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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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See an example

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

Prevent plagiarism. Run a free check.

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

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

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

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

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

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

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

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What is a literature review?

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

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

Why is it important?

A literature review is important because it:

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

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

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

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

2. Decide on the scope of your review

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

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

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

Make a list of the databases you will search. 

Where to find databases:

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

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

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

Review the literature

Some questions to help you analyze the research:

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

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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• Volume 19, Issue 1
• Reviewing the literature
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• Joanna Smith 1 ,
• Helen Noble 2
• 1 School of Healthcare, University of Leeds , Leeds , UK
• 2 School of Nursing and Midwifery, Queens's University Belfast , Belfast , UK
• Correspondence to Dr Joanna Smith , School of Healthcare, University of Leeds, Leeds LS2 9JT, UK; j.e.smith1{at}leeds.ac.uk

https://doi.org/10.1136/eb-2015-102252

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Implementing evidence into practice requires nurses to identify, critically appraise and synthesise research. This may require a comprehensive literature review: this article aims to outline the approaches and stages required and provides a working example of a published review.

Are there different approaches to undertaking a literature review?

What stages are required to undertake a literature review.

The rationale for the review should be established; consider why the review is important and relevant to patient care/safety or service delivery. For example, Noble et al 's 4 review sought to understand and make recommendations for practice and research in relation to dialysis refusal and withdrawal in patients with end-stage renal disease, an area of care previously poorly described. If appropriate, highlight relevant policies and theoretical perspectives that might guide the review. Once the key issues related to the topic, including the challenges encountered in clinical practice, have been identified formulate a clear question, and/or develop an aim and specific objectives. The type of review undertaken is influenced by the purpose of the review and resources available. However, the stages or methods used to undertake a review are similar across approaches and include:

Formulating clear inclusion and exclusion criteria, for example, patient groups, ages, conditions/treatments, sources of evidence/research designs;

Justifying data bases and years searched, and whether strategies including hand searching of journals, conference proceedings and research not indexed in data bases (grey literature) will be undertaken;

Developing search terms, the PICU (P: patient, problem or population; I: intervention; C: comparison; O: outcome) framework is a useful guide when developing search terms;

Developing search skills (eg, understanding Boolean Operators, in particular the use of AND/OR) and knowledge of how data bases index topics (eg, MeSH headings). Working with a librarian experienced in undertaking health searches is invaluable when developing a search.

Once studies are selected, the quality of the research/evidence requires evaluation. Using a quality appraisal tool, such as the Critical Appraisal Skills Programme (CASP) tools, 5 results in a structured approach to assessing the rigour of studies being reviewed. 3 Approaches to data synthesis for quantitative studies may include a meta-analysis (statistical analysis of data from multiple studies of similar designs that have addressed the same question), or findings can be reported descriptively. 6 Methods applicable for synthesising qualitative studies include meta-ethnography (themes and concepts from different studies are explored and brought together using approaches similar to qualitative data analysis methods), narrative summary, thematic analysis and content analysis. 7 Table 1 outlines the stages undertaken for a published review that summarised research about parents’ experiences of living with a child with a long-term condition. 8

• View inline

An example of rapid evidence assessment review

In summary, the type of literature review depends on the review purpose. For the novice reviewer undertaking a review can be a daunting and complex process; by following the stages outlined and being systematic a robust review is achievable. The importance of literature reviews should not be underestimated—they help summarise and make sense of an increasingly vast body of research promoting best evidence-based practice.

• ↵ Centre for Reviews and Dissemination . Guidance for undertaking reviews in health care . 3rd edn . York : CRD, York University , 2009 .
• ↵ Canadian Best Practices Portal. http://cbpp-pcpe.phac-aspc.gc.ca/interventions/selected-systematic-review-sites / ( accessed 7.8.2015 ).
• Bridges J , et al
• ↵ Critical Appraisal Skills Programme (CASP). http://www.casp-uk.net / ( accessed 7.8.2015 ).
• Dixon-Woods M ,
• Shaw R , et al
• Agarwal S ,
• Jones D , et al
• Cheater F ,

Twitter Follow Joanna Smith at @josmith175

Competing interests None declared.

Read the full text or download the PDF:

Literature Reviews for the Health Sciences: Introduction

Introduction.

• Research Question
• How to search
• Where to search
• Grey Literature in Health This link opens in a new window
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• Resources on Literature Reviews

Literature reviews report the current knowledge on a topic and provide a summary of research from previously published studies. The synthesis of the literature reviewed provides a comprehensive overview of the knowledge available on the topic.

The Literature review also builds a case or identifies a research gap which assists an author in positioning his or her own work in the context of the previous studies (Baker 2016).

A literature review is a search and evaluation of the available literature in your chosen topic area; it documents the state of the art with respect to the topic you are writing about.

The process:

• Surveys the literature in your chosen area of study
• Synthesises the information in that literature into a summary
• Critically analyses the information gathered, identifies gaps in the current knowledge, showing limitations of theories and points of view and formulating areas for further research

Types of Literature Reviews

The Purpose of the Literature Review

Related / useful uc library guides.

Baker, Joy. (2016). The Purpose, Process, and Methods of Writing a Literature Review. AORN journal. 103. 265-269. 10.1016/j.aorn.2016.01.016. 

Frey, B. (2018).  The SAGE encyclopedia of educational research, measurement, and evaluation  (Vols. 1-4). Thousand Oaks,, CA: SAGE Publications, Inc. doi: 10.4135/9781506326139

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

Tricco, AC, Lillie, E, Zarin, W, O'Brien, KK, Colquhoun, H, Levac, D, Moher, D, Peters, MD, Horsley, T, Weeks, L, Hempel, S et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018,169(7):467-473.  doi:10.7326/M18-0850.

Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.

(1) Griffith University subject guides : https://libraryguides.griffith.edu.au/systematic-literature-reviews-for-education/introduction 

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Literature Reviews: A How-To Guide

Faculty training: getting started with a literature review, temperature check, what is a literature review, purpose of a literature review, types of literature reviews, traditional (narrative) literature review, systematic review.

• Develop a Research Question
• Search for Previous Reviews
• Search the Literature
• Organize Key Findings
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Searching the literature is a professional skills that takes time and practice.

Learning Outcomes:

• Understand the purpose of a literature review, different types of reviews
• Understand the iterative nature of search and question development
• Develop and document search strategies using appropriate databases, terminology and search tools, revising and iterating the search to improve results
• Stay organized using various productivity tools and templates
• Poll Results

A literature review...

• generally describes what is known (or not) about a topic
• provides background for a larger piece of empirical work or can stand on their own
• guided by a clear and purposeful question
• essential first step in any research project
• helps to situate a study's research question(s), methodology and potential contributions to the field

Steinert, Y. & Thomas, A. (2016). When I say...literature reviews . Medical Education, 50 (4): 398-399.

The study example shown above goes on to review additional literature in the background section of the article.

Gill, A.C., Zhou, Y., Greely, J.T., Beasley, A.T., Purkiss, J., & Juneja, M. (2022). Longitudinal outcomes one year following implicit bias training in medical students. Medical Teacher, 44 (7): 744-751. https://doi.org/10.1080/0142159X.2021.2023120

The term literature reviews refers to both a process and an output product.

As a PROCESS, a literature review is a survey of scholarly publications related to a specific research question or topic.

As a PRODUCT, a literature review can be integrated into a research study

There are a multitude of review types, each differing in their purpose, degree of process and rigor.

For additional information on a variety of review methods, see the following article for an excellent overview:

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

Also see the following two guides from other libraries that include excellent descriptions and examples of a variety of review types (integrative, scoping, meta-analysis, etc.):

• Literature Reviews in Medicine and Health - Unv of Illinois Library
• How to Conduct a Literature Review (Health Sciences and Beyond) - Virginia Commonwealth Unv Library

A traditional (narrative) review summarizes a body of evidence on a topic using informal methods to find and interpret studies.

• summarizes and critiques the body of literature on a specific issue or topic
• research questions tend to be more general and broader
• provides context for research, identifies gaps in the literature, and situates research within an area of study
• often included with introduction to research study
• can be publication in its own right, and provides a deeper look at a specific issue or topic
• can be one or more authors
• can be completed in a few weeks to months

The rest of this guide focuses on the steps to complete a traditional (narrative) review.

Systematic reviews seek to collate evidence that fits pre-specified eligibility criteria in order to answer a specific research question. They aim to minimize bias by using explicit, systematic methods documented in advance with a protocol ( Cochrane Handbook ).

Features of a systematic review:

• Begins with a focused answerable clinical question (PICO framework)
• Establishes pre-specified, explicit, and reproducible eligibility criteria
• Uses comprehensive and exhaustive literature searches in multiple sources
• Employs comprehensive analysis of quality and validity of findings
• Reports collective interpretation of results
• Typically takes up to 1 year or more to complete
• Needs a team of experts - at least 3
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What exactly is a Literature Review?

A literature review describes, summarizes and analyzes previously published literature in a field. What you want to do is demonstrate your knowledge and understanding of what the "conversation" about this topic is, identify gaps in the literature, present research pertinent to your ideas and how your research fits in with, changes, elaborates on, etc., the present conversation.

BOOKS - Literature Review and how to write it

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Research Methods at a Glance

This information on basic business research methods is in part adapted from the book Field Guide to Nonprofit Program Design, Marketing and Evaluation by Carter McNamara (Call number: HD62.6 .M36). 

Research Methods in General

Research Methods in Public Health

• The Literature Review: A Research Journey This guide from the Harvard School of Education is an introduction to the basics of conducting a literature review.

• How to cite effectively and improve readability of your paper?

Improve your writing

The Academic Phrasebank is a general resource for academic writers. It aims to provide you with examples of some of the phraseological ‘nuts and bolts’ of writing organized according to the main sections of a research paper or dissertation:

• Introducing work  - e.g Evidence suggests that X is among the most important factors for …
• Referring to sources  - e.g. A number of authors have considered the effects of … (Smith, 2003; Jones, 2004).
• Describing methods - e.g. Different methods have been proposed to classify … (Johnson, 2021; Petersen, 2019; Appel, 2017).
• Reporting results - e.g. Interestingly, the X was observed to …
• Discussing findings  - e.g. A strong relationship between X and Y has been reported in the literature.
• Writing conclusions  - e.g. One of the more significant findings to emerge from this study is that …

Additional  examples from Academic Phrasebank are below:

Before explaining these theories, it is necessary to …

In a similar case in America, Smith (2021) identified …

This is exemplified in the work undertaken by Smith (2021) ...

Recent cases reported by Smith  et al . (2021) also support the hypothesis that …

This section has reviewed the three key aspects of …

In summary, it has been shown from this review that …

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Literature Reviews

• Organizing/Synthesizing
• Peer Review
• Ulrich's -- One More Way To Find Peer-reviewed Papers

"Literature review," "systematic literature review," "integrative literature review" -- these are terms used in different disciplines for basically the same thing -- a rigorous examination of the scholarly literature about a topic (at different levels of rigor, and with some different emphases).  

1. Our library's guide to Writing a Literature Review

2. Other helpful sites

• Writing Center at UNC (Chapel Hill) -- A very good guide about lit reviews and how to write them
• Literature Review: Synthesizing Multiple Sources (LSU, June 2011 but good; PDF) -- Planning, writing, and tips for revising your paper

3. Welch Library's list of the types of expert reviews

Doing a good job of organizing your information makes writing about it a lot easier.

You can organize your sources using a citation manager, such as refworks , or use a matrix (if you only have a few references):.

• Use Google Sheets, Word, Excel, or whatever you prefer to create a table
• The column headings should include the citation information, and the main points that you want to track, as shown

Synthesizing your information is not just summarizing it. Here are processes and examples about how to combine your sources into a good piece of writing:

• Purdue OWL's Synthesizing Sources
• Synthesizing Sources (California State University, Northridge)

Annotated Bibliography  

An "annotation" is a note or comment. An "annotated bibliography" is a "list of citations to books, articles, and [other items]. Each citation is followed by a brief...descriptive and evaluative paragraph, [whose purpose is] to inform the reader of the relevance, accuracy, and quality of the sources cited."*

• Purdue's OWL (Online Writing Lab) includes definitions and samples of annotations
• Cornell's guide * to writing annotated bibliographies  

* Thank you to Olin Library Reference, Research & Learning Services, Cornell University Library, Ithaca, NY, USA https://guides.library.cornell.edu/annotatedbibliography

What does "peer-reviewed" mean?

• If an article has been peer-reviewed before being published, it means that the article has been read by other people in the same field of study ("peers").
• The author's reviewers have commented on the article, not only noting typos and possible errors, but also giving a judgment about whether or not the article should be published by the journal to which it was submitted.

How do I find "peer-reviewed" materials?

• Most of the the research articles in scholarly journals are peer-reviewed.
• Many databases allow you to check a box that says "peer-reviewed," or to see which results in your list of results are from peer-reviewed sources. Some of the databases that provide this are Academic Search Ultimate, CINAHL, PsycINFO, and Sociological Abstracts.

What kinds of materials are *not* peer-reviewed?

• open web pages
• most newspapers, newsletters, and news items in journals
• letters to the editor
• press releases
• columns and blogs
• book reviews
• anything in a popular magazine (e.g., Time, Newsweek, Glamour, Men's Health)

If a piece of information wasn't peer-reviewed, does that mean that I can't trust it at all?

No; sometimes you can. For example, the preprints submitted to well-known sites such as  arXiv  (mainly covering physics) and  CiteSeerX (mainly covering computer science) are probably trustworthy, as are the databases and web pages produced by entities such as the National Library of Medicine, the Smithsonian Institution, and the American Cancer Society.

Is this paper peer-reviewed? Ulrichsweb will tell you.

1) On the library home page , choose "Articles and Databases" --> "Databases" --> Ulrichsweb

2) Put in the title of the JOURNAL (not the article), in quotation marks so all the words are next to each other

3) Mouse over the black icon, and you'll see that it means "refereed" (which means peer-reviewed, because it's been looked at by referees or reviewers). This journal is not peer-reviewed, because none of the formats have a black icon next to it:

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• Find Articles/Databases
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• What are Literature Reviews?
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• Finding Systematic Reviews
• Tutorials & Tools for Literature Reviews
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• Finding Full Text

Choosing a Review Type

For guidance related to choosing a review type, see:

• "What Type of Review is Right for You?" - Decision Tree (PDF) This decision tree, from Cornell University Library, highlights key difference between narrative, systematic, umbrella, scoping and rapid reviews.
• Reviewing the literature: choosing a review design Noble, H., & Smith, J. (2018). Reviewing the literature: Choosing a review design. Evidence Based Nursing, 21(2), 39–41. https://doi.org/10.1136/eb-2018-102895
• What synthesis methodology should I use? A review and analysis of approaches to research synthesis Schick-Makaroff, K., MacDonald, M., Plummer, M., Burgess, J., & Neander, W. (2016). What synthesis methodology should I use? A review and analysis of approaches to research synthesis. AIMS Public Health, 3 (1), 172-215. doi:10.3934/publichealth.2016.1.172 More information less... ABSTRACT: Our purpose is to present a comprehensive overview and assessment of the main approaches to research synthesis. We use "research synthesis" as a broad overarching term to describe various approaches to combining, integrating, and synthesizing research findings.
• Right Review - Decision Support Tool Not sure of the most suitable review method? Answer a few questions and be guided to suitable knowledge synthesis methods. Updated in 2022 and featured in the Journal of Clinical Epidemiology 10.1016/j.jclinepi.2022.03.004

Types of Evidence Synthesis / Literature Reviews

Literature reviews are comprehensive summaries and syntheses of the previous research on a given topic.  While narrative reviews are common across all academic disciplines, reviews that focus on appraising and synthesizing research evidence are increasingly important in the health and social sciences.  

Most evidence synthesis methods use formal and explicit methods to identify, select and combine results from multiple studies, making evidence synthesis a form of meta-research.  

The review purpose, methods used and the results produced vary among different kinds of literature reviews; some of the common types of literature review are detailed below.

Common Types of Literature Reviews 1

Narrative (literature) review.

• A broad term referring to reviews with a wide scope and non-standardized methodology
• Search strategies, comprehensiveness of literature search, time range covered and method of synthesis will vary and do not follow an established protocol

Integrative Review

• A type of literature review based on a systematic, structured literature search
• Often has a broadly defined purpose or review question
• Seeks to generate or refine and theory or hypothesis and/or develop a holistic understanding of a topic of interest
• Relies on diverse sources of data (e.g. empirical, theoretical or methodological literature; qualitative or quantitative studies)

Systematic Review

• Systematically and transparently collects and categorize existing evidence on a question of scientific, policy or management importance
• Follows a research protocol that is established a priori
• Some sub-types of systematic reviews include: SRs of intervention effectiveness, diagnosis, prognosis, etiology, qualitative evidence, economic evidence, and more.
• Time-intensive and often takes months to a year or more to complete 
• The most commonly referred to type of evidence synthesis; sometimes confused as a blanket term for other types of reviews

Meta-Analysis

• Statistical technique for combining the findings from disparate quantitative studies
• Uses statistical methods to objectively evaluate, synthesize, and summarize results
• Often conducted as part of a systematic review

Scoping Review

• Systematically and transparently collects and categorizes existing evidence on a broad question of scientific, policy or management importance
• Seeks to identify research gaps, identify key concepts and characteristics of the literature and/or examine how research is conducted on a topic of interest
• Useful when the complexity or heterogeneity of the body of literature does not lend itself to a precise systematic review
• Useful if authors do not have a single, precise review question
• May critically evaluate existing evidence, but does not attempt to synthesize the results in the way a systematic review would 
• May take longer than a systematic review

Rapid Review

• Applies a systematic review methodology within a time-constrained setting
• Employs methodological "shortcuts" (e.g., limiting search terms and the scope of the literature search), at the risk of introducing bias
• Useful for addressing issues requiring quick decisions, such as developing policy recommendations

Umbrella Review

• Reviews other systematic reviews on a topic
• Often defines a broader question than is typical of a traditional systematic review
• Most useful when there are competing interventions to consider

1. Adapted from:

Eldermire, E. (2021, November 15). A guide to evidence synthesis: Types of evidence synthesis. Cornell University LibGuides. https://guides.library.cornell.edu/evidence-synthesis/types

Nolfi, D. (2021, October 6). Integrative Review: Systematic vs. Scoping vs. Integrative. Duquesne University LibGuides. https://guides.library.duq.edu/c.php?g=1055475&p=7725920

Delaney, L. (2021, November 24). Systematic reviews: Other review types. UniSA LibGuides. https://guides.library.unisa.edu.au/SystematicReviews/OtherReviewTypes

Further Reading: Exploring Different Types of Literature Reviews

• A typology of reviews: An analysis of 14 review types and associated methodologies 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. doi:10.1111/j.1471-1842.2009.00848.x More information less... ABSTRACT: The expansion of evidence-based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains.
• Clarifying differences between review designs and methods Gough, D., Thomas, J., & Oliver, S. (2012). Clarifying differences between review designs and methods. Systematic Reviews, 1 , 28. doi:10.1186/2046-4053-1-28 More information less... ABSTRACT: This paper argues that the current proliferation of types of systematic reviews creates challenges for the terminology for describing such reviews....It is therefore proposed that the most useful strategy for the field is to develop terminology for the main dimensions of variation.
• Are we talking the same paradigm? Considering methodological choices in health education systematic review Gordon, M. (2016). Are we talking the same paradigm? Considering methodological choices in health education systematic review. Medical Teacher, 38 (7), 746-750. doi:10.3109/0142159X.2016.1147536 More information less... ABSTRACT: Key items discussed are the positivist synthesis methods meta-analysis and content analysis to address questions in the form of "whether and what" education is effective. These can be juxtaposed with the constructivist aligned thematic analysis and meta-ethnography to address questions in the form of "why." The concept of the realist review is also considered. It is proposed that authors of such work should describe their research alignment and the link between question, alignment and evidence synthesis method selected.
• Meeting the review family: Exploring review types and associated information retrieval requirements Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: Exploring review types and associated information retrieval requirements. Health Information & Libraries Journal, 36(3), 202–222. doi: 10.1111/hir.12276

Integrative Reviews

"The integrative review method is an approach that allows for the inclusion of diverse methodologies (i.e. experimental and non-experimental research)." (Whittemore & Knafl, 2005, p. 547).

• The integrative review: Updated methodology Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52 (5), 546–553. doi:10.1111/j.1365-2648.2005.03621.x More information less... ABSTRACT: The aim of this paper is to distinguish the integrative review method from other review methods and to propose methodological strategies specific to the integrative review method to enhance the rigour of the process....An integrative review is a specific review method that summarizes past empirical or theoretical literature to provide a more comprehensive understanding of a particular phenomenon or healthcare problem....Well-done integrative reviews present the state of the science, contribute to theory development, and have direct applicability to practice and policy.

• Conducting integrative reviews: A guide for novice nursing researchers Dhollande, S., Taylor, A., Meyer, S., & Scott, M. (2021). Conducting integrative reviews: A guide for novice nursing researchers. Journal of Research in Nursing, 26(5), 427–438. https://doi.org/10.1177/1744987121997907
• Rigour in integrative reviews Whittemore, R. (2007). Rigour in integrative reviews. In C. Webb & B. Roe (Eds.), Reviewing Research Evidence for Nursing Practice (pp. 149–156). John Wiley & Sons, Ltd. https://doi.org/10.1002/9780470692127.ch11

Scoping Reviews

Scoping reviews are evidence syntheses that are conducted systematically, but begin with a broader scope of question than traditional systematic reviews, allowing the research to 'map' the relevant literature on a given topic.

• Scoping studies: Towards a methodological framework Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8 (1), 19-32. doi:10.1080/1364557032000119616 More information less... ABSTRACT: We distinguish between different types of scoping studies and indicate where these stand in relation to full systematic reviews. We outline a framework for conducting a scoping study based on our recent experiences of reviewing the literature on services for carers for people with mental health problems.
• Scoping studies: Advancing the methodology Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5 (1), 69. doi:10.1186/1748-5908-5-69 More information less... ABSTRACT: We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework.
• Methodology for JBI scoping reviews Peters, M. D. J., Godfrey, C. M., McInerney, P., Baldini Soares, C., Khalil, H., & Parker, D. (2015). The Joanna Briggs Institute reviewers’ manual: Methodology for JBI scoping reviews [PDF]. Retrieved from The Joanna Briggs Institute website: http://joannabriggs.org/assets/docs/sumari/Reviewers-Manual_Methodology-for-JBI-Scoping-Reviews_2015_v2.pdf More information less... ABSTRACT: Unlike other reviews that address relatively precise questions, such as a systematic review of the effectiveness of a particular intervention based on a precise set of outcomes, scoping reviews can be used to map the key concepts underpinning a research area as well as to clarify working definitions, and/or the conceptual boundaries of a topic. A scoping review may focus on one of these aims or all of them as a set.

Systematic vs. Scoping Reviews: What's the Difference? 

YouTube Video 4 minutes, 45 seconds

Rapid Reviews

Rapid reviews are systematic reviews that are undertaken under a tighter timeframe than traditional systematic reviews. 

• Evidence summaries: The evolution of a rapid review approach Khangura, S., Konnyu, K., Cushman, R., Grimshaw, J., & Moher, D. (2012). Evidence summaries: The evolution of a rapid review approach. Systematic Reviews, 1 (1), 10. doi:10.1186/2046-4053-1-10 More information less... ABSTRACT: Rapid reviews have emerged as a streamlined approach to synthesizing evidence - typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review "methods," and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology. This paper outlines our experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program.
• What is a rapid review? A methodological exploration of rapid reviews in Health Technology Assessments Harker, J., & Kleijnen, J. (2012). What is a rapid review? A methodological exploration of rapid reviews in Health Technology Assessments. International Journal of Evidence‐Based Healthcare, 10 (4), 397-410. doi:10.1111/j.1744-1609.2012.00290.x More information less... ABSTRACT: In recent years, there has been an emergence of "rapid reviews" within Health Technology Assessments; however, there is no known published guidance or agreed methodology within recognised systematic review or Health Technology Assessment guidelines. In order to answer the research question "What is a rapid review and is methodology consistent in rapid reviews of Health Technology Assessments?", a study was undertaken in a sample of rapid review Health Technology Assessments from the Health Technology Assessment database within the Cochrane Library and other specialised Health Technology Assessment databases to investigate similarities and/or differences in rapid review methodology utilised.
• Rapid Review Guidebook Dobbins, M. (2017). Rapid review guidebook. Hamilton, ON: National Collaborating Centre for Methods and Tools.
• NCCMT Summary and Tool for Dobbins' Rapid Review Guidebook National Collaborating Centre for Methods and Tools. (2017). Rapid review guidebook. Hamilton, ON: McMaster University. Retrieved from http://www.nccmt.ca/knowledge-repositories/search/308
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Literature Review Overview

What is a Literature Review? Why Are They Important?

A literature review is important because it presents the "state of the science" or accumulated knowledge on a specific topic. It summarizes, analyzes, and compares the available research, reporting study strengths and weaknesses, results, gaps in the research, conclusions, and authors’ interpretations.

Tips and techniques for conducting a literature review are described more fully in the subsequent boxes:

• Literature review steps
• Strategies for organizing the information for your review
• Literature reviews sections
• In-depth resources to assist in writing a literature review
• Templates to start your review
• Literature review examples

Literature Review Steps

Graphic used with permission: Torres, E. Librarian, Hawai'i Pacific University

1. Choose a topic and define your research question

• Try to choose a topic of interest. You will be working with this subject for several weeks to months.
• Ideas for topics can be found by scanning medical news sources (e.g MedPage Today), journals / magazines, work experiences, interesting patient cases, or family or personal health issues.
• Do a bit of background reading on topic ideas to familiarize yourself with terminology and issues. Note the words and terms that are used.
• Develop a focused research question using PICO(T) or other framework (FINER, SPICE, etc - there are many options) to help guide you.
• Run a few sample database searches to make sure your research question is not too broad or too narrow.
• If possible, discuss your topic with your professor. 

2. Determine the scope of your review

The scope of your review will be determined by your professor during your program. Check your assignment requirements for parameters for the Literature Review.

• How many studies will you need to include?
• How many years should it cover? (usually 5-7 depending on the professor)
• For the nurses, are you required to limit to nursing literature?

3. Develop a search plan

• Determine which databases to search. This will depend on your topic. If you are not sure, check your program specific library website (Physician Asst / Nursing / Health Services Admin) for recommendations.
• Create an initial search string using the main concepts from your research (PICO, etc) question. Include synonyms and related words connected by Boolean operators
• Contact your librarian for assistance, if needed.

4. Conduct searches and find relevant literature

• Keep notes as you search - tracking keywords and search strings used in each database in order to avoid wasting time duplicating a search that has already been tried
• Read abstracts and write down new terms to search as you find them
• Check MeSH or other subject headings listed in relevant articles for additional search terms
• Scan author provided keywords if available
• Check the references of relevant articles looking for other useful articles (ancestry searching)
• Check articles that have cited your relevant article for more useful articles (descendancy searching). Both PubMed and CINAHL offer Cited By links
• Revise the search to broaden or narrow your topic focus as you peruse the available literature
• Conducting a literature search is a repetitive process. Searches can be revised and re-run multiple times during the process.
• Track the citations for your relevant articles in a software citation manager such as RefWorks, Zotero, or Mendeley

5. Review the literature

• Read the full articles. Do not rely solely on the abstracts. Authors frequently cannot include all results within the confines of an abstract. Exclude articles that do not address your research question.
• While reading, note research findings relevant to your project and summarize. Are the findings conflicting? There are matrices available than can help with organization. See the Organizing Information box below.
• Critique / evaluate the quality of the articles, and record your findings in your matrix or summary table. Tools are available to prompt you what to look for. (See Resources for Appraising a Research Study box on the HSA, Nursing , and PA guides )
• You may need to revise your search and re-run it based on your findings.

6. Organize and synthesize

• Compile the findings and analysis from each resource into a single narrative.
• Using an outline can be helpful. Start broad, addressing the overall findings and then narrow, discussing each resource and how it relates to your question and to the other resources.
• Cite as you write to keep sources organized.
• Write in structured paragraphs using topic sentences and transition words to draw connections, comparisons, and contrasts.
• Don't present one study after another, but rather relate one study's findings to another. Speak to how the studies are connected and how they relate to your work.

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

• helps provide overview of the literature
• information from individual sources is entered into a grid to enable writers to discern patterns and themes
• article summary, analysis, or results
• thoughts, reflections, or issues
• each reference gets its own row
• mind maps, concept maps, flowcharts
• at top of page record PICO or research question
• record major concepts / themes from literature
• list concepts that branch out from major concepts underneath - keep going downward hierarchically, until most specific ideas are recorded
• enclose concepts in circles and connect the concept with lines - add brief explanation as needed

3. Summary Table

• information is recorded in a grid to help with recall and sorting information when writing
• allows comparing and contrasting individual studies easily
• purpose of study
• methodology (study population, data collection tool)

Efron, S. E., & Ravid, R. (2019). Writing the literature review : A practical guide . Guilford Press.

Literature Review Sections

• Lit reviews can be part of a larger paper / research study or they can be the focus of the paper
• Lit reviews focus on research studies to provide evidence
• New topics may not have much that has been published

* The sections included may depend on the purpose of the literature review (standalone paper or section within a research paper)

Standalone Literature Review (aka Narrative Review):

• presents your topic or PICO question
• includes the why of the literature review and your goals for the review.
• provides background for your the topic and previews the key points
• Narrative Reviews: tmay not have an explanation of methods.
• include where the search was conducted (which databases) what subject terms or keywords were used, and any limits or filters that were applied and why - this will help others re-create the search
• describe how studies were analyzed for inclusion or exclusion
• review the purpose and answer the research question
• thematically - using recurring themes in the literature
• chronologically - present the development of the topic over time
• methodological - compare and contrast findings based on various methodologies used to research the topic (e.g. qualitative vs quantitative, etc.)
• theoretical - organized content based on various theories
• provide an overview of the main points of each source then synthesize the findings into a coherent summary of the whole
• present common themes among the studies
• compare and contrast the various study results
• interpret the results and address the implications of the findings
• do the results support the original hypothesis or conflict with it
• provide your own analysis and interpretation (eg. discuss the significance of findings; evaluate the strengths and weaknesses of the studies, noting any problems)
• discuss common and unusual patterns and offer explanations
•  stay away from opinions, personal biases and unsupported recommendations
• summarize the key findings and relate them back to your PICO/research question
• note gaps in the research and suggest areas for further research
• this section should not contain "new" information that had not been previously discussed in one of the sections above
• provide a list of all the studies and other sources used in proper APA 7

Literature Review as Part of a Research Study Manuscript:

• Compares the study with other research and includes how a study fills a gap in the research.
• Focus on the body of the review which includes the synthesized Findings and Discussion

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

• Literature reviews may or may not follow strict systematic methods to find, select, and analyze articles, but rather they selectively and broadly review the literature on a topic
• Research included in a Literature Review can be "cherry-picked" and therefore, can be very subjective

Systematic Reviews:

• Systemic reviews are designed to provide a comprehensive summary of the evidence for a focused research question
• rigorous and strictly structured, using standardized reporting guidelines (e.g. PRISMA, see link below)
• uses exhaustive, systematic searches of all relevant databases
• best practice dictates search strategies are peer reviewed
• uses predetermined study inclusion and exclusion criteria in order to minimize bias
• aims to capture and synthesize all literature (including unpublished research - grey literature) that meet the predefined criteria on a focused topic resulting in high quality evidence

Literature Review Examples

• Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge (2017). Women and Birth : Journal of the Australian College of Midwives
• Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: A literature review (2017). Journal of Racial and Ethnic Health Disparities

• Vitamin D deficiency in individuals with a spinal cord injury: A literature review (2017). Spinal Cord

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

Aveyard, H. (2010). Doing a literature review in health and social care : A practical guide . McGraw-Hill Education.

Purdue Online Writing Lab. (n.d.). Writing a literature review . Purdue University. https://owl.purdue.edu/owl/research_and_citation/conducting_research/writing_a_literature_review.html

Torres, E. (2021, October 21). Nursing - graduate studies research guide: Literature review. Hawai'i Pacific University Libraries. Retrieved January 27, 2022, from https://hpu.libguides.com/c.php?g=543891&p=3727230

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How to Conduct a Literature Review (Health Sciences and Beyond)

• What is a Literature Review?

The Research Questions

• Selection Criteria
• Database Search
• Documenting Your Search
• Organize Key Findings
• Reference Management

Background vs. Foreground Questions

You may need to find answers to background questions (i.e. about general knowledge) before seeking answers to foreground questions (i.e. about specific knowledge, such as information that might inform a clinical decision).

The research questions on this page are for foreground questions.

A well-formulated research question:

• starts your entire search process
• provides focus for your searches
• guides the selection of literature sources

Question formats are helpful tools researchers can use to structure a question that will facilitate a focused search. Such formats include: PICO , PEO , SPIDER , and  COSMIN . Other formats can be found here .  

The  PICO  format is commonly used in evidence-based clinical practice.  This format creates a "well-built" question that identifies four concepts: (1) the P atient problem or P opulation, (2) the I ntervention, (3) the C omparison (if there is one), and (4) the O utcome(s) .

Example : In adults with recurrent furunculosis (skin boils), do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?  ( Cochrane Library Tutorial, 2005 )

The  PEO  question format is useful for qualitative research questions. Questions based on this format identify three concepts: (1) P opulation, (2) E xposure, and (3) O utcome(s) .

Example:  In infants, is there an association between exposure to soy milk and the subsequent development of peanut allergy ( Levine, Ioannidis, Haines, & Guyatt, 2014 )?

The  SPIDER  question format was adapted from the PICO tool to search for qualitative and mixed-methods research.  Questions based on this format identify the following concepts: (1) S ample, (2) P henomenon of I nterest, (3) D esign, (4) E valuation, and (5) R esearch type .

Example:  What are young parents’ experiences of attending antenatal education? 

Search for ( S  AND  P of I   AND ( D  OR  E ) AND  R ) ( Cooke, Smith, & Booth, 2012 ).

The COSMIN  ( CO nsensus-based  S tandards for the selection of health status M easurement IN struments ) format is used for systematic review of measurement properties.  Questions based on this format identify (1) the construct or the name(s) of the outcome measurement instrument(s) of interest,  (2) the target population, (3) the type of measurement instrument of interest, and (4) the measurement properties on which the review focuses.

Visit the COSMIN website to view the COSMIN manual and checklist.

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Systematic Reviews

Describes what is involved with conducting a systematic review of the literature for evidence-based public health and how the librarian is a partner in the process.

Several CDC librarians have special training in conducting literature searches for systematic reviews.  Literature searches for systematic reviews can take a few weeks to several months from planning to delivery.

Fill out a search request form here  or contact the Stephen B. Thacker CDC Library by email  [email protected] or telephone 404-639-1717.

Campbell Collaboration

Cochrane Collaboration

Eppi Centre

Joanna Briggs Institute

McMaster University

PRISMA Statement

Systematic Reviews – CRD’s Guide

Systematic Reviews of Health Promotion and Public Health Interventions

The Guide to Community Preventive Services

Look for systematic reviews that have already been published. 

• To ensure that the work has not already been done.
• To provides examples of search strategies for your topic

Look in PROSPERO for registered systematic reviews.

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A systematic review attempts to collect and analyze all evidence that answers a specific question.  The question must be clearly defined and have inclusion and exclusion criteria. A broad and thorough search of the literature is performed and a critical analysis of the search results is reported and ultimately provides a current evidence-based answer  to the specific question.

Time:  According to Cochrane , it takes 18 months on average to complete a Systematic Review.

The average systematic review from beginning to end requires 18 months of work. “…to find out about a healthcare intervention it is worth searching research literature thoroughly to see if the answer is already known. This may require considerable work over many months…” ( Cochrane Collaboration )

Review Team: Team Members at minimum…

• Content expert
• 2 reviewers
• 1 tie breaker
• 1 statistician (meta-analysis)
• 1 economist if conducting an economic analysis
• *1 librarian (expert searcher) trained in systematic reviews

“Expert searchers are an important part of the systematic review team, crucial throughout the review process-from the development of the proposal and research question to publication.” ( McGowan & Sampson, 2005 )

*Ask your librarian to write a methods section regarding the search methods and to give them co-authorship. You may also want to consider providing a copy of one or all of the search strategies used in an appendix.

The Question to Be Answered: A clearly defined and specific question or questions with inclusion and exclusion criteria.

Written Protocol: Outline the study method, rationale, key questions, inclusion and exclusion criteria, literature searches, data abstraction and data management, analysis of quality of the individual studies, synthesis of data, and grading of the evidience for each key question.

Literature Searches:  Search for any systematic reviews that may already answer the key question(s).  Next, choose appropriate databases and conduct very broad, comprehensive searches.  Search strategies must be documented so that they can be duplicated.  The librarian is integral to this step of the process. Before your librarian creates a search strategy and starts searching in earnest you should write a detailed PICO question , determine the inclusion and exclusion criteria for your study, run a preliminary search, and have 2-4 articles that already fit the criteria for your review.

What is searched depends on the topic of the review but should include…

• At least 3 standard medical databases like PubMed/Medline, CINAHL, Embase, etc..
• At least 2 grey literature resources like Clinicaltrials.gov, COS Conference Papers Index, Grey Literature Report,  etc…

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Getting Articles:

Articles can be obtained using DocExpress or by searching the electronic journals at the Stephen B. Thacker CDC Library.

IOM Standards for Systematic Reviews: Standard 3.1: Conduct a comprehensive systematic search for evidence

The goal of a systematic review search is to maximize recall and precision while keeping results manageable. Recall (sensitivity) is defined as the number of relevant reports identified divided by the total number of relevant reports in existence. Precision (specificity) is defined as the number of relevant reports identified divided by the total number of reports identified.

Issues to consider when creating a systematic review search:   

• All concepts are included in the strategy
• All appropriate subject headings are used
• Appropriate use of explosion
• Appropriate use of subheadings and floating subheadings
• Use of natural language (text words) in addition to controlled vocabulary terms
• Use of appropriate synonyms, acronyms, etc.
• Truncation and spelling variation as appropriate
• Appropriate use of limits such as language, years, etc.
• Field searching, publication type, author, etc.
• Boolean operators used appropriately
• Line errors: when searches are combined using line numbers, be sure the numbers refer to the searches intended
• Check indexing of relevant articles
• Search strategy adapted as needed for multiple databases
• Cochrane Handbook: Searching for Studies See Part 2, Chapter 6

A step-by-step guide to systematically identify all relevant animal studies

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• Open access
• Published: 12 October 2020

A systematic literature review of researchers’ and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data

• Elizabeth Hutchings   ORCID: orcid.org/0000-0002-6030-954X 1 ,
• Max Loomes   ORCID: orcid.org/0000-0003-1042-0968 2 ,
• Phyllis Butow   ORCID: orcid.org/0000-0003-3562-6954 2 , 3 , 4 &
• Frances M. Boyle   ORCID: orcid.org/0000-0003-3798-1570 1 , 5  

Systematic Reviews volume  9 , Article number:  240 ( 2020 ) Cite this article

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A systematic literature review of researchers and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data was conducted using electronic data searching. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design, or disease setting. Two authors were involved in all stages of the review process; conflicts were resolved by consensus. Data was extracted independently using a pre-piloted data extraction template. Quality and bias were assessed using the QualSyst criteria for qualitative studies. Eighteen eligible articles were identified, and articles were categorised into four key themes: barriers, facilitators, access, and ownership; 14 subthemes were identified. While respondents were generally supportive of data sharing, concerns were expressed about access to data, data storage infrastructure, and consent. Perceptions of data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region. Young researchers were less willing to share data; they were willing to share in circumstances where they were acknowledged. While there is a general consensus that increased data sharing in health is beneficial to the wider scientific community, substantial barriers remain.

Systematic review registration

PROSPERO CRD42018110559

Peer Review reports

Healthcare systems generate large amounts of data; approximately 80 mB of data are generated per patient per year [ 1 ]. It is projected that this figure will continue to grow with an increasing reliance on technologies and diagnostic capabilities. Healthcare data provides an opportunity for secondary data analysis with the capacity to greatly influence medical research, service planning, and health policy.

There are many forms of data collected in the healthcare setting including administrative and clinical trial data which are the focus of this review. Administrative data collected during patients’ care in the primary, secondary, and tertiary settings can be analysed to identify systemic issues and service gaps, and used to inform improved health resourcing. Clinical trials play an essential role in furthering our understanding of disease, advancing new therapeutics, and developing improved supportive care interventions. However, clinical trials are expensive and can take several years to complete; a frequently quoted figure is that it takes 17 years for 14% of clinical research to benefit the patient [ 2 , 3 ].

Those who argue for increased data sharing in healthcare suggest that it may lead to improved treatment decisions based on all available information [ 4 , 5 ], improved identification of causes and clinical manifestations of disease [ 6 ], and provide increased research transparency [ 7 ]. In rare diseases, secondary data analysis may greatly accelerate the medical community’s understanding of the disease’s pathology and influence treatment.

Internationally, there are signs of movement towards greater transparency, particularly with regard to clinical research data. This change has been driven by governments [ 8 ], peak bodies [ 9 ], and clinician led initiatives [ 5 ]. One initiative led by the International Council of Medical Journal Editors (ICMJE) now requires a data sharing plan for all clinical research submitted for publication in a member scientific journal [ 9 ]. Further, international examples of data sharing can be seen in projects such as The Cancer Genome Atlas (TCGA) [ 10 ] dataset and the Surveillance, Epidemiology, and End Results (SEER) [ 11 ] database which have been used extensively for cancer research.

However, consent, data ownership, privacy, intellectual property rights, and potential for misinterpretation of data [ 12 ] remain areas of concern to individuals who are more circumspect about changing the data sharing norm. To date, there has been no published synthesis of views on data sharing from the perspectives of diverse professional stakeholders. Thus, we conducted a systematic review of the literature on the views of researchers and healthcare professionals regarding the sharing of health data.

This systematic literature review was part of a larger review of articles addressing data sharing, undertaken in accordance with the PRISMA statement for systematic reviews and meta-analysis [ 13 ]. The protocol was prospectively registered on PROSPERO ( www.crd.york.ac.uk /PROSPERO, CRD42018110559).

The following databases were searched: EMBASE/MEDLINE, Cochrane Library, PubMed, CINAHL, Informit Health Collection, PROSPERO Database of Systematic Reviews, PsycINFO, and ProQuest. The final search was conducted on 21 October 2018. No date restrictions were placed on the search; key search terms are listed in Table 1 . Papers were considered eligible if they: were published in English; were published in a peer review journal; reported original research, either qualitative or quantitative with any study design, related to data sharing in any disease setting; and included subjects over 18 years of age. Systematic literature reviews were included in the wider search but were not included in the results. Reference list and hand searching were undertaken to identify additional papers. Papers were considered ineligible if they focused on electronic health records, biobanking, or personal health records or were review articles, opinion pieces/articles/letters, editorials, or theses from masters or doctoral research. Duplicates were removed and title and abstract and full-text screening were undertaken using the Cochrane systematic literature review program Covidence [ 14 ]. Two authors were involved in all stages of the review process; conflicts were resolved by consensus.

Quality and bias were assessed at a study level using the QualSyst system for quantitative and qualitative studies as described by Kmet et al. [ 15 ]. A maximum score of 20 is assigned to articles of high quality and low bias; the final QualSyst score is a proportion of the total, with a possible score ranging from 0.0 to 1.0 [ 15 ].

Data extraction was undertaken using a pre-piloted form in Microsoft Office Excel. Data points included author, country and year of study, study design and methodology, health setting, and key themes and results. Where available, detailed information on research participants was extracted including age, sex, clinical/academic employment setting, publication and grant history, career stage, and world region.

Quantitative data were summarised using descriptive statistics. Synthesis of qualitative findings used a meta-ethnographic approach, in accordance with guidelines from Lockwood et al. [ 16 ].The main themes of each qualitative study were first identified and then combined, if relevant, into categories of commonality. Using a constant comparative approach, higher order themes and subthemes were developed. Quantitative data relevant to each theme were then incorporated. Using a framework analysis approach as described by Gale et al. [ 17 ], the perspectives of different professional groups (researchers, healthcare professionals, data custodians, and ethics committees) towards data sharing were identified. Where differences occurred, they are highlighted in the results. Similarly, where systematic differences according to other characteristics (such as age or years of experience), these are highlighted.

This search identified 4019 articles, of which 241 underwent full-text screening; 73 articles met the inclusion criteria for the larger review. Five systematic literature reviews were excluded as was one article which presented duplicate results; this left a total of 67 articles eligible for review. See Fig. 1 for the PRISMA diagram describing study screening.

PRIMSA flow diagram (attached)

This systematic literature review was originally developed to identify attitudes towards secondary use and sharing of health administrative and clinical trial data in breast cancer. However, as there was a paucity of material identified specifically related to this group, we present the multidisciplinary results of this search, and where possible highlight results specific to breast cancer, and cancer more generally. We believe that the material identified in this search is relevant and reflective of the wider attitudes towards data sharing within the scientific and medical communities and can be used to inform data sharing strategies in breast cancer.

Eighteen [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] of the 67 articles addressed the perspectives of clinical and scientific researchers, data custodians, and ethics committees and were analysed for this paper (Table 2 ). The majority ( n = 16) of articles focused on the views of researchers and health professionals, [ 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], only one article focused on data custodians [ 27 ] and ethics committees [ 23 ] respectively. Four articles [ 18 , 19 , 21 , 35 ] included a discussion on the attitudes of both researchers and healthcare professionals and patients; only results relating to researchers/clinicians are included in this analysis (Fig. 1 ).

Study design, location, and disciplines

Several study methodologies were used, including surveys ( n = 11) [ 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], interviews and focus groups ( n = 6) [ 18 , 19 , 20 , 21 , 22 , 23 ], and mixed methods ( n = 1) [ 28 ]. Studies were conducted in a several countries and regions; a breakdown by country and study is available in Table 3 .

In addition to papers focusing on general health and sciences [ 18 , 21 , 22 , 24 , 25 , 26 , 29 , 30 , 31 , 32 , 33 , 34 ], two articles included views from both science and non-science disciplines [ 27 , 28 ]. Multiple sclerosis (MS) [ 19 ], mental health [ 35 ], and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)/tuberculosis (TB) [ 20 ] were each the subject of one article.

Study quality

Results of the quality assessment are provided in Table 2 . QualSyst [15] scores ranged from 0.7 to 1.0 (possible range 0.0 to 1.0). While none were blinded studies, most provided clear information on respondent selection, data analysis methods, and justifiable study design and methodology.

Four key themes, barriers, facilitators, access, and ownership were identified; 14 subthemes were identified. A graphical representation of article themes is presented in Fig. 2 . Two articles reflect the perspective of research ethics committees [ 23 ] and data custodians [ 27 ]; concerns noted by these groups are similar to those highlighted by researchers and healthcare professionals.

Graphic representation of key themes and subthemes identified (attached)

Barriers and facilitators

Reasons for not sharing.

Eleven articles identified barriers to data sharing [ 20 , 22 , 24 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 34 ]. Concerns cited by respondents included other researchers taking their results [ 24 , 25 ], having data misinterpreted or misattributed [ 24 , 27 , 31 , 32 ], loss of opportunities to maximise intellectual property [ 24 , 25 , 27 ], and loss of publication opportunities [ 24 , 25 ] or funding [ 25 ]. Results of a qualitative study showed respondents emphasised the competitive value of research data and its capacity to advance an individual’s career [ 20 ] and the potential for competitive disadvantage with data sharing [ 22 ]. Systematic issues related to increased data sharing were noted in several articles where it was suggested the barriers are ‘deeply rooted in the practices and culture of the research process as well as the researchers themselves’ [ 33 ] (p. 1), and that scientific competition and a lack of incentive in academia to share data remain barriers to increased sharing [ 30 ].

Insufficient time, lack of funding, limited storage infrastructure, and lack of procedural standards were also noted as barriers [ 33 ]. Quantitative results demonstrated that the researchers did not have the right to make the data public or that there was no requirement to share by the study sponsor [ 33 ]. Maintaining the balance between investigator and funder interests and the protection of research subjects [ 31 ] were also cited as barriers. Concerns about privacy were noted in four articles [ 25 , 27 , 29 , 30 ]; one study indicated that clinical researchers were significantly more concerned with issues of privacy compared to scientific researchers [ 25 ]. The results of one qualitative study indicated that clinicians were more cautious than patients regarding the inclusion of personal information in a disease specific registry; the authors suggest this may be a result of potential for legal challenges in the setting of a lack of explicit consent and consistent guidelines [ 19 ]. Researchers, particularly clinical staff, indicated that they did not see sharing data in a repository as relevant to their work [ 29 ]

Trust was also identified as a barrier to greater data sharing [ 32 ]. Rathi et al. identified that researchers were likely to withhold data if they mistrusted the intent of the researcher requesting the information [ 32 ]. Ethical, moral, and legal issues were other potential barriers cited [ 19 , 22 ]. In one quantitative study, 74% of respondents ( N = 317) indicated that ensuring appropriate data use was a concern; other concerns included data not being appropriate for the requested purpose [ 32 ]. Concerns about data quality were also cited as a barrier to data reuse; some respondents suggested that there was a perceived negative association of data reuse among health scientists [ 30 ].

Reasons for sharing

Eleven articles [ 19 , 20 , 21 , 22 , 24 , 25 , 29 , 30 , 31 , 32 , 33 ] discussed the reasons identified by researchers and healthcare professionals for sharing health data; broadly the principle of data sharing was seen as a desirable norm [ 25 , 31 ]. Cited benefits included improvements to the delivery of care, communication and receipt of information, impacts on care and quality of life [ 19 ], contributing to the advancement of science [ 20 , 24 , 29 ], validating scientific outputs, reducing duplication of scientific effort and minimising research costs [ 20 ], and promoting open science [ 31 , 32 ]. Professional reasons for sharing data included academic benefit and recognition, networking and collaborative opportunities [ 20 , 24 , 29 , 31 ], and contributing to the visibility of their research [ 24 ]. Several articles noted the potential of shared data for enabling faster access to a wider pool of patients [ 21 ] for research, improved access to population data for longitudinal studies [ 22 ], and increased responsiveness to public health needs [ 20 ]. In one study, a small percentage of respondents indicated that there were no benefits from sharing their data [ 24 ].

Analysis of quantitative survey data indicated that the perceived usefulness of data was most strongly associated with reuse intention [ 30 ]. The lack of access to data generated by other researchers or institutions was seen as a major impediment to progress in science [ 33 ]. In a second study, quantitative data showed no significant differences in reasons for sharing by clinical trialists’ academic productivity, geographic location, trial funding source or size, or the journal in which the results were published [ 32 ]. Attitudes towards sharing in order to receive academic benefits or recognition differed significantly based on the respondent’s geographic location; those from Western Europe were more willing to share compared to respondents in the USA or Canada, and the rest of the world [ 32 ].

Views on sharing

Seven articles [ 19 , 20 , 21 , 29 , 31 , 33 , 34 ] discussed researchers’ and healthcare professionals’ views relating to sharing data, with a broad range of views noted. Two articles, both qualitative, discussed the role of national registries [ 21 ], and data repositories [ 31 ]. Generally, there was clear support for national research registers and an acceptance for their rationale [ 21 ], and some respondents believed that sharing de-identified data through data repositories should be required and that when requested, investigators should share data [ 31 ]. Sharing de-identified data for reasons beyond academic and public health benefit were cited as a concern [ 20 ]. Two quantitative studies noted a proportion of researchers who believed that data should not be made available [ 33 , 34 ]. Researchers also expressed differences in how shared data should be managed; the requirement for data to be ‘gate-kept’ was preferred by some, while others were happy to relinquish control of their data once curated or on release [ 20 ]. Quantitative results indicated that scientists were significantly more likely to rank data reuse as highly relevant to their work than clinicians [ 29 ], but not all scientists shared data equally or had the same views about data sharing or reuse [ 33 ]. Some respondents argued that not all data were equal and therefore should only be shared in certain circumstances. This was in direct contrast to other respondents who suggested that all data should be shared, all of the time [ 20 ].

Differences by age, background, discipline, professional focus, and world region

Differences in attitudes towards shared data were noted by age, professional focus, and world region [ 25 , 27 , 33 , 34 ]. Younger researchers, aged between 20–39 and 40–49 years, were less likely to share their data with others (39% and 38% respectively) compared to other age groups; respondents aged over 50 years of age were more willing (46%) to share [ 33 ]. Interestingly, while less willing to share, younger researchers also believed that the lack of access to data was a major impediment to science and their research [ 33 ]. Where younger researchers were able to place conditions on access to their data, rates of willingness to share were increased [ 33 ].

Respondents from the disciplines of education, medicine/health science, and psychology were more inclined than others to agree that their data should not be available for others to use in the first place [ 34 ]. However, results from one study indicated that researchers from the medical field and social sciences were less likely to share compared to other disciplines [ 33 ]. For example, results of a quantitative study showed that compared to biologists, who reported sharing 85% of their data, medical and social sciences reported sharing their data 65% and 58% percent of the time, respectively [ 33 ].

One of the primary reasons for controlling access to data, identified in a study of data custodians, was due to a desire to avoid data misuse; this was cited as a factor for all surveyed data repositories except those of an interdisciplinary nature [ 27 ]. Limiting access to certain types of research and ensuring attribution were not listed as a concern for sociology, humanities or interdisciplinary data collections [ 27 ]. Issues pertaining to privacy and sensitive data were only cited as concerns for data collections related to humanities, social sciences, and biology, ecology, and chemistry; concerns regarding intellectual property were also noted [ 27 ]. The disciplines of biology, ecology, and chemistry and social sciences had the most policy restrictions on the use of data held in their repositories [ 27 ].

Differences in data sharing practices were also noted by world region. Respondents not from North American and European countries were more willing to place their data on a central repository; however, they were also more likely to place conditions on the reuse of their data [ 33 , 34 ].

Experience of data sharing

The experience of data sharing among researchers was discussed in nine articles [ 20 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 ]. Data sharing arrangements were highly individual and ranged from ad hoc and informal processes to formal procedures enforced by institutional policies in the form of contractual agreements, with respondents indicating data sharing behaviour ranging from sharing no data to sharing all data [ 20 , 26 , 31 ]. Quantitative data from one study showed that researchers were more inclined to share data prior to publication with people that they knew compared to those they did not; post publication, these figures were similar between groups [ 24 ]. While many researchers were prepared to share data, results of a survey identified a preference of researchers to collect data themselves, followed by their team, or by close colleagues [ 26 ].

Differences in the stated rate of data sharing compared to the actual rate of sharing [ 25 ] were noted. In a large quantitative study ( N = 1329), nearly one third of respondents chose not to answer whether they make their data available to others; of those who responded to the question, 46% reported they do not make their data electronically available to others [ 33 ]. By discipline, differences in the rate of refusal to share were higher in chemistry compared to non-science disciplines such as sociology [ 25 ]. Respondents who were more academically productive (> 25 articles over the past 3 years) reported that they have or would withhold data to protect research subjects less frequently than those who were less academically productive or received industry funding [ 32 ].

Attitudes to sharing de-identified data via data repositories was discussed in two articles [ 29 , 31 ]. A majority of respondents in one study indicated that de-identified data should be shared via a repository and that it should be shared when requested. A lack of experience in uploading data to repositories was noted as a barrier [ 29 ]. When data was shared, most researchers included additional materials to support their data including materials such as metadata or a protocol description [ 29 ].

Two articles [ 28 , 30 ] focused on processes and variables associated with sharing. Factors such as norms, data infrastructure/organisational support, and research communities were identified as important factors in a researcher’s attitude towards data sharing [ 28 , 30 ]. A moderate correlation between data reuse and data sharing suggest that these two variables are not linked. Furthermore, sharing data compared to self-reported data reuse were also only moderately associated (Pearson’s correlation of 0.25 ( p ≤ 0.001)) [ 26 ].

Predictors of data sharing and norms

Two articles [ 26 , 30 ] discussed the role of social norms and an individual’s willingness to share health data. Perceived efficacy and efficiency of data reuse were strong predictors of data sharing [ 26 ] and the development of a ‘positive social norm towards data sharing support(s)[ed] researcher data reuse intention’ [ 30 ] (p. 400).

Policy framework

The establishment of clear policies and procedures to support data sharing was highlighted in two articles [ 22 , 28 ]. The presence of ambiguous data sharing policies was noted as a major limitation, particularly in primary care and the increased adoption of health informatics systems [ 22 ]. Policies that support an efficient exchange system allowing for the maximum amount of data sharing are preferred and may include incentives such as formal recognition and financial reimbursement; a framework for this is proposed in Fecher et al. [ 28 ].

Research funding

The requirement to share data funded by public monies was discussed in one article [ 25 ]. Some cases were reported of researchers refusing to share data funded by tax-payer funds; reasons for refusal included a potential reduction in future funding or publishing opportunities [ 25 ].

Access and ownership

Articles relating to access and ownership were grouped together and seven subthemes were identified.

Access, information systems, and metadata

Ten articles [ 19 , 20 , 21 , 22 , 26 , 27 , 29 , 33 , 34 , 35 ] discussed the themes of access, information systems, and the use of metadata. Ensuring privacy protections in a prospective manner was seen as important for data held in registries [ 19 ]. In the setting of mental health, researchers indicated that patients should have more choices for controlling access to shared registry data [ 35 ]. The use of guardianship committees [ 19 ] or gate-keepers [ 20 ] was seen as important in ensuring the security and access to data held in registries by some respondents; however, many suggested that a researcher should relinquish control of the data collection once curated or released, unless embargoed [ 20 ]. Reasons for maintaining control over registry data included ensuring attribution, restricting commercial research, protecting sensitive (non-personal) information, and limiting certain types of research [ 27 ]. Concerns about security and confidentiality were noted as important and assurances about these needed to be provided; accountability and transparency mechanisms also need to be included [ 21 ]. Many respondents believed that access to the registry data by pharmaceutical companies and marketing agencies was not considered appropriate [ 19 ].

Respondents to a survey from medicine and social sciences were less likely to agree to have all data included on a central repository with no restrictions [ 33 ]; notably, this was also reflected in the results of qualitative research which indicated that health professionals were more cautious than patients about the inclusion of personal data within a disease specific register [ 19 ].

While many researchers stated that they commonly shared data directly with other researchers, most did not have experience with uploading data to repositories [ 29 ]. Results from a survey indicated that younger respondents have more data access restrictions and thought that their data is easier to access significantly more than older respondents [ 34 ]. In the primary care setting, concerns were noted about the potential for practitioners to block patient involvement in a registry by refusing access to a patient’s personal data or by not giving permission for the data to be extracted from their clinical system [ 21 ]. There was also resistance in primary care towards health data amalgamation undertaken for an unspecified purpose [ 22 ]; respondents were not in favour of systems which included unwanted functionality (do not want/need), inadequate attributes (capability and receptivity) of the practice, or undesirable impact on the role of the general practitioner (autonomy, status, control, and workflow) [ 22 ].

Access to ‘comprehensive metadata (is needed) to support the correct interpretation of the data’ [ 26 ] (p. 4) at a later stage. When additional materials were shared, most researchers shared contextualising information or a description of the experimental protocol [ 29 ]. The use of metadata standards was not universal with some respondents using their own [ 33 ].

Several articles highlighted the impact of data curation on researchers’ time [ 20 , 21 , 22 , 29 , 33 ] or finances [ 24 , 28 , 29 , 33 , 34 ]; these were seen as potential barriers to increased registry adoption [ 21 ]. Tasks required for curation included preparing data for dissemination in a usable format and uploading data to repositories. The importance of ensuring that the data is accurately preserved for future reuse was highlighted; it must be presented in a retriable and auditable manner [ 20 ]. The amount of time required to curate data ranged from ‘no additional time’ to ‘greater than ten hours’ [ 29 ]. In one study, no clinical respondent had their data in a sharable format [ 29 ]. In the primary care setting, health information systems which promote sharing were not seen as being beneficial if they required standardisation of processes and/or sharing of clinical notes [ 22 ]. Further, spending time on non-medical issues in a time poor environment [ 22 ] was identified as a barrier. Six articles described the provision of funding or technical support to ensure data storage, maintenance, and the ability to provide access to data when requested. All noted a lack of funding and time as a barrier to increased sharing data [ 20 , 24 , 28 , 29 , 33 , 34 ].

Results of qualitative research indicated a range of views regarding consent mechanisms for future data use [ 18 , 19 , 20 , 23 , 35 ]. Consenting for future research can be complex given that the exact nature of the study will be unknown, and therefore some respondents suggested that a broad statement on future data uses be included [ 19 , 20 ] during the consent process. In contrast, other participants indicated that the current consent processes were too broad and do not reflect patient preferences sufficiently [ 35 ]. The importance of respecting the original consent in all future research was noted [ 20 ]. It was suggested that seeking additional consent for future data use may discourage participation in the original study [ 20 ]. Differences in views regarding the provision of detailed information about sharing individual level data was noted suggesting that the researchers wanted to exert some control over data they had collected [ 20 ]. An opt-out consent process was considered appropriate in some situations [ 18 ] but not all; some respondents suggested that consent to use a patient’s medical records was not required [ 18 ]. There was support by some researchers to provide patients with the option to ‘opt-in’ to different levels of involvement in a registry setting [ 19 ]. Providing patients more granular choices when controlling access to their medical data [ 35 ] was seen as important.

The attitudes of ethics and review boards ( N = 30) towards the use of medical records for research was discussed in one article [ 23 ]. While 38% indicated that no further consent would be required, 47% required participant consent, and 10% said that the requirement for consent would depend on how the potentially identifying variables would be managed [ 23 ]. External researcher access to medical record data was associated with a requirement for consent [ 23 ].

Acknowledgement

The importance of establishing mechanisms which acknowledge the use of shared data were discussed in four articles [ 27 , 29 , 33 , 34 ]. A significant proportion of respondents to a survey believed it was fair to use other researchers’ data if they acknowledged the originator and the funding body in all disseminated work or as a formal citation in published works [ 33 ]. Other mechanisms for acknowledging the data originator included opportunities to collaborate on the project, reciprocal data sharing agreements, allowing the originator to review or comment on results, but not approve derivative works, or the provision of a list of products making use of the data and co-authorship [ 33 , 34 ]. In the setting of controlled data collections, survey results indicated that ensuring attribution was a motivator for controlled access [ 27 ]. Over half of respondents in one survey believed it was fair to disseminate results based either in whole or part without the data provider’s approval [ 33 ]. No significant differences in mechanisms for acknowledgement were noted between clinical and scientific participants; mechanisms included co-authorship, recognition in the acknowledgement section of publications, and citation in the bibliography [ 29 ]. No consentient method for acknowledging shared data reuse was identified [ 29 ].

Data ownership was identified as a potential barrier to increased data sharing in academic research [ 28 ]. In the setting of control of data collections, survey respondents indicated that they wanted to maintain some control over the dataset, which is suggestive of researchers having a perceived ownership of their research data [ 28 ]. Examples of researchers extending ownership over their data include the right to publish first and the control of access to datasets [ 28 ]. Fecher et al. noted that the idea of data ownership by the researcher is not a position always supported legally; ‘the ownership and rights of use, privacy, contractual consent and copyright’ are subsumed [ 28 ] (p. 15). Rather data sharing is restricted by privacy law, which is applied to datasets containing data from individuals. The legal uncertainty about data ownership and the complexity of law can deter data sharing [ 28 ].

Promotion/professional criteria

The role of data sharing and its relation to promotion and professional criteria were discussed in two articles [ 24 , 28 ]. The requirement to share data is rarely a promotion or professional criterion, rather the systems are based on grants and publication history [ 24 , 28 ]. One study noted that while the traditional link between publication history and promotion remains, it is ‘likely that funders will continue to get sub-optimal returns on their investments, and that data will continue to be inefficiently utilised and disseminated’ [ 24 ] (p. 49).

This systematic literature review highlights the ongoing complexity associated with increasing data sharing across the sciences. No additional literature meeting the inclusion criteria were identified in the period between the data search and the submission of this manuscript. Data gaps identified include a paucity of information specifically related to the attitudes of breast cancer researchers and health professionals towards the secondary use and sharing of health administrative and clinical trial data.

While the majority of respondents believed the principles of data sharing were sound, significant barriers remain: issues of consent, privacy, information security, and ownership were key themes throughout the literature. Data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region.

Addressing concerns of privacy, trust, and information security in a technologically changing and challenging landscape is complex. Ensuring the balance between privacy and sharing data for the greater good will require the formation of policy and procedures, which promote both these ideals.

Establishing clear consent mechanisms would provide greater clarity for all parties involved in the data sharing debate. Ensuring that appropriate consent for future research, including secondary data analysis and sharing and linking of datasets, is gained at the point of data collection, would continue to promote research transparency and provide healthcare professionals and researchers with knowledge that an individual is aware that their data may be used for other research purposes. The establishment of policy which supports and promotes the secondary use of data and data sharing will assist in the normalisation of this type of health research. With the increased promotion of data sharing and secondary data analysis as an established tool in health research, over time barriers to its use, including perceptions of ownership and concerns regarding privacy and consent, will decrease.

The importance of establishing clear and formal processes associated with acknowledging the use of shared data has been underscored in the results presented. Initiatives such as the Bioresource Research Impact Factor/Framework (BRIF) [ 36 ] and the Citation of BioResources in journal Articles (CoBRA) [ 37 ] have sought to formalise the process. However, increased academic recognition of sharing data for secondary analysis requires further development and the allocation of funding to ensure that collected data is in a usable, searchable, and retrievable format. Further, there needs to be a shift away from the traditional criteria of academic promotion, which includes research outputs, to one which is inclusive of a researcher’s data sharing history and the availability of their research dataset for secondary analysis.

The capacity to identify and use already collected data was identified as a barrier. Moves to make data findable, accessible, interoperable, and reusable (FAIR) have been promoted as a means to encourage greater accessibility to data in a systematic way [ 38 ]. The FAIR principles focus on data characteristics and should be interpreted alongside the collective benefit, authority to control, responsibility, and ethics (CARE) principles established by the Global Indigenous Data Alliance (GIDA) which a people and purpose orientated [ 39 ].

Limitations

The papers included in this study were limited to those indexed on major databases. Some literature on this topic may have been excluded if it was not identified during the grey literature and hand searching phases.

Implications

Results of this systematic literature review indicate that while there is broad agreement for the principles of data sharing in medical research, there remain disagreements about the infrastructure and procedures associated with the data sharing process. Additional work is therefore required on areas such as acknowledgement, curation, and data ownership.

While the literature confirms that there is overall support for data sharing in medical and scientific research, there remain significant barriers to its uptake. These include concerns about privacy, consent, information security, and data ownership.

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Abbreviations

Bioresource Research Impact Factor/Framework

Collective benefit, authority to control, responsibility, and ethics

Citation of BioResources in journal Articles

Findable, accessible, interoperable, and reusable

Global Indigenous Data Alliance

Human immunodeficiency virus/acquired immunodeficiency

International Council of Medical Journal Editors

Multiple sclerosis

Surveillance, Epidemiology, and End Results

Tuberculosis

The Cancer Genome Atlas

Huesch MD, Mosher TJ. Using it or losing it? The case for data scientists inside health care. NEJM Catalyst. 2017.

Green LW. Closing the chasm between research and practice: evidence of and for change. Health Promot J Australia. 2014;25(1):25–9.

Article   Google Scholar  

Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510–20.

Article   PubMed   PubMed Central   Google Scholar  

Goldacre B. Are clinical trial data shared sufficiently today? No. Br Med J. 2013;347:f1880.

Goldacre B, Gray J. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials. 2016;17(1):164.

Kostkova P, Brewer H, de Lusignan S, Fottrell E, Goldacre B, Hart G, et al. Who owns the data? Open data for healthcare. Front Public Health. 2016;4.

Elliott M. Seeing through the lies: innovation and the need for transparency. Gresham College Lecture Series; 23 November 2016; Museum of London. 2016.

European Medicines Agency. Publication and access to clinical-trial data. London: European Medicines Agency; 2013.

Google Scholar  

Taichman DB, Backus J, Baethge C, Bauchner H, de Leeuw PW, Drazen JM, et al. Sharing clinical trial data: a proposal from the International Committee of Medical Journal Editors. J Am Med Assoc. 2016;315(5):467–8.

Article   CAS   Google Scholar  

National Institue of Health (NIH). The Cancer Genome Atlas (TCGA): program overview United States of America: National Institue of Health (NIH); 2019 [Available from: https://cancergenome.nih.gov/abouttcga/overview ].

National Institue of Health (NIH). Surveillance, Epidemiology, and End Results (SEER) Program Washington: The Government of United States of Ameica; 2019 [Available from: https://seer.cancer.gov ].

Castellani J. Are clinical trial data shared sufficiently today? Yes. Br Med J. 2013;347:f1881.

Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097–e.

Veritas Health Innovation. Covidence systematic review software. Melbourne: Cochrane Collaboration; 2018.

Kmet LM, Cook LS, Lee RC. Standard quality assessment criteria for evaluating primary research papers from a variety of fields; 2004.

Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evidence Based Healthcare. 2015;13(3):179–87.

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.

Asai A, Ohnishi M, Nishigaki E, Sekimoto M, Fukuhara S, Fukui T. Attitudes of the Japanese public and doctors towards use of archived information and samples without informed consent: preliminary findings based on focus group interviews. BMC Medical Ethics. 2002;3(1):1.

Article   PubMed Central   Google Scholar  

Baird W, Jackson R, Ford H, Evangelou N, Busby M, Bull P, et al. Holding personal information in a disease-specific register: the perspectives of people with multiple sclerosis and professionals on consent and access. J Med Ethics. 2009;35(2):92–6.

Article   CAS   PubMed   Google Scholar  

Denny SG, Silaigwana B, Wassenaar D, Bull S, Parker M. Developing ethical practices for public health research data sharing in South Africa: the views and experiences from a diverse sample of research stakeholders. J Empiric Res Human Res Ethics. 2015;10(3):290–301.

Grant A, Ure J, Nicolson DJ, Hanley J, Sheikh A, McKinstry B, et al. Acceptability and perceived barriers and facilitators to creating a national research register to enable 'direct to patient' enrolment into research: the Scottish Health Research register (SHARE). BMC Health Serv Res. 2013;13(1):422.

Knight J, Patrickson M, Gurd B. Understanding GP attitudes towards a data amalgamating health informatics system. Electron J Health Inform. 2008;3(2):12.

Willison DJ, Emerson C, Szala-Meneok KV, Gibson E, Schwartz L, Weisbaum KM, et al. Access to medical records for research purposes: varying perceptions across research ethics boards. J Med Ethics. 2008;34(4):308–14.

Bezuidenhout L, Chakauya E. Hidden concerns of sharing research data by low/middle-income country scientists. Glob Bioethics. 2018;29(1):39–54.

Ceci SJ. Scientists' attitudes toward data sharing. Sci Technol Human Values. 1988;13(1-2):45–52.

Curty RG, Crowston K, Specht A, Grant BW, Dalton ED. Attitudes and norms affecting scientists’ data reuse. PLoS One. 2017;12(12):e0189288.

Article   PubMed   PubMed Central   CAS   Google Scholar  

Eschenfelder K, Johnson A. The limits of sharing: controlled data collections. Proc Am Soc Inf Sci Technol. 2011;48(1):1–10.

Fecher B, Friesike S, Hebing M. What drives academic data sharing? PLoS One. 2015;10(2):e0118053.

Federer LM, Lu Y-L, Joubert DJ, Welsh J, Brandys B. Biomedical data sharing and reuse: attitudes and practices of clinical and scientific research staff. PLoS One. 2015;10(6):e0129506.

Joo S, Kim S, Kim Y. An exploratory study of health scientists’ data reuse behaviors: examining attitudinal, social, and resource factors. Aslib J Inf Manag. 2017;69(4):389–407.

Rathi V, Dzara K, Gross CP, Hrynaszkiewicz I, Joffe S, Krumholz HM, et al. Sharing of clinical trial data among trialists: a cross sectional survey. Br Med J. 2012;345:e7570.

Rathi VK, Strait KM, Gross CP, Hrynaszkiewicz I, Joffe S, Krumholz HM, et al. Predictors of clinical trial data sharing: exploratory analysis of a cross-sectional survey. Trials. 2014;15(1):384.

Tenopir C, Allard S, Douglass K, Aydinoglu AU, Wu L, Read E, et al. Data sharing by scientists: practices and perceptions. PLoS One. 2011;6(6):e21101.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Tenopir C, Dalton ED, Allard S, Frame M, Pjesivac I, Birch B, et al. Changes in data sharing and data reuse practices and perceptions among scientists worldwide. PLoS One. 2015;10(8):e0134826.

Grando MA, Murcko A, Mahankali S, Saks M, Zent M, Chern D, et al. A study to elicit behavioral health patients' and providers' opinions on health records consent. J Law Med Ethics. 2017;45(2):238–59.

Howard HC, Mascalzoni D, Mabile L, Houeland G, Rial-Sebbag E, Cambon-Thomsen A. How to responsibly acknowledge research work in the era of big data and biobanks: ethical aspects of the bioresource research impact factor (BRIF). J Commun Genetics. 2018;9(2):169–76.

Bravo E, Calzolari A, De Castro P, Mabile L, Napolitani F, Rossi AM, et al. Developing a guideline to standardize the citation of bioresources in journal articles (CoBRA). BMC Med. 2015;13:33.

Boeckhout M, Zielhuis GA, Bredenoord AL. The FAIR guiding principles for data stewardship: fair enough? Eur J Human Genetics. 2018;26(7):931–6.

Global Indigenous Data Alliance (GIDA). CARE principles for indigenous data governance GIDA; 2019 [Available from: https://www.gida-global.org/care ].

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Acknowledgements

The authors would like to thank Ms. Ngaire Pettit-Young, Information First, Sydney, NSW, Australia, for her assistance in developing the search strategy.

This project was supported by the Sydney Vital, Translational Cancer Research, through a Cancer Institute NSW competitive grant. The views expressed herein are those of the authors and are not necessarily those of the Cancer Institute NSW. FB is supported in her academic role by the Friends of the Mater Foundation.

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Hutchings, E., Loomes, M., Butow, P. et al. A systematic literature review of researchers’ and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data. Syst Rev 9 , 240 (2020). https://doi.org/10.1186/s13643-020-01485-5

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Ethics in Patients’ Health Literacy: a scoping review and a critical discussion

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Melina Evripidou, Areti Efthymiou, Venetia Velonaki, Athina Kalokairinou, Evridiki Papastavrou, Ethics in Patients’ Health Literacy: a scoping review and a critical discussion, Health Promotion International , Volume 39, Issue 4, August 2024, daae100, https://doi.org/10.1093/heapro/daae100

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A growing body of literature has acknowledged that a high number of populations with low Health Literacy (HL) is related to poor health outcomes, inequities in healthcare and high economic costs. Those findings have formulated the research questions of this review: (i) what ethical issues arise within the context of patients’ HL and (ii) What is the relationship between HL and quality of life? This review followed the guidelines of Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) and it was conducted in five databases: PubMed, CINAHL, MEDLINE, Scopus and Science Direct between June 2022 and December 2023. Out of the 3164 titles retrieved, 285 abstracts were eligible to proceed. Following a thorough examination of the full text of 61 papers, 45 sources were identified that met the inclusion criteria. The data analysis process was guided by the research questions, employing a thematic approach. Four themes were identified: the use of language and patient understanding, human rights, the principlism approach (justice, beneficence, non-maleficence and autonomy) and quality of life. The first theme mainly focused on the relation of HL with the notion of consent forms and national action plans. Human rights in relation to HL were discussed as a minor issue. The bioethical framework by Beauchamp and Childress (Principles of Biomedical Ethics, 6th edn. Oxford University Press, New York, NY, 2009), was addressed by several studies, with a particular focus on justice and the loss of autonomy. Quality of life indicated a positive correlation with HL by most of the authors, while few studies revealed a moderate correlation.

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A systematic review of the impact of post-harvest aquatic food processing technology on gender equality and social justice

• Nitya Rao   ORCID: orcid.org/0000-0002-6318-0147 1 ,
• Lee Hooper   ORCID: orcid.org/0000-0002-7904-3331 2 ,
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• Sudarshan Thakur   ORCID: orcid.org/0009-0009-5416-4282 7 ,
• Abraham Wanyama   ORCID: orcid.org/0009-0009-9185-459X 1 &
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Post-harvest practices and technologies are key to reducing global aquatic harvest loss. The lives of post-harvest fisheries workers, over half of them women, are deeply affected by these technologies, but their equity and equality outcomes are poorly understood. This systematic review synthesizes evidence of post-harvest aquatic food processing technology outcomes, showing that persistent inequalities in social structure and norms disadvantage women across a range of technologies, both traditional and improved, especially regarding control over resources. We found that improved technologies bring enhanced productivity and possibly income for workers, yet contracts are often precarious due to pre-existing social inequities. While power and control of resources is more unequal in factory settings, it is not necessarily equal in traditional contexts either, despite offering greater flexibility. More rigorous comparative research, including voices of diverse actors, is key to understanding the impacts of different technologies on gender equality and social justice and inform policymaking.

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The data that support the findings of this study are available from the corresponding author upon request. The DOIs of the studies included in the systematic review are presented in Supplementary Table 1 .

Food and Agriculture Organization (FAO), Duke University & WorldFish Illuminating Hidden Harvests (FAO, 2023); https://doi.org/10.4060/cc4576en

WorldFish Annual Report 2021 (WorldFish, 2022); https://hdl.handle.net/20.500.12348/5284

The State of World Fisheries and Aquaculture (SOFIA) (FAO, 2020); https://doi.org/10.4060/ca9229en

Agarwal, M., Agarwal, S., Ahmad, S., Singh, R. & KM, J. Food Loss and Waste in India: The Knowns and the Unknowns (World Resources Institute, 2021); https://www.wri.org/research/food-loss-and-waste-india-knowns-and-unknowns

Stathers, T. et al. A scoping review of interventions for crop postharvest loss reduction in sub-Saharan Africa and South Asia. Nat. Sustain. 3 , 821–835 (2020).

Article   Google Scholar  

Gopal, N., Hapke, H. M., Kusakabe, K., Rajaratnam, S. & Williams, M. J. Expanding the horizons for women in fisheries and aquaculture. Gend. Technol. Dev. 24 , 1–9 (2020).

Food Security and Nutrition: Building a Global Narrative towards 2030. A Report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security (Committee on World Food Security, 2020); https://www.fao.org/3/ca9731en/ca9731en.pdf

Bennet, E. Gender, fisheries and development. Mar. Policy 29 , 451–459 (2005).

Gustavsson, M. Women’s changing productive practices, gender relations and identities in fishing through a critical feminisation perspective. J. Rural Stud. 78 , 36–46 (2020).

Bryceson, D. F. & McCall, M. K. Lightening the load on rural women: how appropriate is the technology directed towards Africa? Gend. Technol. Dev. 1 , 23–45 (1997).

Basu, P. & Scholten, B. A. Technological and social dimensions of the Green Revolution: connecting pasts and futures. Int. J. Agric. Sustain. 10 , 109–116 (2012).

Gopal, N., Edwin, L. & Meenakumari, B. Transformation in gender roles with changes in traditional fisheries in Kerala, India. Asian Fish. Sci. 27 , 67–78 (2014).

Google Scholar  

Rola‐Rubzen, M. F., Paris, T., Hawkins, J. & Sapkota, B. Improving gender participation in agricultural technology adoption in Asia: from rhetoric to practical action. Appl. Econ. Perspect. Policy 42 , 113–125 (2020).

Bennett, N. J. Mainstreaming equity and justice in the ocean. Front. Mar. Sci. 9 , 873572 (2022).

Hicks, C. C. et al. Rights and representation support justice across aquatic food systems. Nat. Food 3 , 851–861 (2022).

Article   PubMed   Google Scholar  

Issifu, I., Dahmouni, I., Deffor, E. W. & Sumaila, U. R. Diversity, equity, and inclusion in the Blue Economy: why they matter and how do we achieve them? Front. Polit. Sci. 4 , 106748 (2023).

The State of Food and Agriculture 2013 (FAO, 2013); https://www.fao.org/4/i3300e/i3300e00.htm

The State of World Fisheries and Aquaculture (SOFIA) (FAO, 2022); https://www.fao.org/3/ca9731en/ca9731en.pdf

Kabeer, N. Mainstreaming Gender Equality in Poverty Eradication and the Millennium Development Goals: Handbook for Policy Makers (Commonwealth Secretariat, 2003).

Gopal, N., Williams, M. J., Porter, M. & Kusakabe, K. Gender in aquaculture and fisheries. The long journey to equality. Asian Fish. Sci. 29S , 1–246 (2016).

Training Module—How to Integrate Gender Issues in Climate-Smart Agriculture Projects (FAO, 2017); https://www.fao.org/documents/card/en?details=45d93533-c024-%2f

Komlatsky, V. I., Podoinitsyna, T. A., Verkhoturov, V. V. & Kozub, Y. A. Automation technologies for fish processing and production of fish products. J. Phys. Conf. Ser. 1399 , 044050 (2019).

Turan, H. & Erkoyuncu, İ. in Progress in Food Preservation (eds Bhat, R. et al.) 297–313 (Wiley, 2012).

Tokur, B. & Korkmaz, K. in Innovative Technologies in Seafood Processing (ed. Ozogul, Y.) 303–322 (CRC Press, 2019).

Kamarulzaman, A., Hasanuzzaman, M. & Rahim, N. A. Global advancement of solar drying technologies and its future prospects: a review. Sol. Energy 221 , 559–582 (2021).

Article   ADS   Google Scholar  

Harwood, S. & Eaves, S. Conceptualising technology, its development and future: the six genres of technology. Technol. Forecast. Soc. Change 160 , 120174 (2020).

Article   PubMed   PubMed Central   Google Scholar  

Dosi, G. Technological paradigms and technological trajectories: a suggested interpretation of the determinants and directions of technical change. Res. Policy 11 , 147–162 (1982).

Mamat, H. & Bhandari, B. R. Special issue on innovative food products and processing. Appl. Sci. 13 , 8542 (2023).

Article   CAS   Google Scholar  

Kabeer, N. Reversed Realities: Gender Hierarchies in Development Thought (Verso, 1994).

Kruijssen, F., McDougall, C. L. & van Asseldonk, I. J. M. Gender and aquaculture value chains: a review of key issues and implications for research. Aquaculture 493 , 328–337 (2018).

Njuki, J. et al. A Review of Evidence on Gender Equality, Women’s Empowerment, and Food Systems (International Food Policy Research Institute, 2021); https://ebrary.ifpri.org/digital/collection/p15738coll2/id/134469

Moser, C. Gender planning in the third world: meeting practical and strategic gender needs. World Dev. 17 , 1799–1825 (1989).

Giddens, A. The Constitution of Society: Outline of the Theory of Structuration (Polity, 1986).

Rao, N. et al. A qualitative comparative analysis of women’s agency and adaptive capacity in climate change hotspots in Asia and Africa. Nat. Clim. Change 9 , 964–971 (2019).

McDougall, C. et al. Women’s Empowerment in Fisheries and Aquaculture Index (WEFI): Guidance Notes (WorldFish, 2022); https://hdl.handle.net/20.500.12348/5107

What Does It Mean to Leave No One Behind? A UNDP Discussion Paper and Framework for Implementation (United Nations Development Programme, 2018); https://www.undp.org/publications/what-does-it-mean-leave-no-one-behind

Doneys, P. et al. Gender, technology and development: reflections on the past, and provocations for the future. Gend. Technol. Dev. 26 , 285–294 (2022).

Nagoli, J., Binauli, L. & Chijere, A. Inclusive ecosystems? Women’s participation in the aquatic ecosystem of Lake Malawi. Environments 6 , 3 (2019).

Ngaruiya, F. W., Ogendi, G. M. & Mokua, M. A. Occupational health risks and hazards among the fisherfolk in Kampi Samaki, Lake Baringo, Kenya. Environ. Health Insights https://doi.org/10.1177/11786302198814 (2019).

Environmental Management and Economic Development Organization (EMEDO). Women’s Role, Struggles and Strategies across the Fisheries Value Chain the Case of Lake Victoria-Tanzania (Socio Economics and Extension Services Division, National Institute for Freshwater Fisheries Research, 2017); www.icsf.net

Zelasney, J., Ford, A., Westlund, L., Ward, A. & Peñarubia, O. R. Securing Sustainable Small-Scale Fisheries—Showcasing Applied Practices in Value Chains, Post-harvest Operations and Trade. Case Study 3: The FAO-Thiaroye Processing Technique: Facilitating Social Organization, Empowering Women and Creating Market Access Opportunities in West Africa (FAO, 2020); https://doi.org/10.4060/ca8402en

Picked Apart the Hidden Struggles of Migrant Worker Women in the Maryland Crab Industry (American University Washington College of Law International Human Rights Law Clinic and Centro de los Derechos del Migrante, 2010).

Rafnsdottir, G. L. & Gudmundsdottir, M. L. New technology and its impact on well-being. Work 22 , 31–39 (2004).

PubMed   Google Scholar  

Aasmoe, L. et al. Skin symptoms in the seafood-processing industry in north Norway. Contact Dermatitis 52 , 102–107 (2005).

Article   CAS   PubMed   Google Scholar  

Aasmoe, L., Bang, B., Egeness, C. & Løchen, M. L. Musculoskeletal symptoms among seafood production workers in North Norway. Occup. Med. 58 , 64–70 (2008).

Jeebhay, M. F. et al. Occupational allergy and asthma among salt water fish processing workers. Am. J. Ind. Med. 51 , 899–910 (2008).

Tomita, S. et al. Introduction prevalence and risk factors of low back pain among Thai and Myanmar migrant seafood processing factory workers in Samut Sakorn Province, Thailand. Ind. Health 48 , 283–291 (2010).

Shobhana Warrier, M. V. Women at work: migrant women in fish processing industry. Econ. Polit. Wkly 36 , 3554–3562 (2001).

Howse, D. et al. Gender and snow crab occupational asthma in Newfoundland and Labrador, Canada. Environ. Res. 101 , 163–174 (2006).

Article   ADS   CAS   PubMed   Google Scholar  

Howse, D., Jeebhay, M. F. & Neis, B. The changing political economy of occupational health and safety in fisheries: lessons from Eastern Canada and South Africa. J. Agrar. Change 12 , 344–363 (2012).

Yingst, A. & Skaptadóttir, U. D. Gendered labor in the Icelandic fish processing industry. Marit. Stud. 17 , 125–132 (2018).

Barclay, K. M., Satapornvanit, A. N., Syddall, V. M. & Williams, M. J. Tuna is women’s business too: applying a gender lens to four cases in the Western and Central Pacific. Fish Fish. 23 , 584–600 (2022).

Choudhury, A., McDougall, C., Rajaratnam, S. & Mi Young Park, C. Women’s Empowerment in Aquaculture: Two Case Studies from Bangladesh (FAO, 2017).

Ike-Obasi, J. & Ogubunka, S. O. The roles of women in fish processing activities in some local government areas of Rivers State, Nigeria. Agric. Ext. J. 3 , 73–77 (2019).

Sangaramoorthy, T. Liminal living: everyday injury, disability, and instability among migrant Mexican women in Maryland’s seafood industry. Med. Anthropol. Q. 33 , 557–578 (2019).

Gender Analysis of Post-harvest Fisheries in Cambodia (United Nations Industrial Development Organization, 2021).

Kaminski, A. M. et al. Fish losses for whom? A gendered assessment of post-harvest losses in the Barotse Floodplain fishery, Zambia. Sustainability 12 , 10091 (2020).

Santos, A. N. Fisheries as a way of life: gendered livelihoods, identities and perspectives of artisanal fisheries in eastern Brazil. Mar. Policy 62 , 279–288 (2015).

Ramirez, P. J. B., Narvaez, T. A. & Santos-Ramirez, E. J. Gender-inclusive value chains: the case of seaweed farming in Zamboanga Peninsula, Philippines. Gend. Technol. Dev. 24 , 110–130 (2020).

Torell, E., Manyungwa-Pasani, C., Bilecki, D., Gumulira, I. & Yiwombe, G. Assessing and advancing gender equity in Lake Malawi’s small-scale fisheries sector. Sustainability 13 , 13001 (2021).

Nwabeze, G. O. et al. Gender and Fisheries of Lake Kainji, Nigeria: A Review (Fisheries Society of Nigeria, 2012); http://hdl.handle.net/1834/38238

Omeje, J. E., Anthonia Ifeyinwa, A., Samuel Preye, J. & Queen Mercy, M. Economics of smoked farmed catfish in Kainji Lake Basin, Nigeria. J. Agric. Ext. 26 , 1–14 (2022).

Larson, S., Stoeckl, N., Rimmer, M. A. & Paul, N. A. Understanding feedback relationships between resources, functionings and well-being: a case study of seaweed farming and artisanal processing in Indonesia. Ambio 51 , 914–925 (2022).

Article   ADS   PubMed   Google Scholar  

Salim, S. S. & Geetha, R. Empowerment of fisherwomen in Kerala-an assessment. Ind. J. Fish. 60 , 73–80 (2013).

Davies, R. M. & Davis, O. A. Traditional and improved fish processing technologies in Bayelsa State, Nigeria. Eur. J. Sci. Res. 26 , 539–548 (2009).

Cole, S. M. et al. Postharvest fish losses and unequal gender relations: drivers of the social-ecological trap in the Barotse Floodplain fishery, Zambia. Ecol. Soc. 23 , 1–18 (2018).

Hasniati, Yunus, R. & Hamsinah The empowerment of coastal women through capacity improvement of seaweed farmer groups. Adv. Econ. Bus. Manag. Res. 43 , 97–100 (2017).

Chiwaula, L. S., Chirwa, G. C., Binauli, L. S., Banda, J. & Nagoli, J. Gender differences in willingness to pay for capital-intensive agricultural technologies: the case of fish solar tent dryers in Malawi. Agric. Food Econ. 6 , 1 (2018).

Forkuor, D., Peprah, V. & Alhassan, A. M. Assessment of the processing and sale of marine fish and its effects on the livelihood of women in Mfantseman Municipality, Ghana. Environ. Dev. Sustain. 20 , 1329–1346 (2018).

Solano, N., Lopez-Ercilla, I., Fernandez-Rivera Melo, F. J. & Torre, J. Unveiling women’s roles and inclusion in Mexican small-scale fisheries (SSF). Front. Mar. Sci. 7 , 617965 (2021).

Galappaththi, M., Collins, A. M., Armitage, D. & Nayak, P. K. Linking social wellbeing and intersectionality to understand gender relations in dried fish value chains. Marit. Stud. 20 , 355–370 (2021).

Frink, L. The identity division of labor in Native Alaska. Am. Anthropol. 111 , 21–29 (2009).

Abeledo, L. M. Labour segmentation in the Spanish fish-canning industry: a historical perspective, 1880–1960. Contin. Change 21 , 475–501 (2006).

Hamid, M. A. & Alauddin, M. Coming out of their homesteads? Employment for rural women in shrimp aquaculture in coastal Bangladesh. Int. J. Soc. Econ. 25 , 314–337 (1998).

Griffith, D. C. Nonmarket labor processes in an advanced capitalist economy. Am. Anthropol. 89 , 838–852 (1987).

Friberg, J. H. & Midtbøen, A. H. Ethnicity as skill: immigrant employment hierarchies in Norwegian low-wage labour markets. J. Ethn. Migr. Stud. 44 , 1463–1478 (2018).

Akinpelu, O. M., Ayeloja, A. A., George, F. O. A., Adebisi, G. L. & Jimoh, W. A. Gender analysis of processing activities among commercial catfish processors within Ibadan metropolis, Oyo state south-western Nigeria. J. Aquac. Res. Dev. 4 , 1–5 (2013).

Delaney, A. Transition in nori cultivation: evolution of household contribution and gendered division of labor. Cah. Biol. Mar. 52 , 527–533 (2011).

Mazumi, Y. Migration outside large cities: a comparison of the hiring of migrants for the food processing industry in the United States and Japan. Comp. Migr. Stud. 9 , 46 (2021).

Johnson, N. L., Kovarik, C., Meinzen-Dick, R., Njuki, J. & Quisumbing, A. Gender, assets, and agricultural development: lessons from eight projects. World Dev. 83 , 296–311 (2016).

Thorpe, A. et al. ‘Fishing na everybody business’: women’s work and gender relations in Sierra Leone’s fisheries. Fem. Econ. 20 , 53–77 (2014).

Williams, M. J. & Syddall, V. Women, fisheries technology and development: toward new research approaches. Gend. Technol. Dev. 26 , 357–384 (2022).

Neis, B., Gerrard, S. & Power, N. G. Women and children first: the gendered and generational socioecology of smaller-scale fisheries in Newfoundland and Labrador and Northern Norway. Ecol. Soc. 18 , 64 (2013).

Szaboova, L., Gustavsson, M. & Turner, R. Recognizing women’s wellbeing and contribution to social resilience in fisheries. Soc. Nat. Resour. 35 , 59–74 (2022).

Lynch, M. & Turner, S. Rocking the boat: intersectional resistance to marine conservation policies in Wakatobi National Park, Indonesia. Gend. Place Cult. 29 , 1376–1398 (2022).

Lokuge, G. & Hilhorst, D. Outside the net: intersectionality and inequality in the fisheries of Trincomalee, Sri Lanka. Asian J. Women Stud. 23 , 473–497 (2017).

Warner, L. R. A best practices guide to intersectional approaches in psychological research. Sex Roles 59 , 454–463 (2008).

Tavenner, K., Crane, T. A., Bullock, R. & Galiè, A. Intersectionality in gender and agriculture: toward an applied research design. Gend. Technol. Dev. 26 , 385–403 (2022).

Mikulewicz, M., Caretta, M. A., Sultana, F. & Crawford, N. J. W. Intersectionality & climate justice: a call for synergy in climate change scholarship. Environ. Polit. 32 , 1275–1286 (2023).

Knott, C. The rhythm of making cheaps: a case study of rhythmanalysis and qualitative labour shortages in Canadian fisheries. Appl. Mob. 6 , 202–219 (2021).

Snider, A., Adraki, P. K., Lolig, V. & McNamara, P. E. Assessing gendered impacts of post-harvest technologies in Northern Ghana: gender equity and food security. Gend. Technol. Dev. https://doi.org/10.1080/09718524.2023.2273153 (2023).

Wajcman, J. Feminist theories of technology. Camb. J. Econ. 34 , 143–152 (2010).

Higgins, J. P. T. et al. Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (Wiley, 2022).

Page, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLoS Med. 18 , e1003583 (2021).

Ouzzani, M., Hammady, H., Fedorowicz, Z. & Elmagarmid, A. Rayyan—a web and mobile app for systematic reviews. Syst. Rev. 5 , 210 (2016).

Wells, G. B. et al. The Newcastle–Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses (Ottawa Hospital Research Institute, 2000).

Yosef, S., Jones, A. D., Chakraborty, B. & Gillespie, S. Agriculture and nutrition in Bangladesh: mapping evidence to pathways. Food Nutr. Bull. 36 , 387–404 (2015).

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

Noblit, G. W. & Hare, R. D. Meta-ethnography: Synthesizing Qualitative Studies (Sage Publications, 1988).

De Brauw, A. et al. Food System Innovations for Healthier Diets in Low and Middle-Income Countries (International Food Policy Research Institute, 2019).

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Acknowledgements

This Review received partial funding from the Economic and Social Research Council grant ES/R010404/1 to the project Coastal Transformations and Fisher Wellbeing. We thank our country-level partners S. Velvizhi, M. M. Haque, F. H. Shikha, J. Walakira, A. Atter and K. Addo in India, Bangladesh, Uganda and Ghana for the ground-level insights they have shared with us over the past year and for inputs from E. Allison and S. Haraksingh-Thilsted from WorldFish, which together have motivated this Review.

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This systematic review emerged from discussions between N.R., L.H., J.F., J.B. and N.G. N.R., N.G. and J.F. led the conceptualization and L.H. led the development of the research protocol and study design. Search, screening and extraction was carried out by H.G., G.S., N.M., S.T., M.H., A.W., N.G., J.B. and L.Z., under the guidance of L.H. N.R., L.H., G.S., S.T., N.M., A.W., M.H. and N.G. were responsible for writing sections of the paper based on the preliminary analysis. N.R., N.G., J.F. and J.B. reviewed and edited the paper. M.H., N.M., N.G. and L.H. created the maps, diagrams, figures and tables. H.G. supported referencing. All authors reviewed the final version of the paper.

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Rao, N., Hooper, L., Gray, H. et al. A systematic review of the impact of post-harvest aquatic food processing technology on gender equality and social justice. Nat Food (2024). https://doi.org/10.1038/s43016-024-01034-6

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Cost-effectiveness and health economics for ureteral and kidney stone disease: a systematic review of literature.

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Toxicological Profile for Creosote. Atlanta (GA): Agency for Toxic Substances and Disease Registry (US); 2024 Jul.

Toxicological Profile for Creosote.

• For available Draft for Public Comment versions visit ATSDR

APPENDIX C FRAMEWORK FOR ATSDR’S SYSTEMATIC REVIEW OF HEALTH EFFECTS DATA FOR CREOSOTE

• Step 1. Problem Formulation
• Step 2. Literature Search and Screen for Health Effects Studies
• Step 3. Extract Data from Health Effects Studies
• Step 4. Identify Potential Health Effect Outcomes of Concern
• Step 5. Assess the Risk of Bias for Individual Studies
• Step 6. Rate the Confidence in the Body of Evidence for Each Relevant Outcome
• Step 7. Translate Confidence Rating into Level of Evidence of Health Effects
• Step 8. Integrate Evidence to Develop Hazard Identification Conclusions

C.1. PROBLEM FORMULATION

The objective of the toxicological profile and this systematic review was to identify the potential health hazards associated with inhalation, oral, or dermal/ocular exposure to creosote. The inclusion criteria used to identify relevant studies examining the health effects of creosote are presented in Table C-1 .

Data from human and laboratory animal studies were considered relevant for addressing this objective. Human studies were divided into two broad categories: observational epidemiology studies and controlled exposure studies. The observational epidemiology studies were further divided: cohort studies (retrospective and prospective studies), population studies (with individual data or aggregate data), and case-control studies.

Table C-1 Inclusion Criteria for Identifying Health Effects Studies

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C.2. LITERATURE SEARCH AND SCREEN FOR HEALTH EFFECTS STUDIES

As noted in Appendix B , the current literature search was intended to update the Draft Toxicological Profile for Creosote released for public comment in 2023; thus, the literature search was restricted to studies published between November 2000 and November 2023. See Appendix B for the databases searched and the search strategy.

A total of 377 records relevant to all sections of the toxicological profile were identified (after duplicate removal).

C.2.1. Literature Screening

As described in Appendix B , a two-step process was used to screen the literature search to identify relevant studies examining the health effects of creosote.

Title and Abstract Screen. In the Title and Abstract Screen step, 377 records were reviewed; there were no new documents that were considered to meet the health effects inclusion criteria in Table C-1 and were moved to the next step in the process.

Full Text Screen. In the second step in the literature screening process for the systematic review, a full text review of 155 health effect documents (documents cited in older versions of the profile) was performed. From those 155 documents, 193 studies were considered for inclusion in the qualitative review.

C.3. EXTRACT DATA FROM HEALTH EFFECTS STUDIES

Relevant data extracted from the individual studies selected for inclusion in the systematic review were collected in customized data forms. A summary of the type of data extracted from each study is presented in Table C-2 . For references that included more than one experiment or species, data extraction records were created for each experiment or species.

Table C-2 Data Extracted from Individual Studies

A summary of the extracted data for each study is presented in the Supplemental Document for Creosote and overviews of the results of the inhalation, oral, and dermal exposure studies are presented in Sections 2.2 – 2.18 of the profile and in the Levels Significant Exposures tables in Section 2.1 of the profile ( Tables 2-1 , 2-2 , 2-3 , and 2-4 , respectively).

C.4. IDENTIFY POTENTIAL HEALTH EFFECT OUTCOMES OF CONCERN

Overviews of the potential health effect outcomes for coal tar products and wood creosotes identified in human and animal studies are presented in Tables C-3 , C-4 , C-5 , and C-6 respectively. The available human studies are focused mainly on mortality and cancer following occupational exposure. Additional studies have reported respiratory, dermal, and hepatic effects. Animal studies have examined a number of endpoints following inhalation, oral, or dermal exposure, including cancer, and have reported body weight, respiratory, hematological, hepatic, reproductive, and developmental effects.

Studies were not carried through the systematic review process due to the complicated nature of creosote products. Coal tars products are complex mixtures of PAHs, phenols, heterocyclic oxygen, sulfur, and nitrogen compounds. Wood creosotes are derived from beechwood and the resin from leaves of the creosote bush. Beechwood creosote consists mainly of phenol, cresols, guaiacol, xylenol, and creosol, while creosote bush resin consists of phenolic (e.g., flavonoids and nordihydroguaiaretic acid), neutral (e.g., waxes), basic (e.g., alkaloids), and acidic (e.g., phenolic acids) compounds.

When evaluating health effect data for creosote, it is important to consider the composition of a particular creosote mixture. Wood creosote and coal tar product mixtures have highly variable compositions and the individual components do not always share the same mode of action. The mixtures’ composition is dependent on the sources and preparation parameters of coal tar creosote and, as a result, the creosote components are rarely consistent in their type and concentration. Thus, comparisons across studies are problematic, as toxicological evaluations of one creosote sample, for instance, is most likely inadequate for extrapolation to other creosote samples, unless their compositions are similar. This is demonstrated by inconsistent results observed in studies evaluating the same class of compounds; a single LOAEL value may not be representative for a class of compounds.

Therefore, ATSDR elected not to take the identified studies through the systematic review process for creosote, including wood creosote, coal tar creosote, coal tar, coal tar pitch, and coal tar pitch volatiles.

Table C-3 Overview of the Health Outcomes for Creosote (Coal Tar Products) Evaluated in Human Studies

Table C-4 Overview of the Health Outcomes for Creosote (Coal Tar Products) Evaluated in Experimental Animal Studies

Number of studies examining endpoint includes study evaluating histopathology, but not evaluating function.

Table C-5 Overview of the Health Outcomes for Creosote (Wood Creosotes) Evaluated in Human Studies

Table C-6 Overview of the Health Outcomes for Creosote (Wood Creosotes) Evaluated in Experimental Animal Studies

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