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What is a review article?

Learn how to write a review article.

What is a review article? A review article can also be called a literature review, or a review of literature. It is a survey of previously published research on a topic. It should give an overview of current thinking on the topic. And, unlike an original research article, it will not present new experimental results.

Writing a review of literature is to provide a critical evaluation of the data available from existing studies. Review articles can identify potential research areas to explore next, and sometimes they will draw new conclusions from the existing data.

Why write a review article?

To provide a comprehensive foundation on a topic.

To explain the current state of knowledge.

To identify gaps in existing studies for potential future research.

To highlight the main methodologies and research techniques.

Did you know? 

There are some journals that only publish review articles, and others that do not accept them.

Make sure you check the  aims and scope  of the journal you’d like to publish in to find out if it’s the right place for your review article.

How to write a review article

Below are 8 key items to consider when you begin writing your review article.

Check the journal’s aims and scope

Make sure you have read the aims and scope for the journal you are submitting to and follow them closely. Different journals accept different types of articles and not all will accept review articles, so it’s important to check this before you start writing.

Define your scope

Define the scope of your review article and the research question you’ll be answering, making sure your article contributes something new to the field. 

As award-winning author Angus Crake told us, you’ll also need to “define the scope of your review so that it is manageable, not too large or small; it may be necessary to focus on recent advances if the field is well established.” 

Finding sources to evaluate

When finding sources to evaluate, Angus Crake says it’s critical that you “use multiple search engines/databases so you don’t miss any important ones.” 

For finding studies for a systematic review in medical sciences,  read advice from NCBI . 

Writing your title, abstract and keywords

Spend time writing an effective title, abstract and keywords. This will help maximize the visibility of your article online, making sure the right readers find your research. Your title and abstract should be clear, concise, accurate, and informative. 

For more information and guidance on getting these right, read our guide to writing a good abstract and title  and our  researcher’s guide to search engine optimization . 

Introduce the topic

Does a literature review need an introduction? Yes, always start with an overview of the topic and give some context, explaining why a review of the topic is necessary. Gather research to inform your introduction and make it broad enough to reach out to a large audience of non-specialists. This will help maximize its wider relevance and impact. 

Don’t make your introduction too long. Divide the review into sections of a suitable length to allow key points to be identified more easily.

Include critical discussion

Make sure you present a critical discussion, not just a descriptive summary of the topic. If there is contradictory research in your area of focus, make sure to include an element of debate and present both sides of the argument. You can also use your review paper to resolve conflict between contradictory studies.

What researchers say

Angus Crake, researcher

As part of your conclusion, include making suggestions for future research on the topic. Focus on the goal to communicate what you understood and what unknowns still remains.

Use a critical friend

Always perform a final spell and grammar check of your article before submission. 

You may want to ask a critical friend or colleague to give their feedback before you submit. If English is not your first language, think about using a language-polishing service.

Find out more about how  Taylor & Francis Editing Services can help improve your manuscript before you submit.

What is the difference between a research article and a review article?

Before you submit your review article…

Complete this checklist before you submit your review article:

Have you checked the journal’s aims and scope?

Have you defined the scope of your article?

Did you use multiple search engines to find sources to evaluate?

Have you written a descriptive title and abstract using keywords?

Did you start with an overview of the topic?

Have you presented a critical discussion?

Have you included future suggestions for research in your conclusion?

Have you asked a friend to do a final spell and grammar check?

Expert help for your manuscript

Taylor & Francis Editing Services  offers a full range of pre-submission manuscript preparation services to help you improve the quality of your manuscript and submit with confidence.

Related resources

How to edit your paper

Writing a scientific literature review

Review Paper Format: How To Write A Review Article Fast

This guide aims to demystify the review paper format, presenting practical tips to help you accelerate the writing process. 

From understanding the structure to synthesising literature effectively, we’ll explore how to create a compelling review article swiftly, ensuring your work is both impactful and timely.

Whether you’re a seasoned researcher or a budding scholar, these insights will streamline your writing journey.

Research Paper, Review Paper Format

What Is A Review Paper?

Diving into the realm of scholarly communication, you might have stumbled upon a research review article.

This unique genre serves to synthesise existing data, offering a panoramic view of the current state of knowledge on a particular topic. 

Unlike a standard research article that presents original experiments, a review paper delves into published literature, aiming to: 

• clarify, and
• evaluate previous findings.

Imagine you’re tasked to write a review article. The starting point is often a burning research question. Your mission? To scour various journals, piecing together a well-structured narrative that not only summarises key findings but also identifies gaps in existing literature.

This is where the magic of review writing shines – it’s about creating a roadmap for future research, highlighting areas ripe for exploration.

Review articles come in different flavours, with systematic reviews and meta-analyses being the gold standards. The methodology here is meticulous, with a clear protocol for selecting and evaluating studies.

This rigorous approach ensures that your review is more than just an overview; it’s a critical analysis that adds depth to the understanding of the subject.

Crafting a good review requires mastering the art of citation. Every claim or observation you make needs to be backed by relevant literature. This not only lends credibility to your work but also provides a treasure trove of information for readers eager to delve deeper.

Types Of Review Paper

Not all review articles are created equal. Each type has its methodology, purpose, and format, catering to different research needs and questions.

Systematic Review Paper

First up is the systematic review, the crème de la crème of review types. It’s known for its rigorous methodology, involving a detailed plan for:

• identifying,
• selecting, and
• critically appraising relevant research. 

The aim? To answer a specific research question. Systematic reviews often include meta-analyses, where data from multiple studies are statistically combined to provide more robust conclusions. This review type is a cornerstone in evidence-based fields like healthcare.

Literature Review Paper

Then there’s the literature review, a broader type you might encounter.

Here, the goal is to give an overview of the main points and debates on a topic, without the stringent methodological framework of a systematic review.

Literature reviews are great for getting a grasp of the field and identifying where future research might head. Often reading literature review papers can help you to learn about a topic rather quickly.

Narrative Reviews

Narrative reviews allow for a more flexible approach. Authors of narrative reviews draw on existing literature to provide insights or critique a certain area of research.

This is generally done with a less formal structure than systematic reviews. This type is particularly useful for areas where it’s difficult to quantify findings across studies.

Scoping Reviews

Scoping reviews are gaining traction for their ability to map out the existing literature on a broad topic, identifying:

• key concepts,
• theories, and

Unlike systematic reviews, scoping reviews have a more exploratory approach, which can be particularly useful in emerging fields or for topics that haven’t been comprehensively reviewed before.

Each type of review serves a unique purpose and requires a specific skill set. Whether you’re looking to summarise existing findings, synthesise data for evidence-based practice, or explore new research territories, there’s a review type that fits the bill. 

Knowing how to write, read, and interpret these reviews can significantly enhance your understanding of any research area.

What Are The Parts In A Review Paper

A review paper has a pretty set structure, with minor changes here and there to suit the topic covered. The format not only organises your thoughts but also guides your readers through the complexities of your topic.

Title & Abstract

Starting with the title and abstract, you set the stage. The title should be a concise indicator of the content, making it easier for others to quickly tell what your article content is about.

As for the abstract, it should act as a descriptive summary, offering a snapshot of your review’s scope and findings. 

Introduction

The introduction lays the groundwork, presenting the research question that drives your review. It’s here you:

• justify the importance of your review,
• delineating the current state of knowledge and
• highlighting gaps.

This section aims to articulate the significance of the topic and your objective in exploring it.

Methodology

The methodology section is the backbone of systematic reviews and meta-analyses, detailing the research methods employed to select, assess, and synthesise studies. 

This transparency allows readers to gauge the rigour and reproducibility of your review. It’s a testament to the integrity of your work, showing how you’ve minimised bias.

The heart of your review lies in the body, where you:

• analyse, and
• critique existing literature.

This is where you synthesise evidence, draw connections, and present both sides of any argument. Well-structured paragraphs and clear subheadings guide readers through your analysis, offering insights and fostering a deeper understanding of the subject.

Discussion & Conclusion

The discussion or conclusion section is where you weave together the main points, reflecting on what your findings mean for the field.

It’s about connecting the dots, offering a synthesis of evidence that answers your initial research question. This part often hints at future research directions, suggesting areas that need further exploration due to gaps in existing knowledge.

Lastly, the citation list is your nod to the scholarly community, acknowledging the contributions of others. Each citation is a thread in the larger tapestry of academic discourse, enabling readers to delve deeper into the research that has shaped your review.

Tips To Write An Review Article Fast

Writing a review article quickly without sacrificing quality might seem like a tall order, but with the right approach, it’s entirely achievable. 

Clearly Define Your Research Question

Clearly define your research question. A focused question not only narrows down the scope of your literature search but also keeps your review concise and on track.

By honing in on a specific aspect of a broader topic, you can avoid the common pitfall of becoming overwhelmed by the vast expanse of available literature. This specificity allows you to zero in on the most relevant studies, making your review more impactful.

Efficient Literature Searching

Utilise databases specific to your field and employ advanced search techniques like Boolean operators. This can drastically reduce the time you spend sifting through irrelevant articles.

Additionally, leveraging citation chains—looking at who has cited a pivotal paper in your area and who it cites—can uncover valuable sources you might otherwise miss.

Organise Your Findings Systematically

Developing a robust organisation strategy is key. As you gather sources, categorize them based on themes or methodologies. This not only aids in structuring your review but also in identifying areas where research is lacking or abundant.

Tools like citation management software can be invaluable here, helping you keep track of your sources and their key points. We list out some of the best AI tools for academic research here. 

Build An Outline Before Writing

Don’t underestimate the power of a well-structured outline. A clear blueprint of your article can guide your writing process, ensuring that each section flows logically into the next.

This roadmap not only speeds up the writing process by providing a clear direction but also helps maintain coherence, ensuring your review article delivers a compelling narrative that advances understanding in your field.

Start Writing With The Easiest Sections

When it’s time to write, start with sections you find easiest. This might be the methodology or a particular thematic section where you feel most confident.

Getting words on the page can build momentum, making it easier to tackle more challenging sections later.

Remember, your first draft doesn’t have to be perfect; the goal is to start articulating your synthesis of the literature.

Learn How To Write An Article Review

Mastering the review paper format is a crucial step towards efficient academic writing. By adhering to the structured components outlined, you can streamline the creation of a compelling review article.

Embracing these guidelines not only speeds up the writing process but also enhances the clarity and impact of your work, ensuring your contributions to scholarly discourse are both valuable and timely.

Dr Andrew Stapleton has a Masters and PhD in Chemistry from the UK and Australia. He has many years of research experience and has worked as a Postdoctoral Fellow and Associate at a number of Universities. Although having secured funding for his own research, he left academia to help others with his YouTube channel all about the inner workings of academia and how to make it work for you.

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A Step-by-Step Guide to Writing a Scientific Review Article

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Manisha Bahl, A Step-by-Step Guide to Writing a Scientific Review Article, Journal of Breast Imaging , Volume 5, Issue 4, July/August 2023, Pages 480–485, https://doi.org/10.1093/jbi/wbad028

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Scientific review articles are comprehensive, focused reviews of the scientific literature written by subject matter experts. The task of writing a scientific review article can seem overwhelming; however, it can be managed by using an organized approach and devoting sufficient time to the process. The process involves selecting a topic about which the authors are knowledgeable and enthusiastic, conducting a literature search and critical analysis of the literature, and writing the article, which is composed of an abstract, introduction, body, and conclusion, with accompanying tables and figures. This article, which focuses on the narrative or traditional literature review, is intended to serve as a guide with practical steps for new writers. Tips for success are also discussed, including selecting a focused topic, maintaining objectivity and balance while writing, avoiding tedious data presentation in a laundry list format, moving from descriptions of the literature to critical analysis, avoiding simplistic conclusions, and budgeting time for the overall process.

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How to write a good scientific review article

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• 1 The FEBS Journal Editorial Office, Cambridge, UK.
• PMID: 35792782
• DOI: 10.1111/febs.16565

Literature reviews are valuable resources for the scientific community. With research accelerating at an unprecedented speed in recent years and more and more original papers being published, review articles have become increasingly important as a means to keep up to date with developments in a particular area of research. A good review article provides readers with an in-depth understanding of a field and highlights key gaps and challenges to address with future research. Writing a review article also helps to expand the writer's knowledge of their specialist area and to develop their analytical and communication skills, amongst other benefits. Thus, the importance of building review-writing into a scientific career cannot be overstated. In this instalment of The FEBS Journal's Words of Advice series, I provide detailed guidance on planning and writing an informative and engaging literature review.

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• Critical Reviews

How to Write an Article Review (With Examples)

Last Updated: July 27, 2024 Fact Checked

Preparing to Write Your Review

Writing the article review, sample article reviews, expert q&a.

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 12 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 3,130,584 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."

Article Review 101

• 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.

• 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.

• 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. [9] 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.

You Might Also Like

• ↑ 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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Writing a good review article

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Table of Contents

As a young researcher, you might wonder how to start writing your first review article, and the extent of the information that it should contain. A review article is a comprehensive summary of the current understanding of a specific research topic and is based on previously published research. Unlike research papers, it does not contain new results, but can propose new inferences based on the combined findings of previous research.

Types of review articles

Review articles are typically of three types: literature reviews, systematic reviews, and meta-analyses.

A literature review is a general survey of the research topic and aims to provide a reliable and unbiased account of the current understanding of the topic.

A systematic review , in contrast, is more specific and attempts to address a highly focused research question. Its presentation is more detailed, with information on the search strategy used, the eligibility criteria for inclusion of studies, the methods utilized to review the collected information, and more.

A meta-analysis is similar to a systematic review in that both are systematically conducted with a properly defined research question. However, unlike the latter, a meta-analysis compares and evaluates a defined number of similar studies. It is quantitative in nature and can help assess contrasting study findings.

Tips for writing a good review article

Here are a few practices that can make the time-consuming process of writing a review article easier:

• Define your question: Take your time to identify the research question and carefully articulate the topic of your review paper. A good review should also add something new to the field in terms of a hypothesis, inference, or conclusion. A carefully defined scientific question will give you more clarity in determining the novelty of your inferences.
• Identify credible sources: Identify relevant as well as credible studies that you can base your review on, with the help of multiple databases or search engines. It is also a good idea to conduct another search once you have finished your article to avoid missing relevant studies published during the course of your writing.
• Take notes: A literature search involves extensive reading, which can make it difficult to recall relevant information subsequently. Therefore, make notes while conducting the literature search and note down the source references. This will ensure that you have sufficient information to start with when you finally get to writing.
• Describe the title, abstract, and introduction: A good starting point to begin structuring your review is by drafting the title, abstract, and introduction. Explicitly writing down what your review aims to address in the field will help shape the rest of your article.
• Be unbiased and critical: Evaluate every piece of evidence in a critical but unbiased manner. This will help you present a proper assessment and a critical discussion in your article.
• Include a good summary: End by stating the take-home message and identify the limitations of existing studies that need to be addressed through future studies.
• Ask for feedback: Ask a colleague to provide feedback on both the content and the language or tone of your article before you submit it.
• Check your journal’s guidelines: Some journals only publish reviews, while some only publish research articles. Further, all journals clearly indicate their aims and scope. Therefore, make sure to check the appropriateness of a journal before submitting your article.

Writing review articles, especially systematic reviews or meta-analyses, can seem like a daunting task. However, Elsevier Author Services can guide you by providing useful tips on how to write an impressive review article that stands out and gets published!

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How to Review a Journal Article

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.

Page Content

Overview of the review report format, the first read-through, first read considerations, spotting potential major flaws, concluding the first reading, rejection after the first reading, before starting the second read-through, doing the second read-through, the second read-through: section by section guidance, how to structure your report, on presentation and style, criticisms & confidential comments to editors, the recommendation, when recommending rejection, additional resources, step by step guide to reviewing a manuscript.

When you receive an invitation to peer review, you should be sent a copy of the paper's abstract to help you decide whether you wish to do the review. Try to respond to invitations promptly - it will prevent delays. It is also important at this stage to declare any potential Conflict of Interest.

The structure of the review report varies between journals. Some follow an informal structure, while others have a more formal approach.

" Number your comments!!! " (Jonathon Halbesleben, former Editor of Journal of Occupational and Organizational Psychology)

Informal Structure

Many journals don't provide criteria for reviews beyond asking for your 'analysis of merits'. In this case, you may wish to familiarize yourself with examples of other reviews done for the journal, which the editor should be able to provide or, as you gain experience, rely on your own evolving style.

Formal Structure

Other journals require a more formal approach. Sometimes they will ask you to address specific questions in your review via a questionnaire. Or they might want you to rate the manuscript on various attributes using a scorecard. Often you can't see these until you log in to submit your review. So when you agree to the work, it's worth checking for any journal-specific guidelines and requirements. If there are formal guidelines, let them direct the structure of your review.

In Both Cases

Whether specifically required by the reporting format or not, you should expect to compile comments to authors and possibly confidential ones to editors only.

Following the invitation to review, when you'll have received the article abstract, you should already understand the aims, key data and conclusions of the manuscript. If you don't, make a note now that you need to feedback on how to improve those sections.

The first read-through is a skim-read. It will help you form an initial impression of the paper and get a sense of whether your eventual recommendation will be to accept or reject the paper.

Keep a pen and paper handy when skim-reading.

Try to bear in mind the following questions - they'll help you form your overall impression:

• What is the main question addressed by the research? Is it relevant and interesting?
• How original is the topic? What does it add to the subject area compared with other published material?
• Is the paper well written? Is the text clear and easy to read?
• Are the conclusions consistent with the evidence and arguments presented? Do they address the main question posed?
• If the author is disagreeing significantly with the current academic consensus, do they have a substantial case? If not, what would be required to make their case credible?
• If the paper includes tables or figures, what do they add to the paper? Do they aid understanding or are they superfluous?

While you should read the whole paper, making the right choice of what to read first can save time by flagging major problems early on.

Editors say, " Specific recommendations for remedying flaws are VERY welcome ."

Examples of possibly major flaws include:

• Drawing a conclusion that is contradicted by the author's own statistical or qualitative evidence
• The use of a discredited method
• Ignoring a process that is known to have a strong influence on the area under study

If experimental design features prominently in the paper, first check that the methodology is sound - if not, this is likely to be a major flaw.

You might examine:

• The sampling in analytical papers
• The sufficient use of control experiments
• The precision of process data
• The regularity of sampling in time-dependent studies
• The validity of questions, the use of a detailed methodology and the data analysis being done systematically (in qualitative research)
• That qualitative research extends beyond the author's opinions, with sufficient descriptive elements and appropriate quotes from interviews or focus groups

Major Flaws in Information

If methodology is less of an issue, it's often a good idea to look at the data tables, figures or images first. Especially in science research, it's all about the information gathered. If there are critical flaws in this, it's very likely the manuscript will need to be rejected. Such issues include:

• Insufficient data
• Unclear data tables
• Contradictory data that either are not self-consistent or disagree with the conclusions
• Confirmatory data that adds little, if anything, to current understanding - unless strong arguments for such repetition are made

If you find a major problem, note your reasoning and clear supporting evidence (including citations).

After the initial read and using your notes, including those of any major flaws you found, draft the first two paragraphs of your review - the first summarizing the research question addressed and the second the contribution of the work. If the journal has a prescribed reporting format, this draft will still help you compose your thoughts.

The First Paragraph

This should state the main question addressed by the research and summarize the goals, approaches, and conclusions of the paper. It should:

• Help the editor properly contextualize the research and add weight to your judgement
• Show the author what key messages are conveyed to the reader, so they can be sure they are achieving what they set out to do
• Focus on successful aspects of the paper so the author gets a sense of what they've done well

The Second Paragraph

This should provide a conceptual overview of the contribution of the research. So consider:

• Is the paper's premise interesting and important?
• Are the methods used appropriate?
• Do the data support the conclusions?

After drafting these two paragraphs, you should be in a position to decide whether this manuscript is seriously flawed and should be rejected (see the next section). Or whether it is publishable in principle and merits a detailed, careful read through.

Even if you are coming to the opinion that an article has serious flaws, make sure you read the whole paper. This is very important because you may find some really positive aspects that can be communicated to the author. This could help them with future submissions.

A full read-through will also make sure that any initial concerns are indeed correct and fair. After all, you need the context of the whole paper before deciding to reject. If you still intend to recommend rejection, see the section "When recommending rejection."

Once the paper has passed your first read and you've decided the article is publishable in principle, one purpose of the second, detailed read-through is to help prepare the manuscript for publication. You may still decide to recommend rejection following a second reading.

" Offer clear suggestions for how the authors can address the concerns raised. In other words, if you're going to raise a problem, provide a solution ." (Jonathon Halbesleben, Editor of Journal of Occupational and Organizational Psychology)

Preparation

To save time and simplify the review:

• Don't rely solely upon inserting comments on the manuscript document - make separate notes
• Try to group similar concerns or praise together
• If using a review program to note directly onto the manuscript, still try grouping the concerns and praise in separate notes - it helps later
• Note line numbers of text upon which your notes are based - this helps you find items again and also aids those reading your review

Now that you have completed your preparations, you're ready to spend an hour or so reading carefully through the manuscript.

As you're reading through the manuscript for a second time, you'll need to keep in mind the argument's construction, the clarity of the language and content.

With regard to the argument’s construction, you should identify:

• Any places where the meaning is unclear or ambiguous
• Any factual errors
• Any invalid arguments

You may also wish to consider:

• Does the title properly reflect the subject of the paper?
• Does the abstract provide an accessible summary of the paper?
• Do the keywords accurately reflect the content?
• Is the paper an appropriate length?
• Are the key messages short, accurate and clear?

Not every submission is well written. Part of your role is to make sure that the text’s meaning is clear.

Editors say, " If a manuscript has many English language and editing issues, please do not try and fix it. If it is too bad, note that in your review and it should be up to the authors to have the manuscript edited ."

If the article is difficult to understand, you should have rejected it already. However, if the language is poor but you understand the core message, see if you can suggest improvements to fix the problem:

• Are there certain aspects that could be communicated better, such as parts of the discussion?
• Should the authors consider resubmitting to the same journal after language improvements?
• Would you consider looking at the paper again once these issues are dealt with?

On Grammar and Punctuation

Your primary role is judging the research content. Don't spend time polishing grammar or spelling. Editors will make sure that the text is at a high standard before publication. However, if you spot grammatical errors that affect clarity of meaning, then it's important to highlight these. Expect to suggest such amendments - it's rare for a manuscript to pass review with no corrections.

A 2010 study of nursing journals found that 79% of recommendations by reviewers were influenced by grammar and writing style (Shattel, et al., 2010).

1. The Introduction

A well-written introduction:

• Sets out the argument
• Summarizes recent research related to the topic
• Highlights gaps in current understanding or conflicts in current knowledge
• Establishes the originality of the research aims by demonstrating the need for investigations in the topic area
• Gives a clear idea of the target readership, why the research was carried out and the novelty and topicality of the manuscript

Originality and Topicality

Originality and topicality can only be established in the light of recent authoritative research. For example, it's impossible to argue that there is a conflict in current understanding by referencing articles that are 10 years old.

Authors may make the case that a topic hasn't been investigated in several years and that new research is required. This point is only valid if researchers can point to recent developments in data gathering techniques or to research in indirectly related fields that suggest the topic needs revisiting. Clearly, authors can only do this by referencing recent literature. Obviously, where older research is seminal or where aspects of the methodology rely upon it, then it is perfectly appropriate for authors to cite some older papers.

Editors say, "Is the report providing new information; is it novel or just confirmatory of well-known outcomes ?"

It's common for the introduction to end by stating the research aims. By this point you should already have a good impression of them - if the explicit aims come as a surprise, then the introduction needs improvement.

2. Materials and Methods

Academic research should be replicable, repeatable and robust - and follow best practice.

Replicable Research

This makes sufficient use of:

• Control experiments
• Repeated analyses
• Repeated experiments

These are used to make sure observed trends are not due to chance and that the same experiment could be repeated by other researchers - and result in the same outcome. Statistical analyses will not be sound if methods are not replicable. Where research is not replicable, the paper should be recommended for rejection.

Repeatable Methods

These give enough detail so that other researchers are able to carry out the same research. For example, equipment used or sampling methods should all be described in detail so that others could follow the same steps. Where methods are not detailed enough, it's usual to ask for the methods section to be revised.

Robust Research

This has enough data points to make sure the data are reliable. If there are insufficient data, it might be appropriate to recommend revision. You should also consider whether there is any in-built bias not nullified by the control experiments.

Best Practice

During these checks you should keep in mind best practice:

• Standard guidelines were followed (e.g. the CONSORT Statement for reporting randomized trials)
• The health and safety of all participants in the study was not compromised
• Ethical standards were maintained

If the research fails to reach relevant best practice standards, it's usual to recommend rejection. What's more, you don't then need to read any further.

3. Results and Discussion

This section should tell a coherent story - What happened? What was discovered or confirmed?

Certain patterns of good reporting need to be followed by the author:

• They should start by describing in simple terms what the data show
• They should make reference to statistical analyses, such as significance or goodness of fit
• Once described, they should evaluate the trends observed and explain the significance of the results to wider understanding. This can only be done by referencing published research
• The outcome should be a critical analysis of the data collected

Discussion should always, at some point, gather all the information together into a single whole. Authors should describe and discuss the overall story formed. If there are gaps or inconsistencies in the story, they should address these and suggest ways future research might confirm the findings or take the research forward.

4. Conclusions

This section is usually no more than a few paragraphs and may be presented as part of the results and discussion, or in a separate section. The conclusions should reflect upon the aims - whether they were achieved or not - and, just like the aims, should not be surprising. If the conclusions are not evidence-based, it's appropriate to ask for them to be re-written.

5. Information Gathered: Images, Graphs and Data Tables

If you find yourself looking at a piece of information from which you cannot discern a story, then you should ask for improvements in presentation. This could be an issue with titles, labels, statistical notation or image quality.

Where information is clear, you should check that:

• The results seem plausible, in case there is an error in data gathering
• The trends you can see support the paper's discussion and conclusions
• There are sufficient data. For example, in studies carried out over time are there sufficient data points to support the trends described by the author?

You should also check whether images have been edited or manipulated to emphasize the story they tell. This may be appropriate but only if authors report on how the image has been edited (e.g. by highlighting certain parts of an image). Where you feel that an image has been edited or manipulated without explanation, you should highlight this in a confidential comment to the editor in your report.

6. List of References

You will need to check referencing for accuracy, adequacy and balance.

Where a cited article is central to the author's argument, you should check the accuracy and format of the reference - and bear in mind different subject areas may use citations differently. Otherwise, it's the editor’s role to exhaustively check the reference section for accuracy and format.

You should consider if the referencing is adequate:

• Are important parts of the argument poorly supported?
• Are there published studies that show similar or dissimilar trends that should be discussed?
• If a manuscript only uses half the citations typical in its field, this may be an indicator that referencing should be improved - but don't be guided solely by quantity
• References should be relevant, recent and readily retrievable

Check for a well-balanced list of references that is:

• Helpful to the reader
• Fair to competing authors
• Not over-reliant on self-citation
• Gives due recognition to the initial discoveries and related work that led to the work under assessment

You should be able to evaluate whether the article meets the criteria for balanced referencing without looking up every reference.

7. Plagiarism

By now you will have a deep understanding of the paper's content - and you may have some concerns about plagiarism.

Identified Concern

If you find - or already knew of - a very similar paper, this may be because the author overlooked it in their own literature search. Or it may be because it is very recent or published in a journal slightly outside their usual field.

You may feel you can advise the author how to emphasize the novel aspects of their own study, so as to better differentiate it from similar research. If so, you may ask the author to discuss their aims and results, or modify their conclusions, in light of the similar article. Of course, the research similarities may be so great that they render the work unoriginal and you have no choice but to recommend rejection.

"It's very helpful when a reviewer can point out recent similar publications on the same topic by other groups, or that the authors have already published some data elsewhere ." (Editor feedback)

Suspected Concern

If you suspect plagiarism, including self-plagiarism, but cannot recall or locate exactly what is being plagiarized, notify the editor of your suspicion and ask for guidance.

Most editors have access to software that can check for plagiarism.

Editors are not out to police every paper, but when plagiarism is discovered during peer review it can be properly addressed ahead of publication. If plagiarism is discovered only after publication, the consequences are worse for both authors and readers, because a retraction may be necessary.

For detailed guidelines see COPE's Ethical guidelines for reviewers and Wiley's Best Practice Guidelines on Publishing Ethics .

8. Search Engine Optimization (SEO)

After the detailed read-through, you will be in a position to advise whether the title, abstract and key words are optimized for search purposes. In order to be effective, good SEO terms will reflect the aims of the research.

A clear title and abstract will improve the paper's search engine rankings and will influence whether the user finds and then decides to navigate to the main article. The title should contain the relevant SEO terms early on. This has a major effect on the impact of a paper, since it helps it appear in search results. A poor abstract can then lose the reader's interest and undo the benefit of an effective title - whilst the paper's abstract may appear in search results, the potential reader may go no further.

So ask yourself, while the abstract may have seemed adequate during earlier checks, does it:

• Do justice to the manuscript in this context?
• Highlight important findings sufficiently?
• Present the most interesting data?

Editors say, " Does the Abstract highlight the important findings of the study ?"

If there is a formal report format, remember to follow it. This will often comprise a range of questions followed by comment sections. Try to answer all the questions. They are there because the editor felt that they are important. If you're following an informal report format you could structure your report in three sections: summary, major issues, minor issues.

• Give positive feedback first. Authors are more likely to read your review if you do so. But don't overdo it if you will be recommending rejection
• Briefly summarize what the paper is about and what the findings are
• Try to put the findings of the paper into the context of the existing literature and current knowledge
• Indicate the significance of the work and if it is novel or mainly confirmatory
• Indicate the work's strengths, its quality and completeness
• State any major flaws or weaknesses and note any special considerations. For example, if previously held theories are being overlooked

Major Issues

• Are there any major flaws? State what they are and what the severity of their impact is on the paper
• Has similar work already been published without the authors acknowledging this?
• Are the authors presenting findings that challenge current thinking? Is the evidence they present strong enough to prove their case? Have they cited all the relevant work that would contradict their thinking and addressed it appropriately?
• If major revisions are required, try to indicate clearly what they are
• Are there any major presentational problems? Are figures & tables, language and manuscript structure all clear enough for you to accurately assess the work?
• Are there any ethical issues? If you are unsure it may be better to disclose these in the confidential comments section

Minor Issues

• Are there places where meaning is ambiguous? How can this be corrected?
• Are the correct references cited? If not, which should be cited instead/also? Are citations excessive, limited, or biased?
• Are there any factual, numerical or unit errors? If so, what are they?
• Are all tables and figures appropriate, sufficient, and correctly labelled? If not, say which are not

Your review should ultimately help the author improve their article. So be polite, honest and clear. You should also try to be objective and constructive, not subjective and destructive.

You should also:

• Write clearly and so you can be understood by people whose first language is not English
• Avoid complex or unusual words, especially ones that would even confuse native speakers
• Number your points and refer to page and line numbers in the manuscript when making specific comments
• If you have been asked to only comment on specific parts or aspects of the manuscript, you should indicate clearly which these are
• Treat the author's work the way you would like your own to be treated

Most journals give reviewers the option to provide some confidential comments to editors. Often this is where editors will want reviewers to state their recommendation - see the next section - but otherwise this area is best reserved for communicating malpractice such as suspected plagiarism, fraud, unattributed work, unethical procedures, duplicate publication, bias or other conflicts of interest.

However, this doesn't give reviewers permission to 'backstab' the author. Authors can't see this feedback and are unable to give their side of the story unless the editor asks them to. So in the spirit of fairness, write comments to editors as though authors might read them too.

Reviewers should check the preferences of individual journals as to where they want review decisions to be stated. In particular, bear in mind that some journals will not want the recommendation included in any comments to authors, as this can cause editors difficulty later - see Section 11 for more advice about working with editors.

You will normally be asked to indicate your recommendation (e.g. accept, reject, revise and resubmit, etc.) from a fixed-choice list and then to enter your comments into a separate text box.

Recommending Acceptance

If you're recommending acceptance, give details outlining why, and if there are any areas that could be improved. Don't just give a short, cursory remark such as 'great, accept'. See Improving the Manuscript

Recommending Revision

Where improvements are needed, a recommendation for major or minor revision is typical. You may also choose to state whether you opt in or out of the post-revision review too. If recommending revision, state specific changes you feel need to be made. The author can then reply to each point in turn.

Some journals offer the option to recommend rejection with the possibility of resubmission – this is most relevant where substantial, major revision is necessary.

What can reviewers do to help? " Be clear in their comments to the author (or editor) which points are absolutely critical if the paper is given an opportunity for revisio n." (Jonathon Halbesleben, Editor of Journal of Occupational and Organizational Psychology)

Recommending Rejection

If recommending rejection or major revision, state this clearly in your review (and see the next section, 'When recommending rejection').

Where manuscripts have serious flaws you should not spend any time polishing the review you've drafted or give detailed advice on presentation.

Editors say, " If a reviewer suggests a rejection, but her/his comments are not detailed or helpful, it does not help the editor in making a decision ."

In your recommendations for the author, you should:

• Give constructive feedback describing ways that they could improve the research
• Keep the focus on the research and not the author. This is an extremely important part of your job as a reviewer
• Avoid making critical confidential comments to the editor while being polite and encouraging to the author - the latter may not understand why their manuscript has been rejected. Also, they won't get feedback on how to improve their research and it could trigger an appeal

Remember to give constructive criticism even if recommending rejection. This helps developing researchers improve their work and explains to the editor why you felt the manuscript should not be published.

" When the comments seem really positive, but the recommendation is rejection…it puts the editor in a tough position of having to reject a paper when the comments make it sound like a great paper ." (Jonathon Halbesleben, Editor of Journal of Occupational and Organizational Psychology)

Visit our Wiley Author Learning and Training Channel for expert advice on peer review.

Watch the video, Ethical considerations of Peer Review

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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• Scholarly Journals and Popular Magazines
• Differences in Research, Review, and Opinion Articles

Scholarly Journals and Popular Magazines: Differences in Research, Review, and Opinion Articles

• Where Do I Start?
• How Do I Find Peer-Reviewed Articles?
• How Do I Compare Periodical Types?
• Where Can I find More Information?

Research Articles, Reviews, and Opinion Pieces

Scholarly or research articles are written for experts in their fields. They are often peer-reviewed or reviewed by other experts in the field prior to publication. They often have terminology or jargon that is field specific. They are generally lengthy articles. Social science and science scholarly articles have similar structures as do arts and humanities scholarly articles. Not all items in a scholarly journal are peer reviewed. For example, an editorial opinion items can be published in a scholarly journal but the article itself is not scholarly. Scholarly journals may include book reviews or other content that have not been peer reviewed.

Empirical Study: (Original or Primary) based on observation, experimentation, or study. Clinical trials, clinical case studies, and most meta-analyses are empirical studies.

Review Article: (Secondary Sources) Article that summarizes the research in a particular subject, area, or topic. They often include a summary, an literature reviews, systematic reviews, and meta-analyses.

Clinical case study (Primary or Original sources): These articles provide real cases from medical or clinical practice. They often include symptoms and diagnosis.

Clinical trials ( Health Research): Th ese articles are often based on large groups of people. They often include methods and control studies. They tend to be lengthy articles.

Opinion Piece:  An opinion piece often includes personal thoughts, beliefs, or feelings or a judgement or conclusion based on facts. The goal may be to persuade or influence the reader that their position on this topic is the best.

Book review: Recent review of books in the field. They may be several pages but tend to be fairly short. 

Social Science and Science Research Articles

The majority of social science and physical science articles include

• Journal Title and Author
• Abstract 
• Introduction with a hypothesis or thesis
• Literature Review
• Methods/Methodology
• Results/Findings

Arts and Humanities Research Articles

In the Arts and Humanities, scholarly articles tend to be less formatted than in the social sciences and sciences. In the humanities, scholars are not conducting the same kinds of research experiments, but they are still using evidence to draw logical conclusions.  Common sections of these articles include:

• an Introduction
• Discussion/Conclusion
• works cited/References/Bibliography

Research versus Review Articles

• 6 Article types that journals publish: A guide for early career researchers
• INFOGRAPHIC: 5 Differences between a research paper and a review paper
• Michigan State University. Empirical vs Review Articles
• UC Merced Library. Empirical & Review Articles
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How to Write a Research Proposal: (with Examples & Templates)

Table of Contents

Before conducting a study, a research proposal should be created that outlines researchers’ plans and methodology and is submitted to the concerned evaluating organization or person. Creating a research proposal is an important step to ensure that researchers are on track and are moving forward as intended. A research proposal can be defined as a detailed plan or blueprint for the proposed research that you intend to undertake. It provides readers with a snapshot of your project by describing what you will investigate, why it is needed, and how you will conduct the research.  

Your research proposal should aim to explain to the readers why your research is relevant and original, that you understand the context and current scenario in the field, have the appropriate resources to conduct the research, and that the research is feasible given the usual constraints.  

This article will describe in detail the purpose and typical structure of a research proposal , along with examples and templates to help you ace this step in your research journey.  

What is a Research Proposal ?  

A research proposal¹ ,²  can be defined as a formal report that describes your proposed research, its objectives, methodology, implications, and other important details. Research proposals are the framework of your research and are used to obtain approvals or grants to conduct the study from various committees or organizations. Consequently, research proposals should convince readers of your study’s credibility, accuracy, achievability, practicality, and reproducibility.   

With research proposals , researchers usually aim to persuade the readers, funding agencies, educational institutions, and supervisors to approve the proposal. To achieve this, the report should be well structured with the objectives written in clear, understandable language devoid of jargon. A well-organized research proposal conveys to the readers or evaluators that the writer has thought out the research plan meticulously and has the resources to ensure timely completion.  

Purpose of Research Proposals  

A research proposal is a sales pitch and therefore should be detailed enough to convince your readers, who could be supervisors, ethics committees, universities, etc., that what you’re proposing has merit and is feasible . Research proposals can help students discuss their dissertation with their faculty or fulfill course requirements and also help researchers obtain funding. A well-structured proposal instills confidence among readers about your ability to conduct and complete the study as proposed.  

Research proposals can be written for several reasons:³  

• To describe the importance of research in the specific topic  
• Address any potential challenges you may encounter  
• Showcase knowledge in the field and your ability to conduct a study  
• Apply for a role at a research institute  
• Convince a research supervisor or university that your research can satisfy the requirements of a degree program  
• Highlight the importance of your research to organizations that may sponsor your project  
• Identify implications of your project and how it can benefit the audience  

What Goes in a Research Proposal?    

Research proposals should aim to answer the three basic questions—what, why, and how.  

The What question should be answered by describing the specific subject being researched. It should typically include the objectives, the cohort details, and the location or setting.  

The Why question should be answered by describing the existing scenario of the subject, listing unanswered questions, identifying gaps in the existing research, and describing how your study can address these gaps, along with the implications and significance.  

The How question should be answered by describing the proposed research methodology, data analysis tools expected to be used, and other details to describe your proposed methodology.   

Research Proposal Example  

Here is a research proposal sample template (with examples) from the University of Rochester Medical Center. 4 The sections in all research proposals are essentially the same although different terminology and other specific sections may be used depending on the subject.  

Structure of a Research Proposal  

If you want to know how to make a research proposal impactful, include the following components:¹  

1. Introduction  

This section provides a background of the study, including the research topic, what is already known about it and the gaps, and the significance of the proposed research.  

2. Literature review  

This section contains descriptions of all the previous relevant studies pertaining to the research topic. Every study cited should be described in a few sentences, starting with the general studies to the more specific ones. This section builds on the understanding gained by readers in the Introduction section and supports it by citing relevant prior literature, indicating to readers that you have thoroughly researched your subject.  

3. Objectives  

Once the background and gaps in the research topic have been established, authors must now state the aims of the research clearly. Hypotheses should be mentioned here. This section further helps readers understand what your study’s specific goals are.  

4. Research design and methodology  

Here, authors should clearly describe the methods they intend to use to achieve their proposed objectives. Important components of this section include the population and sample size, data collection and analysis methods and duration, statistical analysis software, measures to avoid bias (randomization, blinding), etc.  

5. Ethical considerations  

This refers to the protection of participants’ rights, such as the right to privacy, right to confidentiality, etc. Researchers need to obtain informed consent and institutional review approval by the required authorities and mention this clearly for transparency.  

6. Budget/funding  

Researchers should prepare their budget and include all expected expenditures. An additional allowance for contingencies such as delays should also be factored in.  

7. Appendices  

This section typically includes information that supports the research proposal and may include informed consent forms, questionnaires, participant information, measurement tools, etc.  

8. Citations  

Important Tips for Writing a Research Proposal  

Writing a research proposal begins much before the actual task of writing. Planning the research proposal structure and content is an important stage, which if done efficiently, can help you seamlessly transition into the writing stage. 3,5  

The Planning Stage  

• Manage your time efficiently. Plan to have the draft version ready at least two weeks before your deadline and the final version at least two to three days before the deadline.
• What is the primary objective of your research?  
• Will your research address any existing gap?  
• What is the impact of your proposed research?  
• Do people outside your field find your research applicable in other areas?  
• If your research is unsuccessful, would there still be other useful research outcomes?  

  The Writing Stage  

• Create an outline with main section headings that are typically used.  
• Focus only on writing and getting your points across without worrying about the format of the research proposal , grammar, punctuation, etc. These can be fixed during the subsequent passes. Add details to each section heading you created in the beginning.   
• Ensure your sentences are concise and use plain language. A research proposal usually contains about 2,000 to 4,000 words or four to seven pages.  
• Don’t use too many technical terms and abbreviations assuming that the readers would know them. Define the abbreviations and technical terms.  
• Ensure that the entire content is readable. Avoid using long paragraphs because they affect the continuity in reading. Break them into shorter paragraphs and introduce some white space for readability.  
• Focus on only the major research issues and cite sources accordingly. Don’t include generic information or their sources in the literature review.  
• Proofread your final document to ensure there are no grammatical errors so readers can enjoy a seamless, uninterrupted read.  
• Use academic, scholarly language because it brings formality into a document.  
• Ensure that your title is created using the keywords in the document and is neither too long and specific nor too short and general.  
• Cite all sources appropriately to avoid plagiarism.  
• Make sure that you follow guidelines, if provided. This includes rules as simple as using a specific font or a hyphen or en dash between numerical ranges.  
• Ensure that you’ve answered all questions requested by the evaluating authority.  

Key Takeaways   

Here’s a summary of the main points about research proposals discussed in the previous sections:  

• A research proposal is a document that outlines the details of a proposed study and is created by researchers to submit to evaluators who could be research institutions, universities, faculty, etc.  
• Research proposals are usually about 2,000-4,000 words long, but this depends on the evaluating authority’s guidelines.  
• A good research proposal ensures that you’ve done your background research and assessed the feasibility of the research.  
• Research proposals have the following main sections—introduction, literature review, objectives, methodology, ethical considerations, and budget.  

Frequently Asked Questions  

Q1. How is a research proposal evaluated?  

A1. In general, most evaluators, including universities, broadly use the following criteria to evaluate research proposals . 6  

• Significance —Does the research address any important subject or issue, which may or may not be specific to the evaluator or university?  
• Content and design —Is the proposed methodology appropriate to answer the research question? Are the objectives clear and well aligned with the proposed methodology?  
• Sample size and selection —Is the target population or cohort size clearly mentioned? Is the sampling process used to select participants randomized, appropriate, and free of bias?  
• Timing —Are the proposed data collection dates mentioned clearly? Is the project feasible given the specified resources and timeline?  
• Data management and dissemination —Who will have access to the data? What is the plan for data analysis?  

Q2. What is the difference between the Introduction and Literature Review sections in a research proposal ?  

A2. The Introduction or Background section in a research proposal sets the context of the study by describing the current scenario of the subject and identifying the gaps and need for the research. A Literature Review, on the other hand, provides references to all prior relevant literature to help corroborate the gaps identified and the research need.  

Q3. How long should a research proposal be?  

A3. Research proposal lengths vary with the evaluating authority like universities or committees and also the subject. Here’s a table that lists the typical research proposal lengths for a few universities.  

Q4. What are the common mistakes to avoid in a research proposal ?  

A4. Here are a few common mistakes that you must avoid while writing a research proposal . 7  

• No clear objectives: Objectives should be clear, specific, and measurable for the easy understanding among readers.  
• Incomplete or unconvincing background research: Background research usually includes a review of the current scenario of the particular industry and also a review of the previous literature on the subject. This helps readers understand your reasons for undertaking this research because you identified gaps in the existing research.  
• Overlooking project feasibility: The project scope and estimates should be realistic considering the resources and time available.   
• Neglecting the impact and significance of the study: In a research proposal , readers and evaluators look for the implications or significance of your research and how it contributes to the existing research. This information should always be included.  
• Unstructured format of a research proposal : A well-structured document gives confidence to evaluators that you have read the guidelines carefully and are well organized in your approach, consequently affirming that you will be able to undertake the research as mentioned in your proposal.  
• Ineffective writing style: The language used should be formal and grammatically correct. If required, editors could be consulted, including AI-based tools such as Paperpal , to refine the research proposal structure and language.  

Thus, a research proposal is an essential document that can help you promote your research and secure funds and grants for conducting your research. Consequently, it should be well written in clear language and include all essential details to convince the evaluators of your ability to conduct the research as proposed.  

This article has described all the important components of a research proposal and has also provided tips to improve your writing style. We hope all these tips will help you write a well-structured research proposal to ensure receipt of grants or any other purpose.  

References  

• Sudheesh K, Duggappa DR, Nethra SS. How to write a research proposal? Indian J Anaesth. 2016;60(9):631-634. Accessed July 15, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037942/  
• Writing research proposals. Harvard College Office of Undergraduate Research and Fellowships. Harvard University. Accessed July 14, 2024. https://uraf.harvard.edu/apply-opportunities/app-components/essays/research-proposals  
• What is a research proposal? Plus how to write one. Indeed website. Accessed July 17, 2024. https://www.indeed.com/career-advice/career-development/research-proposal  
• Research proposal template. University of Rochester Medical Center. Accessed July 16, 2024. https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/pediatrics/research/documents/Research-proposal-Template.pdf  
• Tips for successful proposal writing. Johns Hopkins University. Accessed July 17, 2024. https://research.jhu.edu/wp-content/uploads/2018/09/Tips-for-Successful-Proposal-Writing.pdf  
• Formal review of research proposals. Cornell University. Accessed July 18, 2024. https://irp.dpb.cornell.edu/surveys/survey-assessment-review-group/research-proposals  
• 7 Mistakes you must avoid in your research proposal. Aveksana (via LinkedIn). Accessed July 17, 2024. https://www.linkedin.com/pulse/7-mistakes-you-must-avoid-your-research-proposal-aveksana-cmtwf/  

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Thirty-five years of sensemaking in the business & management research: a bibliometric analysis, review and discussion

• Open access
• Published: 16 August 2024

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• Gary Eckstein   ORCID: orcid.org/0000-0001-9401-0864 1 ,
• Anup Shrestha   ORCID: orcid.org/0000-0002-2952-0072 1 &
• Fiona Russo   ORCID: orcid.org/0000-0002-1652-2589 1  

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Sensemaking is widely acknowledged as providing valuable guidance on how individuals and groups organize to perceive issues at stake, thereby lessening the negative impacts of future unknowns. Sensemaking is not a new field, yet events surrounding the recent COVID-19 pandemic may benefit from a sensemaking perspective. While prior reviews have considered sensemaking research, this is arguably the first bibliometric review of sensemaking and its application across the entire business and management domain. From 2,838 articles, we used performance analysis and science mapping techniques to offer propositions and avenues for future research. We advance theory and offer practical implications by identifying and providing context about prominent theorists, authors, journals, articles, and environments where sensemaking has been studied. Thirty-five years after the first article on sensemaking was published, this paper offers an extensive review demonstrating the evolution, current interests, and future directions of sensemaking research in the business and management discipline.

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Balanced scorecard: trends, developments, and future directions

Making Sense of Strategic Decision Making

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1 Introduction

Sensemaking in business and management is important. Weick ( 1988 , p. 308) stated, “if we can understand the process of sensemaking during a crisis, then we can help people to prevent larger crises by smarter management of small crises.” With a bold vision of equipping practitioners with sensemaking awareness to reduce the negative impact of unknowns, this study helps in gaining an overview and new perspectives of the sensemaking literature.

Sensemaking is a widely studied concept in business research, and practitioners alike acknowledge the value of sensemaking, evidenced by its application in governments and by management consultants (Australian Army 2021 ; PPL 2022 ). The organizational sensemaking process helps comprehend and manage dynamic environments. Understanding and scrutinizing the sensemaking process are significant activities in several practical application areas, such as managing strategic changes, facilitating mergers and acquisitions, providing better healthcare, and saving lives in crises (Gioia et al. 1994 ; Sahay and Dwyer 2021 ; Vaara 2003 ; Weick 1993 ). Yet, with the plenitude of sensemaking literature, there is a dearth of concise guidance for practitioners. Research has an important role in informing practice, thus it is no wonder that business scholars call for more research into sensemaking, considering sensemaking is studied in many fields, like marketing and small business (Christianson and Barton 2021 ; Hollebeek and Macky 2019 ; Holt and Macpherson 2010 ).

However, there are challenges in researching sensemaking in increasingly diverse fields. Sensemaking traditionally employs a constructionist philosophy with associated qualitative methodology (Craig-Lees 2001 ). Yet, fields studied in conjunction with sensemaking may adopt different paradigms, thus potentially affecting the validity, reliability, and acceptance of research by practitioners (De Frutos-Belizón et al. 2019 ; Healy and Perry 2000 ). This issue has received little attention, yet should researchers need to be concerned with philosophical differences, and if so, how are the differences reconciled?

Sensemaking has been investigated with several reviews that propel the concept and guide academics and practitioners; e.g., Cristofaro ( 2022 ) reviewed 402 studies, and Turner et al. ( 2023 ), 60 studies. As reviews are beneficial in summarization, uncovering new perspectives, and identifying trajectories (Fisch and Block 2018 ; Post et al. 2020 ), substantial changes in operating environments, such as COVID-19, precipitates the need for further reviews (Paul et al. 2021 ). This paper is arguably the first sensemaking review conducted since the COVID-19-related public health emergency ended on 4 May 2023 (World Health Organization 2023 ), with a wider literature search and resultant larger corpus than prior studies. With the uncertainty of COVID-19, combined with the origins of sensemaking in crises (Weick 1988 ), and the call by Christianson and Barton ( 2021 ) for a broader scope of sensemaking research, we posit that the significant changes resulting from COVID-19 necessitate a fresh review. Consequently, with the aim of making the sensemaking literature more accessible and further expanding the impact of the literature, we explore sensemaking theory as applied in the business and management discipline via three research questions:

Rq1: How has sensemaking research evolved? Rq2: What are the topics of current interest in sensemaking? Rq3. Where is the future direction of sensemaking research heading, and does the prevailing paradigm support future directions?

Given data analysis is valuable in advancing theory combined with the evolution of technologies that support literature data analysis, there is an increasing uptake of bibliometric research that handles large volumes of scientific data through quantitative and statistical means. As such, we employ performance analysis and science mapping using tools, methods, and techniques such as co-citation analysis and keyword co-occurrence clustering to address the research questions from the corpus of 2,838 articles. Our findings show that sensemaking is an important field that has attracted increasing academic attention, and it bridges many disciplines and environments based on the seminal work initiated by Professor Karl Edward Weick ( 1988 ) who introduced the concept of sensemaking into organizational studies.

Our study makes numerous contributions to the literature. First, identifying and discussing topical clusters provides novel insights and identifies trajectories, such as marketing and international business (IB) being emerging sensemaking topics. Second, philosophical discussion shows sensemaking as adaptable from its traditionally constructionist paradigm to other philosophies, for example, realism. Third, our propositions and discussion identify literature gaps and opportunities to develop sensemaking theory further. Last, we show that sensemaking is a valuable perspective in understanding micro and macro business environment change, thereby raising awareness of the practical applicability and benefits of sensemaking in the business and management discipline.

Next, we explain the sensemaking theory and then our methods and literature selection before presenting results. Discussing our findings follows this, and finally, the implications and future research opportunities are offered.

2 Theoretical context

Sensemaking emerged through five theories associated with seminal authors Brenda Dervin, Gary Klein, Daniel Russell, David Snowden, and Karl Weick (Littlejohn and Foss 2009 ). Dervin focused on information science, Klein on cognitive systems engineering, Russell on human-computer interactions, Snowden on knowledge management, and Weick on organizational communication. Weick’s theory is prominent in management studies (Ann Glynn and Watkiss 2020 ) and has its origins in the 1960s when it was argued that our understandings are socially constructed (e.g., Garfinkel 1967 ; Weick 1969 ; Brown 2018 ).

Weick et al. ( 2005 ) described the sensemaking process in four steps, as illustrated in Fig.  1 : (1) an environmental change is sensed and noticed as unfamiliar and requiring attention. (2) Initial understandings termed bracketing are forthcoming using cognitive frames such as work experience and education. (3) Labeling occurs where a collective plausible story emerges from the bracketing. Finally, in step 4, the learnings are retained, which then acquaint future sensemaking. While action is an outcome of the sensemaking process that informs future sensemaking, sensemaking does not prescribe actions by itself.

Weick’s sensemaking process exhibiting SIR COPE. Note : Adapted from Jennings and Greenwood ( 2003 ), Weick ( 1979 ), and Weick et al. ( 2005 )

Weick ( 2005 ) provides seven conditions for sensemaking, often abbreviated as SIR COPE, that affect the process (Fig.  1 ). First, Social context refers to sensemaking being social in that communication is central to sharing knowledge and forming opinions and understandings. Second, Identity is an individual’s perceived and actual characteristics, such as education, role in an organization, and gender, that influence decision-making for the individual and groups. Third, sensemaking is Retrospective in that the process addresses unknown situations and environments, and people make sense of situations based on prior experiences and understandings. Fourth, Cues are the data and knowledge that individuals attain consciously and subconsciously. Fifth, sensemaking is Ongoing in that information and environments are imperfect, and past learnings inform new perspectives. Sixth, Plausibility implies that with imperfect information and understanding, accuracy is unlikely to be forthcoming; hence, plausible understandings are necessary. Finally, the seventh condition is that people and groups enact their Environment by creating a reality based on their plausible understandings and actions.

Two significant sensemaking constructs are sensegiving and sensebreaking , while other constructs include sensedemanding , sense-exchanging , sensehiding , and sense specification (Maitlis and Christianson 2014 ). Sensegiving shapes others’ meaning construction (Gioia and Chittipeddi 1991 ), while sensebreaking breaks down or destroys interpretations (Maitlis and Christianson 2014 ). Definitions of the variants of constructs that define the sensemaking concept are provided in Table  1 .

Practice and theory have a symbiotic relationship whereby both benefit through learning from and informing each other (Shepherd and Suddaby 2016 ). As we show in this study, sensemaking is a widely studied academic field, often involving practitioner perspectives like case studies, such as Weick ( 1993 ), studying sensemaking in a firefighting event, and Klein and Eckhaus ( 2017 ), analyzing Enron manager communication during its collapse. In addition, the literature provides mitigations; for example, sensemaking may be facilitated via activities such as scenario planning, promoting knowledge sharing between teams and business units, encouraging diversity in human resource experience, skills, and education, and by being aware of the process of sensemaking (Kalaignanam et al. 2021 ; Maitlis and Sonenshein 2010 ; Weick 1993 ).

3 Methods and literature selection

Our research strategy comprised four steps; definition of aims and scope, selection of bibliometric analysis methods and techniques, data collection, and bibliometric analysis and reporting (Donthu et al. 2021 ). While we discuss the process as being step-by-step, in practice it was iterative as we refined, for example, research questions, literature searches, and tools as the study progressed. Our choice of bibliometric analysis and the literature selection are discussed next.

3.1 Bibliometric analysis

The scope of this review is expansive to understand the evolution and structure of the research topic; hence, bibliometric analysis is appropriate (Block and Fisch 2020 ). Bibliometric analysis comprises mapping contributions, i.e., performance analysis, and discussing the relationships, i.e., science mapping (Zupic and Čater 2015 ). Numerous methods, tools, and techniques are available to address research aims and methods, and techniques used in this paper are shown in Table  2 .

In this study, our methods comprise the likes of co-occurrence and co-citation analysis, that are widely used in bibliometric analysis (Hammerschmidt et al. 2023 ). Tools primarily refer to the software used for analysis and charting, and this study uses the Bibliometrix R package (Aria and Cuccurullo 2017 ) for analysis and VOSviewer (van Eck and Waltman 2011 ) for testing and validation. Most tools include techniques the researcher may select; for example, VOSviewer (van Eck and Waltman 2011 ) allows four different normalization options that influence how the data are organized.

3.2 Literature selection

Bibliometric analysis benefits from systematic and broad literature searches with well-defined inclusion and exclusion criteria, while the research questions retain the primary focus throughout the study (Block and Fisch 2020 ; Hiebl 2021 ). The literature search and selection process is illustrated in Fig.  2 .

Flow diagram of review search and selection

To identify relevant records, we first defined search terms that included derivatives of sensemaking and related constructs; sensebreaking , sensedemanding , sense-exchanging , sensegiving , sensehiding , and sense specification (Maitlis and Christianson 2014 ). Then, in January 2024, we searched the Web of Science (WoS) database title, abstract, and keyword fields using the terms. The rationale for the choice of WoS database is that it is frequently used in bibliographic analysis and has a greater number of indexed journals than some other databases (Block and Fisch 2020 ). The initial search returned 9,587 records. Subsequently, two records published in 2024 were removed to limit records to those published up to the end of 2023. Then, we excluded records not in the Business, Business Finance, Economics, or Management WoS categories, resulting in 2,851 remaining records. Thirteen non-English language records were removed, and duplicates were absent due to WoS removing these surplus records (Clarivate 2022 ), resulting in a corpus of 2,838 records. Furthermore, we checked that no retracted articles were present. The relevancy of records is critical in bibliometric studies (Zupic and Čater 2015 ), as is the number of records needed to attain valid results. Donthu et al. ( 2021 ) recommend that several hundred to thousands of records are necessary for bibliometric analysis. Hence, the structured approach to our literature selection and the quantity of records returned supports the methodology in addressing the research questions.

4.1 Performance analysis

4.1.1 evolution of the field based on annual number of articles.

Figure  3 shows the number of records published per year as a scatterplot with a polynomial trendline showing the upward trend. The first record was published in 1988 (Weick 1988 ), and in 2023, 327 were published. Analysis of sensemaking trends by year is of limited relevance in that an event may trigger further associated events that are then studied, and research may continue for many years. It may be deduced, however, that academic interest in the field is consistently rising, as shown by the trendline.

Number of records published from 1988 to 2023 with trendline. Data extracted from WoS on 2 January 2024

4.1.2 Top articles on sensemaking over time

Analysis over time facilitates identifying progression and trends in a field (Block and Fisch 2020 ), and, as such, Table  3 shows the papers with the most citations in four time periods. We categorise the periods as T1 referring to period before 2000 that comprises 77 studies, T2 is between 2000 and 2008 with 349 studies, T3 is between 2009 and 2016 with 888 studies, and T4 refers to the years since the start of 2017 until the end of 2023 with 1,524 studies. The Academy of Management journals are prominent in publishing highly cited sensemaking articles at all times. Gioia authored most-cited articles in all time periods, comprising two primary topics; theory-building and strategic change. His theory-building papers (Gehman et al. 2018 ; Gioia et al. 2013 ) explored inductive case study methodology and highlighted the relevancy of the socially constructed aspects of sensemaking and Weick’s works. In Corley and Gioia ( 2004 ); Gioia and Chittipeddi ( 1991 ); Gioia and Thomas ( 1996 ) Gioia explored the role of identity in strategic sensemaking. Markedly, the understanding of identity has been widely studied in sensemaking. For example, Craig-Lees ( 2001 ) highlighted the importance of sensemaking and recognizing the role of the individual. Meanwhile, van Zoonen et al. ( 2022 ) noted the relevance of adequate communication in sensemaking to reduce employee identity threats that may lead to mental health issues.

Generally, older articles are more likely to be cited (Block et al., 2019). Hence, it is interesting to note that the most cited paper, with 5,528 citations, is Gioia et al. ( 2013 ), published 25 years after the first corpus article (Weick 1988 ). Gioia et al. ( 2013 ) focus on a qualitative methodology and attaining the perceptions of an interviewee as they make sense of a situation.

Paradigm informs methodology and Weick predominantly adopted storytelling and narratives as a means of understanding sensemaking (e.g. Weick 1988 , 1993 ). With sensemaking’s origins in the constructionist paradigm (Craig-Lees 2001 ), it is, therefore, unsurprising that qualitative methodology dominates the field. Of the five most cited articles in each time period, Gioia and Thomas ( 1996 ) and Miron-Spektor et al. ( 2018 ) are alone with quantitative methodology. In addition, a search of corpus titles and abstracts revealed approximately 100 quantitative and 492 qualitative studies.

Not only has Weick’s sensemaking informed the understanding of business and management in novel events, but it has also influenced paradigm and methodology in business and management research. This is unsurprising as Weick authored papers on the nature of theory (e.g. Weick 1989 , 1995 ). Case study is a prominent methodology in the social sciences, and Weick has been influential to prominent case study theorists, such as Gioia and Langley (Gehman et al. 2018 ). The influence of Weick’s sensemaking on methodology and theorization has been ongoing throughout the time periods; for example Gehman et al. ( 2018 ), Gioia et al. ( 2013 ), and Langley ( 1999 ).

4.1.3 Top journals that publish on sensemaking based on the number of published articles

Table  4 shows the 15 journals with the highest volume of articles published after the scientific peer-review process. We used the Australian Business Deans Council (ABDC) INC. ( 2022 ) and Scimago Lab ( 2024 ) (SJR) as the widely used quality indicators for business research (e.g., Benameur et al. 2023 ; Sharma et al. 2023 ). For ABDC, A* is the highest journal quality, followed by A, B, and C rankings, and journals not listed in the ABDC ranking are excluded. Likewise, SJR provides journal quality indicators developed from the information in the Scopus database, where the first quartile journals (Q1 journals) refer to the highest quality (top 25% journals). Likewise, Q4 journals refer to the bottom 25% of journals of the listed sources.

Out of 508 journals in the corpus, 934 articles (30% of the corpus) were published in 15 journals. Organization Studies published the most papers with 121 articles and is a highly rated journal by SJR (Q1) and ABDC (A*) with an h-index of 167. The first Organization Studies sensemaking article was Boyce ( 1995 ), who researched storytelling and sensemaking in a religious organization. All the top publishing journals are of high quality, with the Academy of Management Journal having a h-index of 358 and the lowest in the list being the Scandinavian Journal of Management with an h-index of 65.

Journal research subjects vary, indicating a wide topic range and illustrating sensemaking as relevant to diverse subjects. In addition, all journals continue to publish since first publishing a sensemaking article, with the Journal of Management Studies publishing studies on sensemaking for 35 years, illustrating sensemaking’s ongoing relevance. The journals publishing most articles per year on average are Industrial Marketing Management , Journal of Business Ethics and Organization Studies , with an average of four articles per year.

4.2 Science mapping

Identifying and discussing topic clusters is insightful in bibliometric analysis, and findings aid in providing new insights (Block and Fisch 2020 ). As such, to identify knowledge diffusion in sensemaking, we first performed author keyword co-occurrence. This resulted in identifying close relationships between keywords that we discuss. While keyword co-occurrence analysis is beneficial for historical analysis and helps identify the study topics, it is prone to issues relating to author understanding and bias in selecting keywords (González et al. 2018 ). Thus, we further analyzed the corpus using source co-citation clustering to gain insight into trends and trajectories at a subject level, such as marketing or information systems.

4.2.1 Knowledge diffusion based on keyword co-occurrence

Using the Walktrap algorithm, four clusters were identified based on the 6,824 author keywords in the corpus. Before analysis, we converted select words and phrases to base terms; for example, sense-making and sense making were changed to sensemaking . Repulsion was set at 0.3, the 75 most relevant keywords were selected to be displayed, and isolated nodes were removed. Keywords were absent in 54 articles.

Figure  4 illustrates the clusters, with Table  5 providing examples of keywords in each cluster. Clusters of co-occurring keywords are shown in color (Fig.  4 ) with the node size (keyword) relative to the frequency of co-occurrence, with large nodes indicating higher frequency. Connecting lines indicate co-occurrence, with line width illustrating frequency.

Keyword co-occurrence clusters

The red cluster is the largest, and high co-occurrence keywords in this cluster include sensemaking , communication , emotion , knowledge management , learning , and social . The sensemaking keyword’s large size is unsurprising considering the focus of this study. Of all clusters, keywords in this cluster align most closely with sensemaking theory. For example, Weick et al. ( 2005 ) explain that sensemaking is social and relies on communication, and learnings from sensemaking are used in future understandings. This cluster traverses many decades of research, such as Gioia et al. ( 1994 ) and Whittle et al. ( 2023 ).

The blue cluster considers corporate social responsibility (CSR) , sustainability , and paradox , with few co-occurring keywords in this cluster. While it may be tempting to perceive this small cluster as less important, we posit that it is highly relevant. Topics may be analyzed considering the degree of development (from low to high) and relevancy (Cobo et al. 2011 ). We assume all clusters are highly developed as per our selection of important keywords for analysis. As for relevance, CSR and sustainability are an increasingly studied pairing as government, business, and society awareness of environmental and natural issues grows (Meseguer-Sánchez et al. 2021 ). Paradox is contextually relevant; for example, longer-term environmental objectives may result in near-term unfavorable economic impact (Luo et al. 2020 ). The role of sensemaking is understandable considering the need to appreciate how managers, investors and other stakeholders make sense of CSR (Hahn et al. 2014 ; Meng et al. 2022 ). Hence, the blue cluster, being highly developed and relevant as other clusters are, may be considered a ‘hot topic’ important for the structural and conceptual development of sensemaking (Cobo et al. 2011 ).

The green cluster, which includes knowledge , innovation , technology , and strategy , encapsulates many fields and decades of research. Strategy is interesting in the sensemaking context and relates to the co-occurring keywords. Strategy implies planning rigidity, whereas sensemaking is often described as reactionary and requires innovative thinking (Weick 1988 ). This contradiction is addressed in the literature with mitigations recommended to reduce the chance of, or outcomes of, the unexpected, such as improved knowledge management and sharing, facilitated by technology or people, and pre-planning such as scenario analysis (Akgün et al. 2014 ; Eckstein et al. 2023 ; Kalaignanam et al. 2021 ). Hence sensemaking remains reactionary, however, strategy may be employed to reduce the severity of the unexpected.

The purple cluster is small and comprises recent research, as evidenced by the COVID-19 keyword. Terms also include crisis and resilience . The public health emergency of international concern (PHEIC) comprising COVID-19, which was in place from 30 January 2020 (World Health Organization 2020 , 2023 ), may explain the co-occurrent keywords due to the volatility and unknown of that time. Weick ( 1988 , p. 305) noted that sensemaking environments are “characterized by low probability/high consequence events that threaten the most fundamental goals of an organization,” which is relatable to many organizations during the PHEIC (Bouncken et al. 2022 ).

4.2.2 Evolution of subjects using source cluster analysis

The corpus was analyzed in the four periods, T1-T4, for source co-citation clustering to detect links between subjects over time. The PageRank algorithm identified the 50 most influential sources, and then Walktrap determined clusters based on factors such as centrality and peripherality of sources and proximities and distances (Aria and Cuccurullo 2022 ). A repulsion force of 1 was set to refine clustering, with a higher repulsion helping in aggregating separated nodes, thus graphically identifying nodes in clusters (Quiles et al. 2016 ; Song and Pei 2019 ).

The clusters are summarized in Table  6 and illustrated in Figs.  5 , 6 and 7 , and Fig.  8 , with the cluster colors not suggesting relatedness but used to differentiate clusters within the same figure. Sources clustered together imply strong relatedness in the corpus and, as the subject matter may be inferred from a publishing journal (González et al. 2018 ; Yang et al. 2022 ), the subject of journals was attained from Scopus (Elsevier 2024 ). Clusters contain multiple sources. Thus, we determined the subject matter of each cluster by the subject of the highest PageRank sources in the cluster, shown in the primary subjects column in Table  6 .

Source co-citation during T1 (1988 to 1999)

Source co-citation during T2 (2000 to 2008)

Source co-citation during T3 (2009 to 2016)

Source co-citation during T4 (2017 to 2023)

As per Table  6 in the primary subjects column, ‘organizational studies’ and ‘management’ are clustered together at all times. Thus, an ongoing strong relationship is apparent between these two subjects in sensemaking. ‘Strategy’ is evident in all periods and always clustered with ‘management,’ providing evidence of continued combined relevancy in sensemaking. ‘Psychology’ was prominent until T4, while the relevancy of ‘sociology’ in sensemaking was initially strong (T1) but then faded. In the most recent period (T4), IB is significant in sensemaking. The ‘marketing’ cluster is showing increasing importance and is represented in T1, T3, and T4; however, the T1 cluster of ‘marketing’ has low PageRank, revealing weaker standing in this initial time T1, while there has been a strong PageRank and more journal representation in more recent times (T3 and T4).

5 Discussion and opportunities for future studies

5.1 discussion.

Sensemaking is valuable in understanding business and management in varied subjects, topics, and environments (Christianson and Barton 2021 ). This study presents a bibliometric review of 2,838 papers to summarize existing themes, uncover new perspectives, and identify future research opportunities. In addition this paper delivers an overview of existing studies that may inform future research considering Christianson and Barton ( 2021 ) advancing the need for expanded scope of sensemaking research in light of changes necessitated by COVID-19. Performance analysis identified publishing trends, and articles. Science mapping showed progression of sensemaking theory between subjects and topics.

In response to Rq1 (“how has sensemaking research evolved?”), the volume of published research has trended upward, with reputable journals publishing significant numbers of articles, and top articles receive many citations. Furthermore, sensemaking has evolved to traverse a broad range of subjects and topics. This is unsurprising as sensemaking is a generalized organizing process by design (Weick et al. 2005 ) and is an umbrella construct that accounts “for a diverse set of phenomena” (Floyd et al. 2011 , p. 943).

Relating to Rq2 (“what are the topics of current interests in sensemaking?”) and Rq3 (“where is the future direction of sensemaking research heading, and does the prevailing paradigm support future directions?”), findings from this research showed specific and relevant trends that we discuss further considering the four keyword clusters.

Marketing is an emerging sensemaking subject, and prominent sensemaking keywords we revealed support the alignment of sensemaking and marketing. A criticism of marketing has been its inflexibility in addressing rapidly changing markets, often termed volatile, uncertain, complex, and ambiguous (VUCA) environments (Tarba et al. 2023 ). This has given rise to marketing research and practice combined with concepts that enable responsiveness in marketing. An example is marketing agility (MA), which focuses marketing decisions on customer feedback and notably includes sensemaking (Eckstein et al. 2023 ). Considering marketing becoming more flexible to customers’ needs and wants, including VUCA, the red and purple keyword clusters (including keywords such as communication and COVID-19 ) are emblematic of the tie-in between sensemaking topics and marketing, where communication and COVID-19 are widely studied in marketing and sensemaking (e.g., Behl et al. 2023 ; Sharples et al. 2022 ). Furthermore, the overlap between sensemaking and marketing is prominently seen in the keyword social : While sensemaking is a social activity (Weick 2005 ), marketing is increasingly concerned with social communication and associated implications considering technologies such as social media, often in tandem with sensemaking (e.g., Mirbabaie et al. 2020 ). Pertinent marketing issues are also seen in the green and blue keyword clusters (containing, for example, information and technology ). For instance, generative artificial intelligence (AI) has recently been introduced in widely used software services, such as marketing platforms (Smith-Goodson 2023 ). This has invoked many areas of study applicable to both marketing and sensemaking, such as insight into the impact on employment, consumer perception of the technologies, and consumer data security and privacy (Kshetri et al. 2023 ; Weber et al. 2023 ). We thus propose:

Proposition 1

Sensemaking is a plausible lens through which one can study marketing, particularly in VUCA environments.

IB describes business activities across borders and, while being a relatively new research discipline (Morck and Yeung 2007 ), it has a long history with evidence from many past millennia, such as foreign trade discussed by Plato (Weinstein 2009 ). IB involves VUCA (purple keyword cluster), that is a topical sensemaking research area, with cultural differences, languages, laws, and the like potentially presenting impediments or opportunities (Asseraf and Gnizy 2022 ; Elo and Silva 2022 ); for example, sanctions affecting vehicle exports to Russia may impact the financial performance of brands such as BMW and Toyota (KPMG LLP 2023 ). There are parallels between IB and further sensemaking keywords; for example, in their analysis of Management International Review, an international business journal, Mukherjee et al. ( 2021 ) describe the corporate governance and corporate social responsibility keywords as prevalent, that we found ubiquitous in sensemaking keyword clusters. Hence:

Proposition 2

Sensemaking is a viable perspective to research International Business.

Continuing with the response to Rq3, Craig-Lees ( 2001 ) provided that the constructionist paradigm is dominant in sensemaking. Constructionism perceives sensemaking as individual and subjective, with a reality constructed by the individual. As such, findings are unlikely to be broadly generalizable, and the individual perspective is observed through qualitative methodology (Welch et al. 2010 ). Our findings of storytelling, narratives, and predominantly qualitative methodology support the constructionist position in sensemaking.

Yet marketing and IB, among other business and management fields, favor objective positions such as scientific realism (Aguzzoli et al. 2024 ; Hunt 2018 ). Realism assumes a reality exists independent of any individual, and the researcher’s role is to discover and approximate this reality, which may then be generalized (Welch et al. 2010 ). As such, marketing and IB are biased toward quantitative research (Aguzzoli et al. 2024 ; Crick 2021 ). How may the philosophical divide between constructionism and realism be reconciled to enable relevant marketing, IB, and sensemaking research?

Craig-Lees ( 2001 ) addressed this conundrum in their discussion of sensemaking in psychology and marketing, noting that select researchers perceive sensemaking with a social constructionist perspective. Social constructionists understand that shared social realities exist that can be applied, in part, collectively. While social constructionism somewhat tempers the divide with realism, a gap remains in the underlying assumptions between perceiving reality as independently constructed (social constructionism) and reality existing independently of any one person (realism). Similarities and differences between the two paradigms have been widely discussed with various conceptualizations, such as Cruickshank ( 2012 ) advocating that the two are incompatible, and Williams ( 2016 ) advancing that the two positions can be reconciled. Another stance is that the paradigm may change to meet the needs of the topic (Craig-Lees 2001 ). While the philosophical debate remains unresolved, the realism paradigm has influenced limited sensemaking studies (e.g. Seidel et al. 2018 ; Wiredu et al. 2021 ). As such:

Proposition 3

Realism is a valuable paradigm through which to perceive marketing and International Business in sensemaking.

As shown in cluster analysis, strategy is a prominent theme in all time periods. The research into strategy and sensemaking is broad and voluminous, with 568 studies in the corpus. Many aspects of strategy are apparent, such as strategy formulation (e.g., Siltaloppi et al. 2021 ) and implementation (e.g., Gioia et al. 1994 ). Sensemaking is often a small business research lens (e.g. Holt and Macpherson 2010 ; Liyanagamage and Fernando 2023 ), yet few studies research sensemaking considering small business strategy.

Strategy is important to small business but differs from larger organizations (Handoyo et al. 2023 ). For example, when considering Porter’s generic strategies, cost leadership may be problematic for small business due to limited economies of scale and typically lesser financial resources (Lee et al. 1999 ; Porter 1980 ). Product differentiation strategies however may favor small business that are better able to serve local markets (Lee et al. 1999 ). There is a gap in considering small business research with a sensemaking lens and, as such, we proffer:

Proposition 4

Sensemaking offers a relevant strategy lens for small businesses.

5.2 Future research

As for future research opportunities, the increased volume of sensemaking research considering deep uncertainty is worthy of discussion. We showed that sensemaking is a valuable lens through which to perceive crises that affect business. Recent events, such as COVID-19 and the war in Ukraine, have resulted in deep uncertainty affecting business performance (Schmelzer 2022 ). Theory has an important role in informing practice (Antonakis et al. 2014 ) and sensemaking theory aids practitioners in minimising adverse outcomes (Weick 1988 ); thus it an opportune time for further research in sensemaking considering these, and potential future, deep uncertainties.

The philosophical paradigms underpinning sensemaking research, in consideration of allied topics, will benefit from further exploration. This paper touches on the vast and ongoing topic of business and management philosophies, and these philosophies are fundamental to business research (Hunt 2018 ). For instance, marketing favors realism, while sensemaking skews towards constructionism. The ontologies and epistemologies of realism and constructionism differ greatly, and, with paradigm influencing methodology, the paradigm differences between sensemaking and co-studied topics may negatively impact validity and reliability (Healy and Perry 2000 ). Hence, further debate and understanding of research paradigms will aid researchers, and potentially address the shortage of quantitative research in sensemaking.

5.3 Theoretical and academic contributions

Academics have long highlighted the need for further sensemaking research (Christianson and Barton 2021 ), and a necessity for research is building a solid familiarity with existing knowledge (Bergkvist and Eisend 2021 ). As reviews help develop a holistic overview of a topic (Post et al. 2020 ), this bibliometric review paper is expected to advance sensemaking research by identifying prominent scholars, journals, and research activities on this topic. This review paper will benefit researchers considering their research topic from a sensemaking perspective.

This paper discusses the potential issues in the philosophical foundations of sensemaking and its role as an umbrella construct. The issue of philosophical differences in business and management research is significant and may affect validity and reliability, and acceptance of research by practitioners (De Frutos-Belizón et al. 2019 ; Healy and Perry 2000 ). As such, this paper will aid in making academics aware of potential philosophical tensions. Furthermore, academics will be informed about the paradigms and methodologies prevalent in sensemaking.

Further theoretical contributions include mapping the sensemaking topic across 35 years using keyword and co-citation clustering to identify and discuss trends, thereby adding interesting perspectives on the evolution of the topic. We also provide a richer understanding of the sensemaking topic, thus advancing the ‘big picture’ of the topic. In addition, we hope to progress sensemaking theory by identifying literature gaps and offering propositions to promote future research. Finally, Weick ( 1995 ), the prominent sensemaking theorist, espoused the value of theorizing through disciplined imagination, and we hope that perspectives in this study stimulate thought and debate, as these aspects are necessary to advance theory (Bergkvist and Eisend 2021 ).

5.4 Practical implications

For practitioners new to the application of sensemaking, this study provides a foundation for understanding the often-confusing topic of sensemaking in emerging subjects, the range of events in which sensemaking is applicable, and significant research undertaken on the topic. For practitioners familiar with sensemaking, this study presents an opportunity to refresh and refine their sensemaking knowledge by leveraging the latest research and interdisciplinary insights. For example, we emphasized how the COVID-19 PHEIC presented unprecedented change that may benefit from studies using a sensemaking perspective. In addition, practitioners will benefit from the understanding that sensemaking is applicable in crises and in high probability and low impact events and activities, such as communication between employees, that aids sensemaking. Furthermore, cluster analysis will guide practitioners in perceiving how sensemaking has evolved and is perceived in different contexts. Most important of all, sensemaking may aid in reducing adverse outcomes of unknown situations, and we provide practitioners with an overview of the process and the areas where sensemaking research is prominent.

5.5 Limitations

The selection criteria used to identify sensemaking research has limitations. We only used the WoS database, however other databases may contain more research work in addition to grey literature. We selected only English research articles and those only in the Business, Business Finance, Economics, or Management categories, yet research in other languages and other categories may offer valuable insights. Furthermore, our database search terms may have missed relevant research; for example, we searched for derivatives of sensemaking, yet if authors used terms like make sense or making sense , we might have missed these articles.

Likewise, we use cluster analysis in this review, and we acknowledge that the process of clustering requires interpretation that can be subjective. We selected algorithms that may output different results based on our choice, and, in addition, we picked parameters that may influence output, such as the number of keywords to display co-occurrence.

Our discussion relating to ontology, epistemology, and methodology, collectively termed as paradigm (Healy and Perry 2000 ) is brief. Paradigm is a broad and evolving topic with disparate definitions and terminology. Our understanding and use of terminology reflect the research as cited, however there may be different works or interpretations of these research.

6 Conclusions

We showed that sensemaking is an important research topic traversing a diverse set of subjects, topics, and environments. To reconcile prior research, we mapped the topic of sensemaking and conducted bibliometric analyses. The comprehensive overview and analysis of the literature were used to offer propositions and to identify opportunities for future research. Sensemaking is a broad topic that aids in understanding and preparing for unknown environments. We anticipate that this study will aid academics and practitioners in continue benefitting from applying the sensemaking theory into their research and practice.

Data availability

We have not generated any datasets in researching and documenting this review. All data or research used in analysis has been referenced.

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Why do patients with cancer die?

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Cancer is a major cause of global mortality, both in affluent countries and increasingly in developing nations. Many patients with cancer experience reduced life expectancy and have metastatic disease at the time of death. However, the more precise causes of mortality and patient deterioration before death remain poorly understood. This scarcity of information, particularly the lack of mechanistic insights, presents a challenge for the development of novel treatment strategies to improve the quality of, and potentially extend, life for patients with late-stage cancer. In addition, earlier deployment of existing strategies to prolong quality of life is highly desirable. In this Roadmap, we review the proximal causes of mortality in patients with cancer and discuss current knowledge about the interconnections between mechanisms that contribute to mortality, before finally proposing new and improved avenues for data collection, research and the development of treatment strategies that may improve quality of life for patients.

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Deceptive measures of progress in the NHS long-term plan for cancer: case-based vs. population-based measures

Introduction.

The phrase ‘metastasis accounts for 90% of cancer deaths’ is one of the most widely used in cancer research, yet it is overly simplistic, imprecise and it is difficult to find any primary analysis supporting the statement. Although patients with metastatic disease are overwhelmingly more likely to die than patients with non-metastatic cancer 1 , 2 , the determinants of cancer mortality are multifaceted and frequently involve dysfunction of multiple interconnected systems within the body. Understanding the mechanisms underpinning the causes of mortality, and subsequently intervening, has the potential to make cancer a less destructive disease, improving both the quality and length of life for patients with cancer. However, systematic analyses of the acute and root causes of mortality in patients with cancer are scarce, in part because death certificates rarely record enough information to understand the exact reason why the patient died beyond them having a malignancy. Causes of death may be simply listed as ‘metastatic carcinoma’ or ‘complications of cancer’, which give little insights into why a patient actually died. Potentially concomitant comorbidities are also not fully recorded. Even in cases in which the cause of death may be attributed to a single event, for example, a  thromboembolism , the underlying cause of that specific event may be complex. Indeed, metastatic cancer leads to perturbed function of multiple organ systems, and importantly, not just the organs to which disease has spread. This is probably due to the exuberant activation of local and systemic inflammatory, tissue repair and immune-suppressive programmes.

A simple view would be that death from metastatic disease correlates with the burden of disease. However, evidence suggests that the situation is more complex, with many factors influencing how metastases impact vital functions and ultimately lead to death. First, metastases to different organs will lead to different impacts on overall health. For example, brain metastases can lead to dysfunction of the central nervous system 3 , whereas peritoneal metastases may cause obstruction of the bowel 4 . In addition, the size or extent of metastases may not necessarily correlate with dysfunction of the organ where it is located 5 . Second, the production of the molecular mediators of organ dysfunction can vary between metastases and cancers of different origins. Third, individual patient characteristics such as age, sex, overall health, pre-existing comorbidities, genetics and socio-economic status vary 6 . Together, these factors directly influence the course of and physiological response to metastatic disease and can have profound indirect effects by limiting available treatment options and/or the ability of patients to tolerate or complete all intended treatment 7 , 8 . To understand why patients with cancer die, a closer examination of the factors contributing to mortality in patients with cancer and a dissection of the intricate web of causes that shape the frequency and dynamics of death are required.

Death may be related to an acute event, but the underlying mechanisms which trigger it may be modifiable or even preventable. In addition, other deaths may be the end stage of a continuum of deterioration, allowing the possibility of targeted intervention to improve quality of life. Moreover, it has been noted that early palliative care improves survival 9 . Ultimately, increased understanding of the processes occurring in patients with advanced disease should lead to improved strategies to minimize ill-health and suffering at the end of life. Coupled to this, patients and those around them should be enabled to have essential discussions about their wishes and preferences, minimizing potentially inappropriate treatments and maximizing quality of life 10 . Therefore, in this Roadmap, we briefly review data considering the immediate causes of mortality, highlight the intricate interconnections between different aspects of patient deterioration and conclude with recommendations for future studies of late-stage cancer that may shed new light on this important aspect of cancer biology and medicine.

Acute events leading to mortality

Although some cancers can be considered a chronic condition, with many patients living with their disease for years, the immediate cause of mortality can often be an acute event. Here, we briefly summarize common acute events leading to death in patients with cancer (Fig.  1 ). Although it is not possible to precisely determine, it is likely that the acute causes discussed subsequently may account for up to half of cancer deaths 11 , 12 . Immediate causes of mortality in other patients are less clear, with a more gradual deterioration typically occurring in vital organ systems (Fig.  1 ).

This schematic shows organs that frequently become dysfunctional in patients with late-stage cancer.

Vascular coagulation and cardiac failure

Patients with cancer are at an elevated risk of thromboembolism, which may trigger respiratory failure, fatal strokes, heart failure or myocardial infarction 13 . In some cases, disseminated intravascular coagulation can lead to thrombotic obstruction of small and midsize vessels leading to organ failure 14 . Haemorrhagic complications from depletion of platelets, via either immune or non-immune mechanisms 15 , 16 , and reduced levels of coagulation proteins can also be life-threatening 14 .  Congestive heart failure can also be a proximal cause of mortality, although the underlying causes are complex and include loss of cardiac muscle (associated with cachexia), shifts in intravascular fluid status and thromboembolic events 17 . Interestingly, bone metastases are particularly associated with cardiovascular problems, although the underlying mechanism remains unclear 18 . Comorbidities affecting the cardiovascular system may also make patients more prone to such events. Spatial occlusion of or invasion into vessels by cancer metastases can also lead to failure in blood supply or catastrophic haemorrhage 19 , 20 , 21 , 22 .

Displacement, functional impairment or obstruction of vital organs

The volume of disease may impair the function of a vital organ. This can be the case with brain metastases and glioblastoma or other primary brain cancers, with extensive invasion, brain herniation or oedema resulting in  midline shift or increased intracranial pressure irreversibly compromising brain function 22 , 23 , 24 . In addition, patients may develop seizures, which, if uncontrolled, can result in death 25 , 26 . However, this does not apply to all brain metastases, with  leptomeningeal metastases having minimal impact on intracranial pressure and brain structure; instead, these commonly obstruct cerebrospinal fluid flow and/or affect nerve function resulting in  hydrocephalus , deterioration of neurological function and death 26 .

Large lung metastases may impair the essential function of gas exchange. However, patients with miliary-like disease — characterized by nodules too numerous to count — can live with extensive disease in an organ with surprisingly little impact on function until a hard-to-predict tipping point is reached, which is then followed by rapid deterioration 27 . As with brain metastases, the volume of disease is often not sufficient to account for organ failure, as even a relatively small volume (<100 ml lung metastases volume compared with 4–5 l total lung volume) can be fatal 28 .  Lung oedema and pleural effusion are additional common contributors to death. Oedema may be caused by other pathologies such as infection or heart failure, whereas pleural effusion may be related to the presence of disease within the pleura as opposed to total tumour volume 28 , 29 .

Bowel obstruction can be a cause of mortality, especially in patients with peritoneal disease as found in particular in ovarian, colorectal and gastrointestinal cancers 30 . Both liver and kidney failure will also cause death in patients with cancer. Reasons for the failure of these organs include obstruction of the bile duct or ureters by metastases, therapy-induced toxicity leading to compromised normal organ function (discussed subsequently) and reduced tissue perfusion owing to hypotension or dehydration 31 , 32 , 33 , 34 . In addition, sepsis can result from obstruction of the bile ducts or ureters, which occurs unpredictably and often progresses rapidly leading to multiple organ failure and ultimately death.

Bacterial infections are the most common infection in patients with cancer, owing to impaired immune systems resulting from both the cancer itself and certain cancer treatments (discussed in detail subsequently), which induce myelosuppression and leukopenia. Patients with cancer can have an elevated risk of opportunistic viral, fungal and protozoal infections, which would typically be considered mild in healthy individuals, but which can cause serious life-threatening complications in those with cancer. Pneumonia and other lung infections leading to respiratory failure are often listed as causes of mortality in patients with cancer 35 , 36 . One of the most striking recent examples of this is the increased mortality observed in patients with cancer, particularly those with haematological cancers, who succumbed to COVID-19 compared with the general population 36 , 37 .

Paraneoplastic syndromes

Paraneoplastic syndromes are a group of rare disorders that can occasionally cause irreversible damage to critical organs and death. They are most associated with lung, breast, ovarian and lymphatic cancers, causing tissue or organ dysfunction at sites distinct from the location of the tumour 38 . Various mechanisms underpin paraneoplastic syndromes, including the inappropriate production of cytokines, hormones and antibodies. For example, excess parathyroid hormone-related protein (PTHRP) production by tumours can lead to hypercalcaemia 39 , 40 . Inappropriate anti-diuretic hormone production is commonly associated with small-cell lung cancer resulting in  hyponatraemia 41 . Furthermore, some neuroendocrine pancreatic tumours (insulinomas) secrete large amounts of insulin 42 . Tumours can also trigger the aberrant production of autoantibodies leading to disorders such as  Lambert–Eaton myasthenic syndrome (LEMS) or anti- N -methyl- d -aspartate receptor (NMDAR) encephalitis and myasthenia gravis 43 . Although treatment can usually manage the symptoms, in a subset of cases the syndromes cannot be controlled and are fatal 38 .

Therapy-induced toxicity

Although therapies are developed and administered with the intent of primarily targeting the tumour, almost all have some detrimental impact on normal tissue function. In some cases, the unintended consequences of therapy can be life-threatening. Autoimmune reactions resulting from targeting immune checkpoints can have fatal consequences, including  myocarditis and encephalitis 44 , 45 , 46 . Chemotherapy can lead to death as a result of acute neutropenic sepsis 47 . Depletion of platelets because of therapy can lead to fatal bleeding 16 . Arrhythmias, cardiomyopathy and coronary vasospasm are also a cause of death related to some anticancer treatments such as 5-fluorouracil and capecitabine 48 , 49 , 50 . The long-term detrimental effects of some therapies are discussed in detail subsequently.

Underlying causes

Determination of the proximal cause of mortality prompts further questions around the underlying factors giving rise to lethal pathology and ultimately how metastatic cancer triggers or accelerates those factors. In this section, we consider how chronic disruption of three major physiological organ systems is perturbed in patients with cancer and how these might contribute to mortality.

The immune and haematopoietic systems

In patients with cancer, the immune system becomes progressively less able to mount effective responses to infectious challenge, a phenomenon often generically termed ‘immune exhaustion’ (this usage is distinct from the more specific usage of immune exhaustion as a failure of tumour-reactive T cells to function). As a result, patients with metastatic disease have increased susceptibility to a wide range of infections and typically suffer more severe consequences than would otherwise be observed in healthy individuals 51 . Multiple mechanisms contribute to the reduced capability of the immune system to respond to infection. The presence of cancer cells in diverse organs triggers similar cellular and molecular events to wound responses 52 . The production of cytokines including interleukin 6 (IL-6), granulocyte colony-stimulating factor (GCSF) and granulocyte–macrophage colony-stimulating factor (GM–CSF), both by tumour cells and by other cells of the tumour microenvironment (TME), perturbs haematopoiesis leading to altered subsets of leukocytes 53 . Although, in the short term, this may have limited consequences on the ability of the body to respond to other challenges, prolonged disruption to haematopoiesis can strain the ability of haematopoietic stem cells (HSCs) to generate sufficient cells of the right type to cope with infections, with increased myeloid-to-lymphoid cell ratios.  Clonal haematopoiesis can be increased in patients with cancer, with myeloid skewing of immune cells and overall myeloid-mediated immune suppression and diminished naive T cell reservoirs 53 . Reduced production of platelets and altered iron metabolism leading to compromised oxygen carrying by red blood cells is also observed in many patients 54 . Other problems such as  immunoparesis can arise, with a high frequency observed in patients with multiple myeloma 55 .

T cell responses to infection are impaired in the presence of cancer with decreased proliferation and expression of granzyme B typically observed 56 . The chronic stimulation of T cells with neoantigens arising from ongoing mutational processes may also contribute to their weakened functionality. Moreover, immune surveillance of tumours inevitably selects for the production of immune suppressive factors by cancer cells, which further compound the issue 57 . Once again, comorbidities leading to either immune suppression or autoimmunity can intersect with the detrimental effects of cancer on the immune system.

Other consequences of cancer can indirectly result in an increased likelihood of infection. For example, vessel obstruction from cancer results in decreased flow of fluids such as bile, urine and lymph, creating environments in which bacteria can thrive 58 . Blockage of the bronchial tree can lead to pneumonia 59 . The invasive phenotype of cancer can result in  fistula formation (for example, rectovaginal in colorectal cancer), which enables bacteria to invade 60 . Furthermore, patients are often rendered bedbound or have limited mobility as cancer progresses, resulting in an increased chance of infections through decreased respiratory ventilation and atelectasis , as well as pressure sores and oedema 61 .

Disruption to haematopoiesis can also contribute to defects in coagulation and haemostasis . Elevated platelet numbers, termed thrombocytosis, are found in patients with cancer and are correlated with higher mortality 62 . The altered inflammatory cytokine milieu caused by the tumour may promote megakaryopoiesis, potentially through increasing thrombopoietin (TPO) production by the liver, and leading to higher platelet numbers. The risk of clotting can be further increased by the production of  tissue factor , which is responsible for initiating the clotting cascade, by tumour cells 63 . These mechanisms increase the likelihood of fatal thromboembolisms 63 .

Iatrogenic effects also have a role in the reduced immune function in patients with cancer. Cytotoxic therapies interfere with the proliferation and division of haematopoietic stem cells and can leave the immune system unable to mount effective responses to pathogens, leading to mortality 64 . In severe cases, pancytopenia results, marked by a substantial decrease in all three major blood cell lineages (red cells, white cells and platelets) 65 . This can lead to severe anaemia, increased infection susceptibility and increased likelihood of bleeding 47 , 66 , 67 . In other cases, more limited subsets of haematopoietic cells are affected. Thrombocytopenia — low platelet levels — leads to hypocoagulation and elevates the likelihood of haemorrhage 66 . Therefore, during cancer development and treatment, haemostasis mechanisms may be either augmented or attenuated; in both cases, the result is less predictable and less well-controlled coagulation. Neutropenia — low neutrophil levels — renders patients less able to fight infection and contributes to cancer mortality from infections that in many cases are thought to arise from resident mucosal flora 68 . Treatments, including chemotherapy and radiotherapy, often result in the breakdown of mucosal barriers (for example, oral mucositis) resulting in higher numbers of infections from pathogens, which normally reside on these surfaces 69 . In addition, corticosteroids, which are often given to alleviate symptoms or manage toxicity, can also contribute to the suppression of immune responses and compound the risk of infections in patients 70 . Clonal haematopoiesis, which as mentioned earlier is already more frequent in patients with cancer, can be further increased by chemotherapy 71 . More generally, cancer therapies can increase ageing-associated processes and reduce organ function 72 . Opioid pain relief administered to those with late-stage disease can also suppress the function of various bodily systems 73 . Finally, infections can arise owing to the insertion of drains and stents, or central venous catheters (CVCs; also known as lines) for the delivery of therapies. Infections from such lines are estimated to be around 0.5–10 per 1,000 CVC-days 74 , 75 .

Immunotherapies present a different set of immune complications from conventional therapies. These primarily relate to over-activation of the immune system leading to autoimmunity and, in some cases, cytokine storms that are treated with anti-cytokine therapies such as tocilizumab, anakinra and ruxilitinib, all of which can further suppress the immune response 76 . However, deaths attributable to autoimmune side effects of immune checkpoint inhibitors are rare (<1% in an analysis of more than 8,000 patients) especially if toxicity is managed promptly 77 , 78 . Colitis is a frequent problem, with disruption to colonic barrier function leading to increased susceptibility to perforation, which can be life-threatening.  Guillain–Barré syndrome , hepatitis and myocarditis are also causes of immune checkpoint inhibitor-related deaths 79 , 80 , 81 . Once again, high-dose corticosteroids are the main first-line treatment to manage autoimmune side effects in patients receiving immunotherapy and can lead to suppression of the immune system.  Hyperprogressive disease is observed in some patients following immunotherapy, the reasons for which are still being delineated, but there is probably a role for innate lymphoid cells releasing pro-growth cytokines 82 . Cell-based immunotherapies can also lead to disrupted bone marrow function and subsequent myelosuppression 83 .

The nervous system

The brain serves as a central nexus, orchestrating all vital functions. It is the hub of thought processes, emotions and sensory perception and regulates, directly or indirectly, everything from heartbeat and breathing to appetite. In addition to physical disruption of brain structure and intracranial pressure (discussed earlier) 84 , brain metastases impact the nervous system in multiple ways. Tumours in the brain or its surrounding tissues can substantially impair neural connections, leading to cognitive deficits, motor and sensory dysfunction, and even personality changes 84 , 85 , 86 . Interactions between brain metastases and neurons lead to changes in cortical function 87 , 88 , 89 . Even in regions of the brain without overt metastases, neuro-excitability can be increased, leading to changes in cognition, alertness and mood 90 . Tumours can slow the posterior dominant rhythm, leading to reduced alertness, loss of working memory and deterioration of quality of life 91 . Circadian rhythms are also impacted, leading to problems in memory and sleep, which is vital for the repair processes of the body that are essential for overall health and functioning 92 . Ultimately, many of these changes are not sustainable long-term. How these changes may lead to death is unclear, but they may follow similar trajectories to those in patients with dementia.

Brain function can also be disrupted in patients without brain metastases, with autonomic nervous system dysfunction often reported 93 . Intriguingly, anhedonia — a lack of ability to experience pleasure — occurs in many patients 94 . The mechanistic causes of this are unclear, but it is not restricted to patients with brain metastasis suggesting that circulating systemic factors may play a role. The wider effects of metastatic cancer on the mental well-being of a patient are discussed in Box  1 . However, beyond an effect on well-being, the disruption of brain function can contribute to anorexia, and reduced nutrition can influence many other physiological and pathophysiological processes 95 , 96 .

The role of the  peripheral nervous system in cancer-related death is not well described. Although the burgeoning field of cancer neuroscience provides evidence that the efferent system can support local and metastatic tumour growth 97 , 98 , 99 , at this time, it is unclear whether the reverse is also true. As mentioned earlier, there is clear evidence of autonomic nervous system dysfunction in patients with cancer 93 , raising the possibility that cancer-mediated interruption of afferent impulses might impact overall survival. Further studies are needed to explore this possibility.

Box 1 Psychosocial and societal factors contributing to the deterioration of patients with late-stage cancer

Psychological and social factors can have major and wide-ranging impacts on patients with incurable cancer. This manifests in more than threefold higher suicide rates 145 , 146 , 147 . Of note, these rates were further exacerbated in less advantaged sociodemographic groups 148 , arguing that financial issues and possibly health-care access are linked to suicide in patients with cancer. However, psychological symptoms are far more extensive than those captured in studies of suicide. Anhedonia and depression are frequent in patients with cancer, impacting their overall well-being, treatment adherence and outcomes including mortality 149 . These psychological challenges often intertwine with physical symptoms, compounding the burden of each 150 . Several studies have linked stress-related psychosocial factors to cancer mortality 151 , with recent work beginning to uncover the cellular and molecular mechanisms at play 152 .

Research on the psychosocial aspects of cancer care, including emotional and cognitive well-being, remains under-emphasized. Barriers to the integration of psychosocial care into cancer care include stigma, difficulty identifying substantial distress, limited access to evidence-based psychosocial treatments and concerns about cost 153 . Yet, an integrated system of psychosocial care including population-based screening and targeted treatment and access to good-quality palliative care improves emotional wellbeing 154 and physical symptoms 155 and is likely to be cost-saving 156 . A deeper understanding of the mechanisms underlying neuropsychological systems and insights into how metastatic disease impacts the physiological and chemical axes of the brain will be crucial. Such insights could inform tailored interventions, therapies and support structures that address the emotional toll of cancer, enhancing the holistic care approach and improving quality of life. Expanding psychosocial research can help bridge gaps in addressing mental health in patients with cancer, ultimately improving quality of life of patients during and after treatment 146 , 147 .

Metabolism and cachexia — catabolic effects of cancer

The presence of metastases presents altered energetic and anabolic demands on the body, leading to detrimental imbalances in metabolism 100 . Progressive and involuntary loss of body weight — termed cachexia — is a widespread multiorgan phenomenon commonly seen in patients with metastatic cancer 100 , 101 . This complex syndrome is characterized by a net negative energy balance, driven by the combination of increased energy expenditure and catabolism, with reduced appetite and caloric intake. A persistent decrease in nutrient intake is a key component across patients with many different cancer types, leading to breakdown of host tissues, with the degree of loss of adipose tissue and muscle mass varying between patients and among different cancer types 102 . However, the contribution of increased energy expenditure (as a result of tumour burden) is less clear.  Sarcopenia may be particularly prominent in some patients, possibly representing an independent pathology from other more global tissue wasting phenotypes, and in extreme cases, loss of cardiac or intercostal muscle mass can be fatal owing to insufficient cardiac or respiratory function, respectively 103 , 104 . These events have also been observed in the context of extreme starvation in patients with non-cancer conditions; for example, anorexia nervosa, in which cardiac dysfunction, in particular bradycardia and sinus pauses, can cause pulseless electrical activity and death 105 , 106 . Electrolyte disturbances and hypoglycaemia that are often observed in cases of severe malnutrition may exacerbate the risk of such arrhythmias 105 . Cachexia also has effects on other organs and tissues, including the brain and immune system 107 . Compromised immune function is a major consequence of starvation-induced tissue wasting 108 and suggests that altered systemic metabolism leading to, or associated with cachexia, may be a contributor to the immune dysfunction present in some patients with cancer 108 . Conversely, several studies have shown that both the brain and immune system can contribute to cachexia 100 , 101 .

Cachexia is multifactorial and has many potential causes. In some limited cases, tumour metabolism leads to systemic changes that increase energy usage. For example, high levels of lactate secretion by tumours can trigger the liver to convert lactate back to glucose, which requires energy input — termed the Cori cycle 109 . Such cycles can increase metabolic demand on the liver leading to further perturbation of liver function. However, cachexia does not correlate with disease volume in many cancer types 110 . Therefore, it is hard to reconcile a model in which the energetic and anabolic demands of the volume of disease are the main trigger for cachexia. Numerous studies have begun to reveal the possible molecular underpinnings of cachexia in some cancer types. Disruption of signalling by transforming growth factor-β (TGFβ) and related ligands is a recurring theme 111 , 112 , 113 . For example, circulating growth/differentiation factor 15 (GDF15; also known as MIC1), a highly conserved member of the TGFβ superfamily, is a known mediator of anorexia and weight loss, and increased circulating levels of this molecule in patients with lung cancer have been shown to correlate with cachexia development 114 . Clinical trials are currently underway to determine whether blockade of GDF15 ameliorates cachexia 115 . TGFβ itself can also promote muscle loss via the induction of myostatin 116 , and the induction of signalling by activin — another TGFβ superfamily ligand — can also have similar effects on muscle mass 117 , 118 . Furthermore, modulation of ryanodine receptor 1 (RYR1) downstream of TGFβ can perturb sarcomere organization and thereby lead to muscle weakness 111 . As such, preclinical studies have demonstrated the potential utility of TGFβ blockade in preventing cachexia 112 .

Elevated levels of cytokines, including tumour necrosis factor (TNF), IL-1 and IL-6, can also have roles in cachexia 119 , 120 , 121 . TNF induces multiple aspects of cachexia 122 . Muscle wasting is promoted through increased TNF and downstream nuclear factor-κB (NF-κB)-dependent ubiquitin-mediated proteolysis of muscle protein 123 , 124 . IL-6 triggers muscle loss through both NF-κB-dependent and JAK/STAT-dependent mechanisms 120 . Lipid metabolism is impacted by TNF reducing the expression of lipoprotein lipase and free fatty acid transporters, thereby reducing the accumulation of fat 125 . TNF can also reduce appetite through the production of  corticotropin-releasing hormone (CRH). IL-1, which triggers similar proximal changes in cell signalling to TNF, can activate many of the same processes 125 . It is also interesting to note that TGFβ, IL-1 and IL-6 are associated with programmes in cancer cells that drive metastasis, which could potentially explain why metastatic disease is linked to cachexia more strongly than the presence of primary disease alone.

Whole body dysfunction

Although consideration of different organ systems is useful for highlighting some of the key events contributing to cancer mortality, the interconnected nature of body systems and the pleiotropic characteristics of the molecular mediators at play mean that it is essential to consider whole body dysfunction when thinking about causes of cancer mortality. Furthermore, such analyses may explain cancer deaths without an acute proximal cause. As discussed earlier, cytokines with potent effects on the immune system, as well as effects on appetite, can be contributors to cachexia. Therefore, it is unsurprising that tumours impact both immune and metabolic function. The immune and nervous systems are highly sensitive to metabolite availability; for example, the brain has a high demand for glucose 108 , 126 . Several factors, including lactic acid production and kidney dysfunction, can lead to life-threatening systemic acidosis in patients with cancer, particularly haematological malignancies with high cell turnover 127 . These can be further exacerbated upon initiation of cytotoxic therapy resulting in  tumour lysis syndrome which can be fatal 128 . Consequently, metabolic perturbations and cachexia impact these systems. Over time, the cumulative stress of metabolic alterations caused by metastases, chronic changes in the level of cytokines, constant generation of tumour (neo)-antigens, aggressive therapies and incidental infections lead to exhaustion of the adaptive immune system and hamper the regenerative capacity of many organ systems with debilitating effects 18 . This multifaceted burden can ultimately trigger a body-wide shutdown leading to death.

Are mortality causes cancer-specific?

Although a subset of mortality causes are cancer-specific, such as metastatic invasion compromising specific organ function, the progressive and interconnected deterioration of multiple organ systems probably underlies many cancer-related deaths. This may be further influenced by interaction with other comorbidities. Of note, similar progressive deterioration is sometimes observed in the context of chronic infection and inflammation, with both cachexia and immune exhaustion associated with diseases such as tuberculosis (TB) and human immunodeficiency virus (HIV) infection 129 , 130 , 131 . This raises the question of whether the causes of death in patients with cancer are specific to cancer, or whether cancer (or any other chronic disease) is simply an accelerant of ageing processes occurring in healthy individuals. This hypothesis has practical implications because, if proven, it would suggest that lessons and approaches from other disease contexts could be readily transferable to patients with metastatic cancer. For example, the targeting or modulation of senescent cells is an active area of anti-ageing research, and numerous preclinical studies have indicated that similar strategies can attenuate the systemic effects of cancer 132 , 133 , 134 .

Recommendations

One goal of this Roadmap is to propose ways to improve our understanding of why patients with cancer die and thereby develop better strategies to ameliorate symptoms and prolong life with good quality. To this end, we propose that the following steps would be useful (Fig. 2 ).

This scheme shows how recommendations can interlink to provide both an improved understanding of the underlying biology behind late-stage cancer and strategies to improve quality of life of patients.

Improved records and reporting

It is notable that systematic reviews of the precise causes of cancer mortality are infrequent. This gap in knowledge, and recognition that this is often simply not known, is a major hindrance to learning and progress. Although improved accuracy of reporting on death certificates would be desirable, it would require a shift in longstanding clinical habits and may not be easily achievable in health-care systems under strain. Nonetheless, we advocate for locally enacting more consistency in death certificates, with specific acute causes included in addition to the underlying cause of cancer where known. Palliative care primarily focuses on symptom control for patients while balancing the potential benefits and burdens of additional diagnoses. Nevertheless, to address the gaps in our knowledge, it would be desirable to fund and establish prospective studies that continue active monitoring of patients as they transition from active disease treatment to palliative care. If possible, monitoring should be non-invasive as to not compromise patient comfort at the end of life. The great advances being made in patient monitoring with  wearable technologies might facilitate this and could be used for earlier detection of infections enabling quicker intervention. Caregiver involvement in reporting of symptoms may also play a role. Furthermore, consent to obtain more detailed information from the community and palliative care teams on the contributing factors to death would provide further insight. Patient and public engagement in this type of research will be critical, with studies indicating patient desire to participate in the right context 135 , 136 . In addition to information gathered before death, research autopsies have the potential to shed further light on the aetiology of death, such as thromboembolic events that may not have been detected in the absence of symptoms or diagnostic testing — discussed in Box  2 . Moreover, the availability of post-mortem samples can aid research into the biological underpinnings of metastases and processes leading to death. The greatest amount of information would be gained from cohorts additionally enrolled into warm autopsy programmes (Box  2 ).

Box 2 Research Autopsy Programmes and their optimization

Research autopsies are initiatives that involve the prompt collection of tissues from deceased individuals shortly after death, whereas tissue morphology is intact, and cells and tissues have not undergone substantial post-mortem changes. Research autopsy studies can be labour-intensive, and care is required in their logistical planning. The post-mortem interval (PMI) to autopsy can vary depending on the infrastructure available and can have implications for the utility of samples collected after death. For example, shorter PMIs achieved in rapid warm autopsy studies can more effectively facilitate in vitro (for example, cell line) and in vivo (for example, organoid and xenograft) models and can derive better quality RNA 157 , 158 . However, such studies are not easily established in the absence of out-of-hours facilities and expert input. Autopsies performed with longer PMIs, for example, up to several days after death, have been shown to have maintained tissue morphology and adequate DNA and RNA to facilitate cellular imaging techniques and genomic sequencing approaches 159 , 160 . Therefore, there is merit and general scientific value with autopsies regardless of the PMI, provided that consideration is given to the question being addressed, and the experimental approach.

The most powerful data are obtained from patients already involved in clinical studies before death. Information about disease course, longitudinal scans and tissue and blood analysis (cell counts, electrolytes, cytokines, metabolites and possibly circulating tumour DNA (ctDNA)) greatly enhances what can be learnt from post-mortem tissues. However, sensitivity is required to align the desire to acquire data with the wishes of the patients and their families, such that ultimately each autopsy has the potential to be meaningful and shed light on the biological processes leading to death.

More detailed observational clinical studies

Disease burden is not well correlated with survival; however, we propose that the accurate identification of prognostic factors correlating with survival should provide important insights into what ultimately precipitates mortality. As the cost of both targeted and non-targeted analyses of proteins and metabolites decreases, it should also become more feasible to explore molecular predictors of survival. Once identified, such factors could then be monitored in a targeted way prospectively with the potential to intervene where possible. In this setting, both the tumour and patient trajectory would receive precision-tailored treatments, the impact of which would need to be studied in randomized controlled trials. Even in the context of early phase trials, additional data could be obtained about patient symptoms in addition to safety considerations and tumour burden. Clinical imaging could also be exploited. Many patients receive computed tomography (CT) and positron-emission tomography (PET) scans, which contain abundant information about the burden and location of metastases and offer the opportunity to study changes in extent of adipose and muscle tissue and therefore body composition in relation to cachexia. Machine learning and artificial intelligence can be capitalized on to accurately measure these parameters, meaning that what would have previously been prohibitive owing to hours of radiologist time being required is now feasible 137 , 138 . In addition to the analysis of scans, the application of machine-learning approaches to metabolite, cytokine, immune cell and wearable technology-derived multimodal and multidimensional data may also uncover previously unknown parameters that correlate with mortality 139 . As outlined in Box  1 , incorporating psychosocial metrics into the study of late-stage cancer could also enable improvements in mental well-being of patients.

Increasing the relevance of model systems

Preclinical models will also have a place in determining the linkage between events found to precede death and cause of death; however, there should be an emphasis on reverse translation of questions from human studies to preclinical models. By way of example, this could involve modelling how metastases impinge on the ability of the body to respond to infection by challenging metastatic mouse models with a pathogen. Animal ethics and husbandry considerations mean that mice are housed in controlled environments in which exposure to pathogens is rare and the types of pathogen exposure are very narrow, so this type of information is currently lacking. To be optimally informative, practical and ethical complications around studying end-of-life physiology seen in patients need to be considered. Most models are chosen for their rapid progression, often with less than a month between primary or metastatic tumour seeding and death. These are not optimal for studying longer timescale chronic changes in patients. The development of slower progressing models, implementation of multiple lines of treatment and mimicking presence of other comorbidities should enable models to more accurately recapitulate observations made in patients. Furthermore, most preclinical cancer research currently uses young mice that fail to accurately mirror the interplay between ageing and cancer seen in humans 140 , with differences between chronological and immunological age providing a further confounding factor 141 . Researchers need to recognize the importance of and adopt more age-appropriate mouse models to better understand cancer mortality. In addition, most studies focus solely on tumour burden (which may only be possible at the point of death rather than longitudinally) or tumour size as a marker of disease, owing to the technical challenges of accurately quantifying organ impairment. Furthermore, tumour volume response and progression are poor surrogates of mortality in patients 142 ; therefore, better modelling of other metrics of tumour activity and impact on the body system may lead to better drug development. Minimizing and alleviating suffering in experimental animals is critical; hence ethical considerations limit the ability to study mortality in mice. Therefore, an expanded repertoire of analysis would help to understand how metastases impact specific systems and events, including the haematopoietic and nervous systems, as well as whole-body physiology and metabolism. Analysis of small volumes of blood can provide data on metabolites and cytokines, as well as complete blood counts (red blood cells, white blood cells and platelets), whereas increasingly sophisticated and automated technology is available to monitor mouse behaviour 143 . It is worth noting that weight loss is frequently used as a humane end point, which indicates that many cancer models trigger cachexia and that with appropriate measurements there is an opportunity to learn more about this phenomenon in existing models. We advocate more detailed reporting of why mice were culled in experimental studies — for example, tumour volume, weight loss, laboured breathing, complete blood cell counts and blood chemistry.

Clinical trials

The types of analyses detailed earlier will provide correlation between different factors and mortality, but not causative linkage. Ultimately, this information depends on testing in the context of clinical trials. Many of the mediators of immune dysfunction and cachexia can now be targeted with function blocking antibodies or forms of receptor traps and are being actively explored in clinical trials 115 , 144 . Several of these interventions were originally developed for chronic inflammatory conditions, which further highlights links between cancer and inflammation. The use of appropriately chosen secondary end points would provide an opportunity for testing whether correlative associations have a causal basis. In addition, many cancer drug trials stop providing an intervention at the point where a cancer progresses. The mechanisms behind cancer cachexia suggest that trials should be adapted to additionally consider clinical benefit in terms of weight, muscle loss and other specific determinants of efficacy, rather than solely monitor cancer progression.

Concluding remarks

Although efforts at cancer prevention and the development of curative treatment rightly receive considerable attention, we argue that understanding the precise events leading to cancer mortality should not be overlooked by funding bodies. Understanding the causes of dysfunction across multiple organ systems may provide novel strategies to manage symptoms of advanced cancer. Furthermore, better knowledge of the processes leading to death could enable patients and those around them to have essential discussions about their wishes and preferences, minimizing potentially inappropriate treatments and maximizing quality and enjoyment of life. In addition, more precise biomarkers of the likely timing of death may enable patients and their families to better utilize the time that is left. In the longer term, strategies to prevent organ dysfunction should offer considerable benefits to both patients with high tumour burden and those who have low disease burden but die from factors produced by cancer.

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Acknowledgements

A.B. is funded by National Institutes of Health/National Cancer Institute P30 CA008748 and R01-CA245499. K.B. is employed by the UK National Health Service. T.R.C. acknowledges funding support from the National Health and Medical Research Council (NHMRC) Ideas (2000937), Project (1129766, 1140125), Development (2013881) and Fellowship (1158590) schemes, a Cancer Institute NSW Career Development Fellowship (CDF171105), Cancer Council NSW project support (RG19-09, RG23-11) and Susan G. Komen for the Cure (CCR17483294). T.G. is funded by the Cancer Prevention and Research Institute of Texas Grant 00011633. M.J.-H. has received funding from CRUK, NIH National Cancer Institute, IASLC International Lung Cancer Foundation, Lung Cancer Research Foundation, Rosetrees Trust, UKI NETs and NIHR. T.J. acknowledges funding from Cancer Grand Challenges (NIH: 1OT2CA278690-01; CRUK: CGCATF-2021/100019), the Mark Foundation for Cancer Research (20-028-EDV), the Osprey Foundation, Fortune Footwear, Cold Spring Harbour Laboratory (CSHL) and developmental funds from CSHL Cancer Center Support Grant 5P30CA045508. R.K. is funded by the Intramural Research Program, the National Cancer Institute, NIH Clinical Center and the National Institutes of Health (NIH NCI ZIABC011332-06 and NIH NCI ZIABC011334-10). R.L. is supported by a Wellcome Early Career Investigator Award (225724/Z/22/Z). E.S. is supported by the Francis Crick Institute, which receives its core funding from Cancer Research UK (CC2040), the UK Medical Research Council (CC2040) and the Wellcome Trust (CC2040) and the European Research Council (ERC Advanced Grant CAN_ORGANISE, Grant agreement number 101019366). E.S. reports personal grants from Mark Foundation and the European Research Council. C.S. is a Royal Society Napier Research Professor (RSRP\R\210001). His work is supported by the Francis Crick Institute that receives its core funding from Cancer Research UK (CC2041), the UK Medical Research Council (CC2041) and the Wellcome Trust (CC2041) and the European Research Council under the European Union’s Horizon 2020 research and innovation programme (ERC Advanced Grant PROTEUS Grant agreement number 835297). M.G.V.H. reports support from the Lustgarten Foundation, the MIT Center for Precision Cancer Medicine, the Ludwig Center at MIT and NIH grants R35 CA242379 and P30 CA1405141.

Author information

These authors contributed equally: Adrienne Boire, Katy Burke, Thomas R. Cox, Theresa Guise, Mariam Jamal-Hanjani, Tobias Janowitz, Rosandra Kaplan, Rebecca Lee, Charles Swanton, Matthew G. Vander Heiden, Erik Sahai.

Authors and Affiliations

Memorial Sloan Kettering Cancer Center, New York, NY, USA

Adrienne Boire

University College London Hospitals NHS Foundation Trust and Central and North West London NHS Foundation Trust Palliative Care Team, London, UK

Cancer Ecosystems Program, The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia

Thomas R. Cox

School of Clinical Medicine, St Vincent’s Healthcare Clinical Campus, UNSW Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia

Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Theresa Guise

Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK

Mariam Jamal-Hanjani

Department of Oncology, University College London Hospitals, London, UK

Mariam Jamal-Hanjani & Charles Swanton

Cancer Research UK Lung Centre of Excellence, University College London Cancer Institute, London, UK

Cold Spring Harbour Laboratory, Cold Spring Harbour, New York, NY, USA

Tobias Janowitz

Northwell Health Cancer Institute, New York, NY, USA

Paediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

Rosandra Kaplan

Tumour Cell Biology Laboratory, The Francis Crick Institute, London, UK

Rebecca Lee & Erik Sahai

Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

Rebecca Lee

Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK

Charles Swanton

Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA

Matthew G. Vander Heiden

Dana-Farber Cancer Institute, Boston, MA, USA

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Contributions

All authors researched data for the article. A.B., K.B., T.R.C., T.G., T.J., C.S., M.G.V.H, R.K., M.J.-H. and E.S. contributed substantially to discussion of the content. T.C., R.L. and E.S. wrote the article. All authors reviewed and/or edited the manuscript before submission.

Corresponding authors

Correspondence to Thomas R. Cox or Erik Sahai .

Ethics declarations

Competing interests.

A.B. is an inventor on pending patents 63/449,817, 63/052,139 as well as awarded patents 11,305,014 and 10,413,522; all issued to the Sloan Kettering Institute. She has received personal fees from Apelis Pharmaceuticals and serves as an unpaid member of the Evren Technologies SAB. K.B., T.R.C., T.G., T.J. and R.K. declare no competing interests. M.J.-H. reports support from Achilles Therapeutics Scientific Advisory Board and Steering Committee, Pfizer, Astex Pharmaceuticals, Oslo Cancer Cluster and Bristol Myers Squibb outside the submitted work. R.L. reports personal fees from Pierre Fabre and has research funding from BMS, Astra Zeneca and Pierre Fabre outside the submitted work. E.S. reports grants from Novartis, Merck Sharp Dohme, AstraZeneca and personal fees from Phenomic outside the submitted work. C.S. reports grants and personal fees from Bristol Myers Squibb, AstraZeneca, Boehringer-Ingelheim, Roche-Ventana, personal fees from Pfizer, grants from Ono Pharmaceutical, Personalis, grants, personal fees and other support from GRAIL, other support from AstraZeneca and GRAIL, personal fees and other support from Achilles Therapeutics, Bicycle Therapeutics, personal fees from Genentech, Medixci, China Innovation Centre of Roche (CiCoR) formerly Roche Innovation Centre, Metabomed, Relay Therapeutics, Saga Diagnostics, Sarah Canon Research Institute, Amgen, GlaxoSmithKline, Illumina, MSD, Novartis, other support from Apogen Biotechnologies and Epic Bioscience outside the submitted work; in addition, C.S. has a patent for PCT/US2017/028013 licensed to Natera Inc., UCL Business, a patent for PCT/EP2016/059401 licensed to Cancer Research Technology, a patent for PCT/EP2016/071471 issued to Cancer Research Technology, a patent for PCT/GB2018/051912 pending, a patent for PCT/GB2018/052004 issued to Francis Crick Institute, University College London, Cancer Research Technology Ltd, a patent for PCT/GB2020/050221 issued to Francis Crick Institute, University College London, a patent for PCT/EP2022/077987 pending to Cancer Research Technology, a patent for PCT/GB2017/053289 licensed, a patent for PCT/EP2022/077987 pending to Francis Crick Institute, a patent for PCT/EP2023/059039 pending to Francis Crick Institute and a patent for PCT/GB2018/051892 pending to Francis Crick Institute. C.S. is Co-chief Investigator of the NHS Galleri trial funded by GRAIL. He is Chief Investigator for the AstraZeneca MeRmaiD I and II clinical trials and Chair of the Steering Committee. C.S. is cofounder of Achilles Therapeutics and holds stock options. M.G.V.H. is a scientific adviser for Agios Pharmaceuticals, iTeos Therapeutics, Sage Therapeutics, Faeth Therapeutics, Droia Ventures and Auron Therapeutics on topics unrelated to the presented work.

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An autoimmune encephalitis characterized by complex neuropsychiatric features and the presence of immunoglobulin G (IgG) antibodies against the NR1 subunit of the NMDA receptors in the central nervous system.

Partial collapse or incomplete inflation of the lung.

Pressure-induced movement of brain tissue.

An ageing-associated process in which haematopoiesis becomes dominated by one or a small number of genetically distinct stem or progenitor cells. Clonal haematopoiesis is linked to an increased risk of haematological malignancies.

Inability of the heart to pump blood properly.

Constriction of the arteries that supply blood to the heart.

(CRH). One of the major factors that drives the response of the body to stress.

(DIC). A rare but serious condition in which abnormal blood clotting occurs throughout the blood vessels of the body.

Inflammation of the brain.

An abnormal connection that forms between two body parts, such as an organ or blood vessel and another often unrelated structure in close proximity.

A rare disorder in which the immune system of a body attacks the nerves, which can lead to paralysis.

The stopping of flow of blood, typically associated with the bodies response to prevent and stop bleeding.

A build-up of fluid within the cavities of the brain.

Elevated calcium levels in the blood, often caused by overactive parathyroid glands. Hypercalcaemia is linked to kidney stones, weakened bones, altered digestion and potentially altered cardiac and brain function.

(HPD). Rapid tumour progression sometimes observed during immune checkpoint inhibitor treatment.

The condition that occurs when the level of sodium in the blood is low.

Harm, which is often unavoidable, caused by cancer treatments.

The marked suppression of polyclonal immunoglobulins in the body.

(LEMS). A neuromuscular junction disorder affecting communication between nerves and muscles, which manifests as a result of a paraneoplastic syndrome or a primary autoimmune disorder. Many cases are associated with small-cell lung cancer.

When cancer cells spread to the tissue layers covering the brain and spinal cord (the leptomeninges).

Also known as pulmonary oedema is a condition caused by excess fluid in the lungs. This fluid collects in the alveoli compromising function and making it difficult to breathe.

The observation of displacement of brain tissue across the centre line of the brain, suggestive of uneven intracranial pressure.

Decreased blood flow to the myocardium, commonly called a heart attack.

Inflammation specifically of the middle layer of the heart wall.

A group of rare disorders that occur when the immune system reacts to changes in the body triggered by the presence of a neoplasm.

A dense network of nerves that transmit information from the brain (efferent neurons) to the periphery and conversely transmit information from the periphery to the brain (afferent neurons). A component of the peripheral nervous system is the autonomic nervous system.

A build-up of fluid between the tissues that line the lungs and the chest wall.

A condition characterized by loss of skeletal muscle mass and function.

The lodging of a circulating blood clot within a vessel leading to obstruction. Thromboembolisms may occur in veins (venous thromboembolism) and arteries (arterial thromboembolism).

A key component of the pathway regulating blood clotting, specifically the receptor and cofactor for factor VII/VIIa.

A syndrome occurs when tumour cells release their contents into the bloodstream, either spontaneously or more typically, in response to therapeutic intervention.

Devices worn on the body, typically in the form of accessories or clothing, that incorporate advanced electronics and technology to monitor, track or enhance various aspects of human life. Examples include smartwatches and fitness trackers.

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Boire, A., Burke, K., Cox, T.R. et al. Why do patients with cancer die?. Nat Rev Cancer 24 , 578–589 (2024). https://doi.org/10.1038/s41568-024-00708-4

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Strengthening akis for sustainable agricultural features: insights and innovations from the european unio: a literature review.

1. Introduction

2. materials and methods, 2.1. data collection procedure, 2.2. identification criteria, 2.3. screening and selection criteria, 2.4. eligibility and inclusion criteria.

• The studies that were carried out or considered the 28 countries in the European Union (including the United Kingdom until 2019 and excluding Romania).
• Studies published in the English Language.
• Studies that were published within the past 11 years (the review covers the period from 2014 to 2024, a period in which the two previous Programming Periods of the Common Agricultural Policy were implemented).
• Studies covering the inclusion of a transparent description of the process of data acquisition and interpretation.
• Studies covering a primary or secondary class investigation on the subject matter.
• Studies showcasing the effects of AKISs and FASs on agricultural knowledge advancement.
• Studies published in a non-English language.
• Studies carried out outside the EU.
• Studies with unclear methodology of data collection and analysis.
• Studies lacking author names and affiliation.
• Studies not covering both the main issues of this review (i.e., AKIS and FAS).

4. Discussion

4.1. akis and fas in the foreground through the new cap, 4.2. improving the effectiveness of an akis, 5. conclusions, author contributions, institutional review board statement, data availability statement, conflicts of interest.

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Share and Cite

Kountios, G.; Kanakaris, S.; Moulogianni, C.; Bournaris, T. Strengthening AKIS for Sustainable Agricultural Features: Insights and Innovations from the European Unio: A Literature Review. Sustainability 2024 , 16 , 7068. https://doi.org/10.3390/su16167068

Kountios G, Kanakaris S, Moulogianni C, Bournaris T. Strengthening AKIS for Sustainable Agricultural Features: Insights and Innovations from the European Unio: A Literature Review. Sustainability . 2024; 16(16):7068. https://doi.org/10.3390/su16167068

Kountios, Georgios, Spyridon Kanakaris, Christina Moulogianni, and Thomas Bournaris. 2024. "Strengthening AKIS for Sustainable Agricultural Features: Insights and Innovations from the European Unio: A Literature Review" Sustainability 16, no. 16: 7068. https://doi.org/10.3390/su16167068

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• Reumatologia
• v.59(1); 2021

Peer review guidance: a primer for researchers

Olena zimba.

1 Department of Internal Medicine No. 2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Armen Yuri Gasparyan

2 Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, West Midlands, UK

The peer review process is essential for quality checks and validation of journal submissions. Although it has some limitations, including manipulations and biased and unfair evaluations, there is no other alternative to the system. Several peer review models are now practised, with public review being the most appropriate in view of the open science movement. Constructive reviewer comments are increasingly recognised as scholarly contributions which should meet certain ethics and reporting standards. The Publons platform, which is now part of the Web of Science Group (Clarivate Analytics), credits validated reviewer accomplishments and serves as an instrument for selecting and promoting the best reviewers. All authors with relevant profiles may act as reviewers. Adherence to research reporting standards and access to bibliographic databases are recommended to help reviewers draft evidence-based and detailed comments.

Introduction

The peer review process is essential for evaluating the quality of scholarly works, suggesting corrections, and learning from other authors’ mistakes. The principles of peer review are largely based on professionalism, eloquence, and collegiate attitude. As such, reviewing journal submissions is a privilege and responsibility for ‘elite’ research fellows who contribute to their professional societies and add value by voluntarily sharing their knowledge and experience.

Since the launch of the first academic periodicals back in 1665, the peer review has been mandatory for validating scientific facts, selecting influential works, and minimizing chances of publishing erroneous research reports [ 1 ]. Over the past centuries, peer review models have evolved from single-handed editorial evaluations to collegial discussions, with numerous strengths and inevitable limitations of each practised model [ 2 , 3 ]. With multiplication of periodicals and editorial management platforms, the reviewer pool has expanded and internationalized. Various sets of rules have been proposed to select skilled reviewers and employ globally acceptable tools and language styles [ 4 , 5 ].

In the era of digitization, the ethical dimension of the peer review has emerged, necessitating involvement of peers with full understanding of research and publication ethics to exclude unethical articles from the pool of evidence-based research and reviews [ 6 ]. In the time of the COVID-19 pandemic, some, if not most, journals face the unavailability of skilled reviewers, resulting in an unprecedented increase of articles without a history of peer review or those with surprisingly short evaluation timelines [ 7 ].

Editorial recommendations and the best reviewers

Guidance on peer review and selection of reviewers is currently available in the recommendations of global editorial associations which can be consulted by journal editors for updating their ethics statements and by research managers for crediting the evaluators. The International Committee on Medical Journal Editors (ICMJE) qualifies peer review as a continuation of the scientific process that should involve experts who are able to timely respond to reviewer invitations, submitting unbiased and constructive comments, and keeping confidentiality [ 8 ].

The reviewer roles and responsibilities are listed in the updated recommendations of the Council of Science Editors (CSE) [ 9 ] where ethical conduct is viewed as a premise of the quality evaluations. The Committee on Publication Ethics (COPE) further emphasizes editorial strategies that ensure transparent and unbiased reviewer evaluations by trained professionals [ 10 ]. Finally, the World Association of Medical Editors (WAME) prioritizes selecting the best reviewers with validated profiles to avoid substandard or fraudulent reviewer comments [ 11 ]. Accordingly, the Sarajevo Declaration on Integrity and Visibility of Scholarly Publications encourages reviewers to register with the Open Researcher and Contributor ID (ORCID) platform to validate and publicize their scholarly activities [ 12 ].

Although the best reviewer criteria are not listed in the editorial recommendations, it is apparent that the manuscript evaluators should be active researchers with extensive experience in the subject matter and an impressive list of relevant and recent publications [ 13 ]. All authors embarking on an academic career and publishing articles with active contact details can be involved in the evaluation of others’ scholarly works [ 14 ]. Ideally, the reviewers should be peers of the manuscript authors with equal scholarly ranks and credentials.

However, journal editors may employ schemes that engage junior research fellows as co-reviewers along with their mentors and senior fellows [ 15 ]. Such a scheme is successfully practised within the framework of the Emerging EULAR (European League Against Rheumatism) Network (EMEUNET) where seasoned authors (mentors) train ongoing researchers (mentees) how to evaluate submissions to the top rheumatology journals and select the best evaluators for regular contributors to these journals [ 16 ].

The awareness of the EQUATOR Network reporting standards may help the reviewers to evaluate methodology and suggest related revisions. Statistical skills help the reviewers to detect basic mistakes and suggest additional analyses. For example, scanning data presentation and revealing mistakes in the presentation of means and standard deviations often prompt re-analyses of distributions and replacement of parametric tests with non-parametric ones [ 17 , 18 ].

Constructive reviewer comments

The main goal of the peer review is to support authors in their attempt to publish ethically sound and professionally validated works that may attract readers’ attention and positively influence healthcare research and practice. As such, an optimal reviewer comment has to comprehensively examine all parts of the research and review work ( Table I ). The best reviewers are viewed as contributors who guide authors on how to correct mistakes, discuss study limitations, and highlight its strengths [ 19 ].

Structure of a reviewer comment to be forwarded to authors

Some of the currently practised review models are well positioned to help authors reveal and correct their mistakes at pre- or post-publication stages ( Table II ). The global move toward open science is particularly instrumental for increasing the quality and transparency of reviewer contributions.

Advantages and disadvantages of common manuscript evaluation models

Since there are no universally acceptable criteria for selecting reviewers and structuring their comments, instructions of all peer-reviewed journal should specify priorities, models, and expected review outcomes [ 20 ]. Monitoring and reporting average peer review timelines is also required to encourage timely evaluations and avoid delays. Depending on journal policies and article types, the first round of peer review may last from a few days to a few weeks. The fast-track review (up to 3 days) is practised by some top journals which process clinical trial reports and other priority items.

In exceptional cases, reviewer contributions may result in substantive changes, appreciated by authors in the official acknowledgments. In most cases, however, reviewers should avoid engaging in the authors’ research and writing. They should refrain from instructing the authors on additional tests and data collection as these may delay publication of original submissions with conclusive results.

Established publishers often employ advanced editorial management systems that support reviewers by providing instantaneous access to the review instructions, online structured forms, and some bibliographic databases. Such support enables drafting of evidence-based comments that examine the novelty, ethical soundness, and implications of the reviewed manuscripts [ 21 ].

Encouraging reviewers to submit their recommendations on manuscript acceptance/rejection and related editorial tasks is now a common practice. Skilled reviewers may prompt the editors to reject or transfer manuscripts which fall outside the journal scope, perform additional ethics checks, and minimize chances of publishing erroneous and unethical articles. They may also raise concerns over the editorial strategies in their comments to the editors.

Since reviewer and editor roles are distinct, reviewer recommendations are aimed at helping editors, but not at replacing their decision-making functions. The final decisions rest with handling editors. Handling editors weigh not only reviewer comments, but also priorities related to article types and geographic origins, space limitations in certain periods, and envisaged influence in terms of social media attention and citations. This is why rejections of even flawless manuscripts are likely at early rounds of internal and external evaluations across most peer-reviewed journals.

Reviewers are often requested to comment on language correctness and overall readability of the evaluated manuscripts. Given the wide availability of in-house and external editing services, reviewer comments on language mistakes and typos are categorized as minor. At the same time, non-Anglophone experts’ poor language skills often exclude them from contributing to the peer review in most influential journals [ 22 ]. Comments should be properly edited to convey messages in positive or neutral tones, express ideas of varying degrees of certainty, and present logical order of words, sentences, and paragraphs [ 23 , 24 ]. Consulting linguists on communication culture, passing advanced language courses, and honing commenting skills may increase the overall quality and appeal of the reviewer accomplishments [ 5 , 25 ].

Peer reviewer credits

Various crediting mechanisms have been proposed to motivate reviewers and maintain the integrity of science communication [ 26 ]. Annual reviewer acknowledgments are widely practised for naming manuscript evaluators and appreciating their scholarly contributions. Given the need to weigh reviewer contributions, some journal editors distinguish ‘elite’ reviewers with numerous evaluations and award those with timely and outstanding accomplishments [ 27 ]. Such targeted recognition ensures ethical soundness of the peer review and facilitates promotion of the best candidates for grant funding and academic job appointments [ 28 ].

Also, large publishers and learned societies issue certificates of excellence in reviewing which may include Continuing Professional Development (CPD) points [ 29 ]. Finally, an entirely new crediting mechanism is proposed to award bonus points to active reviewers who may collect, transfer, and use these points to discount gold open-access charges within the publisher consortia [ 30 ].

With the launch of Publons ( http://publons.com/ ) and its integration with Web of Science Group (Clarivate Analytics), reviewer recognition has become a matter of scientific prestige. Reviewers can now freely open their Publons accounts and record their contributions to online journals with Digital Object Identifiers (DOI). Journal editors, in turn, may generate official reviewer acknowledgments and encourage reviewers to forward them to Publons for building up individual reviewer and journal profiles. All published articles maintain e-links to their review records and post-publication promotion on social media, allowing the reviewers to continuously track expert evaluations and comments. A paid-up partnership is also available to journals and publishers for automatically transferring peer-review records to Publons upon mutually acceptable arrangements.

Listing reviewer accomplishments on an individual Publons profile showcases scholarly contributions of the account holder. The reviewer accomplishments placed next to the account holders’ own articles and editorial accomplishments point to the diversity of scholarly contributions. Researchers may establish links between their Publons and ORCID accounts to further benefit from complementary services of both platforms. Publons Academy ( https://publons.com/community/academy/ ) additionally offers an online training course to novice researchers who may improve their reviewing skills under the guidance of experienced mentors and journal editors. Finally, journal editors may conduct searches through the Publons platform to select the best reviewers across academic disciplines.

Peer review ethics

Prior to accepting reviewer invitations, scholars need to weigh a number of factors which may compromise their evaluations. First of all, they are required to accept the reviewer invitations if they are capable of timely submitting their comments. Peer review timelines depend on article type and vary widely across journals. The rules of transparent publishing necessitate recording manuscript submission and acceptance dates in article footnotes to inform readers of the evaluation speed and to help investigators in the event of multiple unethical submissions. Timely reviewer accomplishments often enable fast publication of valuable works with positive implications for healthcare. Unjustifiably long peer review, on the contrary, delays dissemination of influential reports and results in ethical misconduct, such as plagiarism of a manuscript under evaluation [ 31 ].

In the times of proliferation of open-access journals relying on article processing charges, unjustifiably short review may point to the absence of quality evaluation and apparently ‘predatory’ publishing practice [ 32 , 33 ]. Authors when choosing their target journals should take into account the peer review strategy and associated timelines to avoid substandard periodicals.

Reviewer primary interests (unbiased evaluation of manuscripts) may come into conflict with secondary interests (promotion of their own scholarly works), necessitating disclosures by filling in related parts in the online reviewer window or uploading the ICMJE conflict of interest forms. Biomedical reviewers, who are directly or indirectly supported by the pharmaceutical industry, may encounter conflicts while evaluating drug research. Such instances require explicit disclosures of conflicts and/or rejections of reviewer invitations.

Journal editors are obliged to employ mechanisms for disclosing reviewer financial and non-financial conflicts of interest to avoid processing of biased comments [ 34 ]. They should also cautiously process negative comments that oppose dissenting, but still valid, scientific ideas [ 35 ]. Reviewer conflicts that stem from academic activities in a competitive environment may introduce biases, resulting in unfair rejections of manuscripts with opposing concepts, results, and interpretations. The same academic conflicts may lead to coercive reviewer self-citations, forcing authors to incorporate suggested reviewer references or face negative feedback and an unjustified rejection [ 36 ]. Notably, several publisher investigations have demonstrated a global scale of such misconduct, involving some highly cited researchers and top scientific journals [ 37 ].

Fake peer review, an extreme example of conflict of interest, is another form of misconduct that has surfaced in the time of mass proliferation of gold open-access journals and publication of articles without quality checks [ 38 ]. Fake reviews are generated by manipulating authors and commercial editing agencies with full access to their own manuscripts and peer review evaluations in the journal editorial management systems. The sole aim of these reviews is to break the manuscript evaluation process and to pave the way for publication of pseudoscientific articles. Authors of these articles are often supported by funds intended for the growth of science in non-Anglophone countries [ 39 ]. Iranian and Chinese authors are often caught submitting fake reviews, resulting in mass retractions by large publishers [ 38 ]. Several suggestions have been made to overcome this issue, with assigning independent reviewers and requesting their ORCID IDs viewed as the most practical options [ 40 ].

Conclusions

The peer review process is regulated by publishers and editors, enforcing updated global editorial recommendations. Selecting the best reviewers and providing authors with constructive comments may improve the quality of published articles. Reviewers are selected in view of their professional backgrounds and skills in research reporting, statistics, ethics, and language. Quality reviewer comments attract superior submissions and add to the journal’s scientific prestige [ 41 ].

In the era of digitization and open science, various online tools and platforms are available to upgrade the peer review and credit experts for their scholarly contributions. With its links to the ORCID platform and social media channels, Publons now offers the optimal model for crediting and keeping track of the best and most active reviewers. Publons Academy additionally offers online training for novice researchers who may benefit from the experience of their mentoring editors. Overall, reviewer training in how to evaluate journal submissions and avoid related misconduct is an important process, which some indexed journals are experimenting with [ 42 ].

The timelines and rigour of the peer review may change during the current pandemic. However, journal editors should mobilize their resources to avoid publication of unchecked and misleading reports. Additional efforts are required to monitor published contents and encourage readers to post their comments on publishers’ online platforms (blogs) and other social media channels [ 43 , 44 ].

The authors declare no conflict of interest.