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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

What is the purpose of literature review , a. habitat loss and species extinction: , b. range shifts and phenological changes: , c. ocean acidification and coral reefs: , d. adaptive strategies and conservation efforts: .

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 

Frequently asked questions 

What is a literature review .

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field.

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example 

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:  

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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How to write a good literature review 

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review 

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:  

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:  

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:  

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:  

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:  

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:  

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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How to write a literature review faster with Paperpal?  

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• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references in 10,000+ styles into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

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

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

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

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

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

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

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

For each publication, ask yourself:

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

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

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

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

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

Take notes and cite your sources

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

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

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

Prevent plagiarism, run a free check.

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 .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 3 September 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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How To Write A Literature Review - A Complete Guide

Table of Contents

A literature review is much more than just another section in your research paper. It forms the very foundation of your research. It is a formal piece of writing where you analyze the existing theoretical framework, principles, and assumptions and use that as a base to shape your approach to the research question.

Curating and drafting a solid literature review section not only lends more credibility to your research paper but also makes your research tighter and better focused. But, writing literature reviews is a difficult task. It requires extensive reading, plus you have to consider market trends and technological and political changes, which tend to change in the blink of an eye.

Now streamline your literature review process with the help of SciSpace Copilot. With this AI research assistant, you can efficiently synthesize and analyze a vast amount of information, identify key themes and trends, and uncover gaps in the existing research. Get real-time explanations, summaries, and answers to your questions for the paper you're reviewing, making navigating and understanding the complex literature landscape easier.

In this comprehensive guide, we will explore everything from the definition of a literature review, its appropriate length, various types of literature reviews, and how to write one.

What is a literature review?

A literature review is a collation of survey, research, critical evaluation, and assessment of the existing literature in a preferred domain.

Eminent researcher and academic Arlene Fink, in her book Conducting Research Literature Reviews , defines it as the following:

“A literature review surveys 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 explored while researching a particular topic, and to demonstrate to your readers how your research fits within a larger field of study.”

Simply put, a literature review can be defined as a critical discussion of relevant pre-existing research around your research question and carving out a definitive place for your study in the existing body of knowledge. Literature reviews can be presented in multiple ways: a section of an article, the whole research paper itself, or a chapter of your thesis.

A literature review does function as a summary of sources, but it also allows you to analyze further, interpret, and examine the stated theories, methods, viewpoints, and, of course, the gaps in the existing content.

As an author, you can discuss and interpret the research question and its various aspects and debate your adopted methods to support the claim.

What is the purpose of a literature review?

A literature review is meant to help your readers understand the relevance of your research question and where it fits within the existing body of knowledge. As a researcher, you should use it to set the context, build your argument, and establish the need for your study.

What is the importance of a literature review?

The literature review is a critical part of research papers because it helps you:

• Gain an in-depth understanding of your research question and the surrounding area
• Convey that you have a thorough understanding of your research area and are up-to-date with the latest changes and advancements
• Establish how your research is connected or builds on the existing body of knowledge and how it could contribute to further research
• Elaborate on the validity and suitability of your theoretical framework and research methodology
• Identify and highlight gaps and shortcomings in the existing body of knowledge and how things need to change
• Convey to readers how your study is different or how it contributes to the research area

How long should a literature review be?

Ideally, the literature review should take up 15%-40% of the total length of your manuscript. So, if you have a 10,000-word research paper, the minimum word count could be 1500.

Your literature review format depends heavily on the kind of manuscript you are writing — an entire chapter in case of doctoral theses, a part of the introductory section in a research article, to a full-fledged review article that examines the previously published research on a topic.

Another determining factor is the type of research you are doing. The literature review section tends to be longer for secondary research projects than primary research projects.

What are the different types of literature reviews?

All literature reviews are not the same. There are a variety of possible approaches that you can take. It all depends on the type of research you are pursuing.

Here are the different types of literature reviews:

Argumentative review

It is called an argumentative review when you carefully present literature that only supports or counters a specific argument or premise to establish a viewpoint.

Integrative review

It is a type of literature review focused on building a comprehensive understanding of a topic by combining available theoretical frameworks and empirical evidence.

Methodological review

This approach delves into the ''how'' and the ''what" of the research question —  you cannot look at the outcome in isolation; you should also review the methodology used.

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 collect, report, and analyze data from the studies included in the review.

Meta-analysis review

Meta-analysis uses 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 than those derived from the individual studies included within a review.

Historical review

Historical literature reviews focus on examining research throughout a period, often starting with the first time an issue, concept, theory, or phenomenon 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 identify future research's likely directions.

Theoretical Review

This form aims to examine the corpus of theory accumulated regarding an issue, concept, theory, and phenomenon. The theoretical literature review helps to establish what theories exist, the relationships between them, the degree the existing approaches have been investigated, and to develop new hypotheses to be tested.

Scoping Review

The Scoping Review is often used at the beginning of an article, dissertation, or research proposal. It is conducted before the research to highlight gaps in the existing body of knowledge and explains why the project should be greenlit.

State-of-the-Art Review

The State-of-the-Art review is conducted periodically, focusing on the most recent research. It describes what is currently known, understood, or agreed upon regarding the research topic and highlights where there are still disagreements.

Can you use the first person in a literature review?

When writing literature reviews, you should avoid the usage of first-person pronouns. It means that instead of "I argue that" or "we argue that," the appropriate expression would be "this research paper argues that."

Do you need an abstract for a literature review?

Ideally, yes. It is always good to have a condensed summary that is self-contained and independent of the rest of your review. As for how to draft one, you can follow the same fundamental idea when preparing an abstract for a literature review. It should also include:

• The research topic and your motivation behind selecting it
• A one-sentence thesis statement
• An explanation of the kinds of literature featured in the review
• Summary of what you've learned
• Conclusions you drew from the literature you reviewed
• Potential implications and future scope for research

Here's an example of the abstract of a literature review

Is a literature review written in the past tense?

Yes, the literature review should ideally be written in the past tense. You should not use the present or future tense when writing one. The exceptions are when you have statements describing events that happened earlier than the literature you are reviewing or events that are currently occurring; then, you can use the past perfect or present perfect tenses.

How many sources for a literature review?

There are multiple approaches to deciding how many sources to include in a literature review section. The first approach would be to look level you are at as a researcher. For instance, a doctoral thesis might need 60+ sources. In contrast, you might only need to refer to 5-15 sources at the undergraduate level.

The second approach is based on the kind of literature review you are doing — whether it is merely a chapter of your paper or if it is a self-contained paper in itself. When it is just a chapter, sources should equal the total number of pages in your article's body. In the second scenario, you need at least three times as many sources as there are pages in your work.

Quick tips on how to write a literature review

To know how to write a literature review, you must clearly understand its impact and role in establishing your work as substantive research material.

You need to follow the below-mentioned steps, to write a literature review:

• Outline the purpose behind the literature review
• Search relevant literature
• Examine and assess the relevant resources
• Discover connections by drawing deep insights from the resources
• Structure planning to write a good literature review

1. Outline and identify the purpose of  a literature review

As a first step on how to write a literature review, you must know what the research question or topic is and what shape you want your literature review to take. Ensure you understand the research topic inside out, or else seek clarifications. You must be able to the answer below questions before you start:

• How many sources do I need to include?
• What kind of sources should I analyze?
• How much should I critically evaluate each source?
• Should I summarize, synthesize or offer a critique of the sources?
• Do I need to include any background information or definitions?

Additionally, you should know that the narrower your research topic is, the swifter it will be for you to restrict the number of sources to be analyzed.

2. Search relevant literature

Dig deeper into search engines to discover what has already been published around your chosen topic. Make sure you thoroughly go through appropriate reference sources like books, reports, journal articles, government docs, and web-based resources.

You must prepare a list of keywords and their different variations. You can start your search from any library’s catalog, provided you are an active member of that institution. The exact keywords can be extended to widen your research over other databases and academic search engines like:

• Google Scholar
• Microsoft Academic
• Science.gov

Besides, it is not advisable to go through every resource word by word. Alternatively, what you can do is you can start by reading the abstract and then decide whether that source is relevant to your research or not.

Additionally, you must spend surplus time assessing the quality and relevance of resources. It would help if you tried preparing a list of citations to ensure that there lies no repetition of authors, publications, or articles in the literature review.

3. Examine and assess the sources

It is nearly impossible for you to go through every detail in the research article. So rather than trying to fetch every detail, you have to analyze and decide which research sources resemble closest and appear relevant to your chosen domain.

While analyzing the sources, you should look to find out answers to questions like:

• What question or problem has the author been describing and debating?
• What is the definition of critical aspects?
• How well the theories, approach, and methodology have been explained?
• Whether the research theory used some conventional or new innovative approach?
• How relevant are the key findings of the work?
• In what ways does it relate to other sources on the same topic?
• What challenges does this research paper pose to the existing theory
• What are the possible contributions or benefits it adds to the subject domain?

Be always mindful that you refer only to credible and authentic resources. It would be best if you always take references from different publications to validate your theory.

Always keep track of important information or data you can present in your literature review right from the beginning. It will help steer your path from any threats of plagiarism and also make it easier to curate an annotated bibliography or reference section.

4. Discover connections

At this stage, you must start deciding on the argument and structure of your literature review. To accomplish this, you must discover and identify the relations and connections between various resources while drafting your abstract.

A few aspects that you should be aware of while writing a literature review include:

• Rise to prominence: Theories and methods that have gained reputation and supporters over time.
• Constant scrutiny: Concepts or theories that repeatedly went under examination.
• Contradictions and conflicts: Theories, both the supporting and the contradictory ones, for the research topic.
• Knowledge gaps: What exactly does it fail to address, and how to bridge them with further research?
• Influential resources: Significant research projects available that have been upheld as milestones or perhaps, something that can modify the current trends

Once you join the dots between various past research works, it will be easier for you to draw a conclusion and identify your contribution to the existing knowledge base.

5. Structure planning to write a good literature review

There exist different ways towards planning and executing the structure of a literature review. The format of a literature review varies and depends upon the length of the research.

Like any other research paper, the literature review format must contain three sections: introduction, body, and conclusion. The goals and objectives of the research question determine what goes inside these three sections.

Nevertheless, a good literature review can be structured according to the chronological, thematic, methodological, or theoretical framework approach.

Literature review samples

1. Standalone

2. As a section of a research paper

How SciSpace Discover makes literature review a breeze?

SciSpace Discover is a one-stop solution to do an effective literature search and get barrier-free access to scientific knowledge. It is an excellent repository where you can find millions of only peer-reviewed articles and full-text PDF files. Here’s more on how you can use it:

Find the right information

Find what you want quickly and easily with comprehensive search filters that let you narrow down papers according to PDF availability, year of publishing, document type, and affiliated institution. Moreover, you can sort the results based on the publishing date, citation count, and relevance.

Assess credibility of papers quickly

When doing the literature review, it is critical to establish the quality of your sources. They form the foundation of your research. SciSpace Discover helps you assess the quality of a source by providing an overview of its references, citations, and performance metrics.

Get the complete picture in no time

SciSpace Discover’s personalized suggestion engine helps you stay on course and get the complete picture of the topic from one place. Every time you visit an article page, it provides you links to related papers. Besides that, it helps you understand what’s trending, who are the top authors, and who are the leading publishers on a topic.

Make referring sources super easy

To ensure you don't lose track of your sources, you must start noting down your references when doing the literature review. SciSpace Discover makes this step effortless. Click the 'cite' button on an article page, and you will receive preloaded citation text in multiple styles — all you've to do is copy-paste it into your manuscript.

Final tips on how to write a literature review

A massive chunk of time and effort is required to write a good literature review. But, if you go about it systematically, you'll be able to save a ton of time and build a solid foundation for your research.

We hope this guide has helped you answer several key questions you have about writing literature reviews.

Would you like to explore SciSpace Discover and kick off your literature search right away? You can get started here .

Frequently Asked Questions (FAQs)

1. how to start a literature review.

• What questions do you want to answer?

• What sources do you need to answer these questions?

• What information do these sources contain?

• How can you use this information to answer your questions?

2. What to include in a literature review?

• A brief background of the problem or issue

• What has previously been done to address the problem or issue

• A description of what you will do in your project

• How this study will contribute to research on the subject

3. Why literature review is important?

The literature review is an important part of any research project because it allows the writer to look at previous studies on a topic and determine existing gaps in the literature, as well as what has already been done. It will also help them to choose the most appropriate method for their own study.

4. How to cite a literature review in APA format?

To cite a literature review in APA style, you need to provide the author's name, the title of the article, and the year of publication. For example: Patel, A. B., & Stokes, G. S. (2012). The relationship between personality and intelligence: A meta-analysis of longitudinal research. Personality and Individual Differences, 53(1), 16-21

5. What are the components of a literature review?

• A brief introduction to the topic, including its background and context. The introduction should also include a rationale for why the study is being conducted and what it will accomplish.

• A description of the methodologies used in the study. This can include information about data collection methods, sample size, and statistical analyses.

• A presentation of the findings in an organized format that helps readers follow along with the author's conclusions.

6. What are common errors in writing literature review?

• Not spending enough time to critically evaluate the relevance of resources, observations and conclusions.

• Totally relying on secondary data while ignoring primary data.

• Letting your personal bias seep into your interpretation of existing literature.

• No detailed explanation of the procedure to discover and identify an appropriate literature review.

7. What are the 5 C's of writing literature review?

• Cite - the sources you utilized and referenced in your research.

• Compare - existing arguments, hypotheses, methodologies, and conclusions found in the knowledge base.

• Contrast - the arguments, topics, methodologies, approaches, and disputes that may be found in the literature.

• Critique - the literature and describe the ideas and opinions you find more convincing and why.

• Connect - the various studies you reviewed in your research.

8. How many sources should a literature review have?

When it is just a chapter, sources should equal the total number of pages in your article's body. if it is a self-contained paper in itself, you need at least three times as many sources as there are pages in your work.

9. Can literature review have diagrams?

• To represent an abstract idea or concept

• To explain the steps of a process or procedure

• To help readers understand the relationships between different concepts

10. How old should sources be in a literature review?

Sources for a literature review should be as current as possible or not older than ten years. The only exception to this rule is if you are reviewing a historical topic and need to use older sources.

11. What are the types of literature review?

• Argumentative review

• Integrative review

• Methodological review

• Systematic review

• Meta-analysis review

• Historical review

• Theoretical review

• Scoping review

• State-of-the-Art review

12. Is a literature review mandatory?

Yes. Literature review is a mandatory part of any research project. It is a critical step in the process that allows you to establish the scope of your research, and provide a background for the rest of your work.

But before you go,

• Six Online Tools for Easy Literature Review
• Evaluating literature review: systematic vs. scoping reviews
• Systematic Approaches to a Successful Literature Review
• Writing Integrative Literature Reviews: Guidelines and Examples

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How to write a systematic literature review [9 steps]

What is a systematic literature review?

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

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

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

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

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

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

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

A classic systematic literature review can take different approaches:

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

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

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

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

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

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

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

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

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

The protocol for your systematic literature review should include:

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

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

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

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

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

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

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

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

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

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

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

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

➡️ Read more about gray literature .

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

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

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

➡️ Visit our guide on what is an abstract?

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

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

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

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

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

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

Measures of outcome for studies with:

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

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

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

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

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

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

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

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

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

Your systematic review should include the following details:

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

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

20 FREE Literature Review Templates and Examples

When writing a thesis or dissertation, one of the most important segments you will prepare is the literature review. This chapter allows you to analyze and break down written work as it relates to your own research. In this article, we tell you everything that goes into preparing it.

What Is a Literature Review Template?

A Literature Review Template is a formatted document that allows you to capture the available scholarly sources on a given topic of research. It outlines the methods, gaps, and theories in the research while analyzing your understanding of the subject.

Literature Review Templates & Examples

Essential Elements of a Literature Review Template

Since a literary review is a typical academic document, it contains the three basic parts of such texts: the introduction, body, and conclusion. These segments contain the following elements:

• Introduction – Defines the focus and purpose of the review. If the review is a stand-alone, the introduction should give a brief background of the topic. If the review is part of a dissertation or thesis, the intro should capture the research problem or question.
• Body – This is the main content of the review. If the body is lengthy, you should break it into several subheadings.
• Conclusion – The conclusion should summarize the key findings gained from analyzing the literature and explain their effects on future research. For a review within a dissertation, this section should explain how your research can bridge any gaps or provide new knowledge.

Why Write a Literature Review?

Now that you know what a literature review is, here are the main reasons it is prepared:

• To gain and demonstrate an understanding of the current state of a research topic.
• To build a theoretical framework to be used in empirical testing.
• To determine the gaps in a piece of literature and explain how your research bridges them, thus, justifying your research topic.
• To form a criterion for selecting methodological and measurement processes.

How to Write a Literature Review

Preparing a literature review is a long process requiring keen focus, but it is easier when working from a Literature Review Template. Below are the three steps you need for the task:

Step 1: Select the Ideal Literature

Start by locating all the existing research on your topic that could help answer your primary questions. Some strategies for this step include:

• Scanning Google Scholar – Google’s academic search engine – for the articles that apply to your research. Use keywords for the best results.
• Reading other dissertations related to your research. You can access these through databases like Open Access Theses & Dissertations, Stanford SearchWorks, and ProQuest.
• Visiting your University’s database to read through the major journals available in the institution’s online library.
• Running down the references listed at the end of academic journal articles.

Step 2: Analyze the Data

Next, digest and analyze the information you have gathered in step 1. It is natural for this step to take long as your thoughts develop and you identify new sources. Once you have everything you need, follow these three sub-steps to organize the data:

1 . Log the Data

Find a suitable reference manager and load all the articles you read into it. Do so even when you think a piece is irrelevant to your research, as you might need it later.

2. Create a Catalogue

You will notice that the articles are numerous, and you cannot possibly remember the content and context of each item. So, use Excel to create a catalog of the articles and sort them, complete with the following columns:

• Title, author, date
• Keywords or categories
• Main arguments
• Methodology quotations

3. Synthesize The Information

Review the information in your mind to unearth a pattern and create a big-picture link to your research. You can use the following points to synthesize the information:

• The points of agreement and disagreement for leading researchers.
• Gaps in the current research.
• The development of the research over time.
• Answers to your research question as provided by the existing research.

Step 3: Write the Review

Finally, create an outline for your review and then work on an initial draft. Remember that the first draft need not be perfect as long as it captures all your thoughts.

Rule 1: Always define the topic and audience of your review Rule 2: Research the literature widely Rule 3: Write a focused review, but maintain a broad interest Rule 4: Write consistently and critically Rule 5: Include your research but remain objective

Step 1: Identify your topic Step 2: Search for literature Step 3: Read and analyze the selected articles Step 4: Identify patterns and organize your data Step 5: Formulate a purpose statement or thesis Step 6: Write the review Step 7: Review the work

Try to keep informational or historical information (like information from websites) out of your review. If you must include it in your dissertation, place it in the introductory or background section. Additionally, avoid using direct quotes and extended quotations.

No, you should never write a literature review in the first person.

The number of sources you use for a literature review will depend on several factors, such as your scholarship level and the nature of your research. According to Canberra University, a good model to use when determining length is: Doctoral thesis: 50 plus sources Master’s thesis: 40 plus sources Honors dissertation: 20 plus sources Undergraduate review: 5 to 20 sources

Generally, a literature review should account for 10 to 20 percent of your thesis, dissertation, or research paper. For example, in a thesis, the review could be 6,000 to 12,000 words long, depending on the subject.

A Literature Review Template helps you survey the scholarly sources – e.g., theses, books, and journal articles – that cover a given research topic. It could be prepared as part of a research paper, thesis, or dissertation as context for the existing information. Regardless of where it is used, a literary review should be extensively researched, accurately analyzed, and expertly summarized.

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Organizing Your Literature: Spreadsheet Style

By  Kathleen Clarke

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Kathleen Clarke is a Ph.D. candidate in Higher Education at the University of Toronto. You can follow her on Twitter @_KathleenClarke where she tweets about graduate education, mental health, and disability.

There are many different types of reference managers, including Refworks , Zotero , Endnote , and Mendeley . I’ve tried them all and none of have stuck. It’s not that there is anything wrong with them; I know folks who swear by them. They just don’t suit my workflow. Instead, I use a simple spreadsheet (Excel and/or Google Sheets) and a numbering format to keep track of all my resources. The best part about my system: it doesn’t require buying any software and it doesn’t take hours to learn!

The Major Spreadsheet

In her post called “ How I Use Excel to Manage My Literature Review ,” Elaine Campbell outlines her approach to using a spreadsheet to manage literature. I call her approach the Major Spreadsheet, because she is mapping out a very large body of literature for her doctorate in a single spreadsheet. I started a similar spreadsheet very early in my program. Here’s what it looks like:

What you want to do is add a bunch of column headings for things you want to keep track of and then start adding resources to each row. I initially was only adding journal articles, but realized this would work better if it truly housed all my resources. I therefore add anything related to my work: books, policies, blog posts.

Here are two pointers for your Major Spreadsheet:

First, start early and add often. I add to my Major Spreadsheet whenever I come across an article pertinent to my research area (graduate students with mental health challenges and disabilities). I started this in the first year of my program, so I have quite a few articles now. As Campbell points out in her post, this approach is great because it can help you see how far you’ve come and how much you’ve read.

Second, headings . The beautiful thing about workflow and organization is that there is no right way to do it; you can customize anything. The headings of your spreadsheet are where you can make this your own. In my spreadsheet, I have:

• ID number (I’ll come back to this)
• Author(s) + Year
• APA Reference
• Type of Resource
• Location (Canada, United States, United Kingdom, Other)
• Purpose/Objectives
• Research Questions
• Survey/Interview/Focus Group Questions
• Quantitative/Qualitative Design
• Main Findings
• Notes (where I put quotations I might want to use)

Some of these headings may not be of interest to you, but you are free to add any characteristic or metric you may want to use as a filter or sorting feature. These headings can change, too. As you go along you can add or remove as you see fit. You also want to think about the themes you might write about in your literature review. I, for example, have headings like: prevalence, stressors, depression, anxiety, suicide, accommodations, counseling, disclosure, faculty perceptions, and stigma. When an article I’m adding addresses one of these in a research question or as a finding, I add a little x in the cell to show that. Then, when I’m writing about that topic, I sort the column so that I can easily pull all the articles that address that theme.  

The Minor Spreadsheets

In addition to my Major Spreadsheet, I also developed what I call Minor Spreadsheets, which are similar to what Dr. Raul Pacheco-Vega writes about in his post called Synthesizing different bodies of work in your literature review: The conceptual synthesis Excel dump technique . Minor Spreadsheets are much smaller than my Major Spreadsheet and have more specific details. I use Minor Spreadsheets in two different ways.

First, in the picture of my spreadsheets from above you’ll see at the bottom that I have different sheets within the same workbook. These are articles that could be related to other work I want to do. For example, I have a sheet about international students, where I track all the literature concerning international students’ mental health. I also have a sheet with cool studies that I want to come back to later (because who said reviewing literature can’t be fun?). I add to these sheets on an ongoing basis to save me time later.

The second way I use Minor Spreadsheets is when I start a new paper. I pull articles from my Major Spreadsheet and throw them in a new one. Now that I have an existing foundation for the literature, I can go to Google Scholar to build on what I already have instead of starting from scratch.  

These Minor Spreadsheets are typically much more focused than my Major Spreadsheet. For example, in the Major Spreadsheet I use the x to identify articles under one overarching disability theme and in the Minor Spreadsheet I take all these and look more closely at type of disability, level of education, and accommodations.

The Number System

Now, lots of folks would use the spreadsheet approach and then store their articles with annotations in another program. Instead, I include a number system that allows me to easily find any article from my Major/Minor Spreadsheets from a regular folder in my Documents (Shout out to Jeff Burrow for introducing me to this method). If you look back at the screenshot I provided earlier, you’ll see that there is a column called ID Number. Every article I add to my Major or Minor Spreadsheets gets an ID number. I then have a folder for my Major Spreadsheet and all its articles.

My folder for my Major Spreadsheet looks like this:

Everything is nice and clean with the numbers, but it doesn’t always look like this. Here’s an example of what one of my Minor Spreadsheets, Canadian articles, looks like:

For my Minor Spreadsheets, I typically start by copying and pasting articles from the Major Spreadsheet and the folder of articles. This is why you end up with folders for Minor Spreadsheets where the numbers are all over the place, which is okay. The numbers don’t mean anything; it’s just an easy way to find articles other than using author name(s) and article titles.  

A final note: I number dissertations differently than other pieces. I started numbering those at 1000 and have gone up from there. I wanted to differentiate dissertations in some way so that I could easily find them in my folders (usually because I look at dissertations to see how others have done certain things). You could also differentiate other pieces in your folder like books, by starting at 2000, for example. Again, you can customize all of this to what works for you.

I’m curious to hear your thoughts on this spreadsheet approach and to also know what other methods you might be using to organize your literature. Do you think the spreadsheet approach would work for you? What other methods do you use to organize your literature review work?

[Image by Flickr user Craig Chew-Moulding and used under Creative Commons licensing.]

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

• What is a Literature Review?
• Developing a Research Question
• Selection Criteria
• Database Search
• Documenting Your Search

Review Matrix

• Reference Management

Using a spreadsheet or table to organize the key elements (e.g. subjects, methodologies, results) of articles/books you plan to use in your literature review can be helpful. This is called a review matrix.

When you create a review matrix, the first few columns should include (1) the authors, title, journal, (2) publication year, and (3) purpose of the paper. The remaining columns should identify important aspects of each study such as methodology and findings.

Click on the image below to view a sample review matrix.

You can also download this template as a Microsoft Excel file .

The information on this page is from the book below. The 5th edition is available online through VCU Libraries.

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Literature Review Overview

What is a Literature Review? Why Are They Important?

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

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

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

Literature Review Steps

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

1. Choose a topic and define your research question

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

2. Determine the scope of your review

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

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

3. Develop a search plan

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

4. Conduct searches and find relevant literature

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

5. Review the literature

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

6. Organize and synthesize

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

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

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

3. Summary Table

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

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

Literature Review Sections

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

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

Standalone Literature Review (aka Narrative Review):

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

Literature Review as Part of a Research Study Manuscript:

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

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

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

Systematic Reviews:

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

Literature Review Examples

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

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

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

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

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

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

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Doing a literature review using digital tools (with Notion template)

I’ve recently revamped my literature review workflow since discovering Notion . Notion is an organization application that allows you to make various pages and databases. It’s kind of like your own personal wiki- you can link your pages and embed databases into another page, adding filters and sorting them using user-set properties. The databases are what I use the most. I’ve essentially transferred all of my excel sheets into Notion databases and find it much easier to filter and sort things now. In this post, I’ll go through how I do my literature review and share a Notion template that you can use.

I like to organize my literature review using various literature review tools along with two relational Notion databases: a ‘literature tracker’ and a ‘literature notes’ matrix. You can see a flow chart of my literature review process below (it’s inspired by this post by Jenn’s Studious Life and the three pass method for reading papers which I wrote about last week in this post ):

As you can see, this process involves a couple of decision points which helps me focus on the most important papers. This is an iterative process that keeps me up to date on relevant research in my field as I am getting new paper alerts in my inbox most days. I used this method quite successfully to write the literature review for my confirmation report and regularly add to it for the expanded version that will become part of my PhD thesis. In this post, I’ll break down how this works for me and how I implement my Notion databases to synthesise the literature I read into a coherent argument.

You can click on the links below to navigate to a particular section of this article:

The literature search

The literature tracker, the literature synthesis matrix, writing your literature review, iterating your literature review, my literature review notion template, some useful resources.

This is always the first step in building your literature review. There are plenty of resources online all about how to start with your search- I find a mixture of database search tools works for me.

The first thing to do when starting your literature review is to identify some keywords to use in your initial searches. It might be worth chatting to your supervisor to make a list of these and then add or remove terms to it as you go down different research routes. You can use keyword searches relevant to your research questions as well tools that find ‘similar’ papers and look at citation links. I also find that just looking through the bibliographies of literature in your field and seeing which papers are regularly cited gives you a good idea of the core papers in your area (you’ll start recognising the key ones after a while). Another method for finding literature is the snowballing method which is particularly useful for conducting a systematic review.

Here are some digital tools I use to help me find literature relevant to my research questions:

Library building and suggestions

Mendeley was my research management tool of choice prior to when I started using Notion to organize all of my literature and create my synthesis matrix. I still use Mendeley as a library just in case anything happens to my Notion. It’s easy to add new papers to your library using the browser extension with just one click. I like that Mendeley allows you to share your folders with colleagues and that I can export bib.tex files straight from my library into overleaf documents where I’m writing up papers and my thesis. You do need to make sure that all of the details are correct before you export the bib.tex files though as this is taken straight from the information plane. I also like to use the tag function in Mendeley to add more specific identifiers than my folders.

Mendeley is also useful for finding literature related to those in your library- I’ve found quite a few interesting papers through the email updates they send out each week with ‘suggested papers’. You can also browse these suggestions from within Mendeley and use its interface to do initial keyword searches. The key is to just scan the titles and then decide whether it’s worth your time reading the abstract and then the rest of it. It’s easy to get overwhelmed by the sheer amount of papers being published every day so being picky in what you read is important (and something I need to work on more!).

Some similar tools that allow you to build a library and get literature recommendations include Zotero , Researcher , Academia , and ResearchGate . It’s up to you which one you use for your own purposes. One big factor for me when choosing Mendeley was that my supervisor and colleagues use it so it makes it much easier to share libraries with them, so maybe ask your colleagues what they use before settling on one.

Literature databases and keyword alerts

There are a variety of databases out there for finding literature. My go-to is Web of Science as it shows you citation data and has a nice interface. I used this to begin my initial literature search using my keywords.

The other thing you can do with these kinds of tools is set up email alerts to get a list of recent work that has just been published with any keywords you set. These alerts are usually where I find papers to read during journal club with my supervisor. You can customize these emails to what suits you- mine are set to the top 10 most relevant new papers for each keyword weekly and I track around 5 words/phrases. This allows me to stay on top of the most recent literature in my field- I have alerts set up on a variety of services to ensure that I don’t miss anything crucial (and alerts from the ArXiv mean I see preprints too). Again, you need to be picky about what you read from these to ensure that they are very relevant to your research. At this stage, it’s important to spend as little time as possible scanning titles as this can easily become a time suck.

Some of the other tools I have keyword (and author) email alerts set up on are: Scopus , Google Scholar , Dimensions , and ArXiv alerts . I set 10 minutes maximum aside per day to scan through any new email alerts and save anything relevant to me into my literature tracker (which I’ll come to more later).

Literature mapping tools

There are loads of these kinds of tools out there. Literature mapping can be helpful for finding what the seminal papers are in your field and seeing how literature connects. It’s like a huge web and I find these visual interfaces make it much easier to get my head around the relationships between papers. I use two of these tools during the literature search phase of the flowchart: Citation Gecko and Connected Papers .

Citation Gecko builds you a citation tree using ‘seed papers’. You can import these from various reference management software (like Mendeley), bib.tex files or manually search for papers. This is particularly useful if your supervisor has provided you with some core papers to start off with, or you can use the key papers you identified through scanning the bibliographies of literature you read. My project is split into fairly clear ‘subprojects’ so these tools help me see connections between the various things I’m working on (or a lack of them which is good in some ways as it shows I’ve found a clear research gap!).

You can switch between different views and add connecting papers as new seed papers to expand your network. I use this tool from time to time with various different papers associated with my subprojects. It’s helped me make sure I haven’t missed any key papers when doing my literature review and I’ve found it to be fairly accurate, although sometimes more recent papers don’t have any citation data on it so that’s something to bear in mind.

Connected Papers uses a ‘similarity’ algorithm to show paper relationships. This isn’t a citation tree like Citation Gecko but it does also give you prior and derivative works if you want to look at them. All you do is put one of your key papers into the search box and ‘build a graph’. It will then show you related papers, including those which don’t have direct citation links to the key paper. I think this is great for ensuring that you’re not staying inside an insular bubble of the people who all cite each other. It also allows me to see some of the research which is perhaps a bit more tangential to my project and get an overview of where my work sits within the field more broadly.

I like Connected Paper’s key for the generated tree and that it shows where related papers connect between themselves. Again, it’s helpful for ensuring that you haven’t missed a really important work when compiling your literature review and doesn’t just rely on citation links between papers.

This is where I record the details of any paper I come across that I think might be relevant to my PhD. In some ways, it’s very similar to Mendeley but it’s a version that sits within Notion so I have some more customised filtering categories set up, like my ‘status’ field where I track which pass I am on.

Here’s what my literature tracker looks like:

The beauty of Notion is that you can decide which properties you want to record in your database and customize it to your needs. You can sort and filter using these properties including making nested filters and using multiple filters at once. This makes it really easy to find what you’re looking for. For example, say I’m doing my literature review for my ‘FIB etching’ subproject and want to see all of the papers that I marked as relevant to my PhD but haven’t started reading yet. All I need to do is add a couple of filters:

And it filters everything so that I’m just looking at the papers I want to check out. It’s this flexibility that I think really gives Notion the edge when it comes to my literature review process.

The other thing I really like about using Notion rather than excel is that I can add different database views. I especially like using the kanban board view to see where I’m at with my reading workflow:

When I add something to the literature tracker database, I scan the abstract for keywords to add and categorize it in terms of relevant topics. It’s essentially the first pass of the paper, so that involves reading the title, abstract, introduction, section headings, conclusions, and checking the references for anything you recognise. After this is done, I decide whether it’s relevant enough to my PhD to proceed to do a second pass of the paper, at which point I will progress to populating my literature notes database.

Once I’ve decided that I want to do a second pass on a paper, I then add it to the ‘literature notes’ database. This is part of the beauty of Notion: relational databases. I have ‘rollup’ properties set in the literature notes database which shows all of the things I added during my first pass and allows me to filter the matrix using them. You can watch the video below to see exactly how to add a new paper to the ‘notes’ database from the ‘tracker’ database:

During the second pass, I populate the new fields in the ‘notes’ database. These are:

Summary | Objective of study | Key Results | Theory | Materials | Methods | Conclusions | Future work suggested | Critiques | Key connected papers.

I also have various themes/questions/ideas as properties which I add a few notes on for each relevant paper. I then complete my ‘questions for critical engagement’ which are on the entry’s ‘Notes’ page and are stored in the ‘Article Template’. If you want to read more about this process, check out my ‘how to read a scientific paper’ post .

By, doing this I create a synthesis matrix where I can see a breakdown of the key aspects of each paper and can scan down a column to get an overview of all of the papers I have read. For example, if I wanted to see all of the papers about Quantum Point Contacts to get an idea of what previous work has been done so that I can identify my research gap, I can filter using the tag property and can then see the notes I wrote for each entry, broken down by section. I also have tags for my research questions or themes, materials used, experimental techniques, fabrication techniques, and anything else that comes to mind really! The more tags I have for a paper, the easier it is to filter when I want to find a specific thing.

The other property I have included in the literature notes database is ‘Key connected papers’. This is a relation but is within the database itself. So it means that I can link to the page of other papers in the literature matrix. I’ve found this to be useful for connecting to what I call ‘core’ papers. I can also filter using this property, allowing me to see my notes on all of the papers I’ve read that are related to a certain ‘core’ paper. This helps with synthesising all of the information and forming my argument.

For those papers most relevant to my research (the ‘core’ papers) I’ll also do a third pass which involves reimplementing the paper in my own words. This is quite a time-consuming task so not many papers reach this stage, but those which I have done a third pass on are the ones I know really well. My hope is that this will stand me in good stead for my viva. This process also helps me refine my research questions further as I gain a deeper understanding of the field.

I find that writing up a review is extremely intimidating, but having the literature matrix makes this process that bit easier. I won’t go into too many details as there are already loads of resources out there going into the details of writing up a review, but here’s a brief overview of my own process:

Identify your research themes

Using your literature matrix, review each research theme or question and decide which ones you are going to focus on. These will form the different sections of your literature review and help you write your thesis statement(s). You can also think about how your questions link to ensure that you’re telling a coherent story with your review.

Choose and summarize literature related to each theme

For each section, gather up the most important related literature and summarize the key points of each source. A good literature review doesn’t need to cover all the literature out there, just the most significant sources. I try to stick to around 10 or fewer key sources per section.

Critical evaluation of sources

This is where you utilize the ‘questions for critical engagement’. Make sure you evaluate the strengths and weaknesses of the studies you’re writing about. By doing this, you can establish where our knowledge is lacking which will come in helpful later when establishing a research gap.

Analyse each source in relation to other literature

Try to make sure that you are telling a coherent story by linking between your sources. You can go back to the literature matrix here and use it to group similar studies to compare and contrast them. You should also discuss the relevance of the source’s findings in relation to the broader field and core papers.

Situate your research in a research gap

This is where you justify your own research. Using what you have laid out in the rest of the review, show that there is a research gap that you plan to fill and explain how you are going to do that. This should mean that your thesis flows nicely into the next section where you’ll cover the materials and methods you used in your research project.

In some ways, a literature review never really ends. As you can see in the flowchart at the beginning of this post, I regularly update and revise my literature review as well as refining my research questions. At this point in my PhD, I think that most of my research questions are quite well defined, so I’m mostly just adding any newly published work into my review. I don’t spend much time reading literature at the moment but I’m sure I’ll return to it more regularly when I’m in the write-up phase of my PhD. There is a balance to be had between reading and writing for your literature review and actually getting on with your own research!

Here’s the link to my Notion Literature Review Template . You can duplicate it and adapt it however you want, but this should save you some time setting up the initial databases if you’d like to use my method for organizing your own literature review.

Here are some resources on how to do a literature review that I’ve found useful during my PhD:

• The Literature Review: Step-by-Step Guide for Students
• 3 Steps to Save You From Drowning in Your Literature Review
• How to write a literature review
• How to become a literature searching ninja
• Mind the gap
• 7 Secrets to Write a PhD Literature Review The Right Way

If you like my work, I’d love your support!

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11 thoughts on “Doing a literature review using digital tools (with Notion template)”

Thank you so much for your insight and structured process. This will help me a lot kicking off my Master Thesis.

The perfect method to organize the literature that I have read and will read in the future. I am so glad to have found your website, this will save me from thrashing around in the swamp of literature. I was already feeling the limits of my memory when I was doing my master thesis and this will be so helpful during my PhD.

Thank you so much for this detailed post! Lily 🙂

Thank you very much for this. I’m doing my undergrad atm and reading a lot of papers. This seems like an excellent way of tracking everything.

Thank you, you made my beginning less stressful. I like your system and i helped me a lot. I have one question (more might come later), What do you mean by " journal club with my supervisor."

This piece is really really helpful! I started from this one and went through the rest blog writings. I agree on many points with Daisy. I had an unhappy experience of PhD two years ago and now just started a new one in another country. I will take it as an adventure and enjoy it.

This is an AMAZING template. I've found this so helpful for my own workflow. Thank you so much!

I found this post really helpful. Thank you.

thank you very much!

Hi! Thank you very much for posting this guide and sharing your notion template! I do have a question—do you manually enter the references into Notion, or is there any way to speed up the process? Ta x

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Literature Review Templates

50 smart literature review templates (apa).

A literary review template is a type of written work that discusses published information about a specific subject matter. The length of the review doesn’t matter. It can be as simple as a summary of sources or can be as long as several pages. An outline for literature review can also evaluate these sources and advise to the readers regarding what’s relevant depending on certain conditions.

Table of Contents

• 1 Literature Review Templates
• 2 Why do you need a literature review template?
• 3 Literature Review Formats
• 4 Tips for creating a literature review template
• 5 Outlines For Literature Review
• 6 Compose the literature review
• 7 Strategies for composing your literature review template

Why do you need a literature review template?

A literary review template can serve as a guide about a specific topic. If you’re under time constraints to conduct more research, a literature review outline example can do you good as it provides you with an overview of what you intend to research on.

Even professionals of various fields rely on literary reviews to keep them updated in terms of what’s current in their fields. As for scholars, they can detect a writer’s credibility in a certain field by reading their literature review format. You can also use these works as a foundation for the investigation of a research paper.

Literature Review Formats

Tips for creating a literature review template

Literary review templates are surveys of scholarly sources on a specific subject matter. It gives a general summary of information relevant to a certain research problem or question. Here are the steps to follow when creating a literary review.

• Gather, assess, and choose the appropriate literature Before researching for literature for a review, you must have a topic that’s narrowly-defined. If you were to write a review for some research work or dissertation, you have to gather information related to the research problem or question. Having to understand the state of knowledge of your subject is the first step in creating your outline for literature review. Composing a literature review outline example for stand-alone research shouldn’t be that difficult. You only have to a good focus, then come up with a question that directs your search. This should be an answerable question without the need to generate or collect new data. Start the process by making a list of relevant keywords for the research topic in question. Based on the list, whenever you discover useful articles, check your list of references to find other relevant articles. During this process, you can identify any significant publications which didn’t show up when you performed a keyword search through recurring citations. It’s impossible for you to read all the available sources about a single topic. The best thing to do first is to read the abstract and determine if the articles are of any use. You have to do some evaluations on which of the sources are of value and relevant to the question. Also, make sure to only choose credible sources. Make it a point to read major theories and landmark studies in the field of your research. Logically, your scope of work depends upon the discipline and topic you have chosen. Make it a habit of writing down notes while you’re reading. Later on, you can incorporate these notes in your literature review format. Also, consider keeping track of the sources you have cited to avoid any consequential plagiarism cases. Making an annotated bibliography is a good suggestion. Include here a written paragraph for the summary and the analysis for each cited source. This can also be very helpful in reminding you about what you have read.
• Look for themes and connections When you start organizing a literature review format, you should identify the relationships between all of the sources that you have read. Based on what you have read and the notes you have taken, look for: Patterns and trends: Are there approaches which become less or more popular as time goes by? Themes: Identifying concepts or questions that repeat constantly across the different literature. Conflicts, contradictions, and debates: At what points do the sources disagree or agree? Pivotal publications: Identify any influential studies or theories which affected the direction of the field. Gaps: Try looking for answers for the following questions – What’s missing from the literature? Did you find any weaknesses that you need to address? The answers to these questions can help organize the structure of the literary review. If applicable, you can include how your research contributes to the existing knowledge.
• Plan the structure of your literature review template You can organize the whole body of your literary review through various approaches but at this point, you should already have an idea of the strategy you want to use even before writing your review. Depending on how long your review will be, you can use the following strategies: Chronological This is the simplest strategy where you map out the development of your topic over a period of time. If you use this approach, you should avoid merely listing or summarizing your sources chronologically. Make it a point to analyze the patterns, key events, and turning points that have influenced the direction of the field. If possible, give your own ideas about why and how certain developments came to happen. Thematic If you’ve discovered, in the course of your research, some recurring themes, you may organize your literary review into subsections which address the different parts of your topic. Methodology When you’re drawing your sources from various fields or disciplines which use different methods for research, you may end up with different conclusions and results. Perform analysis and try to compare these results that emerged from the different approaches. Theoretical In many cases, a literary review becomes the basis for theoretical frameworks. You may use this to talk about various definitions, theories, and models of important concepts. You may even argue about the significance of a theoretical approach or you can combine different theoretical ideas to come up with your own framework for research.

Outlines For Literature Review

Compose the literature review

The literary review isn’t any different in form from any other kind of academic texts as it also has the basic parts. What you included in each would depend upon your objective for writing the literature review:

• Introduction This part should clearly define the purpose and focus of the review. Dissertation: If you wrote the review as a part of a thesis or dissertation, you must reiterate the research question or central problem. Provide a short summary of the context as well. Stand-Alone: When writing this type of review, provide a short background regarding the topic along with its significance. Talk about the scope you plan to review along with your objective.
• Body If you have a lengthy review, it’s best to divide this part into sub-sections then come up with a subheading for each of them.
• Conclusion State in the conclusion, a summary of the key findings you have derived from the literature and emphasize their significance. Dissertation: Demonstrate how your research can address gaps and how it can contribute to gaining new knowledge. You can also discuss how you have used existing theories and methods to build a framework for your research. Stand-Alone: Discuss the overall effects of the literature or make suggestions for future research based on those gaps you have identified in your review.

Strategies for composing your literature review template

Most people write literature review templates in the sciences although occasionally, some are in the Humanities. In many experiments and laboratory reports, literature reviews constitute a section of the document. At times, some people write the review as the paper itself. Here are some strategies that may prove helpful when tasked to write a literature review:

• Find your focus Although they can differ, a literary review is like a term paper as you would organize both around ideas, not the sources themselves. This means that writing a review is not merely about listing your sources and going into their details one at a time. You also have to consider the themes and issues that connect your sources together.
• Convey your message Literary reviews may not have the usual thesis statement but you still need to inform your readers what to expect. Writing a simple statement is enough to let your readers know what your main organizing principle is.
• Organize the information There are instances when you may need additional sections in your review which are necessary for the study but don’t fit into the body’s organizational strategy. This depends on which sections you want to include. Only put in those that are necessary. To help you out, here are some sections that you may want to include in your review: Current Situation: This refers to the information that’s necessary to easily understand the focus or topic of the review. History: The chronological progression of the field, the literature, or an idea that’s necessary to understand the literature review. Include this only if the body isn’t already arranged chronologically. Methods or Standards: What criteria did you use to choose the sources in your review or the manner in which you want to present the information. Questions for Further Research: Are there questions about your field of research the review had sparked? Based on the review, what steps can you take to advance your research?

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Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

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WTO / Education / 39 Best Literature Review Examples (Guide with Samples)

39 Best Literature Review Examples (Guide with Samples)

A literature review is a compilation of current knowledge on a particular topic derived from the critical evaluation of different scholarly sources such as books, articles, and publications, which is then presented in an organized manner to relate to a specific research problem being investigated.

It highlights the methods, relevant theories, and gaps in existing research on a particular subject. It can be both a summary and synthesis of information on a specific topic. A summary reiterates key information from scholarly sources, while synthesis is a new interpretation or combination of new and old material. 

As a synthesis, it can outline the intellectual progression of knowledge in a particular field or topic, which might involve stating key debates throughout the advancement period.  

Literature Review Examples

Purpose of Literature Review

Literature reviews have different purposes in scholarly articles, research papers , and books, depending on the discipline at hand. First and foremost, reviews are generally meant to showcase the extensive research carried out by an author on a particular topic and their findings, which will form the foundation of the research. It then summarizes the information to show the author’s familiarity with the topic in question.

The review also demonstrates the relationship between the topic being investigated and other topics that were under consideration. Finally, it outlines the gaps in the previous works of other scholars, which create areas of research.

Literature reviews provide a new interpretation of previous scholarly publications and aim to resolve conflicting studies done in the past. In addition, identifying existing gaps in a particular research area illustrates the starting point of the research.

Literature Review vs. Academic Research Paper

A research paper presents new ideas, arguments, and approaches toward a particular topic. The conclusions of a research paper will be based on the analysis and interpretation of raw data collected by the author and an original study. On the other hand, a literature review is based on the findings of other publications. Thus, the review highlights the author’s understanding of a topic based on the previously conducted research. It is part of a research paper.

Where, When, and Why

The need for a literature review in a publication will vary from one situation to the other and the field/discipline of research. These two factors determine what is expected from the lit review. For example, a scientific review will be more analytical on the methods and results of previous research. In contrast, a philosophical review will be more argumentative, highlighting the discrepancies and correspondences between scholars.

It can either be part of a publication or a stand-alone document. As part of a research publication, it is often placed after the introduction to the topic outlining knowledge about a particular topic and critical sources that formed the foundation of the research. As an individual document, it is prepared by students as part of course study to aid the students in familiarizing themselves with different topics in their field of study.

Lit reviews also guide students to help them synthesize theoretical methodologies and frameworks to adopt in academic research . As a publication, literature reviews are used to document existing information about a topic for readers (other scholars) to go through for whatever reasons they may have. Published studies are essentially helpful to new scholars getting into any field of research.

Types of Literature Review

Before looking into how to write a literature review, it is vital to understand the different types. The type will usually depend on the objective approach of the author.

Common types are:  

Argumentative review

An argumentative review is adopted when the research paper or publication is meant to take a contrarian viewpoint on a particular subject. The review analyses an existing argument, philosophical problem, assumption, or conclusion outlined in different studies with an objective to either support or oppose the argument. 

Integrative review

An integrative review integrates secondary data to develop new perspectives and frameworks on a topic. This is more prevalent in research that does not involve primary data. In addition, integrative reviews are more familiar with social sciences.       

Historical review

Historical reviews are used when scholars or authors place a particular idea, concept, theory, or research in a historical context. It examines the idea, theory, or issue from the first time it was discussed and outlines its evolution throughout a given period.  

Methodological review

Methodological reviews look at how a specific theory, concept, results, or findings were developed. Therefore, methodological reviews will analyze the different methods used by different scholars to arrive at conclusions or knowledge about the topic being investigated.

Some of the methods scholars use in different disciplines to obtain information are interviewing, sampling, practical experiments/data collection, research approaches, critical thinking, social experiments, etc.

Methodological reviews are hence used to discuss tested methods of research and ethics that a researcher should be aware of before undertaking their investigations.  

Systematic review

A systematic review is a more detailed and comprehensive review compared to other types of lit reviews. It highlights any existing research evidence associated with a clearly defined research problem or question. The evidence is collected, analyzed, and reported in a summarized but detailed manner. Systematic reviews are popularly presented as a cause-and-effect structure.

Theoretical review

A theoretical review delves into the different theories regarding a particular issue, challenge, concept, or theory. It identifies their inadequacy in explaining the issue or concept at hand. The review then identifies the relationships between the identified theories, and the degree of research done and poses novel hypotheses to be investigated.

Organization of a Literature Review

How an author organizes a literature review will depend on what they aim to achieve. As a consequence, there are multiple ways of organizing it which are discussed below:

Chronological 

A chronological format outlines knowledge on a particular topic based on when the scholarly source of information was published. Starting with the earliest followed up to the most recent chronological order. This format should be used if there is a clear chronological order in the development of the information; therefore, it will not be applicable in some cases. Instead, key turning points, patterns, and events that impacted the direction of the knowledge should be outlined.  

By publication

It can be organized in the scholarly publications reviewed by the author, scholar, or student. The by-publication format should only improve the review and facilitate what the author aims to accomplish. 

Scholars or students can adopt a dominant trend in research, such as history, developmental stages, steps involved in a process, etc.

Methodological

A methodological format is based on the methods used by the researcher. Thus, the order of contents in the lit review will depend on the method they will use to carry out their research, knowledge obtained from the first method appears first, and the rest of the information follows in the same order according to the methods used by the author.  

Literature reviews organized in a thematic format revolve around the subject being investigated in no order. It is, therefore, ordinarily up to the researcher or author to determine how they intend to outline the information. A thematic format will crossover from one period and publication to another, but can sometimes incorporate a chronological order.

Theoretical

Literature reviews organized in a theoretical format have their contents organized in an abstract framework established by the author to discuss different concepts, theories, and concepts and how they relate to the research at hand.

Additional sections

Depending on the objective, other sections do not fit under conventional lit review formats that one may need to add. Below are some of the sections that authors or students can include in the lit review:

• Current situation: The review can have information about the current state of things regarding the topic at hand to facilitate further understanding.
• History: Researchers can summarize the subject under investigation, literature, or concept if the review is not already in chronological format.
• Selection methods: Lit reviews are known to outline the methods or criteria used in selecting the way to present information and scholarly sources referenced in the review.
• Standards: it can also include the standards used in choosing the format to present information in the review and the scholarly literature used in the research.
• Further questions for research: The review can include questions emanating from the review and how the researcher will further explore their research to address the queries raised.

Literature Review Samples

Considerations Before Writing a Literature Review

Preparation is essential when it comes to writing. The objective should be to come up with a review that satisfactorily explores the topic being discussed. The following considerations are steps towards that if incorporated into the writing process:

Authors should seek clarification from mentors or supervisors before commencing the writing process. First, determine what is expected from the lit review. The type and number of sources to be used, the assignment (summarize, synthesize, or critique), and the type of information provided should be clear.

Find models

You should review literature from other authors in the same discipline and evaluate how those authors presented their lit reviews. Previous lit reviews can be used as guides that point authors in the right direction when writing their lit reviews.

Narrow your topic

It is always advantageous to narrow down the research topic to a specific area of research; that way, the number of sources can also be reduced. Even though conducting research will usually involve extensive research on all available materials about a particular topic, having a well-defined topic simplifies the task at hand.

Current sources

Determine if the research project or discipline ought to be based on the most recent findings or information. It is common for knowledge to become obsolete, especially in disciplines where discoveries and new inventions are made fast. If the lit review should be based on current knowledge, limit the sources to the most recent literature. Some disciplines will typically have a limit on how old the sources should be.  

How to Write a Literature Review (Expert Guide)

Once all pre-writing considerations have been taken into account, it is time to write the document. At this point, you should already be aware of what you wish to accomplish with the literature review, and the steps to writing an exemplary lit review are mentioned below:

Problem formulation

First and foremost, clearly define the topic (research area) to be investigated. For students, this will sometimes be given as an assignment. However, the research could be an academic project, which means that the author has to come up with the problem and define it themselves.

Search for relevant studies

Once the problem is clearly expressed, you should search for studies related to the topic, concept, theory, or idea and questions surrounding the topic. Most stand-alone lit reviews will generally attempt to answer a more concentrated question. On the internet, literature can be searched using keywords related to the research area. In addition to keywords, include vital variables such as synonyms and associated terms. The inclusion of Boolean operators and, or not, is also used to narrow down results to more specific publications.

Familiar sources for publications are:

• Google Scholar
• Library catalogue
• Econ lit (economics)
• Project Muse (humanities and social sciences)
• Inspec (physics, engineering, and computer science )
• Medline (life sciences and biomedicine)

Before selecting relevant studies, go through their abstract and determine if they fit the scope needed in the investigation. Use a list to note down any chosen works. Select landmark sources in the discipline.

Evaluation of sources/data

The next step is the evaluation stage . Evaluation involves a lot of reading. Evaluation can be done in two stages; overall skimming and thorough reading. During the second stage of this step, be critical, ask questions, and take many notes.

Some of the questions authors or researchers should ask themselves are:

• What is the author’s objective? What problem, concept, or theory are they putting across?
• What are the main concepts?
• What are the methodologies used by the author to arrive at the results and conclusions?
• What are the strengths and weaknesses of the results and conclusions?

Use credible sources. Most cited sources are preferred as they indicate their influence in the field. Also, keep track of the citations to be later incorporated.

Identify themes, debates, and gaps

While reading the sources, identify key patterns, themes, debates/arguments, and gaps in each literature. These elements help tie the literature to the topic under investigation. Look for consistent patterns, themes, questions, challenges, methods, and inconsistencies in the same. Consistencies present critical information for consideration, while inconsistencies present opportunities for research areas.

Outline the structure

Formatting is part and parcel of a well-written work. Selecting the structure should start by creating an outline with all the information that will go into the lit review, then consider the different types of structures and select the most suitable. Next, take the basic structure of the introduction, body, and conclusion into consideration and start work from there. 

Analysis and interpretation 

Lastly, perform an in-depth analysis and interpretation of the information obtained from the scholarly research and put it into writing. The summarized, synthesized, and critically evaluated information is then written down in well-structured paragraphs that follow the chosen structure. Transition words are used to draw comparisons, connections, and contrasts.

Format 

Ordinarily, a literature review will have three key components: introduction, body, and conclusion. These components should appear in the document in the following order:

Introduction

An introduction should inform the reader which topic is being studied. It gives the reader an overall idea of the purpose and focus of the document. The introduction lets the reader know beforehand the key things that will be highlighted in the document. Therefore, the introduction should be brief and precise.

The next item is the body, where the primary purpose of the lit review is fulfilled. The body should take critical information from all the sources used and comprehensively present them. This is where the author reports the extensive analysis and interpretation results that they gathered from all the sources they reviewed. The body should be categorized into themes, ideas, and concepts within the main topic.

Lastly, a summary of what the lit review entails should be provided as a conclusion. The critical points obtained from examining the sources should be written down and linked to the primary subject of the review. Key points are those that have the most outstanding contribution to the research.

Studies used should be screened based on provenance (author’s credentials or credibility), methodology, objectivity, persuasiveness, and value related to the topic at hand.

Guidelines for Writing a Literature Review

To improve the delivery of information, there are certain elements that authors can incorporate. They are:

Use evidence

The lit review’s findings, interpretations, and general contents should be based on actual evidence or credible literature. Using citations is evidence of authentic information.

Be selective

There will always be a lot of information available from the reviewed sources. Authors should therefore be selective and discuss the key points that focus on the topic. Not all information must be included in the review.  

Word-for-word quotes are acceptable . This is even more so if a critical point or author-specific terminology or knowledge cannot be paraphrased. Quotes should, however, be used sparingly.

Summarize and synthesize

The information obtained from the sources should be summarized, and the author should use it to synthesize new arguments, concepts, or ideas related to their research.

Keep your voice

The literature review should reflect the author’s voice as it is a review of other people’s works. This can be done by starting and ending the paragraphs with an original voice, ideas, and wordings.

Use caution while paraphrasing

Any paraphrased information should be conveyed accurately and in the author’s words. A citation must always be done, even when paraphrasing has been done.

Proofread before submitting or publishing. Go through the document a few times and make the necessary changes. The review should be within the applicable guidelines. Check for language and any other errors and edit accordingly.

Do’s and Don’ts for a Literature Review 

Every researcher wants to introduce their readers to a particular topic in an informative and engaging manner. Below are tips that can be used to this effect.

The following things should be opted by the researcher when writing a lit review:

• Find a focus: Authors should take a direction, idea, concept, or argument and stick to it. The information conveyed should then be made to align with the chosen point of focus. Thus, the review is not simply a list of analyzed sources, but a detailed summary of how different sources have a focal point (intertwined).
• Well-chosen sources: The quality of the information will, to a great extent, be determined by the quality of sources used. Therefore, take time to select suitable sources and more value will be added to the review.
• Create an annotated bibliography: Creating an annotated bibliography is recommended as one reads their sources. The bibliography keeps track of sources and takes notes. This information can be used when writing the final lit review.
• Synthesize research: Information obtained from the relevant studies should be combined to come up with new or original ideas. You should present a new domain based on previous sources’ knowledge, not just restating the information.
• Argumentative approach: Well-written literature reviews will often argue to support an author’s stance on a particular topic. The author can choose to address how the author’s work is filling a particular gap or support one of the scholar’s arguments and perception towards a particular topic. However, this argumentative approach will not work in all situations; it is usually discipline-specific. 
• Convey it to the reader: It should let the reader know the document’s main idea, concept, or argument. This can be done by including a simple statement that compels the reader to think precisely and know what to expect.
• Break out your disciplinary box: The research will often be multi-disciplinary. Literature reviews should then collect interdisciplinary information from multiple sources as they add novel dynamics to the topic under investigation. It should be noted that this does not imply that the researcher should substitute the literature from the topic’s discipline with that from other disciplines. This is usually an improvement strategy that adds substance to the review.
• Look for repeated patterns: Be attentive to pick out repeated ideas, findings, and concepts from different scholars as they will often illustrate agreed research dead-end or a scholarly conclusion.
• Don’t just review for content: When reviewing the literature, examine the content and other writing and presentation techniques. Look out for unique ways information has been presented, methods used, consistent citations, and non-textual elements such as graphs, and figures used to present information. In addition, the researcher identifies theories used to predict, explain, or understand phenomena within the discipline.
• Search Web of Science and Google Scholar: Conduct citation tracking about the leading scholars already identified in the search process. Scholars cited by multiple scholars outside the principal discipline will generally indicate that there are no new publications on the topic.

The following don’ts should be avoided:

• Do not select studies that are not directly related to the topic being investigated.
• Avoid rushing when identifying and selecting sources to use to research the problem.
• Avoid the use of secondary analytical sources. Instead, opt to use sources with primary research studies or data. Secondary analytical sources will often cite primary analytical sources; research should refer to them instead.
• Do not accept other scholarly findings, theories, or interpretations without critically examining and critiquing them.
• Researchers should not outline the search procedures used to identify scholarly sources for reviewing purposes.
• Avoid including isolated statistical findings without illustrating how they were arrived at using chi-squared or meta-analytic methods.
• Do not review studies that only validate the assumptions, stances, and concepts of your thesis; consider contradicting works with alternative and conflicting stances.

Frequently Asked Questions

It is written by researchers, authors, and students who must study literature to gather knowledge on a particular topic they are interested in.

It should be placed right after the introduction of the dissertation. It places the research in a scholarly context by summarizing existing knowledge on the particular topic.

Researchers and authors are not limited in terms of how many sources they can review. Students will usually have a given number of sources to review as an assignment. However, the number of sources referenced in a lit review will vary from one topic or discipline to the other. Some topics have a vast catalog of available sources, while others have minimal sources, especially emerging issues. It is, however, advised that each key point discussed should have at least 2-3 references/sources. For example, a 10-page lit review will have an average of 30 references.

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Literature Review Outline: Examples, Approaches, & Templates

A literature review is an update on the status of current research related to the issue in question . Its purpose is to provide the reader with a guide to a particular research topic. And for the writer, a well-written literature review is the best way to show their competence in the field.

As with any other academic paper, the key to a successful literature review is its outline. Below you’ll find great tips for creating a perfect one. See where you can place your thesis statement in the introduction and when it’s time to reference sources. And you can examine an example of a literature review outline (APA format). Just keep reading this article prepared by Custom-writing experts!

• 🔭 General Information
• 📑 Main Approaches
• 🗺️ Mapping the Concepts
• ✍️ Writing Tips

🔗 References

🔭 literature review outline: general information.

Literature reviews are written mostly in sciences and social sciences, and sometimes in humanities. A literature review aims to discuss published information on the studies in a particular area. The most simple version of a literature review can be a mere summary of the sources. However, it usually features an organizational pattern and implies not only summary but also synthesis.

A literature review aims to provide a reader with a clear and understandable guide to a particular research topic. And for its writer, a solid review is an excellent opportunity to show them as an expert in a chosen field.

As MLA, Chicago, or APA style cover page generators help students with the very first part of any paper, the key to a successful literature review is a good outline . When planning a literature review, remember that no matter whether you’re dealing with a Chicago, MLA, or APA literature review outline, you’ll have to remember several important things.

📑 Literature Review Outline: Approaches to Structuring

A well-formed vision of the writing strategy before you start the main body paragraphs is half of the success. There are four approaches to arranging a literature review. Depending on the intended length of your paper, you can combine some or all of them. For instance, more than often, thematic and methodological strategies comprise a theoretical approach when it comes to details.

Chronological Approach

Tracing the reviewed works in succession, starting with the earliest available materials, is the easiest way to examine the specific topic. Be careful not to list the works in chronological order with their summaries. The purpose of such a review is to find out the key patterns, central debates, and turning points of the prevailing opinion at specific periods.

Here is a sample to make the approach clear. If the first available source dates 1995, and the most recent one was written in 2017, divide your analysis into decades: 1995 – 2000, 2001 – 2010, and 2010 – present.

The chronological approach can perfectly combine with thematic or methodological ones. In such a case, the timescale is divided not by decades but by periods characterized by a predominant methodology or preferred theme.

Thematic Approach

This method is organized around a particular issue, rather than time progression. If you have found recurring themes in the course of your reading, it is an excellent idea to focus the review on them. As a rule, the thematic approach requires an in-depth study of the available scientific literature. It also looks more substantial and time-consuming than the chronological one.

Here, the sections dwell upon different issues or various aspects of one topic. For example, an overview of psychology literature on nonverbal communication can be divided into the following parts: facial expressions, postures, eye contact, gestures, touch, etc.

Methodological Approach

Sometimes the results of findings are not as outstanding as the ways of obtaining those results. A review of research methods provides a profound scientific understanding of the subject field, notably the approaches to data collection, study, and systematization. It also provides an insight into how scientists went from isolated data to a concept, and from the concept to practical conclusions.

This form proves to be the most successful in the analysis of multidisciplinary works. You can list all the methods used and conclude on their efficiency. Alternatively, you can compare the qualitative and quantitative, empirical and theoretical, or any other incompatible methodology. The materials for analysis are the results obtained by such or another method.

Theoretical Approach

Very often, a literature review becomes the basis for a theoretical framework of a research paper. In this case, the theoretical approach is the most effective way to structure the report.

Wherever you can single out several theories on a single phenomenon, different models of a system, or diverging definitions of the same concept, the theoretical approach is the best choice. The purpose is to analyze the corpus of theory that has accumulated regarding an idea, opinion, or event. Usually, this form establishes the existing scientific knowledge gaps and finds out the outstanding research questions.

🗺️ Literature Review Outline: Mapping the Concepts

Wish to outline literature review papers correctly? First, try drawing a concept map for your outline! Create a graphic map with all the concepts and ideas you’ll want to include in the literature review outline. When you start writing, make sure that you’ve included everything you have on the map.

Well, now you’re ready to write the most fantastic outline for a literature review ever! So what are you waiting for? Go ahead and try writing your own outline using the template below – success is just around the corner!

📰 Literature Review Outline: Template

Feel free to use the literature review outline template below! Note that the template is organized thematically.

I. ISSUE #1

A. Its features

1. Positive features

a) Feature #1

b) Feature #2

2. Negative features

B. Its significance

1. Positive effects

a) Effect #1

b) Effect #2

2. Negative effects

II. ISSUE #2…

Check the literature review samples by the University of West Florida to get a clear idea on how to write this type of paper.

And now, it’s time for you to see an example of an outline for literature review writing!

👌 Literature Review Outline: Example

When creating your own review, consider the following literature review example:

Literature Review Outline: Postmodern Literature

• Introduction: postmodern literature
• Definition of the phenomenon
• The development of postmodern literature
• Research studies on postmodern themes
• Research studies on postmodern techniques
• Research studies on postmodern perspectives
• Conclusion: promising ideas for research on postmodern literature

With this literature review outline example, you’ll surely handle even the most complicated literature review structure!

✍️ Literature Review Outline: Writing Tips

When you start writing a literature review, you should keep the following issues in mind:

• Use evidence to support your interpretation of available sources.
• Be selective. Limit your literature review to sources relevant to the topic of your research. You should select only the most important points in each source.
• Compare and contrast the views of different authors. Organize the material for your reader to show trends in the literature.
• Use quotes sparingly. Apply them only when you want to emphasize the author’s point and cannot rewrite it in your own words. Always focus on giving your own summary and interpretation of the literature, showing your original thinking and analysis.
• Paraphrase in your own words to explain authors’ ideas . Give references to other sources when you are writing, but start and end the paragraphs with your own ideas.
• Summarize and synthesize your literature review sources. Identify the main points in a concise manner for your readers. Evaluate your sources , consider their strengths and weaknesses, compare and contrast the results of the studies, and discuss the strength of the evidence.
• Look for gaps in the existing research. Think about what aspects of your literature review topic have not yet been explored.
• Be creative!
• Draft and redraft. Improve the quality of your literature review by editing and proofreading.

Literature Review Essay Topics

• Literature review: aspects of nursing in the emergency department.
• Review the literature that analyzes the specifics of evidence-based nursing practice .
• Write a literature review on the role of hepcidin in the human body.  
• Analysis of challenges faced by small and medium businesses in South Africa: a literature review.
• Explore the literature that examines the interdependence between evidence and practice in healthcare .
• Review the studies examining how peritoneal dialysis influences patients’ mortality rate.
• Analyze the articles studying the connection between obesity and depression.
• Literature review the use of ecology in art .
• Discuss the academic literature examining the algorithms of speaking recognition techniques.
• Study the articles on the importance of environmental biology for preserving nature.
• Write a literature review on the role of digital signatures and cryptography.   
• Examine whether the recent studies prove the connection between peritoneal dialysis and mortality rate.
• Literature analysis on a qualitative study in healthcare.
• Explore the scientific literature researching how to adjust and regulate the effect of autism spectrum disorder .
• Analyze the articles on the causes of chronic fatigue.
• Review the academic literature discussing the effect of the token economy on the behavior of students with autism.   
• The causes and effects of pressure ulcers.   
• >Literature review on the link between COVID-19 infection and eye diseases.
• Literature review on third culture kids. 
• Study the articles reviewing the efficacy of contemporary pressure ulcer prevention methods. 
• Discuss the recent scholarly studies examining the correlation between nursing ratios and cases of hospital-acquired infections.
• Write the literature review on the benefits and side effects of corticosteroids used for asthma treatment.
• Examine the pertinent scholarly articles researching the aspects of irritable bowel syndrome diagnostics.
• Analyze the academic literature on chronic pain management.  
• Provide the synthesis of recent scholarly studies focused on ventilator-associated pneumonia.  
• Review the literature on cholecystitis symptoms and treatment.
• Importance and specifics of evidence-based nursing implementation.  
• Explore the recent studies on anemia of chronic diseases.
• Discuss the academic articles analyzing postoperative readmission rates.
• Literature review on the breakthroughs in treating Alzheimer’s disease .
• Examine the relevant literature on the benefits of Electronic Health Record systems.
• Analyze the role of pressure ulcer protocols in reducing the rates of hospital-acquired pressure ulcer cases.  
• Write a literature review on the effectiveness of the most popular ways of patient fall prevention .
• Review the relevant scholarly articles discussing the role of interprofessional collaboration in healthcare.
• Examine the recent academic literature on childhood obesity issues.  
• Review the literature on the Capstone’s PICOT question .
• Literature review of articles on cyber security of young children.  
• Discuss the latest studies examining the connection between American football and the drop in public health rates.
• Explore the relevant scholarly articles studying the challenges of single African American parents. 
• Can the implementation of special physical exercises improve the balance and stability of elderly patients? 
• Effects of traumatic brain injury: a literature review .
• Analyze the academic literature discussing the course and outcomes of operation Jawbreaker.  
• Write a literature review on the emergency room wait time and healthcare quality.  
• Review the academic articles that examine the causes of substance abuse and the efficacy of modern treatment methods.
• Examine the recent scholarly studies researching the homelessness issue.
• Discuss the academic literature analyzing the concept of biodiversity.  
• Research the archeological articles studying the ancient Roman roads.
• Analyze the literature examining the benefits and drawbacks of flipped classroom approach .
• Literature review on prevention of breast cancer .
• Review the scholarly articles studying the impact of the ZIP code on human health.

Writing a good literature review is not an easy task. It requires quite a lot of reading and researching. Check our 45 great tips on how to format and structure the literature review for more advice.

If you still have any problems in writing your literature review outline, ask for professional writing help online.

✏️ Literature Review FAQ

The way such paper should look like is best presented in the form of an outline . A simplified form would include an introduction, 3+ paragraphs (preferably with 2+ subparagraphs in each) as a review body, and a conclusion.

You should write about your interpretation of the literary piece. Include your understanding of the author’s message and the way he puts that idea across (scenes, characters, allusions, etc.). For a research paper, however, include more precise details than personal impressions.

Outlines for a paper should list concise notes about the structure of the text and its content (usually in the format of bullet points). Remember that an outline is not a research proposal or dissertation, so do not write about the goals, objectives, methods, etc.

Do you have a list of ideas you want to describe in the paper already? If so, just make those notes structured in logical consequence and format them as bullet points highlighting the gist of each part.

• Literature Review Outline
• Literature Review Outline: What You Need to Get Started
• Writing a Literature Review
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please I was asked to write a 3000-word essay Evaluating Approaches to Literature Searching and Literature Review in Educational Research. And I don’t know how write or go about it. Can someone please help me with an outline in writing this. please someone should help

HI, how long would you suggest an undergraduate’s final year research paper should be? ( minimum in pages for both quanti and quali researches) and is 15 pages of literature review( double spacing okay?

It would probably be between 10 and 20 pages. But it all comes down to the specific topic and instructions given. Fifteen pages for a literature review sounds good, if it’s an independent type of assignment. However, if it’s part of the undergraduate’s final year research paper mentioned above, then fifteen pages is probably too much. But, again, it all depends on the instructions, topic, etc.

thankyouuuu!!!!!!! best one so far

useful blog keep going

Very well explained!

Really appreciate the great information guide on writing. It’s outstanding and brilliant how the outline process is explained herewith. Thanks.

Thank you so much. This was so helpful, especially with your examples of an outline.

I am working on a literary review on a couple of articles having to do with college football players getting paid. I have started my intro with info about the college athletic industry and how it is controversial, but how do I introduce/transition into the articles and the actually literary review?

Try to go with the facts, and stick with them. It would work kind of well, Janeth.

Thanks for stopping by. Try to write about features, positive and negative ones.

Matrix Method for Literature Review

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Literature Review

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The template is an easy solution for students preparing their thesis or essays. It provides space for notes on important articles and tags, which are helpful for sorting the papers by topic, key words or status. The template includes few sections: Project description, table with Papers, Literature notes and Literature Tracker.

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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 short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

28 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

Asking questions are actually fastidious thing if you are not understanding anything fully, but this article presents good understanding yet.

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• v.15(4); 2024 Aug
• PMC11349137

Advances in the Diagnosis and Management of Cardiac Amyloidosis: A Literature Review

Jordan llerena-velastegui.

a Medical School, Pontifical Catholic University of Ecuador, Quito, Ecuador

b Research Center, Center for Health Research in Latin America (CISeAL), Quito, Ecuador. Email: moc.liamg@4991anerellnadroj

Kristina Zumbana-Podaneva

Associated data.

All data generated or analyzed during this study are included in this published article, and further inquiries should be directed to the corresponding author.

Cardiac amyloidosis, increasingly recognized for its significant impact on global heart health and patient survival, demands a thorough review to understand its complexity and the urgency of improved management strategies. As a cause of cardiomyopathy and heart failure, particularly in patients with aortic stenosis and atrial fibrillation, this condition also relates to higher incidences of dementia in the affected populations. The objective of this review was to integrate and discuss the latest advancements in diagnostics and therapeutics for cardiac amyloidosis, emphasizing the implications for patient prognosis. We evaluated the latest literature from major medical databases such as PubMed and Scopus, focusing on research from 2020 to 2024, to gather comprehensive insights into the current landscape of this condition. Insights from our review highlight the complex pathophysiology of cardiac amyloidosis and the diagnostic challenges it presents. We detail the effectiveness of emerging treatments, notably gene silencing therapies like patisiran and vutrisiran, which offer transformative potential by targeting the production of amyloidogenic proteins. Additionally, the stabilization therapy acoramidis shows promise in modifying disease progression and improving clinical outcomes. This review underscores the critical need for updated clinical guidelines and further research to expand access to groundbreaking therapies and enhance disease management. Advocating for continued research and policy support, we emphasize the importance of advancing diagnostic precision and treatment effectiveness, which are vital for improving patient outcomes and addressing this debilitating disease globally.

Introduction

Cardiac amyloidosis (CA), an increasingly recognized condition within the realm of cardiology, is characterized by the extracellular deposition of amyloid fibrils in the heart, leading to restrictive cardiomyopathy (RCM) and substantial global health implications [ 1 ]. This condition primarily manifests as transthyretin (amyloid transthyretin (ATTR)) or immunoglobulin light chain (AL) amyloidosis, each posing unique diagnostic challenges and necessitating distinct therapeutic approaches [ 2 ].

CA is classified into several types, each with unique cardiac and extracardiac manifestations [ 3 ]. The three primary forms are AL amyloidosis and transthyretin amyloidosis, which includes wild-type (wild-type transthyretin amyloidosis (wtATTR)) and hereditary variants (hereditary transthyretin amyloidosis (hATTR)) [ 4 ]. AL amyloidosis, associated with plasma cell dyscrasias, is characterized by rapid progression and severe cardiac involvement, leading to high morbidity and mortality [ 5 ]. Transthyretin amyloidosis, on the other hand, often presents in an older population, manifesting predominantly as heart failure with preserved ejection fraction (HFpEF) and significant aortic stenosis [ 6 ].

wtATTR is frequently associated with aortic stenosis in elderly patients. This association is primarily due to the age-related accumulation of transthyretin amyloid deposits in the myocardium and aortic valve. The accumulation of amyloid in the aortic valve can contribute to the restriction of valve opening, thereby exacerbating aortic stenosis. Studies have shown that wtATTR is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis, suggesting a pathological link rather than a mere coincidence [ 7 ]. The amyloid deposits increase the stiffness of the valve and myocardial tissue, leading to decreased compliance and worsening of diastolic function, which further complicates the clinical management of these patients [ 8 ]. Understanding this relationship is crucial for early diagnosis and appropriate management of wtATTR in patients with aortic stenosis. By clearly elucidating the connection between wtATTR and aortic stenosis, this review aims to provide a comprehensive understanding of the pathophysiology and clinical implications of CA, thereby enhancing the management strategies for affected patients.

AL amyloidosis requires specific attention due to its distinct pathophysiology and treatment strategies. The primary treatment for AL amyloidosis involves chemotherapy regimens that target the underlying plasma cell dyscrasia, such as bortezomib, lenalidomide, and dexamethasone [ 7 ]. Autologous stem cell transplantation is also a treatment option for eligible patients, offering potential remission and improved survival rates [ 8 ]. The management of cardiac involvement in AL amyloidosis includes the use of heart failure medications, though these must be carefully tailored due to the unique challenges posed by amyloid infiltration in the myocardium [ 9 ].

In contrast, the treatment of ATTR amyloidosis has seen the advent of novel therapies like tafamidis, patisiran, and vutrisiran, which target the production and stabilization of transthyretin to prevent amyloid fibril formation and deposition [ 10 ]. These therapies offer a different mechanism of action compared to those used for AL amyloidosis, highlighting the need for distinct treatment pathways based on the type of amyloidosis diagnosed.

Recent clinical experiences highlight the complexity of diagnosing and treating CA. For instance, patients often present with nonspecific symptoms such as fatigue and edema, which can lead to misdiagnosis or delayed diagnosis. Advanced imaging techniques, such as echocardiography with strain imaging and cardiac magnetic resonance imaging (CMR), are pivotal in early detection and assessment of the extent of cardiac involvement [ 7 ]. Additionally, novel diagnostic tools like bone scintigraphy using 99mTc-pyrophosphate (99mTc-PYP) have shown high sensitivity and specificity for detecting transthyretin amyloidosis, further aiding in differentiating it from AL amyloidosis [ 8 ].

From a therapeutic perspective, the management of CA has evolved significantly. Therapies such as tafamidis, patisiran, and vutrisiran have shown promising results in clinical trials, offering hope for improved patient outcomes. However, these treatments come with challenges, including high costs and limited availability, which can impact their accessibility and overall effectiveness in real-world settings [ 9 ]. Clinicians must navigate these challenges while considering each patient’s unique clinical presentation and disease progression to optimize treatment strategies.

Through this review, we aim to provide a comprehensive and clinically relevant discussion on the pathophysiology, diagnosis, and management of CA. Our goal is to offer insights that can guide healthcare professionals in making informed decisions, ultimately improving patient care and outcomes in this challenging field.

The pathogenesis of CA involves the misfolding of protein precursors, leading to fibril formation and deposition in cardiac tissues [ 7 ]. This deposition disrupts myocardial structure and function, culminating in heart failure and arrhythmic complications [ 8 ]. Recent epidemiological data highlight a notable underdiagnosis of this condition, particularly among older adults presenting with HFpEF, where systematic screenings have revealed a prevalence as high as 16% in certain cohorts [ 9 ].

Despite the severity of the condition, recent years have witnessed significant advancements in the therapeutic landscape of CA [ 10 ]. Gene silencing therapies, such as patisiran and vutrisiran, target the RNA transcripts of amyloidogenic proteins, reducing their production and potentially altering the course of the disease [ 11 ]. Additionally, stabilizing agents like tafamidis have shown promise in managing TTR variants by preventing protein misfolding and deposition [ 12 ].

The increasing recognition of CA has not only improved our understanding of its clinical presentation but also highlighted the variability in outcomes and discrepancies in the availability of treatment options across different regions and populations [ 13 ]. This review seeks to consolidate current knowledge on the diagnosis, management, and outcomes of CA, with an emphasis on elucidating the pathophysiological mechanisms, optimizing therapeutic strategies, and addressing gaps in current research paradigms.

Thus, the objectives of this review are twofold: to provide a comprehensive overview of the contemporary diagnostic and management approaches in CA and to set a direction for future research that could potentially lead to groundbreaking advancements in the care of patients suffering from this debilitating condition. Through this exploration, we aim to foster a deeper understanding of CA, from its molecular underpinnings to its clinical implications, thereby improving patient outcomes and contributing to the global efforts in combating this intricate disease.

Epidemiology

CA, a form of cardiomyopathy primarily driven by the accumulation of amyloid proteins within the heart, manifests predominantly through transthyretin or immunoglobulin light chains [ 3 ]. The three major forms of CA identified are wtATTR, hATTR, and AL amyloidosis [ 4 ].

Recent epidemiological data suggest a notable underdiagnosis of wtATTR, particularly among older adults presenting with HFpEF and severe aortic stenosis [ 14 ]. Systematic screenings in such cohorts reveal a prevalence of approximately 6% in individuals over 60 years of age with HFpEF, compared to a mere 1% detected without dedicated screening [ 15 ]. Similar studies conducted in hospital settings on patients with HFpEF indicate a prevalence of 13%, and among those undergoing transcatheter aortic valve implantation for aortic stenosis, the detection rate of wtATTR amyloidosis climbs to 16% [ 16 ].

The epidemiology of hATTR (or ATTR variant (ATTRv)) remains less clear due to its association with over 120 pathogenic gene variants, each exhibiting varying geographical and ethnic prevalence [ 17 ]. Common mutations such as Val122Ile and Val30Met suggest a distinct genetic predisposition linked to specific populations, influencing the regional distribution of this amyloidosis type [ 18 ].

AL amyloidosis, although rare with an incidence of approximately one per 100,000 annually in the United States, is associated with plasma cell dyscrasias [ 19 ]. This form presents a critical need for enhanced diagnostic awareness due to its severe prognostic implications if left unidentified [ 20 ].

Demographically, recent insights indicate an increase in the prevalence and incidence of CA globally, with particular emphasis on the elderly and male populations [ 21 ]. This is corroborated by findings from autopsies and clinical screenings which suggest that CA, particularly transthyretin amyloid cardiomyopathy (ATTR-CM), may be significantly more prevalent than previously recognized in the aging population [ 22 ]. Ethnic and racial disparities also emerge in the manifestation and progression of the disease, with non-Hispanic Blacks and Hispanics exhibiting more aggressive disease phenotypes and higher hospitalization rates compared to Whites [ 23 ].

Understanding these epidemiological trends is essential for framing public health strategies and clinical approaches, aiming to enhance screening and early diagnosis, especially in high-risk groups. This is critical not only for improving outcomes through timely interventions but also for addressing disparities in the detection and management of CA across different demographic groups.

Pathophysiology

CA is characterized by the extracellular deposition of misfolded proteins in the myocardium, which results in RCM and progressive heart failure [ 24 ]. The pathophysiology of this disease involves complex molecular and biochemical mechanisms centered around the misfolding and aggregation of specific proteins, primarily transthyretin in ATTR and immunoglobulin light chains in AL [ 25 ].

In ATTR, genetic mutations such as Val122Ile, Thr60Ala, and Glu89Gln destabilize TTR tetramers, facilitating their dissociation into monomeric forms that are prone to misfold [ 26 ]. These misfolded proteins then aggregate into amyloid fibrils, which deposit in the cardiac extracellular matrix [ 27 ]. Similarly, in AL amyloidosis, abnormal immunoglobulin light chains produced by clonal plasma cells fold improperly and form amyloid fibrils [ 28 ].

Once deposited, these amyloid fibrils disrupt the structural integrity and functional capacity of the heart [ 29 ]. They interfere with the alignment and organization of cardiac muscle fibers, increase myocardial stiffness, and reduce elasticity [ 30 ]. This mechanical disruption leads to diastolic dysfunction as the heart becomes less compliant and unable to fill effectively during diastole [ 31 ]. Additionally, amyloid fibrils bind to cellular components such as receptors and enzymes, impairing intracellular signaling and metabolic processes, and disrupting ionic homeostasis [ 7 ]. The presence of amyloid also triggers an inflammatory response in the heart, marked by activation of cardiac fibroblasts and infiltration of inflammatory cells, contributing to further myocardial damage and fibrosis [ 32 ].

These pathophysiological changes culminate in progressive heart failure with symptoms such as dyspnea, fatigue, and edema [ 13 ]. Moreover, amyloid infiltration into the cardiac conduction system can lead to various arrhythmias, including atrial fibrillation (AF) and conduction blocks, further reducing cardiac output and increasing the risk of thromboembolic events [ 33 ].

Understanding these pathophysiological processes is crucial for the clinical management of CA and guides the development of therapeutic strategies [ 7 ]. One such strategy includes gene silencing therapies like patisiran, which target the production of amyloidogenic proteins at the transcriptional level [ 34 ]. By reducing the amount of mutant and wild-type TTR, these therapies aim to lessen the substrate available for amyloid formation [ 35 ]. The pathophysiological insights into how amyloid fibrils affect cardiac function support the use of such therapies, which, although they do not remove existing deposits, can prevent the formation of new amyloid accumulations and potentially ameliorate symptoms and disease progression [ 7 ].

Thus, the molecular and cellular mechanisms underlying the deposition of amyloid fibrils and their impact on cardiac tissues are fundamental to diagnosing and developing interventions for CA [ 36 ]. Further research into these mechanisms is essential for creating therapies that not only alleviate symptoms but also modify the underlying disease dynamics.

Clinical Manifestations

CA manifests through a spectrum of symptoms that vary depending on the type of amyloid protein involved and the extent of cardiac infiltration [ 37 ]. This condition, characterized by the deposition of amyloid proteins in the heart, leads to significant clinical challenges due to its diverse presentations and the progressive nature of the disease [ 38 ].

Patients with ATTR amyloidosis, whether hereditary or wild type, typically present in the later decades of life, with symptoms emerging predominantly after the age of 60 [ 39 ]. The clinical phenotype includes features of RCM such as dyspnea on exertion, fatigue, and lower extremity edema, reflecting the underlying heart failure caused by impaired ventricular filling and reduced diastolic function of the heart [ 13 ]. These symptoms are often more pronounced in patients with wild-type ATTR amyloidosis and certain hereditary variants, where cardiac involvement is the dominant clinical feature [ 5 ].

In contrast, AL amyloidosis affects patients usually beginning at age 40, with a wider range of organ involvement [ 40 ]. In addition to cardiac symptoms, patients may exhibit manifestations related to renal, neurological, and gastrointestinal involvement [ 3 ]. Cardiac-specific symptoms in AL amyloidosis tend to be severe due to the toxic effects of amyloidogenic light chains on myocardial cells, which can exacerbate cardiac dysfunction [ 13 ].

Common cardiac manifestations in all forms of amyloidosis include increased jugular venous pressure, hepatic congestion, and ascites associated with right ventricular failure [ 14 ]. Advanced disease stages are characterized by features of low cardiac output such as diminished pulse pressure and delayed capillary refill, indicating severe cardiac compromise [ 41 ].

Arrhythmias are a prevalent complication, with patients frequently presenting with syncope or presyncope [ 42 ]. These episodes are typically caused by bradyarrhythmias or advanced atrioventricular block, though ventricular arrhythmias can also occur [ 43 ]. The need for pacemaker implantation is common, especially in patients with ATTR amyloidosis due to progressive conduction system disease [ 44 ].

Electrocardiographic findings in CA often reveal a low voltage in the limb leads and a pseudoinfarct pattern in the precordial leads, despite echocardiographic evidence of increased left ventricular wall thickness [ 45 ]. This discordance is a notable diagnostic clue but varies in sensitivity depending on the amyloid type [ 20 ]. Echocardiography typically shows increased wall thickness, biatrial enlargement, and signs of diastolic dysfunction [ 46 ]. These imaging findings are crucial for assessing the severity and extent of myocardial involvement [ 47 ].

AF is another common finding, especially in patients with wtATTR amyloidosis, and is associated with an increased risk of thromboembolic events [ 33 ]. The deposition of amyloid proteins not only in the ventricles but also in the atrial walls can lead to atrial electromechanical dissociation during sinus rhythm, which further complicates the clinical picture [ 44 ].

In summary, the clinical manifestations of CA are complex and varied, often involving a combination of heart failure symptoms, arrhythmias, and conduction system abnormalities. The diagnosis is challenging due to the nonspecific nature of early symptoms and the multifaceted presentations that depend heavily on the type and extent of amyloid deposition within the heart. Early recognition and detailed cardiovascular evaluation are critical to managing this intricate and progressively debilitating disease.

Complications

CA presents significant challenges in clinical management due to its diverse array of complications, which predominantly affect the heart’s electrical system and mechanical function [ 48 ]. This disease process leads to substantial morbidity and mortality, primarily from AF, conduction system disease, heart failure, and sudden cardiac death (SCD) [ 49 ].

AF is notably prevalent in patients with ATTR-CA, occurring in up to 73% of cases. This high incidence is linked with older age, advanced disease stage, and increased left atrial volume index. The management of AF in this group is complicated by the high risk of thromboembolic events and the poor tolerance of rate control medications, often necessitating early adoption of rhythm control strategies [ 50 ]. Although anticoagulation therapy is crucial for preventing strokes in these patients, recent studies indicate that novel oral anticoagulants (NOACs) are associated with a lower risk of major bleeding compared to warfarin, while both options effectively reduce the incidence of thromboembolic events [ 50 ]. Furthermore, AF ablation appears to reduce mortality and hospitalization for heart failure when performed early, emphasizing the need for prompt and tailored treatment interventions [ 51 ].

Conduction system disease also emerges as a frequent complication due to amyloid fibril deposition within the myocardium. This deposition can lead to bundle branch blocks, atrioventricular block, or sick sinus syndrome. Management often requires the implantation of pacemakers, especially in patients exhibiting advanced conduction disorders [ 52 ]. However, the timing for such interventions is critical and demands careful clinical judgment to balance the benefits against potential risks. Moreover, standard arrhythmic drugs like beta-blockers and calcium-channel blockers are typically poorly tolerated in this patient population, complicating traditional therapeutic approaches [ 25 ].

Heart failure in CA is predominantly driven by RCM due to amyloid infiltration in the myocardial extracellular space. This condition leads to both diastolic and, eventually, systolic dysfunction as the disease progresses [ 24 ]. The management of heart failure in these patients is intricate, requiring a combination of standard heart failure therapies and novel disease-modifying treatments that aim to slow or halt the progression of amyloid deposition. Challenges include the systemic nature of the disease and the need for a multidisciplinary approach to address the complex clinical presentation [ 53 ].

SCD is a grave risk for patients with CA, with ventricular arrhythmias and electromechanical dissociation being primary contributors. While implantable cardioverter-defibrillators (ICDs) have been used for the prevention of SCD, their effectiveness in improving overall survival in this group remains uncertain [ 54 ]. This uncertainty is partly due to the high mortality rate observed despite ICD therapy and the complex interplay of risk factors including ventricular tachyarrhythmias, which may not be adequately managed by ICDs alone. Noninvasive measures of myocardial energy metabolism have been explored as potential tools for predicting SCD risk, suggesting that metabolic imaging could play a role in risk stratification [ 55 ].

In conclusion, the complications associated with CA necessitate a nuanced understanding of its pathophysiological impact on cardiac function and a comprehensive approach to management that integrates both symptomatic treatment and strategies aimed at modifying the underlying disease process. The intricate interplay of electrical and mechanical dysfunction requires targeted interventions to mitigate the high risk of morbidity and mortality in this patient population.

Diagnostic Criteria and Challenges

CA is a complex condition characterized by the deposition of amyloid proteins in the myocardium, leading to varied and often nonspecific clinical presentations that can challenge timely and accurate diagnosis. This section outlines the diagnostic criteria and challenges associated with identifying CA, emphasizing the systematic approaches required to confirm this condition [ 24 ].

The suspicion of CA should be raised in several clinical settings, particularly in patients presenting with unexplained left ventricular hypertrophy (LVH), whether they exhibit heart failure symptoms or not. Such cases necessitate a detailed clinical evaluation including a thorough history to note any presence of bilateral carpal tunnel syndrome before the onset of heart failure, which is suggestive of ATTR amyloidosis [ 56 ]. Other scenarios warranting suspicion include instances of low-flow, low-gradient aortic stenosis coupled with echocardiographic signs of impaired longitudinal strain and conditions like systemic AL amyloidosis or ATTR-related peripheral neuropathy, where cardiac involvement may often be secondary [ 57 ].

Once clinical suspicion is established, a structured diagnostic approach is vital. The initial evaluation should integrate a comprehensive clinical examination, detailed family and medical history, routine laboratory tests, and an electrocardiogram to identify cardiac and extracardiac symptoms and signs indicative of amyloidosis [ 58 ]. Subsequently, echocardiography serves as the principal noninvasive imaging modality, offering crucial insights such as the presence of a granular “sparkling” texture of the myocardium, biatrial enlargement, and thickening of the valves and interatrial septum. Notably, the echocardiographic finding of relative apical sparing of longitudinal strain is highly suggestive of CA and can aid in differentiating it from other causes of LVH [ 59 ].

Apical sparing refers to the preservation of myocardial strain in the apical segments of the heart while the basal and mid segments show reduced strain. This pattern is thought to result from the predilection of amyloid deposits to affect the basal and mid segments more extensively than the apex. The exact mechanisms are not fully understood, but it is hypothesized that variations in myocardial blood flow, amyloid deposition patterns, and differences in myocardial fiber orientation contribute to this phenomenon [ 60 ]. By highlighting these echocardiographic features and explaining their underlying mechanisms, this review aims to enhance the diagnostic accuracy and clinical understanding of CA, thereby improving patient management and outcomes.

Further imaging assessments may include cardiovascular magnetic resonance (CMR), which provides detailed myocardial tissue characterization. CMR is particularly useful in visualizing the diffuse subendocardial or transmural late gadolinium enhancement typical of CA. Additionally, T1 mapping during CMR can provide quantitative measures that correlate strongly with the extent of amyloid infiltration, thus supporting the diagnosis even in early stages [ 60 ].

Bone tracer cardiac scintigraphy using radiotracers like 99mTc-PYP plays a critical role in diagnosing ATTR CA. A significant uptake in these scans, especially in the absence of a monoclonal protein indicative of plasma cell dyscrasia, can confirm ATTR without the need for tissue biopsy [ 61 ]. However, when the presence of monoclonal proteins is detected, further hematological evaluation and possibly a bone marrow biopsy are necessary to differentiate AL from ATTR amyloidosis or other forms such as amyloid A (AA) amyloidosis [ 13 ].

In cases where the noninvasive diagnostic modalities are inconclusive, or clinical suspicion remains high despite negative findings, tissue biopsy remains the gold standard. This invasive procedure, typically involving an endomyocardial biopsy, allows for direct visualization and typing of amyloid deposits using Congo red staining, which exhibits apple-green birefringence under polarized light, and further confirmation through immunohistochemical or mass spectrometric methods to determine the precise type of amyloid protein involved [ 40 ].

In conclusion, diagnosing CA requires a high index of clinical suspicion prompted by specific clinical and laboratory indicators, followed by a systematic approach utilizing echocardiography, CMR, and bone scintigraphy to identify the disease. In ambiguous cases, tissue biopsy confirms the diagnosis, allowing for appropriate management and therapeutic interventions tailored to the type of amyloidosis identified.

Differential Diagnosis

The differential diagnosis of CA involves a detailed examination to distinguish it from conditions with similar clinical presentations, such as hypertrophic cardiomyopathy (HCM), constrictive pericarditis, and other forms of RCM, including sarcoidosis and light chain deposition disease [ 62 ]. Each of these conditions presents unique diagnostic challenges and requires specific investigative approaches to ensure accurate diagnosis and appropriate management [ 63 ].

HCM often presents with asymmetric septal hypertrophy, predominantly affecting the interventricular septum, and may involve genetic markers and family history elements absent in amyloidosis. Echocardiographic examination in CA typically reveals symmetrical left ventricular wall thickening with a granular sparkling appearance, distinguishing it from the asymmetrical thickening observed in HCM. Advanced imaging techniques, such as strain imaging, can further enhance differentiation, showing a relative apical sparing of longitudinal strain in CA, a pattern rarely observed in HCM [ 62 ].

Constrictive pericarditis, characterized by a thickened, calcified pericardium on imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI), shows distinct hemodynamic features from CA. These include ventricular interdependence and a dip-and-plateau filling pattern of the ventricles, identifiable through echocardiography and CMR. In contrast, CA does not exhibit these pericardial abnormalities but may show biatrial enlargement and ventricular thickening consistent with infiltrative processes [ 64 ].

RCM other than amyloidosis, such as endomyocardial fibrosis or Loeffler’s syndrome, presents with fibrosis and eosinophilic infiltration distinct from the amyloid fibrils seen in CA. Histological findings from biopsies in RCM reveal specific patterns of fibrosis without the characteristic apple-green birefringence under polarized light, which is indicative of amyloid deposits in CA [ 65 ].

Sarcoidosis involves non-caseating granulomas identifiable on myocardial biopsy, which are absent in CA. Diagnostic criteria for cardiac sarcoidosis include advanced imaging findings such as positron emission tomography (PET) scans, which detect inflammatory activity not present in amyloidosis, aiding in their differentiation [ 66 ].

Light chain deposition disease differs from CA in that the light chain deposits do not form fibrils and, thus, do not exhibit the Congo red positivity seen in CA. Immunofluorescence or immunohistochemistry typically shows positivity for specific light chains in structures like the glomerular basement membrane, contrasting with the diffuse and extensive deposition in CA [ 67 , 68 ].

HFpEF and CA can both present with diastolic dysfunction and similar echocardiographic findings. However, distinguishing these conditions may rely on clinical context, biomarker profiles, and response to treatment, where specific markers like N-terminal pro-B-type natriuretic peptide (NT-proBNP) and echocardiographic indices such as strain patterns may help in differentiation [ 69 ].

A comprehensive diagnostic approach, integrating clinical evaluation, detailed imaging studies, and histopathological analysis, is essential to accurately differentiate CA from other mimicking conditions [ 70 ]. This systematic approach ensures that CA is appropriately diagnosed and managed, taking into consideration the complex interplay of clinical presentations and the specific characteristics of each condition.

Management and Treatment

The management of CA encompasses a broad spectrum of strategies, from pharmacological interventions and gene silencing therapies to supportive care and advanced treatment options like heart transplantation. This comprehensive approach is essential due to the complex nature of CA, which involves the deposition of amyloid proteins in the heart, leading to RCM and heart failure [ 71 ].

Ongoing surveillance of disease progression in CA is critical. This is typically achieved through a combination of biomarker assessments, including natriuretic peptides and troponins, which provide prognostic information. Cardiac imaging plays a pivotal role, with techniques such as echocardiography and CMR being integral for assessing myocardial structure and function. Advanced imaging modalities, including technetium-labeled bone scintigraphy, are increasingly utilized not only for diagnosis but also for monitoring response to therapy [ 72 ].

The pharmacological management of CA must be approached with caution. Traditional heart failure medications often pose risks due to patients’ sensitivity to volume changes and reduced cardiac output. In AL CA, common medications such as beta-blockers and calcium channel blockers may exacerbate heart failure symptoms or lead to adverse events due to their hemodynamic effects. Consequently, these agents are generally avoided or used with stringent monitoring [ 44 ].

Tafamidis has emerged as a cornerstone in the management of ATTR amyloidosis, stabilizing the transthyretin protein and preventing its misfolding and deposition as amyloid fibrils. Recent advancements have introduced gene silencing therapies that target the production of transthyretin at the RNA level, offering new hope for directly addressing the underlying pathophysiology of ATTR [ 73 ].

Acoramidis, a novel therapeutic agent, is garnering attention in the landscape of ATTR-CM management, particularly for its potential to effectively stabilize TTR tetramers. Unlike tafamidis, which shares a similar mechanism, acoramidis has demonstrated promising results in recent clinical trials. It significantly lowers hospitalization rates and offers some improvement in exercise capacity and quality of life for patients with ATTR CA. Although mortality rates did not differ significantly from those observed with placebo, the nuanced benefits in managing symptoms and potentially delaying progression provide a meaningful therapeutic option. Importantly, the robust in vitro evidence supporting acoramidis’s capacity to achieve near-complete TTR stabilization suggests its superior effectiveness over tafamidis, particularly across various genetic forms of the disease. This broad efficacy implies that acoramidis could offer a substantial clinical advantage, contributing to the evolving therapeutic strategies aimed at mitigating the burdensome effects of ATTR [ 74 ].

Among the most promising advancements in the treatment of CA are gene silencing therapies such as patisiran and vutrisiran. These therapies utilize mechanisms of RNA interference to reduce the hepatic synthesis of transthyretin, thereby diminishing the amyloid burden in the myocardium. Recent clinical trials have shown that patisiran can significantly improve cardiac markers and quality of life, although its impact on mortality and hospitalization requires further investigation [ 75 , 76 ].

For patients with refractory CA, options such as heart transplantation may be considered, though the feasibility depends on the patient’s overall health and the specific type of amyloidosis. Mechanical circulatory support devices are less commonly used due to technical challenges related to the myocardial infiltration by amyloid [ 77 ].

Management also includes non-pharmacological strategies such as dietary modifications, fluid management, and avoidance of alcohol and tobacco. In selected cases, surgical interventions may be necessary to address specific complications arising from amyloid deposition in the heart [ 78 ].

The timing of interventions in CA management significantly affects patient outcomes. Early intervention with therapies like tafamidis, patisiran, or vutrisiran, when cardiac function is less compromised, can slow disease progression and improve prognosis. Conversely, advanced-stage interventions may focus more on symptom management and supportive care. This underscores the importance of early diagnosis and timely therapeutic intervention to optimize patient outcomes [ 79 ].

The landscape of CA management is evolving rapidly, with gene silencing therapies at the forefront of this transformation. These treatments offer a mechanism-based approach to reduce the production of amyloidogenic proteins and potentially reverse some of the cardiac damage [ 79 ]. As research progresses, the integration of these new therapies with traditional approaches promises to enhance outcomes for patients suffering from this challenging and often fatal condition.

To provide a comprehensive overview, we have included Table 1 [ 73 - 76 ], summarizing recent therapies introduced in clinical trials, detailing the number of participants, outcomes related to survival and stabilization, and primary trial findings.

TTR: transthyretin; ATTR: amyloid transthyretin.

One very major problem with the new therapies is the cost, which should be considered in light of their limited effect on survival. The cost of therapies such as tafamidis, patisiran, and vutrisiran can be substantial, potentially limiting their accessibility. Tafamidis, for example, is known to be priced at around $225,000 per year, making it one of the most expensive cardiovascular drugs on the market. Patisiran and vutrisiran, while promising, also come with high costs due to their novel RNA interference technology.

An economic analysis reveals that while these therapies can significantly improve the quality of life and reduce hospitalizations, their cost-effectiveness is still under debate. For instance, tafamidis has been shown to reduce cardiovascular-related hospitalizations, but its impact on overall mortality is less pronounced. This brings into question the overall cost-benefit ratio, particularly for healthcare systems with limited resources.

In the context of a cost-benefit analysis, the primary benefits of these therapies include improved cardiac biomarkers, reduced symptoms, and better quality of life, which must be weighed against their financial burden. Policymakers and healthcare providers need to consider these factors when making decisions about the allocation of resources for the treatment of CA.

Addressing the high costs and ensuring broader access to these therapies will be crucial for maximizing their impact on patient outcomes. Future research should also focus on developing more cost-effective treatments and strategies to manage CA, which could provide significant benefits in terms of both health outcomes and economic sustainability.

The prognosis of CA varies significantly based on the type of amyloidosis, the stage at diagnosis, and the response to treatment. In AL amyloidosis with cardiac involvement, the median survival is approximately 5.5 years with contemporary management. Staging methods, such as the Mayo Clinic staging system, which incorporate biomarkers like NT-proBNP and cardiac troponin T, provide a robust framework for predicting survival. These systems demonstrate that higher biomarker levels correlate with more advanced disease and poorer outcomes [ 80 ].

In ATTR amyloidosis, both wild-type (ATTRwt) and variant (ATTRv), staging also relies heavily on NT-proBNP and troponin levels, but includes renal function as measured by estimated glomerular filtration rate (eGFR). Patients with ATTR amyloidosis show a median survival that varies significantly across stages; those in the earliest stage have a substantially longer survival compared to those in the most advanced stage. The staging system specifically for ATTRwt or ATTRv predicts median survival times of 69.2 months, 46.7 months, and 24.1 months for stages I, II, and III, respectively. This demonstrates a clear gradient of risk based on biomarker and renal function profiles [ 81 ].

The predictive factors influencing prognosis in CA are multifaceted. In AL amyloidosis, the Mayo staging system, hematologic response, and cardiac response are significant predictors of survival. Advanced disease stages and lack of early cardiac response, particularly in stage IIIb cardiac AL amyloidosis, are associated with shortened survival. Conversely, patients who achieve an early cardiac response often experience a prolonged survival, underscoring the importance of timely and effective treatment [ 82 ].

Imaging and biomarker studies are indispensable tools for prognostic assessment in CA. CMR, including techniques like late gadolinium enhancement and T1 mapping, provides critical information on myocardial involvement and fibrosis. Additionally, molecular imaging with PET and single-photon emission computed tomography (SPECT) facilitates early assessment of amyloid burden and disease progression [ 83 - 85 ].

Overall, the prognosis of CA depends on a complex interplay of disease subtype, stage at diagnosis, and therapeutic response. Advanced staging systems, coupled with the latest imaging and biomarker technologies, play a crucial role in enhancing prognostic accuracy, thereby guiding therapeutic decisions and improving patient management.

Gaps in the Literature

Despite significant advances in the diagnosis and management of CA, critical gaps in the literature persist, affecting our ability to effectively understand and treat this complex condition. These gaps span across early diagnosis, long-term treatment effects, and the integration of new diagnostic and therapeutic modalities [ 86 ].

In this regard, early diagnostic indicators for CA remain inadequately defined despite the known benefits of early detection in improving patient outcomes. While CMR with late gadolinium enhancement and advanced echocardiography techniques such as speckle tracking have shown promise, the sensitivity and specificity of these methods need further validation. Additionally, a comprehensive set of early “red flags” including clinical, biohumoral, and imaging features has been suggested to facilitate earlier diagnosis, yet a standardized diagnostic pathway incorporating these indicators has not been fully established [ 87 ].

Conversely, there are considerable gaps in understanding the long-term effects of treatments for CA. Although new medications like tafamidis have emerged, comprehensive data on their long-term effectiveness and safety are lacking. The literature calls for novel, non-toxic, and effective treatments for patients with advanced cardiac dysfunction due to amyloidosis, as current therapies are often associated with high rates of early mortality [ 88 ].

Furthermore, while the evolution of epidemiology and natural history of ATTR CA suggests some improvements in short-term outcomes such as the 2-year survival rate with contemporary diagnosis and treatment, comprehensive studies tracking long-term survival and quality of life are still lacking. This highlights the importance of early diagnosis and the timely initiation of disease-modifying treatments to potentially improve overall survival and patient outcomes [ 13 ].

Moreover, the literature indicates that while established biomarkers such as NT-proBNP and high-sensitivity troponin are valuable for the diagnosis of CA, there is a pressing need for the development and validation of novel biomarkers. Emerging technologies and biomarkers could potentially improve the early detection of CA, but gaps remain in their standardization and application in clinical practice [ 89 ].

In terms of imaging, although various noninvasive modalities like MRI, PET, and bone scintigraphy are instrumental in diagnosing CA, comparative studies to delineate their specific roles and improve diagnostic algorithms are needed. In particular, differentiation between the amyloidosis subtypes ATTR and AL remains challenging with current imaging techniques, underscoring the need for advances in this area [ 90 ].

In addition, the integration of genetic testing and personalized medicine into the management of CA represents another critical gap. While genetic testing has facilitated the diagnosis and management of ATTR-CM, comparative trials to clarify treatment options and understand the impact of genetic variations on treatment outcomes are deficient [ 91 ].

To address these gaps, future research should focus on developing standardized, sensitive, and specific diagnostic criteria that incorporate new biomarkers and imaging techniques. Additionally, longitudinal studies are necessary to evaluate the long-term efficacy and safety of new treatments. Finally, improving our understanding of the genetic aspects of amyloidosis will be critical to advancing personalized medicine approaches that could significantly impact treatment outcomes.

Future Directions

Future research and management of CA should focus on enhancing diagnosis, treatment, and patient outcomes. The emphasis is on developing noninvasive diagnostic methods, refining therapeutic options, and implementing comprehensive management strategies tailored to the disease’s complexities [ 92 ].

Advancements in imaging techniques and biomarkers are essential for early detection and accurate diagnosis of CA. Efforts should improve the specificity and sensitivity of CMR and bone scintigraphy to distinguish between ATTR and AL types without invasive biopsies. Additionally, integrating novel biomarkers into clinical practice could provide a better understanding of disease progression. These biomarkers should be validated through clinical trials to establish their roles in enhancing diagnostic accuracy and predicting treatment responses [ 93 ].

In the therapeutic domain, there is a need for treatments that slow amyloid deposition and potentially reverse cardiac tissue damage. Research should focus on refining existing therapies like tafamidis and exploring new drug classes, such as gene silencers and kinetic stabilizers. Combination therapy strategies could address the multifaceted nature of amyloidosis more effectively than monotherapy [ 94 ].

Clinical trials should evaluate the long-term efficacy and safety of emerging treatments, incorporating a range of clinical endpoints to provide a comprehensive assessment of therapeutic benefits. This will facilitate developing personalized treatment regimens considering individual patients’ genetic and biochemical makeup [ 95 ].

Enhancing patient management strategies is also crucial, including optimizing supportive care for heart failure symptoms and refining strategies for managing comorbidities such as AF and thromboembolic disease. Multidisciplinary teams are fundamental in providing comprehensive care that addresses patients’ diverse needs from diagnosis to advanced disease stages [ 96 ].

Collectively, these efforts in research and clinical practice aim to improve outcomes for patients suffering from CA.

Conclusions

CA, a condition marked by the extracellular deposition of amyloid fibrils in the heart, has garnered increasing attention due to its significant impact on global health and its complex management challenges. This review has synthesized key insights into the pathophysiology, epidemiology, and clinical management of the disease, particularly highlighting the underdiagnosed nature of transthyretin amyloidosis among elderly patients with heart failure. Recent advancements in gene silencing therapies offer a promising avenue for targeting the underlying mechanisms of amyloid production, potentially revolutionizing treatment paradigms. However, significant gaps remain in early diagnosis and long-term treatment efficacy. Given these challenges, there is a critical need for continued research and enhanced policy support to refine diagnostic strategies and develop effective treatments, ensuring better management and outcomes for patients suffering from this debilitating condition.

Acknowledgments

The authors have no acknowledgements to declare, reflecting the independent completion of the work.

Funding Statement

No funding was received for the conduct of this study or the preparation of this article, indicating that there are no financial sources to declare.

Conflict of Interest

The authors declare no conflict of interest to ensure the impartiality of the review.

Author Contributions

Jordan Llerena-Velastegui, MD: conceptualization, supervision, project administration, writing - review and editing. Kristina Zumbana-Podaneva: supervision, writing, review, and editing.

Data Availability

• Open access
• Published: 04 September 2024

Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management

• Yvan Gaudex 1 , 2 ,
• Vianney Gandillot 1 , 2 , 7 ,
• Isabelle Fontanille 3 ,
• Philippe Bouchard 1 , 2 ,
• Stephane Kerner 1 , 2 , 4 , 5 &
• Maria Clotilde Carra 1 , 2 , 6  

BMC Oral Health volume  24 , Article number:  1037 ( 2024 ) Cite this article

Metrics details

Palatal groove represents a relatively uncommon developmental root anomaly, usually found on the palatal aspect of maxillary incisors. While its origin is controversial, its presence predisposes to severe periodontal defects.

This study aimed to provide a systematic review of the literature focusing on the varied diagnostic techniques and treatment modalities for periodontal lesions arising from the presence of palatal groove. Based on the existing evidence and knowledge, the study also provides a comprehensive decisional tree, guiding clinicians in the challenging decision-making process face to a palatal groove.

The literature search was conducted on Medline and Cochrane databases by two independent reviewers, who also performed the screening and selection process, looking for English written articles reporting on diagnosis and management (all treatment approaches) of periodontal lesion(s) associated with a palatal groove. Based on this literature, a comprehensive decisional tree, including a standardized palatal groove evaluation and tailored treatment approaches, is proposed. Moreover, a clinical case is described to demonstrate the practical application of the developed decisional tree.

Over a total of 451 articles initially identified, 34 were selected, describing 40 patients with 40 periodontal lesions associated with palatal grooves. The case report illustrates a deep, large, circumferential intra-bony defect on the palatal side of the tooth #22 associated with a shallow, moderately long palatal groove in an 18-year-old male patient. Following reevaluation, a single flap surgery was deemed necessary, combined with a regenerative procedure. At 2 years post-treatment, the tooth #22 is healthy, in a functional and esthetic position. The decision-making process, based on local and systemic patient’s conditions, should allow an early and precise diagnosis to prevent further complications and undertake an adequate treatment.

Palatal grooves are relatively rare; however, they are frequently associated with severe periodontal defects. The identification, diagnosis, prompt, and tailored management of the associated lesion is essential to mitigate potential periodontal and endodontic complications related to the presence of palatal groove.

Systematic Review Registration

[ https://www.crd.york.ac.uk/prospero/ ], identifier [C CRD42022363194].

Peer Review reports

Introduction

Palatal groove (PG) is defined as an anatomic anomaly characterized by the presence of a developmental groove on a dental root that, when present, is usually found on the palatal aspect of maxillary incisors [ 1 ]. Over the years, several terms have been used to describe this anomaly, including palatal or palate-gingival groove [ 2 , 3 ], developmental radicular anomaly [ 4 ], distolingual groove [ 5 ], radicular lingual groove [ 6 , 7 ], palatoradicular groove [ 8 , 9 ], radicular groove [ 10 ], and cinguloradicular groove [ 11 ].

The origin of the PG is controversial, but it is assumed to be related to the infolding of the enamel organ or Hertwig epithelial root sheath during the tooth development [ 12 ]. Additional hypogenetic root formation [ 13 , 14 ] as well as an altered genetic mechanism [ 15 ] have also been suggested.

PG is relatively rare. Everett et al. [ 5 ] reported a prevalence of PG on 2.8% of lateral incisors whereas Withers et al. [ 16 ] observed a PG on 2.3% of maxillary incisors (4.4% of maxillary laterals and 0.28% of maxillary centrals). Kogon et al. [ 8 ] examined 3168 extracted maxillary central and lateral incisors and found PG on 4.6% of them (3.4% of maxillary centrals and 5.6% of maxillary lateral incisors), with over half of the PG extending more than 5 mm apical to the cementoenamel junction leading to a localized periodontal lesion. The most recent study by Mazzi-Chevez et al. [ 17 ] observed 150 maxillary central incisors, lateral incisors, and canines with a micro-CT and found that PG affected 2% of central incisors and 4% of lateral incisors. In 100% of cases, the PG originated in the enamel.

As the term implies, PG is formed around the cingulum of the tooth and continues apically down from the cementoenamel junction, terminating at various depths and length along the root [ 18 ]. In contrast to maxillary bicuspids, incisors generally display a U-shaped groove.

This anatomic anomaly is frequently associated with a breakdown of the periodontal attachment involving the groove; a self-sustaining localized periodontal pocket can develop [ 4 ], where the PG itself provides a site for bacterial accumulation. The subsequent progressive inflammation along the PG and its apical portion may lead to periodontal and endodontic pathologic conditions [ 19 ]. Furthermore, there may be communication between the pulp canal system and the periodontium through the pulp cavity and/or accessory canals, which may also lead to combined endodontic-periodontal lesions [ 20 ]. According to the 2017 classification of periodontal and peri-implant diseases and conditions [ 21 ], PG can be classified as a localized tooth-related factor that modifies or predisposes to plaque-induced gingival diseases/periodontitis [ 22 ], and can be associated with periodontal abscess in non-periodontitis patients.

The prognosis for teeth with PG extending apically is often poor [ 12 ], highlighting the critical need for prompt and accurate diagnosis to avert further periodontal and endodontic complications, ultimately preventing tooth extraction. This study is fundamentally motivated by the scarcity of consolidated guidelines for managing such complex dental conditions. Hence, the objective of this study was to conduct a systematic review of the existing literature, focusing on the diagnosis and management of periodontal lesions linked to PG. Based on this review, the goal was to develop a comprehensive decisional tree, thereby proposing a standardized treatment protocol to aid in the clinical decision-making. This study also includes a clinical case report to demonstrate the practical application of the developed decisional tree, reinforcing its clinical relevance and utility.

Material and methods

Development of the systematic review protocol.

A protocol covering all aspects of the systematic review methodology was developed before starting the review. The protocol included the definition of: a focused question; the literature search strategy; the study selection criteria; the outcome measures; the screening methods; the data extraction; and the data synthesis. The protocol was registered in PROSPERO (CRD42022363194).

Defining the focused question

The research question was formulated according to the PICOS (Population, Intervention, Comparison, Outcome, Study) strategy, which identify the search and selection criteria as follows:

P: Patients with periodontal lesion(s) associated with a PG

I: PG identification (diagnosis) and management. All treatment approaches (non-surgical, surgical, with or without the adjunctive use of potentially regenerative materials, i.e. barrier membranes, grafting materials, growth factors/proteins and combinations thereof) were considered.

C: alternative treatment approach or no comparison.

O: periodontal parameters, including clinical attachment level (CAL, measure in mm), probing pocket depth (PPD, measured in mm), recession (REC, measured in mm), plaque index (PI, any validated clinical score), bleeding on probing (BOP) or other inflammatory indexes, radiographic bone loss.

S: Any type of human studies including case reports, with a minimum of 6 weeks follow-up after treatment. Only studies published in English were considered. Studies written in languages other than English, review articles, cell and/or animal studies, letters, editorials, conference summaries, commentaries, and studies considering PG with only an endodontic involvement or that used self-report assessment of treatment outcomes were not considered.

So, the focused question was formulated as follows: what is the efficacy of treatments for periodontal lesions associated with PG?

Search strategy

The literature was searched for articles published up to June 2022 on MEDLINE and Cochrane databases. Multiple combinations of pertinent search terms were employed (Supplemental Table 1). The reference lists of the included studies were also evaluated in order to identify additional articles. To ensure its reproducibility, the PRISMA guidelines were followed [ 23 ], and the PRISMA flowchart was filled [ 24 ] (Fig.  1 ).

PRISMA flow diagram on the selection process of the studies included in the systematic review

Literature screening and data extraction

The titles and abstracts of the initially identified studies were screened by two independent reviewers (Y.G. and V.G.). Then, the pre-selected studies underwent a full text evaluation to assess the final inclusion or not. All records for which inclusion was obtained “uncertain” for on reviewer, disagreement was solved by discussion between authors. Whenever needed, the authors of the selected studies were contacted to provide missing data.

Study screening and selection was carried out by using the Rayyan online software [ 25 ], which assisted the reviewers in the different step of the literature review process. Duplicate references were removed automatically using Mendeley software. Data extraction was carried out on a dedicated excel spreadsheet. The risk of bias assessment was carried out by using the Joanna Briggs Institute (JBI) scale [ 26 , 27 ].

The literature search resulted in 451 potentially relevant publications (Fig.  1 ). After the first selection step, based upon the title and abstract, 88 articles were pre-selected. After full-text evaluation, 34 articles were included and analyzed. All of them were case series and case reports. A total of 40 patients were described, of which 23 women (57.5%). The characteristics of the selected studies are presented in Table  1 . Their quality assessment is reported in Table  2 .

Qualitative synthesis of the literature

Among those 40 clinical cases, 12 cases report failed to provide a clinical description of the PG. Four studies described the PG depth alone, 17 studies described the PG length alone, and 7 studies provided a combined description of depth and length of the PG. From a periodontal point of view, the periodontal lesion morphology was correctly described (depth and width) in only 4 cases, 2 of which also reported the number of bony walls. Among the 22 cases reporting a diagnosis, 17 (77.3%) described combined endo-periodontal lesions, whereas 5 were purely periodontal lesions.

Endodontic involvement was present in 29 cases: 22 cases presented with a pulp necrosis, and 7 cases with an endodontic treatment. Pulp vitality was present in 10 cases and 1 case failed to report the endodontic status.

The endodontic treatment consisted in either a temporary filling (calcium hydroxide) later replaced by a definitive filling (gutta percha), or directly with a definitive filling (gutta percha) when indicated. Among those 29 endodontically treated teeth, 9 underwent an apicoectomy (using mineral trioxyde aggregate) at the surgical phase.

PG sealing was performed in 16 cases using mainly glass-ionomer cement but also mineral trioxide aggregate (MTA), tricalcium silicate cement, composite flow and amalgam. In 5 cases, an extra-oral filling of the groove was performed before the tooth reimplantation. In all cases, radiculoplasty was performed either for groove removal when it was shallow or by saucerization to allow a proper filling when grooves were deep.

To treat the PG associated periodontal defect, several different intervention types were described, using: allogenic bone, xenogeneic bone, alloplastic materials, barriers, growth factors and biological factors (and combinations thereof). These surgical regenerative procedures were reported in 25 cases. Only 2 cases [ 3 , 40 ], justified the use of biomaterials and flap designs in relation to the analysis of the associated periodontal lesion after PG management.

All cases reported clinical healing except for 2 cases of failures following tooth reimplantation due to external root resorption leading to tooth removal after 36 months [ 33 ] and 2 failures after 6 months following a surgery without regeneration or root filling [ 29 ]. The case with the longest follow-up (324 months) indicated that following an endodontic treatment with a periodontal regeneration and an orthodontic treatment, a recurrent periodontal breakdown occurred 11 years, leading to tooth extraction and implant placement [ 35 ].

Case-report

We describe the case of an 18-year-old male patient referred to the periodontics department of the Rothschild Hospital (AP-HP) in Paris. Written informed consent was obtained for the publication of clinical data and images included in this article. The patient was experiencing pain due to the inflammation on the palatal side of tooth #22 with intermittent suppuration. The clinical examination revealed a central, shallow, and of moderate length (up to 70% of the root length) PG on the tooth #22, with a probing pocket depth of 12 mm on the palatal side associated with a tooth mobility 3 (Mühlemann 1951). The tooth responded positively to electrical test. At the radiographic evaluation, bone loss could be noted mesially and distally of #22 (Fig.  2 ).

Case report. Clinical and radiographical initial situation of the tooth #22 presenting with a palatal groove. The periodontal charting showed deep periodontal pockets on the palatal probing sites associated with bleeding and plaque accumulation

A slight bony bridge could be distinguished between #21 and #22 in the coronal portion. Thus, a localized periodontal defect due to the presence of subgingival PG was diagnosed.

The periodontal treatment first consisted in a non-surgical debridement performed in one session. Tooth splinting was performed from #21 to #23 to minimize mobility (Fig.  3 ).

Root planning and flattening of PG on tooth #22: initial occlusal view of #22 ( a ); Manual scaling 22 ( b ); flattening of PG 22 in the coronal part ( c )

At the re-evaluation 8 weeks later, the tooth presented no superficial inflammation, but a persistent periodontal pocket of 12 mm deep on the palatal side. Surgery was indicated due to the presence of a large, deep, 3-wall intra-bony defect around tooth #22 (Fig.  4 ).

Regenerative therapy: view at the periodontal re-evaluation, 2-months after the initial treatment ( a ); large and deep 3-walls intra-bony defect ( b ); application of EMD ( c ); application of DBBM (soft tissue support, osteoconductive) ( d ); sutures ( e ); radiographic image at the 2-month follow-up ( f )

A SFA (Single Flap Approach) was designed with a surgical access limited on the palatal side for esthetic reason and optimal visualization. A full periosteal flap was raised, and the granulation tissue was removed. The aberrant local anatomy was corrected up to the most apical part and a regenerative procedure combining enamel matrix derivates with a bone substitute was applied to avoid soft tissue shrinkage and collapse. Sutures with a non-resorbable monofilament 6/0 were made using U-crossed and single points. A postoperative radiograph was taken (Fig.  4 f). An antibiotic therapy with amoxicillin (1 g twice a day for 7 days) was administered. Paracetamol was prescribed as a painkiller and a mouthwash containing 0.12% chlorhexidine gluconate were prescribed for 2 weeks postoperatively. Healing was uneventful and sutures were removed 10 days postoperatively.

At the 6 months reevaluation, the periodontal pocket was no deeper than 4 mm on the palatal side with no bleeding on probing. A recession of 1 mm was observed. Radiographically, a mineralized tissue could be observed up to both bony peaks mesially and distally to #22 (Fig.  5 ).

Re-evaluation at 6 months ( a ); 18 months ( b ) and 30 months ( c )

At the 1-year follow-up, periodontal health was maintained and an orthodontic treatment was undertaken. After 2 years of treatment, tooth #22 is still healthy with a CAL gain of 7 mm, a functional and esthetic position resulting in the patient’s satisfaction. These results support that periodontal regeneration can be effectively carried out also for deep intra-bony defect associated with PG, once the local risk factor has been adequately managed.

The results of the present systematic review indicate that PG are relatively uncommon root anomaly, but they are frequently associated with periodontal lesion that require treatment. The selected studies showed that PG can be managed concomitantly with periodontal regeneration, with or without associated endodontic treatment. It must be noted that the presence of a PG may play a significant role in exacerbating periodontal lesions. This could be explained, at least partly, by the mediation role of inflammatory factors like the TGF-B1, which is involved in the regulation of the inflammatory response and in the remodeling of periodontal tissues, as highlighted by recent studies [ 58 , 59 ]. These findings necessitate a nuanced and well-defined diagnostic and therapeutic approach, which should consider not only on the anatomical challenges linked to the presence of a PG but also on the underlying inflammatory mechanisms, in order to ensure an effective treatment and prevent potential endodontic complications.

A variety of treatments approaches has been described in case reports and case series and summarized in the present review. The appreciation of the morphology and origin of PG on maxillary incisors may be challenging and thus delay the diagnosis and treatment planning. Therefore, developing a standardized approach based on the available literature is advisable.

A PG can be classified according to its location, length along the root, and depth of the groove towards the pulp cavity [ 60 ]. The analysis of the associated periodontal lesion is also a key parameter to consider. Based on the work of Kim et al. [ 60 ], a simplified version including the groove description and the periodontal parameters has been suggested. Such a classification (Table  3 ) would provide the clinician with precise criteria to justify the therapeutic approach.

Groove location was disregarded in most cases, only one case [ 40 ] reported a distal location of the PG. It can be explained by the fact that this parameter will not affect the prognosis or the treatment sequence. In the latest study done on extracted teeth, PG appeared to originate in the distal area of the cingulum margin in most cases (65%), followed by the central fossa (25%), and the mesial area of the cingulum margin (10%) [ 61 ].

In terms of depth, only 7 cases reported a shallow PG (50%) and 7 cases reported a deep PG (50%) and no closed tube has been described. This finding is in accordance with Kogon’s study [ 8 ] where 44% percent of the PG were described as shallow depressions, 42% as deep depressions, and 4% as closed tubes.

Considering the groove length, 4 cases reported an extension in the cervical third of the groove (17%), 6 in the middle third (25%) and 14 cases in the apical third (58%). According to Pinheiro’s study [ 61 ], those grooves extended rarely only to the cervical third (5%), followed by the middle thirds (45%) and the apical thirds of the root in most cases (50%). It is of paramount importance for clinicians to understand the combination of both variations of groove depth along with their length to adapt an adequate treatment considering the fact that PG with deeper grooves and greater degree of extension are the determinants and predictors of poor prognosis periodontally and endodontically wise [ 5 , 31 , 42 ].

Considering the groove description in the selected studies, most of them failed to adequately report it. Only 7 of the 40 cases described the depth and length of the PG. This lack of analysis might result in an inadequate treatment highlighting the need for a classification.

Considering the periodontal approach of the associated intra-bony defect, the selection of the regenerative biologic principle (or material) to use with the soft tissue surgical approach dependeds on the morphology of the intra- bony defect (width, depth, and number of residual bony walls) and on the amount (and quality) of the soft tissues available to cover it [ 62 ]. As a general rule, deep and wide defects with only one residual bony wall require a mechanical stabilizer of the blood coagulum (membrane and/or bone filler), whereas in defects with lower defect angles and a greater number of bony walls, biologic mediators of the healing process (e.g. enamel matrix derivates) are indicated [ 62 ]. In the present study, only 2 cases [ 3 , 40 ] succeeded in justifying the use of their regenerative procedure based on the description and analysis of the associated intra-bony lesion. As for PG anatomy, this lack of description of the associated periodontal lesion morphology could mislead the diagnosis and result in a non-optimal treatment. The PG issue had mostly been a concern for endodontist based on those case reports coming from endodontic journals, which might explain the few periodontal parameters reported and the lack of a clear description of the intra-bony defect associated to justify the different management of the periodontal defect. Moreover, the selected case reports do not cover all potentially applicable regenerative techniques, which continue to evolve [ 63 , 64 , 65 ] and should be further investigated in the particular context, from the microbiological and inflammatory perspectives, of PG-associate lesions.

Based on the presented literature review and in order to guide clinicians towards a comprehensive and complete evaluation of PG associated lesion, we suggested a decisional tree (Fig.  6 ) that introduces the periodontal parameter in the PG assessment, after evaluating the endodontic status. Indeed, the successful management of a tooth with a PG is firstly dependent on endodontic status, which should be systematically assessed. In cases of negative pulp response and periapical lesions, an endodontic treatment has to be undertaken in the first place [ 66 ]. But, the periodontal evaluation is also cardinal to obtain a successful and long-lasting management of PG.

Decisional tree. This graph proposes a decision-making process for the management of PG-associated lesions that takes into account the endodontic status, the characteristics of the palatal groove, and the presence of intra-bony defect

The recognition and management of PG for tooth survival has been reported in details in a study done by Kim et al. [ 60 ] in 2017. In the rest of the considered literature, half of the treatments described were made without a clear initial diagnosis or proper description of the associated lesions to justify the type of regenerative strategy and flap design approached. Another interesting observation made in this review is that in the case of intentional replantation, among the 5 reported cases, 2 resulted in a failure necessitating the tooth removal [ 33 ]. This suggests that replantation strategy should be used as a the latest resort for complex cases involving a PG to the apex with a deep groove.

It must be acknowledged that the available literature and thus the present systematic review present several limitations. Firstly, as mentioned above, there is a lack of standardization in the diagnostic and treatment processes, with a high heterogeneity among the selected articles, most of the times case reports or case series. Secondly, the follow-up time was mostly set between 6 and 24 months, which may be too short to assess treatment outcomes or observed complications and relapse. Indeed, after a 36 months follow-up, failures have been reported [ 33 ] and after 10 years, a periodontal breakdown occurred on a treated tooth [ 35 ] and both resulted in the tooth removal. No re-entry surgery and/or histologic evaluations were described and no prospective longitudinal studies evaluating the stability of the clinical and radiographic parameters and the absence of the recurrence of disease were found. Thus, any conclusion about the success achieved with the treatments described in the present review should be drawn with caution as the long-term prognosis of the treatment of PG-associated lesions of teeth remains to be determined. Updates of case series and case reports that could describe results after 5, 10 and 15 years from the initial PG diagnosis are advocated. Finally, the level of the body of evidence on PG is considered as low. Although the nature of PG as rare condition may explain why mainly case reports or case series are published, future clinical and comparative studies should be designed to investigate PG management and treatment success at long term. Nonetheless, based on the currently available literature, a decisional tree (Fig.  6 ) has been proposed to guide clinicians and create a reference for PG management to respond to a patient’s health condition. This should be periodontally updated as new evidence emerges but in the meantime, it can be useful to provide a clinical guidance as well as a model for the standardization of the diagnostic and treatment processes in clinical cases dealing with PG management.

Teeth with PG represent a challenge for clinicians. Despite their rarity (2% of maxillary lateral incisors), the complexities associated with PG, such as diverse anatomical features and clinical scenarios, underscore the necessity for accurate diagnosis and tailored treatment approaches. This study provides a systematic review of pertinent literature, consisting mainly in case reports, and culminates in the proposal of a decision tree, which aims to assist clinicians in the decision-making process through a structured evaluation of the PG characteristics guiding the treatment approach. The ultimate goal is to mitigate potential periodontal and endodontic complications of PG while providing a successful management. In parallel, the present study highlights the need of future research on this topic, particularly with clinical studies with a sufficiently long follow-up to monitor the treatment outcomes and their stability over time. Indeed, further evidence is needed to develop standardized diagnostic and treatment protocols for PG.

Availability of data and materials

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

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Service of Odontology, Rothschild Hospital (AP-HP), 5 Rue Santerre, Paris, 75012, France

Yvan Gaudex, Vianney Gandillot, Philippe Bouchard, Stephane Kerner & Maria Clotilde Carra

Department of Periodontology, UFR of Odontology, Université Paris Cité, 5 Rue Garanciere, Paris, 75006, France

Service of Odontology, CH Eure Seine Hospital, Evreux, France

Isabelle Fontanille

Cordeliers Research Centre, Laboratory of Molecular Oral Physiopathology, Paris, France

Stephane Kerner

Department of Periodontology, Loma Linda University School of Dentistry, Loma Linda, CA, USA

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Y.G. and V.G. drafted the manuscript text, and were involved in the literature review, data acquisition, analysis, and interpretation. Y.G. and V.G. prepared Tables 1 and 2 . Y.G., P.B. and I.F. Contributed the case report and Figs.  2 , 3 , 4 and 5 M.C.C and S.K. prepared Table  3 and Fig.  6 . M.C.C., P.B. and S.K revised the draft of the manuscript and contributed to the general criticism. All authors reviewed and approved the manuscript.

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Gaudex, Y., Gandillot, V., Fontanille, I. et al. Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management. BMC Oral Health 24 , 1037 (2024). https://doi.org/10.1186/s12903-024-04771-z

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