model literature review

Get science-backed answers as you write with Paperpal's Research feature

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. 

Find academic papers related to your research topic faster. Try Research on Paperpal  

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. 

Strengthen your literature review with factual insights. Try Research on Paperpal for free!    

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. 

Write and Cite as you go with Paperpal Research. Start now for free.   

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 . 

Paperpal is an AI writing assistant that help academics write better, faster with real-time suggestions for in-depth language and grammar correction. Trained on millions of research manuscripts enhanced by professional academic editors, Paperpal delivers human precision at machine speed.  

Try it for free or upgrade to  Paperpal Prime , which unlocks unlimited access to premium features like academic translation, paraphrasing, contextual synonyms, consistency checks and more. It’s like always having a professional academic editor by your side! Go beyond limitations and experience the future of academic writing.  Get Paperpal Prime now at just US$19 a month!

Related Reads:

• Empirical Research: A Comprehensive Guide for Academics 
• How to Write a Scientific Paper in 10 Steps 
• How Long Should a Chapter Be?
• How to Use Paperpal to Generate Emails & Cover Letters?

6 Tips for Post-Doc Researchers to Take Their Career to the Next Level

Self-plagiarism in research: what it is and how to avoid it, you may also like, how to ace grant writing for research funding..., how to write a high-quality conference paper, how paperpal’s research feature helps you develop and..., how paperpal is enhancing academic productivity and accelerating..., how to write a successful book chapter for..., academic editing: how to self-edit academic text with..., 4 ways paperpal encourages responsible writing with ai, what are scholarly sources and where can you..., how to write a hypothesis types and examples , measuring academic success: definition & strategies for excellence.

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, automatically generate references for free.

• Knowledge Base
• Dissertation
• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

Instantly correct all language mistakes in your text

Be assured that you'll submit flawless writing. Upload your document to correct all your mistakes.

Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

The only proofreading tool specialized in correcting academic writing

The academic proofreading tool has been trained on 1000s of academic texts and by native English editors. Making it the most accurate and reliable proofreading tool for students.

Correct my document today

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

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

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

Download Word doc Download Google doc

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

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

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

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

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

Search for relevant sources

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

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

You can use boolean operators to help narrow down your search:

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

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

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

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

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

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

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

You can use our free APA Reference Generator for quick, correct, consistent citations.

Prevent plagiarism, run a free check.

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

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

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

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

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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

As you write, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, 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 transitions and topic sentences to draw connections, comparisons and contrasts.

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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

It is often written as part of a dissertation , thesis, research paper , or proposal .

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

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

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

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

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 27 May 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

Is this article helpful?

Shona McCombes

Other students also liked, how to write a dissertation proposal | a step-by-step guide, what is a theoretical framework | a step-by-step guide, what is a research methodology | steps & tips.

Harvey Cushing/John Hay Whitney Medical Library

• Collections
• Research Help

YSN Doctoral Programs: Steps in Conducting a Literature Review

• Biomedical Databases
• Global (Public Health) Databases
• Soc. Sci., History, and Law Databases
• Grey Literature
• Trials Registers
• Data and Statistics
• Public Policy
• Google Tips
• Recommended Books
• Steps in Conducting a Literature Review

What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
• << Previous: Recommended Books
• Last Updated: Jan 4, 2024 10:52 AM
• URL: https://guides.library.yale.edu/YSNDoctoral

Purdue Online Writing Lab Purdue OWL® College of Liberal Arts

Writing a Literature Review

Welcome to the Purdue OWL

This page is brought to you by the OWL at Purdue University. When printing this page, you must include the entire legal notice.

Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission. Use of this site constitutes acceptance of our terms and conditions of fair use.

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.

The Sheridan Libraries

• Write a Literature Review
• Sheridan Libraries
• Find This link opens in a new window
• Evaluate This link opens in a new window

What Will You Do Differently?

Please help your librarians by filling out this two-minute survey of today's class session..

Professor, this one's for you .

Introduction

Literature reviews take time. here is some general information to know before you start.  .

•  VIDEO -- This video is a great overview of the entire process.  (2020; North Carolina State University Libraries) --The transcript is included --This is for everyone; ignore the mention of "graduate students" --9.5 minutes, and every second is important  
• OVERVIEW -- Read this page from Purdue's OWL. It's not long, and gives some tips to fill in what you just learned from the video.  
• NOT A RESEARCH ARTICLE -- A literature review follows a different style, format, and structure from a research article.  

Steps to Completing a Literature Review

• Next: Find >>
• Last Updated: Sep 26, 2023 10:25 AM
• URL: https://guides.library.jhu.edu/lit-review

• University of Texas Libraries

Literature Reviews

Steps in the literature review process.

• What is a literature review?
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support
• You may need to some exploratory searching of the literature to get a sense of scope, to determine whether you need to narrow or broaden your focus
• Identify databases that provide the most relevant sources, and identify relevant terms (controlled vocabularies) to add to your search strategy
• Finalize your research question
• Think about relevant dates, geographies (and languages), methods, and conflicting points of view
• Conduct searches in the published literature via the identified databases
• Check to see if this topic has been covered in other discipline's databases
• Examine the citations of on-point articles for keywords, authors, and previous research (via references) and cited reference searching.
• Save your search results in a citation management tool (such as Zotero, Mendeley or EndNote)
• De-duplicate your search results
• Make sure that you've found the seminal pieces -- they have been cited many times, and their work is considered foundational 
• Check with your professor or a librarian to make sure your search has been comprehensive
• Evaluate the strengths and weaknesses of individual sources and evaluate for bias, methodologies, and thoroughness
• Group your results in to an organizational structure that will support why your research needs to be done, or that provides the answer to your research question  
• Develop your conclusions
• Are there gaps in the literature?
• Where has significant research taken place, and who has done it?
• Is there consensus or debate on this topic?
• Which methodological approaches work best?
• For example: Background, Current Practices, Critics and Proponents, Where/How this study will fit in 
• Organize your citations and focus on your research question and pertinent studies
• Compile your bibliography

Note: The first four steps are the best points at which to contact a librarian. Your librarian can help you determine the best databases to use for your topic, assess scope, and formulate a search strategy.

Videos Tutorials about Literature Reviews

This 4.5 minute video from Academic Education Materials has a Creative Commons License and a British narrator.

Recommended Reading

• Last Updated: Oct 26, 2022 2:49 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

• UWF Libraries

Literature Review: Conducting & Writing

• Sample Literature Reviews
• Steps for Conducting a Lit Review
• Finding "The Literature"
• Organizing/Writing
• APA Style This link opens in a new window
• Chicago: Notes Bibliography This link opens in a new window
• MLA Style This link opens in a new window

Sample Lit Reviews from Communication Arts

Have an exemplary literature review.

• Literature Review Sample 1
• Literature Review Sample 2
• Literature Review Sample 3

Have you written a stellar literature review you care to share for teaching purposes?

Are you an instructor who has received an exemplary literature review and have permission from the student to post?

Please contact Britt McGowan at [email protected] for inclusion in this guide. All disciplines welcome and encouraged.

• << Previous: MLA Style
• Next: Get Help! >>
• Last Updated: Mar 22, 2024 9:37 AM
• URL: https://libguides.uwf.edu/litreview

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.

Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).

Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).

The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).

When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.

The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.

9.2. Overview of the Literature Review Process and Steps

As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:

• formulating the research question(s) and objective(s),
• searching the extant literature,
• screening for inclusion,
• assessing the quality of primary studies,
• extracting data, and
• analyzing data.

Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).

Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).

9.3. Types of Review Articles and Brief Illustrations

EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.

9.3.1. Narrative Reviews

The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).

Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).

Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.

Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.

9.3.2. Descriptive or Mapping Reviews

The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).

In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.

An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).

9.3.3. Scoping Reviews

Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.

Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).

One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).

9.3.4. Forms of Aggregative Reviews

Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.

Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:

• Formulating a review question and developing a search strategy based on explicit inclusion criteria for the identification of eligible studies (usually described in the context of a detailed review protocol).
• Searching for eligible studies using multiple databases and information sources, including grey literature sources, without any language restrictions.
• Selecting studies, extracting data, and assessing risk of bias in a duplicate manner using two independent reviewers to avoid random or systematic errors in the process.
• Analyzing data using quantitative or qualitative methods.
• Presenting results in summary of findings tables.
• Interpreting results and drawing conclusions.

Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.

The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed inde­­pen­dently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.

Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.

A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guide­lines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.

In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).

9.3.5. Realist Reviews

Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).

To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).

The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.

9.3.6. Critical Reviews

Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).

Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.

9.4. Summary

Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.

Typology of Literature Reviews (adapted from Paré et al., 2015).

As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.

9.5. Concluding Remarks

In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.

We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.

To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.

• Ammenwerth E., de Keizer N. An inventory of evaluation studies of information technology in health care. Trends in evaluation research, 1982-2002. International Journal of Medical Informatics. 2004; 44 (1):44–56. [ PubMed : 15778794 ]
• Anderson S., Allen P., Peckham S., Goodwin N. Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services. Health Research Policy and Systems. 2008; 6 (7):1–12. [ PMC free article : PMC2500008 ] [ PubMed : 18613961 ] [ CrossRef ]
• Archer N., Fevrier-Thomas U., Lokker C., McKibbon K. A., Straus S.E. Personal health records: a scoping review. Journal of American Medical Informatics Association. 2011; 18 (4):515–522. [ PMC free article : PMC3128401 ] [ PubMed : 21672914 ]
• Arksey H., O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005; 8 (1):19–32.
• A systematic, tool-supported method for conducting literature reviews in information systems. Paper presented at the Proceedings of the 19th European Conference on Information Systems ( ecis 2011); June 9 to 11; Helsinki, Finland. 2011.
• Baumeister R. F., Leary M.R. Writing narrative literature reviews. Review of General Psychology. 1997; 1 (3):311–320.
• Becker L. A., Oxman A.D. In: Cochrane handbook for systematic reviews of interventions. Higgins J. P. T., Green S., editors. Hoboken, nj : John Wiley & Sons, Ltd; 2008. Overviews of reviews; pp. 607–631.
• Borenstein M., Hedges L., Higgins J., Rothstein H. Introduction to meta-analysis. Hoboken, nj : John Wiley & Sons Inc; 2009.
• Cook D. J., Mulrow C. D., Haynes B. Systematic reviews: Synthesis of best evidence for clinical decisions. Annals of Internal Medicine. 1997; 126 (5):376–380. [ PubMed : 9054282 ]
• Cooper H., Hedges L.V. In: The handbook of research synthesis and meta-analysis. 2nd ed. Cooper H., Hedges L. V., Valentine J. C., editors. New York: Russell Sage Foundation; 2009. Research synthesis as a scientific process; pp. 3–17.
• Cooper H. M. Organizing knowledge syntheses: A taxonomy of literature reviews. Knowledge in Society. 1988; 1 (1):104–126.
• Cronin P., Ryan F., Coughlan M. Undertaking a literature review: a step-by-step approach. British Journal of Nursing. 2008; 17 (1):38–43. [ PubMed : 18399395 ]
• Darlow S., Wen K.Y. Development testing of mobile health interventions for cancer patient self-management: A review. Health Informatics Journal. 2015 (online before print). [ PubMed : 25916831 ] [ CrossRef ]
• Daudt H. M., van Mossel C., Scott S.J. Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O’Malley’s framework. bmc Medical Research Methodology. 2013; 13 :48. [ PMC free article : PMC3614526 ] [ PubMed : 23522333 ] [ CrossRef ]
• Davies P. The relevance of systematic reviews to educational policy and practice. Oxford Review of Education. 2000; 26 (3-4):365–378.
• Deeks J. J., Higgins J. P. T., Altman D.G. In: Cochrane handbook for systematic reviews of interventions. Higgins J. P. T., Green S., editors. Hoboken, nj : John Wiley & Sons, Ltd; 2008. Analysing data and undertaking meta-analyses; pp. 243–296.
• Deshazo J. P., Lavallie D. L., Wolf F.M. Publication trends in the medical informatics literature: 20 years of “Medical Informatics” in mesh . bmc Medical Informatics and Decision Making. 2009; 9 :7. [ PMC free article : PMC2652453 ] [ PubMed : 19159472 ] [ CrossRef ]
• Dixon-Woods M., Agarwal S., Jones D., Young B., Sutton A. Synthesising qualitative and quantitative evidence: a review of possible methods. Journal of Health Services Research and Policy. 2005; 10 (1):45–53. [ PubMed : 15667704 ]
• Finfgeld-Connett D., Johnson E.D. Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. Journal of Advanced Nursing. 2013; 69 (1):194–204. [ PMC free article : PMC3424349 ] [ PubMed : 22591030 ]
• Grady B., Myers K. M., Nelson E. L., Belz N., Bennett L., Carnahan L. … Guidelines Working Group. Evidence-based practice for telemental health. Telemedicine Journal and E Health. 2011; 17 (2):131–148. [ PubMed : 21385026 ]
• Green B. N., Johnson C. D., Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. Journal of Chiropractic Medicine. 2006; 5 (3):101–117. [ PMC free article : PMC2647067 ] [ PubMed : 19674681 ]
• Greenhalgh T., Wong G., Westhorp G., Pawson R. Protocol–realist and meta-narrative evidence synthesis: evolving standards ( rameses ). bmc Medical Research Methodology. 2011; 11 :115. [ PMC free article : PMC3173389 ] [ PubMed : 21843376 ]
• Gurol-Urganci I., de Jongh T., Vodopivec-Jamsek V., Atun R., Car J. Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database System Review. 2013; 12 cd 007458. [ PMC free article : PMC6485985 ] [ PubMed : 24310741 ] [ CrossRef ]
• Hart C. Doing a literature review: Releasing the social science research imagination. London: SAGE Publications; 1998.
• Higgins J. P. T., Green S., editors. Cochrane handbook for systematic reviews of interventions: Cochrane book series. Hoboken, nj : Wiley-Blackwell; 2008.
• Jesson J., Matheson L., Lacey F.M. Doing your literature review: traditional and systematic techniques. Los Angeles & London: SAGE Publications; 2011.
• King W. R., He J. Understanding the role and methods of meta-analysis in IS research. Communications of the Association for Information Systems. 2005; 16 :1.
• Kirkevold M. Integrative nursing research — an important strategy to further the development of nursing science and nursing practice. Journal of Advanced Nursing. 1997; 25 (5):977–984. [ PubMed : 9147203 ]
• Kitchenham B., Charters S. ebse Technical Report Version 2.3. Keele & Durham. uk : Keele University & University of Durham; 2007. Guidelines for performing systematic literature reviews in software engineering.
• Kitsiou S., Paré G., Jaana M. Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases: a critical assessment of their methodological quality. Journal of Medical Internet Research. 2013; 15 (7):e150. [ PMC free article : PMC3785977 ] [ PubMed : 23880072 ]
• Kitsiou S., Paré G., Jaana M. Effects of home telemonitoring interventions on patients with chronic heart failure: an overview of systematic reviews. Journal of Medical Internet Research. 2015; 17 (3):e63. [ PMC free article : PMC4376138 ] [ PubMed : 25768664 ]
• Levac D., Colquhoun H., O’Brien K. K. Scoping studies: advancing the methodology. Implementation Science. 2010; 5 (1):69. [ PMC free article : PMC2954944 ] [ PubMed : 20854677 ]
• Levy Y., Ellis T.J. A systems approach to conduct an effective literature review in support of information systems research. Informing Science. 2006; 9 :181–211.
• Liberati A., Altman D. G., Tetzlaff J., Mulrow C., Gøtzsche P. C., Ioannidis J. P. A. et al. Moher D. The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Annals of Internal Medicine. 2009; 151 (4):W-65. [ PubMed : 19622512 ]
• Lyden J. R., Zickmund S. L., Bhargava T. D., Bryce C. L., Conroy M. B., Fischer G. S. et al. McTigue K. M. Implementing health information technology in a patient-centered manner: Patient experiences with an online evidence-based lifestyle intervention. Journal for Healthcare Quality. 2013; 35 (5):47–57. [ PubMed : 24004039 ]
• Mickan S., Atherton H., Roberts N. W., Heneghan C., Tilson J.K. Use of handheld computers in clinical practice: a systematic review. bmc Medical Informatics and Decision Making. 2014; 14 :56. [ PMC free article : PMC4099138 ] [ PubMed : 24998515 ]
• Moher D. The problem of duplicate systematic reviews. British Medical Journal. 2013; 347 (5040) [ PubMed : 23945367 ] [ CrossRef ]
• Montori V. M., Wilczynski N. L., Morgan D., Haynes R. B., Hedges T. Systematic reviews: a cross-sectional study of location and citation counts. bmc Medicine. 2003; 1 :2. [ PMC free article : PMC281591 ] [ PubMed : 14633274 ]
• Mulrow C. D. The medical review article: state of the science. Annals of Internal Medicine. 1987; 106 (3):485–488. [ PubMed : 3813259 ] [ CrossRef ]
• Evidence-based information systems: A decade later. Proceedings of the European Conference on Information Systems ; 2011. Retrieved from http://aisel ​.aisnet.org/cgi/viewcontent ​.cgi?article ​=1221&context ​=ecis2011 .
• Okoli C., Schabram K. A guide to conducting a systematic literature review of information systems research. ssrn Electronic Journal. 2010
• Otte-Trojel T., de Bont A., Rundall T. G., van de Klundert J. How outcomes are achieved through patient portals: a realist review. Journal of American Medical Informatics Association. 2014; 21 (4):751–757. [ PMC free article : PMC4078283 ] [ PubMed : 24503882 ]
• Paré G., Trudel M.-C., Jaana M., Kitsiou S. Synthesizing information systems knowledge: A typology of literature reviews. Information & Management. 2015; 52 (2):183–199.
• Patsopoulos N. A., Analatos A. A., Ioannidis J.P. A. Relative citation impact of various study designs in the health sciences. Journal of the American Medical Association. 2005; 293 (19):2362–2366. [ PubMed : 15900006 ]
• Paul M. M., Greene C. M., Newton-Dame R., Thorpe L. E., Perlman S. E., McVeigh K. H., Gourevitch M.N. The state of population health surveillance using electronic health records: A narrative review. Population Health Management. 2015; 18 (3):209–216. [ PubMed : 25608033 ]
• Pawson R. Evidence-based policy: a realist perspective. London: SAGE Publications; 2006.
• Pawson R., Greenhalgh T., Harvey G., Walshe K. Realist review—a new method of systematic review designed for complex policy interventions. Journal of Health Services Research & Policy. 2005; 10 (Suppl 1):21–34. [ PubMed : 16053581 ]
• Petersen K., Vakkalanka S., Kuzniarz L. Guidelines for conducting systematic mapping studies in software engineering: An update. Information and Software Technology. 2015; 64 :1–18.
• Petticrew M., Roberts H. Systematic reviews in the social sciences: A practical guide. Malden, ma : Blackwell Publishing Co; 2006.
• Rousseau D. M., Manning J., Denyer D. Evidence in management and organizational science: Assembling the field’s full weight of scientific knowledge through syntheses. The Academy of Management Annals. 2008; 2 (1):475–515.
• Rowe F. What literature review is not: diversity, boundaries and recommendations. European Journal of Information Systems. 2014; 23 (3):241–255.
• Shea B. J., Hamel C., Wells G. A., Bouter L. M., Kristjansson E., Grimshaw J. et al. Boers M. amstar is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. Journal of Clinical Epidemiology. 2009; 62 (10):1013–1020. [ PubMed : 19230606 ]
• Shepperd S., Lewin S., Straus S., Clarke M., Eccles M. P., Fitzpatrick R. et al. Sheikh A. Can we systematically review studies that evaluate complex interventions? PLoS Medicine. 2009; 6 (8):e1000086. [ PMC free article : PMC2717209 ] [ PubMed : 19668360 ]
• Silva B. M., Rodrigues J. J., de la Torre Díez I., López-Coronado M., Saleem K. Mobile-health: A review of current state in 2015. Journal of Biomedical Informatics. 2015; 56 :265–272. [ PubMed : 26071682 ]
• Smith V., Devane D., Begley C., Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. bmc Medical Research Methodology. 2011; 11 (1):15. [ PMC free article : PMC3039637 ] [ PubMed : 21291558 ]
• Sylvester A., Tate M., Johnstone D. Beyond synthesis: re-presenting heterogeneous research literature. Behaviour & Information Technology. 2013; 32 (12):1199–1215.
• Templier M., Paré G. A framework for guiding and evaluating literature reviews. Communications of the Association for Information Systems. 2015; 37 (6):112–137.
• Thomas J., Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. bmc Medical Research Methodology. 2008; 8 (1):45. [ PMC free article : PMC2478656 ] [ PubMed : 18616818 ]
• Reconstructing the giant: on the importance of rigour in documenting the literature search process. Paper presented at the Proceedings of the 17th European Conference on Information Systems ( ecis 2009); Verona, Italy. 2009.
• Webster J., Watson R.T. Analyzing the past to prepare for the future: Writing a literature review. Management Information Systems Quarterly. 2002; 26 (2):11.
• Whitlock E. P., Lin J. S., Chou R., Shekelle P., Robinson K.A. Using existing systematic reviews in complex systematic reviews. Annals of Internal Medicine. 2008; 148 (10):776–782. [ PubMed : 18490690 ]

This publication is licensed under a Creative Commons License, Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0): see https://creativecommons.org/licenses/by-nc/4.0/

• Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
• PDF version of this title (4.5M)
• Disable Glossary Links

In this Page

• Introduction
• Overview of the Literature Review Process and Steps
• Types of Review Articles and Brief Illustrations
• Concluding Remarks

Related information

• PMC PubMed Central citations
• PubMed Links to PubMed

Recent Activity

• Chapter 9 Methods for Literature Reviews - Handbook of eHealth Evaluation: An Ev... Chapter 9 Methods for Literature Reviews - Handbook of eHealth Evaluation: An Evidence-based Approach

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

Chaos to Clarity: Structuring Your Literature Review Format

Master literature review format! Learn key sections, effective citation & analysis tips to write a strong academic review.

Ever wondered how to dive into a mountain of books and articles and come up with something that not just makes sense but shines new light on a topic? What if there was a way to neatly tie together all that information, spot what’s missing, and maybe even pave the way for discoveries? 

That’s what you are going to learn in this article, literature reviews—a place where chaos meets order, and where your insights could set the stage for the next big thing. Let’s break down the literature review format , your essential guide to properly writing a literature review.

Dissecting Literature Review Format 

There are 6 main sections to make a note of while writing a literature review. Those are:

The Introduction Section

Topic background, conceptual framework.

• Synthesis and Evaluation in Literature Reviews
• Conclusion for Your Literature Review
• Reference List in Your Literature Review

Also Read: Essential Components of a Literature Review

The introduction of your literature review is where you set the stage for the entire document. It’s your first opportunity to engage your readers and provide a clear blueprint of what your review will cover and why it matters. This section does more than merely introduce the topic; it establishes the context, defines the scope, and outlines the purpose and objectives of your literature review.

Things to keep in mind while writing an introduction:

• Craft a compelling opening
• Establish the Context and Justification
• Define the Scope and Objectives
• Lay out the Structure
• Give an overview of the Structure

The “Topic Background” section of a literature review serves as the cornerstone for understanding the evolution and current state of the subject matter. It is divided into two crucial sub-sections: Historical Context and Current State of the Topic . 

Delving into these areas provides you with a comprehensive backdrop against which the literature review is framed, enriching the reader’s understanding of why the topic is of interest and what has influenced its development to the current state.

Historical Context

The Historical Context is fundamental in setting the stage for the entire literature review. This section is not just a chronology of events or developments; it’s a curated narrative that highlights the key milestones and turning points that have significantly impacted the topic. 

By examining the historical evolution, the review establishes a timeline of how understanding and perspectives have shifted over the years.

Summary Of Key Historical Developments

This involves identifying and summarizing the major breakthroughs, shifts in thinking, or seminal works that have shaped the topic. It’s important to focus on developments that have a direct relevance to the current understanding and state of the subject. For example, if the topic is about the evolution of renewable energy technologies, this part would outline the initial discovery and use of renewable sources, significant technological innovations, and pivotal policy decisions that have influenced the field.

Relevance Of Historical Context To The Topic

After outlining the key historical developments, it’s crucial to connect these events to the present topic. This means discussing how past events have laid the groundwork for current theories, practices, or debates within the field. It involves analyzing the impact of historical milestones on the subject matter, and explaining how they have contributed to current knowledge, challenges, and research questions. This section makes it clear why understanding history is essential for anyone researching or studying the topic today.

Current State Of The Topic

Moving from the historical context, the review transitions to the present with the Current State of the Topic. This part assesses the latest research, trends, debates, and technological advancements that define the subject area at the moment.

Current Trends Or Updates

Here, the focus shifts to what is happening in the field right now. This could include recent research findings, emerging theories, new methodologies, or the latest technological innovations. The aim is to provide a snapshot of the current research landscape, identifying what themes, questions, or problems are being actively explored. For instance, in the context of digital marketing, this might involve discussing the rise of artificial intelligence in customer relationship management or the impact of social media trends on marketing strategies.

Impact Of These Trends On The Subject Matter

The final step is to assess the implications of these current trends for the topic. This includes considering how recent developments have advanced the field, the challenges they present, and the opportunities they open up for future research. It’s about connecting the dots between what’s happening now and what it means for the subject area moving forward. This not only helps to frame the research questions that the literature review will address but also sets the stage for identifying gaps in the current knowledge, thereby guiding the direction of future studies.

Also Read: What is a literature review? Get the concept and start using it

When doing a literature review, it’s essential to lay a solid foundation for your exploration through a well-defined conceptual framework. This framework acts as a compass, guiding your review’s direction by establishing the key concepts, theories, and perspectives that underpin your topic. 

Definitions And Descriptions

Before diving into the depths of your literature review, it’s crucial to start with the basics. This means clearly identifying and defining the key concepts related to your topic. Think of this as setting the stage for your readers, ensuring they have a clear understanding of the fundamental terms and ideas you will be exploring.

Key Concepts Related To The Topic

Begin by listing the essential concepts central to your review. These are the building blocks of your topic, the terms that will repeatedly appear throughout your exploration. 

Detailed Definitions And Their Relevance

Once you’ve identified these concepts, provide precise and comprehensive definitions for each. Don’t hesitate to explore different dimensions or interpretations of these terms, as this can enrich your readers’ understanding. More importantly, discuss why these concepts are crucial to your review. How do they shape the scope of your exploration? How do they relate to each other and to the broader topic? This step ensures that your readers are not just familiar with the terms but also understand their significance within your review’s context.

Theoretical Perspectives

With the key concepts clearly defined, it’s time to frame your literature review within relevant theoretical perspectives. This is where you align your exploration with existing theories, models, or frameworks that provide insights into your topic.

Important Theories Related To The Topic

Identify the theories that are foundational to your topic. These could range from well-established theories that have long guided research in your field to more contemporary models that offer new insights. For example, a review of organizational behavior might draw on theories of motivation, leadership styles, and organizational culture.

Evaluation Of These Theories And Their Influence On The Topic

After pinpointing the relevant theories, critically assess their contributions to the topic. Consider questions like: How have these theories shaped understanding of the topic? What insights do they offer, and where do they fall short? Are there controversies or debates surrounding these theories? This evaluation not only deepens your review’s analytical depth but also positions your work within the larger academic conversation.

Synthesis And Evaluation In Literature Reviews

The “Synthesis and Evaluation” section is where your literature review truly comes to life. Here, you’re not just summarizing what others have said; you’re weaving together diverse strands of research to present a cohesive picture of the topic at hand.

Comparison And Contrast Of Sources

Synthesizing the literature involves more than listing findings from various studies; it’s about drawing connections between them, highlighting areas of agreement and dispute, and weaving these into a narrative that adds depth and breadth to your understanding of the topic.

Comparative Analysis

Start by grouping your sources based on similarities in their findings, methodologies, or theoretical approaches. This clustering will help you identify trends and common themes across the literature. For example, if several studies have found similar outcomes under comparable conditions, these findings can be grouped to strengthen a particular argument or observation about the topic.

Contrasts Or Conflicts Among Sources

Equally important is the identification of discrepancies in the literature. Do some studies present findings that directly contradict others? Are there differences in how researchers have interpreted similar data? Highlighting these conflicts is crucial, as it can indicate areas where the topic is still evolving or where further research is needed. It also shows your ability to critically engage with the material, a hallmark of scholarly rigor.

Analysis Of Gaps In Literature

One of your primary tasks in the synthesis and evaluation section is to identify what’s missing in the current body of research. This requires a critical eye and a deep understanding of both your topic and the broader field in which it resides.

Identification Of Research Gaps

As you comb through the literature, ask yourself: What questions remain unanswered? Are there underexplored areas or populations? Perhaps certain methodologies have been overlooked, or theoretical perspectives have not been considered. Pinpointing these gaps is not a mere exercise in academic critique; it’s a vital step in advancing knowledge within the field.

Implications Of These Gaps For Future Research

Highlighting gaps in the literature sets the stage for future studies. It’s where you, as the reviewer, can suggest new research directions that could fill these voids or further explore the topic. Discussing the implications of these gaps not only enriches your review but also contributes to the ongoing scholarly conversation. 

Conclusion For Your Literature Review

The conclusion of your literature review is where you bring together all the strands of your argument, synthesizing the insights gained and highlighting the significance of your findings. It’s not just a summary of what has been discussed; it’s an opportunity to underscore the relevance of the review, reflect on the broader implications of your synthesis and evaluation, and suggest directions for future research. 

Summary Of Key Points

Start your conclusion by succinctly summarizing the main points and findings of your review. This isn’t about rehashing every detail but rather about distilling the essence of your exploration. Highlight the critical trends, themes, and conflicts you’ve uncovered, and remind your readers of the significance of these discoveries.

Relevance And Implications Of The Literature For The Topic

Next, focus on the relevance and implications of your findings. This involves stepping back to consider the bigger picture—how does your literature review contribute to the understanding of your topic? Discuss the impact of the trends and gaps you’ve identified on the field, and elaborate on how your synthesis of the literature advances or enriches existing knowledge.

Reflection On The Research Process

Reflecting on the research process itself can provide valuable insights. Consider discussing the challenges you encountered in navigating the literature, such as dealing with conflicting findings or the scarcity of research on certain aspects of your topic. 

Directions For Future Research

One of the most critical aspects of your conclusion is to suggest directions for future research. Be as precise as possible, whether suggesting new methodologies, theoretical frameworks, or specific topics that warrant deeper investigation.

Final Thoughts

End your conclusion with a strong closing statement that reiterates the value of your literature review. Emphasize the importance of continued research on your topic and the potential it holds for advanced understanding within your field. A compelling conclusion reaffirms the significance of your work, leaving your readers with a clear sense of its contribution and the urgent need for further exploration.

Reference List In Your Literature Review

The Reference List is the backbone of your literature review, providing a comprehensive compilation of all the sources you’ve cited throughout your exploration. It’s not merely a formality but a crucial component that lends credibility and rigor to your work.

Importance Of Accuracy And Consistency

The cornerstone of a reliable Reference List is accuracy and consistency in citation style. Whether you’re adhering to APA , MLA , Chicago , or another academic citation format, it’s vital to apply the rules with precision. This includes correctly formatting author names, publication dates, titles, and publication details. 

Organizing Your References

While different citation styles have their own rules for listing references, organizing them in a way that enhances readability and accessibility is universally beneficial. Alphabetical order by the author’s last name is the most common method, as it allows readers to easily locate sources.

Comprehensive Coverage

Your Reference List should be exhaustive, including every work you’ve cited in your review. This extends beyond journal articles and books to encompass reports, conference papers, online resources, and any other materials that have informed your analysis.

The Value Of Annotations

While not always required, providing brief annotations for key sources can add tremendous value to your Reference List. An annotated bibliography offers a succinct summary of each source’s main arguments, methodologies, and findings, as well as its relevance to your literature review.

Digital Accessibility

In today’s digital age, considering the accessibility of your referenced works can greatly enhance the utility of your Reference List. Whenever possible, include Digital Object Identifiers (DOIs) or stable URLs for online sources, ensuring readers can directly access the materials. 

Also read: What Is A DOI? Exploring The Purpose And Importance

Reflecting On Ethical Scholarship

Finally, your Reference List is a reflection of ethical scholarship. By accurately citing all the sources that have informed your work, you’re honoring the intellectual property of other researchers and upholding the academic community’s standards of integrity and respect. 

Crafting a meticulous Reference List is an essential aspect of your literature review that underscores the credibility, depth, and ethical foundation of your research. By adhering to the principles of accuracy, comprehensiveness, and accessibility, you not only facilitate further inquiry but also pay homage to the collective endeavor of knowledge advancement in your field.

Related Article: Navigating the AMA Citation Format: Best Tips for Referencing

In conclusion, writing a literature review involves meticulous structuring, beginning with an engaging introduction that sets the stage, followed by a detailed exploration of the topic’s background, including its historical context and current state. 

A robust conceptual framework lays the groundwork for analysis, leading to a critical synthesis and evaluation of relevant literature. 

The conclusion ties together the review’s key findings and implications, while the reference list meticulously catalogs all cited works. Mastering each section ensures a comprehensive and insightful review, essential for advancing academic understanding and contributing to scholarly discussions.

Related Article: Preliminary Literature Review: A Guide for Effective Research

Science Figures, Graphical Abstracts, And Infographics For Your Research

Revolutionize your research with infographics from Mind the Graph . From science figures, graphical abstracts to infographics, you can unleash the power of creative visuals with this user-friendly platform and make your research captivating. 

Subscribe to our newsletter

Exclusive high quality content about effective visual communication in science.

Unlock Your Creativity

Create infographics, presentations and other scientifically-accurate designs without hassle — absolutely free for 7 days!

About Sowjanya Pedada

Sowjanya is a passionate writer and an avid reader. She holds MBA in Agribusiness Management and now is working as a content writer. She loves to play with words and hopes to make a difference in the world through her writings. Apart from writing, she is interested in reading fiction novels and doing craftwork. She also loves to travel and explore different cuisines and spend time with her family and friends.

Content tags

• USC Libraries
• Research Guides

Organizing Your Social Sciences Research Paper

• The C.A.R.S. Model
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

Introduction

The Creating a Research Space [C.A.R.S.] Model was developed by John Swales based upon his analysis of journal articles representing a variety of discipline-based writing practices. His model attempts to explain and describe the organizational pattern of writing the introduction to scholarly research studies. Following the C.A.R.S. Model can be useful approach because it can help you to: 1) begin the writing process [getting started is often the most difficult task]; 2) understand the way in which an introduction sets the stage for the rest of your paper; and, 3) assess how the introduction fits within the larger scope of your study. The model assumes that writers follow a general organizational pattern in response to two types of challenges [“competitions”] relating to establishing a presence within a particular domain of research: 1) the competition to create a rhetorical space and, 2) the competition to attract readers into that space. The model proposes three actions [Swales calls them “moves”], accompanied by specific steps, that reflect the development of an effective introduction for a research paper. These “moves” and steps can be used as a template for writing the introduction to your own social sciences research papers.

"Introductions." The Writing Lab and The OWL. Purdue University; Coffin, Caroline and Rupert Wegerif. “How to Write a Standard Research Article.” Inspiring Academic Practice at the University of Exeter; Kayfetz, Janet. "Academic Writing Workshop." University of California, Santa Barbara, Fall 2009; Pennington, Ken. "The Introduction Section: Creating a Research Space CARS Model." Language Centre, Helsinki University of Technology, 2005; Swales, John and Christine B. Feak. Academic Writing for Graduate Students: Essential Skills and Tasks. 2nd edition. Ann Arbor, MI: University of Michigan Press, 2004.

Creating a Research Space Move 1: Establishing a Territory [the situation] This is generally accomplished in two ways: by demonstrating that a general area of research is important, critical, interesting, problematic, relevant, or otherwise worthy of investigation and by introducing and reviewing key sources of prior research in that area to show where gaps exist or where prior research has been inadequate in addressing the research problem. The steps taken to achieve this would be:

• Step 1 -- Claiming importance of, and/or  [writing action = describing the research problem and providing evidence to support why the topic is important to study]
• Step 2 -- Making topic generalizations, and/or  [writing action = providing statements about the current state of knowledge, consensus, practice or description of phenomena]
• Step 3 -- Reviewing items of previous research  [writing action = synthesize prior research that further supports the need to study the research problem; this is not a literature review but more a reflection of key studies that have touched upon but perhaps not fully addressed the topic]

Move 2: Establishing a Niche [the problem] This action refers to making a clear and cogent argument that your particular piece of research is important and possesses value. This can be done by indicating a specific gap in previous research, by challenging a broadly accepted assumption, by raising a question, a hypothesis, or need, or by extending previous knowledge in some way. The steps taken to achieve this would be:

• Step 1a -- Counter-claiming, or  [writing action = introduce an opposing viewpoint or perspective or identify a gap in prior research that you believe has weakened or undermined the prevailing argument]
• Step 1b -- Indicating a gap, or  [writing action = develop the research problem around a gap or understudied area of the literature]
• Step 1c -- Question-raising, or  [writing action = similar to gap identification, this involves presenting key questions about the consequences of gaps in prior research that will be addressed by your study. For example, one could state, “Despite prior observations of voter behavior in local elections in urban Detroit, it remains unclear why do some single mothers choose to avoid....”]
• Step 1d -- Continuing a tradition  [writing action = extend prior research to expand upon or clarify a research problem. This is often signaled with logical connecting terminology, such as, “hence,” “therefore,” “consequently,” “thus” or language that indicates a need. For example, one could state, “Consequently, these factors need to examined in more detail....” or “Evidence suggests an interesting correlation, therefore, it is desirable to survey different respondents....”]

Move 3: Occupying the Niche [the solution] The final "move" is to announce the means by which your study will contribute new knowledge or new understanding in contrast to prior research on the topic. This is also where you describe the remaining organizational structure of the paper. The steps taken to achieve this would be:

• Step 1a -- Outlining purposes, or  [writing action = answering the “So What?” question. Explain in clear language the objectives of your study]
• Step 1b -- Announcing present research [writing action = describe the purpose of your study in terms of what the research is going to do or accomplish. In the social sciences, the “So What?” question still needs to addressed]
• Step 2 -- Announcing principle findings  [writing action = present a brief, general summary of key findings written, such as, “The findings indicate a need for...,” or “The research suggests four approaches to....”]
• Step 3 -- Indicating article structure  [writing action = state how the remainder of your paper is organized]

"Introductions." The Writing Lab and The OWL. Purdue University; Atai, Mahmood Reza. “Exploring Subdisciplinary Variations and Generic Structure of Applied Linguistics Research Article Introductions Using CARS Model.” The Journal of Applied Linguistics 2 (Fall 2009): 26-51; Chanel, Dana. "Research Article Introductions in Cultural Studies: A Genre Analysis Explorationn of Rhetorical Structure." The Journal of Teaching English for Specific and Academic Purposes 2 (2014): 1-20; Coffin, Caroline and Rupert Wegerif. “How to Write a Standard Research Article.” Inspiring Academic Practice at the University of Exeter; Kayfetz, Janet. "Academic Writing Workshop." University of California, Santa Barbara, Fall 2009; Pennington, Ken. "The Introduction Section: Creating a Research Space CARS Model." Language Centre, Helsinki University of Technology, 2005; Swales, John and Christine B. Feak. Academic Writing for Graduate Students: Essential Skills and Tasks . 2nd edition. Ann Arbor, MI: University of Michigan Press, 2004; Swales, John M. Genre Analysis: English in Academic and Research Settings . New York: Cambridge University Press, 1990; Chapter 5: Beginning Work. In Writing for Peer Reviewed Journals: Strategies for Getting Published . Pat Thomson and Barbara Kamler. (New York: Routledge, 2013), pp. 93-96.

Writing Tip

Swales showed that establishing a research niche [move 2] is often signaled by specific terminology that expresses a contrasting viewpoint, a critical evaluation of gaps in the literature, or a perceived weakness in prior research. The purpose of using these words is to draw a clear distinction between perceived deficiencies in previous studies and the research you are presenting that is intended to help resolve these deficiencies. Below is a table of common words used by authors.

NOTE: You may prefer not to adopt a negative stance in your writing when placing it within the context of prior research. In such cases, an alternative approach is to utilize a neutral, contrastive statement that expresses a new perspective without giving the appearance of trying to diminish the validity of other people's research. Examples of how to take a more neutral contrasting stance can be achieved in the following ways, with A representing the findings of prior research, B representing your research problem, and X representing one or more variables that have been investigated.

• Prior research has focused primarily on A , rather than on B ...
• Prior research into A can be beneficial but to rectify X , it is important to examine B ...
• These studies have placed an emphasis in the areas of A as opposed to describing B ...
• While prior studies have examined A , it may be preferable to contemplate the impact of B ...
• After consideration of A , it is important to also distinguish B ...
• The study of A has been thorough, but changing circumstances related to X support a need for examining [or revisiting] B ...
• Although research has been devoted to A , less attention has been paid to B ...
• Earlier research offers insights into the need for A , though consideration of B would be particularly helpful to...

In each of these example statements, what follows the ellipsis is the justification for designing a study that approaches the problem in the way that contrasts with prior research but which does not devalue its ongoing contributions to current knowledge and understanding.

Dretske, Fred I. “Contrastive Statements.” The Philosophical Review 81 (October 1972): 411-437; Kayfetz, Janet. "Academic Writing Workshop." University of California, Santa Barbara, Fall 2009; Pennington, Ken. "The Introduction Section: Creating a Research Space CARS Model." Language Centre, Helsinki University of Technology, 2005; Swales, John M. Genre Analysis: English in Academic and Research Settings . New York: Cambridge University Press, 1990

• << Previous: 4. The Introduction
• Next: Background Information >>
• Last Updated: May 25, 2024 4:09 PM
• URL: https://libguides.usc.edu/writingguide

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• My Account Login
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Open access
• Published: 26 May 2024

A double machine learning model for measuring the impact of the Made in China 2025 strategy on green economic growth

• Jie Yuan 1 &
• Shucheng Liu 2  

Scientific Reports volume  14 , Article number:  12026 ( 2024 ) Cite this article

1 Altmetric

Metrics details

• Environmental economics
• Environmental impact
• Sustainability

The transformation and upgrading of China’s manufacturing industry is supported by smart and green manufacturing, which have great potential to empower the nation’s green development. This study examines the impact of the Made in China 2025 industrial policy on urban green economic growth. This study applies the super-slacks-based measure model to measure cities’ green economic growth, using the double machine learning model, which overcomes the limitations of the linear setting of traditional causal inference models and maintains estimation accuracy under high-dimensional control variables, to conduct an empirical analysis based on panel data of 281 Chinese cities from 2006 to 2021. The results reveal that the Made in China 2025 strategy significantly drives urban green economic growth, and this finding holds after a series of robustness tests. A mechanism analysis indicates that the Made in China 2025 strategy promotes green economic growth through green technology progress, optimizing energy consumption structure, upgrading industrial structure, and strengthening environmental supervision. In addition, the policy has a stronger driving effect for cities with high manufacturing concentration, industrial intelligence, and digital finance development. This study provides valuable theoretical insights and policy implications for government planning to promote high-quality development through industrial policy.

Similar content being viewed by others

The influence of AI on the economic growth of different regions in China

The trilemma of sustainable industrial growth: evidence from a piloting OECD’s Green city

Green technology advancement, energy input share and carbon emission trend studies

Introduction.

Since China’s reform and opening up, the nation’s economy has experienced rapid growth for more than 40 years. According to the National Bureau of Statistics, China’s per capita GDP has grown from 385 yuan in 1978 to 85,698 yuan in 2022, with an average annual growth rate of 13.2%. However, obtaining this growth miracle has come at considerable social and environmental costs 1 . Current pollution prevention and control systems have not yet fundamentally alleviated the structural and root causes, impairing China’s economic progress toward high-quality development 2 . The report of the 20th National Congress of the Communist Party of China proposed that the future will be focused on promoting the formation of green modes of production and lifestyles and advancing the harmonious coexistence of human beings and nature. This indicates that transforming the mode of economic development is now the focus of the government’s attention, calling for advancing the practices of green growth aimed at energy conservation, emissions reduction, and sustainability while continuously increasing economic output 3 . As a result, identifying approaches to balance economic growth and green environmental protection in the development process and realize green economic growth has become an arduous challenge and a crucially significant concern for China’s high-quality economic development.

An intrinsic driver of urban economic growth, manufacturing is also the most energy-intensive and pollution-emitting industry, and greatly constrains urban green development 4 . China’s manufacturing industry urgently needs to advance the formation of a resource-saving and environmentally friendly industrial structure and manufacturing system through transformation and upgrading to support for green economic growth 5 . As an incentive-based industrial policy that emphasizes an innovation-driven and eco-civilized development path through the development and implementation of an intelligent and green manufacturing system, Made in China 2025 is a significant initiative for promoting the manufacturing industry’s transformation and upgrading, providing solid economic support for green economic growth 6 . To promote the effective implementation of this industrial policy, fully mobilize localities to explore new modes and paths of manufacturing development, and strengthen the urban manufacturing industry’s influential demonstration role in advancing the green transition, the Ministry of Industry and Information Technology of China successively launched 30 Made in China 2025 pilot cities (city clusters) in 2016 and 2017. The Pilot Demonstration Work Program for “Made in China 2025” Cities specified that significant results should be achieved within three to 5 years. After several years of implementation, has the Made in China 2025 pilot policy promoted green economic growth? What are the policy’s mechanisms of action? Are there differences in green economic growth effects in pilot cities based on various urban development characteristics? This study’s theoretical interpretation and empirical examination of the above questions can add to the growing body of related research and provide valuable insights for cities to comprehensively promote the transformation and upgrading of manufacturing industry to advance China’s high-quality development.

This study constructs an analytical framework at the theoretical level to analyze the impact of the Made in China 2025 strategy on urban green economic growth, and uses the double machine learning (ML) model to test its green economic growth effect. The contributions of this study are as follows. First, focusing on the field of urban green development, the study incorporates variables representing the potential economic and environmental effects of the Made in China 2025 policy into a unified framework to systematically examine the impact of the Made in China 2025 pilot policy on the urban green economic growth, providing a novel perspective for assessing the effects of industrial policies. Second, we investigate potential transmission mechanisms of the Made in China 2025 strategy affecting green economic growth from the perspectives of green technology advancement, energy consumption structure optimization, industrial structure upgrading, and environmental supervision strengthening, establishing a useful supplement for related research. Third, leveraging the advantage of ML algorithms in high-dimensional and nonparametric prediction, we apply a double ML model assess the policy effects of the Made in China 2025 strategy to avoid the “curse of dimensionality” and the inherent biases of traditional econometric models, and improve the credibility of our research conclusions.

The remainder of this paper is structured as follows. Section “ Literature review ” presents a literature review. Section “ Policy background and theoretical analysis ” details our theoretical analysis and research hypotheses. Section “ Empirical strategy ” introduces the model setting and variables selection for the study. Section “ Empirical result ” describes the findings of empirical testing and analyzes the results. Section “ Conclusion and policy recommendation ” summarizes our conclusions and associated policy implications.

Literature review

Measurement and influencing factors of green economic growth.

The Green Economy Report, which was published by the United Nations Environment Program in 2011, defined green economy development as facilitating more efficient use of natural resources and sustainable growth than traditional economic models, with a more active role in promoting combined economic development and environmental protection. The Organization for Economic Co-operation and Development defined green economic growth as promoting economic growth while ensuring that natural assets continue to provide environmental resources and services; a concept that is shared by a large number of institutions and scholars 7 , 8 , 9 . A considerable amount of research has assessed green economic growth, primarily using three approaches. First, single-factor indicators, such as sulfur dioxide emissions, carbon dioxide emissions intensity, and other quantified forms; however, this approach neglects the substitution of input factors such as capital and labor for the energy factor, which has certain limitations 5 , 10 . Second, studies have been based on neoclassical economic growth theory, incorporating factors of capital, technology, energy, and the environment, and constructing a green Solow model to measure green total factor productivity (GTFP) 11 , 12 . Third, based on neoclassical economic growth theory, some studies have simultaneously considered desirable and undesirable output, applying Shepard’s distance function, the directional distance function, and data envelopment analysis to measure GTFP 13 , 14 , 15 .

Economic growth is an extremely complex process, and green economic growth is also subject to a combination of multiple complex factors. Scholars have explored the influence mechanisms of green economic growth from perspectives of resource endowment 16 , technological innovation 17 , industrial structure 18 , human capital 19 , financial support 20 , government regulation 21 , and globalization 22 . In the field of policy effect assessment, previous studies have confirmed the green development effects of pilot policies such as innovative cities 23 , Broadband China 24 , smart cities 25 , and low-carbon cities 26 . However, few studies have focused on the impact of Made in China 2025 strategy on urban green economic growth and identified its underlying mechanisms.

The impact of Made in China 2025 strategy

Since the industrial policy of Made in China 2025 was proposed, scholars have predominantly focused on exploring its economic effects on technological innovation 27 , digital transformation 28 , and total factor productivity (TFP) 29 , while the potential environmental effects have been neglected. Chen et al. (2024) 30 found that Made in China 2025 promotes firm innovation through tax incentives, public subsidies, convenient financing, academic collaboration and talent incentives. Xu (2022) 31 point out that Made in China 2025 policy has the potential to substantially improve the green innovation of manufacturing enterprises, which can boost the green transformation and upgrading of China’s manufacturing industry. Li et al. (2024) 32 empirically investigates the positive effect of Made in China 2025 strategy on digital transformation and exploratory innovation in advanced manufacturing firms. Moreover, Liu and Liu (2023) 33 take “Made in China 2025” as an exogenous shock and find that the pilot policy has a positive impact on the high-quality development of enterprises and capital markets. Unfortunately, scholars have only discussed the impact of Made in China 2025 strategy on green development and environmental protection from a theoretical perspective and lack empirical analysis. Li (2018) 27 has compared Germany’s “Industry 4.0” and China’s “Made in China 2025”, and point out that “Made in China 2025” has clear goals, measures and sector focus. Its guiding principles are to enhance industrial capability through innovation-driven manufacturing, optimize the structure of Chinese industry, emphasize quality over quantity, train and attract talent, and achieve green manufacturing and environment. Therefore, it is necessary to systematically explore the impact and mechanism of Made in China 2025 strategy on urban green economic growth from both theoretical and empirical perspectives.

Causal inference based on double ML

The majority of previous studies have used traditional causal inference models to assess policy effects; however, some limitations are inherent to the application of these models. For example, the parallel trend test of the difference-in-differences model has stringent requirements on appropriate sample data; the synthetic control method can construct a virtual control group that conforms to the parallel trend, but it requires that the treatment group does not have the extreme value characteristics, and it is only applicable to “one-to-many” circumstances; and the propensity score matching (PSM) method involves a considerable amount of subjectivity in selecting matching variables. To compensate for the shortcomings of traditional models, scholars have started to explore the application of ML in the field of causal inference 34 , 35 , 36 , and double ML is a typical representative.

Double ML was formalized in 2018 34 , and the relevant research falls into two main categories. The first strand of literature applies double ML to assess causality concerning economic phenomena. Yang et al. (2020) 37 applied double ML using a gradient boosting algorithm to explore the average treatment effect of top-ranked audit firms, verifying its robustness compared with the PSM method. Zhang et al. (2022) 38 used double ML to quantify the impact of nighttime subway services on the nighttime economy, house prices, traffic accidents, and crime following the introduction of nighttime subway services in London in 2016. Farbmacher et al. (2022) 39 combined double ML with mediating effects analysis to assess the causal relationship between health insurance coverage and youth wellness and examine the indirect mechanisms of regular medical checkups, based on a national longitudinal health survey of youth conducted by the US Bureau of Labor Statistics. The second strand of literature has innovated methodological theory based on double ML. Chiang et al. (2022) 40 proposed an improved multidirectional cross-fitting double ML method, obtaining regression results for high-dimensional parameters while estimating robust standard errors for dual clustering, which can effectively adapt to multidirectional clustered sampled data and improve the validity of estimation results. Bodory et al. (2022) 41 combined dynamic analysis with double ML to measure the causal effects of multiple treatment variables over time, using weighted estimation to assess the dynamic treatment effects of specific subsamples, which enriched the dynamic quantitative extension of double ML.

In summary, previous research has conducted some useful investigations regarding the impact of socioeconomic policies on green development, but limited studies have explored the relationship between the Made in China 2025 strategy and green economic growth. This study takes 281 Chinese cities as the research object, and applies the super-slacks-based measure (SBM) model to quantify Chinese cities’ green economic growth from 2006 to 2021. Based on a quasi-natural experiment of Made in China 2025 pilot policy implementation, we use the double ML model to test the impact and transmission mechanisms of the policy on urban green economic growth. We also conduct a heterogeneity analysis of cities based on different levels of manufacturing agglomeration, industrial intelligence, and digital finance. This study applies a novel approach and provides practical insights for research in the field of industrial policy assessment.

Policy background and theoretical analysis

Policy background.

The Made in China 2025 strategy aims to encourage and support local exploration of new paths and models for the transformation and upgrading of the manufacturing industry, and to drive the improvement of manufacturing quality and efficiency in other regions through demonstration effects. According to the Notice of Creating “Made in China 2025” National Demonstration Zones issued by the State Council, municipalities directly under the central government, sub-provincial cities, and prefecture-level cities can apply for the creation of demonstration zones. Cities with proximity and high industrial correlation can jointly apply for urban agglomeration demonstration zones. The Notice clarifies the goals and requirements for creating demonstration zones in areas such as green manufacturing, clean production, and environmental protection. In 2016, Ningbo became the first Made in China 2025 pilot city, and a total of 12 cities and 4 city clusters were included in the list of Made in China 2025 national demonstration zones. In 2018, the State Council issued the Evaluation Guidelines for “Made in China 2025” National Demonstration Zone, which further clarified the evaluation process and indicator system of the demonstration zone. Seven primary indicators and 29 secondary indicators were formulated, including innovation driven, quality first, green development, structural optimization, talent oriented, organizational implementation, and coordinated development of urban agglomerations. This indicator system can evaluate the creation process and overall effectiveness of pilot cities (city clusters), which is beneficial for the promotion of successful experiences and models in demonstration areas.

Advancing green urban development is a complex systematic project that requires structural adjustment and technological and institutional changes in the socioeconomic system 42 . The Made in China 2025 strategy emphasizes the development and application of smart and green manufacturing systems, which can unblock technological bottlenecks in the manufacturing sector in terms of industrial production, energy consumption, and waste emissions, and empower cities to operate in a green manner. In addition, the Made in China 2025 policy established requirements for promoting technological innovation to advance energy saving and environmental protection, improving the rate of green energy use, transforming traditional industries, and strengthening environmental supervision. For pilot cities, green economy development requires the support of a full range of positive factors. Therefore, this study analyzes the mechanisms by which the Made in China 2025 strategy affects urban green economic growth from the four paths of green technology advancement, energy consumption structure optimization, industrial structure upgrading, and environmental supervision strengthening.

Theoretical analysis and research hypotheses

As noted, the Made in China 2025 strategy emphasizes strengthening the development and application of energy-saving and environmental protection technologies to advance cleaner production. Pilot cities are expected to prioritize the driving role of green innovation, promote clustering carriers and innovation platforms for high-tech enterprises, and guide the progress of enterprises’ implementation of green technology. Specifically, pilot cities are encouraged to optimize the innovation environment by increasing scientific and technological investment and financial subsidies in key areas such as smart manufacturing and high-end equipment and strengthening intellectual property protection to incentivize enterprises to conduct green research and development (R&D) activities. These activities subsequently promote the development of green innovation technologies and industrial transformation 43 . Furthermore, since quality human resources are a core aspect of science and technology innovation 44 , pilot cities prioritize the cultivation and attraction of talent to establish a stable human capital guarantee for enterprises’ ongoing green technology innovation, transform and upgrade the manufacturing industry, and advance green urban development. Green technology advances also contribute to urban green economic growth. First, green technology facilitates enterprises’ adoption of improved production equipment and innovation in green production technology, accelerating the change of production mode and driving the transformation from traditional crude production to a green and intensive approach 45 , promoting green urban development. Second, green technology advancement accelerates green innovations such as clean processes, pollution control technologies, and green equipment, and facilitates the effective supply of green products, taking full advantage of the benefits of green innovations 46 and forming a green economic development model to achieve urban green economic growth.

The Made in China 2025 pilot policy endeavors to continuously increase the rate of green and low-carbon energy use and reduce energy consumption. Under target constraints of energy saving and carbon control, pilot cities will accelerate the cultivation of high-tech industries in green environmental protection and high-end equipment manufacturing with advantages of sustainability and low resource inputs 47 to improve the energy consumption structure. Pilot cities also advance new energy sector development by promoting clean energy projects, subsidizing new energy consumption, and supporting green infrastructure construction and other policy measures 48 to optimize the energy consumption structure. Energy consumption structure optimization can have a profound impact on green economy development. Optimization means that available energy tends to be cleaner, which can reduce the manufacturing industry’s dependence on traditional fossil energy and raise the proportion of clean energy 49 , ultimately promoting green urban development. Pilot cities also provide financial subsidies for new energy technology R&D, which promotes the innovation and application of new technologies, energy-saving equipment, efficient resource use, and energy-saving diagnostics, which allow enterprises to save energy and reduce consumption and improve energy use efficiency and TFP 50 , advancing the growth of urban green economy.

At its core, the Made in China 2025 strategy promotes the transformation and upgrading of the manufacturing sector. Pilot cities guide and develop technology-intensive high-tech industries, adjust the proportion of traditional heavy industry, and improve the urban industrial structure. Pilot cities also implement the closure, merger, and transformation of pollution-intensive industries; guide the fission of professional advantages of manufacturing enterprises 51 ; and expand the establishment and development of service-oriented manufacturing and productive service industries to promote the evolution of the industrial structure toward rationalization and high-quality development 52 . Upgrading the industrial structure can also contribute to urban green economic growth. First, industrial structure upgrading promotes the transition from labor- and capital-intensive industries to knowledge- and technology-intensive industries, which optimizes the industrial distribution patterns of energy consumption and pollutant emissions and promotes the transformation of economic growth dynamics and pollutant emissions control, providing a new impetus for cities’ sustainable development 53 . Second, changes in industrial structure and scale can have a profound impact on the type and quantity of pollutant emissions. By introducing high-tech industries, service-oriented manufacturing, and production-oriented service industries, pilot cities can promote the transformation of pollution-intensive industries, promoting the adjustment and optimization of industrial structure and scale 54 to achieve the purpose of driving green urban development.

The Made in China 2025 strategy proposes strengthening green supervision and conducting green evaluations, establishing green development goals for the manufacturing sector in terms of emissions and consumption reduction and water conservation. This requires pilot cities to implement stringent environmental regulatory policies, such as higher energy efficiency and emissions reduction targets and sewage taxes and charges, strict penalties for excess emissions, and project review criteria 55 , which consolidates the effectiveness of green development. Under the framework of environmental authoritarianism, strengthening environmental supervision is a key measure for achieving pollution control and improving environmental quality 56 . Therefore, environmental regulatory enhancement can help cities achieve green development goals. First, according to the Porter hypothesis 57 , strong environmental regulatory policies encourage firms to internalize the external costs of environmental supervision, stimulate technological innovation, and accelerate R&D and application of green technologies. This response helps enterprises improve input–output efficiency, achieve synergy between increasing production and emissions reduction, partially or completely offset the “environmental compliance cost” from environmental supervision, and realize the innovation compensation effect 58 . Second, strict environmental regulations can effectively mitigate the complicity of local governments and enterprises in focusing on economic growth while neglecting environmental protection 59 , urging local governments to constrain enterprises’ emissions, which compels enterprises to conduct technological innovation and pursue low-carbon transformation, promoting urban green economic growth.

Based on the above analysis, we propose the mechanisms that promote green economic growth through Made in China 2025 strategy, as shown in Fig.  1 . The proposed research hypotheses are as follows:

Mechanism analysis of Made in China 2025 strategy and green economic growth.

Hypothesis 1

The Made in China 2025 strategy promotes urban green economic growth.

Hypothesis 2

The Made in China 2025 strategy drives urban green economic growth through four channels: promoting green technology advancement, optimizing energy consumption structure, upgrading industrial structure, and strengthening environmental supervision.

Empirical strategy

Double ml model.

Compared with traditional causal inference models, double ML has unique advantages in variable selection and model estimation, and is also more applicable to the research problem of this study. Green economic growth is a comprehensive indicator of transformative urban growth that is influenced by many socioeconomic factors. To ensure the accuracy of our policy effects estimation, the interference of other factors on urban green economic growth must be controlled as much as possible; however, when introducing high-dimensional control variables, traditional regression models may face the “curse of dimensionality” and multicollinearity, rendering the accuracy of the estimates questionable. Double ML uses ML and regularization algorithms to automatically filter the preselected set of high-dimensional control variables to obtain an effective set of control variables with higher prediction accuracy. This approach avoids the “curse of dimensionality” caused by redundant control variables and mitigates the estimation bias caused by the limited number of primary control variables 39 . Furthermore, nonlinear relationships between variables are the norm in the evolution of economic transition, and ordinary linear regression may suffer from model-setting bias producing estimates that lack robustness. Double ML effectively overcomes the problem of model misspecification by virtue of the advantages of ML algorithms in handling nonlinear data 37 . In addition, based on the idea of instrumental variable functions, two-stage predictive residual regression, and sample split fitting, double ML mitigates the “regularity bias” in ML estimation and ensures unbiased estimates of the treatment coefficients in small samples 60 .

Based on the analysis above, this study uses the double ML model to assess the policy effects of the Made in China 2025 strategy. The partial linear double ML model is constructed as follows:

where i denotes the city, t denotes the year, and Y it represents green economic growth. Policy it represents the policy variable of Made in China 2025, which is set as 1 if the pilot is implemented and 0 otherwise. θ 0 is the treatment coefficient that is the focus of this study. X it denotes the set of high-dimensional control variables, and the ML algorithm is used to estimate the specific functional form \(\hat{g}(X_{it} )\) . U it denotes the error term with a conditional mean of zero.

Direct estimation of Eqs. ( 1 ) and ( 2 ) yields the following estimate of the treatment coefficient:

where n denotes the sample size.

Notably, the double ML model uses a regularization algorithm to estimate the specific functional form \(\hat{g}(X_{it} )\) , which prevents the variance of the estimate from being too large, but inevitably introduces a “regularity bias,” resulting in a biased estimate. To speed up the convergence of the \(\hat{g}(X_{it} )\) directions so that the estimates of the treatment coefficients satisfy unbiasedness with small samples, the following auxiliary regression is constructed:

where \(m(X_{it} )\) is the regression function of the treatment variable on the high-dimensional control variable, using ML algorithms to estimate the specific functional form \(\hat{m}(X_{it} )\) . V it is the error term with a conditional mean of zero.

The specific operation process follows three stages. First, we use the ML algorithm to estimate the auxiliary regression \(\hat{m}(X_{it} )\) and take its residuals \(\hat{V}_{it} = Policy_{it} - \hat{m}(X_{it} )\) . Second, we use the ML algorithm to estimate \(\hat{g}(X_{it} )\) and change the form of the main regression \(Y_{it} - \hat{g}(X_{it} ) = \theta_{0} Policy_{it} + U_{it}\) . Finally, we regress \(\hat{V}_{it}\) as an instrumental variable for Policy it , obtaining unbiased estimates of the treatment coefficients as follows:

Variable selection

• Green economic growth

We apply the super-SBM model to measure urban green economic growth. The super-SBM model is compatible with radial and nonradial characteristics, which avoids inflated results due to ignoring slack variables and deflated results due to ignoring the linear relationships between elements, and can truly reflect relative efficiency 61 . The SBM model reflects the nature of green economic growth more accurately compared with other models, and has been widely adopted by scholars 62 . The expression of the super-SBM model considering undesirable output is as follows:

where x is the input variable; y and z are the desirable and undesirable output variables, respectively; m denotes the number of input indicators; s 1 and s 2 represent the respective number of indicators for desirable and undesirable outputs; k denotes the period of production; i , r , and t are the decision units for the inputs, desirable outputs, and undesirable outputs, respectively; \(s^{ - }\) , \(s^{ + }\) , and \(s^{z - }\) are the respective slack variables for the inputs, desirable outputs, and undesirable outputs; and γ is a vector of weights. A larger \(\rho_{SE}\) value indicates greater efficiency. If \(\rho_{SE}\)  = 1, the decision unit is effective; if \(\rho_{SE}\)  < 1, the decision unit is relatively ineffective, indicating a loss of efficiency.

Referencing Sarkodie et al. (2023) 63 , the evaluation index system of green economic growth is constructed as shown in Table 1 .

Made in China 2025 pilot policy

The list of Made in China 2025 pilot cities (city clusters) published by the Ministry of Industry and Information Technology of China in 2016 and 2017 is matched with the city-level data to obtain 30 treatment group cities and 251 control group cities. The policy dummy variable of Made in China 2025 is constructed by combining the implementation time of the pilot policies.

Mediating variables

This study also examines the transmission mechanism of the Made in China 2025 strategy affecting urban green economic growth from four perspectives, including green technology advancement, energy consumption structure optimization, industrial structure upgrading, and strengthening of environmental supervision. (1) The number of green patent applications is adopted to reflect green technology advancement. (2) Energy consumption structure is quantified using the share of urban domestic electricity consumption in total energy consumption. (3) The industrial structure upgrading index is calculated using the formula \(\sum\nolimits_{i = 1}^{3} {i \times (GDP_{i} /GDP)}\) , where GDP i denotes the added value of primary, secondary, or tertiary industries. (4) The frequency of words related to the environment in government work reports is the proxy for measuring the intensity of environmental supervision 64 .

Control variables

Double ML can effectively accommodate the case of high-dimensional control variables using regularization algorithms. To control for the effect of other urban characteristics on green economic growth, this study introduces the following 10 control variables. We measure education investment by the ratio of education expenditure to GDP. Technology investment is the ratio of technology expenditure to GDP. The study measures urbanization using the share of urban built-up land in the urban area. Internet penetration is the number of internet users as a share of the total population at the end of the year. We measure resident consumption by the total retail sales of consumer goods per capita. The unemployment rate is the ratio of the number of registered unemployed in urban areas at the end of the year to the total population at the end of the year. Financial scale is the ratio of the balance of deposits and loans of financial institutions at the end of the year to the GDP. Human capital is the natural logarithm of the number of students enrolled in elementary school, general secondary schools, and general tertiary institutions per 10,000 persons. Transportation infrastructure is the natural logarithm of road and rail freight traffic. Finally, openness to the outside world is reflected by the ratio of actual foreign investment to GDP. Quadratic terms for the control variables are also included in the regression analysis to improve the accuracy of the model’s fit. We introduce city and time fixed effects as individual and year dummy variables to avoid missing information on city and time dimensions.

Data sources

This study uses 281 Chinese cities spanning from 2006 to 2021 as the research sample. Data sources include the China City Statistical Yearbook, the China Economic and Social Development Statistics Database, and the EPS Global Statistics Database. We used the average annual growth rate method to fill the gaps for the minimal missing data. To remove the effects of price changes, all data measured in monetary units are deflated using the consumer price index for each province for the 2005 base period. The descriptive statistics of the data are presented in Table 2 .

Empirical result

Baseline results.

The sample split ratio of the double ML model is set to 1:4, and we use the Lasso algorithm to predict and solve the main and auxiliary regressions, presenting the results in Table 3 . Column (1) does not control for fixed effects or control variables, column (2) introduces city and time fixed effects, and columns (3) and (4) add control variables to columns (1) and (2), respectively. The regressions in columns (1) and (2) are highly significant, regardless of whether city and time fixed effects are controlled. Column (4) controls for city fixed effects, time fixed effects, and the primary term of the control variable over the full sample interval, revealing that the regression coefficient of the Made in China 2025 pilot policy on green economic growth is positive and significant at the 1% level, confirming that the Made in China 2025 strategy significantly promotes urban green economic growth. Column (5) further incorporates the quadratic terms of the control variables and the regression coefficients remain significantly positive with little change in values. Therefore, Hypothesis 1 is verified.

Parallel trend test

The prerequisite for the establishment of policy evaluation is that the development status of cities before the pilot policy is introduced is similar. Referring to Liu et al. (2022) 29 , we adopt a parallel trend test to verify the effectiveness of Made in China 2025 pilot policy. Figure  2 shows the result of parallel trend test. None of the coefficient estimates before the Made in China 2025 pilot policy are significant, indicating no significant difference between the level of green economic growth in pilot and nonpilot cities before implementing the policy, which passes the parallel trend test. The coefficient estimates for all periods after the policy implementation are significantly positive, indicating that the Made in China 2025 pilot policy can promote urban green economic growth.

Parallel trend test.

Robustness tests

Replace explained variable.

Referencing Oh and Heshmati (2010) 65 and Tone and Tsutsui (2010) 66 , we use the Malmquist–Luenberger index under global production technology conditions (GML) and an epsilon-based measure (EBM) model to recalculate urban green economic growth. The estimation results in columns (1) and (2) of Table 4 show that the estimated coefficients of the Made in China 2025 pilot policy remain significantly positive after replacing the explanatory variables, validating the robustness of the baseline findings.

Adjusting the research sample

Considering the large gaps in the manufacturing development base between different regions in China, using all cities in the regression analysis may lead to biased estimation 67 . Therefore, we exclude cities in seven provinces with a poor manufacturing development base (Gansu, Qinghai, Ningxia, Xinjiang, Tibet, Yunnan, and Guizhou) and four municipalities with a better development base (Beijing, Tianjin, Shanghai, and Chongqing). The other city samples are retained to rerun the regression analysis, and the results are presented in column (3) of Table 4 . The first batch of pilot cities of the Made in China 2025 strategy was released in 2016, and the second batch of pilot cities was released in 2017. To exclude the effect of point-in-time samples that are far from the time of policy promulgation, the regression is also rerun by restricting the study interval to the three years before and after the promulgation of the policy (2013–2020), and the results are presented in column (4) of Table 4 . The coefficients of the Made in China 2025 pilot policy effect on urban green economic growth decrease after adjusting for the city sample and the time interval, but remain significantly positive at the 1% level. This, once again, verifies the robustness of the benchmark regression results.

Eliminating the impact of potential policies

During the same period of the Made in China 2025 strategy implementation, urban green economy growth may be affected by other relevant policies. To ensure the accuracy of the policy effect estimates, four representative policy categories overlapping with the sample period, including smart cities, low-carbon cities, Broadband China, and innovative cities, were collected and organized. Referencing Zhang and Fan (2023) 25 , dummy variables for these policies are included in the benchmark regression model and the results are presented in Table 5 . The estimated coefficient of the Made in China 2025 pilot policy decreases after controlling for the effects of related policies, but remains significantly positive at the 1% level. This suggests that the positive impact of the Made in China 2025 strategy on urban green economic growth, although overestimated, does not affect the validity of the study’s findings.

Reset double ML model

To avoid the impact of the double ML model imparting bias on the conclusions, we conduct robustness tests by varying the sample splitting ratio, the ML algorithm, and the model estimation form. First, we change the sample split ratio of the double ML model from 1:4 to 3:7 and 1:3. Second, we replace the Lasso ML algorithm with random forest (RF), gradient boosting (GBT), and BP neural network (BNN). Third, we replace the partial linear model based on the dual ML with a more generalized interactive model, using the following main and auxiliary regressions for the analysis:

among them, the meanings of each variable are the same as Eqs. ( 1 ) and ( 2 ).

The estimated coefficients for the treatment effects are obtained from the interactive model as follows:

Table 6 presents the regression results after resetting the double ML model, revealing that the sample split ratio, ML algorithm, and the model estimation form in double ML model did not affect the conclusion that the Made in China 2025 strategy promotes urban green economic growth, and only alters the magnitude of the policy effect, once again validating the robustness of our conclusions.

Difference-in-differences model

To further verify the robustness of the estimation results, we use traditional econometric models for regression. Based on the difference-in-differences (DID) model, a synthetic difference-in-differences (SDID) model is constructed by combining the synthetic control method 68 . It constructs a composite control group with a similar pre-trend to the treatment group by linearly combining several individuals in the control group, and compares it with the treatment group 69 . Table 7 presents the regression results of traditional DID model and SDID model. The estimated coefficient of the Made in China 2025 policy remains significantly positive at the 1% level, which once again verifies the robustness of the study’s findings.

Mechanism verification

This section conducts mechanism verification from four perspectives of green technology advancement, energy consumption structure, industrial structure, and environmental supervision. The positive impacts of the Made in China 2025 strategy on green technology advancement, energy consumption structure optimization, industrial structure upgrading, and strengthening environmental supervision are empirically examined using a dual ML model (see Table A.1 in the Online Appendix for details). Referencing Farbmacher et al. (2022) 39 for causal mediating effect analysis of double ML (see the Appendix for details), we test the transmission mechanism of the Made in China 2025 strategy on green economic growth based on the Lasso algorithm, presenting the results in Table 8 . The findings show that the total effects under different mediating paths are all significantly positive at the 1% level, verifying that the Made in China 2025 strategy positively promotes urban green economic growth.

Mechanism of green technology advancement

The indirect effect of green technological innovation is significantly positive for both the treatment and control groups. After stripping out the path of green technology advancement, the direct effects of the treatment and control groups remain significantly positive, indicating that the increase in the level of green technological innovation brought about by the Made in China 2025 strategy significantly promotes urban green economic growth. The Made in China 2025 strategy proposes to strengthen financial and tax policy support, intellectual property protection, and talent training systems. Through the implementation of policy incentives, pilot cities have fostered the concentration of high-technology enterprises and scientific and technological talent cultivation, exerting a knowledge spillover effect that further promotes green technology advancement. At the same time, policy preferences have stimulated the demand for innovation in energy conservation and emissions reduction, which raises enterprises’ motivation to engage in green innovation activities. Green technology advancement helps cities achieve an intensive development model, bringing multiple dividends such as lower resource consumption, reduced pollution emissions, and improved production efficiency, which subsequently promotes green economic growth.

Mechanism of energy consumption structure

The indirect effect of energy consumption structure is significantly positive for the treatment and control groups, while the direct effect of the Made in China 2025 pilot policy on green economic growth remains significantly positive, indicating that the policy promotes urban green economic growth through energy consumption structure optimization. The policy encourages the introduction of clean energy into production processes, reducing pressure on enterprise performance and the cost of clean energy use, which helps enterprises to reduce traditional energy consumption that is dominated by coal and optimize the energy structure to promote green urban development.

Mechanism of industrial structure

The indirect effects of industrial structure on the treatment and control groups are significantly positive. After stripping out the path of industrial structure upgrading, the direct effects remain significantly positive for both groups, indicating that the Made in China 2025 strategy promotes urban green economic growth through industrial structure optimization. Deepening the restructuring of the manufacturing industry is a strategic task specified in Made in China 2025. Pilot cities focus on transforming and guiding the traditional manufacturing industry toward high-end, intelligent equipment upgrades and digital transformation, driving the regional industrial structure toward rationalization and advancement to achieve rational allocation of resources. Upgrading industrial structure is a prerequisite for cities to advance intensive growth and sustainable development. By assuming the roles of “resource converter” and “pollutant controller,” industrial upgrading can continue to release the dividends of industrial structure, optimize resource allocation, and improve production efficiency, establishing strong support for green economic growth.

Mechanism of environmental supervision

The treatment and control groups of environmental supervision has a positive indirect effect in the process of the Made in China 2025 pilot policy affecting green economic growth that is significant at the 1% level, affirming the transmission path of environmental supervision. The Made in China 2025 strategy states that energy consumption, material consumption, and pollutant emissions per unit of industrial added value in key industries should reach the world’s advanced level by 2025. This requires pilot cities to consolidate and propagate the effectiveness of green development by strengthening environmental supervision while promoting the manufacturing sector’s green development. Strengthening environmental supervision promotes enterprises’ energy saving and emissions reduction through innovative compensation effects, while restraining enterprises’ emissions behaviors by tightening environmental protection policies, promoting environmental legislation, and increasing penalties to advance green urban development. Based on the above analysis, Hypothesis 2 is validated.

Heterogeneity analysis

Heterogeneity of manufacturing agglomeration.

To reduce production and transaction costs and realize economies of scale and scope, the manufacturing industry tends to accelerate its growth through agglomeration, exerting an “oasis effect” 70 . Cities with a high degree of manufacturing agglomeration are prone to scale and knowledge spillover effects, which amplify the agglomeration functions of talent, capital, and technology, strengthening the effectiveness of pilot policies. Based on this, we use the locational entropy of manufacturing employees to measure the degree of urban manufacturing agglomeration in the year (2015) before policy implementation, using the median to divide the full sample of cities into high and low agglomeration groups. Columns (1) and (2) in Table 9 reveal that the Made in China 2025 pilot policy has a stronger effect in promoting green economic growth in cities with high manufacturing concentration compared to those with low concentration. The rationale for this outcome may be that cities with a high concentration of manufacturing industries has large population and developed economy, which is conducive to leveraging agglomeration economies and knowledge spillover effects. Meanwhile, they are able to offer greater policy concessions by virtue of economic scale, public services, infrastructure, and other advantages. These benefits can attract the clustering of productive services and the influx of innovative elements such as R&D talent, accelerating the transformation and upgrading of the manufacturing industry and the integration and advancement of green technologies, empowering the green urban development.

Heterogeneity of industrial intelligence

As a landmark technology for the integration of the new scientific and technological revolution with manufacturing, industrial intelligence is a new approach for advancing the green transformation of manufacturing production methods. Based on this, we use the density of industrial robot installations to measure the level of industrial intelligence in cities in the year (2015) prior to policy implementation 71 , using the median to classify the full sample of cities into high and low level groups. Columns (3) and (4) in Table 9 reveals that the Made in China 2025 pilot policy has a stronger driving effect on the green economic growth of highly industrial intelligent cities. The rationale for this outcome may be that with the accumulation of smart factories, technologies, and equipment, a high degree of industrial intelligence is more likely to leverage the green development effects of pilot policies. For cities where the development of industrial intelligence is in its infancy or has not yet begun, the cost of information and knowledge required for enterprises to undertake technological R&D is higher, reducing the motivation and incentive to conduct innovative activities, diminishing the pilot policy’s contribution to green economic growth.

Heterogeneity of digital finance

As a fusion of traditional finance and information technology, digital finance has a positive impact on the development of the manufacturing industry by virtue of its advantages of low financing thresholds, fast mobile payments, and wide range of services 72 . Cities with a high degree of digital finance development have abundant financial resources and well-developed financial infrastructure that provide enterprises with more complete financial services, with subsequent influence on the effects of pilot policies. We use the Peking University Digital Inclusive Finance Index to measure the level of digital financial development in cities in the year (2015) prior to policy implementation, using the median to divide the full sample of cities into high and low level groups. Columns (5) and (6) in Table 9 reveal that the Made in China 2025 pilot policy has a stronger driving effect on the green economic growth of cities with highly developed digital finance. The rationale for this outcome may be that cities with a high degree of digital finance development can fully leverage the universality of financial resources, provide financial supply for environmentally friendly and technology-intensive enterprises, effectively alleviate the mismatch of financial capital supply, and provide financial security for enterprises to conduct green technology R&D. Digital finance also makes enterprises’ information more transparent through a rich array of data access channels, which strengthens government pollution regulation and public environmental supervision and compels enterprises to engage in green technological innovation to promote green economic growth.

Conclusion and policy recommendation

Conclusions.

This study examines the impact of the Made in China 2025 strategy on urban green economic growth using the double ML model based on panel data for 281 Chinese cities from 2006 to 2021. The relevant research results are threefold. First, the Made in China 2025 strategy significantly promotes urban green economic growth; a conclusion that is supported by a series of robustness tests. Second, regarding mechanisms, the Made in China 2025 strategy promotes urban green economic growth through green technology advancement, energy consumption structure optimization, industrial structure upgrading, and strengthening of environmental supervision. Third, the heterogeneity analysis reveals that the Made in China 2025 strategy has a stronger driving effect on green economic growth for cities with a high concentration of manufacturing and high degrees of industrial intelligence and digital finance.

policy recommendations

We next propose specific policy recommendations based on our findings. First, policymakers should summarize the experience of building pilot cities and create a strategic model to advance the transformation and upgrading of the manufacturing industry to drive green urban development. The Made in China 2025 pilot policy effectively promotes green economic growth and highlights the significance of the transformation and upgrading of the manufacturing industry to empower sustainable urban development. The government should strengthen the model and publicize summaries of successful cases of manufacturing development in pilot cities to promote the experience of manufacturing transformation and upgrading by producing typical samples to guide the transformation of the manufacturing industry to intelligence and greening. Policies should endeavor to optimize the industrial structure and production system of the manufacturing industry to create a solid real economy support for high-quality urban development.

Second, policymakers should explore the multidimensional driving paths of urban green economic growth and actively stimulate the green development dividend of pilot policies by increasing support for enterprise-specific technologies, subsidizing R&D in areas of energy conservation and emissions reduction, consumption reduction and efficiency, recycling and pollution prevention, and promoting the progress of green technologies. The elimination of outdated production capacity must be accelerated and the low-carbon transformation of traditional industries must be targeted, while guiding the clustering of high-tech industries, optimizing cities’ industrial structure, and driving industrial structure upgrading. Policymakers can regulate enterprises’ production practices and enhance the effectiveness of environmental supervision by improving the system of environmental information disclosure and mechanisms of rewards and penalties for pollution discharge. In addition, strategies should consider cities’ own resource endowment, promote large-scale production of new energy, encourage enterprises to increase the proportion of clean energy use, and optimize the structure of energy consumption.

Third, policymakers should engage a combination of urban development characteristics and strategic policy implementation to empower green urban development, actively promoting optimization of manufacturing industry structure, and accelerating the development of high-technology industries under the guidance of policies and the market to promote high-quality development and agglomeration of the manufacturing industry. At the same time, the government should strive to popularize the industrial internet, promote the construction of smart factories and the application of smart equipment, increase investment in R&D to advance industrial intelligence, and actively cultivate new modes and forms of industrial intelligence. In addition, new infrastructure construction must be accelerated, the application of information technology must be strengthened, and digital financial services must be deepened to ease the financing constraints for enterprises conducting R&D on green technologies and to help cities develop in a high-quality manner.

Data availability

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

Cheng, K. & Liu, S. Does urbanization promote the urban–rural equalization of basic public services? Evidence from prefectural cities in China. Appl. Econ. 56 (29), 3445–3459. https://doi.org/10.1080/00036846.2023.2206625 (2023).

Article   Google Scholar  

Yin, X. & Xu, Z. An empirical analysis of the coupling and coordinative development of China’s green finance and economic growth. Resour. Policy 75 , 102476. https://doi.org/10.1016/j.resourpol.2021.102476 (2022).

Fernandes, C. I., Veiga, P. M., Ferreira, J. J. M. & Hughes, M. Green growth versus economic growth: Do sustainable technology transfer and innovations lead to an imperfect choice?. Bus. Strateg. Environ. 30 (4), 2021–2037. https://doi.org/10.1002/bse.2730 (2021).

Orsatti, G., Quatraro, F. & Pezzoni, M. The antecedents of green technologies: The role of team-level recombinant capabilities. Res. Policy 49 (3), 103919. https://doi.org/10.1016/j.respol.2019.103919 (2020).

Lin, B. & Zhou, Y. Measuring the green economic growth in China: Influencing factors and policy perspectives. Energy 241 (15), 122518. https://doi.org/10.1016/j.energy.2021.122518 (2022).

Fang, M. & Chang, C. L. Nexus between fiscal imbalances, green fiscal spending, and green economic growth: Empirical findings from E-7 economies. Econ. Change Restruct. 55 , 2423–2443. https://doi.org/10.1007/s10644-022-09392-6 (2022).

Qian, Y., Liu, J. & Forrest, J. Y. L. Impact of financial agglomeration on regional green economic growth: Evidence from China. J. Environ. Plan. Manag. 65 (9), 1611–1636. https://doi.org/10.1080/09640568.2021.1941811 (2022).

Awais, M., Afzal, A., Firdousi, S. & Hasnaoui, A. Is fintech the new path to sustainable resource utilisation and economic development?. Resour. Policy 81 , 103309. https://doi.org/10.1016/j.resourpol.2023.103309 (2023).

Ahmed, E. M. & Elfaki, K. E. Green technological progress implications on long-run sustainable economic growth. J. Knowl. Econ. https://doi.org/10.1007/s13132-023-01268-y (2023).

Shen, F. et al. The effect of economic growth target constraints on green technology innovation. J. Environ. Manag. 292 (15), 112765. https://doi.org/10.1016/j.jenvman.2021.112765 (2021).

Zhao, L. et al. Enhancing green economic recovery through green bonds financing and energy efficiency investments. Econ. Anal. Policy 76 , 488–501. https://doi.org/10.1016/j.eap.2022.08.019 (2022).

Ferreira, J. J. et al. Diverging or converging to a green world? Impact of green growth measures on countries’ economic performance. Environ. Dev. Sustain. https://doi.org/10.1007/s10668-023-02991-x (2023).

Article   PubMed   PubMed Central   Google Scholar  

Song, X., Zhou, Y. & Jia, W. How do economic openness and R&D investment affect green economic growth?—Evidence from China. Resour. Conserv. Recycl. 149 , 405–415. https://doi.org/10.1016/j.resconrec.2019.03.050 (2019).

Xu, J., She, S., Gao, P. & Sun, Y. Role of green finance in resource efficiency and green economic growth. Resour. Policy 81 , 103349 (2023).

Zhou, Y., Tian, L. & Yang, X. Schumpeterian endogenous growth model under green innovation and its enculturation effect. Energy Econ. 127 , 107109. https://doi.org/10.1016/j.eneco.2023.107109 (2023).

Luukkanen, J. et al. Resource efficiency and green economic sustainability transition evaluation of green growth productivity gap and governance challenges in Cambodia. Sustain. Dev. 27 (3), 312–320. https://doi.org/10.1002/sd.1902 (2019).

Wang, K., Umar, M., Akram, R. & Caglar, E. Is technological innovation making world “Greener”? An evidence from changing growth story of China. Technol. Forecast. Soc. Change 165 , 120516. https://doi.org/10.1016/j.techfore.2020.120516 (2021).

Talebzadehhosseini, S. & Garibay, I. The interaction effects of technological innovation and path-dependent economic growth on countries overall green growth performance. J. Clean. Prod. 333 (20), 130134. https://doi.org/10.1016/j.jclepro.2021.130134 (2022).

Ge, T., Li, C., Li, J. & Hao, X. Does neighboring green development benefit or suffer from local economic growth targets? Evidence from China. Econ. Modell. 120 , 106149. https://doi.org/10.1016/j.econmod.2022.106149 (2023).

Lin, B. & Zhu, J. Fiscal spending and green economic growth: Evidence from China. Energy Econ. 83 , 264–271. https://doi.org/10.1016/j.eneco.2019.07.010 (2019).

Sohail, M. T., Ullah, S. & Majeed, M. T. Effect of policy uncertainty on green growth in high-polluting economies. J. Clean. Prod. 380 (20), 135043. https://doi.org/10.1016/j.jclepro.2022.135043 (2022).

Sarwar, S. Impact of energy intensity, green economy and blue economy to achieve sustainable economic growth in GCC countries: Does Saudi Vision 2030 matters to GCC countries. Renew. Energy 191 , 30–46. https://doi.org/10.1016/j.renene.2022.03.122 (2022).

Park, J. & Page, G. W. Innovative green economy, urban economic performance and urban environments: An empirical analysis of US cities. Eur. Plann. Stud. 25 (5), 772–789. https://doi.org/10.1080/09654313.2017.1282078 (2017).

Feng, Y., Chen, Z. & Nie, C. The effect of broadband infrastructure construction on urban green innovation: Evidence from a quasi-natural experiment in China. Econ. Anal. Policy 77 , 581–598. https://doi.org/10.1016/j.eap.2022.12.020 (2023).

Zhang, X. & Fan, D. Collaborative emission reduction research on dual-pilot policies of the low-carbon city and smart city from the perspective of multiple innovations. Urban Climate 47 , 101364. https://doi.org/10.1016/j.uclim.2022.101364 (2023).

Cheng, J., Yi, J., Dai, S. & Xiong, Y. Can low-carbon city construction facilitate green growth? Evidence from China’s pilot low-carbon city initiative. J. Clean. Prod. 231 (10), 1158–1170. https://doi.org/10.1016/j.jclepro.2019.05.327 (2019).

Li, L. China’s manufacturing locus in 2025: With a comparison of “Made-in-China 2025” and “Industry 4.0”. Technol. Forecast. Soc. Change 135 , 66–74. https://doi.org/10.1016/j.techfore.2017.05.028 (2018).

Wang, J., Wu, H. & Chen, Y. Made in China 2025 and manufacturing strategy decisions with reverse QFD. Int. J. Prod. Econ. 224 , 107539. https://doi.org/10.1016/j.ijpe.2019.107539 (2020).

Liu, X., Megginson, W. L. & Xia, J. Industrial policy and asset prices: Evidence from the Made in China 2025 policy. J. Bank. Finance 142 , 106554. https://doi.org/10.1016/j.jbankfin.2022.106554 (2022).

Chen, K. et al. How does industrial policy experimentation influence innovation performance? A case of Made in China 2025. Humanit. Soc. Sci. Commun. 11 , 40. https://doi.org/10.1057/s41599-023-02497-x (2024).

Article   CAS   Google Scholar  

Xu, L. Towards green innovation by China’s industrial policy: Evidence from Made in China 2025. Front. Environ. Sci. 10 , 924250. https://doi.org/10.3389/fenvs.2022.924250 (2022).

Li, X., Han, H. & He, H. Advanced manufacturing firms’ digital transformation and exploratory innovation. Appl. Econ. Lett. https://doi.org/10.1080/13504851.2024.2305665 (2024).

Liu, G. & Liu, B. How digital technology improves the high-quality development of enterprises and capital markets: A liquidity perspective. Finance Res. Lett. 53 , 103683 (2023).

Chernozhukov, V. et al. Double/debiased machine learning for treatment and structural parameters. Econom. J. 21 (1), C1–C68. https://doi.org/10.1111/ectj.12097 (2018).

Article   MathSciNet   Google Scholar  

Athey, S., Tibshirani, J. & Wager, S. Generalized random forests. Ann. Stat. 47 (2), 1148–1178. https://doi.org/10.1214/18-AOS1709 (2019).

Knittel, C. R. & Stolper, S. Machine learning about treatment effect heterogeneity: The case of household energy use. AEA Pap. Proc. 111 , 440–444 (2021).

Yang, J., Chuang, H. & Kuan, C. Double machine learning with gradient boosting and its application to the Big N audit quality effect. J. Econom. 216 (1), 268–283. https://doi.org/10.1016/j.jeconom.2020.01.018 (2020).

Zhang, Y., Li, H. & Ren, G. Quantifying the social impacts of the London Night Tube with a double/debiased machine learning based difference-in-differences approach. Transp. Res. Part A Policy Pract. 163 , 288–303. https://doi.org/10.1016/j.tra.2022.07.015 (2022).

Farbmacher, H., Huber, M., Lafférs, L., Langen, H. & Spindler, M. Causal mediation analysis with double machine learning. Econom. J. 25 (2), 277–300. https://doi.org/10.1093/ectj/utac003 (2022).

Chiang, H., Kato, K., Ma, Y. & Sasaki, Y. Multiway cluster robust double/debiased machine learning. J. Bus. Econ. Stat. 40 (3), 1046–1056. https://doi.org/10.1080/07350015.2021.1895815 (2022).

Bodory, H., Huber, M. & Lafférs, L. Evaluating (weighted) dynamic treatment effects by double machine learning. Econom. J. 25 (3), 628–648. https://doi.org/10.1093/ectj/utac018 (2022).

Waheed, R., Sarwar, S. & Alsaggaf, M. I. Relevance of energy, green and blue factors to achieve sustainable economic growth: Empirical study of Saudi Arabia. Technol. Forecast. Soc. Change 187 , 122184. https://doi.org/10.1016/j.techfore.2022.122184 (2023).

Taskin, D., Vardar, G. & Okan, B. Does renewable energy promote green economic growth in OECD countries?. Sustain. Account. Manag. Policy J. 11 (4), 771–798. https://doi.org/10.1108/SAMPJ-04-2019-0192 (2020).

Ding, X. & Liu, X. Renewable energy development and transportation infrastructure matters for green economic growth? Empirical evidence from China. Econ. Anal. Policy 79 , 634–646. https://doi.org/10.1016/j.eap.2023.06.042 (2023).

Ferguson, P. The green economy agenda: Business as usual or transformational discourse?. Environ. Polit. 24 (1), 17–37. https://doi.org/10.1080/09644016.2014.919748 (2015).

Pan, D., Yu, Y., Hong, W. & Chen, S. Does campaign-style environmental regulation induce green economic growth? Evidence from China’s central environmental protection inspection policy. Energy Environ. https://doi.org/10.1177/0958305X231152483 (2023).

Zhang, Q., Qu, Y. & Zhan, L. Great transition and new pattern: Agriculture and rural area green development and its coordinated relationship with economic growth in China. J. Environ. Manag. 344 , 118563. https://doi.org/10.1016/j.jenvman.2023.118563 (2023).

Li, J., Dong, K. & Dong, X. Green energy as a new determinant of green growth in China: The role of green technological innovation. Energy Econ. 114 , 106260. https://doi.org/10.1016/j.eneco.2022.106260 (2022).

Herman, K. S. et al. A critical review of green growth indicators in G7 economies from 1990 to 2019. Sustain. Sci. 18 , 2589–2604. https://doi.org/10.1007/s11625-023-01397-y (2023).

Mura, M., Longo, M., Zanni, S. & Toschi, L. Exploring socio-economic externalities of development scenarios. An analysis of EU regions from 2008 to 2016. J. Environ. Manag. 332 , 117327. https://doi.org/10.1016/j.jenvman.2023.117327 (2023).

Huang, S. Do green financing and industrial structure matter for green economic recovery? Fresh empirical insights from Vietnam. Econ. Anal. Policy 75 , 61–73. https://doi.org/10.1016/j.eap.2022.04.010 (2022).

Li, J., Dong, X. & Dong, K. Is China’s green growth possible? The roles of green trade and green energy. Econ. Res.-Ekonomska Istraživanja 35 (1), 7084–7108. https://doi.org/10.1080/1331677X.2022.2058978 (2022).

Zhang, H. et al. Promoting eco-tourism for the green economic recovery in ASEAN. Econ. Change Restruct. 56 , 2021–2036. https://doi.org/10.1007/s10644-023-09492-x (2023).

Article   ADS   Google Scholar  

Ahmed, F., Kousar, S., Pervaiz, A. & Shabbir, A. Do institutional quality and financial development affect sustainable economic growth? Evidence from South Asian countries. Borsa Istanbul Rev. 22 (1), 189–196. https://doi.org/10.1016/j.bir.2021.03.005 (2022).

Yuan, S., Li, C., Wang, M., Wu, H. & Chang, L. A way toward green economic growth: Role of energy efficiency and fiscal incentive in China. Econ. Anal. Policy 79 , 599–609. https://doi.org/10.1016/j.eap.2023.06.004 (2023).

Capasso, M., Hansen, T., Heiberg, J., Klitkou, A. & Steen, M. Green growth – A synthesis of scientific findings. Technol. Forecast. Soc. Change 146 , 390–402. https://doi.org/10.1016/j.techfore.2019.06.013 (2019).

Wei, X., Ren, H., Ullah, S. & Bozkurt, C. Does environmental entrepreneurship play a role in sustainable green development? Evidence from emerging Asian economies. Econ. Res. Ekonomska Istraživanja 36 (1), 73–85. https://doi.org/10.1080/1331677X.2022.2067887 (2023).

Iqbal, K., Sarfraz, M. & Khurshid,. Exploring the role of information communication technology, trade, and foreign direct investment to promote sustainable economic growth: Evidence from Belt and Road Initiative economies. Sustain. Dev. 31 (3), 1526–1535. https://doi.org/10.1002/sd.2464 (2023).

Li, Y., Zhang, J. & Lyu, Y. Toward inclusive green growth for sustainable development: A new perspective of labor market distortion. Bus. Strategy Environ. 32 (6), 3927–3950. https://doi.org/10.1002/bse.3346 (2023).

Chernozhukov, V. et al. Double/Debiased/Neyman machine learning of treatment effects. Am. Econ. Rev. 107 (5), 261–265. https://doi.org/10.1257/aer.p20171038 (2017).

Chen, C. Super efficiencies or super inefficiencies? Insights from a joint computation model for slacks-based measures in DEA. Eur. J. Op. Res. 226 (2), 258–267. https://doi.org/10.1016/j.ejor.2012.10.031 (2013).

Article   ADS   MathSciNet   Google Scholar  

Tone, K., Chang, T. & Wu, C. Handling negative data in slacks-based measure data envelopment analysis models. Eur. J. Op. Res. 282 (3), 926–935 (2020).

Sarkodie, S. A., Owusu, P. A. & Taden, J. Comprehensive green growth indicators across countries and territories. Sci. Data 10 , 413. https://doi.org/10.1038/s41597-023-02319-4 (2023).

Jiang, Z., Wang, Z. & Lan, X. How environmental regulations affect corporate innovation? The coupling mechanism of mandatory rules and voluntary management. Technol. Soc. 65 , 101575 (2021).

Oh, D. H. & Heshmati, A. A sequential Malmquist-Luenberger productivity index: Environmentally sensitive productivity growth considering the progressive nature of technology. Energy Econ. 32 (6), 1345–1355. https://doi.org/10.1016/j.eneco.2010.09.003 (2010).

Tone, K. & Tsutsui, M. An epsilon-based measure of efficiency in DEA - A third pole of technical efficiency. Eur. J. Op. Res. 207 (3), 1554–1563. https://doi.org/10.1016/j.ejor.2010.07.014 (2010).

Lv, C., Song, J. & Lee, C. Can digital finance narrow the regional disparities in the quality of economic growth? Evidence from China. Econ. Anal. Policy 76 , 502–521. https://doi.org/10.1016/j.eap.2022.08.022 (2022).

Arkhangelsky, D., Athey, S., Hirshberg, D. A., Imbens, G. W. & Wager, S. Synthetic difference-in-differences. Am. Econ. Rev. 111 (12), 4088–4118 (2021).

Abadie, A., Diamond, A. & Hainmueller, J. Synthetic control methods for comparative case studies: Estimating the effect of California’s tobacco control program. J. Am. Stat. Assoc. 105 (490), 493–505 (2010).

Article   MathSciNet   CAS   Google Scholar  

Fang, J., Tang, X., Xie, R. & Han, F. The effect of manufacturing agglomerations on smog pollution. Struct. Change Econ. Dyn. 54 , 92–101. https://doi.org/10.1016/j.strueco.2020.04.003 (2020).

Yang, S. & Liu, F. Impact of industrial intelligence on green total factor productivity: The indispensability of the environmental system. Ecol. Econ. 216 , 108021. https://doi.org/10.1016/j.ecolecon.2023.108021 (2024).

Zhang, P., Wang, Y., Wang, R. & Wang, T. Digital finance and corporate innovation: Evidence from China. Appl. Econ. 56 (5), 615–638. https://doi.org/10.1080/00036846.2023.2169242 (2024).

Download references

Acknowledgements

This work was supported by the Major Program of National Fund of Philosophy and Social Science of China (20&ZD133).

Author information

Authors and affiliations.

School of Public Finance and Taxation, Zhejiang University of Finance and Economics, Hangzhou, 310018, China

School of Economics, Xiamen University, Xiamen, 361005, China

Shucheng Liu

You can also search for this author in PubMed   Google Scholar

Contributions

J.Y.: Methodology, Validation. S.L.: Writing - Reviewing and Editing, Validation, Methodology. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Shucheng Liu .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary information., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Yuan, J., Liu, S. A double machine learning model for measuring the impact of the Made in China 2025 strategy on green economic growth. Sci Rep 14 , 12026 (2024). https://doi.org/10.1038/s41598-024-62916-0

Download citation

Received : 05 March 2024

Accepted : 22 May 2024

Published : 26 May 2024

DOI : https://doi.org/10.1038/s41598-024-62916-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Made in China 2025
• Industrial policy
• Double machine learning
• Causal inference

By submitting a comment you agree to abide by our Terms and Community Guidelines . If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing: Anthropocene newsletter — what matters in anthropocene research, free to your inbox weekly.

An official website of the United States government, Department of Justice.

Here's how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Model Programs Guide

Literature Reviews

Implementation Guides

Model Programs Guide Literature Reviews provide practitioners and policymakers with relevant research and evaluations for several youth-related topics and programs.  

• Afterschool Programs  (2010)
• Alternatives to Detention and Confinement  (2024)
• Age Boundaries of the Juvenile Justice System (2024)
• Arts-Based Programs and Arts Therapies for At-Risk, Justice-Involved, and Traumatized Youths  (2021)
• Bullying and Cyberbullying  (2023)
• Child Labor Trafficking  (2016)
• Children Exposed to Violence  (2022)
• Cognitive Behavioral Treatment  (2010)
• Commercial Sexual Exploitation of Children and Sex Trafficking  (2014)
• Community- and Problem-Oriented Policing  (2023)
• Community Awareness/Mobilization  (2009)
• Conflict Resolution/Interpersonal Skills  (2011)
• Day Treatment  (2011)
• Diversion from Formal Juvenile Court Processing  (2017)
• Drug Court  (2010)
• Education for Youth Under Formal Supervision of the Juvenile Justice System  (2019) 
• Family Drug Courts  (2016)
• Family Engagement in Juvenile Justice  (2018)
• Family Therapy  (2014)
• Formal, Post-Adjudication Juvenile Probation Services  (2017)
• Gang Prevention  (2014)
• Girls in the Juvenile Justice System (2023)
• Group Homes  (2008)
• Gun Court  (2010)
• Gun Violence and Youth/Young Adults (2024)
• Hate Crimes and Youth  (2022) 
• Home Confinement and Electronic Monitoring  (2014)
• Implementation Science  (2015)
• Indigent Defense for Juveniles  (2018)
• Interactions between Youth and Law Enforcement  (2018) 
• Intersection between Mental Health and the Juvenile Justice System  (2017)
• Intersection of Juvenile Justice and Child Welfare Systems  (2021)
• Juvenile Reentry  (2017)
• LGBTQ Youths in the Juvenile Justice System  (2014)
• Mental Health Court  (2010)
• Parent Training  (2010)
• Positive Youth Development  (2014)
• Protective Factors Against Delinquency  (2015)
• Racial and Ethnic Disparity in Juvenile Justice Processing  (2022)
• Reentry Court  (2010)
• Residential Programs  (2019)
• Restorative Justice for Juveniles  (2021)
• Risk Factors for Delinquency  (2015)
• Risk/Needs Assessments for Youths  (2015)
• School/Classroom Environment  (2000)
• Status Offenders  (2016)
• Substance Use Prevention Programs  (2022)
• Substance Use Treatment Programs  (2023)
• Teen Dating Violence  (2022)
• Teen/Youth Court  (2010)
• Tribal Youth in the Juvenile Justice System  (2016)
• Truancy Prevention  (2010)
• Vocational/Job Training  (2010)
• Wraparound Process  (2014)
• Youth in the Adult Criminal Justice System (2024)
• Youth Mentoring and Delinquency Prevention  (2019)
• Youths with Intellectual and Developmental Disabilities in the Juvenile Justice System  (2017)

A Literature Review Based Insight into Agile Mindset Through a Lens of Six C’s Grounded Theory Model

• Conference paper
• First Online: 28 May 2024
• Cite this conference paper

• Necmettin Ozkan   ORCID: orcid.org/0000-0001-9876-8728 9 ,
• Karen Eilers   ORCID: orcid.org/0000-0002-4992-3522 10 &
• Mehmet Şahin Gök   ORCID: orcid.org/0000-0003-4072-2641 9  

Part of the book series: Lecture Notes in Business Information Processing ((volume 504))

Included in the following conference series:

• Special Sessions in the Information Technology for Business and Society Track of the Conference on Computer Science and Intelligence Systems
• Conference on Information Systems Management

Agile approaches originated in software development. Due to their various advantages, they are being applied to many different industries and functions. Meanwhile, organizations face extreme challenges and obstacles in their Agile transformations and implementations. One of the major factors causing these challenges and obstacles relies on people related factors. As one of the critical human factors in Agile, Agile Mindset impacts all facets of behaviors and activities. Nevertheless, Agile Mindset-related matters are disregarded by several organizations and literature that focus on concrete and industrialized products of Agile. Motivated by this gap, we aimed to provide a thorough investigation of the research on Agile Mindset-related literature and modeled the obtained results by using Glaser’s Six C’s Grounded Theory coding family. Therefore, we aimed to provide a comprehensive insight into the Agile Mindset construct, which is new yet essential, required but hard to acquire, challenging to observe but important to notice, and cheap to disregard but at an excessive cost.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Ahuvia, A.: Traditional, interpretive, and reception based content analyses: Improving the ability of content analysis to address issues of pragmatic and theoretical concern. Soc. Indic. Res. 54 , 139–172 (2001). https://doi.org/10.1023/A:1011087813505

Article   Google Scholar  

Alexander, C.: Beyond the Agile manifesto: epoch of the team. Crosstalk: J. Defense Softw. Eng. 29 (4) (2016)

Google Scholar  

Asseraf, Y., Gnizy, I.: Translating strategy into action: the importance of an Agile mindset and Agile slack in international business. Int. Bus. Rev. 31 (6), 102036 (2022). https://doi.org/10.1016/j.ibusrev.2022.102036

Beck, K., et al.: The Agile manifesto (2001). https://agilemanifesto.org/

Benaben, F., Vernadat, F.B.: Information System agility to support collaborative organisations. Enterp Inf. Syst. 11 (4), 470–473 (2017). https://doi.org/10.1080/17517575.2016.1269367

Bider, I., Söderberg, O.: Moving towards agility in an ordered fashion. In: Hammoudi, S., Maciaszek, L.A., Missikoff, M.M., Camp, O., Cordeiro, J. (eds.) ICEIS 2016. LNBIP, vol. 291, pp. 175–199. Springer, Cham (2017). https://doi.org/10.1007/978-3-319-62386-3_9

Chapter   Google Scholar  

Calafat, A.L.M., Mas, A., Pacheco, M.: Fake Agile: what is it and how to avoid it? IT Prof. 24 (2), 69–73 (2022). https://doi.org/10.1109/mitp.2021.3139826

Cambridge Dictionary: Meaning of mindset in English (2023). https://dictionary.cambridge.org/dictionary/english/mindset . Accessed 16 May 2023

Cockburn, A., Highsmith, J.: Agile software development, the people factor. Computer 34 (11), 131–133 (2001). https://doi.org/10.1109/2.963450

Conboy, K., Coyle, S., Wang, X., Pikkarainen, M.: People over process: key challenges in Agile development. IEEE Softw. 28 (4), 48–57 (2011). https://doi.org/10.1109/ms.2010.132

Cooke-Davies, T.: The real success factors on projects. Int. J. Proj. Manage. 20 (3), 185–190 (2002). https://doi.org/10.1016/S0263-7863(01)00067-9

Corbin, J.M., Strauss, A.: Grounded theory research: procedures, canons, and evaluative criteria. Qual. Sociol. 13 (1), 3–21 (1990). https://doi.org/10.1515/zfsoz-1990-0602

Crnogaj, K., Tominc, P., Rožman, M.A.: Conceptual model of developing an Agile work environment. Sustainability 14 (22), 14807 (2022). https://doi.org/10.3390/su142214807

Çelik, H., Başer, N.B., Kılıç Memur, H.N.: Nitel veri analizi ve temel ilkeleri. J. Qual. Res. Educ. 8 (1), 379–406 (2020). https://doi.org/10.14689/issn.2148-2624.1.8c.1s.16m . (in Turkish)

Denning, S.: What’s missing in the Agile manifesto: mindset. Forbes (2016). https://www.forbes.com/sites/stevedenning/2016/06/07/the-key-missingingredient-in-the-agile-manifesto-mindset

Dikert, K., Paasivaara, M., Lassenius, C.: Challenges and success factors for large-scale Agile transformations: a systematic literature review. J. Syst. Softw. 119 , 87–108 (2016). https://doi.org/10.1016/j.jss.2016.06.013

Durbin, M., Niederman, F.: Bringing templates to life: overcoming obstacles to the organizational implementation of Agile methods. Int. J. Inf. Syst. Proj. Manage. 9 (3), 5–18 (2021). https://doi.org/10.12821/ijispm090301

Dweck, C.S.: Mindset: The New Psychology of Success. Random House Publishing Group, New York (2006). ISBN 978-0345472328

Eilers, K., Peters, C., Leimeister, J.M.: Why the Agile mindset matters. Technol. Forecast. Soc. Change 179 , 121650 (2022). https://doi.org/10.1016/j.techfore.2022.121650

Fang, T.: Yin Yang: a new perspective on culture. Manag. Organ. Rev. 8 (1), 25–50 (2012). https://doi.org/10.1111/j.1740-8784.2011.00221.x

Fronza, I., Wang, X.: Revealing Agile mindset using LEGO® SERIOUS PLAY®: experience from an online Agile training project. In: 34th International Conference on Software Engineering and Knowledge Engineering, pp. 428–433 (2022). https://doi.org/10.18293/seke2022-117

Geffers, K., Bretschneider, U., Eilers, K., Oeste-Reiß, S.: Leading teams in today’s dynamic organizations: the core characteristics of Agile leadership. In: Hawaii International Conference on System Sciences (HICSS) (2024). ISBN 978-0-9981331-7-1

Gelmis, A., Ozkan, N., Ahmad, A.J., Guler, M.G.: Perspectives on the sustainability and future trajectory of Agile. Systems, software and services process improvement. In: 29th European Conference, EuroSPI 2022, pp. 443–458 (2022). https://doi.org/10.1007/978-3-031-15559-8_32

Glaser, B.G.: Theoretical sensitivity. The Sociology Press, Mill Valley (1978). ISBN 978-1884156014

Gouda, G.K., Tiwari, B.: Ambidextrous leadership: a distinct pathway to build talent agility and engagement. Hum. Resour. Dev. Int. 1–9 (2022). https://doi.org/10.1080/13678868.2022.2163101

Gregory, P., et al.: Onboarding: how newcomers integrate into an Agile project team. In: Agile Processes in Software Engineering and Extreme Programming: 21st International Conference on Agile Software Development, XP 2020, pp. 20–36 (2020). https://doi.org/10.1007/978-3-030-49392-9_2

Gregory, P., Barroca, L., Sharp, H., Deshpande, A., Taylor, K.: The challenges that challenge: engaging with Agile practitioners’ concerns. Inf. Softw. Technol. 77 , 92–104 (2016). https://doi.org/10.1016/j.infsof.2016.04.006

Hajjdiab, H., Taleb, A.: Adopting Agile software development: issues and challenges. IJMVSC 2 (3), 1–10 (2011). https://doi.org/10.5121/ijmvsc.2011.2301

Hoda, R., Noble, J., Marshall, S.: Balancing acts: walking the Agile tightrope. In: ICSE Workshop on Cooperative and Human Aspects of Software Engineering, pp. 5–12 (2010). https://doi.org/10.1145/1833310.1833312

Hoda, R., Noble, J., Marshall, S.: The impact of inadequate customer collaboration on self-organizing Agile teams. Inf. Softw. Technol. 53 (5), 521–534 (2011). https://doi.org/10.1016/j.infsof.2010.10.009

Hohl, P., Klünder, J., van Bennekum, A.: Back to the future: origins and directions of the Agile Manifesto—views of the originators. J. Softw. Eng. Res. Dev. 6 (1) (2010). https://doi.org/10.1186/s40411-018-0059-z

Joskowski, A., Przybyłek, A., Marcinkowski, B.: Scaling scrum with a customized Nexus framework: a report from a joint industry-academia research project. Softw. Pract. Exp. (2023). https://doi.org/10.1002/spe.3201

Kitchenham, B., et al.: Systematic literature reviews in software engineering–a systematic literature review. Inf. Softw. Technol. 51 (1), 7–15 (2009). https://doi.org/10.1016/j.infsof.2008.09.009

Klünder, J., Trommer, F., Prenner, N.: How Agile coaches create an Agile mindset in development teams: insights from an interview study. J. Softw.: Evol. Process 34 (12), e2491 (2022). https://doi.org/10.1002/smr.2491

Kramer, R.: From skillset to mindset: a new paradigm for leader development. Public Adm. Issues, 5 , 26–45 (2016). https://doi.org/10.17323/1999-5431-2016-0-5-26-45

Kuhrmann, M., et al.: What makes Agile software development Agile. IEEE Trans. Softw. Eng. (2021). https://doi.org/10.1109/TSE.2021.3099532

Leeuw, R.T., Joseph, N.: Reciprocal influence between digital emotional intelligence and Agile mindset in an Agile environment. Adm. Sci. 13 (11), 228 (2023). https://doi.org/10.3390/admsci13110228

Lindskog, C., Netz, J.: Balancing between stability and change in Agile teams. Int. J. Manag. Proj. Bus. 14 (7), 1529–1554 (2021). https://doi.org/10.1108/ijmpb-12-2020-0366

Macmillan Dictionary: Definition of mindset in English (2023). https://www.macmillandictionary.com/dictionary/british/mindset . Accessed 16 May 2023

Masood, Z., Hoda, R., Blincoe, K.: Real world scrum a grounded theory of variations in practice. IEEE Trans. Softw. Eng. 48 (5), 1579–1591 (2020). https://doi.org/10.1109/tse.2020.3025317

Melo, C.O., Santana, C., Kon, F.: Developers motivation in Agile teams. In: 38th Euromicro Conference on Software Engineering and Advanced Applications (2012). https://doi.org/10.1109/seaa.2012.45

Mikhieieva, O., Baumgartner, R., Stephan, K., Lipilina, E.: Agile mindset competencies for project leaders. In: IEEE European Technology and Engineering Management Summit (E-TEMS), pp. 208–213. IEEE (2022). https://doi.org/10.1109/e-tems53558.2022.9944538

Miler, J., Gaida, P.: Identification of the Agile mindset and its comparison to the competencies of selected Agile roles. In: Przybyłek, A., Morales-Trujillo, M.E. (eds.) LASD/MIDI -2019. LNBIP, vol. 376, pp. 41–62. Springer, Cham (2020). https://doi.org/10.1007/978-3-030-37534-8_3

Miler, J., Gaida, P.: On the Agile mindset of an effective team—an industrial opinion survey. In: Federated Conference on Computer Science and Information Systems (FEDCSIS) (2019). https://doi.org/10.15439/2019f198

Mordi, A., Schoop, M.: Making it tangible – creating a definition of Agile mindset. In: 28th Conference on Information Systems (ECIS2020) (2020)

Mordi, A., Schoop, M.: Scaling with an Agile mindset-a conceptual approach to large-scale Agile. In: AMCIS (2021)

Muduli, A., Pandya, G.: Psychological empowerment and workforce agility. Psychol. Stud. 63 (3), 276–285 (2018). https://doi.org/10.1007/s12646-018-0456-8

Ozkan, N., Gok, M.S.: Definition synthesis of agility in software development: comprehensive review of theory to practice. Int. J. Mod. Educ. Comput. Sci. 14 (3) (2022). https://doi.org/10.5815/ijmecs.2022.03.02

Ozkan, N., Gok, M.S.: Investigation of Agile mindset elements by using literature review for a better understanding of agility. In: Turkish National Software Engineering Symposium (UYMS), pp. 1–6. IEEE (2020). https://doi.org/10.1109/uyms50627.2020.9247073

Ozkan, N., Erdogan, T.G., Gök, M.Ş.: A bibliometric analysis of Agile software development publications. In: 3rd International Informatics and Software Engineering Conference (IISEC), pp. 1–6. IEEE (2022). https://doi.org/10.1109/iisec56263.2022.9998291

Ozkan, N., Gök, M.Ş., Köse, B.Ö.: Towards a better understanding of Agile mindset by using principles of Agile methods. In: 15th Conference on Computer Science and Information Systems (FedCSIS), pp. 721–730. IEEE (2020). https://doi.org/10.15439/2020f46

Ozkan, N., Eilers, K., Gök, M.Ş.: Back to the essential: a literature-based review on Agile mindset. In: 2023 18th Conference on Computer Science and Intelligence Systems (FedCSIS), pp. 201–211. IEEE (2023). https://doi.org/10.15439/2023f6360

Petermann, M.K., Zacher, H.: Agility in the workplace: conceptual analysis, contributing factors, and practical examples. Ind. Organ. Psychol. 13 (4), 599–609 (2020). https://doi.org/10.1017/iop.2020.106

Ryskowski, J.: Revealing the unobvious social norms and traditional development fantasies that impede Agile adoption. In: 2018 International Conference on Computational Science and Computational Intelligence (CSCI), pp. 829–834. IEEE (2018). https://doi.org/10.1109/aero.2019.8741796

Sathe, C.A., Panse, C.: Analyzing the impact of Agile mindset adoption on software development teams productivity during COVID-19. J. Adv. Manage. Res. (2022). https://doi.org/10.1108/jamr-05-2022-0088

Senapathi, M., Srinivasan, A.: Sustained Agile usage: a systematic literature review. In: 17th International Conference on Evaluation and Assessment in Software Engineering, pp. 119–124 (2013). https://doi.org/10.1145/2460999.2461016

Sommer, A.F.: Agile transformation at LEGO group: implementing Agile methods in multiple departments changed not only processes but also employees’ behavior and mindset. Res. Technol. Manag. 62 (5), 20–29 (2019). https://doi.org/10.1080/08956308.2019.1638486

Thangasamy, S.: Lessons learned in transforming from traditional to Agile development. J. Comput. Sci. 8 (3), 389–392 (2012). https://doi.org/10.3844/jcssp.2012.389.392

Van Manen, H., van Vliet, H.: Organization-wide Agile expansion requires an organization-wide Agile mindset. In: Jedlitschka, A., Kuvaja, P., Kuhrmann, M., Männistö, T., Münch, J., Raatikainen, M. (eds.) PROFES 2014. LNCS, vol. 8892, pp. 48–62. Springer, Cham (2014). https://doi.org/10.1007/978-3-319-13835-0_4

Wang, Z., Pan, S.L., Ouyang, T.H., Chou, T.C.: Achieving IT-enabled enterprise agility in China: an IT organizational identity perspective. IEEE Trans. Eng. Manage. 61 (1), 182–195 (2013). https://doi.org/10.1109/tem.2013.2259494

Weinberg, M.G.: Secrets of consulting: Dorset House (1985). ISBN-13: 978-0932633019

Yang, H., Antunes, P., Tate, M.: Towards a unified conceptualisation of IS agility. In: IEEE 20th International Conference on Computer Supported Cooperative Work in Design (CSCWD), pp. 269–275 (2016). https://doi.org/10.1109/cscwd.2016.7566000

Zablah, A.R., Brown, B.P., Donthu, N.: The relative importance of brands in modified rebuy purchase situations. Int. J. Res. Mark. 27 (3), 248–260 (2010). https://doi.org/10.1016/j.ijresmar.2010.02.005

Ziegler, A., Peisl, T., Ates, A.: The future of Agile coaches: do large companies need a standardized Agile coach certification and what are the alternatives? In: Yilmaz, M., Clarke, P., Riel, A., Messnarz, R. (eds.) EuroSPI 2023. CCIS, vol. 1891, pp. 3–15. Springer, Cham (2023). https://doi.org/10.1007/978-3-031-42310-9_1

Download references

Author information

Authors and affiliations.

Gebze Technical University, Kocaeli, Turkey

Necmettin Ozkan & Mehmet Şahin Gök

Institute for Transformation, Hamburg, Germany

Karen Eilers

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Necmettin Ozkan .

Editor information

Editors and affiliations.

University of Economics in Katowice, Katowice, Poland

University of Warsaw, Warsaw, Poland

Witold Chmielarz

University of Szczecin, Szczecin, Poland

Jarosław Wątróbski

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this paper

Cite this paper.

Ozkan, N., Eilers, K., Gök, M.Ş. (2024). A Literature Review Based Insight into Agile Mindset Through a Lens of Six C’s Grounded Theory Model. In: Ziemba, E., Chmielarz, W., Wątróbski, J. (eds) Information Technology for Management: Solving Social and Business Problems through IT. FedCSIS-ITBS ISM 2023 2023. Lecture Notes in Business Information Processing, vol 504. Springer, Cham. https://doi.org/10.1007/978-3-031-61657-0_13

Download citation

DOI : https://doi.org/10.1007/978-3-031-61657-0_13

Published : 28 May 2024

Publisher Name : Springer, Cham

Print ISBN : 978-3-031-61656-3

Online ISBN : 978-3-031-61657-0

eBook Packages : Computer Science Computer Science (R0)

Share this paper

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

A bibliometric analysis literature review of the common knowledge construction model (CKCM) based instruction of sustainable development

[email protected]

• Split-Screen
• Article contents
• Figures & tables
• Supplementary Data
• Peer Review
• Open the PDF for in another window
• Reprints and Permissions
• Cite Icon Cite
• Search Site

Hana Triana , M. Syarif Sumantri , Firmanul Catur Wibowo; A bibliometric analysis literature review of the common knowledge construction model (CKCM) based instruction of sustainable development. AIP Conf. Proc. 24 May 2024; 3116 (1): 080003. https://doi.org/10.1063/5.0210178

Download citation file:

• Ris (Zotero)
• Reference Manager

In the Primary Years Program, science learning is the exploration of the natural world and the relationships among them. The students lead to an appreciation and awareness of the world from a science perspective. It encourages students’ curiosity and understanding of the world and response to global issues to take action to think and solve problems critically. The ability to understand science concepts and knowledge through CKCM (The Common Knowledge Construction Model) model based-instruction focusing on sustainable-development. Raising awareness of global issues and communicating the knowledge to construct their ideas and solution based on the problems research. The purpose of this study used bibliometric analysis to provide graphical info about the statistical description of the literature from 10 articles issued in reputable international journals. The method with documents access from different types of reliable and relevant resources related to the topic exploration, such as taken from the Scopus database for sustainability development in science education in the form of articles, book chapters, books, and conference papas. Moreover, visualization with software R bibliometric with three visualizations namely Annual Scientific Production, most cited articles, Country scientific production and word cloud and Co-occurrence network. The findings of the analysis show that most resource topic trends in 2017-2022 are from students, engineering education, and teaching. Analysis literature review needed to support continuing research of the development learning and teaching method based-instruction of sustainable development through project and digital-based.

Citing articles via

Publish with us - request a quote.

Sign up for alerts

• Online ISSN 1551-7616
• Print ISSN 0094-243X
• For Researchers
• For Librarians
• For Advertisers
• Our Publishing Partners  
• Physics Today
• Conference Proceedings
• Special Topics

pubs.aip.org

• Privacy Policy
• Terms of Use

Connect with AIP Publishing

This feature is available to subscribers only.

Sign In or Create an Account

Literature Reviews

• Artificial intelligence (AI) tools
• Getting started
• Types of reviews
• 1. Define your research question
• 2. Plan your search
• 3. Search the literature
• 4. Organize your results
• 5. Synthesize your findings
• 6. Write the review

Introduction to AI

Research rabbit, copilot (powered by chatgpt4).

• Thompson Writing Studio This link opens in a new window
• Need to write a systematic review? This link opens in a new window

Contact a Librarian

Ask a Librarian

Generative AI tools have been receiving a lot of attention lately because they can create content like text, images, and music. These tools employ machine learning algorithms that can produce unique and sometimes unexpected results. Generative AI has opened up exciting possibilities in different fields, such as language models like GPT and image generators.

However, students need to approach these tools with awareness and responsibility. Here are some key points to consider:

Novelty and Creativity : Generative AI tools can produce content that is both innovative and unexpected. They allow users to explore new ideas, generate unique artworks, and even compose original music. This novelty is one of their most exciting aspects.

Ethical Considerations : While generative AI offers creative potential, it also raises ethical questions. Students should be aware of potential biases, unintended consequences, and the impact of their generated content. Responsible use involves considering the broader implications.

Academic Integrity : When using generative AI tools for academic purposes, students should consult their instructors. Policies regarding the use of AI-generated content may vary across institutions. Always seek guidance to ensure compliance with academic integrity standards.

In summary, generative AI tools are powerful and fascinating, but students should approach them thoughtfully, seek guidance, and adhere to institutional policies. Please refer to the Duke Community Standard  for questions related to ethical AI use.

Looking for a tool that isn't listed here? Let us know about it!

Research Rabbit is a literature mapping tool that takes one paper and performs backward- and forward citation searching in addition to recommending "similar work." It scans the Web for publicly available content to build its "database" of work.

Best suited for...

Disciplines whose literature is primarily published in academic journals.

Considerations

• Integrates with Zotero
• Works mostly with just journal articles
• Potential for bias in citation searching/mapping

»   researchrabbit.ai   «

What is it?

Elicit is a tool that semi-automates time-intensive research processes, such as summarizing papers , extracting data , and synthesizing information . Elicit pulls academic literature from Semantic Scholar , an academic search engine that also uses machine learning to summarize information.

Empirical research (i.g., the sciences, especially biomedicine).

• Both free and paid versions
• Doesn't work well in identifying facts or in theoretical/non-empirical research (e.g., the humanities)
• Potential biases in the natural language processing (NLP) algorithms
• Summarized information and extracted data will still need to be critically analyzed and verified for accuracy by the user

»   elicit.com   «

Think of Consensus as ChatGPT for research! Consensus is "an AI-powered search engine designed to take in research questions, find relevant insights within research papers, and synthesize the results using the power of large language models" ( Consensus.app ).  Consensus runs its language model over its entire body of scientific literature (which is sourced from Semantic Scholar ) and extracts the “key takeaway” from every paper.

The social sciences and sciences (non-theoretical disciplines).

• Free and paid versions
• Similar to Elicit, Consensus should not be used to ask questions about basic facts
• Consensus recommends that you ask questions related to research that has already been conducted by scientists
• Potential for biases in the input data from participants

»   consensus.app   «

Dubbed the "AI-powered Swiss Army Knife for information discovery," Perplexity is used for answering questions (including basic facts, a function that many other AI tools are not adept at doing), exploring topics in depth utilizing Microsoft's Copilot, organizing your research into a library, and interacting with your data (including asking questions about your files).

Perplexity has wide-reaching applications and could be useful across disciplines.

• Free and paid pro versions (the pro version utilizes Microsoft's Copilot AI tool)
• Available in desktop, iOS, and Android apps
• See  Perplexity's blog for more info
• Your personal information and data on how you use the tool are stored for analytical purposes (however, this feature can be turned off in settings)
• Features a browser plug-in, Perplexity Companion , that is essentially a blend of Google and ChatGPT

»   perplexity.ai   «

Did you know that as Duke faculty, staff, and students, we have free access to ChatGPT4 via Microsoft Copilot ?

Log in with your Duke credentials to start using it today.

The OG of generative AI tools, ChatGPT-4 is the latest iteration of the popular chatbot, answering questions and generating text that sounds like it was written by a human. While not a replacement for conducting research, it can be helpful when it comes to brainstorming topics or research questions and also as a writing tool (rewriting or paraphrasing content, assessing tone, etc.).

All users across all disciplines.

• ChatGPT-3.5 is the default version of free and paid-tier chat users.
• Since it can't verify its sources, be wary of hallucinations (or made-up citations) that can look very real.
• It is not 100% accurate ! While ChatGPT-4 is touted as being 40% more accurate than its predecessor, users are still expected to verify the information generated by it.
• There is always the potential for bias since ChatGPT was trained on a massive dataset of websites, articles, books, etc. (much of which is inherently biased since it was created by humans).

For ChatGPT-4 (access provided by Duke and requires login) »   copilot.microsoft.com   «

For ChatGPT-3.5 (free) »   chat.openai.com   «

• << Previous: 6. Write the review
• Next: Thompson Writing Studio >>
• Last Updated: May 17, 2024 8:42 AM
• URL: https://guides.library.duke.edu/litreviews

Services for...

• Faculty & Instructors
• Graduate Students
• Undergraduate Students
• International Students
• Patrons with Disabilities

• Harmful Language Statement
• Re-use & Attribution / Privacy
• Support the Libraries

• Open access
• Published: 21 May 2024

A modern way to teach and practice manual therapy

• Roger Kerry 1 ,
• Kenneth J. Young   ORCID: orcid.org/0000-0001-8837-7977 2 ,
• David W. Evans 3 ,
• Edward Lee 1 , 4 ,
• Vasileios Georgopoulos 1 , 5 ,
• Adam Meakins 6 ,
• Chris McCarthy 7 ,
• Chad Cook 8 ,
• Colette Ridehalgh 9 , 10 ,
• Steven Vogel 11 ,
• Amanda Banton 11 ,
• Cecilia Bergström 12 ,
• Anna Maria Mazzieri 13 ,
• Firas Mourad 14 , 15 &
• Nathan Hutting 16  

Chiropractic & Manual Therapies volume  32 , Article number:  17 ( 2024 ) Cite this article

113 Altmetric

Metrics details

Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment , patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care.

The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety , comfort , and efficiency . These practical elements are contextualised by positive communication , a collaborative context , and person-centred care . The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies.

A literature review stimulated by a new method of teaching manual therapy, reflecting contemporary evidence, being trialled at a United Kingdom education institute. A group of experienced, internationally-based academics, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through reviews of contemporary literature and discussions in an iterative process. Public presentations were made to multidisciplinary groups and feedback was incorporated. Consensus was achieved through repeated discussion of relevant elements.

Conclusions

Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.

Musculoskeletal (MSK) conditions are leading contributors to the burden of global disability and healthcare [ 1 ]. Amongst other interventions, manual therapy (MT) has been recommended for the management of people with MSK conditions in multiple clinical guidelines, for example [ 2 , 3 ].

MT has been described as the deliberate application of externally generated force upon body tissue, typically via the hands, with therapeutic intent [ 4 ]. It includes touch-based interventions such as thrust manipulation, joint mobilisation, soft-tissue mobilisation, and neurodynamic movements [ 5 ]. For people with MSK conditions, this therapeutic intent is usually to reduce pain and improve movement, thus facilitating a return to function and improved quality of life [ 6 ]. Patient perceptions of MT are, however, vague and sit among wider expectations of treatment including education, self-efficacy and the role of exercise, and prognosis [ 7 ].

Although the teaching and practice of MT has invariably changed over time, its foundations arguably remain unaltered and set in biomedical and outdated principles. This paper sets out to review contemporary literature and propose a revised model to inform the teaching and practice of MT.

The aim of this paper is to stimulate debate about the future teaching and practice of manual therapy through the proposal of an evidence-informed re-conceptualised model of manual therapy. The new model dismisses traditional elements of manual therapy which are not supported by research evidence. In place, the model offers a structure based on common humanistic principles of healthcare.

Consenus methodology

We present the literature synthesis and proposed framework as a consensus document to motivate further professional discussion developed through a simple three-stage iterative process over a 5-year period. The consensus methodology was classed as educational development which did not require ethical approval. Stage 1: a change of teaching practice was adopted by some co-authors (VG, RK, EL) on undergraduate and postgraduate Physiotherapy programmes at a UK University in 2018. This was a result of standard institutional teaching practice development which includes consideration of evidence-informed teaching. Stage 2: Input from a broader spectrum of stakeholders was sought, so a group of experienced, internationally-based educators, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through discussions in an iterative process. Stage 3: Presentations were made by some of the co-authors (VG, RK, SV, KY) to multidisciplinary groups (UK, Europe, North America) and feedback via questions and discussions was incorporated into further co-author discussions on the development of the framework. Consensus was achieved through repeated discussion of relevant elements. Figure  1 summarises the consensus methodology.

Summary and timeline of iterative consensus process for development of framework (MT: Manual Therapy; UG: Undergraduate; PG: Postgraduate)

Clinical & cost effectiveness of manual therapy

Manual therapy has been suggested to be a valuable part of a multimodal approach to managing MSK pain and disability, for example [ 8 ]. The majority of recent systematic reviews of clinical trials report a beneficial effect of MT for a range of MSK conditions, with at least similar effect sizes to other recommended approaches, for example [ 9 ]. Some systematic reviews report inconclusive findings, for example [ 10 ], and a minority report effects that were no better than comparison or sham treatments, for example [ 11 ].

Potential benefits must always be weighed against potential harms, of course. Mild to moderate adverse events from MT (e.g. mild muscle soreness) are common and generally considered acceptable [ 12 ], whilst serious adverse events are very rare and their risk may be mitigated by good practice [ 13 ]. MT has been reported by people with MSK disorders as a preferential and effective treatment with accepted levels of post-treatment soreness [ 14 ].

MT is considered cost-effective [ 15 ] and the addition of MT to exercise packages has been shown to increase clinical and cost-effectiveness compared to exercise alone in several MSK conditions [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Further, manual therapy has been shown to be less costly and more beneficial than evidence-based advice to stay active [ 24 ].

In summary, MT is considered a useful evidence-based addition to care packages for people experiencing pain and disability associated with MSK conditions. As such, MT continues to be included in national and international clinical guidelines for a range of MSK conditions as part of multimodal care.

Principles of traditional manual therapy (TMT)

Manual therapy has been used within healthcare for centuries [ 4 ] with many branches of MT having appeared (and disappeared) over time [ 25 ]. In developed nations today, MT is most commonly utilised by the formalised professional groups of physiotherapy, osteopathy, chiropractic, as well as groups such as soft tissue therapists. All of these groups have a history that borrows heavily from traditional healers and bone-setters [ 26 ].

Although there are many elements of MT, three principles appear to have become ubiquitous within what we shall now refer to as ‘traditional manual therapy’ (TMT): clinician-centred assessment , patho-anatomical reasoning , and technique specificity [ 27 , 28 , 29 , 30 ]. These principles continue to influence the teaching and practice of manual therapy over recent years, for example [ 31 ].

However, they have become increasingly difficult to defend given a growing volume of empirical evidence to the contrary.

Traditional manual therapy (TMT) principles: origins and problems

Clinician-centred assessment.

TMT has long had an emphasis on what we shall refer to as clinician-centred assessments . Within this, we claim, is an assumption that clinical information is both highly accurate and diagnostically important, for example [ 32 ]. Clinician-centred assessments include, for example, routine imaging, the search for patho-anatomical 'lesions’ and asymmetries, and specialised palpation. Although the focus of this paper is on the ‘hands-on’ examples of client-centred assessment, the notion of imaging is presented below to expose some of the flaws in the underlying belief system for TMT.

The emphasis on clinician-centred assessments has probably been driven, in part, by a desire for objective diagnostic tests which align well with gold-standard imaging. Indeed, since the discovery of x-rays, radiological imaging been used as an assessment for spinal pain – and a justification for using spinal manipulation – particularly in the chiropractic profession [ 33 ]. Contrary to many TMT claims, X-ray imaging is not without risk [ 34 ]. Additionally, until relatively recently (with the advent of magnetic resonance imaging) it was not widely appreciated that patho-anatomical ‘lesions’ believed to explain MSK pain conditions were nearly as common in pain-free individuals as those with pain [ 35 ]. Accordingly, the rates of unnecessary treatments, including surgery, are known to increase when imaging is used routinely [ 36 ]. For patients with non-specific low back pain, for example, imaging does not improve outcomes and risks overdiagnosis and overtreatment [ 37 ]. Hence, despite being objective in nature, the value of imaging for many MSK pain conditions (particularly spinal pain) has reduced drastically with clinical guidelines across the globe recommending against routine imaging for MSK pain of non-traumatic origin [ 38 ]. Even so, the practice of routine imaging continues [ 39 ].

Hands-on interventions are inextricably related to hands-on assessment [ 40 ], and often associated with claims of ‘specialisation’ [ 41 ]. By this we mean where a great level of training and precision are claimed to be necessary for influencing the interpretation of assessment findings, treatment decisions, and/or treatment outcomes. Implicit within this claim is that therapists who are unable to achieve such precision are not able to perform MT to an acceptable level (and thereby are not able to provide benefit to patients).

There are numerous studies that cast doubt over claims of highly specialised palpation skills. Palpation of anatomical landmarks does not reach a clinically acceptable level of validity [ 42 ]. Specialised motion palpation does not appear to be a good method for differentiating people with or without low back pain [ 43 ]. Poor content validity of specialised motion tests have been reported, in line with a lack of acceptable reference standards [ 44 ]. Palpable sensations reported by therapists are unlikely to be due to tissue deformation [ 45 ]. Furthermore, the delivery of interventions based on specialised palpatory findings is no better than non-specialised palpation [ 46 ]. Generally poor reliability of motion palpation skills has been reported, for example [ 47 ] and appear to be independent of clinician experience or training, for example [ 48 ]. Notably, person-centred palpation—for pain and tenderness for example—has slightly higher reliability, but is still fair at best [ 49 ].

This does not mean that palpation is of no use at all though; just that effective manual therapy does not depend upon it. For example, expert therapists can display high levels of interrater reliability during specialised motion palpation [ 50 ]. Focused training can improve the interrater reliability of specialised skills [ 51 ]. However, the validity of the phenomenon remains poor. Given the weight of the evidence and consistency of data over recent decades, we suggest that the role of clinician-centred hands-on assessment is no longer central to contemporary manual therapy.

Patho-anatomical reasoning

The justification for selecting particular MT interventions has historically been based upon the patho-anatomical status of local peripheral tissue [ 52 , 53 , 54 , 55 ]. Patho-anatomical reasoning, we propose, is the framework that links clinician-centred assessments to the desire for highly specific delivery of MT interventionsKey to this is the relationship between a patho-anatomic diagnosis and the assumed mechanisms of action of the intervention employed.

Theories for the mechanisms of action of MT interventions are many. Some of the most prominent include reductions of disc herniations [ 56 ], re-positioning of a bone or joint [ 32 ], removal of intra-articular adhesions [ 57 ], changes in the biomechanical properties of soft tissues [ 58 ], central pain modulation [ 59 ], and biochemical changes [ 60 ]. These theories have been used to justify the choice of certain interventions: a matching of diagnosis (i.e., existence of a lesion) to the effect of treatment takes place. However, most of these mechanistic theories either lack evidence or have been directly contested [ 61 ].

The causal relationship between proposed tissue-based factors such as posture, ergonomic settings, etc. and painful experience has also been disputed [ 62 ]. Although local tissue stiffness has been observed in people with pain, this is typically associated with neuromuscular responses, rather than patho-anatomical changes at local tissue level [ 63 , 64 , 65 , 66 ]. Overall, although some local tissue adaptions have been identified in people with recurrent MSK pain, this is inconsistent and the evidence is currently of low quality [ 67 ] are generally limited to short-term follow-up measures [ 68 ].

Technique specificity

TMT techniques have been taught with an emphasis that a particular direction, ‘grade’ of joint movement, or deformation of tissue at a very specific location in a certain way, is required to achieve a successful treatment outcome.

One problem with a demand for technique specificity in manual therapy is that an intervention does not always result in the intended effect. For example, posteroanterior forces applied during spinal mobilization consistently induce sagittal rotation, as opposed to the assumed posteroanterior translation, for example [ 69 ]. Furthermore, irrespective of the MT intervention chosen, restricting movements to a particular spinal segment is difficult and a regional, non-specific motion is typically induced, for example [ 70 ].

To support technique specificity, comparative data must repeatedly and reproducibly show superiority of outcome from specific MT interventions over non-specific MT, which is consistently not observed [ 71 , 72 , 73 ]. Some studies have demonstrated localised effects of targeted interventions [ 74 ] but there appears to be no difference in outcome related to: the way in which techniques are delivered [ 75 ]; whether technique selection is random or clinician-selected [ 41 ]; or variations in the direction of force or targeted spinal level [ 76 ]. Conversely, there is evidence that non-specific technique application may improve outcomes [ 77 , 78 , 79 ]. Further, sham techniques produce comparable results to specialised approaches [ 11 ].

Passive movement and localised touch have been associated with significant analgesic responses [ 80 ]. These data indicate the presence of an analgesic mechanism. Unfortunately, mechanistic explanation for the therapeutic effects of MT upon pain and disability still remain largely in a ‘black box’ state [ 81 ]. Nevertheless, there are several plausible mechanisms of action to explain the analgesic action of MT interventions, including the activation of modulatory spinal and supraspinal responses [ 82 , 83 , 84 , 85 ]. In support of this, MT interventions have been associated with a variety of neurophysiological responses [ 61 ]. However, it must be acknowledged that these studies provide mechanistic evidence based on association, which is insufficient to make causal claims [ 86 ]. Importantly, none of these neurophysiological responses have been directly related to either the analgesic mechanisms or clinical outcome and may therefore be incidental.

There is evidence that MT does not provide analgesia in injured tissues [ 87 , 88 ]. Conversely, MT has been shown to decrease inflammatory biomarkers [ 89 , 90 , 91 , 92 , 93 ], although these changes have not been evaluated in the longer-term, nor associated with clinical outcomes.

A modern framework for manual therapy

We propose a new direction for the future of MT in which the teaching and practice of this core dimension of MSK care are no longer based on the traditional principles of clinician-centred assessment , patho-anatomical reasoning , and technique specificity .

In doing so, this framework places MT more explicitly as part of person-centred care and appeals to common principles of healthcare, best available evidence, and contemporary theory which avoids unnecessary and over-complicated explanations of observed effects. The framework is simple in terms of implementation and delivery and contextualised by common elements of best practice for healthcare, in line with regulated standard of practice, e.g., [ 94 , 95 , 96 , 97 ]. Our proposal simply illustrates the operationalisation of these common elements through manual therapy.

Too much emphasis has been given to clinician-centred assessments and this should be rebalanced with an increased use of patient-centred assessments, such as a thorough case history, the use of validated patient-reported outcome measures (PROMS), and real-time patient feedback during assessments.

The new framework considers fundamental and humanistic dimensions of touch-based therapies, such as non-specific neuromodulation, communication and sense-making, physical education, and contextual clinical effectiveness. This aligns to contemporary ideas regarding therapeutic alliance and a move towards genuinely holistic healthcare [ 98 , 99 ]. The framework needs to be “open” in order to represent and allow expression of the complexity of the therapeutic encounter. However, to prevent the exploitation of this openness the framework is underpinned by evidence, and any manual therapy approaches without plausible and measurable mechanisms are not supported.

To provide the best care, common healthcare elements such as the safety and comfort of the person seeking help and therapist must be considered, and care should be provided as efficiently as possible. Our framework embraces these dimensions and employs an integration of current evidence. It is transdisciplinary in nature and may be adopted by all MT professions. Figure  1 provides a graphical representation of the framework. It is acknowledged that all components overlap, relate, and influence each. There are two main components: the practical elements on the inside, comprised of safety, comfort, and efficiency, and the conceptual themes on the outer regions, consisting of communication, context, and person-centred care Fig. 2 .

Representation of a modern teaching and practice framework for manual therapy. The image is purposefully designed to be simple, and has been developed primarily to be used as a teaching aid. When displayed in a learning environment, learners and clinicians can quickly refer to the image to check their practice against each element. To keep the image clear, each element of the image is described in detail in the text below”

Practical elements

Safety for people seeking help is a primary concern for all healthcare providers, with the aims to “ prevent and reduce risks, errors and harm that occur to patients [sic] during provision of health care… and to deliver quality essential health services ” [ 100 ]. This, and the notion of safety more generally (including that of the therapist), should be central to way MT is taught and practised.

A fundamentally safe context should be created where there is an absence of any obvious danger or risk of harm to physical or mental health. Consideration should be given to ensuring that communication and consent processes are orientated towards the safety of both the person seeking help and the therapist. The therapist should pay attention to any sense of threat that could be present in the physical, emotional, cognitive and environmental domains of the clinical encounter, and use skilful communication to mitigate anxiety about the assessment or therapeutic process.

Safety should also be considered in the clinical context of the assessment and treatment approach, ensuring that relevant and meaningful safety screenings have been undertaken [ 67 , 101 ]. There remains a need for good, skilful practice and development of manually applied techniques, but this can be achieved without reference to the principles of TMT and without the dogma of a proprietary therapeutic approach.

Comfort suggests that both the person seeking help and the therapist are physically and emotionally content during the assessment and therapeutic process. For example, the person seeking help is agreeable with any necessary state of dress (sociocultural difference should be considered); the person is relaxed and untroubled in whatever position they are in, and is adequately supported whether sitting, standing or recumbent during assessment and treatment; the therapist is comfortable with their positioning and posture; any discomfort produced by the therapeutic process is negotiated and agreed. Any physical mobilisation or touch should be applied with respect to the feedback from the person in relation to their comfort, rather than a pre-determined force based on the notion of resistance. This process requires clinical phronesis, sensitivity, responsivity, dexterity, and embodied communication [ 102 ].

The therapeutic process should be undertaken in a well-organised, competent manner aiming to achieve maximum therapeutic benefit with minimum waste of effort, time, or expense. To enhance the efficiency dimension, the assessment and therapeutic process should be an integral part of a holistic educational and/or activity-based approach to the management of the people which might also address psychological, nutritional, or ergonomic aspects of care, while being aware of social determinants to health. Recommendations exist which serve as a useful guide for enhancing care and promoting self-management in an efficient way [ 103 ].

A principle of this new model of MT is that therapists should not lose sight of the goals they develop with the people they help and ensure that there is coherence between their management aims and their techniques. Therapists should aim to support a person’s self-efficacy and use active approaches to empower them in their recovery. The overall number of therapeutic applications should be made in the context of fostering therapeutic alliance and supporting people to make sense of their situation and symptoms. This should be informed by contemporary views of the effects of manual therapy, emphasising a “physical education process” to promote sense-making and self-efficacy in alliance with the people they aim to help.

Clinical interactions need to be reproducible under a person’s own volition, serving to enhance self-empowerment. For example, someone could be taught how to “self-mobilise” if a positive effect is found with a particular therapeutic application. This should be appropriately scaffolded with behavioural change principles and functional contextualism that promote autonomy and self-management, rather than inappropriate reliance on the therapist [ 103 , 104 ].

An important and emergent notion from the proposed model is to question what constitutes indications for MT given that the model excludes traditional factors which would have informed whether manual therapy is indicated or not for a particular person. The response to this sits within the efficiency and safety dimensions: MT can be beneficial as part of a multi-dimensional approach to management across a broad population of people with musculoskeletal dysfunction, with no evidence to suggest any clinician-centered or patho-anatomical finding influences outcomes. The choice of whether or not to include MT as part of a management strategy should therefore be a product of a lack of contraindications and shared-decision making.

This framework aligns with evidence-based propositions that effectiveness and efficiency in assessment, diagnosis, and outcomes are not reliant on the therapist’s skill set of specialised elements of TMT, but rather other factors—for example variations in pain phenotypes [ 5 ].

Conceptual themes

Communication.

Communication is the overriding critical dimension to the whole therapeutic process and should be aimed at addressing peoples’ fundamental needs to make sense of their symptoms and path to recovery. The delivery and uptake of the therapy should therefore be operationalised in a communication process that meaningfully represents shared-decision making and the best possible attempt to contextualise the therapy in positive and evidence-informed explanations of the process and desired effects [ 105 ].

Within a therapeutic encounter, practitioners must give the time to listen to peoples’ accounts and explanations of their symptoms, including their ideas about their cause [ 106 ]. The assessment and diagnostic process should be a shared endeavour, for example, the negotiation of symptom reproduction. This should be done in a manner that facilitates sense-making, and which simultaneously encourages people to move on from unhelpful beliefs about their symptoms [ 107 , 108 ], encouraging understanding of the uncertain nature of pain and injury. Person-centered communication requires attention to what we communicate and how we communicate across the entire clinical interaction including interview, examination, and management planning [ 109 ]. Therapists need to be open, reflective, aware and responsive to verbal and non-verbal cues, and demonstrate a balance between engaging with people (e.g. eye-gaze) and writing/typing notes during the interview [ 110 , 111 , 112 ].

People should be given the opportunity to discuss their understanding of the diagnosis and options for treatment and rehabilitation. The decision-making process is dialogical, in which alternative options to the offered therapy should also be discussed with the comparative risks and benefits of all available management options, including doing nothing [ 113 , 114 ].

The therapist must fully appreciate the potential consequences of touch without consent. Continual dialogue should ensure that all parties are moving towards mutually agreed goals. The context of the therapy should be explicitly communicated to give appropriate context for any particular intervention as part of a holistic, evidence-based approach [ 115 , 116 , 117 ]. Therapists should be aware that their own beliefs can affect the way they communicate with their people; in the same way, a person’s context affects how they communicate what they expect from their treatment [ 107 , 118 , 119 , 120 ]. The construction of contextual healing scenarios which support positive outcomes, whilst minimising nocebic effects, is critical to effective healthcare [ 121 , 122 , 123 ].

There is a growing academic interest in the nature, role, and purpose of social and affective touch, and any re-framing of MT should consider touch as a means of communication to develop and enhance cooperative communications and strengthen the therapeutic relationship [ 124 , 125 , 126 , 127 , 128 , 129 ]. It can be soothing for a person in pain to experience the caring touch of a professional therapist [ 130 ]; on the other hand, probing, diagnostic, and touch can be experienced as alienating [ 131 , 132 , 133 ]. Touch can alter a person’s sense of body ownership and their ability to recognise and process their emotions by modulating interoceptive precision [ 129 , 134 , 135 ], and intentional touch may be perceived differently from casual, unfocussed touch [ 136 , 137 ]. There is also a thesis that touch generates shared understanding and meaning [ 138 , 139 , 140 ]. This wider appreciation of touch should be embedded in modern MT communication.

The contextual quality of a person’s experience of the therapeutic encounter can affect satisfaction and clinical outcomes [ 141 , 142 , 143 , 144 , 145 ]. The context in which therapeutic care takes place should therefore be developed to enhance this experience. There could be very local, practical aspects of the context, such as the type of passive information available in the clinical space, e.g. replacing biomedical and pathological imagery and objects with positive, active artefacts; judicious and thoughtful organisation and use of treatment tables to discourage a sense of passivity and disempowerment; allocating a comfortable space where communication can take place; colour schemes and light sources which facilitate positivity; ensuring consistency through all clinical and administrative staff promoting encouraging and non-nocebic messages. Importantly, the way the therapist dresses influences peoples’ perception of their healthcare experience [ 146 , 147 ], and that in turn should be contextually and culturally sensitive [ 148 , 149 , 150 ].

Beyond the local clinical space is the broader social environment. The undertaking of MT should serve a role in a person’s engagement with their social environment. For example, someone returning home after engaging with their therapist and disseminating positive health messages within their home and social networks; people acting as advocates for self-empowered healthcare. Furthermore, early data have demonstrated that aligning treatment with the beliefs and values of culturally and linguistically diverse communities enhances peoples’ engagement with their healthcare [ 151 ].

Person-centred care

Here we borrow directly from one of the most established and clinically useful definitions of Person-Centered Medicine [ 152 ]:

“(Person-Centered Medicine is) an affordable biomedical and technological advance to be delivered to patients [sic] within a humanistic framework of care that recognises the importance of applying science in a manner that respects the patients [sic] as a whole person and takes full account of [their] values, preferences, aspirations, stories, cultural context, fears, worries and hopes and thus that recognises and responds to [their] emotional, social and spiritual necessities in addition to [their] physical needs” [ 152 ] , p219.

Person-centred care incorporates a person’s perspective as part of the therapeutic process. In practice, therapists need to communicate in a manner that creates adequate conversational space to elicit a person’s agenda (i.e. understanding, impact of pain, concerns, needs, and goals), which guides clinical interactions. This approach encourages greater partnership in management [ 109 , 153 , 154 ].

A roadmap outlining key actions to implement person-centeredness in clinical practice has been outlined in detail elsewhere [ 155 ]. This includes screening for serious pathology, health co-morbidities and psychosocial factors; adopting effective communication; providing positive health education; coaching and supporting people towards active self-management; and facilitating and managing co-care (when needed) [ 154 ].

It is critical and necessary now to make these features explicit and central to the revised model of MT proposed in this paper. We wish to identify common ground across all MT professions in order to achieve a trans-disciplinary understanding of the evidence supporting the use of MT.

We acknowledge that our arguments here are rooted in empiricism and deliberately based on available research data from within the health science disciplines. We also acknowledge that there is a wider debate about future directions in person-centred care arising from the current evolution of the evidence-based health care movement, which has pointed to the need to learn more about peoples’ lived experiences, to redefine the model of the therapeutic relationship. Although beyond the scope of this paper, a full exploration of modern health care provision involves reconsideration of the ethics and legal requirements of communication and shared decision-making [ 156 , 157 , 158 , 159 ]. The authors envision this paper as a stimulus for self-reflection, stakeholder discussions, and ultimately change that can positively impact outcomes for people who seek manual therapy interventions.

Manual therapy has long been part of MSK healthcare and, given that is likely to continue. Current evidence suggests that effectiveness does not rely on the traditional principles historically developed in any of the major manual therapies. Therefore, the continued teaching and practice based on the principles of clinician-centred palpation , patho-anatomical reasoning , and technique specificity are no longer justified and may well even limit the value of MT.

A revised and reconceptualised framework of MT, based on the humanistic domains of safety, comfort and efficiency and underpinned by the dimensions of communication, context and person-centred care will ensure an empowering, biopsychosocial, evidence-informed approach to MSK care. We propose that the future teaching and practice of MT in physiotherapy, osteopathy, chiropractic, and all associated hands-on professions working within the healthcare field should be based on this new framework.

Availability of data and materials

Young C, Argáez C. CADTH Rapid Response Reports. Manual Therapy for Chronic Non-Cancer Back and Neck Pain: A Review of Clinical Effectiveness. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health. Copyright © 2020 Canadian Agency for Drugs and Technologies in Health.; 2020.

Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, et al. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017;47(7):A1-a83.

Article   PubMed   Google Scholar  

NICE. Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59]. 2016.

Pettman E. A history of manipulative therapy. J Man Manip Ther. 2007;15(3):165–74.

Article   PubMed   PubMed Central   Google Scholar  

Damian K, Chad C, Kenneth L, David G. Time to evolve: the applicability of pain phenotyping in manual therapy. J Man Manip Ther. 2022;30(2):61–7.

McCarthy CJ. Combined Movement Theory: Rational Mobilization and Manipulation of the Vertebral Column. London, UK: Churchill Livingstone; 2010.

Google Scholar  

Subialka JA, Smith K, Signorino JA, Young JL, Rhon DI, Rentmeester C. What do patients referred to physical therapy for a musculoskeletal condition expect? A qualitative assessment. Musculoskel Sci Pract. 2022;59:102543.

Article   Google Scholar  

Louw A, Nijs J, Puentedura EJ. A clinical perspective on a pain neuroscience education approach to manual therapy. J Man Manip Ther. 2017;25(3):160–8.

Wilhelm M, Cleland J, Carroll A, Marinch M, Imhoff M, Severini N, et al. The combined effects of manual therapy and exercise on pain and related disability for individuals with nonspecific neck pain: A systematic review with meta-analysis. J Man Manip Ther. 2023;31(6):393–407.

Schenk R, Donaldson M, Parent-Nichols J, Wilhelm M, Wright A, Cleland JA. Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders - a systematic review. J Man Manipulative Therap. 2021:1–10.

Lavazza C, Galli M, Abenavoli A, Maggiani A. Sham treatment effects in manual therapy trials on back pain patients: a systematic review and pairwise meta-analysis. BMJ Open. 2021;11(5):e045106.

Funabashi M, Pohlman KA, Goldsworthy R, Lee A, Tibbles A, Mior S, et al. Beliefs, perceptions and practices of chiropractors and patients about mitigation strategies for benign adverse events after spinal manipulation therapy. Chiropr Man Therap. 2020;28(1):46.

Rushton A, Carlesso LC, Flynn T, Hing WA, Rubinstein SM, Vogel S, et al. International Framework for Examination of the Cervical Region for Potential of Vascular Pathologies of the Neck Prior to Musculoskeletal Intervention: International IFOMPT Cervical Framework. J Orthop Sports Phys Ther. 2022;53(1):7–22.

Thomas M, Thomson OP, Kolubinski DC, Stewart-Lord A. The attitudes and beliefs about manual therapy held by patients experiencing low back pain: a scoping review. Musculoskelet Sci Pract. 2023;65:102752.

Lilje S, van Tulder M, Wykman A, Aboagye E, Persson U. Cost-effectiveness of specialised manual therapy versus orthopaedic care for musculoskeletal disorders: long-term follow-up and health economic model. Ther Adv Musculoskelet Dis. 2023;15:1759720x221147751.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Abbott JH, Robertson MC, Chapple C, Pinto D, Wright AA, Leon de la Barra S, et al. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness. Osteoarthritis Cartilage. 2013;21(4):525–34.

Article   CAS   PubMed   Google Scholar  

Bove AM, Smith KJ, Bise CG, Fritz JM, Childs JD, Brennan GP, et al. Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial. Phys Ther. 2018;98(1):16–27.

Leininger B, McDonough C, Evans R, Tosteson T, Tosteson AN, Bronfort G. Cost-effectiveness of spinal manipulative therapy, supervised exercise, and home exercise for older adults with chronic neck pain. Spine J. 2016;16(11):1292–304.

Tsertsvadze A, Clar C, Court R, Clarke A, Mistry H, Sutcliffe P. Cost-effectiveness of manual therapy for the management of musculoskeletal conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials. J Manipulative Physiol Ther. 2014;37(6):343–62.

UK Beam Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004;329(7479):1377.

Article   PubMed Central   Google Scholar  

UK Beam Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care. BMJ (Clinical research ed). 2004;329(7479):1381.

van Dongen JM, Groeneweg R, Rubinstein SM, Bosmans JE, Oostendorp RA, Ostelo RW, et al. Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial. Eur Spine J. 2016;25(7):2087–96.

Woods B, Manca A, Weatherly H, Saramago P, Sideris E, Giannopoulou C, et al. Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS ONE. 2017;12(3):e0172749.

Aboagye E, Lilje S, Bengtsson C, Peterson A, Persson U, Skillgate E. Manual therapy versus advice to stay active for nonspecific back and/or neck pain: a cost-effectiveness analysis. Chiropr Man Therap. 2022;30(1):27.

Paris SV. A History of Manipulative Therapy Through the Ages and Up to the Current Controversy in the United States. J Man Manipulative Ther. 2000;8(2):66–77.

MacDonald CW, Osmotherly PG, Parkes R, Rivett DA. The current manipulation debate: historical context to address a broken narrative. J Man Manipulative Therap. 2019;27(1):1–4.

Fryer G. Intervertebral dysfunction: a discussion of the manipulable spinal lesion. J Am Osteopath Assoc. 2003;6(2):64–73.

McCarthy CJ. Spinal manipulative thrust technique using combined movement theory. Man Ther. 2001;6(4):197–204.

Vickers A, Zollman C. ABC of complementary medicine Massage therapies. BMJ (Clinical research ed). 1999;319(7219):1254–7.

Evans DW. Osteopathic principles: More harm than good? Int J Osteopath Med. 2013;16(1):46–53.

Mourad F, Yousif MS, Maselli F, Pellicciari L, Meroni R, Dunning J, et al. Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists. Chiropr Man Therap. 2022;30(1):38.

Cyriax JH, Cyriax PJ. Cyriax's Illustrated Manual of Orthopaedic Medicine. 3rd ed: Butterworth-Heinemann; 1996.

Young KJ. Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites. Chiropr Man Therap. 2020;28(1):18.

Jenkins HJ, Downie AS, Moore CS, French SD. Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropr Man Therap. 2018;26:48.

Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–6.

Mafi JN, McCarthy EP, Davis RB, Landon BE. Worsening trends in the management and treatment of back pain. JAMA Intern Med. 2013;173(17):1573–81.

Hall AM, Aubrey-Bassler K, Thorne B, Maher CG. Do not routinely offer imaging for uncomplicated low back pain. BMJ (Clinical research ed). 2021;372:n291.

PubMed   Google Scholar  

Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79.

Hall AM, Scurrey SR, Pike AE, Albury C, Richmond HL, Matthews J, et al. Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework. Implement Sci. 2019;14(1):49.

Eriksson L, Ekenberg L, Melander-Wikman A. The concept of palpation of the shoulder – A basic element of physiotherapy practice: A focus group study with physiotherapists. Adv Physiother. 2012;14(4):183–93.

Nim CG, Downie A, O’Neill S, Kawchuk GN, Perle SM, Leboeuf-Yde C. The importance of selecting the correct site to apply spinal manipulation when treating spinal pain: Myth or reality? A systematic review. Sci Rep. 2021;11(1):23415.

Alexander N, Rastelli A, Webb T, Rajendran D. The validity of lumbo-pelvic landmark palpation by manual practitioners: A systematic review. Int J Osteopath Med. 2021;39:10–20.

Leboeuf-Yde C, van Dijk J, Franz C, Hustad SA, Olsen D, Pihl T, et al. Motion palpation findings and self-reported low back pain in a population-based study sample. J Manipulative Physiol Ther. 2002;25(2):80–7.

Najm WI, Seffinger MA, Mishra SI, Dickerson VM, Adams A, Reinsch S, et al. Content validity of manual spinal palpatory exams - A systematic review. BMC Complement Altern Med. 2003;3:1.

Chaudhry H, Schleip R, Ji Z, Bukiet B, Maney M, Findley T. Three-dimensional mathematical model for deformation of human fasciae in manual therapy. J Am Osteopath Assoc. 2008;108(8):379–90.

Gabriel A, Konrad A, Roidl A, Queisser J, Schleip R, Horstmann T, et al. Myofascial Treatment Techniques on the Plantar Surface Influence Functional Performance in the Dorsal Kinetic Chain. J Sports Sci Med. 2022;21(1):13–22.

PubMed   PubMed Central   Google Scholar  

Nolet PS, Yu H, Côté P, Meyer A-L, Kristman VL, Sutton D, et al. Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review. Chiropr Man Therap. 2021;29(1):33.

Seffinger MA, Najm WI, Mishra SI, Adams A, Dickerson VM, Murphy LS, et al. Reliability of spinal palpation for diagnosis of back and neck pain: a systematic review of the literature. Spine. 2004;29(19):E413–25.

Beynon AM, Hebert JJ, Walker BF. The interrater reliability of static palpation of the thoracic spine for eliciting tenderness and stiffness to test for a manipulable lesion. Chiropr Man Therap. 2018;26:49.

Petersen EJ, Thurmond SM, Shaw CA, Miller KN, Lee TW, Koborsi JA. Reliability and accuracy of an expert physical therapist as a reference standard for a manual therapy joint mobilization trial. J Man Manip Ther. 2021;29(3):189–95.

Petersen EJ, Thurmond SM, Buchanan SI, Chun DH, Richey AM, Nealon LP. The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial. J Man Manip Ther. 2020;28(4):201–11.

Abbott JH, Flynn TW, Fritz JM, Hing WA, Reid D, Whitman JM. Manual physical assessment of spinal segmental motion: intent and validity. Man Ther. 2009;14(1):36–44.

Bialosky JE, Simon CB, Bishop MD, George SZ. Basis for spinal manipulative therapy: a physical therapist perspective. J Electromyogr Kinesiol. 2012;22(5):643–7.

Henderson CN. The basis for spinal manipulation: chiropractic perspective of indications and theory. J Electromyogr Kinesiol. 2012;22(5):632–42.

Sizer PS Jr, Felstehausen V, Sawyer S, Dornier L, Matthews P, Cook C. Eight critical skill sets required for manual therapy competency: a Delphi study and factor analysis of physical therapy educators of manual therapy. J Allied Health. 2007;36(1):30–40.

Ombregt L. A System of Orthopaedic Medicine: Elsevier; 2013.

Cramer GD, Henderson CN, Little JW, Daley C, Grieve TJ. Zygapophyseal joint adhesions after induced hypomobility. J Manipulative Physiol Ther. 2010;33(7):508–18.

George JW, Tunstall AC, Tepe RE, Skaggs CD. The Effects of Active Release Technique on Hamstring Flexibility: A Pilot Study. J Manipulative Physiol Ther. 2006;29(3):224–7.

Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–8.

Plaza-Manzano G, Molina-Ortega F, Lomas-Vega R, Martínez-Amat A, Achalandabaso A, Hita-Contreras F. Changes in biochemical markers of pain perception and stress response after spinal manipulation. J Orthop Sports Phys Ther. 2014;44(4):231–9.

Zusman M. Mechanism of mobilization. Physical Therapy Reviews. 2011;16(4):233–6.

De Carvalho DE, de Luca K, Funabashi M, Breen A, Wong AYL, Johansson MS, et al. Association of Exposures to Seated Postures With Immediate Increases in Back Pain: A Systematic Review of Studies With Objectively Measured Sitting Time. J Manipulative Physiol Ther. 2020;43(1):1–12.

Colloca CJ, Keller TS. Stiffness and neuromuscular reflex response of the human spine to posteroanterior manipulative thrusts in patients with low back pain. J Manipulative Physiol Ther. 2001;24(8):489–500.

Colloca CJ, Keller TS, Gunzburg R. Biomechanical and neurophysiological responses to spinal manipulation in patients with lumbar radiculopathy. J Manipulative Physiol Ther. 2004;27(1):1–15.

Reed WR, Long CR, Kawchuk GN, Sozio RS, Pickar JG. Neural Responses to Physical Characteristics of a High-velocity, Low-amplitude Spinal Manipulation: Effect of Thrust Direction. Spine. 2018;43(1):1–9.

Reed WR, Pickar JG, Sozio RS, Liebschner MAK, Little JW, Gudavalli MR. Characteristics of Paraspinal Muscle Spindle Response to Mechanically Assisted Spinal Manipulation: A Preliminary Report. J Manipulative Physiol Ther. 2017;40(6):371–80.

Devecchi V, Rushton AB, Gallina A, Heneghan NR, Falla D. Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? a systematic review. PLoS ONE. 2021;16(4):e0249220.

Pagé I, Nougarou F, Lardon A, Descarreaux M. Changes in spinal stiffness with chronic thoracic pain: Correlation with pain and muscle activity. PLoS ONE. 2018;13(12):e0208790.

Lee RY, McGregor AH, Bull AM, Wragg P. Dynamic response of the cervical spine to posteroanterior mobilisation. Clin Biomech (Bristol, Avon). 2005;20(2):228–31.

Ross JK, Bereznick DE, McGill SM. Determining cavitation location during lumbar and thoracic spinal manipulation: is spinal manipulation accurate and specific? Spine. 2004;29(13):1452–7.

Donaldson M, Petersen S, Cook C, Learman K. A Prescriptively Selected Nonthrust Manipulation Versus a Therapist-Selected Nonthrust Manipulation for Treatment of Individuals With Low Back Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther. 2016;46(4):243–50.

McCarthy CJ, Potter L, Oldham JA. Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial. BMJ Open Sport  Exerc Med. 2019;5(1):e000514.

Sutlive TG, Mabry LM, Easterling EJ, Durbin JD, Hanson SL, Wainner RS, et al. Comparison of short-term response to two spinal manipulation techniques for patients with low back pain in a military beneficiary population. Mil Med. 2009;174(7):750–6.

Tuttle N, Evans K, Sperotto dos Santos Rocha C. Localised manual therapy treatment has a preferential effect on the kinematics of the targeted motion segment. Musculoskelet Sci Pract. 2021;56:102457.

Ali MN, Sethi K, Noohu MM. Comparison of two mobilization techniques in management of chronic non-specific low back pain. J Bodyw Mov Ther. 2019;23(4):918–23.

de Oliveira RF, Costa LOP, Nascimento LP, Rissato LL. Directed vertebral manipulation is not better than generic vertebral manipulation in patients with chronic low back pain: a randomised trial. J Physiother. 2020;66(3):174–9.

Gevers-Montoro C, Provencher B, Northon S, Stedile-Lovatel JP, Ortega de Mues A, Piché M. Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals. Front Pain Res (Lausanne, Switzerland). 2021;2:702429.

Provencher B, Northon S, Piché M. Segmental Chiropractic Spinal Manipulation Does not Reduce Pain Amplification and the Associated Pain-Related Brain Activity in a Capsaicin-Heat Pain Model. Front Pain Res (Lausanne, Switzerland). 2021;2:733727.

Watanabe N, Piché M. Editorial: Mechanisms and Effectiveness of Complementary and Alternative Medicine for Pain Management. Front Pain Res (Lausanne, Switzerland). 2022;3:863751.

Muhsen A, Moss P, Gibson W, Walker B, Jacques A, Schug S, et al. The Association Between Conditioned Pain Modulation and Manipulation-induced Analgesia in People With Lateral Epicondylalgia. Clin J Pain. 2019;35(5):435–42.

Howick J, Glasziou P, Aronson JK. Evidence-based mechanistic reasoning. J Roy Soc Med. 2010;103(11):433–41.

Haavik Taylor H, Murphy B. The effects of spinal manipulation on central integration of dual somatosensory input observed after motor training: a crossover study. J Manipulative Physiol Ther. 2010;33(4):261–72.

Haavik-Taylor H, Murphy B. Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential study. ClinNeurophysiol. 2007;118(2):391–402.

Ogura T, Tashiro M, Masud M, Watanuki S, Shibuya K, Yamaguchi K, et al. Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain. Altern Ther Health Med. 2011;17(6):12–7.

Sparks C, Cleland JA, Elliott JM, Zagardo M, Liu WC. Using functional magnetic resonance imaging to determine if cerebral hemodynamic responses to pain change following thoracic spine thrust manipulation in healthy individuals. J Orthop Sports Phys Ther. 2013;43(5):340–8.

Evans DW. How to gain evidence for causation in disease and therapeutic intervention: from Koch’s postulates to counter-counterfactuals. Med Health Care Philos. 2022;25(3):509–21.

Lascurain-Aguirrebeña I, Newham D, Critchley DJ. Mechanism of Action of Spinal Mobilizations: A Systematic Review. Spine. 2016;41(2):159–72.

Parravicini G, Bergna A. Biological effects of direct and indirect manipulation of the fascial system Narrative review. J Bodyw Mov Ther. 2017;21(2):435–45.

Crane JD, Ogborn DI, Cupido C, Melov S, Hubbard A, Bourgeois JM, et al. Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Sci Transl Med. 2012;4(119):119ra13.

Degenhardt BF, Darmani NA, Johnson JC, Towns LC, Rhodes DC, Trinh C, et al. Role of osteopathic manipulative treatment in altering pain biomarkers: a pilot study. J Am Osteopath Assoc. 2007;107(9):387–400.

Kovanur-Sampath K, Mani R, Cotter J, Gisselman AS, Tumilty S. Changes in biochemical markers following spinal manipulation-a systematic review and meta-analysis. Musculoskelet Sci Pract. 2017;29:120–31.

Lohman EB, Pacheco GR, Gharibvand L, Daher N, Devore K, Bains G, et al. The immediate effects of cervical spine manipulation on pain and biochemical markers in females with acute non-specific mechanical neck pain: a randomized clinical trial. J Man Manip Ther. 2019;27(4):186–96.

Teodorczyk-Injeyan JA, McGregor M, Triano JJ, Injeyan SH. Elevated Production of Nociceptive CC Chemokines and sE-Selectin in Patients With Low Back Pain and the Effects of Spinal Manipulation: A Nonrandomized Clinical Trial. Clin J Pain. 2018;34(1):68–75.

Council GC. The Code: Standards of conduct, performance and ethics for chiropractors. GCC; 2019.

Council HaCP. Standards of Proficiency - Physiotherapists. HCPC; 2013.

Council GO. Osteopathic Practice Standards. GOC; 2023.

Therapies TCfST. GCMT Code of Practice, Ethics and Proficiency for Professional Associations. GCMT; 2023.

Daluiso-King G, Hebron C. Is the biopsychosocial model in musculoskeletal physiotherapy adequate? An evolutionary concept analysis. Physiotherapy theory and practice. 2020:1–17.

Søndenå P, Dalusio-King G, Hebron C. Conceptualisation of the therapeutic alliance in physiotherapy: is it adequate? Musculoskelet Sci Pract. 2020;46:102131.

World Health Organisation. Patient Safety 2019 [Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety#:~:text=Patient%20Safety%20is%20a%20health,during%20provision%20of%20health%20care .

Vogel S, Mars T, Keeping S, Barton T, Marlin N, Froud R, et al. Clinical Risk Osteopathy and Management Scientific Report. 2012.

Ekerholt K, Bergland A. Learning and knowing bodies: Norwegian psychomotor physiotherapists’ reflections on embodied knowledge. Physiother Theory Pract. 2019;35(1):57–69.

Hutting N, Johnston V, Staal JB, Heerkens YF. Promoting the Use of Self-management Strategies for People With Persistent Musculoskeletal Disorders: The Role of Physical Therapists. J Orthop Sports Phys Ther. 2019;49(4):212–5.

Kongsted A, Ris I, Kjaer P, Hartvigsen J. Self-management at the core of back pain care: 10 key points for clinicians. Braz J Phys Therap. 2021.

Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: multistage consultation process. BMJ (Clinical research ed). 2017;359:j4891.

Broom B. The Practice of Whole Person-Centred Healthcare. In: Anjum RL, Copeland S, Rocca E, editors. Rethinking Causality, Complexity and Evidence for the Unique Patient: A CauseHealth Resource for Healthcare Professionals and the Clinical Encounter. Cham: Springer International Publishing; 2020. p. 215–26.

Chapter   Google Scholar  

Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013;11(6):527–34.

Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018;48(7):519–22.

Lin I, Wiles L, Waller R, Caneiro JP, Nagree Y, Straker L, et al. Patient-centred care: the cornerstone for high-value musculoskeletal pain management. Br J Sports Med. 2020;54(21):1240–2.

Cowell I, O’Sullivan P, O’Sullivan K, Poyton R, McGregor A, Murtagh G. Perceptions of physiotherapists towards the management of non-specific chronic low back pain from a biopsychosocial perspective: A qualitative study. Musculoskelet Sci Pract. 2018;38:113–9.

Edmond SN, Keefe FJ. Validating pain communication: current state of the science. Pain. 2015;156(2):215–9.

O’Keeffe M, Cullinane P, Hurley J, Leahy I, Bunzli S, O’Sullivan PB, et al. What Influences Patient-Therapist Interactions in Musculoskeletal Physical Therapy? Qualitative Systematic Review and Meta-Synthesis. Phys Ther. 2016;96(5):609–22.

Copnell G. Informed consent in physiotherapy practice: it is not what is said but how it is said. Physiotherapy. 2018;104(1):67–71.

Lee A. Bolam’ to “Montgomery” is result of evolutionary change of medical practice towards ’patient-centred care. Postgrad Med J. 2017;93(1095):46–50.

Lewis J, O’Sullivan P. Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? Br J Sports Med. 2018;52(24):1543–4.

Lewis J, Ridehalgh C, Moore A, Hall K. This is the day your life must surely change: Prioritising behavioural change in musculoskeletal practice. Physiotherapy. 2021.

Lewis JS, Stokes EK, Gojanovic B, Gellatly P, Mbada C, Sharma S, et al. Reframing how we care for people with persistent non-traumatic musculoskeletal pain. Suggestions for the rehabilitation community. Physiotherapy. 2021.

Bishop A, Foster NE, Thomas E, Hay EM. How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain. 2008;135(1–2):187–95.

Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain (London, England). 2012;16(1):3–17.

Article   CAS   Google Scholar  

Lakke SE, Soer R, Krijnen WP, van der Schans CP, Reneman MF, Geertzen JH. Influence of Physical Therapists’ Kinesiophobic Beliefs on Lifting Capacity in Healthy Adults. Phys Ther. 2015;95(9):1224–33.

Howe LC, Leibowitz KA, Crum AJ. When Your Doctor “Gets It” and “Gets You”: The Critical Role of Competence and Warmth in the Patient-Provider Interaction. Front Psych. 2019;10:475.

Newell D, Lothe LR, Raven TJL. Contextually Aided Recovery (CARe): a scientific theory for innate healing. Chiropr Man Therap. 2017;25:6.

Rossettini G, Camerone EM, Carlino E, Benedetti F, Testa M. Context matters: the psychoneurobiological determinants of placebo, nocebo and context-related effects in physiotherapy. Arch Physiother. 2020;10:11.

Gallace A. Social Touch. In: Olausson H, Wessberg J, Morrison I, McGlone F, editors. Affective Touch and the Neurophysiology of CT Afferents: Springer; 2016.

Gallace A, Spence C. The science of interpersonal touch: an overview. Neurosci Biobehav Rev. 2010;34(2):246–59.

Kelly MA, Nixon L, McClurg C, Scherpbier A, King N, Dornan T. Experience of Touch in Health Care: A Meta-Ethnography Across the Health Care Professions. Qual Health Res. 2018;28(2):200–12.

McGlone F, Cerritelli F, Walker S, Esteves J. The role of gentle touch in perinatal osteopathic manual therapy. Neurosci Biobehav Rev. 2017;72:1–9.

Olausson H, Wessberg J, Morrison I, McGlone F. Affective Touch and the Neurophysiology of CT Afferents: Springer; 2016.

McParlin Z, Cerritelli F, Rossettini G, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care. Front Behav Neurosci. 2022;16:897247.

Meijer LL, Ruis C, van der Smagt MJ, Scherder EJA, Dijkerman HC. Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration. J Neuropsychol. 2021.

Allen-Collinson J, Pavey A. Touching moments: phenomenological sociology and the haptic dimension in the lived experience of motor neurone disease. Sociol Health Illn. 2014;36(6):793–806.

Bjorbækmo WS, Mengshoel AM. “A touch of physiotherapy” - the significance and meaning of touch in the practice of physiotherapy. Physiother Theory Pract. 2016;32(1):10–9.

Nummenmaa L, Tuominen L, Dunbar R, Hirvonen J, Manninen S, Arponen E, et al. Social touch modulates endogenous μ-opioid system activity in humans. Neuroimage. 2016;138:242–7.

Calsius J, De Bie J, Hertogen R, Meesen R. Touching the Lived Body in Patients with Medically Unexplained Symptoms. How an Integration of Hands-on Bodywork and Body Awareness in Psychotherapy may Help People with Alexithymia. Front Psychol. 2016;7:253.

Gentsch A, Crucianelli L, Jenkinson P, Fotopoulou A. The touched self: Affective touch and body awareness in health and disease. Affective touch and the neurophysiology of CT afferents Springer; 2016.

Cerritelli F, Chiacchiaretta P, Gambi F, Ferretti A. Effect of Continuous Touch on Brain Functional Connectivity Is Modified by the Operator’s Tactile Attention. Front Hum Neurosci. 2017;11:368.

Tramontano M, Cerritelli F, Piras F, Spanò B, Tamburella F, Piras F, et al. Brain Connectivity Changes after Osteopathic Manipulative Treatment: A Randomized Manual Placebo-Controlled Trial. Brain Sci. 2020;10(12):969.

Øberg GK, Blanchard Y, Obstfelder A. Therapeutic encounters with preterm infants: interaction, posture and movement. Physiother Theory Pract. 2014;30(1):1–5.

Øberg GK, Normann B, Gallagher S. Embodied-enactive clinical reasoning in physical therapy. Physiother Theory Pract. 2015;31(4):244–52.

Consedine S, Standen C, Niven E. Knowing hands converse with an expressive body – An experience of osteopathic touch. Int J Osteopath Med. 2016;19:3–12.

Barbosa CD, Balp MM, Kulich K, Germain N, Rofail D. A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence. Patient Prefer Adherence. 2012;6:39–48.

Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R. Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care. 2011;17(1):41–8.

Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368(3):201–3.

Sherriff B, Clark C, Killingback C, Newell D. Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study. Chiropr Man Therap. 2023;31(1):12.

Sherriff B, Clark C, Killingback C, Newell D. Impact of contextual factors on patient outcomes following conservative low back pain treatment: systematic review. Chiropr Manual Therap. 2022;30(1):20.

Mercer E, Mackay-Lyons M, Conway N, Flynn J, Mercer C. Perceptions of outpatients regarding the attire of physiotherapists. Physiother Can. 2008;60(4):349–57.

Petrilli CM, Mack M, Petrilli JJ, Hickner A, Saint S, Chopra V. Understanding the role of physician attire on patient perceptions: a systematic review of the literature— targeting attire to improve likelihood of rapport (TAILOR) investigators. BMJ Open. 2015;5(1):e006578.

Beach MC, Fitzgerald A, Saha S. White Coat Hype: Branding Physicians With Professional Attire. JAMA Intern Med. 2013;173(6):467–8.

Bearman G, Bryant K, Leekha S, Mayer J, Munoz-Price LS, Murthy R, et al. Healthcare Personnel Attire in Non-Operating-Room Settings. Infect Control Hosp Epidemiol. 2014;35(2):107–21.

Rehman SU, Nietert PJ, Cope DW, Kilpatrick AO. What to wear today? Effect of doctor’s attire on the trust and confidence of patients. Am J Med. 2005;118(11):1279–86.

Brady B, Veljanova I, Schabrun S, Chipchase L. Integrating culturally informed approaches into physiotherapy assessment and treatment of chronic pain: a pilot randomised controlled trial. BMJ Open. 2018;8(7):e021999.

Miles A, Mezzich JE. The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of clinical practice. Int J Person Centred Med. 2012;1(2):207–22.

Cowell I, McGregor A, O’Sullivan P, O’Sullivan K, Poyton R, Schoeb V, et al. How do physiotherapists solicit and explore patients’ concerns in back pain consultations: a conversation analytic approach. Physiother Theory Pract. 2021;37(6):693–709.

Hutting N, Caneiro JP, Ong'wen MO, Miciak M, Roberts LE. Patient-centered care in musculoskeletal practice: key elements to support clinicians to focus on the person. 2021.

Caneiro JP, Roos EM, Barton CJ, O’Sullivan K, Kent P, Lin I, et al. It is time to move beyond “body region silos” to manage musculoskeletal pain: five actions to change clinical practice. Br J Sports Med. 2020;54(8):438–9.

Greenhalgh T, Howick J, Maskrey N, EBM Renaissance Group. Evidence based medicine: a movement in crisis? Brit Med J. 2014;348:g3725.

Greenhalgh T, Snow R, Ryan S, Rees S, Salisbury H. Six ‘biases’ against patients and carers in evidence-based medicine. Bmc Med. 2015;13(1):200.

Loughlin M, Fuller J, Bluhm R, Buetow S, Borgerson K. Theory, experience and practice. J Eval Clin Pract. 2016;22(4):459–65.

Simpson JK, Innes S. Informed consent, duty of disclosure and chiropractic: where are we? Chiropr Man Therap. 2020;28(1):60.

Download references

Acknowledgements

Use of any animal or human data or tissue.

No funding was received for this paper.

Author information

Authors and affiliations.

School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK

Roger Kerry, Edward Lee & Vasileios Georgopoulos

Allied Health Research Unit, University of Central Lancashire, Preston, PR1 2HE, UK

Kenneth J. Young

Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

David W. Evans

Nottingham CityCare Partnership, Bennerley Rd, Nottingham, NG6 8WR, UK

School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2HA, UK

Vasileios Georgopoulos

Department of Orthopaedics, West Herts Hospitals Trust, Watford, WD18 0HB, UK

Adam Meakins

School of Physiotherapy, Manchester Metropolitan University, Manchester, M15 6GX, UK

Chris McCarthy

Department of Orthopaedics, Duke University, 200 Morris Street, Durham, NC, 27701, USA

School of Sport and Health Sciences, University of Brighton, Darley Rd, Eastbourne, BN20 7UR, UK

Colette Ridehalgh

Clinical Neuroscience, Trafford Building, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK

University College of Osteopathy, 275 Borough High St, London, SE1 1JE, UK

Steven Vogel & Amanda Banton

Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, S-90187, Umeå, Sweden

Cecilia Bergström

The School of Soft Tissue Therapy, Exmouth, Devon, EX8 1DQ, UK

Anna Maria Mazzieri

Department of health, LUNEX, Differdange, 4671, Luxembourg

Firas Mourad

Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, Differdange, 4671, Luxembourg

Department of Occupation and Health, School of Organization and Development, HAN University of Applied Sciences, Nijmegen, the Netherlands

Nathan Hutting

You can also search for this author in PubMed   Google Scholar

Contributions

Concept and research design: RK, KJY, DWE, EL, AM, VG. Data collection: All authors. Data analysis: All authors. Writing and editing of the manuscript: All authors.

Corresponding author

Correspondence to Kenneth J. Young .

Ethics declarations

Ethics approval and consent to participate.

All participants are co-authors. Ethical approval was not necessary.

Consent for publication

Competing interests.

The authors declare that they have no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary material 1., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Kerry, R., Young, K.J., Evans, D.W. et al. A modern way to teach and practice manual therapy. Chiropr Man Therap 32 , 17 (2024). https://doi.org/10.1186/s12998-024-00537-0

Download citation

Received : 18 October 2023

Accepted : 17 April 2024

Published : 21 May 2024

DOI : https://doi.org/10.1186/s12998-024-00537-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Manual Therapy
• Evidence-based healthcare
• Person-centred healthcare
• Physiotherapy
• Chiropractic
• Soft-tissue therapy

Chiropractic & Manual Therapies

ISSN: 2045-709X

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]