Understanding Literature Reviews in Healthcare: Narrative Reviews

The phrase “systematic review” is commonly used in health sciences to refer to any review that follows well-structured procedures. However, this has created a misunderstanding that a systematic review is the sole valid literature review for healthcare decisions. This view misses out on the diverse range of other review types that can be useful. As a result, many researchers attempt to squeeze their specific research needs—which might align better with other types of literature reviews—into the systematic review format.

Sutton, Clowes, Preston, and Booth recognized 48 unique types of reviews utilized in healthcare.¹ While I won’t dive into all 48 types, I’m excited to share a six-part series that will introduce you to the most common types of reviews found in biomedical literature. In the first five posts, you’ll find a high-level overview of the five kinds of literature reviews. Plus, I’ll provide helpful resources to guide you in exploring each type more deeply. To wrap things up, the final post will assist you in choosing the best review for your project.

To kick off this series, let’s dive into narrative reviews! They’re a fantastic choice, especially if you’re considering a solo review.

Narrative Literature Reviews

A narrative review, often referred to as a traditional literature review, resembles a storytelling journey through existing research. It intertwines key findings, trends, and theories related to a topic without the strict structure characteristic of systematic reviews. Instead of analyzing data, it provides a broader perspective, emphasizing what is known, what is absent, and the current discussions in the field.²

Pros and Cons

Pros of Narrative Literature Reviews

• Big-picture perspective – Offers a broad, thematic overview of a topic 
• Flexibility – No rigid methodology, allowing for a more fluid discussion 
• Identifies trends & gaps – Highlights emerging ideas and identifies research gaps 
• Easy to read – Presented in an engaging and accessible style 
• Useful for theory development – Aids in framing new research questions and concepts ^2-4

Cons of Narrative Literature Reviews

• Subjective and prone to bias – No standardized selection criteria leads to increased author bias 
• Lack of systematic analysis – Does not adhere to a structured approach like systematic reviews 
• Not reproducible – Results may vary based on the author’s perspective 
• Limited evidence strength – Does not offer quantitative synthesis or statistical validation 
• Can overlook contradictory studies – May not fully account for all relevant research ^2–4

Methodology/Guidelines

One great thing about narrative reviews is that they offer flexibility without requiring strict methodologies or guidelines. However, this freedom can sometimes make the idea of writing one feel a bit intimidating. The good news is that there are plenty of resources available to help guide you through the process of writing narrative reviews. I’ve highlighted a couple of these helpful tools!

• Javeed Sukhera of Hartford Hospital, a teaching hospital in Hartford, CT, wrote Narrative Reviews in Medical Education: Key Steps for Researchers, a concise and easy-to-read guide to writing a narrative review for the health sciences.
• The Purdue Online Writing Lab is a popular resource for writing advice, and for good reason. Their guide on Writing a Literature Review offers several great tips for crafting a narrative review in any subject.

Examples

Still not sure what a narrative review should look like? Here are a couple of narrative literature reviews recently published. If you have some other examples to share, please post them in the comments.

• Salih H, Psomadakis C, George SMC. Sunscreens: A narrative review. Skin Health Dis. 2024 Aug 7;4(6):e432. doi: 10.1002/ski2.432. PMID: 39624735; PMCID: PMC11608887.
• Welling W. Return to sports after an ACL reconstruction in 2024 – A glass half full? A narrative review. Phys Ther Sport. 2024 May;67:141-148. doi: 10.1016/j.ptsp.2024.05.001. Epub 2024 May 10. PMID: 38749349.

While there is no defined methodology for narrative reviews, tools for evaluating them are available. One of these is SANRA-A Scale for Quality Assessment of Review Articles by Baethge, Goldbeck-Wood, and Mertens.⁵  How do the above reviews rank on the SANRA scale?

Learn More

If you’re thinking about diving into a narrative review, there are some fantastic resources available to help you get started on the right foot.

• The University of Texas Libraries created this guide to narrative reviews, which is a bit more in-depth and applies to literature reviews for subjects other than health and medicine.
• Watch the 30-minute Writing an Effective Narrative Review by the Medical Research Library at the MD Anderson Cancer Center.  

I’d love to hear your tips or resources for writers working on literature reviews! Feel free to share in the comments below.

And don’t miss out on our next post in this series about Systematic Reviews. Remember to subscribe so you can get the latest updates from the Healthcare Evidence Search Lab!

References

1. Sukhera J. Narrative reviews: flexible, rigorous, and practical. J Grad Med Educ. 2022 Aug;14(4):414–7.
2. Sukhera J. Narrative reviews in medical education: key steps for researchers. J Grad Med Educ. 2022 Aug;14(4):418–9.
3. Sutton A, Clowes M, Preston L, Booth A. Meeting the review family: exploring review types and associated information retrieval requirements. Health Inf Libr J. 2019 Sep 1;36(3):202–22.
4. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J. 2009 Jun 1;26(2):91–108.
5. Baethge C, Goldbeck-Wood S, Mertens S. SANRA—a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019 Mar 26;4(1):5.