About Systematic Reviews
The Difference Between Narrative Review and Systematic Review
Reviews in scientific research are tools that help synthesize literature on a topic of interest and describe its current state. Different types of reviews are conducted depending on the research question and the scope of the review. A systematic review is one such review that is robust, reproducible, and transparent. It involves collating evidence by using all of the eligible and critically appraised literature available on a certain topic. To know more about how to do a systematic review , you can check out our article at the link. The primary aim of a systematic review is to recommend best practices and inform policy development. Hence, there is a need for high-quality, focused, and precise methods and reporting. For more exploratory research questions, methods such as a scoping review are employed. Be sure you understand the difference between a systematic review and a scoping review , if you don’t, check out the link to learn more.
When the word “review” alone is used to describe a research paper, the first thing that should come to mind is that it is a literature review. Almost every researcher starts off their career with literature reviews. To know the difference between a systematic review and a literature review , read on here. Traditional literature reviews are also sometimes referred to as narrative reviews since they use narrative analysis to synthesize data. In this article, we will explore the differences between a systematic review and a narrative review, in further detail.
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Narrative Review vs Systematic Review
Both systematic and narrative reviews are classified as secondary research studies since they both use existing primary research studies e.g. case studies. Despite this similarity, there are key differences in their methodology and scope. The major differences between them lie in their objectives, methodology, and application areas.
Differences In Objective
The main objective of a systematic review is to formulate a well-defined research question and use qualitative and quantitative methods to analyze all the available evidence attempting to answer the question. In contrast, narrative reviews can address one or more questions with a much broader scope. The efficacy of narrative reviews is irreplaceable in tracking the development of a scientific principle, or a clinical concept. This ability to conduct a wider exploration could be lost in the restrictive framework of a systematic review.
Differences in Methodology
For systematic reviews, there are guidelines provided by the Cochrane Handbook, ROSES, and the PRISMA statement that can help determine the protocol, and methodology to be used. However, for narrative reviews, such standard guidelines do not exist. Although, there are recommendations available.
Systematic reviews comprise an explicit, transparent, and pre-specified methodology. The methodology followed in a systematic review is as follows,
- Formulating the clinical research question to answer (PICO approach)
- Developing a protocol (with strict inclusion and exclusion criteria for the selection of primary studies)
- Performing a detailed and broad literature search
- Critical appraisal of the selected studies
- Data extraction from the primary studies included in the review
- Data synthesis and analysis using qualitative or quantitative methods [3].
- Reporting and discussing results of data synthesis.
- Developing conclusions based on the findings.
A narrative review on the other hand does not have a strict protocol to be followed. The design of the review depends on its author and the objectives of the review. As yet, there is no consensus on the standard structure of a narrative review. The preferred approach is the IMRAD (Introduction, Methods, Results, and Discussion) [2]. Apart from the author’s preferences, a narrative review structure must respect the journal style and conventions followed in the respective field.
Differences in Application areas
Narrative reviews are aimed at identifying and summarizing what has previously been published. Their general applications include exploring existing debates, the appraisal of previous studies conducted on a certain topic, identifying knowledge gaps, and speculating on the latest interventions available. They are also used to track and report on changes that have occurred in an existing field of research. The main purpose is to deepen the understanding in a certain research area. The results of a systematic review provide the most valid evidence to guide clinical decision-making and inform policy development [1]. They have now become the gold standard in evidence-based medicine [1].
Although both types of reviews come with their own benefits and limitations, researchers should carefully consider the differences between them before making a decision on which review type to use.
- Aromataris E, Pearson A. The systematic review: an overview. AJN. Am J Nurs. 2014;114(3):53–8.
- Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. J Chiropratic Medicine 2006;5:101–117.
- Linares-Espinós E, Hernández V, Domínguez-Escrig JL, Fernández-Pello S, Hevia V, Mayor J, et al. Metodología de una revisión sistemática. Actas Urol Esp. 2018;42:499–506.
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Why Systematic Review rather than Narrative Review?
1 Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
2 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Sir: Recently review articles including systematic and narrative reviews have been significantly increasing in most psychiatric journals in the world alongside "Psychiatry Investigation (PI)". Since the launch of the "PI" at March 2004, there have been a number of review articles; indeed 54 papers were published as format of regular review papers or special articles in the "PI" from 2004 to 2014. However, of the 54 papers, only one review paper partially met the contemporary criteria of systematic review, otherwise were written as a format of narrative review for diverse topics such as epidemiological findings, concept and hypothesis of certain psychiatric disease, current understandings on certain disease, psychopharmacology, and treatment guidelines. This is unsatisfactory when reflecting the fact that systematic reviews have been rapidly and increasingly replacing traditional narrative (explicit) reviews as a standard platform of providing and updating currently available research findings as confident evidence. Most journals have started to change their policy in acceptance of review papers, they have been giving a priority to systematic review only as a regular review article and excluding narrative reviews, to provide the best evidence for all basic and clinical questions and further hypotheses. Of course, there should be Pros and Cons between systematic and narrative reviews; for instance, the major advantage of systematic reviews is that they are based on the findings of comprehensive and systematic literature searches in all available resources, with minimization of selection bias avoiding subjective selection bias, while narrative reviews, if they can be written experts in certain research area, can provide experts' intuitive, experiential and explicit perspectives in focused topics. 1
The absence of objective and systematic selection criteria in review method substantially results in a number of methodological shortcomings leading to clear bias of the author's interpretation and conclusions. Such differences are quite clear when referring to the review paper of Drs. Cipriani and Geddess, 2 where 7 narrative and 2 systematic reviews were compared and found that narrative reviews including same studies reached different conclusions against each other, indicating the difficulties of appraising and using narrative reviews to have conclusion on specific topic. Hence, narrative reviews may be evidence-based, but they are not truly useful as scientific evidence.
Even in reported as systematic review, it is also frequent that those papers are not true systematic review or they have certain bias in data search method and conclusions. For instance, due to lack of satisfactory pharmacotherapy for post-traumatic stress disorder (PTSD) and its frequent comorbid psychotic symptoms, a possible role of atypical antipsychotics (AAs) for PTSD has been consistently proposed. 3 In fact various AAs have demonstrated positive antidepressant and ant-anxiety effects in a number of small-scale, open-label studies (OLSs) or randomised, controlled clinical trials (RCTs). 4 In this context, a recent systematic review (4 olanzapine, 7 risperidone and 1 ziprasidone trials) by Wang et al. 5 has also suggested the positive prospect on the role of AAs for the treatment of PTSD; however, the review has a number of faulty and wrong selection of clinical trials data and interpretation of studies included in their review. The authors neglected wide range of clinical information such as patient characteristics (particularly, initial severity of disease), comorbidity issues, trial duration issues, trial design characteristics, primary endpoint difference, study sponsoring; that is, heterogeneity of clinical trials would substantially influence the quality and clinical implications of the study results. The basic problem of non-systematic search of data is that beneath the shining surface, it seems that the authors utilizing it often misunderstand the true value, underpinning meanings and correct nature of the data, or their true limitations and strengths, and they often go too far or short with the interpretation. 6 Indeed, the main conclusion of a narrative review may often be based on evidence, but such reviews themselves are not rigorous evidence since such reviews are too selective and thus little good quality information could be included. 2 In addition, I found one olanzapine trial was OLS but they included the study in the result (this is a mixture of data yielding a huge heterogeneity). 7 This clearly indicates they were not consistent in collection of the study for their review. Olanzapine has a lot of OLSs beyond the study, likewise other AAs also have a plenty of OLSs. Regarding an inclusion of OLSs for systematic reviews, an interesting metaanalyses are available on the role of olanzapine for adolescent bipolar disorder 8 and aripiprazole augmentation therapy 9 for depression. According to Pae et al. 9 the treatment effects were not significantly different between OLSs and RCTs in efficacy of aripiprazole augmentation for treating depression; the pooled effect size was statistically significant in both study design and also in a meta-analysis regression, study design was not a significant predictor of mean change in the primary endpoint, clearly indicating that OLSs are useful predictors of the potential safety and efficacy of a given compound. This finding was also supported by another meta-analysis. 8 Hence, the value of OLSs should be carefully re-evaluated for practical information source, development of new drugs or acquisition for new indications, and should not be neglected for data research, especially for narrative reviews. Furthermore, Dr. Wang et al. 5 did not include one important RCT; quetiapine has a RCT for PTSD, 10 which was presented in the thematic meeting of the CINP 2009. A 12-week RCT was conducted for 80 PTSD patients. Finally, Wang et al. 5 surprisingly did not present any effect size (ES) for studies, although such calculations are conventionally included in the review papers. Another critical example is Hickie and Rogers's review, 11 according to their article, agomelatine was efficacious antidepressant; however, subsequent researchers who avoided selection bias have clearly demonstrated its weak efficacy as an antidepressant. 12 Therefore, reflecting two review papers, 5 , 11 we can realize that inappropriate aggregation of studies may definitely bias conclusion. Hence, entire published and unpublished dataset should be considered in systematic review, especially, when clinical data is not sufficient and the medication has no officially approved indication by the regulatory agency.
To summarize, systematic review should include followings respecting recommendation from currently available systematic review guidelines (e.g., The Cochrane Library www.cochrane.org ); clear basic and clinical hypothesis, predefined protocol, designation of search resources, through data search (regardless of publication), transparent selection criteria, qualification of studies selected, synthesis of study data and information, relevant summary and conclusion. Table 1 compares systematic and narrative reviews ( Table 1 ). Since the evidence-based medicine is the current trend and also mandatory for establishment of heath policy, the PI should also turn to encourage submission of systematic reviews rather than narrative reviews.
Acknowledgments
This work was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI12C0003).
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Systematic Review, Scoping Review, Narrative Review – What’s the Difference?
Literature review articles use database searches to identify, collate, and analyze available evidence on a topic. Systematic reviews, scoping reviews, and narrative reviews are different evidence-collection and synthesis approaches.
But which type of review is (and isn’t) right for your research question? And how reliable are the findings of different review types?
There are distinctive features, aims, and scope between systematic reviews, scoping reviews, and narrative reviews . Let’s look at each and then pair them up to know which one you’ll need, whether you need ideas and references or you’re looking to write your own review.
What you’ll learn in this post
• The difference (and similarity) between a systematic review, scoping review, and narrative review.
• The features and value of each of these types of review.
• Side-by-side feature comparison charts of each review type.
• Where to educate yourself on reviews, and how to get expert guidance from published researchers.
What is a systematic review?
Definition and history.
We don’t have a universal or standard definition of systematic reviews . A systematic review usually is a critical assessment of all the literature addressing a well-defined question. It aims to give the best possible answer based on available evidence.
Systematic reviews follow structured and predefined methods to identify, appraise, and synthesize the relevant literature. They use specific inclusion and exclusion criteria based on strict protocols, such as the PRISMA statement or Cochrane Protocol .
A meta-analysis is a systematic review that, in addition to a narrative summary, combines all the studies’ results into a single statistical analysis. The PRISMA 2020 Checklist offers guidance on how to conduct a meta-analysis.
Systematic reviews ensure that the results are reliable and meaningful to end-users, so they’re widely considered the strongest source for evidence-based healthcare .
Systematic reviews in healthcare began to appear in the 1970s and 1980s . Groups promoting evidence-based healthcare, like Cochrane and the Joanna Briggs Institute (JBI), emerged in the 1990s.
Systematic reviews have been widely used since then. They are necessary for clinicians to keep up to date with their field. They are also often used to inform the development of clinical guidelines and practice .
Key functions and features
A systematic review aims to:
- Uncover the international evidence on a particular topic
- Confirm current practice; address uncertainty or variation in practice; identify new practices
- Find and inform areas for future research
- Locate and investigate mixed or conflicting results
- Produce statements to guide decision-making
Traditionally, researchers mainly carried out systematic reviews to assess the effectiveness of health interventions. In this respect, PROSPERO serves as an international database of registered systematic reviews in health and social care sciences. Or in other fields where there is a health-related outcome.
A 2020 systematic review appraising the most effective interventions for depression in heart failure patients is a good example of this approach. They explored six common interventions, medical and non-medical. It found that collaborative care and psychotherapy were the most effective treatments.
But systematic reviews have gone beyond assessing a treatment’s feasibility, appropriateness, meaningfulness, or effectiveness. They’re widely used to measure the cost-effectiveness or impact of socioeconomic interventions.
This review gives an economic appraisal of the clinical outcomes and economic effectiveness of different economic evaluations used for pharmacy services studies in health systems. It found these evaluations are increasingly used to understand which healthcare services provide value for money amid limited healthcare resources.
What is a scoping review?
Systematic reviews are essential for robustly addressing specific questions. But sometimes they might not be able to meet your specific aims or research project requirements. Or you might need a methodologically rigorous and structured preliminary scoping activity to inform how future systematic reviews are done.
That’s where scoping reviews come into play. They’re sometimes called scoping exercises/scoping studies . Scoping reviews rapidly map the size, characteristics, or scope of existing literature in a field of interest. They can help you locate research gaps and needs.
Scoping reviews are “younger” than systematic reviews. They emerged in the early 2000s . There used to be some confusion around their definition and the steps involved in the scoping review process. But, in 2015, a methodological working group of the JBI produced formal guidance for conducting scoping reviews. Likewise, the PRISMA extension for scoping reviews was published in 2018.
Researchers usually carry out a scoping review to:
- Identify the types of evidence in a given field. For example, a scoping review by Challen et al. sought to find the types of available evidence regarding the source and quality of publications and grey literature around emergency planning.
- Clarify crucial concepts or terms in the literature.
- Examine how research is conducted on a specific topic or field. A scoping review of that kind explored the scope of the literature around interventions aimed to improve health care quality in populations with osteoarthritis.
- Identify key characteristics or factors related to a concept.
- As a precursor to a systematic review (examining emerging evidence to confirm the relevance of inclusion criteria and potential questions).
- Identify and analyze knowledge gaps.
What is a narrative review?
A narrative review is a thorough and critical overview of previously published research on the author’s specific topic of interest. It’s also referred to as a traditional review or a literature review.
Narrative reviews are helpful in the following ways:
- You can read them as a general and accurate guide to what is already known about a given topic.
- They are a key part of the research process. They help you establish a theoretical and methodological framework or context for your research.
- By doing a literature review, you can locate existing patterns and trends. This helps you find the gaps in your field and formulate a meaningful research question.
So, like the systematic and scoping reviews, a narrative review appraises, critiques, and summarizes a topic’s available research.
For example, this narrative review sums up the evidence on exercise interventions in improving the health aspects of patients with preclinical Alzheimer’s disease. This narrative review is provided for the clinical development programs for non-oral, non-injectable formulations of dihydroergotamine (DHE) to treat migraine.
But, narrative reviews are far less systematic and rigorous. They’re evidence-based but not always considered massively helpful in terms of the scientific evidence they bring . They’re much more prone to selection bias.
For example, a review paper comparing seven narrative reviews with two systematic reviews found that narrative reviews of the same studies reached different conclusions. So, when you read or assess a narrative review, watch out for certain biases in data search methods.
Main differences between a systematic review and a scoping review
Systematic reviews and scoping reviews similarly use rigorous and transparent methods to comprehensively identify and analyze all the relevant literature. Their differences in aims and scope are subtle but clear.
Main differences between a systematic review and a narrative review
Systematic reviews differ greatly from narrative reviews.
As seen, systematic reviews answer a narrow question through detailed and comprehensive literature searches. But narrative reviews are more descriptive. They provide authors’ subjective perspectives on a focused but broader topic.
Main differences between a scoping review and a narrative review
Scoping reviews and narrative reviews have similar differences to systematic reviews and narrative reviews. Their key difference is that narrative reviews do not follow a standardized methodology.
Any of the above reviews is a big undertaking, and very rewarding. When you need some help in any stage of the process, we have a big range of services. We’ll connect you with publication experts to guide you through the process. Explore Edanz research services here .
Also be sure to grab the free systematic review “12P” checklist below!
The 12P Method for Systematic Reviews
We’ve squeezed all the steps and stages of a typical systematic review onto one page.
You can print it out A4-sized and use it as a handy checklist, or A3-sized for your laboratory wall. You can even share it with your co-authors.
FREE PDF CHECKLIST
Literature Review: Traditional or narrative literature reviews
Traditional or narrative literature reviews.
- Scoping Reviews
- Systematic literature reviews
- Annotated bibliography
- Keeping up to date with literature
- Finding a thesis
- Evaluating sources and critical appraisal of literature
- Managing and analysing your literature
- Further reading and resources
A narrative or traditional literature review is a comprehensive, critical and objective analysis of the current knowledge on a topic. They are an essential part of the research process and help to establish a theoretical framework and focus or context for your research. A literature review will help you to identify patterns and trends in the literature so that you can identify gaps or inconsistencies in a body of knowledge. This should lead you to a sufficiently focused research question that justifies your research.
Onwuegbuzie and Frels (pp 24-25, 2016) define four common types of narrative reviews:
- General literature review that provides a review of the most important and critical aspects of the current knowledge of the topic. This general literature review forms the introduction to a thesis or dissertation and must be defined by the research objective, underlying hypothesis or problem or the reviewer's argumentative thesis.
- Theoretical literature review which examines how theory shapes or frames research
- Methodological literature review where the research methods and design are described. These methodological reviews outline the strengths and weaknesses of the methods used and provide future direction
- Historical literature review which focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.
References and additional resources
Baker, J. D. (2016) The purpose, process and methods of writing a literature review: Editorial . Association of Operating Room Nurses. AORN Journal, 103 (3), 265-269. doi:10.1016/j.aorn.2016.01.016
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Literature Review vs Systematic Review
- Literature Review vs. Systematic Review
- Primary vs. Secondary Sources
- Databases and Articles
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Subject Guide
Definitions
It’s common to confuse systematic and literature reviews because both are used to provide a summary of the existent literature or research on a specific topic. Regardless of this commonality, both types of review vary significantly. The following table provides a detailed explanation as well as the differences between systematic and literature reviews.
Kysh, Lynn (2013): Difference between a systematic review and a literature review. [figshare]. Available at: http://dx.doi.org/10.6084/m9.figshare.766364
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Systematic literature review X narrative review
Scientific literature review articles are methodological studies which use database searches to retrieve results of research, and have as their mail goal the objective and theoretical discussion of a specific topic or theme.
Two main types of review articles are commonly found in the scientific literature: Systematic and narrative review of the literature. These two types of review articles have distinct characteristics and goals.
Narrative literature review articles are publications that describe and discuss the state of the science of a specific topic or theme from a theoretical and contextual point of view. These types of review articles do not list the types of databases and methodological approaches used to conduct the review nor the evaluation criteria for inclusion of retrieved articles during databases search (1) . Narrative review consists of critical analysis of the literature published in books and electronic or paper-based journal articles.
Narrative literature review articles have an important role in continuing education because they provide readers with up-to-date knowledge about a specific topic or theme. However, this type of review does not describe the methodological approach that would permit reproduction of data nor answer to specific quantitative research questions. These review articles normally use a qualitative approach using the following headings: Introduction, Development (using necessary sub-headings to divide and discuss appropriately the topic), Discussion, and References.
On the other hand, systemic literature review "is a well planned review to answer specific research questions using a systematic and explicit methodology to identify, select, and critically evaluate results of the studies included in the literature review" (2) . Systematic literature review articles are considered original work because they are conducted using rigorous methodological approaches.
Methodological approaches to conduct a systematic literature review can be found in Cochrane Handbook of Systematic Reviews of Interventions (3) published by the Cochrane Collaboration as well as in the CRD's Guidance for Carrying Out or Commissioning Reviews published by the NHS Centre for Reviews and Dissemination (4) .
In Brazil, researchers often use the seven steps recommended by Cochrane Collaboration (3) to conduct a systematic literature review. These seven steps are:
a) Posing a Research Question - A systematic literature review must start with a well formulated research question that contains well defined types of patients/illness and interventions that help in the decision-making process determining which articles to include in the literature review.
b) Locating Studies Use several sources to locate and retrieve scientific studies. These sources should include main databases such as Medline, Cinahl, Embase, Lilacs, Cochrane Controlled Trials Database, SciSearch and other information sources such as articles published in conference proceedings, specialized studies, and manual search of articles published in journals that are not indexed in the major scientific databases. A detailed description of the approach should be described for each one of these types of sources used.
c) Critical Evaluation of the Studies Use specific criteria to determine the validity of the selected studies. This approach facilitates the decision-making process determining which articles would be included in the literature review. Studies that are not included in the literature review must be cited and have a rationale for exclusion.
d) Data Collection Describe each study's methodological approach (variables, sample, measures, and data analysis) and findings, which allow comparison between and/or among the selected studies.
e) Data Analysis and Reporting Studies should be grouped together according to their methodological similarities. This approach must be addressed in the project. Numerical and graphical presentation of the results should also be addressed in the project to facilitate reader understanding of the findings. Statistical analysis and synthesis of the results consists of meta-analysis, a statistical method to integrate the results of systematic reviews.
f) Interpretation of the Findings this is determined by the strength of evidence, utilization of the findings, costs and current practice, which dictates the balance between benefits and risks.
g ) Refinement and Updating the Review when published, a systematic review will be scrutinized by the scientific community who will then make recommendations that must be addressed in subsequent reviews, updating the review topic when new studies about the topic are published.
The NHS/York recommends another approach to conduct a systematic literature review (4) , This approach consists of three stages using nine-step, which is not significantly different from the steps of the Cochrane Collaboration (3) .
Thus, systematic literature review uses rigorous methodology to prevent shortcuts and bias in conducting a review. Meta-analysis is a statistical method to integrate the results of the selected studies included in a systematic literature review.
Table 1 summarize the main difference between systematic literature review and narrative literature review
REFERÊNCIAS
1. Bernardo WM, Nobre MRC, Jatene FB. A prática clinica baseada em evidências. Parte II: buscando as evidências em fontes de informação. Rev Assoc Med Bras. 2004; 50(1):1-9.
2. Castro AA. Revisão sistemática e meta-aálise [texto na Internet] [citado 2006 Mai 21]. Disponível em: http://www.metodologia.org/ meta1.PDF
3. Clarke M, Oxman AD, editors. Cochrane Reviewers' Handbook 4.1 [updated June 2000]. In: Review Manager (RevMan) [Computer program]. Version 4.1. Oxford, England: The Cochrane Collaboration, 2000. Available from: http://www.cochrane.dk/ cochrane/handbook/hanbook.htm
4. Khan KS, Ter Riet G, Glanville J, Sowden AJ, Kleijnen J, editors for the NHS Centre for Reviews and Dissemination (CRD). Undertaking Systematic Reviews of Research on Effectiveness. CRD's Guidance for Carrying Out or Commissioning Reviews. 2nd ed. New York: NHS Centre for Reviews and Dissemination, University of York, 2000.[ CRD Report No. 4]. Available from: http://www.york.ac.uk/ inst/cdr/report4.htm
Edna Terezinha Rother
Editora Técnica da Acta Paulista de Enfermagem
Publication Dates
- Publication in this collection 17 July 2007
- Date of issue June 2007
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The two types of literature are written and oral. Written literature includes novels and poetry. It also has subsections of prose, fiction, myths, novels and short stories. Oral literature includes folklore, ballads, myths and fables.
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The main objective of a systematic review is to formulate a well-defined research question and use qualitative and quantitative methods to analyze all the
Narrative reviews take a less formal approach than systematic reviews in that narrative reviews do not require the presentation of the more
they are based on the findings of comprehensive and systematic literature
As seen, systematic reviews answer a narrow question through detailed and comprehensive literature searches. But narrative reviews are more descriptive. They
The Narrative Review ... At its most basic, narrative reviews are most useful for obtaining a broad perspective on a topic and are often more
Reviews provide a synthesis of published literature on a topic and describe its current state-of-art. Reviews in clinical research are thus useful when
However, more importantly, a systematic review is done around a clearly formulated research question. A literature review is simply done around
A narrative or traditional literature review is a comprehensive, critical and objective analysis of the current knowledge on a topic.
I often get asked what the difference between a narrative review and a systematic review, or what is the difference between a narrative
It's common to confuse systematic and literature reviews because both are used to provide a summary of the existent literature or research
Scientific literature review articles are methodological studies which use database searches to retrieve results of research, and have as their mail goal the