method of literature review in research

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Writing a Literature Review

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

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

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

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

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

What are the parts of a lit review?

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

Introduction:

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

Conclusion:

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

How should I organize my lit review?

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

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

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

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

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

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

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

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

Research Methods

• Getting Started
• Literature Review Research
• Research Design
• Research Design By Discipline
• SAGE Research Methods
• Teaching with SAGE Research Methods

Literature Review

• What is a Literature Review?
• What is NOT a Literature Review?
• Purposes of a Literature Review
• Types of Literature Reviews
• Literature Reviews vs. Systematic Reviews
• Systematic vs. Meta-Analysis

Literature Review  is a comprehensive survey of the works published in a particular field of study or line of research, usually over a specific period of time, in the form of an in-depth, critical bibliographic essay or annotated list in which attention is drawn to the most significant works.

Also, we can define a literature review as the collected body of scholarly works related to a topic:

• Summarizes and analyzes previous research relevant to a topic
• Includes scholarly books and articles published in academic journals
• Can be an specific scholarly paper or a section in a research paper

The objective of a Literature Review is to find previous published scholarly works relevant to an specific topic

• Help gather ideas or information
• Keep up to date in current trends and findings
• Help develop new questions

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Helps focus your own research questions or problems
• Discovers relationships between research studies/ideas.
• Suggests unexplored ideas or populations
• Identifies major themes, concepts, and researchers on a topic.
• Tests assumptions; may help counter preconceived ideas and remove unconscious bias.
• Identifies critical gaps, points of disagreement, or potentially flawed methodology or theoretical approaches.
• Indicates potential directions for future research.

All content in this section is from Literature Review Research from Old Dominion University 

Keep in mind the following, a literature review is NOT:

Not an essay 

Not an annotated bibliography  in which you summarize each article that you have reviewed.  A literature review goes beyond basic summarizing to focus on the critical analysis of the reviewed works and their relationship to your research question.

Not a research paper   where you select resources to support one side of an issue versus another.  A lit review should explain and consider all sides of an argument in order to avoid bias, and areas of agreement and disagreement should be highlighted.

A literature review serves several purposes. For example, it

• provides thorough knowledge of previous studies; introduces seminal works.
• helps focus one’s own research topic.
• identifies a conceptual framework for one’s own research questions or problems; indicates potential directions for future research.
• suggests previously unused or underused methodologies, designs, quantitative and qualitative strategies.
• identifies gaps in previous studies; identifies flawed methodologies and/or theoretical approaches; avoids replication of mistakes.
• helps the researcher avoid repetition of earlier research.
• suggests unexplored populations.
• determines whether past studies agree or disagree; identifies controversy in the literature.
• tests assumptions; may help counter preconceived ideas and remove unconscious bias.

As Kennedy (2007) notes*, it is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of field. In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews.

Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

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

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

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

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

Systematic Review      This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyse data from the studies that are included in the review. Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?"

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

* Kennedy, Mary M. "Defining a Literature."  Educational Researcher  36 (April 2007): 139-147.

All content in this section is from The Literature Review created by Dr. Robert Larabee USC

Robinson, P. and Lowe, J. (2015),  Literature reviews vs systematic reviews.  Australian and New Zealand Journal of Public Health, 39: 103-103. doi: 10.1111/1753-6405.12393

What's in the name? The difference between a Systematic Review and a Literature Review, and why it matters . By Lynn Kysh from University of Southern California

Systematic review or meta-analysis?

A  systematic review  answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria.

A  meta-analysis  is the use of statistical methods to summarize the results of these studies.

Systematic reviews, just like other research articles, can be of varying quality. They are a significant piece of work (the Centre for Reviews and Dissemination at York estimates that a team will take 9-24 months), and to be useful to other researchers and practitioners they should have:

• clearly stated objectives with pre-defined eligibility criteria for studies
• explicit, reproducible methodology
• a systematic search that attempts to identify all studies
• assessment of the validity of the findings of the included studies (e.g. risk of bias)
• systematic presentation, and synthesis, of the characteristics and findings of the included studies

Not all systematic reviews contain meta-analysis. 

Meta-analysis is the use of statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects of health care than those derived from the individual studies included within a review.  More information on meta-analyses can be found in  Cochrane Handbook, Chapter 9 .

A meta-analysis goes beyond critique and integration and conducts secondary statistical analysis on the outcomes of similar studies.  It is a systematic review that uses quantitative methods to synthesize and summarize the results.

An advantage of a meta-analysis is the ability to be completely objective in evaluating research findings.  Not all topics, however, have sufficient research evidence to allow a meta-analysis to be conducted.  In that case, an integrative review is an appropriate strategy. 

Some of the content in this section is from Systematic reviews and meta-analyses: step by step guide created by Kate McAllister.

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

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

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

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

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• Methodology
• Open access
• Published: 11 October 2016

Reviewing the research methods literature: principles and strategies illustrated by a systematic overview of sampling in qualitative research

• Stephen J. Gentles 1 , 4 ,
• Cathy Charles 1 ,
• David B. Nicholas 2 ,
• Jenny Ploeg 3 &
• K. Ann McKibbon 1  

Systematic Reviews volume  5 , Article number:  172 ( 2016 ) Cite this article

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Overviews of methods are potentially useful means to increase clarity and enhance collective understanding of specific methods topics that may be characterized by ambiguity, inconsistency, or a lack of comprehensiveness. This type of review represents a distinct literature synthesis method, although to date, its methodology remains relatively undeveloped despite several aspects that demand unique review procedures. The purpose of this paper is to initiate discussion about what a rigorous systematic approach to reviews of methods, referred to here as systematic methods overviews , might look like by providing tentative suggestions for approaching specific challenges likely to be encountered. The guidance offered here was derived from experience conducting a systematic methods overview on the topic of sampling in qualitative research.

The guidance is organized into several principles that highlight specific objectives for this type of review given the common challenges that must be overcome to achieve them. Optional strategies for achieving each principle are also proposed, along with discussion of how they were successfully implemented in the overview on sampling. We describe seven paired principles and strategies that address the following aspects: delimiting the initial set of publications to consider, searching beyond standard bibliographic databases, searching without the availability of relevant metadata, selecting publications on purposeful conceptual grounds, defining concepts and other information to abstract iteratively, accounting for inconsistent terminology used to describe specific methods topics, and generating rigorous verifiable analytic interpretations. Since a broad aim in systematic methods overviews is to describe and interpret the relevant literature in qualitative terms, we suggest that iterative decision making at various stages of the review process, and a rigorous qualitative approach to analysis are necessary features of this review type.

Conclusions

We believe that the principles and strategies provided here will be useful to anyone choosing to undertake a systematic methods overview. This paper represents an initial effort to promote high quality critical evaluations of the literature regarding problematic methods topics, which have the potential to promote clearer, shared understandings, and accelerate advances in research methods. Further work is warranted to develop more definitive guidance.

Peer Review reports

While reviews of methods are not new, they represent a distinct review type whose methodology remains relatively under-addressed in the literature despite the clear implications for unique review procedures. One of few examples to describe it is a chapter containing reflections of two contributing authors in a book of 21 reviews on methodological topics compiled for the British National Health Service, Health Technology Assessment Program [ 1 ]. Notable is their observation of how the differences between the methods reviews and conventional quantitative systematic reviews, specifically attributable to their varying content and purpose, have implications for defining what qualifies as systematic. While the authors describe general aspects of “systematicity” (including rigorous application of a methodical search, abstraction, and analysis), they also describe a high degree of variation within the category of methods reviews itself and so offer little in the way of concrete guidance. In this paper, we present tentative concrete guidance, in the form of a preliminary set of proposed principles and optional strategies, for a rigorous systematic approach to reviewing and evaluating the literature on quantitative or qualitative methods topics. For purposes of this article, we have used the term systematic methods overview to emphasize the notion of a systematic approach to such reviews.

The conventional focus of rigorous literature reviews (i.e., review types for which systematic methods have been codified, including the various approaches to quantitative systematic reviews [ 2 – 4 ], and the numerous forms of qualitative and mixed methods literature synthesis [ 5 – 10 ]) is to synthesize empirical research findings from multiple studies. By contrast, the focus of overviews of methods, including the systematic approach we advocate, is to synthesize guidance on methods topics. The literature consulted for such reviews may include the methods literature, methods-relevant sections of empirical research reports, or both. Thus, this paper adds to previous work published in this journal—namely, recent preliminary guidance for conducting reviews of theory [ 11 ]—that has extended the application of systematic review methods to novel review types that are concerned with subject matter other than empirical research findings.

Published examples of methods overviews illustrate the varying objectives they can have. One objective is to establish methodological standards for appraisal purposes. For example, reviews of existing quality appraisal standards have been used to propose universal standards for appraising the quality of primary qualitative research [ 12 ] or evaluating qualitative research reports [ 13 ]. A second objective is to survey the methods-relevant sections of empirical research reports to establish current practices on methods use and reporting practices, which Moher and colleagues [ 14 ] recommend as a means for establishing the needs to be addressed in reporting guidelines (see, for example [ 15 , 16 ]). A third objective for a methods review is to offer clarity and enhance collective understanding regarding a specific methods topic that may be characterized by ambiguity, inconsistency, or a lack of comprehensiveness within the available methods literature. An example of this is a overview whose objective was to review the inconsistent definitions of intention-to-treat analysis (the methodologically preferred approach to analyze randomized controlled trial data) that have been offered in the methods literature and propose a solution for improving conceptual clarity [ 17 ]. Such reviews are warranted because students and researchers who must learn or apply research methods typically lack the time to systematically search, retrieve, review, and compare the available literature to develop a thorough and critical sense of the varied approaches regarding certain controversial or ambiguous methods topics.

While systematic methods overviews , as a review type, include both reviews of the methods literature and reviews of methods-relevant sections from empirical study reports, the guidance provided here is primarily applicable to reviews of the methods literature since it was derived from the experience of conducting such a review [ 18 ], described below. To our knowledge, there are no well-developed proposals on how to rigorously conduct such reviews. Such guidance would have the potential to improve the thoroughness and credibility of critical evaluations of the methods literature, which could increase their utility as a tool for generating understandings that advance research methods, both qualitative and quantitative. Our aim in this paper is thus to initiate discussion about what might constitute a rigorous approach to systematic methods overviews. While we hope to promote rigor in the conduct of systematic methods overviews wherever possible, we do not wish to suggest that all methods overviews need be conducted to the same standard. Rather, we believe that the level of rigor may need to be tailored pragmatically to the specific review objectives, which may not always justify the resource requirements of an intensive review process.

The example systematic methods overview on sampling in qualitative research

The principles and strategies we propose in this paper are derived from experience conducting a systematic methods overview on the topic of sampling in qualitative research [ 18 ]. The main objective of that methods overview was to bring clarity and deeper understanding of the prominent concepts related to sampling in qualitative research (purposeful sampling strategies, saturation, etc.). Specifically, we interpreted the available guidance, commenting on areas lacking clarity, consistency, or comprehensiveness (without proposing any recommendations on how to do sampling). This was achieved by a comparative and critical analysis of publications representing the most influential (i.e., highly cited) guidance across several methodological traditions in qualitative research.

The specific methods and procedures for the overview on sampling [ 18 ] from which our proposals are derived were developed both after soliciting initial input from local experts in qualitative research and an expert health librarian (KAM) and through ongoing careful deliberation throughout the review process. To summarize, in that review, we employed a transparent and rigorous approach to search the methods literature, selected publications for inclusion according to a purposeful and iterative process, abstracted textual data using structured abstraction forms, and analyzed (synthesized) the data using a systematic multi-step approach featuring abstraction of text, summary of information in matrices, and analytic comparisons.

For this article, we reflected on both the problems and challenges encountered at different stages of the review and our means for selecting justifiable procedures to deal with them. Several principles were then derived by considering the generic nature of these problems, while the generalizable aspects of the procedures used to address them formed the basis of optional strategies. Further details of the specific methods and procedures used in the overview on qualitative sampling are provided below to illustrate both the types of objectives and challenges that reviewers will likely need to consider and our approach to implementing each of the principles and strategies.

Organization of the guidance into principles and strategies

For the purposes of this article, principles are general statements outlining what we propose are important aims or considerations within a particular review process, given the unique objectives or challenges to be overcome with this type of review. These statements follow the general format, “considering the objective or challenge of X, we propose Y to be an important aim or consideration.” Strategies are optional and flexible approaches for implementing the previous principle outlined. Thus, generic challenges give rise to principles, which in turn give rise to strategies.

We organize the principles and strategies below into three sections corresponding to processes characteristic of most systematic literature synthesis approaches: literature identification and selection ; data abstraction from the publications selected for inclusion; and analysis , including critical appraisal and synthesis of the abstracted data. Within each section, we also describe the specific methodological decisions and procedures used in the overview on sampling in qualitative research [ 18 ] to illustrate how the principles and strategies for each review process were applied and implemented in a specific case. We expect this guidance and accompanying illustrations will be useful for anyone considering engaging in a methods overview, particularly those who may be familiar with conventional systematic review methods but may not yet appreciate some of the challenges specific to reviewing the methods literature.

Results and discussion

Literature identification and selection.

The identification and selection process includes search and retrieval of publications and the development and application of inclusion and exclusion criteria to select the publications that will be abstracted and analyzed in the final review. Literature identification and selection for overviews of the methods literature is challenging and potentially more resource-intensive than for most reviews of empirical research. This is true for several reasons that we describe below, alongside discussion of the potential solutions. Additionally, we suggest in this section how the selection procedures can be chosen to match the specific analytic approach used in methods overviews.

Delimiting a manageable set of publications

One aspect of methods overviews that can make identification and selection challenging is the fact that the universe of literature containing potentially relevant information regarding most methods-related topics is expansive and often unmanageably so. Reviewers are faced with two large categories of literature: the methods literature , where the possible publication types include journal articles, books, and book chapters; and the methods-relevant sections of empirical study reports , where the possible publication types include journal articles, monographs, books, theses, and conference proceedings. In our systematic overview of sampling in qualitative research, exhaustively searching (including retrieval and first-pass screening) all publication types across both categories of literature for information on a single methods-related topic was too burdensome to be feasible. The following proposed principle follows from the need to delimit a manageable set of literature for the review.

Principle #1:

Considering the broad universe of potentially relevant literature, we propose that an important objective early in the identification and selection stage is to delimit a manageable set of methods-relevant publications in accordance with the objectives of the methods overview.

Strategy #1:

To limit the set of methods-relevant publications that must be managed in the selection process, reviewers have the option to initially review only the methods literature, and exclude the methods-relevant sections of empirical study reports, provided this aligns with the review’s particular objectives.

We propose that reviewers are justified in choosing to select only the methods literature when the objective is to map out the range of recognized concepts relevant to a methods topic, to summarize the most authoritative or influential definitions or meanings for methods-related concepts, or to demonstrate a problematic lack of clarity regarding a widely established methods-related concept and potentially make recommendations for a preferred approach to the methods topic in question. For example, in the case of the methods overview on sampling [ 18 ], the primary aim was to define areas lacking in clarity for multiple widely established sampling-related topics. In the review on intention-to-treat in the context of missing outcome data [ 17 ], the authors identified a lack of clarity based on multiple inconsistent definitions in the literature and went on to recommend separating the issue of how to handle missing outcome data from the issue of whether an intention-to-treat analysis can be claimed.

In contrast to strategy #1, it may be appropriate to select the methods-relevant sections of empirical study reports when the objective is to illustrate how a methods concept is operationalized in research practice or reported by authors. For example, one could review all the publications in 2 years’ worth of issues of five high-impact field-related journals to answer questions about how researchers describe implementing a particular method or approach, or to quantify how consistently they define or report using it. Such reviews are often used to highlight gaps in the reporting practices regarding specific methods, which may be used to justify items to address in reporting guidelines (for example, [ 14 – 16 ]).

It is worth recognizing that other authors have advocated broader positions regarding the scope of literature to be considered in a review, expanding on our perspective. Suri [ 10 ] (who, like us, emphasizes how different sampling strategies are suitable for different literature synthesis objectives) has, for example, described a two-stage literature sampling procedure (pp. 96–97). First, reviewers use an initial approach to conduct a broad overview of the field—for reviews of methods topics, this would entail an initial review of the research methods literature. This is followed by a second more focused stage in which practical examples are purposefully selected—for methods reviews, this would involve sampling the empirical literature to illustrate key themes and variations. While this approach is seductive in its capacity to generate more in depth and interpretive analytic findings, some reviewers may consider it too resource-intensive to include the second step no matter how selective the purposeful sampling. In the overview on sampling where we stopped after the first stage [ 18 ], we discussed our selective focus on the methods literature as a limitation that left opportunities for further analysis of the literature. We explicitly recommended, for example, that theoretical sampling was a topic for which a future review of the methods sections of empirical reports was justified to answer specific questions identified in the primary review.

Ultimately, reviewers must make pragmatic decisions that balance resource considerations, combined with informed predictions about the depth and complexity of literature available on their topic, with the stated objectives of their review. The remaining principles and strategies apply primarily to overviews that include the methods literature, although some aspects may be relevant to reviews that include empirical study reports.

Searching beyond standard bibliographic databases

An important reality affecting identification and selection in overviews of the methods literature is the increased likelihood for relevant publications to be located in sources other than journal articles (which is usually not the case for overviews of empirical research, where journal articles generally represent the primary publication type). In the overview on sampling [ 18 ], out of 41 full-text publications retrieved and reviewed, only 4 were journal articles, while 37 were books or book chapters. Since many books and book chapters did not exist electronically, their full text had to be physically retrieved in hardcopy, while 11 publications were retrievable only through interlibrary loan or purchase request. The tasks associated with such retrieval are substantially more time-consuming than electronic retrieval. Since a substantial proportion of methods-related guidance may be located in publication types that are less comprehensively indexed in standard bibliographic databases, identification and retrieval thus become complicated processes.

Principle #2:

Considering that important sources of methods guidance can be located in non-journal publication types (e.g., books, book chapters) that tend to be poorly indexed in standard bibliographic databases, it is important to consider alternative search methods for identifying relevant publications to be further screened for inclusion.

Strategy #2:

To identify books, book chapters, and other non-journal publication types not thoroughly indexed in standard bibliographic databases, reviewers may choose to consult one or more of the following less standard sources: Google Scholar, publisher web sites, or expert opinion.

In the case of the overview on sampling in qualitative research [ 18 ], Google Scholar had two advantages over other standard bibliographic databases: it indexes and returns records of books and book chapters likely to contain guidance on qualitative research methods topics; and it has been validated as providing higher citation counts than ISI Web of Science (a producer of numerous bibliographic databases accessible through institutional subscription) for several non-biomedical disciplines including the social sciences where qualitative research methods are prominently used [ 19 – 21 ]. While we identified numerous useful publications by consulting experts, the author publication lists generated through Google Scholar searches were uniquely useful to identify more recent editions of methods books identified by experts.

Searching without relevant metadata

Determining what publications to select for inclusion in the overview on sampling [ 18 ] could only rarely be accomplished by reviewing the publication’s metadata. This was because for the many books and other non-journal type publications we identified as possibly relevant, the potential content of interest would be located in only a subsection of the publication. In this common scenario for reviews of the methods literature (as opposed to methods overviews that include empirical study reports), reviewers will often be unable to employ standard title, abstract, and keyword database searching or screening as a means for selecting publications.

Principle #3:

Considering that the presence of information about the topic of interest may not be indicated in the metadata for books and similar publication types, it is important to consider other means of identifying potentially useful publications for further screening.

Strategy #3:

One approach to identifying potentially useful books and similar publication types is to consider what classes of such publications (e.g., all methods manuals for a certain research approach) are likely to contain relevant content, then identify, retrieve, and review the full text of corresponding publications to determine whether they contain information on the topic of interest.

In the example of the overview on sampling in qualitative research [ 18 ], the topic of interest (sampling) was one of numerous topics covered in the general qualitative research methods manuals. Consequently, examples from this class of publications first had to be identified for retrieval according to non-keyword-dependent criteria. Thus, all methods manuals within the three research traditions reviewed (grounded theory, phenomenology, and case study) that might contain discussion of sampling were sought through Google Scholar and expert opinion, their full text obtained, and hand-searched for relevant content to determine eligibility. We used tables of contents and index sections of books to aid this hand searching.

Purposefully selecting literature on conceptual grounds

A final consideration in methods overviews relates to the type of analysis used to generate the review findings. Unlike quantitative systematic reviews where reviewers aim for accurate or unbiased quantitative estimates—something that requires identifying and selecting the literature exhaustively to obtain all relevant data available (i.e., a complete sample)—in methods overviews, reviewers must describe and interpret the relevant literature in qualitative terms to achieve review objectives. In other words, the aim in methods overviews is to seek coverage of the qualitative concepts relevant to the methods topic at hand. For example, in the overview of sampling in qualitative research [ 18 ], achieving review objectives entailed providing conceptual coverage of eight sampling-related topics that emerged as key domains. The following principle recognizes that literature sampling should therefore support generating qualitative conceptual data as the input to analysis.

Principle #4:

Since the analytic findings of a systematic methods overview are generated through qualitative description and interpretation of the literature on a specified topic, selection of the literature should be guided by a purposeful strategy designed to achieve adequate conceptual coverage (i.e., representing an appropriate degree of variation in relevant ideas) of the topic according to objectives of the review.

Strategy #4:

One strategy for choosing the purposeful approach to use in selecting the literature according to the review objectives is to consider whether those objectives imply exploring concepts either at a broad overview level, in which case combining maximum variation selection with a strategy that limits yield (e.g., critical case, politically important, or sampling for influence—described below) may be appropriate; or in depth, in which case purposeful approaches aimed at revealing innovative cases will likely be necessary.

In the methods overview on sampling, the implied scope was broad since we set out to review publications on sampling across three divergent qualitative research traditions—grounded theory, phenomenology, and case study—to facilitate making informative conceptual comparisons. Such an approach would be analogous to maximum variation sampling.

At the same time, the purpose of that review was to critically interrogate the clarity, consistency, and comprehensiveness of literature from these traditions that was “most likely to have widely influenced students’ and researchers’ ideas about sampling” (p. 1774) [ 18 ]. In other words, we explicitly set out to review and critique the most established and influential (and therefore dominant) literature, since this represents a common basis of knowledge among students and researchers seeking understanding or practical guidance on sampling in qualitative research. To achieve this objective, we purposefully sampled publications according to the criterion of influence , which we operationalized as how often an author or publication has been referenced in print or informal discourse. This second sampling approach also limited the literature we needed to consider within our broad scope review to a manageable amount.

To operationalize this strategy of sampling for influence , we sought to identify both the most influential authors within a qualitative research tradition (all of whose citations were subsequently screened) and the most influential publications on the topic of interest by non-influential authors. This involved a flexible approach that combined multiple indicators of influence to avoid the dilemma that any single indicator might provide inadequate coverage. These indicators included bibliometric data (h-index for author influence [ 22 ]; number of cites for publication influence), expert opinion, and cross-references in the literature (i.e., snowball sampling). As a final selection criterion, a publication was included only if it made an original contribution in terms of novel guidance regarding sampling or a related concept; thus, purely secondary sources were excluded. Publish or Perish software (Anne-Wil Harzing; available at http://www.harzing.com/resources/publish-or-perish ) was used to generate bibliometric data via the Google Scholar database. Figure  1 illustrates how identification and selection in the methods overview on sampling was a multi-faceted and iterative process. The authors selected as influential, and the publications selected for inclusion or exclusion are listed in Additional file 1 (Matrices 1, 2a, 2b).

Literature identification and selection process used in the methods overview on sampling [ 18 ]

In summary, the strategies of seeking maximum variation and sampling for influence were employed in the sampling overview to meet the specific review objectives described. Reviewers will need to consider the full range of purposeful literature sampling approaches at their disposal in deciding what best matches the specific aims of their own reviews. Suri [ 10 ] has recently retooled Patton’s well-known typology of purposeful sampling strategies (originally intended for primary research) for application to literature synthesis, providing a useful resource in this respect.

Data abstraction

The purpose of data abstraction in rigorous literature reviews is to locate and record all data relevant to the topic of interest from the full text of included publications, making them available for subsequent analysis. Conventionally, a data abstraction form—consisting of numerous distinct conceptually defined fields to which corresponding information from the source publication is recorded—is developed and employed. There are several challenges, however, to the processes of developing the abstraction form and abstracting the data itself when conducting methods overviews, which we address here. Some of these problems and their solutions may be familiar to those who have conducted qualitative literature syntheses, which are similarly conceptual.

Iteratively defining conceptual information to abstract

In the overview on sampling [ 18 ], while we surveyed multiple sources beforehand to develop a list of concepts relevant for abstraction (e.g., purposeful sampling strategies, saturation, sample size), there was no way for us to anticipate some concepts prior to encountering them in the review process. Indeed, in many cases, reviewers are unable to determine the complete set of methods-related concepts that will be the focus of the final review a priori without having systematically reviewed the publications to be included. Thus, defining what information to abstract beforehand may not be feasible.

Principle #5:

Considering the potential impracticality of defining a complete set of relevant methods-related concepts from a body of literature one has not yet systematically read, selecting and defining fields for data abstraction must often be undertaken iteratively. Thus, concepts to be abstracted can be expected to grow and change as data abstraction proceeds.

Strategy #5:

Reviewers can develop an initial form or set of concepts for abstraction purposes according to standard methods (e.g., incorporating expert feedback, pilot testing) and remain attentive to the need to iteratively revise it as concepts are added or modified during the review. Reviewers should document revisions and return to re-abstract data from previously abstracted publications as the new data requirements are determined.

In the sampling overview [ 18 ], we developed and maintained the abstraction form in Microsoft Word. We derived the initial set of abstraction fields from our own knowledge of relevant sampling-related concepts, consultation with local experts, and reviewing a pilot sample of publications. Since the publications in this review included a large proportion of books, the abstraction process often began by flagging the broad sections within a publication containing topic-relevant information for detailed review to identify text to abstract. When reviewing flagged text, the reviewer occasionally encountered an unanticipated concept significant enough to warrant being added as a new field to the abstraction form. For example, a field was added to capture how authors described the timing of sampling decisions, whether before (a priori) or after (ongoing) starting data collection, or whether this was unclear. In these cases, we systematically documented the modification to the form and returned to previously abstracted publications to abstract any information that might be relevant to the new field.

The logic of this strategy is analogous to the logic used in a form of research synthesis called best fit framework synthesis (BFFS) [ 23 – 25 ]. In that method, reviewers initially code evidence using an a priori framework they have selected. When evidence cannot be accommodated by the selected framework, reviewers then develop new themes or concepts from which they construct a new expanded framework. Both the strategy proposed and the BFFS approach to research synthesis are notable for their rigorous and transparent means to adapt a final set of concepts to the content under review.

Accounting for inconsistent terminology

An important complication affecting the abstraction process in methods overviews is that the language used by authors to describe methods-related concepts can easily vary across publications. For example, authors from different qualitative research traditions often use different terms for similar methods-related concepts. Furthermore, as we found in the sampling overview [ 18 ], there may be cases where no identifiable term, phrase, or label for a methods-related concept is used at all, and a description of it is given instead. This can make searching the text for relevant concepts based on keywords unreliable.

Principle #6:

Since accepted terms may not be used consistently to refer to methods concepts, it is necessary to rely on the definitions for concepts, rather than keywords, to identify relevant information in the publication to abstract.

Strategy #6:

An effective means to systematically identify relevant information is to develop and iteratively adjust written definitions for key concepts (corresponding to abstraction fields) that are consistent with and as inclusive of as much of the literature reviewed as possible. Reviewers then seek information that matches these definitions (rather than keywords) when scanning a publication for relevant data to abstract.

In the abstraction process for the sampling overview [ 18 ], we noted the several concepts of interest to the review for which abstraction by keyword was particularly problematic due to inconsistent terminology across publications: sampling , purposeful sampling , sampling strategy , and saturation (for examples, see Additional file 1 , Matrices 3a, 3b, 4). We iteratively developed definitions for these concepts by abstracting text from publications that either provided an explicit definition or from which an implicit definition could be derived, which was recorded in fields dedicated to the concept’s definition. Using a method of constant comparison, we used text from definition fields to inform and modify a centrally maintained definition of the corresponding concept to optimize its fit and inclusiveness with the literature reviewed. Table  1 shows, as an example, the final definition constructed in this way for one of the central concepts of the review, qualitative sampling .

We applied iteratively developed definitions when making decisions about what specific text to abstract for an existing field, which allowed us to abstract concept-relevant data even if no recognized keyword was used. For example, this was the case for the sampling-related concept, saturation , where the relevant text available for abstraction in one publication [ 26 ]—“to continue to collect data until nothing new was being observed or recorded, no matter how long that takes”—was not accompanied by any term or label whatsoever.

This comparative analytic strategy (and our approach to analysis more broadly as described in strategy #7, below) is analogous to the process of reciprocal translation —a technique first introduced for meta-ethnography by Noblit and Hare [ 27 ] that has since been recognized as a common element in a variety of qualitative metasynthesis approaches [ 28 ]. Reciprocal translation, taken broadly, involves making sense of a study’s findings in terms of the findings of the other studies included in the review. In practice, it has been operationalized in different ways. Melendez-Torres and colleagues developed a typology from their review of the metasynthesis literature, describing four overlapping categories of specific operations undertaken in reciprocal translation: visual representation, key paper integration, data reduction and thematic extraction, and line-by-line coding [ 28 ]. The approaches suggested in both strategies #6 and #7, with their emphasis on constant comparison, appear to fall within the line-by-line coding category.

Generating credible and verifiable analytic interpretations

The analysis in a systematic methods overview must support its more general objective, which we suggested above is often to offer clarity and enhance collective understanding regarding a chosen methods topic. In our experience, this involves describing and interpreting the relevant literature in qualitative terms. Furthermore, any interpretative analysis required may entail reaching different levels of abstraction, depending on the more specific objectives of the review. For example, in the overview on sampling [ 18 ], we aimed to produce a comparative analysis of how multiple sampling-related topics were treated differently within and among different qualitative research traditions. To promote credibility of the review, however, not only should one seek a qualitative analytic approach that facilitates reaching varying levels of abstraction but that approach must also ensure that abstract interpretations are supported and justified by the source data and not solely the product of the analyst’s speculative thinking.

Principle #7:

Considering the qualitative nature of the analysis required in systematic methods overviews, it is important to select an analytic method whose interpretations can be verified as being consistent with the literature selected, regardless of the level of abstraction reached.

Strategy #7:

We suggest employing the constant comparative method of analysis [ 29 ] because it supports developing and verifying analytic links to the source data throughout progressively interpretive or abstract levels. In applying this approach, we advise a rigorous approach, documenting how supportive quotes or references to the original texts are carried forward in the successive steps of analysis to allow for easy verification.

The analytic approach used in the methods overview on sampling [ 18 ] comprised four explicit steps, progressing in level of abstraction—data abstraction, matrices, narrative summaries, and final analytic conclusions (Fig.  2 ). While we have positioned data abstraction as the second stage of the generic review process (prior to Analysis), above, we also considered it as an initial step of analysis in the sampling overview for several reasons. First, it involved a process of constant comparisons and iterative decision-making about the fields to add or define during development and modification of the abstraction form, through which we established the range of concepts to be addressed in the review. At the same time, abstraction involved continuous analytic decisions about what textual quotes (ranging in size from short phrases to numerous paragraphs) to record in the fields thus created. This constant comparative process was analogous to open coding in which textual data from publications was compared to conceptual fields (equivalent to codes) or to other instances of data previously abstracted when constructing definitions to optimize their fit with the overall literature as described in strategy #6. Finally, in the data abstraction step, we also recorded our first interpretive thoughts in dedicated fields, providing initial material for the more abstract analytic steps.

Summary of progressive steps of analysis used in the methods overview on sampling [ 18 ]

In the second step of the analysis, we constructed topic-specific matrices , or tables, by copying relevant quotes from abstraction forms into the appropriate cells of matrices (for the complete set of analytic matrices developed in the sampling review, see Additional file 1 (matrices 3 to 10)). Each matrix ranged from one to five pages; row headings, nested three-deep, identified the methodological tradition, author, and publication, respectively; and column headings identified the concepts, which corresponded to abstraction fields. Matrices thus allowed us to make further comparisons across methodological traditions, and between authors within a tradition. In the third step of analysis, we recorded our comparative observations as narrative summaries , in which we used illustrative quotes more sparingly. In the final step, we developed analytic conclusions based on the narrative summaries about the sampling-related concepts within each methodological tradition for which clarity, consistency, or comprehensiveness of the available guidance appeared to be lacking. Higher levels of analysis thus built logically from the lower levels, enabling us to easily verify analytic conclusions by tracing the support for claims by comparing the original text of publications reviewed.

Integrative versus interpretive methods overviews

The analytic product of systematic methods overviews is comparable to qualitative evidence syntheses, since both involve describing and interpreting the relevant literature in qualitative terms. Most qualitative synthesis approaches strive to produce new conceptual understandings that vary in level of interpretation. Dixon-Woods and colleagues [ 30 ] elaborate on a useful distinction, originating from Noblit and Hare [ 27 ], between integrative and interpretive reviews. Integrative reviews focus on summarizing available primary data and involve using largely secure and well defined concepts to do so; definitions are used from an early stage to specify categories for abstraction (or coding) of data, which in turn supports their aggregation; they do not seek as their primary focus to develop or specify new concepts, although they may achieve some theoretical or interpretive functions. For interpretive reviews, meanwhile, the main focus is to develop new concepts and theories that integrate them, with the implication that the concepts developed become fully defined towards the end of the analysis. These two forms are not completely distinct, and “every integrative synthesis will include elements of interpretation, and every interpretive synthesis will include elements of aggregation of data” [ 30 ].

The example methods overview on sampling [ 18 ] could be classified as predominantly integrative because its primary goal was to aggregate influential authors’ ideas on sampling-related concepts; there were also, however, elements of interpretive synthesis since it aimed to develop new ideas about where clarity in guidance on certain sampling-related topics is lacking, and definitions for some concepts were flexible and not fixed until late in the review. We suggest that most systematic methods overviews will be classifiable as predominantly integrative (aggregative). Nevertheless, more highly interpretive methods overviews are also quite possible—for example, when the review objective is to provide a highly critical analysis for the purpose of generating new methodological guidance. In such cases, reviewers may need to sample more deeply (see strategy #4), specifically by selecting empirical research reports (i.e., to go beyond dominant or influential ideas in the methods literature) that are likely to feature innovations or instructive lessons in employing a given method.

In this paper, we have outlined tentative guidance in the form of seven principles and strategies on how to conduct systematic methods overviews, a review type in which methods-relevant literature is systematically analyzed with the aim of offering clarity and enhancing collective understanding regarding a specific methods topic. Our proposals include strategies for delimiting the set of publications to consider, searching beyond standard bibliographic databases, searching without the availability of relevant metadata, selecting publications on purposeful conceptual grounds, defining concepts and other information to abstract iteratively, accounting for inconsistent terminology, and generating credible and verifiable analytic interpretations. We hope the suggestions proposed will be useful to others undertaking reviews on methods topics in future.

As far as we are aware, this is the first published source of concrete guidance for conducting this type of review. It is important to note that our primary objective was to initiate methodological discussion by stimulating reflection on what rigorous methods for this type of review should look like, leaving the development of more complete guidance to future work. While derived from the experience of reviewing a single qualitative methods topic, we believe the principles and strategies provided are generalizable to overviews of both qualitative and quantitative methods topics alike. However, it is expected that additional challenges and insights for conducting such reviews have yet to be defined. Thus, we propose that next steps for developing more definitive guidance should involve an attempt to collect and integrate other reviewers’ perspectives and experiences in conducting systematic methods overviews on a broad range of qualitative and quantitative methods topics. Formalized guidance and standards would improve the quality of future methods overviews, something we believe has important implications for advancing qualitative and quantitative methodology. When undertaken to a high standard, rigorous critical evaluations of the available methods guidance have significant potential to make implicit controversies explicit, and improve the clarity and precision of our understandings of problematic qualitative or quantitative methods issues.

A review process central to most types of rigorous reviews of empirical studies, which we did not explicitly address in a separate review step above, is quality appraisal . The reason we have not treated this as a separate step stems from the different objectives of the primary publications included in overviews of the methods literature (i.e., providing methodological guidance) compared to the primary publications included in the other established review types (i.e., reporting findings from single empirical studies). This is not to say that appraising quality of the methods literature is not an important concern for systematic methods overviews. Rather, appraisal is much more integral to (and difficult to separate from) the analysis step, in which we advocate appraising clarity, consistency, and comprehensiveness—the quality appraisal criteria that we suggest are appropriate for the methods literature. As a second important difference regarding appraisal, we currently advocate appraising the aforementioned aspects at the level of the literature in aggregate rather than at the level of individual publications. One reason for this is that methods guidance from individual publications generally builds on previous literature, and thus we feel that ahistorical judgments about comprehensiveness of single publications lack relevance and utility. Additionally, while different methods authors may express themselves less clearly than others, their guidance can nonetheless be highly influential and useful, and should therefore not be downgraded or ignored based on considerations of clarity—which raises questions about the alternative uses that quality appraisals of individual publications might have. Finally, legitimate variability in the perspectives that methods authors wish to emphasize, and the levels of generality at which they write about methods, makes critiquing individual publications based on the criterion of clarity a complex and potentially problematic endeavor that is beyond the scope of this paper to address. By appraising the current state of the literature at a holistic level, reviewers stand to identify important gaps in understanding that represent valuable opportunities for further methodological development.

To summarize, the principles and strategies provided here may be useful to those seeking to undertake their own systematic methods overview. Additional work is needed, however, to establish guidance that is comprehensive by comparing the experiences from conducting a variety of methods overviews on a range of methods topics. Efforts that further advance standards for systematic methods overviews have the potential to promote high-quality critical evaluations that produce conceptually clear and unified understandings of problematic methods topics, thereby accelerating the advance of research methodology.

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The systematic methods overview used as a worked example in this article (Gentles SJ, Charles C, Ploeg J, McKibbon KA: Sampling in qualitative research: insights from an overview of the methods literature. The Qual Rep 2015, 20(11):1772-1789) is available from http://nsuworks.nova.edu/tqr/vol20/iss11/5 .

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SJG wrote the first draft of this article, with CC contributing to drafting. All authors contributed to revising the manuscript. All authors except CC (deceased) approved the final draft. SJG, CC, KAB, and JP were involved in developing methods for the systematic methods overview on sampling.

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Stephen J. Gentles, Cathy Charles & K. Ann McKibbon

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David B. Nicholas

School of Nursing, McMaster University, Hamilton, Ontario, Canada

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CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, IAHS 408, Hamilton, ON, L8S 1C7, Canada

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Gentles, S.J., Charles, C., Nicholas, D.B. et al. Reviewing the research methods literature: principles and strategies illustrated by a systematic overview of sampling in qualitative research. Syst Rev 5 , 172 (2016). https://doi.org/10.1186/s13643-016-0343-0

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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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• University of Texas Libraries

Literature Reviews

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

What is a Literature Review?

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

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

Larayne Dallas : Engineering

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

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

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

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

• October 26, 2022 recording
• Last Updated: Oct 26, 2022 2:49 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

Research Methods: Literature Reviews

• Annotated Bibliographies
• Literature Reviews
• Scoping Reviews
• Systematic Reviews
• Scholarship of Teaching and Learning
• Persuasive Arguments
• Subject Specific Methodology

A literature review involves researching, reading, analyzing, evaluating, and summarizing scholarly literature (typically journals and articles) about a specific topic. The results of a literature review may be an entire report or article OR may be part of a article, thesis, dissertation, or grant proposal. A literature review helps the author learn about the history and nature of their topic, and identify research gaps and problems.

Steps & Elements

Problem formulation

• Determine your topic and its components by asking a question
• Research: locate literature related to your topic to identify the gap(s) that can be addressed
• Read: read the articles or other sources of information
• Analyze: assess the findings for relevancy
• Evaluating: determine how the article are relevant to your research and what are the key findings
• Synthesis: write about the key findings and how it is relevant to your research

Elements of a Literature Review

• Summarize subject, issue or theory under consideration, along with objectives of the review
• Divide works under review into categories (e.g. those in support of a particular position, those against, those offering alternative theories entirely)
• Explain how each work is similar to and how it varies from the others
• Conclude which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of an area of research

Writing a Literature Review Resources

• How to Write a Literature Review From the Wesleyan University Library
• Write a Literature Review From the University of California Santa Cruz Library. A Brief overview of a literature review, includes a list of stages for writing a lit review.
• Literature Reviews From the University of North Carolina Writing Center. Detailed information about writing a literature review.
• Undertaking a literature review: a step-by-step approach Cronin, P., Ryan, F., & Coughan, M. (2008). Undertaking a literature review: A step-by-step approach. British Journal of Nursing, 17(1), p.38-43

Literature Review Tutorial

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A systematic literature review on coping mechanisms and food security during pandemics

• Published: 09 May 2024

Cite this article

• Yeni Budiawati   ORCID: orcid.org/0000-0003-2656-4552 1 ,
• Ronnie S. Natawidjaja 2 ,
• Dhanan Sarwo Utomo 3 ,
• Tomy Perdana 2 &
• Maman H. Karmana 2  

Coping strategies are vital during crises, and this review synthesizes existing research on coping strategies related to food security during pandemics while identifying research gaps. The paper examines implemented and needed policies to enhance individual and household food security, particularly during pandemic, which has garnered increased global academic interest. Endnote X9, following PRISMA guidelines, analyzes data collected from ProQuest, EBSCOhost, and Scopus databases. Publications from 2019 to 2022 predominantly focus on health sciences, utilizing quantitative methods and empirical data, with an emphasis on Asia. Categorizing research based on several sub-criteria reveals pandemic impacts, outcomes, geographic locations, economic development, and basic theories employed in the previous studies. Consequences of the pandemic studied include environmental quality and socioeconomic effects. Practical implications for food security policies, including urban planning, rural vulnerability, institutional strengthening, and support for vulnerable communities, are highlighted. The government should implement targeted policies, particularly for vulnerable groups like babies, children, elderly individuals with low incomes, female heads of families, low-income community groups, farmers, fishermen, those without permanent jobs, and the unemployed.

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Acknowledgements

The authors are grateful to Yusup Hidayat, head of the Doctoral Program in Agricultural Sciences, at Padjadjaran University, who always provided motivation and wise input during the development of this manuscript. The author also thanks Medy Rachmadi, the Dean of the Faculty of Agriculture, who helped the students and provided useful critical insights. The authors also thank Romi Zamhir Islami, Elsy Lediana, and Winy Fetia for providing enthusiasm and motivation for the development of this manuscript.

This study was supported and funded by Padjadjaran University.

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Yeni Budiawati

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Ronnie S. Natawidjaja, Tomy Perdana & Maman H. Karmana

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YB searched three databases, reviewed the literature, summarized the search findings, and compiled the manuscript. RSN provided input for displaying the tables and drafting the manuscript. DSU defined the scope of the research subjects, developed a search strategy by systematically compiling keywords, provided substantial input during the design review stage, critically reviewed the manuscript, and helped shape the final version of the manuscript. TP provided input regarding content that should be displayed in the manuscript and substantial input regarding the final finalization of the manuscript. MHK provided critical input for the overall writing of the systematics and review of the final manuscript. All authors have approved the final manuscript.

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Budiawati, Y., Natawidjaja, R.S., Sarwo Utomo, D. et al. A systematic literature review on coping mechanisms and food security during pandemics. Food Sec. (2024). https://doi.org/10.1007/s12571-024-01445-0

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MINI REVIEW article

Recent insights in the correlation between social media use, personality traits and exercise addiction: a literature review.

• 1 National Centre on Addiction and Doping, Italian National Institute of Health, Rome, Italy
• 2 Università degli Studi Internazionali di Roma, Rome, Italy

Introduction and aim: The excessive involvement in physical activity without stopping in between sessions despite injuries, the continuous thinking to exercise feeling insane thoughts and experiencing withdrawal symptoms are all characteristics of the Exercise Addiction (EA), an addictive behavior. While the primary exercise addiction is directly caused by compulsive exercise, many studies highlighted the relationship between Eating Disorders (ED) and EA, defining the secondary EA. The correlation between EA, social media use (SMU) and other individual traits remains a relatively underexplored domain. Therefore, this review aimed to examine the latest evidence on the relationship between EA, SMU, and some personality traits such as perfectionism and body image.

Methods: Electronic databases including PubMed, Medline, PsycARTICLES, Embase, Web of Science were searched from January 2019 to October 2023, following the PRISMA guidelines.

Results: A total of 15 articles were examined and consolidated in this review. EA was found to be related to different individual traits such perfectionism, body dissatisfaction, depression, obsessive-compulsive personality disorders. While controversial results were found regarding the relationship between EA and SMU.

Conclusion: The interaction between mental health, exercise addiction and social media use is complex. Excessive engagement in these latter may result in negative mental health consequences despite their potential benefits. Understanding individual differences and developing effective interventions is crucial to promoting healthy habits and mitigating the EA risks, ultimately enhancing mental well-being. Further research should focus on the identification of risks and protective factors with the eventual aim of developing and implementing effective prevention strategies.

1 Introduction

The constant pursuit of a healthy lifestyle is widely related to the growing attention to physical and mental health to contrast the acceleration of the societal ageing process. Whereas physical exercise and sports engagement were widely valued, excessive involvement in exercise may drive to addictive behavior, referred to as exercise addiction (EA). Although not formally recognized in diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders 5 ( 1 ), EA, also known as “exercise dependence” or “compulsive exercising”, is acknowledged as a behavioral addiction. Indeed, the discrimination between exercise-addicted and regular exercisers is challenging, making the symptom intensity evaluation of particular importance ( 2 ).

The uncontrollable urge to engage in physical activity that surpasses health or fitness requirements is the main characteristic of this addiction. Conversely to regular and healthy physical exercise, excessive engagement may lead to adverse consequences. Adverse effects include tolerance and withdrawal symptoms, mood alteration, impulsivity, lack of control, detrimental social and financial consequences, physical injuries ( 3 , 4 ). Specifically, when the exercise’s positive effects on mood and well-being are transient, it may exert a feeling of deprivation when exercise is inaccessible, a compulsion to resume exercise promptly, negative emotions, increased exercise duration, inability to cease exercise even when injured, and sleeplessness ( 5 , 6 ). Furthermore, secondary EA was recently defined as an aspect of eating disorders (ED), characterized by obsessive exercising in conjunction with anorexia or bulimia nervosa ( 7 ). In this case, a body image disturbance may exist at the base of the EA, besides heightened levels of anxiety and depression ( 8 ). The pursuit of physical perfection and fixation on maintaining a specific body image may contribute to the onset of EA, detrimentally impacting mental well-being ( 9 , 10 ). Problematic Social media use (PSMU) and ED, like EA, are linked to several psychological and physical health problems including difficulties in emotion regulation, psychological distress, excessive daytime sleepiness and body dissatisfaction ( 11 , 12 ). Some studies suggest that individuals with EA may be inclined more towards using social media to showcase their fitness achievements, seeking validation from online peers ( 13 – 15 ). These individuals may be trapped by the carefully curated nature of social media content, depicting unattainable representations of individuals’ lives, affecting their self-esteem ( 13 , 16 ).

Moreover, a relationship between EA, PSMU or social media addiction (SMA), and perceived discomfort regarding images of physical idealization was corroborated by the so-called “fitspiration” ( 17 – 19 ). This term derives from the fusion of “fitness” and “inspiration,” which involves posting online, primarily through social networking channels, images promoting health, wellness, healthy eating, self-care, and especially physical exercise ( 20 ). Moreover, the “fear of missing out” (FOMO) phenomenon on social media could drive individuals to excessively engage in both exercise and social media use, contributing to adverse mental health outcomes ( 17 , 21 ).

Conversely, excessive exposure to fitness-related content on social media might exacerbate exercise addiction by perpetuating unrealistic body standards and nurturing an obsession with exercise ( 22 , 23 ).

The main focus of studies reported in the literature is on defining, diagnosing, characterizing, and elucidating comorbidities ( 16 , 24 ). Moreover, current researches examine the relationship among EA ED and anxiety ( 25 – 27 ) making the specific correlation between EA, SMU and other personality traits (perfectionism, body image) still a domain that has not yet been fully explored. For this reason we performed a literature review to clarify the relationship between EA, SMU, and mental health outcomes by bringing together existing research and examining the underlying mechanisms that drive their interactions.

We performed comprehensive literature research to identify articles investigating the relationship between exercise addiction, social media use, and personality traits. Considering the recent focus on the EA-related issues, Electronic databases including PubMed, Medline, PsycARTICLES, Embase, Web of Science were searched from January 2019 to October 2023. Preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement was the methodology selected for the present review ( 28 ). According to guidelines of the 2020 PRISMA statement ( 29 ) the research team evaluated the following items: definition of the research question, hypothesis and objectives; bibliographic search; data collection, screening of the scientific papers selected and finally, analysis of the main findings and conclusions including the strengths and weakness of these studies ( Figure 1 ). Our eligibility criteria included: articles written in English, cross-sectional, longitudinal, and case control studies investigating the association between exercise addiction, social media use and individual traits (e.g. perfectionism, perceived body image, depression), original research performed in general population, adolescents or professional athletes, studies using reliable research tools. Papers published in non-English languages were excluded. Reviews were also excluded but were used for the snowball search strategy. The researchers and performed the initial selection of original manuscripts by screening titles and abstracts, creating a reference list of papers for the topics evaluated in the present review using Rayyan software ( 30 ). Two investigators conducted each stage of the studies selection, deleted duplicate inputs and reviewed studies as excluded or requiring further assessment. All data were extracted by two investigators and cross-checked by the other investigator. In case of discrepancies in the selected studies, we opted for reconciliation through team discussion. This narrative review protocol was registered in PROSPERO (international prospective register of systematic reviews) on the 7 th of February 2024, with the registration number CRD42024510767.

Figure 1 PRISMA flow diagram of the study selection.

3.1 Literature research

A total of 96 studies were identified from the initial search, of which 41 duplicates were removed. Titles and abstracts of the rest 55 studies were screened according to the predefined inclusion criteria, and 35 studies were excluded. In total, 15 articles were critically reviewed and consolidated for this review ( Table 1 ). The studies were mainly conducted in the last 2 years (2022 and 2023), with prevalence in Australia (n = 5) and Europe (n = 6). The considered population was more often specific, such as gym instructors, competitive athletes, or clinical populations (individuals with ED).

Table 1 Studies investigating the relationship between exercise addiction, social media use, and personality traits.

3.2 Results in domain investigated

The 15 studies included ( Table 1 ) in the literature search considered 4 main domains, such as body image-related dysfunction, eating disorders, difficult individual traits, and/or problematic social media use. As a result, different connections with EA emerged.

Two different studies highlighted the strong association between EA and ED which have in common weight concerns, perfectionism, perception of body image, body dissatisfaction, depression, psychological distress and insomnia ( 32 , 41 ). Furthermore, compulsive exercise plays a role in mediating the clinical perfectionism and EA, especially in vulnerable athletes or underweight adolescents ( 31 , 37 ).

Body dissatisfaction (BD) is a disorder characterized by individual suffering due to the difference between what is the real and the idealistic image of the body. It has been reported that BD is a risk factor for the development of EA and ED especially in fitness instructors or practitioners ( 32 , 39 ). More recently, cognitive constructs were investigated in relation to EA. Indeed, the relationship between Early Maladaptive Schema (EMS) and EA, the only two specific domains which influenced EA were the other-directedness and the impaired limits. To this concern, individuals unable to set appropriate internal limits and have excessive external focus on others’ desires and needs may be more prone to developing EA ( 33 ).

Recently, the EA was investigated in relation to PSMU consequences on mental health, focusing on anxiety, depression, and stress rather than personality traits such as extraversion, perfectionism, and aggression. As a result, EA appeared to play a mediating role since it is strictly connected to body image concerns, psychological distress and compulsive eating, which may cause negative mental health outcomes influencing the PSMU ( 35 ).

SMA was positively correlated with psychological/addicted eating behavior and unhealthy diet-exercise behavior, but negatively with healthy eating/exercise behavior ( 40 ). SMU impacts the physical activity behavior. The passive SMU corresponds to a low rate of daily physical activity practice (minimum 60 minutes), while the actively SMU is linked to a higher probability of exercise activity ( 43 ). On the other hand, another study reported that EA is not associated with the frequency of active or passive social networking sites usage ( 42 )

SMA may be part of a broader spectrum of addictive behaviors. It was found that EA and substance abuse are weakly related to SMA while this latter is significantly associated with shopping addiction ( 44 ).

The relationship between EA, depression, and anxiety has been extensively studied, indeed many studies reported that EA co-occurs with mental health disorders such as major depressive disorder, anxiety, obsessive-compulsive personality disorder ( 34 , 36 , 45 ). Moreover, people with obsessive-compulsive traits and high levels of self-efficacy are at higher risk of becoming exercise addicts ( 45 ).

4 Discussion

Whereas different EA definitions have been formulated, the terminology is still inconsistently used with “exercise addiction” and “compulsive exercise” or “exercise dependence” used as synonyms, although labile characteristics allow to discriminate the different conditions related to excessive exercise. A panel of experts in the field, including physicians, physiotherapists, coaches, trainers, and athletes defined excessive exercise as an “addiction”, identifying perfectionism, obsessive-compulsive drive, and hedonism as components of EA ( 23 ). The co-occurrence of these components and the excessive exercise was described as a behavioral addiction with a similar mechanism to substance addictions ( 23 ).

In recent years, the scientific community raised concerns about the connection between EA, SMU, and mental health, due to the potential outcomes on mental well-being of the recent spreading of both excessive exercise and extensive social media. Among the others, the complex relationship between EA, and SMA, perfectionism, body image disorders, and “fitspiration” construct have been studied, since 2015 ( 46 ). Interestingly, “fitspiration” diversion into a distortion of body perception could emerge ( 20 , 47 , 48 ). Although “fitspiration” generally conveys positive messages, the images associated with that may have negative effects on the body image of individuals who engage in it, as they predominantly portray a lean and toned body figure. Noteworthy, “fitspiration” emerged as a positive alternative to the “thin-spiration” trend, combining “thin” and “inspiration”. Notably, perfectionism is a personality trait in individuals characterized by unrealistic expectations for themselves and others, with feelings of inadequacy, self-criticism, and guilt ( 49 ), with different mechanisms of connection to EA and ED, although there is still limited clarity on EA mediating role between perfectionism and ED. Furthermore, EA is related to other personality traits such as the tendency towards depression, or an inability to manage it. These traits also constitute risk factors for behavioral addictions, such as SMA, which also involves a distortion of body perception. The EA appears to have a similar developmental pattern to other addiction or addictive behaviors, following the biopsychosocial model ( 50 ). Besides, EA has consistent co-occurrence patterns to depression and anxiety revealing that individuals with obsessive-compulsive traits and high self-efficacy present high risk of becoming exercise addicted.

However, a lack of specific and robust tools to study the EA emerged, imposing the adaptation of diagnostic tools validated for the assessment of other behavioral addictions such as gambling or gaming disorders. Hence, certain diagnostic criteria are still not provided to clinicians to precisely identify the EA. Otherwise, people are widely informed through social media communications about the EA associated risks. Furthermore, the lack of specific tools determines that only the relation with other disorders is evaluated, while EA is never considered alone. Indeed, the EA role as a consequence or cause of a broad spectrum of other disorders should be clarified.

On the other hand, study protocols should be harmonized, preferably based on standardized measurement tools that would ensure result consistency. This approach would facilitate the study of EA, clarifying the mediating role of behavioral addictions on mental health.

A general weakness in EA investigation is represented by the size and the quality of the population involved in the studies. Indeed, only four studies considered at least 1,000 individuals ( 31 , 35 , 41 , 45 ), and only one investigated over 10,000 participants ( 43 ). Moreover, the adult population were the most examined while only one-third of the studies included the adolescent population. To this concern, the adolescent population should be further explored, considering the early onset of behavioral addictions, and ED ( 51 – 54 ).

Lastly, another important issue is the lack of validated intervention and prevention programs with evidence-based efficacy in managing EA.

5 Conclusion

The relationship between EA, SMU, and mental health is intricate and knotted. While both exercise and social media have the potential to contribute positively to mental well-being, their excessive and addictive use can lead to adverse outcomes. Improved knowledge on mechanisms and assessment of individual differences are essential to develop effective interventions, promoting healthy exercise habits and mindful social media use. Eventually, improved mental health and well-being in the digital age would be fostered. Finally, it would be necessary to expand the number of these studies to identify risk factors and protective factors, which in turn are fundamental elements for implementing prevention strategies for behavioral addictions.

Author contributions

AM: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Writing – original draft, Writing – review & editing. AT: Data curation, Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing. VA: Validation, Writing – review & editing. GC: Data curation, Formal analysis, Investigation, Methodology, Writing – original draft. PB: Writing – review & editing. NM: Data curation, Investigation, Methodology, Visualization, Writing – original draft, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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49. Shafran R, Cooper Z, Fairburn CG. Clinical perfectionism: a cognitive–behavioural analysis. Behav Res Ther . (2002) 40:773–91. doi: 10.1016/S0005-7967(01)00059-6

50. Griffiths MA. components’ model of addiction within a biopsychosocial framework. J Subst Use . (2005) 10:191–7. doi: 10.1080/14659890500114359

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Keywords: exercise addiction, body image, perfectionism, behavior, addictive

Citation: Minutillo A, Di Trana A, Aquilina V, Ciancio GM, Berretta P and La Maida N (2024) Recent insights in the correlation between social media use, personality traits and exercise addiction: a literature review. Front. Psychiatry 15:1392317. doi: 10.3389/fpsyt.2024.1392317

Received: 27 February 2024; Accepted: 29 April 2024; Published: 10 May 2024.

Reviewed by:

Copyright © 2024 Minutillo, Di Trana, Aquilina, Ciancio, Berretta and La Maida. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Annagiulia Di Trana, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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• Patient research partner involvement in rheumatology research: a systematic literature review informing the 2023 updated EULAR recommendations for the involvement of patient research partners
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• http://orcid.org/0000-0001-8708-9324 Krystel Aouad 1 ,
• http://orcid.org/0000-0002-8428-6354 Maarten de Wit 2 ,
• Muriel Elhai 3 ,
• http://orcid.org/0000-0001-9119-5330 Diego Benavent 4 ,
• Heidi Bertheussen 5 ,
• Condruta Zabalan 6 ,
• http://orcid.org/0000-0002-1049-4150 Jette Primdahl 7 ,
• http://orcid.org/0000-0002-8895-6941 Paul Studenic 8 , 9 ,
• http://orcid.org/0000-0002-4528-310X Laure Gossec 10 , 11
• 1 Rheumatology Division, Saint George University of Beirut , Saint George Hospital University Medical Center , Beirut , Lebanon
• 2 EULAR Study Group for collaborative research , Patient Research Partner , Amsterdam , The Netherlands
• 3 Rheumatology Department, University of Zurich , University Hospital Zurich , Zurich , Switzerland
• 4 Rheumatology Department , Hospital Universitari de Bellvitge , Barcelona , Spain
• 5 Patient Research Partner , Oslo , Norway
• 6 Patient Research Partner , Bucharest , Romania
• 7 Danish Hospital for Rheumatic Diseases , University Hospital of Southern Denmark , Sønderborg , Denmark
• 8 Rheumatology Division, Department of Medicine(Solna) , Karolinska Institutet , Stockholm , Sweden
• 9 Rheumatology Division, Internal Medicine Department , Medical University of Vienna , Vienna , Austria
• 10 Rheumatology Department , University Hospital Pitié Salpêtrière , Paris , France
• 11 INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique , Sorbonne Université , Paris , France
• Correspondence to Dr Krystel Aouad, Rheumatology Department, Saint George University of Beirut, Saint George Hospital University Medical Center, PO box 166378, Beirut, Lebanon; krystel.aouad{at}hotmail.com

Background Patient research partners (PRPs) are people with a disease who collaborate in a research team as partners. The aim of this systematic literature review (SLR) was to assess barriers and facilitators to PRP involvement in rheumatology research.

Methods The SLR was conducted in PubMed/Medline for articles on PRP involvement in rheumatology research, published between 2017 and 2023; websites were also searched in rheumatology and other specialties. Data were extracted regarding the definition of PRPs, their role and added value, as well as barriers and facilitators to PRP involvement. The quality of the articles was assessed. Quantitative data were analysed descriptively, and principles of thematic content analysis was applied to qualitative data.

Results Of 1016 publications, 53 articles were included; the majority of these studies were qualitative studies (26%), opinion articles (21%), meeting reports (17%) and mixed-methods studies (11%). Roles of PRPs ranged from research partners to patient advocates, advisors and patient reviewers. PRPs were reported/advised to be involved early in the project (32% of articles) and in all research phases (30%), from the conception stage to the implementation of research findings. The main barriers were challenges in communication and support for both PRPs and researchers. Facilitators of PRP involvement included more than one PRP per project, training of PRPs and researchers, a supportive environment for PRPs (including adequate communication, acknowledgement and compensation of PRPs) and the presence of a PRP coordinator.

Conclusion This SLR identified barriers and facilitators to PRP involvement, and was key to updating the European Alliance of Associations for Rheumatology recommendations for PRP–researcher collaboration based on scientific evidence.

• Health services research
• Health-Related Quality Of Life
• Outcome and Process Assessment, Health Care
• Quality Indicators, Health Care

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information. Additional data are available on reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0).

https://doi.org/10.1136/ard-2024-225567

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Patient research partners (PRPs) are increasingly integrated into medical research, particularly in rheumatology.

Major global health organisations recognise the central role of PRPs’ involvement in research.

Previous recommendations have guided researchers and PRPs to build collaborative relations but lack a strong evidence base.

WHAT THIS STUDY ADDS

This systematic literature review provides for the first time a comprehensive overview of the emerging role of PRPs in rheumatology research, emphasising their expanding roles, contributions and the value they bring to the research process.

The review identified key barriers to PRP involvement, ranging from personal factors to challenges in training, communication and collaboration, and also identified strategies to enhance PRP involvement.

Early and sustained involvement of PRPs, as well as a supportive environment and effective communication, were found to be essential to enhance the relevance and impact of PRP contribution to research.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Recognising and addressing the barriers to PRP involvement can lead to better support for PRPs, enhancing their involvement in research.

Some facilitators identified include involvement of PRPs since the early stages of research, a supportive environment for PRPs and encouraging researchers to adopt more flexible strategies and behaviours to maximise the benefit of PRP involvement.

This literature review informed European Alliance of Associations for Rheumatology recommendations, highlighting the importance of active collaboration, training, mutual respect, and transparent communication between PRPs and researchers.

Introduction

Patient research partners (PRPs) are described as individuals living with a health condition who ‘provide input to research, through active collaboration as equal partners with researchers’. 1 Their involvement is essential to make research more patient centred, for instance, by capturing outcomes that matter to patients. Over the past two decades, the magnitude of PRP involvement and their roles in research has grown substantially. 2–8 Patients have transitioned from passive subjects to active collaborators and equal partners, bringing their unique perspectives and valuable insights to the forefront of medical research. 5 This change has not only profoundly modified research practices but has also underscored the integral role PRPs play in shaping the future of medical practice. 9 The importance of PRP involvement in research has become widely recognised as an essential component of high-quality patient care, highlighted by organisations such as the WHO 4 and European Medicine Agency (EMA), 10 and is acknowledged across various medical specialties. 11–13

In rheumatology, this paradigm shift has been significant. In 2011, the European Alliance of Associations for Rheumatology (EULAR) developed recommendations for the involvement of patient representatives in scientific projects based on expert opinion. 14 These recommendations marked a pivotal step, setting the stage for the involvement of PRPs in research projects. Since then, these EULAR recommendations have guided other organisations such as Outcome Measures in Rheumatology (OMERACT), Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and the Foundation for Research in Rheumatology (FOREUM), to recognise the important role of PRPs or to develop their own guidelines for collaborative research. 15–18

As the landscape of patient involvement in research evolves, the literature has witnessed a great surge in data and studies concerning PRP involvement. 2 4 5 15 19–25 These studies not only shed light on the benefits of PRP participation but also highlighted the challenges encountered in this collaborative effort and solutions proposed to overcome barriers. 21 22 25–29

In 2022, EULAR decided to update the 2011 recommendations for PRP involvement in research, focusing specifically on PRPs in the context of chronic conditions. 14 In accordance with the EULAR standardised operational procedures (SOPs) supporting this update, we conducted a systematic literature review (SLR) to inform the EULAR taskforce.

To support the update of the EULAR recommendations, we conducted in 2023 an SLR that encompassed both qualitative and semiquantitative analyses of recent publications in rheumatology, with the goal of identifying factors that affect PRP involvement, including barriers and facilitators.

Literature search

The SLR aimed to identify publications reporting PRP involvement in rheumatology research published between 1 January 2017 and 1 January 2023. We searched the electronic database PubMed MEDLINE using the terms “patient research partner”, “patient expert”, “patient and public involvement (PPI)”, their synonyms and related concepts. Details of the search terms and search strategy can be found in online supplemental table 1 . Two authors (KA, LG) independently assessed the title, abstract and keywords of every publication identified. In the event of disagreement between the reviewers, disparities were discussed and resolved. Additionally, we performed a scoping review of databases to assess PRP involvement and explored six websites from rheumatology: OMERACT, GRAPPA, American College of Rheumatology, EULAR, FOREUM and Osteoarthritis Research Society International. We also searched 2 regulator websites: Food and Drug Administration and EMA, and 10 websites of three selected specialties recognised for significant PRP involvement: cardiology, oncology, endocrinology (diabetes) ( online supplemental table 2 ). A specific search was done in two websites focusing on patient and public involvement: INVOLVE UK by the National Institute for Health Research and Education that empowers (European Patients’ Academy on Therapeutic Innovation), and in orphan diseases to answer specific research questions about training, involvement in grant applications and remuneration of PRPs ( online supplemental table 3 ).

Supplemental material

The scope of the literature search was defined by the EULAR taskforce steering group, 1 and addressed 11 specific research questions ( Box 1 ).

Research topics included in the systematic literature review

1. Definition of patient research partners (PRPs)

How to define a PRP? Is the current definition of PRPs still adequate?

2. Roles and activities undertaken by PRPs

What are the roles and activities of PRPs in rheumatic musculoskeletal disease research?

3. Benefits and added value of PRP involvement for PRPs themselves, researchers, the research itself

What is the added value of PRPs in different types of research and groups?

4. Types of scientific projects that involved PRPs and the stages of the projects in which they participated

What types of projects are (or should) PRPs (be) involved in?

What phases of a project are (or should) PRPs (be) involved in?

5. Selection and recruitment processes for PRPs

How are (or should) PRPs (be) recruited and selected?

How many PRPs are (or should be) involved in the research?

6. Insights into the experiences and feedback provided by PRPs

What are the PRP feedback and experiences, in terms of facilitators and barriers to PRP involvement?

How can we improve the PRP experience and involvement overall?

7. Roles of a coordinator for PRPs in research

Are PRP facilitators involved, if so how, and is it useful?

Is a facilitator/PRP coordinator recommended?

What is the reported usefulness of a facilitator ?

8. Training provided to PRPs or researchers

Do the PRPs involved have a specific training (previously/during the study)?

How should researchers be educated, trained, supported to enhance PRP involvement?

9. Evaluation and monitoring related to PRP involvement

How should PRP involvement be monitored or evaluated? At which time points and by whom?

How should PRP involvement evaluation/monitoring be reported?

10. Recognition, compensation and acknowledgement of PRPs during their involvement in a scientific project

How should PRP involvement be recognised and acknowledged?

Is (should) compensation (be) proposed?

11. Barriers encountered and proposed solutions to enhance PRP involvement

What are the barriers encountered during PRP involvement?

Which strategies and contextual factors enable optimal engagement of PRPs?

Inclusion and exclusion criteria

We included all types of articles reporting PRP involvement in all types of research, including trials and observational studies, qualitative studies, mixed-methods studies and reports of meetings, opinion papers and reviews. We did not exclude published articles from any country, aiming to enhance the generalisability of our findings. Recommendations and guidelines on PRPs were also analysed and were used as supportive information. Articles not focused on rheumatology research or not bringing any information on PRPs (ie, not answering one or more research questions), as well as not in English, were excluded. Articles only mentioning PRPs or their involvement, without providing any details (eg, on their roles, contributions or barriers/facilitators), were excluded as well. Articles with duplicate information (ie, multiple publications reporting on a single study) were excluded if they did not provide additional information relevant to our research questions.

We also identified relevant articles by hand search of the references cited in the included studies, extending the inclusion period to the date of publication of the previous recommendations (2011–2023).

Data extraction

Data collection encompassed both quantitative and qualitative data, addressing various aspects of PRP involvement and providing answers to our research questions ( Box 1 ). Data were extracted and checked independently by two authors (KA and MdW). Discrepancies were resolved by discussion among the core team (KA, MdW, PS, LG).

Quality assessment

Papers were assessed for quality only if they reported original data. Review papers, recommendation papers, opinion papers, case studies, study protocols, report papers and qualitative studies not primarily focused on PRPs were excluded from quality assessment. Given the diversity of study types, we used the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies, literature reviews and cross-sectional studies as described in the EULAR SOP. 30 31 This tool, originally developed for qualitative studies, assesses elements such as the clarity of research aims, appropriateness of methodology, suitability of the research design, adequacy of data collection and clarity in reporting outcomes. For mixed-methods studies, we used the Mixed Methods Appraisal Tool (MMAT, a critical appraisal tool that is designed for the appraisal stage of systematic mixed-studies reviews, that is, reviews that include qualitative, quantitative and mixed-methods studies 32 (see online supplemental tables 4 and 5 for quality assessment). To facilitate interpretation, an overall quality assessment for the level of evidence (LoE) was conducted by evaluating the number of items on the score checklist and on the key items. Subsequently, the authors reached a consensus on classification of the articles’ quality as high, medium or low quality.

This SLR was not considered appropriate by PROSPERO for registration due to the mixed-methods study analyses involved.

Patient and public involvement

This SLR study is the result of a co-production of three PRPs (MdW, CZ, HB) and five researchers, all being members of the EULAR steering committee responsible for updating the EULAR recommendations on PRP involvement. 1 The three PRPs actively contributed to all meetings and discussions within the steering committee. They were involved at the early stage of formulating the research questions until reviewing and agreeing on the final manuscript. They were also actively engaged in planning dissemination and implementation of the study findings within the wider community and patient associations. The recruitment of the PRPs was coordinated by one of the PRPs (MdW), the convenor of the project.

For quantitative data, a descriptive analysis of findings is reported, including characteristics of studies (study design, population, country, study objectives), characteristics of PRPs, selection process of PRPs, type of involvement, phases of the research where their involvement occurred, with numbers and percentages using frequency tables and charts.

The number of PRPs involved in the studies was quantified using two distinct methods: first, coauthorship count: direct examination of the research articles’ authorship lists. PRPs were identified based on explicit mentioning of their role as ‘PRP’ or other specific identification. Second, participation count: this approach assessed the number of broader involvements of PRPs in activities of the research project. For instance, in a GRAPPA meeting report, the number of PRPs who actively participated was counted. 8

Qualitative data were analysed according to the principles of thematic content analysis (more details in online supplemental table 6 ). 33 The results were discussed within the EULAR taskforce, 1 and any disagreements on the interpretation of the findings were resolved by a consensus of the core group (MdW, LG, PS, KA).

Search strategy

The SLR yielded a total of 1016 records of which 941 (92.6%) were excluded based on titles and abstracts. We conducted a full-text screening of 75 papers and 46 (61.3%) were included. The main reasons for exclusion were papers not related to rheumatology, lacking reports of PRP involvement in research, being irrelevant to our research questions, or being duplicates or conference abstracts ( figure 1 ). Additionally, 7 papers were identified by hand search, resulting in a total number of 53 included articles.

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Flow chart of selected article search on PRP involvement in rheumatology research. PRP, patient research partner.

Quality assessment (LoE) of the papers

Nineteen articles were assessed for quality using the predefined scores according to the study type. Overall, 79% (15 of 19) were classified as high quality, 11% (2 of 19) as medium quality and 11% as low quality ( online supplemental table 4 ).

Study characteristics

The included studies were qualitative studies (14 of 53, 26%), opinion articles (11 of 53, 21%), meeting reports (9 of 53, 17%), mixed-methods studies (6 of 53, 11%), recommendation articles (4 of 53, 8%), reviews (SLR or scoping review; 3 of 53, 6%), cross-sectional (2 of 53, 4%), case studies (2 of 53, 4%), observational (1 of 53, 2%) and study protocol (1 of 53, 2%) ( online supplemental tables 4 and 5 ).

Overall, 62% were published in rheumatology journals. Geographically, most of the studies were from Europe (50%), followed by North America (31%).

Identification of barriers encountered and proposed solutions to enhance PRP involvement

Barriers to PRP involvement ( table 1 and online supplemental table 7 ) included emotional and personal factors, communication and relationship challenges, inadequate training and support, difficulties in the research process and pace, as well as collaboration and engagement issues. 2–4 21 22 24–27 34–42 Effective strategies to enhance PRP involvement ( table 1 ) included early involvement, a supportive environment, effective communication and trust, and providing support and training for PRPs and researchers. 7 21 22 26 29 38 40 43 44

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Barriers and strategies to enhance PRP involvement in rheumatology research

Definitions of PRP

Among the 53 included papers, 62% provided a definition of PRP. Importantly, a significant portion (30%) of these papers 4 6 15 26 27 34–36 45 46 adopted the 2011 EULAR definition of PRP as ‘persons with a relevant disease who operate as active research team members on an equal basis with professional researchers, adding the benefit of their experiential knowledge to any phase of the project’. 14 These papers consistently emphasised the importance of active involvement and fostering equal partnerships between PRP and researchers.

Additionally, seven papers (13%) expanded upon this definition by incorporating informal caregivers into the PRP definition, 20 28 37 38 47–49 known as persons, usually family members, who provide unpaid care to someone with whom they share a personal relationship.

The roles and activities of PRPs

The roles and activities of PRPs covered a wide spectrum, extending from research partners to patient advocates, advisory roles and participation as patient reviewers (as detailed in table 2 and online supplemental table 8 ). Their contributions encompassed a diverse range of activities, including providing input in guideline development, shaping research agendas, and actively advocating in scientific and clinical committees.

Activities and roles of PRPs

The added value of PRP involvement

The literature reported that PRPs added significant value across various aspects of research ( table 3 ). Specifically, 53% of the articles indicated that PRP involvement brought benefits for the PRP themselves, that is, better understanding of their medical condition, acquisition of practical skills, improved comprehension of the research process and increased self-confidence. 2 21 25 36 39 Furthermore, 26% of the articles highlighted advantages for the research process, that is, heightened relevance of the research, enhancement of its overall impact and enrichment of the results by adding experiential knowledge. 2 7 21 25 29 36 38 39 45 The positive impact on researchers, reported in 15% of the articles, encompassed deeper insights into research priorities, increased motivation, innovative ideas, awareness of the impact of their work, a comprehensive approach to addressing patients’ needs and improved communication in lay language ( table 3 ). 2 21 25 34 36 38 40 The added value of PRP involvement was also reported as advantageous for the wider community by enhancing the acceptance of research that prioritises community benefits. 2 21 25 36

Articles reporting on added value of PRP involvement in research for PRPs, for researchers and for the research

Types of research that involved PRPs

PRPs were actively involved in a wide range of scientific projects, including basic, translational and clinical research. 50 Although the benefits of PRP involvement were less apparent in basic and translational research, some researchers and PRPs recognised the substantial advantages of collaborative partnerships in this area. 3 25 34 A scoping review highlighted the benefits of PRP engagement in preclinical research, including enhanced understanding of basic science research for PRPs, broadened perspectives for researchers, and positive influence on study questions and methods, along with fostering mutual learning, new collaborations, and improved research quality and efficiency. 40 One study reported that researchers were committed to finding more meaningful ways to integrate PRPs into basic scientific research and dissemination of the project results. 3 Strategies to enhance PRP involvement (ie, training, support, PRP-focused tasks) were also reported. 3

Research phases in which PRP participated

Early involvement of PRPs in the research was reported or recommended in 32% of the included articles, emphasising engaging PRPs from the inception of a research project. 2 19–22 27–29 34 36–38 43 45 47 51 This early engagement was reported to enable PRPs to actively shape research questions and methodologies in line with their priorities. Additionally, 30% of the articles stressed the importance of PRPs’ continuous participation throughout all research stages ( table 4 ). 4 15 21 22 26 35 43 52–54

Articles reporting or recommending PRP involvement in different phases of the research project

Number of PRPs

The number of PRPs involved in research is shown in online supplemental figure 1 . When considering the coauthorship lists, the majority of articles clearly specified the name and identity of PRPs; subsequently, the number of PRPs involved in the writing and reviewing of the article could be easily deducted. Yet, in 19% of cases, the identification of a coauthor as a PRP was unclear. In cases where PRP involvement was explicitly highlighted by coauthorship, 34% of the articles included one or two PRPs per project, 17% of articles included three or four PRPs, and 25% of articles involved more than five PRPs. Notably, single-centre studies commonly involved one or two PRPs as coauthors. One study, which engaged four PRPs, found this number to be beneficial due to the diverse perspectives they brought. 45 Larger-scale international consortia projects recruited a higher number of PRPs, with around six PRPs being identified as an effective group size for facilitating participation and decision-making. 2

On the other hand, when reporting all PRP involvement and activities in a research project, 36% of the articles reported a number of PRP higher than nine ( online supplemental figure 1 ). Therefore, the number of PRPs involved in research can be higher than the number of PRPs mentioned as coauthors.

Selection and recruitment processes for PRPs

The selection process of PRPs was reported in 34% of articles ( figure 2 ). PRP selection criteria were mainly language proficiency (11%), research knowledge (6%), disease diagnosis (9%), communication skills and constructive assertiveness (9%), motivation (8%), educational background (6%), experiential knowledge and expertise (6%) as well as travel capability (4%). 2 3 15 19 21 23 24 27 34 35 55–58 Recruitment methods for PRPs were diverse, relying on patient organisations, marketing companies, rheumatology associations, social media, community outreach, clinic visits, personal connections with patients or researchers, word-of-mouth referrals and volunteering. 2 21 34 38 41 44 53 59 Furthermore, 28% of studies emphasised the importance of clarifying patient roles through clear goal-setting and exchanging mutual expectations early in the project initiation phase. 15 19–21 27 29 36 42 45 47 Additionally, 28% of studies highlighted the need for inclusivity and diverse representation in PRP recruitment. 2 4 15 35 41 42 52

The selection criteria of PRPs reported in the studies. PRP, patient research partner.

Creating a supportive environment for PRPs

A supportive environment for PRPs was reported to depend on several key principles ( table 1 ) 4 19 20 25 36 42 52 53 60 : ensuring a balanced and manageable workload that respects PRP abilities, providing adequate resources and time for PRP involvement, offering support to overcome language barriers, promoting flexibility and offering accessible accommodation to participate in meetings and scientific conferences. 7 21 38 40 43 44 Equal relationships and co-leadership between PRPs and researchers were cited in several papers as crucial, emphasising mutual respect, trust, and open, transparent communication. 7 15 19 Building strong team communication, and establishing informal personal relationships between PRPs and researchers were also found to be important factors to enhance collaboration. 20 38 47 Regular feedback and discussions about the quality of collaboration, combined with ongoing adjustments to meet the needs and preferences of PRPs, were proposed in two papers. 34 45

Roles of a PRP coordinator

A PRP ‘coordinator’ was defined in some papers, as an individual or a role within a research team responsible for facilitating and supporting the collaboration between researchers and PRPs. 2 20 25 47 61 The presence of a PRP coordinator was reported or advised in 29% of the included articles. 2 3 19 28 34 35 40 42 44 48 61 PRP coordinators were reported to be helpful in facilitating effective communication among PRPs, researchers and stakeholders, aligning expectations, organising logistics, moderating group discussions, providing ongoing education and support, and assisting in the recruitment and selection of PRPs in projects ( table 5 ). 2 20 25 35 36 42 47 This role was reported to be taken by a member of the research team, a PRP or a designated person within a patient organisation or academic institution. 2 38

Potential roles of a PRP coordinator

Training of researchers

We found that 34% of the included articles included in the SLR reported or advised training or education of researchers. 4 7 19 21 25 28 29 38–40 44 Researchers could receive training concerning various aspects of working with PRPs ( table 6 ).

Reported training content for researchers and PRPs

Training of PRPs

Educating and training PRPs was proposed in many papers to enhance the quality of their collaboration with researchers. Notably, nearly half of the publications emphasised the importance of training, with 21% recommending it and 25% providing it. 25 28 29 35 37 45 51 62–64 PRP training and support included various aspects ( table 6 ). Training of PRPs was reported to foster well-prepared and empowered PRPs ready to engage effectively in research collaborations. 22 26 29

Evaluation and monitoring related to PRP involvement

Around 21% of the included publications recommended or reported some form of evaluation, 3 4 15 19–21 25 34 35 with 28% collecting feedback from PRPs on their involvement. Regular discussions and evaluations of the quality and impact of PRPs’ collaboration and contributions were reported to enhance understanding, satisfaction and impact, allowing for adjustments and improvements as needed. 4 5 37 60 Some tools were reported for monitoring such as the Patient-Centered Outcomes Research Institute conceptual framework, an evaluative framework for research engagement, 19 surveys to evaluate the impact of PRPs in the project, 3 26 the Public Involvement Impact Assessment Framework Guidance, 53 and the Guidance for Reporting Involvement of Patients and the Public. 25 34

Recognition, compensation and acknowledgement of PRPs

Recognising, compensating and acknowledging the contributions of PRPs during their involvement in a scientific project were reported to be essential components of equal and meaningful partnerships. 27

In the context of recognition, coauthorship was cited as proof of PRP involvement and equality in research collaborations. 5 39 The SLR revealed a growing trend in recognising PRPs through coauthorship in 68% of articles, 2–6 8 15 19–21 23–26 28 29 34 36–40 42 43 45 47–50 52 54 56 58 60 63 65 and acknowledgement in 45% of articles. 3 6 7 25 27 28 34 37 43–45 48 51 53 56–61 63 65–67

Compensation refers to the payment of salary, wages, honorarium, fees or allowances for the time commitment and expertise of PRPs; this is different from reimbursing PRPs for expenses (eg, travel expenses and accommodation). 49 Non-compensation for PRPs was reported as a limitation and challenge for their effective involvement. 4 While PRPs can opt out of payment, several papers reported that researchers should consider compensation in their budget planning. 2 39 49 Some articles advised that institutions should simplify processes for fair PRP payment, and funders should enable researchers to allocate resources for PRP involvement. 5

The role of PRPs in rheumatology research has significantly expanded over recent years. The findings of this SLR underscore the important roles and contributions of PRPs in research projects, and the added value of PRP involvement, not only in clinical research, but also in basic, translational, registry and longitudinal observational studies. This review also highlighted current challenges and barriers, and pulled together proposals of strategies to overcome them.

The exact definition and roles of PRPs remain unclear for some researchers. A wide proportion of the reviewed studies had adopted the 2011 EULAR definition of PRP which reflects the global acknowledgement of the importance of PRP involvement in rheumatology research and the need for specific recommendations. 14 PRPs hold a crucial position in recognising and actively integrating the patient perspective, their voice and needs into research decision-making processes. Diverse roles and activities were undertaken by PRPs in this SLR, from research partners to patient advocates, reflecting the many ways PRPs can contribute. Their involvement, as evident in recent papers shaping research priorities, guideline development, and scientific and clinical committees, suggests a trend towards more inclusive and patient-centred research practices.

Our review revealed specific barriers and challenges in communication, training, research processes and collaboration. These challenges highlight difficulties in communication and relationship dynamics during research, the necessity for training and support for both PRPs and researchers, concerns about the research process and its pace, and obstacles in PRP collaboration, including issues of recognition and diversity. Inclusivity and diversity are important topics for future research. To address these challenges effectively, targeted strategies such as fostering open communication, creating a supportive environment, ensuring early and sustained involvement, using a PRP coordinator and providing appropriate training and support for PRPs and researchers are crucial. These findings underscore the ongoing need for refining and implementing these strategies to enhance PRP involvement more efficiently. 26

A key observation from the SLR is the importance of early and sustained PRP involvement in research projects. Engaging PRPs from the research project’s inception ensures that research questions and methodologies are aligned with patients’ priorities and perspectives right from the start. Sustained involvement further reinforces the trust and collaboration between PRPs and researchers, leading to research outcomes that are more relevant and impactful. The OMERACT recommendations proposed that the level and timing of PRP involvement should vary based on the scope and type of project, emphasising adaptability as a key factor for successful involvement. 15

Evaluation and monitoring are also integral aspects of PRP involvement. This ongoing reflection and feedback process is vital for fostering effective and meaningful PRP involvement in research. Recognition, compensation and acknowledgement of PRPs stand as key elements for fostering a meaningful partnership. Coauthorship serves not only to document the PRP’s contribution but also reinforces the idea of collaborative research. Of note, we observed disparity between the involvement of PRPs in research activities versus their acknowledgement as coauthors. This disparity may arise from some PRPs not prioritising or desiring coauthorship, or being unable to participate in producing and writing a research paper due to health-related challenges such as disease flare-ups or fatigue. In ensuring equitable recognition, a collective effort is essential to guarantee that PRPs receive due acknowledgement and compensation for their valuable contributions to scientific research.

Our study has strengths and weaknesses. One important strength of this SLR is that the findings will equip researchers, healthcare professionals and other stakeholders with evidence-based solutions to improve PRP involvement in medical research. To this end, the findings have supported the process of updating the EULAR recommendations for PRP involvement and made them more evidence based. 1 Another strength is the obtention of a more nuanced understanding of the challenges and complexities surrounding PRP involvement in rheumatology research. Furthermore, our study stands out for its comprehensive approach, analysing a broad spectrum of study types, including quantitative and qualitative studies, reviews, opinion pieces and information from websites. The inclusion of various rheumatic musculoskeletal disease conditions, encompassing both paediatric and adult populations, enhances the robustness of our findings. Another notable strength lies in the co-production of this work by three PRPs. The project was initiated and led by a PRP (MdW) who gave the work direction, participated in article screening, article analysis, overall interpretation and manuscript writing. The two other PRPs brought important insights into PRP roles, facilitators and barriers.

A limitation of the study might be the heterogeneity of the included papers. Because of the expected limited reporting of PRP involvement in rheumatology research, we decided to include a diversity of papers in the SLR, varying from qualitative studies, case studies and original research papers to conference reports and opinion articles. This heterogeneity did not allow for any form of meta-analysis, nor for identifying themes that would benefit individual groups of PRPs such as people with rare diseases, children or young adults, or people with different cultural or ethnic backgrounds. Furthermore, quality assessments could not be uniformly applied across all study types. It is important to note that the traditional evidence hierarchy may not be applicable to this SLR, given the expected absence of randomised controlled studies. Despite this, certain papers were assessed to be of high quality of evidence within their respective study types. While the systematic approach ensured a comprehensive gathering of data, there might be relevant grey literature or non-English-language publications that were not included. Another limitation might be the time period of the last 6 years, including data from articles published between January 2017 and January 2023. This time frame was chosen to reflect studies performed after the 2011 EULAR recommendations were published, taking into account the implementation time gap. 14 Furthermore, the chosen time span resulted in 53 articles which was deemed sufficient for gathering relevant data related to our research questions.

In conclusion, this SLR identified numerous publications reporting on PRP involvement in rheumatology research. Most authors reported that PRP involvement not only enriches the research process but also ensures that research outcomes are more relevant, meaningful and patient centred. However, for this involvement to be genuinely effective, it is essential to address the barriers and challenges that PRPs and researchers are facing. By updating the EULAR 2011 recommendations, based on the findings of this SLR, we can look forward to a future where research is more inclusive, collaborative, and aligned with patient needs and perspectives.

Ethics statements

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Ethics approval

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Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1
• Data supplement 2

Handling editor Kimme L Hyrich

X @krystelaouad, @Stiddyo, @LGossec

Contributors All authors have contributed to this work and approved the final version. KA, MDW and LG accept full responsibility for the work and/or the conduct of thestudy, had access to the data and controlled the decision to publish.

Funding Funded by EULAR grant RES005.

Competing interests KA—research grant (EULAR grant RES005); over the last 3 years, research grants from UCB; consulting fees from Novartis. MdW—over the last 3 years, Stichting Tools has received fees for lectures or consultancy provided by MdW from UCB. ME—congress travel support from Janssen and AstraZeneca outside of the submitted work. DB—research grants from Novartis; speakers bureau from AbbVie, BMS, Galapagos, Janssen and Lilly; consulting fees from Pfizer, Sandoz and UCB. PS—speakers bureau from AstraZeneca; consulting fees from AbbVie; travel support from Janssen and Galapagos. LG—research grants from AbbVie, Biogen, Lilly, Novartis and UCB; consulting fees from AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz and UCB.

Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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