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How to Write an Article Review

Last Updated: September 8, 2023 Fact Checked

This article was co-authored by Jake Adams . Jake Adams is an academic tutor and the owner of Simplifi EDU, a Santa Monica, California based online tutoring business offering learning resources and online tutors for academic subjects K-College, SAT & ACT prep, and college admissions applications. With over 14 years of professional tutoring experience, Jake is dedicated to providing his clients the very best online tutoring experience and access to a network of excellent undergraduate and graduate-level tutors from top colleges all over the nation. Jake holds a BS in International Business and Marketing from Pepperdine University. There are 13 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 3,090,561 times.

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

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

Things You Should Know

• Read the article very closely, and then take time to reflect on your evaluation. Consider whether the article effectively achieves what it set out to.
• Write out a full article review by completing your intro, summary, evaluation, and conclusion. Don't forget to add a title, too!
• Proofread your review for mistakes (like grammar and usage), while also cutting down on needless information. [1] X Research source

Preparing to Write Your Review

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

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

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

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

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

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

Writing the Article Review

• For example, in MLA , a citation may look like: Duvall, John N. "The (Super)Marketplace of Images: Television as Unmediated Mediation in DeLillo's White Noise ." Arizona Quarterly 50.3 (1994): 127-53. Print. [10] X Trustworthy Source Purdue Online Writing Lab Trusted resource for writing and citation guidelines Go to source

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

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

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

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

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

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

Sample Article Reviews

Expert Q&A

You Might Also Like

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

About This Article

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

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How to Review a Journal Article

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For many kinds of assignments, like a  literature review , you may be asked to offer a critique or review of a journal article. This is an opportunity for you as a scholar to offer your  qualified opinion  and  evaluation  of how another scholar has composed their article, argument, and research. That means you will be expected to go beyond a simple  summary  of the article and evaluate it on a deeper level. As a college student, this might sound intimidating. However, as you engage with the research process, you are becoming immersed in a particular topic, and your insights about the way that topic is presented are valuable and can contribute to the overall conversation surrounding your topic.

IMPORTANT NOTE!!

Some disciplines, like Criminal Justice, may only want you to summarize the article without including your opinion or evaluation. If your assignment is to summarize the article only, please see our literature review handout.

Before getting started on the critique, it is important to review the article thoroughly and critically. To do this, we recommend take notes,  annotating , and reading the article several times before critiquing. As you read, be sure to note important items like the thesis, purpose, research questions, hypotheses, methods, evidence, key findings, major conclusions, tone, and publication information. Depending on your writing context, some of these items may not be applicable.

Questions to Consider

To evaluate a source, consider some of the following questions. They are broken down into different categories, but answering these questions will help you consider what areas to examine. With each category, we recommend identifying the strengths and weaknesses in each since that is a critical part of evaluation.

Evaluating Purpose and Argument

• How well is the purpose made clear in the introduction through background/context and thesis?
• How well does the abstract represent and summarize the article’s major points and argument?
• How well does the objective of the experiment or of the observation fill a need for the field?
• How well is the argument/purpose articulated and discussed throughout the body of the text?
• How well does the discussion maintain cohesion?

Evaluating the Presentation/Organization of Information

• How appropriate and clear is the title of the article?
• Where could the author have benefited from expanding, condensing, or omitting ideas?
• How clear are the author’s statements? Challenge ambiguous statements.
• What underlying assumptions does the author have, and how does this affect the credibility or clarity of their article?
• How objective is the author in his or her discussion of the topic?
• How well does the organization fit the article’s purpose and articulate key goals?

Evaluating Methods

• How appropriate are the study design and methods for the purposes of the study?
• How detailed are the methods being described? Is the author leaving out important steps or considerations?
• Have the procedures been presented in enough detail to enable the reader to duplicate them?

Evaluating Data

• Scan and spot-check calculations. Are the statistical methods appropriate?
• Do you find any content repeated or duplicated?
• How many errors of fact and interpretation does the author include? (You can check on this by looking up the references the author cites).
• What pertinent literature has the author cited, and have they used this literature appropriately?

Following, we have an example of a summary and an evaluation of a research article. Note that in most literature review contexts, the summary and evaluation would be much shorter. This extended example shows the different ways a student can critique and write about an article.

Chik, A. (2012). Digital gameplay for autonomous foreign language learning: Gamers’ and language teachers’ perspectives. In H. Reinders (ed.),  Digital games in language learning and teaching  (pp. 95-114). Eastbourne, UK: Palgrave Macmillan.

Be sure to include the full citation either in a reference page or near your evaluation if writing an  annotated bibliography .

In Chik’s article “Digital Gameplay for Autonomous Foreign Language Learning: Gamers’ and Teachers’ Perspectives”, she explores the ways in which “digital gamers manage gaming and gaming-related activities to assume autonomy in their foreign language learning,” (96) which is presented in contrast to how teachers view the “pedagogical potential” of gaming. The research was described as an “umbrella project” consisting of two parts. The first part examined 34 language teachers’ perspectives who had limited experience with gaming (only five stated they played games regularly) (99). Their data was recorded through a survey, class discussion, and a seven-day gaming trial done by six teachers who recorded their reflections through personal blog posts. The second part explored undergraduate gaming habits of ten Hong Kong students who were regular gamers. Their habits were recorded through language learning histories, videotaped gaming sessions, blog entries of gaming practices, group discussion sessions, stimulated recall sessions on gaming videos, interviews with other gamers, and posts from online discussion forums. The research shows that while students recognize the educational potential of games and have seen benefits of it in their lives, the instructors overall do not see the positive impacts of gaming on foreign language learning.

The summary includes the article’s purpose, methods, results, discussion, and citations when necessary.

This article did a good job representing the undergraduate gamers’ voices through extended quotes and stories. Particularly for the data collection of the undergraduate gamers, there were many opportunities for an in-depth examination of their gaming practices and histories. However, the representation of the teachers in this study was very uneven when compared to the students. Not only were teachers labeled as numbers while the students picked out their own pseudonyms, but also when viewing the data collection, the undergraduate students were more closely examined in comparison to the teachers in the study. While the students have fifteen extended quotes describing their experiences in their research section, the teachers only have two of these instances in their section, which shows just how imbalanced the study is when presenting instructor voices.

Some research methods, like the recorded gaming sessions, were only used with students whereas teachers were only asked to blog about their gaming experiences. This creates a richer narrative for the students while also failing to give instructors the chance to have more nuanced perspectives. This lack of nuance also stems from the emphasis of the non-gamer teachers over the gamer teachers. The non-gamer teachers’ perspectives provide a stark contrast to the undergraduate gamer experiences and fits neatly with the narrative of teachers not valuing gaming as an educational tool. However, the study mentioned five teachers that were regular gamers whose perspectives are left to a short section at the end of the presentation of the teachers’ results. This was an opportunity to give the teacher group a more complex story, and the opportunity was entirely missed.

Additionally, the context of this study was not entirely clear. The instructors were recruited through a master’s level course, but the content of the course and the institution’s background is not discussed. Understanding this context helps us understand the course’s purpose(s) and how those purposes may have influenced the ways in which these teachers interpreted and saw games. It was also unclear how Chik was connected to this masters’ class and to the students. Why these particular teachers and students were recruited was not explicitly defined and also has the potential to skew results in a particular direction.

Overall, I was inclined to agree with the idea that students can benefit from language acquisition through gaming while instructors may not see the instructional value, but I believe the way the research was conducted and portrayed in this article made it very difficult to support Chik’s specific findings.

Some professors like you to begin an evaluation with something positive but isn’t always necessary.

The evaluation is clearly organized and uses transitional phrases when moving to a new topic.

This evaluation includes a summative statement that gives the overall impression of the article at the end, but this can also be placed at the beginning of the evaluation.

This evaluation mainly discusses the representation of data and methods. However, other areas, like organization, are open to critique.

How to write a journal article review: Do the writing

• What's in this Guide
• What is a journal article?
• Create a template
• Choose your article to review
• Read your article carefully

Do the writing

• Remember to edit
• Additional resources

Start to write. Follow the instructions of your assessment, then structure your writing accordingly.

The four key parts of a journal article review are:

3. A critique, or a discussion about the key points of the journal article.

A critique is a discussion about the key points of the journal article. It should be a balanced discussion about the  strengths and weaknesses of the key points and structure of the article.

You will also need to discuss if the author(s) points are valid (supported by other literature) and robust (would you get the same outcome if the way the information was gathered was repeated).

Example of part of a critique

4. A conclusion - a final evaluation of the article

1. Give an overall opinion of the text.

2. Briefly summarise key points and determine if they are valid, useful, accurate etc.

3. Remember, do not include new ideas or opinions in the conclusion.

Pathways and Academic Learning Support

• << Previous: Read your article carefully
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• Last Updated: Apr 27, 2023 4:28 PM
• URL: https://libguides.newcastle.edu.au/how-to-write-a-journal-article-review

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How to Write a Peer Review

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

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

Review Outline

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

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

Here’s how your outline might look:

1. Summary of the research and your overall impression

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

2. Discussion of specific areas for improvement

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

Major vs. minor issues

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

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

3. Any other points

Confidential comments for the editors.

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

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

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

Get this outline in a template

Giving Feedback

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

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

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

General guidelines for effective feedback

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

Don’t

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

Before and After: Sample Reviewer Comments

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

✗ Before

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

✓ After

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

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

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

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

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

Suggested Language for Tricky Situations

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

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

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

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

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

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

What does a good review look like?

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

Time to Submit the Review!

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

Tip: Building a relationship with an editor

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

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

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

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

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

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

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

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

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

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

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

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

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

Sample Review:

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

Introduction:

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

Strengths and weaknesses:

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

Implications:

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

Recommendations:

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

Conclusion:

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

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Writing a Scientific Review Article: Comprehensive Insights for Beginners

Ayodeji amobonye.

1 Department of Biotechnology and Food Science, Faculty of Applied Sciences, Durban University of Technology, P.O. Box 1334, KwaZulu-Natal, Durban 4000, South Africa

2 Writing Centre, Durban University of Technology, P.O. Box 1334 KwaZulu-Natal, Durban 4000, South Africa

Japareng Lalung

3 School of Industrial Technology, Universiti Sains Malaysia, Gelugor 11800, Pulau Pinang, Malaysia

Santhosh Pillai

Associated data.

The data and materials that support the findings of this study are available from the corresponding author upon reasonable request.

Review articles present comprehensive overview of relevant literature on specific themes and synthesise the studies related to these themes, with the aim of strengthening the foundation of knowledge and facilitating theory development. The significance of review articles in science is immeasurable as both students and researchers rely on these articles as the starting point for their research. Interestingly, many postgraduate students are expected to write review articles for journal publications as a way of demonstrating their ability to contribute to new knowledge in their respective fields. However, there is no comprehensive instructional framework to guide them on how to analyse and synthesise the literature in their niches into publishable review articles. The dearth of ample guidance or explicit training results in students having to learn all by themselves, usually by trial and error, which often leads to high rejection rates from publishing houses. Therefore, this article seeks to identify these challenges from a beginner's perspective and strives to plug the identified gaps and discrepancies. Thus, the purpose of this paper is to serve as a systematic guide for emerging scientists and to summarise the most important information on how to write and structure a publishable review article.

1. Introduction

Early scientists, spanning from the Ancient Egyptian civilization to the Scientific Revolution of the 16 th /17 th century, based their research on intuitions, personal observations, and personal insights. Thus, less time was spent on background reading as there was not much literature to refer to. This is well illustrated in the case of Sir Isaac Newton's apple tree and the theory of gravity, as well as Gregor Mendel's pea plants and the theory of inheritance. However, with the astronomical expansion in scientific knowledge and the emergence of the information age in the last century, new ideas are now being built on previously published works, thus the periodic need to appraise the huge amount of already published literature [ 1 ]. According to Birkle et al. [ 2 ], the Web of Science—an authoritative database of research publications and citations—covered more than 80 million scholarly materials. Hence, a critical review of prior and relevant literature is indispensable for any research endeavour as it provides the necessary framework needed for synthesising new knowledge and for highlighting new insights and perspectives [ 3 ].

Review papers are generally considered secondary research publications that sum up already existing works on a particular research topic or question and relate them to the current status of the topic. This makes review articles distinctly different from scientific research papers. While the primary aim of the latter is to develop new arguments by reporting original research, the former is focused on summarising and synthesising previous ideas, studies, and arguments, without adding new experimental contributions. Review articles basically describe the content and quality of knowledge that are currently available, with a special focus on the significance of the previous works. To this end, a review article cannot simply reiterate a subject matter, but it must contribute to the field of knowledge by synthesising available materials and offering a scholarly critique of theory [ 4 ]. Typically, these articles critically analyse both quantitative and qualitative studies by scrutinising experimental results, the discussion of the experimental data, and in some instances, previous review articles to propose new working theories. Thus, a review article is more than a mere exhaustive compilation of all that has been published on a topic; it must be a balanced, informative, perspective, and unbiased compendium of previous studies which may also include contrasting findings, inconsistencies, and conventional and current views on the subject [ 5 ].

Hence, the essence of a review article is measured by what is achieved, what is discovered, and how information is communicated to the reader [ 6 ]. According to Steward [ 7 ], a good literature review should be analytical, critical, comprehensive, selective, relevant, synthetic, and fully referenced. On the other hand, a review article is considered to be inadequate if it is lacking in focus or outcome, overgeneralised, opinionated, unbalanced, and uncritical [ 7 ]. Most review papers fail to meet these standards and thus can be viewed as mere summaries of previous works in a particular field of study. In one of the few studies that assessed the quality of review articles, none of the 50 papers that were analysed met the predefined criteria for a good review [ 8 ]. However, beginners must also realise that there is no bad writing in the true sense; there is only writing in evolution and under refinement. Literally, every piece of writing can be improved upon, right from the first draft until the final published manuscript. Hence, a paper can only be referred to as bad and unfixable when the author is not open to corrections or when the writer gives up on it.

According to Peat et al. [ 9 ], “everything is easy when you know how,” a maxim which applies to scientific writing in general and review writing in particular. In this regard, the authors emphasized that the writer should be open to learning and should also follow established rules instead of following a blind trial-and-error approach. In contrast to the popular belief that review articles should only be written by experienced scientists and researchers, recent trends have shown that many early-career scientists, especially postgraduate students, are currently expected to write review articles during the course of their studies. However, these scholars have little or no access to formal training on how to analyse and synthesise the research literature in their respective fields [ 10 ]. Consequently, students seeking guidance on how to write or improve their literature reviews are less likely to find published works on the subject, particularly in the science fields. Although various publications have dealt with the challenges of searching for literature, or writing literature reviews for dissertation/thesis purposes, there is little or no information on how to write a comprehensive review article for publication. In addition to the paucity of published information to guide the potential author, the lack of understanding of what constitutes a review paper compounds their challenges. Thus, the purpose of this paper is to serve as a guide for writing review papers for journal publishing. This work draws on the experience of the authors to assist early-career scientists/researchers in the “hard skill” of authoring review articles. Even though there is no single path to writing scientifically, or to writing reviews in particular, this paper attempts to simplify the process by looking at this subject from a beginner's perspective. Hence, this paper highlights the differences between the types of review articles in the sciences while also explaining the needs and purpose of writing review articles. Furthermore, it presents details on how to search for the literature as well as how to structure the manuscript to produce logical and coherent outputs. It is hoped that this work will ease prospective scientific writers into the challenging but rewarding art of writing review articles.

2. Benefits of Review Articles to the Author

Analysing literature gives an overview of the “WHs”: WHat has been reported in a particular field or topic, WHo the key writers are, WHat are the prevailing theories and hypotheses, WHat questions are being asked (and answered), and WHat methods and methodologies are appropriate and useful [ 11 ]. For new or aspiring researchers in a particular field, it can be quite challenging to get a comprehensive overview of their respective fields, especially the historical trends and what has been studied previously. As such, the importance of review articles to knowledge appraisal and contribution cannot be overemphasised, which is reflected in the constant demand for such articles in the research community. However, it is also important for the author, especially the first-time author, to recognise the importance of his/her investing time and effort into writing a quality review article.

Generally, literature reviews are undertaken for many reasons, mainly for publication and for dissertation purposes. The major purpose of literature reviews is to provide direction and information for the improvement of scientific knowledge. They also form a significant component in the research process and in academic assessment [ 12 ]. There may be, however, a thin line between a dissertation literature review and a published review article, given that with some modifications, a literature review can be transformed into a legitimate and publishable scholarly document. According to Gülpınar and Güçlü [ 6 ], the basic motivation for writing a review article is to make a comprehensive synthesis of the most appropriate literature on a specific research inquiry or topic. Thus, conducting a literature review assists in demonstrating the author's knowledge about a particular field of study, which may include but not be limited to its history, theories, key variables, vocabulary, phenomena, and methodologies [ 10 ]. Furthermore, publishing reviews is beneficial as it permits the researchers to examine different questions and, as a result, enhances the depth and diversity of their scientific reasoning [ 1 ]. In addition, writing review articles allows researchers to share insights with the scientific community while identifying knowledge gaps to be addressed in future research. The review writing process can also be a useful tool in training early-career scientists in leadership, coordination, project management, and other important soft skills necessary for success in the research world [ 13 ]. Another important reason for authoring reviews is that such publications have been observed to be remarkably influential, extending the reach of an author in multiple folds of what can be achieved by primary research papers [ 1 ]. The trend in science is for authors to receive more citations from their review articles than from their original research articles. According to Miranda and Garcia-Carpintero [ 14 ], review articles are, on average, three times more frequently cited than original research articles; they also asserted that a 20% increase in review authorship could result in a 40–80% increase in citations of the author. As a result, writing reviews can significantly impact a researcher's citation output and serve as a valuable channel to reach a wider scientific audience. In addition, the references cited in a review article also provide the reader with an opportunity to dig deeper into the topic of interest. Thus, review articles can serve as a valuable repository for consultation, increasing the visibility of the authors and resulting in more citations.

3. Types of Review Articles

The first step in writing a good literature review is to decide on the particular type of review to be written; hence, it is important to distinguish and understand the various types of review articles. Although scientific review articles have been classified according to various schemes, however, they are broadly categorised into narrative reviews, systematic reviews, and meta-analyses [ 15 ]. It was observed that more authors—as well as publishers—were leaning towards systematic reviews and meta-analysis while downplaying narrative reviews; however, the three serve different aims and should all be considered equally important in science [ 1 ]. Bibliometric reviews and patent reviews, which are closely related to meta-analysis, have also gained significant attention recently. However, from another angle, a review could also be of two types. In the first class, authors could deal with a widely studied topic where there is already an accumulated body of knowledge that requires analysis and synthesis [ 3 ]. At the other end of the spectrum, the authors may have to address an emerging issue that would benefit from exposure to potential theoretical foundations; hence, their contribution would arise from the fresh theoretical foundations proposed in developing a conceptual model [ 3 ].

3.1. Narrative Reviews

Narrative reviewers are mainly focused on providing clarification and critical analysis on a particular topic or body of literature through interpretative synthesis, creativity, and expert judgement. According to Green et al. [ 16 ], a narrative review can be in the form of editorials, commentaries, and narrative overviews. However, editorials and commentaries are usually expert opinions; hence, a beginner is more likely to write a narrative overview, which is more general and is also referred to as an unsystematic narrative review. Similarly, the literature review section of most dissertations and empirical papers is typically narrative in nature. Typically, narrative reviews combine results from studies that may have different methodologies to address different questions or to formulate a broad theoretical formulation [ 1 ]. They are largely integrative as strong focus is placed on the assimilation and synthesis of various aspects in the review, which may involve comparing and contrasting research findings or deriving structured implications [ 17 ]. In addition, they are also qualitative studies because they do not follow strict selection processes; hence, choosing publications is relatively more subjective and unsystematic [ 18 ]. However, despite their popularity, there are concerns about their inherent subjectivity. In many instances, when the supporting data for narrative reviews are examined more closely, the evaluations provided by the author(s) become quite questionable [ 19 ]. Nevertheless, if the goal of the author is to formulate a new theory that connects diverse strands of research, a narrative method is most appropriate.

3.2. Systematic Reviews

In contrast to narrative reviews, which are generally descriptive, systematic reviews employ a systematic approach to summarise evidence on research questions. Hence, systematic reviews make use of precise and rigorous criteria to identify, evaluate, and subsequently synthesise all relevant literature on a particular topic [ 12 , 20 ]. As a result, systematic reviews are more likely to inspire research ideas by identifying knowledge gaps or inconsistencies, thus helping the researcher to clearly define the research hypotheses or questions [ 21 ]. Furthermore, systematic reviews may serve as independent research projects in their own right, as they follow a defined methodology to search and combine reliable results to synthesise a new database that can be used for a variety of purposes [ 22 ]. Typically, the peculiarities of the individual reviewer, different search engines, and information databases used all ensure that no two searches will yield the same systematic results even if the searches are conducted simultaneously and under identical criteria [ 11 ]. Hence, attempts are made at standardising the exercise via specific methods that would limit bias and chance effects, prevent duplications, and provide more accurate results upon which conclusions and decisions can be made.

The most established of these methods is the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines which objectively defined statements, guidelines, reporting checklists, and flowcharts for undertaking systematic reviews as well as meta-analysis [ 23 ]. Though mainly designed for research in medical sciences, the PRISMA approach has gained wide acceptance in other fields of science and is based on eight fundamental propositions. These include the explicit definition of the review question, an unambiguous outline of the study protocol, an objective and exhaustive systematic review of reputable literature, and an unambiguous identification of included literature based on defined selection criteria [ 24 ]. Other considerations include an unbiased appraisal of the quality of the selected studies (literature), organic synthesis of the evidence of the study, preparation of the manuscript based on the reporting guidelines, and periodic update of the review as new data emerge [ 24 ]. Other methods such as PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols), MOOSE (Meta-analysis Of Observational Studies in Epidemiology), and ROSES (Reporting Standards for Systematic Evidence Syntheses) have since been developed for systematic reviews (and meta-analysis), with most of them being derived from PRISMA.

Consequently, systematic reviews—unlike narrative reviews—must contain a methodology section which in addition to all that was highlighted above must fully describe the precise criteria used in formulating the research question and setting the inclusion or exclusion criteria used in selecting/accessing the literature. Similarly, the criteria for evaluating the quality of the literature included in the review as well as for analysing, synthesising, and disseminating the findings must be fully described in the methodology section.

3.3. Meta-Analysis

Meta-analyses are considered as more specialised forms of systematic reviews. Generally, they combine the results of many studies that use similar or closely related methods to address the same question or share a common quantitative evaluation method [ 25 ]. However, meta-analyses are also a step higher than other systematic reviews as they are focused on numerical data and involve the use of statistics in evaluating different studies and synthesising new knowledge. The major advantage of this type of review is the increased statistical power leading to more reliable results for inferring modest associations and a more comprehensive understanding of the true impact of a research study [ 26 ]. Unlike in traditional systematic reviews, research topics covered in meta-analyses must be mature enough to allow the inclusion of sufficient homogeneous empirical research in terms of subjects, interventions, and outcomes [ 27 , 28 ].

Being an advanced form of systematic review, meta-analyses must also have a distinct methodology section; hence, the standard procedures involved in the traditional systematic review (especially PRISMA) also apply in meta-analyses [ 23 ]. In addition to the common steps in formulating systematic reviews, meta-analyses are required to describe how nested and missing data are handled, the effect observed in each study, the confidence interval associated with each synthesised effect, and any potential for bias presented within the sample(s) [ 17 ]. According to Paul and Barari [ 28 ], a meta-analysis must also detail the final sample, the meta-analytic model, and the overall analysis, moderator analysis, and software employed. While the overall analysis involves the statistical characterization of the relationships between variables in the meta-analytic framework and their significance, the moderator analysis defines the different variables that may affect variations in the original studies [ 28 , 29 ]. It must also be noted that the accuracy and reliability of meta-analyses have both been significantly enhanced by the incorporation of statistical approaches such as Bayesian analysis [ 30 ], network analysis [ 31 ], and more recently, machine learning [ 32 ].

3.4. Bibliometric Review

A bibliometric review, commonly referred to as bibliometric analysis, is a systematic evaluation of published works within a specific field or discipline [ 33 ]. This bibliometric methodology involves the use of quantitative methods to analyse bibliometric data such as the characteristics and numbers of publications, units of citations, authorship, co-authorship, and journal impact factors [ 34 ]. Academics use bibliometric analysis with different objectives in mind, which includes uncovering emerging trends in article and journal performance, elaborating collaboration patterns and research constituents, evaluating the impact and influence of particular authors, publications, or research groups, and highlighting the intellectual framework of a certain field [ 35 ]. It is also used to inform policy and decision-making. Similarly to meta-analysis, bibliometric reviews rely upon quantitative techniques, thus avoiding the interpretation bias that could arise from the qualitative techniques of other types of reviews [ 36 ]. However, while bibliometric analysis synthesises the bibliometric and intellectual structure of a field by examining the social and structural linkages between various research parts, meta-analysis focuses on summarising empirical evidence by probing the direction and strength of effects and relationships among variables, especially in open research questions [ 37 , 38 ]. However, similarly to systematic review and meta-analysis, a bibliometric review also requires a well-detailed methodology section. The amount of data to be analysed in bibliometric analysis is quite massive, running to hundreds and tens of thousands in some cases. Although the data are objective in nature (e.g., number of citations and publications and occurrences of keywords and topics), the interpretation is usually carried out through both objective (e.g., performance analysis) and subjective (e.g., thematic analysis) evaluations [ 35 ]. However, the invention and availability of bibliometric software such as BibExcel, Gephi, Leximancer, and VOSviewer and scientific databases such as Dimensions, Web of Science, and Scopus have made this type of analysis more feasible.

3.5. Patent Review

Patent reviews provide a comprehensive analysis and critique of a specific patent or a group of related patents, thus presenting a concise understanding of the technology or innovation that is covered by the patent [ 39 ]. This type of article is useful for researchers as it also enhances their understanding of the legal, technical, and commercial aspects of an intellectual property/innovation; in addition, it is also important for stakeholders outside the research community including IP (intellectual property) specialists, legal professionals, and technology-transfer officers [ 40 ]. Typically, patent reviews encompass the scope, background, claims, legal implications, technical specifications, and potential commercial applications of the patent(s). The article may also include a discussion of the patent's strengths and weaknesses, as well as its potential impact on the industry or field in which it operates. Most times, reviews are time specified, they may be regionalised, and the data are usually retrieved via patent searches on databases such as that of the European Patent Office ( https://www.epo.org/searching.html ), United States Patent and Trademark Office ( https://patft.uspto.gov/ ), the World Intellectual Property Organization's PATENTSCOPE ( https://patentscope.wipo.int/search/en/structuredSearch.jsf ), Google Patent ( https://www.google.com/?tbm=pts ), and China National Intellectual Property Administration ( https://pss-system.cponline.cnipa.gov.cn/conventionalSearch ). According to Cerimi et al. [ 41 ], the retrieved data and analysed may include the patent number, patent status, filing date, application date, grant dates, inventor, assignee, and pending applications. While data analysis is usually carried out by general data software such as Microsoft Excel, an intelligence software solely dedicated to patent research and analysis, Orbit Intelligence has been found to be more efficient [ 39 ]. It is also mandatory to include a methodology section in a patent review, and this should be explicit, thorough, and precise to allow a clear understanding of how the analysis was carried out and how the conclusions were arrived at.

4. Searching Literature

One of the most challenging tasks in writing a review article on a subject is the search for relevant literature to populate the manuscript as the author is required to garner information from an endless number of sources. This is even more challenging as research outputs have been increasing astronomically, especially in the last decade, with thousands of new articles published annually in various fields. It is therefore imperative that the author must not only be aware of the overall trajectory in a field of investigation but must also be cognizant of recent studies so as not to publish outdated research or review articles. Basically, the search for the literature involves a coherent conceptual structuring of the topic itself and a thorough collation of evidence under the common themes which might reflect the histories, conflicts, standoffs, revolutions, and/or evolutions in the field [ 7 ]. To start the search process, the author must carefully identify and select broad keywords relevant to the subject; subsequently, the keywords should be developed to refine the search into specific subheadings that would facilitate the structure of the review.

Two main tactics have been identified for searching the literature, namely, systematic and snowballing [ 42 ]. The systematic approach involves searching literature with specific keywords (for example, cancer, antioxidant, and nanoparticles), which leads to an almost unmanageable and overwhelming list of possible sources [ 43 ]. The snowballing approach, however, involves the identification of a particular publication, followed by the compilation of a bibliography of articles based on the reference list of the identified publication [ 44 ]. Many times, it might be necessary to combine both approaches, but irrespective, the author must keep an accurate track and record of papers cited in the search. A simple and efficient strategy for populating the bibliography of review articles is to go through the abstract (and sometimes the conclusion) of a paper; if the abstract is related to the topic of discourse, the author might go ahead and read the entire article; otherwise, he/she is advised to move on [ 45 ]. Winchester and Salji [ 5 ] noted that to learn the background of the subject/topic to be reviewed, starting literature searches with academic textbooks or published review articles is imperative, especially for beginners. Furthermore, it would also assist in compiling the list of keywords, identifying areas of further exploration, and providing a glimpse of the current state of the research. However, past reviews ideally are not to serve as the foundation of a new review as they are written from someone else's viewpoint, which might have been tainted with some bias. Fortunately, the accessibility and search for the literature have been made relatively easier than they were a few decades ago as the current information age has placed an enormous volume of knowledge right at our fingertips [ 46 ]. Nevertheless, when gathering the literature from the Internet, authors should exercise utmost caution as much of the information may not be verified or peer-reviewed and thus may be unregulated and unreliable. For instance, Wikipedia, despite being a large repository of information with more than 6.7 million articles in the English language alone, is considered unreliable for scientific literature reviews, due to its openness to public editing [ 47 ]. However, in addition to peer-reviewed journal publications—which are most ideal—reviews can also be drawn from a wide range of other sources such as technical documents, in-house reports, conference abstracts, and conference proceedings. Similarly, “Google Scholar”—as against “Google” and other general search engines—is more appropriate as its searches are restricted to only academic articles produced by scholarly societies or/and publishers [ 48 ]. Furthermore, the various electronic databases, such as ScienceDirect, Web of Science, PubMed, and MEDLINE, many of which focus on specific fields of research, are also ideal options [ 49 ]. Advancement in computer indexing has remarkably expanded the ease and ability to search large databases for every potentially relevant article. In addition to searching by topic, literature search can be modified by time; however, there must be a balance between old papers and recent ones. The general consensus in science is that publications less than five years old are considered recent.

It is important, especially in systematic reviews and meta-analyses, that the specific method of running the computer searches be properly documented as there is the need to include this in the method (methodology) section of such papers. Typically, the method details the keywords, databases explored, search terms used, and the inclusion/exclusion criteria applied in the selection of data and any other specific decision/criteria. All of these will ensure the reproducibility and thoroughness of the search and the selection procedure. However, Randolph [ 10 ] noted that Internet searches might not give the exhaustive list of articles needed for a review article; hence, it is advised that authors search through the reference lists of articles that were obtained initially from the Internet search. After determining the relevant articles from the list, the author should read through the references of these articles and repeat the cycle until saturation is reached [ 10 ]. After populating the articles needed for the literature review, the next step is to analyse them individually and in their whole entirety. A systematic approach to this is to identify the key information within the papers, examine them in depth, and synthesise original perspectives by integrating the information and making inferences based on the findings. In this regard, it is imperative to link one source to the other in a logical manner, for instance, taking note of studies with similar methodologies, papers that agree, or results that are contradictory [ 42 ].

5. Structuring the Review Article

The title and abstract are the main selling points of a review article, as most readers will only peruse these two elements and usually go on to read the full paper if they are drawn in by either or both of the two. Tullu [ 50 ] recommends that the title of a scientific paper “should be descriptive, direct, accurate, appropriate, interesting, concise, precise, unique, and not be misleading.” In addition to providing “just enough details” to entice the reader, words in the titles are also used by electronic databases, journal websites, and search engines to index and retrieve a particular paper during a search [ 51 ]. Titles are of different types and must be chosen according to the topic under review. They are generally classified as descriptive, declarative, or interrogative and can also be grouped into compound, nominal, or full-sentence titles [ 50 ]. The subject of these categorisations has been extensively discussed in many articles; however, the reader must also be aware of the compound titles, which usually contain a main title and a subtitle. Typically, subtitles provide additional context—to the main title—and they may specify the geographic scope of the research, research methodology, or sample size [ 52 ].

Just like primary research articles, there are many debates about the optimum length of a review article's title. However, the general consensus is to keep the title as brief as possible while not being too general. A title length between 10 and 15 words is recommended, since longer titles can be more challenging to comprehend. Paiva et al. [ 53 ] observed that articles which contain 95 characters or less get more views and citations. However, emphasis must be placed on conciseness as the audience will be more satisfied if they can understand what exactly the review has contributed to the field, rather than just a hint about the general topic area. Authors should also endeavour to stick to the journal's specific requirements, especially regarding the length of the title and what they should or should not contain [ 9 ]. Thus, avoidance of filler words such as “a review on/of,” “an observation of,” or “a study of” is a very simple way to limit title length. In addition, abbreviations or acronyms should be avoided in the title, except the standard or commonly interpreted ones such as AIDS, DNA, HIV, and RNA. In summary, to write an effective title, the authors should consider the following points. What is the paper about? What was the methodology used? What were the highlights and major conclusions? Subsequently, the author should list all the keywords from these answers, construct a sentence from these keywords, and finally delete all redundant words from the sentence title. It is also possible to gain some ideas by scanning indices and article titles in major journals in the field. It is important to emphasise that a title is not chosen and set in stone, and the title is most likely to be continually revised and adjusted until the end of the writing process.

5.2. Abstract

The abstract, also referred to as the synopsis, is a summary of the full research paper; it is typically independent and can stand alone. For most readers, a publication does not exist beyond the abstract, partly because abstracts are often the only section of a paper that is made available to the readers at no cost, whereas the full paper may attract a payment or subscription [ 54 ]. Thus, the abstract is supposed to set the tone for the few readers who wish to read the rest of the paper. It has also been noted that the abstract gives the first impression of a research work to journal editors, conference scientific committees, or referees, who might outright reject the paper if the abstract is poorly written or inadequate [ 50 ]. Hence, it is imperative that the abstract succinctly represents the entire paper and projects it positively. Just like the title, abstracts have to be balanced, comprehensive, concise, functional, independent, precise, scholarly, and unbiased and not be misleading [ 55 ]. Basically, the abstract should be formulated using keywords from all the sections of the main manuscript. Thus, it is pertinent that the abstract conveys the focus, key message, rationale, and novelty of the paper without any compromise or exaggeration. Furthermore, the abstract must be consistent with the rest of the paper; as basic as this instruction might sound, it is not to be taken for granted. For example, a study by Vrijhoef and Steuten [ 56 ] revealed that 18–68% of 264 abstracts from some scientific journals contained information that was inconsistent with the main body of the publications.

Abstracts can either be structured or unstructured; in addition, they can further be classified as either descriptive or informative. Unstructured abstracts, which are used by many scientific journals, are free flowing with no predefined subheadings, while structured abstracts have specific subheadings/subsections under which the abstract needs to be composed. Structured abstracts have been noted to be more informative and are usually divided into subsections which include the study background/introduction, objectives, methodology design, results, and conclusions [ 57 ]. No matter the style chosen, the author must carefully conform to the instructions provided by the potential journal of submission, which may include but are not limited to the format, font size/style, word limit, and subheadings [ 58 ]. The word limit for abstracts in most scientific journals is typically between 150 and 300 words. It is also a general rule that abstracts do not contain any references whatsoever.

Typically, an abstract should be written in the active voice, and there is no such thing as a perfect abstract as it could always be improved on. It is advised that the author first makes an initial draft which would contain all the essential parts of the paper, which could then be polished subsequently. The draft should begin with a brief background which would lead to the research questions. It might also include a general overview of the methodology used (if applicable) and importantly, the major results/observations/highlights of the review paper. The abstract should end with one or few sentences about any implications, perspectives, or future research that may be developed from the review exercise. Finally, the authors should eliminate redundant words and edit the abstract to the correct word count permitted by the journal [ 59 ]. It is always beneficial to read previous abstracts published in the intended journal, related topics/subjects from other journals, and other reputable sources. Furthermore, the author should endeavour to get feedback on the abstract especially from peers and co-authors. As the abstract is the face of the whole paper, it is best that it is the last section to be finalised, as by this time, the author would have developed a clearer understanding of the findings and conclusions of the entire paper.

5.3. Graphical Abstracts

Since the mid-2000s, an increasing number of journals now require authors to provide a graphical abstract (GA) in addition to the traditional written abstract, to increase the accessibility of scientific publications to readers [ 60 ]. A study showed that publications with GA performed better than those without it, when the abstract views, total citations, and downloads were compared [ 61 ]. However, the GA should provide “a single, concise pictorial, and visual summary of the main findings of an article” [ 62 ]. Although they are meant to be a stand-alone summary of the whole paper, it has been noted that they are not so easily comprehensible without having read through the traditionally written abstract [ 63 ]. It is important to note that, like traditional abstracts, many reputable journals require GAs to adhere to certain specifications such as colour, dimension, quality, file size, and file format (usually JPEG/JPG, PDF, PNG, or TIFF). In addition, it is imperative to use engaging and accurate figures, all of which must be synthesised in order to accurately reflect the key message of the paper. Currently, there are various online or downloadable graphical tools that can be used for creating GAs, such as Microsoft Paint or PowerPoint, Mindthegraph, ChemDraw, CorelDraw, and BioRender.

5.4. Keywords

As a standard practice, journals require authors to select 4–8 keywords (or phrases), which are typically listed below the abstract. A good set of keywords will enable indexers and search engines to find relevant papers more easily and can be considered as a very concise abstract [ 64 ]. According to Dewan and Gupta [ 51 ], the selection of appropriate keywords will significantly enhance the retrieval, accession, and consequently, the citation of the review paper. Ideally, keywords can be variants of the terms/phrases used in the title, the abstract, and the main text, but they should ideally not be the exact words in the main title. Choosing the most appropriate keywords for a review article involves listing down the key terms and phrases in the article, including abbreviations. Subsequently, a quick review of the glossary/vocabulary/term list or indexing standard in the specific discipline will assist in selecting the best and most precise keywords that match those used in the databases from the list drawn. In addition, the keywords should not be broad or general terms (e.g., DNA, biology, and enzymes) but must be specific to the field or subfield of study as well as to the particular paper [ 65 ].

5.5. Introduction

The introduction of an article is the first major section of the manuscript, and it presents basic information to the reader without compelling them to study past publications. In addition, the introduction directs the reader to the main arguments and points developed in the main body of the article while clarifying the current state of knowledge in that particular area of research [ 12 ]. The introduction part of a review article is usually sectionalised into background information, a description of the main topic and finally a statement of the main purpose of the review [ 66 ]. Authors may begin the introduction with brief general statements—which provide background knowledge on the subject matter—that lead to more specific ones [ 67 ]. It is at this point that the reader's attention must be caught as the background knowledge must highlight the importance and justification for the subject being discussed, while also identifying the major problem to be addressed [ 68 ]. In addition, the background should be broad enough to attract even nonspecialists in the field to maximise the impact and widen the reach of the article. All of these should be done in the light of current literature; however, old references may also be used for historical purposes. A very important aspect of the introduction is clearly stating and establishing the research problem(s) and how a review of the particular topic contributes to those problem(s). Thus, the research gap which the paper intends to fill, the limitations of previous works and past reviews, if available, and the new knowledge to be contributed must all be highlighted. Inadequate information and the inability to clarify the problem will keep readers (who have the desire to obtain new information) from reading beyond the introduction [ 69 ]. It is also pertinent that the author establishes the purpose of reviewing the literature and defines the scope as well as the major synthesised point of view. Furthermore, a brief insight into the criteria used to select, evaluate, and analyse the literature, as well as the outline or sequence of the review, should be provided in the introduction. Subsequently, the specific objectives of the review article must be presented. The last part of the “introduction” section should focus on the solution, the way forward, the recommendations, and the further areas of research as deduced from the whole review process. According to DeMaria [ 70 ], clearly expressed or recommended solutions to an explicitly revealed problem are very important for the wholesomeness of the “introduction” section. It is believed that following these steps will give readers the opportunity to track the problems and the corresponding solution from their own perspective in the light of current literature. As against some suggestions that the introduction should be written only in present tenses, it is also believed that it could be done with other tenses in addition to the present tense. In this regard, general facts should be written in the present tense, specific research/work should be in the past tense, while the concluding statement should be in the past perfect or simple past. Furthermore, many of the abbreviations to be used in the rest of the manuscript and their explanations should be defined in this section.

5.6. Methodology

Writing a review article is equivalent to conducting a research study, with the information gathered by the author (reviewer) representing the data. Like all major studies, it involves conceptualisation, planning, implementation, and dissemination [ 71 ], all of which may be detailed in a methodology section, if necessary. Hence, the methodological section of a review paper (which can also be referred to as the review protocol) details how the relevant literature was selected and how it was analysed as well as summarised. The selection details may include, but are not limited to, the database consulted and the specific search terms used together with the inclusion/exclusion criteria. As earlier highlighted in Section 3 , a description of the methodology is required for all types of reviews except for narrative reviews. This is partly because unlike narrative reviews, all other review articles follow systematic approaches which must ensure significant reproducibility [ 72 ]. Therefore, where necessary, the methods of data extraction from the literature and data synthesis must also be highlighted as well. In some cases, it is important to show how data were combined by highlighting the statistical methods used, measures of effect, and tests performed, as well as demonstrating heterogeneity and publication bias [ 73 ].

The methodology should also detail the major databases consulted during the literature search, e.g., Dimensions, ScienceDirect, Web of Science, MEDLINE, and PubMed. For meta-analysis, it is imperative to highlight the software and/or package used, which could include Comprehensive Meta-Analysis, OpenMEE, Review Manager (RevMan), Stata, SAS, and R Studio. It is also necessary to state the mathematical methods used for the analysis; examples of these include the Bayesian analysis, the Mantel–Haenszel method, and the inverse variance method. The methodology should also state the number of authors that carried out the initial review stage of the study, as it has been recommended that at least two reviews should be done blindly and in parallel, especially when it comes to the acquisition and synthesis of data [ 74 ]. Finally, the quality and validity assessment of the publication used in the review must be stated and well clarified [ 73 ].

5.7. Main Body of the Review

Ideally, the main body of a publishable review should answer these questions: What is new (contribution)? Why so (logic)? So what (impact)? How well it is done (thoroughness)? The flow of the main body of a review article must be well organised to adequately maintain the attention of the readers as well as guide them through the section. It is recommended that the author should consider drawing a conceptual scheme of the main body first, using methods such as mind-mapping. This will help create a logical flow of thought and presentation, while also linking the various sections of the manuscript together. According to Moreira [ 75 ], “reports do not simply yield their findings, rather reviewers make them yield,” and thus, it is the author's responsibility to transform “resistant” texts into “docile” texts. Hence, after the search for the literature, the essential themes and key concepts of the review paper must be identified and synthesised together. This synthesis primarily involves creating hypotheses about the relationships between the concepts with the aim of increasing the understanding of the topic being reviewed. The important information from the various sources should not only be summarised, but the significance of studies must be related back to the initial question(s) posed by the review article. Furthermore, MacLure [ 76 ] stated that data are not just to be plainly “extracted intact” and “used exactly as extracted,” but must be modified, reconfigured, transformed, transposed, converted, tabulated, graphed, or manipulated to enable synthesis, combination, and comparison. Therefore, different pieces of information must be extracted from the reports in which they were previously deposited and then refined into the body of the new article [ 75 ]. To this end, adequate comparison and combination might require that “qualitative data be quantified” or/and “quantitative data may be qualitized” [ 77 ]. In order to accomplish all of these goals, the author may have to transform, paraphrase, generalize, specify, and reorder the text [ 78 ]. For comprehensiveness, the body paragraphs should be arranged in a similar order as it was initially stated in the abstract or/and introduction. Thus, the main body could be divided into thematic areas, each of which could be independently comprehensive and treated as a mini review. Similarly, the sections can also be arranged chronologically depending on the focus of the review. Furthermore, the abstractions should proceed from a wider general view of the literature being reviewed and then be narrowed down to the specifics. In the process, deep insights should also be provided between the topic of the review and the wider subject area, e.g., fungal enzymes and enzymes in general. The abstractions must also be discussed in more detail by presenting more specific information from the identified sources (with proper citations of course!). For example, it is important to identify and highlight contrary findings and rival interpretations as well as to point out areas of agreement or debate among different bodies of literature. Often, there are previous reviews on the same topic/concept; however, this does not prevent a new author from writing one on the same topic, especially if the previous reviews were written many years ago. However, it is important that the body of the new manuscript be written from a new angle that was not adequately covered in the past reviews and should also incorporate new studies that have accumulated since the last review(s). In addition, the new review might also highlight the approaches, limitations, and conclusions of the past studies. But the authors must not be excessively critical of the past reviews as this is regarded by many authors as a sign of poor professionalism [ 3 , 79 ]. Daft [ 79 ] emphasized that it is more important for a reviewer to state how their research builds on previous work instead of outright claiming that previous works are incompetent and inadequate. However, if a series of related papers on one topic have a common error or research flaw that needs rectification, the reviewer must point this out with the aim of moving the field forward [ 3 ]. Like every other scientific paper, the main body of a review article also needs to be consistent in style, for example, in the choice of passive vs. active voice and present vs. past tense. It is also important to note that tables and figures can serve as a powerful tool for highlighting key points in the body of the review, and they are now considered core elements of reviews. For more guidance and insights into what should make up the contents of a good review article, readers are also advised to get familiarised with the Boote and Beile [ 80 ] literature review scoring rubric as well as the review article checklist of Short [ 81 ].

5.8. Tables and Figures

An ideal review article should be logically structured and efficiently utilise illustrations, in the form of tables and figures, to convey the key findings and relationships in the study. According to Tay [ 13 ], illustrations often take a secondary role in review papers when compared to primary research papers which are focused on illustrations. However, illustrations are very important in review articles as they can serve as succinct means of communicating major findings and insights. Franzblau and Chung [ 82 ] pointed out that illustrations serve three major purposes in a scientific article: they simplify complex data and relationships for better understanding, they minimise reading time by summarising and bringing to focus on the key findings (or trends), and last, they help to reduce the overall word count. Hence, inserting and constructing illustrations in a review article is as meticulous as it is important. However, important decisions should be made on whether the charts, figures, or tables to be potentially inserted in the manuscript are indeed needed and how best to design them [ 83 ]. Illustrations should enhance the text while providing necessary information; thus, the information described in illustrations should not contradict that in the main text and should also not be a repetition of texts [ 84 ]. Furthermore, illustrations must be autonomous, meaning they ought to be intelligible without having to read the text portion of the manuscript; thus, the reader does not have to flip back and forth between the illustration and the main text in order to understand it [ 85 ]. It should be noted that tables or figures that directly reiterate the main text or contain extraneous information will only make a mess of the manuscript and discourage readers [ 86 ].

Kotz and Cals [ 87 ] recommend that the layout of tables and figures should be carefully designed in a clear manner with suitable layouts, which will allow them to be referred to logically and chronologically in the text. In addition, illustrations should only contain simple text, as lengthy details would contradict their initial objective, which was to provide simple examples or an overview. Furthermore, the use of abbreviations in illustrations, especially tables, should be avoided if possible. If not, the abbreviations should be defined explicitly in the footnotes or legends of the illustration [ 88 ]. Similarly, numerical values in tables and graphs should also be correctly approximated [ 84 ]. It is recommended that the number of tables and figures in the manuscript should not exceed the target journal's specification. According to Saver [ 89 ], they ideally should not account for more than one-third of the manuscript. Finally, the author(s) must seek permission and give credits for using an already published illustration when necessary. However, none of these are needed if the graphic is originally created by the author, but if it is a reproduced or an adapted illustration, the author must obtain permission from the copyright owner and include the necessary credit. One of the very important tools for designing illustrations is Creative Commons, a platform that provides a wide range of creative works which are available to the public for use and modification.

5.9. Conclusion/Future Perspectives

It has been observed that many reviews end abruptly with a short conclusion; however, a lot more can be included in this section in addition to what has been said in the major sections of the paper. Basically, the conclusion section of a review article should provide a summary of key findings from the main body of the manuscript. In this section, the author needs to revisit the critical points of the paper as well as highlight the accuracy, validity, and relevance of the inferences drawn in the article review. A good conclusion should highlight the relationship between the major points and the author's hypothesis as well as the relationship between the hypothesis and the broader discussion to demonstrate the significance of the review article in a larger context. In addition to giving a concise summary of the important findings that describe current knowledge, the conclusion must also offer a rationale for conducting future research [ 12 ]. Knowledge gaps should be identified, and themes should be logically developed in order to construct conceptual frameworks as well as present a way forward for future research in the field of study [ 11 ].

Furthermore, the author may have to justify the propositions made earlier in the manuscript, demonstrate how the paper extends past research works, and also suggest ways that the expounded theories can be empirically examined [ 3 ]. Unlike experimental studies which can only draw either a positive conclusion or ambiguous failure to reject the null hypothesis, four possible conclusions can be drawn from review articles [ 1 ]. First, the theory/hypothesis propounded may be correct after being proven from current evidence; second, the hypothesis may not be explicitly proven but is most probably the best guess. The third conclusion is that the currently available evidence does not permit a confident conclusion or a best guess, while the last conclusion is that the theory or hypothesis is false [ 1 ]. It is important not to present new information in the conclusion section which has link whatsoever with the rest of the manuscript. According to Harris et al. [ 90 ], the conclusions should, in essence, answer the question: if a reader were to remember one thing about the review, what would it be?

5.10. References

As it has been noted in different parts of this paper, authors must give the required credit to any work or source(s) of information that was included in the review article. This must include the in-text citations in the main body of the paper and the corresponding entries in the reference list. Ideally, this full bibliographical list is the last part of the review article, and it should contain all the books, book chapters, journal articles, reports, and other media, which were utilised in the manuscript. It has been noted that most journals and publishers have their own specific referencing styles which are all derived from the more popular styles such as the American Psychological Association (APA), Chicago, Harvard, Modern Language Association (MLA), and Vancouver styles. However, all these styles may be categorised into either the parenthetical or numerical referencing style. Although a few journals do not have strict referencing rules, it is the responsibility of the author to reference according to the style and instructions of the journal. Omissions and errors must be avoided at all costs, and this can be easily achieved by going over the references many times for due diligence [ 11 ]. According to Cronin et al. [ 12 ], a separate file for references can be created, and any work used in the manuscript can be added to this list immediately after being cited in the text [ 12 ]. In recent times, the emergence of various referencing management software applications such as Endnote, RefWorks, Mendeley, and Zotero has even made referencing easier. The majority of these software applications require little technical expertise, and many of them are free to use, while others may require a subscription. It is imperative, however, that even after using these software packages, the author must manually curate the references during the final draft, in order to avoid any errors, since these programs are not impervious to errors, particularly formatting errors.

6. Concluding Remarks

Writing a review article is a skill that needs to be learned; it is a rigorous but rewarding endeavour as it can provide a useful platform to project the emerging researcher or postgraduate student into the gratifying world of publishing. Thus, the reviewer must develop the ability to think critically, spot patterns in a large volume of information, and must be invested in writing without tiring. The prospective author must also be inspired and dedicated to the successful completion of the article while also ensuring that the review article is not just a mere list or summary of previous research. It is also important that the review process must be focused on the literature and not on the authors; thus, overt criticism of existing research and personal aspersions must be avoided at all costs. All ideas, sentences, words, and illustrations should be constructed in a way to avoid plagiarism; basically, this can be achieved by paraphrasing, summarising, and giving the necessary acknowledgments. Currently, there are many tools to track and detect plagiarism in manuscripts, ensuring that they fall within a reasonable similarity index (which is typically 15% or lower for most journals). Although the more popular of these tools, such as Turnitin and iThenticate, are subscription-based, there are many freely available web-based options as well. An ideal review article is supposed to motivate the research topic and describe its key concepts while delineating the boundaries of research. In this regard, experience-based information on how to methodologically develop acceptable and impactful review articles has been detailed in this paper. Furthermore, for a beginner, this guide has detailed “the why” and “the how” of authoring a good scientific review article. However, the information in this paper may as a whole or in parts be also applicable to other fields of research and to other writing endeavours such as writing literature review in theses, dissertations, and primary research articles. Finally, the intending authors must put all the basic rules of scientific writing and writing in general into cognizance. A comprehensive study of the articles cited within this paper and other related articles focused on scientific writing will further enhance the ability of the motivated beginner to deliver a good review article.

Acknowledgments

This work was supported by the National Research Foundation of South Africa under grant number UID 138097. The authors would like to thank the Durban University of Technology for funding the postdoctoral fellowship of the first author, Dr. Ayodeji Amobonye.

Data Availability

Conflicts of interest.

The authors declare that they have no conflicts of interest.

How to Write an Article Review: Template & Examples

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

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

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

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

❓ What Is an Article Review?

• ✍️ Writing Steps

📑 Article Review Format

🔗 references.

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

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

Popular Vs. Scholarly Articles

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

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

Article Review vs. Response Paper

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

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

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

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

✍️ How to Write an Article Review: Step by Step

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

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Read the Article

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

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

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

Summarize the Article

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

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

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

Evaluate the Article

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

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Write the Text

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

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

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

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

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

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

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

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

Article Review in APA

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

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

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

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

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

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

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

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

Article Review in MLA

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

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

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

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

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

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

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

✅ Article Review Template

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

📝 Article Review Examples

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

📃 Men, Women, & Money   

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

📃 When and Why Nationalism Beats Globalism   

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

📃 Sleep Deprivation   

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

✏️ Article Review FAQ

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

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

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

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

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

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

Short Description

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

What Is an Article Review: Grasping the Concept 

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

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

Writing Involves:

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

Types of Review

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

Journal Article Review

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

Research Article Review

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

Science Article Review

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

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Formatting an Article Review

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

How Many Publications Should You Review?

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

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

Using the APA Format

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

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

Using MLA Format

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

Enhance your writing effortlessly with EssayPro.com , where you can order an article review or any other writing task. Our team of expert writers specializes in various fields, ensuring your work is not just summarized, but deeply analyzed and professionally presented. Ideal for students and professionals alike, EssayPro offers top-notch writing assistance tailored to your needs. Elevate your writing today with our skilled team at your article review writing service !

The Pre-Writing Process

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

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

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

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

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

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

Outline and Template

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

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

Your custom essay must contain these constituent parts:

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

Example of an Article Review

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

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

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

View Our Writer’s Sample Before Crafting Your Own!

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Steps for Writing an Article Review

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

Step 1: Write the Title

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

Step 2: Cite the Article

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

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

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

Step 3: Article Identification

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

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

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

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

Step 4: Introduction

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

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

Step 5: Summarize the Article

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

Step 6: Critique It

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

Step 7: Craft a Conclusion

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

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

The Post-Writing Process: Proofread Your Work

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

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

• Punctuation
• Other mistakes

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

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

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What Is A Review Article?

How to write an article review, how to write an article review in apa format, related articles.

Review articles: purpose, process, and structure

• Published: 02 October 2017
• Volume 46 , pages 1–5, ( 2018 )

Cite this article

• Robert W. Palmatier 1 ,
• Mark B. Houston 2 &
• John Hulland 3  

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Avoid common mistakes on your manuscript.

Many research disciplines feature high-impact journals that are dedicated outlets for review papers (or review–conceptual combinations) (e.g., Academy of Management Review , Psychology Bulletin , Medicinal Research Reviews ). The rationale for such outlets is the premise that research integration and synthesis provides an important, and possibly even a required, step in the scientific process. Review papers tend to include both quantitative (i.e., meta-analytic, systematic reviews) and narrative or more qualitative components; together, they provide platforms for new conceptual frameworks, reveal inconsistencies in the extant body of research, synthesize diverse results, and generally give other scholars a “state-of-the-art” snapshot of a domain, often written by topic experts (Bem 1995 ). Many premier marketing journals publish meta-analytic review papers too, though authors often must overcome reviewers’ concerns that their contributions are limited due to the absence of “new data.” Furthermore, relatively few non-meta-analysis review papers appear in marketing journals, probably due to researchers’ perceptions that such papers have limited publication opportunities or their beliefs that the field lacks a research tradition or “respect” for such papers. In many cases, an editor must provide strong support to help such review papers navigate the review process. Yet, once published, such papers tend to be widely cited, suggesting that members of the field find them useful (see Bettencourt and Houston 2001 ).

In this editorial, we seek to address three topics relevant to review papers. First, we outline a case for their importance to the scientific process, by describing the purpose of review papers . Second, we detail the review paper editorial initiative conducted over the past two years by the Journal of the Academy of Marketing Science ( JAMS ), focused on increasing the prevalence of review papers. Third, we describe a process and structure for systematic ( i.e. , non-meta-analytic) review papers , referring to Grewal et al. ( 2018 ) insights into parallel meta-analytic (effects estimation) review papers. (For some strong recent examples of marketing-related meta-analyses, see Knoll and Matthes 2017 ; Verma et al. 2016 ).

Purpose of review papers

In their most general form, review papers “are critical evaluations of material that has already been published,” some that include quantitative effects estimation (i.e., meta-analyses) and some that do not (i.e., systematic reviews) (Bem 1995 , p. 172). They carefully identify and synthesize relevant literature to evaluate a specific research question, substantive domain, theoretical approach, or methodology and thereby provide readers with a state-of-the-art understanding of the research topic. Many of these benefits are highlighted in Hanssens’ ( 2018 ) paper titled “The Value of Empirical Generalizations in Marketing,” published in this same issue of JAMS.

The purpose of and contributions associated with review papers can vary depending on their specific type and research question, but in general, they aim to

Resolve definitional ambiguities and outline the scope of the topic.

Provide an integrated, synthesized overview of the current state of knowledge.

Identify inconsistencies in prior results and potential explanations (e.g., moderators, mediators, measures, approaches).

Evaluate existing methodological approaches and unique insights.

Develop conceptual frameworks to reconcile and extend past research.

Describe research insights, existing gaps, and future research directions.

Not every review paper can offer all of these benefits, but this list represents their key contributions. To provide a sufficient contribution, a review paper needs to achieve three key standards. First, the research domain needs to be well suited for a review paper, such that a sufficient body of past research exists to make the integration and synthesis valuable—especially if extant research reveals theoretical inconsistences or heterogeneity in its effects. Second, the review paper must be well executed, with an appropriate literature collection and analysis techniques, sufficient breadth and depth of literature coverage, and a compelling writing style. Third, the manuscript must offer significant new insights based on its systematic comparison of multiple studies, rather than simply a “book report” that describes past research. This third, most critical standard is often the most difficult, especially for authors who have not “lived” with the research domain for many years, because achieving it requires drawing some non-obvious connections and insights from multiple studies and their many different aspects (e.g., context, method, measures). Typically, after the “review” portion of the paper has been completed, the authors must spend many more months identifying the connections to uncover incremental insights, each of which takes time to detail and explicate.

The increasing methodological rigor and technical sophistication of many marketing studies also means that they often focus on smaller problems with fewer constructs. By synthesizing these piecemeal findings, reconciling conflicting evidence, and drawing a “big picture,” meta-analyses and systematic review papers become indispensable to our comprehensive understanding of a phenomenon, among both academic and practitioner communities. Thus, good review papers provide a solid platform for future research, in the reviewed domain but also in other areas, in that researchers can use a good review paper to learn about and extend key insights to new areas.

This domain extension, outside of the core area being reviewed, is one of the key benefits of review papers that often gets overlooked. Yet it also is becoming ever more important with the expanding breadth of marketing (e.g., econometric modeling, finance, strategic management, applied psychology, sociology) and the increasing velocity in the accumulation of marketing knowledge (e.g., digital marketing, social media, big data). Against this backdrop, systematic review papers and meta-analyses help academics and interested managers keep track of research findings that fall outside their main area of specialization.

JAMS’ review paper editorial initiative

With a strong belief in the importance of review papers, the editorial team of JAMS has purposely sought out leading scholars to provide substantive review papers, both meta-analysis and systematic, for publication in JAMS . Many of the scholars approached have voiced concerns about the risk of such endeavors, due to the lack of alternative outlets for these types of papers. Therefore, we have instituted a unique process, in which the authors develop a detailed outline of their paper, key tables and figures, and a description of their literature review process. On the basis of this outline, we grant assurances that the contribution hurdle will not be an issue for publication in JAMS , as long as the authors execute the proposed outline as written. Each paper still goes through the normal review process and must meet all publication quality standards, of course. In many cases, an Area Editor takes an active role to help ensure that each paper provides sufficient insights, as required for a high-quality review paper. This process gives the author team confidence to invest effort in the process. An analysis of the marketing journals in the Financial Times (FT 50) journal list for the past five years (2012–2016) shows that JAMS has become the most common outlet for these papers, publishing 31% of all review papers that appeared in the top six marketing journals.

As a next step in positioning JAMS as a receptive marketing outlet for review papers, we are conducting a Thought Leaders Conference on Generalizations in Marketing: Systematic Reviews and Meta-Analyses , with a corresponding special issue (see www.springer.com/jams ). We will continue our process of seeking out review papers as an editorial strategy in areas that could be advanced by the integration and synthesis of extant research. We expect that, ultimately, such efforts will become unnecessary, as authors initiate review papers on topics of their own choosing to submit them to JAMS . In the past two years, JAMS already has increased the number of papers it publishes annually, from just over 40 to around 60 papers per year; this growth has provided “space” for 8–10 review papers per year, reflecting our editorial target.

Consistent with JAMS ’ overall focus on managerially relevant and strategy-focused topics, all review papers should reflect this emphasis. For example, the domains, theories, and methods reviewed need to have some application to past or emerging managerial research. A good rule of thumb is that the substantive domain, theory, or method should attract the attention of readers of JAMS .

The efforts of multiple editors and Area Editors in turn have generated a body of review papers that can serve as useful examples of the different types and approaches that JAMS has published.

Domain-based review papers

Domain-based review papers review, synthetize, and extend a body of literature in the same substantive domain. For example, in “The Role of Privacy in Marketing” (Martin and Murphy 2017 ), the authors identify and define various privacy-related constructs that have appeared in recent literature. Then they examine the different theoretical perspectives brought to bear on privacy topics related to consumers and organizations, including ethical and legal perspectives. These foundations lead in to their systematic review of privacy-related articles over a clearly defined date range, from which they extract key insights from each study. This exercise of synthesizing diverse perspectives allows these authors to describe state-of-the-art knowledge regarding privacy in marketing and identify useful paths for research. Similarly, a new paper by Cleeren et al. ( 2017 ), “Marketing Research on Product-Harm Crises: A Review, Managerial Implications, and an Agenda for Future Research,” provides a rich systematic review, synthesizes extant research, and points the way forward for scholars who are interested in issues related to defective or dangerous market offerings.

Theory-based review papers

Theory-based review papers review, synthetize, and extend a body of literature that uses the same underlying theory. For example, Rindfleisch and Heide’s ( 1997 ) classic review of research in marketing using transaction cost economics has been cited more than 2200 times, with a significant impact on applications of the theory to the discipline in the past 20 years. A recent paper in JAMS with similar intent, which could serve as a helpful model, focuses on “Resource-Based Theory in Marketing” (Kozlenkova et al. 2014 ). The article dives deeply into a description of the theory and its underlying assumptions, then organizes a systematic review of relevant literature according to various perspectives through which the theory has been applied in marketing. The authors conclude by identifying topical domains in marketing that might benefit from additional applications of the theory (e.g., marketing exchange), as well as related theories that could be integrated meaningfully with insights from the resource-based theory.

Method-based review papers

Method-based review papers review, synthetize, and extend a body of literature that uses the same underlying method. For example, in “Event Study Methodology in the Marketing Literature: An Overview” (Sorescu et al. 2017 ), the authors identify published studies in marketing that use an event study methodology. After a brief review of the theoretical foundations of event studies, they describe in detail the key design considerations associated with this method. The article then provides a roadmap for conducting event studies and compares this approach with a stock market returns analysis. The authors finish with a summary of the strengths and weaknesses of the event study method, which in turn suggests three main areas for further research. Similarly, “Discriminant Validity Testing in Marketing: An Analysis, Causes for Concern, and Proposed Remedies” (Voorhies et al. 2016 ) systematically reviews existing approaches for assessing discriminant validity in marketing contexts, then uses Monte Carlo simulation to determine which tests are most effective.

Our long-term editorial strategy is to make sure JAMS becomes and remains a well-recognized outlet for both meta-analysis and systematic managerial review papers in marketing. Ideally, review papers would come to represent 10%–20% of the papers published by the journal.

Process and structure for review papers

In this section, we review the process and typical structure of a systematic review paper, which lacks any long or established tradition in marketing research. The article by Grewal et al. ( 2018 ) provides a summary of effects-focused review papers (i.e., meta-analyses), so we do not discuss them in detail here.

Systematic literature review process

Some review papers submitted to journals take a “narrative” approach. They discuss current knowledge about a research domain, yet they often are flawed, in that they lack criteria for article inclusion (or, more accurately, article exclusion), fail to discuss the methodology used to evaluate included articles, and avoid critical assessment of the field (Barczak 2017 ). Such reviews tend to be purely descriptive, with little lasting impact.

In contrast, a systematic literature review aims to “comprehensively locate and synthesize research that bears on a particular question, using organized, transparent, and replicable procedures at each step in the process” (Littell et al. 2008 , p. 1). Littell et al. describe six key steps in the systematic review process. The extent to which each step is emphasized varies by paper, but all are important components of the review.

Topic formulation . The author sets out clear objectives for the review and articulates the specific research questions or hypotheses that will be investigated.

Study design . The author specifies relevant problems, populations, constructs, and settings of interest. The aim is to define explicit criteria that can be used to assess whether any particular study should be included in or excluded from the review. Furthermore, it is important to develop a protocol in advance that describes the procedures and methods to be used to evaluate published work.

Sampling . The aim in this third step is to identify all potentially relevant studies, including both published and unpublished research. To this end, the author must first define the sampling unit to be used in the review (e.g., individual, strategic business unit) and then develop an appropriate sampling plan.

Data collection . By retrieving the potentially relevant studies identified in the third step, the author can determine whether each study meets the eligibility requirements set out in the second step. For studies deemed acceptable, the data are extracted from each study and entered into standardized templates. These templates should be based on the protocols established in step 2.

Data analysis . The degree and nature of the analyses used to describe and examine the collected data vary widely by review. Purely descriptive analysis is useful as a starting point but rarely is sufficient on its own. The examination of trends, clusters of ideas, and multivariate relationships among constructs helps flesh out a deeper understanding of the domain. For example, both Hult ( 2015 ) and Huber et al. ( 2014 ) use bibliometric approaches (e.g., examine citation data using multidimensional scaling and cluster analysis techniques) to identify emerging versus declining themes in the broad field of marketing.

Reporting . Three key aspects of this final step are common across systematic reviews. First, the results from the fifth step need to be presented, clearly and compellingly, using narratives, tables, and figures. Second, core results that emerge from the review must be interpreted and discussed by the author. These revelatory insights should reflect a deeper understanding of the topic being investigated, not simply a regurgitation of well-established knowledge. Third, the author needs to describe the implications of these unique insights for both future research and managerial practice.

A new paper by Watson et al. ( 2017 ), “Harnessing Difference: A Capability-Based Framework for Stakeholder Engagement in Environmental Innovation,” provides a good example of a systematic review, starting with a cohesive conceptual framework that helps establish the boundaries of the review while also identifying core constructs and their relationships. The article then explicitly describes the procedures used to search for potentially relevant papers and clearly sets out criteria for study inclusion or exclusion. Next, a detailed discussion of core elements in the framework weaves published research findings into the exposition. The paper ends with a presentation of key implications and suggestions for the next steps. Similarly, “Marketing Survey Research Best Practices: Evidence and Recommendations from a Review of JAMS Articles” (Hulland et al. 2017 ) systematically reviews published marketing studies that use survey techniques, describes recent trends, and suggests best practices. In their review, Hulland et al. examine the entire population of survey papers published in JAMS over a ten-year span, relying on an extensive standardized data template to facilitate their subsequent data analysis.

Structure of systematic review papers

There is no cookie-cutter recipe for the exact structure of a useful systematic review paper; the final structure depends on the authors’ insights and intended points of emphasis. However, several key components are likely integral to a paper’s ability to contribute.

Depth and rigor

Systematic review papers must avoid falling in to two potential “ditches.” The first ditch threatens when the paper fails to demonstrate that a systematic approach was used for selecting articles for inclusion and capturing their insights. If a reader gets the impression that the author has cherry-picked only articles that fit some preset notion or failed to be thorough enough, without including articles that make significant contributions to the field, the paper will be consigned to the proverbial side of the road when it comes to the discipline’s attention.

Authors that fall into the other ditch present a thorough, complete overview that offers only a mind-numbing recitation, without evident organization, synthesis, or critical evaluation. Although comprehensive, such a paper is more of an index than a useful review. The reviewed articles must be grouped in a meaningful way to guide the reader toward a better understanding of the focal phenomenon and provide a foundation for insights about future research directions. Some scholars organize research by scholarly perspectives (e.g., the psychology of privacy, the economics of privacy; Martin and Murphy 2017 ); others classify the chosen articles by objective research aspects (e.g., empirical setting, research design, conceptual frameworks; Cleeren et al. 2017 ). The method of organization chosen must allow the author to capture the complexity of the underlying phenomenon (e.g., including temporal or evolutionary aspects, if relevant).

Replicability

Processes for the identification and inclusion of research articles should be described in sufficient detail, such that an interested reader could replicate the procedure. The procedures used to analyze chosen articles and extract their empirical findings and/or key takeaways should be described with similar specificity and detail.

We already have noted the potential usefulness of well-done review papers. Some scholars always are new to the field or domain in question, so review papers also need to help them gain foundational knowledge. Key constructs, definitions, assumptions, and theories should be laid out clearly (for which purpose summary tables are extremely helpful). An integrated conceptual model can be useful to organize cited works. Most scholars integrate the knowledge they gain from reading the review paper into their plans for future research, so it is also critical that review papers clearly lay out implications (and specific directions) for research. Ideally, readers will come away from a review article filled with enthusiasm about ways they might contribute to the ongoing development of the field.

Helpful format

Because such a large body of research is being synthesized in most review papers, simply reading through the list of included studies can be exhausting for readers. We cannot overstate the importance of tables and figures in review papers, used in conjunction with meaningful headings and subheadings. Vast literature review tables often are essential, but they must be organized in a way that makes their insights digestible to the reader; in some cases, a sequence of more focused tables may be better than a single, comprehensive table.

In summary, articles that review extant research in a domain (topic, theory, or method) can be incredibly useful to the scientific progress of our field. Whether integrating the insights from extant research through a meta-analysis or synthesizing them through a systematic assessment, the promised benefits are similar. Both formats provide readers with a useful overview of knowledge about the focal phenomenon, as well as insights on key dilemmas and conflicting findings that suggest future research directions. Thus, the editorial team at JAMS encourages scholars to continue to invest the time and effort to construct thoughtful review papers.

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Peer review demystified: part 2

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We continue our explanation of the peer review process at Nature Methods .

In last month’s Editorial 1 , we described how we select peer reviewers and utilize their reports in reaching an editorial decision on a manuscript. We also explained some of the differences between peer reviewing research papers versus nonprimary content.

Over the years we have made several enhancements, including introducing tools to help reviewers evaluate software code 2 , and adapting a version of the Registered Reports format to review proposals for method performance comparisons 3 . Here, we describe our efforts to involve early career researchers as peer reviewers, and to bring more transparency to the peer review process.

Calling early career researchers as reviewers

Asking the same people to review time and again is neither respectful of their precious time, nor good for publishing a well-rounded journal – so we constantly strive to add new reviewers to our pool. We also continuously aim to increase the diversity of our reviewer pool, especially in terms of geographical location, gender, and career level.

We have found that early career researchers (ECRs), who are typically still working at the bench, often provide excellent technical reviews. However, as many ECRs do not yet have a long publication record, potential reviewers from this pool can be a challenge to identify. We also suspect that many reviewer reports are written or supported by postdocs or even graduate students, but unless the reviewer tells the editor this, we will never know.

Inspired by our colleagues at the Nature Reviews journals and Nature Communications 4 , we have made efforts to bring more ECRs into our reviewer pool. We strongly encourage established researchers to involve their trainees in the peer review process – but please let the editor know who they are, and as early as possible. This allows us to ensure that the trainee becomes visible to our editorial team, and to ensure they will receive proper credit for their role in peer review.

We also encourage ECRs to reach out to us! After reviewing our Aims & Scope , if you think your expertise is a good match for our research areas of interest, send a brief e-mail describing your expertise and your CV or link to a list of your publications to your favorite Nature Methods editor, or to [email protected]. We also strongly recommend a free Nature Masterclass training course on peer review , which may be especially helpful to ECRs.

Reviewer credit and transparency

Over the years, various Nature Portfolio journals, including Nature Methods , have adopted several new initiatives to ensure that reviewers are recognized for their valuable efforts.

First, we encourage all reviewers to generate an ORCiD profile and link it their Nature Portfolio account. This will ensure that verification of your reviewing activity can be automatically transferred. We also provide an email receipt when a review is submitted, which can be used as proof of reviewing activity. Reviewers can also obtain proof of activity from their Nature Portfolio accounts.

Second, we offer ‘reviewer recognition’. Reviewers may choose to be acknowledged in the “Peer review” section of a published paper, though authors may not be able to match the reviewer to their report (and authors will not learn who the reviewers were if the paper ultimately gets rejected). Reviewers, however, may sign their reports should they wish to reveal their identities to the authors at an earlier stage.

Third, we also offer ‘ transparent peer review ’, which means that the reviewers’ comments to the authors will be available as a supplementary file to a published paper. It is up to the authors to decide whether they would like the reviewer reports to be published - reviewers are informed in nearly every communication with the editorial team that publishing reviewer reports is the authors’ choice. Reviewer names will not be associated with the reports, unless the reviewers choose them to be.

We strongly encourage transparency in peer review, as we believe this produces the most robust and fair process for all. However, we understand that there are reasons why a reviewer may not feel comfortable revealing their identity, or why an author will choose not to publish the reviewer reports. We do also offer double-anonymized peer review , where both authors and reviewers are anonymous, though it has not been a very popular option, especially as the scientific community pivots towards more openess.

Finally, a word about the use of generative AI tools in peer review : an AI is neither a person nor a peer, and cannot be held accountable in a process based on trust and deep domain knowledge. The limitations and biases of generative AI tools are well-known. Furthermore, uploading manuscripts into generative AI tools can breach the confidentiality of the peer review process. Reviewers should ask the editor for advice before they utilize any kind of AI tool to support their review.

We understand that many of our authors are working in competitive fields, and we therefore consider timeliness to be essential. We aim to send authors a decision in well under 2 months from the time of submission, though circumstances can arise that make the process a bit longer.

We would like to remind our peer reviewers that if you cannot commit to a review (and a possible review of a revised paper in the future!) in a timely manner, please decline the invitation! We realize that work and life circumstances can arise that cause delays, but it is very frustrating when reviewers ghost us. Please drop us a quick line if something comes up so we determine our next steps. Finally, we greatly appreciate reviewers who take the extra time and effort to answer an editor’s follow-up questions about their or another reviewer’s report.

Peer review is a valuable service that editors organize that helps strengthen scientific papers, even if the journal’s ultimate decision is negative. Peer review however is often criticized; we appreciate it is not a perfect process and we applaud the innovations our sister journals and other publishers have initiated to enhance the system. We hope we have provided some valuable insights into our process, and we welcome your feedback and suggestions on how we can continue making improvements.

Nat. Methods 21 , 361 (2024).

Nat. Methods 15 , 641 (2018).

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New Journal of Chemistry

Conjugated polymers – a versatile platform for various photophysical, electrochemical and biomedical applications: a comprehensive review.

* Corresponding authors

a Department of Chemistry, School of Advanced Sciences, VIT University, Vellore-14, Tamil Nadu, India E-mail: [email protected] , [email protected]

In recent decades, there has been a significant quest for a viable medium for multiple applications. Many researchers have devoted all their utmost efforts to identifying such a medium. Finally in this context, conjugated polymers have proven to be a potential platform for a variety of applications due to their diverse nature. The conjugated polymer backbone is made of alternate electron donor and acceptor groups; the properties of such compounds can be tuned by altering the length of conjugation, adjacent group of monomers, energy levels, molecular interaction, etc. This alteration increases the light absorbance range that enables the molecule to be a photoluminescence active material for sensing toxic metal ions, organic molecules and gas detectors. Energy transfer, complexation, charge transfer and active chemical transformations are the common mechanisms of fluorescence based sensing application. Optimization of the HOMO and LUMO levels has been used as an efficient charge transfer ground between a conjugated polymer and analyte for photoluminescence and electrochemical sensing applications, and has subsequently been used in the construction of optoelectronic devices such as NIR sensors and flexible OLEDs. High compatibility conjugated polymers even made these giant molecules apt for mimicking biomolecules; some compounds were suitable for anti-bacterial application and even served as a drug delivery system. This review article intends to provide insights (2015–present) into versatile applications of conjugated polymers with the required diagrammatic explanation and a unique behavior of monomers including fluorene, carbazole, phenyl vinylene, triphenylamine, etc. Thus, we predict that this work will offer a comprehensive overview of an overall application of conjugated polymers and improve their applicability in multiple domains including portable sensors, flexible optoelectronic devices and future drug delivery processes.

• This article is part of the themed collection: 2021 Focus and Perspective articles

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O.J.’s executor says he wants Goldmans to get ‘zero, nothing’ from estate

O.J. Simpson’s will was filed in Clark County court on Friday, a day after his family announced his death from cancer.

O.J. Simpson’s longtime lawyer and executor of his estate said Friday that he will fight to prevent the payout of a $33.5 million judgment awarded to the families of his ex-wife Nicole Brown Simpson and her friend Ron Goldman.

Attorney Malcolm LaVergne, who had represented Simpson since 2009, told the Review-Journal in a phone interview that he specifically does not want the Goldman family seeing any money from Simpson’s estate.

“It’s my hope that the Goldmans get zero, nothing,” LaVergne said. “Them specifically. And I will do everything in my capacity as the executor or personal representative to try and ensure that they get nothing.”

Court documents filed Friday revealed Simpson’s final will, which named LaVergne the executor in charge of overseeing the estate. Simpson’s family announced his death Thursday, a day after he died from prostate cancer.

After rising to fame as a football star, Simpson was then known as the man accused of brutally killing Nicole Brown Simpson and Ronald Goldman in June 1994. He was acquitted of the murders in a monthslong, highly publicized Los Angeles trial.

LaVergne said Simpson had been diagnosed with prostate cancer “several years ago,” and that it had gone into remission before recently returning. Simpson died in hospice care at his home in Rhodes Ranch, in the southwest Las Vegas Valley, LaVergne said.

The will places all of Simpson’s property into a trust that was created in January, court filings show. LaVergne said the entirety of Simpson’s estate has not been tallied.

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LaVergne said he was taken by surprise to be named the estate’s executor.

“I am flummoxed as to why he would name me as the personal representative or the executor, but he did,” he said. “And it’s something I’m going to take very seriously.”

Among LaVergne’s responsibilities as personal representative is to pay for the cost of a “suitable monument” at Simpson’s grave, according to the will. It also said Simpson desired “that this Will be administered as set forth herein without litigation or dispute of any kind” and that any beneficiary, heir “or any other person” seeks to establish a claim on the will, “or attack, oppose or seek to set aside the administration of this Will, have this Will declared null, void or diminish, or to defeat any change any part of the provisions of this will,” they “shall receive, free of trust, one dollar ($1.00) and no more in lieu of any claimed interest in this will or its assets.”

In 1997, Simpson was found liable in a civil wrongful death lawsuit, and was ordered to pay millions in damages to the families of Goldman and Nicole Brown Simpson.

LaVergne said that although the families have pushed for payment, there was never a court order forcing Simpson to pay out the civil judgment. He said his particular ire at the Goldman family came in part due to the events surrounding Simpson’s controversial planned book, titled “If I Did It.”

Goldman’s family, still pursuing the wrongful death judgment, won control of the manuscript and retitled the book “If I Did It: Confessions of the Killer,” according to the Associated Press.

Simpson said he lived only on his NFL and private pensions. Hundreds of valuable possessions were seized as part of the civil jury award, and Simpson was forced to auction his Heisman Trophy, fetching $230,000, the Associated Press has reported.

Simpson later faced legal trouble in Las Vegas , and was convicted of a 2007 robbery of sports memorabilia from a Palace Station hotel room. Simpson was sentenced to between nine and 33 years behind bars.

He was released from prison in 2017, and granted an early discharge from parole in 2021 by the Nevada Board of Parole Commissioners.

LaVergne said Simpson is due to be cremated in the coming days, but that funeral arrangements have not been finalized.

Contact Katelyn Newberg at [email protected] or 702-383-0240.

O.J. Simpson’s executor said he now plans to work with the families of Nicole Brown Simpson and Ron Goldman, who were awarded a $33.5 million civil judgment against Simpson in 1997.

The mother of prisoner Christian Walker filed a lawsuit against the Department of Corrections, challenging how her son died at High Desert State Prison.

Infamously acquitted for the 1994 murders of his ex-wife and her friend, the NFL legend found himself in another trial after an incident at Palace Station.

O.J. Simpson’s story represents one of the most dramatic falls from grace in the history of American pop culture.

Some despised him, but many in Las Vegas seemed eager to meet the former NFL star.

O.J. Simpson, the NFL great who was acquitted of the murders of his ex-wife and her friend in one of the most notorious trials of the 20th century, and was later incarcerated in Nevada for an unrelated robbery, died of cancer.

Lawyers for Daniel Rodimer, the former congressional candidate charged with murder, want texts and phone calls between him and his wife to be ruled private.

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Prosecutors are pushing to see more detailed information contained on Jeff German’s phone, which was seized by police after the investigative reporter was killed.

Colin Andrew Shapard, 23, had been linked to two teens’ drug deaths as a juvenile.

• Open access
• Published: 04 January 2024

Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials

• Ola F. Quotah 1 , 2 ,
• Daria Andreeva 1 ,
• Katarzyna G. Nowak 1 , 3 ,
• Kathryn V. Dalrymple 4 ,
• Aljawharah Almubarak 1 ,
• Anjali Patel 1 ,
• Nirali Vyas 1 ,
• Gözde S. Cakir 1 ,
• Nicola Heslehurst 5 ,
• Zoe Bell 4 ,
• Lucilla Poston 1 ,
• Sara L. White 1   na1 &
• Angela C. Flynn 4 , 6   na1  

Diabetology & Metabolic Syndrome volume  16 , Article number:  8 ( 2024 ) Cite this article

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Women at risk of gestational diabetes mellitus (GDM) need preventative interventions.

To evaluate targeted interventions before and during pregnancy for women identified as being at risk of developing GDM.

Systematic review and meta-analysis conducted following PRISMA guidelines. MEDLINE, EMBASE and the Cochrane Library in addition to reference and citation lists were searched to identify eligible randomised controlled trials (RCTs) utilising risk stratification during the preconception period or in the first/early second trimester. Screening and data extraction were carried out by the authors independently. Quality assessment was conducted based on the Cochrane risk-of-bias tool. Random effects meta-analysis and narrative synthesis were performed.

Eighty-four RCTs were included: two during preconception and 82 in pregnancy, with a pooled sample of 22,568 women. Interventions were behavioural (n = 54), dietary supplementation (n = 19) and pharmacological (n = 11). Predictive factors for risk assessment varied; only one study utilised a validated prediction model. Gestational diabetes was reduced in diet and physical activity interventions (risk difference − 0.03, 95% CI 0.06, − 0.01; I 2 58.69%), inositol (risk difference − 0.19, 95% CI 0.33, − 0.06; I 2 92.19%), and vitamin D supplements (risk difference − 0.16, 95% CI 0.25, − 0.06; I 2 32.27%). Subgroup analysis showed that diet and physical activity interventions were beneficial in women with ≥ 2 GDM risk factors (risk difference − 0.16, 95% CI 0.25, − 0.07; I 2 11.23% ) while inositol supplementation was effective in women with overweight or obesity (risk difference − 0.17, 95% CI 0.22, − 0.11; I 2 0.01%). Effectiveness of all other interventions were not statistically significant.

Conclusions

This review provides evidence that interventions targeted at women at risk of GDM may be an effective strategy for prevention. Further studies using validated prediction tools or multiple risk factors to target high-risk women for intervention before and during pregnancy are warranted.

Introduction

Gestational diabetes mellitus (GDM) is a common pregnancy related complication affecting ~ 14% of pregnancies worldwide, although prevalence varies by country, population and diagnostic criteria [ 1 ]. Women who develop GDM have a higher risk of gestational hypertension, pre-eclampsia, caesarean and preterm delivery than women who do not develop the condition [ 2 , 3 , 4 ]. Infants of mothers with GDM are at increased risk of stillbirth, macrosomia, and neonatal hypoglycaemia [ 3 , 4 ]. In the longer term, GDM is associated with a greater risk of metabolic disease for both the mother and her offspring [ 5 , 6 , 7 ], highlighting the importance of early screening and prevention.

Although the aetiology of GDM is not completely understood, there are obstetric, socio-demographic, clinical and metabolic risk factors implicated [ 8 , 9 ]. The oral glucose tolerance test (OGTT), usually carried out between 24 and 28 weeks of gestation, is used to detect GDM as part of routine antenatal care [ 10 ]. To date there is no consensus on the strategies to identify women at high-risk of developing GDM earlier in pregnancy.

Several antenatal trials have aimed to prevent GDM, suggesting that behavioural interventions (e.g. diet and physical activity (PA)), supplementation (e.g. myo-inositol and vitamin D), and pharmacological intervention using metformin have possible benefits in reducing risk in the general antenatal population [ 11 , 12 , 13 , 14 ]. Moreover, studies have not been able to establish an effect of diet or exercise alone, probiotics, and/or other vitamins and minerals on GDM risk [ 11 , 15 ]. It is not yet clear whether targeting interventions to women with specific risk factors for GDM is an effective approach to GDM prevention.

Additionally, research on the effectiveness of preconception interventions in preventing GDM is lacking [ 11 ], and it is a priortiy area for intervention research [ 16 ]. One preconception nutritional intervention was not successful in reducing maternal glycaemia or GDM in a large multi-site trial; however, this study did not target higher risk women [ 17 ]. Hence, a more selective approach in women who are at risk and planning to conceive might be more effective.

The aim of this review was to evaluate the effect of interventions (behavioural, supplementation and pharmacological) during the preconception period and/or in pregnancy on reducing GDM in women identified at higher risk for developing the condition.

This review was conducted in accordance with the relevant criteria of the PRISMA guidelines for reporting a systematic review and meta-analysis [ 18 ] and was registered in the PROSPERO database (CRD42020177976).

Eligibility criteria

Inclusion and exclusion criteria were developed using the PICOS (population, intervention, comparison, outcomes and study design) framework, summarised in Table 1 . For inclusion, studies had to meet the following criteria: (1) randomised controlled trials (RCTs) that evaluated interventions, in the preconception period and/or during pregnancy compared with no intervention, standard care or placebo; (2) women identified as higher risk of developing GDM using any risk stratification in the preconception period or in early pregnancy; (3) data reporting GDM as a primary or secondary pregnancy outcome. All diagnostic criteria for GDM were deemed acceptable. Studies meeting the following criteria were excluded: (1) non-randomised and observational studies; (2) abstracts, reviews, letters, commentaries and editorials; (3) women aged less than 18 years or older than 50 years; (4) studies designed to treat GDM; (5) interventions starting too late in pregnancy (> 28 weeks’ gestation); (6) studies not published in English.

Database searches

Three electronic databases: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials, were searched up to February 2023 with no date restriction. A comprehensive search strategy was developed (Additional file 1 : Table A1, A2, A3) using search terms related to “pregnancy”, “adiposity” and “randomisation”. Reference lists from all included studies were examined for additional relevant articles to supplement the database searches as per PRISMA guideline recommendations [ 18 ]. Study authors were contacted when further information was required.

Study selection

Records obtained from all databases were imported into the EndNote X9 reference management software to eliminate duplicate publications. Subsequently, studies were imported into the screening management software Rayyan [ 19 ] for screening. All title and abstracts were screened by OFQ and a second independent reviewer (either KGN, AA, GSC, AP or NV). Full-text screening was also carried out independently in duplicate, with disagreements discussed and resolved by consensus opinion among 4 reviewers.

Data extraction and quality assessment

Data were extracted independently and in duplicate by two authors (OFQ, DA) using a standardised table created for this review. Data extraction included: title; authors; publication year; trial periods; study design; country; aim; sample size; population; inclusion/exclusion criteria; period of intervention (preconception and/or pregnancy); risk stratification; intervention characteristics and clinical outcomes. The Cochrane risk-of-bias tool for randomised trials (RoB 2) [ 20 ] was used to assess the validity and bias of each study included according to the Cochrane Handbook for Systematic Reviews of Interventions version 6.3 [ 21 ]. The domains used included randomisation bias (whether the allocation sequence was random and adequately concealed), deviations from the intended interventions (blinding of participants and trial personnel, adherence to intervention), bias due to missing outcome data (including biases introduced by procedures used to impute or otherwise account for missing outcome data), bias in measurements of the outcome (differential errors related to intervention assignment) and bias in selection of the reported results. The quality assessment was based on a series of signalling questions within each domain and was independently performed by two authors (OFQ, DA). Discrepancies were resolved by a third author (ACF). The overall risk was determined, and studies were classified as ‘low risk of bias’, ‘some concerns’ or ‘high risk of bias’.

The interventions and outcomes were evaluated to determine the appropriateness of data pooling in order to perform a meta-analysis. The analysis was built around different intervention types including: behavioural (diet only, PA only, combined diet and PA), dietary supplementation (inositols, vitamin D, fibre, probiotics), and pharmacological (metformin). Any intervention that could not contribute to the analysis or could not be pooled was excluded from the meta-analysis (e.g., studies that are not sufficiently homogeneous to be combined under the prespecified interventions, Table 1 ); and a narrative synthesis was performed to provide a brief summary of these studies and their findings [ 22 ]. Where appropriate, summaries of exposure effect for each intervention were provided using a risk difference, performed using Stata software, version 16.0 (StataCorp, College Station, TX, USA). A random-effects meta-analysis model was used to estimate the effects of each intervention on GDM and an I 2 value greater than 50% was considered an indication of significant heterogeneity across studies [ 23 ]. Furthermore, separate analyses were performed limited to studies where increased body mass index (BMI ≥ 25 kg/m 2 or ≥ 24 kg/m 2 depending on classification used) was the only risk factor as criteria for intervention and studies that utilised more than one risk factor which may or may not have included BMI. Publication bias was investigated using Egger's test and funnel plots, if there were more than 10 RCTs per meta-analysis.

We identified 29,205 results through database searches and an additional 10 through citation searches and reference lists: 4,337 were removed as duplicates and of the remaining 24,878 articles, 24,470 were excluded during title and abstract screening. There were 408 full-texts screened against the eligibility criteria, and 84 met the inclusion criteria (Fig.  1 ). Major reasons for exclusion were: no risk stratification, ongoing RCTs and GDM not a primary/secondary outcome.

PRISMA flow diagram of screening, selection process and inclusion study

Risk stratification for GDM

The included studies used different risk stratification strategies incorporating a variety of risk factors to identify women at high-risk of developing GDM. The number of variables ranged from one to sixteen (Additional file 1 : Table A5). Fifty-four studies recruited women with increased BMI [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ], with three of these using additional risk factors; polycystic ovary syndrome (PCOS) [ 41 ], previous history of GDM [ 41 , 42 , 56 ], family history of diabetes [ 41 , 42 ], high-risk ethnicity [ 41 ] or history of unexplained intrauterine fetal death or macrosomic infant [ 41 ].

Two studies considered a family history of diabetes [ 78 , 79 ], one utilised previous history of GDM [ 80 ] and one targeted women who had previously delivered an infant with macrosomia [ 81 ]. Three studies used elevated fasting blood glucose (FBG) [ 82 , 83 , 84 ] or/and haemoglobin A1c (HbA1c) [ 84 ]. Six studies used a history of PCOS [ 85 , 86 , 87 , 88 , 89 , 90 ] with Valdés et al. [ 90 ] additionally specifying pregestational insulin resistance (PIR) with at least one PIR clinical sign or the diagnosis of PCOS.

Fourteen studies required women to have at least one risk factor for the development of GDM including advanced maternal age [ 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ], PCOS [ 93 , 95 , 98 , 99 , 100 ], BMI above a particular threshold (obesity/overweight) [ 91 , 92 , 93 , 94 , 95 , 96 , 97 , 99 , 100 , 101 , 102 , 103 ], a family history of diabetes [ 91 , 92 , 93 , 94 , 95 , 96 , 99 , 100 , 101 , 104 ], signs of glucose intolerance [ 91 , 92 , 99 ], previous GDM [ 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 104 ] or previous macrosomic infant [ 91 , 92 , 93 , 94 , 96 , 97 , 98 , 99 , 100 , 101 , 104 ]. Seven [ 94 , 97 , 98 , 99 , 100 , 101 , 103 ] of these specified other factors including high-risk ethnicity, chronic hypertension, twin pregnancies, abnormal lipid metabolism, glycosuria, previous pregnancy complications (e.g. gestational hypertension, pre-eclampsia, premature rupture of membranes, small for gestational age (SGA), large for gestational age (LGA), intrauterine growth restriction, low Apgar score, preterm deliveries, fetal anomaly, recurrent abortion, intrauterine fetal death and family history of either GDM or adverse obstetrical outcomes).

One study enrolled women with two or more GDM risk factors; including pre-pregnancy obesity, PCOS, high-risk ethnicity, previous GDM or macrosomic infant and family history of diabetes [ 105 ], while Mohsenzadeh-Ledari et al . [ 106 ] enrolled participants who had at least three components of the metabolic syndrome. One study used a validated prediction tool (simple scoring system) for identification of women at high-risk of developing GDM; this included history of GDM, maternal age, BMI, Asian descent, history of poor obstetric outcome and family history of diabetes [ 107 ].

Characteristics of included studies

Characteristics of the studies are shown in Additional file 1 : Table A4. The majority of the studies (n = 82) were RCTs targeting high-risk women in the antenatal period. Two studies in the preconception period were identified. Among the eighty-four studies included, fifteen were conducted in United States [ 29 , 30 , 31 , 35 , 42 , 48 , 49 , 55 , 56 , 61 , 62 , 66 , 71 , 74 , 84 ], eight in China [ 24 , 25 , 67 , 73 , 93 , 95 , 96 , 99 ], eight in Italy [ 38 , 39 , 44 , 59 , 63 , 78 , 82 , 83 ], eight in Australia [ 36 , 47 , 57 , 58 , 72 , 75 , 80 , 107 ], seven in Iran [ 65 , 68 , 69 , 88 , 94 , 98 , 106 ], five in the United Kingdom [ 26 , 40 , 51 , 100 , 103 ], four in Finland [ 60 , 91 , 92 , 102 ], four in the Republic of Ireland [ 27 , 37 , 79 , 81 ], four in Denmark [ 33 , 43 , 46 , 77 ], three in Norway [ 54 , 85 , 86 ], two in each of India [ 97 , 101 ], Netherlands [ 41 , 104 ], New Zealand [ 28 , 64 ], Brazil [ 34 , 50 ] and one in each of Canada [ 45 ], France [ 70 ], Chile [ 90 ], Belgium [ 53 ], Spain [ 32 ], Bangladesh [ 89 ] and the United Arab Emirates [ 105 ]. Three studies were multi-country; Norway, Sweden and Iceland [ 87 ]; United Kingdom, Republic of Ireland, Austria, Poland, Italy, Spain and Belgium [ 52 , 76 ]; Netherlands, and Denmark [ 76 ].

The sample size of the studies ranged from 40 [ 86 ] to 2,122 [ 58 ] participants and the pooled sample size was 22568. Thirty studies included women of all BMI categories [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 ], while 54 included pregnant women living with overweight and/or obesity [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ].

The intervention design varied between studies (Additional file 1 : Table A5). The majority (n = 34) evaluated the effect of combined diet and PA [ 30 , 31 , 32 , 33 , 34 , 35 , 37 , 48 , 51 , 53 , 55 , 56 , 58 , 59 , 61 , 63 , 65 , 66 , 67 , 69 , 70 , 71 , 74 , 84 , 91 , 92 , 93 , 95 , 96 , 99 , 102 , 105 , 106 , 107 ]. Seven studies focused on modifying diet only [ 24 , 29 , 46 , 49 , 57 , 81 , 103 ], while ten aimed at modifying PA alone [ 25 , 27 , 45 , 54 , 62 , 64 , 72 , 80 , 97 , 104 ]. A multidisciplinary approach (consisting of continuity of care, assessment of weight gain, a brief dietary intervention and psychological approach using solution-focused therapy) was used in one study [ 75 ]. Nine studies based their intervention on the supplement inositol (myo-inositol, d-chiro-inositol or combination of both) [ 38 , 39 , 44 , 68 , 78 , 79 , 82 , 83 , 100 ] while four used probiotic supplementation (Lactobacillus and Bifidobacterium species) [ 36 , 60 , 77 , 98 ]. In three studies, the impact of vitamin D was assessed [ 52 , 94 , 101 ] and two evaluated the intake of soluble fibre [ 42 , 73 ] of which one study additionally provided women with frozen blueberries [ 42 ]. Metformin was used as a pharmacological intervention in eleven RCTs [ 40 , 41 , 47 , 50 , 85 , 86 , 87 , 88 , 89 , 90 , 108 ]. Three studies included more than two arms; Renault et al . [ 43 ] compared PA only and combined diet and PA with standard care, whilst Simmons et al . [ 76 ] compared the effect of diet alone, PA alone, combined diet and PA with standard care. Okesene-Gafa et al. [ 28 ] compared diet alone and probiotic to standard care and placebo arms.

Risk of bias (quality) assessment

The overall quality of the included studies varied and is summarised in Fig.  2 . Twenty-three studies were assessed as ‘low risk of bias’ [ 25 , 28 , 31 , 43 , 47 , 49 , 52 , 55 , 58 , 67 , 68 , 69 , 75 , 76 , 77 , 79 , 80 , 82 , 85 , 87 , 99 , 102 , 103 ], 30 as ‘high risk of bias’ [ 30 , 33 , 34 , 35 , 37 , 38 , 39 , 46 , 50 , 54 , 56 , 57 , 61 , 65 , 66 , 78 , 84 , 86 , 88 , 89 , 90 , 93 , 94 , 95 , 97 , 98 , 104 , 105 , 106 , 107 ] and the remaining 31 studies as ‘some concerns’ [ 24 , 26 , 27 , 29 , 32 , 36 , 40 , 41 , 42 , 44 , 45 , 48 , 51 , 53 , 59 , 60 , 62 , 63 , 64 , 70 , 71 , 72 , 73 , 74 , 81 , 83 , 91 , 92 , 96 , 100 , 101 ]. The main source of bias across all studies was the non-adherence to the assigned intervention regimen.

Quality assessment of intervention studies using Cochrane RoB 2- tool

Behavioural intervention (diet only, PA only, combined diet and PA)

In preconception women, the two included studies [ 55 , 56 ] assessed the impact of behavioural intervention (combined diet and PA) on GDM risk and were pooled in a meta-analysis (Additional file 1 : Table A6). Diet and PA-based interventions prior to pregnancy did not reduce GDM development among those who were considered at higher risk prior to pregnancy (risk difference − 0.01, 95% CI 0.24 to 0.23; I 2 63.72%) (Fig.  3 ).

The effects of pre-pregnancy combined diet and physical activity intervention on GDM prevention

Fifty-three antenatal studies [ 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 43 , 45 , 46 , 48 , 49 , 51 , 53 , 54 , 57 , 58 , 59 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 69 , 70 , 71 , 72 , 74 , 75 , 76 , 80 , 81 , 84 , 91 , 92 , 93 , 95 , 96 , 97 , 99 , 102 , 103 , 104 , 105 , 106 , 107 ] reported the effect of a behavioural intervention during pregnancy on the development of GDM with 52 of those included in the meta-analysis (Additional file 1 : Table A6). One study was considered insufficiently homogenous to be pooled for meta-analysis and was excluded from the analysis since only brief dietary intervention (5 min) was provided as part of the multidisciplinary approach [ 75 ]. In the 34 studies that examined the effect of combined diet and PA interventions on GDM risk [ 30 , 31 , 32 , 33 , 34 , 35 , 37 , 43 , 48 , 51 , 53 , 58 , 59 , 61 , 63 , 65 , 66 , 67 , 69 , 70 , 71 , 74 , 76 , 84 , 91 , 92 , 93 , 95 , 96 , 99 , 102 , 105 , 106 , 107 ], women who received the intervention were 3% less likely to develop GDM (risk difference − 0.03, 95% CI 0.06 to − 0.01; I 2 58.69%) with significant heterogeneity across studies (Fig.  4 ). Nine studies of diet only [ 24 , 28 , 29 , 46 , 49 , 57 , 76 , 81 , 103 ] (Fig.  5 ) and twelve of PA only [ 25 , 27 , 43 , 45 , 54 , 62 , 64 , 72 , 76 , 80 , 97 , 104 ] interventions (Fig.  6 ), showed no significant difference in GDM risk (risk difference − 0.01, 95% CI 0.05 to 0.02; I 2 48.72 and − 0.04, 95% CI 0.09 to 0.01; I 2 38.76% respectively).

The effects of antenatal combined diet and physical activity intervention on GDM prevention

The effects of antenatal diet only intervention on GDM prevention

The effects of antenatal physical activity only intervention on GDM prevention

In the subgroup analyses, three antenatal studies that used combined diet and PA interventions for women who had ≥ 2 risk factors reduced GDM risk (risk difference − 0.16, 95% CI 0.25 to − 0.07; I 2 11.23%; Fig.  7 ). There was no effect in sub-group analyses for BMI as the only risk factor (combined diet and PA: risk difference − 0.02, 95% CI − 0.05 to 0.00; I 2 51.50%; diet only: risk difference − 0.02, 95% CI − 0.07 to 0.03; I 2 22.43%; PA only: risk difference − 0.03, 95% CI − 0.12 to 0.05; I 2 49.46%; Fig.  8 ).

The effects of antenatal interventions A diet and physical activity B metformin on GDM prevention in women who had more than single risk factor

The effects of antenatal interventions including diet only, physical activity only, diet and physical activity, metformin, inositol and probiotic on GDM prevention when body mass index was considered as the only risk factor

Supplementation interventions (inositols, vitamin D, probiotics, fibre)

There were 19 studies [ 28 , 36 , 38 , 39 , 42 , 44 , 52 , 60 , 68 , 73 , 77 , 78 , 79 , 82 , 83 , 94 , 98 , 100 , 101 ] that assessed the effect of dietary supplementation on risk of GDM during pregnancy and all were pooled in the meta-analysis (Additional file 1 : Table A6). Nine used inositol [ 38 , 39 , 44 , 68 , 78 , 79 , 82 , 83 , 100 ] and three vitamin D [ 52 , 94 , 101 ]; both of which reduced risk of GDM (risk difference − 0.19, 95% CI 0.33 to − 0.06; I 2 92.19 and − 0.16, 95% CI 0.25 to − 0.06; I 2 32.27% respectively); however, there was significant heterogeneity among the inositol interventions (Fig.  9 , 10 ). Two studies that tested the use of fibre [ 42 , 73 ] showed a reduction in GDM (risk difference − 0.13, 95% CI 0.25 to − 0.02; I 2 0.01%; Fig.  11 ). There was no evidence of an effect of probiotic use on the prevention of GDM (risk difference 0.03, 95% CI 0.01 to 0.07; I 2 0.01%; Fig.  12 ). In the subgroup analysis, four studies used inositol interventions where BMI was the only risk factor and demonstrated a reduction in GDM (risk difference − 0.17, 95% CI 0.22 to − 0.11; I 2 0.01%; Fig.  8 ). It was not possible to perform a sub-group analysis due to lack of supplementation studies among women with multiple risk factors.

The effects of antenatal inositol supplementation on GDM prevention

The effects of antenatal vitamin D supplementation on GDM prevention

The effects of antenatal fibre supplementation on GDM prevention

The effects of antenatal probiotics supplementation on GDM prevention

Pharmacological intervention

There were eleven studies [ 40 , 41 , 47 , 50 , 85 , 86 , 87 , 88 , 89 , 90 , 108 ] that evaluated the effect of metformin on GDM and all were included in the meta-analysis (Additional file 1 : Table A6). There was no significant effect of metformin in the prevention of GDM either overall (risk difference − 0.00, 95% CI − 0.04 to 0.03; I 2 8.82%; Fig.  13 ) or in the subgroup analyses of women with multiple risk factors (risk difference − 0.03, 95% CI − 0.37 to 0.30; I 2 77.04%; Fig.  7 ) or those with overweight and obesity (risk difference 0.00, 95% CI − 0.04 to 0.04; I 2 0.03%; Fig.  8 ).

The effects of antenatal metformin intervention on GDM prevention

Narrative synthesis

It was not possible to conduct a meta-analysis for one study that used a multidisciplinary approach intervention. Therefore, data has been synthesised narratively. The study reported GDM as a primary outcome in pregnant women with increased BMI (> 25 kg/m 2 ) and the intervention resulted in a significant reduction in the incidence of GDM (n = 4, 6% vs. n = 17, 29%, OR 0.17, 95% CI 0.03–0.95, p  = 0.04) [ 75 ].

Publication bias

There was no evidence of small study effects for any intervention except antenatal combined diet and PA interventions ( p  < 0.05), which may signal publication bias (Additional file 1 : Figure A1, Table A7).

This review aimed to evaluate the effectiveness of preconception and pregnancy interventions in reducing GDM among women at increased risk. The findings from the meta-analysis showed that GDM was reduced using combined diet and PA, inositol and vitamin D supplementation in women identified in early pregnancy as higher risk. The effect was greatest with the dietary supplements. In a sub-group analysis, diet and PA interventions were most effective in women with multiple GDM risk factors while in pregnant women living with overweight and obesity, inositol was effective. The results were limited by high levels of heterogeneity between the included studies, while some studies were not sufficiently powered to detect a difference in GDM. Additionally, there was a lack of preconception studies.

Whilst this analysis showed that the use of antenatal combined diet and PA intervention modestly reduced the risk of GDM when higher risk women were recruited, this same approach did not appear effective when higher BMI was considered the sole risk factor. These findings are consistent with a meta-regression examining moderators of intervention effectiveness for preventing GDM; it showed that behavioural interventions in populations with higher risk of GDM demonstrated greater effectiveness, but also highlighted that BMI before or in early pregnancy was not related to the effect size of the intervention [ 109 ]. This suggests that BMI stratification alone is not an effective strategy for either risk prediction or response to intervention [ 109 ]. Conversely, the current review showed that using a targeted recruitment strategy that includes multiple risk factors for GDM helped maximise the effectiveness of a combined diet and PA intervention. Given the limited number of studies available (n = 3) and the high risk of bias associated with these studies, we still lack certainty and more research is needed to examine targted interventions particularly in women with multiple risk factors.

The current review found that antenatal interventions using inositol in higher-risk women, including those with increased BMI as a sole risk factor, were effective in reducing GDM. This correlates with findings of a recent meta-analysis of inositol interventions in ‌pregnant women living with overweight and obesity [ 110 ]. The insulin-mimetic effects of myo-inositol or its isomers are thought to be related to the production of inositol glycan secondary messengers, resulting in improved glycogen synthesis and glucose peripheral tissue uptake [ 111 , 112 ]. Moreover, a deficit in intracellular d-chiro-inositol (DCI) has been observed in women with PCOS and overweight or obesity, resulting in impaired coupling between insulin action and the release of d-chiro-inositol-containing inositolphosphoglycan (DCI-IPG) that acts as an insulin mediator and sensitizer [ 113 ]. Although further studies of pregnant women with overweight and obesity are required to confirm inositol effectiveness, our analysis suggests that inositol supplementation may reduce the incidence of GDM among pregnant women at increased risk, regardless of the factors used in the risk assessment.

The present meta-analysis also suggests a preventative effect of antenatal vitamin D supplementation on GDM risk, and Cochrane reviews have also previously provided evidence for this possible benefit [ 11 ]. Several mechanistic pathways elucidating an influence of vitamin D on glucose homeostasis and GDM development have been described which impact upon metabolic markers including blood glucose concentrations, insulin resistance and inflammatory biomarkers [ 114 , 115 , 116 ]. Given that only three studies were identified in the current review that used vitamin D interventions, there is a need for further well-designed trials using larger cohorts among pregnant women identified as high-risk.

No effect of probiotics on the development of GDM in higher-risk women was found, consistent with the results of a Cochrane review [ 11 ]. However, in contrast, a recent meta-analysis (n = 10) showed a significant reduction of GDM with probiotic supplementation in the general antenatal population [ 117 ]. Furthermore, metformin was not found to be effective in preventing GDM in higher risk pregnant women. This is consistent with a previous meta-analysis in which the use of metformin started at conception or before 20 weeks of pregnancy did not reduce GDM when BMI was the only risk factor, or another selective risk assessment strategy such as PCOS and/or PIR was used [ 39 ]. A Cochrane systematic review of metformin use to prevent the development of type 2 diabetes mellitus (T2DM) (n = 20 RCTs) in individuals at increased risk supported efficacy in prevention (with or without behavioural interventions) when taken over a minimum of at least a 1-year [ 118 ]. This may imply that given the relatively short period of gestation, women at increased risk might benefit from metformin intervention if commenced during the preconception period. Moreover, our analysis highlights the limited evidence for metformin interventions (n = 2) in women with multiple risk factors, and the significant heterogeneity between them. Again, further research is needed as a potential effect of prolonged preconception metformin use in preventing GDM in such a population cannot be discounted.

Several different approaches for the identification of women at higher risk were utilised in the included studies for this review. Notably, only one study used a validated tool to identify risk while five studies intervened in women with ≥ 2 GDM risk factors. Our finding that interventions with women who had multiple risk factors reduced GDM prevalence supports the use of multiple risk factor clustering or validated tools to screen for risk of GDM. One such tool for identifying which women living with obesity are at higher risk of GDM development early in pregnancy has been developed [ 119 ] and is currently being validated. Better identification of risk amongst women with obesity, most of whom will not develop GDM, should facilitate interventions to be targeted at those most likely to benefit [ 119 ].

This review highlights the paucity of interventions targeting higher risk women in the preconception period, mirroring a lack of interventions globally in individuals preparing for pregnancy [ 120 ]. Moreover, we found no evidence of benefit of preconception behavioural interventions on the development of GDM in the two identified studies. The current interest in the importance of improving preconception health has stimulated recent attempts [ 121 ]. NiPPeR, a double-blind multicentre RCT in healthy women planning pregnancy, examined the effect of a nutritional formulation containing myo-inositol, probiotics, and multiple micronutrients taken preconception and throughout pregnancy, on gestational glycaemia and preterm delivery [ 17 ]. Whilst preterm delivery was reduced, there was no effect on the prevalence of GDM [ 17 ]. Additionally, NiPPeR did not demonstrate any benefit of the intervention in women with overweight or obesity or those with documented dysglycaemia; however, the trial was not powered to detect differences between subgroups [ 17 ]. Appropriately designed RCTs which encompass behavioural, supplementation and pharmacological interventions in high-risk women contemplating pregnancy are needed to evaluate the role of these interventions at the population level.

Strengths and limitations

To date, this study represents the largest review on this subject, with the inclusion of recently published studies targeting higher risk antenatal populations. A robust comprehensive search strategy was utilised using well-defined eligibility criteria. The screening, risk of bias assessment and data extraction were performed independently in duplicate. However, meta-analyses were limited by the quality and methodological variability of studies available. There was considerable variation in criteria for risk stratification and the gestational age at which the intervention was introduced across the trials. The inclusion of studies using different GDM diagnostic criteria may also have contributed to heterogeneity between studies. Due to the limited number of studies in women with multiple risk factors, a subgroup analysis comprising other types of intervention (e.g., diet only, PA only, dietary supplements, preconception interventions) could not be performed. Potential publication bias for combined diet and PA intervention effects was found. Therefore, the interpretation of the findings is limited by the possible bias from selective reporting. Moreover, exclusion of non-English studies may contribute to publication bias.

Recommendations for further research and practice

Further large-scale studies are needed, with higher methodological quality in women with multiple risk factors for GDM to determine if interventions, whether behavioural, dietary supplement or pharmacological, are more effective in reducing GDM and improving other related pregnancy outcomes than unselected population-based approaches or a single risk factor strategy. Future studies in the preconception period should consider risk stratification to identify women who may derive greater benefit. We report here that a variety of strategies were used to identify women at risk of GDM. Validation of groups of risk factors or predictive tools to identify high-risk populations should therefore be considered to harmonise risk assessment and develop effective preventative interventions to improve maternal and infant health in those women who would benefit the most.

This study suggests that identification of women at high-risk of developing GDM in early pregnancy and targeted intervention using combined diet and physical activity, inositol or vitamin D reduces GDM, indicating that a targeted approach provides a promising strategy. The results should be interpreted with caution due to differences in risk stratification strategies, diagnostic criteria for GDM, gestational age for intervention, and in intervention design. Further RCTs using validated prediction tools or multiple risk factors to target high-risk women for interventions before and during pregnancy are required.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its supplementary information files.

Abbreviations

Body mass index

D-chiro-inositol

D-chiro-inositol-containing inositolphosphoglycan

Fasting blood glucose

Gestational diabetes mellitus

Haemoglobin a1c

Large-for-gestational age

Oral glucose tolerance test

• Physical activity

Polycystic ovary syndrome

Pregestational insulin resistance

Preferred reporting items for systematic reviews and meta-analyses

• Randomised controlled trials

The Cochrane risk-of-bias tool for randomised trials

Small for gestational age

Type 2 diabetes mellitus

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Acknowledgements

OFQ is supported by King Abdulaziz University, Jeddah, Saudi Arabia.

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Sara L. White and Angela C. Flynn have contributed equally to this work.

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Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, London, UK

Ola F. Quotah, Daria Andreeva, Katarzyna G. Nowak, Aljawharah Almubarak, Anjali Patel, Nirali Vyas, Gözde S. Cakir, Lucilla Poston & Sara L. White

Department of Clinical Nutrition, Faculty of Applied Medical Science, King Abdulaziz University, Jeddah, Saudi Arabia

Ola F. Quotah

Department of Nutrition and Dietetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

Katarzyna G. Nowak

Department of Nutritional Sciences, School of Life Course Sciences and Population Sciences, King’s College London, London, UK

Kathryn V. Dalrymple, Zoe Bell & Angela C. Flynn

Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK

Nicola Heslehurst

School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland

Angela C. Flynn

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Concept and design: OFQ, ACF and SLW. Literature search: OFQ, KGN, AA, GSC, AP and NV. Quality assessment and data extraction: OFQ & DA. Data analysis and interpreting data: OFQ. Critical discussion and manuscript drafting: OFQ. Revising manuscript: OFQ, ACF, SLW, LP and NH. Manuscript submission: OFQ. All authors read and approved the final manuscript.

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Additional file 1: table a1..

Literature search strategy (MEDLINE). Table A2. Literature search strategy (EMBASE). Table A3. Literature search strategy (Cochrane Library). Table A4. Characteristics of the included studies. Table A5. Summary of criteria used for GDM risk stratification and intervention characteristic. Table A6. Pregnancy outcomes. Table A7. Eggers test of publication bias for antenatal interventions. Figure A1. Funnel plots of publication bias for antenatal interventions.

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Quotah, O.F., Andreeva, D., Nowak, K.G. et al. Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials. Diabetol Metab Syndr 16 , 8 (2024). https://doi.org/10.1186/s13098-023-01217-4

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• Gestational diabetes
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• Preconception
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Diabetology & Metabolic Syndrome

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A scoping review of ‘Pacing’ for management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): lessons learned for the long COVID pandemic

• Nilihan E. M. Sanal-Hayes 1 , 7 ,
• Marie Mclaughlin 1 , 8 ,
• Lawrence D. Hayes 1 ,
• Jacqueline L. Mair   ORCID: orcid.org/0000-0002-1466-8680 2 , 3 ,
• Jane Ormerod 4 ,
• David Carless 1 ,
• Natalie Hilliard 5 ,
• Rachel Meach 1 ,
• Joanne Ingram 6 &
• Nicholas F. Sculthorpe 1  

Journal of Translational Medicine volume  21 , Article number:  720 ( 2023 ) Cite this article

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Metrics details

Controversy over treatment for people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a barrier to appropriate treatment. Energy management or pacing is a prominent coping strategy for people with ME/CFS. Whilst a definitive definition of pacing is not unanimous within the literature or healthcare providers, it typically comprises regulating activity to avoid post exertional malaise (PEM), the worsening of symptoms after an activity. Until now, characteristics of pacing, and the effects on patients’ symptoms had not been systematically reviewed. This is problematic as the most common approach to pacing, pacing prescription, and the pooled efficacy of pacing was unknown. Collating evidence may help advise those suffering with similar symptoms, including long COVID, as practitioners would be better informed on methodological approaches to adopt, pacing implementation, and expected outcomes.

In this scoping review of the literature, we aggregated type of, and outcomes of, pacing in people with ME/CFS.

Eligibility criteria

Original investigations concerning pacing were considered in participants with ME/CFS.

Sources of evidence

Six electronic databases (PubMed, Scholar, ScienceDirect, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched; and websites MEPedia, Action for ME, and ME Action were also searched for grey literature, to fully capture patient surveys not published in academic journals.

A scoping review was conducted. Review selection and characterisation was performed by two independent reviewers using pretested forms.

Authors reviewed 177 titles and abstracts, resulting in 17 included studies: three randomised control trials (RCTs); one uncontrolled trial; one interventional case series; one retrospective observational study; two prospective observational studies; four cross-sectional observational studies; and five cross-sectional analytical studies. Studies included variable designs, durations, and outcome measures. In terms of pacing administration, studies used educational sessions and diaries for activity monitoring. Eleven studies reported benefits of pacing, four studies reported no effect, and two studies reported a detrimental effect in comparison to the control group.

Conclusions

Highly variable study designs and outcome measures, allied to poor to fair methodological quality resulted in heterogenous findings and highlights the requirement for more research examining pacing. Looking to the long COVID pandemic, our results suggest future studies should be RCTs utilising objectively quantified digitised pacing, over a longer duration of examination (i.e. longitudinal studies), using the core outcome set for patient reported outcome measures. Until these are completed, the literature base is insufficient to inform treatment practises for people with ME/CFS and long COVID.

Introduction

Post-viral illness occurs when individuals experience an extended period of feeling unwell after a viral infection [ 1 , 2 , 3 , 4 , 5 , 6 ]. While post-viral illness is generally a non-specific condition with a constellation of symptoms that may be experienced, fatigue is amongst the most commonly reported [ 7 , 8 , 9 ]. For example, our recent systematic review found there was up to 94% prevalence of fatigue in people following acute COVID-19 infection [ 3 ]. The increasing prevalence of long COVID has generated renewed interest in symptomology and time-course of post-viral fatigue, with PubMed reporting 72 articles related to “post-viral fatigue” between 2020 and 2022, but less than five for every year since 1990.

As the coronavirus pandemic developed, it became clear that a significant proportion of the population experienced symptoms which persisted beyond the initial viral infection, meeting the definition of a post-viral illness. Current estimates suggest one in eight people develop long COVID [ 10 ] and its symptomatology has repeatedly been suggested to overlap with clinical demonstrations of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In a study by Wong and Weitzer [ 11 ], long COVID symptoms from 21 studies were compared to a list of ME/CFS symptoms. Of the 29 known ME/CFS symptoms the authors reported that 25 (86%) were reported in at least one long COVID study suggesting significant similarities. Sukocheva et al. [ 12 ] reported that long COVID included changes in immune, cardiovascular, metabolic, gastrointestinal, nervous and autonomic systems. When observed from a pathological stance, this list of symptoms is shared with, or is similar to, the symptoms patients with ME/CFS describe [ 13 ]. In fact, a recent article reported 43% of people with long COVID are diagnosed with ME/CFS [ 13 ], evidencing the analogous symptom loads.

A striking commonality between long COVID and similar conditions such as ME/CFS is the worsening of symptoms including fatigue, pain, cognitive difficulties, sore throat, and/or swollen lymph nodes following exertion. Termed post exertional malaise (PEM) [ 14 , 15 , 16 , 17 ], lasting from hours to several days, it is arguably one of the most debilitating side effects experienced by those with ME/CFS [ 16 , 17 , 18 ]. PEM is associated with considerably reduced quality of life amongst those with ME/CFS, with reduced ability to perform activities of daily living, leading to restraints on social and family life, mental health comorbidities such as depression and anxiety, and devastating employment and financial consequences [ 19 , 20 , 21 , 22 ]. At present, there is no cure or pharmacological treatments for PEM, and therefore, effective symptom management strategies are required. This may be in part because the triggers of PEM are poorly understood, and there is little evidence for what causes PEM, beyond anecdotal evidence. The most common approach to manage PEM is to incorporate activity pacing into the day-to-day lives of those with ME/CFS with the intention of reducing the frequency of severity of bouts of PEM [ 23 ]. Pacing is defined as an approach where patients are encouraged to be as active as possible within the limits imposed by the illness [ 23 , 24 , 25 ]. In practice, pacing requires individuals to determine a level at which they can function, but which does not lead to a marked increase in fatigue and other symptoms [ 26 , 27 ].

Although long COVID is a new condition [ 3 , 14 ], the available evidence suggests substantial overlap with the symptoms of conditions such as ME/CFS and it is therefore pragmatic to consider the utility of management strategies (such as pacing) used in ME/CFS for people with long COVID. In fact, a recent Delphi study recommended that management of long COVID should incorporate careful pacing to avoid PEM relapse [ 28 ]. This position was enforced by a multidisciplinary consensus statement considering treatment of fatigue in long COVID, recommending energy conservation strategies (including pacing) for people with long COVID [ 29 ]. Given the estimated > 2 million individuals who have experienced long COVID in the UK alone [ 30 , 31 , 32 ], there is an urgent need for evidence-based public health strategies. In this context, it seems pragmatic to borrow from the ME/CFS literature.

From a historical perspective, the 2007 NICE guidelines for people with ME/CFS advised both cognitive behavioural therapy (CBT) and graded exercise therapy (GET) should be offered to people with ME/CFS [ 33 ]. As of the 2021 update, NICE guidelines for people with ME/CFS do not advise CBT or GET, and the only recommended management strategy is pacing [ 34 ]. In the years between changes to these guidelines, the landmark PACE trial [ 35 ] was published in 2011. This large, randomised control trial (RCT; n = 639) compared pacing with CBT and reported GET and CBT were more effective than pacing for improving symptoms. Yet, this study has come under considerable criticism from patient groups and clinicians alike [ 36 , 37 , 38 , 39 ]. This may partly explain why NICE do not advise CBT or GET as of 2021, and only recommend pacing for symptom management people with ME/CFS [ 34 ]. There has been some controversy over best treatment for people with ME/CFS in the literature and support groups, potentially amplified by the ambiguity of evidence for pacing efficacy and how pacing should be implemented. As such, before pacing can be advised for people with long COVID, it is imperative previous literature concerning pacing is systematically reviewed. This is because a consensus is needed within the literature for implementing pacing so practitioners treating people with ME/CFS or long COVID can do so effectively. A lack of agreement in pacing implementation is a barrier to adoption for both practitioners and patients. Despite several systematic reviews concerning pharmacological interventions or cognitive behavioural therapy in people with ME/CFS [ 36 , 40 , 41 ], to date, there are no systematic reviews concerning pacing.

Despite the widespread use of pacing, the literature base is limited and includes clinical commentaries, case studies, case series, and few randomised control trials. Consequently, while a comprehensive review of the effects of pacing in ME/CFS is an essential tool to guide symptom management advice, the available literature means that effective pooling of data is not feasible [ 42 ] and therefore, a traditional systematic review and meta-analysis, with a tightly focussed research question would be premature [ 43 ]. Consequently, we elected to undertake a scoping review. This approach retains the systematic approach to literature searching but aims to map out the current state of the research [ 43 ]. Using the framework of Arksey and O'Malley [ 44 ], a scoping review aims to use a broad set of search terms and include a wide range of study designs and methods (in contrast to a systematic review [ 44 ]). This approach, has the benefit of clarifying key concepts, surveying current data collection approaches, and identifying critical knowledge gaps.

We aimed to provide an overview of existing literature concerning pacing in ME/CFS. Our three specific objectives of this scoping review were to (1) conduct a systematic search of the published literature concerning ME/CFS and pacing, (2) map characteristics and methodologies used, and (3) provide recommendations for the advancement of the research area.

Protocol and registration

The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines [ 45 ] and the five-stage framework outlined in Arksey and O’Malley [ 44 ]. Registration is not recommended for scoping reviews.

Studies that met the following criteria were included in this review: (1) published as a full-text manuscript; (2) not a review; (3) participants with ME/CFS; (4) studies employed a pacing intervention or retrospective analysis of pacing or a case study of pacing. Studies utilising sub-analysis of the pacing, graded activity, and cognitive behaviour therapy: a randomised evaluation (PACE) trial were included as these have different outcome measures and, as this is not a meta-analysis, this will not influence effect size estimates. Additionally, due to the paucity of evidence, grey literature has also been included in this review.

Search strategy

The search strategy consisted of a combination of free-text and MeSH terms relating to ME/CFS and pacing, which were developed through an examination of published original literature and review articles. Example search terms for PubMed included: ‘ME/CFS’ OR ‘ME’ OR ‘CFS’ OR ‘chronic fatigue syndrome’ OR ‘PEM’ OR ‘post exertional malaise’ OR ‘pene’ OR ‘post-exertion neurogenic exhaust’ AND ‘pacing’ OR ‘adaptive pacing’. The search was performed within title/abstract. Full search terms can be found in Additional file 1 .

Information sources

Six electronic databases [PubMed, Scholar, ScienceDirect, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL)] were searched to identify original research articles published from the earliest available date up until 02/02/2022. Additional records were identified through reference lists of included studies. ‘Grey literature’ repositories including MEPedia, Action for ME, and ME Action were also searched with the same terms.

Study selection and data items

Once each database search was completed and manuscripts were sourced, all studies were downloaded into a single reference list (Zotero, version 6.0.23) and duplicates were removed. Titles and abstracts were screened for eligibility by two reviewers independently and discrepancies were resolved through discussion between reviewers. Subsequently, full text papers of potentially relevant studies were retrieved and assessed for eligibility by the same two reviewers independently. Any uncertainty by reviewers was discussed in consensus meetings and resolved by agreement. Data extracted from each study included sample size, participant characteristics, study design, trial registration details, study location, pacing description (type), intervention duration, intervention adherence, outcome variables, and main outcome data. Descriptions were extracted with as much detail as was provided by the authors. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale [ 46 , 47 ].

Role of the funding source

The study sponsors had no role in study design, data collection, analysis, or interpretation, nor writing the report, nor submitting the paper for publication.

Study selection

After the initial database search, 281 records were identified (see Fig.  1 ). Once duplicates were removed, 177 titles and abstracts were screened for inclusion resulting in 22 studies being retrieved as full text and assessed for eligibility. Of those, five were excluded, and 17 articles remained and were used in the final qualitative synthesis.

Schematic flow diagram describing exclusions of potential studies and final number of studies. RCT = randomized control trial. CT = controlled trial. UCT = uncontrolled trial

Study characteristics

Study characteristics are summarised in Table 1 . Of the 17 studies included, three were randomised control trials (RCTs [ 35 , 48 , 49 ]); one was an uncontrolled trial [ 50 ]; one was a case series [ 51 ]; one was a retrospective observational study [ 52 ], two were prospective observational studies [ 53 , 54 ]; four were cross-sectional observational studies [ 25 , 55 , 56 ]; and five were cross-sectional analytical studies [ 57 , 58 , 59 , 60 , 61 ] including sub-analysis of the PACE trial [ 35 , 56 , 59 , 61 ]. Seven of the studies were registered trials [ 35 , 48 , 49 , 50 , 56 , 57 , 58 ]. Diagnostic criteria for ME/CFS are summarised in Table 2 .

Types of pacing

Pacing interventions.

Of the 17 studies included, five implemented their own pacing interventions and will be discussed in this section. Sample sizes ranged from n = 7 in an interventional case series [ 51 ] to n = 641 participants in the largest RCT [ 35 ]. The first of these five studies considered an education session on pacing and self-management as the ‘pacing’ group, and a ‘pain physiology education’ group as the control group [ 49 ]. Two studies included educational sessions provided by a therapist plus activity monitoring via ActiGraph accelerometers [ 51 ] and diaries [ 48 ] at baseline and follow-up. In the first of these two studies, Nijs and colleagues [ 51 ] implemented a ‘self-management program’ which asked patients to estimate their current physical capabilities prior to commencing an activity and then complete 25–50% less than their perceived energy envelope. They[ 51 ] did not include a control group and had a sample size of only n = 7. Six years later, the same research group [ 48 ] conducted another pacing study which utilised relaxation as a comparator group (n = 12 and n = 14 in the pacing and relaxation groups, respectively). The pacing group underwent a pacing phase whereby participants again aimed to complete 25–50% less than their perceived energy envelope, followed by a gradual increase in exercise after the pacing phase (the total intervention spanned three weeks, and it is unclear how much was allocated to pacing, and how much to activity increase). Therefore, it could be argued that Kos et al. [ 48 ] really assessed pacing followed by a gradual exercise increase as outcome measures were assessed following the graded activity phase. Another pacing intervention delivered weekly educational sessions for six weeks and utilised a standardised rehabilitation programme using the ‘activity pacing framework’ [ 50 ] in a single-arm, no comparator group feasibility study. Finally, the PACE trial adopted an adaptive pacing therapy intervention consisting of occupational therapists helping patients to plan and pace activities utilising activity diaries to identify activities associated with fatigue and staying within their energy envelope [ 35 ]. This study incorporated standard medical care, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) as comparator groups [ 35 ]. It is worth noting that the pacing group and the CBT group were both ‘encouraged’ to increase physical activity levels as long as participants did not exceed their energy envelope. Although not all five intervention studies explicitly mentioned the “Energy Envelope Theory”, which dictates that people with ME/CFS should not necessarily increase or decrease their activity levels, but moderate activity and practice energy conservation [ 62 ], all intervention studies used language analogous to this theory, such as participants staying within limits, within capacity, or similar.

The interventions included in this review were of varying durations, from a single 30-min education session [ 49 ], a 3-week (one session a week) educational programme [ 51 ], a 3-week (3 × 60–90 min sessions/week) educational programme [ 48 ], a 6-week rehabilitation programme [ 50 ], to a 24-week programme [ 35 ]. Intervention follow-up durations also varied across studies from immediately after [ 49 ], 1-week [ 51 ], 3-weeks [ 48 ], 3-months [ 50 ], and 1-year post-intervention [ 35 ].

Observational studies of pacing

Eight studies were observational and, therefore, included no intervention. Observational study sample sizes ranged from 16 in a cross-sectional interview study [ 25 ] to 1428 in a cross-sectional survey [ 52 ]. One study involved a retrospective analysis of participants’ own pacing strategies varying from self-guided pacing or pacing administered by a therapist compared with implementation of CBT and GET [ 52 ]. Five involved a cross-sectional analysis of participants own pacing strategies which varied from activity adjustment, planning and acceptance [ 50 , 55 ], and the Energy Envelope method [ 58 , 60 ]. Two studies were prospective observational studies investigating the Energy Envelope theory [ 53 , 54 ]. Four studies [ 56 , 57 , 59 , 61 ] included in this review involved sub-analysis of results of the PACE trial [ 35 ].

Outcome measures

Quantitative health outcomes.

ME/CFS severity and general health status were the most common outcome measures across studies (16/17) [ 35 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 63 ]. Studies utilised different instruments, including the Short-Form 36 (SF-36; 8/16) [ 35 , 51 , 53 , 54 , 56 , 57 , 58 , 60 ], SF-12 (2/16) [ 50 , 63 ], ME symptom and illness severity (2/16) [ 52 , 55 ], Patient health (PHQ-15; 1/16) [ 59 ], DePaul symptom questionnaire (DSQ; 1/16) [ 58 ], and the Patient health questionnaire-9 (1/16) [ 50 ]. Additionally, some studies used diagnostic criteria for ME/CFS as an outcome measure to determine recovery [ 57 , 59 , 61 ].

Pain was assessed by most included studies (11/17) [ 35 , 49 , 50 , 51 , 53 , 54 , 55 , 57 , 59 , 60 , 61 , 63 ]. Two studies [ 59 , 61 ] included the international CDC criteria for CFS which contain five painful symptoms central to a diagnosis of CFS: muscle pain and joint pain. Other methods of assessment included Brief Pain Inventory (1/11) [ 53 ], Chronic Pain Coping Inventory (CPCI; 1/11) [ 49 ], Pain Self Efficacy Questionnaire (PSEQ; 1/11) [ 50 ], Tampa Scale for Kinesiophobia–version CFS (1/11) [ 49 ], algometry (1/11) [ 49 ], Knowledge of Neurophysiology of Pain Test (1/12) [ 49 ], Pain Catastrophizing Scale (1/11) [ 49 ], Pain Anxiety Symptoms Scale short version (PASS-20; 1/11) [ 50 ], Pain Numerical Rating Scale (NRS; 1/11) [ 63 ].

Fatigue or post-exertional malaise was assessed by 11 of the 17 studies [ 35 , 48 , 50 , 51 , 53 , 54 , 56 , 57 , 60 , 61 , 63 ]. Again, measurement instruments were divergent between studies and included the Chalder Fatigue Questionnaire (CFQ; 4/11) [ 35 , 50 , 57 , 63 ], Fatigue Severity Scale (2/11) [ 53 , 60 ], the Chronic Fatigue Syndrome Medical Questionnaire (1/11) [ 60 ], and Checklist Individual Strength (CIS; 2/11) [ 48 , 51 ].

Anxiety and depression were also common outcome measures, utilised by four studies (4/17) [ 50 , 53 , 59 , 63 ]. These were also assessed using different instruments including Hospital Anxiety and Depression Scale (HADS; 2/4) [ 59 , 63 ], Generalised Anxiety Disorder Assessment (1/4 [ 50 ]), Beck Depression Inventory (BDI-II; 1/4) [ 53 ], Beck Anxiety Inventory (BAI; 1/4) [ 53 ], and Perceived Stress Scale (PSS; 1/4) [ 53 ].

Outcome measures also included sleep (2/17) [ 53 , 59 ], assessed by The Pittsburgh Sleep Quality Index (1/2) [ 53 ] and Jenkins sleep scale (1/2) [ 59 ]; and quality of life (2/17) [ 50 , 53 ] as assessed by the EuroQol five-dimensions, five-levels (EQ-5D-5L; 1/2) [ 50 ] and The Quality-of-Life Scale (1/2) [ 53 ]. Self-Efficacy was measured in four studies [ 50 , 53 , 59 , 60 ], assessed by the Brief Coping Orientation to Problems Experienced Scale (bCOPE; 1/4) [ 60 ] and the Chronic Disease Self-Efficacy measure (3/4) [ 50 , 53 , 59 ].

Quantitative evaluation of pacing

Some studies (4/17) [ 25 , 50 , 52 , 63 ] included assessments of the participants’ experiences of pacing, using the Activity Pacing Questionnaire (APQ-28; 1/4 [ 50 ], APQ-38 (2/4) [ 25 , 63 ]), a re-analysis of the 228 question survey regarding treatment (1/4) [ 52 ] originally produced by the ME Association [ 55 ], and qualitative semi-structured telephone interviews regarding appropriateness of courses in relation to individual patient needs (1/4) [ 25 ]. The APQ-28 and -38 have been previously validated, but the 228-question survey has not. When outcome measures included physical activity levels (4/17), the Canadian Occupational Performance Measure (COPM) was used in two studies [ 48 , 51 ], and two studies used accelerometers to record physical activity [ 51 , 54 ]. Of these two studies, Nijs [ 51 ] examined accelerometery after a 3-week intervention based on the Energy Envelope Theory and Brown et al. [ 54 ] evaluated the Energy Envelope Theory of pacing over 12 months.

Other outcomes

Two [ 53 , 59 ] of the 17 studies included structured clinical interviews for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) to assess psychiatric comorbidity and psychiatric exclusions. One study included a disability benefits questionnaire [ 55 ], and one study included employment and education questionnaire [ 55 ]. Additionally, satisfaction of primary care was also used as an outcome measure (2/17) [ 25 , 55 ] assessed using the Chronic Pain Coping Inventory (CPCI).

Efficacy of pacing interventions

The majority of studies (12/17) [ 25 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 60 , 63 ] highlighted improvements in at least one outcome following pacing (Fig.  2 ). When the effect of pacing was assessed by ME symptomology and general health outcomes, studies reported pacing to be beneficial [ 25 , 50 , 51 , 53 , 54 , 55 , 56 , 58 ]. It is worth noting however that pacing reportedly worsened ME symptoms in 14% of survey respondents, whilst improving symptoms in 44% of respondents [ 52 ]. Most studies using fatigue as an outcome measure reported pacing to be efficacious (7/10) [ 50 , 51 , 53 , 54 , 56 , 60 , 63 ]. However, one study reported no change in fatigue with a pacing intervention (1/10) [ 35 ], and 2/10 studies [ 53 , 63 ] reported a worsening of fatigue with pacing. Physical function was used to determine the efficacy of pacing in 11 studies [ 35 , 48 , 50 , 51 , 53 , 54 , 56 , 58 , 59 , 60 , 63 ]. Of these, the majority found pacing improved physical functioning (8/10) [ 48 , 50 , 51 , 53 , 54 , 56 , 58 , 60 ], with 1/10 [ 35 ] studies reporting no change in physical functioning, and 1/10 [ 59 ] reporting a worsening of physical functioning from pre- to post-pacing. Of the seven studies [ 35 , 49 , 50 , 51 , 53 , 54 , 60 ] which used pain to assess pacing efficacy, 4/7 [ 50 , 51 , 53 , 60 ] reported improvements in pain and 3/7 [ 35 , 51 , 53 ] reported no change in pain scores with pacing. All studies reporting quality of life (1/1) [ 53 ], self-efficacy (3/3) [ 50 , 53 , 59 ], sleep (2/2) [ 53 , 59 ], and depression and anxiety (4/4) [ 50 , 53 , 59 , 63 ], found pacing to be efficacious for ME/CFS participants.

Bubble plot displaying number of studies reporting each domain (x-axis) and the percentage of studies reporting improvement with pacing (y-axis), including a coloured scale of improvement from 0–100%. PEM = post-exertional malaise, 6MWT = 6-min walk time, CFS = chronic fatigue syndrome, DSQ = DePaul Symptom Questionnaire, PA = Physical Activity, HRQOL = Health-related quality of life, COPM = The Canadian Occupational Performance Measure

Participant characteristics

The majority of studies (10/17) [ 25 , 50 , 52 , 53 , 54 , 58 , 59 , 60 , 61 , 63 ] did not report age of the participants. For those which did report age, this ranged from 32 ± 14 to 43 ± 13 years. Where studies reported sex (11/17) [ 35 , 48 , 49 , 50 , 51 , 54 , 55 , 56 , 57 , 58 , 60 ], this was predominantly female, ranging from 75 to 100% female. Only six studies [ 35 , 54 , 56 , 57 , 58 , 60 ] reported ethnicity, with cohorts predominantly Caucasian (94–98%). Time since diagnosis was mostly unreported (12/17) [ 25 , 48 , 49 , 50 , 52 , 53 , 54 , 58 , 59 , 60 , 61 , 63 ] but ranged from 32 to 96 months, with a cross-sectional survey reporting 2% of the participants were diagnosed 1–2 years previously; 6% 3–4 years since diagnosis; 13% 3–4 years since diagnosis; 12% 5–6 years since diagnosis; 20% 7–10 years since diagnosis; 29% 11–21 years since diagnosis; 13% 21–30 years since diagnosis; and 5% > 30 years since diagnosis. Of the studies which reported comorbidities of the participants (6/17) [ 25 , 35 , 50 , 56 , 57 , 63 ], the comorbidities were chronic pain, depressive disorder, psychiatric disorder.

Study location

Of the 17 studies, 14 were from Europe [ 25 , 35 , 48 , 49 , 50 , 51 , 52 , 55 , 56 , 57 , 58 , 59 , 61 , 63 ], and three from North America [ 53 , 54 , 60 ]. Of the 14 studies[ 25 , 35 , 48 , 49 , 50 , 51 , 52 , 55 , 56 , 57 , 58 , 59 , 61 , 63 ] from Europe, ten [ 25 , 35 , 50 , 52 , 55 , 56 , 57 , 58 , 59 , 61 , 63 ] were conducted in the United Kingdom, three in Belgium [ 48 , 49 , 51 ], and one was a multicentred study between the United Kingdom and Norway [ 58 ].

Recruitment strategy

Of the 17 studies, three [ 53 , 54 , 60 ] used announcements in a newspaper and physician referrals to recruit participants, two [ 50 , 63 ] recruited patients referred by a consultant from a National Health Service (NHS) Trust following a pain diagnosis, two [ 52 , 55 ] concerned online platforms on the web, two [ 59 , 61 ] recruited from secondary care clinics, and two used the PACE trial databases [ 56 , 57 ]. Moreover, one study recruited from the hospital [ 58 ], one from physiotherapist referrals [ 25 ], two from specialist clinic centres [ 35 , 64 ], one from waiting list of rehabilitation centre [ 48 ], and one from medical files [ 49 ].

Study settings

Ten studies were carried out in hospital and clinic setting [ 25 , 35 , 48 , 49 , 50 , 51 , 58 , 59 , 61 , 63 ]. Two studies were performed on online platforms [ 52 , 55 ]. Three studies did not report study setting [ 53 , 54 , 60 ]. Two studies generated output from PACE trial databases [ 56 , 57 ]

Adherence and feasibility

All five intervention studies reported adherence rates (which they defined as number of sessions attended), which ranged from 4–44% (4% [ 49 ], 8% [ 35 ], 25% [ 48 ], 29% [ 51 ], and 44% [ 50 ]). One study reported the median number of rehabilitation programme sessions attended was five out of six possible sessions, with 58.9% [ 50 ] participants attending ≥ 5 sessions; 83.2% participants attending at least one educational session on activity pacing and 56.1% attending both activity pacing sessions.

This scoping review summarises the existing literature, with a view to aid physicians and healthcare practitioners better summarise evidence for pacing in ME/CFS and use this knowledge for other post-viral fatiguing conditions. Overall, studies generally reported pacing to be beneficial for people with ME/CFS. The exception to this trend is the controversial PACE trial [ 36 , 37 , 38 , 39 ], which we will expand on in subsequent sections. We believe information generated within this review can facilitate discussion of research opportunities and issues that need to be addressed in future studies concerning pacing, particularly given the immediate public health issue of the long COVID pandemic. As mentioned, we found some preliminary evidence for improved symptoms following pacing interventions or strategies. However, we wish to caution the reader that the current evidence base is extremely limited and hampered by several limitations which preclude clear conclusions on the efficacy of pacing. Firstly, studies were of poor to fair methodological quality (indicated by the PEDro scores), often with small sample sizes, and therefore unknown power to detect change. Moreover, very few studies implemented pacing, with most studies merely consulting on people’s views on pacing. This may of course lead to multiple biases such as reporting, recruitment, survivorship, confirmation, availability heuristic, to name but a few. Thus, there is a pressing need for more high-quality intervention studies. Secondly, the reporting of pacing strategies used was inconsistent and lacked detail, making it difficult to describe current approaches, or implement them in future research or symptom management strategies. Furthermore, outcome evaluations varied greatly between studies. This prevents any appropriate synthesis of research findings.

The lack of evidence concerning pacing is concerning given pacing is the only NICE recommended management strategy for ME/CFS following the 2021 update [ 34 ]. Given the analogous nature of long COVID with ME/CFS, patients and practitioners will be looking to the ME/CFS literature for guidance for symptom management. There is an urgent need for high quality studies (such as RCTs) investigating the effectiveness of pacing and better reporting of pacing intervention strategies so that clear recommendations can be made to patients. If this does not happen soon, there will be serious healthcare and economic implications for years to come [ 65 , 66 ].

Efficacy of pacing

Most studies (12/17) highlighted improvements in at least one outcome measure following pacing. Pacing was self-reported to be the most efficacious, safe, acceptable, and preferred form of activity management for people with ME/CFS [ 55 ]. Pacing was reported to improve symptoms and improve general health outcomes [ 25 , 50 , 52 , 58 , 63 ], fatigue and PEM [ 48 , 50 , 51 , 53 , 54 , 55 , 56 , 60 , 63 ], physical functioning [ 48 , 50 , 51 , 53 , 56 , 58 , 60 , 63 ], pain [ 25 , 50 , 55 , 63 ], quality of life [ 50 ], self-efficacy [ 50 , 53 ], sleep [ 53 , 55 ], and depression and anxiety [ 50 , 53 , 63 ]. These positive findings provide hope for those with ME/CFS, and other chronic fatiguing conditions such as long COVID, to improve quality of life through symptom management.

Conversely, some studies reported no effects of pacing on ME/CFS symptoms [ 52 ], fatigue, physical functioning [ 35 ], or pain scores [ 49 , 61 ]. Some studies even found pacing to have detrimental effects in those with ME/CFS, including a worsening of symptoms in 14% of survey participants recalling previous pacing experiences [ 52 ]. Furthermore, a worsening of fatigue [ 35 , 59 ], and physical functioning from pre- to post-pacing [ 35 , 57 , 59 , 61 ] was reported by the PACE trial and sub-analysis of the PACE trial [ 56 , 57 , 61 ]. The PACE trial [ 35 ], a large RCT (n = 639) comparing pacing with CBT and GET, reported GET and CBT were more effective for reducing ME/CFS-related fatigue and improving physical functioning than pacing. However, the methodology and conclusions from the PACE trial have been heavily criticised, mainly due to the authors lowering the thresholds they used to determine improvement [ 36 , 37 , 38 , 67 ]. With this in mind, Sharpe et al. [ 56 ] surveyed 75% of the participants from the PACE trial 1-year post-intervention and reported pacing improved fatigue and physical functioning, with effects similar to CBT and GET.

Lessons for pacing implementation

All pacing intervention studies (5/5) implemented educational or coaching sessions. These educational components were poorly reported in terms of the specific content and how and where they had been developed, with unclear pedagogical approaches. Consequently, even where interventions reported reduction in PEM or improved symptoms, it would be impossible to transfer that research into practice, future studies, or clinical guidance, given the ambiguity of reporting. Sessions typically contained themes of pacing such as activity adjustment (decrease, break-up, and reschedule activities based on energy levels), activity consistency (maintaining a consistently low level of activity to prevent PEM), activity planning (planning activities and rest around available energy levels), and activity progression (slowly progressing activity once maintaining a steady baseline) [ 35 , 48 , 49 , 50 , 51 ]. We feel it is pertinent to note here that although activity progression has been incorporated as a pacing strategy in these included studies, some view activity progression as a form of GET. The NICE definition of GET is “first establishing an individual's baseline of achievable exercise or physical activity, then making fixed incremental increases in the time spent being physically active” [ 34 ]. Thus, this form of pacing can also be considered a type of ‘long-term GET’ in which physical activity progression is performed over weeks or months with fixed incremental increases in time spent being physically.

Intervention studies attempted to create behaviour change, through educational programmes to modify physical activity, and plan behaviours. However, none of these studies detailed integrating any evidence-based theories of behaviour change [ 68 ] or reported using any frameworks to support behaviour change objectives. This is unfortunate since there is good evidence that theory-driven behaviour change interventions result in greater intervention effects [ 69 ]. Indeed, there is a large body of work regarding methods of behaviour change covering public health messaging, education, and intervention design, which has largely been ignored by the pacing literature. Interventions relied on subjective pacing (5/5 studies), with strategies including keeping an activity diary (3/5 studies) to identify links between activity and fatigue [ 35 , 48 , 50 ]. Given the high prevalence of ‘brain fog’ within ME/CFS [ 70 , 71 , 72 , 73 ], recall may be extremely difficult and there is significant potential for under-reporting. Other strategies included simply asking participants to estimate energy levels available for daily activities (2/5 studies [ 48 , 51 ]). Again, this is subjective and relies on participants’ ability to recall previous consequences of the activity. Other methods of activity tracking and measuring energy availability, such as wearable technology [ 74 , 75 , 76 , 77 , 78 ] could provide a more objective measure of adherence and pacing strategy fidelity in future studies. Despite technology such as accelerometers being widely accessible since well-before the earliest interventional study included in this review (which was published in 2009), none of the interventional studies utilised objective activity tracking to track pacing and provide feedback to participants. One study considered accelerometery alongside an activity diary [ 51 ]. However, accelerometery was considered the outcome variable, to assess change in activity levels from pre- to post-intervention and was not part of the intervention itself (which was one pacing coaching sessions per week for 3 weeks). Moreover, most research-grade accelerometers cannot be used as part of the intervention since they have no ability to provide continuous feedback and must be retrieved by the research team in order to access any data. Consequently, their use is mostly limited to outcome assessments only. As pacing comprises a limit to physical activity to prevent push-crash cycles, it is an astonishing observation from this scoping review that only two studies objectively measured physical activity to quantify changes to activity as a result of pacing [ 51 , 54 ]. If the aim of pacing is to reduce physical activity, or reduce variations in physical activity (i.e., push-crash cycles), only two studies have objectively quantified the effect pacing had on physical activity, so it is unclear whether pacing was successfully implemented in any of the other studies.

By exploring the pacing strategies previously used, in both intervention studies and more exploratory studies, we can identify and recommend approaches to improve symptoms of ME/CFS. These approaches can be categorised as follows: activity planning, activity consistency, activity progression, activity adjustment and staying within the Energy Envelope [ 50 , 53 , 60 , 63 ]. Activity planning was identified as a particularly effective therapeutic strategy, resulting in improvement of mean scores of all symptoms included in the APQ-28, reducing current pain, improvement of physical fatigue, mental fatigue, self-efficacy, quality of life, and mental and physical functioning [ 50 ]. Activity planning aligns with the self-regulatory behaviour change technique ‘Action Planning’ [ 79 ] which is commonly used to increase physical activity behaviour. In the case of ME/CFS, activity planning is successfully used to minimise rather than increase physical activity bouts to prevent expending too much energy and avoid PEM. Activity consistency, meaning undertaking similar amounts of activity each day, was also associated with reduced levels of depression, exercise avoidance, and higher levels of physical function [ 63 ]. Activity progression was associated with higher levels of current pain. Activity adjustment associated with depression and avoidance, and lower levels of physical function [ 63 ]. Staying within the Energy Envelope was reported to reduce PEM severity [ 53 , 60 ], improve physical functioning [ 53 , 60 ] and ME/CFS symptom scores [ 53 ], and more hours engaged in activity than individuals with lower available energy [ 53 ]. These results suggest that effective pacing strategies would include activity planning, consistency, and energy management techniques while avoiding progression. This data is, of course, limited by the small number of mostly low-quality studies and should be interpreted with some caution. Nevertheless, these are considerations that repeatedly appear in the literature and, as such, warrant deeper investigation. In addition, and as outlined earlier, most studies are relatively old, and we urgently need better insight into how modern technologies, particularly longitudinal activity tracking and contemporaneous heart-rate feedback, might improve (or otherwise) adaptive pacing. Such longitudinal tracking would also enable activities and other behaviours (sleep, diet, stress) to be linked to bouts of PEM. Linking would enable a deeper insight into potential PEM triggers and mitigations that might be possible.

The PACE trial

We feel it would be remiss of us to not specifically address the PACE trial within this manuscript, as five of the 17 included studies resulted from the PACE trial [ 35 , 56 , 57 , 59 , 61 ]. There has been considerable discussion around the PACE trial, which has been particularly divisive and controversial [ 37 , 38 , 39 , 59 , 67 , 80 , 81 ]. In the PACE trial, GET and CBT were deemed superior to pacing by the authors. Despite its size and funding, the PACE trial has received several published criticisms and rebuttals. Notably, NICE's most recent ME/CFS guideline update removed GET and CBT as suggested treatment options, which hitherto had been underpinned by the PACE findings. While we will not restate the criticisms and rebuttals here, what is not in doubt, is that the PACE trial has dominated discussions of pacing, representing almost a third of all the studies in this review. However, the trial results were published over a decade ago, with the study protocol devised almost two decades ago [ 82 ]. The intervening time has seen a revolution in the development of mobile and wearable technology and an ability to remotely track activity and provide real-time feedback in a way which was not available at that time. Furthermore, there has been no substantive research since the PACE trial that has attempted such work. Indeed, possibly driven by the reported lack of effect of pacing in the PACE trial, this review has demonstrated the dearth of progress and innovation in pacing research since its publication. Therefore, regardless of its findings or criticisms, the pacing implementation in the PACE trial is dated, and there is an urgent need for more technologically informed approaches to pacing research.

Limitations of the current evidence

The first limitation to the literature included in this scoping review is that not all studies followed the minimum data set (MDS) of patient-reported outcome measures (PROMs) agreed upon by the British Association of CFS/ME Professionals (BACME) (fatigue, sleep quality, self-efficacy, pain/discomfort, anxiety/depression, mobility, activities of daily living, self-care, and illness severity) [ 83 , 84 ]. All but one study included in this review measured illness severity, most studies included fatigue and pain/discomfort, and some studies included assessments of anxiety/depression. There was a lack of quantitative assessment of sleep quality, self-efficacy, mobility, activities of daily living, and self-care. Therefore, studies did not consistently capture the diverse nature of the symptoms experienced, with crucial domains missing from the analyses. The MDS of PROMs were established in 2012 [ 83 , 84 ] and therefore, for studies published out prior to 2012, these are not applicable [ 35 , 49 , 51 , 53 , 54 ]. However, for the 12 studies carried out after this time, the MDS should have been considered elucidate the effects of pacing on ME/CFS. Importantly, despite PEM being a central characteristic of ME/CFS, only two studies included PEM as an outcome measure [ 55 , 60 ]. This may be because of the difficulty of accurately measuring fluctuating symptoms, as PEM occurs multiple times over a period of months, and therefore pre- to post- studies and cross-sectional designs cannot adequately capture PEM incidence. Therefore, it is likely studies opted for measuring general fatigue instead. More appropriate longitudinal study designs are required to track PEM over time to capture a more representative picture of PEM patterns. Secondly, reporting of participant characteristics was inadequate, but in the studies that did describe participants, characteristics were congruent with the epidemiological literature and reporting of ME/CFS populations (i.e., 60–65% female) [ 85 ]. Therefore, in this respect, studies included herein were representative samples. However, the lack of reporting of participant characteristics limits inferences we can draw concerning any population-related effects (i.e. whether older, or male, or European, or people referred by a national health service would be more or less likely to respond positively to pacing). Thirdly, comparison groups (where included) were not ideal, with CBT or GET sometimes used as comparators to pacing [ 35 ], and often no true control group included. Penultimately, there is a distinct lack of high-quality RCTs (as mentioned throughout this manuscript). Finally, in reference to the previous section, inferences from the literature are dated and do not reflect the technological capabilities of 2023.

Recommendations for advancement of the investigative area

It is clear from the studies included in this scoping review for the last decade or more, progress and innovation in pacing research have been limited. This is unfortunate for several reasons. People with ME/CFS or long COVID are, of course, invested in their recovery. From our patient and public involvement (PPI) group engagement, it is clear many are ahead of the research and are using wearable technology to track steps, heart rate, and, in some cases, heart rate variability to improve their own pacing practice. While the lack of progress in the research means this is an understandable response by patients, it is also problematic. Without underpinning research, patients may make decisions based on an individual report of trial-and-error approaches given the lack of evidence-based guidance.

A more technologically-informed pacing approach could be implemented by integrating wearable trackers [ 77 , 78 , 86 , 87 ] to provide participants with live updates on their activity and could be integrated with research-informed messaging aimed at supporting behaviour change, as has been trialled in other research areas [ 88 , 89 , 90 , 91 ]. However, more work is needed to evaluate how to incorporate wearable activity trackers and which metrics are most helpful.

A more technologically-informed approach could also be beneficial for longitudinal symptom tracking, particularly useful given the highly variable symptom loads of ME/CFS and episodic nature of PEM. This would overcome reliance on assessments at a single point in time (as the studies within this review conducted). Similarly, mobile health (mHealth) approaches also allow questionnaires to be digitised to make it easier for participants to complete if they find holding a pen or reading small font problematic [ 92 ]. Reminders and notifications can also be helpful for patients completing tasks [ 77 , 93 , 94 , 95 ]. This approach has the added advantage of allowing contemporaneous data collection rather than relying on pre- to post-intervention designs limited by recall bias. Future work must try to leverage these approaches, as unless we collect large data sets on symptoms and behaviours (i.e. activity, diet, sleep, and pharmacology) in people with conditions like ME/CFS we will not be able to leverage emerging technologies such as AI and machine learning to improve the support and care for people with these debilitating conditions. The key areas for research outline in the NICE guidelines (2021 update) speaks to this, with specific mention of improved self-monitoring strategies, sleep strategies, and dietary strategies, all of which can be measured using mHealth approaches, in a scalable and labour-inexpensive way.

The potential for existing pacing research to address the long COVID pandemic

There is now an urgent public health need to address long COVID, with over 200 million sufferers worldwide [ 30 ]. Given the analogous symptomology between ME/CFS and long COVID, and the lack of promising treatment and management strategies in ME/CFS, pacing remains the only strategy for managing long COVID symptoms. This is concerning as the quality of evidence to support pacing is lacking. Given long COVID has reached pandemic proportions, scalable solutions will be required. In this context, we propose that technology should be harnessed to a) deliver, but also b) evaluate, pacing. We recently reported on a just-in-time adaptive intervention to increase physical activity during the pandemic [ 78 ]. However, this method could be adapted to decrease or maintain physical activity levels (i.e., pacing) in long COVID. This method has the advantage of scalability and remote data collection, reducing resource commitments and participant burden, essential for addressing a condition with so many sufferers.

This review highlights the need for more studies concerning pacing in chronic fatiguing conditions. Future studies would benefit from examining pacing’s effect on symptomology and PEM with objectively quantified pacing, over a longer duration of examination, using the MDS. It is essential this is conducted as an RCT, given that in the case of long COVID, participants may improve their health over time, and it is necessary to determine whether pacing exerts an additional effect over time elapsing. Future studies would benefit from digitising pacing to support individuals with varying symptom severity and personalise support. This would improve accessibility and reduce selection bias, in addition to improving scalability of interventions. Finally, clinicians and practitioners should be cognisant of the strength of evidence reported in this review and should exert caution when promoting pacing in their patients, given the varying methods utilised herein.

Availability of data and materials

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

Abbreviations

Activity Pacing Questionnaire

Beck Anxiety Inventory

Beck Depression Inventory

Brief Coping Orientation to Problems Experienced Scale

Canadian Occupational Performance Measure

Centers for disease control and prevention

Chalder Fatigue Questionnaire

Checklist Individual Strength

Chronic Pain Coping Inventory

Cognitive behavioural therapy

Cochrane Central Register of Controlled Trials

DePaul symptom questionnaire

EuroQol five-dimensions, five-levels questionnaire

Graded exercise therapy

Hospital Anxiety and Depression Scale

Myalgic encephalomyelitis/chronic fatigue syndrome

Pain Self Efficacy Questionnaire

Pain Anxiety Symptoms Scale short version

Pain Numerical Rating Scale

Patient health questionnaire

Patient reported outcome measures

Physiotherapy Evidence Database

Perceived Stress Scale

Post exertional malaise

Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews

Randomised control trial

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Authors’ contributions are given according to the CRediT taxonomy as follows: Conceptualization, N.E.M.S–H., M.M., L.D.H, and N.F.S.; methodology, N.E.M.S–H., M.M., L.D.H., and N.F.S.; software, N.E.M.S–H., M.M., L.D.H., and N.F.S.B.; validation, N.E.M.S–H., M.M., L.D.H, and N.F.S.; formal analysis, N.E.M.S–H., M.M., L.D.H., and N.F.S.; investigation, N.E.M.S–H., M.M., L.D.H., and N.F.S.; resources, L.D.H., J.O., D.C., N.H., J.L.M., and N.F.S.; data curation, N.E.M.S.-H., M.M., L.D.H., and N.F.S.; writing—original draft preparation, N.E.M.S.-H., M.M., L.D.H., and N.F.S.; writing—review and editing, N.E.M.S–H., M.M., L.D.H., J.O., D.C., N.H., R.M., J.L.M., J.I., and N.F.S.; visualisation, N.E.M.S–H. and M.M., supervision, N.F.S; project administration, N.E.M.S–H., M.M., L.D.H., and N.F.S.; funding acquisition, L.D.H., J.O., D.C., N.H., J.L.M., J.I., and N.F.S. All authors have read and agreed to the published version of the manuscript.

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Sanal-Hayes, N.E.M., Mclaughlin, M., Hayes, L.D. et al. A scoping review of ‘Pacing’ for management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): lessons learned for the long COVID pandemic. J Transl Med 21 , 720 (2023). https://doi.org/10.1186/s12967-023-04587-5

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Received : 30 June 2023

Accepted : 03 October 2023

Published : 14 October 2023

DOI : https://doi.org/10.1186/s12967-023-04587-5

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