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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

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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.

How To Write An A-Grade Literature Review

3 straightforward steps (with examples) + free template.

By: Derek Jansen (MBA) | Expert Reviewed By: Dr. Eunice Rautenbach | October 2019

Quality research is about building onto the existing work of others , “standing on the shoulders of giants”, as Newton put it. The literature review chapter of your dissertation, thesis or research project is where you synthesise this prior work and lay the theoretical foundation for your own research.

Long story short, this chapter is a pretty big deal, which is why you want to make sure you get it right . In this post, I’ll show you exactly how to write a literature review in three straightforward steps, so you can conquer this vital chapter (the smart way).

Overview: The Literature Review Process

• Understanding the “ why “
• Finding the relevant literature
• Cataloguing and synthesising the information
• Outlining & writing up your literature review
• Example of a literature review

But first, the “why”…

Before we unpack how to write the literature review chapter, we’ve got to look at the why . To put it bluntly, if you don’t understand the function and purpose of the literature review process, there’s no way you can pull it off well. So, what exactly is the purpose of the literature review?

Well, there are (at least) four core functions:

• For you to gain an understanding (and demonstrate this understanding) of where the research is at currently, what the key arguments and disagreements are.
• For you to identify the gap(s) in the literature and then use this as justification for your own research topic.
• To help you build a conceptual framework for empirical testing (if applicable to your research topic).
• To inform your methodological choices and help you source tried and tested questionnaires (for interviews ) and measurement instruments (for surveys ).

Most students understand the first point but don’t give any thought to the rest. To get the most from the literature review process, you must keep all four points front of mind as you review the literature (more on this shortly), or you’ll land up with a wonky foundation.

Okay – with the why out the way, let’s move on to the how . As mentioned above, writing your literature review is a process, which I’ll break down into three steps:

• Finding the most suitable literature
• Understanding , distilling and organising the literature
• Planning and writing up your literature review chapter

Importantly, you must complete steps one and two before you start writing up your chapter. I know it’s very tempting, but don’t try to kill two birds with one stone and write as you read. You’ll invariably end up wasting huge amounts of time re-writing and re-shaping, or you’ll just land up with a disjointed, hard-to-digest mess . Instead, you need to read first and distil the information, then plan and execute the writing.

Step 1: Find the relevant literature

Naturally, the first step in the literature review journey is to hunt down the existing research that’s relevant to your topic. While you probably already have a decent base of this from your research proposal , you need to expand on this substantially in the dissertation or thesis itself.

Essentially, you need to be looking for any existing literature that potentially helps you answer your research question (or develop it, if that’s not yet pinned down). There are numerous ways to find relevant literature, but I’ll cover my top four tactics here. I’d suggest combining all four methods to ensure that nothing slips past you:

Method 1 – Google Scholar Scrubbing

Google’s academic search engine, Google Scholar , is a great starting point as it provides a good high-level view of the relevant journal articles for whatever keyword you throw at it. Most valuably, it tells you how many times each article has been cited, which gives you an idea of how credible (or at least, popular) it is. Some articles will be free to access, while others will require an account, which brings us to the next method.

Method 2 – University Database Scrounging

Generally, universities provide students with access to an online library, which provides access to many (but not all) of the major journals.

So, if you find an article using Google Scholar that requires paid access (which is quite likely), search for that article in your university’s database – if it’s listed there, you’ll have access. Note that, generally, the search engine capabilities of these databases are poor, so make sure you search for the exact article name, or you might not find it.

Method 3 – Journal Article Snowballing

At the end of every academic journal article, you’ll find a list of references. As with any academic writing, these references are the building blocks of the article, so if the article is relevant to your topic, there’s a good chance a portion of the referenced works will be too. Do a quick scan of the titles and see what seems relevant, then search for the relevant ones in your university’s database.

Method 4 – Dissertation Scavenging

Similar to Method 3 above, you can leverage other students’ dissertations. All you have to do is skim through literature review chapters of existing dissertations related to your topic and you’ll find a gold mine of potential literature. Usually, your university will provide you with access to previous students’ dissertations, but you can also find a much larger selection in the following databases:

• Open Access Theses & Dissertations
• Stanford SearchWorks

Keep in mind that dissertations and theses are not as academically sound as published, peer-reviewed journal articles (because they’re written by students, not professionals), so be sure to check the credibility of any sources you find using this method. You can do this by assessing the citation count of any given article in Google Scholar. If you need help with assessing the credibility of any article, or with finding relevant research in general, you can chat with one of our Research Specialists .

Alright – with a good base of literature firmly under your belt, it’s time to move onto the next step.

Need a helping hand?

Step 2: Log, catalogue and synthesise

Once you’ve built a little treasure trove of articles, it’s time to get reading and start digesting the information – what does it all mean?

While I present steps one and two (hunting and digesting) as sequential, in reality, it’s more of a back-and-forth tango – you’ll read a little , then have an idea, spot a new citation, or a new potential variable, and then go back to searching for articles. This is perfectly natural – through the reading process, your thoughts will develop , new avenues might crop up, and directional adjustments might arise. This is, after all, one of the main purposes of the literature review process (i.e. to familiarise yourself with the current state of research in your field).

As you’re working through your treasure chest, it’s essential that you simultaneously start organising the information. There are three aspects to this:

• Logging reference information
• Building an organised catalogue
• Distilling and synthesising the information

I’ll discuss each of these below:

2.1 – Log the reference information

As you read each article, you should add it to your reference management software. I usually recommend Mendeley for this purpose (see the Mendeley 101 video below), but you can use whichever software you’re comfortable with. Most importantly, make sure you load EVERY article you read into your reference manager, even if it doesn’t seem very relevant at the time.

2.2 – Build an organised catalogue

In the beginning, you might feel confident that you can remember who said what, where, and what their main arguments were. Trust me, you won’t. If you do a thorough review of the relevant literature (as you must!), you’re going to read many, many articles, and it’s simply impossible to remember who said what, when, and in what context . Also, without the bird’s eye view that a catalogue provides, you’ll miss connections between various articles, and have no view of how the research developed over time. Simply put, it’s essential to build your own catalogue of the literature.

I would suggest using Excel to build your catalogue, as it allows you to run filters, colour code and sort – all very useful when your list grows large (which it will). How you lay your spreadsheet out is up to you, but I’d suggest you have the following columns (at minimum):

• Author, date, title – Start with three columns containing this core information. This will make it easy for you to search for titles with certain words, order research by date, or group by author.
• Categories or keywords – You can either create multiple columns, one for each category/theme and then tick the relevant categories, or you can have one column with keywords.
• Key arguments/points – Use this column to succinctly convey the essence of the article, the key arguments and implications thereof for your research.
• Context – Note the socioeconomic context in which the research was undertaken. For example, US-based, respondents aged 25-35, lower- income, etc. This will be useful for making an argument about gaps in the research.
• Methodology – Note which methodology was used and why. Also, note any issues you feel arise due to the methodology. Again, you can use this to make an argument about gaps in the research.
• Quotations – Note down any quoteworthy lines you feel might be useful later.
• Notes – Make notes about anything not already covered. For example, linkages to or disagreements with other theories, questions raised but unanswered, shortcomings or limitations, and so forth.

If you’d like, you can try out our free catalog template here (see screenshot below).

2.3 – Digest and synthesise

Most importantly, as you work through the literature and build your catalogue, you need to synthesise all the information in your own mind – how does it all fit together? Look for links between the various articles and try to develop a bigger picture view of the state of the research. Some important questions to ask yourself are:

• What answers does the existing research provide to my own research questions ?
• Which points do the researchers agree (and disagree) on?
• How has the research developed over time?
• Where do the gaps in the current research lie?

To help you develop a big-picture view and synthesise all the information, you might find mind mapping software such as Freemind useful. Alternatively, if you’re a fan of physical note-taking, investing in a large whiteboard might work for you.

Step 3: Outline and write it up!

Once you’re satisfied that you have digested and distilled all the relevant literature in your mind, it’s time to put pen to paper (or rather, fingers to keyboard). There are two steps here – outlining and writing:

3.1 – Draw up your outline

Having spent so much time reading, it might be tempting to just start writing up without a clear structure in mind. However, it’s critically important to decide on your structure and develop a detailed outline before you write anything. Your literature review chapter needs to present a clear, logical and an easy to follow narrative – and that requires some planning. Don’t try to wing it!

Naturally, you won’t always follow the plan to the letter, but without a detailed outline, you’re more than likely going to end up with a disjointed pile of waffle , and then you’re going to spend a far greater amount of time re-writing, hacking and patching. The adage, “measure twice, cut once” is very suitable here.

In terms of structure, the first decision you’ll have to make is whether you’ll lay out your review thematically (into themes) or chronologically (by date/period). The right choice depends on your topic, research objectives and research questions, which we discuss in this article .

Once that’s decided, you need to draw up an outline of your entire chapter in bullet point format. Try to get as detailed as possible, so that you know exactly what you’ll cover where, how each section will connect to the next, and how your entire argument will develop throughout the chapter. Also, at this stage, it’s a good idea to allocate rough word count limits for each section, so that you can identify word count problems before you’ve spent weeks or months writing!

PS – check out our free literature review chapter template…

3.2 – Get writing

With a detailed outline at your side, it’s time to start writing up (finally!). At this stage, it’s common to feel a bit of writer’s block and find yourself procrastinating under the pressure of finally having to put something on paper. To help with this, remember that the objective of the first draft is not perfection – it’s simply to get your thoughts out of your head and onto paper, after which you can refine them. The structure might change a little, the word count allocations might shift and shuffle, and you might add or remove a section – that’s all okay. Don’t worry about all this on your first draft – just get your thoughts down on paper.

Once you’ve got a full first draft (however rough it may be), step away from it for a day or two (longer if you can) and then come back at it with fresh eyes. Pay particular attention to the flow and narrative – does it fall fit together and flow from one section to another smoothly? Now’s the time to try to improve the linkage from each section to the next, tighten up the writing to be more concise, trim down word count and sand it down into a more digestible read.

Once you’ve done that, give your writing to a friend or colleague who is not a subject matter expert and ask them if they understand the overall discussion. The best way to assess this is to ask them to explain the chapter back to you. This technique will give you a strong indication of which points were clearly communicated and which weren’t. If you’re working with Grad Coach, this is a good time to have your Research Specialist review your chapter.

Finally, tighten it up and send it off to your supervisor for comment. Some might argue that you should be sending your work to your supervisor sooner than this (indeed your university might formally require this), but in my experience, supervisors are extremely short on time (and often patience), so, the more refined your chapter is, the less time they’ll waste on addressing basic issues (which you know about already) and the more time they’ll spend on valuable feedback that will increase your mark-earning potential.

Literature Review Example

In the video below, we unpack an actual literature review so that you can see how all the core components come together in reality.

Let’s Recap

In this post, we’ve covered how to research and write up a high-quality literature review chapter. Let’s do a quick recap of the key takeaways:

• It is essential to understand the WHY of the literature review before you read or write anything. Make sure you understand the 4 core functions of the process.
• The first step is to hunt down the relevant literature . You can do this using Google Scholar, your university database, the snowballing technique and by reviewing other dissertations and theses.
• Next, you need to log all the articles in your reference manager , build your own catalogue of literature and synthesise all the research.
• Following that, you need to develop a detailed outline of your entire chapter – the more detail the better. Don’t start writing without a clear outline (on paper, not in your head!)
• Write up your first draft in rough form – don’t aim for perfection. Remember, done beats perfect.
• Refine your second draft and get a layman’s perspective on it . Then tighten it up and submit it to your supervisor.

Psst… there’s more!

This post is an extract from our bestselling Udemy Course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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

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

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

Download Word doc Download Google doc

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

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

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

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

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

Search for relevant sources

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

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

You can use boolean operators to help narrow down your search:

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

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

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

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

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

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

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

You can use our free APA Reference Generator for quick, correct, consistent citations.

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

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

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

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

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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

As you write, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, 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 transitions and topic sentences to draw connections, comparisons and contrasts.

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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

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

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

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

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

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

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• v.9(7); 2013 Jul

Ten Simple Rules for Writing a Literature Review

Marco pautasso.

1 Centre for Functional and Evolutionary Ecology (CEFE), CNRS, Montpellier, France

2 Centre for Biodiversity Synthesis and Analysis (CESAB), FRB, Aix-en-Provence, France

Literature reviews are in great demand in most scientific fields. Their need stems from the ever-increasing output of scientific publications [1] . For example, compared to 1991, in 2008 three, eight, and forty times more papers were indexed in Web of Science on malaria, obesity, and biodiversity, respectively [2] . Given such mountains of papers, scientists cannot be expected to examine in detail every single new paper relevant to their interests [3] . Thus, it is both advantageous and necessary to rely on regular summaries of the recent literature. Although recognition for scientists mainly comes from primary research, timely literature reviews can lead to new synthetic insights and are often widely read [4] . For such summaries to be useful, however, they need to be compiled in a professional way [5] .

When starting from scratch, reviewing the literature can require a titanic amount of work. That is why researchers who have spent their career working on a certain research issue are in a perfect position to review that literature. Some graduate schools are now offering courses in reviewing the literature, given that most research students start their project by producing an overview of what has already been done on their research issue [6] . However, it is likely that most scientists have not thought in detail about how to approach and carry out a literature review.

Reviewing the literature requires the ability to juggle multiple tasks, from finding and evaluating relevant material to synthesising information from various sources, from critical thinking to paraphrasing, evaluating, and citation skills [7] . In this contribution, I share ten simple rules I learned working on about 25 literature reviews as a PhD and postdoctoral student. Ideas and insights also come from discussions with coauthors and colleagues, as well as feedback from reviewers and editors.

Rule 1: Define a Topic and Audience

How to choose which topic to review? There are so many issues in contemporary science that you could spend a lifetime of attending conferences and reading the literature just pondering what to review. On the one hand, if you take several years to choose, several other people may have had the same idea in the meantime. On the other hand, only a well-considered topic is likely to lead to a brilliant literature review [8] . The topic must at least be:

• interesting to you (ideally, you should have come across a series of recent papers related to your line of work that call for a critical summary),
• an important aspect of the field (so that many readers will be interested in the review and there will be enough material to write it), and
• a well-defined issue (otherwise you could potentially include thousands of publications, which would make the review unhelpful).

Ideas for potential reviews may come from papers providing lists of key research questions to be answered [9] , but also from serendipitous moments during desultory reading and discussions. In addition to choosing your topic, you should also select a target audience. In many cases, the topic (e.g., web services in computational biology) will automatically define an audience (e.g., computational biologists), but that same topic may also be of interest to neighbouring fields (e.g., computer science, biology, etc.).

Rule 2: Search and Re-search the Literature

After having chosen your topic and audience, start by checking the literature and downloading relevant papers. Five pieces of advice here:

• keep track of the search items you use (so that your search can be replicated [10] ),
• keep a list of papers whose pdfs you cannot access immediately (so as to retrieve them later with alternative strategies),
• use a paper management system (e.g., Mendeley, Papers, Qiqqa, Sente),
• define early in the process some criteria for exclusion of irrelevant papers (these criteria can then be described in the review to help define its scope), and
• do not just look for research papers in the area you wish to review, but also seek previous reviews.

The chances are high that someone will already have published a literature review ( Figure 1 ), if not exactly on the issue you are planning to tackle, at least on a related topic. If there are already a few or several reviews of the literature on your issue, my advice is not to give up, but to carry on with your own literature review,

The bottom-right situation (many literature reviews but few research papers) is not just a theoretical situation; it applies, for example, to the study of the impacts of climate change on plant diseases, where there appear to be more literature reviews than research studies [33] .

• discussing in your review the approaches, limitations, and conclusions of past reviews,
• trying to find a new angle that has not been covered adequately in the previous reviews, and
• incorporating new material that has inevitably accumulated since their appearance.

When searching the literature for pertinent papers and reviews, the usual rules apply:

• be thorough,
• use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and
• look at who has cited past relevant papers and book chapters.

Rule 3: Take Notes While Reading

If you read the papers first, and only afterwards start writing the review, you will need a very good memory to remember who wrote what, and what your impressions and associations were while reading each single paper. My advice is, while reading, to start writing down interesting pieces of information, insights about how to organize the review, and thoughts on what to write. This way, by the time you have read the literature you selected, you will already have a rough draft of the review.

Of course, this draft will still need much rewriting, restructuring, and rethinking to obtain a text with a coherent argument [11] , but you will have avoided the danger posed by staring at a blank document. Be careful when taking notes to use quotation marks if you are provisionally copying verbatim from the literature. It is advisable then to reformulate such quotes with your own words in the final draft. It is important to be careful in noting the references already at this stage, so as to avoid misattributions. Using referencing software from the very beginning of your endeavour will save you time.

Rule 4: Choose the Type of Review You Wish to Write

After having taken notes while reading the literature, you will have a rough idea of the amount of material available for the review. This is probably a good time to decide whether to go for a mini- or a full review. Some journals are now favouring the publication of rather short reviews focusing on the last few years, with a limit on the number of words and citations. A mini-review is not necessarily a minor review: it may well attract more attention from busy readers, although it will inevitably simplify some issues and leave out some relevant material due to space limitations. A full review will have the advantage of more freedom to cover in detail the complexities of a particular scientific development, but may then be left in the pile of the very important papers “to be read” by readers with little time to spare for major monographs.

There is probably a continuum between mini- and full reviews. The same point applies to the dichotomy of descriptive vs. integrative reviews. While descriptive reviews focus on the methodology, findings, and interpretation of each reviewed study, integrative reviews attempt to find common ideas and concepts from the reviewed material [12] . A similar distinction exists between narrative and systematic reviews: while narrative reviews are qualitative, systematic reviews attempt to test a hypothesis based on the published evidence, which is gathered using a predefined protocol to reduce bias [13] , [14] . When systematic reviews analyse quantitative results in a quantitative way, they become meta-analyses. The choice between different review types will have to be made on a case-by-case basis, depending not just on the nature of the material found and the preferences of the target journal(s), but also on the time available to write the review and the number of coauthors [15] .

Rule 5: Keep the Review Focused, but Make It of Broad Interest

Whether your plan is to write a mini- or a full review, it is good advice to keep it focused 16 , 17 . Including material just for the sake of it can easily lead to reviews that are trying to do too many things at once. The need to keep a review focused can be problematic for interdisciplinary reviews, where the aim is to bridge the gap between fields [18] . If you are writing a review on, for example, how epidemiological approaches are used in modelling the spread of ideas, you may be inclined to include material from both parent fields, epidemiology and the study of cultural diffusion. This may be necessary to some extent, but in this case a focused review would only deal in detail with those studies at the interface between epidemiology and the spread of ideas.

While focus is an important feature of a successful review, this requirement has to be balanced with the need to make the review relevant to a broad audience. This square may be circled by discussing the wider implications of the reviewed topic for other disciplines.

Rule 6: Be Critical and Consistent

Reviewing the literature is not stamp collecting. A good review does not just summarize the literature, but discusses it critically, identifies methodological problems, and points out research gaps [19] . After having read a review of the literature, a reader should have a rough idea of:

• the major achievements in the reviewed field,
• the main areas of debate, and
• the outstanding research questions.

It is challenging to achieve a successful review on all these fronts. A solution can be to involve a set of complementary coauthors: some people are excellent at mapping what has been achieved, some others are very good at identifying dark clouds on the horizon, and some have instead a knack at predicting where solutions are going to come from. If your journal club has exactly this sort of team, then you should definitely write a review of the literature! In addition to critical thinking, a literature review needs consistency, for example in the choice of passive vs. active voice and present vs. past tense.

Rule 7: Find a Logical Structure

Like a well-baked cake, a good review has a number of telling features: it is worth the reader's time, timely, systematic, well written, focused, and critical. It also needs a good structure. With reviews, the usual subdivision of research papers into introduction, methods, results, and discussion does not work or is rarely used. However, a general introduction of the context and, toward the end, a recapitulation of the main points covered and take-home messages make sense also in the case of reviews. For systematic reviews, there is a trend towards including information about how the literature was searched (database, keywords, time limits) [20] .

How can you organize the flow of the main body of the review so that the reader will be drawn into and guided through it? It is generally helpful to draw a conceptual scheme of the review, e.g., with mind-mapping techniques. Such diagrams can help recognize a logical way to order and link the various sections of a review [21] . This is the case not just at the writing stage, but also for readers if the diagram is included in the review as a figure. A careful selection of diagrams and figures relevant to the reviewed topic can be very helpful to structure the text too [22] .

Rule 8: Make Use of Feedback

Reviews of the literature are normally peer-reviewed in the same way as research papers, and rightly so [23] . As a rule, incorporating feedback from reviewers greatly helps improve a review draft. Having read the review with a fresh mind, reviewers may spot inaccuracies, inconsistencies, and ambiguities that had not been noticed by the writers due to rereading the typescript too many times. It is however advisable to reread the draft one more time before submission, as a last-minute correction of typos, leaps, and muddled sentences may enable the reviewers to focus on providing advice on the content rather than the form.

Feedback is vital to writing a good review, and should be sought from a variety of colleagues, so as to obtain a diversity of views on the draft. This may lead in some cases to conflicting views on the merits of the paper, and on how to improve it, but such a situation is better than the absence of feedback. A diversity of feedback perspectives on a literature review can help identify where the consensus view stands in the landscape of the current scientific understanding of an issue [24] .

Rule 9: Include Your Own Relevant Research, but Be Objective

In many cases, reviewers of the literature will have published studies relevant to the review they are writing. This could create a conflict of interest: how can reviewers report objectively on their own work [25] ? Some scientists may be overly enthusiastic about what they have published, and thus risk giving too much importance to their own findings in the review. However, bias could also occur in the other direction: some scientists may be unduly dismissive of their own achievements, so that they will tend to downplay their contribution (if any) to a field when reviewing it.

In general, a review of the literature should neither be a public relations brochure nor an exercise in competitive self-denial. If a reviewer is up to the job of producing a well-organized and methodical review, which flows well and provides a service to the readership, then it should be possible to be objective in reviewing one's own relevant findings. In reviews written by multiple authors, this may be achieved by assigning the review of the results of a coauthor to different coauthors.

Rule 10: Be Up-to-Date, but Do Not Forget Older Studies

Given the progressive acceleration in the publication of scientific papers, today's reviews of the literature need awareness not just of the overall direction and achievements of a field of inquiry, but also of the latest studies, so as not to become out-of-date before they have been published. Ideally, a literature review should not identify as a major research gap an issue that has just been addressed in a series of papers in press (the same applies, of course, to older, overlooked studies (“sleeping beauties” [26] )). This implies that literature reviewers would do well to keep an eye on electronic lists of papers in press, given that it can take months before these appear in scientific databases. Some reviews declare that they have scanned the literature up to a certain point in time, but given that peer review can be a rather lengthy process, a full search for newly appeared literature at the revision stage may be worthwhile. Assessing the contribution of papers that have just appeared is particularly challenging, because there is little perspective with which to gauge their significance and impact on further research and society.

Inevitably, new papers on the reviewed topic (including independently written literature reviews) will appear from all quarters after the review has been published, so that there may soon be the need for an updated review. But this is the nature of science [27] – [32] . I wish everybody good luck with writing a review of the literature.

Acknowledgments

Many thanks to M. Barbosa, K. Dehnen-Schmutz, T. Döring, D. Fontaneto, M. Garbelotto, O. Holdenrieder, M. Jeger, D. Lonsdale, A. MacLeod, P. Mills, M. Moslonka-Lefebvre, G. Stancanelli, P. Weisberg, and X. Xu for insights and discussions, and to P. Bourne, T. Matoni, and D. Smith for helpful comments on a previous draft.

Funding Statement

This work was funded by the French Foundation for Research on Biodiversity (FRB) through its Centre for Synthesis and Analysis of Biodiversity data (CESAB), as part of the NETSEED research project. The funders had no role in the preparation of the manuscript.

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The structure of a literature review

A literature review should be structured like any other essay: it should have an introduction, a middle or main body, and a conclusion.

Introduction

The introduction should:

• define your topic and provide an appropriate context for reviewing the literature;
• establish your reasons – i.e. point of view – for
• reviewing the literature;
• explain the organisation – i.e. sequence – of the review;
• state the scope of the review – i.e. what is included and what isn’t included. For example, if you were reviewing the literature on obesity in children you might say something like: There are a large number of studies of obesity trends in the general population. However, since the focus of this research is on obesity in children, these will not be reviewed in detail and will only be referred to as appropriate.

The middle or main body should:

• organise the literature according to common themes;
• provide insight into the relation between your chosen topic and the wider subject area e.g. between obesity in children and obesity in general;
• move from a general, wider view of the literature being reviewed to the specific focus of your research.

The conclusion should:

• summarise the important aspects of the existing body of literature;
• evaluate the current state of the literature reviewed;
• identify significant flaws or gaps in existing knowledge;
• outline areas for future study;
• link your research to existing knowledge.

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

Article   PubMed   Google Scholar  

Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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How to Build a Literature Review

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Structure of a Literature Review

Preliminary steps for literature review.

• Basic Example
• More Examples

What is a Literature Review?

A literature review is a comprehensive summary and analysis of previously published research on a particular topic. Literature reviews should give the reader an overview of the important theories and themes that have previously been discussed on the topic, as well as any important researchers who have contributed to the discourse. This review should connect the established conclusions to the hypothesis being presented in the rest of the paper.

What a Literature Review Is Not:

• Annotated Bibliography: An annotated bibliography summarizes and assesses each resource individually and separately. A literature review explores the connections between different articles to illustrate important themes/theories/research trends within a larger research area. 
• Timeline: While a literature review can be organized chronologically, they are not simple timelines of previous events. They should not be a list of any kind. Individual examples or events should be combined to illustrate larger ideas or concepts.
• Argumentative Paper: Literature reviews are not meant to be making an argument. They are explorations of a concept to give the audience an understanding of what has already been written and researched about an idea. As many perspectives as possible should be included in a literature review in order to give the reader as comprehensive understanding of a topic as possible.

Why Write a Literature Review?

After reading the literature review, the reader should have a basic understanding of the topic. A reader should be able to come into your paper without really knowing anything about an idea, and after reading the literature, feel more confident about the important points.

A literature review should also help the reader understand the focus the rest of the paper will take within the larger topic. If the reader knows what has already been studied, they will be better prepared for the novel argument that is about to be made.

A literature review should help the reader understand the important history, themes, events, and ideas about a particular topic. Connections between ideas/themes should also explored. Part of the importance of a literature review is to prove to experts who do read your paper that you are knowledgeable enough to contribute to the academic discussion. You have to have done your homework.

A literature review should also identify the gaps in research to show the reader what hasn't yet been explored. Your thesis should ideally address one of the gaps identified in the research. Scholarly articles are meant to push academic conversations forward with new ideas and arguments. Before knowing where the gaps are in a topic, you need to have read what others have written.

As mentioned in other tabs, literature reviews should discuss the big ideas that make up a topic. Each literature review should be broken up into different subtopics. Each subtopic should use groups of articles as evidence to support the ideas. There are several different ways of organizing a literature review. It will depend on the patterns one sees in the groups of articles as to which strategy should be used. Here are a few examples of how to organize your review:

Chronological

If there are clear trends that change over time, a chronological approach could be used to organize a literature review. For example, one might argue that in the 1970s, the predominant theories and themes argued something. However, in the 1980s, the theories evolved to something else. Then, in the 1990s, theories evolved further. Each decade is a subtopic, and articles should be used as examples. 

Themes/Theories

There may also be clear distinctions between schools of thought within a topic, a theoretical breakdown may be most appropriate. Each theory could be a subtopic, and articles supporting the theme should be included as evidence for each one. 

If researchers mainly differ in the way they went about conducting research, literature reviews can be organized by methodology. Each type of method could be a subtopic,  and articles using the method should be included as evidence for each one.

• Define your research question
• Compile a list of initial keywords to use for searching based on question
• Search for literature that discusses the topics surrounding your research question
• Assess and organize your literature into logical groups
• Identify gaps in research and conduct secondary searches (if necessary)
• Reassess and reorganize literature again (if necessary)
• Write review

Here is an example of a literature review, taken from the beginning of a research article. You can find other examples within most scholarly research articles. The majority of published scholarship includes a literature review section, and you can use those to become more familiar with these reviews.

Source:  Perceptions of the Police by LGBT Communities

There are many books and internet resources about literature reviews though most are long on how to search and gather the literature. How to literally organize the information is another matter.

Some pro tips:

• Be thoughtful in naming the folders, sub-folders, and sub, sub-folders.  Doing so really helps your thinking and concepts within your research topic.
• Be disciplined to add keywords under the tabs as this will help you search for ALL the items on your concepts/topics.
• Use the notes tab to add reminders, write bibliography/annotated bibliography
• Your literature review easily flows from your statement of purpose (SoP).  Therefore, does your SoP say clearly and exactly the intent of your research?  Your research assumption and argument is obvious?
• Begin with a topic outline that traces your argument. pg99: "First establish the line of argumentation you will follow (the thesis), whether it is an assertion, a contention, or a proposition.
• This means that you should have formed judgments about the topic based on the analysis and synthesis of the literature you are reviewing."
• Keep filling it in; flushing it out more deeply with your references

Other Resources/Examples

• ISU Writing Assistance The Julia N. Visor Academic Center provides one-on-one writing assistance for any course or need. By focusing on the writing process instead of merely on grammar and editing, we are committed to making you a better writer.
• University of Toronto: The Literature Review Written by Dena Taylor, Health Sciences Writing Centre
• Purdue OWL - Writing a Lit Review Goes over the basic steps
• UW Madison Writing Center - Review of Literature A description of what each piece of a literature review should entail.
• USC Libraries - Literature Reviews Offers detailed guidance on how to develop, organize, and write a college-level research paper in the social and behavioral sciences.
• Creating the literature review: integrating research questions and arguments Blog post with very helpful overview for how to organize and build/integrate arguments in a literature review
• Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your “House” Article focusing on constructing a literature review for a dissertation. Still very relevant for literature reviews in other types of content.

A note that many of these examples will be far longer and in-depth than what's required for your assignment. However, they will give you an idea of the general structure and components of a literature review. Additionally, most scholarly articles will include a literature review section. Looking over the articles you have been assigned in classes will also help you.

• Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your “House” Excellent article detailing how to construct your literature review.
• Sample Literature Review (Univ. of Florida) This guide will provide research and writing tips to help students complete a literature review assignment.
• Sociology Literature Review (Univ. of Hawaii) Written in ASA citation style - don't follow this format.
• Sample Lit Review - Univ. of Vermont Includes an example with tips in the footnotes.

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How to Structure Your Literature Review - Quick Guide with Examples

Table of Contents

A literature review is a process of reviewing the existing scholarly literature based on a specific topic. It is one of the critical components of your own research paper. By conducting a thorough literature review, you will get a synopsis of the relevant methods, theories, and research gaps of the existing research on the related topic.

However, writing a good literature review is not as easy as it sounds. It requires rigorous research and extensive exploration of hundreds of journal articles to land on the pertinent information. So, it’s essential to learn the components of a literature review structure before you start writing one.

That’s why this article exists — to help you understand how to structure a literature review in a research paper. Read through the article to get the gist of the components used and how to structure them.

Role of literature review structure in research

Why do you think structuring your literature review is crucial in your research? It plays a significant role in organizing and presenting the research evidence and information effectively to the readers.

A well-structured literature review ensures clarity and coherence in the research which enables readers to follow the logical flow of ideas. It helps researchers to logically present their arguments and findings, making it easier for readers to comprehend the research's context and contribution.

Furthermore, it aids in identifying relationships between diverse studies, identifying key themes, and highlighting any research gaps. In fact, one of the prominent reasons why the proper format of a literature review is important is that it provides a framework for the researchers to present their ideas in a systematic and organized sequence.

Overall, a well structured literature review provides a roadmap for readers to navigate through the existing research or existing knowledge. By clearly indicating the main sections and sub-sections of the research, readers can easily locate the information they are interested in.

It is essential for researchers who are conducting a literature review to gain an overview of a specific topic or to find relevant studies and build a concrete framework for their research.

When should I structure my literature review?

Writing and structuring a literature review imparts the required knowledge to the readers only when you do it at the right time. So, be sure to map out the structure after you conduct a thorough literature review of the existing sources.

You should structure the review once you’re done with reading and digesting the research papers and before you start writing your thesis, dissertation, or research paper. It bridges the gap between reviewing literature and writing a research paper.

In simpler words, once you’ve comprehended the existing literature and gained enough knowledge of the theories, key concepts, and research gaps of your study or topic, you will be in a position to map out a literature review structure. It gives you a boost to set the stage for your research paper writing. Once the structure is ready, you can reiterate or restructure it based on the flow of your research work.

Tip: Use SciSpace Literature Review to compare and contrast multiple research papers on a single screen, saving a significant amount of time. And to comprehend the research papers easily, utilize Copilot which explains even the most complicated nomenclature and context in the simplest way possible. Above all, these tools support 75+ languages making your literature review and research paper reading a breeze.

How to structure a literature review?

A literature review is also one of the chapters or sections in your research paper. The structure varies from one study to another depending on diverse factors. However, a typical structure of a literature review has 3 main parts — an introduction, a body, and a conclusion. Let's get into them in detail.

a) Introduction of the literature review

The literature review introduction should give the readers an overview of what will you cover in the study and how the study is correlated. Ideally, it should provide the outline of your research and also explain the scope of your literature review. The introduction section is the most suitable segment to share your stance or perspective about the research topic and gently convey your contributions to the field through this study.

Since it happens to be the first paragraph, you must include and define its purpose, organization, and critical aspects of your research project.

Your introduction should give the following relevant background information to the readers:

• The “why” of the review? — should provide a reason for why you’re writing the review
• The “takeaway” of the review? — should portray the importance of the research
• Articulate the topics covered in the research in a sequential manner
• “What” of the review? — scope of the review
• How or where your topic is aligned with the niche or subject area

b) Body of the literature reviews

The format and structure of the central body part are of utmost importance in writing a good literature review.. This is the section where you summarize, synthesize, analyze, and critically evaluate your research work. Therefore, you must use sections and subsections to divide the body for each methodological approach or theme aspect of further research.

In this part, you will have to organize and present your discussion in a clear and coherent manner. There are different types of structural approaches to adhere to while organizing the main body part of the literature review. Let’s explore the types based on the length and format of your review.

i) Chronological literature reviews

The chronological approach to building literature review format has been described as one of the most straightforward approaches. It helps you articulate the growth and development of the research topic over time in chronological order.

However, do not restrict yourself to just making a list or summarizing the reference resources. Instead, write a brief discussion and analysis of the critical arguments, research, and trends that have shaped the current status of your research topic.

Additionally, you must provide an interpretation of these events in your curated version. This approach gives you a space to discuss the latest developments, key debates, trends, and gaps focused on your research topic.

Example: Locoregional Management of Breast Cancer: A Chronological Review This chronological review discusses the evolution of locoregional management through some key clinical trials and aims to highlight important points in the time period in which the evidence was generated and emphasize the 10-year outcomes for the comparability of results. Source: SciSpace

ii) Thematic literature review

The thematic literature review is the best way to structure your literature review based on the theme or category of your research. The format of a literature review is structured in sections and sub-sections based on the observed themes or patterns in your review.

Every part stays dedicated to presenting a different aspect of your chosen topic. For example, if you’re working on a topic of climatic conditions in Nigeria, you might find themes such as monsoon climate, tropical savannah climate, and so on. Unlike the chronological approach, the primary focus here is on different aspects of a particular topic, or issue instead of the progression of certain events. Example: A Thematic Review of Current Literature Examining Evidence-Based Practices and Inclusion

This paper provides a thematic summary of current literature combining the topics of evidence-based practices (EBPs) and inclusive settings and summarizes key findings from 27 peer-reviewed articles written in English and published between 2012-2022.

Source: SciSpace

iii) Methodological literature review

The methodological approach helps you formulate the structure of a literature review based on the research methodologies used. These methodologies could be qualitative, quantitative, or mixed. You can present your literature review structure in a form by showing a comparison between crucial findings, gatherings, and outcomes from different research methods.

If you’re working on research derived from different disciplines and methodologies, this approach would be more suitable to structure your literature review. This method majorly focuses on the type of analysis method used in the research (quantitative, qualitative, and mixed).

Example: Methodological review to develop a list of bias items used to assess reviews incorporating network meta-analysis: protocol and rationale

The methodological review aims to develop a list of items relating to biases in reviews with NMA, which will inform a new tool to assess the risk of bias in NMAs, and potentially other reporting or quality checklists for NMAs that are being updated.

iv) Theoretical literature review

Theoretical literature reviews are often used to discuss and analyze vital concepts and theories. Adopting this approach such a way that, you can significantly put forth the relevance and critical findings of a particular field or theoretical method. Proceeding in the same way, you can also outline an entirely new research framework.

Example: Theoretical Review Study: Peran Dan Fungsi Mutu Pelayanan Kesehatan Di Rumah Sakit

This paper analyzes various theories on the role and function of quality management in hospitals, where the authors investigate how the role and functions of the quality of health services in hospitals.

c) Conclusion of the literature review

The conclusion of your literature review must be focused on your key findings, and their results, and an elaborate emphasis on the significance of all aspects. Describing the research gaps and your contributions can be helpful in case you are writing a dissertation or thesis.

Moreover, you must specify the procedure and research methodology for developing the framework of your research topic. Additionally, if the relevant literature review is a standalone assignment for you, present the conclusion centered on the implications and suggestions for future references.

Lastly, you must ensure that your research paper does not lack any critical aspects and must not contain any grammatical or spelling mistakes. For this, you must proofread and edit it to perfection.

Overall, your conclusion should provide the reader with the following information:

• Provide an overview of the literature review.
• Highlight key areas for future research on the topic.
• Establish a connection between the review and your research.

Tip: Keep this checklist handy before writing your literature review!

• Outline the purpose and scope of the study
• Identify relevant and credible scholarly sources (research papers/literature)
• Use AI tools to streamline the literature review process
• Capture the bibliographical details of the sources
• Analyze and interpret the findings
• Identify research gaps in the literature
• Investigate methodologies/theories/hypotheses
• Brainstorm and research multiple standpoints
• Craft an introduction, a body, and a conclusion
• Final proofreading and all set!!

Wrapping up!

If you are working on your thesis, ensure to emphasize structuring your literature reviews and be keen in presenting it in a clear, coherent, and organized manner. The structure of a literature review is critical as it assists researchers in building upon existing knowledge, creating a theoretical framework, identifying relationships between studies, highlighting key concepts, and guiding readers through the research.

Scientific research can be made more accessible, informative, and impactful by structuring the literature review according to the different types of approaches discussed in this blog.

Frequently Asked Questions

When conducting a literature review, it's important to avoid:

1.Disorganization: Keep your review structured and coherent.

2.Lack of alignment: Ensure that your review aligns with your research objectives and questions.

3.Lack of synthesis: Connect and integrate the findings from different sources rather than presenting them in isolation.

Common challenges we encounter while organizing a literature review include:

1.Managing an exhaustive volume of scientific publications.

2.Ensuring coherence and flow between different sections.

3.Striving to maintain objectivity and relevance to your research topic.

When structuring a literature review, you should avoid including irrelevant or outdated sources, biased information, and repetitive content.

No, a literature review is typically not arranged in alphabetical order. Instead, it's usually organized thematically, chronologically, or by relevance to the research topic.

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Types of Literature Review — A Guide for Researchers

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Literature Review

• Getting Started
• Framing the Literature Review

Literature Review Process

• Mistakes to Avoid & Additional Help

The structure of a literature review should include the following :

• 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 of 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)?
• 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/least convincing?
• Value  -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

Development of the Literature Review

Four stages:.

• Introduce the reader to the importance of the topic being studied . The reader is oriented to the significance of the study and the research questions or hypotheses to follow.
• Places the problem into a particular context  that defines the parameters of what is to be investigated.
• Provides the framework for reporting the results  and indicates what is probably necessary to conduct the study and explain how the findings will present this information.
• Literature search -- finding materials relevant to the subject being explored.
• Evaluation of resources  -- determining which literature makes a significant contribution to the understanding of the topic.
• Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review:

Sources and expectations.  if your assignment is not very specific about what form your literature review should take, seek clarification from your professor by asking these questions:.

• Roughly how many sources should I include?
• What types of sources should I review (books, journal articles, websites)?
• Should I summarize, synthesize, or critique your sources by discussing a common theme or issue?
• Should I evaluate the sources?
• Should I provide subheadings and other background information, such as definitions and/or a history?

Find Models.   When reviewing the current literature, examine how authors in your discipline or area of interest have organized their literature reviews. Read not only for information, but also to get a sense of the types of themes you might want to look for in your own research review.

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., consider whether your sources are current and applicable.  s ome disciplines require that you use information that is as current as possible. this is very common in the sciences where research conducted only two years ago could be obsolete. however, when writing a review in the social sciences, a survey of the history of the literature may be what is needed because what is important is how perspectives have changed over the years or within a certain time period. try sorting through some 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 consider what is consider by scholars to be a "hot topic" and what is not., follow the bread crumb trail.  the bibliography or reference section of sources you read are excellent entry points for further exploration. you might find resourced listed in a bibliography that points you in the direction you wish to take your own research., ways to organize your literature review, chronologically:  .

If your review follows the chronological method, you could write about the materials according to when they were published or the time period they cover.

By Publication:  

Order your sources chronologically by publication date, 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.

Conceptual Categories:

The literature review is organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in 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 will still be organized chronologically reflecting technological developments in media. The only difference here between a "chronological" and a "thematic" approach is what is emphasized the most.

Methodological:  

A methodological approach focuses on the methods utilized by the researcher.  A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Sections of Your Literature Review:  

Once you've decided on the organizational method for your literature review, the sections you need to include should be easy to figure out because they arise from your organizational strategy.

Here are examples of other sections you may need to include depending on the type of review you write:

• Current Situation : information necessary to understand the topic or focus of the literature review.
• History : the chronological progression of the field, the 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 : the 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 articles and journals.
• Standards : 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?

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 in this sense is just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence to show 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.

Use Quotes Sparingly:  

Some short quotes are okay if you want to emphasize a point, or if what the author said just cannot be rewritten in your own words. Sometimes you may need to quote certain terms that were coined by the author, not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute your own summary and interpretation of the literature.

Summarize and Synthesize:  

Remember to summarize and synthesize your sources within each 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 their own work.

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.

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Explore different methods on how to structure your literature review.

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• Dissertations & Theses

There is no single, conventional way to structure a literature review. However, there are a range of standard approaches that you can choose from to give your literature review an overall shape. The structure you select will depend on the aims and purpose of your literature review as well as the literature that exists.

The function of your literature review

Every literature review needs to show how the research problem you’re investigating arose, and give a critical overview of how it, or aspects of it, have been addressed by other researchers to date. However, within that overall purpose, the particular function of your literature review may vary, depending on your own research aim, the current state of knowledge in the field, and the amount and breadth of literature that currently exists. For example:

• If there is a large, longstanding body of research already in your field, the function of your might be to give an overview of how it evolved, to show how you build on it and sit within it.
• If there is very little research on your topic or it’s cutting edge, the function of your literature review might be to look at why it’s been overlooked til now, and piece together a useful basis out of comparable work in related fields.
• If your research is interdisciplinary, drawing on and bringing together different strands of the literature in new ways, the function of your literature review might be to identify and connect these previously unrelated strands.
• If your own research takes a clear stance on a contested topic, the function of your literature review might be to outline why the issue is problematic and the different sides of a debate
• If there are various ways you might approach your research or your approach is new, then an overview of the different ways other people have addressed similar research problems might help justify your method.

General approaches

There are four general approaches to structuring a literature review, depending on the main relationship you are creating between the texts you are reviewing, and how they serve your research aims.

The Sequential approach

This approach is useful if your central aim is to:

• Chart the developments in your chosen field in a way that highlights causality and consequence (for instance, how one piece of research informed or gave rise to another and so on)
• Use a chronological sequence to demonstrate how an issue or research area has evolved over time

Thematic approach

Sometimes, your literature review might aim to bring together previously unrelated areas of research, and there is no linear structure to that relationship – you simply identify the different themes under which you want to organise it, depending on which texts you want to talk about as a group. You might choose to arrange your review into different themes, contexts, schools of thought, subject disciplines, or by methods, theories and approaches.

Funnel approach

The funnel structure moves from the broad to the detailed, the general to the specific, or from the abstract to the concrete. So you start with the broader aspects of your topic (the contextual background, for instance) and then gradually narrow your focus until you reach the specific aspect of the topic that you will be addressing. You might equally be looking at the more abstract, theoretical work on your subject before moving to more concrete case studies in which those approaches have been applied, or more general treatments to more detailed and smaller scale studies. That way, you are guiding your reader and helping them build their understanding of your topic: providing them with the background information and context they need in order to grasp your main ideas.

Mixed approach

Often, your literature review has more than one function and there is more than one key point you want to convey. For instance, you may need to define your theoretical framework, evaluate how other researchers have approached your topic more generally, then outline your specific area of focus and how it relates to the existing literature. Your finished literature review will then comprise different sub-sections that each achieve a particular aim.

Deciding on a structure

When deciding on a structure, you might find it useful to consider the following questions:

• What is the function of my literature review?
• What do I want my literature review to demonstrate to the reader? What do I want them to take away from it?
• What structure would best allow me to achieve my purpose and get my key points across, talking about the texts I want to bring together without circling around in my writing?

Whichever of these strucutural principles you decide on as a way to organise the whole literature review, you may well be using others of them as a way to structure subsections or even paragraphs. For example, you might be using a thematic approach overall, but each section could be structured chronologically.

Checking in

Each structural approach or option has its own strengths and weaknesses. It’s important to check in with yourself and review your literature review drafts periodically to see if your structure is working for you. Is it helping you convey your main ideas, bring together the texts you want to talk about together, or is it leading you to be descriptive, repetitive or lose sight of the literature’s relevance to your own research? If not, is there another option that might work better for you? Sometimes, our main ideas and key points don’t become clear to us until we start writing. So it may be that you are better placed to make a more informed idea about your structure once you have begun trying it out.

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Structuring a literature review.

Explore different methods on how to structure your literature review. **PDF Download**

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Structuring a literature review

To decide how to structure your literature review, it's helpful to first of all consider its purpose and what it is that you want to argue about the strengths and weaknesses of existing research. Having an argument about the literature is vital; the absence of an argument means that you'll simply be summarising what others have said about your research topic uncritically. Make it clear to readers how your research fits within the literature and the nature of your contribution to furthering knowledge (whether it builds on what others have already done or challenges exisiting understandings and approaches).

Considering the purpose and argument / key message of your literature review helps you to focus your review on what's relevant and needs to be covered, what's unnecessary and therefore can be excluded, and it can help you to decide how to sequence your ideas. If your purpose is to persuade your readers of your project's value and contribution to the field, and your argument is that there is a gap in the field that your research fills, then your structure should lead the readers logically to this conclusion. 

Like any other chapter, a literature review chapter or section should have an introduction that tells the reader what your argument is. Knowing your argument upfront can help your reader to understand why you are leading them through your selected bodies of literature and concepts.

After the introduction, a literature review often moves broadly from what is well known in the field and narrows down to what is less well known, which is where your research gap or issue is located. Your literature review may draw on different bodies of literature and show how they are relevant and are connected. To work out how best to order your discussion, consider the following questions.

• Which bodies of literature have the broadest or most narrow scope?
• Which bodies of literature are most commonly used in the field/s?
• Which concepts are most widely agreed upon?
• What are the strengths and weaknesses of the commonly used literature, and which of these does my study build on?
• What is the less well known literature that my study relates to?
• Are there studies / aspects of the literature that are minor or tangential within the field/s, but are important to my study?
• How can I convince my readers that this is a worthwhile area to investigate?
• If drawing on literature from different fields, how are they connected? Why am I connecting them?
• What are the studies that are the closest to mine? What are the strengths and weaknesses of these studies?
• What are the common themes in the literature? Can I sequence them from the most common themes down to the themes that are closely connected to my study?

One useful way to plan the structure of your literature review is to brainstorm, draw, and / or do a mind-map. Identify how the different concepts and bodies of literature fit together and how your study builds on them. This can show you logical ways to put your literature review together, as well as give you some ideas about how you can explain to your readers how the various parts fit together. You can also try to explain your literature review structure to someone who knows little about the field, to test whether it is clear and logical.

Language of literature reviews>>

Literature reviews

Purpose of traditional literature reviews

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A Step-by-Step Guide to Writing a Stellar Literature Review (with Help from AI)

Table of contents

Aren’t all of us mini versions of Sherlock Holmes when browsing data and archives for a research piece? As we go through the process, a comprehensive literature review is an essential toolkit to make your research shine.

A literature review consists of scholarly sources that validate the content. Its primary objective is to offer a concise summary of the research and to let you explore relevant theories and methodologies. Through this review, you can identify gaps in the existing research and bridge them with your contribution. 

The real challenge is how to write an excellent literature review. Let’s learn.

What is the purpose of a literature review?

A literature review is an introduction to your research. It helps you put your perspective to the table, along with a summary of the theme.

What does my literature review communicate?

• Explanation of your research: how the information was collected, the research method, the justification of the chosen data sources, and an overview of the data analysis.
• Framework: the journey from where the concept began and how it is presented.
• Connects the previous and current research: 

It presents the broader scope of your research by connecting it to the existing data and debates and underlining how your content fits the prevailing studies. 

In an era of information overload, a literature review must be well-structured. 

Let’s learn all about the structure and style of a literature review that’ll help you strengthen your research.

Literature review– structure and style

Begin with a question and end it with the solution– the key to structuring a literature review. It resembles an essay’s format, with the first paragraph introducing the readers to the topic and the following explaining the research in-depth.

The conclusion reiterates the question and summarizes the overall insights of your research. There’s no word count restriction. —it depends on the type of research. For example, a dissertation demands lengthy work, whereas a short paper needs a few pages. 

In a literature review, maintaining high quality is vital, with a focus on academic writing style. Informal language should be avoided in favor of a more formal tone. 

The content avoids contractions, clearly differentiating between previous and current research through the use of past and present tense. Wordtune assists in establishing a formal tone, enhancing your work with pertinent suggestions. This AI-powered tool ensures your writing remains genuine, lucid, and engaging. 

The option of refining the tonality offers multiple possibilities for rephrasing a single sentence. Thus, pick the best and keep writing.

Get Wordtune for free > Get Wordtune for free >

Your friendly step-by-step guide to writing a literary review (with help from AI)

Do you find it challenging to begin the literature review? Don’t worry! We’re here to get you started with our step-by-step guide.

1. Narrow down the research scope

Simply begin with the question: What am I answering through my research?

Whether it’s cooking or painting, the real challenge is the prep-up for it rather than performing the task. Once you’re done, it smoothly progresses. Similarly, for your literature review, prepare the groundwork by narrowing down the research scope.

Browse and scoop out relevant data inclining well with your research. While you can’t cover every aspect of your research, pick a topic that isn’t too narrow nor too broad to keep your literature review well-balanced. 

2. Hunt relevant literature

The next question: Does this data align with the issue I’m trying to address?

As you review sources of information, hunt out the best ones. Determine which findings help in offering a focused insight on your topic. The best way to pick primary sources is to opt for the ones featured in reliable publications. You can also choose secondary sources from other researchers from a reasonable time frame and a relevant background.

For example, if your research focuses on the Historical Architecture of 18th-century Europe, the first-hand accounts and surveys from the past would hold more weight than the new-age publications. 

3. Observe the themes and patterns in sources

Next comes: What is the core viewpoint in most of the research? Has it stayed constant over time, or have the authors differed in their points of view?

Ensure to scoop out the essential aspects of what each source represents. Once you have collected all this information, combine it and add your interpretations at the end. This process is known as synthesis.

Synthesize ideas by combining arguments, findings and forming your new version.

4. Generate an outline

The next question: How can I organize my review effectively? When navigating multiple data sources, you must have noticed a structure throughout the research. Develop an outline to make the process easier. An outline is a skeletal format of the review, helping you connect the information more strategically.

Here are the three different ways to organize an outline– Chronologically, Thematically, or by Methodology.You can develop the outline chronologically, starting from the older sources and leading to the latest pieces. Another way of organizing is to thematically divide the sections and discuss each under the designated sub-heading.

You can even organize it per the research methods used by the respective authors. The choice of outline depends on the subject. For example, in the case of a science paper, you can divide the information into sections like introduction, types of equipment, method, procedure, findings, etc. In contrast, it’s best to present it in divisions based on timelines like Ancient, Middle Ages, Industrial revolutions, etc., for a history paper.

If you’re confused about how to structure the data, work with Wordtune. 

With the Generate with AI feature, you can mention your research topic and let Wordtune curate a comprehensive outline for your study.

Having a precise prompt is the key to getting the best results.

5. Start filling!

Your next question must be: Am I ready to compose all the parts of the literature review?

Once you’re ready with the basic outline and relevant sources, start filling in the data. Go for an introductory paragraph first to ensure your readers understand the topic and how you will present it. Ensure you clearly explain the section in the first sentence.

However, if beginning from the first paragraph seems intimidating, don’t worry! Add the main body content to the sub-headings, then jump to the introduction. 

Add headings wherever possible to make it more straightforward and guide your readers logically through different sources. Lastly, conclude your study by presenting a key takeaway and summarizing your findings. To make your task easier, work with Wordtune. It helps align your content with the desired tone and refine the structure.

6. Give attention to detail and edit

The last question: Am I satisfied with the language and content written in the literature review? Is it easy to understand?

Once you’re done writing the first draft of a literature review, it’s time to refine it. Take time between writing and reading the draft to ensure a fresh perspective. It makes it easier to spot errors when you disconnect from the content for some time. Start by looking at the document from a bird's eye to ensure the formatting and structure are in order. 

After reviewing the content format, you must thoroughly check your work for grammar, spelling, and punctuation. One of the best approaches to editing and proofreading is to use Wordtune . It helps simplify complex sentences, enhance the content quality, and gain prowess over the tonality.

The dos and don’ts of writing a literature review

Writing a stellar literature review requires following a few dos and don'ts. Just like Sherlock Holmes would never overlook a hint, you must pay attention to every minute detail while writing a perfect narrative. To help you write, below are some dos and don'ts to remember.

Composing a literature review demands a holistic research summary, each part exhibiting your understanding and approach. As you write the content, make sure to cover the following points:

• Keep a historical background of the field of research. Highlight the relevant relation between the old studies and your new research.
• Discuss the core issue, question, and debate of your topic.
• Theories lay the foundation of research. While you’re writing a literature review, make sure to add relevant concepts and ideas to support your statements.
• Another critical thing to keep in mind is to define complex terminologies. It helps the readers understand the content with better clarity. 

Examples of comprehensive literature reviews

Aren’t good examples the best way to understand a subject? Let’s look into a few examples of literature reviews and analyze what makes them well-written.

1. Critical Thinking and Transferability: A Review of the Literature (Gwendolyn Reece)

An overview of scholarly sources is included in the literature review, which explores critical thinking in American education. The introduction stating the subject’s importance makes it a winning literature review. Following the introduction is a well-defined purpose that highlights the importance of research.

As one keeps reading, there is more clarity on the pros and cons of the research. By dividing information into parts with relevant subheadings, the author breaks a lengthy literature review into manageable chunks, defining the overall structure.

Along with other studies and presented perspectives, the author also expresses her opinion. It is presented with minimal usage of ‘I,’ keeping it person-poised yet general. Toward the conclusion, the author again offers an overview of the study. A summary is further strengthened by presenting suggestions for future research as well. 

2. The Use of Technology in English Language Learning: A Literature Review

This literature review is thematically organized on how technology affects language acquisition. The study begins with an introduction to the topic with well-cited sources. It presents the views of different studies to help readers get a sense of different perspectives. After giving these perspectives, the author offers a personalized opinion.

One of the critical aspects that makes this a good literature review is a dedicated paragraph for definitions. It helps readers proceed further with a clear understanding of the crucial terminologies. There’s a comparison of the modern and previous studies and approaches to give an overall picture of the research.

Once the main body is composed, the author integrates recommendations for action-based tips. Thus, the literature review isn’t just summarizing the sources but offering actions relevant to the topics. Finally, the concluding paragraph has a brief overview with key takeaways.

Wordtune: your writing buddy!

A literature review demands the right balance of language and clarity. You must refine the content to achieve a formal tone and clear structure. Do you know what will help you the most? Wordtune !. 

The real-time grammar checker leaves no scope for errors and lets you retain precision in writing. This writing companion is all you need for stress-free working and comprehensive literature review development.

Let the narrative begin

A literary review isn't just about summarizing sources; it's about seamlessly bringing your perspective to the table. Always remember to set a narrative for added interest and a brilliant composition. With structure and style being the pillars of a stellar literature review, work with Wordtune to ensure zero compromises on the quality.

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Literature reviews: structure.

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Structure your Work

Uncertain about how to structure your literature review? Have a look at this revelatory video by Dr Jodie Salter and the University of Guelph. 

Video Link:  Writing the Literature Review: A Banquet Hall Analogy  

Structure of a literature review

A literature review should have an introduction, main body and a conclusion.

As shown in the video, above, the body should NOT be organised author by author (for that, there are annotated bibliographies ). Instead, it should be organised by topic (normally, from general background to specific aspects of the subject your dissertation is dealing with). Some paragraphs can be organised chronologically (for example outlining the development of an idea throughout time), by method, by sector, or other criteria.  

Introduction 

This should be a paragraph that can include some of the following: 

Outlining the scope of your literature review – sources, topics to be discussed / the aims of your review. 

Where/how does your topic fit into the wider subject area. 

Why the topic is important- is it an area of current interest/significance? 

Highlight the relevant issues or debates that have characterised your field of research. 

Has the topic been widely researched? Or not? 

Signposting for the reader, explaining the organisation / sequence of topics covered in the review. 

Provide strong sentences at beginnings of paragraphs: every paragraph shall deal with a topic or make a point.  

Signpost, showing the direction of your writing, and indicating your critical take on the sources you present.  

Use you own voice to comment on and evaluate the literature. 

Identify gaps in the literature.  

Write "so what" summary sentences throughout the review to help the reader understand how the sections of your review are relevant to your research. 

Use language to show confidence or caution, as appropriate: e.g. There is clearly a link... OR This suggests a possible link... 

Avoid "he/she said...": always name the authors. Vary the reporting words. See the guide on  Academic Voice and Language  for more guidance on logic, signposting, reporting words etc.  

Conclusion 

State how your literature review has met the review aim(s) outlined in the introduction. 

Summarise and synthesise the main issues/themes that the literature review has presented in relation to your topic area and research questions. 

If the literature review is part of a dissertation, underline the gaps identified in the literature. This provides a rationale for your chosen dissertation topic. 

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The literature review structure and function

Part 4: Chapter 14

Questions to consider

A. Why is a literature review also referred to as the background or introduction of a paper?

B. What are the functions of a literature review?

C. What is the primary objective of a literature review?

No matter how the literature review is organized (e.g. chronologically, thematically), it follows a standard format: introduction, body, conclusion.  The introduction to the literature review contains a statement or statements about the overall topic of consideration. This might be a paragraph or section that lets the reader know what the literature review will address. Occasionally, writers describe how the literature review will be organized (for example, what main points are going to be dealt with and in what order). Like a methods section, search criteria (keywords, databases, journals) are sometimes identified this section; they may be discussed in the conclusion as well or not attended to.

An introduction to an introduction

The purpose of the introduction to the literature review is to lead the reader through the body and the main points to the ultimate message of the work. The introduction will achieve several goals.

• Define or identify the general topic, issue, or area of concern thereby providing an appropriate context and a historical frame of reference for the remainder of the review.
• Indicate overall trends in what has been previously published on the topic; refer to a landmark or seminal study; or reveal conflicts in theory, methodology, evidence, conclusions, or gaps in research and scholarship.
• Establish the objective for reviewing this research (point of view); explain the criteria used to select the reviewed material; the organization of the review (sequence); and – if necessary – why certain literature either is or is not included (scope).
• Demonstrate how ensuing research either closes a gap in the literature, extends earlier work, or replicates an important study thereby contributing new knowledge to the field.

The body of the literature review

Written information is commonly presented logically, from general to specific, showing how past research relates to a proposed project (for literature reviews that serve as the background or introduction to a research proposal or paper).  Information should be deliberately organized following an obvious progression of ideas (e.g. chronologically, following the development of a research topic) with consistent support from acceptable sources.

This is where a strong synthesis works to illustrate the value of the writer’s contribution and to persuade the reader. To that end, citing two or more sources for a single point demonstrates its strength or general acceptability.

The use of a formal academic voice should be consistently maintained, and the content should be  focused and objective. Author contribution should illustrate important strengths and weaknesses of research studies as well as contradictions and inconsistent findings. Implications and suggestions for further research, or where there are gaps in the current literature, should be specific, original and a logical conclusion based on the sources deployed as evidence.

Strong conclusions

The conclusion often summarizes the major points of the literature review, discusses implications, and reveals an area for future or further research needed. This is where the proportion of writer contribution is often higher and there is relatively less cited source material.

The conclusion will often

• clearly define the topic or issue for an informed audience;
• provide a complete and exhaustive overview of relevant literature;
• be focused throughout;
• critically and consistently evaluate and synthesize extant information;
• present information logically and accurately;
• be relevant and objective; and
• accurately cite all references using one citation style or system.

Documenting the support

The reference list of publications used in a literature review serves two purposes. First, it provides the reader with a means to evaluate the quality of the research. Second, accurately and correctly citing all the sources used protects the author from possible accusations of plagiarism. Using the words or ideas of others without referencing the source is a very serious academic offense.

The reference list reflects the thoroughness of the review. It also allows others to retrieve the cited publications. Errors made in authors’ names, journal or article titles, page numbers and dates present barriers to retrieval of articles and prevent attributing credit to authors for their work. Each reference should be checked carefully for errors. Every in-text citation must have a listing in the references and every title in the reference list should connect to an in-text citation. [1]

Exercise #1

Read the following brief literature review from Attending lectures in person, hybrid or online—how do students choose, and what about the outcome? and complete an simple inventory of it by answering these questions:

• What is the topic and how is it relevant?
• How many unique sources are used?
• How many citations are there?
• What ideas do the authors contribute on this topic?
• What can readers expect from the rest of the article?

Introduction 1 The COVID-19 pandemic has occasionally been viewed as one of the biggest experiments in education (Tomas & Rogers, 2020; Dunrong & Jin, 2020).  2 This might be a misnomer, since “experiment” implies some sort of controlled conditions, while arguably, educational settings were largely controlled by fluctuating, external factors.  3 “Disruption” might be a more fitting characterization of what was essentially an emergency response, and in the aftermath of this disruption, increased flexibility in attendance and delivery modes of education will become the “new normal” (Kortemeyer, 2020; Schapiro, 2021; Hofer et al., 2021). 4 The educational experiment starts now, as the impact of this flexibility can be investigated in more controlled settings. 5 A preliminary “finding” of this experiment is that many faculty members report that live-lecture attendance has decreased—some faculty members even go so far as to demand that streaming, video conferencing, and recording should be discontinued, “now that the pandemic is over,” to force students to return to campus. 6 There might be some justification for that: both students and faculty who knew the university before COVID-19 bemoan the loss of campus culture, and there are certainly cross-disciplinary and social competencies that were implicit in higher education, such as scientific discourse, self-presentation, teamwork, conflict resolution, etc., which may not be fostered anymore when purely focusing on the explicit curriculum of teaching and transmitting facts, methods, and concepts. 7 There are also serious concerns about loneliness, depression, anxiety, and procrastination that need to be addressed (Wang et al., 2020; Pelikan et al., 2021; Copeland et al., 2021; Tasso et al., 2021; Amendola et al., 2021; Buizza et al., 2022), which are consistent with a survey on student well-being conducted at ETH Zurich at the height of the pandemic. 8 The problems and their solutions are likely more complex and reaching deeper—the pandemic may have simply brought some existing inconsistencies in the 21st-century higher-education system to the surface, particularly when it comes to lecturing (Vlachopoulos & Jan, 2020). 9 An immediate question is how student choices regarding attendance may have influenced performance in the subsequent exam session. 10 Finally, throughout the whole pandemic, high-stake exams were conducted in-person on-site at ETH Zurich, and another question is how the students’ perception of these physical exam settings may be connected to their potentially completely virtual attendance during the learning phase. [2]

Review and Reinforce

The goal of the literature review is to present an argument defending the relevance and value of a research question. To that end, a literature review must be balanced. For example, in proposing a new theory, both findings that are consistent with that theory and contradictory evidence must be discussed. It is acceptable to argue that the balance of the research supports the existence of a phenomenon or is consistent with a theory, but it is not acceptable to ignore contradictory evidence. What makes a research question interesting is often the uncertainty about its answer.

Media Attributions

• activist art © Ron Cogswell is licensed under a CC BY (Attribution) license
• Adapted from Frederiksen, L., & Phelps, S. F. (2017). Literature Reviews for Education and Nursing Graduate Students. Open Textbook Library. ↵
• Kortemeyer, G., Dittmann-Domenichini, N., Schlienger, C., Spilling, E., Yaroshchuk, A., & Dissertori, G. (2023). Attending lectures in person, hybrid or online—how do students choose, and what about the outcome?: Revista de Universidad y Sociedad del Conocimiento. International Journal of Educational Technology in Higher Education , 20(1), 19. https://doi.org/10.1186/s41239-023-00387-5. ↵

Sourcing, summarizing, and synthesizing:  Skills for effective research writing  Copyright © 2023 by Wendy L. McBride is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Literature review outline [Write a literature review with these structures]

Welcome to our comprehensive blog on crafting a perfect literature review for your research paper or dissertation.

The ability to write a literature review with a concise and structured outline is pivotal in academic writing.

You’ll get an overview of how to structure your review effectively, address your research question, and demonstrate your understanding of existing knowledge.

We’ll delve into different approaches to literature reviews, discuss the importance of a theoretical approach, and show you how to handle turning points in your narrative.

You’ll learn how to integrate key concepts from your research field and weave them into your paragraphs to highlight their importance.

Moreover, we’ll guide you through the nuances of APA citation style and how to compile a comprehensive bibliography. Lastly, we’ll walk you through the proofreading process to ensure your work is error-free.

As a bonus, this blog will provide useful tips for both seasoned researchers and first-time writers to produce a literature review that’s clear, informative, and engaging. Enjoy the writing process with us!

Structure of a Literature Review – Outline

When you write a literature review outline, you are laying the foundations of great work. Many people rush this part and struggle later on. Take your time and slowly draft the outline for a literature review.

The structure of a literature review consists of five main components:

• Introduction: Provide a brief overview of the chapter, along with the topic and research aims to set the context for the reader.
• Foundation of Theory or Theoretical Framework: Present and discuss the key theories, concepts, and models related to your research topic. Explain how they apply to your study and their significance.
• Empirical Research: Review and analyze relevant empirical related to your research question. Highlight their findings, methodologies, and any limitations they possess.
• Research Gap: Identify any gaps, inconsistencies, or ambiguities in the existing literature. This will help establish the need for your research and justify its relevance.
• Conclusion: Summarize the main findings from the literature review, emphasizing the importance of your research question and the identified research gap. Suggest potential avenues for future research in the field.

Sentence starters for each section of your literature review:

Literature review examples and types.

Based on the typology of literature reviews from Paré et al. (2015), the following list outlines various types of literature reviews and examples of when you’d use each type:

1. Conceptual Review: Analyzes and synthesizes the theoretical and conceptual aspects of a topic. It focuses on understanding key concepts, models, and theories.

Example use: When aiming to clarify the conceptual foundations and explore existing theories in a field, such as investigating the dimensions of job satisfaction.

2. Methodological Review: Evaluates and synthesizes the research approaches, methods, and techniques used in existing literature. It aims to identify methodological strengths and weaknesses in a research area.

Example use: When assessing data collection methods for researching user experiences with a new software application.

3. Descriptive Review: Provides a broad overview of studies in a research area. It aims to describe the existing literature on a topic and document its evolution over time.

Example use: When investigating the history of research on employee motivation and documenting its progress over the years.

4. Integrative Review: Combines and synthesizes findings from different studies to produce a comprehensive understanding of a research topic. It may identify trends, patterns, or common themes among various studies.

Example use: When exploring the links between work-life balance and job satisfaction, aggregating evidence from multiple studies to develop a comprehensive understanding.

5. Theory-driven Review: Examines a research topic through the lens of a specific theoretical framework. It focuses on understanding how the chosen theory explains or predicts phenomena in the literature.

Example use: When studying the impact of leadership styles on team performance, specifically using the transformational leadership theory as a basis for the analysis.

6. Evidence-driven Review: Aims to determine the effectiveness of interventions or practices based on the available research evidence. It can inform the decision-making process in practice or policy by providing evidence-based recommendations.

Example use: When assessing the effectiveness of telemedicine interventions for managing chronic disease outcomes, providing recommendations for healthcare providers and policymakers.

By understanding these types of literature reviews and their appropriate usage, researchers can choose the most suitable approach for their research question and contribute valuable insights to their field.

How to Write a Good Literature Review

To write a good literature review, follow these six steps to help you create relevant and actionable content for a young researcher.

1. Define the review’s purpose: Before starting, establish a clear understanding of your research question or hypothesis. This helps focus the review and prevents unnecessary information from being included.

2. Set inclusion and exclusion criteria: Use predefined criteria for including or excluding sources in your review. Establish these criteria based on aspects such as publication date, language, type of study, and subject relevance. This ensures your review remains focused and meets your objectives.

3. Search for relevant literature: Conduct a comprehensive search for literature relevant to your research question. Use databases, online catalogs, and search engines that focus on academic literature, such as Google Scholar, Scopus, or Web of Science. Consider using multiple search terms and synonyms to cover all related topics.

4. Organize and analyze information: Develop a system for organizing and analyzing the information you find. You can use spreadsheets, note-taking applications, or reference management tools like Mendeley, Zotero, or EndNote. Categorize your sources based on themes, author’s conclusions, methodology, or other relevant criteria.

5. Write a critique of the literature: Evaluate and synthesize the information from your sources. Discuss their strengths, weaknesses, and gaps in knowledge or understanding. Point out any inconsistencies in the findings and explain any varying theories or viewpoints. Provide a balanced critique that highlights the most significant contributions, trends, or patterns.

6. Structure the review: Organize your literature review into sections that present the main themes or findings. Start with an introduction that outlines your research question, the scope of the review, and any limitations you may have encountered. Write clear, concise, and coherent summaries of your literature for each section, and end with a conclusion that synthesizes the main findings, suggests areas for further research, and reinforces your research question or hypothesis.

Incorporating these steps will assist you in crafting a well-structured, focused, and informative literature review for your research project.

Here are some examples of each step in the process. 

Top Tips on How to Write Your Literature Review

Here are the top tips on how to write your literature review, based on the Grad Coach TV video and advice from trusted coach Amy:

1. Develop a rough outline or framework before you start writing your literature review. This helps you avoid creating a jumbled mess and allows you to organize your thoughts coherently and effectively.

2. Use previous literature reviews as a guide to understand the norms and expectations in your field. Look for recently published literature reviews in academic journals or online databases, such as Google Scholar, EBSCO, or ProQuest.

3. Write first and edit later. Avoid perfectionism and don’t be afraid to create messy drafts. This helps you overcome writer’s block and ensures progress in your work.

4. Insert citations as you write to avoid losing track of references. Make sure to follow the appropriate formatting style (e.g. APA or MLA) and use reference management tools like Mendeley to easily keep track of your sources.

5. Organize your literature review logically, whether it’s chronologically, thematically, or methodologically. Identify gaps in the literature and explain how your study addresses them. Keep in mind that the structure isn’t set in stone and can change as you read and write.

Remember that writing your literature review is an iterative process, so give yourself room to improve and make changes as needed. Keep these actionable tips in mind, and you’ll be well on your way to creating a compelling and well-organized literature review.

Wrapping up – Your literature review outline

As we conclude this extensive guide, we hope that you now feel equipped to craft a stellar literature review.

We’ve navigated the intricacies of an effective literature review outline, given you examples of each section, provided sentence starters to ignite your writing process, and explored the diverse types of literature reviews.

This guide has also illustrated how to structure a literature review and organize the research process, which should help you tackle any topic over time.

Emphasizing key themes, we’ve shown you how to identify gaps in existing research and underscore the relevance of your work.

Remember, writing a literature review isn’t just about summarizing existing studies; it’s about adding your own interpretations, arguing for the relevance of specific theoretical concepts, and demonstrating your grasp of the academic field.

Keep the key debates that have shaped your research area in mind, and use the strategies we’ve outlined to add depth to your paper.

So, start writing, and remember, the journey of writing is iterative and a pivotal part of your larger research process.

Dr Andrew Stapleton has a Masters and PhD in Chemistry from the UK and Australia. He has many years of research experience and has worked as a Postdoctoral Fellow and Associate at a number of Universities. Although having secured funding for his own research, he left academia to help others with his YouTube channel all about the inner workings of academia and how to make it work for you.

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Structured literature reviews – A guide for students

This is a step-by-step guide aimed at Master's students undertaking a structured literature review as part of their Master's thesis.

There are several different kinds of literature reviews, but any literature review typically includes an extensive literature search. Whenever a systematic approach is used, the literature search features a methodical step-by-step procedure. However, as a Master's student, it might not be possible to fulfill all the criteria of a systematic review when writing a literature review-based thesis; you should rather do a structured literature review, which will include only certain aspects of the systematic review methodology.

In this guide we will go through the different steps of a structured literature review and provide tips on how to make your search strategy more structured and extensive. Additionally, make sure to follow any programme and course specific requirements.

Step 1: Formulate and delimit your research question

• It will be much easier for you to perform a structured information search if you first define and delimit your research question in a clear way.
• One way to define and structure your question is to break it down into different parts .
• PICO and PEO are two different frameworks that can be used for breaking down a research question into different parts.
• You also need to define the most important key concepts of your research question.

The formulation of your research question is partly connected to what kind of literature review you are doing. This article by Maria J. Grant and Andrew Booth usefully compares different kinds of reviews . While a systematic literature review is usually grounded in a clearly delimited and structured question, a scoping review may, for instance, feature a wider problem formulation. The wider a research question is, the larger number of search hits it tends to generate.

To be able to perform a literature review, you need to consider a subject area in which there seems to be a sufficiently large number of original research studies. Therefore, it may be a good idea to test search a database for previous research on the subject while you are trying to formulate and delimit your research question.

One way to structure your research question is to break it down into different parts. A well-delimited question often consists of three to four different parts. PICO and PEO are two examples of frameworks that can help you identify and define your research question.

• PICO ( P opulation, I ntervention, C omparison, O utcome) is primarily used for quantitative research questions.
• PEO ( P opulation, E xposure, O utcome) is primarily used for qualitative research questions.

Structuring your research question in accordance with a framework, such as PICO or PEO, will also help you decide on the inclusion and exclusion criteria of your literature review.

PICO & PEO

After you have delimited your research question, you also need to identify the key concepts that make up your question. Based on these key concepts, you will create " search blocks " that you will use to organise your search terms.

Step 2: Find search terms and create search blocks

• Test searching is a good way to investigate the terminology of a subject area and find search terms.
• Reading key articles can help you gather additional search terms for your final search strategy.
• Find subject headings  for PubMed with the help of the US National Library of Medicine's MeSH database.
• Find& free-text search terms by investigating what words that occur in the title and abstract of relevant articles.
• A good way of achieving a structured final search query is to arrange your search terms into search blocks ; these blocks should arise from the key concepts of your research question.

While working on a literature review-based thesis, you will need to search for articles on several occasions. In the beginning of your project, it is often good to do a couple of unstructured and simple search queries, so-called test searches, in academic databases. This way you are off to a good start, as test searching helps you investigate the terminology of your subject area and find relevant search terms. While the final search strategy is typically reported in full, you don't need to present your test queries in your thesis.

Try to find a couple of key articles, that is, articles that correspond to the type of studies that you are planning to include in your review. Use key articles to gather additional search terms for your final search strategy. Analyse the terminology of your key articles by examining what subject headings (MeSH terms, etc.) that the articles have been tagged with and what words that occur in the titles and abstracts.

Test search - find keywords and narrow down your topic

Test search in pubmed & cinahl.

To retrieve as many relevant studies as possible, you will need to include free-text search terms as well as subject headings in your final search strategy. Free-text search terms are words that occur in the article's title and abstract – words used by the authors themselves. Subject headings are subject-related words that an article is tagged with when the article is added to the database.

• In PubMed , articles are tagged with MeSH terms ( Me dical  S ubject  H eadings). You can look up and browse MeSH terms in the US National Library of Medicine's  MeSH database .
• Databases such as CINAHL , PsycInfo , ERIC , and Sociological Abstracts  have their own subject heading lists; look up subject headings in each database's subject heading list.
• There are also so-called free-text databases, such as Web of Science . These databases lack subject heading lists. Hence, when searching a free-text database, you can only use free-text search terms.

Find subject headings

An effective way to increase the structure of your final search strategy is to arrange your search terms in so-called  search blocks . Create your search blocks based on the key concepts of your research question.

Create search blocks

This search strategy worksheet might help you document and organise your search terms.

Download worksheet

• Worksheet for search terms (Word, 30.54 KB)

Step 3: Search in a structured way

• To get a comprehensive search result, you will need to search for articles in  several different databases .
• Your search strategy should be as uniform as possible in every database, but you may have to  adapt your use of subject headings .
• As you search the databases, combine your search terms and blocks with the help of  AND  and  OR .
• Save time by  documenting your search queries .

When doing a literature review-based thesis it is often wise to use at least two different databases. Many databases overlap, but may also contain unique content. At KI it is common for Master's students to use PubMed and Web of Science when doing a structured literature review as part of their Master's thesis. Depending on your research question, other databases may also be appropriate and useful. Read more about the most frequently used databases at KI .

Your search strategy should be as uniform as possible in every database. However, as mentioned in Step 2, databases may use different subject headings, and some databases only let you use free-text search terms. This means that you need to adapt your use of subject headings depending on the database.

Example: How subject headings may differ between databases 

If you want to search for articles about day surgery in PubMed, you should use the MeSH term Ambulatory Surgical Procedures . However, if you also want to perform your search in a database such as CINAHL, you need to use the corresponding CINAHL Headings term instead: Ambulatory Surgery .

There are many different ways of searching databases. Most databases have one simple, basic Google-like search box and one advanced search form. One advantage of the latter is that combining search terms with AND and OR is usually easier in an advanced search form, especially if you will be using both AND and OR within the same search query. However, you can often combine search terms with AND and OR in a basic search box too, and in that case, you often isolate your different search blocks from each other by enclosing each block in parentheses.

Example: A search query that contains AND, OR, and parentheses

( inflammatory bowel diseases OR ulcerative colitis OR crohn disease) AND (adolescent OR child OR young adult OR teenager) AND (self-management OR self care OR self efficacy )

By choosing the advanced search form you will also be able to exert more control over your search process. The advanced search form lets you specify more closely and decide exactly how you want the database to interpret your search terms; this way you can make your search query more precise.

You should always document your search strategy in order to remember what search terms you have used, how these search terms have been combined, and whether you have applied any limits to your search. The easiest way to do this is to copy and paste your search history from the database into a text document. Also, academic databases often let you create a personal account, so that you may save your searches online.

How to do a structured search in PubMed

Step 4: narrowing or broadening your search.

• Briefly examine your search results to see if you need to narrow or broaden your search query.
• Investigate whether your key articles are present in the search results.
• By using the advanced search form you can improve your search.

Prepare yourself for having to modify and redo your search query several times, before deciding on your final search strategy. After you have combined all your search terms and made your very first database search, you should examine the search results and analyse whether your search query is able to generate the type of search hits that you are looking for.

Analyse your search results

• Are all your key articles present in the search results, or are there some key articles that your search query is unable to retrieve?
• Are you getting too few search hits ? Investigate why. Perhaps you need to remove one of your search blocks, add one or several synonyms within a search block, or search for parts of words by truncating one or several of your free-text search terms, in order to broaden your search ?
• Does your search strategy generate too many non-relevant search hits that have nothing to do with your research question? Investigate why. Perhaps you need to add another search block, remove one of the synonyms from one of your search blocks, or search for phrases by enclosing one or several of your free-text terms in quotation marks, in order to narrow your search ?
• More tips on how to improve your search strategy .

It is important to remember that there is nothing wrong, per se, if your search query generates irrelevant hits. This is quite normal when performing a structured literature search. What's important is that your search strategy is able to retrieve the type of articles that you are looking for, and that you are not overwhelmed by the total number of hits (given the time frame of your thesis project).

We recommend that you use the advanced search form when improving your search strategy. By using the advanced search form, you will for example be able to specify which search fields your search terms must be present in.

Narrowing your search 

Broaden your search, how to specify the field you would like to search in pubmed, step 5: select and review articles.

• After you have completed your search, you will need to go through all your search hits and select which articles to include in your review.
• When selecting articles, read through the titles and abstracts of each article to decide its relevancy .
• Check the quality of each study that you include in your review.
• When checking the quality of articles, it is common to use critical appraisal worksheets or checklists .

Selecting articles

When you have completed and feel satisfied with your search, it is time to go through all the search hits and select which studies to include in your review. All relevant studies, that is, those studies that correspond to your research question and your previously set inclusion criteria, should be included. You decide on the relevancy of a study primarily by reading through the title and abstract. If you feel unsure, go through the whole article. You can describe your selection process with the help of a flow chart, such as the frequently used PRISMA flow diagram .

One of the challenges of systematic literature searches is that the search strategy should be exhaustive, but at the same time the number of search hits also needs to be kept within reasonable boundaries. A search query needs to be broad enough to retrieve all relevant studies, but on the other hand, this also means that a large portion of the search results will be irrelevant. Hence, even though your search strategy may have generated hundreds of hits, it is fine to only include ten to twenty articles in your review in the end.

Saving articles

If you create a personal account in a database it will be easier for you to save any references that you may find there. Another way of saving and organising article references is to use reference management software. There are several different reference management software, for example Endnote Online and Zotero.

Read more about reference management and see software guides.

Reviewing articles

When you have made your selection, you should critically examine the quality of all articles included in your review. The assessment is typically performed with the help of a critical appraisal guide or checklist. The purpose is to assess the reliability of the study results and whether there are any methodological flaws that may have impacted the results. Qualitative research articles are often reviewed with a focus on authenticity, credibility, and validity.

There are many different critical appraisal worksheets and checklists. Some examples are the SBU checklists for assessing the quality of randomized studies, observational studies, and qualitative research. In the course book How to do a systematic review in nursing there is a review guide that can be used for assessing different kinds of studies (both qualitative and quantitative); the original source is Caldwell, Henshaw & Taylor, 2011 .

Review worksheets and checklists contain criteria and questions that may help you identify flaws, errors, or bias. Sometimes different aspects of the study are scored separately. Later, all scores make up a final score that indicates whether the study is of high, medium, or low quality.

Many programmes and courses provide instructions on which checklists to use when reviewing articles, so check your course guidelines.

Step 6: Report your search strategy

• Describe your search strategy in a manner that makes it possible for your readers to replicate the search and get the same results.
• The search strategy is often presented in the form of a table .
• Look at the search history to see what words and limits that you have used when searching a database.

An important aspect of doing a structured literature review is transparency. It has to be easy for your readers to follow what you did when you searched and selected the articles that you have included in your review. In the method section of your literature review you should describe how you searched different databases. This is also where you describe any manual searches that you did. Search strategies are commonly reported in the form of tables. Present one table for each database.

You can examine your search terms and any limits you have applied when searching a database by visiting its search history.

Read more about how to report your search strategy and view examples.

Checklist for search strategies

Here is a checklist to help you review your own or someone else's search strategy.

If you would like us to get back to you, please submit your contact information in the form below along with your feeback.

• my research
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five ways to structure a literature review

You’ve read. And read. And read. You’ve noted. And noted. And how. You’ve written summaries and memos. You’ve made groupings and mind-maps of the reading. But you’re still a bit away from actually writing about the literatures. You’re still not sure how to wrestle all of that material into a compliant text. You know the purposes of the literature review . But that doesn’t tell you what structure will work for your particular project.

Before you put pen to paper – or hand to mouse – it might help you to now think about the ways in which literature chapters, if you decide to have one, are most often structured. You can then see if one of the usual ways will work for you.

So here’s a set of five possibilities.

• A chronology

As the name suggests, this is an historical map of the field. In writing historically, your intention is to show how your research either adds logically to what has gone before, or to show how your research challenges a taken for granted assumption in the field, or how it advances a particular body of work in the field. In doing this kind of temporal mapping, you need to highlight the key texts, groups and categories that your work is building on and/or speaking to. Even though a chronology is  linear, you need to also trace threads and associations through your chosen timeline.

• Major themes

You might choose to just focus on mapping the current themes or topics in the field Your intention here is to show how your research connects to, uses and adds/speaks to contemporary themes/topics. You structure the thematic review through either an examination of the kinds of questions that have been asked and the topics that have been studied, or a look at the key concepts and categories that have been developed and used, or even a look at methodological and methods that are used.

• The canon/classic studies

This can be standalone, a variation on either (1) or (2) or may also appear as a subsection of either of them. Your intention in a canonic review is to show how your research fits with the studies that can’t be ignored. This kind of literatures review is always heavily evaluative and comparative, so you usually need to set out some explicit criteria, drawn from your research question, that allows you discuss specific texts in some detail. You need to make a very clear connection with your study. One of the metaphors used for this kind of literature work is a tree, where the ‘trunk’ of the discipline is its classic studies.

• The  wheel

Research very often draws on more than one body of literatures. These might be from different disciplines or be literatures that have been used to address very different topics. Your intention in the wheel-like review is to show that the originality of your research stems from the ways in which you’ve brought together areas that are usually kept apart. This bringing together is clearly elaborated in the discussion of literatures, where each formerly separate chunk is discussed in relation to your research interest. You need to draw out the key contributions of each corpus of literatures and their relevance to your research. You also need to show very clearly the ways in which the various spokes work together- you must show how the various spokes relate to and support the centre of the wheel – this is where your research is situated.

• The pyramid

A pyramid literature review places your research in its context. Your intention is to show how your research interest is shaped and framed by other events/practices/people/policies etc. The literature review can be organised to start from the tip – what there is written about your specific topic already – and then move out and down through relevant contextualising literatures. More commonly, the pyramid is inverted, and the review begins with the wider context, honing in ever closer to your topic. The concluding tip section of the inverted pyramid review is what is written about your particular topic. By then you have indicated all of the potential issues and insights you will need to bring to your study.

There are of course variations on these  five structures and various ways to combine them. You will ‘bespoke’ your literature review to fit your topic. However, if you are at a stuck point with structure it can help to simply brainstorm how you would organise your material in some or all of these ways.

It is crucial to remember that the literature review is not a summary, a description or a list! Because the literature review is always an argument about why your research is the way that it is, some play with structure will help you to think through which set of moves allow you to make the most persuasive case.

See also  other posts on work with literatures .

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About pat thomson

13 responses to five ways to structure a literature review.

Dear Pat, I am a great fan of your blog. I find this piece very useful.

Regards, Rakesh

I love all the posts and the shares !it enhances my little knowledge about research!! planning to have some researching! Thanks!

Reblogged this on Cecile Badenhorst and commented: Here’s a blog on writing literature reviews. I particularly liked the idea of the wheel structure.

Pingback: the blogging scramble | patter

would you please explain what the main difference is between a critical review and a systematic review? I mean how the structure of these two reviews are different. Thanks,

This is a systematic review http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=67 . A critical review or narrative review is what’s usually described, see my other posts. A description of differences can be found here http://libguides.sjsu.edu/c.php?g=230370&p=1528399 .

Reblogged this on Emma .

Dear Pat, thank you so much for this blog! I’ve been coming back to it ever since my PhD 7 years ago, and it is a well of inspiration and support!

I want to ask if you may be able to point me to some resources on the ‘wheel’ model of literature review? I am writing an article which draws on several bodies of literatures, and it is a big challenge to draw them together. Thank you!

See https://libguides.unco.edu/c.php?g=236360&p=1569693 .

Using diagrams as research aides

Thank you so much!!

I’ve written you a blog post. Out tomorrow.

It’s really the same as the daisy model, see TW here https://thesiswhisperer.com/2017/02/22/using-diagrams-as-research-aides/ and

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• Open access
• Published: 16 March 2024

Impact of reimbursement systems on patient care – a systematic review of systematic reviews

• Eva Wagenschieber 1 &
• Dominik Blunck   ORCID: orcid.org/0000-0001-8843-2411 1  

Health Economics Review volume  14 , Article number:  22 ( 2024 ) Cite this article

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There is not yet sufficient scientific evidence to answer the question of the extent to which different reimbursement systems influence patient care and treatment quality. Due to the asymmetry of information between physicians, health insurers and patients, market-based mechanisms are necessary to ensure the best possible patient care. The aim of this study is to investigate how reimbursement systems influence multiple areas of patient care in form of structure, process and outcome indicators.

For this purpose, a systematic literature review of systematic reviews is conducted in the databases PubMed, Web of Science and the Cochrane Library. The reimbursement systems of salary, bundled payment, fee-for-service and value-based reimbursement are examined. Patient care is divided according to the three dimensions of structure, process, and outcome and evaluated in eight subcategories.

A total of 34 reviews of 971 underlying primary studies are included in this article. International studies identified the greatest effects in categories resource utilization and quality/health outcomes. Pay-for-performance and bundled payments were the most commonly studied models. Among the systems examined, fee-for-service and value-based reimbursement systems have the most positive impact on patient care.

Patient care can be influenced by the choice of reimbursement system. The factors for successful implementation need to be further explored in future research.

The health care system has a variety of payment and reimbursement systems that provide different financial incentives for patient care. Every payment system carries incentives to over- or underprovide care. There is no optimal solution, as there is constant pressure to adapt and reform in order to ensure the best possible quality of care. Health care systems are reaching their financial limits and therefore it is desirable to achieve an increase in efficiency in patient treatment and, for example, to avoid unnecessary interventions [ 1 ]. To achieve this, health policy must ensure a regulatory framework in which health status is also an economic incentive for all actors in the health system, promoting health benefits and reducing economic disincentives.

Physicians have a stronger position in the physician–patient relationship because of the knowledge and information advantage, and problems arise in the provision of care when physicians’ financial interest do not match the patients’ need for treatment [ 2 ]. In addition to medical necessity, economic and financial factors also play a key role in patient treatment. Medical decisions in the inpatient sector are influenced daily by economic requirements, economic considerations, and financial resources, potentially with negative consequences for the quality of treatment and patient safety. In the hospital setting, economization is exemplified in that physicians often feel ethical conflicts and economic goals occur at the expense of adjustments in length of stay, case numbers, and patient selection [ 3 ]. The influence on patient care is examined under four different reimbursement systems: Salary, bundled payment, fee-for-service (FFS), value-based reimbursement. With a fixed salary, remuneration is based solely on the duration of working hours, whereas the type and volume of service, as well as the number of treatment cases or patients enrolled, have no influence on financial income. At the same time, both an advantage and a disadvantage in this reimbursement system is the dependence of the quality of treatment on the intrinsic motivation of the provider [ 2 ]. Bundled payment is the term for payments such as capitation or disease related groups (DRGs). Services are combined and “bundled” for payment during a single patient contact or over a temporal episode. One disadvantage of this reimbursement system is the incentive for health care providers to treat as many patients as possible with as little effort as possible and thus to engage in risk selection. On the other hand, this can increase the incentive for preventive measures on the part of health care providers [ 4 ]. In FFS reimbursement, the provider’s fee is based on the volume of services rendered. Shared-savings payment models are a mix of FFS and a fixed salary where providers participate from savings they achieve in patient care. This creates the disadvantage of FFS reimbursement that service providers will unnecessarily expand the number of services for monetary reasons, resulting in unnecessary care at the expense of payers and potentially patients. On the other hand, (potentially expensive) diseases can be identified and treated earlier through increased preventive measures [ 2 , 5 ]. Value-based reimbursement additionally promotes the quality and success of medical procedures. Remuneration is expanded to the extent that it is linked to predefined quality targets at the levels of transparency, accessibility to care, indication, structure, process or outcome. While value-based reimbursement can promote the intrinsic motivation of providers, care must be taken to ensure that there is no risk selection for patients who can be treated well or that there are no negative spill-over effects into other areas of treatment. Another disadvantage of this reimbursement system is the large number of factors besides medical treatment that contribute to recovery, such as comorbidities or socioeconomic factors [ 1 ].

Other reviews have addressed effects on patient care in outpatient settings [ 6 ] or included studies from developing countries in their evaluations [ 7 ]. Previous studies only focus on specific areas of patient care [ 8 ], are not methodologically designed as a systematic review [ 9 ], focus only on individual specialties [ 10 ] or reimbursement systems [ 11 ] and do not compare the effect of different reimbursement systems. A comprehensive and structured overview, comparing the outcomes of several reimbursement systems on areas of patient care, is missing.

The objective of this paper, thus, is to provide a review of systematic reviews on the relationship between reimbursement systems and patient care. The research question is narrowed down using the PICOS algorithm: Physicians (Population), Reimbursement systems (Intervention), different reimbursement systems or differences over time (Comparison), effects on patient care divided into the parameters structure, process, outcome (Outcome), systematic reviews and meta-analyses (Study type). The aim is to analyze how reimbursement systems affect patient care across countries.

Materials and methods

The systematic review follows the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Metaanalyses) statement [ 12 ], has been performed via the databases PubMed, Web of Science and Cochrane Database of Systematic Reviews between 02/12/2021 and 22/12/2021 and has been complemented with an additional search on Google Scholar and in the reference lists of relevant studies. The search term was formed by linking keywords and their synonyms from previously published relevant studies on the three aspects of the research questions: impact, reimbursement systems, and patient care (see Table 1 for the full search term for each database).

Inclusion criteria are defined as (a) the paper must be a systematic review or meta-analysis, (b) the countries considered must be industrialized nations, and (c) the effect of payment/reimbursement systems on patient care was examined.

The search period is set to ten years and only studies published in German or English were included. All records were exported to EndNote 20 [ 13 ] and screened by the authors; disagreements were solved by discussion. All studies categorized as “relevant” or “uncertain” in this step were analyzed in full text.

Studies categorized as relevant after full text analysis were included in this work and assessed for study quality using the AMSTAR-2 score, which is a comprehensive questionnaire to assess systematic reviews of (non)randomized trials [ 14 ]. Using the framework of Donabedian, the results are divided into the three dimensions structure, process, outcome [ 15 ] (see Table  2 ). The structure dimension combines the following parameters: “unintended consequences” and “organizational changes”. Unintended consequences are mostly related to changes in risk selection or spill-over effects, whereas organizational changes are related to effects in personnel structures, for example. The dimension of structure is of particular interest for health care authorities as well as payers as it shapes the organizational characteristics of how care is delivered.

The categories “resource utilization”, “access”, and “behavior” are combined under the parameter process. While resource utilization mostly describes changes in readmission rates or length of stay, the access category reflects socioeconomic inequalities in the utilization of health care services. The behavior category includes effects related to intrinsic motivation, preventive services provided by physicians, or documentation of health parameters, among others. The dimension of process defines how providers deliver care as well as the points of contacts for patients.

The outcome dimension, on the other hand, combines the parameters “quality/health outcomes”, “efficiency”, and “economic effects”. Actual changes in mortality, treatment quality, screening or vaccination rates are mapped in the “quality/health outcomes” category. The “efficiency” category deals with the effects on direct savings in the provision of a specific medical service or effects on salaries, whereas the “economic effects” category records effects that are significant for society. The dimension of outcome could be regarded of the main value driver from a patient perspective as it answers to what extent patients’ original need for care is fulfilled. Furthermore, outcomes are of particular interest for payers, as payers commonly decide, for example, what services are reimbursed and therefore potentially have a high interest in a positive cost-outcome-relation.

For all reimbursement systems described, the number of included studies, as well as the examined medical specialties or physician groups and countries in which the interventions are carried out, are also transferred in each case. For each reimbursement system described, it is examined whether it improved or worsened the outcome categories of patient care, whether there were heterogeneous results, or whether no difference was found in the outcome categories before and after the intervention. The frequency reviews found an improvement, worsening, heterogeneous outcome, or no difference for each payment system per outcome category were summarized in a single table. In this study, increases in healthcare utilization, documentation of health parameters, and higher screening rates or lower mortality rates are defined as improvements. A measurable increase in risk selection, negative spill-over effects, longer hospital stays, or higher readmission rates are considered deteriorations in patient care. In the economic categories of efficiency and economic effects, savings in health care spending and total societal spending, respectively, are considered as improvements. Reviews finding heterogeneous results include studies with conflicting findings, because some of the included primary studies find positive results in one category, whereas other primary studies find negative effects or no significant effects at all, leaving the study or respective review with an overall heterogeneous result. It is assumed that health care is optimized by an increase in health care services, shorter lengths of stay, more efficient care, and lower overall societal health care expenditures.

A total of 1,213 hits were identified by the database search on 02/12/2021, with 2 additional hits identified by the search in Google Scholar. After duplicates were removed, 1,053 abstracts were screened by both authors, resulting in 943 hits being initially excluded. The remaining 110 hits were analyzed in full text, whereupon 34 hits were included in this work (see Fig.  1 ).

Overall, the 34 included systematic reviews describe the influences on patient care based on a total of 971 primary studies. Ten of the 34 included reviews are rated as high quality, 16 as moderate quality, and eight as low quality according to the assessment procedure using the AMSTAR-2 questionnaire (see Table  3 ). Some of the identified systematic reviews examined more than one reimbursement system. Therefore, for the sake of clarity, we refer to a total number of 60 studies in the following. Of these, the reimbursement system salary was investigated in four studies, bundled payments in 15, FFS payments in a further eleven studies and value-based reimbursement in a total of 29 studies. Out of the 60 studies 45 were conducted in the USA, 38 in European countries, 28 in the UK, 23 in other countries and 17 in Canada. An overview of the results is provided in Table  4. . In the following, we describe the results of the systematic review regarding Donabedian’s categories of quality: structure, process, and outcome.

Unintended consequences

No unintended consequences in patient care are found for the salary payment system. Studies find heterogeneous results for this category for bundled payments in form of a decrease in treatment volume while there is an increase in risk selection and case complexity [ 16 , 17 ]. An association was found between bundled payments and patient selection based on sociodemographic factors and comorbidities [ 16 ]. Positive changes were noted in indicators that were not included in the FFS model; these were, however, only short-term [ 18 ]. Some reviews find unintended changes after implementation of pay-for-performance models (P4P), a type of value-based reimbursement, in form of risk selection, spill-over effects, protocol-driven and less patient-centered care and neglect of non-incentive indicators [ 19 , 20 , 21 , 22 , 23 ]. Some studies find no evidence for a change in patient risk selection in their included primary studies [ 24 , 25 ].

Organizational changes

There are heterogeneous results on the impact on patient care after the introduction of different payment systems. One study reports effects in the form of increasing numbers of physicians per patient and decreasing numbers for bundled payments [ 26 ]. While one review finds heterogeneous results for salary, bundled payment, FFS, and value-based payment for the structural organization of patient care [ 27 ], others find both positive and negative effects for value-based payment as an improvement in care management processes or a worse organization of large hospitals [ 28 , 29 ].

Resource utilization

Reviews find heterogeneous effects for salary models differentiated by specialty. While induction time and total treatment time increase in anesthesiology, outpatient visits and surgical procedures decrease in gynecology [ 30 ]. When salary and FFS payments are combined, a decrease in clinical services per year and in hospital readmissions is noted [ 27 , 30 ]. Within models of bundled payments, heterogeneous results are found: While one source describes a decline in all-cause hospitalizations and readmissions [ 30 ], other sources find both improvements and deterioration in hospital facility use and the number of acute admissions [ 27 , 31 ]. Deteriorations are described in the following categories: use of patient care resources, number of services provided per patient, shorter lengths of stay, discharges to post-hospital facilities [ 16 , 18 , 24 , 30 , 32 ]. Some reviews find both differences and no differences in the use of health care resources after the introduction of bundled payments [ 17 , 27 , 30 ]. Within DRG models, evidence is heterogeneous and describes no change, an increase, or a decrease in hospital readmissions and in the length of stay [ 26 , 33 ]. For global-based payment, evidence is heterogeneous in terms of higher or lower utilization, and no change in resource utilization [ 34 ]. The heterogeneity of influences on health care resource utilization continues for FFS payments as sources find an increase in the number of physician visits per patient [ 18 , 24 ], a reduction in length of stay and computer tomography exams [ 30 , 31 , 32 ] or heterogeneous results for process indicators [ 27 ]. Negative effects include an increase in the number of patients per physician [ 35 ]. In P4P models, six studies report an improvement in resource utilization as an increase in health care services, physician visits and a shorter length of stay [ 20 , 25 , 28 , 32 , 36 , 37 ]. Other reviews come to very heterogeneous results regarding the change in resource utilization after the introduction of P4P models in the following categories: health care and resource utilization, length of stay, readmission rates, process indicators [ 10 , 11 , 27 , 38 ].

There is no research showing an impact of salary on access to health care. Bundled payments show heterogeneous results in form of changes of the patient structure with respect to insured status or a decline in patients with home dialysis [ 17 , 30 ]. Studies examining FFS payment may also measure the impact on access to care. Improvements are noted in waiting time and a reduction of patients who leave the health care provider without treatment [ 30 , 35 ]. No differences were found in the treatment of social or ethnic inequalities [ 18 , 24 ]. For value-based models, results are heterogeneous regarding the impact on access to patient care. Among them, three studies identify a positive impact after the introduction of P4P models in form of an increase in equity of access to care and a decrease in social inequalities [ 20 , 32 , 36 ]. Other results show no significant reduction in access for disadvantaged groups or no improved access to primary care [ 11 , 19 ].

Salary models lead to a decrease in hours worked per week [ 30 ]. For bundled payment models, the results show both increases and decreases, means heterogeneous results, in the number of preventive consultations [ 18 ] and services as well as increases in preventive consultations, reported illness severity and referral to post-acute care facilities after hospitalization [ 24 , 33 ]. An increased number of services provided were reported for FFS models [ 18 , 24 , 35 ]. Positive changes after the introduction of P4P models were noticed in some categories: increased use of computers and documentation of care, diabetes tests, physician behavior [ 11 , 20 , 35 , 39 ]. Other reviews find results that are more heterogeneous on effects on the behavior in patient care [ 10 , 22 , 23 , 25 , 36 , 40 ]. For example, an improved data collection leads to increased pressure on physicians and thereby provoke negative behavior change [ 36 ]. General heterogeneous effects in terms of a disruption of patient-centered care with less focus on patient needs are reported as well as an increase in blood pressure checks and an improvement in intrinsic motivation among care providers [ 10 , 23 , 25 , 40 ]. Both, an increase and no change in medication prescription is found in two value-based models [ 10 , 41 ].

Quality/health

One review finds a decrease in transfer rates out of hospitals for a salary-based payment [ 30 ]. The results for bundled payments are heterogeneous [ 18 , 27 , 30 , 31 ]. Heterogeneous results, which means improvements as well as decreases and no changes are found within the primary studies in the reviews for mortality, rehospitalization rates, quality of care and numbers of treatment cases [ 16 , 27 , 30 , 31 , 42 ]. Some reviews notice an improvement in the quality and number of screenings [ 30 , 42 ] or a decrease in the case complexity [ 16 ]. Evidence of the impact on quality of care and health outcomes associated with P4P is also examined in reviews. One review reports improvement in terms of an increase in immunization rates among children for FFS payments [ 35 ], whereas other sources find increases, decreases and no changes in number of treatment cases, treatment outcomes, mortality, and hospitalization rates [ 18 , 27 , 31 ]. The most influences on health outcomes or quality of care are found in models of value-based payment. Nine reviews find evidence of improvement with P4P models in these categories: immunization rates [ 35 , 43 ], specific clinical values (e.g., cholesterol, blood pressure, screening rates, birth weight) [ 21 , 39 , 42 , 44 ], quality of care [ 23 , 28 , 45 ]. Heterogeneous outcomes are found in another ten reviews [ 11 , 19 , 20 , 22 , 27 , 36 , 38 , 40 , 46 , 47 ]. Among these, positive as well as negative results are found in patient-related health outcomes [ 19 , 27 ], complication rates [ 38 ], health outcomes, quality of care and screening rates [ 22 , 47 ]. Other sources report heterogeneous effects in patient satisfaction, short-term health outcomes and mortality [ 20 , 22 , 40 , 47 ]. No effects on mortality, quality of care, health outcomes, rehospitalization or patient satisfaction after an implementation of value-based reimbursement are described in six reviews [ 11 , 20 , 31 , 37 , 38 , 46 ].

When providers are reimbursed with fixed salaries in combination with FFS elements, the annual salary increases [ 30 ]. Bundled payments have a positive impact on the efficiency in terms of a decrease in health care spending and hospitalizations [ 16 , 30 , 42 ]. Furthermore, heterogeneous results, means deterioration as well as improvement, in treatment costs are described in one review [ 26 ]. Shared-savings models were found to lead to a reduction in perinatal care spending [ 42 ]. An improvement in the cost-effectiveness of treatments in P4P models by reducing costs was found in one review [ 19 ]. Other sources present heterogeneous results in terms of both positive and negative effects on the (marginal) costs of care [ 29 , 38 ]. No evidence for changes in efficiency are determined in three other reviews [ 20 , 22 , 45 ].

Economic effects

For bundled payments, the results are very heterogeneous. Cuts in health spending as well as increases, no changes or unclear effects are noted [ 31 , 32 , 34 ]. When payment is based on FFS models, positive effects on health care spending are most often found [ 18 , 32 ]. One study, however, reports heterogeneous effects [ 31 ]. The results on the impact of value-based payment models on economic conditions are mostly positive, as they lead to a reduction in the growth of health care spending and costs [ 32 , 41 , 44 ].

Principal results

To answer the question of the relationship of different reimbursement systems and patient care, we conducted a systematic review of systematic reviews in order to structure the existing body of evidence in this topic. We identified 34 studies analyzing 60 reimbursement systems and structured the results from the perspective of the Donabedian framework.

For the reimbursement of health care providers via salary, the results show little to no influence on the subcategories of the dimension structure. For the dimension process, the results are heterogeneous with a tendency toward deterioration, manifested in a reduction in services rendered and hours worked. The classic disincentives of salary-based reimbursement, minimization of the quantity of services and treatments, are confirmed in the results. The categories of the outcome dimension, on the other hand, are clearly improved, with a decrease in hospital discharge rates and an increase in income. The certainty of these results is high due to the high study quality and the risk of bias is low, since three high-quality studies and one medium-quality study were included in the evaluation.

The studies on bundled payments show few and heterogeneous effects on the structural dimension of patient care. The resource utilization subcategory shows heterogeneous results, with most results being equally positive and negative. The remaining categories in the process dimension appear to have mostly heterogeneous effects. Overall, bundled payments are found to have more positive effects on patient care in the outcome dimension categories. The disincentives of bundled payments are confirmed in the form of reductions in services, but also refuted in the form of shorter lengths of stay and lower readmission rates in hospitals. When interpreting the results, the rather below-average study quality must be considered. Although five high-quality reviews examine the effects of the bundled payments, eight reviews with a medium quality and four papers with a low quality are also included in the evaluations, so that the certainty of results is limited and there is a risk of bias.

In the results for FFS models, especially the categories in the dimension process tend to be positively affected. While access to health care and provider behavior tend to be mostly positive, there are as many heterogeneous and negative effects for resource utilization as positive ones. Measured health impact is very heterogeneous and tend to be negative, while efficiency and economic impacts tend to be improved. An increase in the number of health care services, a classic disincentive, is directly confirmed by several studies. The quality of the included reviews and, thus, also the certainty of results tends to be high, since seven reviews with a low risk of bias, four with a medium and only one review with a high risk of bias are included in the evaluation.

For models of value-based reimbursement, results are inconclusive or more negative with respect to subcategories of the structural dimension, noting changes in risk selection, negative spillover effects, and a shift away from patient-centered care [ 19 , 20 , 21 , 22 , 23 ]. In contrast, these payment models achieve substantial improvements in the process dimension and specifically in resource utilization. Although the effects on health outcomes are heterogeneous for P4P models, they indicate a clear tendency toward improvement, whereas no clear improvements or deteriorations were found for the other two subcategories. The misaligned incentives of value-based payment in the form of patient selection described at the beginning are both confirmed [ 21 , 22 , 23 ] and refuted [ 24 , 25 ]. The quality of the included reviews and thus also the certainty of results is average overall. Although seven of the relevant reviews are of high quality, 15 have a medium risk and seven have a high risk of bias, which may affect the results.

Overall, the rate of identified improvements for FFS and VBP is the best compared to heterogeneous effects, deteriorations, or no identified changes. While about 50% of all identified results for FFS show improvements, it is 40% for VBP. On the other hand, only 25% of the identified outcomes for a salary are improvements and 21% for bundled payment. Across all reimbursement systems, most of the results were identified in the categories resource utilization and quality/health outcome. Especially the categories of the process and outcome dimension, specifically the subcategories resource utilization and health outcome are influenced by the choice of reimbursement models and cause a change in patient care. These categories therefore have a greater impact on the overall results than categories in which fewer results have been identified. Mainly models of bundled and value-based reimbursement are affected. The effects of FFS and value-based reimbursement are mostly positive in the results compared to the other two reimbursement systems. Both payment models tend to show positive effects in the categories of the process and outcome dimension, and cite an increase in health care services provided, a reduction in length of stay, an increase in screening rates of patients, and an improvement in health parameters. In the case of value-based reimbursement, however, many endpoints were found to have no or very heterogeneous effects following the introduction of these reimbursement models. Primarily, these endpoints are unintended consequences, resource use, behavior, health outcomes, and efficiency. Bundled payment models show more heterogeneous and more negative than positive results. These are found predominantly in the resource utilization and health outcome categories, indicating a more positive impact of FFS and value-based compensation. Salary receives heterogeneous results, with categories in the process dimension tending to worsen and those in the outcome dimension tending to improve. Although the disincentives of the respective reimbursement systems are confirmed for all models, refutations are found for bundled and value-based reimbursement regarding length of stay, readmission rates, negative spill-over effects and patient selection.

Implication

In particular, the categories of the process and outcome dimension, more precisely defined as the subcategories resource utilization and quality/health outcome, are reported to be influenced by the choice of reimbursement model and cause a change in patient care. Models of bundled and value-based reimbursement seem to be particularly affected. The effects are more positive for FFS and value-based reimbursement in comparison to both other reimbursement systems. FFS as well as VBP models show positive effects in the process and outcome dimension categories, frequently citing an increase in health care services provided, a reduction in length of stay, an increase in patient screening rates, and an improvement in health parameters. Judging by the results and comparison of the four reimbursement systems, it is therefore worthwhile to further expand models of FFS and value-based reimbursement in the health care system and to investigate their successful implementation as well as potential moderating factors.

Limitations

There are some limitations in this review. The AMSTAR-2 tool is only partly appropriate to evaluate the reviews because it also evaluates clinical studies and therefore might underestimate the actual quality of some reviews involved. Not all of the included reviews provide a clear definition of their view on improvement or deterioration of care. Individual primary studies may be integrated into the results of several studies of included reviews and have a greater influence on the analysis than other primary studies included in only one review which bears the risk of overestimation of certain results. When interpreting the results, it is important to note that FFS or P4P models cannot be applied to any health care system; rather, the exact conditions for successful implementation must be individually and critically examined. Finally, publication bias is a limitation and can lead to overrepresentation of improvements due to the implementation of the described reimbursement models. Future studies should also identify more relevant databases to increase the quality of the systematic review and the validity of the results. Additionally, future studies should analyze the monetarization of the effects and aim for a better comparability of study settings as difficulties arise from interpreting health policy analyses which were conducted in different settings as well as causal interpretation might be limited as most underlying studies were not conducted as randomized controlled trials.

Availability of data and materials

No new data generated/Not applicable.

Abbreviations

• Fee-for-service
• Pay-for-performance

Klauber J, Geraedts M, Friedrich J, Wasem J, Beivers A. Krankenhaus-Report 2020. Finanzierung und Vergütung Am Scheideweg. Berlin: Springer; 2020.

Book   Google Scholar  

Gerlinger, T.: Grundprobleme der Vergütung ärztlicher Leistungen. https://www.bpb.de/themen/gesundheit/gesundheitspolitik/252093/grundprobleme-der-verguetungaerztlicher-leistungen/ . Accessed: 2022–03–12 (2017).

Siewert AC, Wehkamp K-H, Krones CJ, Vogd W, Allemeyer E. Bewerbungsgespräche von Chefärzten: Ökonomie hat hohen Stellenwert. Dtsch Arztebl International. 2021;118(4):180–4.

Google Scholar  

Hussey, P.S., Mulcahy, A.W., Schnyer, C., Schneider, E.C.: Closing the quality gap: revisiting the state of the science (vol. 1: bundled payment: effects on health care spending and quality). Evidence report/technology assessment (208.1), 1–155 (2012). https://doi.org/10.23970/ahrqepcerta208.1 .

Bailit M, Hughes C. Key design elements of shared-savings payment arrangements. Issue Brief (Commonw Fund). 2011;20:1–16.

PubMed   Google Scholar  

Flodgren, G., Eccles, M., Shepperd, S., Scott, A., Parmelli, E., Beyer, F.: An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane database of systematic reviews (Online) 7, 009255 (2011). https://doi.org/10.1002/14651858.CD009255 .

Scott, A., Sivey, P., Ouakrim, D., Willenberg, L., Naccarella, L., Furler, J., Young, D.: The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane database of systematic reviews (Online) 9, 008451 (2011). https://doi.org/10.1002/14651858.CD008451.pub2 .

Tao W, Agerholm J, Burström B. The impact of reimbursement systems on equity in access and quality of primary care: A systematic literature review. BMC Health Serv Res. 2016;16:542. https://doi.org/10.1186/s12913-016-1805-8 .

O’Reilly J, Busse R, Hakkinen U, Or Z, Street A, Wiley M. Paying for hospital care: The experience with implementing activity-based funding in five european countries. Health Econ Policy Law. 2012;7:73–101. https://doi.org/10.1017/S1744133111000314 .

Article   PubMed   Google Scholar  

Mitchell AP, Rotter JS, Patel E, Richardson D, Wheeler SB, Basch E, Goldstein DA. Association between reimbursement incentives and physician practice in oncology: A systematic review. JAMA Oncol. 2019;5(6):893–9. https://doi.org/10.1001/jamaoncol.2018.6196 .

Article   PubMed   PubMed Central   Google Scholar  

Gupta N, Ayles H. Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review. Eur J Health Econ. 2019;20. https://doi.org/10.1007/s10198-019-01097-4 .

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372. https://doi.org/10.1136/bmj.n71 .

Endnote. 2021;20.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomized or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358. https://doi.org/10.1136/bmj.j4008 .

Donabedian, A.: The quality of care: How can it be assessed? JAMA 260(12) (1988). https://doi.org/10.1001/jama.1988.03410120089033 .

Agarwal R, Liao JM, Gupta A, Navathe AS. The impact of bundled payment on health care spending, utilization, and quality: A systematic review. Health Aff. 2020;39(1):50–7. https://doi.org/10.1377/hlthaff.2019.00784 .

Article   Google Scholar  

Bernstein DN, Reitblat C, van de Graaf VA, O’Donnell E, Philpotts LL, Terwee CB, Poolman RW. Is there an association between bundled payments and “cherry picking” and “lemon dropping” in orthopaedic surgery? a systematic review. Clin Orthop Realt Res. 2021;479(11):2430–43. https://doi.org/10.1097/CORR.0000000000001792 .

Brocklehurst P, Price J, Glenny A, Tickle M, Birch S, Mertz E, Grytten J. The effect of different methods of remuneration on the behaviour of primary care dentists. Cochrane Database Syst Rev. 2013;11:1465–858. https://doi.org/10.1002/14651858.CD009853.pub2 .

Eijkenaar F, Emmert M, Scheppach M, Schöffski O. Effects of pay for performance in health care: A systematic review of systematic reviews. Health Policy. 2013;110(2):115–30. https://doi.org/10.1016/j.healthpol.2013.01.008 .

Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review. Ann Fam Med. 2012;10(5):461–8. https://doi.org/10.1370/afm.1377 .

Langdown C, Peckham S. The use of financial incentives to help improve health outcomes: is the quality and outcomes framework fit for purpose? A systematic review. J Public Health. 2014;36(2):251–8. https://doi.org/10.1093/pubmed/fdt077 .

Lee JY, Sand-II L, Jo M-W. Lessons from healthcare providers’ attitudes toward pay-for-performance: What should purchasers consider in designing and implementing a successful program? J Prev Med Public Health. 2012;45(3):137–47. https://doi.org/10.3961/jpmph.2012.45.3.137 .

Martin, B., Jones, J., Miller, M., Johnson-Koenke, R.: Health care professionals’ perceptions of pay-for-performance in practice: A qualitative metasynthesis. The Journal of Health Care Organization, Provisions, and Financing 57 (2020). https://doi.org/10.1177/0046958020917491 .

Carter R, Riverin B, Levesque J-F, Gariepy G, Quesnel-Vallee A. The impact of primary care reform on health system performance in canada: a systematic review. BMC Health Serv Res. 2016;16:324. https://doi.org/10.1186/s12913-016-1571-7 .

Kondo KK, Wyse J, Mendelson A, Beard G, Freeman M, Low A, Kansagara D. Pay-for-performance and veteran care in the VHA and the community: a systematic review. J Gen Intern Med. 2018;33(7):1155–66. https://doi.org/10.1007/s11606-018-4444-4 .

Barouni M, Ahmadian L, Anari H, Mohsenbeigi E. Investigation of the impact of drg based reimbursement mechanisms on quality of care, capacity utilization, and efficiency - a systematic review. International Journal of Healthcare Management. 2020;14:1–12. https://doi.org/10.1080/20479700.2020.1782663 .

Heider A-K, Mang H. Effects of monetary incentives in physician groups: A systematic review of reviews. Appl Health Econ Health Policy. 2020;18(5):655–67. https://doi.org/10.1007/s40258-020-00572-x .

de Bruin SR, Baan CA, Struijs JN. Pay-for-performance in disease management: a systematic review of the literature. BMC Health Serv Res. 2011;11:272. https://doi.org/10.1186/1472-6963-11-272 .

Markovitz AA, Ryan AM. Pay-for-performance: Disappointing results or masked heterogeneity? Med Care Res Rev. 2017;74(1):3–78. https://doi.org/10.1177/1077558715619282 .

Quinn AE, Trachtenberg AJ, McBrien KA, Ogundeji Y, Souri S, Manns L, Rennert-May E, Ronksley P, Au F, Arora N, Hemmelgarn B, Tonelli M, Manns BJ. Impact of payment model on the behaviour of specialist physicians: A systematic review. Health Policy. 2020;124(4):345–58. https://doi.org/10.1016/j.healthpol.2020.02.007 .

Brown K, El Husseini N, Grimley R, Ranta A, Kass-Hout T, Kaplan S, Kaufman BG. Alternative payment models and associations with stroke outcomes, spending, and service utilization: A systematic review. Stroke. 2022;53(1):268–78. https://doi.org/10.1161/STROKEAHA.121.033983 .

Feldhaus I, Mathauer I. Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature. BMC Health Servies Research. 2018;18:996. https://doi.org/10.1186/s12913-018-3779-1 .

Palmer, K.S., Agoritsas, T., Martin, D., Scott, T., Mulla, S.M., Miller, A.P., Agarwal, A., Bresnahan, A., Hazzan, A.A., Jeffery, R.A., Merglen, A., Negm, A., Siemieniuk, R.A., Bhatnagar, N., Dhalla, I.A., Lavis, J.N., You, J.J., Duckett, S.J., Guyatt, G.H.: Activity-based funding of hospitals and its impact on mortality, readmission, discharge destination, severity of illness, and volume of care: A systematic review and meta-analysis. PLoS ONE 9(10) (2014). https://doi.org/10.1371/journal.pone.0109975 .

Cattel D, Eijkenaar F. Value-based provider payment initiatives combining global payments with explicit quality incentives: A systematic review. Med Care Res Rev. 2020;77(6):511–37. https://doi.org/10.1177/1077558719856775 .

Jia L, Meng Q, Scott A, Yuan B, Zhang L. Payment methods for healthcare providers working in outpatient healthcare settings. Cochrane Database Syst Rev. 2021;1. https://doi.org/10.1002/14651858 .

Ahmed, K., Hashim, S., Khankhara, M., Said, I., Shandakumar, A., Zaman, S., Veiga, A.: What drives general practitioners in the uk to improve the quality of care? a systematic literature review. BMJ Open Quality 10 (2021). https://doi.org/10.1136/bmjoq-2020-001127 .

Forbes LJ, Marchand C, Doran T, Peckham S. The role of the quality and outcomes framework in the care of long-term conditions: a systematic review. Br J Gen Pract. 2017;67(664):775–84. https://doi.org/10.3399/bjgp17X693077 .

Kim KM, Max W, White JS, Chapman SA, Muench U. Do penalty-based pay-for-performance programs improve surgical care more effectively than other payment strategies? a systematic review. Annals of Medicine and Surgery. 2020;60:623–30. https://doi.org/10.1016/j.amsu.2020.11.060 .

Huang J, Yin S, Lin Y, Jiang Q, He Y, Du L. Impact of pay-for-performance on management of diabetes: A systematic review. J Evid Based Med. 2013;6:173–84. https://doi.org/10.1111/jebm.12052 .

Mendelson, A., Kondo, K., Damberg, C., Low, A., Motuapuaka, M., Freeman, M., O’Neil, M., Relevo, R., Kansagara, D.: The effects of pay-for-performance programs on health, health care use, and processes of care: A systematic review. Annals of Internal Medicine 166 (2017). https://doi.org/10.7326/M16-1881 .

Vlaanderen F, Tanke M, Bloem B, Faber M, Eijkenaar F, Schut F, Jeurissen P. Design and effects of outcome-based payment models in healthcare: a systematic review. Eur J Health Econ. 2019;20(2):217–32. https://doi.org/10.1007/s10198-018-0989-8 .

Article   CAS   PubMed   Google Scholar  

De Vries E, Scheefhals Z, Bruin-Kooistra M, Baan C, Struijs J. A scoping review of alternative payment models in maternity care: Insights in key design elements and effects on health and spending. Int J Integr Care. 2021;21(2):6. https://doi.org/10.5334/ijic.5535 .

Benabbas R, Shan G, Akindutire O, Mehta N, Sinert R. The effect of pay-for-performance compensation model implementation on vaccination rate: A systematic review. Qual Manag Health Care. 2019;28(3):155–62. https://doi.org/10.1097/QMH.0000000000000219 .

Herbst, T., Emmert, M.: Characterization and effectiveness of pay-for-performance in ophthalmology: a systematic review. BMC Health Services Research 17 (2017). https://doi.org/10.1186/s12913-017-2333-x .

Emmert M, Eijkenaar F, Kemter H, Esslinger AS, Schöffski O. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ. 2012;13:755–67. https://doi.org/10.1007/s10198-011-0329-8 .

Mathes, T., Pieper, D., Morche, J., Polus, S., Jaschinski, T., Eikermann, M.: Pay for performance for hospitals. The Cochrane database of systematic reviews 7 (2019). https://doi.org/10.1002/14651858.CD011156.pub2 .

Mauro, M., Rotundo, G., Giancotti, M.: Effect of financial incentives on breast, cervical and colorectal cancerscreening delivery rates: Results from a systematic literature review. Health Policy 123 (2019). https://doi.org/10.1016/j.healthpol.2019.09.012 .

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Partial facial duplication (diprosopus): a  case report and review of the literature

• Fathia Omer Salah   ORCID: orcid.org/0009-0002-0984-9628 1 ,
• Yohannes Girma Zewdie 1 ,
• Semienew Ambachew 2 ,
• Amal Saleh Nour 1 &
• Tewodros Endale 1  

Journal of Medical Case Reports volume  18 , Article number:  176 ( 2024 ) Cite this article

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Diprosopus, or craniofacial duplication, is a rare entity that occurs in approximately 1 in 180,000 to 15 million live births. The degree of duplication varies from complete facial duplication to small facial structure duplication like the nose and eye. The cause of diprosopus is unknown though there are proposed factors.

Case presentation

Our African patient was a term 72 hours old female neonate who was referred to our center with impression of lower facial duplication with two oral cavity that are located side to side separated by large soft tissue, she also had flat nasal bridge with widely separated nostrils and widely spaced eyes. Besides the facial malformation she had multiple episodes of vomiting with aspiration. Her blood tests were normal. Precontract brain computed tomography (CT) scan confirmed partially duplicated mandible and maxilla, two oral cavity separated by large fatty tissue, brain tissue were well formed and the only abnormality was corpus callosum agenesis and interhemispheric lipoma. In her stay at hospital nasogastric tube (NG) tube feed was initiated and started with antibiotics for aspiration pneumonia. After 25th day the neonatal passed away with possible cause of death being respiratory failure.

Craniofacial duplication is a very rare anomaly with only a few cases reported. Most of these patients are stillborn, even if they survive the prognosis is often poor. Early prenatal diagnosis is very important as termination of pregnancy can sometimes be considered an option.

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Introduction

The “Diprosopus” (from Greek: di-two; prosopon-face) is the duplication of facial structures in a single head. Diprosopus is considered a subtype of conjoined twin. However, the pathogenesis of this anomaly is still unknown [ 1 ]. Two possible mechanisms leading to diprosopus formation have been proposed. The first mechanism is possible cranial bifurcation of the notochord during neurulation. Bifurcation causes two vertebral axes and neural plates to develop alongside each other. Another proposal is an increase in the expression of the sonic hedgehog protein, which is essential for craniofacial patterning during development [ 2 ]. Advanced maternal age, polyhydramnious, and consanguineous marriage are considered high‑risk factors for diprosopus. Prenatal diagnosis using ultrasonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) is possible. If diagnosis is made early during pregnancy, termination of pregnancy is sometimes considered an option. Usually, diprosopus patients are stillborn if not the prognosis is poor [ 3 ].

A 72 hour-old term African new born to a 30-year-old Para—II mother presented with sign of neonatal sepsis and lower facial malformation. She had antenatal care (ANC) follow-up, but no obstetric ultrasound was performed. There was no consanguinity between her and her husband.

The neonate was 2700 g female with an APGAR score of 5 and 7 at the first and 5th minutes, respectively.

The neonate was referred to our institution for better evaluation and management of facial malformation.

On physical examination, her vital signs were all within the normal range, she had a depressed nasal bridge, and two nasal openings which were wide apart. There were two eyes that were also widely separated. Two mouths separated by skin covered tissue with two dimples noted and two tongues were seen (Fig.  1 ).

3D reconstructed image showing two oral cavity that are separated by large soft tissue having two dimples. On the same image the nostrils are seen separated by flat nasal bridge and there is increased gap between the eyes

Blood test results and imaging were also recorded. All the blood test results were normal. Pertinent imaging findings with transfontanelle ultrasound, head and neck CT. Transfontanelle ultrasound demonstrate normal well-formed brain tissue with normal ventricular size, the only positive finding was non visualization of the corpus callosum (Fig.  2 ). Head and neck CT findings were widely separated orbits and nostrils. There was also small interhemispheric fat attenuating lesion, which suggested lipoma (Fig.  3 )  Metopic suture was widened, partial duplicated maxilla and mandible covered by redundant subcutaneous tissue was noted  (Fig.  4 ). There was also duplication of the anterior two-thirds of the tongue (Fig.  5 ).

Transfontanelle ultrasound images A coronal image showing absence of corpus callosum with Viking helmet appearance of the anterior horn of lateral ventricles (black arrows) and dilated high riding 3rd ventricle (white arrow), B mid sagittal image absence of corpus callosum and radiating appearance of the grey matters typical for the sun ray appearance (arrows)

Post contrast axial brain CT image showing small midline fat density lesion representing lipoma (white arrow)

3D volume rendered bone window image of head CT [right oblique ( A ), frontal ( B ) and left oblique view ( C )] demonstrating widely separated metopic suture (blue arrow), orbits and partially duplicated mandible (white arrow)

Axial soft tissue window CT image A showing widely separated orbits B more lower down images demonstrating two nasal opening (blue arrow) that are separated by soft tissue (white arrow) C axial image demonstrating partially duplicated tongues anteriorly (orange arrows) which fuse posteriorly directing to the two mouths on each side D axial image at levels of mandibles demonstrating posteriorly fussed lateral diverting tongue bases, no duplication of the posterior aero digestive system is noted

While the neonate was on treatment for early onset neonatal sepsis with antibiotics and nasogastric tube feeding, she developed multiple episodes of vomiting and aspiration complicated with aspiration pneumonia. Despite the treatment given, the neonate passed away on the 25th day after admission possibly because of respiratory failure secondary to aspiration pneumonia.

Diprosopus is a rare clinical entity with very few reported cases in the literature. There are only approximately 36 reported cases in the literature [ 3 ].

There is a predominance of females over males (2:1) [ 4 ]. The duplication can involve structures as small as the nasal to complete facial structures [ 5 ]. A complete duplication or dicephalus is associated with a high incidence of anomalies in the central nervous system (CNS), cardiovascular system (CVS), gastrointestinal system (GI) and respiratory system (RS), as well as in the cleft lip and palate. Partial duplication is less often associated with other anomalies. Infants with partial duplication have a mandible and a mouth, which are most duplicated. The CNS anomalies involve anencephaly, duplication of the brain with two prosencephalon and a single rhombencephalon, two diencephalons (each with a set of thalami and basal ganglia) and two symmetric telencephalons (each with a set of cerebral hemispheres and lobes). Hypoplasia of the medial temporal lobe was also noted. Multiple spinal abnormalities with duplication of the cervical spine and abnormal cervical and thoracic vertebrae have been observed [ 6 ]. The defects in the other organs include diaphragmatic hernia; cardiac defects (VSD, an overriding aorta and a hypoplastic ascending and descending aorta; an aortic arch; and dextrocardia); bilateral dysplastic cystic kidneys; hypoplasia of the ureters and the urinary bladder cleft lip palate and imperforate anus [ 7 , 8 ].

The embryology of this condition has been a matter of debate. The most accepted theory is that conjoined twins result from an embryological disturbance in the separation of the twins during the 2nd week of pregnancy (12–13 days) as a result of the abnormal splitting of post-implantation blastocytes [ 9 ]. Such incomplete, separated, germinal discs lead to this extremely rare fetal anomaly. However, recently, it has been postulated that conjoined twins result from the development of two independent notochords, which were initially destined to become separate twins but were too close to develop independently [ 10 ].

The earliest clinical finding associated with diprosopus is polyhydramnious [ 11 ]. The disease can be diagnosed prenatally by ultrasonography, CT scan, and MRI which reveal all the facial features and associated anomalies but these facilities are not widely available in developing countries. Estimation of serum alpha fetoprotein levels also helps in prenatal diagnosis.

The prognosis depends on the degree of duplication, as cases with complete duplication are still born and those with partial duplication vary from early neonatal death from primary or associated anomalies or acquired disease to possible long term survival after surgical correction [ 6 , 12 ]. With the spread of prenatal follow-up, early detection of cases with conjoined twins, such as diprosopus, is essential for social, economic and ethical reasons and will enable parents to make decisions in the early weeks [ 13 ].

Conclusions

Craniofacial duplication is a rare entity that is more common in females. Pathophysiology is incompletely understood but the most accepted theory is that conjoined twins result from an embryological disturbance in the separation of the twins during the 2nd week of pregnancy. In partial facial duplication CT and MR imaging are important for evaluating the degree of duplication so that cosmetic reconstruction can be planned.

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Bidondo MP, Groisman B, Tardivo A, Tomasoni F, Tejeiro V, Camacho I, Vilas M, Liascovich R, Barbero P. Diprosopus: systematic review and report of two cases. Birth Defects Res A Clin Mol Teratol. 2016;106(12):993–1007. https://doi.org/10.1002/bdra.23549 .

Article   CAS   PubMed   Google Scholar  

Hähnel S, Schramm P, Hassfeld S, Steiner HH, Seitz A. Craniofacial duplication (diprosopus): CT, MR imaging, and MR angiography findings case report. Radiology. 2003;226(1):210–3. https://doi.org/10.1148/radiol.2261011754 .

Article   PubMed   Google Scholar  

Bhuyan M, Haque I. Diprosopus a rare craniofacial malformation. Asian J Neurosurg. 2018;13(4):1257–9. https://doi.org/10.4103/ajns.AJNS_202_17.P .

Article   PubMed   PubMed Central   Google Scholar  

Barr M Jr. Facial duplication: case, review, and embryogenesis. Teratology. 1982;25(2):153–9. https://doi.org/10.1002/tera.1420250205 .

Amr SS, Hammouri MF. Craniofacial duplication (diprosopus): report of a case with a review of the literature. Eur J Obstet Gynecol Reprod Biol. 1995;58(1):77–80. https://doi.org/10.1016/0028-2243(94)01937-3 .

Suryawanshi P, Deshpande M, Verma N, Mahendrakar V, Mahendrakar S. Craniofacial duplication: a case report. J Clin Diagn Res. 2013;7(9):2025–6. https://doi.org/10.7860/JCDR/2013/5658.3395 .

Chervenak FA, Pinto MM, Heller CI, Norooz H. Obstetric significance of fetal craniofacial duplication. A case report. J Reprod Med. 1985;30(1):74–6.

CAS   PubMed   Google Scholar  

Turpin IM, Furnas DW, Amlie RN. Craniofacial duplication (diprosopus). Plast Reconstruct Surg. 1981;67:139–42.

Article   CAS   Google Scholar  

Strauss S, Tamarkin M, Engelberg S, Ben Ami T, Goodman RM. Prenatal sonographic appearance of diprosopus. J Ultrasound Med. 1987;6(2):93–5. https://doi.org/10.7863/jum.1987.6.2.93 .

Spencer R. Conjoined twins: theoretical embryologic basis. Teratology. 1992;45(6):591–602. https://doi.org/10.1002/tera.1420450604 .

Paria P, Halder RC, Ghosh S. Diprosopus twin. Sri Lanka J Child Health. 2016;45(3):231–2. https://doi.org/10.4038/sljch.v45i3.8002 .

Article   Google Scholar  

Yahaya RS, Suwaid MA, Hassan S, Lawal Y, Hassan I, Gwaram BA, et al . A “three-eyed” infant: a case of partial facialduplication (diprosopus monocephalus triophthalmos). West Afr J Radiol. 2018;25:79–83. https://doi.org/10.4103/wajr.wajr_33_17 .

Thornton KM, Bennett T, Singh V, Mardis N, Linebarger J, Kilbride H, Voos K. A case of diprosopus: perinatal counseling and management. Case Rep Pediatr. 2014;2014: 279815. https://doi.org/10.1155/2014/279815 .

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Acknowledgements

We are grateful for the parent of the child, department of radiology and neonatology.

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Fathia Omer Salah, Yohannes Girma Zewdie, Amal Saleh Nour & Tewodros Endale

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FO, YG, AS, TE participated in images revision, sequence alignment and drafted the case report. SA is the neonatologist and participated in case presentation, discussion and patient care writing clinical course. All authors read and approved the final case report.

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Correspondence to Fathia Omer Salah .

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Salah, F.O., Zewdie, Y.G., Ambachew, S. et al. Partial facial duplication (diprosopus): a  case report and review of the literature. J Med Case Reports 18 , 176 (2024). https://doi.org/10.1186/s13256-024-04423-4

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DOI : https://doi.org/10.1186/s13256-024-04423-4

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