Narrative Review

 

Key features of a narrative review

A narrative review is a general approach to literature review and is characterized by the lack of a rigid research methodology, such as PRISMA for a systematic review. As a result, it allows the researcher to choose their own approach and perspective for framing the research, i.e. the narrative. In a narrative review, literature on a topic is collected and summarized, e.g. by theme, perspective, or chronology. A narrative review does not require the researcher to determine inclusion and exclusion criteria prior to conducting the search, and so the researcher has the opportunity to include and discuss articles that are cross-disciplinary, and provide as examples to support the narrative. 

 

Since a narrative review is largely shaped by the researcher's own views, it is generally considered less objective than a scoping review or a systematic review, because the potential for "bias" is more pronounced. With a method that is not transparent, the risk of bias is further exacerbated as it is unclear to the reader how thorough the review really is. Fortunately, there is a checklist available that tests the quality and objectivity of a narrative review, the SANRA. If you are planning to write a narrative review, it is advised to keep this checklist in mind - in addition to the other tips provided in this guide - to increase the quality of your review.

 

There are a number of situations in which a narrative review may be the best choice for your research. First, it is suitable for a chapter in a PhD thesis, as the researcher provides substantiation and evidence for the PhD research. Furthermore, it can serve as a framework for presenting research findings, to describe possible gaps, or reveal discussion points and ambiguities in the literature as a rationale for collecting the data. It may also point out gaps in the research area, using the researcher's view as a starting point. Finally, a narrative review can be a prelude to a more extensive literature review, such as a systematic review.

 

Before you start

Before you start writing a narrative review, always check whether a narrative review is the right review for your research. If you believe a complete overview and review is necessary on a topic in the field, a systematic review might be more fitting. Other considerations are:  

  • Has a narrative, rapid or systematic review already been conducted on the topic?
  • Do you have sufficient knowledge about your topic to conduct a narrative review?
  • Can you adequately substantiate and argue what gaps you find in the professional literature for this topic?

 

What do you need? 

  • Time: varies by topic (approximately 6-12 months);
  • Access to a number of generic databases;
  • Access to a leading domain-specific database;
  • Reference manager (e.g. RefWorks);
  • SANRA form;
  • Log for your literature review ;
  • Consultation with the information specialist (please fill out the intake form for support with your narrative review)

 

 

Determine your research question and associated keywords

You may already have a particular idea in mind for your narrative review that you want to substantiate. Another scenario is that you initially want to learn more about a topic and while reading the literature discover certain trends or gaps, which then lead to the narrative you want to present in your review. Either way, it is advisable to take the time to establish a research query and/or the relevant search terms and document them in a log, for example. 

 

Tips for establishing and fine-tuning your research question and keywords for your literature review can be found in other sections of this guide.

 

Decide which databases you want to consult

Which databases you want to consult depends on your topic, the databases you have access to, and the available time for conducting a literature review. Hanze UAS has a number databases available that you can consult for a literature review. You may also have access to more and other relevant databases through the university where you are pursuing your PhD.

 

Again, take the time to determine which databases are available and useful to search and document your choices in your logbook.

 

Document the steps of your search strategy

Documenting the steps in your literature search is important for substantiating and arguing the aspects you want to address in the narrative review. A log has been developed for this purpose, which you can use to provide insight into your search process, but you are free to adopt your own approach. Another advantage of documenting your search strategy is that, with proper documentation, it is easier to pick up where you left off with your literature search if - unexpectedly - you are unable to work on your literature review for a while. This documentation is not a research protocol as is typically written for a scoping or systematic review, but rather an account of how you arrived at the results. A narrative review does not require protocol registration.

 

Conduct your search

As there is no set method for a narrative review, you can use a combination of free search terms and validated search terms (from a thesaurus or an ontology, for example). Elsewhere in this guide, you'll find helpful tips and tricks for setting up a search string and other search methods, among other things.


Other tips:

  • keep a log (search terms and combinations thereof, databases consulted, filters, etc.)
  • collect references in a reference manager, e.g. RefWorks
  • create a data matrix (see table below), linking the aspects and results of your literature search
     

De-duplicate
Duplicate results may occur when searching across databases. You can use RefWorks to deduplicate your search results; you can read more about this in the library guide on RefWorks

 

Screening abstracts and papers
The next step in the process is to screen the abstracts of the articles. Article abstracts follow an editor's requirements for writing an abstract. An abstract may contain the following elements: 

  • Objective/Background
  • Method
  • Results
  • Conclusions

In most cases, search terms are also included with the abstract of the article or chapter; these can be found under ""keywords." After reading and screening the abstracts, you will become more familiar with the topic and the relevance of the articles, which will help you to substantiate and argue your view on the topic. Screening the papers as a whole allows you to make connections, identify gaps, discover trends in the scientific literature and check them against your own views on the topic.

 

A literature matrix and a reference manager can support you in organizing selection process. A literature matrix is an overview of the papers you screen. You create this overview by answering a number of key questions for each article so that you can easily compare sources.

 

Source Definition of long Covid? Age participants Type of study Describes symptoms? Describes treatment?
Source 1 definition adults (18+) cohort yes, i.e... no
Source 2 definition adolescents (13-17) cohort yes, i.e... no
Source 3 definition children (4-12) case study yes, i.e... yes, i.e...
description adults (18+) case study no no
etc. etc. etc. etc. etc etc. 


Reporting your findings

After conducting the literature review and analyzing the results, writing a narrative review is the next phase. Write an outline of what you want to address in your narrative review. Your structure may be thematic, chronological, or hierarchical, and showcases the different angles and how they relate to the works cited. Some researchers like to first draw out the narrative schematically on a piece of paper, while others prefer to write the outline and then fill it in with the references that support the different parts. 


A narrative review usually adheres to the following format:

  • A summary of the article (article abstract);
  • An introduction to the topic and its context;
  • A motivation as to why a narrative review is needed;
  • A description of the systematic search method, including search string, criteria, etc.;
  • A main text divided into smaller sub-sections describing the similarities and differences of aspects in the literature;
  • A conclusion (evidence and analysis) to highlight gaps and trends in the research field;
  • A comprehensive reference list.

 

If you already have a (scientific) journal in mind where you would like to publish, then make sure to read the author's guide before you start writing. This way, you know in advance what the requirements are for a review publication in the relevant journal (e.g. maximum number of words, structure).

 

For your inspiration, we have added some systematic reviews published by Hanze researchers in the list of resources below. All publications are open access available.

 

SANRA method
SANRA is an acronym for "Scale for the Assessment of Narrative Review Articles," and is a method for assessing the quality of a narrative review. SANRA provides transparency and evidence of the author's personal opinion. SANRA consists of 6 items, which are rated on a scale of 0-2, with 0 representing low level and 2 representing high level.


The following items are part of SANRA:

  1. Explanation of the importance of the topic;
  2. The goals of the narrative review;
  3. Report of the literature review conducted;
  4. References, related to the different aspects of the study;
  5. Presentation of the level of evidence for the author's views;
  6. Relevant data and references that support the research question.

 

To the SANRA review form.

Useful links and resources

 

More on SANRA:

  • Baethge, C., Goldbeck-Wood, S. & Mertens, S. SANRA—a scale for the quality assessment of narrative review articles. Research Integrity Peer Review 4, 5 (2019). https://doi.org/10.1186/s41073-019-0064-8

 

  • Falcão, F., Costa, P. & Pêgo, J.M. (2022) Feasibility assurance: a review of automatic item generation in medical assessment. Advances in Health Sciences Education 27, 405–425. DOI: 10.1007/s10459-022-10092-z
  • Salman, L.A., Ahmed, G., Dakin, S.G. et al. (2023) Osteoarthritis: a narrative review of molecular approaches to disease management. Arthritis Research & Therapy, 25, 27. DOI: 10.1186/s13075-023-03006-w
  • Woodley, S.J., Hay-Smith, E.J.C. (2021). Narrative review of pelvic floor muscle training for childbearing women—why, when, what, and how. International Urogynecology Journal32, 1977–1988. DOI: 10.1007/s00192-021-04804-z
  • Cavada, M., & Rogers, C. D. F. (2020). Serious gaming as a means of facilitating truly smart cities: a narrative review. Behaviour & Information Technology, 39(6), 695–710. DOI: 10.1080/0144929X.2019.1677775
  • Chisholm, J. M., Zamani, R., Negm, A. M., Said, N., Abdel daiem, M. M., Dibaj, M., & Akrami, M. (2021). Sustainable waste management of medical waste in African developing countries: A narrative review. Waste Management & Research, 39(9), 1149-1163. DOI: 10.1177/0734242X211029175

 

If you have questions, please contact the Information Specialist Research of your research center, or go to support & contact for more information and advice. 

 

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