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Review Typologies

There are many types of evidence synthesis projects, including systematic reviews as well as others. The selection of review type is wholly dependent on the research question. Not all research questions are well-suited for systematic reviews.

  • Review Typologies (from LITR-EX) This site explores different review methodologies such as, systematic, scoping, realist, narrative, state of the art, meta-ethnography, critical, and integrative reviews. The LITR-EX site has a health professions education focus, but the advice and information is widely applicable.

Review the table to peruse review types and associated methodologies. Librarians can also help your team determine which review type might be appropriate for your project. 

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

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 mode

Seeks to identify most significant items in the field

No formal quality assessment. Attempts to evaluate according to contribution

Typically narrative, perhaps conceptual or chronological

Significant component: seeks to identify conceptual contribution to embody existing or derive new theory

Generic term: published materials that provide examination of recent or current literature. Can cover wide range of subjects at various levels of completeness and comprehensiveness. May include research findings

May or may not include comprehensive searching

May or may not include quality assessment

Typically narrative

Analysis may be chronological, conceptual, thematic, etc.

Map out and categorize existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature

Completeness of searching determined by time/scope constraints

No formal quality assessment

May be graphical and tabular

Characterizes quantity and quality of literature, perhaps by study design and other key features. May identify need for primary or secondary research

Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results

Aims for exhaustive, comprehensive searching. May use funnel plot to assess completeness

Quality assessment may determine inclusion/ exclusion and/or sensitivity analyses

Graphical and tabular with narrative commentary

Numerical analysis of measures of effect assuming absence of heterogeneity

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

Requires either very sensitive search to retrieve all studies or separately conceived quantitative and qualitative strategies

Requires either a generic appraisal instrument or separate appraisal processes with corresponding checklists

Typically both components will be presented as narrative and in tables. May also employ graphical means of integrating quantitative and qualitative studies

Analysis may characterise both literatures and look for correlations between characteristics or use gap analysis to identify aspects absent in one literature but missing in the other

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

May or may not include comprehensive searching (depends whether systematic overview or not)

May or may not include quality assessment (depends whether systematic overview or not)

Synthesis depends on whether systematic or not. Typically narrative but may include tabular features

Analysis may be chronological, conceptual, thematic, etc.

Method for integrating or comparing the findings from qualitative studies. It looks for ‘themes’ or ‘constructs’ that lie in or across individual qualitative studies

May employ selective or purposive sampling

Quality assessment typically used to mediate messages not for inclusion/exclusion

Qualitative, narrative synthesis

Thematic analysis, may include conceptual models

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

Completeness of searching determined by time constraints

Time-limited formal quality assessment

Typically narrative and tabular

Quantities of literature and overall quality/direction of effect of literature

Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research evidence (usually including ongoing research)

Completeness of searching determined by time/scope constraints. May include research in progress

No formal quality assessment

Typically tabular with some narrative commentary

Characterizes quantity and quality of literature, perhaps by study design and other key features. Attempts to specify a viable review

Tend to address more current matters in contrast to other combined retrospective and current approaches. May offer new perspectives

Aims for comprehensive searching of current literature

No formal quality assessment

Typically narrative, may have tabular accompaniment

Current state of knowledge and priorities for future investigation and research

Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review

Aims for exhaustive, comprehensive searching

Quality assessment may determine inclusion/exclusion

Typically narrative with tabular accompaniment

What is known; recommendations for practice. What remains unknown; uncertainty around findings, recommendations for future research

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

Aims for exhaustive, comprehensive searching

May or may not include quality assessment

Minimal narrative, tabular summary of studies

What is known; recommendations for practice. Limitations

Attempt to include elements of systematic review process while stopping short of systematic review. Typically conducted as postgraduate student assignment

May or may not include comprehensive searching

May or may not include quality assessment

Typically narrative with tabular accompaniment

What is known; uncertainty around findings; limitations of methodology

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

Identification of component reviews, but no search for primary studies

Quality assessment of studies within component reviews and/or of reviews themselves

Graphical and tabular with narrative commentary

What is known; recommendations for practice. What remains unknown; recommendations for future research

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Methodology

  • Systematic Review | Definition, Example, & Guide

Systematic Review | Definition, Example & Guide

Published on June 15, 2022 by Shaun Turney . Revised on November 20, 2023.

A systematic review is a type of review that uses repeatable methods to find, select, and synthesize all available evidence. It answers a clearly formulated research question and explicitly states the methods used to arrive at the answer.

They answered the question “What is the effectiveness of probiotics in reducing eczema symptoms and improving quality of life in patients with eczema?”

In this context, a probiotic is a health product that contains live microorganisms and is taken by mouth. Eczema is a common skin condition that causes red, itchy skin.

Table of contents

What is a systematic review, systematic review vs. meta-analysis, systematic review vs. literature review, systematic review vs. scoping review, when to conduct a systematic review, pros and cons of systematic reviews, step-by-step example of a systematic review, other interesting articles, frequently asked questions about systematic reviews.

A review is an overview of the research that’s already been completed on a topic.

What makes a systematic review different from other types of reviews is that the research methods are designed to reduce bias . The methods are repeatable, and the approach is formal and systematic:

  • Formulate a research question
  • Develop a protocol
  • Search for all relevant studies
  • Apply the selection criteria
  • Extract the data
  • Synthesize the data
  • Write and publish a report

Although multiple sets of guidelines exist, the Cochrane Handbook for Systematic Reviews is among the most widely used. It provides detailed guidelines on how to complete each step of the systematic review process.

Systematic reviews are most commonly used in medical and public health research, but they can also be found in other disciplines.

Systematic reviews typically answer their research question by synthesizing all available evidence and evaluating the quality of the evidence. Synthesizing means bringing together different information to tell a single, cohesive story. The synthesis can be narrative ( qualitative ), quantitative , or both.

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Systematic reviews often quantitatively synthesize the evidence using a meta-analysis . A meta-analysis is a statistical analysis, not a type of review.

A meta-analysis is a technique to synthesize results from multiple studies. It’s a statistical analysis that combines the results of two or more studies, usually to estimate an effect size .

A literature review is a type of review that uses a less systematic and formal approach than a systematic review. Typically, an expert in a topic will qualitatively summarize and evaluate previous work, without using a formal, explicit method.

Although literature reviews are often less time-consuming and can be insightful or helpful, they have a higher risk of bias and are less transparent than systematic reviews.

Similar to a systematic review, a scoping review is a type of review that tries to minimize bias by using transparent and repeatable methods.

However, a scoping review isn’t a type of systematic review. The most important difference is the goal: rather than answering a specific question, a scoping review explores a topic. The researcher tries to identify the main concepts, theories, and evidence, as well as gaps in the current research.

Sometimes scoping reviews are an exploratory preparation step for a systematic review, and sometimes they are a standalone project.

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systematic review type of research

A systematic review is a good choice of review if you want to answer a question about the effectiveness of an intervention , such as a medical treatment.

To conduct a systematic review, you’ll need the following:

  • A precise question , usually about the effectiveness of an intervention. The question needs to be about a topic that’s previously been studied by multiple researchers. If there’s no previous research, there’s nothing to review.
  • If you’re doing a systematic review on your own (e.g., for a research paper or thesis ), you should take appropriate measures to ensure the validity and reliability of your research.
  • Access to databases and journal archives. Often, your educational institution provides you with access.
  • Time. A professional systematic review is a time-consuming process: it will take the lead author about six months of full-time work. If you’re a student, you should narrow the scope of your systematic review and stick to a tight schedule.
  • Bibliographic, word-processing, spreadsheet, and statistical software . For example, you could use EndNote, Microsoft Word, Excel, and SPSS.

A systematic review has many pros .

  • They minimize research bias by considering all available evidence and evaluating each study for bias.
  • Their methods are transparent , so they can be scrutinized by others.
  • They’re thorough : they summarize all available evidence.
  • They can be replicated and updated by others.

Systematic reviews also have a few cons .

  • They’re time-consuming .
  • They’re narrow in scope : they only answer the precise research question.

The 7 steps for conducting a systematic review are explained with an example.

Step 1: Formulate a research question

Formulating the research question is probably the most important step of a systematic review. A clear research question will:

  • Allow you to more effectively communicate your research to other researchers and practitioners
  • Guide your decisions as you plan and conduct your systematic review

A good research question for a systematic review has four components, which you can remember with the acronym PICO :

  • Population(s) or problem(s)
  • Intervention(s)
  • Comparison(s)

You can rearrange these four components to write your research question:

  • What is the effectiveness of I versus C for O in P ?

Sometimes, you may want to include a fifth component, the type of study design . In this case, the acronym is PICOT .

  • Type of study design(s)
  • The population of patients with eczema
  • The intervention of probiotics
  • In comparison to no treatment, placebo , or non-probiotic treatment
  • The outcome of changes in participant-, parent-, and doctor-rated symptoms of eczema and quality of life
  • Randomized control trials, a type of study design

Their research question was:

  • What is the effectiveness of probiotics versus no treatment, a placebo, or a non-probiotic treatment for reducing eczema symptoms and improving quality of life in patients with eczema?

Step 2: Develop a protocol

A protocol is a document that contains your research plan for the systematic review. This is an important step because having a plan allows you to work more efficiently and reduces bias.

Your protocol should include the following components:

  • Background information : Provide the context of the research question, including why it’s important.
  • Research objective (s) : Rephrase your research question as an objective.
  • Selection criteria: State how you’ll decide which studies to include or exclude from your review.
  • Search strategy: Discuss your plan for finding studies.
  • Analysis: Explain what information you’ll collect from the studies and how you’ll synthesize the data.

If you’re a professional seeking to publish your review, it’s a good idea to bring together an advisory committee . This is a group of about six people who have experience in the topic you’re researching. They can help you make decisions about your protocol.

It’s highly recommended to register your protocol. Registering your protocol means submitting it to a database such as PROSPERO or ClinicalTrials.gov .

Step 3: Search for all relevant studies

Searching for relevant studies is the most time-consuming step of a systematic review.

To reduce bias, it’s important to search for relevant studies very thoroughly. Your strategy will depend on your field and your research question, but sources generally fall into these four categories:

  • Databases: Search multiple databases of peer-reviewed literature, such as PubMed or Scopus . Think carefully about how to phrase your search terms and include multiple synonyms of each word. Use Boolean operators if relevant.
  • Handsearching: In addition to searching the primary sources using databases, you’ll also need to search manually. One strategy is to scan relevant journals or conference proceedings. Another strategy is to scan the reference lists of relevant studies.
  • Gray literature: Gray literature includes documents produced by governments, universities, and other institutions that aren’t published by traditional publishers. Graduate student theses are an important type of gray literature, which you can search using the Networked Digital Library of Theses and Dissertations (NDLTD) . In medicine, clinical trial registries are another important type of gray literature.
  • Experts: Contact experts in the field to ask if they have unpublished studies that should be included in your review.

At this stage of your review, you won’t read the articles yet. Simply save any potentially relevant citations using bibliographic software, such as Scribbr’s APA or MLA Generator .

  • Databases: EMBASE, PsycINFO, AMED, LILACS, and ISI Web of Science
  • Handsearch: Conference proceedings and reference lists of articles
  • Gray literature: The Cochrane Library, the metaRegister of Controlled Trials, and the Ongoing Skin Trials Register
  • Experts: Authors of unpublished registered trials, pharmaceutical companies, and manufacturers of probiotics

Step 4: Apply the selection criteria

Applying the selection criteria is a three-person job. Two of you will independently read the studies and decide which to include in your review based on the selection criteria you established in your protocol . The third person’s job is to break any ties.

To increase inter-rater reliability , ensure that everyone thoroughly understands the selection criteria before you begin.

If you’re writing a systematic review as a student for an assignment, you might not have a team. In this case, you’ll have to apply the selection criteria on your own; you can mention this as a limitation in your paper’s discussion.

You should apply the selection criteria in two phases:

  • Based on the titles and abstracts : Decide whether each article potentially meets the selection criteria based on the information provided in the abstracts.
  • Based on the full texts: Download the articles that weren’t excluded during the first phase. If an article isn’t available online or through your library, you may need to contact the authors to ask for a copy. Read the articles and decide which articles meet the selection criteria.

It’s very important to keep a meticulous record of why you included or excluded each article. When the selection process is complete, you can summarize what you did using a PRISMA flow diagram .

Next, Boyle and colleagues found the full texts for each of the remaining studies. Boyle and Tang read through the articles to decide if any more studies needed to be excluded based on the selection criteria.

When Boyle and Tang disagreed about whether a study should be excluded, they discussed it with Varigos until the three researchers came to an agreement.

Step 5: Extract the data

Extracting the data means collecting information from the selected studies in a systematic way. There are two types of information you need to collect from each study:

  • Information about the study’s methods and results . The exact information will depend on your research question, but it might include the year, study design , sample size, context, research findings , and conclusions. If any data are missing, you’ll need to contact the study’s authors.
  • Your judgment of the quality of the evidence, including risk of bias .

You should collect this information using forms. You can find sample forms in The Registry of Methods and Tools for Evidence-Informed Decision Making and the Grading of Recommendations, Assessment, Development and Evaluations Working Group .

Extracting the data is also a three-person job. Two people should do this step independently, and the third person will resolve any disagreements.

They also collected data about possible sources of bias, such as how the study participants were randomized into the control and treatment groups.

Step 6: Synthesize the data

Synthesizing the data means bringing together the information you collected into a single, cohesive story. There are two main approaches to synthesizing the data:

  • Narrative ( qualitative ): Summarize the information in words. You’ll need to discuss the studies and assess their overall quality.
  • Quantitative : Use statistical methods to summarize and compare data from different studies. The most common quantitative approach is a meta-analysis , which allows you to combine results from multiple studies into a summary result.

Generally, you should use both approaches together whenever possible. If you don’t have enough data, or the data from different studies aren’t comparable, then you can take just a narrative approach. However, you should justify why a quantitative approach wasn’t possible.

Boyle and colleagues also divided the studies into subgroups, such as studies about babies, children, and adults, and analyzed the effect sizes within each group.

Step 7: Write and publish a report

The purpose of writing a systematic review article is to share the answer to your research question and explain how you arrived at this answer.

Your article should include the following sections:

  • Abstract : A summary of the review
  • Introduction : Including the rationale and objectives
  • Methods : Including the selection criteria, search method, data extraction method, and synthesis method
  • Results : Including results of the search and selection process, study characteristics, risk of bias in the studies, and synthesis results
  • Discussion : Including interpretation of the results and limitations of the review
  • Conclusion : The answer to your research question and implications for practice, policy, or research

To verify that your report includes everything it needs, you can use the PRISMA checklist .

Once your report is written, you can publish it in a systematic review database, such as the Cochrane Database of Systematic Reviews , and/or in a peer-reviewed journal.

In their report, Boyle and colleagues concluded that probiotics cannot be recommended for reducing eczema symptoms or improving quality of life in patients with eczema. Note Generative AI tools like ChatGPT can be useful at various stages of the writing and research process and can help you to write your systematic review. However, we strongly advise against trying to pass AI-generated text off as your own work.

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

  • Student’s  t -distribution
  • Normal distribution
  • Null and Alternative Hypotheses
  • Chi square tests
  • Confidence interval
  • Quartiles & Quantiles
  • Cluster sampling
  • Stratified sampling
  • Data cleansing
  • Reproducibility vs Replicability
  • Peer review
  • Prospective cohort study

Research bias

  • Implicit bias
  • Cognitive bias
  • Placebo effect
  • Hawthorne effect
  • Hindsight bias
  • Affect heuristic
  • Social desirability bias

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

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

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 .  

A systematic review is secondary research because it uses existing research. You don’t collect new data yourself.

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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

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 mode Seeks to identify most significant items in the field No formal quality assessment. Attempts to evaluate according to contribution Typically narrative, perhaps conceptual or chronological Significant component: seeks to identify conceptual contribution to embody existing or derive new theory
Generic term: published materials that provide examination of recent or current literature. Can cover wide range of subjects at various levels of completeness and comprehensiveness. May include research findings May or may not include comprehensive searching May or may not include quality assessment Typically narrative Analysis may be chronological, conceptual, thematic, etc.
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 Completeness of searching determined by time/scope constraints No formal quality assessment May be graphical and tabular Characterizes quantity and quality of literature, perhaps by study design and other key features. May identify need for primary or secondary research
Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results Aims for exhaustive, comprehensive searching. May use funnel plot to assess completeness Quality assessment may determine inclusion/ exclusion and/or sensitivity analyses Graphical and tabular with narrative commentary Numerical analysis of measures of effect assuming absence of heterogeneity
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 Requires either very sensitive search to retrieve all studies or separately conceived quantitative and qualitative strategies Requires either a generic appraisal instrument or separate appraisal processes with corresponding checklists Typically both components will be presented as narrative and in tables. May also employ graphical means of integrating quantitative and qualitative studies Analysis may characterise both literatures and look for correlations between characteristics or use gap analysis to identify aspects absent in one literature but missing in the other
Generic term: summary of the [medical] literature that attempts to survey the literature and describe its characteristics May or may not include comprehensive searching (depends whether systematic overview or not) May or may not include quality assessment (depends whether systematic overview or not) Synthesis depends on whether systematic or not. Typically narrative but may include tabular features Analysis may be chronological, conceptual, thematic, etc.
Method for integrating or comparing the findings from qualitative studies. It looks for ‘themes’ or ‘constructs’ that lie in or across individual qualitative studies May employ selective or purposive sampling Quality assessment typically used to mediate messages not for inclusion/exclusion Qualitative, narrative synthesis Thematic analysis, may include conceptual models
Assessment of what is already known about a policy or practice issue, by using systematic review methods to search and critically appraise existing research Completeness of searching determined by time constraints Time-limited formal quality assessment Typically narrative and tabular Quantities of literature and overall quality/direction of effect of literature
Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research evidence (usually including ongoing research) Completeness of searching determined by time/scope constraints. May include research in progress No formal quality assessment Typically tabular with some narrative commentary Characterizes quantity and quality of literature, perhaps by study design and other key features. Attempts to specify a viable review
Tend to address more current matters in contrast to other combined retrospective and current approaches. May offer new perspectives Aims for comprehensive searching of current literature No formal quality assessment Typically narrative, may have tabular accompaniment Current state of knowledge and priorities for future investigation and research
Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review Aims for exhaustive, comprehensive searching Quality assessment may determine inclusion/exclusion Typically narrative with tabular accompaniment What is known; recommendations for practice. What remains unknown; uncertainty around findings, recommendations for future research
Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce ‘best evidence synthesis’ Aims for exhaustive, comprehensive searching May or may not include quality assessment Minimal narrative, tabular summary of studies What is known; recommendations for practice. Limitations
Attempt to include elements of systematic review process while stopping short of systematic review. Typically conducted as postgraduate student assignment May or may not include comprehensive searching May or may not include quality assessment Typically narrative with tabular accompaniment What is known; uncertainty around findings; limitations of methodology
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 Identification of component reviews, but no search for primary studies Quality assessment of studies within component reviews and/or of reviews themselves Graphical and tabular with narrative commentary What is known; recommendations for practice. What remains unknown; recommendations for future research
  • << Previous: Home
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  • Last Updated: Jul 23, 2024 3:40 PM
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Easy guide to conducting a systematic review

Affiliations.

  • 1 Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.
  • 2 Department of Nephrology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
  • 3 Education Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
  • PMID: 32364273
  • DOI: 10.1111/jpc.14853

A systematic review is a type of study that synthesises research that has been conducted on a particular topic. Systematic reviews are considered to provide the highest level of evidence on the hierarchy of evidence pyramid. Systematic reviews are conducted following rigorous research methodology. To minimise bias, systematic reviews utilise a predefined search strategy to identify and appraise all available published literature on a specific topic. The meticulous nature of the systematic review research methodology differentiates a systematic review from a narrative review (literature review or authoritative review). This paper provides a brief step by step summary of how to conduct a systematic review, which may be of interest for clinicians and researchers.

Keywords: research; research design; systematic review.

© 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

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Systematic Reviews

  • Introduction to Systematic Reviews

Traditional Systematic Reviews

Meta-analyses, scoping reviews, rapid reviews, umbrella reviews, selecting a review type.

  • Reading Systematic Reviews
  • Resources for Conducting Systematic Reviews
  • Getting Help with Systematic Reviews from the Library
  • History of Systematic Reviews
  • Acknowledgements

Systematic Reviews are a family of review types that include:

This page provides information about the most common types of systematic reviews, important resources and references for conducting them, and some tools for choosing the best type for your research question .

Additional Information

  • A typology of reviews: an analysis of 14 review types and associated methodologies This classic article is a valuable reference point for those commissioning, conducting, supporting or interpreting reviews.
  • Traditional Systematic Reviews follow a rigorous and well-defined methodology to identify, select, and critically appraise relevant research articles on a specific topic and within a specified population of subjects
  • The primary goal of this type of study is to comprehensively find the empirical data available on a topic, identify relevant articles, synthesize their findings and draw evidence-based conclusions to answer a clinical question
  • Cochrane Handbook for Systematic Reviews of Interventions The Cochrane Handbook for Systematic Reviews of Interventions provides direction on the standard methods involved in conducting a systematic review. It is the official guide to the process involved in preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
  • JBI Manual for Evidence Synthesis The JBI Manual for Evidence Synthesis is designed to provide authors with a comprehensive guide to conducting JBI systematic reviews. It describes in detail the process of planning, undertaking and writing up a systematic review using JBI methods. The JBI Manual for Evidence Synthesis should be used in conjunction with the support and tutorials offered at the JBI SUMARI Knowledge Base.

These are some places where protocols for systematic reviews might be published.

  • PROSPERO: International prospective register of systematic reviews PROSPERO is an international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health related outcome. Key features from the review protocol are recorded and maintained as a permanent record. PROSPERO aims to provide a comprehensive listing of systematic reviews registered at inception to help avoid duplication and reduce opportunity for reporting bias by enabling comparison of the completed review with what was planned in the protocol.
  • Guidance Notes for Registering A Systematic Review Protocol with PROSPERO
  • OSF Registries Open Science Framework (OSF) Registries is an open network of study registgrations and pre-registrations. It can be used to pre-register a systematic review protocol. Note that OSF pre-registrations are not reviewed.
  • OSF Preregistration Initiative This page explains the motivation behind preregistrations and best practices for doing so.
  • Protocols.io A secure platform for developing and sharing reproducible methods, including protocols for systematic reviews.
  • PRISMA 2020 Statement The PRISMA 2020 Statement was published in 2021. It consists of a checklist and a flow diagram, and is intended to be accompanied by the PRISMA 2020 Explanation and Elaboration document.
  • Meta-analysis is a statistical method that can be applied during a systematic review to extract and combine the results from multiple studies
  • This pooling of data from compatible studies increases the statistical power and precision of the conclusions made by the systematic review
  • Systematic reviews can be done without doing a meta-analysis, but a meta-analysis must be done in connection with a systematic review
  • Scoping reviews identify the existing literature available on a topic to help identify key concepts, the type and amount of evidence available on a subject, and what research gaps exist in a specific area of study
  • They are particularly useful when a research question is broad and the goal is to provide an understanding of the available evidence on a topic rather than providing a focused synthesis on a narrow question
  • JBI Manual Chapter 11: Scoping Reviews
  • Updated methodological guidance for the conduct of scoping reviews The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR).
  • Steps for Conducting a Scoping Review This article in the Journal of Graduate Medical Education provides a comprehensive yet brief overview of the scoping review process.

Note: Protocols for scoping reviews can be published in all the same places as traditional systematic reviews except PROSPERO.

  • Best practice guidance and reporting items for the development of scoping review protocols The purpose of this article is to clearly describe how to develop a robust and detailed scoping review protocol, which is the first stage of the scoping review process. This paper provides detailed guidance and a checklist for prospective authors to ensure that their protocols adequately inform both the conduct of the ensuing review and their readership.
  • PRISMA for Scoping Reviews (PRISMA-ScR) The PRISMA extension for scoping reviews was published in 2018. The checklist contains 20 essential reporting items and 2 optional items to include when completing a scoping review. Scoping reviews serve to synthesize evidence and assess the scope of literature on a topic. Among other objectives, scoping reviews help determine whether a systematic review of the literature is warranted.
  • Touro College: What is a Scoping Review? This page describes scoping reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis This article from JBI Evidence Synthesis provides a thorough definition of what scoping reviews are and what they are for.
  • The role of scoping reviews in reducing research waste This article from the Journal of Clinical Epidemiology looks at how scoping reviews can reduce research waste.
  • Rapid reviews streamline the systematic review process by omitting certain steps or accelerating the timeline
  • They are useful when there is a need for timely evidence synthesis, such as in response to questions concerning an urgent policy or clinical situation such as the COVID-19 pandemic
  • Rapid Review Guidebook This document provides guidance on the process of conducting rapid reviews to use evidence to inform policy and program decision making.
  • Rapid reviews to strengthen health policy and systems: a practical guide This guide from the World Health Organization offers guidance on how to plan, conduct, and promote the use of rapid reviews to strengthen health policy and systems decisions. The Guide explores different approaches and methods for expedited synthesis of health policy and systems research, and highlights key challenges for this emerging field, including its application in low- and middle-income countries. It touches on the utility of rapid reviews of health systems evidence, and gives insights into applied methods to swiftly conduct knowledge syntheses and foster their use in policy and practice.
  • Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews The Cochrane Rapid Reviews Methods Group offers new, interim guidance to support the conduct of Rapid Reviews.
  • Touro College: What is a Rapid Review? This page describes rapid reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • Umbrella reviews synthesize evidence from multiple systematic reviews and meta-analyses on a specific topic
  • They provide a next-generation level of evidence synthesis, analyzing evidence taken from multiple systematic reviews to offer a broader perspective on a given subject
  • JBI Manual Chapter 10: Umbrella reviews
  • Preferred Reporting Items for Overviews of Reviews (PRIOR) Overviews of reviews (i.e., overviews) compile information from multiple systematic reviews to provide a single synthesis of relevant evidence for healthcare decision-making. Despite their increasing popularity, there are currently no systematically developed reporting guidelines for overviews. This is problematic because the reporting of published overviews varies considerably and is often substandard. Our objective is to use explicit, systematic, and transparent methods to develop an evidence-based and agreement-based reporting guideline for overviews of reviews of healthcare interventions (PRIOR, Preferred Reporting Items for Overviews of Reviews).
  • Touro College: What is an Overview of Reviews? This page describes umbrella reviews, including their limitations, alternate names, and how they differ from traditional systematic reviews.
  • Cornell University Systematic Review Decision Tree This decision tree is designed to assist researchers in choosing a review type.
  • Right Review This tool is designed to provide guidance and supporting material to reviewers on methods for the conduct and reporting of knowledge synthesis.
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  • Next: Reading Systematic Reviews >>
  • Last Updated: Aug 23, 2024 2:52 PM
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  • Research Guides

Evidence Syntheses (Scoping, systematic, & other types of reviews)

  • Types of Reviews

Choosing a Review Type

Types of literature reviews.

  • Should You Do a Systematic Review?
  • Work with a Search Expert
  • Covidence Review Software
  • Evidence in an Evidence Synthesis
  • Information Sources
  • Search Strategy
  • Managing Records
  • Selection Process
  • Data Collection Process
  • Study Risk of Bias Assessment
  • Reporting Results
  • For Search Professionals

This guide focuses on the methodology for systematic reviews (SRs), but an SR may not be the best methodology to use to meet your project's goals. Use the articles listed here or in the Types of Literature Reviews box below for information about additional methodologies that could better fit your project. 

  • Haddaway NR, Lotfi T, Mbuagbaw L. Systematic reviews: A glossary for public health . Scand J Public Health. 2022 Feb 9:14034948221074998. doi: 10.1177/14034948221074998. Epub ahead of print. PMID: 35139715.
  • Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies . Health Info Libr J. 2009 Jun;26(2):91-108. Defines 14 types of reviews and provides a helpful summary table on pp. 94-95.
  • Sutton A, Clowes M, Preston L, Booth A. Meeting the review family: exploring review types and associated information retrieval requirements . Health Info Libr J . 2019;36(3):202–222. doi:10.1111/hir.12276
  • If you're not sure what type of review is right for your quantitative review, use this tool to find the best methodology for your project, What Review is Right for You? https://whatreviewisrightforyou.knowledgetranslation.net

Systematic Reviews

Meta-Analyses

  • Comparative Effectiveness
  • systematically and transparently searches for a broad range of information to synthesize, in order to find the effect of an intervention.
  • uses a protocol 
  • has a clear data extraction and management plan.
  • Time-intensive and often take months to a year or more to complete, even with a multi-person team. 

NOTE: The term "systematic review" is also used incorrectly as a blanket term for other types of reviews.

Methodological Guidance

  • Finding What Works in Health Care: Standards for Systematic Reviews. 2011. Institute of Medicine. http://books.nap.edu/openbook.php?record_id=13059
  • Cochrane Handbook of Systematic Reviews of Interventions, v. 6. 2019. https://training.cochrane.org/handbook
  • The Joanna Briggs Reviewers Manual. 2024. https://jbi-global-wiki.refined.site/space/MANUAL
  • The Community Guide/Methods/Systematic Review Methods. 2014. The Community Preventive Services Task Force. http://www.thecommunityguide.org/about/methods.html

For issues in systematic reviews, especially in social science or other qualitative research: 

  • Some Potential "Pitfalls" in the Construction of Educational Systematic Reviews. https://doi.org/10.1007/s40596-017-0675-7
  • Lescoat, A., Murphy, S. L., Roofeh, D., et al. (2021). Considerations for a combined index for limited cutaneous systemic sclerosis to support drug development and improve outcomes. https://doi.org/10.1177/2397198320961967
  • DeLong, M. R., Tandon, V. J., Bertrand, A. A. (2021). Review of Outcomes in Prepectoral Prosthetic Breast Reconstruction with and without Surgical Mesh Assistance.  https://pubmed.ncbi.nlm.nih.gov/33177453/
  • Carey, M. R., Vaughn, V. M., Mann, J. (2020). Is Non-Steroidal Anti-Inflammatory Therapy Non-Inferior to Antibiotic Therapy in Uncomplicated Urinary Tract Infections: a Systematic Review.  https://pubmed.ncbi.nlm.nih.gov/32270403/
  • Statistical technique for combining the findings from disparate  quantitative studies.
  • Uses statistical methods to objectively evaluate, synthesize, and summarize results.
  • May be conducted independently or as part of a systematic review.
  • Cochrane Handbook, Ch 10: Analysing data and undertaking meta-analyses https://training.cochrane.org/handbook/current/chapter-10
  • Bauer, M. E., Toledano, R. D., Houle, T., et al. (2020). Lumbar neuraxial procedures in thrombocytopenic patients across populations: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/31810860/ 6
  • Mailoa J, Lin GH, Khoshkam V, MacEachern M, et al. Long-Term Effect of Four Surgical Periodontal Therapies and One Non-Surgical Therapy: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/26110453/

Umbrella Reviews

  • Reviews other systematic reviews on a topic. 
  • Often defines a broader question than is typical of a traditional systematic review.
  • Most useful when there are competing interventions to consider.
  • Ioannidis JP. Integration of evidence from multiple meta-analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta-analyses .  https://pubmed.ncbi.nlm.nih.gov/35081993
  • Aromataris, E., Fernandez, R., Godfrey, C. M., Holly, C., Khalil, H., & Tungpunkom, P.  2015 Methodology for JBI Umbrella Reviews. https://ro.uow.edu.au/cgi/viewcontent.cgi?articl.
  • Gastaldon, C., Solmi, M., Correll, C. U., et al. (2022). Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. https://pubmed.ncbi.nlm.nih.gov/35081993/
  • Blodgett, T. J., & Blodgett, N. P. (2021). Melatonin and melatonin-receptor agonists to prevent delirium in hospitalized older adults: An umbrella review.   https://pubmed.ncbi.nlm.nih.gov/34749057/

Comparative effectiveness 

  • Systematic reviews of existing research on the effectiveness, comparative effectiveness, and comparative harms of different health care interventions.
  •  Intended to provide relevant evidence to inform real-world health care decisions for patients, providers, and policymakers.
  • “Methods Guide for Effectiveness and Comparative Effectiveness Reviews.” Methods Guide for Effectiveness and Comparative Effectiveness Reviews https://effectivehealthcare.ahrq.gov/products/collections/cer-methods-guide
  • Main document of above guide :  https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/cer-methods-guide_overview.pdf .
  • Tanni KA, Truong CB, Johnson BS, Qian J. Comparative effectiveness and safety of eribulin in advanced or metastatic breast cancer: a systematic review and meta-analysis. Crit Rev Oncol Hematol. 2021 Jul;163:103375. doi: 10.1016/j.critrevonc.2021.103375. Epub 2021 Jun 2. PMID: 34087344.
  • Rice D, Corace K, Wolfe D, Esmaeilisaraji L, Michaud A, Grima A, Austin B, Douma R, Barbeau P, Butler C, Willows M, Poulin PA, Sproule BA, Porath A, Garber G, Taha S, Garner G, Skidmore B, Moher D, Thavorn K, Hutton B. Evaluating comparative effectiveness of psychosocial interventions adjunctive to opioid agonist therapy for opioid use disorder: A systematic review with network meta-analyses. PLoS One. 2020 Dec 28;15(12):e0244401. doi: 10.1371/journal.pone.0244401. PMID: 33370393; PMCID: PMC7769275.

​ Scoping Review or Evidence Map

Systematically and transparently collect and  categorize  existing evidence on a broad question of  policy or management importance.

Seeks to identify research gaps and opportunities for evidence synthesis rather than searching for the effect of an intervention. 

May critically evaluate existing evidence, but does not attempt to synthesize the results in the way a systematic review would. (see  EE Journal  and  CIFOR )

May take longer than a systematic review.

  • For useful guidance on whether to conduct a scoping review or not, see Figure 1 in this article. Pollock, D , Davies, EL , Peters, MDJ , et al. Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics . J Adv Nurs . 2021 ; 77 : 2102 – 2113 . https://doi.org/10.1111/jan.14743For a helpful

Hilary Arksey & Lisa O'Malley (2005) Scoping studies: towards a methodological framework http://10.1080/1364557032000119616

Aromataris E, Munn Z, eds. (2020) . JBI Manual for Evidence Synthesis.  JBI. Chapter 11: Scoping Reviews. https://wiki.jbi.global/display/MANUAL/Chapter+11%3A+Scoping+reviews

Munn Z, Peters MD, Stern C, Tet al. (2018)  Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. https://pubmed.ncbi.nlm.nih.gov/30453902/

Tricco AC, Lillie E, Zarin W, et al.. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.  https://www.acpjournals.org/doi/epdf/10.7326/M18-0850

Bouldin E, Patel SR, Tey CS, et al. Bullying and Children who are Deaf or Hard-of-hearing: A Scoping Review. https://pubmed.ncbi.nlm.nih.gov/33438758

Finn M, Gilmore B, Sheaf G, Vallières F. What do we mean by individual capacity strengthening for primary health care in low- and middle-income countries? A systematic scoping review to improve conceptual clarity. https://pubmed.ncbi.nlm.nih.gov/33407554/

Hirt J, Nordhausen T, Meichlinger J, Braun V, Zeller A, Meyer G. Educational interventions to improve literature searching skills in the health sciences: a scoping review.  https://pubmed.ncbi.nlm.nih.gov/33013210/

​ Rapid Review

Useful for addressing issues needing timely decisions, such as developing policy recommendations. 

Applies systematic review methodology within a time-constrained setting.

Employs intentional, methodological "shortcuts" (limiting search terms for example) at the risk of introducing bias.

Defining characteristic is the transparency of team methodological choices.

Garritty, Chantelle, Gerald Gartlehner, Barbara Nussbaumer-Streit, Valerie J. King, Candyce Hamel, Chris Kamel, Lisa Affengruber, and Adrienne Stevens. “Cochrane Rapid Reviews Methods Group Offers Evidence-Informed Guidance to Conduct Rapid Reviews.” Journal of Clinical Epidemiology 130 (February 2021): 13–22. https://doi.org/10.1016/j.jclinepi.2020.10.007 .

Klerings I , Robalino S , Booth A , et al. Rapid reviews methods series: Guidance on literature search. BMJ Evidence-Based Medicine. 19 April 2023. https:// 10.1136/bmjebm-2022-112079

WHO. “WHO | Rapid Reviews to Strengthen Health Policy and Systems: A Practical Guide.” World Health Organization. Accessed February 11, 2022. https://iris.who.int/handle/10665/258698 .

Dobbins, Maureen. “Steps for Conducting a Rapid Review,” 2017, 25.  https://www.nccmt.ca/uploads/media/media/0001/01/a816af720e4d587e13da6bb307df8c907a5dff9a.pdf

Norris HC, Richardson HM, Benoit MC, et al. (2021) Utilization Impact of Cost-Sharing Elimination for Preventive Care Services: A Rapid Review.   https://pubmed.ncbi.nlm.nih.gov/34157906/

Marcus N, Stergiopoulos V. Re-examining mental health crisis intervention: A rapid review comparing outcomes across police, co-responder and non-police models. Health Soc Care Community. 2022 Feb 1. doi: 10.1111/hsc.13731. Epub ahead of print. PMID: 35103364.

Narrative ( Literature ) Review

A broad term referring to reviews with a wide scope and non-standardized methodology.

See Baethge 2019 below for a method to provide quality assessment,

Search strategies, comprehensiveness, and time range covered will vary and do not follow an established protocol.

It provides insight into a particular topic by critically examining sources, generally over a particular period of time.

Greenhalgh, T., Thorne, S., & Malterud, K. (2018). Time to challenge the spurious hierarchy of systematic over narrative reviews?. https://pubmed.ncbi.nlm.nih.gov/29578574/

  • Baethge, C., Goldbeck-Wood, S. & Mertens, S. (2019). SANRA—a scale for the quality assessment of narrative review articles. https://doi.org/10.1186/ s41073-019-0064-8   https:// researchintegrityjournal. biomedcentral.com/articles/10. 1186/s41073-019-0064-8
  • Czypionka, T., Greenhalgh, T., Bassler, D., & Bryant, M. B. (2021). Masks and Face Coverings for the Lay Public : A Narrative Update. https://pubmed.ncbi.nlm.nih.gov/33370173/
  • Gardiner, F. W., Nwose, E. U., Bwititi, P. T., et al.. (2017). Services aimed at achieving desirable clinical outcomes in patients with chronic kidney disease and diabetes mellitus: A narrative review. https://pubmed.ncbi.nlm.nih.gov/29201367/
  •  Dickerson, S. S., Connors, L. M., Fayad, A., & Dean, G. E. (2014). Sleep-wake disturbances in cancer patients: narrative review of literature focusing on improving quality of life outcomes.  https://pubmed.ncbi.nlm.nih.gov/25050080/

Introduction to Systematic Reviews

In this guide.

  • Introduction
  • Types of Reviews
  • Systematic Review Process
  • Protocols & Guidelines
  • Data Extraction and Screening
  • Resources & Tools

Before You Start Checklist

Are you ready to carry out a knowledge synthesis project such as a systematic review, meta-analysis, or scoping review? Remember that systematic reviews require:

  • a team to carry out screening, extraction, and critical appraisal methods
  • a significant amount of time to complete
  • enough high quality studies to make a systematic review feasible
  • a rigorous protocol (that should be registered)
  • adherence to transparent and rigorous methods
  • a strong project management component with defined goals, responsibilities, deliverables, and timelines 
  • financial resources to complete the project 

What Review Is Right For You?

If you're unsure what type of knowledge synthesis best suits your research purposes, follow along this flowchart or complete this short quiz to find your personalized review methodologies: https://whatreviewisrightforyou.knowledgetranslation.net/

systematic review type of research

Reproduced from  "What type of review could you write?" Yale Medical Library. 

Types of Knowledge Syntheses

Conducting effective reviews is essential to advance the knowledge and understand the breadth of research on a topic; synthesize existing evidence; develop theories or provide a conceptual background for subsequent research; and identify research gaps. However, there are over 100 different kinds of reviews to choose from. The following provides a comparison of common review types.

Generic term: published materials that provide an examination of recent or current literature. Can cover a wide range of subjects at various levels of completeness and comprehensiveness. May include research findings

May or may not include comprehensive

searching

May or may not include quality

assessment

Typically narrative

Analysis may be chronological, conceptual, thematic, etc.

Seeks to systematically search for, appraise and synthesize research evidence, often adhering to guidelines on the conduct of a review

Aims for exhaustive,

Comprehensive searching

Quality assessment

may determine

inclusion/exclusion

Typically narrative

with tabular

accompaniment

What is known; recommendations

for practice. What remains unknown; uncertainty around findings, recommendations for

future research

Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results

Aims for exhaustive searching. May use funnel plot to assess completeness

Quality assessment may determine inclusion/exclusion and/or sensitivity analyses

Graphical and tabular with narrative commentary

Numerical analysis of measures of effect assuming absence of heterogeneity

Preliminary assessment of potential size and scope of available research literature. Aims to identify the nature and extent of research evidence (usually including ongoing research)

Completeness of searching determined by time/scope constraints. May include research in progress

No formal quality assessment

Typically tabular with some narrative commentary

Characterizes quantity and quality of literature, perhaps by study design and other key features. Attempts to specify a viable 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

Requires either very sensitive search to retrieve all studies or separately conceived quantitative and qualitative strategies

Requires either a generic appraisal instrument or separate appraisal processes with corresponding checklists

Typically both components will be presented as narrative and in tables. May also employ graphical means of integrating quantitative and qualitative studies

Analysis may characterize both works of literature and look for correlations between characteristics or use gap analysis to identify aspects absent in one literature but missing in the other

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

Identification of component reviews, but no search for primary studies

Quality assessment of studies within component reviews and/or of reviews themselves

Graphical and tabular with narrative commentary

What is known; recommendations for practice. What remains unknown; recommendations for future research

Reproduced from Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26 (2), 91-108. DOI: 10.1111/J.1471-1842.2009.00848.X

Fifty Shades of Review - Dr Andrew Booth from ScHARR Library on Youtube .

Books on Knowledge Synthesis

Cover Art

  • Finding What Works in Health Care by Jill Eden (Editor); Laura Levit (Editor); Alfred Berg (Editor); Sally Morton (Editor); Committee on Standards for Systematic Reviews of Comparative Effectiveness Research; Institute of Medicine; Board on Health Care Services Staff ISBN: 0309164257 Publication Date: 2011

Cover Art

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Library Research Guides - University of Wisconsin Ebling Library

Uw-madison libraries research guides.

  • Course Guides
  • Subject Guides
  • University of Wisconsin-Madison
  • Research Guides
  • Ebling Systematic Reviews
  • Systematic Reviews
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Systematic Reviews : Types of Reviews

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Choosing a Review Type

What type of review is right for you.

  • The Systematic Review Process
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What Review Should I Do?

systematic review type of research

The  Right Review tool  guides you through a series of questions to see what review type is recommended for your evidence synthesis project. Choose between qualitative or quantitative reviews to start using the tool. 

Systematic reviews are just one type of evidence synthesis. Not all research questions are well-suited for systematic reviews. The scope of the question, and time and/or resource constraints are key factors in choosing a review methodology type. Use articles listed here or the What Type of Review Is Right for You? decision tree below for information on what other methodologies might be a better fit for you project. 

  • Grant MJ, Booth A.  A typology of reviews: an analysis of 14 review types and associated methodologies . Health Info Libr J. 2009 Jun;26(2):91-108. Defines 14 types of reviews and provides a helpful summary table on pp. 94-95.
  • Sutton A, Clowes M, Preston L, Booth A.  Meeting the review family: exploring review types and associated information retrieval requirements .  Health Info Libr J . 2019;36(3):202–222. doi:10.1111/hir.12276
  • Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach .  BMC Med Res Methodol . 2018;18(1):143. doi:10.1186/s12874-018-0611-x

systematic review type of research

" W hat Type of Review is Right for You ?" by Cornell University Library is licensed under  CC BY 4.0

Parts of this guide are adapted from " S ystematic Reviews " by Taubman Health Sciences Library, University of Michigan , used under  CC BY 4.0 . 

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  • Korean J Anesthesiol
  • v.71(2); 2018 Apr

Introduction to systematic review and meta-analysis

1 Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea

2 Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea

Systematic reviews and meta-analyses present results by combining and analyzing data from different studies conducted on similar research topics. In recent years, systematic reviews and meta-analyses have been actively performed in various fields including anesthesiology. These research methods are powerful tools that can overcome the difficulties in performing large-scale randomized controlled trials. However, the inclusion of studies with any biases or improperly assessed quality of evidence in systematic reviews and meta-analyses could yield misleading results. Therefore, various guidelines have been suggested for conducting systematic reviews and meta-analyses to help standardize them and improve their quality. Nonetheless, accepting the conclusions of many studies without understanding the meta-analysis can be dangerous. Therefore, this article provides an easy introduction to clinicians on performing and understanding meta-analyses.

Introduction

A systematic review collects all possible studies related to a given topic and design, and reviews and analyzes their results [ 1 ]. During the systematic review process, the quality of studies is evaluated, and a statistical meta-analysis of the study results is conducted on the basis of their quality. A meta-analysis is a valid, objective, and scientific method of analyzing and combining different results. Usually, in order to obtain more reliable results, a meta-analysis is mainly conducted on randomized controlled trials (RCTs), which have a high level of evidence [ 2 ] ( Fig. 1 ). Since 1999, various papers have presented guidelines for reporting meta-analyses of RCTs. Following the Quality of Reporting of Meta-analyses (QUORUM) statement [ 3 ], and the appearance of registers such as Cochrane Library’s Methodology Register, a large number of systematic literature reviews have been registered. In 2009, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [ 4 ] was published, and it greatly helped standardize and improve the quality of systematic reviews and meta-analyses [ 5 ].

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Levels of evidence.

In anesthesiology, the importance of systematic reviews and meta-analyses has been highlighted, and they provide diagnostic and therapeutic value to various areas, including not only perioperative management but also intensive care and outpatient anesthesia [6–13]. Systematic reviews and meta-analyses include various topics, such as comparing various treatments of postoperative nausea and vomiting [ 14 , 15 ], comparing general anesthesia and regional anesthesia [ 16 – 18 ], comparing airway maintenance devices [ 8 , 19 ], comparing various methods of postoperative pain control (e.g., patient-controlled analgesia pumps, nerve block, or analgesics) [ 20 – 23 ], comparing the precision of various monitoring instruments [ 7 ], and meta-analysis of dose-response in various drugs [ 12 ].

Thus, literature reviews and meta-analyses are being conducted in diverse medical fields, and the aim of highlighting their importance is to help better extract accurate, good quality data from the flood of data being produced. However, a lack of understanding about systematic reviews and meta-analyses can lead to incorrect outcomes being derived from the review and analysis processes. If readers indiscriminately accept the results of the many meta-analyses that are published, incorrect data may be obtained. Therefore, in this review, we aim to describe the contents and methods used in systematic reviews and meta-analyses in a way that is easy to understand for future authors and readers of systematic review and meta-analysis.

Study Planning

It is easy to confuse systematic reviews and meta-analyses. A systematic review is an objective, reproducible method to find answers to a certain research question, by collecting all available studies related to that question and reviewing and analyzing their results. A meta-analysis differs from a systematic review in that it uses statistical methods on estimates from two or more different studies to form a pooled estimate [ 1 ]. Following a systematic review, if it is not possible to form a pooled estimate, it can be published as is without progressing to a meta-analysis; however, if it is possible to form a pooled estimate from the extracted data, a meta-analysis can be attempted. Systematic reviews and meta-analyses usually proceed according to the flowchart presented in Fig. 2 . We explain each of the stages below.

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Flowchart illustrating a systematic review.

Formulating research questions

A systematic review attempts to gather all available empirical research by using clearly defined, systematic methods to obtain answers to a specific question. A meta-analysis is the statistical process of analyzing and combining results from several similar studies. Here, the definition of the word “similar” is not made clear, but when selecting a topic for the meta-analysis, it is essential to ensure that the different studies present data that can be combined. If the studies contain data on the same topic that can be combined, a meta-analysis can even be performed using data from only two studies. However, study selection via a systematic review is a precondition for performing a meta-analysis, and it is important to clearly define the Population, Intervention, Comparison, Outcomes (PICO) parameters that are central to evidence-based research. In addition, selection of the research topic is based on logical evidence, and it is important to select a topic that is familiar to readers without clearly confirmed the evidence [ 24 ].

Protocols and registration

In systematic reviews, prior registration of a detailed research plan is very important. In order to make the research process transparent, primary/secondary outcomes and methods are set in advance, and in the event of changes to the method, other researchers and readers are informed when, how, and why. Many studies are registered with an organization like PROSPERO ( http://www.crd.york.ac.uk/PROSPERO/ ), and the registration number is recorded when reporting the study, in order to share the protocol at the time of planning.

Defining inclusion and exclusion criteria

Information is included on the study design, patient characteristics, publication status (published or unpublished), language used, and research period. If there is a discrepancy between the number of patients included in the study and the number of patients included in the analysis, this needs to be clearly explained while describing the patient characteristics, to avoid confusing the reader.

Literature search and study selection

In order to secure proper basis for evidence-based research, it is essential to perform a broad search that includes as many studies as possible that meet the inclusion and exclusion criteria. Typically, the three bibliographic databases Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) are used. In domestic studies, the Korean databases KoreaMed, KMBASE, and RISS4U may be included. Effort is required to identify not only published studies but also abstracts, ongoing studies, and studies awaiting publication. Among the studies retrieved in the search, the researchers remove duplicate studies, select studies that meet the inclusion/exclusion criteria based on the abstracts, and then make the final selection of studies based on their full text. In order to maintain transparency and objectivity throughout this process, study selection is conducted independently by at least two investigators. When there is a inconsistency in opinions, intervention is required via debate or by a third reviewer. The methods for this process also need to be planned in advance. It is essential to ensure the reproducibility of the literature selection process [ 25 ].

Quality of evidence

However, well planned the systematic review or meta-analysis is, if the quality of evidence in the studies is low, the quality of the meta-analysis decreases and incorrect results can be obtained [ 26 ]. Even when using randomized studies with a high quality of evidence, evaluating the quality of evidence precisely helps determine the strength of recommendations in the meta-analysis. One method of evaluating the quality of evidence in non-randomized studies is the Newcastle-Ottawa Scale, provided by the Ottawa Hospital Research Institute 1) . However, we are mostly focusing on meta-analyses that use randomized studies.

If the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system ( http://www.gradeworkinggroup.org/ ) is used, the quality of evidence is evaluated on the basis of the study limitations, inaccuracies, incompleteness of outcome data, indirectness of evidence, and risk of publication bias, and this is used to determine the strength of recommendations [ 27 ]. As shown in Table 1 , the study limitations are evaluated using the “risk of bias” method proposed by Cochrane 2) . This method classifies bias in randomized studies as “low,” “high,” or “unclear” on the basis of the presence or absence of six processes (random sequence generation, allocation concealment, blinding participants or investigators, incomplete outcome data, selective reporting, and other biases) [ 28 ].

The Cochrane Collaboration’s Tool for Assessing the Risk of Bias [ 28 ]

DomainSupport of judgementReview author’s judgement
Sequence generationDescribe the method used to generate the allocation sequence in sufficient detail to allow for an assessment of whether it should produce comparable groups.Selection bias (biased allocation to interventions) due to inadequate generation of a randomized sequence.
Allocation concealmentDescribe the method used to conceal the allocation sequence in sufficient detail to determine whether intervention allocations could have been foreseen in advance of, or during, enrollment.Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment.
BlindingDescribe all measures used, if any, to blind study participants and personnel from knowledge of which intervention a participant received.Performance bias due to knowledge of the allocated interventions by participants and personnel during the study.
Describe all measures used, if any, to blind study outcome assessors from knowledge of which intervention a participant received.Detection bias due to knowledge of the allocated interventions by outcome assessors.
Incomplete outcome dataDescribe the completeness of outcome data for each main outcome, including attrition and exclusions from the analysis. State whether attrition and exclusions were reported, the numbers in each intervention group, reasons for attrition/exclusions where reported, and any re-inclusions in analyses performed by the review authors.Attrition bias due to amount, nature, or handling of incomplete outcome data.
Selective reportingState how the possibility of selective outcome reporting was examined by the review authors, and what was found.Reporting bias due to selective outcome reporting.
Other biasState any important concerns about bias not addressed in the other domains in the tool.Bias due to problems not covered elsewhere in the table.
If particular questions/entries were prespecified in the reviews protocol, responses should be provided for each question/entry.

Data extraction

Two different investigators extract data based on the objectives and form of the study; thereafter, the extracted data are reviewed. Since the size and format of each variable are different, the size and format of the outcomes are also different, and slight changes may be required when combining the data [ 29 ]. If there are differences in the size and format of the outcome variables that cause difficulties combining the data, such as the use of different evaluation instruments or different evaluation timepoints, the analysis may be limited to a systematic review. The investigators resolve differences of opinion by debate, and if they fail to reach a consensus, a third-reviewer is consulted.

Data Analysis

The aim of a meta-analysis is to derive a conclusion with increased power and accuracy than what could not be able to achieve in individual studies. Therefore, before analysis, it is crucial to evaluate the direction of effect, size of effect, homogeneity of effects among studies, and strength of evidence [ 30 ]. Thereafter, the data are reviewed qualitatively and quantitatively. If it is determined that the different research outcomes cannot be combined, all the results and characteristics of the individual studies are displayed in a table or in a descriptive form; this is referred to as a qualitative review. A meta-analysis is a quantitative review, in which the clinical effectiveness is evaluated by calculating the weighted pooled estimate for the interventions in at least two separate studies.

The pooled estimate is the outcome of the meta-analysis, and is typically explained using a forest plot ( Figs. 3 and ​ and4). 4 ). The black squares in the forest plot are the odds ratios (ORs) and 95% confidence intervals in each study. The area of the squares represents the weight reflected in the meta-analysis. The black diamond represents the OR and 95% confidence interval calculated across all the included studies. The bold vertical line represents a lack of therapeutic effect (OR = 1); if the confidence interval includes OR = 1, it means no significant difference was found between the treatment and control groups.

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Forest plot analyzed by two different models using the same data. (A) Fixed-effect model. (B) Random-effect model. The figure depicts individual trials as filled squares with the relative sample size and the solid line as the 95% confidence interval of the difference. The diamond shape indicates the pooled estimate and uncertainty for the combined effect. The vertical line indicates the treatment group shows no effect (OR = 1). Moreover, if the confidence interval includes 1, then the result shows no evidence of difference between the treatment and control groups.

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Forest plot representing homogeneous data.

Dichotomous variables and continuous variables

In data analysis, outcome variables can be considered broadly in terms of dichotomous variables and continuous variables. When combining data from continuous variables, the mean difference (MD) and standardized mean difference (SMD) are used ( Table 2 ).

Summary of Meta-analysis Methods Available in RevMan [ 28 ]

Type of dataEffect measureFixed-effect methodsRandom-effect methods
DichotomousOdds ratio (OR)Mantel-Haenszel (M-H)Mantel-Haenszel (M-H)
Inverse variance (IV)Inverse variance (IV)
Peto
Risk ratio (RR),Mantel-Haenszel (M-H)Mantel-Haenszel (M-H)
Risk difference (RD)Inverse variance (IV)Inverse variance (IV)
ContinuousMean difference (MD), Standardized mean difference (SMD)Inverse variance (IV)Inverse variance (IV)

The MD is the absolute difference in mean values between the groups, and the SMD is the mean difference between groups divided by the standard deviation. When results are presented in the same units, the MD can be used, but when results are presented in different units, the SMD should be used. When the MD is used, the combined units must be shown. A value of “0” for the MD or SMD indicates that the effects of the new treatment method and the existing treatment method are the same. A value lower than “0” means the new treatment method is less effective than the existing method, and a value greater than “0” means the new treatment is more effective than the existing method.

When combining data for dichotomous variables, the OR, risk ratio (RR), or risk difference (RD) can be used. The RR and RD can be used for RCTs, quasi-experimental studies, or cohort studies, and the OR can be used for other case-control studies or cross-sectional studies. However, because the OR is difficult to interpret, using the RR and RD, if possible, is recommended. If the outcome variable is a dichotomous variable, it can be presented as the number needed to treat (NNT), which is the minimum number of patients who need to be treated in the intervention group, compared to the control group, for a given event to occur in at least one patient. Based on Table 3 , in an RCT, if x is the probability of the event occurring in the control group and y is the probability of the event occurring in the intervention group, then x = c/(c + d), y = a/(a + b), and the absolute risk reduction (ARR) = x − y. NNT can be obtained as the reciprocal, 1/ARR.

Calculation of the Number Needed to Treat in the Dichotomous table

Event occurredEvent not occurredSum
InterventionABa + b
ControlCDc + d

Fixed-effect models and random-effect models

In order to analyze effect size, two types of models can be used: a fixed-effect model or a random-effect model. A fixed-effect model assumes that the effect of treatment is the same, and that variation between results in different studies is due to random error. Thus, a fixed-effect model can be used when the studies are considered to have the same design and methodology, or when the variability in results within a study is small, and the variance is thought to be due to random error. Three common methods are used for weighted estimation in a fixed-effect model: 1) inverse variance-weighted estimation 3) , 2) Mantel-Haenszel estimation 4) , and 3) Peto estimation 5) .

A random-effect model assumes heterogeneity between the studies being combined, and these models are used when the studies are assumed different, even if a heterogeneity test does not show a significant result. Unlike a fixed-effect model, a random-effect model assumes that the size of the effect of treatment differs among studies. Thus, differences in variation among studies are thought to be due to not only random error but also between-study variability in results. Therefore, weight does not decrease greatly for studies with a small number of patients. Among methods for weighted estimation in a random-effect model, the DerSimonian and Laird method 6) is mostly used for dichotomous variables, as the simplest method, while inverse variance-weighted estimation is used for continuous variables, as with fixed-effect models. These four methods are all used in Review Manager software (The Cochrane Collaboration, UK), and are described in a study by Deeks et al. [ 31 ] ( Table 2 ). However, when the number of studies included in the analysis is less than 10, the Hartung-Knapp-Sidik-Jonkman method 7) can better reduce the risk of type 1 error than does the DerSimonian and Laird method [ 32 ].

Fig. 3 shows the results of analyzing outcome data using a fixed-effect model (A) and a random-effect model (B). As shown in Fig. 3 , while the results from large studies are weighted more heavily in the fixed-effect model, studies are given relatively similar weights irrespective of study size in the random-effect model. Although identical data were being analyzed, as shown in Fig. 3 , the significant result in the fixed-effect model was no longer significant in the random-effect model. One representative example of the small study effect in a random-effect model is the meta-analysis by Li et al. [ 33 ]. In a large-scale study, intravenous injection of magnesium was unrelated to acute myocardial infarction, but in the random-effect model, which included numerous small studies, the small study effect resulted in an association being found between intravenous injection of magnesium and myocardial infarction. This small study effect can be controlled for by using a sensitivity analysis, which is performed to examine the contribution of each of the included studies to the final meta-analysis result. In particular, when heterogeneity is suspected in the study methods or results, by changing certain data or analytical methods, this method makes it possible to verify whether the changes affect the robustness of the results, and to examine the causes of such effects [ 34 ].

Heterogeneity

Homogeneity test is a method whether the degree of heterogeneity is greater than would be expected to occur naturally when the effect size calculated from several studies is higher than the sampling error. This makes it possible to test whether the effect size calculated from several studies is the same. Three types of homogeneity tests can be used: 1) forest plot, 2) Cochrane’s Q test (chi-squared), and 3) Higgins I 2 statistics. In the forest plot, as shown in Fig. 4 , greater overlap between the confidence intervals indicates greater homogeneity. For the Q statistic, when the P value of the chi-squared test, calculated from the forest plot in Fig. 4 , is less than 0.1, it is considered to show statistical heterogeneity and a random-effect can be used. Finally, I 2 can be used [ 35 ].

I 2 , calculated as shown above, returns a value between 0 and 100%. A value less than 25% is considered to show strong homogeneity, a value of 50% is average, and a value greater than 75% indicates strong heterogeneity.

Even when the data cannot be shown to be homogeneous, a fixed-effect model can be used, ignoring the heterogeneity, and all the study results can be presented individually, without combining them. However, in many cases, a random-effect model is applied, as described above, and a subgroup analysis or meta-regression analysis is performed to explain the heterogeneity. In a subgroup analysis, the data are divided into subgroups that are expected to be homogeneous, and these subgroups are analyzed. This needs to be planned in the predetermined protocol before starting the meta-analysis. A meta-regression analysis is similar to a normal regression analysis, except that the heterogeneity between studies is modeled. This process involves performing a regression analysis of the pooled estimate for covariance at the study level, and so it is usually not considered when the number of studies is less than 10. Here, univariate and multivariate regression analyses can both be considered.

Publication bias

Publication bias is the most common type of reporting bias in meta-analyses. This refers to the distortion of meta-analysis outcomes due to the higher likelihood of publication of statistically significant studies rather than non-significant studies. In order to test the presence or absence of publication bias, first, a funnel plot can be used ( Fig. 5 ). Studies are plotted on a scatter plot with effect size on the x-axis and precision or total sample size on the y-axis. If the points form an upside-down funnel shape, with a broad base that narrows towards the top of the plot, this indicates the absence of a publication bias ( Fig. 5A ) [ 29 , 36 ]. On the other hand, if the plot shows an asymmetric shape, with no points on one side of the graph, then publication bias can be suspected ( Fig. 5B ). Second, to test publication bias statistically, Begg and Mazumdar’s rank correlation test 8) [ 37 ] or Egger’s test 9) [ 29 ] can be used. If publication bias is detected, the trim-and-fill method 10) can be used to correct the bias [ 38 ]. Fig. 6 displays results that show publication bias in Egger’s test, which has then been corrected using the trim-and-fill method using Comprehensive Meta-Analysis software (Biostat, USA).

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Funnel plot showing the effect size on the x-axis and sample size on the y-axis as a scatter plot. (A) Funnel plot without publication bias. The individual plots are broader at the bottom and narrower at the top. (B) Funnel plot with publication bias. The individual plots are located asymmetrically.

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Funnel plot adjusted using the trim-and-fill method. White circles: comparisons included. Black circles: inputted comparisons using the trim-and-fill method. White diamond: pooled observed log risk ratio. Black diamond: pooled inputted log risk ratio.

Result Presentation

When reporting the results of a systematic review or meta-analysis, the analytical content and methods should be described in detail. First, a flowchart is displayed with the literature search and selection process according to the inclusion/exclusion criteria. Second, a table is shown with the characteristics of the included studies. A table should also be included with information related to the quality of evidence, such as GRADE ( Table 4 ). Third, the results of data analysis are shown in a forest plot and funnel plot. Fourth, if the results use dichotomous data, the NNT values can be reported, as described above.

The GRADE Evidence Quality for Each Outcome

Quality assessment Number of patients Effect QualityImportance
NROBInconsistencyIndirectnessImprecisionOthersPalonosetron (%)Ramosetron (%)RR (CI)
PON6SeriousSeriousNot seriousNot seriousNone81/304 (26.6)80/305 (26.2)0.92 (0.54 to 1.58)Very lowImportant
POV5SeriousSeriousNot seriousNot seriousNone55/274 (20.1)60/275 (21.8)0.87 (0.48 to 1.57)Very lowImportant
PONV3Not seriousSeriousNot seriousNot seriousNone108/184 (58.7)107/186 (57.5)0.92 (0.54 to 1.58)LowImportant

N: number of studies, ROB: risk of bias, PON: postoperative nausea, POV: postoperative vomiting, PONV: postoperative nausea and vomiting, CI: confidence interval, RR: risk ratio, AR: absolute risk.

When Review Manager software (The Cochrane Collaboration, UK) is used for the analysis, two types of P values are given. The first is the P value from the z-test, which tests the null hypothesis that the intervention has no effect. The second P value is from the chi-squared test, which tests the null hypothesis for a lack of heterogeneity. The statistical result for the intervention effect, which is generally considered the most important result in meta-analyses, is the z-test P value.

A common mistake when reporting results is, given a z-test P value greater than 0.05, to say there was “no statistical significance” or “no difference.” When evaluating statistical significance in a meta-analysis, a P value lower than 0.05 can be explained as “a significant difference in the effects of the two treatment methods.” However, the P value may appear non-significant whether or not there is a difference between the two treatment methods. In such a situation, it is better to announce “there was no strong evidence for an effect,” and to present the P value and confidence intervals. Another common mistake is to think that a smaller P value is indicative of a more significant effect. In meta-analyses of large-scale studies, the P value is more greatly affected by the number of studies and patients included, rather than by the significance of the results; therefore, care should be taken when interpreting the results of a meta-analysis.

When performing a systematic literature review or meta-analysis, if the quality of studies is not properly evaluated or if proper methodology is not strictly applied, the results can be biased and the outcomes can be incorrect. However, when systematic reviews and meta-analyses are properly implemented, they can yield powerful results that could usually only be achieved using large-scale RCTs, which are difficult to perform in individual studies. As our understanding of evidence-based medicine increases and its importance is better appreciated, the number of systematic reviews and meta-analyses will keep increasing. However, indiscriminate acceptance of the results of all these meta-analyses can be dangerous, and hence, we recommend that their results be received critically on the basis of a more accurate understanding.

1) http://www.ohri.ca .

2) http://methods.cochrane.org/bias/assessing-risk-bias-included-studies .

3) The inverse variance-weighted estimation method is useful if the number of studies is small with large sample sizes.

4) The Mantel-Haenszel estimation method is useful if the number of studies is large with small sample sizes.

5) The Peto estimation method is useful if the event rate is low or one of the two groups shows zero incidence.

6) The most popular and simplest statistical method used in Review Manager and Comprehensive Meta-analysis software.

7) Alternative random-effect model meta-analysis that has more adequate error rates than does the common DerSimonian and Laird method, especially when the number of studies is small. However, even with the Hartung-Knapp-Sidik-Jonkman method, when there are less than five studies with very unequal sizes, extra caution is needed.

8) The Begg and Mazumdar rank correlation test uses the correlation between the ranks of effect sizes and the ranks of their variances [ 37 ].

9) The degree of funnel plot asymmetry as measured by the intercept from the regression of standard normal deviates against precision [ 29 ].

10) If there are more small studies on one side, we expect the suppression of studies on the other side. Trimming yields the adjusted effect size and reduces the variance of the effects by adding the original studies back into the analysis as a mirror image of each study.

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Not sure what type of review you want to conduct?

There are many types of reviews ---  narrative reviews ,  scoping reviews , systematic reviews, integrative reviews, umbrella reviews, rapid reviews and others --- and it's not always straightforward to choose which type of review to conduct. These Review Navigator tools (see below) ask a series of questions to guide you through the various kinds of reviews and to help you determine the best choice for your research needs.

  • Which review is right for you? (Univ. of Manitoba)
  • What type of review is right for you? (Cornell)
  • Review Ready Reckoner - Assessment Tool (RRRsAT)
  • A typology of reviews: an analysis of 14 review types and associated methodologies. by Grant & Booth
  • Meeting the review family: exploring review types and associated information retrieval requirements | Health Info Libr J, 2019
Label Description Search Appraisal Synthesis Analysis
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 Seeks to identify most significant items in the field No formal quality assessment. Attempts to evaluate according to contribution Typically narrative, perhaps conceptual or chronological Significant component: seeks to identify conceptual contribution to embody existing or derive new theory
Literature Review Generic term: published materials that provide examination of recent or current literature. Can cover wide range of subjects at various levels of completeness and comprehensiveness. May include research findings May or may not include comprehensive searching May or may not include quality assessment Typically narrative Analysis may be chronological, conceptual, thematic, etc.
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 Completeness of searching determined by time/scope constraints No formal quality assessment May be graphical and tabular Characterizes quantity and quality of literature, perhaps by study design and other key features. May identify need for primary or secondary research
Meta-analysis Technique that statistically combines the results of quantitative studies to provide a more precise effect of the results Aims for exhaustive, comprehensive searching. May use funnel plot to assess completeness Quality assessment may determine inclusion/exclusion and/or sensitivity analyses Graphical and tabular with narrative commentary Numerical analysis of measures of effect assuming absence of heterogeneity
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 Requires either very sensitive search to retrieve all studies or separately conceived quantitative and qualitative strategies Requires either a generic appraisal instrument or separate appraisal processes with corresponding checklists Typically both components will be presented as narrative and in tables. May also employ graphical means of integrating quantitative and qualitative studies Analysis may characterise both literatures and look for correlations between characteristics or use gap analysis to identify aspects absent in one literature but missing in the other
Overview Generic term: summary of the [medical] literature that attempts to survey the literature and describe its characteristics May or may not include comprehensive searching (depends whether systematic overview or not) May or may not include quality assessment (depends whether systematic overview or not) Synthesis depends on whether systematic or not. Typically narrative but may include tabular features Analysis may be chronological, conceptual, thematic, etc.
Qualitative systematic review/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 May employ selective or purposive sampling Quality assessment typically used to mediate messages not for inclusion/exclusion Qualitative, narrative synthesis Thematic analysis, may include conceptual models
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 Completeness of searching determined by time constraints Time-limited formal quality assessment Typically narrative and tabular Quantities of literature and overall quality/direction of effect of literature
Scoping review Preliminary assessment of potential size and scope of available research literature. Aims to identify nature and extent of research evidence (usually including ongoing research) Completeness of searching determined by time/scope constraints. May include research in progress No formal quality assessment Typically tabular with some narrative commentary Characterizes quantity and quality of literature, perhaps by study design and other key features. Attempts to specify a viable review
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 Aims for comprehensive searching of current literature No formal quality assessment Typically narrative, may have tabular accompaniment Current state of knowledge and priorities for future investigation and research
Systematic review Seeks to systematically search for, appraise and synthesis research evidence, often adhering to guidelines on the conduct of a review Aims for exhaustive, comprehensive searching Quality assessment may determine inclusion/exclusion Typically narrative with tabular accompaniment What is known; recommendations for practice. What remains unknown; uncertainty around findings, recommendations for future research
Systematic search and review Combines strengths of critical review with a comprehensive search process. Typically addresses broad questions to produce ‘best evidence synthesis’ Aims for exhaustive, comprehensive searching May or may not include quality assessment Minimal narrative, tabular summary of studies What is known; recommendations for practice. Limitations
Systematized review Attempt to include elements of systematic review process while stopping short of systematic review. Typically conducted as postgraduate student assignment May or may not include comprehensive searching May or may not include quality assessment
Typically narrative with tabular accompaniment  

Reproduced from Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies . Health Info Libr J. 2009 Jun;26(2):91-108. doi: 10.1111/j.1471-1842.2009.00848.x

  • Last Updated: Aug 12, 2024 8:26 AM
  • URL: https://guides.lib.utexas.edu/systematicreviews

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Systematic Reviews for Non-Health Sciences

  • Getting started

Types of reviews and examples

Choosing a review type.

  • 0. Planning the systematic review
  • 1. Formulating the research question
  • 2. Developing the protocol
  • 3. Searching, screening, and selection of articles
  • 4. Critical appraisal
  • 5. Writing and publishing
  • Guidelines & standards
  • Software and tools
  • Software tutorials
  • Resources by discipline
  • Duke Med Center Library: Systematic reviews This link opens in a new window
  • Overwhelmed? General literature review guidance This link opens in a new window

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systematic review type of research

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  • Meta-analysis
  • Systematized

Definition:

"A term used to describe a conventional overview of the literature, particularly when contrasted with a systematic review (Booth et al., 2012, p. 265).

Characteristics:

  • Provides examination of recent or current literature on a wide range of subjects
  • Varying levels of completeness / comprehensiveness, non-standardized methodology
  • May or may not include comprehensive searching, quality assessment or critical appraisal

Mitchell, L. E., & Zajchowski, C. A. (2022). The history of air quality in Utah: A narrative review.  Sustainability ,  14 (15), 9653.  doi.org/10.3390/su14159653

Booth, A., Papaioannou, D., & Sutton, A. (2012). Systematic approaches to a successful literature review. London: SAGE Publications Ltd.

"An assessment of what is already known about a policy or practice issue...using systematic review methods to search and critically appraise existing research" (Grant & Booth, 2009, p. 100).

  • Assessment of what is already known about an issue
  • Similar to a systematic review but within a time-constrained setting
  • Typically employs methodological shortcuts, increasing risk of introducing bias, includes basic level of quality assessment
  • Best suited for issues needing quick decisions and solutions (i.e., policy recommendations)

Learn more about the method:

Khangura, S., Konnyu, K., Cushman, R., Grimshaw, J., & Moher, D. (2012). Evidence summaries: the evolution of a rapid review approach.  Systematic reviews, 1 (1), 1-9.  https://doi.org/10.1186/2046-4053-1-10

Virginia Commonwealth University Libraries. (2021). Rapid Review Protocol .

Quarmby, S., Santos, G., & Mathias, M. (2019). Air quality strategies and technologies: A rapid review of the international evidence.  Sustainability, 11 (10), 2757.  https://doi.org/10.3390/su11102757

Grant, M.J. & Booth, A. (2009). A typology of reviews: an analysis of the 14 review types and associated methodologies.  Health Information & Libraries Journal , 26(2), 91-108. https://www.doi.org/10.1111/j.1471-1842.2009.00848.x

Developed and refined by the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), this review "map[s] out and categorize[s] existing literature on a particular topic, identifying gaps in research literature from which to commission further reviews and/or primary research" (Grant & Booth, 2009, p. 97).

Although mapping reviews are sometimes called scoping reviews, the key difference is that mapping reviews focus on a review question, rather than a topic

Mapping reviews are "best used where a clear target for a more focused evidence product has not yet been identified" (Booth, 2016, p. 14)

Mapping review searches are often quick and are intended to provide a broad overview

Mapping reviews can take different approaches in what types of literature is focused on in the search

Cooper I. D. (2016). What is a "mapping study?".  Journal of the Medical Library Association: JMLA ,  104 (1), 76–78. https://doi.org/10.3163/1536-5050.104.1.013

Miake-Lye, I. M., Hempel, S., Shanman, R., & Shekelle, P. G. (2016). What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products.  Systematic reviews, 5 (1), 1-21.  https://doi.org/10.1186/s13643-016-0204-x

Tainio, M., Andersen, Z. J., Nieuwenhuijsen, M. J., Hu, L., De Nazelle, A., An, R., ... & de Sá, T. H. (2021). Air pollution, physical activity and health: A mapping review of the evidence.  Environment international ,  147 , 105954.  https://doi.org/10.1016/j.envint.2020.105954

Booth, A. (2016). EVIDENT Guidance for Reviewing the Evidence: a compendium of methodological literature and websites . ResearchGate. https://doi.org/10.13140/RG.2.1.1562.9842 . 

Grant, M.J. & Booth, A. (2009). A typology of reviews: an analysis of the 14 review types and associated methodologies.  Health Information & Libraries Journal , 26(2), 91-108.  https://www.doi.org/10.1111/j.1471-1842.2009.00848.x

"A type of review that has as its primary objective the identification of the size and quality of research in a topic area in order to inform subsequent review" (Booth et al., 2012, p. 269).

  • Main purpose is to map out and categorize existing literature, identify gaps in literature—great for informing policy-making
  • Search comprehensiveness determined by time/scope constraints, could take longer than a systematic review
  • No formal quality assessment or critical appraisal

Learn more about the methods :

Arksey, H., & O'Malley, L. (2005) Scoping studies: towards a methodological framework.  International Journal of Social Research Methodology ,  8 (1), 19-32.  https://doi.org/10.1080/1364557032000119616

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science: IS, 5, 69. https://doi.org/10.1186/1748-5908-5-69

Example : 

Rahman, A., Sarkar, A., Yadav, O. P., Achari, G., & Slobodnik, J. (2021). Potential human health risks due to environmental exposure to nano-and microplastics and knowledge gaps: A scoping review.  Science of the Total Environment, 757 , 143872.  https://doi.org/10.1016/j.scitotenv.2020.143872

A review that "[compiles] evidence from multiple...reviews into one accessible and usable document" (Grant & Booth, 2009, p. 103). While originally intended to be a compilation of Cochrane reviews, it now generally refers to any kind of evidence synthesis.

  • Compiles evidence from multiple reviews into one document
  • Often defines a broader question than is typical of a traditional systematic review

Choi, G. J., & Kang, H. (2022). The umbrella review: a useful strategy in the rain of evidence.  The Korean Journal of Pain ,  35 (2), 127–128.  https://doi.org/10.3344/kjp.2022.35.2.127

Aromataris, E., Fernandez, R., Godfrey, C. M., Holly, C., Khalil, H., & Tungpunkom, P. (2015). Summarizing systematic reviews: Methodological development, conduct and reporting of an umbrella review approach. International Journal of Evidence-Based Healthcare , 13(3), 132–140. https://doi.org/10.1097/XEB.0000000000000055

Rojas-Rueda, D., Morales-Zamora, E., Alsufyani, W. A., Herbst, C. H., Al Balawi, S. M., Alsukait, R., & Alomran, M. (2021). Environmental risk factors and health: An umbrella review of meta-analyses.  International Journal of Environmental Research and Public Dealth ,  18 (2), 704.  https://doi.org/10.3390/ijerph18020704

A meta-analysis is a "technique that statistically combines the results of quantitative studies to provide a more precise effect of the result" (Grant & Booth, 2009, p. 98).

  • Statistical technique for combining results of quantitative studies to provide more precise effect of results
  • Aims for exhaustive, comprehensive searching
  • Quality assessment may determine inclusion/exclusion criteria
  • May be conducted independently or as part of a systematic review

Berman, N. G., & Parker, R. A. (2002). Meta-analysis: Neither quick nor easy. BMC Medical Research Methodology , 2(1), 10. https://doi.org/10.1186/1471-2288-2-10

Hites R. A. (2004). Polybrominated diphenyl ethers in the environment and in people: a meta-analysis of concentrations.  Environmental Science & Technology ,  38 (4), 945–956.  https://doi.org/10.1021/es035082g

A systematic review "seeks to systematically search for, appraise, and [synthesize] research evidence, often adhering to the guidelines on the conduct of a review" provided by discipline-specific organizations, such as the Cochrane Collaboration (Grant & Booth, 2009, p. 102).

  • Aims to compile and synthesize all known knowledge on a given topic
  • Adheres to strict guidelines, protocols, and frameworks
  • Time-intensive and often takes months to a year or more to complete
  • The most commonly referred to type of evidence synthesis. Sometimes confused as a blanket term for other types of reviews

Gascon, M., Triguero-Mas, M., Martínez, D., Dadvand, P., Forns, J., Plasència, A., & Nieuwenhuijsen, M. J. (2015). Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review.  International Journal of Environmental Research and Public Health ,  12 (4), 4354–4379.  https://doi.org/10.3390/ijerph120404354

"Systematized reviews attempt to include one or more elements of the systematic review process while stopping short of claiming that the resultant output is a systematic review" (Grant & Booth, 2009, p. 102). When a systematic review approach is adapted to produce a more manageable scope, while still retaining the rigor of a systematic review such as risk of bias assessment and the use of a protocol, this is often referred to as a  structured review  (Huelin et al., 2015).

  • Typically conducted by postgraduate or graduate students
  • Often assigned by instructors to students who don't have the resources to conduct a full systematic review

Salvo, G., Lashewicz, B. M., Doyle-Baker, P. K., & McCormack, G. R. (2018). Neighbourhood built environment influences on physical activity among adults: A systematized review of qualitative evidence.  International Journal of Environmental Research and Public Health ,  15 (5), 897.  https://doi.org/10.3390/ijerph15050897

Huelin, R., Iheanacho, I., Payne, K., & Sandman, K. (2015). What’s in a name? Systematic and non-systematic literature reviews, and why the distinction matters. https://www.evidera.com/resource/whats-in-a-name-systematic-and-non-systematic-literature-reviews-and-why-the-distinction-matters/

Flowchart of review types

  • Review Decision Tree - Cornell University For more information, check out Cornell's review methodology decision tree.
  • LitR-Ex.com - Eight literature review methodologies Learn more about 8 different review types (incl. Systematic Reviews and Scoping Reviews) with practical tips about strengths and weaknesses of different methods.
  • Right Review This tool is designed to provide guidance and supporting material to reviewers on methods for the conduct and reporting of knowledge synthesis.
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  • Last Updated: Jul 26, 2024 10:38 AM
  • URL: https://guides.library.duke.edu/systematicreviews

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Systematic reviews and other evidence synthesis projects

Types of reviews, a summary of review types, further reading on review types.

  • Systematic Reviews
  • 0. Plan your Review
  • 1. Define the Question
  • 2. Check for Recent Systematic Reviews and Protocols
  • 3. Write and register your protocol
  • Developing your Search Terms
  • Database Search Tips and Filters
  • Grey Literature
  • Record and Report your Search Strategy
  • Covidence This link opens in a new window
  • 6. Appraise the Studies
  • 7. Extract Data
  • 8. Analyze / Synthesize Data
  • 9. Write the Review
  • Rapid Reviews
  • Scoping Reviews
  • Equity in Evidence Synthesis
  • Automation, AI, and other upcoming review technologies
  • Librarian Support

Although systematic reviews are one of the most well-known review types, there are a variety of different types of reviews that vary in terms of scope, comprehensiveness, time constraints, and types of studies included.

The best review for your project depends on the intersection of:

  • your research goals
  • your research question
  • your time frame
  • your research team

Several tools are provided below to help you identify which type of review is best suited for your research.

Identifying the right review type for your project - start here!

  • Review Methodology Decision Tree from Cornell University Library
  • Flow chart for selecting review type from Yale's Cushing/Whitney Medical Library
  • What review is right for you? is a tool to help guide your choice of an appropriate knowledge synthesis method when looking at quantitative studies.
Type of Review Description Time to Complete Search Strategy Other Information

Narrative/Literature Review

Collates relevant studies and draws conclusions from them.

2+ months

Search strategy not typically reported. Not comprehensive, which could introduce bias.
Librarian advising available.

Collins JA, Fauser BC. .  . 2005;11(2):103-104. doi:10.1093/humupd/dmh058

Assesses what is already known about a policy or practice issue by using systematic review methods to search and critically appraise existing research.

2-6+ months

Completeness of searching determined by time constraints. Librarian collaboration recommended.

Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. .  . 2012;1:10. Published 2012 Feb 10. doi:10.1186/2046-4053-1-10

Tricco AC, Langlois EV, Straus SE. . Geneva: World Health Organization, 2017.

video series from Cochrane Training, 2017

Integrative Review

Reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated.

2-10+ months

Aims for exhaustive, comprehensive search. Librarian collaboration recommended.

Whittemore R, Knafl K. .  . 2005;52(5):546-553. doi:10.1111/j.1365-2648.2005.03621.x

Umbrella Review

Reviews other systematic reviews and meta-analyses on a topic.
Focuses on a broad condition or problem for which there are competing interventions and highlights reviews that address these interventions and their results.

2+ months

Identification of component reviews but no search for primary studies. Librarian collaboration recommended.

Aromataris E, Fernandez R, Godfrey C, Holly C, Khalil H, Tungpunkom P. . In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020. Available from  . doi:10.46658/JBIMES-20-11

Smith V, Devane D, Begley CM, Clarke M. .  . 2011;11(1):15. Published 2011 Feb 3. doi:10.1186/1471-2288-11-15

Scoping Review

Presents a preliminary assessment of the potential size and scope of available research literature.
Aims to identify nature and extent of research evidence (usually including ongoing research).

10-12+ months

Completeness of searching determined by time/scope constraints. Librarian collaboration recommended.

Arskey H, O'Malley L.  .  2005; 8:1.

Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. . In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. doi:10.46658/JBIMES-20-12

Daudt HM, van Mossel C, Scott SJ. .  . 2013;13:48. Published 2013 Mar 23. doi:10.1186/1471-2288-13-48

Systematic Review

Attempts to identify, appraise, and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question.
Uses explicit methods aimed at minimizing bias in order to produce more reliable findings that can be used to inform decision making.

10-12+ months

Aims for exhaustive, comprehensive search. Librarian collaboration recommended.

Lodge M. .  . 2011;4(2):135-139. doi:10.1111/j.1756-5391.2011.01130.x

 

. . 2018;18(1):143.

 

 

Meta-Analysis

A statistical test that combines the results from multiple studies to answer one or more research questions

10-12+ months

Aims for exhaustive, comprehensive search. Statistician collaboration recommended. Librarian collaboration recommended.

Møller AM, Myles PS. .  . 2016;117(4):428-430. doi:10.1093/bja/aew264

Based on University of North Carolina at Chapel Hill Health Sciences Library. Types of Reviews. Systematic Reviews website. Updated January 29, 2021. Accessed September 21, 2021. https://guides.lib.unc.edu/systematic-reviews

  • Meeting the review family: exploring review types and associated information retrieval requirements ; by Sutton A, Clowes M, Preston L, Booth A. Health Info Libr J . 2019;36(3):202-222. doi:10.1111/hir.12276
  • A typology of reviews: an analysis of 14 review types and associated methodologies ; by Grant MJ, Booth A. Health Info Libr J . 2009;26(2):91-108. doi:10.1111/j.1471-1842.2009.00848.x
  • Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach ; by Zachary Munn, Micah D. J. Peters, Cindy Stern, Catalin Tufanaru, Alexa McArthur & Edoardo Aromataris. BMC Med Res Methodol 18, 143 (2018). https://doi.org/10.1186/s12874-018-0611-x
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  • Last Updated: Jul 29, 2024 9:16 AM
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Systematic Reviews

Describes what is involved with conducting a systematic review of the literature for evidence-based public health and how the librarian is a partner in the process.

Several CDC librarians have special training in conducting literature searches for systematic reviews.  Literature searches for systematic reviews can take a few weeks to several months from planning to delivery.

Fill out a search request form here  or contact the Stephen B. Thacker CDC Library by email  [email protected] or telephone 404-639-1717.

Campbell Collaboration

Cochrane Collaboration

Eppi Centre

Joanna Briggs Institute

McMaster University

PRISMA Statement

Systematic Reviews – CRD’s Guide

Systematic Reviews of Health Promotion and Public Health Interventions

The Guide to Community Preventive Services

Look for systematic reviews that have already been published. 

  • To ensure that the work has not already been done.
  • To provides examples of search strategies for your topic

Look in PROSPERO for registered systematic reviews.

Search Cochrane and CRD-York for systematic reviews.

Search filter for finding systematic reviews in PubMed

Other search filters to locate systematic reviews

A systematic review attempts to collect and analyze all evidence that answers a specific question.  The question must be clearly defined and have inclusion and exclusion criteria. A broad and thorough search of the literature is performed and a critical analysis of the search results is reported and ultimately provides a current evidence-based answer  to the specific question.

Time:  According to Cochrane , it takes 18 months on average to complete a Systematic Review.

The average systematic review from beginning to end requires 18 months of work. “…to find out about a healthcare intervention it is worth searching research literature thoroughly to see if the answer is already known. This may require considerable work over many months…” ( Cochrane Collaboration )

Review Team: Team Members at minimum…

  • Content expert
  • 2 reviewers
  • 1 tie breaker
  • 1 statistician (meta-analysis)
  • 1 economist if conducting an economic analysis
  • *1 librarian (expert searcher) trained in systematic reviews

“Expert searchers are an important part of the systematic review team, crucial throughout the review process-from the development of the proposal and research question to publication.” ( McGowan & Sampson, 2005 )

*Ask your librarian to write a methods section regarding the search methods and to give them co-authorship. You may also want to consider providing a copy of one or all of the search strategies used in an appendix.

The Question to Be Answered: A clearly defined and specific question or questions with inclusion and exclusion criteria.

Written Protocol: Outline the study method, rationale, key questions, inclusion and exclusion criteria, literature searches, data abstraction and data management, analysis of quality of the individual studies, synthesis of data, and grading of the evidience for each key question.

Literature Searches:  Search for any systematic reviews that may already answer the key question(s).  Next, choose appropriate databases and conduct very broad, comprehensive searches.  Search strategies must be documented so that they can be duplicated.  The librarian is integral to this step of the process. Before your librarian creates a search strategy and starts searching in earnest you should write a detailed PICO question , determine the inclusion and exclusion criteria for your study, run a preliminary search, and have 2-4 articles that already fit the criteria for your review.

What is searched depends on the topic of the review but should include…

  • At least 3 standard medical databases like PubMed/Medline, CINAHL, Embase, etc..
  • At least 2 grey literature resources like Clinicaltrials.gov, COS Conference Papers Index, Grey Literature Report,  etc…

Citation Management: EndNote is a bibliographic management tools that assist researchers in managing citations.  The Stephen B. Thacker CDC Library oversees the site license for EndNote.

To request installation:   The library provides EndNote  to CDC staff under a site-wide license. Please use the ITSO Software Request Tool (SRT) and submit a request for the latest version (or upgraded version) of EndNote. Please be sure to include the computer name for the workstation where you would like to have the software installed.

EndNote Training:   CDC Library offers training on EndNote on a regular basis – both a basic and advanced course. To view the course descriptions and upcoming training dates, please visit the CDC Library training page .

For assistance with EndNote software, please contact [email protected]

Vendor Support and Services:   EndNote – Support and Services (Thomson Reuters)  EndNote – Tutorials and Live Online Classes (Thomson Reuters)

Getting Articles:

Articles can be obtained using DocExpress or by searching the electronic journals at the Stephen B. Thacker CDC Library.

IOM Standards for Systematic Reviews: Standard 3.1: Conduct a comprehensive systematic search for evidence

The goal of a systematic review search is to maximize recall and precision while keeping results manageable. Recall (sensitivity) is defined as the number of relevant reports identified divided by the total number of relevant reports in existence. Precision (specificity) is defined as the number of relevant reports identified divided by the total number of reports identified.

Issues to consider when creating a systematic review search:   

  • All concepts are included in the strategy
  • All appropriate subject headings are used
  • Appropriate use of explosion
  • Appropriate use of subheadings and floating subheadings
  • Use of natural language (text words) in addition to controlled vocabulary terms
  • Use of appropriate synonyms, acronyms, etc.
  • Truncation and spelling variation as appropriate
  • Appropriate use of limits such as language, years, etc.
  • Field searching, publication type, author, etc.
  • Boolean operators used appropriately
  • Line errors: when searches are combined using line numbers, be sure the numbers refer to the searches intended
  • Check indexing of relevant articles
  • Search strategy adapted as needed for multiple databases
  • Cochrane Handbook: Searching for Studies See Part 2, Chapter 6

A step-by-step guide to systematically identify all relevant animal studies

Materials listed in these guides are selected to provide awareness of quality public health literature and resources. A material’s inclusion does not necessarily represent the views of the U.S. Department of Health and Human Services (HHS), the Public Health Service (PHS), or the Centers for Disease Control and Prevention (CDC), nor does it imply endorsement of the material’s methods or findings. HHS, PHS, and CDC assume no responsibility for the factual accuracy of the items presented. The selection, omission, or content of items does not imply any endorsement or other position taken by HHS, PHS, and CDC. Opinion, findings, and conclusions expressed by the original authors of items included in these materials, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of HHS, PHS, or CDC. References to publications, news sources, and non-CDC Websites are provided solely for informational purposes and do not imply endorsement by HHS, PHS, or CDC.

EHSLibrary, UofU

Eccles Health Sciences Library

Spencer s. eccles health sciences library.

  • University of Utah
  • ULibraries Research Guides
  • * Eccles Health Sciences Library Research Guides

Systematic Reviews

Choosing a review type.

  • Systematic Review Process: At a Glance
  • Learn Systematic Reviews
  • Appraise Systematic Reviews
  • Conducting Scoping Reviews

Review types and evidence level

Selected review types, additional discussion of review types, involve a librarian.

  • ULibraries Evidence Review Services

Not every research question requires systematic review methodology.

Be sure to select the review type that matches the purpose and scope of your project., all reviews should be methodical - conducted in a careful and deliberate manner.  , questions to ask yourself:, what is the purpose of this review , what is the research question, how long do i have to complete it, am i doing it alone or part of a team, how much of the literature do i need to capture, do my literature search and methods need  to be transparent and replicable.

Right Review -   a tool providing guidance and supporting material on methods for conduct and reporting of knowledge synthesis.

Reviews of increasing complexity, from narrative reviews to systematic reviews... with complexity comes an increase in time & resources needed. -from Scoping Studies. Health Libraries Portal . HLWIKI International

Narrative Reviews or Literature Reviews

  • Useful in tracing concept development
  • Scope can be broad or focused
  • Methodology is not standardized 
  • Can be conducted by an individual or a team
  • Journal requirements vary -  check the journal's instruction for authors

Making literature reviews more reliable through application of lessons from systematic reviews. Haddaway NR, Woodcock P, Macura B, Collins A. Conserv Biol. 2015;29(6):1596-605. Epub 20150601. doi: 10.1111/cobi.12541. PubMed PMID: 26032263.

SANRA-a scale for the quality assessment of narrative review articles. Baethge C, Goldbeck-Wood S, Mertens S.  Res Integr Peer Rev. 2019;4:5. Epub 20190326. doi: 10.1186/s41073-019-0064-8. PubMed PMID: 30962953; PubMed Central PMCID: PMC643487

Time to challenge the spurious hierarchy of systematic over narrative reviews? Greenhalgh T, Thorne S, Malterud K.  Eur J Clin Invest. 2018;48(6):e12931. Epub 2018/03/27. doi: 10.1111/eci.12931. PubMed PMID: 29578574; PubMed Central PMCID: PMC6001568.

Evidence Reviews listed below which utilize explicit methodologies, reduce bias, increase transparency & reproducibility and a team.

  • Addresses a specific question
  • Uses specified methodology to reduce bias
  • Requires a team and time commitment
  • May include meta-analysis, dependent upon heterogeneity

Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach.  Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E.     BMC Med Res Methodol. Nov 19 2018;18(1):143. doi:10.1186/s12874-018-0611-x

What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences . Munn, Z., Stern, C., Aromataris, E. et al.  BMC Med Res Methodol 18, 5 (2018). doi:10.1186/s12874-017-0468-4  

Conducting a systematic review: finding the evidence . Lodge, M. (2011). J Evid Based Med, 4(2), 135-139. doi: 10.1111/j.1756-5391.2011.01130.x PubMed PMID: 23672704

Reviews of Reviews (Umbrella)

  • Systematic review using only systematic reviews as subjects
  • Synthesizes systematic reviews of same topic
  • Assesses scope and quality of individual systematic reviews

Conducting umbrella reviews. Belbasis L, Bellou V, Ioannidis JPA.  BMJ Medicine. 2022;1(1). doi: 10.1136/bmjmed-2021-000071. PubMed PMID: 36936579

Methodology in conducting a systematic review of systematic reviews of healthcare interventions . Smith V, Devane D, Begley CM, Clarke M. BMC Med Res Methodol. 2011 Feb 3;11(1):15. doi: 10.1186/1471-2288-11-15.

Scoping Reviews

  • Looks at broad research question
  • Creates broad literature map to find gaps
  • Requires a team and time
  • Uses qualitative analysis

What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. Munn Z, Pollock D, Khalil H, Alexander L, McLnerney P, Godfrey CM, et al.  JBI Evid Synth. 2022;20(4):950-2. Epub 20220401. doi: 10.11124/JBIES-21-00483. PubMed PMID: 35249995 .

Conducting high quality scoping reviews-challenges and solution s. Khalil H, Peters MD, Tricco AC, Pollock D, Alexander L, McInerney P, et al.  J Clin Epidemiol. 2020. Epub 2020/10/31. doi: 10.1016/j.jclinepi.2020.10.009. PubMed PMID: 33122034

Realist Reviews

  • Focuses on context and process
  • Uses an iterative protocol
  • Useful for complex policy interventions     

Realist synthesis: illustrating the method for implementation research . Rycroft-Malone J, McCormack B, Hutchinson AM, DeCorby K, Bucknall TK, Kent B, Schultz A, Snelgrove-Clarke E, Stetler CB, Titler M, Wallin L, Wilson V. Implement Sci.2012 Apr 19;7:33. doi: 10.1186/1748-5908-7-33.

Rapid Reviews

  • Used on emerging issues needing quick answers
  • Uses systematic review methods
  • Time constraints (often ≤3 months)

Evidence summaries: the evolution of a rapid review approach . Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Syst Rev. 2012 Feb 10;1:10. doi:10.1186/2046-4053-1-10.

Moher D, Stewart L, Shekelle P. All in the Family: systematic reviews, rapid reviews, scoping reviews, realist reviews, and more . Syst Rev. 2015 Dec 22;4:183.doi: 10.1186/s13643-015-0163-7. PubMed PMID: 26693720 ; PubMed Central PMCID: PMC4688988.

Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies . Health Info Libr J. 2009 Jun;26(2):91-108. doi:10.1111/j.1471-1842.2009.00848.x. PubMed PMID: 1949148

Fourteen review types and associated methodologies were compared and contrasted using  the SALSA (Search, AppraisaL, Synthesis and Analysis) framework.

Rethlefsen ML, Murad MH, Livingston EH. Engaging Medical Librarians to Improve the Quality of Review Articles . JAMA. 2014 Sep 10;312(10):999-1000. PubMed PMID: 25203078

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  • What Type of Review is Right for You? From Cornell University Library
  • A typology of reviews: an analysis of 14 review types and associated methodologies Grant MJ, Booth A. Health Info Libr J. 2009 Jun;26(2):91-108. PMID: 19490148
  • Meeting the review family: exploring review types and associated information retrieval requirements. Sutton A, Clowes M, Preston L, Booth A. Health Info Libr J. 2019 Sep;36(3):202-222.
  • Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. Munn, Z. 2018 BMC Medical Research Methodology, 18(1), 143. PMID: 30453902
  • Systematic Reviews (OA journal)
  • JBI Manual for Evidence Synthesis Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020. more... less... For systematic reviews of: • Qualitative evidence • Effectiveness • Text and Opinion • Prevalence and Incidence • Economic evidence • Etiology and Risk • Mixed methods • Diagnostic test accuracy • Umbrella reviews • Scoping reviews • Measurement properties
  • Summary of research that addresses a focused clinical question in a systematic reproducible manner.
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plus a subject-specific database such as:

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  • Often also includes a search for grey literature and hand-searching methods.
  • Generally follows reporting guidelines such as PRISMA .
  • A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research. Muka, T., Glisic, M., Milic, J., Verhoog, S., Bohlius, J., Bramer, W., Chowdhury, R., & Franco, O. H. (2020). European journal of epidemiology, 35(1), 49–60. PMID: 31720912
  • Cochrane Handbook for Systematic Reviews of Interventions (V. 6)
  • Guidance to best tools and practices for systematic reviews. Kolaski K, Logan LR, Ioannidis JPA. Syst Rev. 2023 Jun 8;12(1):96. PMID: 37291658.

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  • A literature review that is performed to rapidly outline the breadth, depth and type of literature available regarding a particular research topic.
  • An attempt to map out the evidence based on a research topic.
  • The completeness of the search is dictated by time restraints. This type of search may include research in progress.
  • JBI - Scoping Reviews Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Scoping Reviews (2020). Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024
  • Updated methodological guidance for the conduct of scoping reviews. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. JBI Evid Implement. 2021 Mar;19(1):3-10. doi: 10.1097/XEB.0000000000000277. PMID: 33570328.
  • Methods for Research Evidence Synthesis: The Scoping Review Approach Sucharew, H., & Macaluso, M. (2019). Journal of hospital medicine, 14(7), 416–418. https://doi.org/10.12788/jhm.3248
  • Scoping Studies: Towards a Methodological Framework. Arksey, H., & O’Malley, L. Intl Journal of Social Research Methodology, 2005 8(1), 19–32.
  • Reviews that include both qualitative and quantitative evidence.
  • May be useful in research areas where there are few published trials.
  • May include literature from experimental and non-experimental research methodologies.
  • Often implemented by the nursing research community.

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  • Chapter 10: Integrative Review In Cheryl Holly, E. R. A. F. (2019). Practice-Based Scholarly Inquiry and the DNP Project. 2nd edition.
  • Writing Integrative Literature Reviews: Guidelines and Examples Torraco, R. J. (2005). Writing Integrative Literature Reviews: Guidelines and Examples. Human Resource Development Review, 4(3), 356–367.
  • The integrative review: updated methodology. Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of advanced nursing, 52(5), 546–553.
  • Reviews that generally follow the guidelines of a systematic review, but are conducted in a condensed time by implementing documented time-saving measures.
  • Searching only one database.
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  • Reviews: Rapid! Rapid! Rapid! …and systematic Holger J Schünemann and Lorenzo Moja. Systematic Reviews 2015 4:4.
  • Expediting Systematic Reviews: Methods and Implications of Rapid Reviews Ganann, R., Ciliska, D., & Thomas, H. (2010). Implementation science: 5, 56.
  • A scoping review of rapid review methods. Tricco AC, Antony J, et al. BMC Med. 2015 Sep 16;13:224.
  • A general term that describes a study that assimilates, synthesizes or describes the findings of more than one study or review.
  • This is a review with a wide scope and non-standardized methodology. Synthesis is typically narrative.
  • The literature search does not need to be comprehensive or systematic.
  • These reviews typically do not attempt to address a single research question, but are more broad in scope and have no explicit criteria for inclusion.
  • Also known as a Systematized Review.
  • Not formally defined.
  • Usually attempts to include elements of the systematic review process.
  • Often conducted as a postgraduate assignment or thesis.

"We define an LSR as a systematic review which is continually updated, incorporating relevant new evidence as it becomes available." - Cochrane Living Evidence Network

  • Feasibility and acceptability of living systematic reviews: results from a mixed-methods evaluation Tanya Millard et al. Systematic Reviews volume 8, 325 (2019).
  • Living systematic review: 1. Introduction-the why, what, when, and how. Elliott, J. H., & Living Systematic Review Network (2017). Journal of clinical epidemiology, 91, 23–30.
  • Boland, A., Cherry, M. G., & Dickson, R. (2014). Doing a systematic review: a student's guide. London; Thousand Oakes, California: SAGE.
  • Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., . . . Moher, D. (2014). Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol, 67(12), 1291-1294. doi:10.1016/j.jclinepi.2014.03.013
  • Foster, M. J., & Jewell, S. T. (2017). Assembling the pieces of a systematic review: guide for librarians. Lanham: Rowman & Littlefield.  Full text for Emory Users
  • Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J, 26(2), 91-108. doi:10.1111/j.1471-1842.2009.00848.x
  • Guyatt, G., Rennie, D., Meade, M., Cook, D., & American Medical Association. (2015). Users' guides to the medical literature. A manual for evidence-based clinical practice (Third edition. ed.). New York: McGraw-Hill Education Medical.  Full Text for Emory Users
  • Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review. Scand J Caring Sci, 30(4), 662-669. doi:10.1111/scs.12327
  • Library, B. U. Systematic and Literature Reviews. Retrieved from http://libguides.brown.edu/Reviews/types
  • Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. J Adv Nurs, 52(5), 546-553. doi:10.1111/j.1365-2648.2005.03621.x
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Impacts of long-term transit system disruptions and transitional periods on travelers: a systematic review

  • Open access
  • Published: 27 August 2024
  • Volume 1 , article number  15 , ( 2024 )

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systematic review type of research

  • Mohamed G. Noureldin 1 &
  • Ehab Diab 1  

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Governments around the world are heavily investing in building new transit infrastructures and expanding existing ones. The construction of these projects does not happen overnight and can lead to extended long-term disruptions in the transit network, which can have undesirable impacts. Research regarding such disruptive periods, or transitional periods, seems to be thematically and geographically dispersed in the literature. Similarly, a consolidated understanding of the impacts of long-term transit service disruptions due to other causes, such as labor strikes and transit system failures, on travelers’ behavior seems missing from the literature. Using a systematic review method, this study aims at providing a comprehensive review of the academic literature that focused on analyzing the impacts of the aforementioned issues on transit users’ travel behavior and perceptions, while understanding the mitigation strategies applied to address these effects. Given the wide array of disruption types, durations, spatial coverage, and the modes affected, the review indicates a dearth of knowledge regarding their impacts along with a very limited understanding of the relative benefits of mitigation strategies. The most common impacts are mode changes. Some evidence, which is rather limited, shows that transit users did return to their previous travel behavior after the end of long-term service disruptions. The study offers a better understanding of the relative impacts of transit systems’ long-term disruptions and transitional periods, while highlighting important gaps in the current literature.

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1 Introduction

Governments around the world are heavily investing in building new transit infrastructure or upgrading or expanding existing ones [ 1 , 2 ]. This is in order to draw higher levels of transit ridership, while decreasing the attractiveness of non-sustainable modes of transport (such as private car use). Achieving these goals would help societies in reaching their emerging climate goals by reducing the emissions from the transport sector. The construction of these new transit projects does not happen overnight and can take from a few weeks to several months or even years, which can lead to extended long-term disruptions in the transit network. These long-term disruptions, or transitional periods, can have undesirable impacts on people’s travel behavior, and they could also increase traffic congestion as well as decrease air quality in the short and long terms. The impacts of these transitional periods, in general, seem thematically and geographically dispersed. Similarly, a consolidated understanding of the impacts of long-term disruptions due to other causes, such as labor strikes and transit system failures, on travelers’ behavior seems to be missing from the literature. Albeit different in their origins and characteristics, both transitional periods and long-term disruptions share several attributes, especially in terms of their effects on travel behavior as well as travelers’ needs and perceptions. They both impact travelers for an extended period, which can lead to them developing new habits and attitudes to adapt to such changes. Therefore, both transitional periods and long-term disruptions that resulted from transit system construction and repairs, infrastructure failure, and labor strikes were included in this study.

In this study, the term “transitional periods” refers to any planned changes in the transit system that alter the service’s structure and quality and require an extended period of disruption of regular service operations to implement, such as the construction of new transit infrastructure or the substantial upgrade of such infrastructure. After these periods, users expect to have improved transit service quality or options (Fig.  1 ), which may have an impact on their travel behavior and perception. It should be noted that not all infrastructure-related disruptions should be considered transitional periods, as some projects may not improve service afterwards. For example, maintenance-related projects can lead to similar levels of service.

figure 1

Conceptual framework

The term “long-term disruptions” was used to refer to any long-term transit system disruptions in which transit returns to its initial service configuration after the disruption, with no to minor changes to the service. For both types of disruptions, transit agencies and cities implement a wide array of mitigation strategies. Therefore, this study aims at achieving the following three goals: comprehending the current state of knowledge in the academic literature regarding the impacts of long-term transit system disruptions and transitional periods on travel behavior, travelers’ perceptions and travel needs; understanding the applied mitigation strategies and technologies used to address any undesirable impacts of these disruptions; and synthesizing the findings to identify areas of overlap between studies and prominent gaps in the current state of knowledge. Exploring these issues together informs transit planners and practitioners of lessons learned across studies regarding similarities and differences in terms of impacts, thereby guiding their future practice.

2 Research context

A considerable number of academic studies explored the factors affecting travel behavior and ridership at the city, route, and stop level during regular operational periods of the transit service. Several studies provided a systematic literature review of these factors’ impacts on travel behavior and ridership [ 3 , 4 ]. Nevertheless, there are numerous types of disruptions that can affect the normal operations of the transit network. There are also various classifications for these disruptions. Some studies differentiated between them in terms of whether they are planned or unplanned [ 5 , 6 , 7 ], while another categorization can be in terms of duration (long-term or short-term disruption) as was discussed by Kattan, de Barros [ 8 ].

Disruptions can also be divided based on the transport mode or system they affect (like rail transit or road disruptions) or in terms of magnitude—whether these disruptions resulted in closures of the affected transit stations or only caused the redirection of the stations’ lines, for example [ 9 ]. Furthermore, Zhu and Levinson [ 10 ] categorized transport network disruptions based on their causes; this included transit strikes, bridge closures, earthquakes and special events. A considerable number of researchers investigated the impacts of short-term transit system disruptions that last from a few minutes to hours on travel behavior and transit users’ perceptions [ 11 ]. For example, Saxena, Hossein Rashidi [ 12 ] compared how travelers weigh trip attributes differently in the case of either canceled or delayed transit service when choosing a mode of transport. Other studies focused on understanding the impacts of long-term disruptions of the transport network [ 6 , 8 , 10 , 13 , 14 , 15 , 16 , 17 ].

In regard to review papers that focused on transport network disruptions, Shalaby, Li [ 18 ] conducted a systematic review to identify and analyze journal articles that focused on management strategies for short-term rail transit disruptions and modeling approaches. Zhang, Lo [ 19 ] provided a similar review of the academic literature concerning metro system disruption management and substitute bus service, whilst Zhu and Levinson [ 10 ] discussed theoretical and empirical studies that focus on traffic and behavioral impacts of transport network disruptions. To the best of the authors’ knowledge, none of the previous research efforts provided an in-depth systematic review of the contemporary academic literature concerning the impacts of long-term transit system disruptions and transitional periods on travel behavior, travelers’ perceptions and travel needs. To address this gap, this paper focuses on developing a comprehensive systematic review of the literature regarding the topic.

3 Methodology

A comprehensive systematic review of the academic literature was carried out. Systematic literature reviews are a powerful approach to identify and analyze all relevant research on a given topic within certain parameters. The research process followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews [ 20 ]. It was initiated by conducting a scan of a few relevant articles to establish the keyword search syntax that would then be used to conduct an article search on three notable research databases. These databases were the Transport Research International Documentation (TRID), the Web of Science Core Collection and Scopus. TRID is a comprehensive database that includes more than one million records of transport research [ 21 ]. Following this initial review, four different combinations of keyword search syntaxes were generated based, mainly, on the different categories of long-term transit system disruptions within the scope. More specifically, the four themes of the search queries were as follows: construction and maintenance, general disruptions and closures, labor disputes and strikes, and a more general search related to transport system upgrades or improvements (Table  1 ). It should be noted that the database search queries pertaining to the fourth keyword category were developed and carried out at a later stage to further expand the limited pool of relevant articles found.

Using EndNote, research records for all the documents, which included the abstracts, were organized and some duplicate records were removed. Afterwards, the entire list of records was uploaded to the Rayyan web application [ 22 ] where the remaining duplicates were removed and the record screening process was initialized. Rayyan provided a platform for a collaborative work environment for both authors to screen articles, add notes, label articles, and conduct keyword searches. The screening was mainly done by the first author, while checking the undecided articles was done by both authors. To establish clear guidelines to elucidate the process of determining which documents are relevant, inclusion and exclusion criteria were formulated and subsequently followed to filter out the out-of-scope documents (Table  2 ).

The criteria that guided the selection process included that all papers must be in English and must be full peer-reviewed journal articles published no earlier than in 2011. They must also be mainly concerned with the effects of long-term transit system disruptions. There is no clear distinction between short- and long-term disruptions in the literature. Some researchers generally classified short-term disruptions by lasting up to two or three days [ 23 ]. Therefore, and to increase the number of included studies in this literature review, we considered the threshold of 2 days or more for identifying long-term transit service disruption. Moreover, research articles investigating disruptions due to highway construction or road maintenance works or that study long-term disruptions of other transport modes, such as air travel and ferries, were beyond the scope of this review and, as a result, were excluded. Additionally, efforts that investigated the effects of natural disasters, epidemics, and pandemics such as the COVID-19 pandemic were removed from the analysis, as these types of events are not only impacting the transit system, but also impacting all transportation modes and people’s willingness to make trips to different destinations.

Based on the criteria presented, the number of records that had their titles and/or abstracts manually reviewed by the authors and were subsequently excluded was 6,588, while the number of records deemed preliminarily relevant and were then pursued for full text retrieval were 47 articles. The review of the articles was based on reviewing the papers’ titles first, if the paper title is not clear or suspected of inclusion, the abstract was then reviewed. Afterwards, a swift review of the full text was carried out for these 47 articles. As a result, 30 articles were excluded, and 17 were included (end of Phase 1). Phase 2, the final phase of this process, comprised scanning the reference lists of the 17 acquired articles for any new articles, while applying the same inclusion and exclusion criteria. This step led to the procurement of 5 additional articles that required a full-text review. Only 2 were deemed relevant and were included in the finalized list of articles for the systematic review (19 in total). This process is illustrated in Fig.  2 , which was adapted from Page, McKenzie [ 20 ]. Articles that made it to the finalized list were categorized based on the type of disruption that they each discuss. Subsequent to this categorization, a full review of the 19 articles was performed, and the relevant information regarding the different aspects of each paper, such as the issues addressed; the data used; the utilized research methods; and the key findings, was extracted and organized. This was followed by conducting a qualitative analysis of the papers by analyzing the information on individual, categorical, and general scales as well as synthesizing and comparing the findings and other significant features of the articles.

figure 2

Flow diagram of the systematic review process conducted

In total, 19 articles were found to focus on long-term transit system disruptions and transitional periods. Even though this may seem like an inconsiderable number of articles for a systematic review, other systematic reviews in the field had similar numbers [ 24 , 25 , 26 ]. Of these 19, three focused generally on long-term disruptions. Seven papers discussed construction-related transit disruptions, and nine papers explored the effects of transit labor disputes and strikes. Appendices 1, 2, and 3 depict the results of this systematic review. In the appendices, studies that have modeled the impact of a mitigation strategy or controlled for it in the model, or  have critically discussed the effects of a mitigation strategy were highlighted.

4.1 General disruptions studies

As can be seen in Appendix 1, only three articles focused on general long-term transit service disruptions or included sections that focused on them. One paper used semi-structured interviews to understand the factors influencing the mode shift to car among transit users in the case of a transit service disruption. In this study, long-term disruptions referred to the hypothetical absence of transit for 10 years [ 27 ]. Pnevmatikou, Karlaftis [ 17 ] investigated the impact of a 5-month partial closure of a metro line in Athens, Greece. Lastly, Yap, Nijënstein [ 28 ] analyzed the impacts of four tram line disruptions in The Hague, the Netherlands. These analyzed disruptions lasted 5 and 20 days.

4.1.1 Methods and data

Nguyen-Phuoc, Currie [ 27 ] used a discourse analysis approach to analyze data collected from semi-structured interview responses of 30 transit users in Melbourne. Most of the participants were from an academic institution (i.e., Monash University). Interviews were coupled with brief questionnaires to collect participants’ socioeconomic information (age, income, occupation, car ownership and driving license) and current travel behavior (i.e., last transit trip). In contrast, Pnevmatikou, Karlaftis [ 17 ] adopted nested logit (NL) and multinomial logit (MNL) models to analyze revealed preference (RP) and stated preference (SP) data. The RP survey (1038 responses) examined the impact of a 5-month metro line closure on transport mode choice, which was conducted immediately after the line’s reopening. The SP survey of transit users was web-based and was collected to understand stated preferences towards travel patterns during hypothetical metro closures. In contrast to the previous two studies, Yap, Nijënstein [ 28 ] utilized smart card data obtained from an automated fare collection (AFC) system during disruptions to compare between predicted and realized transit ridership.

4.1.2 Studies key findings

Nguyen-Phuoc, Currie [ 27 ] found that in the long term, only context-specific factors (travel distance, travel time, travel cost, trip destination and flexibility of alternative mode) have an influence on transport mode shift. The postulated reasons were that participants did not perceive any alteration to the individual-specific factors in the future and that the authors focused on the unavailability of transit for an extremely long period (i.e., next ten years). The study indicated that the prolonged absence of transit services is expected to have an impact on land use and individuals in terms of changing their residential or workplace locations, or both. Participants did not consider trip cancellations during the long-term unavailability of the transit service.

Pnevmatikou, Karlaftis [ 17 ] showed that a metro user’s income was an important element in their decision-making process regarding whether to shift to buses or cars during metro service disruptions. Low-income metro users, regardless of car ownership, prefer using buses during metro disruptions. Additionally, during the disruptions, using a car for travel was negatively correlated with having a flexible work schedule. Yap, Nijënstein [ 28 ] indicated that in-vehicle time in the shuttle bus service (i.e., rail replacement buses) was perceived about 1.1 times more negatively compared to the in-vehicle time in the initial tram line, while waiting times for the shuttle bus service were perceived as approximately 1.3 times higher compared to the waiting times for the regular bus and tram services. The paper also indicated that if the prediction model does not account for vehicle capacity, integrating the positive effect of higher bus frequency would only overestimate the level of service provided by the shuttle buses during disruptions.

4.1.3 Section summary

Very few studies focused on long-term transit service disruptions or included sections that centered around long-term disruptions. One of them used a qualitative approach to develop a conceptual model of mode shift to car among transit users. The other two articles used specific case studies of partial closures of the metro and tram system in Athens and The Hague, respectively. There were no studies exploring system-wide (or a large portion of the system’s) long-term disruptions, nor were there studies that explored long-term disruptions within the North American context. All three studies focused primarily on current transit users’ travel behaviors. Nevertheless, other travelers may respond differently to additional costs imposed by increased traffic congestion. Additionally, since these studies explored only two cases of disruptions, future work is needed to include a wider array of disruptions because transit users’ responses will depend on: available travel options; duration, type, and degree of disruptions; and the used mitigation strategies’ effectiveness. The two quantitative studies investigated the impacts of providing shuttle buses and using an existing parallel transit service to mitigate the impacts of tram and metro closures, respectively. However, the effectiveness of other mitigation strategies is yet to be explored.

4.2 Construction studies

As seen in Appendix 2, seven studies explored the impacts of construction-related disruptions. Most of them focused on the impacts of heavy rail systems’ (e.g., metro and rail systems) construction and maintenance, while only two discussed light rail transit (LRT) systems [ 8 , 9 ]. Construction studies are related to the idea of transitional periods, in which people are expected to have improved transit service quality (or options) after these periods. Of the seven papers, 3 focused on the impacts of construction-related transit disruptions on bike-sharing systems usage. The four others investigated the impacts of construction on: travel behavior changes and travelers’ responses to enroute real-time information disseminated through variable message signs (VMS) [ 8 , 13 ], local air quality [ 29 ], and bus performance [ 14 ]. Additionally, only five articles critically discussed or analyzed the impacts of mitigation strategies.

4.2.1 Methods and data

Of the seven studies, five utilized statistical models to investigate construction-related transit disruptions’ effects on travel behavior and air quality. Bike-share system studies used ridership data from fixed docking stations [ 30 ] or from free-floating bike-sharing systems [ 9 ]. Based on bike-share data, these studies explored the impact of metro and LRT closures that lasted from 7 to 25 days in Washington, D.C., USA and Cologne, Germany. They used autoregressive Poisson log-level time series modeling [ 30 ], negative binomial regression [ 9 ] and linear regressions [ 31 ] to analyze ride-share data for periods before, during, and after disruptions, while controlling for a set of variables (weather conditions, season, day, time of day, etc.). One study [ 31 ] did not directly model changes in ridership due to disruptions, but rather used sensitivity analysis to explore the effects of implementing a new $2 single-trip fare (STF) on ridership, which was introduced concurrently with the SafeTrack program’s operations in Washington, D.C. Another study modeled bike-sharing usage from geographical and temporal perspectives [ 9 ].

On the other hand, other papers used participant survey data to understand changes in travel behavior using summary statistics. For example, Kattan, de Barros [ 8 ] used a revealed preference survey (430 responses) collected one year after the West LRT line’s construction in Calgary, Alberta, Canada, had started but before it ended (the construction project’s duration was ~ 3 years). Nevertheless, it did not model travel mode changes but focused on multinomial logit modeling to study travelers’ behavioral responses to VMS information. Zhu, Masud [ 13 ] used descriptive statistics to analyze panel survey data before (318 and 420 responses) and after (74 and 64 responses) two reductions and closures of service. Another study used fixed-effect modeling to understand the impacts of rail transit construction on the air quality index using air quality data from 28 cities in China [ 29 ]. Lastly, Shiqi, Zhengfeng [ 14 ] used fuzzy aggregation and summary statistics to evaluate the bus layout adjustment scheme from passenger and car driver perspectives and investigated passenger volumes at stops.

4.2.2 Studies key findings

Usage of bike-sharing systems generally increased during construction-related transit disruptions but at different levels. For example, Younes, Nasri [ 30 ] reported ridership increases on weekdays during disruption. Once the affected metro stations reopened, bike-share ridership returned to its pre-surge levels, suggesting a limited lasting effect of the studied disruptions. They also suggested the likelihood of travelers using bike-share as a first- and last-mile solution rather than as an alternative to transit. Similarly, Schimohr and Scheiner [ 9 ] reported a reversion to the original bike-share ridership levels once the disruption had ceased. On another note, Kaviti, Venigalla [ 31 ] indicated that implementing a new $2 single-trip fare increased the number of first-time bike-share riders by as much as 79% immediately after its introduction. The introduction of this new fare co-existed with metro service closures. Additionally, there was also a statistically significant increase in the daily ridership of registered members and casual users at docks near metro stations impacted by the metro service closures.

In regard to the other four studies, Kattan, de Barros [ 8 ] stated that the total demand for travel in areas affected by the construction did not decrease, neither were trip departure times rescheduled. Travel behavior changes were mainly route switching, followed by mode shifting, and then by destination changing. Zhu, Masud [ 13 ] indicated that transit users changed modes or destinations instead of departure time during the complete closure of metro stations. They also reported that ~ 20% of respondents did not return to using the metro even after the service’s full restoration. However, it is not known whether these mode changes are temporary or permanent. Additionally, they observed that wealthier riders are more likely to drive or switch to for-hire options (e.g., Uber and Lyft). On another note, Sun, Zhang [ 29 ] found that rail construction has a greater impact on improving air quality than urban road reconstruction, while Shiqi, Zhengfeng [ 14 ] suggested that factors attributed to transit service and traffic were degraded when bus routing schemes were implemented during disruptions.

4.2.3 Section summary

Few studies in the literature focus on long-term disruptions caused by transit construction or maintenance projects. Three of the seven studies focused exclusively on understanding the disruptions’ impacts on bike-share ridership rather than their effects on using active transportation modes and cycling behavior. Only two articles employed traveler surveys to gain a better picture of people’s travel behavior instead of their tendency to use one specific mode (bike-share) during such disruptions. Moreover, none modeled transport mode changes due to transit system construction projects, but they rather used descriptive statistics to provide information regarding, for example, route and mode changes, while indicating limited trip cancellations or changes in trip departure times.

Additionally, very few studies looked into long-term changes in travel behavior or home and work location decisions influenced by long-term disruptions as Nguyen-Phuoc, Currie [ 27 ] discussed. Most studies focused on immediate impacts and accounted for disruptions within limited time frames. Only five studies explored or modeled the impacts of mitigation strategies on travelers’ travel behaviors or perceptions (Appendix 2). Similarly, it was rare to find articles utilizing detailed mitigation strategy data (e.g., shuttle buses and travel information communications) and travelers’ data in combination with disruption data to explore the mitigation strategies’ effectiveness during transit construction projects. Furthermore, none of the studies were concerned with the relative impact of bus rapid transit (BRT) system construction projects; most of them focused on LRT and metro service construction.

4.3 Labor dispute and strike studies

Only nine papers focused on labor disputes and strikes (Appendix 3). Four of them discussed the impacts of transit operators’ strikes on air quality [ 32 , 33 , 34 , 35 ]. Three focused on transit service strikes’ effects on traffic conditions, while one article investigated the strikes’ impacts on the usage of bike-sharing systems. The remaining paper explored a strike’s effect on undergraduate students’ travel choices.

4.3.1 Methods and data

Of the nine articles, six utilized statistical models to investigate transit labor disputes’ effects on people’s travel behavior and on air quality. Regarding air quality studies, they used pollutant levels as proxies to investigate people’s shifting from transit to using private vehicles. Using air quality monitoring stations data, most of them used case studies that lasted from 3 days [ 32 ] to 51 days [ 33 , 34 ]. Additionally, two used a 2013 strike that occurred in Ottawa as their case study, and only one used a sample of more than one long-term strike for investigating their impacts on air quality [ 35 ]. The most commonly used data analysis methods included regression, difference-in-difference models [ 34 , 35 ], and summary statistics [ 33 ].

On the other hand, three studies explored transit strikes’ effects on traffic conditions using freeways and highways’ loop detector data [ 36 , 37 , 38 ]. These studies used different indicators to understand changes in traffic conditions such as changes in average delay, traffic flow, mean speed, and travel time. The used methodological approaches include summary statistics and developing regression and generalized linear models [ 36 , 37 ]. Only one study [ 39 ] used statistical modeling to isolate strikes’ impacts on bike-sharing system usage; it analyzed the impact of one strike that lasted 7 days in Philadelphia, Pennsylvania, USA, using interrupted time series models. Additionally, only one study [ 40 ] explored strikes’ impacts on transit users and non-users’ travel behavior using surveys and mobile phone app (called iEpi) data. Using four weeks of data, comprising two weeks during the strike and two weeks of normal operation after the strike ended, they developed descriptive statistics to understand changes in walking distance, trips frequency, and visited locations.

4.3.2 Studies key findings

Most of the air quality studies showed substantial increases in fine particulate matter (PM) concentrations during strikes, particularly in busy urban areas. Moreover, some studies indicated large increases in O 3 and CO concentrations. These impacts were mainly attributed to travel behavioral changes; transit users shifted to using private cars. In contrast, two articles reported reductions in NO concentrations during strikes. NO is a gas that is mainly produced by diesel engines, which can be found in public transit buses. Interestingly, one article suggested that PM and O 3 concentrations significantly decreased in the strike’s final 3 weeks. This was attributed to travel behavioral changes; travelers started using more environmentally friendly transport modes as they adapted to the transit service’s absence.

Regarding traffic studies, Anderson [ 37 ] reported an about 47% increase in highway delays during a 35-day strike in Los Angeles, California, USA. More delays were observed along freeways with parallel transit lines that are characterized by heavy ridership. Other researchers made the same spatial observation [ 38 ]. Furthermore, Spyropoulou [ 36 ], using a case study from Athens, Greece, of several strikes lasting between 1 and 5 days, reported similar results. Spyropoulou [ 36 ] stated that strikes increased congestions by increasing traffic flow (up to 30%), reducing mean speed (up to 27%) and increasing travel times (up to 25%).

Strikes also had significant impacts on using active transportation modes. Fuller, Luan [ 39 ] reported a 57% increase in bike-sharing system usage by members and non-members during the 7-day transit operators’ strike. However, bike-share usage quickly returned to previous trends directly after the strike. Additionally, some results suggest that non-members might have used bike-sharing for a slightly longer period. In contrast to previous studies that analyzed the usage of one mode during the strikes (i.e., car or bike-share system), Stanley, Bell [ 40 ] focused on the overall changes in the travel behavior of transit and non-transit users during a longer strike that lasted for more than 30 days. They indicated that transit users visited fewer places and walked more during the 30-day strike.

4.3.3 Section summary

Traffic studies showed that the impacts on the transport network were not equal; this is usually not captured by studies that used aggregate air quality data from fixed monitoring stations. Most of the studies examined changes in using one mode, namely cars or bike-sharing systems. However, only very few studies explored and modeled overall alterations in travel behavior. Moreover, most of the articles used passive data sources from traffic loop detectors, air quality stations, or a bike-sharing system at the aggregate level; this does not offer insights into individuals’ behavioral changes in terms of route choice, departure time, travel perception and overall experience. In fact, none of the studies relied on using social surveys to investigate the short- and long-term impacts of transit operators’ strikes on users. In other words, none of them explicitly focused on understanding changes in transit users’ perceptions and needs. Instead, studies tried to draw conclusions regarding transit users’ and non-transit users’ travel behavior.

Only one study utilized mobile-phone data to explore changes in travelers’ behaviors in more detail. This calls for more investigation into possibly using such tools in obtaining larger and more representative samples that can be combined with surveys to better understand different aspects of travelers’ decision-making behaviors during transit operators’ strikes. Furthermore, none of the reviewed studies explored the impacts of service strikes and information availability on travelers’ perceptions using data collected from social media platforms such as Twitter, for example. Table 3 shows an aggregated summary of the analyzed papers from the three categories (general causes, construction-related, and labor-related disruptions) and their different aspects including users’ perceptions and travel behaviors that were investigated.

4.4 Mitigation strategies

Several mitigation strategies were discussed in the reviewed literature. They generally fall under three broad categories: backup transport services, policy-based measures, and impact assessments (Table  4 ). In the table, articles are also sorted by the disruption type that they are associated with. Of the 19 papers chosen for this review, 10 articles discussed disruption mitigation strategies in some form.

Backup transport services are mitigative actions where some alternative form(s) of transport is provided during disruptions to regular transit services. They can be considered to be a form of policy-based measures; however, a distinction has been made between the two since not all of the policy-based measures discussed in the articles were backup transport services. Several articles discussed the level of backup transport services and their impact. For example, Kattan, de Barros [ 8 ] discussed the benefits of implementing a temporary BRT service, which followed an alignment similar to that of the LRT under construction, as a proactive mitigation measure that encouraged travelers to shift to using transit. Yap, Nijënstein [ 28 ] found that people overestimated the in-vehicle and waiting times associated with using bridging buses compared to their in-vehicle and waiting times using the initial tram service. On another note, Schimohr and Scheiner [ 9 ] indicated that travelers’ proximity to stations with substitute or redirected lines was associated with a decrease in the number of bike-sharing trips, suggesting that people used transit at these locations more than they used the bike-share system during service disruption. Nevertheless, most of the studies that discuss this point agree that bus bridging involves a higher level of inconvenience for users, thereby encouraging them to change modes or destinations.

The second category is policy-based measures. This strategy includes providing and improving communications and the dissemination of information to travelers through delivering consistent updates regarding the disrupted transit services, traffic conditions, available alternative modes of transport, etc. It could also include reduced fares, for using transit or a form of active transportation for example, to promote using sustainable transport modes during the disruption to alleviate the hike in traffic congestion. The reviewed articles discussed or analyzed several policy-related amendments or measures. They include introducing a single-trip fare option to encourage riders to use the bike-sharing system and using improved communications methods to disseminate information; those approaches were studied by Kaviti, Venigalla [ 31 ] and Kattan, de Barros [ 8 ], respectively. In addition, Anderson [ 37 ] reported that an additional transit service was contracted (i.e., the Red Line Special bus service) to duplicate part of a closed metro route; this could also be considered a backup transport service. Similarly, Moylan, Foti [ 38 ] indicated that during the Bay Area Rapid Transit (BART) service shutdown, a local bus agency (i.e., AC Transit) increased frequencies on Transbay bus service routes. However, the benefits of policies like contracting new services or increasing transit services offered by other agencies were not explicitly measured in previous efforts. Regarding the third category, only one paper [ 14 ] focused on evaluating a metro construction project’s disruptive effects on bus performance in the city of Ningbo, China.

5 Discussions and policy implications

The results of this study demonstrate that there is generally a lack of academic research concerning long-term transit service disruptions and transitional periods. Nevertheless, the majority of the identified academic papers are relatively recent and were published during the past five years. This may suggest that this key topic has been gaining more traction in recent years. This showcases this topic’s relevance and the possibility of having more efforts in this area soon. This is in alignment with the increase in worldwide governmental funding opportunities to develop new transit infrastructure to foster economic growth and face climate change. For example, Canada’s federal government revealed a new sizeable funding of $14.9 B for new public transit infrastructure in February 2020 [ 41 ]. Similar efforts dedicated to providing more funding for building and upgrading public transport can be found in Europe, the US and China [ 44 , 45 , 46 ]

According to the number of identified documents, there is a wide agreement and overlap in the reviewed literature regarding the negative impacts such disruptions and transitional periods have on travelers and also regarding the importance of using a range of mitigation strategies. The most common impacts are mode changes. Very few studies indicated other types of changes such as route changes, trip departure time changes, and destination changes. Some evidence, which is rather limited, shows that transit users did return to their previous travel behavior after the end of long-term service disruptions. Nevertheless, it is not clear if these changes are temporary or permanent. Other studies indicated that bike-share systems ridership increased during disruptions. However, these ridership levels returned to their pre-disruption levels after the reopening of the transit service, suggesting a limited lasting effect of long-term disruptions on people’s mode choice to continue using the bike-sharing systems. Providing new backup transit services and rerouting and enhancing parallel services were the most common mitigation approaches widely discussed in the literature to deal with long-term transit disruptions. Previous efforts showed good use of passive data sources from air quality monitoring stations, highway loop detectors, bike-share system counters, and automated fare collection systems to establish evidence of the negative effects of such periods.

Despite these efforts in the literature, travelers’ perceptions and needs during these periods are minimally addressed or analyzed. Additionally, it was rare to find studies that explicitly incorporated or controlled for the expected impacts of the transit projects after their completion. In other words, transitional periods may have more positive outcomes on transit users’ perceptions and travel behaviors after the project is finalized, due to enhanced service quality for instance, compared to other long-term disruptions. Such effects were underexplored in the literature.

The academic literature on long-term disruptions and transitional periods is currently quite divorced from the practice. For example, there is a dearth of studies that seek to derive lessons from past and current practices to help advance the practice of using effective mitigation strategies in different contexts and for different purposes. Additionally, a considerable number of the articles focused solely on understanding the impacts of long-term service disruptions on the usage of one transport mode, such as bike-sharing system usage, or one element, such as air quality or traffic conditions, rather than drawing a complete picture of people’s decision-making process and changes in their travel behaviors and needs. It was also rare to find studies that used a statistical model to better understand travelers’ behaviors during and/or following different types of long-term disruptions and transitional periods.

Most of the studies focused on measuring the short-term impacts of transit service disruptions. This may be related to the fact that most of the analyzed disruptions in the academic literature lasted for a few days or weeks. Nevertheless, articles exploring both short- and long-term impacts of longer transit service disruptions and transitional periods that last for a few months or even years were very limited. In fact, only two studies focused on exploring the impacts of longer disruptions that lasted more than a few months. Using surveys, one study regarding disruptions in Athens explored the immediate impact of a 5-month disruption on travel behaviors, while another study from Calgary explored the 1-year impact of an LRT system construction project, which lasted for about 3 years. Therefore, it is challenging, based on the limited research available, to understand the changes in travel behavior during these prolonged periods and to understand whether these long-term disruptions have an extended or permanent impact on travelers’ behaviors. Potential changes that may not be considered in shorter disruptions include relocation and/or reductions in travel demand because of moving closer to work or school, changing jobs, joining a ride-sharing program, and increasing telecommuting. Some of the key policy recommendations of this research are listed below.

With the need for academic studies that focus on the short- and long-term impacts of different long-term disruptions and transitional periods, cities and transit agencies are encouraged to work with the academic community to test different sets of mitigation strategies in different contexts, scenarios, and at different scales. These studies should also include information about changes in travelers’ behaviors, perceptions, and well-being in order to evaluate the used mitigation strategies and their relative impacts, which would inform future policy making.

With the emergence of more academic studies, as well as non-academic reports, in this area, lessons from the literature and practice should be organized and used in more systematic ways to assist in developing a policy guide to help in managing these disruptions. This will aid in guiding future practices that should aim to maintain higher levels of the transit services’ attractiveness during such periods for both transit and non-transit users. The prospect of providing adequate active transport alternatives that would encourage people to shift to using active transportation modes should also be explored. This could potentially reduce the stress on the public transportation and road networks.

Using agreements with private bus operators, ride-hailing services, bike shops, advocacy groups, and bike-sharing and scooter-sharing companies, cities can help reduce the impact of such periods on travelers. As seen in the literature, offering bike-sharing services and making them cheaper or more accessible by offering more payment options during long-term transit service disruptions can work as a mitigation strategy. This could be coupled with looking beyond the physical availability of alternative modes by testing different pricing scenarios to provide transport alternative(s).

Research suggests that using greener transport options may be adopted more widely by travelers if adequate policies were in place during such disruptions. This would capitalize on the increased flexibility of travelers to try out new transport modes during such periods. This might help in increasing cities’ shares of active transportation if such mode changes could be sustained after the disruption and adopted permanently by travelers. Nevertheless, currently, there is limited evidence that this is the case.

People will not benefit or suffer increases in their monetary and non-monetary costs equally because of any long-term transit system disruptions or transitional periods. Therefore, transit agencies should assess the equity impacts of such extended time periods on different groups of travelers. This will be context-specific and will help in articulating more sensitive policies that match different groups of users’ needs.

Finally, it was reported in the literature that the provision of alternative public transport options with a high transit service level coupled with the efficient dissemination of pre-trip and enroute, real-time travel information (e.g., updates on traffic and on areas affected by the disruption) resulted in an increase in transit use during the disruption. Moreover, evidence of the importance of using social media, graphics, and short videos in communicating information during the COVID-19 pandemic was discussed in the literature [ 47 ]. Learning from these lessons, more understanding of the importance of efficient and timely dissemination of information plans using social media or other platforms is essential. This is to help cities in informing people about expected impacts and options, which can help in alleviating stress on transit segments.

6 Conclusions

This study aimed to explore the current state of knowledge concerning transit systems’ transitional periods and long-term disruptions and to understand the actively used disruption mitigation strategies and technologies that are implemented to address or alleviate any of their undesirable impacts on travelers. To achieve these goals, a comprehensive systematic review of the academic literature was conducted. In total, 19 peer-reviewed journal articles were identified and analyzed. This systematic review helps identify the major knowledge gaps in the literature. The results of this study demonstrate that there is generally a lack of academic research works concerning long-term transit service disruptions and transitional periods. In fact, travelers’ perceptions, travel behaviors and changing needs during these disruptive periods were minimally addressed or analyzed. Key conclusions and recommendations are discussed below.

Given the range of different types of long-term transit system disruptions (e.g., construction, labor disputes and service failures); various disruption time frames (from a few days to several years); varying spatial coverage (from one line to system level); and different disrupted modes (e.g., bus, metro and tram), much more work can be done to explore the effects of such disruptions on people’s travel behavior and perceptions.

The possible impact of long-term disruptions on travelers in terms of changing modes, routes, trip departure times, frequency of trips, destinations, and work and home locations in addition to increasing telecommuting and trip sharing are widely recognized in the literature. However, studies rarely explored explicitly the factors affecting changes in travel behavior like shifting to different routes or changing the frequency of trips or the factors influencing relocation for transit and non-transit users using statistical models. This can be an important area for future work.

The relative importance and impact of disruption mitigation measures, while understanding how these measures could work together, within the context of long-term disruptions are rarely investigated in the literature. In fact, the current academic literature provides transit agencies with very limited information to assist them. Such knowledge can inform the processes of planning for long-term disruptions to implement more efficient and effective strategies.

Most of the studies were quantitative in nature and provided some relevant findings; however, qualitative studies can provide in-depth insights into the intersection between how, why, who, and what questions that are related to different types of disruptions. For example, it can help in understanding the importance of using different mitigation strategies for different groups of the population and their relation to different types of disruptions. Therefore, future research can focus on using qualitative approaches to elicit information not only from transit and non-transit users, but also from transit agencies and operators to understand their perspectives.

The reviewed literature generally used data from two main sources: from traveler surveys and from passive data sources that are obtained from air quality monitoring stations, bike-share systems, and highway loop detectors. Therefore, using emerging data sources such as cellular phone data and mobile app data can be explored for future studies to give a better understanding of the different long-term disruptions’ impacts. Social media data, farebox system data, and web surveys can be also incorporated in these studies.

Several studies used summary statistics, difference-in-difference approaches, or a dummy variable to isolate the impacts of long-term disruptions on different aspects (e.g., air quality, traffic conditions, and bike-share usage). However, these studies ignore that a long-term disruption entails an extended period of time, which can see different movement patterns within this period as indicated by Chandler and Shymko [ 34 ]. They stated that relying only on short-term results to draw conclusions regarding long-term impacts of long-term disruptions can lead to an overestimation of the negative effects. Therefore, future research could look into different patterns within such time frames.

Similarly, temporal changes in travel behavior after long-term disruptions or transitional periods end are rarely explored in the literature, particularly for longer disruptions that last for more than a few weeks. Some authors indicated that transit ridership can take several weeks to reach pre-disruption levels [ 37 ]. Therefore, exploring changes occurring over time to travelers and, more specifically, transit users’ travel behavior could be a viable future research endeavor.

Previous studies explored the impacts of long-term disruptions and transitional periods on bike-share usage; however, the academic literature is lacking in studies that investigate their impacts on using other active transportation modes, such as walking and cycling. Since these trips, particularly walking trips, are usually underreported in travel surveys, using sensors data from mobile phone apps can be beneficial to understand changes before, during, and after long-term disruptions for different groups of travelers.

It was found that very few articles explored changes in travelers’ perceptions, satisfaction, and needs due to transitional periods in comparison with long-term transit system disruptions triggered by other causes. Transitional periods, which usually lead to different outcomes in terms of improved service quality after ending compared to other long-term disruption periods, were not explicitly explored in the literature. Transitional periods’ ultimate positive outcomes on users’ perceptions and travel behaviors could be a viable focal point for future research efforts.

Incorporating social issues, such as equity concerns, and seeking to derive lessons to help understand the equity impacts of long-term disruptions and transitional periods on different groups of populations are yet to be accomplished. These groups can include Indigenous populations, visible minorities, and people with systemic barriers to using other transportation modes. Additionally, there is a lack of research to both understand and address the sociopolitical, institutional and community capacity dimensions, which is an important aspect during such periods.

Finally, this study aimed to derive lessons from the current academic literature on the effects of transit systems’ long-term disruptions and transitional periods. Exploration of this rather diverse research area will not only inform professionals but will also highlight important gaps in the current literature for researchers. Future research can expand the presented efforts and focus on reviewing transit agency reports and studies and conducting surveys and interviews with transit planners to record their experience and to better understand their perspective of the effects of transit systems’ long-term disruptions and transitional periods. This is to help cities and transit agencies to better anticipate and manage “change”. This will, in turn, help to facilitate and secure the development of their public transport networks while planning and being better prepared for long-term transit system disruptions, thereby aiding them in achieving their overarching sustainability goals.

Data availability

No datasets were generated or analysed during the current study.

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European Commission. EU invests €6.2 billion in sustainable, safe and efficient transport infrastructure. 2023 https://ec.europa.eu/commission/presscorner/detail/en/ip_23_3436 . Accessed on 2 June 2024

Woodhouse, S. Biden Offers $9.8 Billion to Bolster Public Transit Agencies . 2024 https://www.bloomberg.com/news/articles/2024-02-29/biden-offers-9-8-billion-to-bolster-public-transit-agencies?embedded-checkout=true . Accessed on 2 June 2024

Diaz F, et al. Canadian transit agencies response to COVID-19: understanding strategies, information accessibility and the use of social media. Trans Res Int Pers. 2021;12: 100465.

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We would like to thank the Social Sciences and Humanities Research Council (SSHRC) of Canada and Infrastructure Canada (INFC) for partially funding this research.

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Mohamed G. Noureldin & Ehab Diab

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The authors confirm contribution to the paper as follows: study conception and design: Noureldin & Diab; data collection: Noureldin; analysis and interpretation of results: Noureldin & Diab; draft manuscript preparation: Noureldin & Diab. All authors reviewed the results and approved the final version of the manuscript.

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1.1 General disruptions studies

Paper

Disruption & duration

Issues addressed

Data/methods

Main investigated factors in model(s)

Key summary statistics used

Key findings

[ ]

Hypothetical absence of transit due to long-term disruption. 10 years

To understand the factors influencing the mode shift to car among transit users in the case of a transit disruption

Semi-structured interview responses of 30 transit users from different age groups and areas of Melbourne

 

Conceptual model of the factors affecting transit user mode shift in the short and long terms

In the long term, only context-specific factors (travel distance, time, cost, trip destination, and flexibility of alternative mode) have an influence on transport mode shift

[ ]

Tram lines closures (4 lines). 5 and 20 days

The impacts of 4 planned transit system disruptions on transit ridership to adjust a parameter set in order to provide more accurate estimation of ridership during planned disruptions

•AFC system data collected during the disruptions were utilized to compare between predicted and realized transit ridership

Transit ridership prediction modeling of different time periods

Factors considered in the modeling include generalized costs on origin–destination (OD) pair, in-vehicle travel time, walking time, waiting time, # of transfers, value of time, distance travelled, and demand on OD pair, elasticity, and frequency

Prediction accuracy for predefined scenarios

Comparison between the default and proposed parameter sets’ values

Comparison between the new parameter set and the default set on predicted ridership reduction, the average generalized travel costs per passenger, and the prediction accuracy for all 4 disruptions investigated

In-vehicle time and waiting time for the shuttle bus service were perceived about 1.1 and 1.3 times more negatively in comparison to the perception of in-vehicle and waiting time of the initial services

Passengers do not perceive the benefit behind the higher frequency of shuttle bus services in comparison to that of the replaced tram line’s frequency

For different case studies, the new parameter set improves prediction accuracy by 3% to 13% in comparison to predictions based on the default parameter set

[ ]

Metro service disruptions. 5 months

Investigates changes in travel patterns due to long-term metro service disruption

RP survey (1038 responses) and SP survey (1944 records) data

MNL model for RP data, MNL model for SP data, Joint RP-SP MNL, and Joint RP-SP NL

Y = Mode alternatives

X = Modes, level of service (door-to-door time, in-vehicle time, out-of-vehicle time, transfer inconvenience, cost), socio-demographics (income, age, gender), trip purpose, and flexible work schedule

 

The odds of shifting to using buses or cars during metro disruptions are mainly related to income

Using a car was negatively correlated with the possibility of having a flexible work schedule during metro disruptions

The Joint RP-SP NL

model generally performed better than the joint RP-SP MNL model

  • Rows 2 and 3 include a study that has modeled a mitigation strategy’s impact. Automated fare collection (AFC). Stated preference (SP). Revealed preference (RP). Multinomial Logit Model (MNL). Nested logit (NL). “Y” refers to the model’s dependent variable(s). “X” refers to the model’s independent variables

2.1 Construction studies

Paper

Disruption & duration

Issues addressed

Data/methods

Main investigated factors in model(s)

Key summary statistics used

Key findings

[ ]

Construction of LRT line. ~ 3 years

LRT construction impacts on travel behavior, and travelers’ preferences about different sources of traffic information and responses to enroute VMS

RP survey. 430 responses

1 year after construction started and before it ended

Summary statistics

Multinomial logit model

Y = Route choice in reaction to VMS

X = Profession, driving experience, frequency of using affected roads, travel time, trip purpose, time of trip, type of trip information, and delays

Perceived travel times on the affected roads and

travelers’ preferred modes before and during construction

Preference of use and response to different sources of traffic information

Only 1.5% of trips were cancelled or rescheduled, many travelers shifted to transit

43% of people took routes of their choice, while 27% followed VMS

Travel behavioral reactions to VMS are highly influenced by the traveled path, trip travel time, departure time and trip purpose

[ ]

Construction of rail infrastructure and urban roads. Unspecified long-term periods

To compare the effect of rail construction with the improvement effect of road reconstruction on air quality

Quarterly panel data of 28 cities in China with rail transit from 2013–16

Operational rail length, length of rail built in season, and air quality data

Fixed effect models (364 records)

Y = Air quality index, SO , NO , PM and PM

X = Rail length in operations, rail length built in season, road area, GDP, and a set of control variables

Correlation between the operational rail length and air quality index

Correlation between the length of rail built in season and air quality index

Rail construction has greater impact on improving air quality than urban road reconstruction

Rail transit reduces air pollution in the long run. However, it has a negative short-term effect

Improvement effect on PM , PM and SO is apparent, but improvement effect on NO is relatively weak

[ ]

Large LRT construction

 ~ 14 days

Changes in free-floating bike-sharing system usage during disruptions caused by a light rail construction project

76,859 trips for 1,110 bikes for periods before, during and after the disruption (35 days)

Summary statistics

Two negative binomial regression models (spatial and temporal models)

Y = # of trips starting within a grid cell, # of trips within one hour

X = Land uses, # of points of interest, distances to selected destinations, socio-demographics, weather variables, weekday, time of day, and periods (semester and construction)

The aggregated number of trips that started during each hour per weekday during the study period

The number of trips per day during different weather conditions

The number of trips per day to destinations within 300 m of stations affected by the construction

The disruptions and subsequent changes in the transit network that were caused by the construction project had only minor impacts on bike-sharing usage patterns in the short term

The average number of total daily trips increased during construction but decreased afterwards to, roughly, its original level

[ ]

Metro closures. 12 and 16 days in 2016

Travel behavior changes due to Metro SafeTrack maintenance projects (or surges)

Panel survey data before and after Surge 1 and 2

318 responses before Surge 1, 420 before Surge 2

74 follow-up responses for Surge 1 and 68 for Surge 2

Summary statistics

 

Stated changes in travel behavior due to metro closure before disruption

Comparison between the stated preferences and the actual behavior

% of respondents who explored alternative modes of transport during SafeTrack Surge 1 and 2

Transit users changed modes or destinations instead of changing departure time with complete metro station shutdown

Wealthier riders are more likely to drive or switch to for-hire options

Many did not choose the option they reported in survey before the disruption. Also, 20% of people did not return to using metro after service was fully restored

[ ]

Metro closures. From 7 to 25 days in 2016

Changes in bike-share ridership due to metro closures as a result of the SafeTrack projects

Bike-share trip data

included periods before, during, and after closures (Jan 1st, 2015, to Dec 31st, 2017)

Autoregressive Poisson log-level time series model

Y = Daily bike-share activity for stations within 0.8 km of affected stations for Surges 2, 4, and 10

X = Weather, summer, weekends/holidays, 3 lag terms, and surge presence

Daily number of trips during study period

Description of ridership for each surge location for periods before, during, and after each surge

Kernel density estimation visualization of the top 80% of increases in ridership during surges

Disruptions increased bike-share ridership at the local level, mainly during weekdays. Peak-hour usage largely increased for Surge 10 but not for the other 2 surges (Surge 10 lasted nearly a month and spanned a busier and wider area)

After metro reopened, bike-share ridership returned to its original levels

[ ]

Metro construction. Unspecified period

The impact of metro

construction on bus performance, transit users, and car drivers

Quantitative data regarding subway construction, covering 64 bus lines in vicinity of metro line

Fuzzy weighted average technique

 

Transit service level: non-linear coefficient, line length, transfer distance and average waiting time

Traffic impact: saturation degree on work-zone section, at intersection, and volumes

Factors attributed to transit service level and traffic impact degree were degraded when bus routing scheme was implemented during construction

Bus routing scheme may have increased traffic on some roads but did not hinder daily travel of residents

[ ]

Metro closures

Several durations

The effects of implementing a new $2 single-trip fare (STF) for bike-share trips on the ridership and revenue, which included studying the influence of metro closures on ridership

Revenue and bike-share ridership data before and after the implementation of STF for a period more than 2 years

Summary statistics

ANOVA tests

Regression analysis

Y = Daily bike-share ridership

X = Weather conditions (temperature and precipitation), day of the week, STF, and season

Daily ridership of registered and casual users for one week before closure, during closure, and one week after closure for bike-sharing stations within 0.25 and 0.5-mile (0.4 and 0.8 km) radii of affected metro stations

There was a statistically significant increase in the daily ridership of registered members and casual users at docks located near metro stations that were impacted by metro service closures

The concurrency of STF introduction with the SafeTrack maintenance projects might have influenced this increase

  • Rows 1, 3, and 7 include a study that has modeled the impact of a mitigation strategy. Rows 4 and 6 include a study that has discussed or investigated the impact of a mitigation strategy using summary statistics. “Y” refers to the model’s dependent variable(s). “X” refers to the model’s independent variables. Stated preference (SP). Revealed preference (RP). Sulfur dioxide (SO 2 ). Nitrogen dioxide (NO 2 ). Fine particulate matter smaller than or equal to 10 µm in diameter (PM 10 ). Fine particulate matter smaller than or equal to 2.5 µm in diameter (PM 2.5 ). Gross domestic product (GDP). Analysis of variance (ANOVA). Variable message signs (VMS). Light rail transit (LRT)

3.1 Labor dispute and strike studies

Paper

Disruption & its duration

Issues addressed

Data/methods

Main investigated factors in model(s)

Key summary statistics used

Key findings

[ ]

Bus strike. 3 days

Biomonitoring of air genotoxicity during and after a transit strike

Two monitoring sites’ data during and after the strike

Summary statistics

Regression model

Y = Frequency of micronuclei

X = PM concentration, # of buses, weather conditions

Frequency of buses, PM levels, micronuclei levels, and weather conditions

The frequency of micronuclei was significantly higher in the city centre compared to that of the control site, and the highest levels recorded were during the transit strike

[ ]

Strike affecting all transit services (city bus, subway and trolley services). 7 days

Impact of a public transit strike on bicycle-share usage

Bike-share systems data, January to December of 2016

Interrupted time series and Bayesian structural time series models

Y = Daily bicycle share

X = Time period (pre-strike, during strike period, post-strike), weather conditions, other cities’ bicycle-share use

Total number of daily bicycle-share trips (pre-strike, strike, post-strike) in the cities of Philadelphia, Boston, Chicago, and Washington

Observed vs predicted data regarding number of bike-share trips

The strike resulted in short-term increased bike-share use for members and non-members. However, usage quickly returned to previous trends after the strike

Increase in ridership during strike was about 57%. Results suggest that non-members might have used bike-share for a slightly longer period

[ ]

Strike affecting bus and train services. 51 days

Changes in the chemical composition and the mass concentration levels of airborne pollutants

Downtown air monitoring station data during and after the strike

Summary statistics and condition probability function

 

CPF plots for the total particle number levels and geometric mean diameter during and after strikes

Particle number size distributions, and average mass concentrations of PM

During the strike, ambient particles were dominated by ultrafine particles with diameters as minute as 15 nm throughout the day

There was more than a 100% increase in mass concentrations of the particulate matter, elemental carbon, and organic carbon

[ ]

Strike affecting bus, bus rapid transit (BRT) and light rail transit (LRT) operations. 51 days

The environmental impact of public transit on 4 air pollutants: PM , sulphur dioxide (SO ), ozone (O ) and nitrogen oxide (NO)

19 air monitoring stations’ data for weekdays in Ontario for four years

Summary statistics

Difference-in-difference models

Y = Hourly levels of PM , SO , O and NO

X = Pre-strike, strike, pre-strike * Ottawa, strike * Ottawa, weather condition, and fixed-effect control variables

X = Pre-strike, strike phase 1, strike phase 2, strike phase 3, pre-strike * Ottawa, strike phases interactions with Ottawa, and fixed-effect control variables

Distribution of the pollutants

Kernel Density Function charts for the distribution of the concentration of pollutants

Average daily concentrations in Ottawa and the other Ontario-based stations

During the strike, there was a significant increase in PM and O levels, along with a decrease in NO levels, which is a gas produced by diesel engines found in transit buses

The PM and O levels significantly decreased in the final 3 weeks of the strike, suggesting that travelers started using environmentally friendly means of transport. Thus, previous studies that only investigated short-term strikes may overestimate the long-term environmental effects of transit

[ ]

Strike. 35 days

The impacts of the Metropolitan Transportation Authority’s (MTA) strike on traffic congestion

Freeways loop detector data for all major freeways

Mathematical model development

RD (Regression Discontinuity) model

Y = Average delay in min per mile for detector, share of time detector is occupied and hourly lane traffic flow

X = Date, strike, and date & strike interactions

No strike vs. during strike traffic flow and delay

Weekly peak hour average delay and changes in hourly traffic flow

Average highway delay increased by 47% during the strike. This increase continues through the strike

More delays were observed along freeways with parallel transit lines with heavy ridership

[ ]

Strike. 4 and 5 days

2013 Bay Area Rapid Transit (BART) strike impacts on freeway traffic conditions

Freeways loop detectors data for one year

Summary statistics

Non-parametric modeling to compare travel-time distributions

 

Traffic conditions (travel times & volume-weighted travel times) during typical conditions and strike days

Differences between the observed median baseline and strike traffic volumes as well as travel rates

Insignificant changes to network conditions, but segments parallel to the BART lines saw large delays like those of the worst day of a week

For one bottleneck, strikes showed a significant impact on travel times and volumes nearly doubling the median values on the worst day

[ ]

Strike. Various durations

Identified the short-term effect of public transit on air pollution

Air monitoring stations’ data and transit strikes data

Econometric models

Y = Daily levels of NO, CO and PM

X = Strike dummy, weather, and fixed-effect control variables

Changes in pollutant levels due to transit strike

Transit strikes lead to a large and statistically significant decrease in NO concentrations and an increase in CO; however, they have mixed effects on PM concentrations

[ ]

Strike. + 30 days

The benefit of using mobile phone-based sensor monitoring for analyzing longitudinal behavior

Mobile phone app (iEpi) data of 28 participants, month-long monitoring and demographic surveys

Summary statistics

 

Behavior of participants (dwell time, trip length, walking steps and visit frequency) for transit and non-transit users during and after the strike

The paper demonstrated the benefits of automated data for understanding travel behavior and the impact of strikes

Transit users visited fewer places during the strike and walked more

[ ]

Mostly metro service strikes. 1, 2, 3, and 5 days

The effect of public transport strikes on traffic conditions

Loop detector data from 8 major arterials

Generalized Linear Models (GLMs)

Y = Traffic flow, mean speed, and travel time

X = Site, strike type (metro, bus, all), time, day, direction, toll, traffic light, transit, area, road type and saturation level

Changes in hourly traffic flow per lane, mean traffic flow per lane, and mean speed

Traffic flow and mean speed changes for two selected sites

Strikes increased congestion by increasing traffic flow, reducing mean speed, and increasing travel times

Strike coverage was a major factor in congestion

Other related factors were and

  • Row 9 includes a study that has modeled the impact of a mitigation strategy. Rows 5 and 6 include a study that has discussed or investigated the impact of a mitigation strategy using summary statistics. “Y” refers to the model’s dependent variable(s). “X” refers to the model’s independent variables. Fine particulate matter smaller than or equal to 10 μm in diameter (PM 10 ). Fine particulate matter smaller than or equal to 2.5 μm in diameter (PM 2.5 ). Sulphur dioxide (SO 2 ). Ozone (O 3 ). Nitrogen oxide (NO or NO X ). Carbon monoxide (CO). Condition probability function (CPF). Bay Area Rapid Transit (BART). Los Angeles County Metropolitan Transportation Authority (MTA)

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Noureldin, M.G., Diab, E. Impacts of long-term transit system disruptions and transitional periods on travelers: a systematic review. Discov Cities 1 , 15 (2024). https://doi.org/10.1007/s44327-024-00015-5

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    A systematic review of preprocessing techniques employed on wearable sensor data to ensure their readiness for artificial intelligence/machine learning ("AI/ML-ready") applications and a general framework for those multiple types of databases has been proposed. BACKGROUND Wearable sensors are increasingly being explored in healthcare, including in cancer care, for their potential in ...

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    The molecular and neurochemical effects of exercise on the brain.• Exercise mitigating neurodegenerative disorders and age-related cognitive decline.• Effects of physical exercise on brain development and neuroplasticity.Manuscript types desired for this topic are Original Research, Review, Systematic Review, Mini Review, Perspectiv...