what is a literature review article

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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Methodology

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

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Libraries | Research Guides

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

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

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

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

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

• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

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

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

What are Literature Reviews?

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

Goals of Literature Reviews

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

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

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

What kinds of sources require a Literature Review?

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

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

Types of Literature Reviews

What kinds of literature reviews are written?

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

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

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

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

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

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

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

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

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
• Last Updated: Sep 21, 2022 2:16 PM
• URL: https://guides.lib.uconn.edu/literaturereview

How to Write a Literature Review

What is a literature review.

• What Is the Literature
• Writing the Review

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

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

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

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

Types of Literature Reviews

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

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

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

Examples of Literature Reviews

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

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

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

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

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

This article has a standard breakdown of sections:

• Introduction
• Literature Review
• Some discussion sections

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

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

• Next: What Is the Literature >>
• Last Updated: Jan 11, 2024 9:48 AM
• URL: https://libguides.wesleyan.edu/litreview

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

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

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

Interviews have been edited for length and clarity.

Updates & Corrections

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

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

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Literature Reviews

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What is a Literature Review?

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

A literature review should: 

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

From  S age Research Methods

Purpose of a Literature Review

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

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

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

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

Limitations of a Literature Review

Some of the limitations of a literature review are:

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

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

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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Literature Review - what is a Literature Review, why it is important and how it is done

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

Source NC State University Libraries. This video is published under a Creative Commons 3.0 BY-NC-SA US license.

What are the goals of creating a Literature Review?

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

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

When do you need to write a Literature Review?

• When writing a prospectus or a thesis/dissertation
• When writing a research paper
• When writing a grant proposal

In all these cases you need to dedicate a chapter in these works to showcase what have been written about your research topic and to point out how your own research will shed a new light into these body of scholarship.

Literature reviews are also written as standalone articles as a way to survey a particular research topic in-depth. This type of literature reviews look at a topic from a historical perspective to see how the understanding of the topic have change through time.

What kinds of literature reviews are written?

• Narrative Review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.
• Book review essays/ Historiographical review essays : This is a type of review that focus on a small set of research books on a particular topic " to locate these books within current scholarship, critical methodologies, and approaches" in the field. - LARR
• Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L.K. (2013). Research in Communication Sciences and Disorders . San Diego, CA: Plural Publishing.
• Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M.C. & Ilardi, S.S. (2003). Handbook of Research Methods in Clinical Psychology . Malden, MA: Blackwell Pub.
• Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). "Qualitative meta-synthesis: A question of dialoguing with texts," Journal of Advanced Nursing , 53(3), 311-318.

Guide adapted from "Literature Review" , a guide developed by Marisol Ramos used under CC BY 4.0 /modified from original.

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

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

Table of Contents

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

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

Frequently asked questions 

What is a literature review .

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

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

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

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

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

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

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

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

Literature review example 

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

Literature Review on Climate Change Impacts on Biodiversity:  

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

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

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

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

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

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How to write a good literature review 

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

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

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

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

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

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

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

Conducting a literature review 

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

Choose a Topic and Define the Research Question:  

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

Decide on the Scope of Your Review:  

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

Select Databases for Searches:  

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

Conduct Searches and Keep Track:  

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

Review the Literature:  

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

Organize and Write Your Literature Review:  

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

Whether you’re exploring a new research field or finding new angles to develop an existing topic, sifting through hundreds of papers can take more time than you have to spare. But what if you could find science-backed insights with verified citations in seconds? That’s the power of Paperpal’s new Research feature!  

How to write a literature review faster with Paperpal?  

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research | Cite feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface. It also allows you auto-cite references in 10,000+ styles and save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research | Cite” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 

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

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

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

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

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

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

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

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

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

References 

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

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What Is A Literature Review?

A plain-language explainer (with examples).

By:  Derek Jansen (MBA) & Kerryn Warren (PhD) | June 2020 (Updated May 2023)

If you’re faced with writing a dissertation or thesis, chances are you’ve encountered the term “literature review” . If you’re on this page, you’re probably not 100% what the literature review is all about. The good news is that you’ve come to the right place.

Literature Review 101

• What (exactly) is a literature review
• What’s the purpose of the literature review chapter
• How to find high-quality resources
• How to structure your literature review chapter
• Example of an actual literature review

What is a literature review?

The word “literature review” can refer to two related things that are part of the broader literature review process. The first is the task of  reviewing the literature  – i.e. sourcing and reading through the existing research relating to your research topic. The second is the  actual chapter  that you write up in your dissertation, thesis or research project. Let’s look at each of them:

Reviewing the literature

The first step of any literature review is to hunt down and  read through the existing research  that’s relevant to your research topic. To do this, you’ll use a combination of tools (we’ll discuss some of these later) to find journal articles, books, ebooks, research reports, dissertations, theses and any other credible sources of information that relate to your topic. You’ll then  summarise and catalogue these  for easy reference when you write up your literature review chapter. 

The literature review chapter

The second step of the literature review is to write the actual literature review chapter (this is usually the second chapter in a typical dissertation or thesis structure ). At the simplest level, the literature review chapter is an  overview of the key literature  that’s relevant to your research topic. This chapter should provide a smooth-flowing discussion of what research has already been done, what is known, what is unknown and what is contested in relation to your research topic. So, you can think of it as an  integrated review of the state of knowledge  around your research topic. 

What’s the purpose of a literature review?

The literature review chapter has a few important functions within your dissertation, thesis or research project. Let’s take a look at these:

Purpose #1 – Demonstrate your topic knowledge

The first function of the literature review chapter is, quite simply, to show the reader (or marker) that you  know what you’re talking about . In other words, a good literature review chapter demonstrates that you’ve read the relevant existing research and understand what’s going on – who’s said what, what’s agreed upon, disagreed upon and so on. This needs to be  more than just a summary  of who said what – it needs to integrate the existing research to  show how it all fits together  and what’s missing (which leads us to purpose #2, next). 

Purpose #2 – Reveal the research gap that you’ll fill

The second function of the literature review chapter is to  show what’s currently missing  from the existing research, to lay the foundation for your own research topic. In other words, your literature review chapter needs to show that there are currently “missing pieces” in terms of the bigger puzzle, and that  your study will fill one of those research gaps . By doing this, you are showing that your research topic is original and will help contribute to the body of knowledge. In other words, the literature review helps justify your research topic.  

Purpose #3 – Lay the foundation for your conceptual framework

The third function of the literature review is to form the  basis for a conceptual framework . Not every research topic will necessarily have a conceptual framework, but if your topic does require one, it needs to be rooted in your literature review. 

For example, let’s say your research aims to identify the drivers of a certain outcome – the factors which contribute to burnout in office workers. In this case, you’d likely develop a conceptual framework which details the potential factors (e.g. long hours, excessive stress, etc), as well as the outcome (burnout). Those factors would need to emerge from the literature review chapter – they can’t just come from your gut! 

So, in this case, the literature review chapter would uncover each of the potential factors (based on previous studies about burnout), which would then be modelled into a framework. 

Purpose #4 – To inform your methodology

The fourth function of the literature review is to  inform the choice of methodology  for your own research. As we’ve  discussed on the Grad Coach blog , your choice of methodology will be heavily influenced by your research aims, objectives and questions . Given that you’ll be reviewing studies covering a topic close to yours, it makes sense that you could learn a lot from their (well-considered) methodologies.

So, when you’re reviewing the literature, you’ll need to  pay close attention to the research design , methodology and methods used in similar studies, and use these to inform your methodology. Quite often, you’ll be able to  “borrow” from previous studies . This is especially true for quantitative studies , as you can use previously tried and tested measures and scales. 

How do I find articles for my literature review?

Finding quality journal articles is essential to crafting a rock-solid literature review. As you probably already know, not all research is created equally, and so you need to make sure that your literature review is  built on credible research . 

We could write an entire post on how to find quality literature (actually, we have ), but a good starting point is Google Scholar . Google Scholar is essentially the academic equivalent of Google, using Google’s powerful search capabilities to find relevant journal articles and reports. It certainly doesn’t cover every possible resource, but it’s a very useful way to get started on your literature review journey, as it will very quickly give you a good indication of what the  most popular pieces of research  are in your field.

One downside of Google Scholar is that it’s merely a search engine – that is, it lists the articles, but oftentimes  it doesn’t host the articles . So you’ll often hit a paywall when clicking through to journal websites. 

Thankfully, your university should provide you with access to their library, so you can find the article titles using Google Scholar and then search for them by name in your university’s online library. Your university may also provide you with access to  ResearchGate , which is another great source for existing research. 

Remember, the correct search keywords will be super important to get the right information from the start. So, pay close attention to the keywords used in the journal articles you read and use those keywords to search for more articles. If you can’t find a spoon in the kitchen, you haven’t looked in the right drawer. 

Need a helping hand?

How should I structure my literature review?

Unfortunately, there’s no generic universal answer for this one. The structure of your literature review will depend largely on your topic area and your research aims and objectives.

You could potentially structure your literature review chapter according to theme, group, variables , chronologically or per concepts in your field of research. We explain the main approaches to structuring your literature review here . You can also download a copy of our free literature review template to help you establish an initial structure.

In general, it’s also a good idea to start wide (i.e. the big-picture-level) and then narrow down, ending your literature review close to your research questions . However, there’s no universal one “right way” to structure your literature review. The most important thing is not to discuss your sources one after the other like a list – as we touched on earlier, your literature review needs to synthesise the research , not summarise it .

Ultimately, you need to craft your literature review so that it conveys the most important information effectively – it needs to tell a logical story in a digestible way. It’s no use starting off with highly technical terms and then only explaining what these terms mean later. Always assume your reader is not a subject matter expert and hold their hand through a journe y of the literature while keeping the functions of the literature review chapter (which we discussed earlier) front of mind.

Example of a literature review

In the video below, we walk you through a high-quality literature review from a dissertation that earned full distinction. This will give you a clearer view of what a strong literature review looks like in practice and hopefully provide some inspiration for your own. 

Wrapping Up

In this post, we’ve (hopefully) answered the question, “ what is a literature review? “. We’ve also considered the purpose and functions of the literature review, as well as how to find literature and how to structure the literature review chapter. If you’re keen to learn more, check out the literature review section of the Grad Coach blog , as well as our detailed video post covering how to write a literature review . 

Psst… there’s more!

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

16 Comments

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Conduct a literature review

What is a literature review.

A literature review is a summary of the published work in a field of study. This can be a section of a larger paper or article, or can be the focus of an entire paper. Literature reviews show that you have examined the breadth of knowledge and can justify your thesis or research questions. They are also valuable tools for other researchers who need to find a summary of that field of knowledge.

Unlike an annotated bibliography, which is a list of sources with short descriptions, a literature review synthesizes sources into a summary that has a thesis or statement of purpose—stated or implied—at its core.

How do I write a literature review?

Step 1: define your research scope.

• What is the specific research question that your literature review helps to define?
• Are there a maximum or minimum number of sources that your review should include?

Ask us if you have questions about refining your topic, search methods, writing tips, or citation management.

Step 2: Identify the literature

Start by searching broadly. Literature for your review will typically be acquired through scholarly books, journal articles, and/or dissertations. Develop an understanding of what is out there, what terms are accurate and helpful, etc., and keep track of all of it with citation management tools . If you need help figuring out key terms and where to search, ask us .

Use citation searching to track how scholars interact with, and build upon, previous research:

• Mine the references cited section of each relevant source for additional key sources
• Use Google Scholar or Scopus to find other sources that have cited a particular work

Step 3: Critically analyze the literature

Key to your literature review is a critical analysis of the literature collected around your topic. The analysis will explore relationships, major themes, and any critical gaps in the research expressed in the work. Read and summarize each source with an eye toward analyzing authority, currency, coverage, methodology, and relationship to other works. The University of Toronto's Writing Center provides a comprehensive list of questions you can use to analyze your sources.

Step 4: Categorize your resources

Divide the available resources that pertain to your research into categories reflecting their roles in addressing your research question. Possible ways to categorize resources include organization by:

• methodology
• theoretical/philosophical approach

Regardless of the division, each category should be accompanied by thorough discussions and explanations of strengths and weaknesses, value to the overall survey, and comparisons with similar sources. You may have enough resources when:

• You've used multiple databases and other resources (web portals, repositories, etc.) to get a variety of perspectives on the research topic.
• The same citations are showing up in a variety of databases.

Additional resources

Undergraduate student resources.

• Literature Review Handout (University of North Carolina at Chapel Hill)
• Learn how to write a review of literature (University of Wisconsin-Madison)

Graduate student and faculty resources

• Information Research Strategies (University of Arizona)
• Literature Reviews: An Overview for Graduate Students (NC State University)
• Oliver, P. (2012). Succeeding with Your Literature Review: A Handbook for Students [ebook]
• Machi, L. A. & McEvoy, B. T. (2016). The Literature Review: Six Steps to Success [ebook]
• Graustein, J. S. (2012). How to Write an Exceptional Thesis or Dissertation: A Step-by-Step Guide from Proposal to Successful Defense [ebook]
• Thomas, R. M. & Brubaker, D. L. (2008). Theses and Dissertations: A Guide to Planning, Research, and Writing

Literature Reviews and Annotated Bibliographies

Initial databases for a literature review.

What is a Literature Review?

• How to Write a Literature Review?
• Graduate Research and the Literature Review
• What is an Annotated Bibliography?
• How to Evaluate Sources?
• Citation & Avoiding Plagiarism

The databases listed here are interdisciplinary and suitable for most disciplines. For databases specific to your discipline see our Research Guides  

Academic Search Ultimate  Includes some full text

A great place to start to search for magazine and journal articles on almost all topics. Tip : Check "peer reviewed" box to limit your search to scholarly journals.

Dissertations and Theses   (1861+) Indexes dissertations accepted for doctoral degrees by accredited North American educational institutions and over 200 other institutions. Also covers masters theses since 1962. Starting in the early to mid-1900's, the full text is included for an increasingly comprehensive number of dissertations and theses. 

Google Scholar   Enables you to search specifically for scholarly literature, including peer-reviewed papers, theses, books, preprints, abstracts and technical reports from all broad areas of research. Use Google Scholar to find articles from a widevariety of academic publishers, professional societies, preprint repositories and universities, as well as scholarly articles available across the web

Humanities and Social Science Retrospective   Bibliographic database that provides citations to articles in a wide range of English language journals in the humanities and social sciences for the period 1907-1984.

  JSTOR Includes full text Includes long runs of backfiles of scholarly journals. Subjects covered include Anthropology, Asian Studies, Ecology, Economics, Education, Finance, History, Mathematics, Philosophy, Political Science, Population Studies, and Sociology.

Periodical Archives Online- (1770-1995) Includes full text; Full text archive of hundreds of periodicals in the humanities and social sciences from their first issues to 1995 Allows date-limited searching. Periodical Index Online, 1665 - 1995

"A literature review is an account of what has been published on a topic by accredited scholars and researchers. Occasionally you will be asked to write one as a separate assignment, ..., but more often it is part of the introduction to an essay, research report, or thesis. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries."

--Written by Dena Taylor, Health Sciences Writing Centre and available at http://www.writing.utoronto.ca/advice/specific-types-of-writing/literature-review (Accessed August 8th, 2011)

Writing the Literature Review sites :

  Literature Reviews: UNC - Chapel Hill

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Methods Map: Literature Review

What are the goals of creating a Literature Review?

• To develop a new theory
• To evaluate a theory or theories
• To survey what’s known about a topic
• Identify a problem in a field of research 
• Provide a historical overview of the development of a topic

Type of Literature Reviews:

• Mature and/or established topic: Topic is well-known and the purpose of this type of review is to analyze and synthesize this accumulated body of research.
• Emerging Topic: The purpose of this type of review to identify understudy or new emerging research area.
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What is a review article?

Learn how to write a review article.

What is a review article? A review article can also be called a literature review, or a review of literature. It is a survey of previously published research on a topic. It should give an overview of current thinking on the topic. And, unlike an original research article, it will not present new experimental results.

Writing a review of literature is to provide a critical evaluation of the data available from existing studies. Review articles can identify potential research areas to explore next, and sometimes they will draw new conclusions from the existing data.

Why write a review article?

To provide a comprehensive foundation on a topic.

To explain the current state of knowledge.

To identify gaps in existing studies for potential future research.

To highlight the main methodologies and research techniques.

Did you know? 

There are some journals that only publish review articles, and others that do not accept them.

Make sure you check the  aims and scope  of the journal you’d like to publish in to find out if it’s the right place for your review article.

How to write a review article

Below are 8 key items to consider when you begin writing your review article.

Check the journal’s aims and scope

Make sure you have read the aims and scope for the journal you are submitting to and follow them closely. Different journals accept different types of articles and not all will accept review articles, so it’s important to check this before you start writing.

Define your scope

Define the scope of your review article and the research question you’ll be answering, making sure your article contributes something new to the field. 

As award-winning author Angus Crake told us, you’ll also need to “define the scope of your review so that it is manageable, not too large or small; it may be necessary to focus on recent advances if the field is well established.” 

Finding sources to evaluate

When finding sources to evaluate, Angus Crake says it’s critical that you “use multiple search engines/databases so you don’t miss any important ones.” 

For finding studies for a systematic review in medical sciences,  read advice from NCBI . 

Writing your title, abstract and keywords

Spend time writing an effective title, abstract and keywords. This will help maximize the visibility of your article online, making sure the right readers find your research. Your title and abstract should be clear, concise, accurate, and informative. 

For more information and guidance on getting these right, read our guide to writing a good abstract and title  and our  researcher’s guide to search engine optimization . 

Introduce the topic

Does a literature review need an introduction? Yes, always start with an overview of the topic and give some context, explaining why a review of the topic is necessary. Gather research to inform your introduction and make it broad enough to reach out to a large audience of non-specialists. This will help maximize its wider relevance and impact. 

Don’t make your introduction too long. Divide the review into sections of a suitable length to allow key points to be identified more easily.

Include critical discussion

Make sure you present a critical discussion, not just a descriptive summary of the topic. If there is contradictory research in your area of focus, make sure to include an element of debate and present both sides of the argument. You can also use your review paper to resolve conflict between contradictory studies.

What researchers say

Angus Crake, researcher

As part of your conclusion, include making suggestions for future research on the topic. Focus on the goal to communicate what you understood and what unknowns still remains.

Use a critical friend

Always perform a final spell and grammar check of your article before submission. 

You may want to ask a critical friend or colleague to give their feedback before you submit. If English is not your first language, think about using a language-polishing service.

Find out more about how  Taylor & Francis Editing Services can help improve your manuscript before you submit.

What is the difference between a research article and a review article?

[tableshd id=”17295″]

Before you submit your review article…

Complete this checklist before you submit your review article:

Have you checked the journal’s aims and scope?

Have you defined the scope of your article?

Did you use multiple search engines to find sources to evaluate?

Have you written a descriptive title and abstract using keywords?

Did you start with an overview of the topic?

Have you presented a critical discussion?

Have you included future suggestions for research in your conclusion?

Have you asked a friend to do a final spell and grammar check?

Expert help for your manuscript

Taylor & Francis Editing Services  offers a full range of pre-submission manuscript preparation services to help you improve the quality of your manuscript and submit with confidence.

Related resources

How to edit your paper

Writing a scientific literature review

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• 1 The FEBS Journal Editorial Office, Cambridge, UK.
• PMID: 35792782
• DOI: 10.1111/febs.16565

Literature reviews are valuable resources for the scientific community. With research accelerating at an unprecedented speed in recent years and more and more original papers being published, review articles have become increasingly important as a means to keep up to date with developments in a particular area of research. A good review article provides readers with an in-depth understanding of a field and highlights key gaps and challenges to address with future research. Writing a review article also helps to expand the writer's knowledge of their specialist area and to develop their analytical and communication skills, amongst other benefits. Thus, the importance of building review-writing into a scientific career cannot be overstated. In this instalment of The FEBS Journal's Words of Advice series, I provide detailed guidance on planning and writing an informative and engaging literature review.

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Education: Lit Review + Methods

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What is a Literature Review?

A literature review is a comprehensive and up-to-date overview of the principal research about the topic being studied. Your literature review should contain the following information:

• The most pertinent studies and important past and current research and practices in the field
• An overview of sources you have explored while researching a particular topic
• An explanation to your readers as to how your research fits within a larger field of study.

The review helps form the intellectual framework for the study.

17 - what is a literature review  from  Joshua Vossler  on  Vimeo .

Why do a Literature Review?

At its core, a literature provides a summary of existing knowledge on a subject or topic and identifies areas where research is lacking: missing information, incomplete studies or studies that draw conflicting conclusions, or perhaps even outdated methods of research.

This can be especially helpful if you intend to conduct research of your own on this topic; by explaining where the previous studies have fallen short or leave openings for further examination, you provide a strong foundation and justification for the research project you intend to embark on.

Literature reviews can stand on their own as an article or assignment for a class, or they can serve as an introduction to a larger work, such as an article describing a study or even a book. They can also vary in granularity: a literature review in the beginning of an article might only summarize the largest or most influential studies, while an academic literature review will not only describe the research so far but look for common themes, analyze the quality of the research, and explain gaps where further research is needed.

Elements of a Successful Literature Review

When preparing your literature review, keep these questions in mind:

• What is your literature review about?
• Why are you studying this topic?
• How will you organize your sources?  (You could group them by themes or subtopics, or perhaps keep them in chronological order. The way you present your sources is important, so make sure you think hard about this!)
• What are the major themes/subtopics that you discovered when reading your sources?
• Where could more research be done to increase our understanding of this topic?

For each individual source, be prepared to analyze:

• Who were the key researchers and what are their qualifications?
• How was the research conducted?
• The similarities and differences between this source and the others in your literature review
• How this source contributes to greater understanding of the topic as a whole
• Any questions you have about the research done, which could identify opportunities for further study

When preparing your literature review, examine these elements and determine which ones would be best for your paper. (Tip: If you're not sure which parts of the literature review to include, ask your professor!)

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The Literature Review: A Foundation for High-Quality Medical Education Research

a  These are subscription resources. Researchers should check with their librarian to determine their access rights.

Despite a surge in published scholarship in medical education 1 and rapid growth in journals that publish educational research, manuscript acceptance rates continue to fall. 2 Failure to conduct a thorough, accurate, and up-to-date literature review identifying an important problem and placing the study in context is consistently identified as one of the top reasons for rejection. 3 , 4 The purpose of this editorial is to provide a road map and practical recommendations for planning a literature review. By understanding the goals of a literature review and following a few basic processes, authors can enhance both the quality of their educational research and the likelihood of publication in the Journal of Graduate Medical Education ( JGME ) and in other journals.

The Literature Review Defined

In medical education, no organization has articulated a formal definition of a literature review for a research paper; thus, a literature review can take a number of forms. Depending on the type of article, target journal, and specific topic, these forms will vary in methodology, rigor, and depth. Several organizations have published guidelines for conducting an intensive literature search intended for formal systematic reviews, both broadly (eg, PRISMA) 5 and within medical education, 6 and there are excellent commentaries to guide authors of systematic reviews. 7 , 8

• A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact.
• A literature review provides context, informs methodology, maximizes innovation, avoids duplicative research, and ensures that professional standards are met.
• Literature reviews take time, are iterative, and should continue throughout the research process.
• Researchers should maximize the use of human resources (librarians, colleagues), search tools (databases/search engines), and existing literature (related articles).
• Keeping organized is critical.

Such work is outside the scope of this article, which focuses on literature reviews to inform reports of original medical education research. We define such a literature review as a synthetic review and summary of what is known and unknown regarding the topic of a scholarly body of work, including the current work's place within the existing knowledge . While this type of literature review may not require the intensive search processes mandated by systematic reviews, it merits a thoughtful and rigorous approach.

Purpose and Importance of the Literature Review

An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the “journal-as-conversation” metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: “Imagine yourself joining a conversation at a social event. After you hang about eavesdropping to get the drift of what's being said (the conversational equivalent of the literature review), you join the conversation with a contribution that signals your shared interest in the topic, your knowledge of what's already been said, and your intention.” 9

The literature review helps any researcher “join the conversation” by providing context, informing methodology, identifying innovation, minimizing duplicative research, and ensuring that professional standards are met. Understanding the current literature also promotes scholarship, as proposed by Boyer, 10 by contributing to 5 of the 6 standards by which scholarly work should be evaluated. 11 Specifically, the review helps the researcher (1) articulate clear goals, (2) show evidence of adequate preparation, (3) select appropriate methods, (4) communicate relevant results, and (5) engage in reflective critique.

Failure to conduct a high-quality literature review is associated with several problems identified in the medical education literature, including studies that are repetitive, not grounded in theory, methodologically weak, and fail to expand knowledge beyond a single setting. 12 Indeed, medical education scholars complain that many studies repeat work already published and contribute little new knowledge—a likely cause of which is failure to conduct a proper literature review. 3 , 4

Likewise, studies that lack theoretical grounding or a conceptual framework make study design and interpretation difficult. 13 When theory is used in medical education studies, it is often invoked at a superficial level. As Norman 14 noted, when theory is used appropriately, it helps articulate variables that might be linked together and why, and it allows the researcher to make hypotheses and define a study's context and scope. Ultimately, a proper literature review is a first critical step toward identifying relevant conceptual frameworks.

Another problem is that many medical education studies are methodologically weak. 12 Good research requires trained investigators who can articulate relevant research questions, operationally define variables of interest, and choose the best method for specific research questions. Conducting a proper literature review helps both novice and experienced researchers select rigorous research methodologies.

Finally, many studies in medical education are “one-offs,” that is, single studies undertaken because the opportunity presented itself locally. Such studies frequently are not oriented toward progressive knowledge building and generalization to other settings. A firm grasp of the literature can encourage a programmatic approach to research.

Approaching the Literature Review

Considering these issues, journals have a responsibility to demand from authors a thoughtful synthesis of their study's position within the field, and it is the authors' responsibility to provide such a synthesis, based on a literature review. The aforementioned purposes of the literature review mandate that the review occurs throughout all phases of a study, from conception and design, to implementation and analysis, to manuscript preparation and submission.

Planning the literature review requires understanding of journal requirements, which vary greatly by journal ( table 1 ). Authors are advised to take note of common problems with reporting results of the literature review. Table 2 lists the most common problems that we have encountered as authors, reviewers, and editors.

Sample of Journals' Author Instructions for Literature Reviews Conducted as Part of Original Research Article a

Common Problem Areas for Reporting Literature Reviews in the Context of Scholarly Articles

Locating and Organizing the Literature

Three resources may facilitate identifying relevant literature: human resources, search tools, and related literature. As the process requires time, it is important to begin searching for literature early in the process (ie, the study design phase). Identifying and understanding relevant studies will increase the likelihood of designing a relevant, adaptable, generalizable, and novel study that is based on educational or learning theory and can maximize impact.

Human Resources

A medical librarian can help translate research interests into an effective search strategy, familiarize researchers with available information resources, provide information on organizing information, and introduce strategies for keeping current with emerging research. Often, librarians are also aware of research across their institutions and may be able to connect researchers with similar interests. Reaching out to colleagues for suggestions may help researchers quickly locate resources that would not otherwise be on their radar.

During this process, researchers will likely identify other researchers writing on aspects of their topic. Researchers should consider searching for the publications of these relevant researchers (see table 3 for search strategies). Additionally, institutional websites may include curriculum vitae of such relevant faculty with access to their entire publication record, including difficult to locate publications, such as book chapters, dissertations, and technical reports.

Strategies for Finding Related Researcher Publications in Databases and Search Engines

Search Tools and Related Literature

Researchers will locate the majority of needed information using databases and search engines. Excellent resources are available to guide researchers in the mechanics of literature searches. 15 , 16

Because medical education research draws on a variety of disciplines, researchers should include search tools with coverage beyond medicine (eg, psychology, nursing, education, and anthropology) and that cover several publication types, such as reports, standards, conference abstracts, and book chapters (see the box for several information resources). Many search tools include options for viewing citations of selected articles. Examining cited references provides additional articles for review and a sense of the influence of the selected article on its field.

Box Information Resources

• Web of Science a
• Education Resource Information Center (ERIC)
• Cumulative Index of Nursing & Allied Health (CINAHL) a
• Google Scholar

Once relevant articles are located, it is useful to mine those articles for additional citations. One strategy is to examine references of key articles, especially review articles, for relevant citations.

Getting Organized

As the aforementioned resources will likely provide a tremendous amount of information, organization is crucial. Researchers should determine which details are most important to their study (eg, participants, setting, methods, and outcomes) and generate a strategy for keeping those details organized and accessible. Increasingly, researchers utilize digital tools, such as Evernote, to capture such information, which enables accessibility across digital workspaces and search capabilities. Use of citation managers can also be helpful as they store citations and, in some cases, can generate bibliographies ( table 4 ).

Citation Managers

Knowing When to Say When

Researchers often ask how to know when they have located enough citations. Unfortunately, there is no magic or ideal number of citations to collect. One strategy for checking coverage of the literature is to inspect references of relevant articles. As researchers review references they will start noticing a repetition of the same articles with few new articles appearing. This can indicate that the researcher has covered the literature base on a particular topic.

Putting It All Together

In preparing to write a research paper, it is important to consider which citations to include and how they will inform the introduction and discussion sections. The “Instructions to Authors” for the targeted journal will often provide guidance on structuring the literature review (or introduction) and the number of total citations permitted for each article category. Reviewing articles of similar type published in the targeted journal can also provide guidance regarding structure and average lengths of the introduction and discussion sections.

When selecting references for the introduction consider those that illustrate core background theoretical and methodological concepts, as well as recent relevant studies. The introduction should be brief and present references not as a laundry list or narrative of available literature, but rather as a synthesized summary to provide context for the current study and to identify the gap in the literature that the study intends to fill. For the discussion, citations should be thoughtfully selected to compare and contrast the present study's findings with the current literature and to indicate how the present study moves the field forward.

To facilitate writing a literature review, journals are increasingly providing helpful features to guide authors. For example, the resources available through JGME include several articles on writing. 17 The journal Perspectives on Medical Education recently launched “The Writer's Craft,” which is intended to help medical educators improve their writing. Additionally, many institutions have writing centers that provide web-based materials on writing a literature review, and some even have writing coaches.

The literature review is a vital part of medical education research and should occur throughout the research process to help researchers design a strong study and effectively communicate study results and importance. To achieve these goals, researchers are advised to plan and execute the literature review carefully. The guidance in this editorial provides considerations and recommendations that may improve the quality of literature reviews.

SOC 200 - Sims: How to Write a Lit Review

• What are Literature Reviews?
• How to Write a Lit Review
• How to Choose a Topic
• Finding the Literature

How to write a literature review

Below are the steps you should follow when crafting a lit review for your class assignment.

• It's preferable if you can select a topic that you find interesting, because this will make the work seem less like work. 
• It's also important to select a topic that many researchers have already explored. This way, you'll actually have "literature" to "review."
• Sometimes, doing a very general search and reading other literature reviews can reveal a topic or avenue of research to you. 
• It's important to gain an understanding of your topic's research history, in order to properly comprehend how and why the current (emerging) research exists.
• One trick is to look at the References (aka Bibliographies aka Works Cited pages) of any especially relevant articles, in order to expand your search for those same sources. This is because there is often overlap between works, and if you're paying attention, one source can point you to several others.
• One method is to start with the most recently-published research and then use their citations to identify older research, allowing you to piece together a timeline and work backwards. 
• Chronologically : discuss the literature in order of its writing/publication. This will demonstrate a change in trends over time, and/or detail a history of controversy in the field, and/or illustrate developments in the field.
• Thematically : group your sources by subject or theme. This will show the variety of angels from which your topic has been studied. This method works well if you are trying to identify a sub-topic that has so far been overlooked by other researchers.
• Methodologically : group your sources by methodology. For example, divide the literature into categories like qualitative versus quantitative, or by population or geographical region, etc. 
• Theoretically : group your sources by theoretical lens. Your textbook should have a section(s) dedicated to the various theories in your field. If you're unsure, you should ask your professor.
• Are there disagreements on some issues, and consensus on others?
• How does this impact the path of research and discovery?
• Many articles will have a Limitations section, or a Discussion section, wherein suggestions are provided for next steps to further the research.
• These are goldmines for helping you see a possible outlook of the situation. 
• Identifying any gaps in the literature that are of a particular interest to your research goals will help you justify why your own research should be performed. 
• Be selective about which points from the source you use. The information should be the most important and the most relevant. 
• Use direct quotes sparingly, and don't rely too heavily on summaries and paraphrasing. You should be drawing conclusions about how the literature relates to your own analysis or the other literature. 
• Synthesize your sources. The goal is not to make a list of summaries, but to show how the sources relate to one another and to your own analysis. 
• At the end, make suggestions for future research. What subjects, populations, methodologies, or theoretical lenses warrant further exploration? What common flaws or biases did you identify that could be corrected in future studies? 
• Common citation styles for sociology classes include APA and ASA.

Understanding how a literature review is structured will help you as you craft your own. 

Below is information and example articles that you should review, in order to comprehend why they are written a certain way.

Below are some very good examples of Literature Reviews:

Cyberbullying: How Physical Intimidation Influences the Way People are Bullied

Use of Propofol and Emergence Agitation in Children

Eternity and Immortality in Spinoza's 'Ethics'

As you read these, take note of the sections that comprise the main structure of each one:

• Introduction 
• Summarize sources
• Synthesize sources

Below are some articles that provide very good examples of an "Introduction" section, which includes a "Review of the Literature."

• Sometimes, there is both an Introduction section, and a separate Review of the Literature section (oftentimes, it simply depends on the publication)

Krimm, H., & Lund, E. (2021). Efficacy of online learning modules for teaching dialogic reading strategies and phonemic awareness.  Language, Speech & Hearing Services in Schools,  52 (4), 1020-1030.  https://doi.org/10.1044/2021_LSHSS-21-00011

Melfsen, S., Jans, T., Romanos, M., & Walitza, S. (2022). Emotion regulation in selective mutism: A comparison group study in children and adolescents with selective mutism.  Journal of Psychiatric Research,  151 , 710-715.  https://doi.org/10.1016/j.jpsychires.2022.05.040

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Suggested Reading

• How to: Conduct a Lit Review (from Central Michigan University)
• Purdue OWL Writing Lab's Advice for Writing a Lit Review

How to Read a Scholarly Article

 read:.

• Things to consider when reading a scholarly article This helpful guide, from Meriam Library at California State University in Chico, explains what a scholarly article is and provides tips for reading them.

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• How to read a scholarly article (YouTube) This tutorial, from Western University, quickly and efficiently describes how to read a scholarly article.
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Scholarly Articles: How can I tell?

• Journal Information

Literature Review

• Author and affiliation
• Introduction
• Specialized Vocabulary
• Methodology
• Research sponsors
• Peer-review

The literature review section of an article is a summary or analysis of all the research the author read before doing his/her own research. This section may be part of the introduction or in a section called Background. It provides the background on who has done related research, what that research has or has not uncovered and how the current research contributes to the conversation on the topic. When you read the lit review ask:

• Does the review of the literature logically lead up to the research questions?
• Do the authors review articles relevant to their research study?
• Do the authors show where there are gaps in the literature?

The lit review is also a good place to find other sources you may want to read on this topic to help you get the bigger picture.

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Sequential therapy for extramedullary plasmacytoma of the palate: a rare case report with seven years of follow-up and literature review

• Case Report
• Open access
• Published: 28 September 2024
• Volume 150 , article number  431 , ( 2024 )

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• Tianqi Zhang 1   na1 ,
• Weidong Liu 2   na1 ,
• Guijun Liu 1 &
• Tengda Zhao 1  

Extramedullary plasmacytoma (EMP) is a rare solitary malignancy that accounts for 3% of plasma cell neoplasms, and EMP with a primary occurrence in the palate is extremely uncommon. Owing to the long course of EMP and the limited available data on treatment outcomes, there are no definitive guidelines for its management, especially for high-risk patients who are more susceptible to early progression to multiple myeloma.

Case presentation

In this study, we review nine relevant studies and describe a 54-year-old woman who presented with an asymptomatic nonulcerative mass localized in the palate. After initial radical surgical resection of the lesion, the patient was definitively diagnosed with EMP with minimal plasmacytosis in the bone marrow, and adjuvant intensity-modulated radiation therapy with a minimum dose of 39.6 Gy was administrated in the surgical area. There was no evidence of local recurrence, nodal metastasis or progression to multiple myeloma (MM) during the seven-year follow-up period.

Given the atypical clinical features of palate EMP reported in the literature and the encouraging results of our patient, sequential therapy involving surgery and adjuvant radiotherapy for primary palatal lesions in high-risk EMP patients without nodal involvement could be an effective treatment modality.

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Plasma cell neoplasms are mature B-cell malignancies characterized by the abnormal monoclonal proliferation of plasma cells, and most patients are diagnosed with multiple myeloma (MM), exhibiting diffuse bone marrow and other organ involvement; less than 5% of patients present with solitary plasmacytomas (SPs), a single mass of clonal plasma cells localized either in bone as solitary bone plasmacytomas (SBPs) or in soft tissues as extramedullary plasmacytomas (EMPs) (Fend et al. 2023 ; Zhu et al. 2021 ).

EMP is an unusual condition comprising nearly one-third of all SPs and is predominantly found in men aged 40–70 years, with the most common pathogenic sites being the submucosal tissues of the head and neck (HN) region (sinuses, nasopharynx, and oropharynx) (Wiebe et al. 2022 ; Zhu et al. 2021 ). Primary EMP of the oral cavity is extremely rare, especially with involvement of the palate. Approximately 20% of EMP patients develop MM within three years after diagnosis; in particular, patients with minimal bone marrow plasmacytosis have a greater risk of developing symptomatic MM (Caers et al. 2018 ). For decades, due to the rarity of cases and limited available data regarding prognosis parameters and response assessment, there have been no clear guidelines for the management of EMP; high-dose radiation remains the primary treatment of choice, and surgery or chemotherapy alone is an alternative treatment option (Vasudevan et al. 2024 ; Merzouqi et al. 2021 ). Because the results of this monotherapy are highly uncertain for EMP patients, especially those with a high risk of developing MM, studies exploring the potential benefit of sequential therapies for EMP are urgently needed.

In this clinical study, we present a high-risk female patient with primary EMP of the palate presenting palatal bone compressive resorption and minimal bone marrow plasmacytosis. The patient underwent sequential therapy with surgery and adjuvant radiation with good outcomes after seven years of postoperative follow-up. We also review the relevant literature available in PubMed and expand on the clinical features and therapeutic management of primary EMP of the palate for high-risk patients.

A 54-year-old woman was referred to our unit in November 2016, with a chief complaint of a painless mass in the palate causing difficulty in restoring dentures after residual root extraction. The patient reported that she had suffered from Sjogren syndrome with a dry oral cavity and dry eyes for 10 years, and she had undergone esophageal cancer resection 12 years prior. There was no history of smoking or alcohol consumption.

Clinical investigations

Physical examination revealed a fixed, nonulcerative mass (3.5 × 3.0 cm in size) on the right side of the hard palate–soft palate junction. There were no enlarged lymph nodes that were palpable in the submental or cervical regions. A CT scan revealed the presence of a contrast-enhanced mass localized in the soft palate area without deep invasion of the palatal bone (Fig.  1 ). Moreover, no osteolytic lesions were noted in the skeletal radiographic survey. Laboratory examination revealed that the blood and urine indicators as well as liver and kidney function indicators were within the normal ranges, except for alkaline phosphatase (207 U/L; normal range, 23–140 U/L).

Preoperative images. Transverse ( a ), coronal ( b ), and sagittal ( c ) CT scan images showing a contrast-enhanced mass located on the right side of the hard palate–soft palate junction with no invasion of its walls

Sequential therapy

The patient underwent tumor excision with an adequate margin. Mildly compressive bone absorption of the palatal bone towards the tumor was observed during the operation. Histologic examination revealed that the underlying submucosa was heavily infiltrated by a dense monomorphic population of plasmacytoid cells with atypical nuclei (Fig.  2 a). Immunohistochemically, these tumor cells were diffusely immunoreactive for kappa light chains, CD38, CD138, LCA, vimentin, and MUM-1 (Fig.  2 b–d, Fig.  3 a-c) but negative for lambda light chains, CD3, CD5, CD20, and CD56. Approximately 10% of the cells were Ki-67-positive (Fig.  3 d). These findings support a diagnosis of plasmacytomas.

Histological and immunohistochemical characteristics of EMPs. ( a ) H&E staining showing diffuse atypical plasmacytoid cell infiltration of the submucosa at 100×. ( b – d ) Immunohistochemistry (200×) results are consistent with a diagnosis of EMP. Tumor cells are positive for kappa light chains ( b ), CD38 ( c ), and CD138 ( d )

Immunohistochemical characteristics of plasmacytomas. ( a – c ) Tumor cells are positive for LCA ( a ), vimentin ( b ), and MUM-1 ( c ). ( d ) Proportion of Ki-67-positive plasma cells

During the immediate postoperative period, the patient underwent hematologic and oncologic evaluation. Bone marrow aspiration revealed that the proportion of monoclonal plasma cells was slightly increased (2%; normal range, 0.3–1.2%). Serum electrophoresis revealed an increased level of IgG (27.05 g/L; normal range, 7.00–16.00 g/L) with a kappa light chain. The urinalysis results were negative for Bence Jones protein. On the basis of these features, a definite diagnosis of primary EMP arising in the palate was established. Additionally, minimal BM plasmacytosis was associated with a greater risk of early progression to symptomatic MM. To achieve better local control following surgical radicality, the patient subsequently received adjuvant intensity-modulated radiation therapy (IMRT) at a dose of DT of 39.6 Gy/22 times/32 days around the tumor bed.

Follow-up and outcomes

Three and six months after radiotherapy, the blood values and liver and kidney function indicators showed no abnormalities. MRI scans from the skull base to the chest and abdomen revealed no high signal intensity in the palate or other sites (Fig.  4 ). Periodic follow-up was performed to assess the clinical condition of the patient every six months. The patient has been followed for seven years after systemic treatment and currently remains well, with no evidence of local recurrence or progression to MM. A longer period of close care is still needed for our patient.

Follow-up (6 months after radiotherapy). Coronal MR images, including T2WI ( a ) and contrast-enhanced T1WI ( b ), showing no abnormal signal intensity in the palate

EMP is a rare solitary soft tissue lesion without clinical, histological, or radiological evidence of MM (Caers et al. 2018 ). The etiology of EMP remains undefined, with a possible relationship to chronic stimulation or viral infection, but the epidemiological risk factors for the clinical outcomes of HN EMP mainly include the primary site, size of the lesion, nodal status, and type of treatment (Venkatesulu et al. 2018 ). Primary EMP of the palate is extremely rare, with only nine cases since 1962 that are included in this review; the clinical features of these patients are summarized in Table  1 . The age distribution of the reviewed cases at diagnosis ranged from 25 to 72 years, with a mean age of 52 years. There was a marked predilection for males (M/F 7:2), and the mean size of EMPs arising from the palate was 2.9 cm (range, 0.8–6.2 cm). Here, we report a female patient who developed EMP in the palate at the age of 54 years.

According to our literature review of the clinical symptoms of EMP of the palate, patients usually do not experience any specific manifestations in the early stages of EMP development until the discomfort of dysphagia or dyspnea caused by the swollen lesion becomes obvious. As the clinical morphology of palatal EMP is most similar to that of minor salivary gland tumor, such as pleomorphic adenoma, it is not initially easy to distinguish it from them, until a diagnosis of plasmacytoma can be made by histological and immunohistochemical confirmation of the presence of a homogenous infiltrate of monoclonal plasma cells, typically expressing CD138, CD38 and monotypic light-chain restriction with positive kappa light chains; additionally, the absence of CD56 in our patient indicated the absence of an osteolytic lesion, as previously reported (Ely and Knowles. 2002 ). Furthermore, all criteria for the diagnosis of EMP of the palate, i.e., the absence of abnormal calcium levels, renal impairment, anemia, and bone lesions (CRAB features) (Rajkumar et al. 2014 ), were strictly fulfilled but inconsistent with the negative BM cytology results available in the literature (Caers et al. 2018 ). In addition, the minimal infiltration of monoclonal plasma cells (< 10%), as revealed by morphological examination in our patient, indicated a high risk of early progression to MM over a period of 2–3 years.

Although EMP is relatively benign, it can spread locally and has a poor prognosis due to the presence of various clinical risk factors. Approximately 10–20% of EMP patients have lymph node metastasis at initial diagnosis (Zhang et al. 2022 ). Our literature review of primary EMP of the palate revealed that only one of nine (11%) patients had regional node metastasis two months after treatment of the primary lesion and subsequently progressed to MM, suggesting that the incidence of lymph node metastasis in the palate is significantly lower than that in other HN sites. In addition, tumor size is also a clinical risk factor for local control and overall survival (Barzenje et al. 2018 ). Venkatesulu et al. reported that EMP tumors > 5.0 cm were associated with lower 5- and 10-year overall survival in HN patients (Venkatesulu et al. 2018 ). Among the five cases of EMP of the palate with available data on tumor size reported in the literature, four patients’ tumors were < 5.0 cm, and only one tumor was > 5.0 cm. However, considering that the anatomic area of the palate is more limited than other parts of the HN and was supported by compressive bone resorption at the palate in our patient, a size of 5.0 cm may not be an appropriate criterion for a risk factor for EMP of the palate. In addition, the short-term follow-up data in the literature revealed that the patients were all alive and disease free, but the results are insufficient to analyse the associations between tumor size and local recurrence or overall survival. In our patient, the disease was detected without clinical lymph node involvement, and the tumor size was approximately 3.5 cm, which seems to have no direct correlation with local recurrence; however, compressive palate bone resorption caused by tumor growth should be considered another risk factor for the treatment of these patients.

Epidemiologic evidence has revealed that most cases of progression from EMP to MM occur within the first five years, with late dissemination being possible after treatment (Oertel et al. 2019 ). Although no randomized prospective trials have been conducted on EMP patients to date, to achieve optimally durable long-term local control and minimal morbidity, radiation therapy is widely accepted as the primary treatment of choice for EMP because of its high radiosensitivity (Tsang et al. 2018 ). Other therapeutic strategies, including surgery and chemotherapy, are still under discussion. For example, Zhu et al. reported in a retrospective study that surgery alone can favorably improve the prognosis of HN and non-HN EMP patients without functional impairment (Zhu et al. 2021 ). Holler et al. reported that the combination of surgery with adjuvant radiotherapy can provide the best control in patients with EMP in the upper aero-digestive tract, whereas Jeyaraj reported that chemotherapy alone achieved excellent locoregional control in one case of EMP of the maxillary sinus (Holler et al. 2022 ; Jeyaraj et al. 2016 ). A review of the literature on localized EMP of the palate revealed that the treatment approach still varies. Among the six patients with palatal EMP who underwent a monotherapy modality, two out of three patients who underwent surgery alone experienced no recurrence in the following two years of the postoperative follow-up period, whereas one patient developed local recurrence. In addition, two patients who underwent radiation alone experienced good outcomes after one year of treatment, and the patient treated with chemotherapy alone remained disease-free one year later. In contrast, in three patients who received the combined therapy modality, two patients who underwent combined surgery and radiation treatment achieved favorable local control; although nodal relapse occurred in the third patient after primary EMP radiotherapy and conversion to MM was observed six months later, the combined radio/chemotherapy treatment resulted in good local and nodal control. Unlike the palatal EMP tumor reported in the literature, in our high-risk patient with palatal bone compressive resorption and minimal bone marrow plasmacytosis, after complete surgical resection of the EMP, a sequential treatment plan was chosen by a multidisciplinary team including a surgeon, a hematologist, and a radiotherapist, and complete recovery of the lesion was achieved by adjuvant radiotherapy rather than chemotherapy.

The optimal radiation dose for EMP is currently not clearly established, and the guidelines from the International Lymphoma Radiation Oncology Group suggest a radiation dose for EMP of 40–60 Gy (Zhang et al. 2024 ). Oetel et al. reported that low-dose regimens (≤ 45 Gy) have a complete response rate comparable to that of high-dose regimens (> 45 Gy) for controlling local EMP progression (Oertel et al. 2019 ). However, for effective local control of high-risk EMP patients after radical surgery, the proper relationship between the surgical area and radiation dose also remains to be elucidated. In our patient, the palatal lesion was irradiated with a minimum dose of 39.6 Gy delivered by IMRT to limit toxicity in the oral cavity, resulting in favorable local control and a seven-year disease-free period.

Beyond the benefit of sequential l therapy for the primary lesions of EMP patients, the necessity of prophylactic neck nodal irradiation is debatable, although nodal dissection is not regularly recommended (Tsang et al. 2018 ). In our literature review, one patient who received localized radiotherapy developed nodal metastasis two months later and thus received nodal irradiation; afterwards, he underwent chemotherapy due to progression to MM after another two months. Finally, this patient recovered well with local nodal control during a 5.5-year follow-up period. A retrospective study by Zhu et al. reported that two EMP patients with regional node metastasis had distinct prognosis because of the disparity between their ages and health statuses (Zhu et al. 2021 ), suggesting that regional lymph node involvement is not necessarily an indicator of poor prognosis for EMP patients. In our case, as the patient had no apparent lymph node metastasis after diagnosis, she did not undergo regional lymph node irradiation and had no lymph node metastasis during the seven-year follow-up period, indicating that elective neck irradiation is not necessary for high-risk EMP patients without obvious regional nodal involvement.

The present study describes the atypical clinical features of a rare high-risk case of EMP arising from the palate, which may cause clinical uncertainty prior to arriving at a histologic and hematologic diagnosis. Importantly, in the absence of obvious nodal involvement, an encouraging outcome was achieved through sequential therapy involving surgery and adjuvant radiation for our patient, who had minimal plasma cell infiltration and palatal bone compressive resorption. There was no recurrence or metastasis during the seven-year follow-up period. Therefore, based on the atypical clinical features of EMP of the palate reported in the literature and the encouraging results of our present case, a sequential therapy of surgery with adjuvant radiotherapy for primary palate lesions in high-risk EMP patients can be an effective treatment modality when there is no obvious nodal involvement.

Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors highly appreciate the help of Professor Dianshen Yu on reviewing this cases, including advising on treatment options.

This work was supported by the Natural Science Foundation of Shandong Province (grant no. ZR2021MH384) and the Study Abroad Program (grant no. 201803053) of Shandong Province.

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Tianqi Zhang and Weidong Liu contributed equally to this work.

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Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jing Six Road, Jinan, Shandong, 250021, China

Tianqi Zhang, Guijun Liu & Tengda Zhao

Department of Stomatology, Zibo First Hospital, Zibo, Shandong, 255200, China

Weidong Liu

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Tianqi Zhang and Weidong Liu contributed equally to this work and wrote the first draft of the manuscript. They share the first authorship. Guijun Liu and Tengda Zhao contributed to analysis and interpretation of data. All authors contributed to the writing, review, revision of the manuscript and approved the submitted version.

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Correspondence to Tengda Zhao .

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Zhang, T., Liu, W., Liu, G. et al. Sequential therapy for extramedullary plasmacytoma of the palate: a rare case report with seven years of follow-up and literature review. J Cancer Res Clin Oncol 150 , 431 (2024). https://doi.org/10.1007/s00432-024-05958-1

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DOI : https://doi.org/10.1007/s00432-024-05958-1

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Full-mouth rehabilitation with lithium disilicate ceramic crowns in hypoplastic amelogenesis imperfecta: a case report and review of literature

• Ranran Chen 1   na1 ,
• Ye Lin 2   na1 ,
• Xinni Pan 2 ,
• Yuedan Xu 2 ,
• Xiangxing Kong 3 &
• Ling Zhang 2  

BMC Oral Health volume  24 , Article number:  1139 ( 2024 ) Cite this article

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Metrics details

Amelogenesis imperfecta (AI) is a group of genetic disorders characterized by tooth discoloration and enamel defects. Patients with AI always exhibit generalized attrition and defective tooth structure, leading to the loss of occlusal vertical dimension (OVD). Appropriate rehabilitation is challenging and essential to improve patients’ aesthetics and function.

Case presentation

This case report presents a comprehensive management of a 30-year-old woman with hypoplastic AI. A 52-month follow-up revealed satisfactory full-mouth rehabilitation performances of lithium disilicate ceramic crowns after clinical crown lengthening, with increased vertical dimension.

Conclusions

Patients with severe hypoplastic AI require proper full-mouth rehabilitation. Using full-crown lithium disilicate restorations to increase the OVD by 2‒4 mm is a safe and predictable recommendation for such cases. In addition, patients with AI require complex and comprehensive management. The long-term effects of full-mouth rehabilitation with lithium disilicate ceramic crowns still necessitate further follow-ups.

Peer Review reports

Amelogenesis imperfecta (AI) is a group of rare genetic disorders characterized by tooth discoloration and enamel defects affecting primary and permanent teeth [ 1 ]. AI may occur in isolation or be associated with other symptoms in different syndromes [ 2 , 3 ], with an inheritance pattern of autosomal dominant, autosomal recessive, or X-linked [ 4 , 5 ]. Both genetic and environmental factors play essential roles in the occurrence of AI [ 6 ]. The prevalence of AI is between 1 in 700 and 1 in 140,000 [ 7 ].

Based on clinical phenotype, AI is classified as hypoplastic (Type I), hypomaturation (Type II), hypocalcification (Type III), and hypomaturation-hypoplastic with taurodontism (Type IV) [ 8 ]. Type I is characterized by normal enamel maturation with reduced thickness [ 9 ]. Type II features normal enamel thickness; however, the radiopacity of enamel is similar to dentin [ 10 ]. In Type III, the enamel has a normal thickness but exhibits higher radiolucency than dentin. The enamel in Types II and III can easily peel off [ 3 , 9 ]. Clinically, affected teeth often exhibit compromised aesthetics, tooth structure loss, dentin sensitivity, progressive loss of occlusal vertical dimension (OVD), and open bite [ 9 , 11 , 12 ].

Early diagnosis and treatment of AI are crucial to achieving a good prognosis [ 13 ]. AI can be diagnosed and classified through clinical features, radiographic manifestations, and genetic identification [ 4 , 14 ]. Different prosthodontic options could be considered depending on the severity of the disorder, including direct or indirect repair, fixed or removable restorations, or implant repair after tooth extraction [ 1 , 15 , 16 ]. The final treatment plan depends on the patient’s age, oral hygiene status, remaining tooth structure, periodontal condition, and orthodontic considerations [ 3 , 17 ]. Overall, the AI treatment aims to prevent further decrease in OVD, improve oral health, and restore aesthetics and function [ 10 ].

Here, we report a case of occlusal reconstruction in a hypoplastic AI patient and provide clinical recommendations for similar cases.

A 30-year-old female patient diagnosed with hypoplastic AI presented with a chief complaint of dental sensitivity to hot and cold. She requested a durable solution to relieve pain and improve the aesthetics. Five years previously, she had received porcelain-fused-to-metal (PFM) crowns for the maxillary anterior teeth. She had suffered severe pain while chewing for the past four months, especially in the lower anterior region.

Extraoral examinations revealed good facial symmetry, normal mouth opening without abnormalities, no clicking or pain in the temporomandibular joints (TMJs). By observing facial proportions and evaluating freeway space at the rest position, we found that there was no significant decrease in the OVD. The patient had a straight profile and a high smile line (Fig.  1 a).

a - f Extraoral and intraoral views before treatment. a Extraoral view. b Maxillary view. c Mandibular view. d Right lateral occlusion view. e Frontal view. f Left lateral occlusion view

Intraoral examinations showed an anterior deep bite and generalized AI (Fig.  1 b-f). Porcelain-fused-to-metal crowns were presented on teeth #14‒24, and the width-to-length ratio of upper central incisors was not satisfactory. The occlusal surfaces and the lower incisal edges exhibited severe attrition, with pitted and defective enamel on the bilateral posterior teeth, where yellowish-brown dentin was exposed. Defective amalgam restorations were present in posterior regions. Generally, the patient’s oral hygiene was poor, with red and inflamed gingiva.

Radiographic examination showed that the enamel in the occlusal surfaces of posterior areas was thin, contrasting normally with dentin. No periapical radiolucency or radiopacity was detected. In addition, there were no significant radiographic alterations of the bilateral condyle on the Schuller’s view (Fig.  2 a-b).

a-b Imageological examination before treatment. a Panoramic radiograph. b TMJ tanscranial lateral oblique radiographs

Treatment was undertaken to eliminate the symptoms of dentin sensitivity, improve the aesthetic appearance, and restore the masticatory function through occlusal reconstruction. The treatment plan consisted of:

Oral hygiene instructions and ultrasonic scaling to maintain the patient’s oral health status;

Clinical crown lengthening on teeth #14‒24 to restore the normal width-to-length ratio of the upper anterior teeth and improve the gummy smile;

Increasing OVD to obtain sufficient space for reconstruction;

Lithium disilicate ceramic crowns on all teeth to restore severe attrition;

Periodic follow-ups.

After removing the old crowns, a diagnostic wax-up was prepared, and a surgical guide was designed for crown lengthening and provisional restorations on teeth #14‒24 based on the results of the digital smile design (Fig.  3 ). The centric relation was obtained six months postoperatively, and a full-mouth diagnostic wax-up was prepared. OVD was increased by 2.9 mm in the centric relation position to provide the minimum space required for anterior tooth aesthetics and posterior occlusal surface reconstruction. A mandibular repositioning splint was fabricated to evaluate function in the new OVD (Fig.  4 a-d).

Digital smile design

a-d Diagnostic wax up and repositioning splint fabrication. a Centric relation position on the semi adjustable articulator. b Diagnostic wax up. c Repositioning splint. d The height of the anterior area before and after inserting the repositioning splint

After wearing the mandibular repositioning splint for two months, the patient was satisfied with the aesthetic appearance, with no discomfort symptoms. A silicone rubber index was prepared for a full-arch diagnostic mock-up. Under the guidance of the diagnostic mock-up, full-mouth tooth preparation was performed. The posterior teeth were prepared with an occlusal reduction of approximately 1.5 mm, and a chamfer preparation margin 0.3‒0.5 mm subgingivally was designed to increase the height of the axial walls and improve the mechanical retention of the full crown. The anterior teeth were also prepared with a subgingival chamfer margin of 0.3‒0.5 mm to ensure optimal aesthetic outcomes. Resin crowns (CAD/CAM PMMA, Shandong Huge Dental Material Co., Ltd., China) were fabricated as provisional restorations (Fig.  5 a-f).

a-f Intraoral views after wearing the provisional restorations. a Frontal view. b Right lateral occlusion view. c Left lateral occlusion view. d Protrusive occlusion view. e Right lateral excursion view. f Left lateral excursion view

The patient reported no aesthetic or functional abnormalities after wearing the provisional restorations for 12 months. Final impressions were made by two-step technique with heavy and light body vinyl polysiloxane impression material (Imprint™ II, 3 M ESPE). Lithium disilicate ceramic crowns (IPS E.max, Ivoclar Vivadent, Schaan, Liechtenstein) were fabricated according to the sequence of posterior and anterior quadrants. After delivering the final restoration, the width-to-length ratio of the anterior teeth was appropriate, the lip‒tooth relationship was ideal, and the incisor guidance was stable during protrusive movements, with the canine-protected occlusion in lateral movements (Fig.  6 a-i and Fig.  7 a-c). To protect the restorations, an acrylic occlusal night guard was delivered.

a - i Intraoral views and panoramic radiograph after restoration. a Frontal view. b Right lateral occlusion view. c Left lateral occlusion view. d Protrusive occlusion view. e Right lateral excursion view. f Left lateral excursion view. g Maxillary view. h Mandibular view. i Panoramic radiograph

a - c Extraoral view before and after restoration. a Frontal smile view before restoration. b Frontal smile view after restoration. c Frontal laugh view after restoration

The patient was satisfied with the aesthetic appearance and functional performance 52 months after restoration. There was a stable canine-protected occlusion, no occlusal interference during non-centric movements, and no significant porcelain fracture or wear in the restorations (Fig.  8 a-e).

a - e Intraoral views after 52 months of restoration. a Maxillary view. b Mandibular view. c Frontal view. d Right lateral occlusion view. e Left lateral occlusion view

Literature search

A literature search was conducted for AI-affected permanent dentition with vertical dimension loss in four electronic databases, including PubMed, Medline, and Embase, from inception to 1 April 2024 using the following keywords: “amelogenesis imperfecta” and “vertical dimension”. The language adopted was English, and 27 articles with 30 patients were included after screening the titles, abstracts, and full texts. Among them, 14 cases were diagnosed as Type I, 6 as Type II, 2 as Type III, and 8 without type classification. Although the range of the increased OVD was from 0 to 10 mm, the values in 13 cases were 2‒4 mm. The mentioned adapted time to the new OVD ranged from 1.5 to 4 months, and the adapted time in 11 cases was 2‒3 months. The prosthodontic treatments included crowns, veneers, direct or indirect composite restorations, and dowel-core crowns. Table 1 presents the data.

Discussion and Conclusions

AI is a group of inherited disorders that affect the enamel development, resulting in pitted and hypoplastic teeth with a thin layer of enamel [ 42 ]. Clinically, the affected teeth are discolored and hypersensitive. The enamel is easy to cleave and peel off, leading to severe attrition and OVD loss [ 14 , 43 ]. The treatment plan for AI patients with severe attrition is supposed to be aesthetically and functionally oriented [ 44 ], considering various factors, such as the patient’s age, financial budget, and oral conditions [ 45 , 46 ]. Previous reports on AI restorations include veneers, onlays, removable partial dentures, full crowns, and implants [ 1 , 9 , 27 , 41 ].

In this case, the patient was diagnosed with a typical hypoplastic AI with tooth structure loss and generalized severe attrition and underwent full-mouth rehabilitation with lithium disilicate ceramic crowns after clinical crown lengthening and increasing the OVD to improve aesthetics and function.

Clinically, before undertaking prosthodontic treatment, crown lengthening is often required to increase the height of the clinical crowns, decrease gingival exposure, and provide adequate retention [ 11 ]. This patient had a pronounced gummy smile and an unfavorable length-to-width ratio, while the incisal margins were still properly positioned. Therefore, crown lengthening was undertaken to reestablish the normal width-to-length ratio of the maxillary anterior teeth and improve the gummy smile.

OVD loss frequently occurs in AI patients, due to qualitative and quantitative enamel defects, tooth wear, and tooth loss [ 10 ]. A tooth may continue to erupt during long-term tooth wear, resulting in a non-significant decrease in OVD [ 44 , 46 ]. In this case, the patient experienced more than five years of attrition. The dentoalveolar compensatory mechanism may contribute to preserve the original OVD. However, the OVD should be increased to achieve adequate restorative space for posterior teeth. According to the 30 cases investigated in this paper, we found that the OVD was raised ranging from 0 to 10 mm after 1.5‒4 months of observation to confirm adaptation and appropriateness, of which 13 cases were 2‒4 mm, with safe and pain-free follow-up outcomes. Wearing a splint or provisional restoration is necessary to adapt to the new OVD and assess aesthetics. In general, aesthetics, phonetics, and patient feedback determine the final amount of the OVD increase [ 29 ]. However, the ideal guidelines for increasing the OVD are still unclear. Jaafar et al. [ 47 ] reviewed many occlusal reconstruction cases and concluded that a 5-mm increase in OVD is relatively safe. Based on the aesthetics and reconstruction space, the OVD was increased by 2.9 mm in this case. The patient’s TMJs and masticatory muscles adapted well after wearing the mandibular repositioning splint for 2 months and the fixed provisional restorations for 12 months.

When selecting final restoration types, materials and workflow, the specific AI phenotype and the patient’s main symptoms should be considered [ 42 ]. Hypoplastic enamel microstructure and composition in AI significantly differ from normal enamel, with smaller crystal grains, higher porosity, and lower calcium concentration [ 48 ]. Removing the irregular AI-affected enamel layer and using full-crown restorations might be a better option [ 49 ]. In this case, the patient had suffered from hot and cold sensitivity for many years and strongly desired to improve dentin sensitivity. Therefore, providing mechanical retention and improving hypersensitivity through full crowns was preferred.

The most prescribed all-ceramic materials for single crowns currently are monolithic zirconia and lithium disilicate [ 50 , 51 ]. Lithium disilicate materials exhibit good biocompatibility, high strength, superior aesthetics, and can bond to enamel and dentin [ 52 , 53 , 54 ]. According to in vitro findings, 1-mm-thick lithium disilicate materials can be bonded to the enamel by hydrofluoric acid etching and silylation and offer sufficient strength for crown restoration, minimizing the reduction of tooth structure [ 55 , 56 ]. Hypoplastic teeth are usually small, with a thin or almost absent but usually fully calcified enamel layer [ 48 ]. Therefore, aesthetic restorative treatment of AI is recommended to follow a minimal tooth preparation protocol [ 57 ]. According to a randomized controlled trial, the 5-year survival rate and success rates of ceramic crown therapy in patients with AI were 99.6% and 94.7%, respectively [ 58 ]. In this case, we selected lithium disilicate material for the full-mouth restoration to ensure adequate bond strength of the severely worn dentition [ 59 ]. In addition, the homogeneity of the material could facilitate uniform wear of the full-mouth restoration during long-term use and maintain the stability of the curve of Spee.

Follow-up is vital to ensure a good prognosis for the prosthesis. Of the 27 articles, we found that the follow-up period was usually between 6 months and 5 years. In this case, at 52-months follow-up visit, the patient adapted well without any TMJ symptoms. The restorations were fully functional with no porcelain fracture or wear. In this case, the increase in OVD and selection of final restorative material achieved satisfactory results in the short term, but the long-term outcomes of full-mouth rehabilitation with glass ceramic crowns still require further follow-up.

AI is an inherited disorder that affects the development of enamel. Patients with severe hypoplastic AI require proper full-mouth rehabilitation. As reported in this case, using full-crown lithium disilicate restorations to increase the OVD by 2–4 mm is a safe and predictable recommendation for such cases. In addition, patients with AI require multidisciplinary and systematic management. The long-term outcomes of full-mouth rehabilitation with glass ceramic crowns still require further follow-ups.

Availability of data and materials

All data generated or analyzed during this study are included in this published report and its figures.

Abbreviations

• Amelogenesis imperfecta
• Occlusal vertical dimension

Porcelain-fused-to-metal

Temporomandibular joints

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The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

Ranran Chen

Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Blomaterials and Devices of Zhejlang Province, Hangzhou, 310000, China

Ye Lin, Yi Sun, Xinni Pan, Yuedan Xu & Ling Zhang

Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

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RC was responsible for the patient management, drafting, review and editing of the case report. YL contributed to data curation, drafting, review and editing of the case report. YS and XP helped to edit the case report and data curation. YX, XK, and LZ were responsible for conceptualization and the revision of the manuscript. All authors have viewed and approved the final manuscript.

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Chen, R., Lin, Y., Sun, Y. et al. Full-mouth rehabilitation with lithium disilicate ceramic crowns in hypoplastic amelogenesis imperfecta: a case report and review of literature. BMC Oral Health 24 , 1139 (2024). https://doi.org/10.1186/s12903-024-04929-9

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Asymptomatic thrombocytopenia after nintedanib initiation in a patient with progressive pulmonary fibrosis: a case report and review of literature

• Xinxin Zhang 1 ,
• Zhang Kan 1 ,
• Nannan Zhao 1 ,
• Na Xi 2 &
• Tiemei Zhao 1  

Journal of Medical Case Reports volume  18 , Article number:  451 ( 2024 ) Cite this article

Metrics details

Nintedanib is a primary antifibrosing medication available for idiopathic pulmonary fibrosis, systemic sclerosis-interstitial lung disease, and progressive pulmonary fibrosis, with scattered report of drug-induced thrombocytopenia.

A 60-year-old Asian male with no history of thrombocytopenia was administered with nintedanib to treat progressive pulmonary fibrosis. The platelet count dropped rapidly after introduction of nintedanib and resolved gradually by withdrawal of the medication along with thrombopoietin receptor agonist.

Based on experience from the limited reports, nintedanib-induced thrombocytopenia is typically reversible and manageable. Close monitoring of platelet counts in patients receiving this medication should be warranted.

Peer Review reports

Introduction

Nintedanib is an orally active tyrosine kinase inhibitor that primarily targets platelet-derived growth factor receptors (PDGFRs), fibroblast growth factor receptors (FGFRs), and vascular endothelial growth factor receptors (VEGFRs) [ 1 ]. It has noteworthy antifibrotic property and has been approved for treating idiopathic pulmonary fibrosis (IPF), systemic sclerosis-interstitial lung disease (SSc-ILD), and progressive pulmonary fibrosis (PPF). In addition to its antifibrotic effects, nintedanib’s inhibition of the aforementioned receptors also disrupts angiogenesis and coagulation processes, leading to bleeding events observed in clinical trials and postmarketing surveillance [ 2 ]. Furthermore, nintedanib-induced thrombocytopenia, although rare, has been identified as a potential serious side effect. This study contributes to the limited literature on nintedanib-induced thrombocytopenia by presenting a case of asymptomatic thrombocytopenia that developed shortly after initiating nintedanib treatment, along with a review of similar cases. To our knowledge, it is the first study to report nintedanib-induced thrombocytopenia in patients with an autoimmune feature and diagnosed with PPF.

A 60-year-old Asian male was admitted due to a productive cough and progressive dyspnea. He was diagnosed with interstitial pneumonia with autoimmune features (IPAF) 4 years ago, presenting with exertional dyspnea, interstitial pneumonia on computed tomography (CT) scan, and the presence of antinuclear antibodiy (ANA) (1:1000) and anti-Mi-2 antibodies. He had neither skin lesions nor muscle weakness and was tested normal in bilateral thigh muscle magnetic resonance imaging (MRI) scan and electromyography. He had been on long-term corticoid therapy for 2 years with prednisone 5 mg daily. Two months ago, his dyspnea worsened along with a productive cough following an influenza infection. Initial blood tests showed a normal platelet count of 258 × 10 9 /L, elevated white cell count of 10.15 × 10 9 /L, and C-reactive protein of 36.5 mg/L. Procalcitonin (PCT), (1,3)-β- d -glucan and galactomannan testing were negative. Autoimmune tests revealed positive anti-Mi2 antibodies. A CT scan (Fig.  1 ) indicated increased reticular septal thickening, worsened traction bronchiectasis and newly appeared ground-glass opacities distributed along the bronchovascular bundle and in the subpleural area. Lung function tests demonstrated a decline of 24.1% in forced vital capacity (FVC) compared with the results of 15 months ago. A diagnosis of PPF was confirmed. The corticoid dosage was increased to 20 mg/day of methylprednisolone, and nintedanib 150 mg was administered twice daily, along with ceftriaxone because infection could not be ruled out. Following this treatment, the patient experienced profound alleviation of shortness of breath and cough.

Chest computed tomography (CT) findings. Reticular septal thickening, worsened traction bronchiectasis, and newly appeared ground-glass opacities distributed along the bronchovascular bundle and in the subpleural area

The patient did not have a history of thrombocytopenia and still had a normal platelet count on the fourth day after starting nintedanib. However, the platelet count dropped to 39 × 10 9 /L on the eighth day after nintedanib initiation (Fig.  2 ). d -dimer and fibrin/fibrinogen degradation products (FDP) levels were normal. Ultrasound examination of the lower-limb veins showed no thrombosis. There were no signs of hepatic cirrhosis or splenomegaly. The most recent influenza infection occurred over 2 months before the onset of thrombocytopenia. Concurrent medications, including methylprednisolone, ceftriaxone, and calcium carbonate, did not include commonly known causes of thrombocytopenia. Further examination detected no platelet-specific autoantibodies in the serum.

Platelet count changes since nintedanib initiation

Nintedanib was suspected to be responsible for the thrombocytopenia and was stopped immediately upon the onset of the latter. The platelet count decreased to 12 × 10 9 /L by the fifth day post withdrawal. A single adult dose of platelets was transfused, and the thrombopoietin receptor agonist, herombopag olamine, was initiated at a dose of 2.5 mg/day. Subsequently, the platelet count gradually increased to 39 × 10 9 /L by the 17th day after discontinuation of nintedanib. Due to the relatively slow rise in platelet count, the dose of hetrombopag olamine was raised to 5 mg/day, leading to an increase in platelet count to 58 × 10 9 /L 3 days later. Following this improvement, the patient was discharged home and continued treatment with herombopag olamine. The platelet count further rose to 240 × 10 9 /L 1 week post discharge and remained stable at a normal level thereafter. Notably, no bleeding events were observed during the period of thrombocytopenia.

Nintedanib, a small-molecule nonselective tyrosine kinase inhibitor, targets key receptors in the pulmonary fibrosis signaling pathway, including vascular endothelial growth factor receptors (VEGFR1-3), platelet-derived growth factor receptors (PDGFRα and β), and fibroblast growth factor receptors (FGFR1-4) [ 1 ]. Nintedanib has been approved in over 80 countries for IPF treatment and has shown efficacy in patients with non-IPF interstitial lung disease (ILD) developing PPF. Up to 18–32% of patients with non-IPF ILD are at risk of developing PPF, resulting in rapid decline in lung function, poor life quality, and premature death. Following positive results in the INBUILD trial [ 3 ], Nintedanib was authorized for PPF treatment in 2020. Thrombocytopenia, a rare side effect of nintedanib, has been reported in three cases, with varying onset times, as listed in Table  1 . A recent report highlighted thrombocytopenia occurring 3 months after nintedanib initiation [ 4 ]. In another case study by Ochi et al ., a decrease in platelet count was observed 1 month after nintedanib administration [ 5 ]. In the present case, thrombocytopenia developed rapidly, with platelet count dropping significantly at the eighth day post nintedanib introduction, consistent with drug-induced thrombocytopenia (DIT) patterns where platelet count typically decreases 5–10 days after drug administration [ 6 ]. Patients experienced non-to-mild hemorrhage, potentially influenced by concurrent medications, as seen in a case study by Dumic et al ., where a patient taking aspirin exhibited easy bruising despite mild thrombocytopenia [ 4 ].

Diagnosing DIT has been a challenging and exclusive process. In this particular case, the possibility of nintedanib-induced thrombocytopenia was considered based on several factors. First, the patient had no previous history of thrombocytopenia, which ruled out congenital conditions such as Fanconi anemia. Second, the serum platelet count decreased upon initiation of nintedanib and increased after its discontinuation, albeit at a slow pace. Additionally, the patient was also taking methylprednisolone, ceftriaxone, and calcium carbonate. Among these, ceftriaxone has been reported to induce thrombotic thrombocytopenic purpura (TTP) in one case [ 8 ], while our patient showed no other signs of TTP (normal bilirubin level, no anemia and undisturbed renal function). Besides, the patient received standard dose of ceftriaxone of 2g daily, while retrospective analysis has shown that high dose of ceftriaxone, other than standard dose, was associated with thrombocytopenia [ 9 ]. Furthermore, a thorough investigation for other potential acquired causes of thrombocytopenia yielded no evidence of common triggers as illustrated below.

Immune thrombocytopenia can manifest either as a primary condition or secondary to various triggers such as autoimmune diseases, infections, and drugs. In both cases, the presence of antiplatelet specific antibodies is a key characteristic. Primary immune thrombocytopenia is a common cause of low platelet count due to the body’s loss of self-tolerance to platelet antigens and abnormal activation of both humoral and cellular immunity, resulting in the presentation of antiplatelet glycoprotein autoantibodies. Secondary immune thrombocytopenia is often seen in autoimmune connective tissue diseases, particularly in systemic lupus erythematosus and primary Sjögren’s syndrome (pSS). Thrombocytopenia associated with dermatomyositis is rare and has been minimally reported. A notable portion of these cases have shown positive antiplatelet autoantibodies [ 10 ]. Our patient tested positive for anti-Mi2 antibody, a myositis⁃specific autoantibody, but exhibited no distinct skin lesions or myopathy symptoms and, thus, was not diagnosed as dermatomyositis. Interestingly, the presence of this antibody was detected 3 years prior without any impact on the platelet count. Drugs can induce platelet-specific glycoprotein autoantibodies, and nintedanib may also induce thrombocytopenia in an immune-dependent manner, as demonstrated in the case study by Yusuke Ochi, where a high level of serum PA-IgG was observed, suggesting autoimmunological effects on platelets. But serum tests for platelet-specific glycoprotein autoantibodies were not detected in our patient, hinting a potential nonimmune mechanism underlying the thrombocytopenia.

Thrombocytopenia also occurs following or during many viral infections, with the underlying cause(s) remaining elusive. In this case, influenza infection was speculated as a trigger for exacerbation of interstitial lung disease but not as the direct cause of thrombocytopenia, which occurred 2 months after the infection. Conversely, decrease in platelet count was noted during the acute infection phase of influenza A/H1N1 virus [ 11 ]. Other viral infections known to cause thrombocytopenia, such as human immunodeficiency virus (HIV) and hepatitis B/C viruses, were examined and excluded. No evidence of H. pylori infection was observed, and there were no signs of disseminated intravascular coagulation, TTP (as discussed above), or splenomegaly. A bone marrow biopsy was not performed due to the patient’s undisturbed white cell and red cell numbers, and the platelet count eventually rose after withdrawal of nintedanib.

Over 300 therapeutic agents have been linked to thrombocytopenia through either immune-mediated or nonimmune-mediated mechanisms [ 6 ]. Nonimmune-mediated thrombocytopenia is multifaceted and can result from toxicity-related bone marrow suppression, leading to a decrease in all blood cell lines, from selective impairment in platelet release from megakaryocytes, or from reduced platelet survival in the peripheral circulation. Conversely, drug-induced immune thrombocytopenia involves the development of drug-induced IgG (less commonly IgM/A) that targets and binds to platelet-specific glycoprotein complexes, leading to their destruction via either complement activation and/or phagocytosis [ 6 , 12 ].

Whether nintedanib induces thrombocytopenia through the suppression of key signaling pathways it targets remains unclear. It is hypothesized that inhibiting PDGFR α and β may impact thrombocyte production. Factors such as stromal-derived factor (SDF)-1 chemokine and FGF-4 have been shown to direct megakaryocytes interactions with the bone marrow stroma and megakaryocyte maturation, with FGF‐4, in particular, enhancing megakaryocytes adhesion to marrow endothelium [ 13 ].

Withdrawal of the suspected drugs is the initial step in managing drug-induced thrombocytopenia. Typically, platelet count begins to recover after four to five half-lives of the offending drug or its metabolite once treatment is discontinued [ 6 ]. In our case, the platelet count continued to decline after withdrawing nintedanib, although at a slower rate, contrasting a previous report where thrombocytopenia resolved promptly within a week of stopping the medication [ 4 ]. The exact mechanism is still unknown. The prolonged duration of thrombocytopenia may be attributed to the presence of non-drug-dependent antiplatelet antibodies that persist even after the clearance of the responsible medication. Given the limited sensitivity of antibody-testing methods, it is possible that there is an under-detected immunological effect induced by nintedanib. High-dose corticosteroids and/or IVIG (1 g/kg body weight) are recommended for immune-mediated drug-induced thrombocytopenia to hasten platelet recovery in patients with severe platelet count drops below 50 × 10 9 /L (grades 3 and 4) and bleeding or those at high bleeding risk. Additional therapies such as rituximab or thrombopoietin receptor agonists may be considered for patients not responding to initial treatment [ 4 ]. In our case, the thrombopoietin receptor agonist, herombopag olamine, was added as the patient was already on corticosteroid treatment and had a low bleeding risk.

In this study, we presented a case of thrombocytopenia associated with nintedanib administration, highlighting a clear temporal relationship. Our findings suggest that nintedanib-induced thrombocytopenia is typically reversible and manageable, based on the limited reports available. As the use of nintedanib becomes more widespread, it is likely that more cases of thrombocytopenia will be observed. Therefore, we recommend close monitoring of platelet levels in patients receiving nintedanib, particularly those also on anticoagulants and antiplatelet therapy. Further research is needed to elucidate the mechanisms underlying this rare but potentially serious side effect.

Availability of supporting data

Data and material supporting this report are available on request from the corresponding author.

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Xinxin Zhang, Zhang Kan, Nannan Zhao & Tiemei Zhao

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ZNN and ZK collected the clinical data, and ZXX reviewed the literature and wrote the manuscript. XN contributed in a consultant role and made critical suggestions to address differential diagnoses. ZTM, as senior practitioner of the practice, was responsible for the clinical management of the patient and reviewed the manuscript.

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Zhang, X., Zhang, K., Zhao, N. et al. Asymptomatic thrombocytopenia after nintedanib initiation in a patient with progressive pulmonary fibrosis: a case report and review of literature. J Med Case Reports 18 , 451 (2024). https://doi.org/10.1186/s13256-024-04790-y

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Received : 18 July 2024

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DOI : https://doi.org/10.1186/s13256-024-04790-y

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