Systematic narrative review methods

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  • systematic reviews; knowledge synthesis; concept synthesis; critical interpretive synthesis; integrative review; meta-synthesis; meta ethnography; metastudy; meta-interpretation narrative synthesis; realist review
  • See also: rapid review, rapid approach, rapid synthesis, meta-method, meta-evaluation, rapid evidence assessment, expedited review, accelerated review and realist review


See also Evidence-based health care | Expert searching | Hand-searching | Network meta-analysis | Realist reviews in medicine | Systematic reviews

Systematic narrative review methods are a hybrid method of systematic literature searching combined with narrative syntheses and analyses. These reviews are seen to be very useful in scientific research due to the sheer volume of the literature. Traditional and/or narrative review mthods present a range of methodological concerns such as bias. Normally the personal bias of the author/s, bias in the selection of included material, and lack of clear methodology independently irreproducible, are some of the problems that can result in traditional reviews. Also, in a traditional narrative review, there may be a lack of an underlying hypothesis and/or theory presented. A ‘theory’ can refer to everything from grand theories (e.g. Marxism, realism, positivism) to hypotheses (13 levels in realistic evaluations or reviews). Theories often refer to a philosophical orientation (both as ontology and epistemology) or substantive theory in an academic area or program.


"...qualitative research is no longer the poor stepchild of quantitative inquiries. Over the past ten years, qualitative research has come into its own, particularly in terms of wider acceptance in academic and policy communities. At the same time, evidence-based medicine (or EBM—‘a politically correct term’) has given birth to the systematic review with all of its complexities and conundrums. Some, however, have begun to question the systematic review approach and its appropriateness, particularly in the generation of evidence-based policy (Packwood, 2002, p. 268), and its usefulness in reviewing qualitative studies continues to be debated. Nonetheless, because qualitative research is now ignored at peril within the systematic review camp, such reviews have become the proving ground for qualitative work as well as the quantitative study. A mistake is often made, however, in transposing methods best suited to systematic review of quantitative studies into qualitative ones. Check-lists, ‘standards’, matrices, ‘hierarchies of evidence’ and other terminology borrowed from the arsenal of the quantitative camp pepper qualitative ground like so many cluster bombs; therein lies the danger of the loss of much of the ground that qualitative research has won over the past decade or so. It is my belief that this rush to imitate quantitative procedures is producing a kind of ‘mission drift’ in many qualitative ‘systematic’ research reviews." ~ Jones, 2004

Narrative reviews

"...[narrative review] studies provide informative explanatory analysis “discerning what works for whom, in what circumstances, in what respects and how." ~ Pawson, 2005


According to Greenhalgh (2009), "... a meta-narrative embraces a shared set of concepts, theories, and preferred methods (including an explicit or implied set of quality criteria against which good research is judged). It also includes a time dimension: researchers look back (e.g., in editorials or book chapters) to consolidate what has been achieved to date and into the future to identify unanswered questions and find new avenues to explore. Greenhalgh et al have also developed a meta-narrative method of systematically making sense of complex, heterogeneous and conflicting bodies of literature. For anyone interested in using this approach for information science-related research, see the Greenhalgh et al paper from 2005. The essential technique in meta-narrativization is interpretive synthesis; primary sources are read and narratives are used to summarize their key methods and findings. Kuhn’s notion of scientific paradigms are also used to map the meta-narratives (overarching story lines) of research as they unfold in different research traditions thus revealing aspects of how a topic is viewed differently by different groups of scholars over time (Kuhn 1962).

The meta-narrative should be regarded not as the unified voice of a community of scholars but as the unfolding of what they are currently disagreeing on (Greenhalgh, 2009).

Realist reviews in medicine

There are many uses of the term realism. Hammersley distinguishes between ‘naïve realism’ and ‘subtle realism’. Pawson and Tilley termed their construct ‘scientific realism’ (see realistic evaluation for their framing of it.) Holden uses realism in the sense that Hammersley refers to it as ‘naïve realism’, which others might see as positivism. ‘Subtle realism’, critical realism, scientific realism are all constructed to sit between the extremes of positivism and constructivism. That said, a) words have many meanings, b) interpretations vary and evolve, and c) ‘there’s no such thing as final truth or knowledge’ (a realist tenet). Therefore, there isn’t truly a ‘correct’ description except insofar as one should make sure one understands and accurately represents whichever author one is discussing at any one time. Further, there are at least two meanings for ‘stratified reality’. One is of ‘systems within systems’ in that every system comprises sub-systems and is part of larger systems, regardless of whether one is discussing material reality, social reality or ideas. The other is Bhaskar’s philosophical construct of the empirical, the actual and the real. Both are, in my view, necessary to understanding realism. For further discussion, see Pawson, 2005

"...participatory research is the co-construction of research between researchers and people affected by the issues under study (e.g., patients, community members, community health professionals, representatives of community-based organizations)... (Jagosh et al, 2012)

"...a realist review differs from empirically focused qualitative or quantitative methods in a number of ways, including its theory-driven and abductive (informed-intuitive) approach to understanding context, mechanism, and outcome..." (Jagosh et al, 2012)

"...the realist review was originally developed by Pawson (2005) for complex social interventions to explore systematically how contextual factors influence the link between intervention and outcome (summed up in the question "what works, how, for whom, in what circumstances and to what extent?")..." (Greenhalgh et al, 2011)


  • This listserv is for researchers interested in learning about realist and meta-narrative reviews. The group hopes to build a community that enables peer-to-peer knowledge construction ultimately leading to a community of members with greater understanding and competence in undertaking these types of reviews. If you would like to join this list, please email Geoff Wong.


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