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How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-Analyses, and Meta-Syntheses

Affiliations.

  • 1 Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling FK9 4LA, United Kingdom; email: [email protected].
  • 2 Department of Psychological and Behavioural Science, London School of Economics and Political Science, London WC2A 2AE, United Kingdom.
  • 3 Department of Statistics, Northwestern University, Evanston, Illinois 60208, USA; email: [email protected].
  • PMID: 30089228
  • DOI: 10.1146/annurev-psych-010418-102803

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 They involve a comprehensive search to locate all relevant published and unpublished work on a subject; a systematic integration of search results; and a critique of the extent, nature, and quality of evidence in relation to a particular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

Keywords: evidence; guide; meta-analysis; meta-synthesis; narrative; systematic review; theory.

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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.

Literature review guide

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See an example

an example of a systematic literature review

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.

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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  • Systematic Review | Definition, Examples & Guide

Systematic Review | Definition, Examples & Guide

Published on 15 June 2022 by Shaun Turney . Revised on 17 October 2022.

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

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

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

Table of contents

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A systematic review has many pros .

  • They minimise research b ias by considering all available evidence and evaluating each study for bias.
  • Their methods are transparent , so they can be scrutinised by others.
  • They’re thorough : they summarise all available evidence.
  • They can be replicated and updated by others.

Systematic reviews also have a few cons .

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

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

Step 1: Formulate a research question

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

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

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

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

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

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

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

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

Their research question was:

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

Step 2: Develop a protocol

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

Your protocol should include the following components:

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

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

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

Step 3: Search for all relevant studies

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

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

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

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

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

Step 4: Apply the selection criteria

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

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

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

You should apply the selection criteria in two phases:

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

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

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

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

Step 5: Extract the data

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

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

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

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

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

Step 6: Synthesise the data

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

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

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

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

Step 7: Write and publish a report

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

Your article should include the following sections:

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

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

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

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

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

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

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

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

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

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How to write a systematic literature review [9 steps]

Systematic literature review

What is a systematic literature review?

Where are systematic literature reviews used, what types of systematic literature reviews are there, how to write a systematic literature review, 1. decide on your team, 2. formulate your question, 3. plan your research protocol, 4. search for the literature, 5. screen the literature, 6. assess the quality of the studies, 7. extract the data, 8. analyze the results, 9. interpret and present the results, registering your systematic literature review, frequently asked questions about writing a systematic literature review, related articles.

A systematic literature review is a summary, analysis, and evaluation of all the existing research on a well-formulated and specific question.

Put simply, a systematic review is a study of studies that is popular in medical and healthcare research. In this guide, we will cover:

  • the definition of a systematic literature review
  • the purpose of a systematic literature review
  • the different types of systematic reviews
  • how to write a systematic literature review

➡️ Visit our guide to the best research databases for medicine and health to find resources for your systematic review.

Systematic literature reviews can be utilized in various contexts, but they’re often relied on in clinical or healthcare settings.

Medical professionals read systematic literature reviews to stay up-to-date in their field, and granting agencies sometimes need them to make sure there’s justification for further research in an area. They can even be used as the starting point for developing clinical practice guidelines.

A classic systematic literature review can take different approaches:

  • Effectiveness reviews assess the extent to which a medical intervention or therapy achieves its intended effect. They’re the most common type of systematic literature review.
  • Diagnostic test accuracy reviews produce a summary of diagnostic test performance so that their accuracy can be determined before use by healthcare professionals.
  • Experiential (qualitative) reviews analyze human experiences in a cultural or social context. They can be used to assess the effectiveness of an intervention from a person-centric perspective.
  • Costs/economics evaluation reviews look at the cost implications of an intervention or procedure, to assess the resources needed to implement it.
  • Etiology/risk reviews usually try to determine to what degree a relationship exists between an exposure and a health outcome. This can be used to better inform healthcare planning and resource allocation.
  • Psychometric reviews assess the quality of health measurement tools so that the best instrument can be selected for use.
  • Prevalence/incidence reviews measure both the proportion of a population who have a disease, and how often the disease occurs.
  • Prognostic reviews examine the course of a disease and its potential outcomes.
  • Expert opinion/policy reviews are based around expert narrative or policy. They’re often used to complement, or in the absence of, quantitative data.
  • Methodology systematic reviews can be carried out to analyze any methodological issues in the design, conduct, or review of research studies.

Writing a systematic literature review can feel like an overwhelming undertaking. After all, they can often take 6 to 18 months to complete. Below we’ve prepared a step-by-step guide on how to write a systematic literature review.

  • Decide on your team.
  • Formulate your question.
  • Plan your research protocol.
  • Search for the literature.
  • Screen the literature.
  • Assess the quality of the studies.
  • Extract the data.
  • Analyze the results.
  • Interpret and present the results.

When carrying out a systematic literature review, you should employ multiple reviewers in order to minimize bias and strengthen analysis. A minimum of two is a good rule of thumb, with a third to serve as a tiebreaker if needed.

You may also need to team up with a librarian to help with the search, literature screeners, a statistician to analyze the data, and the relevant subject experts.

Define your answerable question. Then ask yourself, “has someone written a systematic literature review on my question already?” If so, yours may not be needed. A librarian can help you answer this.

You should formulate a “well-built clinical question.” This is the process of generating a good search question. To do this, run through PICO:

  • Patient or Population or Problem/Disease : who or what is the question about? Are there factors about them (e.g. age, race) that could be relevant to the question you’re trying to answer?
  • Intervention : which main intervention or treatment are you considering for assessment?
  • Comparison(s) or Control : is there an alternative intervention or treatment you’re considering? Your systematic literature review doesn’t have to contain a comparison, but you’ll want to stipulate at this stage, either way.
  • Outcome(s) : what are you trying to measure or achieve? What’s the wider goal for the work you’ll be doing?

Now you need a detailed strategy for how you’re going to search for and evaluate the studies relating to your question.

The protocol for your systematic literature review should include:

  • the objectives of your project
  • the specific methods and processes that you’ll use
  • the eligibility criteria of the individual studies
  • how you plan to extract data from individual studies
  • which analyses you’re going to carry out

For a full guide on how to systematically develop your protocol, take a look at the PRISMA checklist . PRISMA has been designed primarily to improve the reporting of systematic literature reviews and meta-analyses.

When writing a systematic literature review, your goal is to find all of the relevant studies relating to your question, so you need to search thoroughly .

This is where your librarian will come in handy again. They should be able to help you formulate a detailed search strategy, and point you to all of the best databases for your topic.

➡️ Read more on on how to efficiently search research databases .

The places to consider in your search are electronic scientific databases (the most popular are PubMed , MEDLINE , and Embase ), controlled clinical trial registers, non-English literature, raw data from published trials, references listed in primary sources, and unpublished sources known to experts in the field.

➡️ Take a look at our list of the top academic research databases .

Tip: Don’t miss out on “gray literature.” You’ll improve the reliability of your findings by including it.

Don’t miss out on “gray literature” sources: those sources outside of the usual academic publishing environment. They include:

  • non-peer-reviewed journals
  • pharmaceutical industry files
  • conference proceedings
  • pharmaceutical company websites
  • internal reports

Gray literature sources are more likely to contain negative conclusions, so you’ll improve the reliability of your findings by including it. You should document details such as:

  • The databases you search and which years they cover
  • The dates you first run the searches, and when they’re updated
  • Which strategies you use, including search terms
  • The numbers of results obtained

➡️ Read more about gray literature .

This should be performed by your two reviewers, using the criteria documented in your research protocol. The screening is done in two phases:

  • Pre-screening of all titles and abstracts, and selecting those appropriate
  • Screening of the full-text articles of the selected studies

Make sure reviewers keep a log of which studies they exclude, with reasons why.

➡️ Visit our guide on what is an abstract?

Your reviewers should evaluate the methodological quality of your chosen full-text articles. Make an assessment checklist that closely aligns with your research protocol, including a consistent scoring system, calculations of the quality of each study, and sensitivity analysis.

The kinds of questions you'll come up with are:

  • Were the participants really randomly allocated to their groups?
  • Were the groups similar in terms of prognostic factors?
  • Could the conclusions of the study have been influenced by bias?

Every step of the data extraction must be documented for transparency and replicability. Create a data extraction form and set your reviewers to work extracting data from the qualified studies.

Here’s a free detailed template for recording data extraction, from Dalhousie University. It should be adapted to your specific question.

Establish a standard measure of outcome which can be applied to each study on the basis of its effect size.

Measures of outcome for studies with:

  • Binary outcomes (e.g. cured/not cured) are odds ratio and risk ratio
  • Continuous outcomes (e.g. blood pressure) are means, difference in means, and standardized difference in means
  • Survival or time-to-event data are hazard ratios

Design a table and populate it with your data results. Draw this out into a forest plot , which provides a simple visual representation of variation between the studies.

Then analyze the data for issues. These can include heterogeneity, which is when studies’ lines within the forest plot don’t overlap with any other studies. Again, record any excluded studies here for reference.

Consider different factors when interpreting your results. These include limitations, strength of evidence, biases, applicability, economic effects, and implications for future practice or research.

Apply appropriate grading of your evidence and consider the strength of your recommendations.

It’s best to formulate a detailed plan for how you’ll present your systematic review results. Take a look at these guidelines for interpreting results from the Cochrane Institute.

Before writing your systematic literature review, you can register it with OSF for additional guidance along the way. You could also register your completed work with PROSPERO .

Systematic literature reviews are often found in clinical or healthcare settings. Medical professionals read systematic literature reviews to stay up-to-date in their field and granting agencies sometimes need them to make sure there’s justification for further research in an area.

The first stage in carrying out a systematic literature review is to put together your team. You should employ multiple reviewers in order to minimize bias and strengthen analysis. A minimum of two is a good rule of thumb, with a third to serve as a tiebreaker if needed.

Your systematic review should include the following details:

A literature review simply provides a summary of the literature available on a topic. A systematic review, on the other hand, is more than just a summary. It also includes an analysis and evaluation of existing research. Put simply, it's a study of studies.

The final stage of conducting a systematic literature review is interpreting and presenting the results. It’s best to formulate a detailed plan for how you’ll present your systematic review results, guidelines can be found for example from the Cochrane institute .

an example of a systematic literature review

Introduction to Systematic Reviews

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an example of a systematic literature review

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  • Ian J. Saldanha 4 &
  • Karen A. Robinson 5  

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A systematic review identifies and synthesizes all relevant studies that fit prespecified criteria to answer a research question. Systematic review methods can be used to answer many types of research questions. The type of question most relevant to trialists is the effects of treatments and is thus the focus of this chapter. We discuss the motivation for and importance of performing systematic reviews and their relevance to trialists. We introduce the key steps in completing a systematic review, including framing the question, searching for and selecting studies, collecting data, assessing risk of bias in included studies, conducting a qualitative synthesis and a quantitative synthesis (i.e., meta-analysis), grading the certainty of evidence, and writing the systematic review report. We also describe how to identify systematic reviews and how to assess their methodological rigor. We discuss the challenges and criticisms of systematic reviews, and how technology and innovations, combined with a closer partnership between trialists and systematic reviewers, can help identify effective and safe evidence-based practices more quickly.

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Li, T., Saldanha, I.J., Robinson, K.A. (2022). Introduction to Systematic Reviews. In: Piantadosi, S., Meinert, C.L. (eds) Principles and Practice of Clinical Trials. Springer, Cham. https://doi.org/10.1007/978-3-319-52636-2_194

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Systematic Review

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  • What is a Systematic Review (SR)?

Steps of a Systematic Review

  • Framing a Research Question
  • Developing a Search Strategy
  • Searching the Literature
  • Managing the Process
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  • PICO Template
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   • PRISMA Flow Diagram  - Record the numbers of retrieved references and included/excluded studies. You can use the Create Flow Diagram tool to automate the process.

   •  PRISMA Checklist - Checklist of items to include when reporting a systematic review or meta-analysis

PRISMA 2020 and PRISMA-S: Common Questions on Tracking Records and the Flow Diagram

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from the UMB HSHSL Guide. (26 min) on how to conduct and write a systematic review from RMIT University  from the VU Amsterdam . , (1), 6–23. https://doi.org/10.3102/0034654319854352

. (1), 49-60. . (4), 471-475.

 (2020)  (2020) - Methods guide for effectiveness and comparative effectiveness reviews (2017)  - Finding what works in health care: Standards for systematic reviews (2011)  - Systematic reviews: CRD’s guidance for undertaking reviews in health care (2008)

entify your research question. Formulate a clear, well-defined research question of appropriate scope. Define your terminology. Find existing reviews on your topic to inform the development of your research question, identify gaps, and confirm that you are not duplicating the efforts of previous reviews. Consider using a framework like  or to define you question scope. Use to record search terms under each concept. 

 It is a good idea to register your protocol in a publicly accessible way. This will help avoid other people completing a review on your topic. Similarly, before you start doing a systematic review, it's worth checking the different registries that nobody else has already registered a protocol on the same topic.

- Systematic reviews of health care and clinical interventions  - Systematic reviews of the effects of social interventions (Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies) - The protocol is published immediately and subjected to open peer review. When two reviewers approve it, the paper is sent to Medline, Embase and other databases for indexing. - upload a protocol for your scoping review - Systematic reviews of healthcare practices to assist in the improvement of healthcare outcomes globally - Registry of a protocol on OSF creates a frozen, time-stamped record of the protocol, thus ensuring a level of transparency and accountability for the research. There are no limits to the types of protocols that can be hosted on OSF.  - International prospective register of systematic reviews. This is the primary database for registering systematic review protocols and searching for published protocols. . PROSPERO accepts protocols from all disciplines (e.g., psychology, nutrition) with the stipulation that they must include health-related outcomes.  - Similar to PROSPERO. Based in the UK, fee-based service, quick turnaround time. - Submit a pre-print, or a protocol for a scoping review.   - Share your search strategy and research protocol. No limit on the format, size, access restrictions or license.

outlining the details and documentation necessary for conducting a systematic review:

, (1), 28.
Clearly state the criteria you will use to determine whether or not a study will be included in your search. Consider study populations, study design, intervention types, comparison groups, measured outcomes. Use some database-supplied limits such as language, dates, humans, female/male, age groups, and publication/study types (randomized controlled trials, etc.).
Run your searches in the to your topic. Work with to help you design comprehensive search strategies across a variety of databases. Approach the grey literature methodically and purposefully. Collect ALL of the retrieved records from each search into , such as  , or , and prior to screening. using the  and .
- export your Endnote results in this screening software Start with a title/abstract screening to remove studies that are clearly not related to your topic. Use your to screen the full-text of studies. It is highly recommended that two independent reviewers screen all studies, resolving areas of disagreement by consensus.
Use , or systematic review software (e.g. , ), to extract all relevant data from each included study. It is recommended that you pilot your data extraction tool, to determine if other fields should be included or existing fields clarified.
Risk of Bias (Quality) Assessment -  (download the Excel spreadsheet to see all data) Use a Risk of Bias tool (such as the ) to assess the potential biases of studies in regards to study design and other factors. Read the to learn about the topic of assessing risk of bias in included studies. You can adapt  ( ) to best meet the needs of your review, depending on the types of studies included.

-

-

Clearly present your findings, including detailed methodology (such as search strategies used, selection criteria, etc.) such that your review can be easily updated in the future with new research findings. Perform a meta-analysis, if the studies allow. Provide recommendations for practice and policy-making if sufficient, high quality evidence exists, or future directions for research to fill existing gaps in knowledge or to strengthen the body of evidence.

For more information, see: 

. (2), 217–226. https://doi.org/10.2450/2012.0247-12  - Get some inspiration and find some terms and phrases for writing your manuscript - Automated high-quality spelling, grammar and rephrasing corrections using artificial intelligence (AI) to improve the flow of your writing. Free and subscription plans available.

8. Find the best journal to publish your work. Identifying the best journal to submit your research to can be a difficult process. To help you make the choice of where to submit, simply insert your title and abstract in any of the listed under the tab. 

Adapted from  A Guide to Conducting Systematic Reviews: Steps in a Systematic Review by Cornell University Library

This diagram illustrates in a visual way and in plain language what review authors actually do in the process of undertaking a systematic review.

This diagram illustrates what is actually in a published systematic review and gives examples from the relevant parts of a systematic review housed online on The Cochrane Library. It will help you to read or navigate a systematic review.

Source: Cochrane Consumers and Communications  (infographics are free to use and licensed under Creative Commons )

Check the following visual resources titled " What Are Systematic Reviews?"

  • Video  with closed captions available
  • Animated Storyboard

 

Image:   

-  the methods of the systematic review are generally decided before conducting it.  
- searching for studies which match the preset criteria in a systematic manner
- sort all retrieved articles (included or  excluded) and assess the risk of bias for each included study
- each study is coded with preset form, either qualitatively or quantitatively synthesize data.
- place results of synthesis into context, strengths and weaknesses of the studies 
- report provides description of methods and results in a clear and transparent manner

 

Source: Foster, M. (2018). Systematic reviews service: Introduction to systematic reviews. Retrieved September 18, 2018, from

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Systematic Literature Review: Some Examples

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Overview of systematic literature review (AMJED).

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Writing a Systematic Literature Review

Investigating concepts associated with psychology requires an indefinite amount of reading. Hence, good literature reviews are an inevitably needed part of providing the modern scientists with a broad spectrum of knowledge. In order to help, this blog post will introduce you to the basics of literature reviews and explain a specific methodological approach towards writing one, known as the systematic literature review.

Literature review is a term associated with the process of collecting, checking and (re)analysing data from the existing literature with a particular search question in mind. The latter could be for example:

  • What are the effects of yoga associated with individual’s subjective well-being?
  • Does brief psychotherapy produce beneficial outcomes for individuals diagnosed with agoraphobia?
  • What personality traits are most commonly associated with homelessness in the modern literature?

A literature review (a) defines a specific issue, concept, theory, phenomena; (b) compiles published literature on a topic; (c) summarises critical points of current knowledge about the problem and (d) suggests next steps in addressing it.

Literature reviews can be based on all sorts of information found in scientific journals, books, academic dissertations, electronic bibliographic databases and the rest of the Internet.  Electronic databases such as PsycINFO , PubMed , Web of Science could be a good starting point. Some of them, like EBSCOhost , ScienceDirect , SciELO , and ProQuest , provide full-text information, while others provide the users mostly with the abstracts of the material. Besides scientific literature, literature reviews often include the so called gray literature . This refers to the material that is either unpublished or published in non-commercial form (e.g., theses, dissertations, government reports, fact sheets, pre-prints of articles). Excluding it completely from a literature review is inappropriate because the search should be always as complete as possible in order to reduce the risk of publication bias. However, when reviewing the material on for example Google Scholar , Science.gov , Social Science Research Network , or PsycEXTRA it should be kept in mind that such search engines also display the material without peer-review and have therefore less credibility regarding the information they are disclosing.

When performing literature reviews, the use of appropriately selected terminology is essential, since it allows the researchers much clearer communication. In psychology, without some commonly agreed lists of terms, we would all get lost in the variety of concepts and vocabularies that could be applied. A typical recommendation for where to look for such index terms would be ‘ Thesaurus of Psychological Index Terms (2007) ’, which includes nearly 9,000 most commonly cross-referenced terms in psychology. In addition, electronic databases mentioned before sometimes prompt the use of the so-called Boolean operators , simple words such as AND, OR, NOT, or AND NOT. These are used for combining and/or excluding specific terms in your search and sometimes allow to obtain more focused and productive results in the search. Other tools to make search strategy more comprehensive and focused are also truncations – a tool for searching terminologies that have same initial roots (e.g., anxiety and anxious) and wildcards for words with spelling deviations (e.g., man and men). It is worth noting that the databases slightly differ in how they label the index terms and utilize specific search tools in their systems.

Among authors, there is not much coherence about different types of literature reviews but in general, most recognize at least two: traditional and systematic. The main difference between them is situated in the process of collecting and selecting data and the material for the review. Systematic literature review, as the name implies, is the more structured of the two and is thought to be more credible. On the other hand, traditional is thought to heavily depend on the researcher’s decisions regarding the data selection and, consequently, evaluation and results. Systematic protocol of the systematic literature review can be therefore understood as an optional solution for controlling the incomplete and possibly biased reports of traditional reviews.

THE SYSTEMATIC LITERATURE REVIEW

The systematic literature review is a method/process/protocol in which a body of literature is aggregated, reviewed and assessed while utilizing pre-specified and standardized techniques. In other words, to reduce bias, the rationale, the hypothesis, and the methods of data collection are prepared before the review and are used as a guide for performing the process. Just like it is for the traditional literature reviews, the goal is to identify, critically appraise, and summarize the existing evidence concerning a clearly defined problem.

Systematic literature reviews allow us to examine conflicting and/or coincident findings, as well as to identify themes that require further investigation. Furthermore, they include the possibility of evaluating consistency and generalization of the evidence regarding specific scientific questions and are, therefore, also of great practical value within the psychological field. The method is particularly useful to integrate the information of a group of studies investigating the same phenomena and it typically focuses on a very specific empirical question, such as ‘Does the Rational Emotive Therapy intervention benefit the well-being of the patients diagnosed with depression?’.

Systematic literature reviews include all (or most) of the following characteristics:

  • Objectives clearly defined a priori;
  • Explicit pre-defined criteria for inclusion/exclusion of the literature;
  • Predetermined search strategy in the collection of the information and systematic following of the process;
  • Predefined characteristic criteria applied to all the sources utilized and clearly presented in the review;
  • Systematic evaluation of the quality of the studies included in the review;
  • Identification of the excluded sources of literature and justification for excluding them;
  • Analysis/synthesis of the information (i.e., comparison of the results, qualitative synthesis of the results, meta-analysis);
  • References to the incoherences and the errors found in the selected material.

The process of performing a systematic literature review consists of several stages and can be reported in a form of an original research article with the same name (i.e., systematic literature review):

an example of a systematic literature review

1: Start by clearly defining the objective of the review or form a structured research question.

Place in the research article: Title, Abstract, Introduction.

Example of the objective: The objective of this literature revision is to systematically review and analyse the current research on the effects of music on the anxiety levels of children in hospital settings.

Example of a structured research question: What are the most important factors associated with the development of PTSD in soldiers?

Tip: In the title, identify that the report is a systematic literature review.

2: Clearly specify the methodology of the review and define eligibility criteria (i.e., study selection criteria that the published material must meet in order to be included or excluded from the study). The search should be extensive.

Place in the research article: Methods.

Examples of inclusion criteria: Publication was an academic and peer-reviewed study. Publication was a study that examined the effects of regular physical exercise intervention on depression and included a control group.

Examples of exclusion criteria: Publication was involving male adults. Studies that also examined non-physical activities as interventions. Studies that were only published in a language other than English.

Tips: The eligibility criteria sometimes fit to be presented in tables.

3: Retrieve eligible literature and thoroughly report your search strategy throughout the process. (Ideally, the selection process is performed by at least two independent investigators.)

Example: The EBSCOhost and PsychInfo electronic databases from 2010 to 2017 were searched. These were chosen because of the psychological focus that encompasses psychosocial effects of emotional abuse in childhood. Search terms were ‘emotional abuse’, ‘childhood’, ‘psychosocial effects’, and ‘psychosocial consequences’.  The EBSCOhost produced 200 results from the search criteria, while PsychInfo produced 467, for a total of 667 articles. […] Articles were rejected if it was determined from the title and the abstract that the study failed to meet the inclusion criteria. Any ambiguities regarding the application of the selection criteria were resolved through discussions between all the researchers involved.

Tip: Sometimes it is nice to represent the selection process in a graphical representation; in the form of a decision tree or a flow diagram (check PRISMA ).

4: Assess the methodological quality of the selected literature whenever possible and exclude the articles with low methodological quality. Keep in mind that the quality of the systematic review depends on the validity and the quality of the studies included in the review.

Examples of the instruments available for evaluating the quality of the studies: PEDro, Jadad scale, the lists of Delphi, OTseeker, Maastricht criteria.

Tip: Present the excluded articles as a part of the selection process mentioned in step 3.

5: Proceed with the so-called characterization of the studies. Decide which data to look for in all the selected studies and present it in a summarized way. If the information is missing in some specific paper, always register it in your reports. (Ideally, the characterization of the studies is performed by at least two independent investigators.)

Place in the research article: Results.

Examples of the information that should and/or could be collected for characterization of the literature: authors, year, sample size, study design, aims and objectives, findings/results, limitations.

Tip: Sometimes results can be presented nicely in a form of a table depicting the main characteristics.

6: Write a synthesis of the results – integrate the results of different studies and  interpret them in a narrative form.

Place in the research article: Interpretation, Conclusions.

Patterns discovered as results should be summarized in a qualitative, narrative form. Modulate one (or more) general arguments for organizing the review. Some trick to help you do this is to choose two or three main information sources (e.g., articles, books, other literature reviews) to explain the results of other studies through a similar way of organization. Connect the information reported by different sources and do not just summarize the results. Find patterns in the results of different studies, identify them, address the theoretical and/or methodological conflicts and try to interpret them. Summarize the principal conclusions and evaluate the current state on the subject by pointing out possible further directions.

CONCLUSIONS

The results emerging from the data that were included in such retrospective studies can lead to a certain level of credibility regarding their conclusions. Actually, systematic literature reviews are thought to be one of our best methods to summarize and synthesize evidence about some specific research question and are often used as the main ‘practice making guidelines’ in many health care disciplines. Therefore, it is no wonder why systematic reviews are gaining popularity among researchers and why journals are moving in this direction as well. This also shows in the development of more and more specific guidelines and checklists for writing systematic literature reviews (see for example PRISMA or Cochrane Handbook for Systematic Reviews of Interventions ). To find examples of systematic literature review articles you can check Cochrane Database of Systematic Reviews , BioMed Central’s Systematic Reviews Journal , and PROSPERO . If you are aware of the concept of ‘registered reports’, it is worth mentioning that submitting with PROSPERO provides you with the option of publishing the latter as well. I suggest that you go through the list of useful resources provided below and hopefully, you can get enough information about anything related that remained unanswered. Now, I encourage you to try to be a little more to be systematic whenever researching some topic, to try to write a systematic literature review yourself and to maybe even consider submitting it to JEPS .

USEFUL RESOURCES

  • Cochrane Database of Systematic Reviews : http://www.cochranelibrary.com/cochrane-database-of-systematic-reviews/

EBSCOhost : https://search.ebscohost.com/

Google Scholar : https://scholar.google.com/

PRISMA : http://www.prisma-statement.org/

PROSPERO : https://www.crd.york.ac.uk/prospero/

ProQuest : http://www.proquest.com/

PsycEXTRA : http://www.apa.org/pubs/databases/psycextra/index.aspx :

PsycINFO : http://www.apa.org/pubs/databases/psycinfo/index.aspx

PubMed : https://www.ncbi.nlm.nih.gov/pubmed/

SciELO : http://www.scielo.org/php/index.php?lang=en

Science.gov : https://www.science.gov/

ScienceDirect : http://www.sciencedirect.com/

Scorpus : http://www.scopus.com/freelookup/form/author.uri

Social Science Research Network : https://www.ssrn.com/en/

Systematic Reviews Journal (BIOMED) : https://systematicreviewsjournal.biomedcentral.com/

Web of Science : https://webofknowledge.com/

Other sources

  • Sampaio, R. F., & Mancini, M. C. (2007). Systematic review studies: A guide for a careful synthesis of scientific evidence. Brasilian Journal of Physical Therapy, 11 (1), 77-82. doi:http://dx.doi.org/10.1590/S1413-35552
  • Tuleya, L. G. (2007). Thesaurus of psychological index terms . Washington, DC: American Psychological Association.

Eva Štrukelj

Eva Štrukelj

Eva Štrukelj is currently studying Clinical and Health Psychology at the University of Algarve in Portugal. Her main areas of interest are social psychology and health psychology. Regarding research, she is particularly curious about stigma and with it related topics.

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What is a Systematic Review?

A simplified process map, how can the library help, publications by hsl librarians, systematic reviews in non-health disciplines, resources for performing systematic reviews.

  • Step 1: Complete Pre-Review Tasks
  • Step 2: Develop a Protocol
  • Step 3: Conduct Literature Searches
  • Step 4: Manage Citations
  • Step 5: Screen Citations
  • Step 6: Assess Quality of Included Studies
  • Step 7: Extract Data from Included Studies
  • Step 8: Write the Review

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A systematic review is a literature review that gathers all of the available evidence matching pre-specified eligibility criteria to answer a specific research question. It uses explicit, systematic methods, documented in a protocol, to minimize bias , provide reliable findings , and inform decision-making.  ¹  

There are many types of literature reviews.

Before beginning a systematic review, consider whether it is the best type of review for your question, goals, and resources. The table below compares a few different types of reviews to help you decide which is best for you. 

Comparing Systematic, Scoping, and Systematized Reviews
Systematic Review Scoping Review Systematized Review
Conducted for Publication Conducted for Publication Conducted for Assignment, Thesis, or (Possibly) Publication
Protocol Required Protocol Required No Protocol Required
Focused Research Question Broad Research Question Either
Focused Inclusion & Exclusion Criteria Broad Inclusion & Exclusion Criteria Either
Requires Large Team Requires Small Team Usually 1-2 People
  • Scoping Review Guide For more information about scoping reviews, refer to the UNC HSL Scoping Review Guide.

Systematic Reviews: A Simplified, Step-by-Step Process Map

  • UNC HSL's Simplified, Step-by-Step Process Map A PDF file of the HSL's Systematic Review Process Map.
  • Text-Only: UNC HSL's Systematic Reviews - A Simplified, Step-by-Step Process A text-only PDF file of HSL's Systematic Review Process Map.

Creative commons license applied to systematic reviews image requires that reusers give credit to the creator. It allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, for noncommercial purposes only.

The average systematic review takes 1,168 hours to complete. ¹   A librarian can help you speed up the process.

Systematic reviews follow established guidelines and best practices to produce high-quality research. Librarian involvement in systematic reviews is based on two levels. In Tier 1, your research team can consult with the librarian as needed. The librarian will answer questions and give you recommendations for tools to use. In Tier 2, the librarian will be an active member of your research team and co-author on your review. Roles and expectations of librarians vary based on the level of involvement desired. Examples of these differences are outlined in the table below.

Roles and expectations of librarians based on level of involvement desired.
Tasks Tier 1: Consultative Tier 2: Research Partner / Co-author
Guidance on process and steps Yes Yes
Background searching for past and upcoming reviews Yes Yes
Development and/or refinement of review topic Yes Yes
Assistance with refinement of PICO (population, intervention(s), comparator(s), and key questions Yes Yes
Guidance on study types to include Yes Yes
Guidance on protocol registration Yes Yes
Identification of databases for searches Yes Yes
Instruction in search techniques and methods Yes Yes
Training in citation management software use for managing and sharing results Yes Yes
Development and execution of searches No Yes
Downloading search results to citation management software and removing duplicates No Yes
Documentation of search strategies No Yes
Management of search results No Yes
Guidance on methods Yes Yes
Guidance on data extraction, and management techniques and software Yes Yes
Suggestions of journals to target for publication Yes Yes
Drafting of literature search description in "Methods" section No Yes
Creation of PRISMA diagram No Yes
Drafting of literature search appendix No Yes
Review other manuscript sections and final draft No Yes
Librarian contributions warrant co-authorship No Yes
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The following are systematic and scoping reviews co-authored by HSL librarians.

Only the most recent 15 results are listed. Click the website link at the bottom of the list to see all reviews co-authored by HSL librarians in PubMed

Researchers conduct systematic reviews in a variety of disciplines.  If your focus is on a topic outside of the health sciences, you may want to also consult the resources below to learn how systematic reviews may vary in your field.  You can also contact a librarian for your discipline with questions.

  • EPPI-Centre methods for conducting systematic reviews The EPPI-Centre develops methods and tools for conducting systematic reviews, including reviews for education, public and social policy.

Cover Art

Environmental Topics

  • Collaboration for Environmental Evidence (CEE) CEE seeks to promote and deliver evidence syntheses on issues of greatest concern to environmental policy and practice as a public service

Social Sciences

an example of a systematic literature review

  • Siddaway AP, Wood AM, Hedges LV. How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-Analyses, and Meta-Syntheses. Annu Rev Psychol. 2019 Jan 4;70:747-770. doi: 10.1146/annurev-psych-010418-102803. A resource for psychology systematic reviews, which also covers qualitative meta-syntheses or meta-ethnographies
  • The Campbell Collaboration

Social Work

Cover Art

Software engineering

  • Guidelines for Performing Systematic Literature Reviews in Software Engineering The objective of this report is to propose comprehensive guidelines for systematic literature reviews appropriate for software engineering researchers, including PhD students.

Cover Art

Sport, Exercise, & Nutrition

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  • Application of systematic review methodology to the field of nutrition by Tufts Evidence-based Practice Center Publication Date: 2009
  • Systematic Reviews and Meta-Analysis — Open & Free (Open Learning Initiative) The course follows guidelines and standards developed by the Campbell Collaboration, based on empirical evidence about how to produce the most comprehensive and accurate reviews of research

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  • Systematic Reviews by David Gough, Sandy Oliver & James Thomas Publication Date: 2020

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Updating reviews

  • Updating systematic reviews by University of Ottawa Evidence-based Practice Center Publication Date: 2007
  • Next: Step 1: Complete Pre-Review Tasks >>
  • Last Updated: May 16, 2024 3:24 PM
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Systematic Reviews

Aims and scope.

Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of human health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies.  The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.

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An overview of methodological approaches in systematic reviews

Prabhakar veginadu.

1 Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo Victoria, Australia

Hanny Calache

2 Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln UK

Akshaya Pandian

3 Department of Orthodontics, Saveetha Dental College, Chennai Tamil Nadu, India

Mohd Masood

Associated data.

APPENDIX B: List of excluded studies with detailed reasons for exclusion

APPENDIX C: Quality assessment of included reviews using AMSTAR 2

The aim of this overview is to identify and collate evidence from existing published systematic review (SR) articles evaluating various methodological approaches used at each stage of an SR.

The search was conducted in five electronic databases from inception to November 2020 and updated in February 2022: MEDLINE, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and APA PsycINFO. Title and abstract screening were performed in two stages by one reviewer, supported by a second reviewer. Full‐text screening, data extraction, and quality appraisal were performed by two reviewers independently. The quality of the included SRs was assessed using the AMSTAR 2 checklist.

The search retrieved 41,556 unique citations, of which 9 SRs were deemed eligible for inclusion in final synthesis. Included SRs evaluated 24 unique methodological approaches used for defining the review scope and eligibility, literature search, screening, data extraction, and quality appraisal in the SR process. Limited evidence supports the following (a) searching multiple resources (electronic databases, handsearching, and reference lists) to identify relevant literature; (b) excluding non‐English, gray, and unpublished literature, and (c) use of text‐mining approaches during title and abstract screening.

The overview identified limited SR‐level evidence on various methodological approaches currently employed during five of the seven fundamental steps in the SR process, as well as some methodological modifications currently used in expedited SRs. Overall, findings of this overview highlight the dearth of published SRs focused on SR methodologies and this warrants future work in this area.

1. INTRODUCTION

Evidence synthesis is a prerequisite for knowledge translation. 1 A well conducted systematic review (SR), often in conjunction with meta‐analyses (MA) when appropriate, is considered the “gold standard” of methods for synthesizing evidence related to a topic of interest. 2 The central strength of an SR is the transparency of the methods used to systematically search, appraise, and synthesize the available evidence. 3 Several guidelines, developed by various organizations, are available for the conduct of an SR; 4 , 5 , 6 , 7 among these, Cochrane is considered a pioneer in developing rigorous and highly structured methodology for the conduct of SRs. 8 The guidelines developed by these organizations outline seven fundamental steps required in SR process: defining the scope of the review and eligibility criteria, literature searching and retrieval, selecting eligible studies, extracting relevant data, assessing risk of bias (RoB) in included studies, synthesizing results, and assessing certainty of evidence (CoE) and presenting findings. 4 , 5 , 6 , 7

The methodological rigor involved in an SR can require a significant amount of time and resource, which may not always be available. 9 As a result, there has been a proliferation of modifications made to the traditional SR process, such as refining, shortening, bypassing, or omitting one or more steps, 10 , 11 for example, limits on the number and type of databases searched, limits on publication date, language, and types of studies included, and limiting to one reviewer for screening and selection of studies, as opposed to two or more reviewers. 10 , 11 These methodological modifications are made to accommodate the needs of and resource constraints of the reviewers and stakeholders (e.g., organizations, policymakers, health care professionals, and other knowledge users). While such modifications are considered time and resource efficient, they may introduce bias in the review process reducing their usefulness. 5

Substantial research has been conducted examining various approaches used in the standardized SR methodology and their impact on the validity of SR results. There are a number of published reviews examining the approaches or modifications corresponding to single 12 , 13 or multiple steps 14 involved in an SR. However, there is yet to be a comprehensive summary of the SR‐level evidence for all the seven fundamental steps in an SR. Such a holistic evidence synthesis will provide an empirical basis to confirm the validity of current accepted practices in the conduct of SRs. Furthermore, sometimes there is a balance that needs to be achieved between the resource availability and the need to synthesize the evidence in the best way possible, given the constraints. This evidence base will also inform the choice of modifications to be made to the SR methods, as well as the potential impact of these modifications on the SR results. An overview is considered the choice of approach for summarizing existing evidence on a broad topic, directing the reader to evidence, or highlighting the gaps in evidence, where the evidence is derived exclusively from SRs. 15 Therefore, for this review, an overview approach was used to (a) identify and collate evidence from existing published SR articles evaluating various methodological approaches employed in each of the seven fundamental steps of an SR and (b) highlight both the gaps in the current research and the potential areas for future research on the methods employed in SRs.

An a priori protocol was developed for this overview but was not registered with the International Prospective Register of Systematic Reviews (PROSPERO), as the review was primarily methodological in nature and did not meet PROSPERO eligibility criteria for registration. The protocol is available from the corresponding author upon reasonable request. This overview was conducted based on the guidelines for the conduct of overviews as outlined in The Cochrane Handbook. 15 Reporting followed the Preferred Reporting Items for Systematic reviews and Meta‐analyses (PRISMA) statement. 3

2.1. Eligibility criteria

Only published SRs, with or without associated MA, were included in this overview. We adopted the defining characteristics of SRs from The Cochrane Handbook. 5 According to The Cochrane Handbook, a review was considered systematic if it satisfied the following criteria: (a) clearly states the objectives and eligibility criteria for study inclusion; (b) provides reproducible methodology; (c) includes a systematic search to identify all eligible studies; (d) reports assessment of validity of findings of included studies (e.g., RoB assessment of the included studies); (e) systematically presents all the characteristics or findings of the included studies. 5 Reviews that did not meet all of the above criteria were not considered a SR for this study and were excluded. MA‐only articles were included if it was mentioned that the MA was based on an SR.

SRs and/or MA of primary studies evaluating methodological approaches used in defining review scope and study eligibility, literature search, study selection, data extraction, RoB assessment, data synthesis, and CoE assessment and reporting were included. The methodological approaches examined in these SRs and/or MA can also be related to the substeps or elements of these steps; for example, applying limits on date or type of publication are the elements of literature search. Included SRs examined or compared various aspects of a method or methods, and the associated factors, including but not limited to: precision or effectiveness; accuracy or reliability; impact on the SR and/or MA results; reproducibility of an SR steps or bias occurred; time and/or resource efficiency. SRs assessing the methodological quality of SRs (e.g., adherence to reporting guidelines), evaluating techniques for building search strategies or the use of specific database filters (e.g., use of Boolean operators or search filters for randomized controlled trials), examining various tools used for RoB or CoE assessment (e.g., ROBINS vs. Cochrane RoB tool), or evaluating statistical techniques used in meta‐analyses were excluded. 14

2.2. Search

The search for published SRs was performed on the following scientific databases initially from inception to third week of November 2020 and updated in the last week of February 2022: MEDLINE (via Ovid), Embase (via Ovid), Web of Science Core Collection, Cochrane Database of Systematic Reviews, and American Psychological Association (APA) PsycINFO. Search was restricted to English language publications. Following the objectives of this study, study design filters within databases were used to restrict the search to SRs and MA, where available. The reference lists of included SRs were also searched for potentially relevant publications.

The search terms included keywords, truncations, and subject headings for the key concepts in the review question: SRs and/or MA, methods, and evaluation. Some of the terms were adopted from the search strategy used in a previous review by Robson et al., which reviewed primary studies on methodological approaches used in study selection, data extraction, and quality appraisal steps of SR process. 14 Individual search strategies were developed for respective databases by combining the search terms using appropriate proximity and Boolean operators, along with the related subject headings in order to identify SRs and/or MA. 16 , 17 A senior librarian was consulted in the design of the search terms and strategy. Appendix A presents the detailed search strategies for all five databases.

2.3. Study selection and data extraction

Title and abstract screening of references were performed in three steps. First, one reviewer (PV) screened all the titles and excluded obviously irrelevant citations, for example, articles on topics not related to SRs, non‐SR publications (such as randomized controlled trials, observational studies, scoping reviews, etc.). Next, from the remaining citations, a random sample of 200 titles and abstracts were screened against the predefined eligibility criteria by two reviewers (PV and MM), independently, in duplicate. Discrepancies were discussed and resolved by consensus. This step ensured that the responses of the two reviewers were calibrated for consistency in the application of the eligibility criteria in the screening process. Finally, all the remaining titles and abstracts were reviewed by a single “calibrated” reviewer (PV) to identify potential full‐text records. Full‐text screening was performed by at least two authors independently (PV screened all the records, and duplicate assessment was conducted by MM, HC, or MG), with discrepancies resolved via discussions or by consulting a third reviewer.

Data related to review characteristics, results, key findings, and conclusions were extracted by at least two reviewers independently (PV performed data extraction for all the reviews and duplicate extraction was performed by AP, HC, or MG).

2.4. Quality assessment of included reviews

The quality assessment of the included SRs was performed using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). The tool consists of a 16‐item checklist addressing critical and noncritical domains. 18 For the purpose of this study, the domain related to MA was reclassified from critical to noncritical, as SRs with and without MA were included. The other six critical domains were used according to the tool guidelines. 18 Two reviewers (PV and AP) independently responded to each of the 16 items in the checklist with either “yes,” “partial yes,” or “no.” Based on the interpretations of the critical and noncritical domains, the overall quality of the review was rated as high, moderate, low, or critically low. 18 Disagreements were resolved through discussion or by consulting a third reviewer.

2.5. Data synthesis

To provide an understandable summary of existing evidence syntheses, characteristics of the methods evaluated in the included SRs were examined and key findings were categorized and presented based on the corresponding step in the SR process. The categories of key elements within each step were discussed and agreed by the authors. Results of the included reviews were tabulated and summarized descriptively, along with a discussion on any overlap in the primary studies. 15 No quantitative analyses of the data were performed.

From 41,556 unique citations identified through literature search, 50 full‐text records were reviewed, and nine systematic reviews 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 were deemed eligible for inclusion. The flow of studies through the screening process is presented in Figure  1 . A list of excluded studies with reasons can be found in Appendix B .

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Study selection flowchart

3.1. Characteristics of included reviews

Table  1 summarizes the characteristics of included SRs. The majority of the included reviews (six of nine) were published after 2010. 14 , 22 , 23 , 24 , 25 , 26 Four of the nine included SRs were Cochrane reviews. 20 , 21 , 22 , 23 The number of databases searched in the reviews ranged from 2 to 14, 2 reviews searched gray literature sources, 24 , 25 and 7 reviews included a supplementary search strategy to identify relevant literature. 14 , 19 , 20 , 21 , 22 , 23 , 26 Three of the included SRs (all Cochrane reviews) included an integrated MA. 20 , 21 , 23

Characteristics of included studies

Author, yearSearch strategy (year last searched; no. databases; supplementary searches)SR design (type of review; no. of studies included)Topic; subject areaSR objectivesSR authors’ comments on study quality
Crumley, 2005 2004; Seven databases; four journals handsearched, reference lists and contacting authorsSR;  = 64RCTs and CCTs; not specifiedTo identify and quantitatively review studies comparing two or more different resources (e.g., databases, Internet, handsearching) used to identify RCTs and CCTs for systematic reviews.Most of the studies adequately described reproducible search methods, expected search yield. Poor quality in studies was mainly due to lack of rigor in reporting selection methodology. Majority of the studies did not indicate the number of people involved in independently screening the searches or applying eligibility criteria to identify potentially relevant studies.
Hopewell, 2007 2002; eight databases; selected journals and published abstracts handsearched, and contacting authorsSR and MA;  = 34 (34 in quantitative analysis)RCTs; health careTo review systematically empirical studies, which have compared the results of handsearching with the results of searching one or more electronic databases to identify reports of randomized trials.The electronic search was designed and carried out appropriately in majority of the studies, while the appropriateness of handsearching was unclear in half the studies because of limited information. The screening studies methods used in both groups were comparable in most of the studies.
Hopewell, 2007 2005; two databases; selected journals and published abstracts handsearched, reference lists, citations and contacting authorsSR and MA;  = 5 (5 in quantitative analysis)RCTs; health careTo review systematically research studies, which have investigated the impact of gray literature in meta‐analyses of randomized trials of health care interventions.In majority of the studies, electronic searches were designed and conducted appropriately, and the selection of studies for eligibility was similar for handsearching and database searching. Insufficient data for most studies to assess the appropriateness of handsearching and investigator agreeability on the eligibility of the trial reports.
Horsley, 2011 2008; three databases; reference lists, citations and contacting authorsSR;  = 12Any topic or study areaTo investigate the effectiveness of checking reference lists for the identification of additional, relevant studies for systematic reviews. Effectiveness is defined as the proportion of relevant studies identified by review authors solely by checking reference lists.Interpretability and generalizability of included studies was difficult. Extensive heterogeneity among the studies in the number and type of databases used. Lack of control in majority of the studies related to the quality and comprehensiveness of searching.
Morrison, 2012 2011; six databases and gray literatureSR;  = 5RCTs; conventional medicineTo examine the impact of English language restriction on systematic review‐based meta‐analysesThe included studies were assessed to have good reporting quality and validity of results. Methodological issues were mainly noted in the areas of sample power calculation and distribution of confounders.
Robson, 2019 2016; three databases; reference lists and contacting authorsSR;  = 37N/RTo identify and summarize studies assessing methodologies for study selection, data abstraction, or quality appraisal in systematic reviews.The quality of the included studies was generally low. Only one study was assessed as having low RoB across all four domains. Majority of the studies were assessed to having unclear RoB across one or more domains.
Schmucker, 2017 2016; four databases; reference listsSR;  = 10Study data; medicineTo assess whether the inclusion of data that were not published at all and/or published only in the gray literature influences pooled effect estimates in meta‐analyses and leads to different interpretation.Majority of the included studies could not be judged on the adequacy of matching or adjusting for confounders of the gray/unpublished data in comparison to published data.
Also, generalizability of results was low or unclear in four research projects
Morissette, 2011 2009; five databases; reference lists and contacting authorsSR and MA;  = 6 (5 included in quantitative analysis)N/RTo determine whether blinded versus unblinded assessments of risk of bias result in similar or systematically different assessments in studies included in a systematic review.Four studies had unclear risk of bias, while two studies had high risk of bias.
O'Mara‐Eves, 2015 2013; 14 databases and gray literatureSR;  = 44N/RTo gather and present the available research evidence on existing methods for text mining related to the title and abstract screening stage in a systematic review, including the performance metrics used to evaluate these technologies.Quality appraised based on two criteria‐sampling of test cases and adequacy of methods description for replication. No study was excluded based on the quality (author contact).

SR = systematic review; MA = meta‐analysis; RCT = randomized controlled trial; CCT = controlled clinical trial; N/R = not reported.

The included SRs evaluated 24 unique methodological approaches (26 in total) used across five steps in the SR process; 8 SRs evaluated 6 approaches, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 while 1 review evaluated 18 approaches. 14 Exclusion of gray or unpublished literature 21 , 26 and blinding of reviewers for RoB assessment 14 , 23 were evaluated in two reviews each. Included SRs evaluated methods used in five different steps in the SR process, including methods used in defining the scope of review ( n  = 3), literature search ( n  = 3), study selection ( n  = 2), data extraction ( n  = 1), and RoB assessment ( n  = 2) (Table  2 ).

Summary of findings from review evaluating systematic review methods

Key elementsAuthor, yearMethod assessedEvaluations/outcomes (P—primary; S—secondary)Summary of SR authors’ conclusionsQuality of review
Excluding study data based on publication statusHopewell, 2007 Gray vs. published literaturePooled effect estimatePublished trials are usually larger and show an overall greater treatment effect than gray trials. Excluding trials reported in gray literature from SRs and MAs may exaggerate the results.Moderate
Schmucker, 2017 Gray and/or unpublished vs. published literatureP: Pooled effect estimateExcluding unpublished trials had no or only a small effect on the pooled estimates of treatment effects. Insufficient evidence to conclude the impact of including unpublished or gray study data on MA conclusions.Moderate
S: Impact on interpretation of MA
Excluding study data based on language of publicationMorrison, 2012 English language vs. non‐English language publicationsP: Bias in summary treatment effectsNo evidence of a systematic bias from the use of English language restrictions in systematic review‐based meta‐analyses in conventional medicine. Conflicting results on the methodological and reporting quality of English and non‐English language RCTs. Further research required.Low
S: number of included studies and patients, methodological quality and statistical heterogeneity
Resources searchingCrumley, 2005 Two or more resources searching vs. resource‐specific searchingRecall and precisionMultiple‐source comprehensive searches are necessary to identify all RCTs for a systematic review. For electronic databases, using the Cochrane HSS or complex search strategy in consultation with a librarian is recommended.Critically low
Supplementary searchingHopewell, 2007 Handsearching only vs. one or more electronic database(s) searchingNumber of identified randomized trialsHandsearching is important for identifying trial reports for inclusion in systematic reviews of health care interventions published in nonindexed journals. Where time and resources are limited, majority of the full English‐language trial reports can be identified using a complex search or the Cochrane HSS.Moderate
Horsley, 2011 Checking reference list (no comparison)P: additional yield of checking reference listsThere is some evidence to support the use of checking reference lists to complement literature search in systematic reviews.Low
S: additional yield by publication type, study design or both and data pertaining to costs
Reviewer characteristicsRobson, 2019 Single vs. double reviewer screeningP: Accuracy, reliability, or efficiency of a methodUsing two reviewers for screening is recommended. If resources are limited, one reviewer can screen, and other reviewer can verify the list of excluded studies.Low
S: factors affecting accuracy or reliability of a method
Experienced vs. inexperienced reviewers for screeningScreening must be performed by experienced reviewers
Screening by blinded vs. unblinded reviewersAuthors do not recommend blinding of reviewers during screening as the blinding process was time‐consuming and had little impact on the results of MA
Use of technology for study selectionRobson, 2019 Use of dual computer monitors vs. nonuse of dual monitors for screeningP: Accuracy, reliability, or efficiency of a methodThere are no significant differences in the time spent on abstract or full‐text screening with the use and nonuse of dual monitorsLow
S: factors affecting accuracy or reliability of a method
Use of Google translate to translate non‐English citations to facilitate screeningUse of Google translate to screen German language citations
O'Mara‐Eves, 2015 Use of text mining for title and abstract screeningAny evaluation concerning workload reductionText mining approaches can be used to reduce the number of studies to be screened, increase the rate of screening, improve the workflow with screening prioritization, and replace the second reviewer. The evaluated approaches reported saving a workload of between 30% and 70%Critically low
Order of screeningRobson, 2019 Title‐first screening vs. title‐and‐abstract simultaneous screeningP: Accuracy, reliability, or efficiency of a methodTitle‐first screening showed no substantial gain in time when compared to simultaneous title and abstract screening.Low
S: factors affecting accuracy or reliability of a method
Reviewer characteristicsRobson, 2019 Single vs. double reviewer data extractionP: Accuracy, reliability, or efficiency of a methodUse two reviewers for data extraction. Single reviewer data extraction followed by the verification of outcome data by a second reviewer (where statistical analysis is planned), if resources precludeLow
S: factors affecting accuracy or reliability of a method
Experienced vs. inexperienced reviewers for data extractionExperienced reviewers must be used for extracting continuous outcomes data
Data extraction by blinded vs. unblinded reviewersAuthors do not recommend blinding of reviewers during data extraction as it had no impact on the results of MA
Use of technology for data extractionUse of dual computer monitors vs. nonuse of dual monitors for data extractionUsing two computer monitors may improve the efficiency of data extraction
Data extraction by two English reviewers using Google translate vs. data extraction by two reviewers fluent in respective languagesGoogle translate provides limited accuracy for data extraction
Computer‐assisted vs. double reviewer extraction of graphical dataUse of computer‐assisted programs to extract graphical data
Obtaining additional dataContacting study authors for additional dataRecommend contacting authors for obtaining additional relevant data
Reviewer characteristicsRobson, 2019 Quality appraisal by blinded vs. unblinded reviewersP: Accuracy, reliability, or efficiency of a methodInconsistent results on RoB assessments performed by blinded and unblinded reviewers. Blinding reviewers for quality appraisal not recommendedLow
S: factors affecting accuracy or reliability of a method
Morissette, 2011 Risk of bias (RoB) assessment by blinded vs. unblinded reviewersP: Mean difference and 95% confidence interval between RoB assessment scoresFindings related to the difference between blinded and unblinded RoB assessments are inconsistent from the studies. Pooled effects show no differences in RoB assessments for assessments completed in a blinded or unblinded manner.Moderate
S: qualitative level of agreement, mean RoB scores and measures of variance for the results of the RoB assessments, and inter‐rater reliability between blinded and unblinded reviewers
Robson, 2019 Experienced vs. inexperienced reviewers for quality appraisalP: Accuracy, reliability, or efficiency of a methodReviewers performing quality appraisal must be trained. Quality assessment tool must be pilot tested.Low
S: factors affecting accuracy or reliability of a method
Use of additional guidance vs. nonuse of additional guidance for quality appraisalProviding guidance and decision rules for quality appraisal improved the inter‐rater reliability in RoB assessments.
Obtaining additional dataContacting study authors for obtaining additional information/use of supplementary information available in the published trials vs. no additional information for quality appraisalAdditional data related to study quality obtained by contacting study authors improved the quality assessment.
RoB assessment of qualitative studiesStructured vs. unstructured appraisal of qualitative research studiesUse of structured tool if qualitative and quantitative studies designs are included in the review. For qualitative reviews, either structured or unstructured quality appraisal tool can be used.

There was some overlap in the primary studies evaluated in the included SRs on the same topics: Schmucker et al. 26 and Hopewell et al. 21 ( n  = 4), Hopewell et al. 20 and Crumley et al. 19 ( n  = 30), and Robson et al. 14 and Morissette et al. 23 ( n  = 4). There were no conflicting results between any of the identified SRs on the same topic.

3.2. Methodological quality of included reviews

Overall, the quality of the included reviews was assessed as moderate at best (Table  2 ). The most common critical weakness in the reviews was failure to provide justification for excluding individual studies (four reviews). Detailed quality assessment is provided in Appendix C .

3.3. Evidence on systematic review methods

3.3.1. methods for defining review scope and eligibility.

Two SRs investigated the effect of excluding data obtained from gray or unpublished sources on the pooled effect estimates of MA. 21 , 26 Hopewell et al. 21 reviewed five studies that compared the impact of gray literature on the results of a cohort of MA of RCTs in health care interventions. Gray literature was defined as information published in “print or electronic sources not controlled by commercial or academic publishers.” Findings showed an overall greater treatment effect for published trials than trials reported in gray literature. In a more recent review, Schmucker et al. 26 addressed similar objectives, by investigating gray and unpublished data in medicine. In addition to gray literature, defined similar to the previous review by Hopewell et al., the authors also evaluated unpublished data—defined as “supplemental unpublished data related to published trials, data obtained from the Food and Drug Administration  or other regulatory websites or postmarketing analyses hidden from the public.” The review found that in majority of the MA, excluding gray literature had little or no effect on the pooled effect estimates. The evidence was limited to conclude if the data from gray and unpublished literature had an impact on the conclusions of MA. 26

Morrison et al. 24 examined five studies measuring the effect of excluding non‐English language RCTs on the summary treatment effects of SR‐based MA in various fields of conventional medicine. Although none of the included studies reported major difference in the treatment effect estimates between English only and non‐English inclusive MA, the review found inconsistent evidence regarding the methodological and reporting quality of English and non‐English trials. 24 As such, there might be a risk of introducing “language bias” when excluding non‐English language RCTs. The authors also noted that the numbers of non‐English trials vary across medical specialties, as does the impact of these trials on MA results. Based on these findings, Morrison et al. 24 conclude that literature searches must include non‐English studies when resources and time are available to minimize the risk of introducing “language bias.”

3.3.2. Methods for searching studies

Crumley et al. 19 analyzed recall (also referred to as “sensitivity” by some researchers; defined as “percentage of relevant studies identified by the search”) and precision (defined as “percentage of studies identified by the search that were relevant”) when searching a single resource to identify randomized controlled trials and controlled clinical trials, as opposed to searching multiple resources. The studies included in their review frequently compared a MEDLINE only search with the search involving a combination of other resources. The review found low median recall estimates (median values between 24% and 92%) and very low median precisions (median values between 0% and 49%) for most of the electronic databases when searched singularly. 19 A between‐database comparison, based on the type of search strategy used, showed better recall and precision for complex and Cochrane Highly Sensitive search strategies (CHSSS). In conclusion, the authors emphasize that literature searches for trials in SRs must include multiple sources. 19

In an SR comparing handsearching and electronic database searching, Hopewell et al. 20 found that handsearching retrieved more relevant RCTs (retrieval rate of 92%−100%) than searching in a single electronic database (retrieval rates of 67% for PsycINFO/PsycLIT, 55% for MEDLINE, and 49% for Embase). The retrieval rates varied depending on the quality of handsearching, type of electronic search strategy used (e.g., simple, complex or CHSSS), and type of trial reports searched (e.g., full reports, conference abstracts, etc.). The authors concluded that handsearching was particularly important in identifying full trials published in nonindexed journals and in languages other than English, as well as those published as abstracts and letters. 20

The effectiveness of checking reference lists to retrieve additional relevant studies for an SR was investigated by Horsley et al. 22 The review reported that checking reference lists yielded 2.5%–40% more studies depending on the quality and comprehensiveness of the electronic search used. The authors conclude that there is some evidence, although from poor quality studies, to support use of checking reference lists to supplement database searching. 22

3.3.3. Methods for selecting studies

Three approaches relevant to reviewer characteristics, including number, experience, and blinding of reviewers involved in the screening process were highlighted in an SR by Robson et al. 14 Based on the retrieved evidence, the authors recommended that two independent, experienced, and unblinded reviewers be involved in study selection. 14 A modified approach has also been suggested by the review authors, where one reviewer screens and the other reviewer verifies the list of excluded studies, when the resources are limited. It should be noted however this suggestion is likely based on the authors’ opinion, as there was no evidence related to this from the studies included in the review.

Robson et al. 14 also reported two methods describing the use of technology for screening studies: use of Google Translate for translating languages (for example, German language articles to English) to facilitate screening was considered a viable method, while using two computer monitors for screening did not increase the screening efficiency in SR. Title‐first screening was found to be more efficient than simultaneous screening of titles and abstracts, although the gain in time with the former method was lesser than the latter. Therefore, considering that the search results are routinely exported as titles and abstracts, Robson et al. 14 recommend screening titles and abstracts simultaneously. However, the authors note that these conclusions were based on very limited number (in most instances one study per method) of low‐quality studies. 14

3.3.4. Methods for data extraction

Robson et al. 14 examined three approaches for data extraction relevant to reviewer characteristics, including number, experience, and blinding of reviewers (similar to the study selection step). Although based on limited evidence from a small number of studies, the authors recommended use of two experienced and unblinded reviewers for data extraction. The experience of the reviewers was suggested to be especially important when extracting continuous outcomes (or quantitative) data. However, when the resources are limited, data extraction by one reviewer and a verification of the outcomes data by a second reviewer was recommended.

As for the methods involving use of technology, Robson et al. 14 identified limited evidence on the use of two monitors to improve the data extraction efficiency and computer‐assisted programs for graphical data extraction. However, use of Google Translate for data extraction in non‐English articles was not considered to be viable. 14 In the same review, Robson et al. 14 identified evidence supporting contacting authors for obtaining additional relevant data.

3.3.5. Methods for RoB assessment

Two SRs examined the impact of blinding of reviewers for RoB assessments. 14 , 23 Morissette et al. 23 investigated the mean differences between the blinded and unblinded RoB assessment scores and found inconsistent differences among the included studies providing no definitive conclusions. Similar conclusions were drawn in a more recent review by Robson et al., 14 which included four studies on reviewer blinding for RoB assessment that completely overlapped with Morissette et al. 23

Use of experienced reviewers and provision of additional guidance for RoB assessment were examined by Robson et al. 14 The review concluded that providing intensive training and guidance on assessing studies reporting insufficient data to the reviewers improves RoB assessments. 14 Obtaining additional data related to quality assessment by contacting study authors was also found to help the RoB assessments, although based on limited evidence. When assessing the qualitative or mixed method reviews, Robson et al. 14 recommends the use of a structured RoB tool as opposed to an unstructured tool. No SRs were identified on data synthesis and CoE assessment and reporting steps.

4. DISCUSSION

4.1. summary of findings.

Nine SRs examining 24 unique methods used across five steps in the SR process were identified in this overview. The collective evidence supports some current traditional and modified SR practices, while challenging other approaches. However, the quality of the included reviews was assessed to be moderate at best and in the majority of the included SRs, evidence related to the evaluated methods was obtained from very limited numbers of primary studies. As such, the interpretations from these SRs should be made cautiously.

The evidence gathered from the included SRs corroborate a few current SR approaches. 5 For example, it is important to search multiple resources for identifying relevant trials (RCTs and/or CCTs). The resources must include a combination of electronic database searching, handsearching, and reference lists of retrieved articles. 5 However, no SRs have been identified that evaluated the impact of the number of electronic databases searched. A recent study by Halladay et al. 27 found that articles on therapeutic intervention, retrieved by searching databases other than PubMed (including Embase), contributed only a small amount of information to the MA and also had a minimal impact on the MA results. The authors concluded that when the resources are limited and when large number of studies are expected to be retrieved for the SR or MA, PubMed‐only search can yield reliable results. 27

Findings from the included SRs also reiterate some methodological modifications currently employed to “expedite” the SR process. 10 , 11 For example, excluding non‐English language trials and gray/unpublished trials from MA have been shown to have minimal or no impact on the results of MA. 24 , 26 However, the efficiency of these SR methods, in terms of time and the resources used, have not been evaluated in the included SRs. 24 , 26 Of the SRs included, only two have focused on the aspect of efficiency 14 , 25 ; O'Mara‐Eves et al. 25 report some evidence to support the use of text‐mining approaches for title and abstract screening in order to increase the rate of screening. Moreover, only one included SR 14 considered primary studies that evaluated reliability (inter‐ or intra‐reviewer consistency) and accuracy (validity when compared against a “gold standard” method) of the SR methods. This can be attributed to the limited number of primary studies that evaluated these outcomes when evaluating the SR methods. 14 Lack of outcome measures related to reliability, accuracy, and efficiency precludes making definitive recommendations on the use of these methods/modifications. Future research studies must focus on these outcomes.

Some evaluated methods may be relevant to multiple steps; for example, exclusions based on publication status (gray/unpublished literature) and language of publication (non‐English language studies) can be outlined in the a priori eligibility criteria or can be incorporated as search limits in the search strategy. SRs included in this overview focused on the effect of study exclusions on pooled treatment effect estimates or MA conclusions. Excluding studies from the search results, after conducting a comprehensive search, based on different eligibility criteria may yield different results when compared to the results obtained when limiting the search itself. 28 Further studies are required to examine this aspect.

Although we acknowledge the lack of standardized quality assessment tools for methodological study designs, we adhered to the Cochrane criteria for identifying SRs in this overview. This was done to ensure consistency in the quality of the included evidence. As a result, we excluded three reviews that did not provide any form of discussion on the quality of the included studies. The methods investigated in these reviews concern supplementary search, 29 data extraction, 12 and screening. 13 However, methods reported in two of these three reviews, by Mathes et al. 12 and Waffenschmidt et al., 13 have also been examined in the SR by Robson et al., 14 which was included in this overview; in most instances (with the exception of one study included in Mathes et al. 12 and Waffenschmidt et al. 13 each), the studies examined in these excluded reviews overlapped with those in the SR by Robson et al. 14

One of the key gaps in the knowledge observed in this overview was the dearth of SRs on the methods used in the data synthesis component of SR. Narrative and quantitative syntheses are the two most commonly used approaches for synthesizing data in evidence synthesis. 5 There are some published studies on the proposed indications and implications of these two approaches. 30 , 31 These studies found that both data synthesis methods produced comparable results and have their own advantages, suggesting that the choice of the method must be based on the purpose of the review. 31 With increasing number of “expedited” SR approaches (so called “rapid reviews”) avoiding MA, 10 , 11 further research studies are warranted in this area to determine the impact of the type of data synthesis on the results of the SR.

4.2. Implications for future research

The findings of this overview highlight several areas of paucity in primary research and evidence synthesis on SR methods. First, no SRs were identified on methods used in two important components of the SR process, including data synthesis and CoE and reporting. As for the included SRs, a limited number of evaluation studies have been identified for several methods. This indicates that further research is required to corroborate many of the methods recommended in current SR guidelines. 4 , 5 , 6 , 7 Second, some SRs evaluated the impact of methods on the results of quantitative synthesis and MA conclusions. Future research studies must also focus on the interpretations of SR results. 28 , 32 Finally, most of the included SRs were conducted on specific topics related to the field of health care, limiting the generalizability of the findings to other areas. It is important that future research studies evaluating evidence syntheses broaden the objectives and include studies on different topics within the field of health care.

4.3. Strengths and limitations

To our knowledge, this is the first overview summarizing current evidence from SRs and MA on different methodological approaches used in several fundamental steps in SR conduct. The overview methodology followed well established guidelines and strict criteria defined for the inclusion of SRs.

There are several limitations related to the nature of the included reviews. Evidence for most of the methods investigated in the included reviews was derived from a limited number of primary studies. Also, the majority of the included SRs may be considered outdated as they were published (or last updated) more than 5 years ago 33 ; only three of the nine SRs have been published in the last 5 years. 14 , 25 , 26 Therefore, important and recent evidence related to these topics may not have been included. Substantial numbers of included SRs were conducted in the field of health, which may limit the generalizability of the findings. Some method evaluations in the included SRs focused on quantitative analyses components and MA conclusions only. As such, the applicability of these findings to SR more broadly is still unclear. 28 Considering the methodological nature of our overview, limiting the inclusion of SRs according to the Cochrane criteria might have resulted in missing some relevant evidence from those reviews without a quality assessment component. 12 , 13 , 29 Although the included SRs performed some form of quality appraisal of the included studies, most of them did not use a standardized RoB tool, which may impact the confidence in their conclusions. Due to the type of outcome measures used for the method evaluations in the primary studies and the included SRs, some of the identified methods have not been validated against a reference standard.

Some limitations in the overview process must be noted. While our literature search was exhaustive covering five bibliographic databases and supplementary search of reference lists, no gray sources or other evidence resources were searched. Also, the search was primarily conducted in health databases, which might have resulted in missing SRs published in other fields. Moreover, only English language SRs were included for feasibility. As the literature search retrieved large number of citations (i.e., 41,556), the title and abstract screening was performed by a single reviewer, calibrated for consistency in the screening process by another reviewer, owing to time and resource limitations. These might have potentially resulted in some errors when retrieving and selecting relevant SRs. The SR methods were grouped based on key elements of each recommended SR step, as agreed by the authors. This categorization pertains to the identified set of methods and should be considered subjective.

5. CONCLUSIONS

This overview identified limited SR‐level evidence on various methodological approaches currently employed during five of the seven fundamental steps in the SR process. Limited evidence was also identified on some methodological modifications currently used to expedite the SR process. Overall, findings highlight the dearth of SRs on SR methodologies, warranting further work to confirm several current recommendations on conventional and expedited SR processes.

CONFLICT OF INTEREST

The authors declare no conflicts of interest.

Supporting information

APPENDIX A: Detailed search strategies

ACKNOWLEDGMENTS

The first author is supported by a La Trobe University Full Fee Research Scholarship and a Graduate Research Scholarship.

Open Access Funding provided by La Trobe University.

Veginadu P, Calache H, Gussy M, Pandian A, Masood M. An overview of methodological approaches in systematic reviews . J Evid Based Med . 2022; 15 :39–54. 10.1111/jebm.12468 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

Machine learning in internet financial risk management: A systematic literature review

  • Tian, ZongYi
  • Khatib, Saleh F. A.

Internet finance has permeated into myriad households, bringing about lifestyle convenience alongside potential risks. Presently, internet finance enterprises are progressively adopting machine learning and other artificial intelligence methods for risk alertness. What is the current status of the application of various machine learning models and algorithms across different institutions? Is there an optimal machine learning algorithm suited for the majority of internet finance platforms and application scenarios? Scholars have embarked on a series of studies addressing these questions; however, the focus predominantly lies in comparing different algorithms within specific platforms and contexts, lacking a comprehensive discourse and summary on the utilization of machine learning in this domain. Thus, based on the data from Web of Science and Scopus databases, this paper conducts a systematic literature review on all aspects of machine learning in internet finance risk in recent years, based on publications trends, geographical distribution, literature focus, machine learning models and algorithms, and evaluations. The research reveals that machine learning, as a nascent technology, whether through basic algorithms or intricate algorithmic combinations, has made significant strides compared to traditional credit scoring methods in predicting accuracy, time efficiency, and robustness in internet finance risk management. Nonetheless, there exist noticeable disparities among different algorithms, and factors such as model structure, sample data, and parameter settings also influence prediction accuracy, although generally, updated algorithms tend to achieve higher accuracy. Consequently, there is no one-size-fits-all approach applicable to all platforms; each platform should enhance its machine learning models and algorithms based on its unique characteristics, data, and the development of AI technology, starting from key evaluation indicators to mitigate internet finance risks.

American Psychological Association

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  28. Machine learning in internet financial risk management: A systematic

    Thus, based on the data from Web of Science and Scopus databases, this paper conducts a systematic literature review on all aspects of machine learning in internet finance risk in recent years, based on publications trends, geographical distribution, literature focus, machine learning models and algorithms, and evaluations.

  29. Reference examples

    More than 100 reference examples and their corresponding in-text citations are presented in the seventh edition Publication Manual.Examples of the most common works that writers cite are provided on this page; additional examples are available in the Publication Manual.. To find the reference example you need, first select a category (e.g., periodicals) and then choose the appropriate type of ...