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Types of Literature Review — A Guide for Researchers

Table of Contents

Researchers often face challenges when choosing the appropriate type of literature review for their study. Regardless of the type of research design and the topic of a research problem , they encounter numerous queries, including:

What is the right type of literature review my study demands?

• How do we gather the data?
• How to conduct one?
• How reliable are the review findings?
• How do we employ them in our research? And the list goes on.

If you’re also dealing with such a hefty questionnaire, this article is of help. Read through this piece of guide to get an exhaustive understanding of the different types of literature reviews and their step-by-step methodologies along with a dash of pros and cons discussed.

Heading from scratch!

What is a Literature Review?

A literature review provides a comprehensive overview of existing knowledge on a particular topic, which is quintessential to any research project. Researchers employ various literature reviews based on their research goals and methodologies. The review process involves assembling, critically evaluating, and synthesizing existing scientific publications relevant to the research question at hand. It serves multiple purposes, including identifying gaps in existing literature, providing theoretical background, and supporting the rationale for a research study.

What is the importance of a Literature review in research?

Literature review in research serves several key purposes, including:

• Background of the study: Provides proper context for the research. It helps researchers understand the historical development, theoretical perspectives, and key debates related to their research topic.
• Identification of research gaps: By reviewing existing literature, researchers can identify gaps or inconsistencies in knowledge, paving the way for new research questions and hypotheses relevant to their study.
• Theoretical framework development: Facilitates the development of theoretical frameworks by cultivating diverse perspectives and empirical findings. It helps researchers refine their conceptualizations and theoretical models.
• Methodological guidance: Offers methodological guidance by highlighting the documented research methods and techniques used in previous studies. It assists researchers in selecting appropriate research designs, data collection methods, and analytical tools.
• Quality assurance and upholding academic integrity: Conducting a thorough literature review demonstrates the rigor and scholarly integrity of the research. It ensures that researchers are aware of relevant studies and can accurately attribute ideas and findings to their original sources.

Types of Literature Review

Literature review plays a crucial role in guiding the research process , from providing the background of the study to research dissemination and contributing to the synthesis of the latest theoretical literature review findings in academia.

However, not all types of literature reviews are the same; they vary in terms of methodology, approach, and purpose. Let's have a look at the various types of literature reviews to gain a deeper understanding of their applications.

1. Narrative Literature Review

A narrative literature review, also known as a traditional literature review, involves analyzing and summarizing existing literature without adhering to a structured methodology. It typically provides a descriptive overview of key concepts, theories, and relevant findings of the research topic.

Unlike other types of literature reviews, narrative reviews reinforce a more traditional approach, emphasizing the interpretation and discussion of the research findings rather than strict adherence to methodological review criteria. It helps researchers explore diverse perspectives and insights based on the research topic and acts as preliminary work for further investigation.

Steps to Conduct a Narrative Literature Review

Source:- https://www.researchgate.net/figure/Steps-of-writing-a-narrative-review_fig1_354466408

Define the research question or topic:

The first step in conducting a narrative literature review is to clearly define the research question or topic of interest. Defining the scope and purpose of the review includes — What specific aspect of the topic do you want to explore? What are the main objectives of the research? Refine your research question based on the specific area you want to explore.

Conduct a thorough literature search

Once the research question is defined, you can conduct a comprehensive literature search. Explore and use relevant databases and search engines like SciSpace Discover to identify credible and pertinent, scholarly articles and publications.

Select relevant studies

Before choosing the right set of studies, it’s vital to determine inclusion (studies that should possess the required factors) and exclusion criteria for the literature and then carefully select papers. For example — Which studies or sources will be included based on relevance, quality, and publication date?

*Important (applies to all the reviews): Inclusion criteria are the factors a study must include (For example: Include only peer-reviewed articles published between 2022-2023, etc.). Exclusion criteria are the factors that wouldn’t be required for your search strategy (Example: exclude irrelevant papers, preprints, written in non-English, etc.)

Critically analyze the literature

Once the relevant studies are shortlisted, evaluate the methodology, findings, and limitations of each source and jot down key themes, patterns, and contradictions. You can use efficient AI tools to conduct a thorough literature review and analyze all the required information.

Synthesize and integrate the findings

Now, you can weave together the reviewed studies, underscoring significant findings such that new frameworks, contrasting viewpoints, and identifying knowledge gaps.

Discussion and conclusion

This is an important step before crafting a narrative review — summarize the main findings of the review and discuss their implications in the relevant field. For example — What are the practical implications for practitioners? What are the directions for future research for them?

Write a cohesive narrative review

Organize the review into coherent sections and structure your review logically, guiding the reader through the research landscape and offering valuable insights. Use clear and concise language to convey key points effectively.

Structure of Narrative Literature Review

A well-structured, narrative analysis or literature review typically includes the following components:

• Introduction: Provides an overview of the topic, objectives of the study, and rationale for the review.
• Background: Highlights relevant background information and establish the context for the review.
• Main Body: Indexes the literature into thematic sections or categories, discussing key findings, methodologies, and theoretical frameworks.
• Discussion: Analyze and synthesize the findings of the reviewed studies, stressing similarities, differences, and any gaps in the literature.
• Conclusion: Summarizes the main findings of the review, identifies implications for future research, and offers concluding remarks.

Pros and Cons of Narrative Literature Review

• Flexibility in methodology and doesn’t necessarily rely on structured methodologies
• Follows traditional approach and provides valuable and contextualized insights
• Suitable for exploring complex or interdisciplinary topics. For example — Climate change and human health, Cybersecurity and privacy in the digital age, and more
• Subjectivity in data selection and interpretation
• Potential for bias in the review process
• Lack of rigor compared to systematic reviews

Example of Well-Executed Narrative Literature Reviews

Paper title:  Examining Moral Injury in Clinical Practice: A Narrative Literature Review

Source: SciSpace

You can also chat with the papers using SciSpace ChatPDF to get a thorough understanding of the research papers.

While narrative reviews offer flexibility, academic integrity remains paramount. So, ensure proper citation of all sources and maintain a transparent and factual approach throughout your critical narrative review, itself.

2. Systematic Review

A systematic literature review is one of the comprehensive types of literature review that follows a structured approach to assembling, analyzing, and synthesizing existing research relevant to a particular topic or question. It involves clearly defined criteria for exploring and choosing studies, as well as rigorous methods for evaluating the quality of relevant studies.

It plays a prominent role in evidence-based practice and decision-making across various domains, including healthcare, social sciences, education, health sciences, and more. By systematically investigating available literature, researchers can identify gaps in knowledge, evaluate the strength of evidence, and report future research directions.

Steps to Conduct Systematic Reviews

Source:- https://www.researchgate.net/figure/Steps-of-Systematic-Literature-Review_fig1_321422320

Here are the key steps involved in conducting a systematic literature review

Formulate a clear and focused research question

Clearly define the research question or objective of the review. It helps to centralize the literature search strategy and determine inclusion criteria for relevant studies.

Develop a thorough literature search strategy

Design a comprehensive search strategy to identify relevant studies. It involves scrutinizing scientific databases and all relevant articles in journals. Plus, seek suggestions from domain experts and review reference lists of relevant review articles.

Screening and selecting studies

Employ predefined inclusion and exclusion criteria to systematically screen the identified studies. This screening process also typically involves multiple reviewers independently assessing the eligibility of each study.

Data extraction

Extract key information from selected studies using standardized forms or protocols. It includes study characteristics, methods, results, and conclusions.

Critical appraisal

Evaluate the methodological quality and potential biases of included studies. Various tools (BMC medical research methodology) and criteria can be implemented for critical evaluation depending on the study design and research quetions .

Data synthesis

Analyze and synthesize review findings from individual studies to draw encompassing conclusions or identify overarching patterns and explore heterogeneity among studies.

Interpretation and conclusion

Interpret the findings about the research question, considering the strengths and limitations of the research evidence. Draw conclusions and implications for further research.

The final step — Report writing

Craft a detailed report of the systematic literature review adhering to the established guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). This ensures transparency and reproducibility of the review process.

By following these steps, a systematic literature review aims to provide a comprehensive and unbiased summary of existing evidence, help make informed decisions, and advance knowledge in the respective domain or field.

Structure of a systematic literature review

A well-structured systematic literature review typically consists of the following sections:

• Introduction: Provides background information on the research topic, outlines the review objectives, and enunciates the scope of the study.
• Methodology: Describes the literature search strategy, selection criteria, data extraction process, and other methods used for data synthesis, extraction, or other data analysis..
• Results: Presents the review findings, including a summary of the incorporated studies and their key findings.
• Discussion: Interprets the findings in light of the review objectives, discusses their implications, and identifies limitations or promising areas for future research.
• Conclusion: Summarizes the main review findings and provides suggestions based on the evidence presented in depth meta analysis.

*Important (applies to all the reviews): Remember, the specific structure of your literature review may vary depending on your topic, research question, and intended audience. However, adhering to a clear and logical hierarchy ensures your review effectively analyses and synthesizes knowledge and contributes valuable insights for readers.

Pros and Cons of Systematic Literature Review

• Adopts rigorous and transparent methodology
• Minimizes bias and enhances the reliability of the study
• Provides evidence-based insights
• Time and resource-intensive
• High dependency on the quality of available literature (literature research strategy should be accurate)
• Potential for publication bias

Example of Well-Executed Systematic Literature Review

Paper title: Systematic Reviews: Understanding the Best Evidence For Clinical Decision-making in Health Care: Pros and Cons.

Read this detailed article on how to use AI tools to conduct a systematic review for your research!

3. Scoping Literature Review

A scoping literature review is a methodological review type of literature review that adopts an iterative approach to systematically map the existing literature on a particular topic or research area. It involves identifying, selecting, and synthesizing relevant papers to provide an overview of the size and scope of available evidence. Scoping reviews are broader in scope and include a diverse range of study designs and methodologies especially focused on health services research.

The main purpose of a scoping literature review is to examine the extent, range, and nature of existing studies on a topic, thereby identifying gaps in research, inconsistencies, and areas for further investigation. Additionally, scoping reviews can help researchers identify suitable methodologies and formulate clinical recommendations. They also act as the frameworks for future systematic reviews or primary research studies.

Scoping reviews are primarily focused on —

• Emerging or evolving topics — where the research landscape is still growing or budding. Example — Whole Systems Approaches to Diet and Healthy Weight: A Scoping Review of Reviews .
• Broad and complex topics : With a vast amount of existing literature.
• Scenarios where a systematic review is not feasible: Due to limited resources or time constraints.

Steps to Conduct a Scoping Literature Review

While Scoping reviews are not as rigorous as systematic reviews, however, they still follow a structured approach. Here are the steps:

Identify the research question: Define the broad topic you want to explore.

Identify Relevant Studies: Conduct a comprehensive search of relevant literature using appropriate databases, keywords, and search strategies.

Select studies to be included in the review: Based on the inclusion and exclusion criteria, determine the appropriate studies to be included in the review.

Data extraction and charting : Extract relevant information from selected studies, such as year, author, main results, study characteristics, key findings, and methodological approaches.  However, it varies depending on the research question.

Collate, summarize, and report the results: Analyze and summarize the extracted data to identify key themes and trends. Then, present the findings of the scoping review in a clear and structured manner, following established guidelines and frameworks .

Structure of a Scoping Literature Review

A scoping literature review typically follows a structured format similar to a systematic review. It includes the following sections:

• Introduction: Introduce the research topic and objectives of the review, providing the historical context, and rationale for the study.
• Methods : Describe the methods used to conduct the review, including search strategies, study selection criteria, and data extraction procedures.
• Results: Present the findings of the review, including key themes, concepts, and patterns identified in the literature review.
• Discussion: Examine the implications of the findings, including strengths, limitations, and areas for further examination.
• Conclusion: Recapitulate the main findings of the review and their implications for future research, policy, or practice.

Pros and Cons of Scoping Literature Review

• Provides a comprehensive overview of existing literature
• Helps to identify gaps and areas for further research
• Suitable for exploring broad or complex research questions
• Doesn’t provide the depth of analysis offered by systematic reviews
• Subject to researcher bias in study selection and data extraction
• Requires careful consideration of literature search strategies and inclusion criteria to ensure comprehensiveness and validity.

In short, a scoping review helps map the literature on developing or emerging topics and identifying gaps. It might be considered as a step before conducting another type of review, such as a systematic review. Basically, acts as a precursor for other literature reviews.

Example of a Well-Executed Scoping Literature Review

Paper title: Health Chatbots in Africa Literature: A Scoping Review

Check out the key differences between Systematic and Scoping reviews — Evaluating literature review: systematic vs. scoping reviews

4. Integrative Literature Review

Integrative Literature Review (ILR) is a type of literature review that proposes a distinctive way to analyze and synthesize existing literature on a specific topic, providing a thorough understanding of research and identifying potential gaps for future research.

Unlike a systematic review, which emphasizes quantitative studies and follows strict inclusion criteria, an ILR embraces a more pliable approach. It works beyond simply summarizing findings — it critically analyzes, integrates, and interprets research from various methodologies (qualitative, quantitative, mixed methods) to provide a deeper understanding of the research landscape. ILRs provide a holistic and systematic overview of existing research, integrating findings from various methodologies. ILRs are ideal for exploring intricate research issues, examining manifold perspectives, and developing new research questions.

Steps to Conduct an Integrative Literature Review

• Identify the research question: Clearly define the research question or topic of interest as formulating a clear and focused research question is critical to leading the entire review process.
• Literature search strategy: Employ systematic search techniques to locate relevant literature across various databases and sources.
• Evaluate the quality of the included studies : Critically assess the methodology, rigor, and validity of each study by applying inclusion and exclusion criteria to filter and select studies aligned with the research objectives.
• Data Extraction: Extract relevant data from selected studies using a structured approach.
• Synthesize the findings : Thoroughly analyze the selected literature, identify key themes, and synthesize findings to derive noteworthy insights.
• Critical appraisal: Critically evaluate the quality and validity of qualitative research and included studies by using BMC medical research methodology.
• Interpret and present your findings: Discuss the purpose and implications of your analysis, spotlighting key insights and limitations. Organize and present the findings coherently and systematically.

Structure of an Integrative Literature Review

• Introduction : Provide an overview of the research topic and the purpose of the integrative review.
• Methods: Describe the opted literature search strategy, selection criteria, and data extraction process.
• Results: Present the synthesized findings, including key themes, patterns, and contradictions.
• Discussion: Interpret the findings about the research question, emphasizing implications for theory, practice, and prospective research.
• Conclusion: Summarize the main findings, limitations, and contributions of the integrative review.

Pros and Cons of Integrative Literature Review

• Informs evidence-based practice and policy to the relevant stakeholders of the research.
• Contributes to theory development and methodological advancement, especially in the healthcare arena.
• Integrates diverse perspectives and findings
• Time-consuming process due to the extensive literature search and synthesis
• Requires advanced analytical and critical thinking skills
• Potential for bias in study selection and interpretation
• The quality of included studies may vary, affecting the validity of the review

Example of Integrative Literature Reviews

Paper Title: An Integrative Literature Review: The Dual Impact of Technological Tools on Health and Technostress Among Older Workers

5. Rapid Literature Review

A Rapid Literature Review (RLR) is the fastest type of literature review which makes use of a streamlined approach for synthesizing literature summaries, offering a quicker and more focused alternative to traditional systematic reviews. Despite employing identical research methods, it often simplifies or omits specific steps to expedite the process. It allows researchers to gain valuable insights into current research trends and identify key findings within a shorter timeframe, often ranging from a few days to a few weeks — unlike traditional literature reviews, which may take months or even years to complete.

When to Consider a Rapid Literature Review?

• When time impediments demand a swift summary of existing research
• For emerging topics where the latest literature requires quick evaluation
• To report pilot studies or preliminary research before embarking on a comprehensive systematic review

Steps to Conduct a Rapid Literature Review

• Define the research question or topic of interest. A well-defined question guides the search process and helps researchers focus on relevant studies.
• Determine key databases and sources of relevant literature to ensure comprehensive coverage.
• Develop literature search strategies using appropriate keywords and filters to fetch a pool of potential scientific articles.
• Screen search results based on predefined inclusion and exclusion criteria.
• Extract and summarize relevant information from the above-preferred studies.
• Synthesize findings to identify key themes, patterns, or gaps in the literature.
• Prepare a concise report or a summary of the RLR findings.

Structure of a Rapid Literature Review

An effective structure of an RLR typically includes the following sections:

• Introduction: Briefly introduce the research topic and objectives of the RLR.
• Methodology: Describe the search strategy, inclusion and exclusion criteria, and data extraction process.
• Results: Present a summary of the findings, including key themes or patterns identified.
• Discussion: Interpret the findings, discuss implications, and highlight any limitations or areas for further research
• Conclusion: Summarize the key findings and their implications for practice or future research

Pros and Cons of Rapid Literature Review

• RLRs can be completed quickly, authorizing timely decision-making
• RLRs are a cost-effective approach since they require fewer resources compared to traditional literature reviews
• Offers great accessibility as RLRs provide prompt access to synthesized evidence for stakeholders
• RLRs are flexible as they can be easily adapted for various research contexts and objectives
• RLR reports are limited and restricted, not as in-depth as systematic reviews, and do not provide comprehensive coverage of the literature compared to traditional reviews.
• Susceptible to bias because of the expedited nature of RLRs. It would increase the chance of overlooking relevant studies or biases in the selection process.
• Due to time constraints, RLR findings might not be robust enough as compared to systematic reviews.

Example of a Well-Executed Rapid Literature Review

Paper Title: What Is the Impact of ChatGPT on Education? A Rapid Review of the Literature

A Summary of Literature Review Types

Tools and Resources for Conducting Different Types of Literature Reviews

Online scientific databases.

Platforms such as SciSpace , PubMed , Scopus , Elsevier , and Web of Science provide access to a vast array of scholarly literature, facilitating the search and data retrieval process.

Reference management software

Tools like SciSpace Citation Generator , EndNote, Zotero , and Mendeley assist researchers in organizing, annotating, and citing relevant literature, streamlining the review process altogether.

Automate Literature Review with AI tools

Automate the literature review process by using tools like SciSpace literature review which helps you compare and contrast multiple papers all on one screen in an easy-to-read matrix format. You can effortlessly analyze and interpret the review findings tailored to your study. It also supports the review in 75+ languages, making it more manageable even for non-English speakers.

Goes without saying — literature review plays a pivotal role in academic research to identify the current trends and provide insights to pave the way for future research endeavors. Different types of literature review has their own strengths and limitations, making them suitable for different research designs and contexts. Whether conducting a narrative review, systematic review, scoping review, integrative review, or rapid literature review, researchers must cautiously consider the objectives, resources, and the nature of the research topic.

If you’re currently working on a literature review and still adopting a manual and traditional approach, switch to the automated AI literature review workspace and transform your traditional literature review into a rapid one by extracting all the latest and relevant data for your research!

There you go!

Frequently Asked Questions

Narrative reviews give a general overview of a topic based on the author's knowledge. They may lack clear criteria and can be biased. On the other hand, systematic reviews aim to answer specific research questions by following strict methods. They're thorough but time-consuming.

A systematic review collects and analyzes existing research to provide an overview of a topic, while a meta-analysis statistically combines data from multiple studies to draw conclusions about the overall effect of an intervention or relationship between variables.

A systematic review thoroughly analyzes existing research on a specific topic using strict methods. In contrast, a scoping review offers a broader overview of the literature without evaluating individual studies in depth.

A systematic review thoroughly examines existing research using a rigorous process, while a rapid review provides a quicker summary of evidence, often by simplifying some of the systematic review steps to meet shorter timelines.

A systematic review carefully examines many studies on a single topic using specific guidelines. Conversely, an integrative review blends various types of research to provide a more comprehensive understanding of the topic.

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Types of journal articles

It is helpful to familiarise yourself with the different types of articles published by journals. Although it may appear there are a large number of types of articles published due to the wide variety of names they are published under, most articles published are one of the following types; Original Research, Review Articles, Short reports or Letters, Case Studies, Methodologies.

Original Research:

This is the most common type of journal manuscript used to publish full reports of data from research. It may be called an  Original Article, Research Article, Research, or just  Article, depending on the journal. The Original Research format is suitable for many different fields and different types of studies. It includes full Introduction, Methods, Results, and Discussion sections.

Short reports or Letters:

These papers communicate brief reports of data from original research that editors believe will be interesting to many researchers, and that will likely stimulate further research in the field. As they are relatively short the format is useful for scientists with results that are time sensitive (for example, those in highly competitive or quickly-changing disciplines). This format often has strict length limits, so some experimental details may not be published until the authors write a full Original Research manuscript. These papers are also sometimes called Brief communications .

Review Articles:

Review Articles provide a comprehensive summary of research on a certain topic, and a perspective on the state of the field and where it is heading. They are often written by leaders in a particular discipline after invitation from the editors of a journal. Reviews are often widely read (for example, by researchers looking for a full introduction to a field) and highly cited. Reviews commonly cite approximately 100 primary research articles.

TIP: If you would like to write a Review but have not been invited by a journal, be sure to check the journal website as some journals to not consider unsolicited Reviews. If the website does not mention whether Reviews are commissioned it is wise to send a pre-submission enquiry letter to the journal editor to propose your Review manuscript before you spend time writing it.  

Case Studies:

These articles report specific instances of interesting phenomena. A goal of Case Studies is to make other researchers aware of the possibility that a specific phenomenon might occur. This type of study is often used in medicine to report the occurrence of previously unknown or emerging pathologies.

Methodologies or Methods

These articles present a new experimental method, test or procedure. The method described may either be completely new, or may offer a better version of an existing method. The article should describe a demonstrable advance on what is currently available.

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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See an example

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
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• Null hypothesis
• Statistical power
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• Effect size
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Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
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A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

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

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

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

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

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

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

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

Cite this Scribbr article

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McCombes, S. (2023, September 11). How to Write a Literature Review | Guide, Examples, & Templates. Scribbr. Retrieved September 3, 2024, from https://www.scribbr.com/dissertation/literature-review/

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• University of Wisconsin–Madison
• University of Wisconsin-Madison
• Research Guides
• Evidence Synthesis, Systematic Review Services
• Literature Review Types, Taxonomies

Evidence Synthesis, Systematic Review Services : Literature Review Types, Taxonomies

• Develop a Protocol
• Develop Your Research Question
• Select Databases
• Select Gray Literature Sources
• Write a Search Strategy
• Manage Your Search Process
• Register Your Protocol
• Citation Management
• Article Screening
• Risk of Bias Assessment
• Synthesize, Map, or Describe the Results
• Find Guidance by Discipline
• Manage Your Research Data
• Browse Evidence Portals by Discipline
• Automate the Process, Tools & Technologies
• Adapting Systematic Review Methods
• Additional Resources

Choosing a Literature Review Methodology

Growing interest in evidence-based practice has driven an increase in review methodologies. Your choice of review methodology (or literature review type) will be informed by the intent (purpose, function) of your research project and the time and resources of your team. 

• Decision Tree (What Type of Review is Right for You?) Developed by Cornell University Library staff, this "decision-tree" guides the user to a handful of review guides given time and intent.

Types of Evidence Synthesis*

Critical Review - Aims to demonstrate writer has extensively researched literature and critically evaluated its quality. Goes beyond mere description to include degree of analysis and conceptual innovation. Typically results in hypothesis or model.

Mapping Review (Systematic Map) - Map out and categorize existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature.

Meta-Analysis - Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results.

Mixed Studies Review (Mixed Methods Review) - Refers to any combination of methods where one significant component is a literature review (usually systematic). Within a review context it refers to a combination of review approaches for example combining quantitative with qualitative research or outcome with process studies.

Narrative (Literature) Review - Broad, generic term - Refers to an examination and general synthesis of the research literature, often with a wide scope; completeness and comprehensiveness may vary. Does not follow an established protocol.

Overview - Generic term: summary of the [medical] literature that attempts to survey the literature and describe its characteristics.

Qualitative Systematic Review or Qualitative Evidence Synthesis - Method for integrating or comparing the findings from qualitative studies. It looks for ‘themes’ or ‘constructs’ that lie in or across individual qualitative studies.

Rapid Review - Assessment of what is already known about a policy or practice issue, by using systematic review methods to search and critically appraise existing research.

Scoping Review or Evidence Map - Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research.

State-of-the-art Review - Tend to address more current matters in contrast to other combined retrospective and current approaches. May offer new perspectives on issue or point out area for further research.

Systematic Review - Seeks to systematically search for, appraise and synthesize research evidence, often adhering to guidelines on the conduct of a review. (An emerging subset includes Living Reviews or Living Systematic Reviews - A [review or] systematic review which is continually updated, incorporating relevant new evidence as it becomes available.)

Systematic Search and Review - Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce ‘best evidence synthesis.’

Umbrella Review - Specifically refers to review compiling evidence from multiple reviews into one accessible and usable document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address these interventions and their results.

*Apart from some qualifying description for "Narrative (Literature) Review", these definitions are provided in Grant & Booth's "A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies."

Literature Review Types/Typologies, Taxonomies

Grant, M. J., and A. Booth. "A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies."  Health Information and Libraries Journal  26.2 (2009): 91-108.  DOI: 10.1111/j.1471-1842.2009.00848.x  Link

Munn, Zachary, et al. “Systematic Review or Scoping Review? Guidance for Authors When Choosing between a Systematic or Scoping Review Approach.” BMC Medical Research Methodology , vol. 18, no. 1, Nov. 2018, p. 143. DOI: 10.1186/s12874-018-0611-x. Link

Sutton, A., et al. "Meeting the Review Family: Exploring Review Types and Associated Information Retrieval Requirements."  Health Information and Libraries Journal  36.3 (2019): 202-22.  DOI: 10.1111/hir.12276  Link

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• Next: The Systematic Review Process >>
• Last Updated: Aug 29, 2024 3:55 PM
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• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

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

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

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Updates & Corrections

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

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

Article   Google Scholar  

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

Article   PubMed   Google Scholar  

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

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

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Libraries | Research Guides

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

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

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

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

• Next: Planning the Review >>
• Last Updated: Jul 8, 2024 11:22 AM
• URL: https://libguides.northwestern.edu/literaturereviews

Types of Articles found in Scholarly Journals

• How to Limit to Empirical Articles

Literature Review Articles

• Theoretical Articles
• News, Book Reviews, Opinion, Letters to the Editor, etc.
• Video: How to Read a Scholarly Article

What if I see words often found in other articles?

Since literature reviews reference others articles, you may find the buzz words commons in theoretical and empirical articles..  Existence of these words is common in review articles.   The phrase literature review is option predominantly featured in the title or abstract. These are really great finds for your research to help you lead ahead in your research.

• Purpose of a literature review
• Key Questions for a lit review
• What does a literature review article look like
• There's a literature review in my empirical article

A literature summarizes & analyzes published work on a topic in order to

• evaluate the state of research on the topic.
• provide an overview of previous research on a topic that critically evaluates, classifies, and compares what has already been published on a particular topic.
• suggest future research and/or gaps in knowledge.
• synthesize and place into context original research and scholarly literature relevant to the topic (as in the literature review prior within an empirical research article.

A literature review should try to answer questions such as

1. Who are the key researchers on this topic?

2. What has been the focus of the research efforts so far and what is the current status?

3. How have certain studies built on prior studies? Where are the connections? Are there new interpretations of the research?

4. Have there been any controversies or debates about the research? Is there a consensus? Are there any contradictions?

5. Which areas have been identified as needing further research? Have any pathways been suggested?

6. How will your topic uniquely contribute to this body of knowledge?

7. Which methodologies have researchers used and which appear to be the most productive?

8. What sources of information or data were identified that might be useful to you?

9. How does your particular topic fit into the larger context of what has already been done?

10. How has the research that has already been done help frame your current investigation?

The format  is usually a bibliographic essay; sources are briefly cited within the body of the essay, with full bibliographic citations at the end.

The introduction should define the topic and set the context for the literature review. It will include the author's perspective or point of view on the topic, how they have defined the scope of the topic (including what's not included), and how the review will be organized. It can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.

The body of the review should organize the research into major topics and subtopics. These groupings may be by subject, (e.g., globalization of clothing manufacturing), type of research (e.g., case studies), methodology (e.g., qualitative), genre, chronology, or other common characteristics. Within these groups the author can then discuss the merits of each article and provide analysis and comparison of the importance of each article to similar ones.

The conclusion will summarize the main findings, make clear how this review of the literature supports (or not) the research to follow, and may point the direction for further research.

The list of references will include full citations for all of the items mentioned in the lit review.

In this context, the "literature" refers published scholarly work in a field. Literature includes journal articles, conference proceedings, technical reports, and books. 

A literature review can also be a short introductory section of a research article, report or policy paper that focuses on recent research. In the anatomy of a scholarly research article example, the literature review is a part of the introduction. Sometimes in empirical research, the literature review is its own section.

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Literature Reviews

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

What is a Literature Review?

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

Librarian Assistance

For help, please contact the librarian for your subject area.  We have a guide to library specialists by subject .

• Last Updated: Aug 26, 2024 5:59 AM
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Pharmacy : Types of Review Articles (Literature, Scoping and Systematic)

• Pharmacy Library (Lower Level, Room 0013)
• Creating a Search Strategy
• Databases (PubMed, Embase, +more)
• Grey Literature Sources (Websites, theses, clinical trials +more)
• Electronic Journals (Browse journals, or look for a place to publish)
• Types of Review Articles (Literature, Scoping and Systematic)
• Research Methods (Designing your own research; calculating statistics)
• Indigenous Research and Resources
• Patents - Where to Search
• Artificial Intelligence Tools for Research
• Critical Appraisal
• Cite Using the AMA Style
• Reference (Citation) Management Programs - Zotero, RefWorks, Mendeley
• Writing Tips
• Research Data Management

Their Uniqueness, Characteristics and Differences

• Types of Review Articles

The above slides explore:

• The purpose of each type of review article
• Their methodology
• Practical examples for each article type
• Systematic Reviews, Scoping Reviews, and other Knowledge Syntheses (McGill University) Learn about the different types of knowledge syntheses and how to conduct them.
• Knowledge syntheses: Systematic & Scoping Reviews, and other review types (University of Toronto) Useful information and resources on the process of conducting various types of reviews or knowledge syntheses.
• Review Types (Temple University) Outlines other types of reviews like rapid reviews, mixed methods reviews, overview of reviews, etc. For each review, includes: definition, process, timeframe, limitations, + links to useful resources for conducting the review.
• Review Comparison Chart (Unity Health Toronto/St. Michael's Health Sciences Library) Compares the key elements of major knowledge synthesis methodologies in an infographic.
• Knowledge Synthesis Decision Tool (Unity Health Toronto/St. Michael's Health Sciences Library) This tool assists in making a decision about what type of review is right for you based on your research question(s) and the required parameters of each type of review. It is meant to be used with the comparison chart.

Systematic Review Management Software

• Covidence - a systematic review software tool Web-based software to support systematic screening and data abstraction for systematic and scoping reviews. Free for Waterloo students, faculty and researchers.
• Distiller Subscription-based, but student pricing available.
• Rayyan A free web-tool designed to manage the stages of systematic reviews and other knowledge synthesis projects.

What is the Project's Goal?

Always ask yourself:

• Do I want to systematically/comprehensively search the literature?
• Or, do I want to conduct a systematic review?

Conducting a comprehensive search of the literature involves very different methods than a systematic review. If you are unsure as to which project best meets your needs, consult the Pharmacy Liaison Librarian, Caitlin Carter at [email protected]

Writing the Protocol (Plan)

• What information should be provided in a protocol? (University of Toronto)
• JBI Chapter 11: Scoping Reviews (see 11.2, "Development of a Scoping Review Protocol")
• Template for a systematic literature review protocol (Durham University)
• Knowledge Synthesis Protocol Template (Unity Health Toronto/St. Michael's Health Sciences Library)

Avoid duplication: register your scoping or systematic review protocol (plan)

• Where to prospectively register a systematic review? A short article describing the differences between the various available registration options.
• PROSPERO Protocol registry for systematic reviews. Does not accept scoping reviews or literature reviews. Research topic must be health or social care related.
• Joanna Briggs Institute Registry Register scoping and systematic reviews (must be JBI-affiliated).
• Research Registry Register reviews, randomized controlled trials, case reports, cohort studies, etc.
• Center for Open Science Register any research type.
• Protocols.io Register any research type.
• Nature's Protocol Exchange Protocols from all areas of the natural sciences.

Literature (Narrative) Reviews

These resources offer practical insight into literature reviews:

• The literature review: A few tips on conducting it
• Literature reviews: An overview for graduate students (video)
• Health sciences literature review made easy: The matrix method
• Doing a literature review in health and social care: A practical guide
• Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade
• The four-part literature review process: breaking it down for students
• Advanced Research Skills: Conducting Literature and Systematic Reviews (free, online short course)

Scoping Reviews

These resources offer practical insight into scoping reviews:

• Scoping studies: Towards a methodological framework
• Enhancing the scoping study methodology: A large, inter-professional team’s experience with Arksey and O’Malley’s framework
• Scoping studies: Advancing the methodology
• The Joanna Briggs Institute - Chapter 11: Scoping Reviews
• Updated methodological guidance for the conduct of scoping reviews

Systematic Reviews

These resources offer practical insight into systematic reviews:

• Cochrane handbook for systematic reviews of interventions
• Systematic Reviews: The Process (Duke University)
• Database of Abstracts of Reviews of Effects (DARE) Find out if reviews and economic evaluations have already been done before embarking on new projects. Last batch of records was added in 2015.
• PRISMA - what to report in a systematic review
• Doing a systematic review: A student's guide Available in PRINT in Pharmacy Library, Call number: R853.S94 D65 2017
• Finding what works in health care: Standards for systematic reviews Click on "download free PDF"
• Systematic Reviews (University of Ottawa) Systematic Reviews explained using the PIECES Model: planning, identifying, evaluating, collecting and combining, explaining and summarizing.

Library Support for Systematic Reviews

• UW Library Systematic Review Support Overview of the types of UW Library support for systematic/scoping review projects.
• UW Library Systematic Review Protocol Use the "UW Library Systematic Review Protocol" to identify the various aspects of your systematic review (SR) project. This protocol will help minimize the likelihood of bias throughout the SR process, which is vital to a SR.
• << Previous: Electronic Journals (Browse journals, or look for a place to publish)
• Next: Research Methods (Designing your own research; calculating statistics) >>
• Last Updated: Sep 4, 2024 3:42 PM
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How to Write a Literature Review

What is a literature review.

• What Is the Literature
• Writing the Review

A literature review is much more than an annotated bibliography or a list of separate reviews of articles and books. It is a critical, analytical summary and synthesis of the current knowledge of a topic. Thus it should compare and relate different theories, findings, etc, rather than just summarize them individually. In addition, it should have a particular focus or theme to organize the review. It does not have to be an exhaustive account of everything published on the topic, but it should discuss all the significant academic literature and other relevant sources important for that focus.

This is meant to be a general guide to writing a literature review: ways to structure one, what to include, how it supplements other research. For more specific help on writing a review, and especially for help on finding the literature to review, sign up for a Personal Research Session .

The specific organization of a literature review depends on the type and purpose of the review, as well as on the specific field or topic being reviewed. But in general, it is a relatively brief but thorough exploration of past and current work on a topic. Rather than a chronological listing of previous work, though, literature reviews are usually organized thematically, such as different theoretical approaches, methodologies, or specific issues or concepts involved in the topic. A thematic organization makes it much easier to examine contrasting perspectives, theoretical approaches, methodologies, findings, etc, and to analyze the strengths and weaknesses of, and point out any gaps in, previous research. And this is the heart of what a literature review is about. A literature review may offer new interpretations, theoretical approaches, or other ideas; if it is part of a research proposal or report it should demonstrate the relationship of the proposed or reported research to others' work; but whatever else it does, it must provide a critical overview of the current state of research efforts. 

Literature reviews are common and very important in the sciences and social sciences. They are less common and have a less important role in the humanities, but they do have a place, especially stand-alone reviews.

Types of Literature Reviews

There are different types of literature reviews, and different purposes for writing a review, but the most common are:

• Stand-alone literature review articles . These provide an overview and analysis of the current state of research on a topic or question. The goal is to evaluate and compare previous research on a topic to provide an analysis of what is currently known, and also to reveal controversies, weaknesses, and gaps in current work, thus pointing to directions for future research. You can find examples published in any number of academic journals, but there is a series of Annual Reviews of *Subject* which are specifically devoted to literature review articles. Writing a stand-alone review is often an effective way to get a good handle on a topic and to develop ideas for your own research program. For example, contrasting theoretical approaches or conflicting interpretations of findings can be the basis of your research project: can you find evidence supporting one interpretation against another, or can you propose an alternative interpretation that overcomes their limitations?
• Part of a research proposal . This could be a proposal for a PhD dissertation, a senior thesis, or a class project. It could also be a submission for a grant. The literature review, by pointing out the current issues and questions concerning a topic, is a crucial part of demonstrating how your proposed research will contribute to the field, and thus of convincing your thesis committee to allow you to pursue the topic of your interest or a funding agency to pay for your research efforts.
• Part of a research report . When you finish your research and write your thesis or paper to present your findings, it should include a literature review to provide the context to which your work is a contribution. Your report, in addition to detailing the methods, results, etc. of your research, should show how your work relates to others' work.

A literature review for a research report is often a revision of the review for a research proposal, which can be a revision of a stand-alone review. Each revision should be a fairly extensive revision. With the increased knowledge of and experience in the topic as you proceed, your understanding of the topic will increase. Thus, you will be in a better position to analyze and critique the literature. In addition, your focus will change as you proceed in your research. Some areas of the literature you initially reviewed will be marginal or irrelevant for your eventual research, and you will need to explore other areas more thoroughly. 

Examples of Literature Reviews

See the series of Annual Reviews of *Subject* which are specifically devoted to literature review articles to find many examples of stand-alone literature reviews in the biomedical, physical, and social sciences. 

Research report articles vary in how they are organized, but a common general structure is to have sections such as:

• Abstract - Brief summary of the contents of the article
• Introduction - A explanation of the purpose of the study, a statement of the research question(s) the study intends to address
• Literature review - A critical assessment of the work done so far on this topic, to show how the current study relates to what has already been done
• Methods - How the study was carried out (e.g. instruments or equipment, procedures, methods to gather and analyze data)
• Results - What was found in the course of the study
• Discussion - What do the results mean
• Conclusion - State the conclusions and implications of the results, and discuss how it relates to the work reviewed in the literature review; also, point to directions for further work in the area

Here are some articles that illustrate variations on this theme. There is no need to read the entire articles (unless the contents interest you); just quickly browse through to see the sections, and see how each section is introduced and what is contained in them.

The Determinants of Undergraduate Grade Point Average: The Relative Importance of Family Background, High School Resources, and Peer Group Effects , in The Journal of Human Resources , v. 34 no. 2 (Spring 1999), p. 268-293.

This article has a standard breakdown of sections:

• Introduction
• Literature Review
• Some discussion sections

First Encounters of the Bureaucratic Kind: Early Freshman Experiences with a Campus Bureaucracy , in The Journal of Higher Education , v. 67 no. 6 (Nov-Dec 1996), p. 660-691.

This one does not have a section specifically labeled as a "literature review" or "review of the literature," but the first few sections cite a long list of other sources discussing previous research in the area before the authors present their own study they are reporting.

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Literature Reviews: Types of Literature

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• Types of Clinical Study Designs

Types of Literature

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• 4. Read & Analyze the Literature
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Different types of publications have different characteristics.

Primary Literature Primary sources means original studies, based on direct observation, use of statistical records, interviews, or experimental methods, of actual practices or the actual impact of practices or policies. They are authored by researchers, contains original research data, and are usually published in a peer-reviewed journal. Primary literature may also include conference papers, pre-prints, or preliminary reports. Also called empirical research .

Secondary Literature Secondary literature consists of interpretations and evaluations that are derived from or refer to the primary source literature. Examples include review articles (such as meta-analysis and systematic reviews) and reference works. Professionals within each discipline take the primary literature and synthesize, generalize, and integrate new research.

Tertiary Literature Tertiary literature consists of a distillation and collection of primary and secondary sources such as textbooks, encyclopedia articles, and guidebooks or handbooks. The purpose of tertiary literature is to provide an overview of key research findings and an introduction to principles and practices within the discipline.

Adapted from the Information Services Department of the Library of the Health Sciences-Chicago , University of Illinois at Chicago.

Types of Scientific Publications

These examples and descriptions of publication types will give you an idea of how to use various works and why you would want to write a particular kind of paper.

• Scholarly article aka empirical article
• Review article
• Conference paper

Scholarly (aka empirical) article -- example

Empirical studies use data derived from observation or experiment. Original research papers (also called primary research articles) that describe empirical studies and their results are published in academic journals.  Articles that report empirical research contain different sections which relate to the steps of the scientific method.

      Abstract - The abstract provides a very brief summary of the research.

     Introduction - The introduction sets the research in a context, which provides a review of related research and develops the hypotheses for the research.

     Method - The method section describes how the research was conducted.

     Results - The results section describes the outcomes of the study.

     Discussion - The discussion section contains the interpretations and implications of the study.

     References - A references section lists the articles, books, and other material cited in the report.

Review article -- example

A review article summarizes a particular field of study and places the recent research in context. It provides an overview and is an excellent introduction to a subject area. The references used in a review article are helpful as they lead to more in-depth research.

Many databases have limits or filters to search for review articles. You can also search by keywords like review article, survey, overview, summary, etc.

Conference proceedings, abstracts and reports -- example

Conference proceedings, abstracts and reports are not usually peer-reviewed.  A conference article is similar to a scholarly article insofar as it is academic. Conference articles are published much more quickly than scholarly articles. You can find conference papers in many of the same places as scholarly articles.

How Do You Identify Empirical Articles?

To identify an article based on empirical research, look for the following characteristics:

     The article is published in a peer-reviewed journal .

     The article includes charts, graphs, or statistical analysis .

     The article is substantial in size , likely to be more than 5 pages long.

     The article contains the following parts (the exact terms may vary): abstract, introduction, method, results, discussion, references .

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Guide to Scholarly Articles

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Types of Scholarly Articles

Qualitative, quantitative, and mixed-methods articles, why does this matter.

• Anatomy of Scholarly Articles
• Tips for Reading Scholarly Articles

Scholarly articles come in many different formats each with their own function in the scholarly conversation. The following are a few of the major types of scholarly articles you are likely to encounter as you become a part of the conversation. Identifying the different types of scholarly articles and knowing their function will help you become a better researcher.

Original/Empirical Studies

• Note: Empirical studies can be subdivided into qualitative studies, quantitative studies, or mixed methods studies. See below for more information  
• Usefulness for research:  Empirical studies are useful because they provide current original research on a topic which may contain a hypothesis or interpretation to advance or to disprove. 

Literature Reviews

• Distinguishing characteristic:  Literature reviews survey and analyze a clearly delaminated body of scholarly literature.  
• Usefulness for research: Literature reviews are useful as a way to quickly get up to date on a particular topic of research.

Theoretical Articles

• Distinguishing characteristic:  Theoretical articles draw on existing scholarship to improve upon or offer a new theoretical perspective on a given topic.
• Usefulness for research:  Theoretical articles are useful because they provide a theoretical framework you can apply to your own research.

Methodological Articles

• Distinguishing characteristic:  Methodological articles draw on existing scholarship to improve or offer new methodologies for exploring a given topic.
• Usefulness for research:  Methodological articles are useful because they provide a methodologies you can apply to your own research.

Case Studies

• Distinguishing characteristic:  Case studies focus on individual examples or instances of a phenomenon to illustrate a research problem or a a solution to a research problem.
• Usefulness for research:  Case studies are useful because they provide information about a research problem or data for analysis.

Book Reviews

• Distinguishing characteristic:  Book reviews provide summaries and evaluations of individual books.
• Usefulness for research:  Book reviews are useful because they provide summaries and evaluations of individual books relevant to your research.

Adapted from the Publication manual of the American Psychological Association : the official guide to APA style. (Sixth edition.). (2013). American Psychological Association.

Qualitative articles  ask "why" questions where as  quantitative  articles  ask "how many/how much?" questions. These approaches are are not mutually exclusive. In fact, many articles combine the two in a  mixed-methods  approach. 

We can think of these different kinds of scholarly articles as different tools designed for different tasks. What research task do you need to accomplish? Do you need to get up to date on a give topic? Find a literature review. Do you need to find a hypothesis to test or to extend? Find an empirical study. Do you need to explore methodologies? Find a methodological article.

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Literature Reviews: An Overview of Systematic, Integrated, and Scoping Reviews

• First Online: 01 October 2023

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• John R. Turner 4  

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Literature reviews are a main part of the research process. Literature Reviews can be stand-alone research projects, or they can be part of a larger research study. In both cases, literature reviews must follow specific guidelines so they can meet the rigorous requirements for being classified as a scientific contribution. More importantly, these reviews must be transparent so that they can be replicated or reproduced if desired. The rigorous requirements set out by the National Science Foundation (NSF) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) aim to support researchers in conducting literature reviews as well as address the replication crisis that has challenged scientific disciplines over the past decade. The current chapter identifies some of the requirements along with highlighting different types of reviews and recommendations for conducting a rigorous review.

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Systematic Reviews and Meta-Analysis: A Guide for Beginners

Literature reviews as independent studies: guidelines for academic practice

Systematic Literature Review

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Turner, J.R. (2023). Literature Reviews: An Overview of Systematic, Integrated, and Scoping Reviews. In: Jagadeesh, G., Balakumar, P., Senatore, F. (eds) The Quintessence of Basic and Clinical Research and Scientific Publishing. Springer, Singapore. https://doi.org/10.1007/978-981-99-1284-1_38

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Literature Reviews, Critiquing, & Synthesizing Literature

• Literature Review

Types of Literature Reviews

Literature review types -- comparing, learning about study designs, critically appraised topics -- writing, integrative lit review.

• Literature Review Steps Videos
• Critiquing Literature / Critical Review
• Synthesizing Literature
• Summarizing Articles
• Other Lit Review LibGuides

Types of Literature Reviews:

Critically Appraised Topic (CATs) :  A critically appraised topic (or CAT) is a short summary of evidence on a topic of interest, usually focused around a clinical question. A CAT is like a shorter and less rigorous version of a systematic review, summarizing the best available research evidence on a topic.

Integrative Review: A review via a systematic approach that uses a detailed search strategy to find relevant evidence to answer a targeted clinical question. Evidence can come from RCTs, observational studies, qualitative research, clinical experts, and other types of evidence. Does not use summary statistics.

Meta-analysis:  a quantitative statistical analysis of several separate but similar experiments or studies in order to test the pooled data for statistical significance.

Narrative or Traditional Review:  Critical research summary on a topic of interest, often to put a research problem into context. Captures a “snapshot” of the clinical problem or issue.

Rapid Review :  A rapid literature review (RLR) is an alternative to systematic literature review (SLR) that can speed up the analysis of newly published data.

Scoping Review  A s coping review is a descriptive approach, designed to chart the literature around a particular topic. It involves an extensive literature search and often uses structured mapping or charting of the literature.

Systematic Review : Comprehensive search strategies and rigorous research appraisal methods surrounding a clinical issue or question. Evidence is primarily based upon  RCTs . Used to summarize, appraise, & communicate contradictory results or unmanageable amounts of research.

Umbrella Review : An umbrella review is a systematic collection and assessment of multiple systematic reviews and meta-analyses on a specific research topic

• Lit Review vs Systematic Rev vs Meta Analysis
• A typology of reviews: an analysis of 14 review types and associated methodologies. Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health information and libraries journal, 26(2), 91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
• Chart comparing Systematic Review Vs Literature Review Chart explaining differences. Chart by L. Kysh, MLIS from U. Ca
• Conducting umbrella reviews Belbasis, L., Bellou, V., & Ioannidis, J. P. (2022). Conducting umbrella reviews. BMJ medicine, 1(1).
• Meeting the review family: exploring review types and associated information retrieval requirements. Sutton, A., Clowes, M., Preston, L., & Booth, A. (2019). Meeting the review family: exploring review types and associated information retrieval requirements. Health Information & Libraries Journal, 36(3), 202-222.
• Part 1: Difference between systematic reviews and rapid reviews (4:43) Cochrane Training video.
• Rapid literature review: definition and methodology Smela, B., Toumi, M., Świerk, K., Francois, C., Biernikiewicz, M., Clay, E., & Boyer, L. (2023). Rapid literature review: definition and methodology. Journal of market access & health policy, 11(1), 2241234. https://doi.org/10.1080/20016689.2023.2241234
• Reviewing Research: Literature Reviews, Scoping Reviews, Systematic Reviews: Differentiating the Three Review Types University of Buffalo LibGuide
• Scoping reviews, systematic reviews, and meta-analysis: Applications in veterinary medicine Sargeant, J. M., & O'Connor, A. M. (2020). Scoping reviews, systematic reviews, and meta-analysis: Applications in veterinary medicine. Frontiers in Veterinary Science, 7, 11-11. https://doi.org/10.3389/fvets.2020.00011
• Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach Munn, Z., Peters, M.D.J., Stern, C. et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 18, 143 (2018). https://doi.org/10.1186/s12874-018-0611-x
• Systematic Review Service: What Type of Review is Right for You? University of Maryland Health Sciences and Human Services Library Decide with type of review. Decision Tree included.
• Systematic vs. Scoping vs. Integrative References Getting Help Systematic vs. Scoping vs. Integrative Review Duquesne University
• What Type of Review is Right for You? Cornell University Library Flowchart to decide about which review to use.
• Combining abbreviated literature searches with single-reviewer screening: Three case studies of rapid reviews. Affengruber, L., Wagner, G., Waffenschmidt, S., Lhachimi, S. K., Nussbaumer-Streit, B., Thaler, K., Griebler, U., Klerings, I., & Gartlehner, G. (2020). Combining abbreviated literature searches with single-reviewer screening: Three case studies of rapid reviews. Systematic Reviews, 9(1), 162-162. https://doi.org/10.1186/s13643-020-01413-7
• Study Design 101 Tutorial by George Washington University. Describes different study designs.

Critically Appraised Topics (CATs)

• CEBMa Guideline for Critically Appraised Topics in Management and Organizations Barends, E., Rousseau, D. M., & Briner, R. B. (2017). CEBMa guideline for critically appraised topics in management and organizations. Center for Evidence-Based Management. https://cebma. org/wp-content/uploads/CEBMa-CAT-Guidelines. pdf.
• Critical Appraisal Skills Programme (CASP) The Critical Appraisal Skills Programme (CASP) was developed in Oxford in 1993 and has since helped to develop an evidence based approach in health and social care, working with local, national and international partner organisations.
• Evidence Based Medicine IV: how to find an evidence-based answer to a clinical question? Make a critically appraised topic! Beckers, G. M. A., Herbst, K., Kaefer, M., Harper, L., Castagnetti, M., Bagli, D., Kalfa, N., Fossum, M., & ESPU Research Committee. (2019). Evidence based medicine IV: How to find an evidence-based answer to a clinical question? make a critically appraised topic. Journal of Pediatric Urology, 15(4), 409-411. https://doi.org/10.1016/j.jpurol.2019.05.009
• EXAMPLE: The Use of Orthotic Insoles to Prevent Lower Limb Overuse Injuries: A Critically Appraised Topic Kelly JL, Valier AR. The Use of Orthotic Insoles to Prevent Lower Limb Overuse Injuries: A Critically Appraised Topic. J Sport Rehabil. 2018 Nov 1;27(6):591-595. doi: 10.1123/jsr.2016-0142. Epub 2018 Oct 13. PMID: 28952905.
• How to Perform a Critically Appraised Topic: Part 1, Ask, Search, and Apply Aine Marie Kelly and Paul Cronin American Journal of Roentgenology November 2011, Volume 197, Number 5
• How to Perform a Critically Appraised Topic: Part 2, Appraise, Evaluate, Generate, and Recommend Aine Marie Kelly and Paul Cronin American Journal of Roentgenology November 2011, Volume 197, Number 5
• How to write a critically appraised topic (CAT) Sadigh, G., Parker, R., Kelly, A. M., & Cronin, P. (2012). How to write a critically appraised topic (CAT). Academic radiology, 19(7), 872–888. https://doi.org/10.1016/j.acra.2012.02.005
• How to write a Critically Appraised Topic: evidence to underpin routine clinical practice Callander J, Anstey AV, Ingram JR, Limpens J, Flohr C, Spuls PI. How to write a Critically Appraised Topic: evidence to underpin routine clinical practice. Br J Dermatol. 2017 Oct;177(4):1007-1013. doi: 10.1111/bjd.15873. Epub 2017 Oct 1. PMID: 28967117.
• What is a Critically Appraised Topic (CAT) Physiopedia

Integrative Review:  A review via a systematic approach that uses a detailed search strategy to find relevant evidence to answer a targeted clinical question. Evidence can come from RCTs, observational studies, qualitative research, clinical experts, and other types of evidence. Does not use summary statistics.

• Conducting integrative reviews: a guide for novice nursing researchers Dhollande S, Taylor A, Meyer S, Scott M. Conducting integrative reviews: a guide for novice nursing researchers. J Res Nurs. 2021 Aug;26(5):427-438. doi: 10.1177/1744987121997907. Epub 2021 Aug 5. PMID: 35251272; PMCID: PMC8894639.
• The integrative review: Updated methodology. Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. https://doi.org/10.1111/j.1365-2648.2005.03621.x
• Strategies for completing a successful integrative review Oermann, M. H., & Knafl, K. A. (2021). Strategies for completing a successful integrative review. Nurse Author & Editor, 31(3-4), 65-68.
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Reproduced from Grant, M. J. and Booth, A. (2009), A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26: 91–108. doi:10.1111/j.1471-1842.2009.00848.x

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A systematic literature review of the clinical and socioeconomic burden of bronchiectasis

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Background The overall burden of bronchiectasis on patients and healthcare systems has not been comprehensively described. Here, we present the findings of a systematic literature review that assessed the clinical and socioeconomic burden of bronchiectasis with subanalyses by aetiology (PROSPERO registration: CRD42023404162).

Methods Embase, MEDLINE and the Cochrane Library were searched for publications relating to bronchiectasis disease burden (December 2017–December 2022). Journal articles and congress abstracts reporting on observational studies, randomised controlled trials and registry studies were included. Editorials, narrative reviews and systematic literature reviews were included to identify primary studies. PRISMA guidelines were followed.

Results 1585 unique publications were identified, of which 587 full texts were screened and 149 were included. A further 189 citations were included from reference lists of editorials and reviews, resulting in 338 total publications. Commonly reported symptoms and complications included dyspnoea, cough, wheezing, sputum production, haemoptysis and exacerbations. Disease severity across several indices and increased mortality compared with the general population was reported. Bronchiectasis impacted quality of life across several patient-reported outcomes, with patients experiencing fatigue, anxiety and depression. Healthcare resource utilisation was considerable and substantial medical costs related to hospitalisations, treatments and emergency department and outpatient visits were accrued. Indirect costs included sick pay and lost income.

Conclusions Bronchiectasis causes significant clinical and socioeconomic burden. Disease-modifying therapies that reduce symptoms, improve quality of life and reduce both healthcare resource utilisation and overall costs are needed. Further systematic analyses of specific aetiologies and paediatric disease may provide more insight into unmet therapeutic needs.

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Bronchiectasis imposes a significant clinical and socioeconomic burden on patients, their families and employers, and on healthcare systems. Therapies that reduce symptoms, improve quality of life and reduce resource use and overall costs are needed. https://bit.ly/4bPCHlp

• Introduction

Bronchiectasis is a heterogeneous chronic respiratory disease clinically characterised by chronic cough, excessive sputum production and recurrent pulmonary exacerbations [ 1 ], and radiologically characterised by the abnormal widening of the bronchi [ 2 ]. Bronchiectasis is associated with several genetic, autoimmune, airway and infectious disorders [ 3 ]. Regardless of the underlying cause, the defining features of bronchiectasis are chronic airway inflammation and infection, regionally impaired mucociliary clearance, mucus hypersecretion and mucus obstruction, as well as progressive structural lung damage [ 4 , 5 ]. These features perpetuate one another in a “vicious vortex” leading to a decline in lung function, pulmonary exacerbations and associated morbidity, mortality and worsened quality of life [ 4 , 5 ]. Bronchiectasis can be further categorised into several infective and inflammatory endotypes and is associated with multiple comorbidities and underlying aetiologies [ 6 ].

Bronchiectasis has been described as an emerging global epidemic [ 7 ], with prevalence and incidence rates increasing worldwide [ 8 – 12 ]. The prevalence of bronchiectasis, as well as of the individual aetiologies, varies widely across geographic regions [ 13 ]. In Europe, the reported prevalence ranges from 39.1 (females) and 33.3 (males) cases per 100 000 inhabitants in Spain and 68 (females) and 65 (males) cases per 100 000 inhabitants in Germany, to as high as 566 cases (females) and 486 cases (males) per 100 000 inhabitants in the UK [ 10 – 12 ]. In the US, the average overall prevalence was reported to be 139 cases per 100 000 [ 14 ], in Israel, the prevalence was reported to be 234 cases per 100 000 [ 15 ], and in China the prevalence was reported to be 174 per 100 000 [ 8 ]. Studies show that bronchiectasis prevalence increases with age [ 14 ]. This may increase the socioeconomic impact of bronchiectasis on countries with disproportionately higher number of older citizens. Large registry studies in patients with bronchiectasis have been published from the US (Bronchiectasis Research Registry) [ 16 ], Europe and Israel (European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC)); the largest and most comprehensive report available to date) [ 17 ], India (EMBARC-India) [ 18 , 19 ], Korea (Korean Multicentre Bronchiectasis Audit and Research Collaboration) [ 20 ] and Australia (Australian Bronchiectasis Registry) [ 21 ].

Although there are currently no approved disease-modifying therapies for bronchiectasis [ 4 ], comprehensive clinical care recommendations for the management of patients with bronchiectasis have been published [ 22 , 23 ]. However, the burden that bronchiectasis imposes on patients and their families, as well as on healthcare systems, payers and employers, remains poorly understood. No review to date has used a systematic method to evaluate the overall disease burden of bronchiectasis. This is the first systematic literature review aimed at investigating and synthesising the clinical and socioeconomic burden of bronchiectasis. A better understanding of the overarching burden of bronchiectasis, both overall and by individual aetiologies and associated diseases, will highlight the need for new therapies and assist healthcare systems in planning care and required resources.

The protocol of this systematic review was registered on PROSPERO (reference number: CRD42023404162).

Search strategy

This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines [ 24 ]. Embase, MEDLINE and the Cochrane Library were searched for studies related to the clinical and socioeconomic burden of bronchiectasis (noncystic fibrosis bronchiectasis (NCFBE) and cystic fibrosis bronchiectasis (CFBE)) using the search terms available in supplementary table S1 . Articles written in English and published over a 5-year period (December 2017–December 2022) were included.

Selection criteria

The following article types reporting on prospective and retrospective observational studies, registry studies and randomised controlled trials (only baseline data extracted) were included: journal articles, preprints, research letters, conference proceedings, conference papers, conference abstracts, meeting abstracts and meeting posters. Reviews, literature reviews, systematic reviews and meta-analyses, as well as editorials, commentaries, letters and letters to the editor, were included for the purpose of identifying primary studies. A manual search of references cited in selected articles was performed and references were only included if they were published within the 5 years prior to the primary article being published.

Screening and data extraction

A reviewer screened all titles and abstracts to identify publications for full-text review. These publications then underwent full-text screening by the same reviewer for potential inclusion. A second reviewer independently verified the results of both the title/abstract screen and the full-text screen. Any discrepancies were resolved by a third independent reviewer. Data relating to aetiology, symptoms, disease severity, exacerbations, lung function, infection, comorbidities, patient-reported outcomes (PROs), exercise capacity, mortality, impact on family and caregivers, healthcare resource utilisation (HCRU), treatment burden, medical costs, and indirect impacts and costs, as well as data relating to the patient population, study design, sample size and country/countries of origin, were extracted from the final set of publications into a standardised Excel spreadsheet by one reviewer. Studies were grouped based on the burden measure, and aggregate data (range of reported values) were summarised in table or figure format. For the economic burden section, costs extracted from studies reporting in currencies other than the euros were converted to euros based on the average exchange rate for the year in which the study was conducted.

Data from patients with specific bronchiectasis aetiologies and in children (age limits varied from study to study and included upper age limits of 15, 18, 19 and 20 years) were reported separately, where available. As literature relating to NCFBE and CFBE is generally distinct, any data related to CFBE are reported separately in the tables and text. We conducted subanalyses of key disease burden indicators, in which we extracted data from multicentre studies or those with a sample size >1000 subjects, to try to identify estimates from the most representative datasets. These data from larger and multicentre studies are reported in square brackets in tables 1 – 3 and supplementary tables S2–S7 , where available.

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Prevalence and severity of bronchiectasis symptoms overall, in children, during exacerbations and in individual bronchiectasis aetiologies

Patient-reported outcome scores in patients with bronchiectasis overall and in individual bronchiectasis aetiologies

Healthcare resource utilisation (HCRU) in patients with bronchiectasis overall and in individual bronchiectasis aetiologies

Given the nature of the data included in this systematic literature review (that is, a broad range of patient clinical and socioeconomic characteristics rather than the outcome(s) of an intervention), in addition to the broad range of study types included, meta-analyses to statistically combine data of similar studies were not deemed appropriate and therefore not performed.

Summary of included studies

A total of 1834 citations were retrieved from the Embase, MEDLINE and Cochrane Library databases, of which 1585 unique citations were identified. Abstract/title screening led to the inclusion of 587 citations for full-text screening. Following full-text screening, 149 primary citations and 110 literature reviews, systematic reviews and meta-analyses as well as editorials and letters to the editor remained. From the reference lists of these 110 citations, a further 189 primary citations were identified. These articles were only included if 1) the primary articles contained data relating to the burden of bronchiectasis and 2) the primary articles were published within the 5 years prior to the original article's publication date. In total, 338 publications were considered eligible and included in this review ( supplementary figure S1 ). This included 279 journal articles, 46 congress abstracts and 13 letters to the editor or scientific/research letters. The results are summarised in the sections below. For the results from individual studies, including a description of the patient population, study design, sample size and country/countries of origin, please see the supplemental Excel file .

The most frequently reported aetiologies included post-infectious, genetic (primary ciliary dyskinesia (PCD), alpha-1 antitrypsin deficiency (AATD) and cystic fibrosis (CF)), airway diseases (COPD and asthma), allergic bronchopulmonary aspergillosis (ABPA), aspiration and reflux-related, immunodeficiency and autoimmune aetiologies ( supplementary figure S2 ). However, in up to 80.7% of adult cases and 53.3% of paediatric cases, the aetiology was not determined (referred to as “idiopathic bronchiectasis”) ( supplementary figure S2 ). When limited to larger or multicentre studies, the frequency of idiopathic bronchiectasis ranged from 11.5 to 66.0% in adults and from 16.5 to 29.4% in children. Further details and additional aetiologies can be seen in the supplemental Excel file .

Clinical burden

Symptom burden and severity.

Commonly reported symptoms in patients with bronchiectasis included cough, sputum production, dyspnoea, wheezing and haemoptysis, with these symptoms more prevalent in adults compared with children ( table 1 ). Other reported symptoms included chest discomfort, pain or tightness (both generally and during an exacerbation), fever and weight loss in both adults and children, and fatigue, tiredness or asthenia, appetite loss, and sweating in adults. In children, respiratory distress, hypoxia during an exacerbation, sneezing, nasal and ear discharge, thriving poorly including poor growth and weight loss, exercise intolerance, malaise, night sweats, abdominal pain, recurrent vomiting, and diarrhoea were reported ( supplemental Excel file ). Classic bronchiectasis symptoms such as sputum production (range of patients reporting sputum production across all studies: 22.0–92.7%) and cough (range of patients reporting cough across all studies: 24.0–98.5%) were not universally reported ( table 1 ).

In a study comparing bronchiectasis (excluding CFBE) in different age groups (younger adults (18–65 years), older adults (66–75 years) and elderly adults (≥76 years) [ 63 ]), no significant differences across age groups were reported for the presence of cough (younger adults: 73.9%; older adults: 72.8%; elderly adults: 72.9%; p=0.90), sputum production (younger adults: 57.8%; older adults: 63.8%; elderly adults: 6.0%; p=0.16) or haemoptysis (younger adults: 16.5%; older adults: 19.3%; elderly adults: 16.3%; p=0.47).

Disease severity

Disease severity was reported according to several measures including the bronchiectasis severity index (BSI), the forced expiratory volume in 1 s (FEV 1 ), Age, Chronic Colonisation, Extension, Dyspnoea (FACED) score and the Exacerbations-FACED (E-FACED) score, all of which are known to be associated with future exacerbations, hospitalisations and mortality ( supplementary table S2 and the supplemental Excel file ). Up to 78.7, 41.8 and 40.8% of patients with bronchiectasis reported severe disease according to the BSI, FACED score and E-FACED score, respectively ( supplementary table S2 ). In most studies, severity scores were greater among people with bronchiectasis secondary to COPD or post-tuberculosis (TB) than idiopathic bronchiectasis ( supplementary table S2 ). No data relating to disease severity were reported for CFBE specifically.

Exacerbations

The number of exacerbations experienced by patients with bronchiectasis in the previous year, per year and during follow-up are presented in figure 1 . For further details, please see the supplemental Excel file . Two studies reported exacerbation length in patients with bronchiectasis; this ranged from 11 to 16 days (both small studies; sample sizes of 191 and 32, respectively) [ 25 , 64 ]. A study in children with NCFBE reported a median of one exacerbation in the previous year. Additionally, the same study reported that 31.1% of children with bronchiectasis experienced ≥3 exacerbations per year [ 65 ].

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Range of bronchiectasis exacerbations in the previous year, per year and in the first and second years of follow-up. # : Two studies reported significant differences in the number of exacerbations experienced in the previous year across individual aetiologies. Study 1 [ 90 ]: Patients with idiopathic bronchiectasis had significantly fewer exacerbations in the previous year compared with other aetiologies (primary ciliary dyskinesia (PCD), COPD and post-infectious) (p<0.021). Study 2 [ 33 ]: significant difference between post-tuberculosis (TB) bronchiectasis (mean: 2.8) and other aetiologies excluding idiopathic bronchiectasis (mean: 1.7) (p<0.05).

Lung function

Reduced lung function was reported across several different measures in adults and children with bronchiectasis overall, including FEV 1 (absolute values and % predicted), forced vital capacity (FVC; absolute values and % pred) and lung clearance index (adults only) ( supplementary table S3 and the supplemental Excel file ). In most studies, lung function was lowest among people with post-TB bronchiectasis and bronchiectasis secondary to COPD or PCD ( supplementary table S2 ). Additional measures of lung function are detailed in the supplemental Excel file . Lung clearance index, considered more sensitive than spirometry to early airway damage, was elevated in two studies in adults with bronchiectasis, with a range of 9.0–12.8 (normal: 6–7 or less) [ 66 , 67 ].

In a study comparing bronchiectasis (people with CFBE excluded) in different age groups, elderly adults (≥76 years) had significantly lower FEV 1 % pred (median: 67) compared with both younger (18–65 years; median: 78) and older adults (66–75 years; median: 75) (p<0.017 for both comparisons) [ 63 ]. FVC % pred was found to be significantly lower in elderly adults (mean: 65) compared with both younger adults (median: 78) and older adults (median: 75) (p<0.017 for both comparisons) [ 63 ].

Chronic infection with at least one pathogen was reported in 22.3–79.6% of patients with bronchiectasis, although each study defined chronic infection differently (number of studies: 20). When limited to larger or multicentre studies, chronic infection with at least one pathogen was reported in 10.7–54.5% of patients with bronchiectasis (number of studies: 12). In two studies in NCFBE, significant differences in the proportion of patients chronically infected with at least one pathogen were reported across aetiologies (p<0.001 for both studies) [ 68 , 69 ]. Patients with post-infectious (other than TB) bronchiectasis (34.9%) [ 68 ] and patients with PCD-related bronchiectasis (68.3%) [ 69 ] had the highest prevalence of chronic infection.

The most commonly reported bacterial and fungal pathogens are shown in supplementary table S4 . The two most common bacterial pathogens were Pseudomonas ( P .) aeruginosa and Haemophilus ( H. ) influenzae . In several studies, more patients with PCD, TB and COPD as the aetiology of their bronchiectasis reported infection with P. aeruginosa . Additionally, in one study, significantly more children with CFBE had P. aeruginosa infection compared with children with NCFBE [ 70 ]. Further details and additional pathogens are reported in the supplemental Excel file .

Diversity of the sputum microbiome was assessed in two studies. In the first study in people with bronchiectasis (people with CFBE excluded), reduced microbiome alpha diversity (defined as the relative abundance of microbial species within a sample), particularly associated with Pseudomonas or Proteobacteria dominance, was associated with greater disease severity, increased frequency and severity of exacerbations, and a higher risk of mortality [ 71 ]. In the second study (unknown whether people with CFBE were excluded), a lower Shannon–Wiener diversity index (a measure of species diversity, with lower scores indicating lower diversity) score was associated with multiple markers of disease severity, including a higher BSI score (p=0.0003) and more frequent exacerbations (p=0.008) [ 72 ].

In a study comparing bronchiectasis (people with CFBE excluded) in different age groups (younger adults: 18–65 years; older adults: 66–75 years; elderly adults: ≥76 years) [ 63 ], chronic infection with H. influenzae was reported in 18.3% of younger adults, 12.8% of older adults and 8.8% of elderly adults, and chronic infection with Streptococcus ( Str. ) pneumoniae was reported in 5.3% of younger adults, 2.8% of older adults and 1.3% of elderly adults. For both of the above, the prevalence was significantly higher in younger adults compared with elderly adults (p<0.017 for both comparisons). However, no significant differences across age groups were reported for P. aeruginosa , Moraxella catarrhalis or Staphylococcus ( Sta .) aureus chronic infection.

P. aeruginosa infection was significantly associated with reduced FEV 1 [ 73 ], more severe disease [ 74 ], more frequent exacerbations [ 35 , 49 , 75 , 76 ], increased hospital admissions, reduced quality of life based on St. George's Respiratory Questionnaire (SGRQ) and increased and 4-year mortality [ 49 , 76 ]. Additionally, in a study reporting healthcare use and costs in the US between 2007–2013, healthcare costs and hospitalisation costs were found to be increased in patients infected with P. aeruginosa ($56 499 and $41 972 more than patients not infected with P. aeruginosa , respectively) [ 77 ]. In the same study, HCRU was also higher in patients infected with P. aeruginosa (fivefold increase in the number of hospitalisations and 84% more emergency department (ED) visits compared with patients not infected with P. aeruginosa ) [ 77 ].

Comorbidities

The most frequently reported comorbidities included cardiovascular (including heart failure, cerebrovascular disease and hypertension), respiratory (including asthma, COPD and sinusitis), metabolic (including diabetes and dyslipidaemia), malignancy (including haematological and solid malignancies), bone and joint-related (including osteoporosis and rheumatological disease), neurological (including anxiety and depression), renal, hepatic, and gastrointestinal comorbidities ( supplementary table S5 ). No data relating to comorbidities were reported for CFBE specifically. For further details and additional comorbidities, please see the supplemental Excel file .

In a study comparing bronchiectasis (people with CFBE excluded) in different age groups (younger adults: 18–65 years; older adults: 66–75 years; elderly adults: ≥76 years), younger adults had a significantly lower prevalence of diabetes compared with older adults, a significantly lower prevalence of stroke compared with elderly adults and a significantly lower prevalence of heart failure, solid tumours and renal failure compared with both older and elderly adults (p<0.0017 for all comparisons). Additionally, the prevalence of COPD was significantly lower in both younger and older adults compared with elderly adults (p<0.017) [ 63 ]. In studies reporting in children with bronchiectasis, the prevalence of comorbid asthma ranged from 22.2 to 25.8% [ 65 , 78 ] and the prevalence of sinusitis was reported to be 12.7% in a single study [ 79 ].

Charlson comorbidity index (CCI)

CCI scores can range from 0 to 37, with higher scores indicating a decreased estimate of 10-year survival. In this review, CCI scores ranged from 0.7 to 6.6 in studies reporting means (number of studies: 7). In one study, adults with bronchiectasis (people with CFBE excluded) who experienced ≥2 exacerbations per year were found to have significantly higher CCI scores (3.3) compared with patients who experienced less than two exacerbations per year (2.2) (p=0.001) [ 35 ]. In another study in adults with bronchiectasis (people with CFBE excluded), CCI scores increased significantly with increasing disease severity, with patients with mild (FACED score of 0–2), moderate (FACED score of 3–4) and severe (FACED score of 5–7) bronchiectasis reporting mean CCI scores of 3.9, 5.7 and 6.3, respectively [ 80 ]. No CCI scores were reported for CFBE specifically.

Prevalence of comorbidities in patients with bronchiectasis compared with control individuals

Several studies reported a higher prevalence of cardiovascular comorbidities. such as heart failure [ 81 ], stroke [ 82 , 83 ] and hypertension [ 82 – 84 ] in patients with bronchiectasis compared with a matched general population or healthy controls. Conversely, several additional studies reported no significant differences [ 81 , 85 , 86 ]. Two large studies reported an increased prevalence of diabetes in patients with bronchiectasis compared with nonbronchiectasis control groups [ 83 , 84 ]; however, three additional smaller studies reported no significant differences [ 81 , 82 , 86 ]. The prevalence of gastro–oesophageal reflux disease was found to be significantly higher in patients with bronchiectasis compared with matched nonbronchiectasis controls in one study [ 87 ], but no significant difference was reported in a second study [ 85 ]. Both anxiety and depression were found to be significantly more prevalent in patients with bronchiectasis compared with matched healthy controls in one study [ 55 ]. Lastly, two large studies reported an increased prevalence of asthma [ 84 , 87 ] and five studies reported a significantly higher prevalence of COPD [ 81 , 82 , 84 , 85 , 87 ] in patients with bronchiectasis compared with matched nonbronchiectasis controls or the general population. A smaller study reported conflicting evidence whereby no significant difference in the prevalence of asthma in patients with bronchiectasis compared with matched controls was reported [ 85 ].

Socioeconomic burden

Patient-reported outcomes.

Health-related quality of life (HRQoL), fatigue, anxiety and depression were reported across several PRO measures and domains. The most frequently reported PROs are discussed in further detail in the sections below ( table 2 ). Further details and additional PROs can be seen in the supplemental Excel file .

In a study comparing bronchiectasis (people with CFBE excluded) in different age groups (younger adults: 18–65 years; older adults: 66–75 years; elderly adults: ≥76 years), the median SGRQ total score was significantly higher in elderly adults (50.8) compared with younger adults (36.1), indicating a higher degree of limitation (p=0.017) [ 63 ].

In a study that reported Leicester Cough Questionnaire (LCQ) scores in men and women with bronchiectasis (people with CFBE excluded) separately, women had significantly lower LCQ total scores (14.9) when compared with men (17.5) (p=0.006), indicating worse quality of life [ 88 ]. Additionally, women had significantly lower scores across all three LCQ domains (p=0.014, p=0.005 and p=0.011 for physical, psychological and social domains, respectively) [ 88 ].

Exercise capacity

Exercise capacity in patients with bronchiectasis was reported using walking tests namely the 6-minute walk test (6MWT) and the incremental shuttle walk test (ISWT) ( supplementary table S6 ). The 6MWT data from patients with bronchiectasis generally fell within the normal range for healthy people; however, the ISWT data was below the normal range for healthy people ( supplementary table S6 ). Studies also reported on daily physical activity, daily sedentary time and number of steps per day in patients with bronchiectasis, and in children specifically ( supplementary table S6 ). No data relating to disease severity were reported for CFBE specifically. Further details can be seen in the supplemental Excel file .

Exercise capacity in patients with bronchiectasis compared with control individuals

In one study, the ISWT distance was reported to be significantly lower in patients with NCFBE compared with healthy controls (592.6 m versus 882.9 m; difference of ∼290 m; p<0.001) [ 89 ]. Additionally, patients with bronchiectasis spent significantly less time on activities of moderate and vigorous intensity compared with healthy controls (p=0.030 and 0.044, respectively) [ 89 ]. Lastly, a study reported that patients with NCFBE had a significantly lower step count per day compared with healthy controls (p<0.001) [ 89 ].

Mortality rate during study period

Mortality ranged from 0.24 to 67.6%; however, it should be noted that the study duration differed across studies. When limited to larger or multicentre studies, the mortality rate ranged from 0.24 to 28.1%. One study reported more deaths in patients with NCFBE (9.1%; 5.9-year mean follow-up period) compared with patients without bronchiectasis (0.8%; 5.4-year mean follow-up period) [ 84 ]. In one study, significantly more patients with COPD-related bronchiectasis died (37.5%) compared with other aetiologies (19.0%) (3.4-year mean follow-up period; p<0.001). After adjusting for several factors, multivariate analysis showed that the diagnosis of COPD as the primary cause of bronchiectasis increased the risk of death by 1.77 compared with the patients with other aetiologies [ 41 ]. Similarly, in another study, COPD-associated bronchiectasis was associated with higher mortality (55%) in multivariate analysis as compared with other aetiologies (rheumatic disease: 20%; post-infectious: 16%; idiopathic: 14%; ABPA: 13%; immunodeficiency: 11%) (hazard ratio 2.12, 95% CI 1.04–4.30; p=0.038; 5.2-year median follow-up period) [ 90 ].

Mortality rates by year

The 1-, 2-, 3-, 4- and 5-year mortality rates in patients with bronchiectasis (people with CFBE excluded, unless unspecified) ranged from 0.0 to 12.3%, 0.0 to 13.0%, 0.0 to 21.0%, 5.5 to 39.1% and 12.4 to 53.0%, respectively (number of studies: 9, 4, 7, 1 and 4, respectively). When limited to larger or multicentre studies, the 1-, 2-, 3- and 5-year mortality rates ranges were 0.4–7.9%, 3.9–13.0%, 3.7–21.0% and 12.4–53.0% (no 4-year mortality data from larger or multicentre studies). No data relating to mortality rates were reported for CFBE specifically.

Two studies reported mortality rate by bronchiectasis aetiology (people with CFBE excluded). In the first study, no significant difference in the 4-year mortality rate was reported across aetiologies (p=0.7; inflammatory bowel disease: 14.3%; post-TB: 13.4%; rheumatoid arthritis: 11.4%; idiopathic or post-infectious: 10.1%; ABPA: 6.1%; other aetiologies: 6.1%) [ 49 ]. In the second study, patients with post-TB bronchiectasis had a significantly higher 5-year mortality rate (30.0%) compared with patients with idiopathic bronchiectasis (18.0%) and other aetiologies (10.0%) (p<0.05 for both comparisons) [ 32 ].

In-hospital and intensive care unit mortality

In-hospital mortality ranged from 2.9 to 59.3% in patients with bronchiectasis (people with CFBE excluded, unless unspecified) hospitalised for an exacerbation or for other reasons (number of studies: 7). When limited to larger or multicentre studies, in-hospital mortality rate was reported in only one study (33.0%). One study reported mortality in bronchiectasis patients admitted to a tertiary care centre according to aetiology; in-hospital mortality was highest in patients with post-pneumonia bronchiectasis (15.8%), followed by patients with idiopathic (7.1%) and post-TB (2.6%) bronchiectasis. No deaths were reported in patients with COPD, ABPA or PCD aetiologies [ 42 ]. Intensive care unit mortality was reported in two studies and ranged from 24.6 to 36.1% [ 62 , 91 ]. No data relating to mortality rates were reported for CFBE specifically.

Impact on family and caregivers

Only two studies discussed the impact that having a child with bronchiectasis has on parents/caregivers. In the first study, parents of children with bronchiectasis (not specified whether children with CFBE were excluded) were more anxious and more depressed according to both the Hospital Anxiety and Depression Scale (HADS) and the Centre of Epidemiological Studies depression scale, compared with parents of children without any respiratory conditions (both p<0.001; sample size of 29 participants) [ 53 ]. In the second study, parents or carers of children with bronchiectasis (multicentre study with a sample size of 141 participants; children with CFBE excluded) were asked to vote for their top five greatest concerns or worries; the most common worries or concerns that were voted for by over 15% of parents were “impact on his/her adult life in the future, long-term effects, normal life” (29.8%), “ongoing declining health” (25.5%), “the cough” (24.8%), “impact on his/her life now as a child (play, development)” (24.1%), “lack of sleep/being tired” (24.1%), “concerns over aspects of antibiotic use” (22.7%), “missing school or daycare” (17.7%) and “breathing difficulties/shortness of breath” (16.3%) [ 92 ].

HCRU in terms of hospitalisations, ED visits, outpatient visits and length of stay overall and by bronchiectasis aetiology are reported in table 3 . No data relating to HCRU were reported for CFBE specifically.

In a study in children with bronchiectasis (children with CFBE excluded), 30.0% of children were hospitalised at least once in the previous year [ 65 ]. The median number of hospitalisations per year was 0 (interquartile range: 0–1) [ 65 ]. In another study, the mean length of hospital stay for children with bronchiectasis was 6.7 days (standard deviation: 4.8 days) [ 93 ]. In a study comparing bronchiectasis (people with CFBE excluded) in different age groups, significantly more elderly adults (≥76 years; 26.0%) were hospitalised at least once during the first year of follow-up compared with younger adults (18–65 years; 17.0%) and older adults (66–75 years; 17.0%) (p<0.017 for both comparisons) [ 63 ]. Additionally, length of stay was found to be significantly longer in male patients (mean: 17.6 days) compared with female patients (mean: 12.5 days) (p=0.03) [ 94 ].

HCRU in patients with bronchiectasis compared with control individuals

Length of stay was found to be 38% higher in patients with bronchiectasis (mean: 15.4 days; people with CFBE excluded) compared with patients with any other respiratory illness (mean: 9.6 days) (p<0.001) [ 94 ]. In a study reporting on HCRU in patients with bronchiectasis (people with CFBE excluded) over a 3-year period (Germany; 2012–2015) [ 85 ], a mean of 24.7 outpatient appointments per patient were reported; there was no significant difference in the number of outpatient appointments between patients with bronchiectasis and matched controls (patients without bronchiectasis matched by age, sex and distribution, and level of comorbidities) (mean: 23.4) (p=0.12). When assessing specific outpatient appointments over the 3-year period, patients with bronchiectasis attended a mean of 9.2 general practitioner appointments, 2.9 radiology appointments, 2.5 chest physician appointments and 0.8 cardiologist appointments. Patients with bronchiectasis had significantly fewer general practitioner appointments compared with matched controls (mean: 9.8) (p=0.002); however, they had significantly more radiology appointments (mean for matched controls: 2.3) and chest physician appointments (mean for matched controls: 1.4) compared with matched controls (p<0.001 for both comparisons).

Hospital admission rates

In England, Wales and Northern Ireland, the crude hospital admission rate in 2013 was 88.4 (95% CI 74.0–105.6) per 100 000 person-years [ 91 ]. In New Zealand (2008–2013), the crude and adjusted hospital admission rates were 25.7 and 20.4 per 100 000 population, respectively [ 95 ]. Lastly, in Australia and New Zealand (2004–2008) the hospital admission rate ranged from 0.7 to 2.9 per person-year [ 96 ]. In all of the abovementioned studies, people with CFBE were excluded.

Treatment burden

In two studies, the percentage of patients with bronchiectasis receiving any respiratory medication at baseline ranged from 60.8 to 85.7% [ 97 , 98 ]. Additionally, in a study comparing healthcare costs in patients with bronchiectasis before and after confirmation of P. aeruginosa infection, mean pharmacy visits in the year preceding diagnosis were reported to be 23.2; this increased significantly by 56.5% to 36.2 in the year post-diagnosis (p<0.0001) [ 99 ]. In another study, patients with bronchiectasis were prescribed a mean of 12 medications for bronchiectasis and other comorbidities [ 100 ]. In all of the abovementioned studies, people with CFBE were excluded. The most frequently reported respiratory treatments can be seen in supplementary table S7 . These included antibiotics (including macrolides), corticosteroids, bronchodilators, mucolytics and oxygen. No treatment data were reported for CFBE specifically. Other respiratory treatments included saline, anticholinergics and leukotriene receptor antagonists ( supplemental Excel file ).

In studies reporting in children with bronchiectasis, 23.9% of children were receiving any bronchodilator at baseline [ 101 ], 9.0–21.7% of children were receiving inhaled corticosteroids (ICS) at baseline [ 101 , 102 ], 4.3% of children were receiving oral corticosteroids at baseline [ 101 ] and 12.1% of children were receiving long-term oxygen therapy [ 103 ].

Medical and nonmedical indirect impacts and costs

Medical costs for bronchiectasis included overall costs, hospitalisation costs, ED visits and outpatient visit costs and costs of treatment; indirect impacts and costs included sick leave and sick pay, missed work and income loss for caregivers, and missed school or childcare for children ( table 4 and the supplemental Excel file ). People with CFBE were excluded from all of the studies in table 4 below. In studies reporting in currencies other than the €, costs were converted to € based on the average exchange rate for the year in which the study was conducted.

Bronchiectasis-related medical costs and indirect impacts and costs (individual studies)

No review to date has systematically evaluated the overall disease burden of bronchiectasis. Here, we present the first systematic literature review that comprehensively describes the clinical and socioeconomic burden of bronchiectasis overall and across individual aetiologies and associated diseases. A total of 338 publications were included in the final analysis. Together, the results indicate that the burden of clinically significant bronchiectasis on patients and their families, as well as on healthcare systems, is substantial, highlighting the urgent need for new disease-modifying therapies for bronchiectasis.

Bronchiectasis is associated with genetic, autoimmune, airway and infectious disorders. However, in many patients with bronchiectasis, an underlying aetiology cannot be identified (idiopathic bronchiectasis) [ 1 , 3 , 4 ]. This is supported by the results of this systematic literature review, in which up to 80.7% of patients were reported to have idiopathic bronchiectasis. The results are in line with those reported in a systematic literature review of bronchiectasis aetiology conducted by G ao et al. [ 13 ] (studies from Asia, Europe, North and South America, Africa and Oceania included) in which an idiopathic aetiology was reported in approximately 45% of patients with bronchiectasis, with a range of 5–82%. The maximum of 80.7% of patients with idiopathic bronchiectasis identified by this systematic literature review is much higher than in the recent report on the disease characteristics of the EMBARC where idiopathic bronchiectasis was the most common aetiology and reported in only ∼38% of patients with bronchiectasis [ 17 ]. This highlights the importance of sample size and geographic variation (80.7% reported from a single-country study with a small sample size versus ∼38% reported from a continent-wide study with a large sample size). Nevertheless, identifying the underlying aetiology is a recommendation of bronchiectasis guidelines as this can considerably alter the clinical management and prognosis [ 23 , 110 ]. Specific therapeutic interventions may be required for specific aetiologies, such as ICS for people with asthma-related bronchiectasis, antifungal treatment for those with ABPA-associated bronchiectasis and immunoglobulin replacement therapy for those with common variable immunodeficiency-related bronchiectasis [ 23 , 111 ]. Indeed, an observational study has shown that identification of the underlying aetiology affected management in 37% of people with bronchiectasis [ 112 ]. Future studies to determine the impact of identifying the underlying aetiology on management and prognosis are needed to fully understand its importance.

Patients with bronchiectasis experienced a significant symptom burden, with dyspnoea, cough, wheezing, sputum production and haemoptysis reported most commonly. These symptoms were also reported in children with bronchiectasis at slightly lower frequencies. Dealing with bronchiectasis symptoms are some of the greatest concerns from a patient's perspective. In a study assessing the aspects of bronchiectasis that patients found most difficult to deal with, sputum, dyspnoea and cough were the first, fifth and sixth most common answers, respectively [ 113 ]. Some aetiologies were reported to have a higher prevalence of certain symptoms. For example, in single studies, patients with PCD-related bronchiectasis were found to have a significantly higher prevalence of cough and wheezing [ 39 ], patients with COPD-related bronchiectasis were found to have a significantly higher prevalence of sputum production [ 41 ], and patients with post-TB bronchiectasis were found to have a higher prevalence of haemoptysis [ 30 ] compared with other aetiologies. Together, these results highlight the need for novel treatments that reduce the symptom burden of bronchiectasis. They also highlight the importance of teaching patients to perform and adhere to regular nonpharmacological interventions, such as airway clearance using physiotherapy techniques, which have been shown to improve cough-related health status and chronic sputum production [ 110 ]. Future studies assessing when airway clearance techniques should be started, and which ones are the most effective, are a research priority [ 113 ].

The burden of exacerbations in patients with bronchiectasis was high, with patients experiencing three or more exacerbations in the previous year (up to 73.6%), per year (up to 55.6%) or in the first year of follow-up (up to 32.4%). Few studies reported significant differences between aetiologies. Importantly, exacerbations are the second-most concerning aspect of bronchiectasis from the patient's perspective [ 113 ]. Patients with frequent exacerbations have more frequent hospitalisations and increased 5-year mortality [ 114 ] and exacerbations are also associated with poorer quality of life [ 114 , 115 ]. Therefore, prevention of exacerbations is of great importance in the management of bronchiectasis [ 116 ]. The exact cause of exacerbations in bronchiectasis (believed to be multifactorial) is not fully understood due a lack of mechanistic studies [ 116 ]. Future studies into the causes and risk factors for exacerbations [ 113 ] may lead to improvements in their prevention.

Many patients with bronchiectasis, including children, experienced chronic infections with bacterial pathogens such as P. aeruginosa , H. influenzae , Sta. aureus and Str. pneumoniae as well as non-tuberculous mycobacteria. Importantly, P. aeruginosa infection was significantly associated with more severe disease, reduced lung function and quality of life, and increased exacerbations, hospital admission, morality, HCRU and healthcare costs. Due to the clear and consistent association between P. aeruginosa and poor outcomes, patients with chronic P. aeruginosa colonisation should be considered to be at a higher risk of bronchiectasis-related complications [ 110 ]. Additionally, regular sputum microbiology screening should be performed in people with clinically significant bronchiectasis to detect new isolation of P. aeruginosa [ 110 ]; in which case, patients should be offered eradication antibiotic treatment [ 23 ]. Eradication of P. aeruginosa is not only of clinical importance, but also of economic importance due to the associated HCRU and healthcare costs. As such, a better understanding of the key factors leading to P. aeruginosa infection is a priority for future research [ 113 ].

Bronchiectasis markedly impacted HRQoL across several PROs including the SGRQ, Quality of Life–Bronchiectasis score, LCQ, COPD Assessment Test and Bronchiectasis Health Questionnaire. In children with bronchiectasis, significantly lower quality of life (according to the Paediatric Quality of Life Inventory score) compared with age-matched controls was reported [ 53 ]. The majority of studies reporting HRQoL in individual aetiologies and associated diseases either reported in a single aetiology, did not perform any statistical analyses to compare aetiologies, or reported no significant differences across aetiologies. Patients also experienced mild-to-moderate anxiety and depression according to the HADS-Anxiety, HADS-Depression and 9-question Patient Health Questionnaire scores, with very limited data reported in individual aetiologies. When compared with healthy controls, anxiety and depression were found to be significantly more prevalent in patients with bronchiectasis [ 55 ]. Additionally, exercise capacity was reduced, with patients with bronchiectasis reported to spend significantly less time on activities of moderate and vigorous intensity and have a significantly lower step count per day compared with healthy controls [ 89 ]. Improvements in anxiety, depression and exercise capacity are important priorities for people with bronchiectasis; in a study assessing the aspects of bronchiectasis that patients found most difficult to manage, “not feeling fit for daily activities”, anxiety and depression were the fourth, eighth and ninth most common answers, respectively [ 113 ].

The studies relating to HCRU and costs in this review were heterogeneous in terms of methodology, time period, country and currency, making them challenging to compare. Nevertheless, this study found that HCRU was substantial, with patients reporting a maximum of 1.3 hospitalisation, 1.3 ED and 21.0 outpatient visits per year. Length of stay was found to be significantly longer in patients with bronchiectasis compared with patients with any other respiratory illness in one study [ 91 ]. In another study, patients with bronchiectasis reported significantly more specialist appointments (radiologist appointments and chest physician appointments) compared with matched controls [ 85 ]. Patients with bronchiectasis also experienced a significant treatment burden, with up to 36.4, 58.0 and 83.0% of patients receiving long-term inhaled antibiotics, oral antibiotics and macrolides, respectively, up to 80.4% receiving long-term ICS and up to 61.7% and 81.4% receiving long-term long-acting muscarinic antagonists and long-acting beta agonists, respectively. Wide ranges of treatment use were reported in this study, which may reflect geographic variation in treatment patterns. Heterogeneous treatment patterns across Europe were observed in the EMBARC registry data with generally higher medication use in the UK and Northern/Western Europe and lower medication use in Eastern Europe (inhaled antibiotics: 1.8–8.9%; macrolides: 0.9–24.4%; ICS: 37.2–58.5%; long-acting beta agonists: 42.7–52.8%; long-acting muscarinic antagonists: 26.5–29.8%) [ 17 ]. Similarly, data from the Indian bronchiectasis registry indicate that the treatment of bronchiectasis in India is also diverse [ 19 ]. Furthermore, in a comparison of the European and Indian registry data, both long-term oral and inhaled antibiotics were more commonly used in Europe compared with India [ 19 ].

Cost varied widely across studies. However, patients, payers and healthcare systems generally accrued substantial medical costs due to hospitalisations, ED visits, outpatient visits, hospital-in-the-home and treatment-related costs. Other medical costs incurred included physiotherapy and outpatient remedies (including breathing or drainage techniques), outpatient medical aids (including nebulisers and respiration therapy equipment) and the cost of attending convalescence centres. Only one study compared the medical costs in patients with bronchiectasis and matched controls (age, sex and comorbidities) and found that patients with bronchiectasis had significantly higher total direct medical expenditure, hospitalisation costs, treatment costs for certain medications and costs associated with outpatient remedies and medical aids [ 85 ]. Bronchiectasis was also associated with indirect impacts and costs, including sick leave, sick pay and income lost due to absenteeism and missed work, and lost wages for caregivers of patients with bronchiectasis. Children with bronchiectasis also reported absenteeism from school or childcare.

Our findings regarding HRCU and costs in bronchiectasis are mirrored by a recent systematic literature review by R oberts et al . [ 117 ] estimating the annual economic burden of bronchiectasis in adults and children over the 2001–2022 time period. R oberts et al . [ 117 ] found that annual total healthcare costs per adult patient ranged from €3027 to €69 817 (costs were converted from USD to € based on the average exchange rate in 2021), predominantly driven by hospitalisation costs. Likewise, we report annual costs per patient ranging from €218 to €51 033, with annual hospital costs ranging from €1215 to €27 612 (adults and children included) ( table 4 ). Further, R oberts et al . [ 117 ] reports a mean annual hospitalisation rate ranging from 0.11 to 2.9, which is similar to our finding of 0.03–1.3 hospitalisations per year ( table 3 ). With regard to outpatient visits, R oberts et al . [ 117 ] reports a mean annual outpatient respiratory physician attendance ranging from 0.83 to 6.8 visits, whereas we report a maximum of 21 visits per year ( table 3 ). It should be noted, however, that our value is not restricted to visits to a respiratory physician. With regard to indirect annual costs per adult patient, R oberts et al . [ 117 ] reports a loss of income because of illness of €1109–€2451 (costs were converted from USD to € based on the average exchange rate in 2021), whereas we report a figure of ∼€1410 ( table 4 ). Finally, burden on children is similarly reported by us and R oberts et al . [ 117 ], with children missing 12 days of school per year per child ( table 4 ).

Limitations of this review and the existing literature

Due to the nature of this systematic literature review, no formal statistical analyses or formal risk of bias assessments were performed.

Several limitations within the existing literature were identified. Firstly, the vast majority of studies reported patients with NCFBE overall, with limited availability of literature reporting on individual aetiologies and associated disease. Furthermore, where this literature was available, it was limited to a handful of individual aetiologies and associated diseases, and in many of these studies, no statistical analyses to compare different aetiologies and associated disease were performed. Additionally, the methods used to determine aetiologies within individual studies may have differed. Literature on NCFBE and CFBE has traditionally been very distinct; as such, most of the studies included in this review have excluded people with CF. As the general term “CF lung disease” was not included in our search string in order to limit the number of hits, limited data on CFBE are included in this review. Bronchiectasis remains largely under-recognised and underdiagnosed, thus limiting the availability of literature. There is a particular knowledge gap with respect to paediatric NCFBE; however, initiatives such as the Children's Bronchiectasis Education Advocacy and Research Network (Child-BEAR-Net) ( www.improvebe.org ) are aiming to create multinational registries for paediatric bronchiectasis.

There were variations in the amount of literature available for the individual burdens. While there was more literature available on the clinical burden of bronchiectasis, economic data (related to both medical costs and indirect costs) and data on the impact of bronchiectasis on families and caregivers, were limited. Additionally, cost comparisons across studies and populations were difficult due to differences in cost definitions, currencies and healthcare systems.

Sample sizes of the studies included in this systematic literature review varied greatly, with the majority of studies reporting on a small number of participants. Furthermore, many of the studies were single-centre studies, thus limiting the ability to make generalisations about the larger bronchiectasis population, and cross-sectional, thus limiting the ability to assess the clinical and socioeconomic burden of bronchiectasis over a patient's lifetime. Furthermore, there may be potential sex/gender bias in reporting that has not been considered in this systematic literature review.

Finally, for many of the reported outcomes, data varied greatly across studies, with wide estimates for the frequency of different aetiologies and comorbidities as well as disease characteristics such as exacerbations and healthcare costs noted. This reflects the heterogeneity of both the study designs (including sample size and inclusion and exclusion criteria) and the study populations themselves. Additionally, the use of non-standardised terms across articles posed a limitation for data synthesis. Systematic collection of standardised data across multiple centres, with standardised inclusion and exclusion criteria such as that being applied in international registries, is likely to provide more accurate estimates than those derived from small single-centre studies.

• Conclusions

Collectively, the evidence identified and presented in this systematic literature review show that bronchiectasis imposes a significant clinical and socioeconomic burden on patients and their families and employers, as well as on healthcare systems. Disease-modifying therapies that reduce symptoms, improve quality of life, and reduce both HCRU and overall costs are urgently needed. Further systematic analyses of the disease burden of specific bronchiectasis aetiologies and associated disease (particularly PCD-, COPD- and post-TB-associated bronchiectasis, which appear to impose a greater burden in some aspects) and paediatric bronchiectasis (the majority of data included in this study were obtained from adults) may provide more insight into the unmet therapeutic needs for these specific patient populations.

Questions for future research

Further research into the clinical and socioeconomic burden of bronchiectasis for individual aetiologies and associated diseases is required.

• Supplementary material

Supplementary Material

Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

Supplementary figures and tables ERR-0049-2024.SUPPLEMENT

Supplementary Excel file ERR-0049-2024.SUPPLEMENT

• Acknowledgements

Laura Cottino, PhD, of Nucleus Global, provided writing, editorial support, and formatting assistance, which was contracted and funded by Boehringer Ingelheim.

Provenance: Submitted article, peer reviewed.

Conflict of interest: The authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE). J.D. Chalmers has received research grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Gilead Sciences, Grifols, Novartis, Insmed and Trudell, and received consultancy or speaker fees from Antabio, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Insmed, Janssen, Novartis, Pfizer, Trudell and Zambon. M.A. Mall reports research grants paid to their institution from the German Research Foundation (DFG), German Ministry for Education and Research (BMBF), German Innovation Fund, Vertex Pharmaceuticals and Boehringer Ingelheim; consultancy fees from AbbVie, Antabio, Arrowhead, Boehringer Ingelheim, Enterprise Therapeutics, Kither Biotec, Prieris, Recode, Santhera, Splisense and Vertex Pharmaceuticals; speaker fees from Vertex Pharmaceuticals; and travel support from Boehringer Ingelheim and Vertex Pharmaceuticals. M.A. Mall also reports advisory board participation for AbbVie, Antabio, Arrowhead, Boehringer Ingelheim, Enterprise Therapeutics, Kither Biotec, Pari and Vertex Pharmaceuticals and is a fellow of ERS (unpaid). P.J. McShane is an advisory board member for Boehringer Ingelheim's Airleaf trial and Insmed's Aspen trial. P.J. McShane is also a principal investigator for clinical trials with the following pharmaceutical companies: Insmed: Aspen, 416; Boehringer Ingelheim: Airleaf; Paratek: oral omadacycline; AN2 Therapeutics: epetraborole; Renovian: ARINA-1; Redhill; Spero; and Armata. K.G. Nielsen reports advisory board membership for Boehringer Ingelheim. M. Shteinberg reports having received research grants from Novartis, Trudell Pharma and GlaxoSmithKline; travel grants from Novartis, Actelion, Boehringer Ingelheim, GlaxoSmithKline and Rafa; speaker fees from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Insmed, Teva, Novartis, Kamada and Sanofi; and advisory fees (including steering committee membership) from GlaxoSmithKline, Boehringer Ingelheim, Kamada, Syncrony Medical, Zambon and Vertex Pharmaceuticals. M. Shteinberg also reports data and safety monitoring board participation for Bonus Therapeutics, Israel and is an ERS Task Force member on bronchiectasis guideline development. S.D. Sullivan has participated in advisory boards for Boehringer Ingelheim and has research grants from Pfizer, Bayer and GlaxoSmithKline. S.H. Chotirmall is on advisory boards for CSL Behring, Boehringer Ingelheim and Pneumagen Ltd, served on a data and safety monitoring board for Inovio Pharmaceuticals Inc., and has received personal fees from AstraZeneca and Chiesi Farmaceutici.

Support statement: This systematic literature review was funded by Boehringer Ingelheim International GmbH. The authors did not receive payment related to the development of the manuscript. Boehringer Ingelheim was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. Funding information for this article has been deposited with the Crossref Funder Registry .

• Received March 8, 2024.
• Accepted June 4, 2024.
• Copyright ©The authors 2024

This version is distributed under the terms of the Creative Commons Attribution Licence 4.0.

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• Published: 05 September 2024

Exploring instructional design in K-12 STEM education: a systematic literature review

• Suarman Halawa 1 ,
• Tzu-Chiang Lin 2 , 3 &
• Ying-Shao Hsu   ORCID: orcid.org/0000-0002-1635-8213 4  

International Journal of STEM Education volume  11 , Article number:  43 ( 2024 ) Cite this article

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This study aimed to analyze articles published in the Web of Science database from 2012 to 2021 to examine the educational goals and instructional designs for STEM education. We selected articles based on the following criteria: (a) empirical research; (b) incorporating instructional design and strategies into STEM teaching; (c) including intervention; (d) focusing on K-12 education and on assessment of learning outcomes; and (e) excluding higher education and STEAM education. Based on the criteria, 229 articles were selected for coding educational goals and instructional designs for STEM education. The aspects of STEM educational goals were coded including engagement and career choice, STEM literacy, and twenty-first century competencies. The categories of instructional designs for STEM education were examined including design-based learning, inquiry-based learning, project-based learning, and problem-based learning. The results showed that engagement and career choices and STEM literacy were mainly emphasized in STEM education. Design-based learning was adopted more than inquiry-based, project-based, or problem-based learning, and this instructional design was mainly used to achieve STEM literacy. It is suggested that studies on twenty-first century competencies may require more research efforts in future STEM education research.

Introduction

Emphasizing STEM (science, technology, engineering, and mathematics) has been the main focus of policy makers in many countries (English, 2016 ; National Academy of Engineering & National Research Council, 2014 ; National Research Council, 2012 , 2013 ) to meet economic challenges (Kelley & Knowles, 2016 ). Educational systems are accordingly prioritizing STEM to prepare students’ capability for the workplace to face the sophisticated technologies and competitive economy (Kayan-Fadlelmula et al., 2022 ). Hence, students are expected to be interested in STEM so that they will engage in and pursue careers in STEM-related fields (Lie et al., 2019 ; Struyf et al., 2019 ). Besides, we need a new generation that has the abilities to develop proficient knowledge, to apply such knowledge to solve problems, and to face existing and upcoming issues of the twenty-first century (Bybee, 2010 ).

Although STEM education has been proved to benefit students, there is a lack of understanding of instructional design for STEM education, despite the fact that such understanding is critical to research and to classroom practices. Limited understanding of relevant instructional design may lead to problems in implementing STEM education in the classroom. There is hence a need to examine educational goals, specific designs, and features of the instructional designs consistently and specifically documented in the STEM education literature. Therefore, this current study conducted systematic analysis of the literature to understand the educational goals and instructional designs for STEM education. Based on the analysis, we present a thorough picture of how researchers have developed instructional designs for STEM education.

Despite the fact that many researchers have promoted STEM education, the definition of STEM education has not reached a consensus in the literature, and there is a certain degree of disagreement in the scientific community. Lamb et al. ( 2015 ) defined STEM as a broad area encompassing many disciplines and epistemological practices. Other researchers, such as Breiner et al. ( 2012 ), defined STEM as applying transdisciplinary knowledge and skills in solving real-world problems. A similar definition established by Shaughnessy ( 2013 ) regarding STEM education is problem solving based on science and mathematics concepts that incorporate engineering strategies and technology. Another study defined STEM education as teaching approaches based on technology and engineering design that integrate the concepts and practices of science and mathematics (Sanders & Wells, 2006 ). In this study, we clarify STEM education as an approach that utilizes integrations of knowledge and skills from science, technology, engineering, and/or mathematics to solve real-world problems that help students to succeed in school learning, future careers, and/or society.

The definition of STEM as an integrated approach involving science, technology, engineering, and mathematics raises several pertinent questions about its composition and expectations. First, the requirement for all four disciplines to be present in order to qualify an educational program or project as “STEM” is debatable. Conceptually, integrating any two or more fields helps foster the interdisciplinary learning that is the hallmark of STEM education. This flexibility allows educators to tailor their programs to match the available resources and specific learning outcomes without necessarily incorporating all four disciplines in every instance. Regarding the classification of “science” within STEM, it is more a conglomerate of disciplines—such as biology, chemistry, physics, and earth sciences—than a single field. This diversity within science enriches STEM education, providing a broader knowledge base and problem-solving skills. Each scientific discipline brings a unique perspective and set of tools to the interdisciplinary mix, enhancing the complexity and richness of STEM learning experiences.

Furthermore, previous studies have identified several challenges to the implementation of STEM education in the classroom including poor motivation of students, weak connection with individual learners, little support from the school system, poor content without integration across disciplines, lack of quality assessments, poor facilities, and lack of hands-on experience (Ejiwale, 2013 ; Hsu & Fang, 2019 ; Margot & Kettler, 2019 ). To help teachers face challenges in the advancement of STEM education, Hsu and Fang ( 2019 ) proposed a 5-step STEM curriculum designs framework and provided examples of how to apply it to a lesson plan to help teachers design their instruction. This previous study also suggested that researchers conduct more investigations related to instructional design to enrich our understanding of various aspects of STEM education. Teachers of STEM require more opportunities to construct their perspective and a vision of STEM education as well as to conduct appropriate instructional designs. Moreover, from review articles published from 2000 to 2016, Margot and Kettler ( 2019 ) found that in multiple studies concerning similar challenges and supports, teachers believed that the availability of a quality curriculum would enhance the success of STEM education. Teachers need to provide and use an appropriate instructional design for STEM education and understand the educational goals. Therefore, we see the need to conduct research related to STEM education, especially exploring the instructional design because identifying and using a quality instructional design could increase the effectivess of STEM education.

According to the previous literature review, educational goals for instructional design were highlighted in STEM education. First, engagement and career choice need to be emphasized in STEM learning to improve students’ interest and self-efficacy (Vongkulluksn et al., 2018 ). Students need to engage in STEM education to raise their interest and engagement in STEM and to increase and develop a STEM-capable workforce (Honey et al., 2014 ; Hsu & Fang, 2019 ; Schütte & Köller, 2015 ). Engaging students in STEM education could improve their attitudes (Vossen et al., 2018 ) and their interest in STEM fields, and encourage them to pursue STEM careers (Means et al., 2017 ).

Second, STEM literacy needs to be promoted in K-12 schools (Falloon et al., 2020 ; Jackson et al., 2021 ) to develop students’ ability to encounter global challenges (Bybee, 2010 ). Students need to have the ability to apply concepts from science, technology, engineering, and mathematics, and skills to solve problems related to social, personal, and global issues in society (Bybee, 2010 ; Jackson et al., 2021 ). Besides, improving students’ STEM literacy is needed for their decision-making, participation in civic and cultural affairs, and economic productivity (National Academy of Engineering & National Research Council, 2014 ; National Research Council, 2011 ).

Last, regarding the twenty-first century competencies, students are anticipated to have abilities of creativity and innovation, problem solving, critical thinking, collaboration and communication (Boon, 2019 ) as citizens, workers, and leaders in the twenty-first century (Bryan et al., 2015 ; National Academy of Engineering & National Research Council, 2014 ; Stehle & Peters-Burton, 2019 ). These abilities are critical for students to adapt and thrive in a changing world (National Research Council, 2013 ). Also, students need to have the abilities to adapt to the twenty-first century in order to succeed in the new workforce (Bybee, 2013 ).

Considering the achievement of students’ engagement, motivation, STEM literacy, as well as twenty-first century competencies, many countries have significantly enlarged the funding for research and education relevant to STEM (Sanders, 2009 ). One of the strands of the existing research is to help teachers know how to implement STEM education in schools (Aranda, 2020 ; Barak & Assal, 2018 ; English, 2017 ). Researchers have proposed instructional designs for STEM education including design-based learning (Kelley & Knowles, 2016 ; Yata et al., 2020 ), inquiry-based learning (Bybee, 2010 ), project-based learning (Capraro et al., 2013 ), and problem-based learning (Carpraro & Slough, 2013 ).

Design-based learning focuses on technological and engineering design. This instructional design engages students in learning about engineering design practices (Fan et al., 2021 ; Guzey et al., 2016 ; Hernandez et al., 2014 ) through the steps of designing, building, and testing (Yata et al., 2020 ). Design-based learning promotes problem solving, design, building, testing, and communication skills (Johnson et al., 2015 ) and improves students’ interest in STEM activities (Vongkulluksn et al., 2018 ). Also, design-based learning improves students’ engineering abilities and twenty-first century competencies (Wu et al., 2019 ) and attitudes (Vossen et al., 2018 ), and engages them in understanding core disciplinary ideas (Guzey et al., 2016 ).

Inquiry-based learning focuses on engaging students in hands-on activities to investigate scientific phenomena (Lederman & Lederman, 2012 ) and to construct their new knowledge (Bybee, 2010 ; Halawa et al., 2020 ). Students are encouraged to plan and design their experiments, analyze and interpret data, argue, and communicate their findings (Halawa et al., 2023 ; National Research Council, 2012 , 2013 ). Inquiry-based learning is also deemed to improve students’ knowledge, interest, engagement (Sinatra et al., 2017 ) and creativity (Smyrnaiou et al., 2020 ). Besides, researchers have noticed the importance of inquiry-based learning for improving students’ attitudes toward science-related careers (Kim, 2016 ). Although inquiry-based learning mainly focuses on science education to engage students in authentic learning (Halawa et al., 2024 ), it has been known to share common goals and characteristics with mathematics, technology, and engineering (Grangeat et al., 2021 ; Lin et al., 2020 ). Common elements in STEM education are engaging students in asking questions and testing their ideas in a systematic and interactive way (Grangeat et al., 2021 ).

Project-based learning and problem-based learning, both instructional designs, engage students in experiential and authentic learning with open-ended and real-world problems (English, 2017 ). Yet, project-based learning tends to be of longer duration and occurs over an extended period of time (Wilson, 2021 ), while problem-based learning is usually embedded in multiple problems (Carpraro & Slough, 2013 ). STEM project-based learning focuses on engaging students in an ill-defined task within a well-defined outcome situated with a contextually rich task, requiring them to solve certain problems (Capraro et al., 2013 ). Project-based learning and problem-based learning are both used to develop students’ problem solving, creativity, collaboration skills (Barak & Assal, 2018 ), and attitude (Preininger, 2017 ).

According to previous studies, researchers have adopted STEM instructional designs to achieve certain educational goals. For instance, in the aspects of engagement and career choice, Sullivan and Bers ( 2019 ) used design-based learning to improve students’ interest in engineering and students’ performance in elementary school. Kang et al. ( 2021 ) adopted inquiry-based learning for secondary school by embedding careers education to foster the students’ interest in science. Vallera and Bodzin ( 2020 ) adopted project-based learning at primary school in the northeastern United States to improve students’ STEM literacy and attitude. Preininger ( 2017 ) used problem-based learning to influence students’ attitudes toward mathematics and careers involving mathematics. In the aspect of STEM literacy, King and English ( 2016 ) adopted design-based learning to enable students to apply STEM concepts to the model of the construction of an optical instrument. Han et al. ( 2015 ) adopted STEM project-based learning to improve the performance of low-performing students in mathematics. Lastly, regarding the twenty-first century competencies, English et al. ( 2017 ) adopted design-based learning to improve students’ capabilities of handling the complexity of the task (English et al., 2017 ).

In conclusion, studies have grown to explore educational goals related to instructional designs for STEM education. However, consistent and systematic reviews related to instructional designs in K-12 STEM education are comparatively scarce. Although there are some reviews of the STEM education literature (Andrews et al., 2022 ; Gladstone & Cimpian, 2021 ; Kaya-Fadlelmula et al., 2022 ; López et al., 2022 ; Margot & Kettler, 2019 ; Martín-Páez et al., 2019 ; Nguyen et al., 2021 ), it is noteworthy that previous studies only explored undergraduate instruction in STEM education (Andrews et al., 2022 ; Henderson et al., 2011 ; Nguyen et al., 2021 ). Therefore, to fill the research gap, this current study conducted a systematic analysis of literature to understand the educational goals and instructional designs for K-12 STEM education from articles published between 2012 and 2021. The research questions of this study were formulated as follows:

What STEM education goals were more focused on in the reviewed articles? What was the trend of educational goals in the reviewed articles?

What instructional designs were more focused on in the reviewed articles? What was the trend of the instructional design in the review articles?

What instructional designs were more focused on to achieve certain educational goals in the reviewed articles?

What features of instructional designs were more focused on in the reviewed articles?

Data collection

To identify the target literature for further analysis, this study conducted several rounds of searching the Web of Science (WOS) database for articles (Gough et al., 2012 ; Møller & Myles, 2016 ). A systematic literature review using the PRISMA guidelines was used for article selection (Møller & Myles, 2016 ). First, we searched for articles using the keyword “STEM Education” along with “learning”, “teaching”, “curriculum”, and “professional development”, to refine the search results. The search identified a total of 1,531 articles published in the Web of Science from 2012 to 2021 (Fig.  1 ). We initially excluded duplicated articles; the search retrieved a total of 1,513 articles. We then screened the titles, abstract, and keywords of the articles based on the following criteria: (a) empirical research; (b) incorporating instructional design and strategies into STEM teaching; (c) including intervention; (d) focusing on K-12 education and on assessment of learning outcomes; and (e) excluding higher education and STEAM education. During this screening, we discussed which articles met the criteria through round-table discussions, and determined the preliminary target candidates composed of 394 articles. A full-text examination was then conducted. In this round of examination, we removed the articles without clear information about the educational goals and instructional designs related to STEM education. Finally, a corpus of literature comprising 229 articles was formed for further analysis.

PRISMA flow diagram of articles selection

Data analysis

According to the research questions, for this study, we developed a coding framework to conduct content analysis and to categorize the target literature. We first selected paradigmatic references of STEM education and instructional design from high quality publications. These articles provided sets of core concepts and terms to shape the provisional coding categories. We then constantly reviewed the paradigmatic references and discussed them to improve the coding scheme. The final analytic framework with coding categories was developed as follows. The first category, STEM educational goals, includes engagement and career choice (Honey et al., 2014 ; Hsu & Fang, 2019 ), STEM literacy (Falloon et al., 2020 ; Jackson et al., 2021 ), and twenty-first century competencies (Boon, 2019 ) (see Appendix 1). The second category, instructional design, includes design-based learning (Yata et al., 2020 ), inquiry-based learning (Bybee, 2010 ; Halawa et al., 2020 ), project-based learning (Capraro & Slough, 2013 ), and problem-based learning (Priemer et al., 2020 ). From the review articles, we found that 6E - oriented STEM (engage, explore, explain, engineer, enrich, and evaluate) and game-based learning were used for STEM education. These two instructional designs were added to our coding scheme. Articles that did not specify the instructional design were coded as “others”. We then analyzed the outcomes to see whether instructional design successfully improved STEM educational goals. We analyzed design-based, inquiry-based, and project-based learning to achieve engagement and career choice, STEM literacy, and a combination of engagement and career choice and STEM literacy because the selected articles mainly concentrated on them. We categorized the outcomes as positively improved, partially improved, and none (Amador et al., 2021 ). Instructional design that successfully increased STEM educational goals was categorized as positively improved. Instructional design that only increased a part of STEM educational goals was categorized as partially improved. If the instructional design did not increase STEM educational goals, we categorized it as none.

We then extended our coding scheme to identify the features of design-based, inquiry-based, and project-based learning. We focused on these three instructional designs because the selected articles mainly adopted them. Yata et al. ( 2020 ) proposed designing, building, and testing as the features of design-based learning. Other features of instructional designs including questioning or identifying problems, experimenting, analyzing, explaining, collaborating, communicating, and reflecting were proposed as features of inquiry-based learning (Bybee, 2010 ; Halawa et al., 2020 ) and project-based learning (Capraro et al., 2013 ). From the review articles, we found that redesigning was one of the features of instructional design and so added it to the coding scheme. These features of instructional designs were adopted for our coding scheme including questioning or identifying problems, designing, building, testing, experimenting, analyzing, collaborating, reflecting, communicating, and redesigning (Appendix 2). We then calculated the number of articles that adopted these features of instructional designs. We further summarized the features of instructional designs that were frequently used in the selected articles.

In order to make sure the coding process was reliable, we conducted a trial coding by randomly selecting 40 articles and individually categorizing the articles into the aforementioned categories: (a) STEM education goal, and (b) instructional design. Interrater reliability was calculated using a percent agreement metric reaching an acceptable level of 0.85 (McHugh, 2012 ). The discrepancies between authors were negotiated and solved through discussions. The NVivo 11 software was utilized to complete coding works on the remaining articles. We then calculated and reported descriptive statistics of the coded data as the analytic results.

Engagement and career choice as the main focused STEM educational goals

Table 1 shows that more articles focused on engagement and career choice (64 articles) and STEM literacy (61 articles) than twenty-first century competencies (16 articles). The articles also mainly focused on a combination of engagement and career choice and STEM literacy (47 articles) and a combination of engagement and career choice and twenty-first century competencies (18 articles). Nine articles were found that focused on the three learning goals of engagement and career choice, STEM literacy, and twenty-first century competencies.

Table 1 shows the numbers of articles regarding educational goals for STEM education for each 2 years in the review papers. The number of articles per 2 years increased from 2012 to 2021. The trend analysis indicated that engagement and career choice and STEM literacy increased greatly from 2014 to 2021. The numbers of articles focused on the combination of two educational goals (STEM literacy and twenty-first competencies) and three learning goals (engagement and career choice, STEM literacy, and twenty-first competencies) from 2016 to 2021 are also presented.

Design-based and inquiry-based learning as the main instructional designs for STEM

Table 2 reveals the numbers of articles that used instructional design for STEM education. The instructional designs of design-based, inquiry-based, project-based, and problem-based learning were mainly used and continued to be used over the study period. The trend analysis indicated a big jump in design-based, inquiry-based, and project-based learning from 2018 to 2021.

Table 2 also shows the instructional designs and educational goals for STEM from review papers. Most articles adopted design-based (80 articles), inquiry-based (46 articles), project-based (42 articles), and problem-based (27 articles) learning.

Design-based learning mainly used to achieve STEM literacy

The findings shown in Table  3 identified that STEM instructional designs were used differently to achieve engagement and career choice, STEM literacy, and the combination of engagement and career choice and STEM literacy. We found that design-based learning was mainly adopted to achieve STEM literacy (28 articles), while inquiry-based learning was mainly used to achieve engagement and career choice (14 articles) and the combination of engagement and career choice and STEM literacy (14 articles). Also, more articles (15 articles) adopted project-based learning to achieve engagement and career choice. Furthermore, more design-based learning (7 articles) and problem-based learning (4 articles) than inquiry-based learning (2 articles) and project-based learning (1) articles were adopted to achieve twenty-first century competencies.

As we identified that a major portion of the articles adopted design-based learning, inquiry-based learning, and project-based learning focused on engagement and career choice, STEM literacy, and a combination of engagement and career choice and STEM literacy (see Table  3 ), we focused further analysis on the outcomes of STEM educational goals in the articles. The total number of selected articles was 124, of which 54 adopted design-based learning, 37 adopted inquiry-based learning, and 33 adopted project-based learning (Table  4 ).

We categorized the outcomes of STEM education goals into three categories (positively improved, partially improved, and none) (Amador et al., 2021 ). Table 4 shows that the majority of selected articles adopted design-based, inquiry-based, and project-based learning, improving STEM educational goals positively. Most selected articles found that design-based learning positively improved engagement and career choice (10 articles), STEM literacy (26 articles), and a combination of engagement and career choice and STEM literacy (15 articles). Also, most of the selected articles indicated that inquiry learning has a positive impact on engagement and career choice (14 articles), STEM literacy (7 articles), and a combination of engagement and career choice and STEM literacy (13 articles). Project-based learning has demonstrated a beneficial impact on various outcomes, as reported across the selected literature. Specifically, 12 articles documented the enhancement of engagement and career decisions, nine indicated the advancement of STEM literacy, and six discussed a combined effect on engagement, career choice, and STEM literacy.

Frequently used features of STEM instructional designs

To identify the frequently used features of STEM instructional design, we further explored the activities in the selected articles. As previous results show that the major part of articles adopted design-based learning, inquiry-based learning, and project-based learning, we further analyzed the frequently used features of these STEM instructional designs that focused on engagement and career choice, STEM literacy, and combination of engagement and career choice and STEM literacy (see Table  3 ). We selected 54 articles that adopted design-based learning, 37 adopted inquiry-based learning, and 33 adopted project-based learning (Table  5 ).

Frequently used features of design-based learning

Based on the findings, a large portion of the selected articles adopted design-based learning for STEM education (54 articles). Table 5 shows the features that were adopted to implement instructional design for design-based learning. More than half of the selected articles adopted designing, building, testing, collaborating, experimenting, and reflecting. Building (88.9%), designing (87.0%), and testing (70.4%) were used to engage students in engineering (Yata et al., 2020 ). Besides, engaging students in these activities required students to use their knowledge and skills (Kelley & Knowles, 2016 ). For example, Aranda et al. ( 2020 ) and Lie et al. ( 2019 ) implemented design-based learning by asking students to design a process to both prevent and test for cross-pollination of non-GMO from GMO fields. In these selected articles, the curriculums were focused on helping students with designing, building, and testing.

Collaborating, which engages students in working with their classmates in the process of design-based learning, was also mainly emphasized in the selected articles (64.8%). For instance, English and King ( 2019 ) asked students to work with their groups to discuss the possible design of the bridge. Researchers also emphasized experimenting (53.7%) to engage students in design-based learning. English ( 2019 ) engaged students in investigating their feet and shoes. Students collected, represented, analyzed data, and drew conclusions from their findings. Lie et al. ( 2019 ) helped students conduct an investigation to prevent cross-contamination of non-GMO from GMO corn fields. The last critical feature of design-based learning is reflecting (51.9%). In this activity, students engaged in assessing their solutions against a set of criteria and constraints, generating, and evaluating solutions (Cunningham et al., 2019 ). By engaging students in reflecting, students have an opportunity to improve their design and choose their best strategy (Aranda et al., 2020 ; Lie et al., 2019 ).

Frequently used features of inquiry-based learning

As shown in Table  5 , the inquiry-based learning approach was frequently adopted by researchers for STEM education. The features of this approach applied to achieve specific STEM education goals (e.g., engagement and career choice, and STEM literacy) included experimenting (91.9%), collaborating (83.8%), reflecting (62.2%), and communicating (51.4%) (see Table  5 ). This finding indicated that the top three frequently used features of inquiry-based learning in STEM were experimenting, collaborating, and reflecting, which play an essential role when learners try out their ideas about a real-world problem related to STEM. For example, a four-phase inquiry (clarifying the situation, hands-on experiments, representing, analyzing the produced data, and reporting/whole-class discussions) for authentic modeling tasks guided students to develop their credibility of the tasks and to acquire STEM knowledge (Carreira & Baioa, 2018 ).

Frequently used features of project-based learning

As previously mentioned, project-based learning is one of the major approaches to support instructional design in the reviewed STEM education studies. The results shown in Table  5 further indicate the features that researchers tended to integrate into instructional design for project-based learning. More than half (51.5%) of the selected articles reported “reflecting” as a pivotal part of teaching that triggered students’ project-based learning. Reflecting is deemed to depict learners’ active perceptions and deliberation of what they encounter and what they are doing. This may contribute to their competence to retrieve appropriate information, to provide feedback, and to revise the project underlying their learning. For example, in Dasgupta et al.’s ( 2019 ) study, a design journal was utilized to help students’ reflection on what they knew, what is necessary to know, as well as their learning outcomes. Vallera and Bodzin ( 2020 ) also addressed the critical design features of their curriculum to help students achieve information obtaining, evaluating, and communicating in the learning project based on real-world contexts.

Besides, researchers focused on project-based learning regarding STEM have a tendency to foster students’ learning via “identifying problems” (48.5%). These studies can be differentiated into two types based on whether the researchers provided a driving question for the learning project. In Vallera and Bodzin’s ( 2020 ) study, the instructional design arranged a clear-cut driving question to guide students’ thinking about helping farmers to prepare products for sale in a farmers’ market. This led students to extend their thinking and identify further problems while solving the driving question. As for Barak and Assal’s ( 2018 ) study, their instructional design provided open-ended tasks and ill-defined problems. Such arrangements were deemed to afford students’ learning through problem defining and learning objective setting.

It is also noteworthy to mention that the percentages of “experimenting” and “collaborating” in studies involved with project-based learning design were lower than those of studies with design-based learning or inquiry-based learning. However, researchers who were interested in STEM project-based learning would still to some extent agree with instructional design that may provide opportunities to students to access authentic scientific activities and social communications.

This study focused on analyzing the STEM educational goals and instructional designs adopted in the 2012–2021 articles. The findings of this study present knowledge and understanding of the educational goals that need to be considered in STEM education, and how these goals could be achieved by adopting various STEM instructional designs.

Educational goals for STEM education

The majority of reviewed articles adopted instructional designs to achieve the goals of engagement, career choice and STEM literacy. In contrast, few articles focused on twenty-first century competencies. It is not surprising because many recent studies in nature emphasized economic viewpoints and workplace-readiness outcomes in the STEM education field (Cheng et al., 2021 ; Kelley & Knowles, 2016 ). The aspects of engagement and career choice were frequently considered in many previous studies on STEM education (Struyf et al., 2019 ; Vongkulluksn et al., 2018 ; Vossen et al., 2018 ). It indicated that engagement and career choice are important goals for STEM education (Honey et al., 2014 ; Hsu & Fang, 2019 ; Kelley & Knowles, 2016 ). Engaging and motivating students in STEM education are necessary to enhance their understanding of their future careers (Fleer, 2021 ) and to cultivate them to continue STEM learning (Maltese et al., 2014 ). Students who were motivated and interested in STEM education would pursue STEM careers (Maltese & Tai, 2011 ). Furthermore, the aspects of STEM literacy are also addressed in the reviewed articles. The aspects of STEM literacy (e.g., knowledge and capabilities) are deemed important for students’ productive engagement with STEM studies, issues, and practices (Falloon et al., 2020 ). The focus of STEM literacy encourages students to apply their knowledge to life situations and solve problems (Bybee, 2010 ). The importance of STEM literacy has been highlighted in several national documents (e.g., Committee on STEM Education of the National Science & Technology Council, 2018 ; National Research Council, 2011 ; U.S. Department of Education, 2016 ). These findings provide insights into what teaching goals have been focused on in STEM education. For instance, engagement and career choice have been mainly focused on in STEM education because the STEM teaching was designed to connect to the students’ real-world experiences or future professional situations (Strobel et al., 2013 ). The authentic and meaningful experience could engage and motivate students in the activity, and later they should pursue their future careers related to what they have learned.

However, there are few selected articles focused on twenty-first century competencies, although many previous studies considered the twenty-first century competencies as important goals for students. Some studies have advocated that students should be engaged in interdisciplinary sets of complex problems and encourage them to use critical thinking and develop their creativity and innovation as well as collaboration (Finegold & Notabartolo, 2010 ; Jang, 2016 ). Engaging students in STEM education focused on twenty-first century competencies could prepare them for the workplace and help them become successful in STEM-related fields (Jang, 2016 ). Future researchers should consider integrating twenty-first century competencies into STEM education to complement the existing focus on engagement, career choice, and STEM literacy, preparing students for a broader range of skills necessary for the modern workforce.

Instructional design for STEM education

Although the reviewed articles adopted various instructional designs for STEM education, the articles mostly adopted design-based rather than inquiry-based, project-based, or problem-based learning. The findings are in accordance with the existing literature on STEM education. Notably, these results corroborate the conclusions drawn from a comprehensive systematic review conducted by Mclure et al. ( 2022 ). Design-based learning was adopted to achieve the goals of STEM literacy, engagement and career choice, and this instructional design tended to be used more often according to the trend analysis. This indicated that design-based learning was considered as a main instructional design for STEM education. This instructional design has become an essential approach to engaging K-12 students in STEM education (Bybee, 2013 ; National Academy of Engineering & National Research Council, 2014 ; National Research Council, 2013 ). Some researchers claimed that students who participate in design-based learning could make meaningful connections between knowledge and skills by solving problems (English & King, 2019 ; Kelley et al., 2010 ). Design-based learning engages students in authentic problems and challenges that increase their level of engagement (Sadler et al., 2000 ), help students learn fundamental scientific principles (Mehalik et al., 2008 ), and build students’ natural and intuitive experience (Fortus et al., 2004 ). In the process of design, students learn the concepts of science, technology, and mathematics in the process of designing, building, or testing products (Yata et al., 2020 ). For instance, students have to learn the concept of energy to design a house that produces more renewable energy than it consumes over a period of 1 year (Zheng et al., 2020 ). It was also found that the majority of selected articles which adopted design-based learning successfully improved learners’ engagement, career choice, and STEM literacy (Table  4 ). The results align with the findings of a previous meta-analysis focusing on STEM education at the middle school level (Thomas & Larwin, 2023 ). K-12 students’ STEM learning successfully improved because the selected articles reported studies conducting design-based learning in K-12 education. For example, Cunningham et al. ( 2019 ) successfully implemented design-based learning to improve elementary students’ learning outcomes, while Fan et al. ( 2018 ) found that design-based learning positively improved secondary students’ conceptual knowledge and attitude.

However, the selected articles have not equally used the features of design-based learning such as collaborating, reflecting, and redesigning. We identified that the selected articles mainly used designing, building, and testing to engage students in engineering activities. One of the explanations for this finding is that researchers may face challenges in implementing a full cycle of design-based learning because of the time limit of instruction, so they only focus on the process of designing, building, and testing. Collaborating, reflecting, and redesigning should be emphasized while adopting effective design-based learning because students could solve complex problems by collaborating with others. With collaboration, the students can learn/solve problems through discussion within the group. This activity allows students to share new ideas and debate with others to generate solutions. Reflecting on the data and experience allows students to make improvements to their model and leads them to redesign it to produce a better model. This process could also grow students’ science knowledge (Fortus et al., 2004 ). This finding hence suggests future studies, and educators emphasize more collaborating, reflecting, and redesigning for design-based learning for STEM instruction.

Moreover, inquiry-based learning, project-based learning, and problem-based learning were adopted in some selected articles. Inquiry-based learning was considered to enable and to promote connections within and across curriculum disciplines and improve students’ engagement in STEM education (Attard et al., 2021 ). Project-based and problem-based learning can be used to engage students in authentic problems (Blumenfeld et al., 1991 ) and to improve their engagement in STEM education (Beckett et al., 2016 ). Furthermore, we identified that inquiry-based learning mainly engages students in experimenting, collaborating, and reflecting (Kim, 2016 ), and project-based learning (Han et al., 2015 ) mainly engages students in identifying problems and reflecting. This finding reveals the frequently used features of inquiry-based learning and project-based learning. Teachers could use these components of instructional design for preparing their instruction for teaching STEM. Given these findings, it is advisable to explore the integration of inquiry-based, project-based, and problem-based learning alongside design-based learning in STEM education. Such an approach may enhance the effectiveness of STEM education by providing a more comprehensive strategy to improve STEM literacy, engagement, and career choice among K-12 students.

However, we identified that some essentials of these instructional designs have not been included in selected articles. For instance, studies adopting inquiry-based learning rarely asked students to propose their questions, although questioning is one of the frequently used features of inquiry (National Research Council, 2012 , 2013 ). One of the possible explanations for this finding is that students may have a lack of experience with inquiry learning and not know how to formulate meaningful questions, and they may tend to propose low-level factual questions related to their personal interests (Krajcik et al., 1998 ). Besides, STEM education requires students to engage in complex real-world problems, which requires sufficient ability to propose meaningful questions. Yet, we expect that future studies and teachers should encourage students to propose their own questions because questioning improves students’ creativity, critical thinking, and problem solving skills (Hofstein et al., 2005 ). Teachers could start asking students to propose their own questions once they have experience and ability to propose good questions. Krajcik et al. ( 1998 ) suggested providing situations in which students can receive informative and critical feedback from teachers, classmates, and others so as to propose their own significant questions.

Conclusions

From an instructional design perspective, this study provides crucial insights into practical STEM education approaches. The findings underscore the importance of aligning instructional designs with specific STEM educational goals. The trend analysis revealed a significant increase in focus on engagement, career choice, and STEM literacy from 2014 to 2021, with a particularly sharp rise observed between 2018 and 2021. Each instructional design approach demonstrated unique strengths: design-based learning fosters STEM literacy. In contrast, inquiry-based and project-based learning effectively enhanced engagement and career choice. The study delineates specific features of these instructional designs that contribute to their success, such as building and testing in design-based learning, experimenting and collaborating in inquiry-based learning, and reflecting and problem identification in project-based learning.

Furthermore, this study advocates for a deliberate and systematic application of inquiry-based and project-based learning alongside design-based learning. Such integration is likely to cultivate a more dynamic and interactive learning environment that encourages critical thinking, problem-solving, and collaborative skills among students. The integration of twenty-first century competencies in the instructional design of STEM, though less presented, suggests a potential research space for further exploration of STEM teaching. This study recommends an expanded focus on incorporating these competencies to ensure a holistic educational approach that addresses immediate educational goals and equips students with essential skills for future challenges.

Teachers’ limited understanding of STEM instructional design also presents a significant challenge, necessitating targeted professional development initiatives. Educators must comprehend and implement a comprehensive approach that aligns educational goals with appropriate instructional designs to optimize STEM learning outcomes. This approach involves clearly defining learning objectives, such as STEM literacy, selecting suitable instructional designs, and effectively guiding students through the chosen learning process.

The findings in this study furnish instructional designers and educators with a clear framework for developing targeted STEM curricula. The research accentuates the importance of aligning instructional design features with specific educational goals, suggesting that a nuanced, goal-oriented approach to STEM instruction can significantly enhance student outcomes in literacy, engagement, and career readiness. These insights offer a robust foundation for refining and optimizing instructional design strategies in STEM education.

Availability of data and materials

No applicable.

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The authors express their sincere gratitude to the editors and reviewers for their invaluable inputs and suggestions, which have significantly enhanced the quality of this work.

This work was financially supported by the Institute for Research Excellence in Learning Sciences of National Taiwan Normal University (NTNU) from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan.

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SH contributed to the conception of the study, research question, methods, analysis, and interpretation of the data. TC contributed to the data collection, analysis and interpretation of data, and editing of the manuscript. YS contributed to the conception of the study, data analysis and interpretation, and editing of the manuscript. All authors equally contributed to writing, reading, and approving the manuscript.

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Halawa, S., Lin, TC. & Hsu, YS. Exploring instructional design in K-12 STEM education: a systematic literature review. IJ STEM Ed 11 , 43 (2024). https://doi.org/10.1186/s40594-024-00503-5

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DOI : https://doi.org/10.1186/s40594-024-00503-5

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