A literature review:
Within healthcare literature reviews are often known as 'evidence synthesis reviews' and usually have specific methods and processes which are detailed in more depth in the section below titled 'Literature reviewing - the process'. This can differ from other field areas so if you have not done a healthcare evidence synthesis review before you may find it very different to previous expectations or experiences.
There are also a number of different types of evidence synthesis reviews within healthcare and the type of review impacts the purpose and methods. The next tab gives more information about different types of review. If you are doing a review as part of an academic assignment then please ensure you follow the requirements and any methods set out in your assignment brief.
Taking a Systematic Approach
Within healthcare evidence synthesis reviews there is an expectation that the approach taken, no matter what type of review is being done, is systematic. Whilst a systematic review is a specific review type, any review type can still take a systematic approach which strengths the quality of the methods, and therefore also strengthens the quality of the findings, write up, and usefulness/applicability of the review.
In health and social care there are a number of different types of review. The resources below give an outline of the different types and outline the differences between them:
Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26(2), 91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: exploring review types and associated information retrieval requirements. Health Information and Libraries Journal, 36(3), 202–222. https://doi.org/10.1111/hir.12276
If you are doing a literature review as part of an academic assignment then please ensure you follow the requirements and any methods set out in your assignment brief. You may be advised to do a specific type of review, but when reading the guidance of how to conduct one find that it differs from your assignment brief. If so, discuss this with your supervisor or module leader.
Choosing a Review Type
You need to understand the purpose of different review types and match this up with what you are intending to achieve from carrying out your review in order to select the most appropriate type. You can include this explanation and justification within your write up. As well as the guidance above please see some further resources below to support your decision making.
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143–143. https://doi.org/10.1186/s12874-018-0611-x
Jonkoping University. (n.d.). Which review is right for you? https://guides.library.ju.se/c.php?g=690269&p=4943634
Right Review. (2024). Right Review Tool. https://rightreview.knowledgetranslation.net/
There are a number of published reporting and conducting guidelines and handbooks to support you in both carrying out and writing up your review. These help to ensure the quality and transparency of your review by ensuring you have included and conducted your review in a way that meets established methodological expectations.
Reporting guidelines give information on what you need to include in the write up of the review. Conducting guidelines provide more methodological guidance on how to carry out and undertake each stage of a review, not just stating what you need to include/report. When using these they need to be cited and referenced and the wording you would use needs to distinguish if it is a reporting or conducting resource, and therefore how it has been used. Examples:
'this review/protocol was reported using . . . '
'the conducting of this review was guided by . . . '
A lot of these were designed for quantitative systematic reviews of interventions, however a number of resources now exist for different types of evidence synthesis reviews. Below are resources of some of the most commonly used guidelines.
PRISMA
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement consists of a 27-item checklist that covers the elements needed in the write up of a systematic review, and a flow diagram.
There is an article giving further explanation of every element of the checklist and a glossary of terms.
PRISMA also have guidance for reporting protocols, known as the PRISMA-P extension.
There is also a checklist extension for Scoping Reviews called PRISMA-ScR, which is very similar to the Systematic Review checklist but with some key differences.
Also a more in-depth explanatory paper for this checklist as well.
Cochrane
The Cochrane Handbook for Systematic Reviews of Interventions needs to be followed if you were to publish a review or review protocol in the Cochrane Library of Systematic Reviews.
There are a set a reporting guidelines for both review protocols and full reviews.
Key aspects of the Cochrane handbook are collated as the Methodological Expectations for Cochrane Intervention Reviews – takes you through steps needed to conduct.
The Cochrane Handbook Chapter V also details methodology for conducting Overviews of Reviews.
The Cochrane Qualitative and Implementation Methods Group have published a series of 6 papers covering qualitative evidence synthesis methods.
Other Guides
The JBI Manual for Evidence Synthesis separates SRs out by types of evidence included, as well as having chapters on Mixed Methods Reviews, Scoping Reviews and Umbrella Reviews.
RAMSES reporting can be used for realist reviews and meta-narrative reviews.
The ENTREQ checklist can be used to report reviews of qualitative literature, alongside a fuller article explaining the development of the checklist.
Further reporting and conducting guidelines can be found on this useful page from the University of Illinois.
Booth, A. (2016). EVIDENT Guidance for reviewing the evidence: a compendium of methodological literature and websites. https://www.researchgate.net/publication/292991575_EVIDENT_Guidance_for_Reviewing_the_Evidence_a_compendium_of_methodological_literature_and_websites
A good literature review should:
Common Mistakes
Here are 5 top tips towards a stress free literature review
Formulating a review question is a key stage of the review process as this impacts the development of the outcomes of the review, the eligibility criteria for selection, and the development of the search strategy. If you make changes to your review question after already moving on to other stages of the review you may need to go back and make changes to these other steps.
Ideally a review should add new knowledge to that topic or field, so you want to develop a question that has a new focus or outcomes that has not previously been explored. Sometimes it is appropriate to update a previous review using the same question and outcomes to see if the findings of the review have changed with the inclusion of new literature since the previous one was published.
If you are a Masters student it is particularly important that you choose a topic that is both viable and manageable within the word count and timescales for completion. Viable means a topic where there is published literature, you cannot do a literature review on a question where there is no available literature. Manageable means selecting a focused topic where there will not be too vast an amount of literature to include as you have a word count limit and a timescale in which to submit the assignment.
To help you develop a question try and identify an area from practice that you are interested in – ideally something the practice area can benefit from which will give value to your review findings.
The question you develop from this topic should be focused, manageable and answerable within the timescales you have.
Scoping the Literature
This is where we run initial literature searches around our topic of interest to get an initial idea of what literature is out there. This will help us to:
From these initial searches of the literature you can start to refine your review question, broadening or focusing as necessary. Please see the following video on Scoping Searches to Refine Your Topic for an example of how this works in practice.
Question Formulation Frameworks
Question formulation frameworks are used particularly within healthcare to help you identify the key concepts of your topic, to then structure into a research or review question. The following document shows you examples of the most commonly used ones in healthcare, breaking down each framework into what the concepts mean, giving examples in practice of questions structured using that framework, and suggestions of review outcomes and types best suited to each framework.
The eligibility criteria can also be referred to as the inclusion and exclusion criteria. This is a set of criteria you will develop which you will use during the selection process of the review to decide which sources of literature to include and exclude. This criteria helps to reduce selection bias, because every decision you make should be based on this pre-determined set of criteria.
When take a systematic approach to searching and selecting the literature your eligibility criteria needs to be very detailed, both for you to be able to make decisions for each of the pieces of literature you have found, but also for someone else to be able to use the criteria with the same set of literature and make the same decisions as you. If you are doing a review as part of a review team for publication then there should be a minimum of two people involved in the selection of the literature, both using the same criteria to make selection decisions. This aligns to the systematic criteria of transparency.
When developing your eligibility criteria think about the following elements:
E.g. your population group is people with dementia, so as inclusion criteria you would state that each literature source needs this population group and any source without this population group would be excluded. But what about literature where participants and both people with dementia and people with Parkinsons. Would this be included or excluded? Your criteria needs to be detailed enough to capture all of the potential decisions you would need to make.
E.g. you're question is exploring the experiences and views of a particular group of participants, therefore the data most appropriate to 'answer' this question would be qualitative.
E.g. there has been a new guideline in your topic area published in a specific year with major changes to how a specific procedure is done in practice, meaning that older literature is not relevant to the current guideline. Topics related to technology could be outdated more easily due to specific technological developments in a specific field or equipment.
A search strategy includes where and how you are searching. Can someone else use your process to find what you found? This aligns with the systematic criteria of being transparent.
You need to plan and include the following detail in your write up to allow someone else to replicate your search:
When searching in databases most of the time you want to use the advanced search feature to build a search that will find a more relevant set of search results. To do this you need to be able to plan effective search strategies, using appropriate keyword search terms, and inputting these into the database in the most effective combination.
The videos below demonstrate how to input a planned systematic search strategy into a database. Different database platforms will look slightly different, but the principles for doing an advanced search are the same across them all, but differences are demonstrated.
Searching in EBSCO databases (CINAHL, Medline, APA PsycInfo etc.)
The selection process is where you will use your eligibility criteria to select the literature for inclusion in your review. Considerations needed are:
Keeping track of literature
Writing a literature review will mean that you will collect a large number of pieces of information from many sources. Before you begin searching, give some thought as to how you are going to manage this information.
Reference management software will enable you to automatically export references you collect from database searches and store them in the reference manager. Once you have read each paper you can then make personal research notes and store these within each reference inside the reference manager.
Use the software to format the citations within the text of your review. It will also produce the reference list at the end of your document formatted in a style of your choosing e.g. APA 7th.
See our Reference Management LibGuide on how to get started with Endnote or Mendeley, Edinburgh Napier’s referencing management software.
NHS Scotland users can also use the Refworks ref management software supplied on the NHS Knowledge network site instead of Endnote, if they would prefer.
What is critical appraisal?
Critical appraisal/quality assessment is a specific aspect of critical analysis where you examine and assess research in order to judge its:
You are evaluating the quality of the research and how it has been conducted, as well as the findings themselves and how it has been reported. Please see the following video by Cochrane on an Introduction to Critical Appraisal for a more in depth description.
Why do we do it?
Critical appraisal is often carried out using checklists that help signpost areas to look for while reading a paper. There are different types of checklist depending on the type of research you are reviewing.
The following document lists some of the main appraisal tools used in published reviews and would be a good place to start when deciding on which tool to use.
Further Critical Appraisal Resources
Book
Greehalgh, T (2019) How to read a paper : the basics of evidence-based medicine. 6th ed. Wiley Blackwell
Videos
Two excellent videos from Andrew Booth at SCHARR at the University of Sheffield. These take you through the actual process of appraising papers using the CASP tool.
Appraising a Quantitative Study [13 mins]
Data Extraction and Charting
Your literature findings need to be presented and discussed both descriptively and analytically. It is usually to present a summary of the included sources in the form of a data extraction or study characteristics table, a process also referred to as data extraction and charting your results. The video below covers how to present your findings in this way.
Analysing and Synthesising the Findings of the Literature
Depending on the type of review you are doing and also whether the review is being done as an assignment, there may be differing expectations of how you analyse the included literature sources.
At Masters dissertation level you would be expected as a minimum to provide a narrative thematic analysis, where you compare and contrast the literature to identify patterns and themes and interpret these in relation to your review question. You can use a deductive approach where you start with a pre-existing framework of themes, or an inductive approach where themes are generated from reading the literature.
At PhD or researcher for publication level there would be an expectation of a more complex analysis of the literature, appropriate to the literature sources. A scoping review including a wide range of source types would likely best be suited to a narrative analysis, but if the review literature is all research then an appropriate quantitative, qualitative, or mixed methods form of analysis of the data would be expected.
Most Systematic Review conduction and reporting guidelines are designed around an analysis of quantitative data, so if this does not fit the data of your literature you may need to use different analysis and synthesis guidance. There are a number of different analysis methods, some examples and resources are listed below as a starting point but you may also want to look at examples of similar reviews fur further methods.