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How to Write a Peer Review

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

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

Review Outline

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

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

Here’s how your outline might look:

1. Summary of the research and your overall impression

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

2. Discussion of specific areas for improvement

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

Major vs. minor issues

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

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

3. Any other points

Confidential comments for the editors.

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

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

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

Get this outline in a template

Giving Feedback

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

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

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

General guidelines for effective feedback

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

Don’t

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

Before and After: Sample Reviewer Comments

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

✗ Before

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

✓ After

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

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

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

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

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

Suggested Language for Tricky Situations

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

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

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

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

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

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

What does a good review look like?

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

Time to Submit the Review!

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

Tip: Building a relationship with an editor

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

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

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

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

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

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Review of Educational Research

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• Description
• Aims and Scope
• Editorial Board
• Abstracting / Indexing
• Submission Guidelines

The Review of Educational Research ( RER , quarterly, begun in 1931; approximately 640 pp./volume year) publishes critical, integrative reviews of research literature bearing on education. Such reviews should include conceptualizations, interpretations, and syntheses of literature and scholarly work in a field broadly relevant to education and educational research. RER encourages the submission of research relevant to education from any discipline, such as reviews of research in psychology, sociology, history, philosophy, political science, economics, computer science, statistics, anthropology, and biology, provided that the review bears on educational issues. RER does not publish original empirical research unless it is incorporated in a broader integrative review. RER will occasionally publish solicited, but carefully refereed, analytic reviews of special topics, particularly from disciplines infrequently represented.

The Review of Educational Research publishes critical, integrative reviews of research literature bearing on education. Such reviews should include conceptualizations, interpretations, and syntheses of literature and scholarly work in a field broadly relevant to education and educational research. RER encourages the submission of research relevant to education from any discipline, such as reviews of research in psychology, sociology, history, philosophy, political science, economics, computer science, statistics, anthropology, and biology, provided that the review bears on educational issues. RER does not publish original empirical research, and all analyses should be incorporated in a broader integrative review. RER will occasionally publish solicited, but carefully refereed, analytic reviews of special topics, particularly from disciplines infrequently represented. The following types of manuscripts fall within the journal’s purview:

Integrative reviews pull together the existing work on an educational topic and work to understand trends in that body of scholarship. In such a review, the author describes how the issue is conceptualized within the literature, how research methods and theories have shaped the outcomes of scholarship, and what the strengths and weaknesses of the literature are. Meta-analyses are of particular interest when they are accompanied by an interpretive framework that takes the article beyond the reporting of effect sizes and the bibliographic outcome of a computer search.

Theoretical reviews should explore how theory shapes research. To the extent that research is cited and interpreted, it is in the service of the specification, explication, and illumination of a theory. Theoretical reviews and integrative reviews have many similarities, but the former are primarily about how a theory is employed to frame research and our understandings, and refer to the research as it relates to the theory.

Methodological reviews are descriptions of research design, methods, and procedures that can be employed in literature reviews or research in general. The articles should highlight the strengths and weaknesses of methodological tools and explore how methods constrain or open up opportunities for learning about educational problems. They should be written in a style that is accessible to researchers in education rather than methodologists.

Historical reviews provide analyses that situate literature in historical contexts. Within these reviews, explanations for educational phenomena are framed within the historical forces that shape language and understanding.

Commissioned reviews and thematic issues. The editors may commission and solicit authors to review areas of literature. In all other respects, commissioned reviews are subject to the same review process as submitted reviews. The editors also encourage readers to propose thematic topics for special issues and, as potential guest editors, to submit plans for such issues.

In addition to review articles, RER will occasionally publish notes and responses which are short pieces of no more than 1,200 words on any topic that would be of use to reviewers of research. Typically, they point out shortcomings and differences in interpretation in RER articles and policy.

The standards and criteria for review articles in RER are the following:

1. Quality of the Literature. Standards used to determine quality of literature in education vary greatly. Any review needs to take into account the quality of the literature and its impact on findings. Authors should attempt to review all relevant literature on a topic (e.g., international literature, cross-disciplinary work, etc.).

2. Quality of Analysis. The review should go beyond description to include analysis and critiques of theories, methods, and conclusions represented in the literature. This analysis should also examine the issue of access—which perspectives are included or excluded in a body of work? Finally, the analysis should be reflexive—how does the scholars’ framework constrain what can be known in this review?

3. Significance of the Topic. The review should seek to inform and/or illuminate questions important to the field of education. While these questions may be broad-based, they should have implications for the educational problems and issues affecting our national and global societies.

4. Impact of the Article. The review should be seen as an important contribution and tool for the many different educators dealing with the educational problems and issues confronting society.

5. Advancement of the Field. The review should validate or inform the knowledge of researchers and guide and improve the quality of their research and scholarship.

6. Style. The review must be well written and conform to style of the Publication Manual of the American Psychological Association (6th edition). Authors should avoid the use of unexplained jargon and parochialism.

7. Balance and Fairness. The review should be careful not to misrepresent the positions taken by others, or be disrespectful of contrary positions.

8. Purpose. Any review should be accessible to the broad readership of RER. The purpose of any article should be to connect the particular problem addressed by the researcher(s) to a larger context of education.

We also encourage all authors interested in submitting a manuscript to RER to read our Editorial Vision for more information on our publication aims.

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1. Publication Standards 2. Submission Preparation Checklist 3. How to Get Help With the Quality of English in Your Submission 4. Copyright Information 5. For authors who use figures or other materials for which they do not own copyright 6. Right of Reply 7. Sage Choice and Open Access

The Review of Educational Research (RER) publishes comprehensive reviews of literature related to education and does not publish new empirical work, except in the context of meta-analytic reviews of an area. Please check the journal’s Aims and Scope to see if your manuscript is appropriate to submit to RER.

All manuscripts should be submitted electronically to the editorial team at http://mc.manuscriptcentral.com/rer . For questions or inquiries about manuscripts, email us at [email protected] . Manuscripts may not be submitted via e-mail.

Publication Standards

Researchers who intend to submit studies for publication should consult the Standards for Research Conduct adopted by the AERA Council. We also recommend consulting (a) the Guidelines for Reviewers , which outline the criteria under which manuscripts are reviewed for publication by AERA and (b) recent previous editions of the journal. Individuals submitting systematic reviews or meta-analyses should also consult The PRISMA Statement ( http://www.prisma-statement.org ) as well the article on “Reporting Standards for Research in Psychology” in American Psychologist, 63 , 839 – 851 (doi:10.1037/0003-066X.63.9.839).

Submission Preparation Checklist

When you upload your initial submission, upload (1) a separate title page that is not anonymized. Please format the title page as described by the 7th edition of the APA Manual and (2) the main manuscript, which includes an ANONYMIZED title page, an abstract with keywords at the bottom, and the rest of the document including tables and figures, and finally (c) Author Bios.

Please ensure that your manuscript complies with the “ RER Formatting Requirements and Common Formatting Errors ” (see PDF on the RER website). If your submission does not meet these requirements, it will be returned to you.

Additionally, your submission should meet the following guidelines:

1. The submission has not been previously published and is not under consideration for publication elsewhere; or an explanation has been provided in the Cover Letter. Authors should indicate in the Author Note on the separate title page if sections of the manuscript have been published in other venues.

2. THE MANUSCRIPT CONTAINS NO IDENTIFYING INFORMATION, EVEN ON THE ANONYMIZED TITLE PAGE. Please anonymize any work of limited circulation (e.g., in press papers, manuscripts under submission) that would point to the author, both in the body of the manuscript and the reference list. More information on anonymizing is described subsequently. Please double check that the author’s name has been removed from the document’s Properties, which in Microsoft Word is found in the File menu (select “File,” “Properties,” “Summary,” and remove the author’s name; select “OK” to save).

3. The text conforms to APA style (currently the 7th ed.). Consult the guidelines spelled out under “Manuscript Style, Length, and Format” on this webpage and in the RER Formatting Requirements PDF included on our website.

4. The submission must be in Microsoft Word format (.doc or .docx), which will be converted into a PDF file. Please do not upload PDF files, or they will be returned to you.

5. All URL addresses and DOIs in the manuscript (e.g., http://www.aera.net ) should be activated and ready to click.

6. An abstract of 150 words maximum is included (both separately and on the second page of the main document after the ANONYMIZED title page). Please also include three to five keywords—the terms that researchers will use to find your article in indexes and databases.

Manuscript Style, Length, and Format

The style guide for the Review of Educational Research and all AERA journals is the Publication Manual of the American Psychological Association, 7th ed., 2020. The manual is available for purchase here . Guidelines are also available on the APA website .

Manuscripts should NOT exceed 65 pages (or 15,000 words), including tables, figures, appendices, notes, and references, but excluding anonymized title page, abstract, and any supplementary files. Pages should be numbered consecutively in the top right-hand corner, with a fully capitalized running head in the top-left corner. All manuscripts should begin with the anonymized title page (p.1). Manuscripts should be typed for 8½” x 11” paper, in upper and lower case, with 1-inch margins on all sides. Manuscripts should be typed in 12-point Times New Roman font. Manuscripts that exceed 65 pages may be returned without review.

All text, from the title page to the end of the manuscript should be double-spaced , including the abstract, block quotations, bulleted text, and the reference list. Single-spacing is allowed in tables when it is useful in making the table clearer. Do not leave blank lines after paragraphs or before sub-headings. However, if a heading or subheading is the last line on a page, use a page break to move it to the top of the next page. The Abstract, Introduction (beginning with the title), the References, and all tables and figures begin on new pages.

Please use the five subheadings as appropriate based on the 7th edition of the APA style manual. In addition to being on the title page, the title should also be placed at the beginning of the Introduction (in lieu of the word, “Introduction,” which should not appear) and the title at the beginning of the Introduction should be a Level 1 heading.

Tables and figures are to be placed after the references—all tables precede all figures—and should not be included in the body of the text. Each figure and table should begin on a separate page. Do NOT use the “Place Table 5 here” or “Place Figure 1 here” convention. The tables and figures will be placed nearest to where they are mentioned as appropriate when copyediting is done.

Figures and tables should present data to the reader in a clear and unambiguous manner, and should be referred to in the text. If the illustration/table/figure and text are redundant, eliminate the illustration or reduce the amount of detail provided in text. The use of lines in tables is limited (please consult the APA style manual for formatting guidelines ). Figure captions should be placed at the bottom of the figure. One high-quality electronic version of each figure must be submitted with the manuscript. Tables will be typeset. Note that any figures and tables uploaded separately from the main manuscript will still count toward the total 65-page limit.

Italics can be used for emphasis or contrast in special situations but should be used sparingly. Ideally, sentence structure should be used for these issues. All words to be set in italics (e.g., book titles, journal names) should be typed in italics. There should be no underlined text . Abbreviations and acronyms should be spelled out the first time they are mentioned unless they are found as entries in their abbreviated form in Merriam-Webster’s Collegiate Dictionary , 11th ed., 2003 (e.g., “IQ” can be used without being spelled out). Mathematical symbols and symbols for vectors should be clearly formatted in italics and boldface, respectively.

You can use the footnote or endnote feature of Microsoft Word. However, notes are only for explanations or amplifications of textual material that cannot be incorporated into the regular text; they are not for reference information. Moreover, notes are distracting to readers and expensive to produce and should be used sparingly and avoided whenever possible.

The reference list should contain only references that are cited in the text. Its accuracy and completeness are the responsibility of the authors. Reference each publicly available dataset with its title, author, date, and a persistent Web identifier such as a digital object identifier (doi), a handle, or a uniform resource name (URN). If necessary, this last element may be replaced by a web address. Additionally, any references that were included in the analysis but not cited in-text in the main manuscript can be included in a separate reference list that is uploaded as a Supplementary File for Review (this may assist in meeting the page limit).

Authors should anonymize their manuscripts for review . Anonymizing does not mean removing all self-citations. Authors should only anonymize citations of limited circulation (e.g., forthcoming, in press, unpublished) that point to the author. Publications already in the extant literature (e.g., books, book chapters, journal articles) should be cited normally, but authors should include self-citations judiciously . When anonymizing, please use “Author” or “Authors” as in the examples below and place this alphabetically in the reference list and not where the author’s actual name would typically appear.

For examples of common types of references, consult the APA 7th edition manual, or visit the webpage here: https://apastyle.apa.org/style-grammar-guidelines/references

How to Get Help with the Quality of English in Your Submission

Authors who would like to refine the use of English in their manuscripts might consider using the services of a professional English-language editing company. We highlight some of these companies at  https://languageservices.sagepub.com/en/ .

Please be aware that Sage has no affiliation with these companies and makes no endorsement of them. An author's use of these services in no way guarantees that his or her submission will ultimately be accepted. Any arrangement an author enters into will be exclusively between the author and the particular company, and any costs incurred are the sole responsibility of the author.

Copyright Information Accepted authors will be asked to  assign copyright  to AERA, in return for which AERA grants several rights to authors.

Permission to reproduce your own published material

No written or oral permission is necessary to reproduce a table, a figure, or an excerpt of fewer than 500 words from this journal, or to make photocopies for classroom use. Authors are granted permission, without fee, to photocopy their own material or make printouts from the final pdf of their article. Copies must include a full and accurate bibliographic citation and the following credit line: “Copyright [year] by the American Educational Research Association; reproduced with permission from the publisher.” Written permission must be obtained to reproduce or reprint material in circumstances other than those just described. Please review Sage Publishing’s  Journal Permissions  for further information on policies and fees.

Permission to submit material for which you do not own copyright

Authors who wish to use material, such as figures or tables, for which they do not own the copyright must obtain written permission from the copyright holder (usually the publisher) and submit it along with their manuscript. However, no written or oral permission is necessary to reproduce a table, a figure, or an excerpt of fewer than 500 words from an AERA journal.

Copyright transfer agreements for accepted works with more than one author

This journal uses a transfer of copyright agreement that requires just one author (the corresponding author) to sign on behalf of all authors. Please identify the corresponding author for your work when submitting your manuscript for review. The corresponding author will be responsible for the following:

1. Ensuring that all authors are identified on the copyright agreement, and notifying the editorial office of any changes in the authorship.

2. Securing written permission (by letter or e-mail) from each co-author to sign the copyright agreement on the co-author’s behalf.

3. Warranting and indemnifying the journal owner and publisher on behalf of all co-authors. Although such instances are very rare, you should be aware that in the event that a co-author has included content in his or her portion of the article that infringes the copyright of another or is otherwise in violation of any other warranty listed in the agreement, you will be the sole author indemnifying the publisher and the editor of the journal against such violation.

Please contact the publications office at  AERA  if you have questions or if you prefer to use a copyright agreement for all coauthors to sign.

Right of Reply

The right of reply policy encourages comments on recently published articles in AERA publications. They are, of course, subject to the same editorial review and decision process as articles. If the comment is accepted for publication, the editor shall inform the author of the original article. If the author submits a reply to the comment, the reply is also subject to editorial review and decision. The editor may allot a specific amount of journal space for the comment (ordinarily about 1,500 words) and for the reply (ordinarily about 750 words). The reply may appear in the same issue as the comment or in a later issue (Council, June 1980).

If an article is accepted for publication in an AERA journal that, in the judgment of the editor, has as its main theme or thrust a critique of a specific piece of work or a specific line of work associated with an individual or program of research, then the individual or representative of the research program whose work is critiqued should be notified in advance about the upcoming publication and given the opportunity to reply, ideally in the same issue. The author of the original article should also be notified. Normal guidelines for length and review of the reply and publication of a rejoinder by the original article’s author(s) should be followed. Articles in the format “an open letter to …” may constitute prototypical exemplars of the category defined here, but other formats may well be used, and would be included under the qualifications for response prescribed here (Council, January 2002).

Sage Choice and Open Access

If you or your funder wish your article to be freely available online to nonsubscribers immediately upon publication (gold open access), you can opt for it to be included in Sage Choice, subject to payment of a publication fee. The manuscript submission and peer review procedure is unchanged. On acceptance of your article, you will be asked to let Sage know directly if you are choosing Sage Choice. To check journal eligibility and the publication fee, please visit  Sage Choice . For more information on open access options and compliance at Sage, including self author archiving deposits (green open access) visit  Sage Publishing Policies  on our Journal Author Gateway.

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The  Review of Educational Research  ( RER , bimonthly, begun in 1931) publishes critical, integrative reviews of research literature bearing on education. Such reviews should include conceptualizations, interpretations, and syntheses of literature and scholarly work in a field broadly relevant to education and educational research.  RER  encourages the submission of research relevant to education from any discipline, such as reviews of research in psychology, sociology, history, philosophy, political science, economics, computer science, statistics, anthropology, and biology, provided that the review bears on educational issues.  RER  does not publish original empirical research unless it is incorporated in a broader integrative review.  RER  will occasionally publish solicited, but carefully refereed, analytic reviews of special topics, particularly from disciplines infrequently represented.

Impact Factor : 11.2 5-Year Impact Factor : 16.6 Ranking : 1/263 in Education & Educational Research

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How to Review a Journal Article

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

IMPORTANT NOTE!!

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

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

Questions to Consider

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

Evaluating Purpose and Argument

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

Evaluating the Presentation/Organization of Information

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

Evaluating Methods

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

Evaluating Data

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Writing a Scientific Review Article: Comprehensive Insights for Beginners

Ayodeji amobonye.

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

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

Japareng Lalung

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

Santhosh Pillai

Associated data.

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

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

1. Introduction

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

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

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

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

2. Benefits of Review Articles to the Author

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

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

3. Types of Review Articles

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

3.1. Narrative Reviews

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

3.2. Systematic Reviews

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

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

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

3.3. Meta-Analysis

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

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

3.4. Bibliometric Review

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

3.5. Patent Review

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

4. Searching Literature

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

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

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

5. Structuring the Review Article

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

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

5.2. Abstract

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

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

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

5.3. Graphical Abstracts

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

5.4. Keywords

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

5.5. Introduction

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

5.6. Methodology

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

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

5.7. Main Body of the Review

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

5.8. Tables and Figures

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

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

5.9. Conclusion/Future Perspectives

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

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

5.10. References

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

6. Concluding Remarks

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

Acknowledgments

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

Data Availability

Conflicts of interest.

The authors declare that they have no conflicts of interest.

• Open access
• Published: 19 April 2024

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact

• Aklilu Endalamaw 1 , 2 ,
• Resham B Khatri 1 , 3 ,
• Tesfaye Setegn Mengistu 1 , 2 ,
• Daniel Erku 1 , 4 , 5 ,
• Eskinder Wolka 6 ,
• Anteneh Zewdie 6 &
• Yibeltal Assefa 1  

BMC Health Services Research volume  24 , Article number:  487 ( 2024 ) Cite this article

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The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts.

This qualitative scoping review was conducted using Arksey and O’Malley’s methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works.

A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI.

Conclusions

Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it’s crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.

Peer Review reports

Continuous quality improvement (CQI) initiative is a crucial initiative aimed at enhancing quality in the health system that has gradually been adopted in the healthcare industry. In the early 20th century, Shewhart laid the foundation for quality improvement by describing three essential steps for process improvement: specification, production, and inspection [ 1 , 2 ]. Then, Deming expanded Shewhart’s three-step model into ‘plan, do, study/check, and act’ (PDSA or PDCA) cycle, which was applied to management practices in Japan in the 1950s [ 3 ] and was gradually translated into the health system. In 1991, Kuperman applied a CQI approach to healthcare, comprising selecting a process to be improved, assembling a team of expert clinicians that understands the process and the outcomes, determining key steps in the process and expected outcomes, collecting data that measure the key process steps and outcomes, and providing data feedback to the practitioners [ 4 ]. These philosophies have served as the baseline for the foundation of principles for continuous improvement [ 5 ].

Continuous quality improvement fosters a culture of continuous learning, innovation, and improvement. It encourages proactive identification and resolution of problems, promotes employee engagement and empowerment, encourages trust and respect, and aims for better quality of care [ 6 , 7 ]. These characteristics drive the interaction of CQI with other quality improvement projects, such as quality assurance and total quality management [ 8 ]. Quality assurance primarily focuses on identifying deviations or errors through inspections, audits, and formal reviews, often settling for what is considered ‘good enough’, rather than pursuing the highest possible standards [ 9 , 10 ], while total quality management is implemented as the management philosophy and system to improve all aspects of an organization continuously [ 11 ].

Continuous quality improvement has been implemented to provide quality care. However, providing effective healthcare is a complicated and complex task in achieving the desired health outcomes and the overall well-being of individuals and populations. It necessitates tackling issues, including access, patient safety, medical advances, care coordination, patient-centered care, and quality monitoring [ 12 , 13 ], rooted long ago. It is assumed that the history of quality improvement in healthcare started in 1854 when Florence Nightingale introduced quality improvement documentation [ 14 ]. Over the passing decades, Donabedian introduced structure, processes, and outcomes as quality of care components in 1966 [ 15 ]. More comprehensively, the Institute of Medicine in the United States of America (USA) has identified effectiveness, efficiency, equity, patient-centredness, safety, and timeliness as the components of quality of care [ 16 ]. Moreover, quality of care has recently been considered an integral part of universal health coverage (UHC) [ 17 ], which requires initiatives to mobilise essential inputs [ 18 ].

While the overall objective of CQI in health system is to enhance the quality of care, it is important to note that the purposes and principles of CQI can vary across different contexts [ 19 , 20 ]. This variation has sparked growing research interest. For instance, a review of CQI approaches for capacity building addressed its role in health workforce development [ 21 ]. Another systematic review, based on random-controlled design studies, assessed the effectiveness of CQI using training as an intervention and the PDSA model [ 22 ]. As a research gap, the former review was not directly related to the comprehensive elements of quality of care, while the latter focused solely on the impact of training using the PDSA model, among other potential models. Additionally, a review conducted in 2015 aimed to identify barriers and facilitators of CQI in Canadian contexts [ 23 ]. However, all these reviews presented different perspectives and investigated distinct outcomes. This suggests that there is still much to explore in terms of comprehensively understanding the various aspects of CQI initiatives in healthcare.

As a result, we conducted a scoping review to address several aspects of CQI. Scoping reviews serve as a valuable tool for systematically mapping the existing literature on a specific topic. They are instrumental when dealing with heterogeneous or complex bodies of research. Scoping reviews provide a comprehensive overview by summarizing and disseminating findings across multiple studies, even when evidence varies significantly [ 24 ]. In our specific scoping review, we included various types of literature, including systematic reviews, to enhance our understanding of CQI.

This scoping review examined how CQI is conceptualized and measured and investigated models and tools for its application while identifying implementation challenges and facilitators. It also analyzed the purposes and impact of CQI on the health systems, providing valuable insights for enhancing healthcare quality.

Protocol registration and results reporting

Protocol registration for this scoping review was not conducted. Arksey and O’Malley’s methodological framework was utilized to conduct this scoping review [ 25 ]. The scoping review procedures start by defining the research questions, identifying relevant literature, selecting articles, extracting data, and summarizing the results. The review findings are reported using the PRISMA extension for a scoping review (PRISMA-ScR) [ 26 ]. McGowan and colleagues also advised researchers to report findings from scoping reviews using PRISMA-ScR [ 27 ].

Defining the research problems

This review aims to comprehensively explore the conceptualization, models, tools, barriers, facilitators, and impacts of CQI within the healthcare system worldwide. Specifically, we address the following research questions: (1) How has CQI been defined across various contexts? (2) What are the diverse approaches to implementing CQI in healthcare settings? (3) Which tools are commonly employed for CQI implementation ? (4) What barriers hinder and facilitators support successful CQI initiatives? and (5) What effects CQI initiatives have on the overall care quality?

Information source and search strategy

We conducted the search in PubMed, Web of Science, Scopus, and EMBASE databases, and the Google Scholar search engine. The search terms were selected based on three main distinct concepts. One group was CQI-related terms. The second group included terms related to the purpose for which CQI has been implemented, and the third group included processes and impact. These terms were selected based on the Donabedian framework of structure, process, and outcome [ 28 ]. Additionally, the detailed keywords were recruited from the primary health framework, which has described lists of dimensions under process, output, outcome, and health system goals of any intervention for health [ 29 ]. The detailed search strategy is presented in the Supplementary file 1 (Search strategy). The search for articles was initiated on August 12, 2023, and the last search was conducted on September 01, 2023.

Eligibility criteria and article selection

Based on the scoping review’s population, concept, and context frameworks [ 30 ], the population included any patients or clients. Additionally, the concepts explored in the review encompassed definitions, implementation, models, tools, barriers, facilitators, and impacts of CQI. Furthermore, the review considered contexts at any level of health systems. We included articles if they reported results of qualitative or quantitative empirical study, case studies, analytic or descriptive synthesis, any review, and other written documents, were published in peer-reviewed journals, and were designed to address at least one of the identified research questions or one of the identified implementation outcomes or their synonymous taxonomy as described in the search strategy. Based on additional contexts, we included articles published in English without geographic and time limitations. We excluded articles with abstracts only, conference abstracts, letters to editors, commentators, and corrections.

We exported all citations to EndNote x20 to remove duplicates and screen relevant articles. The article selection process includes automatic duplicate removal by using EndNote x20, unmatched title and abstract removal, citation and abstract-only materials removal, and full-text assessment. The article selection process was mainly conducted by the first author (AE) and reported to the team during the weekly meetings. The first author encountered papers that caused confusion regarding whether to include or exclude them and discussed them with the last author (YA). Then, decisions were ultimately made. Whenever disagreements happened, they were resolved by discussion and reconsideration of the review questions in relation to the written documents of the article. Further statistical analysis, such as calculating Kappa, was not performed to determine article inclusion or exclusion.

Data extraction and data items

We extracted first author, publication year, country, settings, health problem, the purpose of the study, study design, types of intervention if applicable, CQI approaches/steps if applicable, CQI tools and procedures if applicable, and main findings using a customized Microsoft Excel form.

Summarizing and reporting the results

The main findings were summarized and described based on the main themes, including concepts under conceptualizing, principles, teams, timelines, models, tools, barriers, facilitators, and impacts of CQI. Results-based convergent synthesis, achieved through mixed-method analysis, involved content analysis to identify the thematic presentation of findings. Additionally, a narrative description was used for quantitative findings, aligning them with the appropriate theme. The authors meticulously reviewed the primary findings from each included material and contextualized these findings concerning the main themes1. This approach provides a comprehensive understanding of complex interventions and health systems, acknowledging quantitative and qualitative evidence.

Search results

A total of 11,251 documents were identified from various databases: SCOPUS ( n  = 4,339), PubMed ( n  = 2,893), Web of Science ( n  = 225), EMBASE ( n  = 3,651), and Google Scholar ( n  = 143). After removing duplicates ( n  = 5,061), 6,190 articles were evaluated by title and abstract. Subsequently, 208 articles were assessed for full-text eligibility. Following the eligibility criteria, 121 articles were excluded, leaving 87 included in the current review (Fig.  1 ).

Article selection process

Operationalizing continuous quality improvement

Continuous Quality Improvement (CQI) is operationalized as a cyclic process that requires commitment to implementation, teamwork, time allocation, and celebrating successes and failures.

CQI is a cyclic ongoing process that is followed reflexive, analytical and iterative steps, including identifying gaps, generating data, developing and implementing action plans, evaluating performance, providing feedback to implementers and leaders, and proposing necessary adjustments [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].

CQI requires committing to the philosophy, involving continuous improvement [ 19 , 38 ], establishing a mission statement [ 37 ], and understanding quality definition [ 19 ].

CQI involves a wide range of patient-oriented measures and performance indicators, specifically satisfying internal and external customers, developing quality assurance, adopting common quality measures, and selecting process measures [ 8 , 19 , 35 , 36 , 37 , 39 , 40 ].

CQI requires celebrating success and failure without personalization, leading each team member to develop error-free attitudes [ 19 ]. Success and failure are related to underlying organizational processes and systems as causes of failure rather than blaming individuals [ 8 ] because CQI is process-focused based on collaborative, data-driven, responsive, rigorous and problem-solving statistical analysis [ 8 , 19 , 38 ]. Furthermore, a gap or failure opens another opportunity for establishing a data-driven learning organization [ 41 ].

CQI cannot be implemented without a CQI team [ 8 , 19 , 37 , 39 , 42 , 43 , 44 , 45 , 46 ]. A CQI team comprises individuals from various disciplines, often comprising a team leader, a subject matter expert (physician or other healthcare provider), a data analyst, a facilitator, frontline staff, and stakeholders [ 39 , 43 , 47 , 48 , 49 ]. It is also important to note that inviting stakeholders or partners as part of the CQI support intervention is crucial [ 19 , 38 , 48 ].

The timeline is another distinct feature of CQI because the results of CQI vary based on the implementation duration of each cycle [ 35 ]. There is no specific time limit for CQI implementation, although there is a general consensus that a cycle of CQI should be relatively short [ 35 ]. For instance, a CQI implementation took 2 months [ 42 ], 4 months [ 50 ], 9 months [ 51 , 52 ], 12 months [ 53 , 54 , 55 ], and one year and 5 months [ 49 ] duration to achieve the desired positive outcome, while bi-weekly [ 47 ] and monthly data reviews and analyses [ 44 , 48 , 56 ], and activities over 3 months [ 57 ] have also resulted in a positive outcome.

Continuous quality improvement models and tools

There have been several models are utilized. The Plan-Do-Study/Check-Act cycle is a stepwise process involving project initiation, situation analysis, root cause identification, solution generation and selection, implementation, result evaluation, standardization, and future planning [ 7 , 36 , 37 , 45 , 47 , 48 , 49 , 50 , 51 , 53 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ]. The FOCUS-PDCA cycle enhances the PDCA process by adding steps to find and improve a process (F), organize a knowledgeable team (O), clarify the process (C), understand variations (U), and select improvements (S) [ 55 , 71 , 72 , 73 ]. The FADE cycle involves identifying a problem (Focus), understanding it through data analysis (Analyze), devising solutions (Develop), and implementing the plan (Execute) [ 74 ]. The Logic Framework involves brainstorming to identify improvement areas, conducting root cause analysis to develop a problem tree, logically reasoning to create an objective tree, formulating the framework, and executing improvement projects [ 75 ]. Breakthrough series approach requires CQI teams to meet in quarterly collaborative learning sessions, share learning experiences, and continue discussion by telephone and cross-site visits to strengthen learning and idea exchange [ 47 ]. Another CQI model is the Lean approach, which has been conducted with Kaizen principles [ 52 ], 5 S principles, and the Six Sigma model. The 5 S (Sort, Set/Straighten, Shine, Standardize, Sustain) systematically organises and improves the workplace, focusing on sorting, setting order, shining, standardizing, and sustaining the improvement [ 54 , 76 ]. Kaizen principles guide CQI by advocating for continuous improvement, valuing all ideas, solving problems, focusing on practical, low-cost improvements, using data to drive change, acknowledging process defects, reducing variability and waste, recognizing every interaction as a customer-supplier relationship, empowering workers, responding to all ideas, and maintaining a disciplined workplace [ 77 ]. Lean Six Sigma, a CQI model, applies the DMAIC methodology, which involves defining (D) and measuring the problem (M), analyzing root causes (A), improving by finding solutions (I), and controlling by assessing process stability (C) [ 78 , 79 ]. The 5 C-cyclic model (consultation, collection, consideration, collaboration, and celebration), the first CQI framework for volunteer dental services in Aboriginal communities, ensures quality care based on community needs [ 80 ]. One study used meetings involving activities such as reviewing objectives, assigning roles, discussing the agenda, completing tasks, retaining key outputs, planning future steps, and evaluating the meeting’s effectiveness [ 81 ].

Various tools are involved in the implementation or evaluation of CQI initiatives: checklists [ 53 , 82 ], flowcharts [ 81 , 82 , 83 ], cause-and-effect diagrams (fishbone or Ishikawa diagrams) [ 60 , 62 , 79 , 81 , 82 ], fuzzy Pareto diagram [ 82 ], process maps [ 60 ], time series charts [ 48 ], why-why analysis [ 79 ], affinity diagrams and multivoting [ 81 ], and run chart [ 47 , 48 , 51 , 60 , 84 ], and others mentioned in the table (Table  1 ).

Barriers and facilitators of continuous quality improvement implementation

Implementing CQI initiatives is determined by various barriers and facilitators, which can be thematized into four dimensions. These dimensions are cultural, technical, structural, and strategic dimensions.

Continuous quality improvement initiatives face various cultural, strategic, technical, and structural barriers. Cultural dimension barriers involve resistance to change (e.g., not accepting online technology), lack of quality-focused culture, staff reporting apprehensiveness, and fear of blame or punishment [ 36 , 41 , 85 , 86 ]. The technical dimension barriers of CQI can include various factors that hinder the effective implementation and execution of CQI processes [ 36 , 86 , 87 , 88 , 89 ]. Structural dimension barriers of CQI arise from the organization structure, process, and systems that can impede the effective implementation and sustainability of CQI [ 36 , 85 , 86 , 87 , 88 ]. Strategic dimension barriers are, for example, the inability to select proper CQI goals and failure to integrate CQI into organizational planning and goals [ 36 , 85 , 86 , 87 , 88 , 90 ].

Facilitators are also grouped to cultural, structural, technical, and strategic dimensions to provide solutions to CQI barriers. Cultural challenges were addressed by developing a group culture to CQI and other rewards [ 39 , 41 , 80 , 85 , 86 , 87 , 90 , 91 , 92 ]. Technical facilitators are pivotal to improving technical barriers [ 39 , 42 , 53 , 69 , 86 , 90 , 91 ]. Structural-related facilitators are related to improving communication, infrastructure, and systems [ 86 , 92 , 93 ]. Strategic dimension facilitators include strengthening leadership and improving decision-making skills [ 43 , 53 , 67 , 86 , 87 , 92 , 94 , 95 ] (Table  2 ).

Impact of continuous quality improvement

Continuous quality improvement initiatives can significantly impact the quality of healthcare in a wide range of health areas, focusing on improving structure, the health service delivery process and improving client wellbeing and reducing mortality.

Structure components

These are health leadership, financing, workforce, technology, and equipment and supplies. CQI has improved planning, monitoring and evaluation [ 48 , 53 ], and leadership and planning [ 48 ], indicating improvement in leadership perspectives. Implementing CQI in primary health care (PHC) settings has shown potential for maintaining or reducing operation costs [ 67 ]. Findings from another study indicate that the costs associated with implementing CQI interventions per facility ranged from approximately $2,000 to $10,500 per year, with an average cost of approximately $10 to $60 per admitted client [ 57 ]. However, based on model predictions, the average cost savings after implementing CQI were estimated to be $5430 [ 31 ]. CQI can also be applied to health workforce development [ 32 ]. CQI in the institutional system improved medical education [ 66 , 96 , 97 ], human resources management [ 53 ], motivated staffs [ 76 ], and increased staff health awareness [ 69 ], while concerns raised about CQI impartiality, independence, and public accountability [ 96 ]. Regarding health technology, CQI also improved registration and documentation [ 48 , 53 , 98 ]. Furthermore, the CQI initiatives increased cleanliness [ 54 ] and improved logistics, supplies, and equipment [ 48 , 53 , 68 ].

Process and output components

The process component focuses on the activities and actions involved in delivering healthcare services.

Service delivery

CQI interventions improved service delivery [ 53 , 56 , 99 ], particularly a significant 18% increase in the overall quality of service performance [ 48 ], improved patient counselling, adherence to appropriate procedures, and infection prevention [ 48 , 68 ], and optimised workflow [ 52 ].

Coordination and collaboration

CQI initiatives improved coordination and collaboration through collecting and analysing data, onsite technical support, training, supportive supervision [ 53 ] and facilitating linkages between work processes and a quality control group [ 65 ].

Patient satisfaction

The CQI initiatives increased patient satisfaction and improved quality of life by optimizing care quality management, improving the quality of clinical nursing, reducing nursing defects and enhancing the wellbeing of clients [ 54 , 76 , 100 ], although CQI was not associated with changes in adolescent and young adults’ satisfaction [ 51 ].

CQI initiatives reduced medication error reports from 16 to 6 [ 101 ], and it significantly reduced the administration of inappropriate prophylactic antibiotics [ 44 ], decreased errors in inpatient care [ 52 ], decreased the overall episiotomy rate from 44.5 to 33.3% [ 83 ], reduced the overall incidence of unplanned endotracheal extubation [ 102 ], improving appropriate use of computed tomography angiography [ 103 ], and appropriate diagnosis and treatment selection [ 47 ].

Continuity of care

CQI initiatives effectively improve continuity of care by improving client and physician interaction. For instance, provider continuity levels showed a 64% increase [ 55 ]. Modifying electronic medical record templates, scheduling, staff and parental education, standardization of work processes, and birth to 1-year age-specific incentives in post-natal follow-up care increased continuity of care to 74% in 2018 compared to baseline 13% in 2012 [ 84 ].

The CQI initiative yielded enhanced efficiency in the cardiac catheterization laboratory, as evidenced by improved punctuality in procedure starts and increased efficiency in manual sheath-pulls inside [ 78 ].

Accessibility

CQI initiatives were effective in improving accessibility in terms of increasing service coverage and utilization rate. For instance, screening for cigarettes, nutrition counselling, folate prescription, maternal care, immunization coverage [ 53 , 81 , 104 , 105 ], reducing the percentage of non-attending patients to surgery to 0.9% from the baseline 3.9% [ 43 ], increasing Chlamydia screening rates from 29 to 60% [ 45 ], increasing HIV care continuum coverage [ 51 , 59 , 60 ], increasing in the uptake of postpartum long-acting reversible contraceptive use from 6.9% at the baseline to 25.4% [ 42 ], increasing post-caesarean section prophylaxis from 36 to 89% [ 62 ], a 31% increase of kangaroo care practice [ 50 ], and increased follow-up [ 65 ]. Similarly, the QI intervention increased the quality of antenatal care by 29.3%, correct partograph use by 51.7%, and correct active third-stage labour management, a 19.6% improvement from the baseline, but not significantly associated with improvement in contraceptive service uptake [ 61 ].

Timely access

CQI interventions improved the time care provision [ 52 ], and reduced waiting time [ 62 , 74 , 76 , 106 ]. For instance, the discharge process waiting time in the emergency department decreased from 76 min to 22 min [ 79 ]. It also reduced mean postprocedural length of stay from 2.8 days to 2.0 days [ 31 ].

Acceptability

Acceptability of CQI by healthcare providers was satisfactory. For instance, 88% of the faculty, 64% of the residents, and 82% of the staff believed CQI to be useful in the healthcare clinic [ 107 ].

Outcome components

Morbidity and mortality.

CQI efforts have demonstrated better management outcomes among diabetic patients [ 40 ], patients with oral mucositis [ 71 ], and anaemic patients [ 72 ]. It has also reduced infection rate in post-caesarean Sect. [ 62 ], reduced post-peritoneal dialysis peritonitis [ 49 , 108 ], and prevented pressure ulcers [ 70 ]. It is explained by peritonitis incidence from once every 40.1 patient months at baseline to once every 70.8 patient months after CQI [ 49 ] and a 63% reduction in pressure ulcer prevalence within 2 years from 2008 to 2010 [ 70 ]. Furthermore, CQI initiatives significantly reduced in-hospital deaths [ 31 ] and increased patient survival rates [ 108 ]. Figure  2 displays the overall process of the CQI implementations.

The overall mechanisms of continuous quality improvement implementation

In this review, we examined the fundamental concepts and principles underlying CQI, the factors that either hinder or assist in its successful application and implementation, and the purpose of CQI in enhancing quality of care across various health issues.

Our findings have brought attention to the application and implementation of CQI, emphasizing its underlying concepts and principles, as evident in the existing literature [ 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 43 , 45 , 46 ]. Continuous quality improvement has shared with the principles of continuous improvement, such as a customer-driven focus, effective leadership, active participation of individuals, a process-oriented approach, systematic implementation, emphasis on design improvement and prevention, evidence-based decision-making, and fostering partnership [ 5 ]. Moreover, Deming’s 14 principles laid the foundation for CQI principles [ 109 ]. These principles have been adapted and put into practice in various ways: ten [ 19 ] and five [ 38 ] principles in hospitals, five principles for capacity building [ 38 ], and two principles for medication error prevention [ 41 ]. As a principle, the application of CQI can be process-focused [ 8 , 19 ] or impact-focused [ 38 ]. Impact-focused CQI focuses on achieving specific outcomes or impacts, whereas process-focused CQI prioritizes and improves the underlying processes and systems. These principles complement each other and can be utilized based on the objectives of quality improvement initiatives in healthcare settings. Overall, CQI is an ongoing educational process that requires top management’s involvement, demands coordination across departments, encourages the incorporation of views beyond clinical area, and provides non-judgemental evidence based on objective data [ 110 ].

The current review recognized that it was not easy to implement CQI. It requires reasonable utilization of various models and tools. The application of each tool can be varied based on the studied health problem and the purpose of CQI initiative [ 111 ], varied in context, content, structure, and usability [ 112 ]. Additionally, overcoming the cultural, technical, structural, and strategic-related barriers. These barriers have emerged from clinical staff, managers, and health systems perspectives. Of the cultural obstacles, staff non-involvement, resistance to change, and reluctance to report error were staff-related. In contrast, others, such as the absence of celebration for success and hierarchical and rational culture, may require staff and manager involvement. Staff members may exhibit reluctance in reporting errors due to various cultural factors, including lack of trust, hierarchical structures, fear of retribution, and a blame-oriented culture. These challenges pose obstacles to implementing standardized CQI practices, as observed, for instance, in community pharmacy settings [ 85 ]. The hierarchical culture, characterized by clearly defined levels of power, authority, and decision-making, posed challenges to implementing CQI initiatives in public health [ 41 , 86 ]. Although rational culture, a type of organizational culture, emphasizes logical thinking and rational decision-making, it can also create challenges for CQI implementation [ 41 , 86 ] because hierarchical and rational cultures, which emphasize bureaucratic norms and narrow definitions of achievement, were found to act as barriers to the implementation of CQI [ 86 ]. These could be solved by developing a shared mindset and collective commitment, establishing a shared purpose, developing group norms, and cultivating psychological preparedness among staff, managers, and clients to implement and sustain CQI initiatives. Furthermore, reversing cultural-related barriers necessitates cultural-related solutions: development of a culture and group culture to CQI [ 41 , 86 ], positive comprehensive perception [ 91 ], commitment [ 85 ], involving patients, families, leaders, and staff [ 39 , 92 ], collaborating for a common goal [ 80 , 86 ], effective teamwork [ 86 , 87 ], and rewarding and celebrating successes [ 80 , 90 ].

The technical dimension barriers of CQI can include inadequate capitalization of a project and insufficient support for CQI facilitators and data entry managers [ 36 ], immature electronic medical records or poor information systems [ 36 , 86 ], and the lack of training and skills [ 86 , 87 , 88 ]. These challenges may cause the CQI team to rely on outdated information and technologies. The presence of barriers on the technical dimension may challenge the solid foundation of CQI expertise among staff, the ability to recognize opportunities for improvement, a comprehensive understanding of how services are produced and delivered, and routine use of expertise in daily work. Addressing these technical barriers requires knowledge creation activities (training, seminar, and education) [ 39 , 42 , 53 , 69 , 86 , 90 , 91 ], availability of quality data [ 86 ], reliable information [ 92 ], and a manual-online hybrid reporting system [ 85 ].

Structural dimension barriers of CQI include inadequate communication channels and lack of standardized process, specifically weak physician-to-physician synergies [ 36 ], lack of mechanisms for disseminating knowledge and limited use of communication mechanisms [ 86 ]. Lack of communication mechanism endangers sharing ideas and feedback among CQI teams, leading to misunderstandings, limited participation and misinterpretations, and a lack of learning [ 113 ]. Knowledge translation facilitates the co-production of research, subsequent diffusion of knowledge, and the developing stakeholder’s capacity and skills [ 114 ]. Thus, the absence of a knowledge translation mechanism may cause missed opportunities for learning, inefficient problem-solving, and limited creativity. To overcome these challenges, organizations should establish effective communication and information systems [ 86 , 93 ] and learning systems [ 92 ]. Though CQI and knowledge translation have interacted with each other, it is essential to recognize that they are distinct. CQI focuses on process improvement within health care systems, aiming to optimize existing processes, reduce errors, and enhance efficiency.

In contrast, knowledge translation bridges the gap between research evidence and clinical practice, translating research findings into actionable knowledge for practitioners. While both CQI and knowledge translation aim to enhance health care quality and patient outcomes, they employ different strategies: CQI utilizes tools like Plan-Do-Study-Act cycles and statistical process control, while knowledge translation involves knowledge synthesis and dissemination. Additionally, knowledge translation can also serve as a strategy to enhance CQI. Both concepts share the same principle: continuous improvement is essential for both. Therefore, effective strategies on the structural dimension may build efficient and effective steering councils, information systems, and structures to diffuse learning throughout the organization.

Strategic factors, such as goals, planning, funds, and resources, determine the overall purpose of CQI initiatives. Specific barriers were improper goals and poor planning [ 36 , 86 , 88 ], fragmentation of quality assurance policies [ 87 ], inadequate reinforcement to staff [ 36 , 90 ], time constraints [ 85 , 86 ], resource inadequacy [ 86 ], and work overload [ 86 ]. These barriers can be addressed through strengthening leadership [ 86 , 87 ], CQI-based mentoring [ 94 ], periodic monitoring, supportive supervision and coaching [ 43 , 53 , 87 , 92 , 95 ], participation, empowerment, and accountability [ 67 ], involving all stakeholders in decision-making [ 86 , 87 ], a provider-payer partnership [ 64 ], and compensating staff for after-hours meetings on CQI [ 85 ]. The strategic dimension, characterized by a strategic plan and integrated CQI efforts, is devoted to processes that are central to achieving strategic priorities. Roles and responsibilities are defined in terms of integrated strategic and quality-related goals [ 115 ].

The utmost goal of CQI has been to improve the quality of care, which is usually revealed by structure, process, and outcome. After resolving challenges and effectively using tools and running models, the goal of CQI reflects the ultimate reason and purpose of its implementation. First, effectively implemented CQI initiatives can improve leadership, health financing, health workforce development, health information technology, and availability of supplies as the building blocks of a health system [ 31 , 48 , 53 , 68 , 98 ]. Second, effectively implemented CQI initiatives improved care delivery process (counselling, adherence with standards, coordination, collaboration, and linkages) [ 48 , 53 , 65 , 68 ]. Third, the CQI can improve outputs of healthcare delivery, such as satisfaction, accessibility (timely access, utilization), continuity of care, safety, efficiency, and acceptability [ 52 , 54 , 55 , 76 , 78 ]. Finally, the effectiveness of the CQI initiatives has been tested in enhancing responses related to key aspects of the HIV response, maternal and child health, non-communicable disease control, and others (e.g., surgery and peritonitis). However, it is worth noting that CQI initiative has not always been effective. For instance, CQI using a two- to nine-times audit cycle model through systems assessment tools did not bring significant change to increase syphilis testing performance [ 116 ]. This study was conducted within the context of Aboriginal and Torres Strait Islander people’s primary health care settings. Notably, ‘the clinics may not have consistently prioritized syphilis testing performance in their improvement strategies, as facilitated by the CQI program’ [ 116 ]. Additionally, by applying CQI-based mentoring, uptake of facility-based interventions was not significantly improved, though it was effective in increasing community health worker visits during pregnancy and the postnatal period, knowledge about maternal and child health and exclusive breastfeeding practice, and HIV disclosure status [ 117 ]. The study conducted in South Africa revealed no significant association between the coverage of facility-based interventions and Continuous Quality Improvement (CQI) implementation. This lack of association was attributed to the already high antenatal and postnatal attendance rates in both control and intervention groups at baseline, leaving little room for improvement. Additionally, the coverage of HIV interventions remained consistently high throughout the study period [ 117 ].

Regarding health care and policy implications, CQI has played a vital role in advancing PHC and fostering the realization of UHC goals worldwide. The indicators found in Donabedian’s framework that are positively influenced by CQI efforts are comparable to those included in the PHC performance initiative’s conceptual framework [ 29 , 118 , 119 ]. It is clearly explained that PHC serves as the roadmap to realizing the vision of UHC [ 120 , 121 ]. Given these circumstances, implementing CQI can contribute to the achievement of PHC principles and the objectives of UHC. For instance, by implementing CQI methods, countries have enhanced the accessibility, affordability, and quality of PHC services, leading to better health outcomes for their populations. CQI has facilitated identifying and resolving healthcare gaps and inefficiencies, enabling countries to optimize resource allocation and deliver more effective and patient-centered care. However, it is crucial to recognize that the successful implementation of Continuous Quality Improvement (CQI) necessitates optimizing the duration of each cycle, understanding challenges and barriers that extend beyond the health system and settings, and acknowledging that its effectiveness may be compromised if these challenges are not adequately addressed.

Despite abundant literature, there are still gaps regarding the relationship between CQI and other dimensions within the healthcare system. No studies have examined the impact of CQI initiatives on catastrophic health expenditure, effective service coverage, patient-centredness, comprehensiveness, equity, health security, and responsiveness.

Limitations

In conducting this review, it has some limitations to consider. Firstly, only articles published in English were included, which may introduce the exclusion of relevant non-English articles. Additionally, as this review follows a scoping methodology, the focus is on synthesising available evidence rather than critically evaluating or scoring the quality of the included articles.

Continuous quality improvement is investigated as a continuous and ongoing intervention, where the implementation time can vary across different cycles. The CQI team and implementation timelines were critical elements of CQI in different models. Among the commonly used approaches, the PDSA or PDCA is frequently employed. In most CQI models, a wide range of tools, nineteen tools, are commonly utilized to support the improvement process. Cultural, technical, structural, and strategic barriers and facilitators are significant in implementing CQI initiatives. Implementing the CQI initiative aims to improve health system blocks, enhance health service delivery process and output, and ultimately prevent morbidity and reduce mortality. For future researchers, considering that CQI is context-dependent approach, conducting scale-up implementation research about catastrophic health expenditure, effective service coverage, patient-centredness, comprehensiveness, equity, health security, and responsiveness across various settings and health issues would be valuable.

Availability of data and materials

The data used and/or analyzed during the current study are available in this manuscript and/or the supplementary file.

Shewhart WA, Deming WE. Memoriam: Walter A. Shewhart, 1891–1967. Am Stat. 1967;21(2):39–40.

Article   Google Scholar  

Shewhart WA. Statistical method from the viewpoint of quality control. New York: Dover; 1986. ISBN 978-0486652320. OCLC 13822053. Reprint. Originally published: Washington, DC: Graduate School of the Department of Agriculture, 1939.

Moen R, editor Foundation and History of the PDSA Cycle. Asian network for quality conference Tokyo. https://www.deming.org/sites/default/files/pdf/2015/PDSA_History_Ron_MoenPdf . 2009.

Kuperman G, James B, Jacobsen J, Gardner RM. Continuous quality improvement applied to medical care: experiences at LDS hospital. Med Decis Making. 1991;11(4suppl):S60–65.

Article   CAS   PubMed   Google Scholar  

Singh J, Singh H. Continuous improvement philosophy–literature review and directions. Benchmarking: An International Journal. 2015;22(1):75–119.

Goldstone J. Presidential address: Sony, Porsche, and vascular surgery in the 21st century. J Vasc Surg. 1997;25(2):201–10.

Radawski D. Continuous quality improvement: origins, concepts, problems, and applications. J Physician Assistant Educ. 1999;10(1):12–6.

Shortell SM, O’Brien JL, Carman JM, Foster RW, Hughes E, Boerstler H, et al. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation. Health Serv Res. 1995;30(2):377.

CAS   PubMed   PubMed Central   Google Scholar  

Lohr K. Quality of health care: an introduction to critical definitions, concepts, principles, and practicalities. Striving for quality in health care. 1991.

Berwick DM. The clinical process and the quality process. Qual Manage Healthc. 1992;1(1):1–8.

Article   CAS   Google Scholar  

Gift B. On the road to TQM. Food Manage. 1992;27(4):88–9.

CAS   PubMed   Google Scholar  

Greiner A, Knebel E. The core competencies needed for health care professionals. health professions education: A bridge to quality. 2003:45–73.

McCalman J, Bailie R, Bainbridge R, McPhail-Bell K, Percival N, Askew D et al. Continuous quality improvement and comprehensive primary health care: a systems framework to improve service quality and health outcomes. Front Public Health. 2018:6 (76):1–6.

Sheingold BH, Hahn JA. The history of healthcare quality: the first 100 years 1860–1960. Int J Afr Nurs Sci. 2014;1:18–22.

Google Scholar  

Donabedian A. Evaluating the quality of medical care. Milbank Q. 1966;44(3):166–206.

Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US). 2001. 2, Improving the 21st-century Health Care System. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222265/ .

Rubinstein A, Barani M, Lopez AS. Quality first for effective universal health coverage in low-income and middle-income countries. Lancet Global Health. 2018;6(11):e1142–1143.

Article   PubMed   Google Scholar  

Agency for Healthcare Reserach and Quality. Quality Improvement and monitoring at your fingertips USA,: Agency for Healthcare Reserach and Quality. 2022. Available from: https://qualityindicators.ahrq.gov/ .

Anderson CA, Cassidy B, Rivenburgh P. Implementing continuous quality improvement (CQI) in hospitals: lessons learned from the International Quality Study. Qual Assur Health Care. 1991;3(3):141–6.

Gardner K, Mazza D. Quality in general practice - definitions and frameworks. Aust Fam Physician. 2012;41(3):151–4.

PubMed   Google Scholar  

Loper AC, Jensen TM, Farley AB, Morgan JD, Metz AJ. A systematic review of approaches for continuous quality improvement capacity-building. J Public Health Manage Pract. 2022;28(2):E354.

Hill JE, Stephani A-M, Sapple P, Clegg AJ. The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review. Implement Sci. 2020;15(1):1–14.

Candas B, Jobin G, Dubé C, Tousignant M, Abdeljelil AB, Grenier S, et al. Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review. Endoscopy Int Open. 2016;4(02):E118–133.

Peters MD, Marnie C, Colquhoun H, Garritty CM, Hempel S, Horsley T, et al. Scoping reviews: reinforcing and advancing the methodology and application. Syst Reviews. 2021;10(1):1–6.

Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.

McGowan J, Straus S, Moher D, Langlois EV, O’Brien KK, Horsley T, et al. Reporting scoping reviews—PRISMA ScR extension. J Clin Epidemiol. 2020;123:177–9.

Donabedian A. Explorations in quality assessment and monitoring: the definition of quality and approaches to its assessment. Health Administration Press, Ann Arbor. 1980;1.

World Health Organization. Operational framework for primary health care: transforming vision into action. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF); 2020 [updated 14 December 2020; cited 2023 Nov Oct 17]. Available from: https://www.who.int/publications/i/item/9789240017832 .

The Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual :2014 edition. Australia: The Joanna Briggs Institute. 2014:88–91.

Rihal CS, Kamath CC, Holmes DR Jr, Reller MK, Anderson SS, McMurtry EK, et al. Economic and clinical outcomes of a physician-led continuous quality improvement intervention in the delivery of percutaneous coronary intervention. Am J Manag Care. 2006;12(8):445–52.

Ade-Oshifogun JB, Dufelmeier T. Prevention and Management of Do not return notices: a quality improvement process for Supplemental staffing nursing agencies. Nurs Forum. 2012;47(2):106–12.

Rubenstein L, Khodyakov D, Hempel S, Danz M, Salem-Schatz S, Foy R, et al. How can we recognize continuous quality improvement? Int J Qual Health Care. 2014;26(1):6–15.

O’Neill SM, Hempel S, Lim YW, Danz MS, Foy R, Suttorp MJ, et al. Identifying continuous quality improvement publications: what makes an improvement intervention ‘CQI’? BMJ Qual Saf. 2011;20(12):1011–9.

Article   PubMed   PubMed Central   Google Scholar  

Sibthorpe B, Gardner K, McAullay D. Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting. Aust J Prim Health. 2016;22(4):270–5.

Bennett CL, Crane JM. Quality improvement efforts in oncology: are we ready to begin? Cancer Invest. 2001;19(1):86–95.

VanValkenburgh DA. Implementing continuous quality improvement at the facility level. Adv Ren Replace Ther. 2001;8(2):104–13.

Loper AC, Jensen TM, Farley AB, Morgan JD, Metz AJ. A systematic review of approaches for continuous quality improvement capacity-building. J Public Health Manage Practice. 2022;28(2):E354–361.

Ryan M. Achieving and sustaining quality in healthcare. Front Health Serv Manag. 2004;20(3):3–11.

Nicolucci A, Allotta G, Allegra G, Cordaro G, D’Agati F, Di Benedetto A, et al. Five-year impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics. Diabetes Care. 2008;31(1):57–62.

Wakefield BJ, Blegen MA, Uden-Holman T, Vaughn T, Chrischilles E, Wakefield DS. Organizational culture, continuous quality improvement, and medication administration error reporting. Am J Med Qual. 2001;16(4):128–34.

Sori DA, Debelew GT, Degefa LS, Asefa Z. Continuous quality improvement strategy for increasing immediate postpartum long-acting reversible contraceptive use at Jimma University Medical Center, Jimma, Ethiopia. BMJ Open Qual. 2023;12(1):e002051.

Roche B, Robin C, Deleaval PJ, Marti MC. Continuous quality improvement in ambulatory surgery: the non-attending patient. Ambul Surg. 1998;6(2):97–100.

O’Connor JB, Sondhi SS, Mullen KD, McCullough AJ. A continuous quality improvement initiative reduces inappropriate prescribing of prophylactic antibiotics for endoscopic procedures. Am J Gastroenterol. 1999;94(8):2115–21.

Ursu A, Greenberg G, McKee M. Continuous quality improvement methodology: a case study on multidisciplinary collaboration to improve chlamydia screening. Fam Med Community Health. 2019;7(2):e000085.

Quick B, Nordstrom S, Johnson K. Using continuous quality improvement to implement evidence-based medicine. Lippincotts Case Manag. 2006;11(6):305–15 ( quiz 16 – 7 ).

Oyeledun B, Phillips A, Oronsaye F, Alo OD, Shaffer N, Osibo B, et al. The effect of a continuous quality improvement intervention on retention-in-care at 6 months postpartum in a PMTCT Program in Northern Nigeria: results of a cluster randomized controlled study. J Acquir Immune Defic Syndr. 2017;75(Suppl 2):S156–164.

Nyengerai T, Phohole M, Iqaba N, Kinge CW, Gori E, Moyo K, et al. Quality of service and continuous quality improvement in voluntary medical male circumcision programme across four provinces in South Africa: longitudinal and cross-sectional programme data. PLoS ONE. 2021;16(8):e0254850.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Wang J, Zhang H, Liu J, Zhang K, Yi B, Liu Y, et al. Implementation of a continuous quality improvement program reduces the occurrence of peritonitis in PD. Ren Fail. 2014;36(7):1029–32.

Stikes R, Barbier D. Applying the plan-do-study-act model to increase the use of kangaroo care. J Nurs Manag. 2013;21(1):70–8.

Wagner AD, Mugo C, Bluemer-Miroite S, Mutiti PM, Wamalwa DC, Bukusi D, et al. Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge. AIDS. 2017;31(Suppl 3):S243–252.

Le RD, Melanson SE, Santos KS, Paredes JD, Baum JM, Goonan EM, et al. Using lean principles to optimise inpatient phlebotomy services. J Clin Pathol. 2014;67(8):724–30.

Manyazewal T, Mekonnen A, Demelew T, Mengestu S, Abdu Y, Mammo D, et al. Improving immunization capacity in Ethiopia through continuous quality improvement interventions: a prospective quasi-experimental study. Infect Dis Poverty. 2018;7:7.

Kamiya Y, Ishijma H, Hagiwara A, Takahashi S, Ngonyani HAM, Samky E. Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial. Int J Qual Health Care. 2017;29(1):32–9.

Kibbe DC, Bentz E, McLaughlin CP. Continuous quality improvement for continuity of care. J Fam Pract. 1993;36(3):304–8.

Adrawa N, Ongiro S, Lotee K, Seret J, Adeke M, Izudi J. Use of a context-specific package to increase sputum smear monitoring among people with pulmonary tuberculosis in Uganda: a quality improvement study. BMJ Open Qual. 2023;12(3):1–6.

Hunt P, Hunter SB, Levan D. Continuous quality improvement in substance abuse treatment facilities: how much does it cost? J Subst Abuse Treat. 2017;77:133–40.

Azadeh A, Ameli M, Alisoltani N, Motevali Haghighi S. A unique fuzzy multi-control approach for continuous quality improvement in a radio therapy department. Qual Quantity. 2016;50(6):2469–93.

Memiah P, Tlale J, Shimabale M, Nzyoka S, Komba P, Sebeza J, et al. Continuous quality improvement (CQI) institutionalization to reach 95:95:95 HIV targets: a multicountry experience from the Global South. BMC Health Serv Res. 2021;21(1):711.

Yapa HM, De Neve JW, Chetty T, Herbst C, Post FA, Jiamsakul A, et al. The impact of continuous quality improvement on coverage of antenatal HIV care tests in rural South Africa: results of a stepped-wedge cluster-randomised controlled implementation trial. PLoS Med. 2020;17(10):e1003150.

Dadi TL, Abebo TA, Yeshitla A, Abera Y, Tadesse D, Tsegaye S, et al. Impact of quality improvement interventions on facility readiness, quality and uptake of maternal and child health services in developing regions of Ethiopia: a secondary analysis of programme data. BMJ Open Qual. 2023;12(4):e002140.

Weinberg M, Fuentes JM, Ruiz AI, Lozano FW, Angel E, Gaitan H, et al. Reducing infections among women undergoing cesarean section in Colombia by means of continuous quality improvement methods. Arch Intern Med. 2001;161(19):2357–65.

Andreoni V, Bilak Y, Bukumira M, Halfer D, Lynch-Stapleton P, Perez C. Project management: putting continuous quality improvement theory into practice. J Nurs Care Qual. 1995;9(3):29–37.

Balfour ME, Zinn TE, Cason K, Fox J, Morales M, Berdeja C, et al. Provider-payer partnerships as an engine for continuous quality improvement. Psychiatric Serv. 2018;69(6):623–5.

Agurto I, Sandoval J, De La Rosa M, Guardado ME. Improving cervical cancer prevention in a developing country. Int J Qual Health Care. 2006;18(2):81–6.

Anderson CI, Basson MD, Ali M, Davis AT, Osmer RL, McLeod MK, et al. Comprehensive multicenter graduate surgical education initiative incorporating entrustable professional activities, continuous quality improvement cycles, and a web-based platform to enhance teaching and learning. J Am Coll Surg. 2018;227(1):64–76.

Benjamin S, Seaman M. Applying continuous quality improvement and human performance technology to primary health care in Bahrain. Health Care Superv. 1998;17(1):62–71.

Byabagambi J, Marks P, Megere H, Karamagi E, Byakika S, Opio A, et al. Improving the quality of voluntary medical male circumcision through use of the continuous quality improvement approach: a pilot in 30 PEPFAR-Supported sites in Uganda. PLoS ONE. 2015;10(7):e0133369.

Hogg S, Roe Y, Mills R. Implementing evidence-based continuous quality improvement strategies in an urban Aboriginal Community Controlled Health Service in South East Queensland: a best practice implementation pilot. JBI Database Syst Rev Implement Rep. 2017;15(1):178–87.

Hopper MB, Morgan S. Continuous quality improvement initiative for pressure ulcer prevention. J Wound Ostomy Cont Nurs. 2014;41(2):178–80.

Ji J, Jiang DD, Xu Z, Yang YQ, Qian KY, Zhang MX. Continuous quality improvement of nutrition management during radiotherapy in patients with nasopharyngeal carcinoma. Nurs Open. 2021;8(6):3261–70.

Chen M, Deng JH, Zhou FD, Wang M, Wang HY. Improving the management of anemia in hemodialysis patients by implementing the continuous quality improvement program. Blood Purif. 2006;24(3):282–6.

Reeves S, Matney K, Crane V. Continuous quality improvement as an ideal in hospital practice. Health Care Superv. 1995;13(4):1–12.

Barton AJ, Danek G, Johns P, Coons M. Improving patient outcomes through CQI: vascular access planning. J Nurs Care Qual. 1998;13(2):77–85.

Buttigieg SC, Gauci D, Dey P. Continuous quality improvement in a Maltese hospital using logical framework analysis. J Health Organ Manag. 2016;30(7):1026–46.

Take N, Byakika S, Tasei H, Yoshikawa T. The effect of 5S-continuous quality improvement-total quality management approach on staff motivation, patients’ waiting time and patient satisfaction with services at hospitals in Uganda. J Public Health Afr. 2015;6(1):486.

PubMed   PubMed Central   Google Scholar  

Jacobson GH, McCoin NS, Lescallette R, Russ S, Slovis CM. Kaizen: a method of process improvement in the emergency department. Acad Emerg Med. 2009;16(12):1341–9.

Agarwal S, Gallo J, Parashar A, Agarwal K, Ellis S, Khot U, et al. Impact of lean six sigma process improvement methodology on cardiac catheterization laboratory efficiency. Catheter Cardiovasc Interv. 2015;85:S119.

Rahul G, Samanta AK, Varaprasad G A Lean Six Sigma approach to reduce overcrowding of patients and improving the discharge process in a super-specialty hospital. In 2020 International Conference on System, Computation, Automation and Networking (ICSCAN) 2020 July 3 (pp. 1-6). IEEE

Patel J, Nattabi B, Long R, Durey A, Naoum S, Kruger E, et al. The 5 C model: A proposed continuous quality improvement framework for volunteer dental services in remote Australian Aboriginal communities. Community Dent Oral Epidemiol. 2023;51(6):1150–8.

Van Acker B, McIntosh G, Gudes M. Continuous quality improvement techniques enhance HMO members’ immunization rates. J Healthc Qual. 1998;20(2):36–41.

Horine PD, Pohjala ED, Luecke RW. Healthcare financial managers and CQI. Healthc Financ Manage. 1993;47(9):34.

Reynolds JL. Reducing the frequency of episiotomies through a continuous quality improvement program. CMAJ. 1995;153(3):275–82.

Bunik M, Galloway K, Maughlin M, Hyman D. First five quality improvement program increases adherence and continuity with well-child care. Pediatr Qual Saf. 2021;6(6):e484.

Boyle TA, MacKinnon NJ, Mahaffey T, Duggan K, Dow N. Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx. Res Social Adm Pharm. 2012;8(6):499–508.

Price A, Schwartz R, Cohen J, Manson H, Scott F. Assessing continuous quality improvement in public health: adapting lessons from healthcare. Healthc Policy. 2017;12(3):34–49.

Gage AD, Gotsadze T, Seid E, Mutasa R, Friedman J. The influence of continuous quality improvement on healthcare quality: a mixed-methods study from Zimbabwe. Soc Sci Med. 2022;298:114831.

Chan YC, Ho SJ. Continuous quality improvement: a survey of American and Canadian healthcare executives. Hosp Health Serv Adm. 1997;42(4):525–44.

Balas EA, Puryear J, Mitchell JA, Barter B. How to structure clinical practice guidelines for continuous quality improvement? J Med Syst. 1994;18(5):289–97.

ElChamaa R, Seely AJE, Jeong D, Kitto S. Barriers and facilitators to the implementation and adoption of a continuous quality improvement program in surgery: a case study. J Contin Educ Health Prof. 2022;42(4):227–35.

Candas B, Jobin G, Dubé C, Tousignant M, Abdeljelil A, Grenier S, et al. Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review. Endoscopy Int Open. 2016;4(2):E118–133.

Brandrud AS, Schreiner A, Hjortdahl P, Helljesen GS, Nyen B, Nelson EC. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members. BMJ Qual Saf. 2011;20(3):251–9.

Lee S, Choi KS, Kang HY, Cho W, Chae YM. Assessing the factors influencing continuous quality improvement implementation: experience in Korean hospitals. Int J Qual Health Care. 2002;14(5):383–91.

Horwood C, Butler L, Barker P, Phakathi S, Haskins L, Grant M, et al. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa. Hum Resour Health. 2017;15(1):39.

Hyrkäs K, Lehti K. Continuous quality improvement through team supervision supported by continuous self-monitoring of work and systematic patient feedback. J Nurs Manag. 2003;11(3):177–88.

Akdemir N, Peterson LN, Campbell CM, Scheele F. Evaluation of continuous quality improvement in accreditation for medical education. BMC Med Educ. 2020;20(Suppl 1):308.

Barzansky B, Hunt D, Moineau G, Ahn D, Lai CW, Humphrey H, et al. Continuous quality improvement in an accreditation system for undergraduate medical education: benefits and challenges. Med Teach. 2015;37(11):1032–8.

Gaylis F, Nasseri R, Salmasi A, Anderson C, Mohedin S, Prime R, et al. Implementing continuous quality improvement in an integrated community urology practice: lessons learned. Urology. 2021;153:139–46.

Gaga S, Mqoqi N, Chimatira R, Moko S, Igumbor JO. Continuous quality improvement in HIV and TB services at selected healthcare facilities in South Africa. South Afr J HIV Med. 2021;22(1):1202.

Wang F, Yao D. Application effect of continuous quality improvement measures on patient satisfaction and quality of life in gynecological nursing. Am J Transl Res. 2021;13(6):6391–8.

Lee SB, Lee LL, Yeung RS, Chan J. A continuous quality improvement project to reduce medication error in the emergency department. World J Emerg Med. 2013;4(3):179–82.

Chiang AA, Lee KC, Lee JC, Wei CH. Effectiveness of a continuous quality improvement program aiming to reduce unplanned extubation: a prospective study. Intensive Care Med. 1996;22(11):1269–71.

Chinnaiyan K, Al-Mallah M, Goraya T, Patel S, Kazerooni E, Poopat C, et al. Impact of a continuous quality improvement initiative on appropriate use of coronary CT angiography: results from a multicenter, statewide registry, the advanced cardiovascular imaging consortium (ACIC). J Cardiovasc Comput Tomogr. 2011;5(4):S29–30.

Gibson-Helm M, Rumbold A, Teede H, Ranasinha S, Bailie R, Boyle J. A continuous quality improvement initiative: improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women. BJOG: Int J Obstet Gynecol. 2015;122:400–1.

Bennett IM, Coco A, Anderson J, Horst M, Gambler AS, Barr WB, et al. Improving maternal care with a continuous quality improvement strategy: a report from the interventions to minimize preterm and low birth weight infants through continuous improvement techniques (IMPLICIT) network. J Am Board Fam Med. 2009;22(4):380–6.

Krall SP, Iv CLR, Donahue L. Effect of continuous quality improvement methods on reducing triage to thrombolytic interval for Acute myocardial infarction. Acad Emerg Med. 1995;2(7):603–9.

Swanson TK, Eilers GM. Physician and staff acceptance of continuous quality improvement. Fam Med. 1994;26(9):583–6.

Yu Y, Zhou Y, Wang H, Zhou T, Li Q, Li T, et al. Impact of continuous quality improvement initiatives on clinical outcomes in peritoneal dialysis. Perit Dial Int. 2014;34(Suppl 2):S43–48.

Schiff GD, Goldfield NI. Deming meets Braverman: toward a progressive analysis of the continuous quality improvement paradigm. Int J Health Serv. 1994;24(4):655–73.

American Hospital Association Division of Quality Resources Chicago, IL: The role of hospital leadership in the continuous improvement of patient care quality. American Hospital Association. J Healthc Qual. 1992;14(5):8–14,22.

Scriven M. The Logic and Methodology of checklists [dissertation]. Western Michigan University; 2000.

Hales B, Terblanche M, Fowler R, Sibbald W. Development of medical checklists for improved quality of patient care. Int J Qual Health Care. 2008;20(1):22–30.

Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, et al. Communication in healthcare: a narrative review of the literature and practical recommendations. Int J Clin Pract. 2015;69(11):1257–67.

Eljiz K, Greenfield D, Hogden A, Taylor R, Siddiqui N, Agaliotis M, et al. Improving knowledge translation for increased engagement and impact in healthcare. BMJ open Qual. 2020;9(3):e000983.

O’Brien JL, Shortell SM, Hughes EF, Foster RW, Carman JM, Boerstler H, et al. An integrative model for organization-wide quality improvement: lessons from the field. Qual Manage Healthc. 1995;3(4):19–30.

Adily A, Girgis S, D’Este C, Matthews V, Ward JE. Syphilis testing performance in Aboriginal primary health care: exploring impact of continuous quality improvement over time. Aust J Prim Health. 2020;26(2):178–83.

Horwood C, Butler L, Barker P, Phakathi S, Haskins L, Grant M, et al. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa. Hum Resour Health. 2017;15:1–11.

Veillard J, Cowling K, Bitton A, Ratcliffe H, Kimball M, Barkley S, et al. Better measurement for performance improvement in low- and middle-income countries: the primary Health Care Performance Initiative (PHCPI) experience of conceptual framework development and indicator selection. Milbank Q. 2017;95(4):836–83.

Barbazza E, Kringos D, Kruse I, Klazinga NS, Tello JE. Creating performance intelligence for primary health care strengthening in Europe. BMC Health Serv Res. 2019;19(1):1006.

Assefa Y, Hill PS, Gilks CF, Admassu M, Tesfaye D, Van Damme W. Primary health care contributions to universal health coverage. Ethiopia Bull World Health Organ. 2020;98(12):894.

Van Weel C, Kidd MR. Why strengthening primary health care is essential to achieving universal health coverage. CMAJ. 2018;190(15):E463–466.

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Endalamaw, A., Khatri, R.B., Mengistu, T.S. et al. A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact. BMC Health Serv Res 24 , 487 (2024). https://doi.org/10.1186/s12913-024-10828-0

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Navigating the Ethical Terrain Around the Challenges of Fake News and False Narratives: An Integrative Literature Review and a Proposed Agenda for Future Research

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• Pramukh Nanjundaswamy Vasist 1 &
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Research on fake news and false narratives is growing, and their ethical implications are increasingly garnering academic attention. This escalating crisis demands prompt consideration since its proliferation poses a significant threat to organizations and societies. As scholarly investigations garner pace in this field of inquiry, it warrants a critical appraisal of the extant body of knowledge on ethical issues related to fake news and false narratives. To this end, we analyze this growing corpus of research through an integrative review. We discuss the themes that emerge from the review, leverage key observations to establish links with business ethics, and offer propositions and a conceptual framework that serves as a basis for scholars to advance the literary space at the nexus of falsehood and business ethics. We deliberate on potential future research avenues and implications to practice.

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Aftergood, S. (2016). Ethics: Taming our technologies. Nature, 536 (7616), 271. https://doi.org/10.1038/536271a

Article   Google Scholar  

Ahmed, A. (2018). “Fake News” and “Retweets”: News Reporting and Dissemination Ethics in the Qur’ān. Journal of Islamic and Muslim Studies , 3 (2): 61–84. https://muse.jhu.edu/article/722547

Alder, G. S. (1998). Ethical issues in electronic performance monitoring: A consideration of deontological and teleological perspectives. Journal of Business Ethics, 17 (7), 729–743. https://doi.org/10.1023/A:1005776615072

Alhojailan, M. I. (2012). Thematic analysis: A critical review of its process and evaluation. WEI International European Academic Conference Proceedings, 1 (1), 9.

Google Scholar  

Allcott, H., & Gentzkow, M. (2017). Social Media and Fake News in the 2016 Election. Journal of Economic Perspectives, 31 (2), 211–236. https://doi.org/10.1257/jep.31.2.211

Anand, B. N. (2017). The U.S. Media’s Problems Are Much Bigger than Fake News and Filter Bubbles. Harvard Business Review . https://hbr.org/2017/01/the-u-s-medias-problems-are-much-bigger-than-fake-news-and-filter-bubbles

Annas, G. J. (1998). Some choice: Law, medicine, and the market . Oxford University Press.

Anshari, M., Hamdan, M., Ahmad, N., Ali, E., & Haidi, H. (2023). COVID-19, artificial intelligence, ethical challenges and policy implications. AI & SOCIETY, 38 (2), 707–720. https://doi.org/10.1007/s00146-022-01471-6

Apuke, O. D., & Omar, B. (2021). The ethical challenges and issues of online journalism practice in Nigeria: What do professionals and academics think? Technology in Society, 67 , 101713. https://doi.org/10.1016/j.techsoc.2021.101713

Ashrafi-rizi, H., Kazempour, Z., Sheikhshoaei, F., & Ghazavi, Z. (2020). Designing a model of professional ethics excellence for clinical librarians. Journal of the Medical Library Association : JMLA, 108 (4), 574–583. https://doi.org/10.5195/jmla.2020.893

Baird, C., & Calvard, T. S. (2019). epistemic vices in organizations: Knowledge, truth, and unethical conduct. Journal of Business Ethics, 160 (1), 263–276. https://doi.org/10.1007/s10551-018-3897-z

Bakir, V., & McStay, A. (2018). Fake news and the economy of emotions. Digital Journalism, 6 (2), 154–175. https://doi.org/10.1080/21670811.2017.1345645

Barbakoff, A. (2010). Libraries Build Autonomy: A Philosophical Perspective on the Social Role of Libraries and Librarians. Library Philosophy and Practice (e-Journal) . https://digitalcommons.unl.edu/libphilprac/463

Baten, R. A., & Hoque, E. (2021). Technology-driven alteration of nonverbal cues and its effects on negotiation. Negotiation Journal, 37 (1), 35–47. https://doi.org/10.1111/nejo.12347

Bay, M. (2021). Four challenges to confucian virtue ethics in technology. Journal of Information, Communication and Ethics in Society, 19 (3), 358–373. https://doi.org/10.1108/JICES-01-2021-0004

Bedi, S. (2022). Not the (Speech) Chilling Effect We Think Archives . ThinkND. https://think.nd.edu/bq/not-the-speech-chilling-effect-we-think/

Benedict, S., Shields, L., & O’Donnell, A. J. (2009). Children’s “Euthanasia” in Nazi Germany. Journal of Pediatric Nursing, 24 (6), 506–516. https://doi.org/10.1016/j.pedn.2008.07.012

Benham, J. (2020). Best practices for journalistic balance: Gatekeeping, imbalance and the fake news Era. Journalism Practice, 14 (7), 791–811. https://doi.org/10.1080/17512786.2019.1658538

Beu, D., & Buckley, M. R. (2001). The hypothesized relationship between accountability and ethical behavior. Journal of Business Ethics, 34 (1), 57–73. https://doi.org/10.1023/A:1011957832141

Bjola, C. (2018). The ethics of countering digital propaganda. Ethics & International Affairs, 32 (3), 305–315. https://doi.org/10.1017/S0892679418000436

Borden, S. L., & Tew, C. (2007). The role of journalist and the performance of journalism: Ethical lessons from “Fake” News (Seriously). Journal of Mass Media Ethics, 22 (4), 300–314. https://doi.org/10.1080/08900520701583586

Bradshaw, J. L. (2020). Rhetorical exhaustion & the ethics of amplification. Computers and Composition, 56 , 102568. https://doi.org/10.1016/j.compcom.2020.102568

Breen, D. C. (2021). Silent no more: How deepfakes will force courts to reconsider video admission standards. Journal of High Technology Law , 21 (1), 122–161. https://heinonline.org/HOL/Page?handle=hein.journals/jhtl21&id=123&div=&collection =

Brinkmann, J. (2019). The potential use of sociological perspectives for business ethics teaching. Journal of Business Ethics, 156 (1), 273–287. https://doi.org/10.1007/s10551-017-3636-x

Britt, M., & Sharda, C. (2000). The Business Interest in a Community’s Health . Washington Business Group on Health (WBGH) prepared for the W.K. Kellogg Foundation.

Brown, E. (2019). “Fake News” and conceptual ethics. Journal of Ethics and Social Philosophy . https://doi.org/10.26556/jesp.v16i2.648

Bryant, A. G., & Swartz, J. J. (2018). Why crisis pregnancy centers are legal but unethical. AMA Journal of Ethics, 20 (1), 269–277. https://doi.org/10.1001/journalofethics.2018.20.3.pfor1-1803

Burrell, G., Hyman, M. R., Michaelson, C., Nelson, J. A., Taylor, S., & West, A. (2022). The ethics and politics of academic knowledge production: thoughts on the future of business ethics. Journal of Business Ethics . https://doi.org/10.1007/s10551-022-05243-6

Carrigan, M., & Szmigin, I. (2000). The ethical advertising covenant: Regulating ageism in UK advertising. International Journal of Advertising, 19 (4), 509–528. https://doi.org/10.1080/02650487.2000.11104818

Chang, T.-K., & Lin, F. (2014). From propaganda to public diplomacy: Assessing China’s international practice and its image, 1950–2009. Public Relations Review . https://doi.org/10.1016/j.pubrev.2014.04.008

Chatterjee, S., Chaudhuri, R., & Vrontis, D. (2022). Role of fake news and misinformation in supply chain disruption: Impact of technology competency as moderator. Annals of Operations Research . https://doi.org/10.1007/s10479-022-05001-x

Chauhan, R. S., Connelly, S., Howe, D. C., Soderberg, A. T., & Crisostomo, M. (2022). The danger of “fake news”: How using social media for information dissemination can inhibit the ethical decision making process. Ethics & Behavior, 32 (4), 287–306. https://doi.org/10.1080/10508422.2021.1890598

Cherinet, Y. M. (2018). Blended skills and future roles of librarians. Library Management, 39 (1/2), 93–105. https://doi.org/10.1108/LM-02-2017-0015

Cho, C. H., Martens, M. L., Kim, H., & Rodrigue, M. (2011). Astroturfing global warming: It isn’t always greener on the other side of the fence. Journal of Business Ethics, 104 (4), 571–587. https://doi.org/10.1007/s10551-011-0950-6

Ciampaglia, G. L., & Menczer, F. (2018, June 21). Biases Make People Vulnerable to Misinformation Spread by Social Media . Scientific American. Retrieved on November 4, 2022, from https://www.scientificamerican.com/article/biases-make-people-vulnerable-to-misinformation-spread-by-social-media/

Cinelli, M., Quattrociocchi, W., Galeazzi, A., Valensise, C. M., Brugnoli, E., Schmidt, A. L., Zola, P., Zollo, F., & Scala, A. (2020). The COVID-19 social media infodemic. Scientific Reports . https://doi.org/10.1038/s41598-020-73510-5

Cohen, J. (2019). Bringing Down the Average: The Case for a “Less Sophisticated” Reasonableness Standard in US and EU Consumer Law. Loyola Consumer Law Review , 32 (1), 1. Retrieved on November 3, 2022, from https://lawecommons.luc.edu/lclr/vol32/iss1/2

Coll, S. (2017). Donald Trump’s “Fake News” Tactics. The New Yorker . Retrieved on Febrauary 23, 2023, from https://www.newyorker.com/magazine/2017/12/11/donald-trumps-fake-news-tactics

Conlin, W. E., & Boness, C. L. (2019). Ethical considerations for addressing distorted beliefs in psychotherapy. Psychotherapy (Chicago, Ill.), 56 (4), 449–458. https://doi.org/10.1037/pst0000252

Cornfield, M. (1987). Presidential rhetoric and the credibility gap. Communication Research, 14 (4), 462–469. https://doi.org/10.1177/009365087014004006

Crane, A., & Matten, D. (2004). Questioning the domain of the business ethics curriculum. Journal of Business Ethics, 54 (4), 357–369. https://doi.org/10.1007/s10551-004-1825-x

Cronin, M. A., & George, E. (2020). The why and how of the integrative review. Organizational Research Methods . https://doi.org/10.1177/1094428120935507

Cunningham, S. B. (1992). Sorting out the ethics of propaganda. Communication Studies, 43 (4), 233–245. https://doi.org/10.1080/10510979209368375

D’Cruz, P., Du, S., Noronha, E., Parboteeah, K. P., Trittin-Ulbrich, H., & Whelan, G. (2022). Technology, megatrends and work: Thoughts on the future of business ethics. Journal of Business Ethics, 180 (3), 879–902. https://doi.org/10.1007/s10551-022-05240-9

Davis, C., & Craft, S. (2000). New media synergy: Emergence of institutional conflicts of interest. Journal of Mass Media Ethics, 15 (4), 219–231. https://doi.org/10.1207/S15327728JMME1504_2

de Beer, D., & Matthee, M. (2021). Approaches to identify fake news: A systematic literature review. In T. Antipova (Ed.), Integrated science in digital age 2020 (pp. 13–22). Springer International Publishing. https://doi.org/10.1007/978-3-030-49264-9_2

Chapter   Google Scholar  

de Ruiter, A. (2021). The distinct wrong of deepfakes. Philosophy & Technology . https://doi.org/10.1007/s13347-021-00459-2

Dennis, A. R., Galletta, D. F., & Webster, J. (2021). Special issue: Fake news on the internet. Journal of Management Information Systems., 38 (4), 893–897. https://doi.org/10.1080/07421222.2021.1990609

Di Domenico, G., & Ding, Y. (2023). Between brand attacks and broader narratives: How direct and indirect misinformation erode consumer trust. Current Opinion in Psychology, 54 , 101716. https://doi.org/10.1016/j.copsyc.2023.101716

Ding, K., Shu, K., Li, Y., Bhattacharjee, A., & Liu, H. (2020). Challenges in Combating COVID-19 Infodemic—Data, Tools, and Ethics . Retrieved on November 4, 2022, from arXiv:2005.13691 . arXiv. https://doi.org/10.48550/arXiv.2005.13691

Domenico, G. D., Sit, J., Ishizaka, A., & Nunan, D. (2021). Fake news, social media and marketing: A systematic review. Journal of Business Research, 124 , 329–341. https://doi.org/10.1016/j.jbusres.2020.11.037

Donovan, J., & Boyd, D. (2021). Stop the presses? Moving from strategic silence to strategic amplification in a networked media ecosystem. American Behavioral Scientist, 65 (2), 333–350. https://doi.org/10.1177/0002764219878229

Du, S. (2022). Reimagining the future of technology: “The Social Dilemma” review. Journal of Business Ethics, 177 (1), 213–215. https://doi.org/10.1007/s10551-021-04816-1

Dubnick, M. (1998). Clarifying Accountability: An Ethical Theory Framework. Political Science . https://scholars.unh.edu/polisci_facpub/46

Edwards, L. (2021). Organised lying and professional legitimacy: Public relations’ accountability in the disinformation debate. European Journal of Communication, 36 (2), 168–182. https://doi.org/10.1177/0267323120966851

Effron, D. A. (2018). It could have been true: how counterfactual thoughts reduce condemnation of falsehoods and increase political polarization. Personality and Social Psychology Bulletin, 44 (5), 729–745. https://doi.org/10.1177/0146167217746152

Effron, D. A., & Miller, D. T. (2012). How the moralization of issues grants social legitimacy to act on one’s attitudes. Personality and Social Psychology Bulletin, 38 (5), 690–701. https://doi.org/10.1177/0146167211435982

Engelbrecht, C. (2019). A Judge Jacob Zuma and the Practitioners of Post truth Politics Micro history Singularization and Context . https://www.academia.edu/41154084/A_Judge_Jacob_Zuma_and_the_Practitioners_of_Post_truth_Politics_Micro_history_Singularization_and_Context20191202_72596_rt2i2h

European Commission, D.-G. for E., Youth, Sport and Culture. (2022). Guidelines for teachers and educators on tackling disinformation and promoting digital literacy through education and training . Publications Office of the European Union. Retrieved on February 24, 2023, from https://data.europa.eu/doi/10.2766/28248

Farkas, J., & Schou, J. (2019). Post-Truth, Fake News and Democracy: Mapping the Politics of Falsehood .

Fawkes, J. (2007). Public relations models and persuasion ethics: A new approach. Journal of Communication Management, 11 (4), 313–331. https://doi.org/10.1108/13632540710843922

Feenstra, R. A., & Esteban, E. (2019). Autocontrol: A critical study of achievements and challenges in the pursuit of ethical advertising through an advertising self-regulation system. Journal of Business Ethics, 154 (2), 341–354. https://doi.org/10.1007/s10551-016-3423-0

Feingold, R., Herman, L., Finkel, J., Jiang, S., Luo, M., Mears, R., Metaxa-Kakavouli, D., Peeples, C., Sasso, B., Shenoy, A., Sheu, V., & Torres-Echeverry, N. (2017). Fake News and Misinformation: The Roles of the Nation’s Digital Newsstands, Facebook, Google, Twitter, and Reddit . Law & Policy Lab. Retrieved on October 17, 2023, from https://law.stanford.edu/publications/fake-news-and-misinformation-the-roles-of-the-nations-digital-newsstands-facebook-google-twitter-and-reddit/

Ferguson, S., & Weckert, J. (1998). The Librarian’s Duty of Care: Emerging Professionalism or Can of Worms? The Library Quarterly: Information, Community, Policy , 68 (4), 365–389. Retrieved on May 18, 2022, from https://www.jstor.org/stable/4309244?seq=1

Figueira, Á., Guimaraes, N., & Torgo, L. (2019). A brief overview on the strategies to fight back the spread of false information. Journal of Web Engineering., 18 (4), 319–352. https://doi.org/10.13052/jwe1540-9589.18463

Fisher, C., Flew, T., Park, S., Lee, J. Y., & Dulleck, U. (2021). Improving trust in news: Audience solutions. Journalism Practice, 15 (10), 1497–1515. https://doi.org/10.1080/17512786.2020.1787859

Fisher, J. (2001). Lessons for business ethics from bioethics. Journal of Business Ethics, 34 (1), 15–24. https://doi.org/10.1023/A:1011916709062

Fiske, S. (2021). On the Wrongs of Fake News. CMC Senior Theses . Retrieved on February 22, 2023, from https://scholarship.claremont.edu/cmc_theses/2742

Floridi, L. (2009). Network ethics: Information and business ethics in a networked society. Journal of Business Ethics, 90 (4), 649–659. https://doi.org/10.1007/s10551-010-0598-7

Floridi, L. (2013). The ethics of information . OUP Oxford.

Book   Google Scholar  

Fogg, B. J. (2003). Introduction. In B. J. Fogg (Ed.), Persuasive technology. Morgan Kaufmann (pp. 1–13). Elsevier. https://doi.org/10.1016/B978-155860643-2/50002-0

França, K., Patel, T. N., Patel, S. B., & Nouri, K. (2019). Medical ethics and bioethics in pediatric dermatology. Pediatric dermatologic surgery (pp. 303–313). John Wiley & Sons Ltd. https://doi.org/10.1002/9781118769836.ch26

Frandsen, F., & Johansen, W. (2015). Organizations, stakeholders, and intermediaries: Towards a general theory. International Journal of Strategic Communication . https://doi.org/10.1080/1553118X.2015.1064125

Gelders, D., & Ihlen, Ø. (2010). Government communication about potential policies: Public relations, propaganda or both? Public Relations Review, 36 (1), 59–62. https://doi.org/10.1016/j.pubrev.2009.08.012

Gelfert, A. (2018). Fake news: A definition. Informal Logic., 38 (1), 84–117. https://doi.org/10.22329/il.v38i1.5068

Girona, R., & Xifra, J. (2010). From the “strategy of truth” to the “weapon of truth”: The Government Information Manual for the Motion Picture Industry, 1942. Public Relations Review, 36 (3), 306–309. https://doi.org/10.1016/j.pubrev.2010.04.011

Glisson, L. (2019). Breaking the spin cycle: Teaching complexity in the age of fake news. Portal Libraries and the Academy., 19 (3), 461–484. https://doi.org/10.1353/pla.2019.0027

Gomboș, C. (2021, December 2). FAKE NEWS: The European Commission “cancels” Christmas and bans the use of the Christian name “Mary.” . Retrieved February 2, 2023, from https://www.veridica.ro/en/fake-news/fake-news-the-european-commission-cancels-christmas-and-bans-the-use-of-the-christian-name-mary

Green, J., Petty, J., Whiting, L., Orr, F., Smart, L., Brown, A.-M., & Jones, L. (2022). “Blurred boundaries”: When nurses and midwives give anti-vaccination advice on Facebook. Nursing Ethics . https://doi.org/10.1177/09697330211041749

Hanna, R. (2022). Kant’s Theory of Judgment. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Spring 2022). Metaphysics Research Lab, Stanford University. Retrieved on February 23, 2023, from https://plato.stanford.edu/archives/spr2022/entries/kant-judgment/

Hatton, A., & Nielsen, M. (2016). “War on Terror” in our backyard: Effects of framing and violent ISIS propaganda on anti-Muslim prejudice. Behavioral Sciences of Terrorism and Political Aggression, 8 , 1–14. https://doi.org/10.1080/19434472.2015.1126341

Heath, J., Moriarty, J., & Norman, W. (2010). Business ethics and (or as) political philosophy. Business Ethics Quarterly, 20 (3), 427–452. https://doi.org/10.5840/beq201020329

Helm, R. K., & Nasu, H. (2021). Regulatory responses to ‘Fake News’ and freedom of expression: normative and empirical evaluation. Human Rights Law Review, 21 (2), 302–328. https://doi.org/10.1093/hrlr/ngaa060

Henschke, A., & Reed, A. (2021). Toward an ethical framework for countering extremist propaganda online. Studies in Conflict & Terrorism . https://doi.org/10.1080/1057610X.2020.1866744

Herzog, L. (2022). Shared standards versus competitive pressures in journalism. Journal of Applied Philosophy, 39 (3), 393–406. https://doi.org/10.1111/japp.12491

Hight, C. (2021). Deepfakes and documentary practice in an age of misinformation. Continuum . https://doi.org/10.1080/10304312.2021.2003756

Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review. Scandinavian Journal of Caring Sciences, 30 (4), 662–669. https://doi.org/10.1111/scs.12327

Huang, Y. L., Starbird, K., Orand, M., Stanek, S. A., & Pedersen, H. T. (2015). Connected Through Crisis: Emotional Proximity and the Spread of Misinformation Online. Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work & Social Computing . pp. 969–980. https://doi.org/10.1145/2675133.2675202

Ikonen, P., Luoma-aho, V., & Bowen, S. A. (2017). Transparency for sponsored content: analysing codes of ethics in public relations, marketing, advertising and journalism. International Journal of Strategic Communication, 11 (2), 165–178. https://doi.org/10.1080/1553118X.2016.1252917

Irving, D. N. (1993). The impact of “Scientific Misinformation” on other fields: Philosophy theology, biomedical ethics. Public Policy. Accountability in Research, 2 (4), 243–272. https://doi.org/10.1080/08989629308573821

Jalli, N., Jalli, N., & Idris, I. (2019). Fake News and Elections in Two Southeast Asian Nations: A Comparative Study of Malaysia General Election 2018 and Indonesia Presidential Election 2019 . pp. 138–148. https://doi.org/10.2991/icdesa-19.2019.30

John, B. S. (2006). The case for ethical propaganda within a democracy: Ivy Lee’s successful 1913–1914 railroad rate campaign. Public Relations Review, 32 (3), 221–228. https://doi.org/10.1016/j.pubrev.2006.05.023

Jowett, G. S., & O’Donnell, V. (2018). Propaganda & Persuasion . SAGE Publications.

Kane, E. J. (2004). Continuing dangers of disinformation in corporate accounting reports. Review of Financial Economics, 13 (1), 149–164. https://doi.org/10.1016/j.rfe.2003.09.007

Kaptein, M. (2008). Developing a measure of unethical behavior in the workplace: A stakeholder perspective. Journal of Management, 34 (5), 978–1008. https://doi.org/10.1177/0149206308318614

Kates, S. (1998). A qualitative exploration into voters’ ethical perceptions of political advertising: discourse, disinformation, and moral boundaries. Journal of Business Ethics, 17 (16), 1871–1885. https://doi.org/10.1023/A:1005796113389

Keyes, R. (2004). The post-truth era: Dishonesty and deception in contemporary life . Martin’s Publishing Group.

Kitta, A. (2018). Alternative health websites and fake news: Taking a stab at definition, genre, and belief. Journal of American Folklore, 131 (522), 405–412. https://doi.org/10.5406/jamerfolk.131.522.0405

Koshiyama, A., Kazim, E., Treleaven, P., Rai, P., Szpruch, L., Pavey, G., Ahamat, G., Leutner, F., Goebel, R., Knight, A., Adams, J., Hitrova, C., Barnett, J., Nachev, P., Barber, D., Chamorro-Premuzic, T., Klemmer, K., Gregorovic, M., Khan, S., & Lomas, E. (2021). Towards Algorithm Auditing: A Survey on Managing Legal, Ethical and Technological Risks of AI, ML and Associated Algorithms (SSRN Scholarly Paper 3778998). https://doi.org/10.2139/ssrn.3778998

Kovach, B., & Rosenstiel, T. (2014). The Elements of Journalism, Revised and Updated 3rd Edition: What Newspeople Should Know and the Public Should Expect . Crown.

Lacity, M. C. (2021). Fake news, technology and ethics: Can AI and blockchains restore integrity? Journal of Information Technology Teaching Cases . https://doi.org/10.1177/2043886921999065

Lamy, E. (2022). Epistemic responsibility in business: An integrative framework for an epistemic ethics. Journal of Business Ethics . https://doi.org/10.1007/s10551-022-05078-1

Landon-Murray, M., Mujkic, E., & Nussbaum, B. (2019). Disinformation in contemporary U.S. foreign policy: Impacts and ethics in an era of fake news, social media, and artificial intelligence. Public Integrity, 21 (5), 512–522. https://doi.org/10.1080/10999922.2019.1613832

Laufer, W. S. (2003). Social accountability and corporate greenwashing. Journal of Business Ethics, 43 (3), 253–261. https://doi.org/10.1023/A:1022962719299

Lazer, D. M. J., Baum, M. A., Benkler, Y., Berinsky, A. J., Greenhill, K. M., Menczer, F., Metzger, M. J., Nyhan, B., Pennycook, G., Rothschild, D., Schudson, M., Sloman, S. A., Sunstein, C. R., Thorson, E. A., Watts, D. J., & Zittrain, J. L. (2018). The science of fake news. Science, 359 (6380), 1094–1096. https://doi.org/10.1126/science.aao2998

Lee, T. (2019). The global rise of “fake news” and the threat to democratic elections in the USA. Public Administration and Policy, 22 (1), 15–24. https://doi.org/10.1108/PAP-04-2019-0008

Legg, T., Legendre, M., & Gilmore, A. B. (2021). Paying lip service to publication ethics: Scientific publishing practices and the Foundation for a Smoke-Free World. Tobacco Control, 30 (e1), e65–e72. https://doi.org/10.1136/tobaccocontrol-2020-056003

Leitner, S., Gula, B., Jannach, D., Krieg-Holz, U., & Wall, F. (2021). Understanding the dynamics emerging from infodemics: A call to action for interdisciplinary research. SN Business & Economics, 1 (1), 23. https://doi.org/10.1007/s43546-020-00027-4

Lim, J. S., & Ki, E.-J. (2007). Resistance to ethically suspicious parody video on youtube: A test of inoculation theory. Journalism & Mass Communication Quarterly, 84 (4), 713–728. https://doi.org/10.1177/107769900708400404

Lobschat, L., Mueller, B., Eggers, F., Brandimarte, L., Diefenbach, S., Kroschke, M., & Wirtz, J. (2021). Corporate digital responsibility. Journal of Business Research, 122 , 875–888. https://doi.org/10.1016/j.jbusres.2019.10.006

Lock, I., & Ludolph, R. (2020). Organizational propaganda on the Internet: A systematic review. Public Relations Inquiry, 9 (1), 103–127. https://doi.org/10.1177/2046147X19870844

Lock, I., Seele, P., & Heath, R. L. (2016). Where grass has no roots: The concept of ‘shared strategic communication’ as an answer to unethical astroturf lobbying. International Journal of Strategic Communication, 10 (2), 87–100. https://doi.org/10.1080/1553118X.2015.1116002

Locke, K. D. (2022, January 20). Grounded Theory in Management Research . SAGE India. Retrieved on January 21, 2022, from https://in.sagepub.com/en-in/sas/grounded-theory-in-management-research/book209772

Lor, P. (2021). Re-thinking information ethics: Truth, conspiracy theories, and librarians in the COVID-19 era. Libri International Journal of Libraries & Information Services . https://doi.org/10.1515/libri-2020-0158

Lovari, A., & Bowen, S. A. (2020). Social media in disaster communication: A case study of strategies, barriers, and ethical implications. Journal of Public Affairs, 20 (1), e1967. https://doi.org/10.1002/pa.1967

MacFarlane, A., Missaoui, S., Makri, S., & Gutierrez Lopez, M. (2021). Sender vs. recipient-orientated information systems revisited. Journal of Documentation, 78 (2), 485–509. https://doi.org/10.1108/JD-10-2020-0177

Magill, G., & Prybil, L. (2004). Stewardship and Integrity in health care: A role for organizational ethics. Journal of Business Ethics, 50 (3), 225–238. https://doi.org/10.1023/B:BUSI.0000024742.62802.1a

Marshall, N. (2017, November 2). 7 reasons why fake news goes viral, according to experts . Independent.Ie. Retrieved on February 23, 2023, from https://www.independent.ie/world-news/and-finally/7-reasons-why-fake-news-goes-viral-according-to-experts-36283450.html

Martin, K. (2022). Who Counts in Business Ethics (SSRN Scholarly Paper 4238129). https://doi.org/10.2139/ssrn.4238129

Mbinjama-Gamatham, A., & Olivier, B. (2020). ‘Dark technology’ aggressiveness and the question of cyber-ethics. Acta Academica Critical Views on Society Culture and Politics . https://doi.org/10.18820/24150479/aa52i1/1

Mbunge, E., Fashoto, S. G., Akinnuwesi, B., Metfula, A., Simelane, S., & Ndumiso, N. (2021). Ethics for integrating emerging technologies to contain COVID-19 in Zimbabwe. Human Behavior and Emerging Technologies, 3 (5), 876–890. https://doi.org/10.1002/hbe2.277

McManus, J. H. (1997). Who’s responsible for journalism? Journal of Mass Media Ethics, 12 (1), 5–17. https://doi.org/10.1207/s15327728jmme1201_1

Mehta, A. M., Liu, B. F., Tyquin, E., & Tam, L. (2021). A process view of crisis misinformation: How public relations professionals detect, manage, and evaluate crisis misinformation. Public Relations Review, 47 (2), 102040. https://doi.org/10.1016/j.pubrev.2021.102040

Melchior, C., & Oliveira, M. (2021). Health-related fake news on social media platforms: A systematic literature review. New Media & Society . https://doi.org/10.1177/14614448211038762

Menczer, F. (2021). Facebook’s algorithms fueled massive foreign propaganda campaigns during the 2020 election – here’s how algorithms can manipulate you . The Conversation. Retrieved on February 26, 2023, from http://theconversation.com/facebooks-algorithms-fueled-massive-foreign-propaganda-campaigns-during-the-2020-election-heres-how-algorithms-can-manipulate-you-168229

Meskys, E., Liaudanskas, A., Kalpokiene, J., & Jurcys, P. (2020). Regulating deep fakes: Legal and ethical considerations. Journal of Intellectual Property Law & Practice, 15 (1), 24–31. https://doi.org/10.1093/jiplp/jpz167

Michelson, E. (2019). The ethical knower: Rethinking our pedagogy in the age of trump. Adult Education Quarterly, 69 (2), 142–156. https://doi.org/10.1177/0741713619834626

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook . SAGE.

Miller, J. E. (2013). How a clinical trial registry became a symbol of misinformation. The Hastings Center Report, 43 (6), 11–12. https://doi.org/10.1002/hast.226

Miranda, J., Fidalgo, J., & Martins, P. (2021). Journalism in Time of Pandemic: New Professional Routines, New Ethical Challenges (H. Antunes, Trans.). Comunicação e Sociedade . Retrieved on May 12, 2022, from https://journals.openedition.org/cs/5688

Moriarty, J. (2005). On the relevance of political philosophy to business ethics. Business Ethics Quarterly, 15 (3), 455–473. https://doi.org/10.5840/beq200515330

Mukhudwana, R. F. (2021). The rise of peripheral actors in media regulation in South Africa: An entry of social media Mob(s). African Journalism Studies, 42 (4), 153–178. https://doi.org/10.1080/23743670.2022.2032783

Mullender, R. (2008). Nazi Law and the Concept of Community. The University of Toronto Law Journal , 58 (3), 377–387. Retrieved on May 3, 2022, from https://www.jstor.org/stable/20109853

Muramoto, O. (1998). Bioethics of the refusal of blood by Jehovah’s Witnesses: Part 2. A novel approach based on rational non-interventional paternalism. Journal of Medical Ethics., 24 (5), 295–301. https://doi.org/10.1136/jme.24.5.295

Nass, S. J., Levit, L. A., Gostin, L. O., & Rule, I. of M. (US) C. on H. R. and the P. of H. I. T. H. P. (2009). The Value and Importance of Health Information Privacy. In Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research . National Academies Press (US). Retrieved on June 18, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK9579/

Neesham, C., & Macklin, R. (2017). Political philosophy and business ethics. In D. C. Poff & A. C. Michalos (Eds.), Encyclopedia of business and professional ethics (pp. 1–6). Springer International Publishing. https://doi.org/10.1007/978-3-319-23514-1_174-1

Nickell, D., & Herzog, H. A. (1996). Ethical ideology and moral persuasion: Personal moral philosophy, gender, and judgments of pro- and anti-animal research propaganda. Society & Animals: Social Scientific Studies of the Human Experience of Other Animals, 4 (1), 53–64. https://doi.org/10.1163/156853096x00043

Nie, J.-B. (2004). The west’s dismissal of the Khabarovsk trial as ‘Communist Propaganda’: Ideology, evidence and international bioethics. Journal of Bioethical Inquiry, 1 (1), 32–42. https://doi.org/10.1007/BF02448905

Nie, J.-B. (2020). In the shadow of biological warfare: Conspiracy theories on the origins of COVID-19 and enhancing global governance of biosafety as a matter of urgency. Journal of Bioethical Inquiry, 17 (4), 567–574. https://doi.org/10.1007/s11673-020-10025-8

NIH. (2021). Bioethics . National Institute of Environmental Health Sciences. Retrieved on June 18, 2023, from https://www.niehs.nih.gov/research/resources/bioethics/index.cfm

North-Samardzic, A. (2020). Biometric technology and ethics: Beyond security applications. Journal of Business Ethics, 167 (3), 433–450. https://doi.org/10.1007/s10551-019-04143-6

Nyilasy, G. (2019). Fake news: When the dark side of persuasion takes over. International Journal of Advertising, 38 (2), 336–342. https://doi.org/10.1080/02650487.2019.1586210

Obregon, S. L., Lopes, L. F. D., Kaczam, F., da Veiga, C. P., & da Silva, W. V. (2022). Religiosity, spirituality and work: A systematic literature review and research directions. Journal of Business Ethics, 179 (2), 573–595. https://doi.org/10.1007/s10551-021-04856-7

Park, B., Rao, D. L., & Gudivada, V. N. (2021). Dangers of bias in data-intensive information systems. In P. Deshpande, A. Abraham, B. Iyer, & K. Ma (Eds.), Next generation information processing system (pp. 259–271). Springer. https://doi.org/10.1007/978-981-15-4851-2_28

Phillips, W. (2020). You’re Fake News: The Problem with Accusations of Falsehood. In: Fake News: Understanding Media and Misinformation in the Digital Age . https://doi.org/10.7551/mitpress/11807.003.0007

Phillips, N. (1991). The sociology of knowledge: Toward an existential view of business ethics. Journal of Business Ethics, 10 (10), 787–795. https://doi.org/10.1007/BF00705713

Picard, R. (2004). Corporate Governance: Rating Leading Public Media Companies . Workshop on corporate governance of media companies, Jönköping International Business School, Stockholm, Sweden.

Picard, R. G. (2021). Media business ethics, corporate social responsibility, and governance. In S. J. A. Ward (Ed.), Handbook of global media ethics (pp. 59–70). Springer International Publishing. https://doi.org/10.1007/978-3-319-32103-5_4

Polizzi, G., & Harrison, T. (2022). Wisdom in the digital age: A conceptual and practical framework for understanding and cultivating cyber-wisdom. Ethics and Information Technology, 24 (1), 16. https://doi.org/10.1007/s10676-022-09640-3

Pretorius, L., & Barnard, A. (2004). Email and Misinformation: A South African Case Study. Informing Science: The International Journal of an Emerging Transdiscipline , 7 , 0047–0066. Retrieved on May 12, 2022, from https://www.informingscience.org/Publications/502

Price, R. (2017). Research offers insight into fake news and how to build a culture of truth . Digital Content Next. Retrieved on February 23, 2023, from https://digitalcontentnext.org/blog/2017/05/09/research-offers-insight-fake-news-build-culture-truth/

Radeljić, B. (2020). In favour of censorship and propaganda: Elites, media capture and the journalistic profession in the Western Balkans. Journal of Contemporary Central and Eastern Europe, 28 (2–3), 155–173. https://doi.org/10.1080/25739638.2020.1848984

Rahimi, S., Soheili, F., Naseri, V., & Bahrami Nia, S. (2022). Investigating the relationship between job satisfaction with organizational commitment and ethical atmosphere among librarians using structural equation modeling. Sciences and Techniques of Information Management . https://doi.org/10.22091/stim.2020.5756.1410

Rauf, A. A. (2021). New moralities for new media? Assessing the role of social media in acts of terror and providing points of deliberation for business ethics. Journal of Business Ethics, 170 (2), 229–251. https://doi.org/10.1007/s10551-020-04635-w

Reisach, U. (2021). The responsibility of social media in times of societal and political manipulation. European Journal of Operational Research, 291 (3), 906–917. https://doi.org/10.1016/j.ejor.2020.09.020

Rendtorff, J. D. (2020). Principles of business ethics and business legitimacy. In J. D. Rendtorff (Ed.), Handbook of business legitimacy: responsibility, ethics and society (pp. 783–797). Springer International Publishing. https://doi.org/10.1007/978-3-030-14622-1_90

Revez, J., & Corujo, L. (2021). Librarians against fake news: A systematic literature review of library practices (Jan. 2018–Sept. 2020). The Journal of Academic Librarianship, 47 (2), 102304. https://doi.org/10.1016/j.acalib.2020.102304

Richardson, S., Petter, S., & Carter, M. (2021). Five ethical issues in the big data analytics age. Communications of the Association for Information Systems . https://doi.org/10.17705/1CAIS.04918

Rini, R. (2017). Fake news and partisan epistemology. Kennedy Institute of Ethics Journal, 27 (2), 43. https://doi.org/10.1353/ken.2017.0025

Robertson, E. (2014). Propaganda and ‘manufactured hatred’: A reappraisal of the ethics of First World War British and Australian atrocity propaganda. Public Relations Inquiry, 3 (2), 245–266. https://doi.org/10.1177/2046147X14542958

Rochlin, N. (2017). Fake news: Belief in post-truth. Library Hi Tech, 35 (3), 386–392. https://doi.org/10.1108/LHT-03-2017-0062

Ruiz del Olmo, F.-J., & Xifra, J. (2017). Public relations discourse, ethical propaganda and collective identity in Luis Buñuel’s Spanish Civil War films. Public Relations Review, 43 (2), 358–365. https://doi.org/10.1016/j.pubrev.2017.02.009

Russell, B. (1966). On the nature of truth and falsehood. Philosophical essays (pp. 147–159). Allen & Unwin.

Ryan, M., & Switzer, L. (2009). Propaganda and the subversion of objectivity: Media coverage of the war on terrorism in Iraq. Critical Studies on Terrorism, 2 (1), 45–64. https://doi.org/10.1080/17539150902752721

Sample, C., Jensen, M. J., Scott, K., McAlaney, J., Fitchpatrick, S., Brockinton, A., Ormrod, D., & Ormrod, A. (2020). Interdisciplinary lessons learned while researching fake news. Frontiers in Psychology, 11 , 2947. https://doi.org/10.3389/fpsyg.2020.537612

Santis, E. L., & Zavattaro, S. M. (2019). Performative ethics in the trump era: A postmodern examination. Public Integrity, 21 (5), 503–511. https://doi.org/10.1080/10999922.2019.1600351

Schmann, M. (2019). Cynical Social Media Voices Can Erode Trust in News Media . School of Communication and Information | Rutgers University. Retrieved on February 26, 2023, from https://comminfo.rutgers.edu/news/cynical-social-media-voices-can-erode-trust-news-media

Schuldt, L. (2022). Shaping the fake news discourse laws, electoral arenas and the emergence of truth as a public interest. In: Fake news and elections in Southeast Asia . Routledge.

Schwartz, O. (2018). You thought fake news was bad? Deep fakes are where truth goes to die. The Guardian . Retrieved on February 23, 2023, from https://www.theguardian.com/technology/2018/nov/12/deep-fakes-fake-news-truth

Serra, J. P. (2014). Beyond propaganda and the internet: The ethics of journalism. Comunicação e Sociedade., 25 , 301–310. https://doi.org/10.17231/comsoc.25(2014).1876

Seyam, A., Bou Nassif, A., Abu Talib, M., Nasir, Q., & Al Blooshi, B. (2021). Deep Learning Models to Detect Online False Information: A Systematic Literature Review. The 7th Annual International Conference on Arab Women in Computing in Conjunction with the 2nd Forum of Women in Research . pp. 1–5. https://doi.org/10.1145/3485557.3485580

Shapter, M. J. (1993). Image manipulation and the question of ethics. The Journal of Audiovisual Media in Medicine, 16 (3), 130–132. https://doi.org/10.3109/17453059309064840

Sheila, J. (2016). The Ethics of Invention: Technology and the Human Future . W.W.Norton. Retrieved on November 06, 2022, from https://www.hks.harvard.edu/publications/ethics-invention-technology-and-human-future

Silverman, H. I. (2011). Reuters: Principles Of Trust Or Propaganda? Journal of Applied Business Research , 27 (6), 93–115. Retrieved on May 12, 2022, from https://www.proquest.com/docview/906022193/abstract/4381252CC2414137PQ/1

Simms, M. (2004). On linking business ethics, bioethics and bioterrorism. Journal of Business Ethics, 51 (2), 211–220. https://doi.org/10.1023/B:BUSI.0000033614.40676.2f

Skitka, L. J., & Bauman, C. W. (2008). Moral conviction and political engagement. Political Psychology, 29 (1), 29–54. https://doi.org/10.1111/j.1467-9221.2007.00611.x

Smith, J. (2022, September 14). Are Fake News Laws The Best Way To Tackle Disinformation? Human Rights Pulse. Retrieved on February 24, 2023, from https://www.humanrightspulse.com/mastercontentblog/are-fake-news-laws-the-best-way-to-tackle-disinformation

Snyder, J., & Cohen, I. G. (2019). Medical crowdfunding for unproven medical treatments: Should gofundme become a gatekeeper? The Hastings Center Report, 49 (6), 32–38. https://doi.org/10.1002/hast.1066

Song, R., Kim, H., Lee, G. M., & Jang, S. (2019). Does deceptive marketing pay? The evolution of consumer sentiment surrounding a pseudo-product-harm crisis. Journal of Business Ethics, 158 (3), 743–761. https://doi.org/10.1007/s10551-017-3720-2

Spinello, R. A. (2006). Online Brands and Trademark Conflicts: A Hegelian Perspective. Business Ethics Quarterly , 16 (3), 343–367. Retrieved on May 3, 2022, from https://www.jstor.org/stable/3857920

Stroud, S. R. (2019). Pragmatist media ethics and the challenges of fake news. Journal of Media Ethics: Exploring Questions of Media Morality, 34 (4), 178–192. https://doi.org/10.1080/23736992.2019.1672554

Taagepera, R. (2018). Science walks on two legs, but social sciences try to hop on one. International Political Science Review, 39 (1), 145–159. https://doi.org/10.1177/0192512116682185

Tandoc, E. C., Jr. (2019). The facts of fake news: A research review. Sociology Compass, 13 (9), e12724. https://doi.org/10.1111/soc4.12724

Tandoc, E. C., Lee, J. C. B., Lee, S., & Quek, P. J. (2022). Does length matter? The impact of fact-check length in reducing COVID-19 vaccine misinformation. Mass Communication and Society . https://doi.org/10.1080/15205436.2022.2155195

Tandoc, E. C., Lim, Z. W., & Ling, R. (2018). Defining “Fake News”: A typology of scholarly definitions. Digital Journalism, 6 (2), 137–153. https://doi.org/10.1080/21670811.2017.1360143

Tao, W., & Ferguson, M. A. (2015). The overarching effects of ethical reputation regardless of CSR cause fit and information source. International Journal of Strategic Communication, 9 (1), 23–43. https://doi.org/10.1080/1553118X.2014.954285

Timmer, J., Kool, L., & van Est, R. (2015). Ethical challenges in emerging applications of persuasive technology. In T. MacTavish & S. Basapur (Eds.), Persuasive technology (pp. 196–201). Springer International Publishing. https://doi.org/10.1007/978-3-319-20306-5_18

Tong, C., Gill, H., Li, J., Valenzuela, S., & Rojas, H. (2020). “Fake news is anything they say!”—Conceptualization and weaponization of fake news among the American Public. Mass Communication and Society, 23 (5), 755–778. https://doi.org/10.1080/15205436.2020.1789661

Torraco, R. J. (2005). Writing integrative literature reviews: Guidelines and examples. Human Resource Development Review, 4 (3), 356–367. https://doi.org/10.1177/1534484305278283

Tucker, J. A., Guess, A., Barbera, P., Vaccari, C., Siegel, A., Sanovich, S., Stukal, D., & Nyhan, B. (2018). Social media, political polarization, and political disinformation: A review of the scientific literature. Social Science Research Network . https://doi.org/10.2139/ssrn.3144139

Vanzo, A. (2010). Kant on the Nominal Definition of Truth. Kant-Studien , 101 (2), 147–166. https://doi.org/10.1515/kant.2010.011

Vasist, P. N., & Krishnan, S. (2022a). Deepfakes: An Integrative Review of the Literature and an Agenda for Future Research. Communications of the Association for Information Systems , 51 (1). Retrieved on August 29, 2022, from https://aisel.aisnet.org/cais/vol51/iss1/14

Vasist, P. N., & Krishnan, S. (2022b). Demystifying fake news in the hospitality industry: A systematic literature review, framework, and an agenda for future research. International Journal of Hospitality Management, 106 , 103277. https://doi.org/10.1016/j.ijhm.2022.103277

Vazquez, P. (2018). Family business ethics: At the crossroads of business ethics and family business. Journal of Business Ethics, 150 (3), 691–709. https://doi.org/10.1007/s10551-016-3171-1

Velichety, S., & Shrivastava, U. (2022). Quantifying the impacts of online fake news on the equity value of social media platforms—Evidence from Twitter. International Journal of Information Management, 64 , 102474. https://doi.org/10.1016/j.ijinfomgt.2022.102474

Villagran, M. A. L., Madali, N. P., Green, A. S., & Hawamdeh, S. (2022). Information ethics from a multicultural perspective: Content analysis of selected library and information science publications. Journal of Education for Library and Information Science . https://doi.org/10.3138/jelis-2021-0056

Vukić, T. (2020). Journalism education and fake news: A literature review. Medijska Istraživanja: Znanstveno-Stručni Časopis Za Novinarstvo i Medije., 26 (2), 77–99. https://doi.org/10.22572/mi.26.2.4

Wang, C.-C. (2020). Fake news and related concepts: definitions and recent research development. Contemporary Management Research . https://doi.org/10.7903/cmr.20677

Warhol, R. R., & Herndl, D. P. (1997). Feminisms: An anthology of literary theory and criticism . Rutgers University Press.

Weber, L. J. (2001). Business Ethics in Healthcare: Beyond Compliance . Indiana University Press. Retrieved on June 5, 2023, from https://muse.jhu.edu/pub/3/monograph/book/3946

Webster, J., & Watson, R. T. (2002). Analyzing the Past to Prepare for the Future: Writing a Literature Review. MIS Quarterly , 26 (2), xiii–xxiii. Retrieved on November 30, 2022, from https://www.jstor.org/stable/4132319

Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52 (5), 546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

Wiesenberg, M., & Tench, R. (2020). Deep strategic mediatization: Organizational leaders’ knowledge and usage of social bots in an era of disinformation. International Journal of Information Management, 51 , 102042. https://doi.org/10.1016/j.ijinfomgt.2019.102042

Wirtz, J., Kunz, W. H., Hartley, N., & Tarbit, J. (2022). Corporate digital responsibility in service firms and their ecosystems. Journal of Service Research . https://doi.org/10.1177/10946705221130467

Wu, Y., Ngai, E. W. T., Wu, P., & Wu, C. (2022). Fake news on the internet: A literature review, synthesis and directions for future research. Internet Research . https://doi.org/10.1108/INTR-05-2021-0294

Yang, Y., & Bennett, L. (2021). Interactive Propaganda: How Fox News and Donald Trump Co-produced False Narratives about the COVID-19 Crisis. In: Political communication in the time of coronavirus . Routledge.

Yin, R. K. (2011). Qualitative research from start to finish (p. 348). The Guilford Press.

Young, J. C., Boyd, B., Yefimova, K., Wedlake, S., Coward, C., & Hapel, R. (2021). The role of libraries in misinformation programming: A research agenda. Journal of Librarianship and Information Science, 53 (4), 539–550. https://doi.org/10.1177/0961000620966650

Yusof, A. N. M., Muuti, M. Z., Ariffin, L. A., & Tan, M. K. M. (2020). Sharing Information on COVID-19: The ethical challenges in the Malaysian setting. Asian Bioethics Review, 12 (3), 349–361. https://doi.org/10.1007/s41649-020-00132-4

Zekavat, M. (2019). Satire, humor and ecological thought. Neohelicon, 46 (1), 369–386. https://doi.org/10.1007/s11059-018-00471-0

Zhang, X., & Ghorbani, A. A. (2020). An overview of online fake news: Characterization, detection, and discussion. Information Processing & Management, 57 (2), 102025. https://doi.org/10.1016/j.ipm.2019.03.004

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This paper is in the following e-collection/theme issue:

Published on 23.4.2024 in Vol 26 (2024)

Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis

Authors of this article:

• Xiaoning Han * , PhD   ; 
• Enze Zhou * , MA   ; 
• Dong Liu * , PhD  

School of Journalism and Communication, Renmin University of China, Beijing, China

*all authors contributed equally

Corresponding Author:

Dong Liu, PhD

School of Journalism and Communication

Renmin University of China

No. 59 Zhongguancun Street, Haidian District

Beijing, 100872

Phone: 86 13693388506

Email: [email protected]

Background: This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations.

Objective: The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality.

Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis software (version 3.0) was used to perform the meta-analysis. Statistical methods such as funnel plots were used to assess the presence of asymmetry and a p -curve test to test the p -hacking problem, which can indicate publication bias.

Results: Following a thorough screening process, the study involved 55 papers (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into “general use” and “problematic use.” The meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality ( P <.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k =20). Problematic use was associated with a significant increase in sleep problems ( P ≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k =36). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r =0.33 (95% CI 0.27-0.40), which was the highest among the general group. The effect of problematic internet use and sleep problems was r =0.51 (95% CI 0.43-0.59), which was the highest among the problematic groups. There were significant differences among these subgroups (general: Q between =14.46, P =.001; problematic: Q between =27.37, P <.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between Eastern and Western culture was significant ( Q between =6.69; P =.01). All funnel plots and p -curve analyses showed no evidence of publication and selection bias.

Conclusions: Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, which is notably more significant in Eastern cultures.

Introduction

Sleep is vital to our health. Research has shown that high sleep quality can lead to improvements in a series of health outcomes, such as an improved immune system, better mood and mental health, enhanced physical performance, lower risk of chronic diseases, and a longer life span [ 1 - 5 ].

Electronic media refers to forms of media or communication that use electronic devices or technology to create, distribute, and display content. This can include various forms of digital media such as smartphones, tablets, instant messaging, phone calls, social media, online games, short video platforms, etc. Electronic media has permeated every aspect of our lives [ 6 ]. Many prefer to use smartphones or tablets before sleep, which can negatively affect sleep in many aspects, including delayed sleep onset, disrupted sleep patterns, shortened sleep duration, and poor sleep quality [ 7 - 10 ]. Furthermore, problematic use occurs when the behavior surpasses a certain limit. In this study, problematic use of electronic media is not solely determined by the amount of time spent on these platforms, but rather by behavioral indicators that suggest an unhealthy or harmful relationship with them.

Smartphones or tablet use can affect sleep quality in many ways. At first, the use of these devices may directly displace, delay, or interrupt sleep time, resulting in inadequate sleep quantity [ 11 ]. The sound of notifications and vibrations of these devices may interrupt sleep. Second, the screens of smartphones and tablets emit blue light, which can suppress the production of melatonin, the hormone responsible for regulating sleep-wake cycles [ 12 ]. Third, consuming emotionally charged content, such as news, suspenseful movies, or engaging in online arguments, can increase emotional arousal, making it harder to relax and fall asleep. This emotional arousal can also lead to disrupted sleep and nightmares [ 13 ]. Finally, the use of electronic devices before bedtime can lead to a delay in bedtime and a shortened sleep duration, as individuals may lose track of time while engaging with their devices. This can result in a disrupted sleep routine and decreased sleep quality [ 14 ].

Some studies have conducted meta-analyses on screen media use and sleep outcomes in 2016, 2019, and 2021 [ 15 - 17 ]. However, these studies had their own limitations. First, the sample size included in their meta-analyses was small (around 10). Second, these studies only focused on 1 aspect of the effect of digital media on sleep quality. For example, Carter et al [ 16 ] focused only on adolescents, and both Alimoradi et al [ 15 ] and Kristensen et al [ 17 ] only reviewed the relationship between problematic use of digital media or devices and sleep quality. Despite of the high heterogeneity found in the meta-analyses, none have compared the effects of different digital media or devices. This study aims to clarify and compare the effects of these different channels.

Literature Search

The research adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines ( Multimedia Appendix 1 ) and followed a predetermined protocol [ 18 , 19 ]. As the idea and scope of this study evolved over time, the meta-analysis was not preregistered. However, the methodology was defined a priori and strictly followed to reduce biases, and the possible influence of post hoc decisions was minimized. All relevant studies in English, published from January 1, 2018, to October 9, 2023, were searched. We searched the following databases: Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar. The abstracts were examined manually. The keywords used to search were the combination of the following words: “sleep” OR “sleep duration” OR “sleep quality” OR “sleep problems” AND “electronic media” OR “smartphone” OR “tablet” OR “social media” OR “Facebook” OR “Twitter” OR “online gaming” OR “internet” OR “addiction” OR “problematic” ( Multimedia Appendix 2 ). Additionally, the reference lists of relevant studies were examined.

Two trained coders independently screened the titles and abstracts of the identified papers for eligibility, followed by a full-text review of the selected studies. Discrepancies between the coders were resolved through discussion until a consensus was reached. The reference lists of the included studies were also manually screened to identify any additional relevant studies. Through this rigorous process, we ensured a comprehensive and replicable literature search that could contribute to the robustness of our meta-analysis findings.

Inclusion or Exclusion Criteria

Titles and abstracts from search results were scrutinized for relevance, with duplicates removed. Full texts of pertinent papers were obtained, and their eligibility for inclusion was evaluated. We mainly included correlational studies that used both continuous measures of time spent using electronic media use and sleep quality. Studies must have been available in English. Four criteria were used to screen studies: (1) only peer-reviewed empirical studies, published in English, were considered for inclusion in the meta-analysis; (2) the studies should report quantitative statistics on electronic media use and sleep quality, including sample size and essential information to calculate the effect size, and review papers, qualitative studies, case studies, and conference abstracts were excluded; (3) studies on both general use and problematic use of electronic media or devices should be included; and (4) only studies that used correlation, regression, or odds ratio were included to ensure consistency.

Study Coding

Two trained coders were used to code the characteristics of the studies independently. Discrepancies were discussed with the first author of the paper to resolve. Sample size and characteristics of participants were coded: country, female ratio, average age, publication year, and electronic types. Effect sizes were either extracted directly from the original publications or manually calculated. If a study reported multiple dependent effects, the effects were merged into one. If a study reported multiple independent effects from different samples, the effects were included separately. Additionally, to evaluate the study quality, the papers were classified into 3 tiers (high, middle, and low) according to Journal Citation Reports 2022 , a ranking of journals based on their impact factor as reported in the Web of Science. The few unindexed papers were rated based on their citation counts as reported in Google Scholar.

Meta-Analysis and Moderator Analyses

The effect sizes were calculated using the correlation coefficient ( r ) as a standardized measure of the relationship between electronic media or device use and sleep quality across studies. When studies reported multiple effect sizes, we selected the one that best represented the overall association between electronic media use and sleep quality. If studies did not provide correlation coefficients, we converted other reported statistics (eg, standardized regression coefficients) into correlation coefficients using established formulas. Once calculated, the correlation coefficients were transformed into Fisher z scores to stabilize the variance and normalize the distribution.

Previous meta-studies have shown high levels of heterogeneity. Hence, the random effects model was adopted for all analyses. To explore potential factors contributing to the heterogeneity and to further understand the relationship between electronic media use and sleep quality, we conducted moderator analyses. The following categorical and continuous moderators were examined: media types (online gaming, social media, smartphone, or intent), participants’ average age, culture, female ratio, and sleep quality assessment method. For categorical moderators, subgroup analyses were performed, while for continuous moderators, meta-regression analyses were conducted. All analyses were completed in the Comprehensive Meta-Analysis software (version 3.0; Biostat, Inc).

Publication Bias

We used statistical methods such as funnel plots to assess the presence of asymmetry and a p -curve test to test the p -hacking problem, which may indicate publication bias. In case of detected asymmetry, we applied techniques such as the trim-and-fill method to adjust the effect size estimates.

By addressing publication bias, we aimed to provide a more accurate and reliable synthesis of the available evidence, enhancing the validity and generalizability of our meta-analytic findings. Nevertheless, it is essential for readers to interpret the results cautiously, considering the potential limitations imposed by publication bias and other methodological concerns.

Search Findings

A total of 98,806 studies were identified from databases, especially Scopus (n=49,643), Google Scholar (n=18,600), Science Direct (n=15,084), and Web of Science (n=11,689). Upon removing duplicate records and excluding studies that did not meet the inclusion criteria, 754 studies remained for the screening phase. After screening titles, abstracts, and full texts, 703 studies were excluded. A total of 4 additional studies were identified from the references of relevant reviews. Finally, 55 studies [ 20 - 74 ] were included in the meta-analysis. The flow diagram of the selection is shown in Figure 1 .

Characteristics of Included Studies

In 20 studies, 21,594 participants were included in the analysis of the general use of electronic media and sleep quality. The average age of the sample ranged from 9.9 to 44 years. The category of general online gaming and sleep quality included 4 studies, with 14,837 participants; the category of general smartphone use and sleep quality included 10 studies, with 5011 participants; and the category of general social media use and sleep quality included 6 studies, with 1746 participants.

These studies came from the following countries or areas: Germany, Serbia, Indonesia, India, China, Italy, Saudi Arabia, New Zealand, the United Kingdom, the United States, Spain, Qatar, Egypt, Argentina, and Portugal. The most frequently used measure of electronic media use was the time spent on it. The most frequently used measure of sleep was the Pittsburgh Sleep Quality Index.

In 35 studies, 20,122 participants were included in the analysis of the problematic use of electronic media and sleep quality. The average age of the sample ranged from 14.76 to 65.62 years. The category of problematic online gaming and sleep quality included 5 studies, with 1874 participants; the category of problematic internet use and sleep quality included 2 studies, with 774 participants; the category of problematic smartphone use and sleep quality included 18 studies, with 12,204 participants; and the category of problematic social media use and sleep quality included 11 studies, with 5270 participants. There was a study that focused on both social media and online gaming, which led to its inclusion in the analysis. These studies came from 14 countries or areas: Turkey, the United States, Indonesia, China, France, Taiwan, India, South Korea, Hong Kong, Iran, Poland, Israel, Hungary, and Saudi Arabia. The most frequently used measures of problematic electronic media use were the Internet Gaming Disorder Scale-Short Form, Smartphone Addiction Scale-Short Form, and Bergen Social Media Addiction Scale.

With respect to study quality, the 56 papers were published in 50 journals, 41 of which were indexed in Journal Citation Reports 2022 , while the remaining 9 journals were rated based on their citation counts as reported in Google Scholar. As a result, of the 56 papers included in the study, 22 papers were assigned a high rating, 18 papers were assigned a middle rating, and 16 papers were assigned a low rating. More information about the included studies is listed in Multimedia Appendix 3 [ 20 - 74 ].

Meta-Analysis

The results of the meta-analysis of the relationship between general electronic media use and sleep quality showed that electronic media use was associated with a significant decrease in sleep quality ( P <.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k =20), indicating that individuals who used electronic media more frequently were generally associated with more sleeping problems.

The second meta-analysis showed that problematic electronic media use was associated with a significant increase in sleep problems ( P ≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k =36), indicating that participants who used electronic media more frequently were more likely to have more sleep problems.

Moderator Analyses

At first, we conducted subgroup analyses for different media or devices. The results are shown in Tables 1 and 2 . The effect of the relationship between general online gaming and sleep problems was r =0.14 (95% CI 0.06-0.22); the effect of the relationship between general smartphone use and sleep problems was r =0.33 (95% CI 0.27-0.40); and the effect of the relationship between general social media use and sleep problems was r =0.28 (95% CI 0.21-0.34). There are significant differences among these groups ( Q between =14.46; P =.001).

The effect of the relationship between problematic gaming and sleep problems was r =0.49, 95% CI 0.23-0.69; the effect of the relationship between problematic internet use and sleep problems was r =0.51 (95% CI 0.43-0.59); the effect of the relationship between problematic smartphone use and sleep problems was r =0.25 (95% CI 0.20-0.30); and the effect of the relationship between problematic social media use and sleep problems was r =0.35 (95% CI 0.29-0.40). There are significant differences among these groups ( Q between =27.37; P <.001).

We also used age, gender, and culture as moderators to conduct meta-regression analyses. The results are shown in Tables 3 and 4 . Only cultural difference in the relationship between Eastern and Western culture was significant ( Q between =6.694; P =.01). All other analyses were not significant.

a Not applicable.

All funnel plots of the analyses were symmetrical, showing no evidence of publication bias ( Figures 2 - 5 ). We also conducted p -curve analyses to see whether there were any selection biases. The results also showed that there were no biases.

Principal Findings

This study indicated that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. General use was associated with a significant decrease in sleep quality. Problematic use was associated with a significant increase in sleep problems. A significant cultural difference was also observed by the meta-regression analysis.

First, there is a distinction in the impact on sleep quality between problematic use and general use, with the former exhibiting a higher correlation strength. However, both have a positive correlation, suggesting that the deeper the level of use, the more sleep-related issues are observed. In addressing this research question, the way in which electronic media use is conceptualized and operationalized may have a bearing on the ultimate outcomes. Problematic use is measured through addiction scales, while general use is predominantly assessed by duration of use (time), leading to divergent results stemming from these distinct approaches. The key takeaway is that each measurement possesses unique strengths and weaknesses, and the pathways affecting sleep quality differ. Consequently, the selection of a measurement approach should be tailored to the specific research question at hand. The duration of general use reflects an individual’s comprehensive involvement with electronic media, and its impact on sleep quality is evident in factors such as an extended time to fall asleep and reduced sleep duration. The addiction scale for problematic use illuminates an individual’s preferences, dependencies, and other associations with electronic media. Its impact on sleep quality is evident through physiological and psychological responses, including anxiety, stress, and emotional reactions.

Second, notable variations exist in how different types of electronic media affect sleep quality. In general, the positive predictive effects of smartphone, social media, and online gaming use durations on sleep problems gradually decrease. In the problematic context, the intensity of addiction to the internet and online gaming has the most significant positive impact on sleep problems, followed by social media, while smartphones exert the least influence. On one hand, longitudinal comparisons within the same context reveal that the content and format of electronic media can have varying degrees of negative impact on sleep quality, irrespective of whether it involves general or problematic use. On the other hand, cross-context comparisons suggest that both general and problematic use play a role in moderating the impact of electronic media types on sleep quality. As an illustration, problematic use reinforces the positive impact of online gaming and social media on sleep problems, while mitigating the influence of smartphones. Considering smartphones as electronic media, an extended duration of general use is associated with lower sleep quality. However, during problematic use, smartphones serve as the platform for other electronic media such as games and social media, resulting in a weakened predictive effect on sleep quality. Put differently, in the context of problematic use, the specific type of electronic media an individual consumes on their smartphones becomes increasingly pivotal in shaping sleep quality.

Third, cultural differences were found to be significant moderators of the relationship between electronic media use and sleep problems in both our study and Carter et al [ 16 ]. Kristensen et al [ 17 ], however, did not specifically address the role of cultural differences but revealed that there was a strong and consistent association between bedtime media device use and sleep outcomes across the studies included. Our findings showed that the association between problematic social media use was significantly larger in Eastern culture. We speculate that the difference may be attributed to cultural differences in social media use patterns, perceptions of social norms and expectations, variations in bedtime routines and habits, and diverse coping mechanisms for stress. These speculations warrant further investigation to understand better the underlying factors contributing to the observed cultural differences in the relationship between social media use and sleep quality.

Fourth, it was observed that gender and age had no significant impact on sleep quality. The negative effects of electronic media use are not only confined to the sleep quality of adults, and the association with gender differences remains unclear. Recent studies point out that electronic media use among preschoolers may result in a “time-shifting” process, disrupting their sleep patterns [ 75 ]. Similarly, children and adolescent sleep patterns have been reported to be adversely affected by electronic media use [ 76 - 78 ]. These findings underscore the necessity of considering age group variations in future research, as electronic media use may differently impact sleep quality across age demographics.

In conclusion, our study, Carter et al [ 16 ], and Kristensen et al [ 17 ] collectively emphasize the importance of understanding and addressing the negative impact of electronic media use, particularly problematic online gaming and smartphone use, on sleep quality and related issues. Further research is warranted to explore the underlying mechanisms and specific factors contributing to the relationship between electronic media use and sleep problems.

Strengths and Limitations

Our study, supplemented with research by Carter et al [ 16 ] and Kristensen et al [ 17 ], contributes to the growing evidence supporting a connection between electronic media use and sleep quality. We found that both general and problematic use of electronic media correlates with sleep issues, with the strength of the correlation varying based on the type of electronic media and cultural factors, with no significant relationship observed with age or gender.

Despite the vast amount of research on the relationship between electronic media use and sleep, several gaps and limitations still exist.

First, the inclusion criteria were restricted to English-language, peer-reviewed empirical studies published between January 2018 and October 2023. This may have led to the exclusion of relevant studies published in other languages or before 2018, potentially limiting the generalizability of our findings. Furthermore, the exclusion of non–peer-reviewed studies and conference abstracts may have introduced publication bias, as significant results are more likely to be published in peer-reviewed journals.

Second, although we used a comprehensive search strategy, the possibility remains that some relevant studies may have been missed. Additionally, the search strategies were not linked with Medical Subject Headings headers and may not have captured all possible electronic media types, resulting in an incomplete representation of the effects of electronic media use on sleep quality.

Third, the studies included in our meta-analysis exhibited considerable heterogeneity in sample characteristics, electronic media types, and measures of sleep quality. This heterogeneity might have contributed to the variability in effect sizes observed across studies. Although we conducted moderator analyses to explore potential sources of heterogeneity, other unexamined factors may still have influenced the relationship between electronic media use and sleep quality.

Fourth, our meta-analysis relied on the correlation coefficient ( r ) as the primary effect size measure, which may not fully capture the complex relationships between electronic media use and sleep quality. Moreover, the conversion of other reported statistics into correlation coefficients could introduce additional sources of error. The correlational nature of the included studies limited our ability to draw causal inferences between electronic media use and sleep quality. Experimental and longitudinal research designs would provide stronger evidence for the directionality of this relationship.

Given these limitations, future research should aim to include a more diverse range of studies, examine additional potential moderators, and use more robust research designs to better understand the complex relationship between electronic media use and sleep quality.

Conclusions

In conclusion, our updated meta-analysis affirms the consistent negative impact of electronic media use on sleep outcomes, with problematic online gaming and smartphone use being particularly impactful. Notably, the negative effect of problematic social media use on sleep quality appears more pronounced in Eastern cultures. This research emphasizes the need for public health initiatives to increase awareness of these impacts, particularly for adolescents. Further research, including experimental and longitudinal studies, is necessary to delve deeper into the complex relationship between electronic media use and sleep quality, considering potential moderators like cultural differences.

Acknowledgments

This research was supported by the Journalism and Marxism Research Center, Renmin University of China (MXG202215), and by funds for building world-class universities (disciplines) of Renmin University of China (23RXW195).

A statement on the use of ChatGPT in the process of writing this paper can be found in Multimedia Appendix 4.

Data Availability

The data sets analyzed during this study are available from the corresponding author on reasonable request.

Conflicts of Interest

None declared.

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist.

Search strategies.

Characteristics of included studies.

Large language model statement.

• Brink-Kjaer A, Leary EB, Sun H, Westover MB, Stone KL, Peppard PE, et al. Age estimation from sleep studies using deep learning predicts life expectancy. NPJ Digit Med. 2022;5(1):103. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Killgore WDS. Effects of sleep deprivation on cognition. Prog Brain Res. 2010;185:105-129. [ CrossRef ] [ Medline ]
• Lee S, Mu CX, Wallace ML, Andel R, Almeida DM, Buxton OM, et al. Sleep health composites are associated with the risk of heart disease across sex and race. Sci Rep. 2022;12(1):2023. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Prather AA. Sleep, stress, and immunity. In: Grandner MA, editor. Sleep and Health, 1st Edition. Cambridge. Academic Press; 2019;319-330.
• Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: a meta-analysis of randomised controlled trials. Sleep Med Rev. Dec 2021;60:101556. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Guttmann A. Statista. 2023. URL: https://www.statista.com/topics/1536/media-use/#topicOverview [accessed 2023-06-10]
• Hysing M, Pallesen S, Stormark KM, Jakobsen R, Lundervold AJ, Sivertsen B. Sleep and use of electronic devices in adolescence: results from a large population-based study. BMJ Open. Feb 02, 2015;5(1):e006748. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lavender RM. Electronic media use and sleep quality. Undergrad J Psychol. 2015;28(1):55-62. [ FREE Full text ]
• Exelmans L, Van den Bulck J. Bedtime mobile phone use and sleep in adults. Soc Sci Med. 2016;148:93-101. [ CrossRef ] [ Medline ]
• Twenge JM, Krizan Z, Hisler G. Decreases in self-reported sleep duration among U.S. adolescents 2009-2015 and association with new media screen time. Sleep Med. 2017;39:47-53. [ CrossRef ] [ Medline ]
• Exelmans L. Electronic media use and sleep: a self-control perspective. Curr Sleep Med Rep. 2019;5:135-140. [ CrossRef ]
• Jniene A, Errguig L, El Hangouche AJ, Rkain H, Aboudrar S, El Ftouh M, et al. Perception of sleep disturbances due to bedtime use of blue light-emitting devices and its impact on habits and sleep quality among young medical students. Biomed Res Int. 2019;2019:7012350. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Munezawa T, Kaneita Y, Osaki Y, Kanda H, Minowa M, Suzuki K, et al. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. Sleep. 2011;34(8):1013-1020. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Smith LJ, Gradisar M, King DL, Short M. Intrinsic and extrinsic predictors of video-gaming behaviour and adolescent bedtimes: the relationship between flow states, self-perceived risk-taking, device accessibility, parental regulation of media and bedtime. Sleep Med. 2017;30:64-70. [ CrossRef ] [ Medline ]
• Alimoradi Z, Lin CY, Broström A, Bülow PH, Bajalan Z, Griffiths MD, et al. Internet addiction and sleep problems: a systematic review and meta-analysis. Sleep Med Rev. 2019;47:51-61. [ CrossRef ] [ Medline ]
• Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS. Association between portable screen-based media device access or use and sleep outcomes: a systematic review and meta-analysis. JAMA Pediatr. 2016;170(12):1202-1208. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kristensen JH, Pallesen S, King DL, Hysing M, Erevik EK. Problematic gaming and sleep: a systematic review and meta-analysis. Front Psychiatry. 2021;12:675237. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Akçay D, Akçay BD. The effect of computer game playing habits of university students on their sleep states. Perspect Psychiatr Care. 2020;56(4):820-826. [ CrossRef ] [ Medline ]
• Alahdal WM, Alsaedi AA, Garrni AS, Alharbi FS. The impact of smartphone addiction on sleep quality among high school students in Makkah, Saudi Arabia. Cureus. 2023;15(6):e40759. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Alam A, Alshakhsi S, Al-Thani D, Ali R. The role of objectively recorded smartphone usage and personality traits in sleep quality. PeerJ Comput Sci. 2023;9:e1261. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Almeida F, Marques DR, Gomes AA. A preliminary study on the association between social media at night and sleep quality: the relevance of FOMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation. Scand J Psychol. 2023;64(2):123-132. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Alshobaili FA, AlYousefi NA. The effect of smartphone usage at bedtime on sleep quality among Saudi non-medical staff at King Saud University Medical City. J Family Med Prim Care. 2019;8(6):1953-1957. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Alsulami A, Bakhsh D, Baik M, Merdad M, Aboalfaraj N. Assessment of sleep quality and its relationship to social media use among medical students. Med Sci Educ. 2019;29(1):157-161. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Altintas E, Karaca Y, Hullaert T, Tassi P. Sleep quality and video game playing: effect of intensity of video game playing and mental health. Psychiatry Res. 2019;273:487-492. [ CrossRef ] [ Medline ]
• Asbee J, Slavish D, Taylor DJ, Dietch JR. Using a frequentist and Bayesian approach to examine video game usage, substance use, and sleep among college students. J Sleep Res. 2023;32(4):e13844. [ CrossRef ] [ Medline ]
• Bae ES, Kang HS, Lee HN. The mediating effect of sleep quality in the relationship between academic stress and social network service addiction tendency among adolescents. J Korean Acad Community Health Nurs. 2020;31(3):290-299. [ FREE Full text ] [ CrossRef ]
• Chatterjee S, Kar SK. Smartphone addiction and quality of sleep among Indian medical students. Psychiatry. 2021;84(2):182-191. [ CrossRef ] [ Medline ]
• Chung JE, Choi SA, Kim KT, Yee J, Kim JH, Seong JW, et al. Smartphone addiction risk and daytime sleepiness in Korean adolescents. J Paediatr Child Health. 2018;54(7):800-806. [ CrossRef ] [ Medline ]
• Demir YP, Sumer MM. Effects of smartphone overuse on headache, sleep and quality of life in migraine patients. Neurosciences (Riyadh). 2019;24(2):115-121. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Dewi RK, Efendi F, Has EMM, Gunawan J. Adolescents' smartphone use at night, sleep disturbance and depressive symptoms. Int J Adolesc Med Health. 2018;33(2):20180095. [ CrossRef ] [ Medline ]
• Eden A, Ellithorpe ME, Meshi D, Ulusoy E, Grady SM. All night long: problematic media use is differentially associated with sleep quality and depression by medium. Commun Res Rep. 2021;38(3):143-149. [ CrossRef ]
• Ellithorpe ME, Meshi D, Tham SM. Problematic video gaming is associated with poor sleep quality, diet quality, and personal hygiene. Psychol Pop Media. 2023;12(2):248-253. [ CrossRef ]
• Elsheikh AA, Elsharkawy SA, Ahmed DS. Impact of smartphone use at bedtime on sleep quality and academic activities among medical students at Al -Azhar University at Cairo. J Public Health (Berl.). Jun 15, 2023.:1-10. [ FREE Full text ] [ CrossRef ]
• Gaya AR, Brum R, Brites K, Gaya A, de Borba Schneiders L, Duarte Junior MA, et al. Electronic device and social network use and sleep outcomes among adolescents: the EHDLA study. BMC Public Health. 2023;23(1):919. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Gezgin DM. Understanding patterns for smartphone addiction: age, sleep duration, social network use and fear of missing out. Cypriot J Educ Sci. 2018;13(2):166-177. [ CrossRef ]
• Graham S, Mason A, Riordan B, Winter T, Scarf D. Taking a break from social media improves wellbeing through sleep quality. Cyberpsychol Behav Soc Netw. 2021;24(6):421-425. [ CrossRef ] [ Medline ]
• Guerrero MD, Barnes JD, Chaput JP, Tremblay MS. Screen time and problem behaviors in children: exploring the mediating role of sleep duration. Int J Behav Nutr Phys Act. 2019;16(1):105. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hamvai C, Kiss H, Vörös H, Fitzpatrick KM, Vargha A, Pikó BF. Association between impulsivity and cognitive capacity decrease is mediated by smartphone addiction, academic procrastination, bedtime procrastination, sleep insufficiency and daytime fatigue among medical students: a path analysis. BMC Med Educ. 2023;23(1):537. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Herlache AD, Lang KM, Krizan Z. Withdrawn and wired: problematic internet use accounts for the link of neurotic withdrawal to sleep disturbances. Sleep Sci. 2018;11(2):69-73. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huang Q, Li Y, Huang S, Qi J, Shao T, Chen X, et al. Smartphone use and sleep quality in chinese college students: a preliminary study. Front Psychiatry. 2020;11:352. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hussain Z, Griffiths MD. The associations between problematic social networking site use and sleep quality, attention-deficit hyperactivity disorder, depression, anxiety and stress. Int J Ment Health Addict. 2021;19:686-700. [ FREE Full text ] [ CrossRef ]
• Imani V, Ahorsu DK, Taghizadeh N, Parsapour Z, Nejati B, Chen HP, et al. The mediating roles of anxiety, depression, sleepiness, insomnia, and sleep quality in the association between problematic social media use and quality of life among patients with cancer. Healthcare (Basel). 2022;10(9):1745. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Jeong CY, Seo YS, Cho EH. The effect of SNS addiction tendency on trait-anxiety and quality of sleep in university students'. J Korean Clin Health Sci. 2018;6(2):1147-1155. [ CrossRef ]
• Karaş H, Küçükparlak İ, Özbek MG, Yılmaz T. Addictive smartphone use in the elderly: relationship with depression, anxiety and sleep quality. Psychogeriatrics. 2023;23(1):116-125. [ CrossRef ] [ Medline ]
• Kater MJ, Schlarb AA. Smartphone usage in adolescents: motives and link to sleep disturbances, stress and sleep reactivity. Somnologie. 2020;24(4):245-252. [ CrossRef ]
• Kharisma AC, Fitryasari R, Rahmawati PD. Online games addiction and the decline in sleep quality of college student gamers in the online game communities in Surabaya, Indonesia. Int J Psychosoc Rehabil. 2020;24(7):8987-8993. [ FREE Full text ] [ CrossRef ]
• Kumar VA, Chandrasekaran V, Brahadeeswari H. Prevalence of smartphone addiction and its effects on sleep quality: a cross-sectional study among medical students. Ind Psychiatry J. 2019;28(1):82-85. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lee Y, Blebea J, Janssen F, Domoff SE. The impact of smartphone and social media use on adolescent sleep quality and mental health during the COVID-19 pandemic. Hum Behav Emerg Technol. 2023;2023:3277040. [ FREE Full text ] [ CrossRef ]
• Li L, Griffiths MD, Mei S, Niu Z. Fear of missing out and smartphone addiction mediates the relationship between positive and negative affect and sleep quality among Chinese university students. Front Psychiatry. 2020;11:877. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Li Y, Mu W, Sun C, Kwok SYCL. Surrounded by smartphones: relationship between peer phubbing, psychological distress, problematic smartphone use, daytime sleepiness, and subjective sleep quality. Appl Res Qual Life. 2023;18:1099-1114. [ CrossRef ]
• Luo X, Hu C. Loneliness and sleep disturbance among first-year college students: the sequential mediating effect of attachment anxiety and mobile social media dependence. Psychol Sch. 2022;59(9):1776-1789. [ CrossRef ]
• Luqman A, Masood A, Shahzad F, Shahbaz M, Feng Y. Untangling the adverse effects of late-night usage of smartphone-based SNS among university students. Behav Inf Technol. 2021;40(15):1671-1687. [ CrossRef ]
• Makhfudli, Aulia A, Pratiwi A. Relationship intensity of social media use with quality of sleep, social interaction, and self-esteem in urban adolescents in Surabaya. Sys Rev Pharm. 2020;11(5):783-788. [ CrossRef ]
• Ozcan B, Acimis NM. Sleep quality in Pamukkale university students and its relationship with smartphone addiction. Pak J Med Sci. 2021;37(1):206-211. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Peltz JS, Bodenlos JS, Kingery JN, Abar C. Psychological processes linking problematic smartphone use to sleep disturbance in young adults. Sleep Health. 2023;9(4):524-531. [ CrossRef ] [ Medline ]
• Pérez-Chada D, Bioch SA, Schönfeld D, Gozal D, Perez-Lloret S, Sleep in Adolescents Collaborative Study Group. Screen use, sleep duration, daytime somnolence, and academic failure in school-aged adolescents. PLoS One. 2023;18(2):e0281379. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Przepiorka A, Blachnio A. The role of Facebook intrusion, depression, and future time perspective in sleep problems among adolescents. J Res Adolesc. 2020;30(2):559-569. [ CrossRef ] [ Medline ]
• Rudolf K, Bickmann P, Froböse I, Tholl C, Wechsler K, Grieben C. Demographics and health behavior of video game and eSports players in Germany: the eSports study 2019. Int J Environ Res Public Health. 2020;17(6):1870. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sami H, Danielle L, Lihi D, Elena S. The effect of sleep disturbances and internet addiction on suicidal ideation among adolescents in the presence of depressive symptoms. Psychiatry Res. 2018;267:327-332. [ CrossRef ] [ Medline ]
• Scott H, Woods HC. Fear of missing out and sleep: cognitive behavioural factors in adolescents' nighttime social media use. J Adolesc. 2018;68:61-65. [ CrossRef ] [ Medline ]
• Spagnoli P, Balducci C, Fabbri M, Molinaro D, Barbato G. Workaholism, intensive smartphone use, and the sleep-wake cycle: a multiple mediation analysis. Int J Environ Res Public Health. 2019;16(19):3517. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Stanković M, Nešić M, Čičević S, Shi Z. Association of smartphone use with depression, anxiety, stress, sleep quality, and internet addiction. empirical evidence from a smartphone application. Pers Individ Differ. Jan 2021;168:110342. [ CrossRef ]
• Tandon A, Kaur P, Dhir A, Mäntymäki M. Sleepless due to social media? investigating problematic sleep due to social media and social media sleep hygiene. Comput Hum Behav. Dec 2020;113:106487. [ FREE Full text ] [ CrossRef ]
• Wang PY, Chen KL, Yang SY, Lin PH. Relationship of sleep quality, smartphone dependence, and health-related behaviors in female junior college students. PLoS One. 2019;14(4):e0214769. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Wang Q, Zhong Y, Zhao G, Song R, Zeng C. Relationship among content type of smartphone use, technostress, and sleep difficulty: a study of university students in China. Educ Inf Technol. Aug 02, 2022;28(2):1697-1714. [ CrossRef ]
• Wong HY, Mo HY, Potenza MN, Chan MNM, Lau WM, Chui TK, et al. Relationships between severity of internet gaming disorder, severity of problematic social media use, sleep quality and psychological distress. Int J Environ Res Public Health. 2020;17(6):1879. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Xie X, Dong Y, Wang J. Sleep quality as a mediator of problematic smartphone use and clinical health symptoms. J Behav Addict. 2018;7(2):466-472. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Yang SY, Chen KL, Lin PH, Wang PY. Relationships among health-related behaviors, smartphone dependence, and sleep duration in female junior college students. Soc Health Behav. 2019;2(1):26-31. [ FREE Full text ] [ CrossRef ]
• Yıldırım M, Öztürk A, Solmaz F. Fear of COVID-19 and sleep problems in Turkish young adults: mediating roles of happiness and problematic social networking sites use. Psihologija. 2023;56(4):497-515. [ FREE Full text ] [ CrossRef ]
• Zhai X, Ye M, Wang C, Gu Q, Huang T, Wang K, et al. Associations among physical activity and smartphone use with perceived stress and sleep quality of Chinese college students. Mental Health and Physical Activity. Mar 2020;18:100323. [ CrossRef ]
• Zhang MX, Wu AMS. Effects of smartphone addiction on sleep quality among Chinese university students: the mediating role of self-regulation and bedtime procrastination. Addict Behav. 2020;111:106552. [ CrossRef ] [ Medline ]
• Zhang MX, Zhou H, Yang HM, Wu AMS. The prospective effect of problematic smartphone use and fear of missing out on sleep among Chinese adolescents. Curr Psychol. May 24, 2021;42(7):5297-5305. [ CrossRef ]
• Beyens I, Nathanson AI. Electronic media use and sleep among preschoolers: evidence for time-shifted and less consolidated sleep. Health Commun. 2019;34(5):537-544. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Mazurek MO, Engelhardt CR, Hilgard J, Sohl K. Bedtime electronic media use and sleep in children with autism spectrum disorder. J Dev Behav Pediatr. 2016;37(7):525-531. [ CrossRef ] [ Medline ]
• King DL, Delfabbro PH, Zwaans T, Kaptsis D. Sleep interference effects of pathological electronic media use during adolescence. Int J Ment Health Addict. 2014;12:21-35. [ CrossRef ]
• Kubiszewski V, Fontaine R, Rusch E, Hazouard E. Association between electronic media use and sleep habits: an eight-day follow-up study. Int J Adolesc Youth. 2013;19(3):395-407. [ FREE Full text ] [ CrossRef ]

Abbreviations

Edited by G Eysenbach, T Leung; submitted 20.04.23; peer-reviewed by M Behzadifar, F Estévez-López, R Prieto-Moreno; comments to author 18.05.23; revised version received 15.06.23; accepted 26.03.24; published 23.04.24.

©Xiaoning Han, Enze Zhou, Dong Liu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 23.04.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.