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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.

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.

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Research bias

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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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McCombes, S. (2023, September 11). How to Write a Literature Review | Guide, Examples, & Templates. Scribbr. Retrieved March 20, 2024, from https://www.scribbr.com/dissertation/literature-review/

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Research Methods

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

Literature Review

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

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

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

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

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

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

A literature review is important because it:

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

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

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

Not an essay 

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

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

A literature review serves several purposes. For example, it

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

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

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

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

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

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

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

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

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

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

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

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

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

Systematic review or meta-analysis?

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

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

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

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

Not all systematic reviews contain meta-analysis. 

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

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

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

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

• << Previous: Getting Started
• Next: Research Design >>
• Last Updated: Aug 21, 2023 4:07 PM
• URL: https://guides.lib.udel.edu/researchmethods

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• Knowledge Base
• Dissertation
• 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.

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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McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 20 March 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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Teaching and Research guides

Literature reviews.

• Introduction
• Plan your search
• Where to search
• Refine and update your search
• Finding grey literature
• Writing the review
• Referencing

Research methods overview

Finding literature on research methodologies, sage research methods online.

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What are research methods?

Research methodology is the specific strategies, processes, or techniques utilised in the collection of information that is created and analysed.

The methodology section of a research paper, or thesis, enables the reader to critically evaluate the study’s validity and reliability by addressing how the data was collected or generated, and how it was analysed.

Types of research methods

There are three main types of research methods which use different designs for data collection.  

(1) Qualitative research

Qualitative research gathers data about lived experiences, emotions or behaviours, and the meanings individuals attach to them. It assists in enabling researchers to gain a better understanding of complex concepts, social interactions or cultural phenomena. This type of research is useful in the exploration of how or why things have occurred, interpreting events and describing actions.

Examples of qualitative research designs include:

• focus groups
• observations
• document analysis
• oral history or life stories  

(2) Quantitative research

Quantitative research gathers numerical data which can be ranked, measured or categorised through statistical analysis. It assists with uncovering patterns or relationships, and for making generalisations. This type of research is useful for finding out how many, how much, how often, or to what extent.

Examples of quantitative research designs include:

• surveys or questionnaires
• observation
• document screening
• experiments  

(3) Mixed method research

Mixed Methods research integrates both Qualitative research and Quantitative research. It provides a holistic approach combining and analysing the statistical data with deeper contextualised insights. Using Mixed Methods also enables triangulation, or verification, of the data from two or more sources.

Sometimes in your literature review, you might need to discuss and evaluate relevant research methodologies in order to justify your own choice of research methodology.

When searching for literature on research methodologies it is important to search across a range of sources. No single information source will supply all that you need. Selecting appropriate sources will depend upon your research topic.

Developing a robust search strategy will help reduce irrelevant results. It is good practice to plan a strategy before you start to search.

Search tips

(1) free text keywords.

Free text searching is the use of natural language words to conduct your search. Use selective free text keywords such as: phenomenological, "lived experience", "grounded theory", "life experiences", "focus groups", interview, quantitative, survey, validity, variance, correlation and statistical.

To locate books on your desired methodology, try LibrarySearch . Remember to use  refine  options such as books, ebooks, subject, and publication date.  

(2) Subject headings in Databases

Databases categorise their records using subject terms, or a controlled vocabulary (thesaurus). These subject headings may be useful to use, in addition to utilising free text keywords in a database search.

Subject headings will differ across databases, for example, the PubMed database uses 'Qualitative Research' whilst the CINHAL database uses 'Qualitative Studies.'  

(3) Limiting search results

Databases enable sets of results to be limited or filtered by specific fields, look for options such as Publication Type, Article Type, etc. and apply them to your search.  

(4) Browse the Library shelves

To find books on  research methods  browse the Library shelves at call number  001.42

• SAGE Research Methods Online SAGE Research Methods Online (SRMO) is a research tool supported by a newly devised taxonomy that links content and methods terms. It provides the most comprehensive picture available today of research methods (quantitative, qualitative and mixed methods) across the social and behavioural sciences.

SAGE Research Methods Overview  (2:07 min) by SAGE Publishing  ( YouTube ) 

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Organizing Your Social Sciences Research Paper

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

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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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 Structure Your Literature Review

3 options to help structure your chapter.

By: Amy Rommelspacher (PhD) | Reviewer: Dr Eunice Rautenbach | November 2020 (Updated May 2023)

Writing the literature review chapter can seem pretty daunting when you’re piecing together your dissertation or thesis. As  we’ve discussed before , a good literature review needs to achieve a few very important objectives – it should:

• Demonstrate your knowledge of the research topic
• Identify the gaps in the literature and show how your research links to these
• Provide the foundation for your conceptual framework (if you have one)
• Inform your own  methodology and research design

To achieve this, your literature review needs a well-thought-out structure . Get the structure of your literature review chapter wrong and you’ll struggle to achieve these objectives. Don’t worry though – in this post, we’ll look at how to structure your literature review for maximum impact (and marks!).

But wait – is this the right time?

Deciding on the structure of your literature review should come towards the end of the literature review process – after you have collected and digested the literature, but before you start writing the chapter. 

In other words, you need to first develop a rich understanding of the literature before you even attempt to map out a structure. There’s no use trying to develop a structure before you’ve fully wrapped your head around the existing research.

Equally importantly, you need to have a structure in place before you start writing , or your literature review will most likely end up a rambling, disjointed mess. 

Importantly, don’t feel that once you’ve defined a structure you can’t iterate on it. It’s perfectly natural to adjust as you engage in the writing process. As we’ve discussed before , writing is a way of developing your thinking, so it’s quite common for your thinking to change – and therefore, for your chapter structure to change – as you write. 

Need a helping hand?

Like any other chapter in your thesis or dissertation, your literature review needs to have a clear, logical structure. At a minimum, it should have three essential components – an  introduction , a  body   and a  conclusion . 

Let’s take a closer look at each of these.

1: The Introduction Section

Just like any good introduction, the introduction section of your literature review should introduce the purpose and layout (organisation) of the chapter. In other words, your introduction needs to give the reader a taste of what’s to come, and how you’re going to lay that out. Essentially, you should provide the reader with a high-level roadmap of your chapter to give them a taste of the journey that lies ahead.

Here’s an example of the layout visualised in a literature review introduction:

Your introduction should also outline your topic (including any tricky terminology or jargon) and provide an explanation of the scope of your literature review – in other words, what you  will   and  won’t   be covering (the delimitations ). This helps ringfence your review and achieve a clear focus . The clearer and narrower your focus, the deeper you can dive into the topic (which is typically where the magic lies). 

Depending on the nature of your project, you could also present your stance or point of view at this stage. In other words, after grappling with the literature you’ll have an opinion about what the trends and concerns are in the field as well as what’s lacking. The introduction section can then present these ideas so that it is clear to examiners that you’re aware of how your research connects with existing knowledge .

2: The Body Section

The body of your literature review is the centre of your work. This is where you’ll present, analyse, evaluate and synthesise the existing research. In other words, this is where you’re going to earn (or lose) the most marks. Therefore, it’s important to carefully think about how you will organise your discussion to present it in a clear way. 

The body of your literature review should do just as the description of this chapter suggests. It should “review” the literature – in other words, identify, analyse, and synthesise it. So, when thinking about structuring your literature review, you need to think about which structural approach will provide the best “review” for your specific type of research and objectives (we’ll get to this shortly).

There are (broadly speaking)  three options  for organising your literature review.

Option 1: Chronological (according to date)

Organising the literature chronologically is one of the simplest ways to structure your literature review. You start with what was published first and work your way through the literature until you reach the work published most recently. Pretty straightforward.

The benefit of this option is that it makes it easy to discuss the developments and debates in the field as they emerged over time. Organising your literature chronologically also allows you to highlight how specific articles or pieces of work might have changed the course of the field – in other words, which research has had the most impact . Therefore, this approach is very useful when your research is aimed at understanding how the topic has unfolded over time and is often used by scholars in the field of history. That said, this approach can be utilised by anyone that wants to explore change over time .

For example , if a student of politics is investigating how the understanding of democracy has evolved over time, they could use the chronological approach to provide a narrative that demonstrates how this understanding has changed through the ages.

Here are some questions you can ask yourself to help you structure your literature review chronologically.

• What is the earliest literature published relating to this topic?
• How has the field changed over time? Why?
• What are the most recent discoveries/theories?

In some ways, chronology plays a part whichever way you decide to structure your literature review, because you will always, to a certain extent, be analysing how the literature has developed. However, with the chronological approach, the emphasis is very firmly on how the discussion has evolved over time , as opposed to how all the literature links together (which we’ll discuss next ).

Option 2: Thematic (grouped by theme)

The thematic approach to structuring a literature review means organising your literature by theme or category – for example, by independent variables (i.e. factors that have an impact on a specific outcome).

As you’ve been collecting and synthesising literature , you’ll likely have started seeing some themes or patterns emerging. You can then use these themes or patterns as a structure for your body discussion. The thematic approach is the most common approach and is useful for structuring literature reviews in most fields.

For example, if you were researching which factors contributed towards people trusting an organisation, you might find themes such as consumers’ perceptions of an organisation’s competence, benevolence and integrity. Structuring your literature review thematically would mean structuring your literature review’s body section to discuss each of these themes, one section at a time.

Here are some questions to ask yourself when structuring your literature review by themes:

• Are there any patterns that have come to light in the literature?
• What are the central themes and categories used by the researchers?
• Do I have enough evidence of these themes?

PS – you can see an example of a thematically structured literature review in our literature review sample walkthrough video here.

Option 3: Methodological

The methodological option is a way of structuring your literature review by the research methodologies used . In other words, organising your discussion based on the angle from which each piece of research was approached – for example, qualitative , quantitative or mixed  methodologies.

Structuring your literature review by methodology can be useful if you are drawing research from a variety of disciplines and are critiquing different methodologies. The point of this approach is to question  how  existing research has been conducted, as opposed to  what  the conclusions and/or findings the research were.

For example, a sociologist might centre their research around critiquing specific fieldwork practices. Their literature review will then be a summary of the fieldwork methodologies used by different studies.

Here are some questions you can ask yourself when structuring your literature review according to methodology:

• Which methodologies have been utilised in this field?
• Which methodology is the most popular (and why)?
• What are the strengths and weaknesses of the various methodologies?
• How can the existing methodologies inform my own methodology?

3: The Conclusion Section

Once you’ve completed the body section of your literature review using one of the structural approaches we discussed above, you’ll need to “wrap up” your literature review and pull all the pieces together to set the direction for the rest of your dissertation or thesis.

The conclusion is where you’ll present the key findings of your literature review. In this section, you should emphasise the research that is especially important to your research questions and highlight the gaps that exist in the literature. Based on this, you need to make it clear what you will add to the literature – in other words, justify your own research by showing how it will help fill one or more of the gaps you just identified.

Last but not least, if it’s your intention to develop a conceptual framework for your dissertation or thesis, the conclusion section is a good place to present this.

Example: Thematically Structured Review

In the video below, we unpack a literature review chapter so that you can see an example of a thematically structure review in practice.

Let’s Recap

In this article, we’ve  discussed how to structure your literature review for maximum impact. Here’s a quick recap of what  you need to keep in mind when deciding on your literature review structure:

• Just like other chapters, your literature review needs a clear introduction , body and conclusion .
• The introduction section should provide an overview of what you will discuss in your literature review.
• The body section of your literature review can be organised by chronology , theme or methodology . The right structural approach depends on what you’re trying to achieve with your research.
• The conclusion section should draw together the key findings of your literature review and link them to your research questions.

If you’re ready to get started, be sure to download our free literature review template to fast-track your chapter outline.

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 .

You Might Also Like:

27 Comments

Great work. This is exactly what I was looking for and helps a lot together with your previous post on literature review. One last thing is missing: a link to a great literature chapter of an journal article (maybe with comments of the different sections in this review chapter). Do you know any great literature review chapters?

I agree with you Marin… A great piece

I agree with Marin. This would be quite helpful if you annotate a nicely structured literature from previously published research articles.

Awesome article for my research.

I thank you immensely for this wonderful guide

It is indeed thought and supportive work for the futurist researcher and students

Very educative and good time to get guide. Thank you

Great work, very insightful. Thank you.

Thanks for this wonderful presentation. My question is that do I put all the variables into a single conceptual framework or each hypothesis will have it own conceptual framework?

Thank you very much, very helpful

This is very educative and precise . Thank you very much for dropping this kind of write up .

Pheeww, so damn helpful, thank you for this informative piece.

I’m doing a research project topic ; stool analysis for parasitic worm (enteric) worm, how do I structure it, thanks.

comprehensive explanation. Help us by pasting the URL of some good “literature review” for better understanding.

great piece. thanks for the awesome explanation. it is really worth sharing. I have a little question, if anyone can help me out, which of the options in the body of literature can be best fit if you are writing an architectural thesis that deals with design?

I am doing a research on nanofluids how can l structure it?

Beautifully clear.nThank you!

Lucid! Thankyou!

Brilliant work, well understood, many thanks

I like how this was so clear with simple language 😊😊 thank you so much 😊 for these information 😊

Insightful. I was struggling to come up with a sensible literature review but this has been really helpful. Thank you!

You have given thought-provoking information about the review of the literature.

Thank you. It has made my own research better and to impart your work to students I teach

I learnt a lot from this teaching. It’s a great piece.

I am doing research on EFL teacher motivation for his/her job. How Can I structure it? Is there any detailed template, additional to this?

You are so cool! I do not think I’ve read through something like this before. So nice to find somebody with some genuine thoughts on this issue. Seriously.. thank you for starting this up. This site is one thing that is required on the internet, someone with a little originality!

I’m asked to do conceptual, theoretical and empirical literature, and i just don’t know how to structure it

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Literature Review for Grad Students in Education

• Library Guide: Literature Review

Introduction to Literature Review

If you cannot access the above video, you can watch it here

What is a Literature Review

  The purpose of an academic research paper is to express and document an original idea. Literature Review is one part of that process of writing a research paper. In a research paper, you use the literature as a starting point, a building block and as evidence of a new insight. The goal of the literature review is only to summarize and synthesize the arguments and ideas of others. You should not present your original idea.

The reading that you do as part of a literature review will answer one of two questions:

“What do we know about the subject of our study?” “Based on what we know, what conclusions can we draw about the research question?”

Notice that the conclusions to be drawn are about the research question , as opposed to a novel theory. 

The types of conclusions about your research question that you want to discover are: ❖ gaps in the knowledge on a subject area ❖ questions about your topic that remain unanswered ❖ areas of disagreement in your subject area that need to be settled.

Purpose of Literature Review?

There are a number of differing descriptions of the purpose of a literature review. Primarily it is a tool for

❖ researching the history of scholarly publication on a topic

❖ becoming aware of the scholarly debate within a topic

❖  a summary or restatement of conclusions from research which has been published

❖ synthesis or recombining, comparing and contrasting, the ideas of others.

❖ evaluate sources

❖ search for gaps

A literature review provides a comprehensive overview of a topic , supporting the fundamental purpose of a research paper, which is to present a new point of view or insight on a topic. The literature review supports the new insight. It does not present or argue for it.

Structure of Literature Review

• Choose a topic
• Find research
• Organize sources/notetaking
• Evaluate Sources
• Synthesize: think of this phase as a narrative . 

There are various ways of organizing the literature review process- if one of these seems closer to your purpose, try it out.

Different Types of Literature Sources

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Literature Review & Research Methods

What is a literature review?

Research Methods in General

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In brief, the lit review is the part of a scholarly paper that discusses the relevant research, theoretical and methodological contributions on the topic. Watch these videos to learn more!

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Research Methods in Social Science

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Search Strategies 

1. Use the following  keywords  to identify qualitative research.  

These keywords will search the titles, abstracts and keywords of records held in the databases. Use quotations to search as a phrase:

2. Use  controlled vocabulary

Databases use controlled vocabulary to categorize each record stored. The terms they use are known as  thesaurus terms  or subject headings .  The thesaurus terms vary for each database according to their indexing system.

For example, qualitative research is indexed in  PubMed  as "Qualitative Research" or "Nursing Methodology Research", while in CINAHL  their subject heading "Qualitative Studies" is complemented by more detailed terms, including "Phenomenological Research" and "Grounded Theory".

Tutorials  for searching subject headings:

3. Use  qualitative research filters

Qualitative research filters are pre-formulated search strategies that have been constructed by librarians to help you retrieve articles in databases that deal with qualitative research. You can use the filter and then combine the results with your subject.

• Go to  PsychINFO  database in  Database Finder .
• Enter your topic in the search box.
• In right column, under  Methodoly,   MATHEMATICAL MODEL , select  Qualitative study .
• Under  Refine Search  section on the left, limit further your search under  Methodology  drop down menu.

Modify your search strategy accordingly by using thesaurus terms, such as qualitative research, grounded theory, interviews, observation methods, etc.

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SYSTEMATIC REVIEW article

Promoting mental health in children and adolescents through digital technology: a systematic review and meta-analysis.

• Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan, China

Background: The increasing prevalence of mental health issues among children and adolescents has prompted a growing number of researchers and practitioners to explore digital technology interventions, which offer convenience, diversity, and proven effectiveness in addressing such problems. However, the existing literature reveals a significant gap in comprehensive reviews that consolidate findings and discuss the potential of digital technologies in enhancing mental health.

Methods: To clarify the latest research progress on digital technology to promote mental health in the past decade (2013–2023), we conducted two studies: a systematic review and meta-analysis. The systematic review is based on 59 empirical studies identified from three screening phases, with basic information, types of technologies, types of mental health issues as key points of analysis for synthesis and comparison. The meta-analysis is conducted with 10 qualified experimental studies to determine the overall effect size of digital technology interventions and possible moderating factors.

Results: The results revealed that (1) there is an upward trend in relevant research, comprising mostly experimental and quasi-experimental designs; (2) the common mental health issues include depression, anxiety, bullying, lack of social emotional competence, and mental issues related to COVID-19; (3) among the various technological interventions, mobile applications (apps) have been used most frequently in the diagnosis and treatment of mental issues, followed by virtual reality, serious games, and telemedicine services; and (4) the meta-analysis results indicated that digital technology interventions have a moderate and significant effect size ( g  = 0.43) for promoting mental health.

Conclusion: Based on these findings, this study provides guidance for future practice and research on the promotion of adolescent mental health through digital technology.

Systematic review registration: https://inplasy.com/inplasy-2023-12-0004/ , doi: 10.37766/inplasy2023.12.0004 .

1 Introduction

In recent years, the mental health status of children and adolescents (6–18 years old) has been a matter of wide societal concern. The World Health Organization noted that one in seven adolescents suffers from mental issues, accounting for 13% of the global burden of disease in this age group ( World Health Organization, 2021 ). In particular, the emergence of COVID-19 has led to an increase in depression, anxiety, and other psychological symptoms ( Jones et al., 2021 ; Shah et al., 2021 ). There is thus an urgent need to monitor and diagnose the mental health of teenagers.

The development of digital technology has brought about profound socio-economic changes; it also provides new opportunities for mental health diagnosis and intervention ( Goodyear and Armour, 2018 ; Giovanelli et al., 2020 ). First, digital technology breaks the constraints of time and space. It not only provides adolescents with mental health services at a distance but also enables real-time behavioral monitoring for the timely acquisition of dynamic data on adolescents’ mental health ( Naslund et al., 2017 ). Second, due to the still-developing stage of mental health resource building, traditional intervention methods may not be able to meet the increasing demand for mental health services among children and adolescents ( Villarreal, 2018 ; Aschbrenner et al., 2019 ). In addition, as digital natives in the information age, adolescents have the ability to use digital technology proficiently, and social media, such as the internet, has long been integrated into all aspects of adolescents’ lives ( Uhlhaas and Torous, 2019 ). However, it is worth noting that excessive reliance on digital technology (e.g., internet and smartphone addiction) are also common triggers of mental problems among youth ( Wacks and Weinstein, 2021 ). Therefore, we must be aware of the risks posed by digital technology to better utilize it for promoting the mental health of young people.

Mental health, sometimes referred to as psychological health in the literature, encompasses three different perspectives: pathological orientation, positive orientation, and complete orientation ( Keyes, 2009 ). Pathological orientation refers to whether patients exhibit symptoms of mental issues, including internalized mental disorders (e.g., depression and anxiety) and behavioral dysfunctions (e.g., aggression, self-harm) as well as other mental illnesses. Studies have indicated that both internalizing and externalizing disorders belong to different dimensions of mental disorders ( Scott et al., 2020 ), and internalizing symptoms often occur simultaneously with externalizing behaviors ( Essau and de la Torre-Luque, 2023 ). The positive orientation suggests that mental health is a positive mental state, characterized by a person’s ability to fully participate in various activities and to express positive and negative emotions ( Kenny et al., 2016 ). The complete orientation integrates pathological and positive orientation ( Antaramian et al., 2010 ), suggesting that mental health means the absence of mental issues and the presence of subjective well-being ( Suldo and Shaffer, 2008 ). The development of social emotional abilities helps to promote subjective well-being for adolescents during social, emotional, and cognitive development ( Cejudo et al., 2019 ). Adolescents with mental health issues may thus exhibit pathological symptoms or lack of subjective well-being due to a lack of social emotional abilities. In this study, mental health is defined as a psychological state advocated by the complete orientation.

Promoting mental health using digital technology involves providing help through digital tools such as computers, tablets, or phones with internet-based programs ( Hollis et al., 2017 ). Currently, various digital technologies have been tested to address mental health issues in young individuals, including apps, video games, telemedicine, chatbots, and virtual reality (VR). However, the impact of digital technology interventions is affected by various factors ( Piers et al., 2023 ). Efficacy varies based on the kind of mental health issues. Individuals with mental illness related to COVID-19 may profit more from digital interventions than those experiencing depression and anxiety. Moreover, studies reveal that several mental health conditions in young people deteriorate with age, particularly anxiety and suicide attempts ( Tang et al., 2019 ). The impact of digital technology interventions may therefore differ depending on the adolescent’s age. Having psychological problems usually indicates that people are in an unhealthy mental state for a long time, so an enduring intervention may have greater efficacy than a short-term one. Earlier studies have also suggested that the outcomes of treatment are linked to its duration, with patients receiving long-term treatment experiencing better results ( Grist et al., 2019 ).

Although more digital technologies are being used to treat mental health issues, the most important clinical findings have come from strict randomized controlled trials ( Mohr et al., 2018 ). It is still unclear how these interventions affect long-term care or how they would function in real-world settings ( Folker et al., 2018 ). There is much relevant empirical research, but it is scattered, and there is a need for systematic reviews in this area. In previous studies about technology for mental health, Grist et al. (2019) analyzed how digital interventions affect teenagers with depression and anxiety, but their study only considered mental disorders, without considering other mental health issues. Cheng et al. (2019) examined serious games and their application of gamification elements to enhance mental health; however, they overlooked various technological approaches beyond serious games and did not give adequate consideration to the diverse types and features of technology. Eisenstadt et al. (2021) reviewed how mobile apps can help adults between 18 and 45 years of age improve their emotional regulation, mental health, and overall well-being; however, they did not investigate the potential benefits of apps for teenagers.

The present study reviews research from the past decade on digital technology for promoting adolescent mental health. A systematic literature review and meta-analysis are used to explore which types and features of technology can enhance mental health. We believe that the present study makes a meaningful contribution to scholarship because it is among the earliest to report on the impact of technology-enhanced mental health interventions and has revealed crucial influencing factors that merit careful consideration during both research and practical implementation. The following three research questions guided our systematic review and meta-analysis:

1. What is the current status of global research on digital technology for promoting children and adolescent mental health?

2. What digital technology characteristics support the development of mental health among children and adolescents?

3. How effective is digital technology in promoting the mental health of children and adolescents? What factors have an impact on the effectiveness of digital technology interventions?

2 Study 1: systematic literature review

2.1.1 study design.

This study used the systematic literature review method to analyze the relevant literature on the promotion of mental health through digital technology. It followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement for the selection and use of research methods. The protocol for this study was registered with INPLASY (2023120004). Standardized systematic review protocol is used to strictly identify, screen, analyze, and integrate literature ( Bearman et al., 2012 ). To clarify the research issues, systematic literature reviews typically comprise the following six key procedures: planning, literature search, literature assessment, data extraction, data synthesis, and review composition ( Lacey and Matheson, 2011 ).

2.1.2 Literature search

To access high-quality empirical research literature from the past decade, this study selected SCIE and SSCI index datasets from the Web of Science core database and Springer Link. Abstracts containing the English search terms “mental health or psychological health or psychological wellbeing” AND “technology or technological or technologies or digital media” AND “K-12 or teenager or children or adolescents or youth” were retrieved. The search period spanned from January 1, 2013, to July 1, 2023, and 1,032 studies were obtained. To ensure the relevance of the studies to the research question, the relevant inclusion and exclusion criteria were developed based on the 1,032 studies retrieved. The specific criteria are listed in Table 1 .

Table 1 . Literature screening criteria.

In this study, we followed a systematic literature review approach and screened the retrieved studies based on the above selection criteria. We conducted three rounds of screening and supplemented new studies through snowballing, ultimately including 59 effective sample documents. The specific process is shown in Figure 1 .

Figure 1 . Screening process and results.

2.1.3 Coding protocol

To extract key information from the included papers, we systematically analyzed 59 studies on the basis of reading the full text. Our coding protocol encompassed the following aspects: (a) basic information about the study, including the first author, publication year, publication region, study type, study object, and intervention duration; (b) the type of technology used in the study, including apps, chatbots, serious games, VR/AR, short messaging service (SMS), telemedicine services, and others; (c) mental health issues, including depression and anxiety, mental illness, bullying, lack of social and emotional competence, mental health issues caused by COVID-19, and other mental health issues; and (d) experimental data (mean, sample size, standard deviation or p -value, t -value, etc.). By capturing basic study information, we establish a foundation for comparing and contextualizing the selected studies. The type of technology used is crucial as it reflects the innovative approaches and their technical affordances. Mental health issues are the core focus that dictates the objectives of the technological interventions as well as their suitability and relevance. Experimental data provides quantifiable evidence to support the effectiveness claims and lays a foundation for the meta-analysis. Together, these four coding aspects offer a holistic view for a comprehensive understanding and analysis of the existing literature. The document coding was completed jointly by the researchers after confirming the coding rules and details through multiple rounds of negotiation. Problems arising in the coding process were intensively discussed to ensure consistency and accuracy of the coding.

2.2 Results and discussion

2.2.1 study and sample characteristics.

As shown in Figure 2 , in terms of the time of publication, the number of studies has gradually increased from 2013 to 2021 along with the development of digital technology. The proportion of studies published in the past 5 years (2019–2023) accounted for 76.3% of the total (45/59), with a peak in 2021 with 15 papers. Social isolation, school suspension, and reduced extracurricular activities caused by COVID-19 may exacerbate mental health issues among children and adolescents, which has attracted more researchers to explore the application of digital technology to mental health treatment.

Figure 2 . Trend in the number of studies published in the past decade.

From the perspective of published journals, all of the studies were published in 41 kinds of journals, but two fields were clear leaders: 46 studies (77.97%) were published in medical journals, followed by psychological journals (13.56%). Table 2 shows the source distribution and types of the sample studies. Looking at the country of the first author, the largest number of articles came from the Americas, including the United States and Canada, accounting for 40.7%, followed by European countries, including the United Kingdom and Finland. Only one article came from the African region. In terms of the research types, experimental research was the main type, followed by mixed research, and the number of investigation- and design-based research was relatively small.

Table 2 . Coding results for sample studies.

Looking more specifically at the research objects, the age range varied from 6 to 18 years. Overall, adolescents aged 13–18 years received more attention, while only six articles considered the younger age group aged 6–12 years. In addition, by coding the sample size of the studies, we found that the quality and size of the studies varied, ranging from small pilot studies or case studies to large-scale cluster studies. For example, Orlowski et al. (2016) conducted a qualitative study on adolescents with experience of seeking help in mental health care institutions in rural Australia; in their study, 10 adolescents with an average age of 18 years were recruited for semi-structured interviews to determine their attitudes and views on the use of technology as a mental health care tool. Another large-scale, randomized controlled trial is planned to enroll 10,000 eighth graders to investigate whether cognitive behavioral therapy (CBT) provided by a smartphone app can prevent depression ( Werner-Seidler et al., 2020 ).

2.2.2 Mental health issues and technology interventions

Based on the coding results, we present the total number of studies that correspond to both mental health issues and technological interventions in Figure 3 . Our findings indicate that apps represent the most prevalent form of digital technology, particularly in addressing depression and anxiety. Telemedicine services also rank highly in terms of utilization. Contrarily, there are comparatively fewer apps involving virtual reality (VR), augmented reality (AR), chatbots, and serious games. Below, we delve into the specifics of digital technology application and its unique affordances, tailored to distinct mental health issues.

Figure 3 . Numbers of studies by mental health issues and technology interventions.

2.2.2.1 Depression and anxiety

Depression and anxiety in adolescents have become increasingly common, and their presence may signal the beginning of long-term mental health issues, with approximately one in five people experiencing a depressive episode before the age of 18 years ( Lewinsohn et al., 1993 ). This has a range of adverse consequences, including social dysfunction, substance abuse, and suicidal tendency. From the 59 articles considered here, 29 studies used digital technology to treat depression- and anxiety-related symptoms in adolescents. Among the many types of digital technology considered, 19 studies used apps or educational websites as intervention tools, accounting for 76%, followed by serious games, chatbots, and VR with two articles each.

Apps are a broad concept, but they typically refer to software that can be downloaded from app stores to mobile devices such as phones or tablets. Due to characteristics such as their clear structure, ease of use, accessibility, strong privacy, interactivity, and multi-modularity, apps and educational websites are commonly used as tools for technological interventions. For example, Gladstone et al. (2015) developed an interactive website called CATCH-IT to prevent depression in adolescents; the site includes 14 optional modules. The course design of each module applies educational design theories, such as attracting learners’ attention, reviewing content, enhancing memory, and maintaining transfer. Apps and websites can also combine CBT with digital technology. The theoretical framework of CBT is rooted in a core assumption that depression is caused and maintained by unhelpful cognitions and behaviors. Treatment thus focuses on improving the function of these areas by applying skill-based behavioral strategies ( Wenzel, 2017 ). Multiple studies have incorporated CBT’s emphasis on reducing cognitive errors and strengthening positive behavior into their designs by, for example, using fictional storylines to help participants correct irrational thought patterns during reflective tasks, thereby improving patients’ depression conditions ( Stasiak et al., 2014 ; Topooco et al., 2019 ; Neumer et al., 2021 ).

In addition to the intervention methods involving apps and websites, serious games have also become a prospect for treating depression due to their interesting and interactive characteristics. Low-intensity human support combined with smartphone games may potentially reduce the resource requirements of traditional face-to-face counseling. Games contain complete storylines and competitive and cooperative tasks between peers in the form of levels that encourage adolescents to reflect on quizzes at the end of each challenge ( Gonsalves et al., 2019 ). Game designs tend to use flow theory, which emphasizes the dynamic matching of game challenges and the user’s own skill level ( Csikszentmihalyi, 2014 ). During game design, it is necessary to provide users with an easy-to-use and interesting gaming experience, as well as appropriate difficulty challenges, clear rules and goals, and instant feedback, which will help them relax and relieve stress, concentrate on changing cognitive processes, and improve their mood.

Two articles also consider the use of chatbots in interventions. Chatbots act as a dialog agent ( Mariamo et al., 2021 ), which makes the intervention process more interactive. Establishing a relationship of trust between adolescents and chatbots may also help lead to better results in depression and anxiety treatment. Chatbot functions are typically integrated into apps ( Werner-Seidler et al., 2020 ) and tend to be developed as part of the program rather than as a separate technological tool.

In recent years, with the gradual marketization of head-mounted VR devices, VR technology has been increasingly applied to mental health interventions. Studies have shown that the effectiveness of VR apps is often attributed to the distraction created by immersive environments, which produce an illusion of being in a virtual world, thus reducing users’ awareness of painful stimuli in the real world ( Ahmadpour et al., 2020 ). In the treatment of depression and anxiety for adolescents, active distraction supported by VR can engage users in games or cognitive tasks to redirect their attention to virtual objects and away from negative stimuli. Studies have also shown that, in addition to providing immersion, VR should create a pleasant emotional experience (e.g., the thrill of riding a roller coaster) and embed narrative stories (e.g., adventure and exploration) to meet adolescents’ need for achievement ( Ahmadpour et al., 2019 ).

2.2.2.2 Mental illness

In this study, we define mental illness as neurological developmental problems other than depression and anxiety. Among the 59 reviewed articles, 10 were coded as mental illness, including obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, personality disorder, drug addiction, bipolar disorder, and non-suicidal self-injury. For the treatment of mental illness, mobile apps based on CBT appeared twice in 10 articles, while other technology types included SMS intervention, serious games, remote video conferencing, and mobile sensing technology.

Similar to apps for treating depression and anxiety, adolescent patients believe that the apps have good usability and ease of use and can encourage them to share their thoughts, feelings, and behavioral information more openly and honestly while protecting their privacy ( Adams et al., 2021 ). However, due to the severe condition of patients with mental illness, the apps not only are used independently by patients but also serves as a bridge between therapists and patients. Therapists can thus closely monitor treatment progress through behavioral records, which can provide direct feedback to both patients and therapists ( Babiano-Espinosa et al., 2021 ).

SMS interventions send specific content text messages to patients. As a longitudinal intervention method, it is convenient, easy to operate, and low cost. For example, Owens and Charles (2016) sent text messages to adolescents with non-suicidal self-injury behaviors in an attempt to reduce their self-mutilation behaviors. The ultimate effect seemed to be unsatisfactory, as interventions for adolescents with self-mutilation behaviors may be better applied in schools and adolescents’ service agencies, which can help them control their self-mutilation behaviors in the early stages and prevent such behaviors from escalating.

There are also studies that have designed six serious games based on CBT frameworks to treat typical developmental disorders in adolescents, including attention-deficit/hyperactivity disorder, conduct disorder, and oppositional defiant disorder ( Ong et al., 2019 ). In the safe environment provided by the game world, the research subjects shape the behavior of the characters in the context through rule learning and task repetition, which allows them to master emotional management strategies and problem-solving skills. In addition to interventions, digital technology can also be used to evaluate treatment effectiveness and the type of disease. Orr et al. (2023) used mobile sensing technology and digital phenotyping to quantify people’s behavioral data in real time, thereby allowing diagnosis and evaluation of diseases.

2.2.2.3 Bullying

Bullying generally includes traditional bullying and cyberbullying. Traditional bullying usually manifests as direct physical violence or threats of abuse against victims, as well as indirect methods such as spreading rumors and social exclusion. Cyberbullying is defined as intentional harm to others through computers, mobile phones, and other electronic devices. Data show that, as of 2021, the proportion of adolescents who have experienced cyberbullying in the United States may be as high as 45.5% ( Patchin, 2021 ), which indicates that it has become a serious social problem. Among the nine articles on the topic of bullying and cyberbullying, three used SMS intervention methods, and two used mobile apps; chatbots, technology-supported courses, and CBT-based telemedicine services were also used in the mental health treatment for patients who had been bullied and cyberbullied.

The SMS intervention for bullying implemented personalized customization, and the automatic SMS content can be customized based on the subjects’ previous questionnaire or completed self-report status ( Ranney et al., 2019 ). The subjects are required to rate their feelings at the end of the day and report whether they were bullied that day. The psychotherapist then made adjustments based on their actual situation, and if necessary, the psychotherapist would also contact specific subjects to provide offline psychological counseling services ( Ranney et al., 2019 ). In addition to having similar functions as the SMS intervention ( Kutok et al., 2021 ), mobile apps can provide opportunities for personalized learning, where a variety of learning methods can be applied (e.g., providing therapist guidance, conducting meetings, and conducting family practice activities) to promote the acquisition of mental health skills ( Davidson et al., 2019 ). Furthermore, for adolescents, touchscreen learning, interactive games, and video demonstrations can enhance their enthusiasm for participating in the treatment process.

Chatbots with specific names and images were also used to guide research subjects through a series of online tasks in the form of conversations, including watching videos involving bullying and cyberbullying among adolescents, provoking self-reflection through questions and suggestions, and providing constructive strategic advice ( Gabrielli et al., 2020 ). Digital technology-supported courses and CBT-based telemedicine services both make full use of the convenience of technology, effectively addressing the time- and location-based limitations of traditional face-to-face treatment. Digital courses can be implemented on a large scale in schools through teacher training, and compared with professional medical services, such courses have a wider target audience and can play a scientific and preventive role in bullying and cyberbullying. Telemedicine services refer to the use of remote communication technology to provide psychological services ( Joint Task Force for the Development of Telepsychology Guidelines for Psychologists, 2013 ). For families with severely troubled adolescents, telemedicine allows parents and children to meet together, increasing the flexibility of timing, and one-on-one video services can help to build a closer relationship between patients and therapists.

2.2.2.4 Lack of social emotional competence

In research, social emotional competence typically refers to the development of emotional intelligence in adolescents ( De la Barrera et al., 2021 ), which also includes personal abilities (self-awareness and self-management), interpersonal relationships (social awareness and interpersonal skills), and cognitive abilities (responsible decision-making) ( Collaborative for Academic, Social, and Emotional Learning, 2020 ). It is an important indicator for measuring the mental health level of adolescents. People with positive social emotional intelligence are less likely to experience mental health issues such as depression, anxiety, and behavioral disorders. Using digital technology to promote social emotional development is becoming increasingly common, and in six intervention studies on social emotional competence, apps, serious games, VR technology, and SMS interventions were used.

The studies considered all emphasized the importance of interactive design in digital technology to enhance social and emotional skills, as interactive technology can increase students’ engagement, resulting in positive learning experiences. For example, Cherewick et al. (2021) designed a smartphone app that can be embedded with multimedia learning materials, allowing adolescents to watch social and emotional skill–related learning videos autonomously and complete topic reflection activities with family/peers after school. The app also has rich teaching interaction functions, allowing teachers to evaluate and share course and learning materials, which can provide pleasant learning experiences to students while also improving the flexibility of teaching. In addition to teacher–student interaction, another paper also mentioned the importance of human–computer interaction for developing social emotional competence. The fun and interactivity of the app are the key to attracting adolescents to download and use it, and it can also have a positive effect on improving students’ self-management and decision-making skills ( Kenny et al., 2016 ).

Unlike the treatment of depression and anxiety, the application of VR in the cultivation of social emotional competence not only relies on its highly immersive characteristics but also emphasizes the positive effects of multi-sensory experiences on emotional regulation. By utilizing various sensor devices and visualization devices, adolescents are provided with ideal visual, auditory, and tactile guidance and regulation, which can enhance their emotional regulation abilities and relieve psychological stress ( Wu et al., 2022 ). Existing studies have integrated dance and music into virtual scenes ( Liu et al., 2021 ), using virtual harmonic music therapy to allow users to relax physically and mentally while enjoying music, thereby reducing stress and anxiety. VR technology is also highly adaptable and generalizable, which can help in building diverse scenes that meet the psychological expectations of patients based on the characteristics of the different treatment objects.

2.2.2.5 Mental health issues caused by the COVID-19 pandemic

The global outbreak of COVID-19 created severe challenges for the mental health of adolescents. Factors such as lack of social contact, lack of personal space at home, separation from parents and relatives, and concerns about academics and the future have exacerbated mental health risks, leading to increased loneliness, pain, social isolation, mental disorders, and symptoms of anxiety, depression, and stress. The reports from five studies indicated that the COVID-19 pandemic has exacerbated mental health issues in adolescents. During the pandemic, technology—which is not limited by time and space—became the preferred method of treatment. Apps, remote health services, and online training courses were used in research. The apps were resource-oriented and evidence-based interventions that allowed patients to interact with therapists through remote conferencing and encouraged patients to self-reflect and express themselves after the conference to improve their mental condition ( Gómez-Restrepo et al., 2022 ). Remote health services combined CBT and dialectical behavior therapy with professional counselors engaging in online communication with patients for several weeks. This was in line with research that indicates that the establishment of a positive relationship between therapists and patients is the foundation for obtaining good effect ( Zepeda et al., 2021 ).

2.2.2.6 Other mental health issues

In addition to the common mental health issues mentioned above, there were also interventions mentioned in the literature for improving body image anxiety, mental issues caused by hospitalization, and reading disabilities through digital technology means. Due to its high-immersion and simulation characteristics, VR technology was selected for improving mental health issues such as loneliness, disconnection from peers, and academic anxiety caused by hospitalization ( Thabrew et al., 2022 ). Immersive VR experience technology used 360° panoramic live broadcast and VR headphones to enable hospitalized adolescents to indirectly participate in social activities through cameras in school or home environments, as well as to contact peers and teachers through methods such as text messages; such interventions are conducive to improving social inclusion, social connectivity, and happiness. Furthermore, two studies mentioned body image anxiety, especially targeting female audiences, and the research integrated body image CBT techniques into serious games and chatbots ( Mariamo et al., 2021 ; Matheson et al., 2021 ), using interesting interactive exploration and free dialog forms to help adolescents gain a correct understanding of body image and solve body image anxiety issues.

Another study used eye-tracking technology to treat children with reading disabilities ( Davidson et al., 2019 ). The researcher developed a reading evaluation platform called Lexplore, which used eye-tracking technology to monitor children’s eye movements when reading to determine the cognitive processes behind each child’s individual reading style and then design appropriate strategies to improve their reading difficulties.

3 Study 2: meta-analysis

To explore the effect of digital technology in promoting mental health, this study used a meta-analysis to assess 10 papers. It includes both experimental and quasi-experimental research studies. CMA3.0 (Comprehensive Meta-Analysis 3.0) was used, and the meta-analysis process consisted of five phases.

Phase 1: Literature screening, based on the prior stage of literature information coding. Relevant literature was filtered using the following criteria for meta-analysis: (a) the study must compare “technical intervention” and “traditional intervention”; (b) the study should report complete data that can generate the effect amount (e.g., average, sample size, standard deviation or t -values, p -values, etc.); and (c) the dependent variables in the study should contain at least one aspect of mental health.

Phase 2: Effect size calculation. In the case of a large sample size, there is little difference between Cohen’s d, Glass, and Hedges’ g values, but Cohen’s d can significantly overestimate the effect size for studies with a small sample ( Hedges, 1981 ). Therefore, Hedges’ g was used as the effect size indicator in this study.

Phase 3: Model selection. Meta-analyses include fixed- and random-effects models. Different models may produce different effect sizes. Due to the differences in sample size, experimental procedures, and methods among the initial studies included in the meta-analysis, the estimated average effect values may not be completely consistent with the true population effect values, which results in sample heterogeneity. This study used the method proposed by Borenstein et al. (2009) to establish fixed- and random-effects models to eliminate the influence of sample heterogeneity. When the heterogeneity test ( Q value) results were significant, the random-effects model was used; otherwise, the fixed-effects model was used.

Phase 4: Testing of main effects and moderating effects. Based on the selected model, a test of the main effects was conducted. Meanwhile, if heterogeneity was present, a test of moderating effects could be conducted.

Phase 5: Publication bias test. Publication bias is a common systematic error in meta-analyses and refers to a tendency for significantly significant research results to be more likely to be published than non-significant results. This study used a funnel plot to visually assess publication bias qualitatively and then further quantitatively assessed publication bias using Begg’s rank correlation method and the trim and fill method.

3.2 Results and discussion

3.2.1 inclusion and coding results.

For the studies that met the requirements of the meta-analysis, detailed classification was carried out based on the following variables one-by-one on the basis of the systematic review coding: (a) basic information (authors, year, sample size); (b) age stage, which is divided into three categories: primary school, junior high school, and senior high school; (c) mental health issues, including depression, bullying, and mental health issues caused by COVID-19; (d) technology type, including app, telemedicine, and chatbots; (e) intervention duration, coded as short-term for interventions less than a month and long-term for intervention that lasted more than a month; and (f) effect size. The coding results are shown in Table 3 .

Table 3 . Research coding results included in meta-analysis.

3.2.2 The overall effect of digital technology on mental health outcomes

According to the results of the heterogeneity test in Table 4 , the Q test is significant ( p  < 0.001), which indicates that there is significant heterogeneity among the samples. The random-effects model was therefore selected as the more reasonable option. The pooled effect size is 0.43. According to the criteria proposed by Cohen (1992) , 0.2, 0.5, and 0.8 are considered the boundaries of small, medium, and large effect sizes, respectively. It can be seen that the effect size for the promotion of mental health by digital technology is moderate and significant. At the same time, the lower limit of the 95% confidence interval is greater than 0 for each study, which indicates that the probability of the effect size being caused by chance is very small. In addition, the I 2 value is 78.164, which indicates that the heterogeneity between studies is high. Important moderating variables therefore may exist ( Higgins and Green, 2008 ), and additional moderating effect tests need to be conducted.

Table 4 . Overall effect of technology on mental health.

3.2.3 Moderating effect test

Moderating effect tests were conducted on four variables: age stage, mental health issues, technology type, and intervention duration. As shown in Table 5 , among the four moderating variables, only the age stage has a significant moderating effect ( p  < 0.05). In particular, the effect size is the largest for the primary school stage, followed by the senior high school stage with a moderate promoting effect. In addition, although the effect size for the junior high school stage is small, it is still significant, which may be related to the limited number of studies considering this population. The results also indicate that the moderating effects of mental health issues, technology type, and intervention duration are not significant. However, it can be seen that digital technology methods have the largest effect size for treating psychological problems caused by COVID-19, while compared with apps and chatbots, remote medical services can achieve better effects. In terms of treatment duration, the effect size for short-term interventions is greater than that for long-term interventions.

Table 5 . Regulatory effect test of technology (random-effect model).

3.2.4 Publication bias test

This study used funnel plots, Begg’s test, and the trim and fill method for the publication bias test. As shown in Figure 4 , the distribution of effect values in the study shows uneven and asymmetric distribution on both sides of the mean effect value, which initially suggests the possibility of publication bias. Begg’s test was thus used for further testing. Begg’s test is a method of quantitatively identifying bias using a rank correlation test, and it applies to studies with a small sample. The result of Begg’s test shows that t  = 0.267, p  = 0.283, Z  = 1.01 < 1.96, which indicates that there is no obvious publication bias. Finally, the censoring method was used to censor the literature on both sides of the effect value, and this revealed that the effect value was still significant. In summary, there is negligible publication bias.

Figure 4 . Distributions of effect sizes for mental health treatment outcomes.

4 Conclusion and implications

4.1 summary of key findings.

This study made a systematic review and meta-analysis of 59 studies on digital technology promoting adolescents’ mental health over the past decade. Based on the investigation of current research, the types and characteristics of the commonly used technology interventions for different mental health issues were analyzed, and the actual effects and potential regulatory variables of digital technology in promoting mental health were investigated in the meta-analysis. The main findings are outlined below.

• Over the past decade, especially between 2013 and 2021, the number of studies on digital technology promoting adolescents’ mental health has generally shown an upward trend, with nearly 80% of the literature being published in medical journals.

• Digital technology is most commonly used to intervene in the mental health issues of adolescents aged 13–18 years, and children in the younger age group (6–12 years old) receive relatively less attention.

• Depression and anxiety disorders are the mental health issues that received the most research attention, followed by obsessive-compulsive disorder, attention-deficit hyperactivity disorder, conduct disorder, and other mental illnesses. There were also studies on, in decreasing order of the number of studies, bullying, social emotional competence deficiency, and mental health issues caused by COVID-19, dyslexia, and adolescent body image anxiety.

• Apps with convenience, ease of use, interactivity, and remote communication were most commonly used to treat mental health issues. Serious games, remote health services, and text message intervention were less often used, and only three studies used VR, which is difficult to realize for mental health treatment.

• Digital technology plays a significant role in promoting the treatment of mental health issues of adolescents, especially in primary and senior high school.

4.2 Interpretation and insights

The findings of this study highlight the nuanced role played by digital technology in promoting mental health for children and adolescents. While technology has broadened the scope of mental health interventions with innovative apps and programs, it should be viewed as a complement to traditional face-to-face approaches, not a replacement ( Aguilera, 2015 ), as they cannot replicate the personal connection and empathy provided by a trained mental health professional. Moreover, different technologies vary in effectiveness for specific mental health issues, emphasizing the need for careful evaluation of their benefits and limitations. For instance, virtual reality, cognitive behavioral therapy apps, and online support platforms have shown promise for in addressing depression and anxiety, but their effects vary depending on individual needs and contexts, suggesting the non-uniform efficacy of digital technologies across mental health conditions.

Furthermore, this study also draws attention to the limited incorporation of digital technology in mental health education, especially among children aged 6 to 12. Given the significance of this developmental stage, where emotional management, relationships, and mental health knowledge are crucial, innovative digital approaches that draw upon the unique affordances of mobile apps, online courses, and virtual reality are warranted to deliver interactive and personalized learning experiences. Nevertheless, this innovation poses challenges and risks, including addiction to virtual environments and a reduction in social activities, which can also negatively impact the mental health of youth ( Taylor et al., 2020 ). Therefore, striking a balance between harnessing technology’s potential and mitigating its risks is essential, emphasizing the need for responsible and targeted use of digital tools in mental healthcare and education.

4.3 Implication for practice and future research

Based on the results of the systematic review and meta-analysis, this study puts forward the relevant implications for practice and research. First, for mental health education service personnel, we suggest that the first step is to fully utilize the characteristics of digital technology and select the most appropriate digital intervention tools for different mental health issues. For example, apps are more suitable for the treatment of depression, anxiety, and mental illnesses. When facing adolescents who have been bullied, text message interventions may be a good choice. In addition, serious games and VR could play a greater role in developing adolescents’ social emotional competence.

Second, for mental health counselors or school mental health workers, it is necessary to consider learner characteristics and intervention duration, among other factors. In contrast to previous research results ( Tang et al., 2019 ), we found that the regulating effect of age was significant, so therapists need to implement personalized technical interventions for adolescents at different age stages. Short-term interventions seem to induce a greater effect size, so lengthy interventions should be avoided, as they are more likely to cause marginal effect and develop technical immunity for the youth population.

Third, for technology intervention developers, it is important to recognize that not all practitioners (e.g., psychologists, therapists) are technology savvy. In the process of designing mental health apps and VR interventions, it is necessary to provide sufficient technical support, such as instructional manuals and tutorial videos, to reduce the potential digital divide. It is also essential to arrange for appropriate technical personnel to provide safeguard services and training continuously, ensuring the personal safety and cybersecurity of practitioners and patients during intervention sessions.

For researchers, we suggest that, first, more empirical studies are needed to report first-hand experimental results. Most of the existing studies only described the experimental scheme and lacked key research results. It is hoped that future research will report the results as comprehensively as possible to improve the credibility and reliability of meta-analytical results. Second, the number of studies on moderating effects in the meta-analysis was relatively small. For example, there was only one study on the primary school population. Future research needs to focus on people who have paid less attention to existing studies and thus enhance the understanding of technology interventions in mental health. Finally, there have been few studies that analyze cost-effectiveness, which is key to determining whether technical interventions can be normalized and sustainable. Future studies need to conduct sufficient investigation and report on the cost-effectiveness of digital technology interventions, including the development and maintenance costs of VR ( Kraft, 2020 ).

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Author contributions

TC: Data curation, Formal analysis, Investigation, Visualization, Writing – original draft. JO: Formal analysis, Investigation, Writing – original draft. GL: Formal analysis, Writing – review & editing. HL: Conceptualization, Methodology, Supervision, Writing – review & editing.

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

Conflict of interest

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

Publisher’s note

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

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Keywords: children and adolescents, digital technology, systematic literature review, meta-analysis, mental health issues

Citation: Chen T, Ou J, Li G and Luo H (2024) Promoting mental health in children and adolescents through digital technology: a systematic review and meta-analysis. Front. Psychol . 15:1356554. doi: 10.3389/fpsyg.2024.1356554

Received: 15 December 2023; Accepted: 29 February 2024; Published: 12 March 2024.

Reviewed by:

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

*Correspondence: Heng Luo, [email protected]

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

Critical success factors of infrastructure construction projects

• Technical Paper
• Published: 11 March 2024
• Volume 9 , article number  95 , ( 2024 )

Cite this article

• Mohamed S. Yamany   ORCID: orcid.org/0000-0002-7828-6075 1 ,
• Abdelnaser Abdelhameed 1 ,
• Emad Elbeltagi 2 , 3 &
• Hany Abd Elshakour Mohamed 1  

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Civil infrastructure projects, including roads, bridges, distribution networks, and treatment facilities, need to be executed successfully to actualize the expected return on investment, deliver the planned services, and fulfill national objectives. Hence, this research investigates the critical success factors (CSFs) influencing the performance of infrastructure construction projects using qualitative and quantitative methods. The qualitative methodology comprises a thorough and systematic literature review to identify the CSFs affecting infrastructure project performance. The CSFs were categorized by the construction project phases to assess the significance of each phase on project performance. The quantitative technique entails two stages: a pilot study with structured interviews and a questionnaire survey administered to subject matter experts. The data was analyzed using three statistical techniques: one-sample t-test, mean score, and factor analysis. Furthermore, the CSFs were classified into five categories using principal component analysis. According to the findings, the key CSFs of infrastructure projects include the project manager’s competency, commitment, and involvement; sufficient funding throughout the project’s life cycle; and effective communication and coordination among stakeholders. The results will provide construction professionals with valuable insights into the topmost CSFs that contribute to the success of infrastructure construction projects.

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Mohamed S. Yamany, Abdelnaser Abdelhameed & Hany Abd Elshakour Mohamed

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Department of Structural Engineering, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt

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Yamany, M.S., Abdelhameed, A., Elbeltagi, E. et al. Critical success factors of infrastructure construction projects. Innov. Infrastruct. Solut. 9 , 95 (2024). https://doi.org/10.1007/s41062-024-01394-9

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DOI : https://doi.org/10.1007/s41062-024-01394-9

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Understanding and Evaluating Survey Research

A variety of methodologic approaches exist for individuals interested in conducting research. Selection of a research approach depends on a number of factors, including the purpose of the research, the type of research questions to be answered, and the availability of resources. The purpose of this article is to describe survey research as one approach to the conduct of research so that the reader can critically evaluate the appropriateness of the conclusions from studies employing survey research.

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Survey research is defined as "the collection of information from a sample of individuals through their responses to questions" ( Check & Schutt, 2012, p. 160 ). This type of research allows for a variety of methods to recruit participants, collect data, and utilize various methods of instrumentation. Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e., mixed methods). As it is often used to describe and explore human behavior, surveys are therefore frequently used in social and psychological research ( Singleton & Straits, 2009 ).

Information has been obtained from individuals and groups through the use of survey research for decades. It can range from asking a few targeted questions of individuals on a street corner to obtain information related to behaviors and preferences, to a more rigorous study using multiple valid and reliable instruments. Common examples of less rigorous surveys include marketing or political surveys of consumer patterns and public opinion polls.

Survey research has historically included large population-based data collection. The primary purpose of this type of survey research was to obtain information describing characteristics of a large sample of individuals of interest relatively quickly. Large census surveys obtaining information reflecting demographic and personal characteristics and consumer feedback surveys are prime examples. These surveys were often provided through the mail and were intended to describe demographic characteristics of individuals or obtain opinions on which to base programs or products for a population or group.

More recently, survey research has developed into a rigorous approach to research, with scientifically tested strategies detailing who to include (representative sample), what and how to distribute (survey method), and when to initiate the survey and follow up with nonresponders (reducing nonresponse error), in order to ensure a high-quality research process and outcome. Currently, the term "survey" can reflect a range of research aims, sampling and recruitment strategies, data collection instruments, and methods of survey administration.

Given this range of options in the conduct of survey research, it is imperative for the consumer/reader of survey research to understand the potential for bias in survey research as well as the tested techniques for reducing bias, in order to draw appropriate conclusions about the information reported in this manner. Common types of error in research, along with the sources of error and strategies for reducing error as described throughout this article, are summarized in the Table .

Sources of Error in Survey Research and Strategies to Reduce Error

The goal of sampling strategies in survey research is to obtain a sufficient sample that is representative of the population of interest. It is often not feasible to collect data from an entire population of interest (e.g., all individuals with lung cancer); therefore, a subset of the population or sample is used to estimate the population responses (e.g., individuals with lung cancer currently receiving treatment). A large random sample increases the likelihood that the responses from the sample will accurately reflect the entire population. In order to accurately draw conclusions about the population, the sample must include individuals with characteristics similar to the population.

It is therefore necessary to correctly identify the population of interest (e.g., individuals with lung cancer currently receiving treatment vs. all individuals with lung cancer). The sample will ideally include individuals who reflect the intended population in terms of all characteristics of the population (e.g., sex, socioeconomic characteristics, symptom experience) and contain a similar distribution of individuals with those characteristics. As discussed by Mady Stovall beginning on page 162, Fujimori et al. ( 2014 ), for example, were interested in the population of oncologists. The authors obtained a sample of oncologists from two hospitals in Japan. These participants may or may not have similar characteristics to all oncologists in Japan.

Participant recruitment strategies can affect the adequacy and representativeness of the sample obtained. Using diverse recruitment strategies can help improve the size of the sample and help ensure adequate coverage of the intended population. For example, if a survey researcher intends to obtain a sample of individuals with breast cancer representative of all individuals with breast cancer in the United States, the researcher would want to use recruitment strategies that would recruit both women and men, individuals from rural and urban settings, individuals receiving and not receiving active treatment, and so on. Because of the difficulty in obtaining samples representative of a large population, researchers may focus the population of interest to a subset of individuals (e.g., women with stage III or IV breast cancer). Large census surveys require extremely large samples to adequately represent the characteristics of the population because they are intended to represent the entire population.

DATA COLLECTION METHODS

Survey research may use a variety of data collection methods with the most common being questionnaires and interviews. Questionnaires may be self-administered or administered by a professional, may be administered individually or in a group, and typically include a series of items reflecting the research aims. Questionnaires may include demographic questions in addition to valid and reliable research instruments ( Costanzo, Stawski, Ryff, Coe, & Almeida, 2012 ; DuBenske et al., 2014 ; Ponto, Ellington, Mellon, & Beck, 2010 ). It is helpful to the reader when authors describe the contents of the survey questionnaire so that the reader can interpret and evaluate the potential for errors of validity (e.g., items or instruments that do not measure what they are intended to measure) and reliability (e.g., items or instruments that do not measure a construct consistently). Helpful examples of articles that describe the survey instruments exist in the literature ( Buerhaus et al., 2012 ).

Questionnaires may be in paper form and mailed to participants, delivered in an electronic format via email or an Internet-based program such as SurveyMonkey, or a combination of both, giving the participant the option to choose which method is preferred ( Ponto et al., 2010 ). Using a combination of methods of survey administration can help to ensure better sample coverage (i.e., all individuals in the population having a chance of inclusion in the sample) therefore reducing coverage error ( Dillman, Smyth, & Christian, 2014 ; Singleton & Straits, 2009 ). For example, if a researcher were to only use an Internet-delivered questionnaire, individuals without access to a computer would be excluded from participation. Self-administered mailed, group, or Internet-based questionnaires are relatively low cost and practical for a large sample ( Check & Schutt, 2012 ).

Dillman et al. ( 2014 ) have described and tested a tailored design method for survey research. Improving the visual appeal and graphics of surveys by using a font size appropriate for the respondents, ordering items logically without creating unintended response bias, and arranging items clearly on each page can increase the response rate to electronic questionnaires. Attending to these and other issues in electronic questionnaires can help reduce measurement error (i.e., lack of validity or reliability) and help ensure a better response rate.

Conducting interviews is another approach to data collection used in survey research. Interviews may be conducted by phone, computer, or in person and have the benefit of visually identifying the nonverbal response(s) of the interviewee and subsequently being able to clarify the intended question. An interviewer can use probing comments to obtain more information about a question or topic and can request clarification of an unclear response ( Singleton & Straits, 2009 ). Interviews can be costly and time intensive, and therefore are relatively impractical for large samples.

Some authors advocate for using mixed methods for survey research when no one method is adequate to address the planned research aims, to reduce the potential for measurement and non-response error, and to better tailor the study methods to the intended sample ( Dillman et al., 2014 ; Singleton & Straits, 2009 ). For example, a mixed methods survey research approach may begin with distributing a questionnaire and following up with telephone interviews to clarify unclear survey responses ( Singleton & Straits, 2009 ). Mixed methods might also be used when visual or auditory deficits preclude an individual from completing a questionnaire or participating in an interview.

FUJIMORI ET AL.: SURVEY RESEARCH

Fujimori et al. ( 2014 ) described the use of survey research in a study of the effect of communication skills training for oncologists on oncologist and patient outcomes (e.g., oncologist’s performance and confidence and patient’s distress, satisfaction, and trust). A sample of 30 oncologists from two hospitals was obtained and though the authors provided a power analysis concluding an adequate number of oncologist participants to detect differences between baseline and follow-up scores, the conclusions of the study may not be generalizable to a broader population of oncologists. Oncologists were randomized to either an intervention group (i.e., communication skills training) or a control group (i.e., no training).

Fujimori et al. ( 2014 ) chose a quantitative approach to collect data from oncologist and patient participants regarding the study outcome variables. Self-report numeric ratings were used to measure oncologist confidence and patient distress, satisfaction, and trust. Oncologist confidence was measured using two instruments each using 10-point Likert rating scales. The Hospital Anxiety and Depression Scale (HADS) was used to measure patient distress and has demonstrated validity and reliability in a number of populations including individuals with cancer ( Bjelland, Dahl, Haug, & Neckelmann, 2002 ). Patient satisfaction and trust were measured using 0 to 10 numeric rating scales. Numeric observer ratings were used to measure oncologist performance of communication skills based on a videotaped interaction with a standardized patient. Participants completed the same questionnaires at baseline and follow-up.

The authors clearly describe what data were collected from all participants. Providing additional information about the manner in which questionnaires were distributed (i.e., electronic, mail), the setting in which data were collected (e.g., home, clinic), and the design of the survey instruments (e.g., visual appeal, format, content, arrangement of items) would assist the reader in drawing conclusions about the potential for measurement and nonresponse error. The authors describe conducting a follow-up phone call or mail inquiry for nonresponders, using the Dillman et al. ( 2014 ) tailored design for survey research follow-up may have reduced nonresponse error.

CONCLUSIONS

Survey research is a useful and legitimate approach to research that has clear benefits in helping to describe and explore variables and constructs of interest. Survey research, like all research, has the potential for a variety of sources of error, but several strategies exist to reduce the potential for error. Advanced practitioners aware of the potential sources of error and strategies to improve survey research can better determine how and whether the conclusions from a survey research study apply to practice.

The author has no potential conflicts of interest to disclose.

• News Releases

Illinois study: Systematic review of agricultural injuries can help inform safety measures

University of Illinois College of Agricultural, Consumer and Environmental Sciences

University of Illinois researchers reviewed U.S. and global literature on agricultural injuries, helping to inform safety education and policies.

Credit: College of ACES

URBANA, Ill. – Agricultural occupations are  hazardous with one of the highest rates of workplace injuries and fatalities in the U.S. The manual and often strenuous nature of the work, combined with the use of machinery and exposure to environmental hazards create a challenging work environment. Understanding the nature and causes of injuries can help improve safety guidelines and policy measures. However, obtaining a comprehensive overview of injuries is hindered by the absence of a central reporting system. Two new papers from the University of Illinois Urbana-Champaign provide a systematic review of academic literature on agricultural injuries in the U.S. and globally.

“When it comes to agriculture, there's no single source for injury data. In other occupations, work injuries in the U.S. must be reported to the Occupational Safety and Health Administration (OSHA), but farm work is often exempt from these requirements because many farms are small and have less than 10 full-time employees,” said Salah Issa , an assistant professor in the Department of Agricultural and Biological Engineering (ABE) and an Illinois Extension specialist; both units are part of the College of Agricultural, Consumer and Environmental Sciences (ACES) at Illinois. ABE is also part of The Grainger College of Engineering at Illinois.

“There have been a lot of grassroots efforts to track surveillance data, but they are based on different methods so it’s hard to get a complete look at agricultural injuries. Our work combines results into one large dataset, providing a comprehensive overview of previous research,” Issa explained.

In the first study, the researchers conducted a systematic literature review of 48 academic papers published in the U.S. and Canada from 1985 to 2022.

“We identified five different surveillance methods: newspaper clippings, surveys, death certificates, hospital records and emergency medical services (EMS) data, and multiple sources,” said Sihan Li , a doctoral student in ABE and lead author on the first paper. 

The researchers also analyzed and categorized information such as the type and source of injury, the event leading up to it, and the gender of the victim.

Overall, vehicles (including tractors and ATVs) were the most common source of injury, with over 55,000 incidents reported, as well as the leading source of fatalities. Other significant causes of injury included machinery, slips and trips, animals, chemicals, and tools. Men were more than twice as likely as women to be victims of injury. Age varied by surveillance method, with newspaper clippings skewed to younger victims (22% of incidents) and death certificates skewed to older victims (30% over 65).

In the second study , the researchers reviewed 69 articles from 17 countries in North America, Europe, and Asia, including the U.S., Canada, Turkey, India, Pakistan, Austria, Italy, and others. 

The main data sources identified in these studies were hospital records, followed by surveys, government records (including death certificates), insurance claims, and multiple sources.

“For the global perspective, we narrowed our scope to focus primarily on machine-related injuries, which involves tractors and farm equipment,” said Mian Muhammad Sajid Raza , a doctoral student in ABE and lead author on the second paper.

The researchers found that tractors stand out as the leading cause of fatal incidents, with tractor overturns accounting for 45% of all machinery-related incidents in North America. Furthermore, injuries linked overall to agricultural machinery significantly contribute to both fatal and non-fatal incidents.

“It is also interesting to look at other sources of injury. In North America and Europe, animals are the cause of less than 3% of all injuries. But in Asia, animals represent 7% of the total injuries and 35% of the fatalities. This is likely because farming is less automated and animals are still used extensively in some Asian countries,” Raza said. 

The research shows agriculture is a dangerous occupation globally, with injuries reported in at least three continents. Overall trends are as expected, with vehicles and machinery playing a large role in injuries and fatalities, Issa noted.

“One of our most important findings is that the way you conduct injury surveillance will have an impact on your results,” he said. “For example, if you use newspaper clippings, your findings will skew towards a younger age group. The discrepancies are so large it’s clearly worth evaluating the type of surveillance methods employed, and it’s important to use multiple sources to get a good picture of what’s going on.”

Understanding the nature and source of injuries is important for developing educational programs and interventions, Issa concluded.  

Both papers, “Agricultural Injury Surveillance in the United States and Canada: A Systematic Literature Review’ [DOI: 10.1080/1059924X.2024.2304699 ] and “Global Patterns of Agricultural Machine and Equipment Injuries- A Systematic Literature Review” [DOI: 10.1080/1059924X.2024.2304704 ] are published in the Journal of Agromedicine.

Journal of Agromedicine

10.1080/1059924X.2024.2304699

Method of Research

Literature review

Article Title

Agricultural Injury Surveillance in the United States and Canada: A Systematic Literature Review

Article Publication Date

22-Jan-2024

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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• Economic impact of a clinical pharmacist in the orthopaedic sector: a review of the literature
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• Joshua Dray 1 ,
• http://orcid.org/0000-0001-6230-0306 Annaelle Soubieux 1 ,
• Catherine Chenailler 1 ,
• Remi Varin 1 ,
• Franck Dujardin 2 ,
• Jonathan Curado 2 ,
• http://orcid.org/0000-0001-5300-6244 Eric Barat 1
• 1 Department of Pharmacy , Rouen University Hospital , Rouen , France
• 2 Department of Orthopedics , Rouen University Hospital , Rouen , France
• Correspondence to Dr Annaelle Soubieux, Pharmacy, CHU de Rouen, Rouen, Normandie, France; a.soubieux-bourbon{at}chu-rouen.fr

Objectives This review of the literature aimed to evaluate the economic impact of a clinical pharmacist in the orthopaedic sector.

Methods The review followed the PRISMA recommendations. A bibliographic search was conducted on 23 June 2023 using PubMed, Cochrane Library and Web of Science. All articles in French or English with economic data on clinical pharmacy activities in orthopaedics were included. Articles not mentioning the term ‘orthopaedics’ and those published prior to 1990 were excluded. Data from the studies were compiled in an Excel table. A bias analysis using the ROBINS-I Cochrane tool was performed. The methodology of the studies was compared and weighted using the CHEERS and STROBE checklists.

Results Among 529 articles initially identified, 10 were included in the review. The cost–benefit ratio of a clinical pharmacist in orthopaedics ranged from 0.47:1 to 28:1. The maximum savings reached US$73 410 /year in the American study and €1 42 356 /year in the French study. For three studies, the cost of a clinical pharmacist was not evaluated. Eight studies showed a positive economic impact. The Dutch study showed a balance and the Danish study showed a negative economic impact of €3442/month.

Conclusions This literature review has shown an economic benefit of a clinical pharmacist in the orthopaedic sector despite several biases and methodological limitations. The two studies that did not confirm this benefit only evaluated a limited number of expected benefits. Nevertheless, the economic impact of the clinical pharmacist in the orthopaedic sector seems positive and undervalued.

• PHARMACY SERVICE, HOSPITAL
• ECONOMICS, PHARMACEUTICAL
• Education, Pharmacy, Continuing
• EDUCATION, PHARMACY
• MEDICATION SYSTEMS, HOSPITAL

https://doi.org/10.1136/ejhpharm-2023-003727

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WHAT IS ALREADY KNOWN ON THIS TOPIC

The clinical relevance of a clinical pharmacist in the orthopaedic sector is known.

The major issue is the economic viability of a clinical pharmacist in the orthopaedic sector.

WHAT THIS STUDY ADDS

These new data show that a clinical pharmacist in the orthopaedic sector is likely to generate health savings.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

This study could promote clinical pharmacy practices in the orthopaedic sector.

This study could encourage pharmacists to carry out pharmacoeconomic studies to strengthen the data in the literature.

Introduction

Medication errors and adverse drug events (ADE) are responsible for many hospitalisations. The French ENEIS study on serious adverse events (SAE) associated with medical care showed that, among the SAE responsible for hospitalisation, 57.5% were related to a health product and more than half could be avoidable. 1 A recent meta-analysis showed that the number of deaths related to an ADE corresponded to 5.6% of all deaths, of which 45.2% were preventable. 2 In 1995 in the USA the cost linked to the management of morbidity and mortality related to drugs was US$76.6 billion. 3 Another study estimated the cost of a preventable ADE at US$4700, or US$2.8 million per year. 4 More recently, others estimated the annual cost of prescription drug-related morbidity and mortality resulting from non-optimised drug treatment (ADE, treatment failure, etc) at US$528.4 billion. 5

The presence of a clinical pharmacist in care services reduces ADE. 6 The French Society of Clinical Pharmacy (Société Française de Pharmacie Clinique, SFPC) defines pharmaceutical care as ‘a discipline centred on the patient […], contributing to the security, relevance and efficiency of the use of health products’. 7 The literature has shown a benefit of clinical pharmacy activities on the quality and security of prescriptions in the hospital as well as on discharge prescriptions. 8 9 Other studies have reported a decrease in readmissions at 30 and 90 days. 10 11

Patients treated in orthopaedic surgery require surgical care, but also potentially heavy and expensive medical care resulting in complex prescriptions often in elderly patients with multiple pathologies and associated treatments, increasing the risk of ADE. In one study, prescription errors were reported in 62% of cases. 12 Several studies have suggested that a clinical pharmacist is likely to improve these performances in specific treatments—namely, analgesics, 13 anticoagulants 14 and antibiotics. 15

In this context, our hypothesis was that a clinical pharmacist could reduce medication errors in the orthopaedic sector and thus ADE, improving the quality of care and generating health savings. The main objective of the study was to conduct a review of the literature to assess the economic impact of a clinical pharmacist in the orthopaedic sector.

Study selection and data extraction

The literature review was conducted followed the PRISMA recommendations. 16 The bibliographic search was carried out on 23 June 2023 using PubMed, Cochrane Library and Web of Science. A manual search was also conducted. The queries used included the keywords: ‘cost’, ‘economics’, pharmacoecon*, finan* ‘orthopaedic’, ‘pharmacy’, ‘pharmaceutical intervention’, ‘pharmaceutical care’, ‘medication error’, ‘medication reconciliation’. The complete database search is detailed in online supplemental material S1 . All articles in French or English presenting quantified economic data related to clinical pharmacy activities in orthopaedics were included even if economic evaluation was not the main objective of the study. Articles that did not explicitly mention the term ‘orthopaedics’ (eg, general surgery) and those with publication date prior to 1990 were excluded.

Supplemental material

The data of the studies included were compiled in an Excel table including authors, year of publication, country of study, objective, composition of the pharmaceutical team, clinical pharmacy activities described in the study, main drug classes concerned by the pharmaceutical interventions, costs and savings generated by the clinical pharmacist and pharmaceutical care. The extracted data were independently validated by two members of the research team (JD and AS).

Assessment of risk of bias of included studies

To determine the risk of bias of studies, three authors (AS, EB and JD) independently assessed the risk of bias using the ROBINS-I tool described in the Cochrane Library. 17 Differences of opinion between authors were resolved by consensus. The following risk of bias domains were assessed:

Confounding bias

Bias in selection of study patients.

Bias in the classification of interventions

Bias due to deviations from planned interventions

Bias due to missing data, bias in outcome measurement.

Bias in selection of reported outcome

Assessment of quality of studies

The CHEERS and STROBE checklists were used to assess study methodologies. Articles were reviewed independently by two authors (JD and AS). The CHEERS checklist, which provides guidelines for economic evaluation studies, was used to assess the methodology of studies whose main aim was to provide an economic evaluation of the activity of clinical pharmacists in orthopaedics.

Other studies were assessed using the STROBE combined criteria, which provide guidelines for observational studies.

Among 529 articles initially identified, 10 were included in the review. 18–27 Figure 1 shows the article selection process. The studies were conducted in seven different countries: five in Europe (Denmark, France, Czech Republic, Netherlands and Hungary), one in the USA and four in China. Eight articles studied orthopaedics only and two articles studied orthopaedics among other departments. Table 1 summarises the objectives, the methods of the studies and details the pharmaceutical activities carried out as well as the main drug classes in which the pharmacists intervened.

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Selection of studies.

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Data on the type of clinical pharmacy activity carried out in the orthopaedic sector and main drug classes concerned

The clinical pharmacy activities presented were: pharmaceutical analysis including visits (9/10), medication reconciliation at admission (3/10), medication reviews (3/10) and training for prescribers (3/10). The pharmacist teams were made up of senior pharmacists (4/10), resident pharmacists (2/10), student pharmacists (1/10), pharmacy technicians (1/10) or unspecified (6/10). The direct savings were medication savings (5/10), time saved by other professionals (1/10), days of hospitalisation avoided by extension of stay or readmission (3/10), cost of a medication error avoided (1/10). For seven studies, these direct savings were balanced by the cost of a clinical pharmacist. The cost–benefit ratio of a clinical pharmacist in orthopaedics ranged from 0.47:1 to 28:1. For three studies, the cost of a clinical pharmacist was not evaluated. Table 2 shows the economic data related to pharmacy activities and the savings reported for each study. For studies detailing both the savings and costs of pharmaceutical care, the total savings reported were US$48 000 and US$73 410/year or €142 356/year. Eight studies showed a positive economic impact. 18–25 The Dutch study showed a balance 26 and the Danish study showed a negative economic impact of €3442/month. 27

Economic data of clinical pharmacy activities in the orthopaedic sector

Assessment of risk of bias

Risk of bias was assessed only in the four studies in which the economic data reported were part of the primary objective. 18 21 22 24 For studies in which the economic data reported were part of a secondary objective, it was not considered necessary to study the risk of bias (on the primary objective) in detail. 19 20 23 25–27 The economic data from these studies should be considered to have a high risk of bias.

The results of the risk of bias analysis of the four included studies are shown in table 3 .

Summary of risk of bias analysis of included studies

Two studies were considered to have a low risk of confounding bias 21 24 and one had a moderate risk, 22 the authors having acknowledged the presence of this bias in the discussion. One study 25 had a high risk of bias because the authors did not evaluate all the criteria contributing to the prevention of infections (which therefore had an effect on the cost of hospitalisation).

Three studies were considered to have a low risk of bias in the selection of study patients. 18 22 24 One study was considered to have a high risk of bias because it excluded patients with complications (admission to intensive care). 21

Bias in classification of studies

Three studies were considered to have a low risk of bias in the classification of studies. 18 21 22 For one study the evaluation was not applicable because there was no comparator group.

All studies had a high risk of bias due to deviations from planned interventions except the study by Zheng et al 19 because the before/after design means it is not known if the conditions were exactly the same.

Three studies were considered to have a low risk of bias due to missing outcome data (no patients lost to follow-up). 18 21 24 For one study the authors stated: “Discharge disposition data were not available for most of the study timeframe so is unfortunately beyond the scope of this analysis”. 22

One study was considered to have a low risk of bias in outcome measurement because the extraction of data was blinded. 18 In the other three studies, the risk of bias in the measurement of the result was considered high because the results were not blinded. 21 22 24

Bias in selection of the reported outcome

All four studies were considered to have major bias. In discussing this work, the authors of the studies showed that some costs were overlooked.

The four studies by Zhou, Fesus, Hyland and Renaudin, 18 21 22 24 whose main objective was to provide an economic evaluation of the activity of the clinical pharmacist, respectively met 68% (19/28), 54% (15/28), 79% (22/28) and 75% (21/28) of the CHEERS checklist criteria. Details of the criteria met by each item are shown in figure 2 .

Quality of studies according to the CHEERS checklist.

All of them present the context that leads us to question the economic evaluation of pharmacists’ activities.

Three studies (Zhou et al , 18 Hyland et al 22 and Renaudin et al 24 ) explain the method used to carry out their economic analysis. The fourth (Fesus et al 21 ) takes into account only the cost of antibiotics used without relating it to the pharmacist’s salary costs.

Only two studies (Hyland et al 22 and Renaudin et al 24 ) indicate the perspective adopted for the economic evaluation, which is for the care facility and for the health system, respectively.

Zhou et al 18 indicate that costs were recovered via a form but do not indicate the source. The study by Fesus et al 21 does not give precise details of the dates, quantities and costs of resources accounted for.

Certain methodological peculiarities may also be noted: Renaudin et al 24 do not use a comparator but employ an economic evaluation method sourced from the literature. The study by Hyland et al 22 is the only one of the four studies to evaluate readmission rates, patients’ understanding of their discharge treatments and their satisfaction with the pharmacist’s activity. The study by Fesus et al 21 does not take into account the pharmacist’s salary costs in its economic evaluation.

The remaining six studies 19 20 23 25–27 met 64% (23/36), 56% (20/36), 33% (12/36), 61% (22/36), 67% (24/36) and 61% (22/36), respectively, of the STROBE combined checklist criteria. Details of the criteria met by each study are shown in figure 3 .

Quality of studies according to the STROBE combined checklist.

All presented the context of the study and the specific research objectives.

Only one study (Rychlíčková et al 25 ) does not have an explicit study design; it would be a prospective, observational study.

Two studies (Rychlíčková et al 25 and Zheng et al 19 ) do not make explicit the data sources and details of evaluation methods.

Three studies (Bos et al , 26 Zheng et al 19 and Zhou et al 23 ) explain the efforts made to reduce potential sources of bias.

None of the studies discuss how missing data were managed.

Only one study 25 conducted a sensitivity study.

Five studies 19 20 23 26 27 provided results adjusted for patient demographics and potential confounders.

All studies discussed the limitations of their methods and gave a cautious interpretation of their results, particularly the economic data.

It should also be noted that the paper by Zhou et al 23 presents a cost–benefit ratio of the pharmacist’s economic impact without making explicit the salary cost.

This study highlights the small number of articles dealing with the economic benefits of clinical pharmacists in the orthopaedic hospital sector. To our knowledge, this is the first study to address this topic.

This literature review has shown that a clinical pharmacist in the orthopaedic sector is likely to enable health savings. The cost–benefit ratio was positive in five of the 10 studies, 18 22–25 with a range between 1.53:1 and 28:1. Buck et al 27 found an opposite result with a cost–benefit ratio of 0.47:1, but the authors only assessed the savings made in four out of 10 interventions. Moreover, despite the negative ratio, they presented the results as a positive investment by stating: “It is surprising that four of the 10 pre-selected interventions can cover 47% of the costs of clinical pharmacy services, while these four interventions represent only 43% of the prescriptions adjusted by the clinical pharmacist”. The four other studies 19–21 26 that do not compare pharmacists’ salary costs with their economic evaluation describe a favourable economic impact of clinical pharmacy activities, but do not allow us to precisely answer our main objective of evaluating the cost–benefit of a clinical pharmacist in orthopaedics. Bos et al 26 showed a benefit of clinical pharmacy activities in the orthopaedic sector compared with routine pharmacy activities previously practised, but this benefit was cancelled out by the additional cost incurred, with a balance in the end.

Only four of the 10 studies had the primary objective of demonstrating a financial benefit. 18 21 22 24 Costs are not comparable among them for variables such as the pharmacist’s salary: US$24 000/year in the Czech Republic (Rychlíčková et al 25 ) vs US$125 694/year in the USA (Hyland et al 22 ). This salary is sometimes expressed as pharmacist cost per intervention 23 or per admission. 26 It seems that most studies consider the wage cost of the clinical pharmacist as a variable to evaluate the expenses related to the activities of clinical pharmacy. 18 22 24–27 The difference in the wage cost of a pharmacist for the healthcare system between countries thus appears to be one of the main limitations to the reproducibility of evaluations of its economic impact.

The methodologies used also vary and examine different variables ( table 2 ). In these different studies, the activities of clinical pharmacists focused, for example, on the proper use of antibiotics, reducing postoperative complications and reducing the occurrence of ADE during hospital stays. Some studies 18 22–27 quantified the savings made on a limited list of standard pharmaceutical interventions or on a limited choice of medication errors. Renaudin et al 19 considered the savings by a single ADE avoided, judging that it was unlikely that two errors would occur in the same patient. Moreover, Rychlíčková et al 25 pointed out that the role of clinical pharmacists in the Czech Republic was not yet stable in 2016 while, in the USA, Hyland et al 22 highlighted their positive impact on drug optimisation and quality improvement in orthopaedic surgery care based on data dating from 2013 to 2019. 14 28 29 The role and missions of clinical pharmacists therefore vary from one country to another and, to date, are not yet reproducible in different countries. The considerable variability of clinical pharmacy activities in these different studies makes them difficult to compare, especially from a financial perspective.

The use of certain outcomes would seem to enable comparisons between countries. For example, measuring the post-surgery readmission rate with or without the presence of the pharmacist would seem to be a good indicator of the economic impact of the clinical pharmacist, since a patient’s hospitalisation generates healthcare costs in a non-ambiguous way, regardless of the payer. The defined daily dose per patient could be used in the context of employing a clinical pharmacist to rationalise antibiotic prescriptions for preoperative prophylaxis but seems of little relevance in the context of patient medication reconciliation, since a pharmacist may be led to suggest prescribing additional drugs if there are justified indications. Presenting a ratio between costs and savings allows us to disregard the monetary currency and organisational variations in healthcare institutions and thus show whether investment in clinical pharmacy activities presents the establishment with a net benefit or loss.

Due to the limited number of articles and these methodological divergences, it was not possible for this study to propose a meta-analysis on the economic impact of the clinical pharmacist in orthopaedics.

Another limitation to the reproducibility of these pharmacoeconomic evaluations is related to the fact that the different countries in the studies have health organisations with very different sources of funding. In the USA, health coverage is primarily based on private insurance systems at the expense of the patients while, in France and Hungary, care is instead mainly at the expense of the community. In China, institutions are subsidised by the government, private investors and patients alike. Due to these funding disparities, it is difficult to propose an indicator of the societal impact of clinical pharmacist interventions that is relevant for all countries. Furthermore, indicating the perspective of the study (institution or healthcare system) is a necessary piece of information to be able to compare studies in a relevant way.

In addition, the studies did not take into account the savings generated in drugs or in indirect costs such as better coordination of the care team, a better link between city and hospital or even patient satisfaction. Another uncertainty, this time inverse, is derived from neglect of additional costs generated by the recommendations of the pharmacist such as additional biological analyses. In addition, some studies did not take into account the costs of pharmaceutical care. 19–21 The data found in the literature concerning the economic impact of clinical pharmacists in the orthopaedic sector also contain methodological biases, as shown by the analysis using the Cochrane tool. 17

Comparison of the economic data of a clinical pharmacist in the orthopaedic sector confirms that studies in orthopaedics underestimated the savings, except for the study by Rychlíčková et al 25 which reported a cost–benefit ratio of 28:1 for all drugs. Perez et al 30 showed that the median cost–benefit ratio of clinical pharmacy activities was 4.81:1. Butt et al measured the economic impact of a pharmaceutical intervention to improve the prescription of post-surgical prophylactic antibiotics and found a very similar median ratio of 4.8:1. 31 More generally, a review of the literature carried out in 2020 on the economic impact of clinical pharmacy in hospitals showed that the cost–benefit ratio ranged between 0.21:1 and 18:1. 32 Thus, the trend observed in our study of a decrease in costs due to clinical pharmacists is confirmed in the literature, with similar ratios despite the small number of studies. Although the economic benefits may appear to be small in some of the studies reported, they were all accompanied by a clinical benefit for the patient and therefore improvement and safety during their treatment. Finally, in all of these studies the benefits only took into account the direct costs, neglecting the indirect economic impact (eg, being off work due to sick leave). The absence of these indirect costs is almost certainly explained by the difficulty in measuring and quantifying them.

Therefore, it is difficult to assess the societal impact of the savings achieved by the clinical pharmacist. The readmission rate calculated by Hyland et al 22 and Zheng et al 19 before and after the pharmacist is, in our view, the most appropriate measure of the impact of the clinical pharmacist on the patient’s care process. Other parameters, such as the cost of setting up medical aids in the home, the cost of medical transport for patients attributable to hospitalisation, and the cost of extended sick leave would also seem to be relevant parameters to consider.

In this respect, it seems necessary to highlight the limitations of these studies insofar as none of them evaluated all the benefits identified by each of them. Thus, the financial benefits of clinical pharmacy activities are probably often underestimated. Despite these limitations, this study deserves credit for providing a synthesis of the existing literature on the subject; the data collected yield encouraging results regarding the economic benefits of the clinical pharmacist in orthopaedics.

Conclusions

This review of the literature highlights the limited existing data on the economic impact of a clinical pharmacist in the orthopaedic sector despite certain methodological limitations leading to a lack of reproducibility and certain bias, mostly in the measurement and selection of the reported outcome. Nevertheless, the presence of a clinical pharmacist in orthopaedics seems positive and is likely undervalued. A prospective randomised study should be set up to provide a precise, robust and exhaustive quantification of the advantages and disadvantages of clinical pharmacy activities dedicated to orthopaedics.

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Acknowledgments.

The authors are grateful to Gaetan Kerdelhue for help with the database search, Romain Leguillon for methodology support and Nikki Sabourin-Gibbs, CHU Rouen, for her help in editing the manuscript.

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Supplementary materials

Supplementary data.

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• Data supplement 1
• Data supplement 2

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Contributors JD designed the study, collected and analysed the study data, drafted the manuscript and gave final approval for the publication of this article. AS designed the study, collected and analysed the study data, drafted the manuscript, supervised the article and gave final approval for its publication. CC critically reviewed the article and gave final approval for its publication. FD drafted the manuscript, critically reviewed the article and gave final approval for its publication. RV critically reviewed the article, supervised the article and gave final approval for its publication. JC critically reviewed the article, supervised the article and gave final approval for its publication. EB designed the study, collected and analysed the study data, drafted the manuscript and gave final approval for its publication.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests JD, AS, EB do not have any conflicts of interest. CC received non-monetary benefits (hospitality) from Biogen France SA. FD has a consulting role with Amplitude, Serf, Stryker, Zimmer, Heraeus, Leo Pharma unrelated to this work. RV has an expert role with Biomarin, LFB, Lilly, Novartis, Novonordisk, Roche, Sanofi and Sobi. He also received support (conferences) from Mylan, Sobi and Takeda. JC received non-monetary benefits from Smith & Nephew, Zimmer Biomet, Riv’Ortho, Lépine, SERF and Sanofi-Aventis (hospitality). No competing interest related to the study.

Provenance and peer review Not commissioned; externally peer reviewed.

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