how to do research article review

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How to Write an Article Review (With Examples)

Last Updated: April 24, 2024 Fact Checked

Preparing to Write Your Review

Writing the article review, sample article reviews, expert q&a.

This article was co-authored by Jake Adams . Jake Adams is an academic tutor and the owner of Simplifi EDU, a Santa Monica, California based online tutoring business offering learning resources and online tutors for academic subjects K-College, SAT & ACT prep, and college admissions applications. With over 14 years of professional tutoring experience, Jake is dedicated to providing his clients the very best online tutoring experience and access to a network of excellent undergraduate and graduate-level tutors from top colleges all over the nation. Jake holds a BS in International Business and Marketing from Pepperdine University. There are 12 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 3,102,573 times.

An article review is both a summary and an evaluation of another writer's article. Teachers often assign article reviews to introduce students to the work of experts in the field. Experts also are often asked to review the work of other professionals. Understanding the main points and arguments of the article is essential for an accurate summation. Logical evaluation of the article's main theme, supporting arguments, and implications for further research is an important element of a review . Here are a few guidelines for writing an article review.

Education specialist Alexander Peterman recommends: "In the case of a review, your objective should be to reflect on the effectiveness of what has already been written, rather than writing to inform your audience about a subject."

Article Review 101

• Read the article very closely, and then take time to reflect on your evaluation. Consider whether the article effectively achieves what it set out to.
• Write out a full article review by completing your intro, summary, evaluation, and conclusion. Don't forget to add a title, too!
• Proofread your review for mistakes (like grammar and usage), while also cutting down on needless information.

• Article reviews present more than just an opinion. You will engage with the text to create a response to the scholarly writer's ideas. You will respond to and use ideas, theories, and research from your studies. Your critique of the article will be based on proof and your own thoughtful reasoning.
• An article review only responds to the author's research. It typically does not provide any new research. However, if you are correcting misleading or otherwise incorrect points, some new data may be presented.
• An article review both summarizes and evaluates the article.

• Summarize the article. Focus on the important points, claims, and information.
• Discuss the positive aspects of the article. Think about what the author does well, good points she makes, and insightful observations.
• Identify contradictions, gaps, and inconsistencies in the text. Determine if there is enough data or research included to support the author's claims. Find any unanswered questions left in the article.

• Make note of words or issues you don't understand and questions you have.
• Look up terms or concepts you are unfamiliar with, so you can fully understand the article. Read about concepts in-depth to make sure you understand their full context.

• Pay careful attention to the meaning of the article. Make sure you fully understand the article. The only way to write a good article review is to understand the article.

• With either method, make an outline of the main points made in the article and the supporting research or arguments. It is strictly a restatement of the main points of the article and does not include your opinions.
• After putting the article in your own words, decide which parts of the article you want to discuss in your review. You can focus on the theoretical approach, the content, the presentation or interpretation of evidence, or the style. You will always discuss the main issues of the article, but you can sometimes also focus on certain aspects. This comes in handy if you want to focus the review towards the content of a course.
• Review the summary outline to eliminate unnecessary items. Erase or cross out the less important arguments or supplemental information. Your revised summary can serve as the basis for the summary you provide at the beginning of your review.

• What does the article set out to do?
• What is the theoretical framework or assumptions?
• Are the central concepts clearly defined?
• How adequate is the evidence?
• How does the article fit into the literature and field?
• Does it advance the knowledge of the subject?
• How clear is the author's writing? Don't: include superficial opinions or your personal reaction. Do: pay attention to your biases, so you can overcome them.

• For example, in MLA , a citation may look like: Duvall, John N. "The (Super)Marketplace of Images: Television as Unmediated Mediation in DeLillo's White Noise ." Arizona Quarterly 50.3 (1994): 127-53. Print. [9] X Trustworthy Source Purdue Online Writing Lab Trusted resource for writing and citation guidelines Go to source

• For example: The article, "Condom use will increase the spread of AIDS," was written by Anthony Zimmerman, a Catholic priest.

• Your introduction should only be 10-25% of your review.
• End the introduction with your thesis. Your thesis should address the above issues. For example: Although the author has some good points, his article is biased and contains some misinterpretation of data from others’ analysis of the effectiveness of the condom.

• Use direct quotes from the author sparingly.
• Review the summary you have written. Read over your summary many times to ensure that your words are an accurate description of the author's article.

• Support your critique with evidence from the article or other texts.
• The summary portion is very important for your critique. You must make the author's argument clear in the summary section for your evaluation to make sense.
• Remember, this is not where you say if you liked the article or not. You are assessing the significance and relevance of the article.
• Use a topic sentence and supportive arguments for each opinion. For example, you might address a particular strength in the first sentence of the opinion section, followed by several sentences elaborating on the significance of the point.

• This should only be about 10% of your overall essay.
• For example: This critical review has evaluated the article "Condom use will increase the spread of AIDS" by Anthony Zimmerman. The arguments in the article show the presence of bias, prejudice, argumentative writing without supporting details, and misinformation. These points weaken the author’s arguments and reduce his credibility.

• Make sure you have identified and discussed the 3-4 key issues in the article.

You Might Also Like

• ↑ https://libguides.cmich.edu/writinghelp/articlereview
• ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548566/
• ↑ Jake Adams. Academic Tutor & Test Prep Specialist. Expert Interview. 24 July 2020.
• ↑ https://guides.library.queensu.ca/introduction-research/writing/critical
• ↑ https://www.iup.edu/writingcenter/writing-resources/organization-and-structure/creating-an-outline.html
• ↑ https://writing.umn.edu/sws/assets/pdf/quicktips/titles.pdf
• ↑ https://owl.purdue.edu/owl/research_and_citation/mla_style/mla_formatting_and_style_guide/mla_works_cited_periodicals.html
• ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548565/
• ↑ https://writingcenter.uconn.edu/wp-content/uploads/sites/593/2014/06/How_to_Summarize_a_Research_Article1.pdf
• ↑ https://www.uis.edu/learning-hub/writing-resources/handouts/learning-hub/how-to-review-a-journal-article
• ↑ https://writingcenter.unc.edu/tips-and-tools/editing-and-proofreading/

About This Article

If you have to write an article review, read through the original article closely, taking notes and highlighting important sections as you read. Next, rewrite the article in your own words, either in a long paragraph or as an outline. Open your article review by citing the article, then write an introduction which states the article’s thesis. Next, summarize the article, followed by your opinion about whether the article was clear, thorough, and useful. Finish with a paragraph that summarizes the main points of the article and your opinions. To learn more about what to include in your personal critique of the article, keep reading the article! Did this summary help you? Yes No

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• CAREER FEATURE
• 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).

Article   Google Scholar  

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

Article   PubMed   Google Scholar  

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

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

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College Textbooks Costs: Everything You Need to Know

What is an ahk file, keeping yourself safe in college: everything you need to know, myths about online high schools: everything you need to know, reasons you should study geography: everything you need to know, the vtoman jump 1800 portable power station: the best of the best, key roles of a school superintendent: everything you need to know, is earning a degree online worthwhile and beneficial, why learners cheat: everything you need to know, top issues in education: everything you need to know, how to write an article review (with sample reviews)  .

An article review is a critical evaluation of a scholarly or scientific piece, which aims to summarize its main ideas, assess its contributions, and provide constructive feedback. A well-written review not only benefits the author of the article under scrutiny but also serves as a valuable resource for fellow researchers and scholars. Follow these steps to create an effective and informative article review:

1. Understand the purpose: Before diving into the article, it is important to understand the intent of writing a review. This helps in focusing your thoughts, directing your analysis, and ensuring your review adds value to the academic community.

2. Read the article thoroughly: Carefully read the article multiple times to get a complete understanding of its content, arguments, and conclusions. As you read, take notes on key points, supporting evidence, and any areas that require further exploration or clarification.

3. Summarize the main ideas: In your review’s introduction, briefly outline the primary themes and arguments presented by the author(s). Keep it concise but sufficiently informative so that readers can quickly grasp the essence of the article.

4. Evaluate the strengths and weaknesses: In subsequent paragraphs, assess the strengths and limitations of the article based on factors such as methodology, quality of evidence presented, coherence of arguments, and alignment with existing literature in the field. Be fair and objective while providing your critique.

5. Discuss any implications: Deliberate on how this particular piece contributes to or challenges existing knowledge in its discipline. You may also discuss potential improvements for future research or explore real-world applications stemming from this study.

6. Provide recommendations: Finally, offer suggestions for both the author(s) and readers regarding how they can further build on this work or apply its findings in practice.

7. Proofread and revise: Once your initial draft is complete, go through it carefully for clarity, accuracy, and coherence. Revise as necessary, ensuring your review is both informative and engaging for readers.

Sample Review:

A Critical Review of “The Effects of Social Media on Mental Health”

Introduction:

“The Effects of Social Media on Mental Health” is a timely article which investigates the relationship between social media usage and psychological well-being. The authors present compelling evidence to support their argument that excessive use of social media can result in decreased self-esteem, increased anxiety, and a negative impact on interpersonal relationships.

Strengths and weaknesses:

One of the strengths of this article lies in its well-structured methodology utilizing a variety of sources, including quantitative surveys and qualitative interviews. This approach provides a comprehensive view of the topic, allowing for a more nuanced understanding of the effects of social media on mental health. However, it would have been beneficial if the authors included a larger sample size to increase the reliability of their conclusions. Additionally, exploring how different platforms may influence mental health differently could have added depth to the analysis.

Implications:

The findings in this article contribute significantly to ongoing debates surrounding the psychological implications of social media use. It highlights the potential dangers that excessive engagement with online platforms may pose to one’s mental well-being and encourages further research into interventions that could mitigate these risks. The study also offers an opportunity for educators and policy-makers to take note and develop strategies to foster healthier online behavior.

Recommendations:

Future researchers should consider investigating how specific social media platforms impact mental health outcomes, as this could lead to more targeted interventions. For practitioners, implementing educational programs aimed at promoting healthy online habits may be beneficial in mitigating the potential negative consequences associated with excessive social media use.

Conclusion:

Overall, “The Effects of Social Media on Mental Health” is an important and informative piece that raises awareness about a pressing issue in today’s digital age. Given its minor limitations, it provides valuable

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How to Write a Peer Review

When you write a peer review for a manuscript, what should you include in your comments? What should you leave out? And how should the review be formatted?

This guide provides quick tips for writing and organizing your reviewer report.

Review Outline

Use an outline for your reviewer report so it’s easy for the editors and author to follow. This will also help you keep your comments organized.

Think about structuring your review like an inverted pyramid. Put the most important information at the top, followed by details and examples in the center, and any additional points at the very bottom.

Here’s how your outline might look:

1. Summary of the research and your overall impression

In your own words, summarize what the manuscript claims to report. This shows the editor how you interpreted the manuscript and will highlight any major differences in perspective between you and the other reviewers. Give an overview of the manuscript’s strengths and weaknesses. Think about this as your “take-home” message for the editors. End this section with your recommended course of action.

2. Discussion of specific areas for improvement

It’s helpful to divide this section into two parts: one for major issues and one for minor issues. Within each section, you can talk about the biggest issues first or go systematically figure-by-figure or claim-by-claim. Number each item so that your points are easy to follow (this will also make it easier for the authors to respond to each point). Refer to specific lines, pages, sections, or figure and table numbers so the authors (and editors) know exactly what you’re talking about.

Major vs. minor issues

What’s the difference between a major and minor issue? Major issues should consist of the essential points the authors need to address before the manuscript can proceed. Make sure you focus on what is  fundamental for the current study . In other words, it’s not helpful to recommend additional work that would be considered the “next step” in the study. Minor issues are still important but typically will not affect the overall conclusions of the manuscript. Here are some examples of what would might go in the “minor” category:

• Missing references (but depending on what is missing, this could also be a major issue)
• Technical clarifications (e.g., the authors should clarify how a reagent works)
• Data presentation (e.g., the authors should present p-values differently)
• Typos, spelling, grammar, and phrasing issues

3. Any other points

Confidential comments for the editors.

Some journals have a space for reviewers to enter confidential comments about the manuscript. Use this space to mention concerns about the submission that you’d want the editors to consider before sharing your feedback with the authors, such as concerns about ethical guidelines or language quality. Any serious issues should be raised directly and immediately with the journal as well.

This section is also where you will disclose any potentially competing interests, and mention whether you’re willing to look at a revised version of the manuscript.

Do not use this space to critique the manuscript, since comments entered here will not be passed along to the authors.  If you’re not sure what should go in the confidential comments, read the reviewer instructions or check with the journal first before submitting your review. If you are reviewing for a journal that does not offer a space for confidential comments, consider writing to the editorial office directly with your concerns.

Get this outline in a template

Giving Feedback

Giving feedback is hard. Giving effective feedback can be even more challenging. Remember that your ultimate goal is to discuss what the authors would need to do in order to qualify for publication. The point is not to nitpick every piece of the manuscript. Your focus should be on providing constructive and critical feedback that the authors can use to improve their study.

If you’ve ever had your own work reviewed, you already know that it’s not always easy to receive feedback. Follow the golden rule: Write the type of review you’d want to receive if you were the author. Even if you decide not to identify yourself in the review, you should write comments that you would be comfortable signing your name to.

In your comments, use phrases like “ the authors’ discussion of X” instead of “ your discussion of X .” This will depersonalize the feedback and keep the focus on the manuscript instead of the authors.

General guidelines for effective feedback

• Justify your recommendation with concrete evidence and specific examples.
• Be specific so the authors know what they need to do to improve.
• Be thorough. This might be the only time you read the manuscript.
• Be professional and respectful. The authors will be reading these comments too.
• Remember to say what you liked about the manuscript!

Don’t

• Recommend additional experiments or  unnecessary elements that are out of scope for the study or for the journal criteria.
• Tell the authors exactly how to revise their manuscript—you don’t need to do their work for them.
• Use the review to promote your own research or hypotheses.
• Focus on typos and grammar. If the manuscript needs significant editing for language and writing quality, just mention this in your comments.
• Submit your review without proofreading it and checking everything one more time.

Before and After: Sample Reviewer Comments

Keeping in mind the guidelines above, how do you put your thoughts into words? Here are some sample “before” and “after” reviewer comments

✗ Before

“The authors appear to have no idea what they are talking about. I don’t think they have read any of the literature on this topic.”

✓ After

“The study fails to address how the findings relate to previous research in this area. The authors should rewrite their Introduction and Discussion to reference the related literature, especially recently published work such as Darwin et al.”

“The writing is so bad, it is practically unreadable. I could barely bring myself to finish it.”

“While the study appears to be sound, the language is unclear, making it difficult to follow. I advise the authors work with a writing coach or copyeditor to improve the flow and readability of the text.”

“It’s obvious that this type of experiment should have been included. I have no idea why the authors didn’t use it. This is a big mistake.”

“The authors are off to a good start, however, this study requires additional experiments, particularly [type of experiment]. Alternatively, the authors should include more information that clarifies and justifies their choice of methods.”

Suggested Language for Tricky Situations

You might find yourself in a situation where you’re not sure how to explain the problem or provide feedback in a constructive and respectful way. Here is some suggested language for common issues you might experience.

What you think : The manuscript is fatally flawed. What you could say: “The study does not appear to be sound” or “the authors have missed something crucial”.

What you think : You don’t completely understand the manuscript. What you could say : “The authors should clarify the following sections to avoid confusion…”

What you think : The technical details don’t make sense. What you could say : “The technical details should be expanded and clarified to ensure that readers understand exactly what the researchers studied.”

What you think: The writing is terrible. What you could say : “The authors should revise the language to improve readability.”

What you think : The authors have over-interpreted the findings. What you could say : “The authors aim to demonstrate [XYZ], however, the data does not fully support this conclusion. Specifically…”

What does a good review look like?

Check out the peer review examples at F1000 Research to see how other reviewers write up their reports and give constructive feedback to authors.

Time to Submit the Review!

Be sure you turn in your report on time. Need an extension? Tell the journal so that they know what to expect. If you need a lot of extra time, the journal might need to contact other reviewers or notify the author about the delay.

Tip: Building a relationship with an editor

You’ll be more likely to be asked to review again if you provide high-quality feedback and if you turn in the review on time. Especially if it’s your first review for a journal, it’s important to show that you are reliable. Prove yourself once and you’ll get asked to review again!

• Getting started as a reviewer
• Responding to an invitation
• Reading a manuscript
• Writing a peer review

The contents of the Peer Review Center are also available as a live, interactive training session, complete with slides, talking points, and activities. …

The contents of the Writing Center are also available as a live, interactive training session, complete with slides, talking points, and activities. …

There’s a lot to consider when deciding where to submit your work. Learn how to choose a journal that will help your study reach its audience, while reflecting your values as a researcher…

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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.

• Research Process

Writing a good review article

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Table of Contents

As a young researcher, you might wonder how to start writing your first review article, and the extent of the information that it should contain. A review article is a comprehensive summary of the current understanding of a specific research topic and is based on previously published research. Unlike research papers, it does not contain new results, but can propose new inferences based on the combined findings of previous research.

Types of review articles

Review articles are typically of three types: literature reviews, systematic reviews, and meta-analyses.

A literature review is a general survey of the research topic and aims to provide a reliable and unbiased account of the current understanding of the topic.

A systematic review , in contrast, is more specific and attempts to address a highly focused research question. Its presentation is more detailed, with information on the search strategy used, the eligibility criteria for inclusion of studies, the methods utilized to review the collected information, and more.

A meta-analysis is similar to a systematic review in that both are systematically conducted with a properly defined research question. However, unlike the latter, a meta-analysis compares and evaluates a defined number of similar studies. It is quantitative in nature and can help assess contrasting study findings.

Tips for writing a good review article

Here are a few practices that can make the time-consuming process of writing a review article easier:

• Define your question: Take your time to identify the research question and carefully articulate the topic of your review paper. A good review should also add something new to the field in terms of a hypothesis, inference, or conclusion. A carefully defined scientific question will give you more clarity in determining the novelty of your inferences.
• Identify credible sources: Identify relevant as well as credible studies that you can base your review on, with the help of multiple databases or search engines. It is also a good idea to conduct another search once you have finished your article to avoid missing relevant studies published during the course of your writing.
• Take notes: A literature search involves extensive reading, which can make it difficult to recall relevant information subsequently. Therefore, make notes while conducting the literature search and note down the source references. This will ensure that you have sufficient information to start with when you finally get to writing.
• Describe the title, abstract, and introduction: A good starting point to begin structuring your review is by drafting the title, abstract, and introduction. Explicitly writing down what your review aims to address in the field will help shape the rest of your article.
• Be unbiased and critical: Evaluate every piece of evidence in a critical but unbiased manner. This will help you present a proper assessment and a critical discussion in your article.
• Include a good summary: End by stating the take-home message and identify the limitations of existing studies that need to be addressed through future studies.
• Ask for feedback: Ask a colleague to provide feedback on both the content and the language or tone of your article before you submit it.
• Check your journal’s guidelines: Some journals only publish reviews, while some only publish research articles. Further, all journals clearly indicate their aims and scope. Therefore, make sure to check the appropriateness of a journal before submitting your article.

Writing review articles, especially systematic reviews or meta-analyses, can seem like a daunting task. However, Elsevier Author Services can guide you by providing useful tips on how to write an impressive review article that stands out and gets published!

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How to Write an Article Review: Tips and Examples

Did you know that article reviews are not just academic exercises but also a valuable skill in today's information age? In a world inundated with content, being able to dissect and evaluate articles critically can help you separate the wheat from the chaff. Whether you're a student aiming to excel in your coursework or a professional looking to stay well-informed, mastering the art of writing article reviews is an invaluable skill.

Short Description

In this article, our research paper writing service experts will start by unraveling the concept of article reviews and discussing the various types. You'll also gain insights into the art of formatting your review effectively. To ensure you're well-prepared, we'll take you through the pre-writing process, offering tips on setting the stage for your review. But it doesn't stop there. You'll find a practical example of an article review to help you grasp the concepts in action. To complete your journey, we'll guide you through the post-writing process, equipping you with essential proofreading techniques to ensure your work shines with clarity and precision!

What Is an Article Review: Grasping the Concept 

A review article is a type of professional paper writing that demands a high level of in-depth analysis and a well-structured presentation of arguments. It is a critical, constructive evaluation of literature in a particular field through summary, classification, analysis, and comparison.

If you write a scientific review, you have to use database searches to portray the research. Your primary goal is to summarize everything and present a clear understanding of the topic you've been working on.

Writing Involves:

• Summarization, classification, analysis, critiques, and comparison.
• The analysis, evaluation, and comparison require the use of theories, ideas, and research relevant to the subject area of the article.
• It is also worth nothing if a review does not introduce new information, but instead presents a response to another writer's work.
• Check out other samples to gain a better understanding of how to review the article.

Types of Review

When it comes to article reviews, there's more than one way to approach the task. Understanding the various types of reviews is like having a versatile toolkit at your disposal. In this section, we'll walk you through the different dimensions of review types, each offering a unique perspective and purpose. Whether you're dissecting a scholarly article, critiquing a piece of literature, or evaluating a product, you'll discover the diverse landscape of article reviews and how to navigate it effectively.

Journal Article Review

Just like other types of reviews, a journal article review assesses the merits and shortcomings of a published work. To illustrate, consider a review of an academic paper on climate change, where the writer meticulously analyzes and interprets the article's significance within the context of environmental science.

Research Article Review

Distinguished by its focus on research methodologies, a research article review scrutinizes the techniques used in a study and evaluates them in light of the subsequent analysis and critique. For instance, when reviewing a research article on the effects of a new drug, the reviewer would delve into the methods employed to gather data and assess their reliability.

Science Article Review

In the realm of scientific literature, a science article review encompasses a wide array of subjects. Scientific publications often provide extensive background information, which can be instrumental in conducting a comprehensive analysis. For example, when reviewing an article about the latest breakthroughs in genetics, the reviewer may draw upon the background knowledge provided to facilitate a more in-depth evaluation of the publication.

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Formatting an Article Review

The format of the article should always adhere to the citation style required by your professor. If you're not sure, seek clarification on the preferred format and ask him to clarify several other pointers to complete the formatting of an article review adequately.

How Many Publications Should You Review?

• In what format should you cite your articles (MLA, APA, ASA, Chicago, etc.)?
• What length should your review be?
• Should you include a summary, critique, or personal opinion in your assignment?
• Do you need to call attention to a theme or central idea within the articles?
• Does your instructor require background information?

When you know the answers to these questions, you may start writing your assignment. Below are examples of MLA and APA formats, as those are the two most common citation styles.

Using the APA Format

Articles appear most commonly in academic journals, newspapers, and websites. If you write an article review in the APA format, you will need to write bibliographical entries for the sources you use:

• Web : Author [last name], A.A [first and middle initial]. (Year, Month, Date of Publication). Title. Retrieved from {link}
• Journal : Author [last name], A.A [first and middle initial]. (Publication Year). Publication Title. Periodical Title, Volume(Issue), pp.-pp.
• Newspaper : Author [last name], A.A [first and middle initial]. (Year, Month, Date of Publication). Publication Title. Magazine Title, pp. xx-xx.

Using MLA Format

• Web : Last, First Middle Initial. “Publication Title.” Website Title. Website Publisher, Date Month Year Published. Web. Date Month Year Accessed.
• Newspaper : Last, First M. “Publication Title.” Newspaper Title [City] Date, Month, Year Published: Page(s). Print.
• Journal : Last, First M. “Publication Title.” Journal Title Series Volume. Issue (Year Published): Page(s). Database Name. Web. Date Month Year Accessed.

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The Pre-Writing Process

Facing this task for the first time can really get confusing and can leave you unsure of where to begin. To create a top-notch article review, start with a few preparatory steps. Here are the two main stages from our dissertation services to get you started:

Step 1: Define the right organization for your review. Knowing the future setup of your paper will help you define how you should read the article. Here are the steps to follow:

• Summarize the article — seek out the main points, ideas, claims, and general information presented in the article.
• Define the positive points — identify the strong aspects, ideas, and insightful observations the author has made.
• Find the gaps —- determine whether or not the author has any contradictions, gaps, or inconsistencies in the article and evaluate whether or not he or she used a sufficient amount of arguments and information to support his or her ideas.
• Identify unanswered questions — finally, identify if there are any questions left unanswered after reading the piece.

Step 2: Move on and review the article. Here is a small and simple guide to help you do it right:

• Start off by looking at and assessing the title of the piece, its abstract, introductory part, headings and subheadings, opening sentences in its paragraphs, and its conclusion.
• First, read only the beginning and the ending of the piece (introduction and conclusion). These are the parts where authors include all of their key arguments and points. Therefore, if you start with reading these parts, it will give you a good sense of the author's main points.
• Finally, read the article fully.

These three steps make up most of the prewriting process. After you are done with them, you can move on to writing your own review—and we are going to guide you through the writing process as well.

Outline and Template

As you progress with reading your article, organize your thoughts into coherent sections in an outline. As you read, jot down important facts, contributions, or contradictions. Identify the shortcomings and strengths of your publication. Begin to map your outline accordingly.

If your professor does not want a summary section or a personal critique section, then you must alleviate those parts from your writing. Much like other assignments, an article review must contain an introduction, a body, and a conclusion. Thus, you might consider dividing your outline according to these sections as well as subheadings within the body. If you find yourself troubled with the pre-writing and the brainstorming process for this assignment, seek out a sample outline.

Your custom essay must contain these constituent parts:

• Pre-Title Page - Before diving into your review, start with essential details: article type, publication title, and author names with affiliations (position, department, institution, location, and email). Include corresponding author info if needed.
• Running Head - In APA format, use a concise title (under 40 characters) to ensure consistent formatting.
• Summary Page - Optional but useful. Summarize the article in 800 words, covering background, purpose, results, and methodology, avoiding verbatim text or references.
• Title Page - Include the full title, a 250-word abstract, and 4-6 keywords for discoverability.
• Introduction - Set the stage with an engaging overview of the article.
• Body - Organize your analysis with headings and subheadings.
• Works Cited/References - Properly cite all sources used in your review.
• Optional Suggested Reading Page - If permitted, suggest further readings for in-depth exploration.
• Tables and Figure Legends (if instructed by the professor) - Include visuals when requested by your professor for clarity.

Example of an Article Review

You might wonder why we've dedicated a section of this article to discuss an article review sample. Not everyone may realize it, but examining multiple well-constructed examples of review articles is a crucial step in the writing process. In the following section, our essay writing service experts will explain why.

Looking through relevant article review examples can be beneficial for you in the following ways:

• To get you introduced to the key works of experts in your field.
• To help you identify the key people engaged in a particular field of science.
• To help you define what significant discoveries and advances were made in your field.
• To help you unveil the major gaps within the existing knowledge of your field—which contributes to finding fresh solutions.
• To help you find solid references and arguments for your own review.
• To help you generate some ideas about any further field of research.
• To help you gain a better understanding of the area and become an expert in this specific field.
• To get a clear idea of how to write a good review.

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Steps for Writing an Article Review

Here is a guide with critique paper format on how to write a review paper:

Step 1: Write the Title

First of all, you need to write a title that reflects the main focus of your work. Respectively, the title can be either interrogative, descriptive, or declarative.

Step 2: Cite the Article

Next, create a proper citation for the reviewed article and input it following the title. At this step, the most important thing to keep in mind is the style of citation specified by your instructor in the requirements for the paper. For example, an article citation in the MLA style should look as follows:

Author's last and first name. "The title of the article." Journal's title and issue(publication date): page(s). Print

Abraham John. "The World of Dreams." Virginia Quarterly 60.2(1991): 125-67. Print.

Step 3: Article Identification

After your citation, you need to include the identification of your reviewed article:

• Title of the article
• Title of the journal
• Year of publication

All of this information should be included in the first paragraph of your paper.

The report "Poverty increases school drop-outs" was written by Brian Faith – a Health officer – in 2000.

Step 4: Introduction

Your organization in an assignment like this is of the utmost importance. Before embarking on your writing process, you should outline your assignment or use an article review template to organize your thoughts coherently.

• If you are wondering how to start an article review, begin with an introduction that mentions the article and your thesis for the review.
• Follow up with a summary of the main points of the article.
• Highlight the positive aspects and facts presented in the publication.
• Critique the publication by identifying gaps, contradictions, disparities in the text, and unanswered questions.

Step 5: Summarize the Article

Make a summary of the article by revisiting what the author has written about. Note any relevant facts and findings from the article. Include the author's conclusions in this section.

Step 6: Critique It

Present the strengths and weaknesses you have found in the publication. Highlight the knowledge that the author has contributed to the field. Also, write about any gaps and/or contradictions you have found in the article. Take a standpoint of either supporting or not supporting the author's assertions, but back up your arguments with facts and relevant theories that are pertinent to that area of knowledge. Rubrics and templates can also be used to evaluate and grade the person who wrote the article.

Step 7: Craft a Conclusion

In this section, revisit the critical points of your piece, your findings in the article, and your critique. Also, write about the accuracy, validity, and relevance of the results of the article review. Present a way forward for future research in the field of study. Before submitting your article, keep these pointers in mind:

• As you read the article, highlight the key points. This will help you pinpoint the article's main argument and the evidence that they used to support that argument.
• While you write your review, use evidence from your sources to make a point. This is best done using direct quotations.
• Select quotes and supporting evidence adequately and use direct quotations sparingly. Take time to analyze the article adequately.
• Every time you reference a publication or use a direct quotation, use a parenthetical citation to avoid accidentally plagiarizing your article.
• Re-read your piece a day after you finish writing it. This will help you to spot grammar mistakes and to notice any flaws in your organization.
• Use a spell-checker and get a second opinion on your paper.

The Post-Writing Process: Proofread Your Work

Finally, when all of the parts of your article review are set and ready, you have one last thing to take care of — proofreading. Although students often neglect this step, proofreading is a vital part of the writing process and will help you polish your paper to ensure that there are no mistakes or inconsistencies.

To proofread your paper properly, start by reading it fully and checking the following points:

• Punctuation
• Other mistakes

Afterward, take a moment to check for any unnecessary information in your paper and, if found, consider removing it to streamline your content. Finally, double-check that you've covered at least 3-4 key points in your discussion.

And remember, if you ever need help with proofreading, rewriting your essay, or even want to buy essay , our friendly team is always here to assist you.

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What Is A Review Article?

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Related Articles

How to Write an Article Review: Template & Examples

An article review is an academic assignment that invites you to study a piece of academic research closely. Then, you should present its summary and critically evaluate it using the knowledge you’ve gained in class and during your independent study. If you get such a task at college or university, you shouldn’t confuse it with a response paper, which is a distinct assignment with other purposes (we’ll talk about it in detail below).

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In this article, prepared by Custom-Writing experts, you’ll find:

• the intricacies of article review writing;
• the difference between an article review and similar assignments;
• a step-by-step algorithm for review composition;
• a couple of samples to guide you throughout the writing process.

So, if you wish to study our article review example and discover helpful writing tips, keep reading.

❓ What Is an Article Review?

• ✍️ Writing Steps

📑 Article Review Format

🔗 references.

An article review is an academic paper that summarizes and critically evaluates the information presented in your selected article.

The first thing you should note when approaching the task of an article review is that not every article is suitable for this assignment. Let’s have a look at the variety of articles to understand what you can choose from.

Popular Vs. Scholarly Articles

In most cases, you’ll be required to review a scholarly, peer-reviewed article – one composed in compliance with rigorous academic standards. Yet, the Web is also full of popular articles that don’t present original scientific value and shouldn’t be selected for a review.

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Not sure how to distinguish these two types? Here is a comparative table to help you out.

Article Review vs. Response Paper

Now, let’s consider the difference between an article review and a response paper:

• If you’re assigned to critique a scholarly article , you will need to compose an article review .
• If your subject of analysis is a popular article , you can respond to it with a well-crafted response paper .

The reason for such distinctions is the quality and structure of these two article types. Peer-reviewed, scholarly articles have clear-cut quality criteria, allowing you to conduct and present a structured assessment of the assigned material. Popular magazines have loose or non-existent quality criteria and don’t offer an opportunity for structured evaluation. So, they are only fit for a subjective response, in which you can summarize your reactions and emotions related to the reading material.

All in all, you can structure your response assignments as outlined in the tips below.

✍️ How to Write an Article Review: Step by Step

Here is a tried and tested algorithm for article review writing from our experts. We’ll consider only the critical review variety of this academic assignment. So, let’s get down to the stages you need to cover to get a stellar review.

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Read the Article

As with any reviews, reports, and critiques, you must first familiarize yourself with the assigned material. It’s impossible to review something you haven’t read, so set some time for close, careful reading of the article to identify:

• The author’s main points and message.
• The arguments they use to prove their points.
• The methodology they use to approach the subject.

In terms of research type , your article will usually belong to one of three types explained below.

Summarize the Article

Now that you’ve read the text and have a general impression of the content, it’s time to summarize it for your readers. Look into the article’s text closely to determine:

• The thesis statement , or general message of the author.
• Research question, purpose, and context of research.
• Supporting points for the author’s assumptions and claims.
• Major findings and supporting evidence.

As you study the article thoroughly, make notes on the margins or write these elements out on a sheet of paper. You can also apply a different technique: read the text section by section and formulate its gist in one phrase or sentence. Once you’re done, you’ll have a summary skeleton in front of you.

Evaluate the Article

The next step of review is content evaluation. Keep in mind that various research types will require a different set of review questions. Here is a complete list of evaluation points you can include.

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Write the Text

After completing the critical review stage, it’s time to compose your article review.

The format of this assignment is standard – you will have an introduction, a body, and a conclusion. The introduction should present your article and summarize its content. The body will contain a structured review according to all four dimensions covered in the previous section. The concluding part will typically recap all the main points you’ve identified during your assessment.

It is essential to note that an article review is, first of all, an academic assignment. Therefore, it should follow all rules and conventions of academic composition, such as:

• No contractions . Don’t use short forms, such as “don’t,” “can’t,” “I’ll,” etc. in academic writing. You need to spell out all those words.
• Formal language and style . Avoid conversational phrasing and words that you would naturally use in blog posts or informal communication. For example, don’t use words like “pretty,” “kind of,” and “like.”
• Third-person narrative . Academic reviews should be written from the third-person point of view, avoiding statements like “I think,” “in my opinion,” and so on.
• No conversational forms . You shouldn’t turn to your readers directly in the text by addressing them with the pronoun “you.” It’s vital to keep the narrative neutral and impersonal.
• Proper abbreviation use . Consult the list of correct abbreviations , like “e.g.” or “i.e.,” for use in your academic writing. If you use informal abbreviations like “FYA” or “f.i.,” your professor will reduce the grade.
• Complete sentences . Make sure your sentences contain the subject and the predicate; avoid shortened or sketch-form phrases suitable for a draft only.
• No conjunctions at the beginning of a sentence . Remember the FANBOYS rule – don’t start a sentence with words like “and” or “but.” They often seem the right way to build a coherent narrative, but academic writing rules disfavor such usage.
• No abbreviations or figures at the beginning of a sentence . Never start a sentence with a number — spell it out if you need to use it anyway. Besides, sentences should never begin with abbreviations like “e.g.”

Finally, a vital rule for an article review is properly formatting the citations. We’ll discuss the correct use of citation styles in the following section.

When composing an article review, keep these points in mind:

• Start with a full reference to the reviewed article so the reader can locate it quickly.
• Ensure correct formatting of in-text references.
• Provide a complete list of used external sources on the last page of the review – your bibliographical entries .

You’ll need to understand the rules of your chosen citation style to meet all these requirements. Below, we’ll discuss the two most common referencing styles – APA and MLA.

Article Review in APA

When you need to compose an article review in the APA format , here is the general bibliographical entry format you should use for journal articles on your reference page:

• Author’s last name, First initial. Middle initial. (Year of Publication). Name of the article. Name of the Journal, volume (number), pp. #-#. https://doi.org/xx.xxx/yyyy

Horigian, V. E., Schmidt, R. D., & Feaster, D. J. (2021). Loneliness, mental health, and substance use among US young adults during COVID-19. Journal of Psychoactive Drugs, 53 (1), pp. 1-9. https://doi.org/10.1080/02791072.2020.1836435

Your in-text citations should follow the author-date format like this:

• If you paraphrase the source and mention the author in the text: According to Horigian et al. (2021), young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic.
• If you paraphrase the source and don’t mention the author in the text: Young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (Horigian et al., 2021).
• If you quote the source: As Horigian et al. (2021) point out, there were “elevated levels of loneliness, depression, anxiety, alcohol use, and drug use among young adults during COVID-19” (p. 6).

Note that your in-text citations should include “et al.,” as in the examples above, if your article has 3 or more authors. If you have one or two authors, your in-text citations would look like this:

• One author: “According to Smith (2020), depression is…” or “Depression is … (Smith, 2020).”
• Two authors: “According to Smith and Brown (2020), anxiety means…” or “Anxiety means (Smith & Brown, 2020).”

Finally, in case you have to review a book or a website article, here are the general formats for citing these source types on your APA reference list.

Article Review in MLA

If your assignment requires MLA-format referencing, here’s the general format you should use for citing journal articles on your Works Cited page:

• Author’s last name, First name. “Title of an Article.” Title of the Journal , vol. #, no. #, year, pp. #-#.

Horigian, Viviana E., et al. “Loneliness, Mental Health, and Substance Use Among US Young Adults During COVID-19.” Journal of Psychoactive Drugs , vol. 53, no. 1, 2021, pp. 1-9.

In-text citations in the MLA format follow the author-page citation format and look like this:

• According to Horigian et al., young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (6).
• Young adults experienced increased levels of loneliness, depression, and anxiety during the pandemic (Horigian et al. 6).

Like in APA, the abbreviation “et al.” is only needed in MLA if your article has 3 or more authors.

If you need to cite a book or a website page, here are the general MLA formats for these types of sources.

✅ Article Review Template

Here is a handy, universal article review template to help you move on with any review assignment. We’ve tried to make it as generic as possible to guide you in the academic process.

📝 Article Review Examples

The theory is good, but practice is even better. Thus, we’ve created three brief examples to show you how to write an article review. You can study the full-text samples by following the links.

📃 Men, Women, & Money  

This article review examines a famous piece, “Men, Women & Money – How the Sexes Differ with Their Finances,” published by Amy Livingston in 2020. The author of this article claims that men generally spend more money than women. She makes this conclusion from a close analysis of gender-specific expenditures across five main categories: food, clothing, cars, entertainment, and general spending patterns. Livingston also looks at men’s approach to saving to argue that counter to the common perception of women’s light-hearted attitude to money, men are those who spend more on average.

📃 When and Why Nationalism Beats Globalism

This is a review of Jonathan Heidt’s 2016 article titled “When and Why Nationalism Beats Globalism,” written as an advocacy of right-wing populism rising in many Western states. The author illustrates the case with the election of Donald Trump as the US President and the rise of right-wing rhetoric in many Western countries. These examples show how nationalist sentiment represents a reaction to global immigration and a failure of globalization.

📃 Sleep Deprivation  

This is a review of the American Heart Association’s article titled “The Dangers of Sleep Deprivation.” It discusses how the national organization concerned with the American population’s cardiovascular health links the lack of high-quality sleep to far-reaching health consequences. The organization’s experts reveal how a consistent lack of sleep leads to Alzheimer’s disease development, obesity, type 2 diabetes, etc.

✏️ Article Review FAQ

A high-quality article review should summarize the assigned article’s content and offer data-backed reactions and evaluations of its quality in terms of the article’s purpose, methodology, and data used to argue the main points. It should be detailed, comprehensive, objective, and evidence-based.

The purpose of writing a review is to allow students to reflect on research quality and showcase their critical thinking and evaluation skills. Students should exhibit their mastery of close reading of research publications and their unbiased assessment.

The content of your article review will be the same in any format, with the only difference in the assignment’s formatting before submission. Ensure you have a separate title page made according to APA standards and cite sources using the parenthetical author-date referencing format.

You need to take a closer look at various dimensions of an assigned article to compose a valuable review. Study the author’s object of analysis, the purpose of their research, the chosen method, data, and findings. Evaluate all these dimensions critically to see whether the author has achieved the initial goals. Finally, offer improvement recommendations to add a critique aspect to your paper.

• Scientific Article Review: Duke University
• Book and Article Reviews: William & Mary, Writing Resources Center
• Sample Format for Reviewing a Journal Article: Boonshoft School of Medicine
• Research Paper Review – Structure and Format Guidelines: New Jersey Institute of Technology
• Article Review: University of Waterloo
• Article Review: University of South Australia
• How to Write a Journal Article Review: University of Newcastle Library Guides
• Writing Help: The Article Review: Central Michigan University Libraries
• Write a Critical Review of a Scientific Journal Article: McLaughlin Library
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How to write a good scientific review article

Affiliation.

• 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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How to write a review article?

In the medical sciences, the importance of review articles is rising. When clinicians want to update their knowledge and generate guidelines about a topic, they frequently use reviews as a starting point. The value of a review is associated with what has been done, what has been found and how these findings are presented. Before asking ‘how,’ the question of ‘why’ is more important when starting to write a review. The main and fundamental purpose of writing a review is to create a readable synthesis of the best resources available in the literature for an important research question or a current area of research. Although the idea of writing a review is attractive, it is important to spend time identifying the important questions. Good review methods are critical because they provide an unbiased point of view for the reader regarding the current literature. There is a consensus that a review should be written in a systematic fashion, a notion that is usually followed. In a systematic review with a focused question, the research methods must be clearly described. A ‘methodological filter’ is the best method for identifying the best working style for a research question, and this method reduces the workload when surveying the literature. An essential part of the review process is differentiating good research from bad and leaning on the results of the better studies. The ideal way to synthesize studies is to perform a meta-analysis. In conclusion, when writing a review, it is best to clearly focus on fixed ideas, to use a procedural and critical approach to the literature and to express your findings in an attractive way.

The importance of review articles in health sciences is increasing day by day. Clinicians frequently benefit from review articles to update their knowledge in their field of specialization, and use these articles as a starting point for formulating guidelines. [ 1 , 2 ] The institutions which provide financial support for further investigations resort to these reviews to reveal the need for these researches. [ 3 ] As is the case with all other researches, the value of a review article is related to what is achieved, what is found, and the way of communicating this information. A few studies have evaluated the quality of review articles. Murlow evaluated 50 review articles published in 1985, and 1986, and revealed that none of them had complied with clear-cut scientific criteria. [ 4 ] In 1996 an international group that analyzed articles, demonstrated the aspects of review articles, and meta-analyses that had not complied with scientific criteria, and elaborated QUOROM (QUality Of Reporting Of Meta-analyses) statement which focused on meta-analyses of randomized controlled studies. [ 5 ] Later on this guideline was updated, and named as PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). [ 6 ]

Review articles are divided into 2 categories as narrative, and systematic reviews. Narrative reviews are written in an easily readable format, and allow consideration of the subject matter within a large spectrum. However in a systematic review, a very detailed, and comprehensive literature surveying is performed on the selected topic. [ 7 , 8 ] Since it is a result of a more detailed literature surveying with relatively lesser involvement of author’s bias, systematic reviews are considered as gold standard articles. Systematic reviews can be diivded into qualitative, and quantitative reviews. In both of them detailed literature surveying is performed. However in quantitative reviews, study data are collected, and statistically evaluated (ie. meta-analysis). [ 8 ]

Before inquring for the method of preparation of a review article, it is more logical to investigate the motivation behind writing the review article in question. The fundamental rationale of writing a review article is to make a readable synthesis of the best literature sources on an important research inquiry or a topic. This simple definition of a review article contains the following key elements:

• The question(s) to be dealt with
• Methods used to find out, and select the best quality researches so as to respond to these questions.
• To synthetize available, but quite different researches

For the specification of important questions to be answered, number of literature references to be consulted should be more or less determined. Discussions should be conducted with colleagues in the same area of interest, and time should be reserved for the solution of the problem(s). Though starting to write the review article promptly seems to be very alluring, the time you spend for the determination of important issues won’t be a waste of time. [ 9 ]

The PRISMA statement [ 6 ] elaborated to write a well-designed review articles contains a 27-item checklist ( Table 1 ). It will be reasonable to fulfill the requirements of these items during preparation of a review article or a meta-analysis. Thus preparation of a comprehensible article with a high-quality scientific content can be feasible.

PRISMA statement: A 27-item checklist

Contents and format

Important differences exist between systematic, and non-systematic reviews which especially arise from methodologies used in the description of the literature sources. A non-systematic review means use of articles collected for years with the recommendations of your colleagues, while systematic review is based on struggles to search for, and find the best possible researches which will respond to the questions predetermined at the start of the review.

Though a consensus has been reached about the systematic design of the review articles, studies revealed that most of them had not been written in a systematic format. McAlister et al. analyzed review articles in 6 medical journals, and disclosed that in less than one fourth of the review articles, methods of description, evaluation or synthesis of evidence had been provided, one third of them had focused on a clinical topic, and only half of them had provided quantitative data about the extend of the potential benefits. [ 10 ]

Use of proper methodologies in review articles is important in that readers assume an objective attitude towards updated information. We can confront two problems while we are using data from researches in order to answer certain questions. Firstly, we can be prejudiced during selection of research articles or these articles might be biased. To minimize this risk, methodologies used in our reviews should allow us to define, and use researches with minimal degree of bias. The second problem is that, most of the researches have been performed with small sample sizes. In statistical methods in meta-analyses, available researches are combined to increase the statistical power of the study. The problematic aspect of a non-systematic review is that our tendency to give biased responses to the questions, in other words we apt to select the studies with known or favourite results, rather than the best quality investigations among them.

As is the case with many research articles, general format of a systematic review on a single subject includes sections of Introduction, Methods, Results, and Discussion ( Table 2 ).

Structure of a systematic review

Preparation of the review article

Steps, and targets of constructing a good review article are listed in Table 3 . To write a good review article the items in Table 3 should be implemented step by step. [ 11 – 13 ]

Steps of a systematic review

The research question

It might be helpful to divide the research question into components. The most prevalently used format for questions related to the treatment is PICO (P - Patient, Problem or Population; I-Intervention; C-appropriate Comparisons, and O-Outcome measures) procedure. For example In female patients (P) with stress urinary incontinence, comparisons (C) between transobturator, and retropubic midurethral tension-free band surgery (I) as for patients’ satisfaction (O).

Finding Studies

In a systematic review on a focused question, methods of investigation used should be clearly specified.

Ideally, research methods, investigated databases, and key words should be described in the final report. Different databases are used dependent on the topic analyzed. In most of the clinical topics, Medline should be surveyed. However searching through Embase and CINAHL can be also appropriate.

While determining appropriate terms for surveying, PICO elements of the issue to be sought may guide the process. Since in general we are interested in more than one outcome, P, and I can be key elements. In this case we should think about synonyms of P, and I elements, and combine them with a conjunction AND.

One method which might alleviate the workload of surveying process is “methodological filter” which aims to find the best investigation method for each research question. A good example of this method can be found in PubMed interface of Medline. The Clinical Queries tool offers empirically developed filters for five different inquiries as guidelines for etiology, diagnosis, treatment, prognosis or clinical prediction.

Evaluation of the Quality of the Study

As an indispensable component of the review process is to discriminate good, and bad quality researches from each other, and the outcomes should be based on better qualified researches, as far as possible. To achieve this goal you should know the best possible evidence for each type of question The first component of the quality is its general planning/design of the study. General planning/design of a cohort study, a case series or normal study demonstrates variations.

A hierarchy of evidence for different research questions is presented in Table 4 . However this hierarchy is only a first step. After you find good quality research articles, you won’t need to read all the rest of other articles which saves you tons of time. [ 14 ]

Determination of levels of evidence based on the type of the research question

Formulating a Synthesis

Rarely all researches arrive at the same conclusion. In this case a solution should be found. However it is risky to make a decision based on the votes of absolute majority. Indeed, a well-performed large scale study, and a weakly designed one are weighed on the same scale. Therefore, ideally a meta-analysis should be performed to solve apparent differences. Ideally, first of all, one should be focused on the largest, and higher quality study, then other studies should be compared with this basic study.

Conclusions

In conclusion, during writing process of a review article, the procedures to be achieved can be indicated as follows: 1) Get rid of fixed ideas, and obsessions from your head, and view the subject from a large perspective. 2) Research articles in the literature should be approached with a methodological, and critical attitude and 3) finally data should be explained in an attractive way.

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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: 

How to write a good literature review 

• 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.

What is the purpose of literature review?

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: 

a. Habitat Loss and Species Extinction:

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. 

b. Range Shifts and Phenological Changes:

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. 

c. Ocean Acidification and Coral Reefs:

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. 

d. Adaptive Strategies and Conservation Efforts:

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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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 feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to 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” 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 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.  

Frequently asked questions

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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Reviewing review articles

A review article is written to summarize the current state of understanding on a topic, and peer reviewing these types of articles requires a slightly different set of criteria compared with empirical articles. Unless it is a systematic review/meta-analysis methods are not important or reported. The quality of a review article can be judged on aspects such as timeliness, the breadth and accuracy of the discussion, and if it indicates the best avenues for future research. The review article should present an unbiased summary of the current understanding of the topic, and therefore the peer reviewer must assess the selection of studies that are cited by the paper. As review article contains a large amount of detailed information, its structure and flow are also important.

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But what we perceive as deception is AI mindlessly achieving the goals we’ve set for it.

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A wave of AI systems have “deceived” humans in ways they haven’t been explicitly trained to do, by offering up untrue explanations for their behavior or concealing the truth from human users and misleading them to achieve a strategic end. 

This issue highlights how difficult artificial intelligence is to control and the unpredictable ways in which these systems work, according to a review paper published in the journal Patterns today that summarizes previous research.

Talk of deceiving humans might suggest that these models have intent. They don’t. But AI models will mindlessly find workarounds to obstacles to achieve the goals that have been given to them. Sometimes these workarounds will go against users’ expectations and feel deceitful.

One area where AI systems have learned to become deceptive is within the context of games that they’ve been trained to win—specifically if those games involve having to act strategically.

In November 2022, Meta announced it had created Cicero , an AI capable of beating humans at an online version of Diplomacy, a popular military strategy game in which players negotiate alliances to vie for control of Europe.

Meta’s researchers said they’d trained Cicero on a “truthful” subset of its data set to be largely honest and helpful, and that it would “never intentionally backstab” its allies in order to succeed. But the new paper’s authors claim the opposite was true: Cicero broke its deals, told outright falsehoods, and engaged in premeditated deception. Although the company did try to train Cicero to behave honestly, its failure to achieve that shows how AI systems can still unexpectedly learn to deceive, the authors say. 

Meta neither confirmed nor denied the researchers’ claims that Cicero displayed deceitful behavior, but a spokesperson said that it was purely a research project and the model was built solely to play Diplomacy. “We released artifacts from this project under a noncommercial license in line with our long-standing commitment to open science,” they say. “Meta regularly shares the results of our research to validate them and enable others to build responsibly off of our advances. We have no plans to use this research or its learnings in our products.” 

But it’s not the only game where an AI has “deceived” human players to win. 

AlphaStar , an AI developed by DeepMind to play the video game StarCraft II, became so adept at making moves aimed at deceiving opponents (known as feinting) that it defeated 99.8% of human players. Elsewhere, another Meta system called Pluribus learned to bluff during poker games so successfully that the researchers decided against releasing its code for fear it could wreck the online poker community. 

Beyond games, the researchers list other examples of deceptive AI behavior. GPT-4, OpenAI’s latest large language model, came up with lies during a test in which it was prompted to persuade a human to solve a CAPTCHA for it. The system also dabbled in insider trading during a simulated exercise in which it was told to assume the identity of a pressurized stock trader, despite never being specifically instructed to do so.

The fact that an AI model has the potential to behave in a deceptive manner without any direction to do so may seem concerning. But it mostly arises from the “ black box” problem that characterizes state-of-the-art machine-learning models: it is impossible to say exactly how or why they produce the results they do—or whether they’ll always exhibit that behavior going forward, says Peter S. Park, a postdoctoral fellow studying AI existential safety at MIT, who worked on the project. 

“Just because your AI has certain behaviors or tendencies in a test environment does not mean that the same lessons will hold if it’s released into the wild,” he says. “There’s no easy way to solve this—if you want to learn what the AI will do once it’s deployed into the wild, then you just have to deploy it into the wild.”

Our tendency to anthropomorphize AI models colors the way we test these systems and what we think about their capabilities. After all, passing tests designed to measure human creativity doesn’t mean AI models are actually being creative. It is crucial that regulators and AI companies carefully weigh the technology’s potential to cause harm against its potential benefits for society and make clear distinctions between what the models can and can’t do, says Harry Law, an AI researcher at the University of Cambridge, who did not work on the research.“These are really tough questions,” he says.

Fundamentally, it’s currently impossible to train an AI model that’s incapable of deception in all possible situations, he says. Also, the potential for deceitful behavior is one of many problems—alongside the propensity to amplify bias and misinformation—that need to be addressed before AI models should be trusted with real-world tasks. 

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Anne J. Manning

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Researchers publish largest-ever dataset of neural connections

A cubic millimeter of brain tissue may not sound like much. But considering that that tiny square contains 57,000 cells, 230 millimeters of blood vessels, and 150 million synapses, all amounting to 1,400 terabytes of data, Harvard and Google researchers have just accomplished something stupendous.   

Led by Jeff Lichtman, the Jeremy R. Knowles Professor of Molecular and Cellular Biology and newly appointed dean of science , the Harvard team helped create the largest 3D brain reconstruction to date, showing in vivid detail each cell and its web of connections in a piece of temporal cortex about half the size of a rice grain.

Published in Science, the study is the latest development in a nearly 10-year collaboration with scientists at Google Research, combining Lichtman’s electron microscopy imaging with AI algorithms to color-code and reconstruct the extremely complex wiring of mammal brains. The paper’s three first co-authors are former Harvard postdoc Alexander Shapson-Coe, Michał Januszewski of Google Research, and Harvard postdoc Daniel Berger.

The ultimate goal, supported by the National Institutes of Health BRAIN Initiative , is to create a comprehensive, high-resolution map of a mouse’s neural wiring, which would entail about 1,000 times the amount of data the group just produced from the 1-cubic-millimeter fragment of human cortex.  

“The word ‘fragment’ is ironic,” Lichtman said. “A terabyte is, for most people, gigantic, yet a fragment of a human brain — just a minuscule, teeny-weeny little bit of human brain — is still thousands of terabytes.”  

Jeff Lichtman.

Kris Snibbe/Harvard Staff Photographer

The latest map contains never-before-seen details of brain structure, including a rare but powerful set of axons connected by up to 50 synapses. The team also noted oddities in the tissue, such as a small number of axons that formed extensive whorls. Because the sample was taken from a patient with epilepsy, the researchers don’t know whether such formations are pathological or simply rare.

Lichtman’s field is connectomics, which seeks to create comprehensive catalogs of brain structure, down to individual cells. Such completed maps would unlock insights into brain function and disease, about which scientists still know very little.

Google’s state-of-the-art AI algorithms allow for reconstruction and mapping of brain tissue in three dimensions. The team has also developed a suite of publicly available tools researchers can use to examine and annotate the connectome.

“Given the enormous investment put into this project, it was important to present the results in a way that anybody else can now go and benefit from them,” said Google collaborator Viren Jain.

Next the team will tackle the mouse hippocampal formation, which is important to neuroscience for its role in memory and neurological disease.

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Differences in quality of anticoagulation care delivery according to ethnoracial group in the United States: A scoping review

• Open access
• Published: 11 May 2024

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• Sara R. Vazquez   ORCID: orcid.org/0000-0002-9267-8980 1 ,
• Naomi Y. Yates 2 ,
• Craig J. Beavers 3 , 4 ,
• Darren M. Triller 3 &
• Mary M. McFarland 5  

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Anticoagulation therapy is standard for conditions like atrial fibrillation, venous thromboembolism, and valvular heart disease, yet it is unclear if there are ethnoracial disparities in its quality and delivery in the United States. For this scoping review, electronic databases were searched for publications between January 1, 2011 – March 30, 2022. Eligible studies included all study designs, any setting within the United States, patients prescribed anticoagulation for any indication, outcomes reported for ≥ 2 distinct ethnoracial groups. The following four research questions were explored: Do ethnoracial differences exist in 1) access to guideline-based anticoagulation therapy, 2) quality of anticoagulation therapy management, 3) clinical outcomes related to anticoagulation care, 4) humanistic/educational outcomes related to anticoagulation therapy. A total of 5374 studies were screened, 570 studies received full-text review, and 96 studies were analyzed. The largest mapped focus was patients’ access to guideline-based anticoagulation therapy (88/96 articles, 91.7%). Seventy-eight articles made statistical outcomes comparisons among ethnoracial groups. Across all four research questions, 79 articles demonstrated favorable outcomes for White patients compared to non-White patients, 38 articles showed no difference between White and non-White groups, and 8 favored non-White groups (the total exceeds the 78 articles with statistical outcomes as many articles reported multiple outcomes). Disparities disadvantaging non-White patients were most pronounced in access to guideline-based anticoagulation therapy (43/66 articles analyzed) and quality of anticoagulation management (19/21 articles analyzed). Although treatment guidelines do not differentiate anticoagulant therapy by ethnoracial group, this scoping review found consistently favorable outcomes for White patients over non-White patients in the domains of access to anticoagulation therapy for guideline-based indications and quality of anticoagulation therapy management. No differences among groups were noted in clinical outcomes, and very few studies assessed humanistic or educational outcomes.

Graphical Abstract

Scoping Review: Differences in quality of United States anticoagulation care delivery by ethnoracial group. AF = atrial fibrillation; AMS = anticoagulation management service; DOACs = direct oral anticoagulants; INR = international normalized ratio; PSM = patient self-management; PST = patient self-testing

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Introduction

It is well-established that in the United States (US) ethnoracial disparities exist in various aspects of health care. Specifically, persons identifying with an ethnoracial minority group may have more challenging access to health care, worse clinical outcomes, and higher dissatisfaction with care compared to White persons [ 1 , 2 , 3 , 4 , 5 ]. There are differences by ethnoracial group in the prevalence of the three most common indications for which anticoagulants are prescribed, stroke prevention in atrial fibrillation (AF), treatment of venous thromboembolism (VTE), and valvular heart disease [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Specifically, VTE is most prevalent in Black patients compared to White and Asian patients, whereas AF is most prevalent in White patients compared to Black, Asian, and Hispanic patients [ 9 , 10 , 15 ]. Calcific heart valve disease has the most relevance to the US population, and epidemiologic data has shown that aortic stenosis is more prevalent in White patients compared to Black, Asian, and Hispanic patients [ 17 ]. Despite these epidemiologic differences, there is no evidence to suggest there should be any difference in treatment strategies across ethnoracial patient groups.

While studies have demonstrated genotypic differences that may result in different warfarin dose requirements[ 18 ], and early studies may indicate genotypic differences in direct oral anticoagulant (DOAC) response [ 19 ], no US-based labeling or guidelines recommend a difference in prescription or delivery of anticoagulation care based on race or ethnicity. However, it is unclear if there are in fact differences in the type and quality of anticoagulation therapy, which is standard of care for each of these conditions [ 20 , 21 , 22 , 23 , 24 ]. Anticoagulants remain in the top three classes of drugs causing adverse drug events (primarily bleeding) in the United States, according to the 2014 National Action Plan for Adverse Drug Event Prevention. One of the goals of the National Action Plan was to identify patient populations at higher risk for these adverse drug events to inform the development of targeted harm reduction strategies [ 25 ]. If ethnoracial minority patients are receiving sub-optimal anticoagulation therapy in certain measurable areas of anticoagulation quality, it is vital to highlight the areas of disparity so that these can be explored and care optimized. Anticoagulation providers often have high frequency contact with their patients and can be a reliable connection between disproportionately affected patients and a system in need of change. Systematic reviews of ethnoracial disparities in AF and VTE have been conducted. The AF review assessed AF prevalence among racial groups as well as differences in symptoms and management, including stroke prevention with warfarin or DOACs [ 9 ]. The VTE review specifically assessed VTE prevalence and racial differences in COVID-19 and did report the use of any prophylactic anticoagulation, but this was not part of the analysis [ 26 ]. No review of racial disparities in quality of anticoagulation therapy was found in search results conducted prior to protocol.

In this study we aimed to identify any potential ethnoracial disparities in anticoagulation care quality in the US. The decision to limit the study to a US population was based on our observation that the US has a unique history of interactions between racial and ethnic groups that may not necessarily be reflected by studies conducted in other countries. Additionally, health care delivery systems vary widely across the world, and we wanted to include the data most relevant to the potential racial disparities existing in the US health care system. The term “race” was used to identify a group of people with shared physical characteristics believed to be of common ancestry whereas the term “ethnicity” refers to a group of people with shared cultural traditions [ 27 ]. We recognize these terms may be far more complex. In order to encompass both the physical and cultural aspects of a patient’s identity we have chosen to use the term “ethnoracial” for this study [ 27 ]. Highlighting existing differences will serve as a stimulus for institutions and clinicians to assess current services, implement quality improvement measures, and inform future research efforts to deliver optimal anticoagulation care for all patients. The scoping review protocol was registered December 22, 2021 to Open Science Framework, https://doi.org/10.17605/OSF.IO/9SE7H [ 28 ].

We conducted this scoping review with guidance from the 2020 version of the JBI Manual for Evidence Synthesis and organized to Arksey's five stages: 1) identifying the research question, 2) identifying relevant studies, 3) study selection, 4) charting the data and 5) collating, summarizing and reporting the results [ 29 , 30 ]. For transparency and reproducibility, we followed the PRISMA-ScR and PRISMA-S reporting guidelines in reporting our results [ 31 ]. We used Covidence (Veritas Health Innovation,) an online systematic reviewing platform to screen and select studies. Citation management and duplicate detection and removal was accomplished with EndNote, version 19 (Clarivate Analytics.) Data was charted from our selected studies using REDCap, an electronic data capture tool hosted at the University of Utah [ 32 ].

Literature searching

An information specialist developed and translated search strategies for the online databases using a combination of keywords and controlled subject headings unique to each database along with team feedback. Peer review of the strategies was conducted by library colleagues using the PRESS guidelines. [ 33 ] Electronic databases searched included Medline (Ovid) 2011–2022, Embase (embase.com) 2011–2022, CINAHL Complete (Ebscohost) 2011–2022, Sociological Abstracts (ProQuest) 2011–2022, International Pharmaceutical Abstracts (Ovid) 2011–2022, Scopus (scopus.org) 2011–2022 and Web of Science Core Collection (Clarivate Analytics) 2011–2022. Limits included a date range from January 1, 2011 to March 30—April 19, 2022, as not all database results were exported on the same day. See Supplemental File 1 for detailed search strategies. A search of grey literature was not conducted due to time and resource constraints.

Study Selection

For inclusion, each study required two votes by independent reviewers for screening of titles and abstracts followed by full-text review. A third reviewer provided the deciding vote. Data extraction was performed by two independent reviewers, and consensus on any discrepancies was reached via discussion between the reviewers. The data form was piloted by two team members using sentinel articles prior to data extraction.

Eligible studies included all types of study designs in any setting with a population of patients of any age or gender located within the US who were prescribed anticoagulant therapy for any indication, published between January 1, 2011 – March 30, 2022 in order to capture contemporary and clinically relevant practices.

We defined the following research questions for this scoping review as described in Table  1 .

Studies must have reported any of these anticoagulation care delivery outcomes for at least 2 distinct racial or ethnic groups. We excluded genotyping studies and non-English language articles at full text review, as we had no funding for translation services. In checking references of included studies, no additional studies met inclusion criteria. In accordance with scoping review methodology, no quality assessment of included studies was conducted as our goal was to rapidly map the literature. As this is a scoping review of the literature, no aggregate or pooled analysis was performed; however, for ease of interpretation, when assessing for the directionality of the outcomes in the various studies, we categorized studies into Favoring White Group, Favoring Non-White Group, and No Differences Among Ethnoracial Groups. If studies had mixed outcomes of favoring one group for one outcome and no difference for another, then the study was categorized with the favoring group.

A PRISMA flow diagram in Fig.  1 depicts search results, exclusions, and inclusions. The search strategies retrieved 6900 results with 1526 duplicates removed. Following title and abstract screening of 5374 references, 570 articles received full-text review. The most common reason for the exclusion of 474 studies was that outcomes were not reported for two distinct ethnoracial groups (171 studies). Ninety-six studies underwent data extraction.

PRISMA Flow Diagram

Study characteristics-overall

Fifty of the 96 studies were published between 2011 and 2018 (an average of 6.25 articles per year that compared outcomes between two ethnoracial groups) and 43 of 96 studies were published in the years 2019–2021 (average 14.3 articles per year; 2022 excluded here because only 4 months of data was captured) (Fig.  2 ). Most studies analyzed an outpatient population (65.6%) for an indication of stroke prevention in AF (67.7%) in patients taking warfarin (71.9%) or DOACs (49.0%). Study population size was heterogenous, ranging from a study size of 24 patients to over 1.3 million patients (median 5,238 patients) in the 69 studies that reported population size by racial group. When stratified by size, 60.9% of the articles in the scoping review (42 articles) represented < 10,000 patients (Table  2 ).

Number of Articles by Publication Year. *2022 excluded from this figure since the search period did not capture the entire year

Study characteristics-by ethnoracial group

There were 50 studies (52.1%) where race or ethnicity was either mentioned in the title or objective of the article, with 24 of these published over the 7-year period 2011–2018 and 26 published over the 3-year period 2019 to first quarter 2022. The method for reporting race or ethnicity was unclear or unspecified in most studies (77.1%) and 16 articles (16.7%) utilized self-reporting of race or ethnicity. Most studies analyzed White or Caucasian racial groups (94.8%), followed by Black or African-American (80.2%), and many studies grouped all other racial groups into an “Other” category (41.7%) (Fig.  3 ).

Number of Articles by Ethnoracial Groups. *For study inclusion, a study had to compare outcomes for least two distinct ethnoracial groups 

White patients accounted for a median 77% of study populations, Black patients 9.5%, Hispanic/Latino patients 6.2%, “Other” racial groups 5.3%, and Asian patients 2.5%.

Study outcomes-overall

Of the 4 research questions, most studies included in this review analyzed patients’ access to guideline-based anticoagulation therapy (88/96 articles, 91.7%), clinical outcomes (42/96 articles, 43.8%), or quality of anticoagulation management (24/96 articles, 25.0%), while very few addressed humanistic or educational outcomes (5/96 articles, 5.2%) (Fig.  4 ). Many studies addressed multiple outcomes within the single study.

Number of Articles Mapped by Research Question

Seventy-eight of the 96 included studies provided statistical comparisons between ethnoracial groups, and these data are presented below.

Outcomes for research question 1: Do ethnoracial differences exist in access to guideline-based anticoagulation therapy?

Anticoagulation for a guideline-based indication.

This question focused on patients who had an indication for anticoagulation actually receiving an anticoagulant, specifically AF and VTE prophylaxis (based on risk stratification) and acute VTE. The majority of the AF studies (25/34 studies) demonstrated White patients receiving anticoagulation at significantly higher rates compared to non-White patients [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], while the six VTE studies largely demonstrated no difference among ethnoracial groups [ 61 , 62 , 63 , 64 , 65 , 66 ].

DOACs as first-line therapy for AF or VTE

Eighteen individual studies statistically assessed the outcome of DOAC as first-line therapy (compared to warfarin) for AF (15 studies), VTE treatment (2 studies), or both indications (1 study). Twelve of the 15 AF studies showed a significantly higher proportion of White patients received DOACs as first-line therapy compared to non-White patients [ 36 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 54 , 55 , 67 , 68 ]. Of those 12, 9 specifically compared White patients to Black patients. Both VTE treatment studies and the study that assessed both AF and VTE indications showed significantly higher DOAC prescribing rates for White patients compared to Black patients [ 69 , 70 , 71 ].

Anticoagulant therapy adherence/persistence

The eight studies that addressed anticoagulation therapy adherence/persistence showed variability in outcome directionality by ethnoracial group: 5 no difference [ 41 , 72 , 73 , 74 , 75 ], 2 showed better treatment adherence/persistence for White patients compared to Black patients[ 76 ] or non-White patients [ 77 ], and one showed better treatment adherence/persistence for White patients compared to Hispanic patients, but no difference in White versus Black patients [ 78 ].

Figure  5 summarizes the outcome directionality for Research Question 1 regarding access to guideline-based anticoagulation therapy. Overall, the areas of disparity identified included anticoagulation for atrial fibrillation and preferential use of DOAC therapy for AF and VTE treatment.

Outcome Directionality for the 4 Research Questions and their Subcategories. AC = anticoagulant; AMS = anticoagulation management service; INR = international normalized ratio; PST = patient self-testing; PSM = patient self-management

Research question 2: Do ethnoracial differences exist in the quality of anticoagulation therapy management?

A total of 21 studies assessed quality of anticoagulation therapy management: Warfarin time in therapeutic range (TTR)/INR (International Normalized Ratio) control 12 studies, appropriate anticoagulant dosing 3 studies, enrollment in an anticoagulation management service 5 studies, and PST/PSM one study.

In statistical comparisons of INR control in warfarin patients, all 12 studies (7 assessed mean or median TTR, 5 assessed other measures of INR control such as days spent above/below range, gaps in INR monitoring) showed White patients had favorable INR control compared to non-White patients (most comparisons included Black patients) [ 41 , 75 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ]. Enrollment in an anticoagulation management service was statistically compared among ethnoracial groups in 5 studies, and this opportunity favored White patients compared to other racial groups in four of the five [ 41 , 82 , 86 , 88 ]. Two of the three studies that statistically analyzed appropriate anticoagulant dosing showed a higher rate of appropriate DOAC dosing in White patients compared to non-White patients [ 41 , 89 ], and the third showed no difference among ethnoracial groups for enoxaparin dosing in the emergency department [ 90 ]. The one study assessing access to PST/PSM showed that more White patients used PST compared to Black or Hispanic patients[ 91 ] (Fig.  5 ).

Research question 3: Do ethnoracial differences exist in the clinical outcomes related to anticoagulation care?

Articles assessing clinical outcomes among ethnoracial groups primarily assessed bleeding (15 articles) or thrombosis (9 articles) outcomes, and 8 articles assessing anticoagulation related hospitalization or mortality. One article addressed a net clinical outcome including major bleeding, stroke or systemic embolism, and death from any cause. This was included in the bleeding outcomes category so that it was not double-counted in the other two outcome categories. Additional details about the 24 unique studies that statistically assessed clinical outcomes including the study design, population size, ethnoracial groups studied, anticoagulants used, and statistical outcomes measured can be found in Supplementary Tables 1 and 2 .

Sixteen studies statistically assessed bleeding outcomes of varying definitions (major bleeding 13 studies, clinically relevant non-major bleeding 3 studies, any bleeding 3 studies, bleeding otherwise defined 3 studies). Six studies demonstrated no difference in bleeding outcomes by ethnoracial group [ 55 , 92 , 93 , 94 , 95 , 96 ]9 reported that White patients had lower rates of bleeding compared to Black or Asian patients,[ 53 , 80 , 83 , 85 , 97 , 98 , 99 , 100 , 101 ]. In the remaining study, Asian patients had a more favorable net clinical outcome compared to non-Asian patients [ 102 ].

Nine studies statistically assessed thrombosis outcomes among ethnoracial groups, including stroke/systemic embolism (5 studies), recurrent VTE (3 studies), or any thrombosis (1 study). The stroke outcomes by racial group were heterogeneous, with 3 studies showing better outcomes for White patients compared to Black patients[ 103 , 104 , 105 ] and two studies showing no difference in outcomes when White patients were compared to Non-White patients [ 55 , 95 ]. In three of the four VTE studies there were no differences in outcomes by ethnoracial group [ 61 , 93 , 96 ], and in one study White patients had more favorable outcomes compared to Black patients [ 106 ].

Nine studies assessed anticoagulation-related hospitalizations or mortality by ethnoracial group. Outcomes were mixed, as four studies showed no difference in hospitalizations or mortality among ethnoracial groups,[ 89 , 95 , 96 , 107 ], three studies showed White patients had a lower rate of hospitalizations[ 85 , 105 ] or mortality[ 104 , 105 ] Another study showed lower rate of mortality or hospice after intracranial hemorrhage in Black and Other race patients [ 108 ].(Fig.  5 ).

Research question 4: Do ethnoracial differences exist in the humanistic/educational outcomes related to anticoagulation therapy?

The five studies reporting this category of outcomes were heterogeneous. Of the two studies assessing anticoagulation knowledge, one showed no difference by ethnoracial group [ 109 ], and the other favored the non-White group in appropriately estimating bleeding risk [ 110 ]. One study assessed an atrial fibrillation quality of life score at 2-year follow-up after AF diagnosis and found the outcomes favored White patients [ 79 ]. Another study assessed satisfaction with VTE care and found no difference among ethnoracial groups [ 111 ]. A third study found no difference in the percentage of racial groups having a cost conversation when initiating DOAC therapy (78% Whites, 72.2% non-Whites)[ 112 ] (Fig.  5 ).

Overall outcome directionality for all four research questions is shown in Fig.  6 . A total of 79 articles demonstrated favorable outcomes for White patients compared to non-White patients, 38 articles showed no difference between White and non-White groups, and 8 articles had outcomes favoring non-White groups (the total exceeds the 78 articles with statistical outcomes as many articles reported multiple outcomes). The biggest areas of disparity between White and non-White groups are access to guideline-based anticoagulation therapy and quality of anticoagulation therapy management. Clinical outcomes relating to anticoagulation care had the least difference among ethnoracial groups. Relatively few studies assessed potential ethnoracial disparities in humanistic and educational outcomes.

Outcome Directionality for All 4 Research Questions

This scoping review assessing ethnoracial differences in the quality of anticoagulation care and its delivery to patients in the United States encompassed eleven full years of literature and resulted in the inclusion of 96 studies, 78 of which contained statistical outcomes comparisons among ethnoracial groups. The most common reason for study exclusion was that outcomes were not reported for at least two distinct ethnoracial groups. We observed that beginning in 2019 and following the racial unrest of 2020, the density of articles addressing ethnoracial disparities in anticoagulation care more than doubled. During the entire study period, half of studies had race or ethnicity as the focus or objective of the paper, but this was largely driven by articles published after 2019.

Only 16% of included articles documented self-reporting of racial identity, with most of the remainder using an unspecified method for documenting racial identity. It is likely that many studies utilize demographic information extracted from an electronic medical record (EMR), but it is often unclear if that is truly self-reported race. A second element this scoping review identified was that many studies analyzed two or three ethnoracial groups and then categorized all others into a heterogenous “Other” category. For example, frequently studies would categorize patients as White, Black, and “Other.” It is unclear whether those in a racial category labeled as “Other” had an unknown or missing racial identity in the EMR, or intentionally chose not to disclose. It is also likely that study investigators decided to classify ethnoracial groups with lower population sizes into a miscellaneous category. There were few studies (15%) that specifically assessed patients identifying as Native American/Alaska Native, Native Hawaiian/Pacific Islander, and multiracial. While Hispanic/Latino is an ethnicity, most studies categorized it as a separate “race” category. Of the 37 studies that analyzed “Asian” patient populations, none specifically defined “Asian” beyond that. The US Census Bureau defines “Asian” race as a person having origins of the Far East, Southeast Asia, or the Indian subcontinent [ 113 ]. This broad definition encompasses many different ethnicities which could represent variability in health outcomes if better defined and more frequently analyzed. These may be opportunities for EMR systems to improve transparency for how race, ethnicity, and language preference are captured and for those designing research studies to be thoughtful and intentional about analyzing the ethnoracial identities of the study population, perhaps in alignment with the minimum 5 racial categories utilized by the US Census Bureau, the National Institutes of Health, and the Office of Management and Budget (White, Black, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, with permission for a “some other race” category and the option to select multiple races) [ 113 ]. Since 2017 Clinicaltrials.gov has required the reporting of race/ethnicity if collected, and there is good compliance with this requirement, but less so in publication of the work [ 114 ].

We examined the proportion of ethnoracial groups represented for each of the disease states in the studies included in this scoping review, relative to disease state prevalence and found a discrepancy. For AF, prevalence in White patients was 11.3%, in Black patients 6.6%, and in Hispanic patients 7.8% [ 15 ]. However, the representation in AF studies in this review were 74% White, 13% Black, and 8% Hispanic. Assessing VTE incidence by race is more difficult, as studies have shown regional and time variation, with Black patients typically having a higher incidence compared to other ethnoracial groups [ 16 ]. In this review, however, of the studies assessing VTE treatment or prophylaxis, only 16% of the patient population identified as Black, whereas 70% identified as White. There were only 3 studies that assessed a valvular heart disease population, making ethnoracial group representation difficult to assess.

The majority of studies captured in this review analyzed patients in the outpatient setting, for the anticoagulation indication of stroke prevention in AF, taking either warfarin or DOAC. Few studies involved the acute care setting or injectable anticoagulants, representing an area for future study of potential ethnoracial disparities.

Overall, the majority of studies in this scoping review addressed ethnoracial disparities in patients’ access to guideline-based anticoagulation therapy, clinical outcomes related to anticoagulation care, and quality of anticoagulation management. A research gap identified was more study is needed to assess gaps in educational outcomes such as anticoagulation and disease state knowledge, shared decision-making willingness and capability, and humanistic outcomes such as quality of life or satisfaction with anticoagulation therapy.

In analyzing the first research question regarding ethnoracial differences in access to guideline-based anticoagulation therapy, the majority of studies addressed use of any anticoagulation for stroke prevention in AF in patients above a threshold risk score and the preferential use of DOACs as first-line therapy instead of warfarin for AF. In both categories, patients in a non-White ethnoracial group (particularly Black patients) received recommended therapy less often than patients identified as White. It is unclear why this is the case. It could be on the patient, provider, and/or system level. It is possible that some studies more successfully adjusted for covariates than others. Sites or settings with systematic processes like order sets or clinical decision support systems in place for standard prescribing may be more successful in equitably prescribing indicated therapies. In one large study in the Veterans Affairs population of AF patients, even after adjusting for numerous variables that included clinical, demographic, socioeconomic, prescriber, and geographic site factors, DOAC prescribing remained lower in Asian and Black patients when compared with White patients. The authors in that study postulate that non-White populations may be less receptive to novel therapies due to historical mistrust of the health care system or have reduced access to education about the latest treatments, and they give the example of direct-to-consumer advertising [ 42 ]. It has also previously been demonstrated that prescribing of oral anticoagulation and particularly DOACs is lower in non-White patients [ 41 ]. These are difficult to capture as standard covariates, which is why further study is needed. We examined the publication dates for both access categories to see if perhaps there was a lack of contemporary data skewing the outcomes. However, for both anticoagulation for a guideline-based indication and DOACs as first-line therapy, the majority of articles came from the time period 2019–2021 (24 of 40 articles, and 15 of 18 articles, respectively), well after guideline updates preferentially recommended DOACs [ 34 , 35 ]. Also, there were relatively few studies addressing guideline-based therapy for VTE treatment and prophylaxis, making assessment of disparities difficult. Regarding access, it is well established that race and ethnicity often determine a patient’s socioeconomic status and that low socioeconomic status and its correlates (e.g., reduced education, income, and healthcare access) are associated with poorer health outcomes [ 115 ]. However, at each level of income or education, Black patients experience worse health outcomes than Whites [ 116 ]. So, low socioeconomic status does not fully explain poorer health outcomes for non-White individuals.

After examining access to appropriate and preferred anticoagulation therapy, the second research question of this scoping review examined potential ethnoracial disparities in the quality of anticoagulation therapy management. INR control measures such as time in therapeutic INR range are a surrogate measure of both thrombotic and bleeding outcomes and frequently used as a way to assess quality of warfarin therapy. The studies identified in this review showed clear disparity between White and non-White patient groups (especially Black patients), however all twelve studies comparing TTR among ethnoracial groups were published prior to 2019. This could be due to the decline in warfarin prescribing relative to increases in DOAC prescribing [ 117 , 118 , 119 ], but there remain patient populations that require or choose warfarin, so this marker of anticoagulation control remains relevant and requires continued reassessment. There were relatively few studies assessing other markers of anticoagulation management quality such as anticoagulation management service enrollment, appropriate DOAC dosing, and access to quality improvement strategies like PST or PSM. Few studies assessed educational outcomes, yet this may have relevance to the above anticoagulation care quality question. For those patients who remain on warfarin, dietary Vitamin K consistency is an example of a key educational point that links directly to INR control. It is unclear if there are disparities in this type of education among ethnoracial groups that may have more far-reaching effects.

Of note, clinical outcomes related to anticoagulant therapy seemed to have the fewest areas of disparity, although the number of articles was small. This suggests that if patients have access to high quality anticoagulation therapy, there is a promising sign that optimal clinical outcomes can be achieved for all ethnoracial groups.

There are some limitations of this scoping review that warrant consideration. First, we chose fairly broad inclusion criteria (all anticoagulants, all study types) because a review of this type had never been performed before. This resulted in a relatively large number of included articles for a scoping review. Second, there is likely a high degree of heterogeneity among patient populations and outcomes definitions. However, as this is a scoping review with the goal to present an overview of the literature and not report on composite outcomes, a risk of bias assessment was not performed. Third is our decision to group patients into White and non-White groups for assessment of outcome directionality. In doing so, we may have missed subtle differences in outcomes between various non-White ethnoracial groups. Fourth, in our main search we included all studies that reported outcomes, but due to scope, we only reported outcome directionality for studies that statistically compared outcomes between ethnoracial groups. Finally, due to the large number of studies that required review and analysis, this was a lengthy undertaking and we are certain that additional studies have been published since the closure of our search period.

In line with the 2014 National Action Plan for Adverse Drug Event Prevention’s goal of identifying patient populations at higher risk of adverse drug events, this scoping review highlights several areas where quality of anticoagulation care can be optimized for all patients. Future research opportunities in ethnoracial differences in the quality of anticoagulation care are summarized in Table  3 . While the scoping review focused exclusively on the evaluation of peer-reviewed manuscripts, the heterogeneity of terminology and methodologies identified in the published papers may have implications for national health policy relating to the quality and safety of care (e.g.the Medicare Quality Payment Program) [ 120 ]. To accurately and reliably quantify important disparities in AC-related care and support effective improvement initiatives, attention and effort will need to be invested across the full continuum of quality measure development [ 121 ], measure endorsement [ 122 ], measure selection, and status assignment within value-based payment programs (e.g., required/optional, measure weighting) [ 123 ]. The findings of the scoping review may be of utility to such efforts, and the development and implementation of suitable quality measures will likely be of value to future research efforts in this important therapeutic area.

Conclusions

Treatment guidelines do not recommend differentiating anticoagulant therapy by ethnoracial group, yet this scoping review of the literature demonstrates consistent directionality in favor of White patients over non-White patients in the domains of access to anticoagulation therapy for guideline-based indications, prescription of preferred anticoagulation therapies, and quality of anticoagulation therapy management. These data should serve as a stimulus for an assessment of current services, implementation of quality improvement measures, and inform future research to make anticoagulation care quality more equitable.

Data Availability

Data are available on request from the corresponding author.

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Acknowledgements

The authors wish to acknowledge the following individuals for their work in screening articles for this scoping review: April Allen, PharmD, CACP; Allison Burnett, PharmD, PhC, CACP; Stacy Ellsworth, RN, MSN, CCRC; Danielle Jenkins, MBA, RN, BSN, CRNI; Amanda Katz, MBA; Lea Kistenmacher, Julia Mulheman, PharmD; Surhabi Palkimas, PharmD, MBA; Terri Schnurr, RN, CCRC; Deborah Siegal, MD, MSc, FRCPC; Kimberly Terry, PharmD, BCPS, BCCCP; and Terri Wiggins, MS.

The authors wish to acknowledge the support of the Anticoagulation Forum in the development of this manuscript. The Anticoagulation Forum is a non-profit organization dedicated to improving the quality of care for patients taking antithrombotic medications.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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University of Kentucky College of Pharmacy, 789 S Limestone, Lexington, KY, 40508, USA

Craig J. Beavers

University of Utah Spencer S. Eccles Health Sciences Library, 10 N 1900 E, Salt Lake City, UT, 84112, USA

Mary M. McFarland

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All authors contributed to the study conception and design. Material preparation was performed by Sara Vazquez, Naomi Yates, and Mary McFarland. Data collection and analysis were performed by Sara Vazquez, Naomi Yates, Craig Beavers, and Darren Triller. The first draft of the manuscript was written by Sara Vazquez and all authors edited subsequent drafts. All authors read and approved the final manuscript.

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Correspondence to Sara R. Vazquez .

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Competing interests.

Dr. Vazquez discloses that she is a member of the Anticoagulation Forum Advisory Council and an editorial consultant for UptoDate, Inc.

Dr. Yates has no conflicts of interest to disclose.

Dr. Beavers has no conflicts of interest to disclose.

Dr. Triller has no conflicts of interest to disclose.

Ms. McFarland has no conflicts of interest to disclose.

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Vazquez, S.R., Yates, N.Y., Beavers, C.J. et al. Differences in quality of anticoagulation care delivery according to ethnoracial group in the United States: A scoping review. J Thromb Thrombolysis (2024). https://doi.org/10.1007/s11239-024-02991-2

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DOI : https://doi.org/10.1007/s11239-024-02991-2

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Are We Talking Too Much About Mental Health?

Recent studies cast doubt on whether large-scale mental health interventions are making young people better. Some even suggest they can have a negative effect.

By Ellen Barry

In recent years, mental health has become a central subject in childhood and adolescence. Teenagers narrate their psychiatric diagnosis and treatment on TikTok and Instagram. School systems, alarmed by rising levels of distress and self-harm, are introducing preventive coursework in emotional self-regulation and mindfulness.

Now, some researchers warn that we are in danger of overdoing it. Mental health awareness campaigns, they argue, help some young people identify disorders that badly need treatment — but they have a negative effect on others, leading them to over-interpret their symptoms and see themselves as more troubled than they are.

The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness , cognitive behavioral therapy and dialectical behavior therapy did not emerge healthier than peers who did not participate, and some were worse off, at least for a while.

And new research from the United States shows that among young people, “self-labeling” as having depression or anxiety is associated with poor coping skills, like avoidance or rumination.

In a paper published last year , two research psychologists at the University of Oxford, Lucy Foulkes and Jack Andrews, coined the term “prevalence inflation” — driven by the reporting of mild or transient symptoms as mental health disorders — and suggested that awareness campaigns were contributing to it.

“It’s creating this message that teenagers are vulnerable, they’re likely to have problems, and the solution is to outsource them to a professional,” said Dr. Foulkes, a Prudence Trust Research Fellow in Oxford’s department of experimental psychology, who has written two books on mental health and adolescence.

Until high-quality research has clarified these unexpected negative effects, they argue, school systems should proceed cautiously with large-scale mental health interventions.

“It’s not that we need to go back to square one, but it’s that we need to press pause and reroute potentially,” Dr. Foulkes said. “It’s possible that something very well-intended has overshot a bit and needs to be brought back in.”

This remains a minority view among specialists in adolescent mental health, who mostly agree that the far more urgent problem is lack of access to treatment.

About 60 percent of young Americans with severe depression receive no treatment, according to Mental Health America, a nonprofit research group. In crisis, desperate families fall back on emergency rooms, where teens often remain for days before a psychiatric bed opens up. There is good reason to embrace a preventive approach, teaching schoolchildren basic skills that might forestall crises later, experts say.

Dr. Foulkes said she understood that her argument runs counter to that consensus, and when she began to present it, she braced for a backlash. To her surprise, she said, many educators reached out to express quiet agreement.

“There’s definitely a fear about being the one to say it,” she said.

A deflating result

In the summer of 2022, the results of a landmark study on mindfulness training in British classrooms landed — like a lead balloon.

The trial, My Resilience in Adolescence, or MYRIAD, was ambitious, meticulous and expansive, following about 28,000 teenagers over eight years. It had been launched in a glow of optimism that the practice would pay off, improving the students’ mental health outcomes in later years.

Half of the teenagers were trained by their teachers to direct their attention to the present moment — breathing, physical sensations or everyday activities — in 10 lessons of 30 to 50 minutes apiece.

The results were disappointing . The authors reported “no support for our hypothesis” that mindfulness training would improve students’ mental health. In fact, students at highest risk for mental health problems did somewhat worse after receiving the training, the authors concluded.

But by the end of the eight-year project, “mindfulness is already embedded in a lot of schools, and there are already organizations making money from selling this program to schools,” said Dr. Foulkes, who had assisted on the study as a postdoctoral research associate. “And it’s very difficult to get the scientific message out there.”

Why, one might ask, would a mental health program do harm?

Researchers in the study speculated that the training programs “bring awareness to upsetting thoughts,” encouraging students to sit with darker feelings, but without providing solutions, especially for societal problems like racism or poverty. They also found that the students didn’t enjoy the sessions and didn’t practice at home.

Another explanation is that mindfulness training could encourage “co-rumination,” the kind of long, unresolved group discussion that churns up problems without finding solutions.

As the MYRIAD results were being analyzed, Dr. Andrews led an evaluation of Climate Schools, an Australian intervention based on the principles of cognitive behavioral therapy, in which students observed cartoon characters navigating mental health concerns and then answered questions about practices to improve mental health.

Here, too, he found negative effects. Students who had taken the course reported higher levels of depression and anxiety symptoms six months and 12 months later.

Co-rumination appears to be higher in girls, who tend to come into the program more distressed, as well as more attuned to their friends, he said. “It might be,” he said, “that they kind of get together and make things a little bit worse for each other.”

Dr. Andrews, a Wellcome Trust research fellow, has since joined an effort to improve Climate Schools by addressing negative effects. And he has concluded that schools should slow down until “we know the evidence base a bit more.” Sometimes, he said, “doing nothing is better than doing something.”

The awareness paradox

One problem with mental health awareness, some research suggests, is that it may not help to put a label to your symptoms.

Isaac Ahuvia, a doctoral candidate at Stony Brook University, recently tested this in a study of 1,423 college students . Twenty-two percent “self-labeled” as having depression, telling researchers “I am depressed” or “I have depression,” but 39 percent met the diagnostic criteria for depression.

He found that the students who self-labeled felt that they had less control over depression and were more likely to catastrophize and less likely to respond to distress by putting their difficulties in perspective, compared with peers who had similar depression symptoms.

Jessica L. Schleider, a co-author of the self-labeling study, said this was no surprise. People who self-label “appear to be viewing depression as a biological inevitability,” she said. “People who don’t view emotions as malleable, view them as set and stuck and uncontrollable, tend to cope less well because they don’t see a point to trying.”

But Dr. Schleider, an associate professor of medical social sciences at Northwestern University and the director of the university’s Lab for Scalable Mental Health, pushed back on the prevalence inflation hypothesis. She disagreed with the claim that students are overdiagnosing themselves, noting that Mr. Ahuvia’s findings suggest otherwise.

Awareness campaigns are bound to have multiple effects, helping some students and not others. And ultimately, she argued, the priority for public health should be reaching young people in the most distress.

“The urgency of the mental health crisis is so clear,” she said. “In the partnerships that I have, the emphasis is on the kids truly struggling right now who have nothing — we need to help them — more so than a possible risk for a subset of kids who aren’t really struggling.”

Maybe, she said, we need to look beyond the “universal, school-assembly-style approach,” to targeted, light-touch interventions, which research has shown can be effective at decreasing anxiety and conduct disorders, especially in younger children.

“There is a risk of throwing the baby out with the bathwater,” Dr. Schleider said. “The response can’t be ‘Forget all of it.’ It should be ‘What about this intervention was unhelpful?’”

Other researchers echoed her concern, pointing to studies that show that on average, students benefit from social and emotional learning courses.

One of the largest, a 2023 meta-analysis of 252 classroom programs in 53 countries, found that students who participated performed better academically, displayed better social skills and had lower levels of emotional distress or behavioral problems. In that context, negative effects in a handful of trials appear modest, the researchers said.

“We clearly have not figured out how to do them yet, but I can’t imagine any population-based intervention that the field got right the first time,” said Dr. Andrew J. Gerber, the president and medical director of Silver Hill Hospital and a practicing child and adolescent psychiatrist.

“Really, if you think about almost everything we do in schools, we don’t have great evidence for it working,” he added. “That doesn’t mean we don’t do it. It just means that we’re constantly thinking about ways to improve it.”

‘We want everyone to have it’

These debates are taking place a long way away from classrooms, where mental health curriculums are increasingly commonplace.

Allyson Kangisser, a counselor at Woodsdale Elementary School in Wheeling, W.Va., said the focus in her school is on basic coping skills. In the early grades, students are asked, “What things can you do to take care of yourself when you’re having big feelings?”

Starting in third grade, they take on more complex material, such as watching cartoon characters to distinguish transient stress from chronic conditions like depression. “We’re not trying to have them diagnose themselves,” Ms. Kangisser said. “We are saying, what do you feel — this one? Or this one?”

At the school’s sixth annual mental health fair last month, Woodsdale students walked through a giant inflatable brain, its lobes neatly labeled. They did yoga stretches and talked about regulating their emotions. Ms. Kangisser said the event is valuable precisely because it is universal, so troubled children are not singled out.

“The mental health fair, everybody does it,” she said. “It’s not ‘You need it, and you don’t.’ We want everyone to have it, because you just never know.”

By the time the students reach college, they will have absorbed enormous amounts of information about mental health — from school, but also from social media and from one another.

Dr. Jessica Gold, chief wellness officer for the University of Tennessee system, said the college students she sees are recognizably different — more comfortable speaking about their emotions and more willing to be vulnerable. They also overuse diagnostic terms and have the self-assurance to question a psychiatrist’s judgment.

“It’s sort of a double-edged sword,” she said. “We want people to talk about this more, but we don’t want that to lead to overdiagnosis or incorrect diagnosis or overtreatment. We want it to lead to normalizing of having feelings.”

Lucy Kim, a Yale senior who has lobbied for better mental health support on campus, described the prevalence inflation hypothesis as “disheartening, dismissive and potentially dangerous,” providing another way to discount the experiences of young people.

“As a college student, I see a generation of young people around me impacted by a depth and breadth of loneliness, exhaustion and disillusionment suggestive of a malaise that goes deeper than the general vicissitudes of life,” said Ms. Kim, 23.

Overdiagnosis does happen, she said, and so does glorification of mental health disorders. But stigma and barriers to treatment remain the bigger problem. “I can confidently say I have never heard anyone respond to disclosures of depression with ‘That’s so cool, I wish I had that, too,’” she said.

Ellen Barry is a reporter covering mental health for The Times. More about Ellen Barry

Managing Anxiety and Stress

Stay balanced in the face of stress and anxiety with our collection of tools and advice..

How are you, really? This self-guided check-in will help you take stock of your emotional well-being — and learn how to make changes .

These simple and proven strategies will help you manage stress , support your mental health and find meaning in the new year.

First, bring calm and clarity into your life with these 10 tips . Next, identify what you are dealing with: Is it worry, anxiety or stress ?

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Research: Negotiating Is Unlikely to Jeopardize Your Job Offer

• Einav Hart,
• Julia Bear,
• Zhiying (Bella) Ren

A series of seven studies found that candidates have more power than they assume.

Job seekers worry about negotiating an offer for many reasons, including the worst-case scenario that the offer will be rescinded. Across a series of seven studies, researchers found that these fears are consistently exaggerated: Candidates think they are much more likely to jeopardize a deal than managers report they are. This fear can lead candidates to avoid negotiating altogether. The authors explore two reasons driving this fear and offer research-backed advice on how anxious candidates can approach job negotiations.

Imagine that you just received a job offer for a position you are excited about. Now what? You might consider negotiating for a higher salary, job flexibility, or other benefits , but you’re apprehensive. You can’t help thinking: What if I don’t get what I ask for? Or, in the worst-case scenario, what if the hiring manager decides to withdraw the offer?

• Einav Hart is an assistant professor of management at George Mason University’s Costello College of Business, and a visiting scholar at the Wharton School. Her research interests include conflict management, negotiations, and organizational behavior.
• Julia Bear is a professor of organizational behavior at the College of Business at Stony Brook University (SUNY). Her research interests include the influence of gender on negotiation, as well as understanding gender gaps in organizations more broadly.
• Zhiying (Bella) Ren is a doctoral student at the Wharton School of the University of Pennsylvania. Her research focuses on conversational dynamics in organizations and negotiations.

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