, the purpose of education was to …’ (Smith, 2000:150). In the final part of the  Theses on Feuerbach , Marx writes: ‘Philosophers have hitherto only …’ Smith concludes: ‘The idea of development stands today like a ruin in …’ (Smith, 1992: 156).

Summarising the review or parts of the review

Together, these studies indicate that … Overall, these studies highlight the need for … Considering all of this evidence, it seems that … Collectively, these studies outline a critical role for… In all the studies reviewed here, X is recognised as … The evidence presented in this section suggests that … The studies presented thus far provide evidence that … Taken together, these studies support the notion that … Overall, there seems to be some evidence to indicate that … Together these studies provide important insights into the … All of the studies reviewed here support the hypothesis that … Two important themes emerge from the studies discussed so far: However, such studies remain narrow in focus dealing only with … The evidence reviewed here seems to suggest a pertinent role for … These studies clearly indicate that there is a relationship between … In view of all that has been mentioned so far, one may suppose that … There remain several aspects of X about which relatively little is known.

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Academic Phrases for Writing Literature Review Section of a Research Paper

Overview |   Abstract   | Introduction | Literature Review | Materials & Methods | Results & Discussion | Conclusion & Future Work | Acknowledgements & Appendix

The literature review should clearly demonstrate that the author has a good knowledge of the research area. Literature review typically occupies one or two passages in the introduction section. A well-written literature review should provide a critical appraisal of previous studies related to the current research area rather than a simple summary of prior works. The author shouldn’t shy away from pointing out the shortcomings of previous works. However, criticising other’s work without any basis can weaken your paper. This is a perfect place to coin your research question and justify the need for such a study. It is also worth pointing out towards the end of the review that your study is unique and there is no direct literature addressing this issue. Add a few sentences about the significance of your research and how this will add value to the body of knowledge.

The literature review section of your research paper should include the following:

• Previous literature
• Limitations of previous research
• Research questions
• Research to be explored

1. Previous literature

The literature review shows that __ Previous research showed __ Seminal contributions have been made by __ A series of recent studies has indicated that __ Several theories have been proposed to __, some focusing on __, others on __ There has been numerous studies to investigate __ This has been used in several studies to assess __ Previous studies have shown __ Several studies suggest that __ This has also been explored in prior studies by __ Prior research suggests that __ Previous studies have emphasized __ The majority of prior research has applied __ Most early studies as well as current work focus on __ For instance, the following studies were conducted on __ Studies of __are well documented, it is also well acknowledged that __ A number of authors have recognized __ Some authors have also suggested that  __ Some authors have driven the further development of __ This has been discussed by a great number of authors in literature. For example, research has provided evidence for __ The authors bring some information about the background of the problem, __ As has been previously reported in the literature, __ A large number of existing studies in the broader literature have examined __ The literature review shows that __ There exists a considerable body of literature on  __ In short, the literature pertaining to __ strongly suggests that __ Over time, an extensive literature has developed on __ This section presents a review of recent literature on __ This paper begins with a short review of the literature regarding the __ Several methods are reported in the literature to address this issue. There is a wide choice of __ available in the literature. This section reviews the literature related to __ It was reported in literature that __ A recent study by __ concluded that __ In the light of reported __ it is conceivable that __ The method introduced by __ has the advantage that __ One method employed by __ is __ A more comprehensive description can be found in __ For example, recent research suggests that __ This was successfully established as described by __ The author employed a __ methodology which prescribes the use of __

2. Limitations of previous research

A number of questions regarding __ remain to be addressed. A closer look to the literature on __, however, reveals a number of gaps and shortcomings. This question has previously never been addressed because__ Most studies have relied on __ Previous studies by __ cannot be considered as conclusive because __ Previous studies have almost exclusively focused on __ This has been previously assessed only to a very limited extent because __ In the present studies __ were constrained to __ In previous studies were limited to __ Although results appear consistent with prior research, they appear inconsistent with __ These are previously unstudied because __ As far as we know, no previous research has investigated __ Moreover, although research has illuminated __ no study to date has examined __ Despite decades of research, this continues to be debated among __ This section points out some of the problems encountered in the extant research. Although there are many studies, the research in __ remains limited. However, the existing research has many problems in representing __ The literature on __ is less consistent Historically, there has been a great deal of confusion in the literature regarding __ This approach remains briefly addressed in the literature. These are rarely analyzed in the literature as __ There are key questions and notions that are still not discussed in the literature __ This is not clearly presented in the literature because __ This paper addresses the need for __, so far lacking in the scientific literature. To fill this literature gap, this paper identifies __ Only a few works in literature demonstrate __ Although studies have been conducted by many authors, this problem is still insufficiently explored. To our knowledge, no prior studies have examined __ However, the existing research has many problems in __ Therefore, important issue in the literature is __ However, we argue that previous literature suffers from certain weaknesses: __ Previous research can only be considered a first step towards a more profound understanding of __ The previous studies reveal that __ are usually the most problematic to __

3. Research questions

More specific research questions will be introduced and investigated in __ A further question is whether __ Finally, another promising line of research would be __ The study addresses several further questions on __ Some of the interesting questions in this context are __ In order to address the questions outlined above, we report here __ These questions are of central interest as much recent research in __ Furthermore, __ is arguably an important question to be addressed. The question now is how __ can be used to explain __ Study addresses the research question __ In order to properly address this question, we __ An important question associated with __ is __ A critical open question is whether __ A still unsolved question is whether __ This remains an open question as __ This question has previously never been addressed because __ This study offers a test of __ research question Study addresses the research question __ Even in general __ research strategies is needed to explain __ The researcher should be interested here in __ Many questions remain unanswered __ There are some potentially open questions about the validity of __ The question that then naturally arises is __ The question then becomes how best to define__ This was an important question to study as __

4. Research to be explored

A more systematic and theoretical analysis is required for __ As the authors note earlier, more work is necessary to__ Additional studies to understand more completely the key tenets of __ are required. The unexpected findings signal the need for additional studies to understand more about __ This paper addresses __, so far lacking in the scientific literature. A new approach is therefore needed for __ One of the tough challenges for all researchers in this domain is __

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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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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).

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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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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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I wish I come across GradCoach earlier enough.

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 🙂

This has been really helpful. Will make full use of it. 🙂

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It is very good video of guidance for writing a research proposal and a dissertation. Since I have been watching and reading instructions, I have started my research proposal to write. I appreciate to Mr Jansen hugely.

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I was really stuck in reading and gathering information but after watching these things are cleared thanks, it is so helpful.

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Thank you for this whole literature writing review.You have simplified the process.

I’m so glad I found GradCoach. Excellent information, Clear explanation, and Easy to follow, Many thanks Derek!

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

Thank you Coach, you have greatly enriched and improved my knowledge

Great piece, so enriching and it is going to help me a great lot in my project and thesis, thanks so much

This is THE BEST site for ANYONE doing a masters or doctorate! Thank you for the sound advice and templates. You rock!

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I am doing two papers on my final year thesis, and I must stay I feel very confident to face both headlong after reading this article.

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if anyone is to get a paper done on time and in the best way possible, GRADCOACH is certainly the go to area!

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Good morning scholar. I’m delighted coming to know you even before the commencement of my dissertation which hopefully is expected in not more than six months from now. I would love to engage my study under your guidance from the beginning to the end. I love to know how to do good job

Thank you so much Derek for such useful information on writing up a good literature review. I am at a stage where I need to start writing my one. My proposal was accepted late last year but I honestly did not know where to start

Like the name of your YouTube implies you are GRAD (great,resource person, about dissertation). In short you are smart enough in coaching research work.

This is a very well thought out webpage. Very informative and a great read.

Very timely.

I appreciate.

Very comprehensive and eye opener for me as beginner in postgraduate study. Well explained and easy to understand. Appreciate and good reference in guiding me in my research journey. Thank you

Thank you. I requested to download the free literature review template, however, your website wouldn’t allow me to complete the request or complete a download. May I request that you email me the free template? Thank you.

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Writing an effective literature review

Lorelei lingard.

Schulich School of Medicine & Dentistry, Health Sciences Addition, Western University, London, Ontario Canada

In the Writer’s Craft section we offer simple tips to improve your writing in one of three areas: Energy, Clarity and Persuasiveness. Each entry focuses on a key writing feature or strategy, illustrates how it commonly goes wrong, teaches the grammatical underpinnings necessary to understand it and offers suggestions to wield it effectively. We encourage readers to share comments on or suggestions for this section on Twitter, using the hashtag: #how’syourwriting?

This Writer’s Craft instalment is the second in a two-part series that offers strategies for effectively presenting the literature review section of a research manuscript. This piece argues that citation is not just a technical practice but also a rhetorical one, and offers writers an expanded vocabulary for using citation to maximal effect.

Many writers think of citation as the formal system we use to avoid plagiarism and acknowledge others’ work. But citation is a much more nuanced practice than this. Not only does citation allow us to represent the source of knowledge, but it also allows us to position ourselves in relation to that knowledge, and to place that knowledge in relation to other knowledge . In short, citation is how we artfully tell the story of what the field knows, how it came to that knowledge, and where we stand in relation to it as we write the literature review section to frame our own work. Seen this way, citation is a sophisticated task, requiring in-depth knowledge of the literature in a domain.

Citation is more than just referencing; it is how we represent the social construction of knowledge in a field. A citation strategy is any indication in the text about the source and nature of knowledge. Consider the following passage, in which all citation strategies are italicized:

Despite years of effort to teach and enforce positive professional norms and standards, many reports of challenges to medical professionalism continue to appear, both in the medical and education literature and, often in reaction, in the lay press . 1,2,3,4,5 Examples of professional lapses dot the health care landscape: regulations are thwarted, records are falsified, patients are ignored, colleagues are berated. 2,4,6 The medical profession has articulated its sense of what professionalism is in a number of important position statements . 7,8 These statements tend to be built upon abstracted principles and values, such as the taxonomy presented in the American Board of Internal Medicine’s (ABIM’s) Project Professionalism : altruism, accountability, excellence, duty, honour, integrity, and respect for others. 7 (From Ginsburg et al., The anatomy of a professional lapse [ 1 ])

In this passage, citation as referencing (in the form of Vancouver format superscript numbers) is used to acknowledge the source of knowledge. There are more than just references in this passage, however. Citation strategies also include statements that characterize the density of that knowledge (‘many reports’), its temporal patterns (‘continue to appear’), its diverse origins (‘both in the medical and education literature’), its social nature (‘often in reaction’), and its social import (‘important position statements’). Citation does more than just acknowledge the source of something you’ve read. It is how you represent the social nature of knowledge as coming from somewhere, being debated and developed, and having impact on the world [ 2 ]. If we remove all these citation strategies, the passage sounds at best like common sense or, at worst, like unsubstantiated personal opinion:

Despite years of effort to teach and enforce positive professional norms and standards, challenges to medical professionalism continue. Examples of professional lapses dot the health care landscape: regulations are thwarted, records are falsified, patients are ignored, colleagues are berated. Professionalism is a set of principles and values: altruism, accountability, excellence, duty, honour, integrity, and respect for others.

But perhaps you’ve been told that your literature review should be ‘objective’—that you should simply present what is known without taking a stance on it. This is largely untrue, for two reasons. The first involves the distinction between summary and critical summary. A summary is a neutral description of material, but a good literature review contains very little pure summary because, as we review, we must also judge the quality, source and reliability of the knowledge claims we are presenting [ 3 ]. To do this, we engage in critical summary, not only summarizing existing knowledge but offering a stance on it.

The second reason is that, even when we’re aiming for simple summary, a completely neutral presentation of knowledge claims is very difficult to achieve. We take a stance in ways we hardly even notice. Consider how the verb in each of these statements adds a flavour of stance to what is otherwise a summary of a knowledge claim in the field:

Anderson describes how the assessment is overly time-consuming for use in the Emergency Department. Anderson discovered that the assessment was overly time-consuming for use in the Emergency Department. Anderson claims that the assessment is overly time-consuming for use in the Emergency Department.

The first verb, ‘describes’, is neutral: it is not possible to ascertain the writer’s stance on the knowledge Anderson has contributed to the field. The second verb, ‘discovered’, expresses an affiliation or positive stance in the writer, while the third verb, ‘claims’, distances the writer from Anderson’s work. Even these brief summary sentences contain a flavour of critical summary. This is not a flaw; in fact, it is an important method of portraying existing knowledge as a conversation in which the writer is positioning herself and her work. But it should be done consciously and strategically. Tab.  1 offers examples to help writers think about how the verbs in their literature review position them in relation to existing knowledge in the field. Meaning is subject to context and these examples should only be taken as a guide: e. g., ‘suggests’ can be used to signal neutrality or distancing.

Verbs to position the writer in relation to the literature being reviewed

Most of us have favourite verbs that we default to almost unconsciously when we are writing—reports, argues, describes, studies, explains, asserts—but these verbs are not interchangeable. They each inscribe a slightly different stance towards the knowledge—not only the writer’s stance, but also the stance of the researcher who created the knowledge. It is critical to get the original stance right in your critical summary. Nothing irritates me more than seeing my stance mispresented in someone else’s literature review. For example, if I wrote a paragraph offering tentative reflections on a new idea, I don’t want to see that summarized in someone’s literature review as ‘Lingard argues’, when more accurate would be ‘Lingard suggests’ or ‘Lingard explored’.

Writers need to extend their library of citation verbs to allow themselves to accurately and persuasively position knowledge claims published by authors in their field. You can find many online resources to help extend your vocabulary: Tab.  2 , adapted from one such online source [ 4 ], provides some suggestions. Tables like these should be thought of as tools, not rules—keep in mind that words have flexible meanings depending on context and purpose. This is why one word, such as suggest or conclude , can appear in more than one list.

Verbs to represent the nature and strength of an author’s contributions to the literature

Knowledge is a social construction and it accumulates as researchers debate, extend and refine one another’s contributions. To avoid your literature review reading like a laundry list of disconnected ‘facts’, reporting verbs are an important resource. Tab.  3 offers a selection of verbs organized to reflect different relationships among authors in the field of knowledge being reviewed.

Verbs to express relations among authors in the field

Finally, although we have focused on citation verbs in this article, adverbs (e. g., similarly, consequently) and prepositional phrases (e. g., by contrast, in addition) are also important for expressing similar, contrasting or responding relations among knowledge claims and their authors in the field being reviewed.

In summary, an effective literature review not only summarizes existing knowledge, it also critically presents that knowledge to depict an evolving conversation and understanding in a particular domain of study. As writers we need to know when we are summarizing and when we are critically summarizing—summary alone makes for a literature review that reads like a laundry list of undigested ‘facts-in-the-world’. Finally, writers need to attend to the subtle power of citation verbs to position themselves and the authors they are citing in relation to the knowledge being reviewed. Broadening our catalogue of ‘go-to’ verbs is an important step in enlivening and strengthening our writing.

Acknowledgements

Thanks to Mark Goldszmidt for his feedback on an early version of this manuscript.

PhD, is director of the Centre for Education Research & Innovation at Schulich School of Medicine & Dentistry, and professor for the Department of Medicine at Western University in London, Ontario, Canada.

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Writing a Literature Review

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

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

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

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

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

What are the parts of a lit review?

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

Introduction:

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

Conclusion:

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

How should I organize my lit review?

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

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

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

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

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

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

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

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

• Directories

Language of the literature review

The language that you use in a literature review is important for informing readers where you stand on relevant debates on your topic or issue. In a writer-responsible academic culture, it is your job to lead readers to the meanings and conclusions that you want them to make. Since literature reviews can involve complex ideas and various bodies of literature, it is necessary to be explicit about how the the studies that you cite are connected to each other and are relevant for your own research, and how the ideas introduced are relevant for developing your argument. You can achieve this by using language that clearly indicates your position and strengthens your voice in relation to others'.

In your introduction, you should make it clear what the purpose of the literature review is, as in the following.

Note how the author explains the purpose of the literature review ("The aim of the chapter is to define the kinds of intervention that will have the most beneficial impact"). The author also generally identifies the literature review's key message ("Answers to these questions are found in accounts of both cause and action"). In your own introduction, you could go into more detail about your argument. For example, consider the introduction below, which explains the key points more directly.

To see how other people in your field write literature reviews in a thesis, check out the ANU Digital Thesis Collection to find other theses, and ask your supervisor to show you some past samples.

Within paragraphs, your choice of language can help you to explain connections between the literature's concepts. Take a look at the words in bold in the sample text below, and note how they help the author to guide you through the ideas.

Critically evaluating the literature

A key role of your literature review is to show your critical interpretation and evaluation of the literature. When taking notes and researching, you can develop this critical evaluation by asking yourself questions such as:

• what are the strengths and weaknesses/limitations of the different bodies of literature/studies you are reviewing?
• what accounts for authors' different findings-how can these be explained (e.g. theory or methodology adopted etc.)? (Hold your sources in relation)
• to which issues, gaps, ambiguities, unresolved problems, etc. in the literature do you wish to particularly draw attention and why?
• what are the implications of your discussions? (Don't leave your reader thinking: "This is an interesting piece of critical analysis, but what's the point of it all?" "So what?")

When it comes to writing up your literature review, you can use language to show your critical interpretation and evaluation. For example, take a look at the words in bold in the sample text below. How do they show interpretation and evaluation?

Positioning your research in relation to the literature

It could be that you are expected to reserve detailed discussion of your own research for a distinct section within or following your literature review. More likely though, you will be expected to situate your own research in relation to the literature during the review. The examples below shows how the authors relate their own research to the literature they review. Note how they tell you what they are doing, why they are doing it, where they are going, and where you can find more detailed information within other areas of the thesis.

Literature reviews

Purpose of traditional literature reviews

Placement of traditional literature reviews

Structuring a literature review

Systematic literature reviews

Grounded theory literature reviews

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3 Literature Review

Charitianne Williams

By the end of this chapter, you will be able to do the following:

• Understand the purpose and function of a literature review.
• Structure a literature review according to basic genre expectations.
• Synthesize ideas from multiple sources using a synthesis matrix.
• Choose between narrative or parenthetical citation and direct quoting, or paraphrase with intent and purpose.

I. Introduction

The purpose of a literature review is just that—it reviews. This means that literature reviews examine a text after it was produced, with all the benefits that hindsight allows a reader. In popular culture, we commonly review movies, restaurants, vacation spots, products, etc. In those reviews, you look back at the single thing you are reviewing and your experience with it. You focus on the strengths and weaknesses of your experience and judge the experience as positive or negative while recommending or not recommending the place or product and explaining why.

An academic literature review does something different, although some of the skills and strategies you use remain the same. The job of a literature review is to examine a collection of research or scholarship (not a single thing or text) on a given topic and show how that scholarship fits together. Literature reviews summarize, describe, evaluate, and synthesize the work of other authors and researchers while looking for common trends/patterns, themes, inconsistencies, and gaps in this previous research. The main strategy writers of a literature review use is synthesis.

SYNTHESIS: the combination of ideas and elements to form a complete system or theory.

A good metaphor for synthesis is cooking! Imagine the ingredients for a loaf of bread laid out on a kitchen cabinet. Each ingredient—eggs, milk, flour, sugar, salt, yeast—have their own purpose and can be combined in different ways to form food other than bread. Knowing all of those individual attributes that make an egg an egg, or the difference between yeast and flour, is what makes you a chef. When you combine all these ingredients according to the recipe, you get something different than all the ingredients on their own: and most of us would rather eat a slice of bread than a spoonful of flour. The product of synthesis is like bread. Synthesis takes a list of ingredients and makes them into something more than the ingredients alone.

Usually, the writers of a literature review will start with a question that they want to answer through informed and research-based evidence gathered while reading others’ work on related topics. The “thesis” or controlling idea of a literature review may be that same question ( “This review seeks to answer…” ) or it may be a statement describing the reviewed research. The thesis reflects the purpose of the literature review as a genre and is different from the thesis you will write for the research paper that argues a claim or asserts a new idea.

Example 3.1: Look at this thesis statement taken from the introduction of a literature review in environmental psychology on the relationship between “nature sounds” and restorative environments:

From this example, we can learn many things about literature reviews:

• They are explicit and focused on their topic. The opening states an observable truth about the current research ( emphasizes nature ), is followed by a general condition ( positive psychological experiences) within that research, and then finally focuses on describing how a particular outcome is achieved (listening to nature sounds is restorative).
• They seek to pre vent or eliminate misunderstanding. Note the use of specialized key terms, exacting transitional phrases, and meaningful verbs in the thesis such as “ restorative environments,” “in particular,” and “ generate .”
• They seek to forward understanding. In other words, literature reviews examine and link together evidence described and validated in the research of others so a reader can learn how a field is developing. ( Research seems to agree that nature sounds can relieve stress and fatigue–this review will examine that conclusion so readers can understand/ build on how and why.)

Moving from the beginning to the very end of the literature review, we can also learn many things about literature reviews from the sources used. Think of each text listed in the References section of a literature review as contributing pieces to a gigantic puzzle.

Example 3.2: Look at the first three articles listed in the References for the article excerpted above:

Abbott, L. C., Taff, D., Newman, P., Benfield, J. A., and Mowen, A. J. (2016). The influence of natural sounds on attention restoration. J. Park Recreation Adm. 34, 5–15. doi: 10.18666/JPRA-2016-V34-I3-6893

Aletta, F., and Kang, J. (2019). Promoting healthy and supportive acoustic environments: going beyond the quietness. Int. J. Environ. Res. Public Health 16:4988. doi: 10.3390/ijerph16244988

Aletta, F., Oberman, T., and Kang, J. (2018). Associations between positive health-related effects and soundscapes perceptual constructs: a systematic review. Int. J. Environ. Res. Public Health 15:2392. doi: 10.3390/ijerph15112392

None of these sources are exactly the same. One focuses on sound and attention, the next two on sound and health, and none of them are quite the same as sound and restoration —but they are all pieces of the puzzle that give a full understanding of how sound and restorative environments relate.

As the author of the literature review, it is your job to join the pieces together, giving your reader a complete picture of what researchers know about your topic.

Literature reviews are an indispensable tool for researchers. Instead of having to read dozens of articles on a topic, a researcher could instead read a literature review that synthesizes what is known and puts each piece of scholarship into conversation with the others. This could be not only quicker, but also more valuable.

Have you heard the saying that the whole is more than the sum of its parts? The knowledge constructed by a well-written literature review often outweighs the knowledge constructed by simply reading each article in the References section on its own because the author of a literature review processes and analyzes the information for the reader.

Literature reviews occur in two general forms—as a background section in a scholarly work or as a stand-alone genre in and of itself. In both situations, the basic purpose and structure of the literature review is similar: it is the length and the scope that varies. For example, consider the previous chapter, the Proposal. In most proposals, you will want to convince your audience that you are informed on the background of your topic—a literature review is how you would do that. Since a proposal is commonly a short text, you do not have the space to summarize every piece of research. You must select an important set and synthesize that information into a small section signaling your expertise.

On the other hand, consider a professional journal intended to keep its readers up to date on new technologies and findings in a specific field or career. New ideas and discoveries are emerging every day, and it can be difficult to stay on top of all of these new findings, understand how they fit together, and also keep track of your own career responsibilities! A magazine might hire an author to read all the new research on a specific topic and synthesize it into a single article, a state-of-the-art review, so that practitioners in a field can read a single 25-page article instead of 100 25-page articles.

More Resources 3.1: Literature Reviews

II. Rhetorical Considerations: Voice

Using the scholarship of other writers and researchers is one of the things that differentiates academic writing from other types of writing. Using others’ scholarship in a meaningful way that creates new knowledge without mischaracterizing the original findings takes effort, attention, and usually several rounds of revision and rewriting. One of the issues is voice , which refers to the attitude and tone of a text—think of it as what the text “sounds like” in your head as you read it. Voice is an important element of cohesion , or what some people think of as “flow.” Creating a consistent voice in the mind of your reader helps them fit all the information in a text together in the way the author intends. Check out this advice from APAstyle.org about academic style and voice.

Think back to your annotated bibliography and how you created your summaries. You probably used key terms from the original authors’ texts, but because you had to take whole articles and restate the meaning in a short paragraph, there wasn’t room to just repeat the words of the original author. So you had to write the summaries in your voice . If you used those key terms correctly and in ways similar to original authors, those key terms probably did not interfere with cohesiveness and voice. However, in the literature review, you have many more voices to synthesize than you did to summarize in the annotated bibliography. Maintaining a consistent and cohesive voice will be challenging. An important way to maintain voice is through paraphrasing, discussed later in this chapter.

More Resources 3.2: Transitions

Another important way to maintain cohesion is through the use of metadiscourse (see Chapter 2) and transitional phrases. See this link for the use and meaning of transitional phrases, sometimes called signposts .

III. The Literature Review Across the Disciplines

Example 3.3: Academic and Professional Examples

Structure of Literature Reviews

While the details vary across disciplines, all literature reviews tend to have similar basic structure. The introduction of a literature review informs the reader on the topic by defining key terms, citing key researchers or research periods in the field, and introducing the main focus of the review in a descriptive thesis statement. The introduction also explains the organization of the review. In a literature review, you organize your discussion of the research by topic or theme— not article or author. This is in direct contrast to the annotated bibliography, which is often the first step in the writing process for a literature review.

In the annotated bibliography, you organize your entries in alphabetical order by authors’ last names. Each annotation is directly connected to a single text. A literature review is connected to a collection of texts, and therefore must be organized in a way that reflects this.

Example 3.4: Let’s examine the full paragraph that the thesis statement we analyzed earlier came from:

A systematic review by Aletta et al. (2018) has identified links between positive urban soundscapes (which may also include nature sounds) and health and well-being, including stress recovery. Given the emphasis on nature w ithin restorative environments (see Hartig et al., 2014 ), the present narrative literature review focuses on evidence for positive psychological experiences of nature sounds and soundscapes specifically, and in particular how listening to these can generate perceptions and outcomes of restoration from stress and fatigue. This review has five key objectives, summarized in Figure 1 [in the article] . First, it explores literature regarding the impact of nature sounds on perceptions and experiences of wider natural environments. Second, it examines evidence regarding cognitive and affective appraisals of nature sounds and their contributions to overall perceptions of restorative environments. Third, literature regarding restorative outcomes in response to nature sounds is assessed. Fourth, the relevance of key restoration theories to this top ic is examined and areas where these theories are limited are identified. Fifth, a possible new theoretical area of interest—semantic associations with nature—is discussed and exemplified by recent acoustics research (Ratcliffe, 2021, emphasis added).

Notice how the thesis statement (in bold ) is followed by an explicit description of the five key objectives—which correspond to the titles (usually called headings ) of the five major sections of the body of the literature review. The introduction basically outlines the body of the literature review to make it easier for a researcher to find the specific information they are looking for. What follows each of these headings is an analysis and synthesis of the topic described in the heading—which is what we mean when we say a literature review is organized by topic.

Example 3.5: See how the body sections of a literature review synthesize research and evidence in relation to a focused topic. Read this example taken from a literature review in another discipline, nursing.

The introduction states that the review’s purpose is to understand the issues facing nurses in situations such as the COVID-19 pandemic. The researchers found several themes in the research that all contributed to nurses’ experiences. This paragraph describes one of those themes which the authors label “Professional collegiality”:

3.2.2. Professional collegiality

Professional camaraderie amongst nursing colleagues working during a pandemic was high (Ives et al., 2009, Kim, 2018, Liu a nd Liehr , 2009). Nurses acknowledged the importance of caring for their co-workers and in sharing the load. Some nurses associated the experience with working on a battlefield, whereby they worked together as a team protecting one another (Chung et al., 20 05, Kang et al., 2018, Liu and Liehr , 2009). Appreciation of their nursing colleagues was demonstrated through sharing their experiences, willingness to work together and encouraging a team spirit (Shih et al., 2007, Chung et al., 2005, Chiang et al., 2007 ). (Ratcliffe, 2021, p.4)

In this single paragraph, there are seven different research articles cited, and some of them are cited twice. There is no way to write a coherent paragraph summarizing seven different research articles at once—instead, the authors of this paragraph reviewed what the researchers said about collegiality, found where their findings pointed in the same direction, and put those connections into their own words. This is the importance of the review’s body section: it is here where you really dig into the content, meaning, and implications of the scholarship you are discussing.

The end of a literature review looks different from the one- or two-paragraph conclusion we are used to in other texts. The end is often made up of multiple sections, each with a slightly different purpose, although all are probably recognizable to you. A “Discussion” section is almost always present, where the author summarizes the most important findings of each section. In most cases, the “Discussion” section does not contain new information, but ties the different body sections together in ways that provide a deeper analysis.

The end of a literature review may also contain an “Implications for Future Research” or “Resolution” after the Discussion—sometimes this final section is even called “Conclusion.” What this last section looks like is often dependent upon the type of review you are writing, and whether the review is standing alone as a complete text or part of a larger project.

In any situation, across all disciplines, it is important to understand how your literature review is meant to inform the reader and what kind of review is appropriate for the context, in order to decide how you should structure the beginning and end of your review.

Types of Literature Reviews

There are different types of literature reviews, although in undergraduate study the Traditional or Narrative Review is most common. Narrative reviews are somewhat exploratory in their content—in a narrative review you are synthesizing the results of specific texts selected for their connection to your topic. Narrative reviews almost always end with a section describing areas for future research if they are a stand-alone text, or a section describing why the author’s research is so needed if part of a larger research article. The chart below outlines the key differences between three major literature review types. Notice that each type has a slightly different purpose. You might think about which type best fits your project as you read.

Table 3.1: Types of Literature Reviews

More Resources 3.3: Literature Review Structures

IV. Research Strategies: Developing a Methodology

Systematic and scoping reviews should always contain a Research Methodology that explains to your reader exactly how you found the research you are reviewing. Often Narrative Reviews will also contain a research methodology, although it will be slightly different since they are not comprehensive reviews, meaning, they do not attempt to find all the research on a topic—by design, they cover only a specific portion. Even if you are not required to write up your methodology, you need clear research strategies to find the appropriate scholarship for your literature review.

Example 3.6: Check out this excerpt from the methods sections from a psychology literature review. Note how the authors clearly describe what types of sources they’ll be using as well as their steps throughout the research process.

Drawing on individual case studies, archival reports, correlational studies, and laboratory and field experiments, this monograph scrutinizes a sequence of events during which confessions may be obtained from criminal suspects and used as evidence. First, we examine the pre-interrogation interview, a process by which police …( Kassin and Gudjonsson , 2004, p.33)

Example 3.7: Here is another example from the field of education. In it the authors describe two separate searches they performed to gather the literature—the first search used key terms they decided upon before reading any scholarship, and the second search used the terms that they found were common to that first set of texts (see more about key terms here and in the Annotated Bibliography chapter).

We conducted two rounds of literature searches, utilizing the following databases: World CAT (general search), EB SCO Academic Search Complete, EBSCO Education Source, and Linguistics and Language Behavior Abstracts (ProQuest). In the first round, we searched using every possible combination of the following terms: ‘race,’ ‘language teaching,’ ‘ethnicity,’ ‘language p edagogy,’ ‘Whiteness,’ ‘racialized,’ ‘antiracism,’ and ‘ nativeness .’ For the second round of our literature search, we searched using terms that we saw emerging from the literature such as ‘racial identities of language learners,’ ‘racial identities of lan guage teachers,’ ‘language varieties and language teaching,’ ‘race and language teacher education,’ ‘race and educational policy,’ ‘race and language programs,’ and ‘race and language curriculum’ and also repeated our earlier searches in order to keep the literature updated. (Von Esch et al., 2020, p. 392)

No matter the type of research (see a description of qualitative vs. quantitative research ), the specific genres (see descriptions of academic research genres ), or the time frame (see a discussion on the importance of publication date ) you use for your review, it is important to think through the options, make a decision, and incorporate all your research knowledge—use of key terms, use of subject filters, use of specialized databases, etc.—into a coherent and meaningful process that results in the best scholarship for your inquiry and review.

Here’s a video to help you get started on using databases for research:

Library Referral: Connecting the Conversation with Scholarly Sources and Beyond​

(by Annie R. Armstrong)

Research involves drawing from numerous voices from a range of source types. The sources you choose to include in your conversation are context-specific and might vary depending on your topic or the parameters of your assignment. Review your assignment description and talk to your instructor about guidelines. While most research papers emphasize scholarly sources, expertise isn’t always equated with scholarliness and you might want to branch out. For example, a research paper focusing on exploitation of Native American land and communities by the mining industry should make some attempt to include sources generated by the communities under discussion, especially if their point of view is not represented in the peer-reviewed, scholarly sources you’ve found. Think about who the stakeholders are as related to various aspects of your topic and how you can tap into their voices through available resources. You may want to consult a librarian about this.

The chart below summarizes the breadth of source types available through library websites versus the open web:

Table 3.2: Scholarly Sources and Beyond

V. Reading Strategies: Intertextuality and Graphic Organizers

Typically we think of reading as something we do to learn the content of a text—and this is absolutely true! But true understanding means knowing the relationships between and impact of separate but related topics, which might mean understanding how different texts—generally focused on one topic—overlap or differ.

Intertextuality refers to the connections that exist between texts. Intertextuality as a reading strategy means looking for the connections between the text you are reading and others you have already read; anticipating connections with other texts that you have not yet read, but plan to; as well as connections to whole disciplines, fields, and social phenomena. Reading for intertextuality means looking for opportunities to connect texts with each other, and keeping track of those connections in a productive way.

This means note-taking is essential to intertextual reading. Once you have thought carefully about why you are reading a text, what types of information to look for, and what you will do with that information, you can better decide how to keep track of that information. In regards to literature reviews, one type of graphic organizer dominates: the Synthesis Matrix.

The synthesis matrix is a way to keep track of the themes, concepts, and patterns that are emerging from your reading—NOT all the individual content of each article. This is important, yes, and you will need the citations, but literature reviews move one step further into the topic than simply identifying the pieces. You will need to synthesize.

If you have an annotated bibliography of sources already, it is the perfect way to start your synthesis matrix. An annotated bibliography is often the first step in preparing for a literature review, and is quite similar to an ingredient list, if we are using the metaphor from the introduction. (For a detailed description of how to write an annotated bibliography, see Chapter 1 ).

In your annotations, you will have selected the most important information that text supplies in relation to your topic. For an example, let’s take the Conference on College Composition and Communication’s statement “ Students’ Right to Their Own Language ,” which contains two annotated bibliographies. The second uses more recent sources and looks most like the annotated bibliographies you will write as a student, so let’s start there.

Example 3.8: Here are three annotations from that bibliography. As you read, take notice of the different highlighted colors. Phrases italicized and highlighted green identify ideas related to linguistic identity , phrases bolded and highlighted in blue identify concepts related to grammar analysis , and phrases underlined and highlighted orange identify groups and ideas related to educational objectives :

Fought, Carmen. Chicano English in Context. New York: Palgrave Macmillan, 2003.

Based primarily on data collected from adolescent and young adult native speakers in Los Angeles , this book is a comprehensive sociolinguistic study of language and language change in Latino/a communities. It provides the basics of Chicano English (CE) structure (phonology, syntax, and semantics) and its connection to the social and cultural identity of its speakers, along with detailed analyses of particular sociolinguistic variables. Emphasis is given to the historical, social, and linguistic contexts of CE. In addition, the differences between native and non-native CE speakers are covered. A final chapter discusses the future of research on CE.

Lippi-Green, Rosina. English with an Accent: Language, Ideology, and Discrimination in the United States . London and New York: Routledge, 1997.

The author examines linguistic facts about the structure and function of language , explores commonly held myths about language, and develops a model of “the language subordination process.” Then, using a case-study approach, she applies the model to specific institutional practices (e.g., in education, news media, business) to show how false assumptions about language lead to language subordination. The author analyzes specific groups and individuals (speakers of African American English, Southern U.S. English, and the foreign-language accent of Latinos and Asian Americans) and discusses why and how some embrace linguistic assimilation while others resist it.

Nero, Shondel J. Englishes in Contact: Anglophone Caribbean Students in an Urban College. Cresskill, NJ: Hampton Press, 2001.

This qualitative study of four anglophone Caribbean students at a New York City college offers an in-depth examination of the students’ written and spoken language and the challenges faced by both students and teachers as such students acquire academic literacy. Case studies of the four participants include excerpts from tape-recorded interviews, which reflect their linguistic self-perception, and sociolinguistic and educational experiences in their home countries and in New York City. Samples of their college writing over four semesters are represented and analyzed on morphosyntactic and discourse levels to determine the patterns that emerge when Creole English speakers attempt to write Standard Written English. Related issues such as language and identity , language attitudes, and educational responses to ethnolinguistic diversity are also discussed.

Once you have identified a concept like “language and identity” for your literature review, you can start getting “intertextual”! Review your other annotated sources and your new sources for their discussion of language and identity, as well as parallel concepts—what else do researchers address when they discuss language and identity? What do they discuss instead? Go back to the methods you used to come up with key terms for your literature search—the same strategies now apply to your reading. Also look for “umbrella” concepts, patterns in methodologies—anything that emerges while you read intertextually, focusing on the text in front of you while also remembering all the others you read before. Look for the themes in your annotated bibliography and keep track of the page numbers where these themes appear—plan to go back to those pages several times as you write your literature review.

This is a different type of reading than you did for the annotated bibliography, and might mean you go back and reread your sources several times in this new way—don’t think of this as just repeating labor you have already performed. This is new work, designed to uncover new things in the research. Re-reading articles multiple times is something all serious writers do, and something you should do, too. It isn’t redundant, it is recur sive .

Table 3.3: Synthesis Matrix for Individuals’ Choices in Linguistic Identity

Put your sources into conversations around your themes, as shown in the table above. Notice that the top row names the themes covered in that column, put into original wording similar, but not identical, to the wording in the annotated bibliographies. Not every source will address every topic—not every article is the same. The last row starts to describe what is happening in each column across the whole collection of texts. In this way, your synthesis matrix takes the ingredient list provided by the annotated bibliography and makes it into a recipe for your final product—the literature review.

More Resources 3.4: Synthesis Matrix

VI. Writing Strategies: Citation, Quotation, and Paraphrase

Citation is when you use the work of other authors in your writing and mark that portion of your writing so your reader understands what idea is being “borrowed.” Citation also tells your reader where they could find that original idea in the original text, and how your text fits together with the web of other texts related to your topic: in other words, citations help create intertextuality. A citation placed in your sentences should refer directly to the full bibliographic information in your Works Cited or References page.

As you read in Chapter 1, there are different styles of citation including AMA, APA, CMS, and MLA. You can refer back to that chapter for a more detailed explanation of each. In this section, we’ll cover the basics that are common to citation practices. Most academic styles use the original author’s last name as the central part of the in-text citation, since References pages usually list cited works alphabetically by last name, but some use footnotes or endnotes instead, listing works in the order they were cited. It is important to know which academic style you are using for your literature review so that you can make the right choice.

In-text citation takes one of two forms: parenthetical or narrative. In a narrative citation the author of the original work is mentioned in the sentence.

Example 3.9: Here’s an example taken from the introduction of the same literature review discussed in the Research Strategies: Developing a Methodology section of this chapter.

Several pieces offered a comprehensive review of the historical literature on the formation of Black English as a construct in the context of slavery and Jim Crow, and the historical teaching of Black English within the U .S. context, including Wheeler ( 2016 ) and Alim and Baugh (2007). Wheeler (2016) equated Standard English with ‘White’ English and challenged its hegemony in dialectically diverse classrooms. She named the “racism inherent in [fostering] bidialectalism [th rough teaching]” (p. 380), arguing that we are acknowledging that the only way for African-Americans to be upwardly mobile was to learn how to speak ‘White’ English. Alim (2010) , explained, “By uncritically presenting language varieties as ‘equal’ but diff ering in levels of ‘appropriateness,’ language and Dialect Awareness programs run the risk of silently legitimizing ‘Standard English’” (p. 215)…. Current work addressing AAVE studies has been shifting focus to translingualism and to promoting such pedag ogies as code-meshing (Young, Barrett, Young Rivera and Lovejoy, 2014) and translanguaging (García & Wei, García and Wei, 2014) , embedded in a critical analysis of the racial logics underpinning the denigration of some languages. This work, combined with e xtensive examinations of the connections between race, language, teaching, and identity ( e.g. Flores & Rosa, 2015; Alim et al., 2016 ), has laid a foundation for a raciolinguistics approach to teaching, which we return to later in this article. (Von Esch et al., 2020, p. 399, emphasis added .)

In the first sentence, we see two narrative citations just before the period. These citations state the authors’ names as a part of the sentence, and put the publication date of the articles in parenthesis. It makes sense to use a narrative citation in the topic sentence, since most of the paragraph is a synthesis of Wheeler and Alim’s research. The second sentence starts with Wheeler’s name in the subject position, and the fourth sentence starts with Alim’s name in the subject position—both are narrative citations, a form chosen by the author to emphasize the importance and similarities in the two articles.

In the last two sentences, we see parenthetical citations. The citation information is in parenthesis within the sentences, which focuses the reader on the ideas, not the research itself. Imagine you were reading this article out loud—you would most certainly say the narrative citations “Wheeler” and “Alim”; you might choose not to say “Young, Barrett, Young-Rivera, & Lovejoy, 2014,” though, and no one listening to you would notice the omission. This is the most important difference between narrative and parenthetical citation—narrative draws attention to the researchers, while parenthetical allows a focus on ideas. In academic writing, you often have reason to use both, but it is important to note that using parenthetical citation is less disruptive to your voice—it keeps a reader focused on the ideas you are explaining.

Usually you are citing a type of quotation in your text (although different disciplines have other situations that they cite). Direct quotation and paraphrase are usually what we talk about when we talk about using resources in your writing, although summary is cited as well.

Direct quotation is when you take the original words of one author and place them in your own text. When you quote in your own writing, you mark the copied text—usually with quotation marks “” around the text and a citation afterwards. Quoting is useful when the original author is an important authority on a topic or if you want to define/describe another’s point of view in a way that leaves no room for misinterpretation.

In a literature review, a direct quote will almost always be accompanied by a narrative citation. But direct quoting can cause some issues in your own text, such as a sudden shift in voice and a loss of cohesion; the potential for misunderstanding and misrepresentation, since the quote has been separated from its original context; and wordiness —quotes can take up too much space both in terms of the quote itself, and of the explanation and context you must provide for the introduced idea. For these reasons, literature reviews do not contain much direct quoting.

Paraphrasing is a way to accomplish similar goals to direct quoting without causing the same problems. Paraphrasing is when you use only the original author’s key terms and ideas, but your own words. Paraphrasing still contains a citation afterwards that directs the reader to the full bibliographic information in your Works Cited, but does not require quotation marks since the language is yours. Paraphrase may be longer or shorter than the original author’s text, and uses both narrative and parenthetical citation. Paraphrase also allows you to cite more than one piece of research containing the same idea in a single sentence, such as the last sentence in the example paragraph above. This kind of citation string is important to literature reviews because it clearly identifies patterns and trends in research findings.

Key Takeaways

• Literature reviews are a synthesis of what other researchers have discovered on your topic. Think of reviews as “the big picture.”
• Taking so much information from other sources can get confusing–use section headings to keep your review organized and clear.
• Diverse citation, quotation, and paraphrasing techniques are necessary to help your reader understand where the ideas are coming from, AND to help make the ideas “stick together.”
• Keeping all the new knowledge you are learning from your sources organized is hard! Take notes using citations and use a graphic organizer to keep yourself on track.

Fernandez, Lord, H., Halcomb, E., Moxham, L., Middleton, R., Alananzeh, I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies , 111. https://doi.org/10.1016/j.ijnurstu.2020.103637

Kassin, S. M., & Gudjonsson, G. H. (2004). The psychology of confessions. Psychological Science in the Public Interest , 5 (2), 33–67. https://doi.org/10.1111/j.1529-1006.2004.00016.x

National Council of Teachers of English. (2018, June 16). Students’ right to their own language (with bibliography) . Conference on College Composition and Communication. Retrieved July 24, 2022, from https://cccc.ncte.org/cccc/resources/positions/srtolsummary

NEIU Libraries. (2020). “How should I search in a database?”  YouTube . https://www.youtube.com/watch?v=8fgBF0EuH_o

Ratcliffe, E. (2021). Summary Flowchart [Image]. Frontiers in Psychology. https://www.frontiersin.org/articles/10.3389/fpsyg.2021.570563/full#B3

Ratcliffe, E. (2021). Sound and soundscape in restorative natural environments: A narrative literature review. Frontiers in Psychology , 12 . https://doi.org/10.3389/fpsyg.2021.570563

Sasaki. K. (2022). Synthesis and Recipes [Image].

Von Esch, K., Motha, S., & Kubota, R. (2020). Race and language teaching. Language Teaching, 53 (4), 391-421. doi:10.1017/S0261444820000269

Writing for Inquiry and Research Copyright © 2023 by Charitianne Williams is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Impressive Academic Phrases for Writing Manuscripts

If you are a graduate student or a researcher, you definitely know the challenges involved in composing academic documents. Right from the abstract to the conclusion, every section must follow a logical structure. Using appropriate language, tense, voice, and perspective to present your ideas is very important. As a good practice, researchers prior to writing a manuscript extensively read previously published literature. However, scanning for the right phrases and then using them as templates to fill in data obtained from their work can be extremely time-consuming! In the following article we present to you a “quick reference guide for impressive academic phrases”. Collated from hundreds of published manuscripts, these frequently used academic phrases are tailored to what every section of your article should achieve.

Benefits of Using Tailor-made Academic Phrases

• Using these phrases will simplify your writing process. You can invest your time and efforts for something more productive.
• These phrases will help you write in a clear and concise manner.
• Ready-made phrases can expedite your process of organizing your data in a logical manner.
• There are far less chances of plagiarism as these are generic phrases that find acceptance across all disciplines.
• Editors and peer reviewers may find it easier to run through your data when expressed using standard or conventional phrases. This may assist in speeding up the review process and increasing your chances of a faster publication.
• Think about your target audience – busy researchers and academicians! They will surely enjoy reading a manuscript that is crisp and engaging.
• Structure of a manuscript is paramount! These phrases may also help you create a logical framework for your data.

Abstract is that element of a manuscript that convinces your reader why your article is worth reading. It is like a miniature article that clearly states the objectives and briefly explains all your key findings.

XYZ is the primary/main/leading/major cause of… XYZ is /are attracting considerable interest/gaining widespread attention due to… An intriguing/important/challenging aspect of XYZ is… As far as we know/to our knowledge this is the first study/no previous research has investigated… Very few studies have investigated/have shown/examined/focused on… One approach /alternative approach to solve these problems… The aim /overall objective/ultimate goal of… This paper reports/outlines/proposes/describes/presents a novel approach.. This manuscript examines/focusses on/addresses/investigates/sheds light on how to.. The aim of this study/work/research was to broaden/widen/extend/further the current knowledge about… Here, we describe/present a simple/novel/radical/effective/interesting solution for

Introduction and literature review

This section focuses on – what did you investigate and why it is important? Consequently, you have to provide some background information and thereafter introduce the aims or arguments of the paper.

An ever-increasing body of literatures shows that.. Very recently, XYZ have provided new evidences for… Several studies have hypothesized /proposed/put forward.. In recent years, there has been growing/considerable interest in… The last few years has witnessed/ seen a huge growth in XYZ. This study constitutes a relatively new area of research which has emerged from… In order to elucidate/reveal/understand the XYZ mechanism… For several years, researchers have been focusing on XYZ in an attempt to understand… To address these three gaps in research outlined above, we formulated the following research question… Overall, this review paper puts an emphasis on… Preliminary/ initial studies on XYZ primarily focused on… An increase/decrease in factor X was first reported/noted/identified by… Several studies, for instance [1], [4], and [9]  have suggested/highlighted/revealed/proposed/demonstrated…. XYZ et al. calculated/analyzed/estimated… ABC traced the developments/advancements /evolution of XYZ… PQR  maintains/suggests/underlines/argues/suggests that… Few authors have also suggested that… Although there are several studies consistent with XYZ , no study has till date examined… Previous studies reported by [A], [B] and [C] cannot be considered conclusive as…. Studies by XYZ have led to a more profound understanding of… Only a few studies in literature demonstrate… To fill this gap in literature, this manuscript/paper identifies… To develop/establish a novel/effective alternative… Our findings might be useful/vital/crucial for developing a simple/effective/cost-effective…method for.. Despite several reviews in the literature that address the importance of XYZ none of the recently published articles have comprehensively discussed the important roles of… While XYZ is well documented in literature ([1],[5],[8],[16]), to date, no research has… However, we argue that the reported literature suffers from certain limitations…

Materials and Methods

This sections provides details about the study site, organisms studies, experimental design, and computational or statistical methods used to analyze the data.

In our preliminary experiments, we determined that… This phenomenon was experimentally investigated by… The principle focus of this experiment was to calculate… The XYZ strain used in this study was kindly supplied by… Statistical analyses were performed by using … test with a significance level of … Data analysis (regression analysis/correlation studies) and graphical representations were performed using…

Results and Discussion

This section discusses all the outcomes relevant to the research question. One needs to highlight the significance of the results and indicate whether your findings support or reject the hypothesis.

When analyzing the data, we applied XYZ technique and… The current study confirmed the findings/found clear support for the… Our results demonstrated/found evidence that… From the results it is evident/clear that… Moreover, the results of the empirical studies showed that… Additionally, researchers have found a positive/negative relationship/correlation between… These findings/results are consistent/in line/in accordance with… in addition we assessed…, the findings revealed significant differences in… On the contrary, very few studies have reported… Equally important is the fact that there is strong correlation between… The limitations of the present study include… Although widely accepted, this method suffers from certain limitations .. It is interesting to note that… Further investigation/studies are required to precisely/accurately understand/elucidate… In addition to these findings, the results of our previous studies demonstrate…

Conclusions

The conclusions section highlights all the important trends and comparisons identified in the study. It also states the limitations as well as future recommendations to carry out subsequent research.

XYZ has shown promising results and thus could be a powerful technique/tool/method for… These findings could provide new insights into… The significant benefits/key contributions/main achievements of this study can be summarized as.. We believe that XYZ merits further research to discover/explore… and potential for… Also this remains a subject for future studies/experiments. Although further investigations are needed, the present study contributes to a better understanding/characterization of… In this review/article we addressed the current progress and challenges in… Nevertheless, there are still critical challenges regarding.. Furthermore, XYZ is a domain where much remains to be studied… As a final remark, it is also vital to mention…

We hope these academic phrases will assist you in the logical development of your manuscript and making it impactful. Let us know your feedback in the comments section below!

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Literature Review

How to search effectively.

• Find examples of literature reviews
• How to write a literature review
• Grey literature

The  Literature searching interactive tutorial  includes self-paced, guided activities to assist you in developing  effective search skills..

1. Identify search words

Analyse your research topic or question.

• What are the main ideas?
• What concepts or theories have you already covered?
• Write down your main ideas, synonyms, related words and phrases.
• If you're looking for specific types of research, use these suggested terms: qualitative, quantitative, methodology, review, survey, test, trend (and more).
• Be aware of UK and US spelling variations. E.g. organisation OR organization, ageing OR aging.
• Interactive Keyword Builder
• Identifying effective keywords

2. Connect your search words

Find results with one or more search words.

Use OR between words that mean the same thing.

E.g.  adolescent  OR  teenager

This search will find results with either (or both) of the search words.

Find results with two search words

Use AND between words which represent the main ideas in the question.

E.g. adolescent AND “physical activity”

This will find results with both of the search words.

Exclude search words

Use NOT to exclude words that you don’t want in your search results.

E.g. (adolescent OR teenager) NOT “young adult”

3. Use search tricks

Search for different word endings.

Truncation *

The asterisk symbol * will help you search for different word endings.

E.g. teen* will find results with the words: teen, teens, teenager, teenagers

Specific truncation symbols will vary. Check the 'Help' section of the database you are searching.

Search for common phrases

Phrase searching “...........”

Double quotation marks help you search for common phrases and make your results more relevant.

E.g. “physical activity” will find results with the words physical activity together as a phrase.

Search for spelling variations within related terms

Wildcards ?

Wildcard symbols allow you to search for spelling variations within the same or related terms.

E.g. wom?n will find results with women OR woman

Specific wild card symbols will vary. Check the 'Help' section of the database you are searching.

Search terms within specific ranges of each other

Proximity  w/#

Proximity searching allows you to specify where your search terms will appear in relation to each other.

E.g.  pain w/10 morphine will search for pain within ten words of morphine

Specific proximity symbols will vary. Check the 'Help' section of the database you are searching.

4. Improve your search results

All library databases are different and you can't always search and refine in the same way. Try to be consistent when transferring your search in the library databases you have chosen.

Narrow and refine your search results by:

• year of publication or date range (for recent or historical research)
• document or source type (e.g. article, review or book)
• subject or keyword (for relevance). Try repeating your search using the 'subject' headings or 'keywords' field to focus your search
• searching in particular fields, i.e. citation and abstract. Explore the available dropdown menus to change the fields to be searched.

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Adapt your search and keep trying.

Searching for information is a process and you won't always get it right the first time. Improve your results by changing your search and trying again until you're happy with what you have found.

Keep track of your searches

Keeping track of searches saves time as you can rerun them, store references, and set up regular alerts for new research relevant to your topic.

Most library databases allow you to register with a personal account. Look for a 'log in', 'sign in' or 'register' button to get started.

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Mastering Transition Words for a Strong Literature Review

• backlinkworks
• Writing Articles & Reviews
• December 29, 2023

Transition words play a crucial role in writing a literature review. They help in connecting ideas, demonstrating relationships between different pieces of information, and providing a smooth flow to the overall narrative. Mastering transition words can significantly enhance the quality of your literature review. In this article, we will discuss the importance of transition words and provide a comprehensive guide to mastering them.

Importance of Transition Words in a Literature Review

In a literature review, you are expected to synthesize and critically analyze existing research and literature on a specific topic. The use of transition words is essential in accomplishing this task effectively. Transition words help in structuring your review by organizing your ideas and arguments in a coherent manner. They also contribute to the overall clarity and readability of your literature review.

Furthermore, transition words enable you to make smooth transitions between different paragraphs and sections of your literature review. This is crucial as IT helps your readers to follow the logical progression of your arguments and understand the relationships between different sources and ideas.

Types of Transition Words

There are various types of transition words that you can use in your literature review to achieve different purposes. Some of the common types of transition words include:

• Adding Information: e.g., additionally, furthermore, moreover
• Comparing Ideas: e.g., similarly, likewise, in the same way
• Contrasting Ideas: e.g., however, on the other hand, in contrast
• Showing Cause and Effect: e.g., therefore, thus, as a result
• Sequencing Ideas: e.g., first, second, finally
• Providing Examples: e.g., for example, for instance, specifically

IT is important to understand the different types of transition words and their usage in order to effectively convey the relationships between different pieces of information in your literature review.

Mastering Transition Words

Mastering transition words requires a good understanding of their meanings and applications. Here are some tips to help you master the use of transition words in your literature review:

• Understand the Purpose: Before using a transition word, consider the purpose IT serves in the context of your literature review. Is IT adding information, comparing ideas, contrasting ideas, showing cause and effect, or sequencing ideas?
• Use Appropriate Transition Words: Choose transition words that are suitable for the relationships you want to express. For example, use “in addition” to add information and “however” to contrast ideas.
• Consider the Context: Pay attention to the context of your literature review and use transition words that fit the overall coherence and logic of your arguments and analysis.
• Practice and Feedback: Practice using transition words in your writing and seek feedback from peers or mentors to improve your usage of transition words.

Examples of Transition Words in Literature Reviews

Here are some examples of how transition words can be used effectively in a literature review:

“Additionally, the study found that the effects of the intervention were consistent across different demographic groups.”

“On the other hand, Smith (2018) argues that the findings of the previous study are limited in scope and may not be generalizable to other populations.”

Mastering transition words is essential for writing a strong literature review. By understanding the importance of transition words, knowing the different types, and practicing their usage, you can significantly enhance the clarity and coherence of your literature review. Transition words not only help in structuring your review but also make IT more engaging and persuasive to your readers.

1. What are transition words?

Transition words are words or phrases that connect ideas, sentences, and paragraphs, and show the relationships between them. They help in creating a smooth flow and logical progression in writing .

2. How can transition words improve the quality of a literature review?

Transition words can improve the quality of a literature review by organizing ideas, demonstrating relationships between different pieces of information, and providing a coherent structure to the overall narrative.

3. Is IT important to use transition words in a literature review?

Yes, IT is important to use transition words in a literature review as they contribute to the clarity, coherence, and readability of the review. They also help in guiding the reader through the logical progression of ideas and arguments.

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• Case report
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• Published: 27 May 2024

A rare incidence of severe dermatological toxicities triggered by concomitant administration of all-trans retinoic acid and triazole antifungal in patients with acute promyelocytic leukemia: a case series and review of the literature

• Aisha Jamal   ORCID: orcid.org/0000-0001-5022-7498 1 , 3 ,
• Rafia Hassam 1 ,
• Qurratulain Rizvi 1 ,
• Ali Saleem 1 ,
• Anum Khalid 2 &
• Nida Anwar 1  

Journal of Medical Case Reports volume  18 , Article number:  261 ( 2024 ) Cite this article

266 Accesses

2 Altmetric

Metrics details

All-trans retinoic acid (ATRA) is an indispensable part of the treatment of acute promyelocytic leukemia (APL). Although, mild cutaneous toxicities like mucocutaneous xerosis, rash, and pruritus are well reported, ATRA associated severe dermatological toxicities are extremely rare. ATRA is primary metabolized by cytochrome P450 (CYP450) enzyme system, and triazole antifungals are notorious for their strong inhibitory effect on CYP450.

Case presentation

Three Asian APL patients experienced rare ATRA-induced severe dermatological toxicities: exfoliative dermatitis (ED) in cases 1 and 2, and necrotic scrotal ulceration in case 3. Both case 1 (33-year-old female), and case 2 (28-year-old male) landed in emergency department with dehydration, generalized skin erythema and xerosis during their induction chemotherapy. Both of these patients also developed invasive aspergillosis and required concomitant triazole antifungals during their chemotherapy. For ED, intravenous fluids and broad-spectrum antibiotics were started along with application of local emollients to prevent transdermal water loss. Although their general condition improved but skin exfoliation continued with complete desquamation of palms and soles. Dermatology was consulted, and clinical diagnosis of ED was established. Discontinuation of ATRA resulted in complete resolution of ED. Case 3 (15-year-old boy) reported two blackish mildly tender scrotal lesions during induction chemotherapy. He also had mucocutaneous candidiasis at presentation and was kept on triazole antifungal. Local bacterial & fungal cultures, and serological testing for herpes simplex virus were reported negative. Despite adequate local care and optimal antibiotic support, his lesions persisted, and improved only after temporary discontinuation of ATRA. After a thorough literature review and considering the temporal association of cutaneous toxicities with triazole antifungals, we speculate that the concomitant use of triazole antifungals inhibited the hepatic metabolism of ATRA, resulting in higher serum ATRA concentration, and markedly accentuated cutaneous toxicities in our patients.

By highlighting this crucial pharmacokinetic interaction, we want to caution the fellow oncologists to be mindful of the inhibitory effect of triazole antifungals on CYP450. We propose using a non-myelosuppressive combination of ATRA and arsenic trioxide for management of APL hence, obliterating the need of prophylactic antifungals. However, in the event of invasive fungal infection (IFI), we suggest using alternative class of antifungals.

Peer Review reports

Acute promyelocytic leukemia (APL) is a rare and potentially curable subtype of acute myeloid leukemia (AML), accounting for 5–8% of AML cases [ 1 ]. Genetically, APL is characterized by reciprocal translocation t(15:17) (q22;q11–12), with consequent fusion of promyelocytic (PML) gene on chromosome 15q22 to retinoic acid receptor-alpha (RAR-alpha) gene on chromosome 17q21. The resultant fusion oncoprotein, PML-RARA, induces transcriptional repression, chromatin condensation, maturation arrest, and accumulation of abnormal promyelocytes [ 2 ]. Advent of all-trans retinoic acid (ATRA) has revolutionized the treatment landscape of APL, and along with the backbone of anthracycline based chemotherapy, it is considered to be the standard of care for APL patients. Combination treatment with ATRA plus anthracycline based chemotherapy achieves an overall complete remission and cure rate of 95% and 80% respectively, rendering ATRA indispensable in the management of APL [ 3 ].

ATRA, an active metabolite of vitamin A, belongs to a class of retinoids. Although retinoids are well known for their dermatological side effects like xerosis, xerostomia, erythema, pruritis, and exfoliation; severe dermatological side effects of ATRA, especially in the dosage pertinent to APL (45 mg/m 2 ), are rare. So far, only a single case of exfoliative dermatitis (ED) and a few cases of scrotal ulceration have been reported in literature [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. We, here in, report a case series of three patients with serious and rare ATRA associated dermatological complications. We have also discussed upon the potentially precipitating pharmacokinetic interactions, as well as the detailed clinical course and management of our patients as simply withholding ATRA can jeopardize the outcome of this potentially curable malignant disorder.

In all three patients, ATRA was started as soon as abnormal promyelocytes were documented on peripheral smear/bone marrow aspirate examination (Figs.  1 , 2 , 3 ). Diagnosis was further confirmed through cytogenetic analysis as well as PML-RARA detection by polymerase chain reaction. Additionally, in all three patients, chemotherapeutic treatment was instituted according to European APL protocol, based on their risk-group classification.

Exfoliative dermatitis &Onychomadesis (CASE 1). a Peripheral smear. b Bone marrow aspirate. c Desquamation of soles. d Desquamation of palms. e Dry exfoliation of feet and shins. f Onychomadesis

Exfoliative dermatitis (CASE 2). a Peripheral smear. b Bone marrow aspirate. c and d Erythema and scaling of hands. e Cutaneous desquamation of soles

Scrotal lesions (CASE 3). a Peripheral smear. b Bone marrow aspirate. c and d Necrotic scrotal lesions with black eschar

Case 1: A 33-year-old Asian female presented in ER with history of fever, heavy menstrual bleeding and rash all over body. Induction chemotherapy and steroid prophylaxis was promptly started to prevent differentiation syndrome (DS). On Day-10 of induction chemotherapy, she developed high grade fever, cough and shortness of breath. High-resolution computerized tomography (HRCT) showed randomly scattered discrete nodular opacities with surrounding ground glass haze in both lung fields, suggestive of invasive fungal infection (IFI). Voriconazole was immediately started along with broad-spectrum antibiotics. She improved over the following 72 hour, and was discharged from hospital on Day-17. Subsequently, she landed in emergency department on Day-23 with severe dehydration, shivering, tachycardia, generalized skin erythema and discoloration of nail beds. Intravenous fluids and broad-spectrum antibiotics were started along with application of local emollients to prevent transdermal water loss. Over the next 24-36 hour, her general condition was stabilized however; skin exfoliation continued with complete desquamation of palms and soles (Fig.  1 ). Dermatology was consulted, and a clinical diagnosis of onychomadesis and exfoliative dermatitis (ED) was made. A review of her clinical case demonstrated no apparent cause for ED except for a rare association with ATRA. However, considering the curative potential of ATRA, it was continued till Day-28 as per protocol. Her skin condition gradually resolved over next 10–14 days after discontinuation of ATRA. She had recurrence of similar skin condition upon re-exposure to ATRA in her consolidation chemotherapeutic cycles, however, the exfoliation was mild and patchy that responded well to good oral hydration and local skin emollients.

Case 2: A 28-year-old Asian male presented in the out-patient clinic with the history of generalized weakness, high-grade-fever, productive cough and bruises over body. On examination, he had multiple ecchymosis and petechiae with coarse crepitations involving right-middle and left-lower lung fields. He was promptly started on broad-spectrum antibiotics. Additionally, as per protocol, induction chemotherapy and dexamethasone prophylaxis was also instituted. His fever and cough remained unresponsive despite broad-spectrum antibiotics. Voriconazole was instituted upon the identification of IFI on HRCT findings. By day-10, coagulopathy was normalized, and clearance of abnormal promyelocytes was documented by Day-18. On Day-20, he complained of skin dryness, itching and scaling; physical examination revealed generalized xerosis and erythema (Fig.  2 ). Despite aggressive skin care, generalized skin exfoliation, most pronounced on palms and soles, ensued. Clinical diagnosis of ED was established after obtaining dermatological consultation. However, in view of his clinical stability, ATRA was continued. Bone marrow aspirate on Day-28 showed morphological remission. Recurrence of erythema and exfoliation was documented during consolidation phase of chemotherapy, but the condition was responsive to local emollients and oral hydration.

Case 3: A 15-year-old Asian male presented in the out-patient clinic with complains of high-grade-fever, muco-cutaneous bleeding and pancytopenia. On presentation, patient was febrile and had oral thrush. After sending his baseline tests he was taken on broad-spectrum antibiotics and triazole antifungal (itraconazole). After completion of induction chemotherapy, patient was discharged with bi-weekly follow-ups.On Day15, he reported two blackish, mildly tender scrotal lesions with minimal serous discharge (Fig.  3 ). Antibiotic cover for soft tissue infection was commenced along with local wound care with topical steroids and antibiotics. He had no sign of systemic infection/sepsis. Local bacterial & fungal cultures and serological testing for herpes simplex virus were reported negative. Despite adequate local care and optimal antibiotic support, his lesions showed no sign of healing, and two new lesions were developed. Lesion biopsy for histopathological evaluation was declined by the patient. Keeping the rare but reported occurrence of ATRA-induced scrotal ulceration and fournier's gangrene; ATRA was transiently withheld for ten days and the lesions started to regress. However, considering the indispensable role of ATRA in APL, it was reinstituted. Scrotal lesions persisted without any worsening. ATRA was stopped after completion of protocol. Complete resolution of scrotal lesions was documented over the following two weeks. Afterwards, he received two cycles of consolidation chemotherapy, but no recurrence was reported.

Discussion and conclusion

The antineoplastic role of ATRA remains indispensable in the curative management of APL. It is considered a relatively safe drug with a well-known toxicity profile. Commonly reported adverse events include DS, pseudotumor-cerebri, hypertriglyceridemia, transaminitis, and headache. Although, mild cutaneous toxicities like muco-cutaneous xerosis, photosensitivity, rash, pruritus and sweet’s syndrome are well reported, severe dermatological toxicities are rarely reported in literature [ 18 , 19 ]. In this case series, we have discussed three cases of ATRA-induced rare dermatological complications in APL.

Case 1 and 2 developed ED during remission induction phase of chemotherapy. Literature review revealed only a single reported occurrence of ATRA-induced ED in APL by YonelIpek et al. [ 4 ]. ED is a potentially life-threatening cutaneous manifestation that is characterized by diffuse skin erythema and scaling. Various underlying disorders can trigger its onset through a complex interplay of inflammatory cytokines and phagocytes. In contrast to our cases, the case reported by Yonel Ipek et al. developed xerosis in consolidation phase, which akin to our cases started after two weeks of ATRA exposure and rapidly deteriorated to generalized erythroderma and scaling. In both cases, discontinuation of ATRA resulted in complete resolution of ED.

In case 3, we have reported ATRA-induced necrotic scrotal ulceration. Literature review revealed that over the last two decades, a total of twenty cases of ATRA-induced scrotal ulceration have been reported. Histopathological evaluation of these lesions revealed atypical granulocytic infiltration, pointing towards the possible etiological role of differentiated APL cells in the pathogenesis. Most of these cases, including ours, developed genital-lesions almost after two weeks of ATRA exposure and remained unresponsive to local and systemic antibiotics. ATRA had to be halted in most of the cases to prevent progression to fournier’s gangrene [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].

Scattered over the span of three years and considered in isolation, it was not initially apparent to us that all three cases had one striking similarity: concomitant use of ATRA and triazole antifungals. ATRA is primary metabolized by cytochrome P450 enzyme system. Triazole antifungals are notorious for their strong inhibitory effect on CYP450 enzyme system, resulting in supra-therapeutic drug levels and toxicity [ 20 , 21 , 22 ].

Potentiation of serum ATRA levels by inhibition of CYP450 system was first explored by Rigas et al. [ 23 ]. This study reported 1.8 times higher serum concentration of ATRA with concomitant use of ketoconazole. Since then a number of cases have reported the augmentation of ATRA-induced toxicities due to this pharmacokinetic interaction. Concomitant use of ATRA and triazole antifungals that is voriconazole and posaconazole has been implicated to cause severe hypercalcemia [ 24 , 25 , 26 , 27 ]. Similarly, combination with fluconazole has been reported to cause severe neurotoxicity and nephrotoxicity [ 28 , 29 ].

Considering the temporal association of dermatological complications with triazole antifungals in our patients, we speculate that the concomitant use of triazole antifungals inhibited the metabolism of ATRA, resulting in higher serum concentrations and markedly accentuated cutaneous toxicities. A study further strengthening our hypothesis was conducted by Kurzrock et al. to evaluate the maximum tolerable dose of ATRA in myelodysplastic syndrome. The study reported severe dose-limiting cutaneous toxicities, such as generalized desquamation and genital ulceration, at doses > 150 mg/m 2 /day, compared to mild xerosis and erythema in the dose range of 45–100 mg/m 2 /day. Akin to our cases, the study reported complete resolution of cutaneous toxicities within 1–2 weeks of ATRA discontinuation [ 30 ].

Another important point is the recurrence of ED in both case 1 and 2 during their consolidation chemotherapy cycles, whereas recurrent scrotal ulceration was not documented in case 3. The most likely explanation is the continuation of voriconazole as secondary prophylaxis in patients with invasive fungal infections (IFI) (case 1 and 2), whereas itraconazole was discontinued after remission induction in case 3. This once again underscores the pharmacokinetic potentiation of ATRA-induced cutaneous toxicities by triazole antifungals. An important limitation of our study is that, due to the unavailability of serum voriconazole testing, we couldn’t document serum voriconazole levels, something that could provide valuable insights into the effect of serum azole levels on the severity of cutaneous manifestations.

By highlighting this crucial pharmacokinetic interaction and its potentially severe implications, we urge our fellow oncologists to remain vigilant regarding the inhibitory effects of triazole antifungals on the metabolism of ATRA. We propose the use of a non-myelosuppressive combination of ATRA and arsenic trioxide for APL, thereby eliminating the need for prophylactic antifungals. In the case of invasive fungal infections (IFI), we recommend considering alternative classes of antifungals. However, if triazole antifungals are deemed unavoidable, we suggest close monitoring for potential side effects and implementing prophylactic measures as clinically necessary.

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Data sharing is not applicable to this manuscript as no datasets were generated or analyzed during the current study.

Abbreviations

Acute promyelocytic leukemia

All-trans retinoic acid

Cytochrome P450

Differentiation syndrome

• Exfoliative dermatitis

High-resolution computerized tomography

Invasive fungal infections

Promyelocytic leukemia-retinoic acid receptor alpha

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Aisha Jamal, Rafia Hassam, Qurratulain Rizvi, Ali Saleem & Nida Anwar

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Aisha Jamal: Conceptualization, writing-original draft, writing-review & editing. Rafia Hassam: Conceptualization, writing-original draft. Qurratulain Rizvi: Writing-review & editing. Ali Saleem: Data curation, writing—review & editing. Anum Khalid: Writing—review &editing. Nida Anwar: Writing—review & editing.

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Jamal, A., Hassam, R., Rizvi, Q. et al. A rare incidence of severe dermatological toxicities triggered by concomitant administration of all-trans retinoic acid and triazole antifungal in patients with acute promyelocytic leukemia: a case series and review of the literature. J Med Case Reports 18 , 261 (2024). https://doi.org/10.1186/s13256-024-04577-1

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Received : 19 December 2023

Accepted : 01 May 2024

Published : 27 May 2024

DOI : https://doi.org/10.1186/s13256-024-04577-1

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