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Scoping Reviews

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• Health & medicine
• Social sciences
• Technologically-enhanced psychological interventions for older adults: A scoping review. (2020).
• The effects of Toxic Early Childhood Experiences on depression according to Young Schema Model: A scoping review. (2019).

Rehab sciences

• Occupational therapists' contributions to fostering older adults' social participation: A scoping review. (2018).
• Physiotherapy interventions for people with dementia and a hip fracture—a scoping review of the literature. (2017).
• Speech, language and swallowing impairments in functional neurological disorder: A scoping review. (2019).

Veterinary sciences

• A scoping review of the evidence for efficacy of acupuncture in companion animals. (2017).
• Scoping review of indicators and methods of measurement used to evaluate the impact of dog population management interventions. (2017).
• Promoting social creativity in science education with digital technology to overcome inequalities: A scoping review. (2019).
• Simulation in social work education: A scoping review. (2020).
• Performance management: A scoping review of the literature and an agenda for future research. (2019).
• A scoping review of feed interventions and livelihoods of small-scale livestock keepers. (2020).
• Ice-jam flood research: A scoping review. (2018).
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• Published: 08 October 2021

Scoping reviews: reinforcing and advancing the methodology and application

• Micah D. J. Peters 1 , 2 , 3 ,
• Casey Marnie 1 ,
• Heather Colquhoun 4 , 5 ,
• Chantelle M. Garritty 6 ,
• Susanne Hempel 7 ,
• Tanya Horsley 8 ,
• Etienne V. Langlois 9 ,
• Erin Lillie 10 ,
• Kelly K. O’Brien 5 , 11 , 12 ,
• Ӧzge Tunçalp 13 ,
• Michael G. Wilson 14 , 15 , 16 ,
• Wasifa Zarin 17 &
• Andrea C. Tricco   ORCID: orcid.org/0000-0002-4114-8971 17 , 18 , 19  

Systematic Reviews volume  10 , Article number:  263 ( 2021 ) Cite this article

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Scoping reviews are an increasingly common approach to evidence synthesis with a growing suite of methodological guidance and resources to assist review authors with their planning, conduct and reporting. The latest guidance for scoping reviews includes the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews. This paper provides readers with a brief update regarding ongoing work to enhance and improve the conduct and reporting of scoping reviews as well as information regarding the future steps in scoping review methods development. The purpose of this paper is to provide readers with a concise source of information regarding the difference between scoping reviews and other review types, the reasons for undertaking scoping reviews, and an update on methodological guidance for the conduct and reporting of scoping reviews.

Despite available guidance, some publications use the term ‘scoping review’ without clear consideration of available reporting and methodological tools. Selection of the most appropriate review type for the stated research objectives or questions, standardised use of methodological approaches and terminology in scoping reviews, clarity and consistency of reporting and ensuring that the reporting and presentation of the results clearly addresses the review’s objective(s) and question(s) are critical components for improving the rigour of scoping reviews.

Rigourous, high-quality scoping reviews should clearly follow up to date methodological guidance and reporting criteria. Stakeholder engagement is one area where further work could occur to enhance integration of consultation with the results of evidence syntheses and to support effective knowledge translation. Scoping review methodology is evolving as a policy and decision-making tool. Ensuring the integrity of scoping reviews by adherence to up-to-date reporting standards is integral to supporting well-informed decision-making.

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Introduction

Given the readily increasing access to evidence and data, methods of identifying, charting and reporting on information must be driven by new, user-friendly approaches. Since 2005, when the first framework for scoping reviews was published, several more detailed approaches (both methodological guidance and a reporting guideline) have been developed. Scoping reviews are an increasingly common approach to evidence synthesis which is very popular amongst end users [ 1 ]. Indeed, one scoping review of scoping reviews found that 53% (262/494) of scoping reviews had government authorities and policymakers as their target end-user audience [ 2 ]. Scoping reviews can provide end users with important insights into the characteristics of a body of evidence, the ways, concepts or terms have been used, and how a topic has been reported upon. Scoping reviews can provide overviews of either broad or specific research and policy fields, underpin research and policy agendas, highlight knowledge gaps and identify areas for subsequent evidence syntheses [ 3 ].

Despite or even potentially because of the range of different approaches to conducting and reporting scoping reviews that have emerged since Arksey and O’Malley’s first framework in 2005, it appears that lack of consistency in use of terminology, conduct and reporting persist [ 2 , 4 ]. There are many examples where manuscripts are titled ‘a scoping review’ without citing or appearing to follow any particular approach [ 5 , 6 , 7 , 8 , 9 ]. This is similar to how many reviews appear to misleadingly include ‘systematic’ in the title or purport to have adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement without doing so. Despite the publication of the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and other recent guidance [ 4 , 10 , 11 , 12 , 13 , 14 ], many scoping reviews continue to be conducted and published without apparent (i.e. cited) consideration of these tools or only cursory reference to Arksey and O’Malley’s original framework. We can only speculate at this stage why many authors appear to be either unaware of or unwilling to adopt more recent methodological guidance and reporting items in their work. It could be that some authors are more familiar and comfortable with the older, less prescriptive framework and see no reason to change. It could be that more recent methodologies such as JBI’s guidance and the PRISMA-ScR appear more complicated and onerous to comply with and so may possibly be unfit for purpose from the perspective of some authors. In their 2005 publication, Arksey and O’Malley themselves called for scoping review (then scoping study) methodology to continue to be advanced and built upon by subsequent authors, so it is interesting to note a persistent resistance or lack of awareness from some authors. Whatever the reason or reasons, we contend that transparency and reproducibility are key markers of high-quality reporting of scoping reviews and that reporting a review’s conduct and results clearly and consistently in line with a recognised methodology or checklist is more likely than not to enhance rigour and utility. Scoping reviews should not be used as a synonym for an exploratory search or general review of the literature. Instead, it is critical that potential authors recognise the purpose and methodology of scoping reviews. In this editorial, we discuss the definition of scoping reviews, introduce contemporary methodological guidance and address the circumstances where scoping reviews may be conducted. Finally, we briefly consider where ongoing advances in the methodology are occurring.

What is a scoping review and how is it different from other evidence syntheses?

A scoping review is a type of evidence synthesis that has the objective of identifying and mapping relevant evidence that meets pre-determined inclusion criteria regarding the topic, field, context, concept or issue under review. The review question guiding a scoping review is typically broader than that of a traditional systematic review. Scoping reviews may include multiple types of evidence (i.e. different research methodologies, primary research, reviews, non-empirical evidence). Because scoping reviews seek to develop a comprehensive overview of the evidence rather than a quantitative or qualitative synthesis of data, it is not usually necessary to undertake methodological appraisal/risk of bias assessment of the sources included in a scoping review. Scoping reviews systematically identify and chart relevant literature that meet predetermined inclusion criteria available on a given topic to address specified objective(s) and review question(s) in relation to key concepts, theories, data and evidence gaps. Scoping reviews are unlike ‘evidence maps’ which can be defined as the figural or graphical presentation of the results of a broad and systematic search to identify gaps in knowledge and/or future research needs often using a searchable database [ 15 ]. Evidence maps can be underpinned by a scoping review or be used to present the results of a scoping review. Scoping reviews are similar to but distinct from other well-known forms of evidence synthesis of which there are many [ 16 ]. Whilst this paper’s purpose is not to go into depth regarding the similarities and differences between scoping reviews and the diverse range of other evidence synthesis approaches, Munn and colleagues recently discussed the key differences between scoping reviews and other common review types [ 3 ]. Like integrative reviews and narrative literature reviews, scoping reviews can include both research (i.e. empirical) and non-research evidence (grey literature) such as policy documents and online media [ 17 , 18 ]. Scoping reviews also address broader questions beyond the effectiveness of a given intervention typical of ‘traditional’ (i.e. Cochrane) systematic reviews or peoples’ experience of a particular phenomenon of interest (i.e. JBI systematic review of qualitative evidence). Scoping reviews typically identify, present and describe relevant characteristics of included sources of evidence rather than seeking to combine statistical or qualitative data from different sources to develop synthesised results.

Similar to systematic reviews, the conduct of scoping reviews should be based on well-defined methodological guidance and reporting standards that include an a priori protocol, eligibility criteria and comprehensive search strategy [ 11 , 12 ]. Unlike systematic reviews, however, scoping reviews may be iterative and flexible and whilst any deviations from the protocol should be transparently reported, adjustments to the questions, inclusion/exclusion criteria and search may be made during the conduct of the review [ 4 , 14 ]. Unlike systematic reviews where implications or recommendations for practice are a key feature, scoping reviews are not designed to underpin clinical practice decisions; hence, assessment of methodological quality or risk of bias of included studies (which is critical when reporting effect size estimates) is not a mandatory step and often does not occur [ 10 , 12 ]. Rapid reviews are another popular review type, but as yet have no consistent, best practice methodology [ 19 ]. Rapid reviews can be understood to be streamlined forms of other review types (i.e. systematic, integrative and scoping reviews) [ 20 ].

Guidance to improve the quality of reporting of scoping reviews

Since the first 2005 framework for scoping reviews (then termed ‘scoping studies’) [ 13 ], the popularity of this approach has grown, with numbers doubling between 2014 and 2017 [ 2 ]. The PRISMA-ScR is the most up-to-date and advanced approach for reporting scoping reviews which is largely based on the popular PRISMA statement and checklist, the JBI methodological guidance and other approaches for undertaking scoping reviews [ 11 ]. Experts in evidence synthesis including authors of earlier guidance for scoping reviews developed the PRISMA-ScR checklist and explanation using a robust and comprehensive approach. Enhancing transparency and uniformity of reporting scoping reviews using the PRISMA-ScR can help to improve the quality and value of a scoping review to readers and end users [ 21 ]. The PRISMA-ScR is not a methodological guideline for review conduct, but rather a complementary checklist to support comprehensive reporting of methods and findings that can be used alongside other methodological guidance [ 10 , 12 , 13 , 14 ]. For this reason, authors who are more familiar with or prefer Arksey and O’Malley’s framework; Levac, Colquhoun and O’Brien’s extension of that framework or JBI’s methodological guidance could each select their preferred methodological approach and report in accordance with the PRISMA-ScR checklist.

Reasons for conducting a scoping review

Whilst systematic reviews sit at the top of the evidence hierarchy, the types of research questions they address are not suitable for every application [ 3 ]. Many indications more appropriately require a scoping review. For example, to explore the extent and nature of a body of literature, the development of evidence maps and summaries; to inform future research and reviews and to identify evidence gaps [ 2 ]. Scoping reviews are particularly useful where evidence is extensive and widely dispersed (i.e. many different types of evidence), or emerging and not yet amenable to questions of effectiveness [ 22 ]. Because scoping reviews are agnostic in terms of the types of evidence they can draw upon, they can be used to bring together and report upon heterogeneous literature—including both empirical and non-empirical evidence—across disciplines within and beyond health [ 23 , 24 , 25 ].

When deciding between whether to conduct a systematic review or a scoping review, authors should have a strong understanding of their differences and be able to clearly identify their review’s precise research objective(s) and/or question(s). Munn and colleagues noted that a systematic review is likely the most suitable approach if reviewers intend to address questions regarding the feasibility, appropriateness, meaningfulness or effectiveness of a specified intervention [ 3 ]. There are also online resources for prospective authors [ 26 ]. A scoping review is probably best when research objectives or review questions involve exploring, identifying, mapping, reporting or discussing characteristics or concepts across a breadth of evidence sources.

Scoping reviews are increasingly used to respond to complex questions where comparing interventions may be neither relevant nor possible [ 27 ]. Often, cost, time, and resources are factors in decisions regarding review type. Whilst many scoping reviews can be quite large with numerous sources to screen and/or include, there is no expectation or possibility of statistical pooling, formal risk of bias rating, and quality of evidence assessment [ 28 , 29 ]. Topics where scoping reviews are necessary abound—for example, government organisations are often interested in the availability and applicability of tools to support health interventions, such as shared decision aids for pregnancy care [ 30 ]. Scoping reviews can also be applied to better understand complex issues related to the health workforce, such as how shift work impacts employee performance across diverse occupational sectors, which involves a diversity of evidence types as well as attention to knowledge gaps [ 31 ]. Another example is where more conceptual knowledge is required, for example, identifying and mapping existing tools [ 32 ]. Here, it is important to understand that scoping reviews are not the same as ‘realist reviews’ which can also be used to examine how interventions or programmes work. Realist reviews are typically designed to ellucide the theories that underpin a programme, examine evidence to reveal if and how those theories are relevant and explain how the given programme works (or not) [ 33 ].

Increased demand for scoping reviews to underpin high-quality knowledge translation across many disciplines within and beyond healthcare in turn fuels the need for consistency, clarity and rigour in reporting; hence, following recognised reporting guidelines is a streamlined and effective way of introducing these elements [ 34 ]. Standardisation and clarity of reporting (such as by using a published methodology and a reporting checklist—the PRISMA-ScR) can facilitate better understanding and uptake of the results of scoping reviews by end users who are able to more clearly understand the differences between systematic reviews, scoping reviews and literature reviews and how their findings can be applied to research, practice and policy.

Future directions in scoping reviews

The field of evidence synthesis is dynamic. Scoping review methodology continues to evolve to account for the changing needs and priorities of end users and the requirements of review authors for additional guidance regarding terminology, elements and steps of scoping reviews. Areas where ongoing research and development of scoping review guidance are occurring include inclusion of consultation with stakeholder groups such as end users and consumer representatives [ 35 ], clarity on when scoping reviews are the appropriate method over other synthesis approaches [ 3 ], approaches for mapping and presenting results in ways that clearly address the review’s research objective(s) and question(s) [ 29 ] and the assessment of the methodological quality of scoping reviews themselves [ 21 , 36 ]. The JBI Scoping Review Methodology group is currently working on this research agenda.

Consulting with end users, experts, or stakeholders has been a suggested but optional component of scoping reviews since 2005. Many of the subsequent approaches contained some reference to this useful activity. Stakeholder engagement is however often lost to the term ‘review’ in scoping reviews. Stakeholder engagement is important across all knowledge synthesis approaches to ensure relevance, contextualisation and uptake of research findings. In fact, it underlines the concept of integrated knowledge translation [ 37 , 38 ]. By including stakeholder consultation in the scoping review process, the utility and uptake of results may be enhanced making reviews more meaningful to end users. Stakeholder consultation can also support integrating knowledge translation efforts, facilitate identifying emerging priorities in the field not otherwise captured in the literature and may help build partnerships amongst stakeholder groups including consumers, researchers, funders and end users. Development in the field of evidence synthesis overall could be inspired by the incorporation of stakeholder consultation in scoping reviews and lead to better integration of consultation and engagement within projects utilising other synthesis methodologies. This highlights how further work could be conducted into establishing how and the extent to which scoping reviews have contributed to synthesising evidence and advancing scientific knowledge and understandings in a more general sense.

Currently, many methodological papers for scoping reviews are published in healthcare focussed journals and associated disciplines [ 6 , 39 , 40 , 41 , 42 , 43 ]. Another area where further work could also occur is to gain greater understanding on how scoping reviews and scoping review methodology is being used across disciplines beyond healthcare including how authors, reviewers and editors understand, recommend or utilise existing guidance for undertaking and reporting scoping reviews.

Whilst available guidance for the conduct and reporting of scoping review has evolved over recent years, opportunities remain to further enhance and progress the methodology, uptake and application. Despite existing guidance, some publications using the term ‘scoping review’ continue to be conducted without apparent consideration of available reporting and methodological tools. Because consistent and transparent reporting is widely recongised as important for supporting rigour, reproducibility and quality in research, we advocate for authors to use a stated scoping review methodology and to transparently report their conduct by using the PRISMA-ScR. Selection of the most appropriate review type for the stated research objectives or questions, standardising the use of methodological approaches and terminology in scoping reviews, clarity and consistency of reporting and ensuring that the reporting and presentation of the results clearly addresses the authors’ objective(s) and question(s) are also critical components for improving the rigour of scoping reviews. We contend that whilst the field of evidence synthesis and scoping reviews continues to evolve, use of the PRISMA-ScR is a valuable and practical tool for enhancing the quality of scoping reviews, particularly in combination with other methodological guidance [ 10 , 12 , 44 ]. Scoping review methodology is developing as a policy and decision-making tool, and so ensuring the integrity of these reviews by adhering to the most up-to-date reporting standards is integral to supporting well informed decision-making. As scoping review methodology continues to evolve alongside understandings regarding why authors do or do not use particular methodologies, we hope that future incarnations of scoping review methodology continues to provide useful, high-quality evidence to end users.

Availability of data and materials

All data and materials are available upon request.

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Acknowledgements

The authors would like to acknowledge the other members of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) working group as well as Shazia Siddiqui, a research assistant in the Knowledge Synthesis Team in the Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto.

The authors declare that no specific funding was received for this work. Author ACT declares that she is funded by a Tier 2 Canada Research Chair in Knowledge Synthesis. KKO is supported by a Canada Research Chair in Episodic Disability and Rehabilitation with the Canada Research Chairs Program.

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Micah D. J. Peters & Casey Marnie

Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, 101 Currie St, Adelaide, 5001, South Australia

Micah D. J. Peters

The Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence, Faculty of Health and Medical Sciences, The University of Adelaide, 5006, Adelaide, South Australia

Department of Occupational Science and Occupational Therapy, University of Toronto, Terrence Donnelly Health Sciences Complex, 3359 Mississauga Rd, Toronto, Ontario, L5L 1C6, Canada

Heather Colquhoun

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Tanya Horsley

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Ӧzge Tunçalp

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Contributions

MDJP, CM, HC, CMG, SH, TH, EVL, EL, KKO, OT, MGW, WZ and AT all made substantial contributions to the conception, design and drafting of the work. MDJP and CM prepared the final version of the manuscript. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Andrea C. Tricco .

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Peters, M.D.J., Marnie, C., Colquhoun, H. et al. Scoping reviews: reinforcing and advancing the methodology and application. Syst Rev 10 , 263 (2021). https://doi.org/10.1186/s13643-021-01821-3

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Published : 08 October 2021

DOI : https://doi.org/10.1186/s13643-021-01821-3

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What is a Scoping Review?

Our Systematic Review Service can also assist you and your team with Scoping Reviews. 

A scoping review is a relatively new approach to evidence synthesis and differs from systematic reviews in its purpose and aims. The purpose of a scoping review is to provide an overview of the available research evidence without producing a summary answer to a guide clinical decision-making.

Scoping reviews are a form of knowledge synthesis, which incorporate a range of study designs to comprehensively summarize and synthesize evidence with the aim of informing practice, programs, and policy and providing direction to future research priorities.

The general purpose for conducting scoping reviews is to identify and map the available evidence.

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

Sucharew H, Macaluso, M. Methods for Research Evidence Synthesis: The Scoping Review Approach. J. Hosp. Med 2019;7;416-418.

How is this different from a Systematic Review?

• Scoping reviews share a number of the same processes as systematic reviews, as they both use rigorous and transparent methods to comprehensively identify and analyze all the relevant literature pertaining to a research question.
• The key differences between the two review methods can be attributed to their differing purposes and aims. The purpose of a scoping review is to map the body of literature on a topic area . The purpose of a systematic review is to synthesize the best available research on a specific intervention . 
• Scoping reviews identify key characteristics or factors related to a concept. They do not produce statements to guide decision-making. 
• A scoping review seeks to present an overview of a potentially large and diverse body of literature pertaining to a broad topic . A systematic review attempts to collate empirical evidence from a relatively smaller number of studies pertaining to a focused research question. 
• Scoping reviews aim to provide a descriptive overview of the reviewed material without critically appraising individual studies or synthesizing evidence from different studies (no risk of bias or meta-analysis/statistical pooling is performed). In contrast, systematic reviews aim to provide a synthesis of evidence from studies assessed for risk of bias .

Adapted from: Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods. 2014 Dec;5(4):371–85.  

The PCC Question Development Framework

Because the aim of a scoping review differs from that of a systematic review, question development may not fit into the PICO (Patient/Intervention/Comparison/Outcome) framework . Therefore, PCC (Population/Concept/Context) may be a more useful framework.

Per JBI's Scoping Review Manual : "The 'PCC' mnemonic is recommended as a guide to construct a clear and meaningful title for a scoping review. The PCC mnemonic stands for the Population, Concept, and Context. There is no need for explicit outcomes, interventions or phenomena of interest to be stated for a scoping review; however elements of each of these may be implicit in the concept under examination."

When do I perform a Systematic Review? When do I perform a Scoping Review?

• When you have a specific clinical question that fits into the PICO framework or a hypothesis you are looking to test, you'll want to perform a systematic review. 
• If you are looking for a broad overview on a topic, with no hypothesis or specific clinical question, you'll want to perform a scoping review.  

Adapted from: Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018 Nov 19;18(1):143.

How are both Systematic and Scoping Reviews different from Traditional Literature Reviews?

Systematic and scoping reviews aim to be comprehensive, transparent, reproducible, and unbiased – this is not typically the case with a traditional literature review. With clear and explicit methodology, the reader knows exactly how the authors of a study came to their conclusions, rather than relying on expert opinion or subjective selection that is usually found in a literature review. 

Additional Resources

• Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. Updated methodological guidance for the conduct of scoping reviews . JBI Evid Synth. 2020 Oct;18(10):2119-2126.
• 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 Oct 2;169(7):467–73.
• Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version) . In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020.
• Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach . BMC Med Res Methodol. 2018 Nov 19;18(1):143.
• Arksey H, O’Malley L. Scoping studies: towards a methodological framework . Int J Soc Res Methodol. 2005 Feb;8(1):19–32.
• Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency . Res Synth Methods. 2014 Dec;5(4):371–85.
• Colquhoun HL, Levac D, O’Brien KK, Straus S, Tricco AC, Perrier L, et al. Scoping reviews: time for clarity in definition, methods, and reporting . J Clin Epidemiol. 2014 Dec;67(12):1291–4.
• Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews . Int J Evid Based Healthc. 2015 Sep;13(3):141–6.
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When is a Scoping Review methodology appropriate?

Outline of stages, methods and guidance, examples of scoping reviews, supplementary resources.

According to Colquhoun et al. (2014) , a scoping review can be defined as: "a form of knowledge synthesis, which incorporate a range of study designs to comprehensively summarize and synthesize evidence with the aim of informing practice, programs, and policy and providing direction to future research priorities" (p.1291).

Characteristics

• Answers a broad question
• Scoping reviews serve the purpose of identifying the scope and extent of existing research on a topic
• Similar to systematic reviews, scoping reviews follow a step-by-step process and aim to be transparent and replicable in its methods

When to Use It: A scoping review might be right for you if you are interested in:

• Examining the extent, range, and nature of research activity
• Determining the value of undertaking a full systematic review (e.g. Do any studies exist? Have systematic reviews already been conducted?)
• Summarizing the disseminating research findings
• Identifying gaps in an existing body of literature

The following stages of conducting a review of complex interventions are derived from  Peters et al. (2015)  and Levac et al. (2010) .

Timeframe:  12+ months, (same amount of time as a systematic review or longer)

*Varies beyond the type of review. Depends on many factors such as but not limited to: resources available, the quantity and quality of the literature, and the expertise or experience of reviewers" ( Grant & Booth, 2009 ).

Question:  Answers broader and topic focused questions beyond those relating to the effectiveness of treatments or interventions. A priori review protocol is recommended. 

Is your review question a complex intervention? Learn more about  Reviews of Complex Interventions .

Sources and searches:  Comprehensive search-may be limited by time/scope restraints, still aims to be thorough and repeatable of all literature. May involve multiple structured searches rather than a single structured search. This will produce more results than a systematic review. Must include a modified PRISMA flow diagram.

Selection:  Based on inclusion/exclusion criteria, due to the iterative nature of a scoping review some changes may be necessary. May require more time spent screening articles due to the larger volume of results from broader questions.

Appraisal:  Critical appraisal (optional), Risk of Bias assessment (optional) is not applicable for scoping reviews. 

Synthesis:  (Tabular with some narrative) The extraction of data for a scoping review may include a charting table or form but a formal synthesis of findings from individual studies and the generation of a 'summary of findings' (SOF) table is not required. Results may include a logical diagram or table or any descriptive form that aligns with the scope and objectives of the review. May incorporate a numerical summary and qualitative thematic analysis.

Consultation:  (optional) 

The following resources provide methods and guidance in the field of scoping reviews.

Methods & Guidance

• Cochrane Training: Scoping reviews: what they are and how you can do them A series of videos presented by Dr Andrea C. Tricco and Kafayat Oboirien. Learn the about what a scoping review is, see examples, learn the steps involved, and common methods from Dr. Tricco. Oboirien presents her experiences of conducting a scoping review on strengthening clinical governance in low and middle income countries.
• Current Best Practices for the Conduct of Scoping Reviews by Heather Colquhoun An overview on best practices when executing a scoping review.
• Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Chapter 11: Scoping Reviews An extensive and detailed outline within the JBI Manual for Evidence Synthesis on how to properly conduct a scoping review.

Reporting Guideline

• PRISMA for Scoping Reviews (PRISMA-ScR) Contains a 20-item checklist for proper reporting of a scoping review plus 2 optional items.
• Håkonsen, S. J., Pedersen, P. U., Bjerrum, M., Bygholm, A., & Peters, M. (2018). Nursing minimum data sets for documenting nutritional care for adults in primary healthcare: a scoping review .  JBI database of systematic reviews and implementation reports ,  16 (1), 117–139. doi: 10.11124/JBISRIR-2017-003386
• Kao, S. S., Peters, M., Dharmawardana, N., Stew, B., & Ooi, E. H. (2017). Scoping review of pediatric tonsillectomy quality of life assessment instruments .  The Laryngoscope ,  127 (10), 2399–2406. doi: 10.1002/lary.26522
• Tricco, A. C., Zarin, W., Rios, P., Nincic, V., Khan, P. A., Ghassemi, M., Diaz, S., Pham, B., Straus, S. E., & Langlois, E. V. (2018). Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review .  Implementation science: IS ,  13 (1), 31. doi: 10.1186/s13012-018-0717-x

Anderson, S., Allen, P., Peckham, S., & Goodwin, N. (2008). Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services .  Health research policy and systems ,  6 , 7. doi: 10.1186/1478-4505-6-7

Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework .  International journal of social research methodology, 8 (1), 19-32. doi: 10.1080/1364557032000119616

Armstrong, R., Hall, B. J., Doyle, J., & Waters, E. (2011). Cochrane Update. 'Scoping the scope' of a cochrane review .  Journal of public health (Oxford, England) ,  33 (1), 147–150. doi: 10.1093/pubmed/fdr015

Colquhoun, H. (2016). Current best practices for the conducting of scoping reviews . Symposium Presentation - Impactful Biomedical Research: Achieving Quality and Transparency . https://www.equator-network.org/wp-content/uploads/2016/06/Gerstein-Library-scoping-reviews_May-12.pdf

Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., Kastner, M., & Moher, D. (2014). Scoping reviews: time for clarity in definition, methods, and reporting .  Journal of clinical epidemiology ,  67 (12), 1291–1294. doi: 10.1016/j.jclinepi.2014.03.013

Davis, K., Drey, N., & Gould, D. (2009). What are scoping studies? A review of the nursing literature .  International journal of nursing studies ,  46 (10), 1386–1400. doi: 10.1016/j.ijnurstu.2009.02.010

Khalil, H., Peters, M., Godfrey, C. M., McInerney, P., Soares, C. B., & Parker, D. (2016). An evidence-based approach to scoping reviews .  Worldviews on evidence-based nursing ,  13 (2), 118–123. doi: 10.1111/wvn.12144

Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: advancing the methodology .  Implementation science: IS ,  5 , 69. doi: 10.1186/1748-5908-5-69

Lockwood, C., Dos Santos, K. B., & Pap, R. (2019). Practical guidance for knowledge synthesis: scoping review methods .  Asian nursing research ,  13 (5), 287–294. doi: 10.1016/j.anr.2019.11.002

Morris, M., Boruff, J. T., & Gore, G. C. (2016). Scoping reviews: establishing the role of the librarian .  Journal of the Medical Library Association: JMLA ,  104 (4), 346–354. doi: 10.3163/1536-5050.104.4.020

Munn, Z., Peters, M., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach .  BMC medical research methodology ,  18 (1), 143. doi: 10.1186/s12874-018-0611-x

O'Brien, K. K., Colquhoun, H., Levac, D., Baxter, L., Tricco, A. C., Straus, S., Wickerson, L., Nayar, A., Moher, D., & O'Malley, L. (2016). Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps .  BMC health services research ,  16 , 305. doi: 10.1186/s12913-016-1579-z

Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews .  International journal of evidence-based healthcare ,  13 (3), 141–146. doi: 10.1097/XEB.0000000000000050

Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Chapter 11: Scoping Reviews . In Aromataris, E. & Munn, Z. (Eds.),  JBI Manual for Evidence Synthesis . Joanna Briggs Institute. doi: 10.46658/JBIMES-20-12

Peters, M., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2021). Updated methodological guidance for the conduct of scoping reviews .  JBI evidence implementation ,  19 (1), 3–10. doi: 10.1097/XEB.0000000000000277

Pham, M. T., Rajić, A., Greig, J. D., Sargeant, J. M., Papadopoulos, A., & McEwen, S. A. (2014). A scoping review of scoping reviews: advancing the approach and enhancing the consistency .  Research synthesis methods ,  5 (4), 371–385. doi: 10.1002/jrsm.1123

Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., Lewin, S., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation .  Annals of internal medicine ,  169 (7), 467–473. doi: 10.7326/M18-0850

Tricco, A., Oboirien, K., Lotfi, T., & Sambunjak, D. (2017, August).  Scoping reviews: what they are and how you can do them . Cochrane Training. https://training.cochrane.org/resource/scoping-reviews-what-they-are-and-how-you-can-do-them

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Other Names for a Scoping Review

• Scoping Study
• Systematic Scoping Review
• Scoping Report
• Scope of the Evidence
• Rapid Scoping Review
• Structured Literature Review
• Scoping Project
• Scoping Meta Review

Limitations of a Scoping Review

The following challenges of conducting a scoping review are derived from Grant & Booth (2009) , Peters et al. (2015) , and O'Brien (2016) .

• Is not easier than a systematic review.
• Is not faster than a systematic review; may take longer .
• More citations to screen.
• Different screening criteria/process than a systematic review.
• Often leads to a broader, less defined search.
• Requires multiple structured searches instead of one.
• Increased emphasis for hand searching the literature.
• May require larger teams because of larger volume of literature.
• Inconsistency in the conduct of scoping reviews.

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Systematic reviews and other evidence synthesis projects

• Scoping Reviews
• Types of Reviews
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• 0. Plan your Review
• 1. Define the Question
• 2. Check for Recent Systematic Reviews and Protocols
• 3. Write and register your protocol
• Developing your Search Terms
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• 6. Appraise the Studies
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What is a Scoping Review?

Scoping review steps, scoping reviews vs. systematic reviews, the pcc framework, learning resources, guide design credit.

• Equity in Evidence Synthesis
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• Librarian Support

A scoping review is a broad overview of a general topic that maps a large and diverse body of literature to provide forms of evidence. 

Objectives of a Scoping Review

• To identify the types of available evidence in a given field
• To clarify key concepts/ definitions in the literature
• To examine how research is conducted on a certain topic or field
• To identify key characteristics or factors related to a concept
• As a precursor to a systematic review
• To identify and analyze knowledge gaps

Note: The full scoping review methodology is outside the scope of almost all class assignments or dissertation/thesis. If you are considering assigning one, please meet with a librarian about a modified version that will fit your course's needs and limits.

The following are the steps for the scoping review process:

• Determine subject for review and develop some general questions
• Highly recommended to develop a protocol after the first step!
• Use the PCC framework
• Conduct systematic searches
• Determine eligibility of papers from results with a screening process
• Data extraction of relevant information
• Document the evidence
• See also: the JBI scoping review YouTube playlist

Scoping reviews share a lot of the same methodology as systematic reviews, but there are some differences.

Scoping reviews answer different types of questions than systematic reviews. Arksey and O'Malley identified 4 reasons to conduct a scoping review:

• To examine the extent, range and nature of research activity
• To determine the value of undertaking a full systematic review
• To summarize and disseminate research findings
• To identify research gaps in the existing literature

Writing your protocol

The JBI Scoping Review chapter has guidance on writing your protocol. Also, the National Institutes of Health (NIH) Library has developed a Scoping Review Protocol Guidance template and informational document containing goals and requirements for the protocol plus helpful tips and examples.

Registering your protocol

There is not as centralized a location for registering scoping review protocols as there is for systematic reviews, but there are a few ways to do it. You can put it into an open science repository such as:

These have the added features of being a place where you can make any supplemental materials available, such as the full text of your searches, and the advantage of being fast since they don’t require the approval process of the journals below. They have the disadvantage of the protocol only being findable by people searching that repository.

There are also several journals that publish protocols:

• BMC Systematic Reviews  
• JMIR Research Protocols
• JBI Evidence Synthesis

These have the advantage of being included in several databases, but the disadvantage of having to go through the submission and approval process.

The PCC framework stand for the following and include these elements:

This framework can be used for mixed methods of qualitative and quantitative research.

By using this framework, it is also important to surface the varying including and excluding criteria to explicitly guide the scope of what is being investigated. This is helpful to document in your protocol to provide clarity about what information needs to be looked for in supporting your research question. 

• Systematic vs Scoping Review: What's the Difference? A short video from Carrie Price.
• Should I undertake a scoping review or a systematic review? A video from JBI.
• Scoping reviews: What they are and how you can do them on YouTube  or on Cochrane's website   Cochrane video training series.
• Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods. 2014 Dec;5(4):371-85. doi: 10.1002/jrsm.1123. Epub 2014 Jul 24. PMID: 26052958; PMCID: PMC4491356.
• Levac, Danielle, Heather Colquhoun, and Kelly K. O'Brien. "Scoping studies: advancing the methodology." Implementation Science 5.1 (2010): 1-9. https://doi.org/10.1186/1748-5908-5-69
• Scoping reviews: reinforcing and advancing the methodology and application . Micah D. J. Peters, Casey Marnie, Heather Colquhoun, Chantelle M. Garritty, Susanne Hempel, Tanya Horsley, Etienne V. Langlois, Erin Lillie, Kelly K. O’Brien, Ӧzge Tunçalp, Michael G. Wilson, Wasifa Zarin & Andrea C. Tricco. Systematic Reviews volume 10, Article number: 263 (2021)
• Khalil H, Peters M, Godfrey CM, McInerney P, Soares CB, Parker D. An Evidence-Based Approach to Scoping Reviews. Worldviews Evid Based Nurs. 2016 Apr;13(2):118-23. doi: 10.1111/wvn.12144 . Epub 2016 Jan 28. PMID: 26821833 .
• Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach ; by Zachary Munn, Micah D. J. Peters, Cindy Stern, Catalin Tufanaru, Alexa McArthur & Edoardo Aromataris. BMC Med Res Methodol 18, 143 (2018). https://doi.org/10.1186/s12874-018-0611-x
• Evidence maps - often based on a ScR: Miake-Lye IM, Hempel S, Shanman R, Shekelle PG. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products . Syst Rev. 2016;5(1):28.

Reporting Guidelines

• PRISMA Extension for Scoping Reviews The PRISMA extension for scoping reviews, or PRISMA-ScR for short, contains 20 essential reporting items and 2 optional items to include when completing a scoping review.

Dev Wilder UW MLIS Candidate 2023

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What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis

Affiliations.

• 1 JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
• 2 La Trobe University, School of Psychology and Public Health, Department of Public Health, Melbourne, VIC, Australia.
• 3 School of Health Sciences, Robert Gordon University, Aberdeen, UK.
• 4 The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Aberdeen, UK.
• 5 The Wits-JBI Centre for Evidenced-Based Practice: A JBI Affiliated Group, University of the Witwa-tersrand, Johannesburg, South Africa.
• 6 Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University School of Nursing, Kingston, ON, Canada.
• 7 University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre, Adelaide, SA, Australia.
• 8 Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
• 9 The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence, The University of Adelaide, Adelaide, SA, Australia.
• 10 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
• 11 Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
• PMID: 35249995
• DOI: 10.11124/JBIES-21-00483

Evidence synthesis encompasses a broad range of review types, and scoping reviews are an increasingly popular approach to synthesizing evidence in a number of fields. They sit alongside other evidence synthesis methodologies, such as systematic reviews, qualitative evidence synthesis, realist synthesis, and many more. Until now, scoping reviews have been variously defined in the literature. In this article, we provide the following formal definition for scoping reviews: Scoping reviews are a type of evidence synthesis that aims to systematically identify and map the breadth of evidence available on a particular topic, field, concept, or issue, often irrespective of source (ie, primary research, reviews, non-empirical evidence) within or across particular contexts. Scoping reviews can clarify key concepts/definitions in the literature and identify key characteristics or factors related to a concept, including those related to methodological research.

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• What guidance is available for researchers conducting overviews of reviews of healthcare interventions? A scoping review and qualitative metasummary. Pollock M, Fernandes RM, Becker LA, Featherstone R, Hartling L. Pollock M, et al. Syst Rev. 2016 Nov 14;5(1):190. doi: 10.1186/s13643-016-0367-5. Syst Rev. 2016. PMID: 27842604 Free PMC article. Review.
• Updated methodological guidance for the conduct of scoping reviews. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. Peters MDJ, et al. JBI Evid Synth. 2020 Oct;18(10):2119-2126. doi: 10.11124/JBIES-20-00167. JBI Evid Synth. 2020. PMID: 33038124 Review.
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• Published: 19 November 2018

Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach

• Zachary Munn   ORCID: orcid.org/0000-0002-7091-5842 1 ,
• Micah D. J. Peters 1 ,
• Cindy Stern 1 ,
• Catalin Tufanaru 1 ,
• Alexa McArthur 1 &
• Edoardo Aromataris 1  

BMC Medical Research Methodology volume  18 , Article number:  143 ( 2018 ) Cite this article

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Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate.

Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions.

Conclusions

Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.

Peer Review reports

Systematic reviews in healthcare began to appear in publication in the 1970s and 1980s [ 1 , 2 ]. With the emergence of groups such as Cochrane and the Joanna Briggs Institute (JBI) in the 1990s [ 3 ], reviews have exploded in popularity both in terms of the number conducted [ 1 ], and their uptake to inform policy and practice. Today, systematic reviews are conducted for a wide range of purposes across diverse fields of inquiry, different evidence types and for different questions [ 4 ]. More recently, the field of evidence synthesis has seen the emergence of scoping reviews, which are similar to systematic reviews in that they follow a structured process, however they are performed for different reasons and have some key methodological differences [ 5 , 6 , 7 , 8 ]. Scoping reviews are now seen as a valid approach in those circumstances where systematic reviews are unable to meet the necessary objectives or requirements of knowledge users. There now exists clear guidance regarding the definition of scoping reviews, how to conduct scoping reviews and the steps involved in the scoping review process [ 6 , 8 ]. However, the guidance regarding the key indications or reasons why reviewers may choose to follow a scoping review approach is not as straightforward, with scoping reviews often conducted for purposes that do not align with the original indications as proposed by Arksey and O’Malley [ 5 , 6 , 7 , 8 , 9 , 10 ]. As editors and peer reviewers for various journals we have noticed that there is inconsistency and confusion regarding the indications for scoping reviews and a lack of clarity for authors regarding when a scoping review should be performed as opposed to a systematic review. The purpose of this article is to provide practical guidance for reviewers on when to perform a systematic review or a scoping review, supported with some key examples.

Indications for systematic reviews

Systematic reviews can be broadly defined as a type of research synthesis that are conducted by review groups with specialized skills, who set out to identify and retrieve international evidence that is relevant to a particular question or questions and to appraise and synthesize the results of this search to inform practice, policy and in some cases, further research [ 11 , 12 , 13 ]. According to the Cochrane handbook, a systematic review ‘uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable findings from which conclusions can be drawn and decisions made.’ [ 14 ] Systematic reviews follow a structured and pre-defined process that requires rigorous methods to ensure that the results are both reliable and meaningful to end users. These reviews may be considered the pillar of evidence-based healthcare [ 15 ] and are widely used to inform the development of trustworthy clinical guidelines [ 11 , 16 , 17 ].

A systematic review may be undertaken to confirm or refute whether or not current practice is based on relevant evidence, to establish the quality of that evidence, and to address any uncertainty or variation in practice that may be occurring. Such variations in practice may be due to conflicting evidence and undertaking a systematic review should (hopefully) resolve such conflicts. Conducting a systematic review may also identify gaps, deficiencies, and trends in the current evidence and can help underpin and inform future research in the area. Systematic reviews can be used to produce statements to guide clinical decision-making, the delivery of care, as well as policy development [ 12 ]. Broadly, indications for systematic reviews are as follows [ 4 ]:

Uncover the international evidence

Confirm current practice/ address any variation/ identify new practices

Identify and inform areas for future research

Identify and investigate conflicting results

Produce statements to guide decision-making

Despite the utility of systematic reviews to address the above indications, there are cases where systematic reviews are unable to meet the necessary objectives or requirements of knowledge users or where a methodologically robust and structured preliminary searching and scoping activity may be useful to inform the conduct of the systematic reviews. As such, scoping reviews (which are also sometimes called scoping exercises/scoping studies) [ 8 ] have emerged as a valid approach with rather different indications to those for systematic reviews. It is important to note here that other approaches to evidence synthesis have also emerged, including realist reviews, mixed methods reviews, concept analyses and others [ 4 , 18 , 19 , 20 ]. This article focuses specifically on the choice between a systematic review or scoping review approach.

Indications for scoping reviews

True to their name, scoping reviews are an ideal tool to determine the scope or coverage of a body of literature on a given topic and give clear indication of the volume of literature and studies available as well as an overview (broad or detailed) of its focus. Scoping reviews are useful for examining emerging evidence when it is still unclear what other, more specific questions can be posed and valuably addressed by a more precise systematic review [ 21 ]. They can report on the types of evidence that address and inform practice in the field and the way the research has been conducted.

The general purpose for conducting scoping reviews is to identify and map the available evidence [ 5 , 22 ]. Arskey and O’Malley, authors of the seminal paper describing a framework for scoping reviews, provided four specific reasons why a scoping review may be conducted [ 5 , 6 , 7 , 22 ]. Soon after, Levac, Colquhoun and O’Brien further clarified and extended this original framework [ 7 ]. These authors acknowledged that at the time, there was no universally recognized definition of scoping reviews nor a commonly acknowledged purpose or indication for conducting them. In 2015, a methodological working group of the JBI produced formal guidance for conducting scoping reviews [ 6 ]. However, we have not previously addressed and expanded upon the indications for scoping reviews. Below, we build upon previously described indications and suggest the following purposes for conducting a scoping review:

To identify the types of available evidence in a given field

To clarify key concepts/ definitions in the literature

To examine how research is conducted on a certain topic or field

To identify key characteristics or factors related to a concept

As a precursor to a systematic review.

To identify and analyse knowledge gaps

Deciding between a systematic review and a scoping review approach

Authors deciding between the systematic review or scoping review approach should carefully consider the indications discussed above for each synthesis type and determine exactly what question they are asking and what purpose they are trying to achieve with their review. We propose that the most important consideration is whether or not the authors wish to use the results of their review to answer a clinically meaningful question or provide evidence to inform practice. If the authors have a question addressing the feasibility, appropriateness, meaningfulness or effectiveness of a certain treatment or practice, then a systematic review is likely the most valid approach [ 11 , 23 ]. However, authors do not always wish to ask such single or precise questions, and may be more interested in the identification of certain characteristics/concepts in papers or studies, and in the mapping, reporting or discussion of these characteristics/concepts. In these cases, a scoping review is the better choice.

As scoping reviews do not aim to produce a critically appraised and synthesised result/answer to a particular question, and rather aim to provide an overview or map of the evidence. Due to this, an assessment of methodological limitations or risk of bias of the evidence included within a scoping review is generally not performed (unless there is a specific requirement due to the nature of the scoping review aim) [ 6 ]. Given this assessment of bias is not conducted, the implications for practice (from a clinical or policy making point of view) that arise from a scoping review are quite different compared to those of a systematic review. In some cases, there may be no need or impetus to make implications for practice and if there is a need to do so, these implications may be significantly limited in terms of providing concrete guidance from a clinical or policy making point of view. Conversely, when we compare this to systematic reviews, the provision of implications for practice is a key feature of systematic reviews and is recommended in reporting guidelines for systematic reviews [ 13 ].

Exemplars for different scoping review indications

In the following section, we elaborate on each of the indications listed for scoping reviews and provide a number of examples for authors considering a scoping review approach.

Scoping reviews that seek to identify the types of evidence in a given field share similarities with evidence mapping activities as explained by Bragge and colleagues in a paper on conducting scoping research in broad topic areas [ 24 ]. Chambers and colleagues [ 25 ] conducted a scoping review in order to identify current knowledge translation resources (and any evaluations of them) that use, adapt and present findings from systematic reviews to suit the needs of policy makers. Following a comprehensive search across a range of databases, organizational websites and conference abstract repositories based upon predetermined inclusion criteria, the authors identified 20 knowledge translation resources which they classified into three different types (overviews, summaries and policy briefs) as well as seven published and unpublished evaluations. The authors concluded that evidence synthesists produce a range of resources to assist policy makers to transfer and utilize the findings of systematic reviews and that focussed summaries are the most common. Similarly, a scoping review was conducted by Challen and colleagues [ 26 ] in order to determine the types of available evidence identifying the source and quality of publications and grey literature for emergency planning. A comprehensive set of databases and websites were investigated and 1603 relevant sources of evidence were identified mainly addressing emergency planning and response with fewer sources concerned with hazard analysis, mitigation and capability assessment. Based on the results of the review, the authors concluded that while there is a large body of evidence in the field, issues with its generalizability and validity are as yet largely unknown and that the exact type and form of evidence that would be valuable to knowledge users in the field is not yet understood.

To clarify key concepts/definitions in the literature

Scoping reviews are often performed to examine and clarify definitions that are used in the literature. A scoping review by Schaink and colleagues 27 was performed to investigate how the notion of “patient complexity” had been defined, classified, and understood in the existing literature. A systematic search of healthcare databases was conducted. Articles were assessed to determine whether they met the inclusion criteria and the findings of included articles were grouped into five health dimensions. An overview of how complexity has been described was presented, including the varying definitions and interpretations of the term. The results of the scoping review enabled the authors to then develop a complexity framework or model to assist in defining and understanding patient complexity [ 27 ].

Hines et al. [ 28 ] provide a further example where a scoping review has been conducted to define a concept, in this case the condition bronchopulmonary dysplasia. The authors revealed significant variation in how the condition was defined across the literature, prompting the authors to call for a ‘comprehensive and evidence-based definition’. [ 28 ]

To examine how research is conducted on a certain topic

Scoping reviews can be useful tools to investigate the design and conduct of research on a particular topic. A scoping review by Callary and colleagues 29 investigated the methodological design of studies assessing wear of a certain type of hip replacement (highly crosslinked polyethylene acetabular components) [ 29 ]. The aim of the scoping review was to survey the literature to determine how data pertinent to the measurement of hip replacement wear had been reported in primary studies and whether the methods were similar enough to allow for comparison across studies. The scoping review revealed that the methods to assess wear (radiostereometric analysis) varied significantly with many different approaches being employed amongst the investigators. The results of the scoping review led to the authors recommending enhanced standardization in measurements and methods for future research in this field [ 29 ].

There are other examples of scoping reviews investigating research methodology, with perhaps the most pertinent examples being two recent scoping reviews of scoping review methods [ 9 , 10 ]. Both of these scoping reviews investigated how scoping reviews had been reported and conducted, with both advocating for a need for clear guidance to improve standardization of methods [ 9 , 10 ]. Similarly, a scoping review investigating methodology was conducted by Tricco and colleagues 30 on rapid review methods that have been evaluated, compared, used or described in the literature. A variety of rapid review approaches were identified with many instances of poor reporting identified. The authors called for prospective studies to compare results presented by rapid reviews versus systematic reviews.

Scoping reviews can be conducted to identify and examine characteristics or factors related to a particular concept. Harfield and colleagues (2015) conducted a scoping review to identify the characteristics of indigenous primary healthcare service delivery models [ 30 , 31 , 32 ]. A systematic search was conducted, followed by screening and study selection. Once relevant studies had been identified, a process of data extraction commenced to extract characteristics referred to in the included papers. Over 1000 findings were eventually grouped into eight key factors (accessible health services, community participation, culturally appropriate and skilled workforce, culture, continuous quality improvement, flexible approaches to care, holistic health care, self-determination and empowerment). The results of this scoping review have been able to inform a best practice model for indigenous primary healthcare services.

Scoping reviews conducted as precursors to systematic reviews may enable authors to identify the nature of a broad field of evidence so that ensuing reviews can be assured of locating adequate numbers of relevant studies for inclusion. They also enable the relevant outcomes and target group or population for example for a particular intervention to be identified. This can have particular practical benefits for review teams undertaking reviews on less familiar topics and can assist the team to avoid undertaking an “empty” review [ 33 ]. Scoping reviews of this kind may help reviewers to develop and confirm their a priori inclusion criteria and ensure that the questions to be posed by their subsequent systematic review are able to be answered by available, relevant evidence. In this way, systematic reviews are able to be underpinned by a preliminary and evidence-based scoping stage.

A scoping review commissioned by the United Kingdom Department for International Development was undertaken to determine the scope and nature of literature on people’s experiences of microfinance. The results of this scoping review were used to inform the development of targeted systematic review questions that focussed upon areas of particular interest [ 34 ].

In their recent scoping review on the conduct and reporting of scoping reviews, Tricco and colleagues 10 reveal only 12% of scoping reviews contained recommendations for the development of ensuing systematic reviews, suggesting that the majority of scoping review authors do not conduct scoping reviews as a precursor to future systematic reviews.

To identify and analyze gaps in the knowledge base

Scoping reviews are rarely solely conducted to simply identify and analyze gaps present in a given knowledge base, as examination and presentation of what hasn’t been investigated or reported generally requires exhaustive examination of all of what is available. In any case, because scoping reviews tend to be a useful approach for reviewing evidence rapidly in emerging fields or topics, identification and analysis of knowledge gaps is a common and valuable indication for conducting a scoping review. A scoping review was recently conducted to review current research and identify knowledge gaps on the topic of “occupational balance”, or the balance of work, rest, sleep, and play [ 35 ]. Following a systematic search across a range of relevant databases, included studies were selected and in line with predetermined inclusion criteria, were described and mapped to provide both an overall picture of the current state of the evidence in the field and to identify and highlight knowledge gaps in the area. The results of the scoping review allowed the authors to illustrate several research ‘gaps’, including the absence of studies conducted outside of western societies, the lack of knowledge around peoples’ levels of occupational balance, as well as a dearth of evidence regarding how occupational balance may be enhanced. As with other scoping reviews focussed upon identifying and analyzing knowledge gaps, results such as these allow for the identification of future research initiatives.

Scoping reviews are now seen as a valid review approach for certain indications. A key difference between scoping reviews and systematic reviews is that in terms of a review question, a scoping review will have a broader “scope” than traditional systematic reviews with correspondingly more expansive inclusion criteria. In addition, scoping reviews differ from systematic reviews in their overriding purpose. We have previously recommended the use of the PCC mnemonic (Population, Concept and Context) to guide question development [ 36 ]. The importance of clearly defining the key questions and objectives of a scoping review has been discussed previously by one of the authors, as a lack of clarity can result in difficulties encountered later on in the review process [ 36 ].

Considering their differences from systematic reviews, scoping reviews should still not be confused with traditional literature reviews. Traditional literature reviews have been used as a means to summarise various publications or research on a particular topic for many years. In these traditional reviews, authors examine research reports in addition to conceptual or theoretical literature that focuses on the history, importance, and collective thinking around a topic, issue or concept. These types of reviews can be considered subjective, due to their substantial reliance on the author’s pre-exiting knowledge and experience and as they do not normally present an unbiased, exhaustive and systematic summary of a topic [ 12 ]. Regardless of some of these limitations, traditional literature reviews may still have some use in terms of providing an overview of a topic or issue. Scoping reviews provide a useful alternative to literature reviews when clarification around a concept or theory is required. If traditional literature reviews are contrasted with scoping reviews, the latter [ 6 ]:

Are informed by an a priori protocol

Are systematic and often include exhaustive searching for information

Aim to be transparent and reproducible

Include steps to reduce error and increase reliability (such as the inclusion of multiple reviewers)

Ensure data is extracted and presented in a structured way

Another approach to evidence synthesis that has emerged recently is the production of evidence maps [ 37 ]. The purpose of these evidence maps is similar to scoping reviews to identify and analyse gaps in the knowledge base [ 37 , 38 ]. In fact, most evidence mapping articles cite seminal scoping review guidance for their methods [ 38 ]. The two approaches therefore have many similarities, with perhaps the most prominent difference being the production of a visual database or schematic (i.e. map) which assists the user in interpreting where evidence exists and where there are gaps [ 38 ]. As Miake-Lye states, at this stage ‘it is difficult to determine where one method ends and the other begins.’ [ 38 ] Both approaches may be valid when the indication is for determining the extent of evidence on a particular topic, particularly when highlighting gaps in the research.

A further popular method to define and scope concepts, particularly in nursing, is through the conduct of a concept analysis [ 39 , 40 , 41 , 42 ]. Formal concept analysis is ‘a process whereby concepts are logically and systematically investigated to form clear and rigorously constructed conceptual definitions,’ [ 42 ] which is similar to scoping reviews where the indication is to clarify concepts in the literature. There is limited methodological guidance on how to conduct a concept analysis and recently they have been critiqued for having no impact on practice [ 39 ]. In our opinion, scoping reviews (where the purpose is to systematically investigate a concept in the literature) offer a methodologically rigorous alternative to concept analysis with their results perhaps being more useful to inform practice.

Comparing and contrasting the characteristics of traditional literature reviews, scoping reviews and systematic reviews may help clarify the true essence of these different types of reviews (see Table 1 ).

Rapid reviews are another emerging type of evidence synthesis and a substantial amount of literature have addressed these types of reviews [ 43 , 44 , 45 , 46 , 47 ]. There are various definitions for rapid reviews, and for simplification purposes, we define these review types as ‘systematic reviews with shortcuts.’ In this paper, we have not discussed the choice between a rapid or systematic review approach as we are of the opinion that perhaps the major consideration for conducting a rapid review (as compared to a systematic or scoping review) is not the purpose/question itself, but the feasibility of conducting a full review given financial/resource limitations and time pressures. As such, a rapid review could potentially be conducted for any of the indications listed above for the scoping or systematic review, whilst shortening or skipping entirely some steps in the standard systematic or scoping review process.

There is some overlap across the six listed purposes for conducting a scoping review described in this paper. For example, it is logical to presume that if a review group were aiming to identify the types of available evidence in a field they would also be interested in identifying and analysing gaps in the knowledge base. Other combinations of purposes for scoping reviews would also make sense for certain questions/aims. However, we have chosen to list them as discrete reasons in this paper in an effort to provide some much needed clarity on the appropriate purposes for conducting scoping reviews. As such, scoping review authors should not interpret our list of indications as a discrete list where only one purpose can be identified.

It is important to mention some potential abuses of scoping reviews. Reviewers may conduct a scoping review as an alternative to a systematic review in order to avoid the critical appraisal stage of the review and expedite the process, thinking that a scoping review may be easier than a systematic review to conduct. Other reviewers may conduct a scoping review in order to ‘map’ the literature when there is no obvious need for ‘mapping’ in this particular subject area. Others may conduct a scoping review with very broad questions as an alternative to investing the time and effort required to craft the necessary specific questions required for undertaking a systematic review. In these cases, scoping reviews are not appropriate and authors should refer to our guidance regarding whether they should be conducting a systematic review instead.

This article provides some clarification on when to conduct a scoping review as compared to a systematic review and clear guidance on the purposes for conducting a scoping review. We hope that this paper will provide a useful addition to this evolving methodology and encourage others to review, modify and build upon these indications as the approach matures. Further work in scoping review methods is required, with perhaps the most important advancement being the recent development of an extension to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for scoping reviews [ 48 ] and the development of software and training programs to support these reviews [ 49 , 50 ]. As the methodology advances, guidance for scoping reviews (such as that included in the Joanna Briggs Institute Reviewer’s Manual) will require revision, refining and updating.

Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Researchers may preference the conduct of a scoping review over a systematic review where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts, investigate research conduct, or to inform a systematic review. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.

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Munn, Z., Peters, M.D.J., Stern, C. et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 18 , 143 (2018). https://doi.org/10.1186/s12874-018-0611-x

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Doing a Scoping Review: A Practical, Step-by-Step Guide

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What is a Scoping Review?

A scoping review is a type of research synthesis that maps the existing literature on a broad topic to identify key concepts, research gaps, and types of evidence.

This mapping exercise involves systematically searching for, identifying, and charting relevant literature to understand its characteristics, such as the volume of research, types of studies conducted, key concepts addressed, and prevalent research gaps.

Unlike systematic reviews, which aim to answer specific questions, scoping reviews are exploratory and often used to assess the extent of available evidence and inform future research directions. They involve comprehensive searches and data extraction but do not typically include a detailed synthesis of findings or a critical appraisal of study quality.

When a scoping review methodology would be appropriate:

Scoping reviews can be used as a preliminary step to a systematic review , helping to identify the types of evidence available, potential research questions, and relevant inclusion criteria.

They can save time and resources by identifying potential challenges or limitations before embarking on a full systematic review.

Scoping reviews can help clarify key concepts/definitions in the literature. If a research area has inconsistent terminology or definitions, a scoping review can map out how different concepts are used and potentially propose a unified understanding. This can help refine the focus and scope of a subsequent systematic review.

• To determine if a systematic review is feasible and worthwhile . By identifying the breadth of evidence, researchers can gauge whether there is sufficient literature to warrant a full systematic review.
• To identify gaps in the existing research . Scoping reviews can highlight areas where little or no research has been conducted, helping inform future research priorities.
• To clarify key concepts and definitions in the field . This can help refine the focus and scope of a subsequent systematic review.
• To examine how research is conducted on a certain topic . This can inform the methodology of a future systematic review
• To refine and narrow down research questions . The broad overview provided by a scoping review can help researchers develop more specific, focused questions for a systematic review.

When not to choose a scoping review methodology:

• If a systematic review already exists on the topic: A systematic review will offer a more rigorous and comprehensive analysis of the evidence if one is already available.
• Examining the range of interventions for a health condition
• Identifying types of studies conducted
• Noting populations studied
• Summarizing outcomes measured

Scoping reviews help identify areas needing further research, whereas systematic reviews aim to draw conclusions about intervention effectiveness.

Methodological Guidelines

Methodological guidelines aim to improve the consistency and transparency of scoping reviews, enabling researchers to synthesize evidence effectively.

Methodological guidelines for scoping reviews have evolved over time:

• Arksey and O’Malley (2005) proposed the initial framework.
• Levac et al. (2010) refined and extended this framework, offering more detailed guidance.
• The Joanna Briggs Institute ( JBI ) further developed the methodology, introducing a more structured and transparent process.

1. Developing review objective(s) & question(s)

A well-defined objective and a set of aligned research questions are crucial for a scoping review’s coherence and direction.

They guide the subsequent steps of the review process, including determining the inclusion and exclusion criteria, developing a search strategy, and guiding data extraction and analysis.

This stage involves a thoughtful and iterative process to ensure that the review’s aims and questions are explicitly stated and closely intertwined.

Defining Objectives:

This step outlines the overarching goals of the scoping review. It explains the rationale behind conducting the review and what the reviewers aim to achieve.

The objective statement should succinctly capture the essence of the review and provide a clear understanding of its purpose.

For instance, a scoping review’s objective might be to map the existing literature on a particular topic and identify knowledge gaps.

“Parents, in particular, greatly influence participation at school, at home and in the community. They undertake many actions to improve their children’s participation in daily life. Understanding the actions of parents and also their challenges and needs will contribute to how society can support these parents and thereby enable the participation of children with physical disabilities. Pediatric rehabilitation, aiming for optimal participation, could benefit from this understanding to improve Family-centered services (FCS)… However, it is unclear what kind of information is available in literature about what parents live through, do, and what kind of problems and needs they have in supporting their child’s participation? For these reasons, a scoping review was conducted in order to systematically map the research done in this area, as well as to identify any existing gaps in knowledge”

Piškur, B., Beurskens, A. J., Jongmans, M. J., Ketelaar, M., Norton, M., Frings, C. A., … & Smeets, R. J. (2012). Parents’ actions, challenges, and needs while enabling participation of children with a physical disability: a scoping review.  BMC pediatrics ,  12 , 1-13.

Developing Research Questions:

The research question(s) stem from the objectives and provide a focused roadmap for the review. These questions should be answerable through the scoping review process. The research question(s) should be clear, concise, and directly relevant to the overall objectives.

Using Frameworks: While not mandatory, frameworks can be helpful tools to guide the development of objectives and research questions. Frameworks like PCC (Population, Concept, Context).

• Population: Clearly define the specific group of individuals or entities that the scoping review will focus on. This could be patients, healthcare professionals, or even organizations.
• Concept: Articulate the central idea, topic, or phenomenon that the review aims to investigate. This might include interventions, diagnostic tests, or theoretical models.
• Context: Specify the setting, environment, or circumstances relevant to the research question. This could involve geographical locations, healthcare systems, or cultural contexts.

How do cultural beliefs and practices ( C -context) influence the ways in which parents ( P -parents of children with physical disabilities) perceive and address ( C -concept) their children’s physical disabilities? 

What are the barriers and facilitators ( C -concept) to mental health service utilization ( C -concept) among veterans ( P -population) experiencing homelessness ( C -context)?

This scoping review aims to summarize what is known in the African scientific literature ( C -context) among cisgender persons ( P ) about a) individual experiences of GBS within health care settings ( C -concept) and b) associations between GBS experiences and health care-related outcomes ( C -concept).

What are the main theoretical and methodological characteristics ( C -concept) of the current literature ( C -context) in the area of stigma and hearing loss and stigma and hearing aids in the elderly population ( P -older adults with acquired hearing impairment), and how should future research proceed in expanding this important field of enquiry?

2. Write A Research Protocol

A research protocol is a detailed plan that outlines the methodology to be employed throughout the review process, detailing steps like documenting results, outlining search strategy, and stating the review’s objective

The protocol should be created a priori (before starting the review) to ensure transparency and reproducibility.

While not mandatory, registering your protocol is highly recommended, e.g. FigShare and Open Science Framework (OSF).

Some journals, such as the Journal of Advanced Nursing , Systematic Reviews , BMC Medical Research Methodology , BMJ Open , and JBI Evidence Synthesis , accept scoping review protocols for publication.

It’s important to note that PROSPERO, the international prospective register of systematic reviews, does not currently accept scoping review protocols for registration.

Registering a scoping review protocol is highly recommended, even if not mandatory, as it promotes transparency, reduces duplication of effort, and helps to prevent publication bias

Example Protocols:

• The nutritional care of people living with dementia at home: a protocol for a scoping study
• End-of-life care in long-term care homes: A scoping review protocol
• Delaying knee flexion following knee arthroplasty surgery: A Scoping Review Protocol

Report in the Methods Section

“Our protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMAP…), which was revised by the research team and members of Health Canada, and was disseminated through our programme’s Twitter account (@KT-Canada) and newsletter to solicit additional feedback. The final protocol was registered prospectively with the Open Science Framework on 6 September 2016 ( https://osf.io/kv9hu/ ).”

Tricco, A. C., Zarin, W., Lillie, E., Pham, B., & Straus, S. E. (2017). Utility of social media and crowd-sourced data for pharmacovigilance: a scoping review protocol.  BMJ open ,  7 (1), e013474.

“ Our protocol was developed using the scoping review methodological framework proposed by Arksey and O’Malley (2005) [1] and further refined by the Joanna Briggs Institute [3]. The draft protocol was revised upon receiving feedback from the research team, including methodologists and healthcare providers, as well as the peer-review panel of the Canadian Institutes of Health Research. The final version of the protocol is available upon request from the corresponding author. ”

Tricco, A. C., Lillie, E., Zarin, W., O’brien, K., Colquhoun, H., Kastner, M., … & Straus, S. E. (2016). A scoping review on the conduct and reporting of scoping reviews.  BMC medical research methodology ,  16 , 1-10.

3. Developing eligibility criteria

This step involves developing and aligning the inclusion criteria with the objective(s) and question(s).

By providing transparent and well-justified eligibility criteria, researchers can ensure the replicability of their scoping review and allow readers to assess the relevance and appropriateness of the included sources.

When reporting eligibility criteria, emphasize the importance of clarity, justification, and a clear link to the review’s objectives.

• Describe the eligibility criteria with a rationale for why they were selected : It’s crucial to clearly articulate the specific characteristics of sources that make them eligible for inclusion in the review. Each criterion should be accompanied by a rationale explaining why it was chosen. This rationale should be grounded in scientific arguments and clearly demonstrate how the criterion aligns with the review’s objectives.
• Identify specific restrictions and provide a rationale : Restrictions, such as date range, language, or publication status, also need clear justification. For instance, limiting the review to articles published within the past ten years might be necessary to capture the most current evidence. Similarly, restricting the review to sources in a specific language, like English, should be justified, acknowledging the potential exclusion of relevant research in other languages.

When specifying the inclusion and exclusion criteria, consider the following aspects:

By using the PCC framework, researchers can systematically establish boundaries for their scoping review, ensuring that the included sources are relevant to the research question. The framework helps to ensure that the eligibility criteria are comprehensive and well-defined, enabling a more focused and meaningful synthesis of the literature

• Population : The specific characteristics of the individuals or groups being studied. For instance, a scoping review about interventions for heart failure should specify the intended patient population (e.g., adults with heart failure, elderly patients with heart failure).
• Concept : This refers to the central idea, topic, or phenomenon under investigation. In the heart failure example, the concept could be “interventions for heart failure” itself, or it could be narrowed down to a specific type of intervention, such as “exercise interventions for heart failure.”
• Context : This element considers the setting or environment in which the concept is being explored. For instance, the context of the heart failure review could be “hospital settings,” “community-based care,” or “telehealth interventions.”

It is important to note that the absence of an explicitly stated framework (e.g. PCC) does not necessarily mean that the authors did not utilize a systematic approach when developing their eligibility criteria. It is possible that they employed a framework implicitly or that their criteria development was guided by other factors.

Iterative Process

The initial set of eligibility criteria outlined in the protocol may be subject to adjustments based on the type and volume of studies identified in the initial searches.

• Initial Development : Establish preliminary inclusion and exclusion criteria at the onset of the review based on their existing knowledge of the subject area. This can be adjusted as you become more familiar with the literature and data retrieved during the search process.
• Iterative Refinement : Inclusion criteria are refined iteratively based on pilot searches and the evolving understanding of the data. This initial search is crucial as it exposes researchers to a broader range of literature, revealing additional keywords, relevant concepts, and potentially useful search terms that might not have been initially considered.

“ Studies that identified the key terms in the title, abstract, article, or MeSH heading were retained for further examination. Studies published as abstracts, conference proceedings or pilot results published in non-peer-reviewed journals were excluded. In addition, books, book chapters, comments on publications, and dissertations were also excluded. No exclusion criteria were established regarding the type of research design. Inclusion criteria were (a) older adults with progressive hearing loss being the population of interest and (b) the outcome measure was clearly focused on (or at least on some aspects of) stigma regarding hearing loss and/or hearing aids. Although given the descriptive aim of the review, no definitions of stigma and/or hearing aids were set a priori, and all articles including these terms were retrieved, the analysis of the data relied on the most common dimensions of the concept of stigma cited in the literarture: the cognitive dimension (i.e., stereotypes), the emotional dimension (i.e., prejudice) and the behavioral dime. ”

• David, D., & Werner, P. (2016). Stigma regarding hearing loss and hearing aids: A scoping review.  Stigma and Health ,  1 (2), 59.

“ An extensive search was conducted to locate peer-reviewed articles that addressed questions related to parent involvement in organized youth sport. To guide article retrieval, two inclusion criteria were used. First, articles were required to highlight some form of parent involvement in organized youth sport. In the present study, organized youth sport was operationalized as “adultorganized and controlled athletic programs for young people,” wherein “participants are formally organized [and] attend practices and scheduled competitions under the supervision of an adult leader” (Smoll & Smith, 2002, p. xi). In line with this criterion, we did not include physical activity, exercise, physical education, and free play settings, which comprise a substantial volume of research in sport and exercise psychology. We also excluded research that simply collected data on parents or from parents but did not explicitly assess their involvement in their children’s sport participation. Second, articles were required to have been published in peer-reviewed, Englishlanguage, academic journals. As such, we did not include books, chapters, reviews, conceptual papers, conference proceedings, theses and (Jones, 2004) dissertations, or organizational “white papers” in this scoping review. ”

Dorsch, T. E., Wright, E., Eckardt, V. C., Elliott, S., Thrower, S. N., & Knight, C. J. (2021). A history of parent involvement in organized youth sport: A scoping review.  Sport, Exercise, and performance psychology ,  10 (4), 536.

“…to be included in the review, papers needed to measure or focus on specific dimensions of treatment burden, developed in the conceptual framework (e.g. financial, medication, administrative, lifestyle, healthcare and time/travel). Peer-reviewed journal papers were included if they were: published between the period of 2000–2016, written in English, involved human participants and described a measure for burden of treatment, e.g. including single measurements, measuring and/or incorporating one or two dimensions of burden of treatment. Quantitative, qualitative and mixed-method studies were included in order to consider different aspects of measuring treatment burden. Papers were excluded if they did not fit into the conceptual framework of the study, focused on a communicable chronic condition, for example human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) or substance abuse. Papers talking about carer burden, in addition to patient burden of treatment, were also included.”

Sav, A., Salehi, A., Mair, F. S., & McMillan, S. S. (2017). Measuring the burden of treatment for chronic disease: implications of a scoping review of the literature.  BMC medical research methodology ,  17 , 1-14.

4. Information Sources

Scoping reviews aim to identify a broad range of relevant studies, including both published and unpublished literature, to provide a comprehensive overview of the topic.

The goal is to be inclusive rather than exhaustive, which differentiates scoping reviews from systematic reviews that seek to collate all empirical evidence fitting pre-specified criteria to answer specific research questions.

Information sources for scoping reviews can include a wide range of resources like scholarly databases, unpublished literature, conference papers, books, and even expert consultations.

Report who developed and executed the search strategy, such as an information specialist or librarian. Mention if the search strategy was peer-reviewed using the Peer Review of Electronic Search Strategies (PRESS) checklist.

• Electronic   Databases : Make a comprehensive list of all electronic databases you used. Common databases for health-related scoping reviews include: CINAHL, Medline, Embase, PsycINFO, SocINDEX with Full Text, and Web of Science: Core Collections.
• Specify date ranges : For each database, note the date range of your search. For example: “MEDLINE was searched from inception to July 30, 2024.”
• Grey Literature : In addition to databases, forensic or ‘expansive’ searches can be conducted. This includes: grey literature database searches (e.g.  OpenGrey , WorldCat ,  Ethos ),  conference proceedings, unpublished reports,  theses  ,  clinical trial databases , searches by names of authors of relevant publications.
• Citation chasing : If you manually searched specific journals or reference lists, document this. For example: “We hand-searched the reference lists of all included studies and relevant systematic reviews.”
• Contacting Experts : If you contacted experts in the field for additional sources, mention this: “We contacted five experts in the field of [topic] to identify any additional relevant studies.”

“To identify potentially relevant documents, the following bibliographic databases were searched from 2004 to June 2015: MEDLINE, EMBASE, LexisNexis Academic, the Legal Scholarship Network, Justis, LegalTrac, QuickLaw, and HeinOnline. The search strategies were drafted by an experienced librarian [name] and further refined through team discussion. The final search strategy for MEDLINE can be found in Additional file 3. The final search results were exported into EndNote, and duplicates were removed by a library technician. The electronic database search was supplemented by searching the Canadian Medical Protective Association website (https://www.cmpa-acpm.ca/en) and scanning relevant reviews.”

Cardoso, R., Zarin, W., Nincic, V., Barber, S. L., Gulmezoglu, A. M., Wilson, C., … & Tricco, A. C. (2017). Evaluative reports on medical malpractice policies in obstetrics: a rapid scoping review.  Systematic reviews ,  6 , 1-11.

5. Searching for the evidence

Scoping reviews typically start with a broader, more inclusive search strategy. The initial search is intentionally wide-ranging to capture the breadth of available literature on the topic

To balance breadth and depth in your initial search strategy for a scoping review, consider the following tips based on the gathered search results:

• Start with a broad initial search : Begin with a broad search across at least two relevant databases (e.g., MEDLINE and Scopus) to capture a wide range of literature. This helps identify the scope of available studies and key themes in the field .
• Test and refine your search strategy : After initial searches, review the titles and abstracts of retrieved articles to assess relevance. Analyze the text words and index terms used in these articles to refine your understanding of the topic and identify additional keywords, synonyms, and subject headings to include in subsequent searches .
• Multiple Databases : Search across a variety of databases to ensure a comprehensive literature capture. Each database may index different journals and articles, which can help broaden your search results .
• Boolean operators:  The use of Boolean operators (AND/OR/NEAR/NOT) helps to combine these terms effectively, ensuring that the search strategy is both sensitive and specific. For instance, using “AND” narrows the search to include only results containing both terms, while “OR” expands it to include results containing either term.
• Truncation symbols : These broaden the search by capturing variations of a keyword. They function by locating every word that begins with a specific root. For example, if a user was researching interventions for smoking, they might use a truncation symbol to search for “smok*” to retrieve records with the words “smoke,” “smoker,” “smoking,” or “smokes.” This can save time and effort by eliminating the need to input every variation of a word into a database.
• Citation chasing : Document the specific studies whose reference lists were examined. Include the titles, authors, and publication years of these studies. Note how you identified articles that cite the studies. This could be through citation databases like Google Scholar, Scopus, or Web of Science.
• Detailed documentation : Keep thorough records of your search strategies, including the databases searched, keywords used, and any filters applied. This documentation is crucial for transparency and reproducibility .

” The planned literature search was developed on June 23, 2022. The inclusion and exclusion criteria were further refined, along with electronic databases to identify psychological and education literature (e.g., ProQuest), programs for storing data (i.e., Covidence, n.d. accessed via https://www.covidence.org/) and key search terms (e.g., resistance and transgender). The key search terms were “transgender/trans/LGBT/gender diverse/gender expansive/nonbinary,” “resistance,” and “faith/economic status/ethnicity/gender.” Daniel Abela used terms such as nonbinary, gender diverse, LGBT, and gender expansive to capture the broad spectrum of language employed in the literature when relating to individuals whose gender identification extends beyond conventional norms associated with their assigned sex at birth. Moreover, the authors wanted a diverse sample through an intersectionality lens; therefore, terms such as faith, economic status, and ethnicity were used. These terms were selected as they were deemed by all authors to be most appropriate to evaluate this study’s research question. A complete list of the final search terms and the entire electronic search strategy for the Ovid database are presented in Table 1. ”

Abela, D., Patlamazoglou, L., & Lea, S. (2024). The resistance of transgender and gender expansive people: A scoping review.  Psychology of Sexual Orientation and Gender Diversity .

Ovid Search Strategy (Table 1)

• transgender.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• trans.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• LGBT.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• gender diverse.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• gender expansive.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• non-binary.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• 1 or 2 or 3 or 4 or 5 or 6
• resistance.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• faith.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• economic status.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• ethnicity.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• gender identification.mp. [mp = title, abstract, heading word, table of contents, key concepts, original title, tests & measures, mesh word]
• 10 or 11 or 12 or 13
• limit 15 to (peer-reviewed journal and English language and “0110 peer-reviewed journal” and English and yr = “2012-Current”)

Search strategy can also be reported in the appendix. For example: Supplementary A: Search strategy for scoping review .

Citation Chasing Process

Citation chasing involves reviewing the reference lists of included studies and examining articles that cite those studies to identify additional relevant literature. This process helps ensure that you capture a comprehensive view of the research landscape.

If citation chasing leads to the identification of new keywords or concepts, document these adjustments and how they were incorporated into the overall search strategy.

• Document the rationale : Clearly state why citation chasing is being conducted. This could include the goal of identifying additional studies that may not have been captured through database searches or to explore the context and impact of key studies.
• Reference list review : Document the specific studies whose reference lists were examined. Include the titles, authors, and publication years of these studies.
• Citing articles : Note how you identified articles that cite the studies. This could be through citation databases like Google Scholar, Scopus, or Web of Science.
• Record number of additional studies identified : Keep a count of how many additional studies were found through citation chasing.
• A flowchart : Adapt the PRISMA flow diagram to illustrate the stages of citation chasing, the number of sources identified at each stage, and reasons for exclusion.
• Tables : Summarize key information about the sources identified through citation chasing, such as author, year, title, and reasons for inclusion or exclusion.

6. Selecting the evidence

While articles included in a scoping review are selected systematically, it is important to acknowledge that there is no assumption that the evidence reviewed is exhaustive. This is often due to limitations in the search strategy or difficulty locating specific types of sources.

The search results are screened against pre-defined eligibility criteria to determine inclusion in the review.

The goal is to identify relevant studies, with less emphasis on methodological quality. Scoping reviews generally do not appraise the quality of included studies.

Instead, scoping reviews prioritize mapping the existing literature and identifying gaps in research, regardless of the quality of the individual studies.

Two reviewers should independently screen titles and abstracts, removing duplicates and irrelevant studies based on predefined inclusion and exclusion criteria.

• Initial screening of titles and abstracts:  After applying a strategy to search the literature, the next step involves screening the titles and abstracts of the identified articles against the predefined inclusion and exclusion criteria. During this initial screening, reviewers aim to identify potentially relevant studies while excluding those clearly outside the scope of the review. It is crucial to prioritize over-inclusion at this stage, meaning that reviewers should err on the side of keeping studies even if there is uncertainty about their relevance. This cautious approach helps minimize the risk of inadvertently excluding potentially valuable studies.
• Retrieving and assessing full texts:  For studies which a definitive decision cannot be made based on the title and abstract alone, reviewers need to obtain the full text of the articles for a comprehensive assessment against the predefined inclusion and exclusion criteria. This stage involves meticulously reviewing the full text of each potentially relevant study to determine its eligibility definitively.
• Resolution of disagreements : In cases of disagreement between reviewers regarding a study’s eligibility, a predefined strategy involving consensus-building discussions or arbitration by a third reviewer should be in place to reach a final decision. This collaborative approach ensures a fair and impartial selection process, further strengthening the review’s reliability.

“To increase consistency among reviewers, all reviewers screened the same 50 publications, discussed the results and amended the screening and data extraction manual before beginning screening for this review. Nine reviewers working in pairs sequentially evaluated the titles, abstracts and then full text of all publications identified by our searches for potentially relevant publications. . . . We resolved disagreements on study selection and data extraction by consensus and discussion with other reviewers if needed.”

Duffett, M., Choong, K., Hartling, L., Menon, K., Thabane, L., & Cook, D. J. (2013). Randomized controlled trials in pediatric critical care: a scoping review.  Critical care ,  17 , 1-9.

7. Extracting the evidence

Charting, also known as data extraction, is a crucial stage in conducting a scoping review.

This process involves systematically collecting relevant information from the sources included in the review using a structured form. It is considered best practice to have at least two reviewers independently extract data from each source

Data charting in scoping reviews differs from data extraction in systematic reviews. While systematic reviews aim to synthesize the results and assess the quality of individual studies, scoping reviews focus on mapping the existing literature and identifying key concepts, themes, and gaps in the research.

Therefore, the data charting process in scoping reviews is typically broader in scope and may involve collecting a wider range of data items compared to the more focused data extraction process used in systematic reviews.

This process goes beyond simply extracting data; it involves characterizing and summarizing research evidence, which ultimately helps identify research gaps.

• Develop a Standardized Form: Creating a structured form helps to standardize the selection of sources. The form should incorporate clear questions that align with the eligibility criteria defined in the review protocol. The specific software used to create and manage the form should be specified in the review, with options such as Covidence , EndNote , or JBI SUMARI .
• Year of publication
• Origin/country of origin (where the study was published or conducted)
• Aims/purpose
• Study population and sample size (if applicable)
• Methodology/methods
• Outcomes and details of these (e.g. how measures) (if applicable)
• Key findings that relate to the scoping review question/s.
• Testing the Form: All reviewers involved in the selection process should participate in testing the standardized form. Screen the titles and abstracts of the identified articles against the predefined inclusion and exclusion criteria. 
• Sample Size: A random sample of 5–10 citations can be used for the initial calibration of title and abstract screening.
• Resolving Inconsistencies: After independent screening, discrepancies between reviewers are identified and discussed. A roundtable discussion involving the review team is an effective method to address these inconsistencies and clarify any ambiguities in the form or eligibility criteria.
• Form Refinement: Based on the calibration exercise, the standardized form and its accompanying explanation should be revised and refined as needed to enhance clarity and consistency. A second calibration exercise might be necessary if the desired agreement level, typically 70%–80%, is not achieved or if reviewers require further training.
• Number of Reviewers: A minimum of two independent reviewers should be engaged in the screening process.
• Duplicate Screening: The review process should clearly state how duplicates were managed, ideally removing them before proceeding to the screening stage.
• Verification: The sources describe different approaches to verification, including independent screening by two reviewers followed by comparison of their results or a single reviewer screening followed by verification from another reviewer. The chosen approach and its rationale should be explicitly stated in the scoping review.
• Resolving Disagreements: Any disagreements arising during the screening process should be documented and resolved, ideally through discussion and consensus among the reviewers. If consensus cannot be reached, involving a third reviewer to provide an independent assessment can help in making the final decision.
• The number of reviewers involved at each stage
• How duplicates were addressed
• The software used to manage the screening process
• How disagreements were resolved
• The number of sources excluded at each stage, along with a clear rationale for their exclusion

“Search results for all databases were merged. Duplicates and nonrelated papers were excluded. Titles and abstracts of the remaining papers were assessed against the inclusion and exclusion criteria independently by both authors. The resulting papers were pooled and disagreements were resolved through discussion based on the full text article. Following this stage, a standardized form was used to summarize the information in each article. The variables extracted were: reference/ country, aim of the study, study design, year of publication, and main finding/results.”

“A data-charting form was jointly developed by two reviewers to determine which variables to extract. The two reviewers independently charted the data, discussed the results and continuously updated the data-charting form in an iterative process.”

Lenzen, S. A., Daniëls, R., van Bokhoven, M. A., van der Weijden, T., & Beurskens, A. (2017). Disentangling self-management goal setting and action planning: A scoping review.  PloS one ,  12 (11), e0188822.

If an article was eligible for inclusion in this study, data related to the patient-centered care framework or model presented in the article was extracted by the lead author and reviewed by a second author (JCM). Data extracted from the reviewed patient-centered care frameworks and models was entered into data extraction records and synthesized in summary format. Data were systematically charted using the data charting form developed in Microsoft Excel. Information on authorship, article type, population, and patientcentered care approach were recorded on this form. A second data charting form was developed to chart data on the communication systematic reviews identified. Information on clinical context, patient-centered care focus, number of studies reviewed and key findings were recorded on this form.

Constand, M. K., MacDermid, J. C., Dal Bello-Haas, V., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare.  BMC health services research ,  14 , 1-9.

The final charting form, which clearly defines each item, should be included in the scoping review as an appendix or supplementary file, if possible.

• Author: This information is essential for referencing and should be consistent throughout the scoping review document.
• Year of Publication: Noting the publication year of each source helps analyze trends and changes in research over time. This variable can highlight areas where research has progressed or where further investigation is necessary.
• Country: This variable involves noting the country of the study and the bibliographic details of each source. The country of origin provides context and helps assess the generalizability of findings to other settings.
• Objective(s): The objectives of each included source of evidence should be clearly stated. This variable helps understand the aim of each study and how it contributes to the overall scoping review question.
• Participants (characteristics/total number): This variable involves describing the defining characteristics of the participants in the included sources of evidence. Details like diagnostic criteria, age, ethnicity, and the total number of participants are crucial elements of this variable. This information provides context to the scoping review findings.
• Concept: This variable pertains to extracting and mapping data related to the core concept being investigated in the scoping review. The specific data extracted will depend on the nature of the concept, which should be clearly defined in the scoping review.
• Intervention Type: If applicable to the scoping review question, the type of intervention used in each source should be recorded. This might include details like the specific intervention method, the comparator used, and the duration of the intervention. This information helps compare and contrast different interventions explored in the included studies.
• Methodology: Describing the methodology employed by each source is essential to understand how the research was conducted. This variable provides insights into the study design, data collection methods, and analysis techniques used. Categorizing study designs is essential to compare and contrast different research approaches and their potential implications for the scoping review’s conclusions.
• Outcome Measures: This variable focuses on the tools or methods used to assess the effects of an intervention or phenomenon. It’s essential to describe the specific outcome measures used in each study, including details on how they were measured. This information helps compare findings across studies using similar outcome assessment tools.
• Main Finding: This variable focuses on extracting the primary findings or results of each study that are relevant to the scoping review’s research question. These findings form the core evidence base and are crucial for addressing the scoping review objectives.

“We abstracted data on article characteristics (e.g., country of origin, funder), engagement characteristics and contextual factors (e.g., type of knowledge user, country income level, type of engagement activity, frequency and intensity of engagement, use of a framework to inform the intervention), barriers and facilitators to engagement, and results of any formal assessment of engagement (e.g., attitudes, beliefs, knowledge, benefits, unintended consequences).”

Tricco, A. C., Zarin, W., Rios, P., Nincic, V., Khan, P. A., Ghassemi, M., … & Langlois, E. V. (2018). Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review.  Implementation Science ,  13 , 1-19.

8. Analyzing the evidence

The key element of a scoping review is the synthesis: that is the process that brings together the findings from the set of included studies in order to draw conclusions based on the body of evidence.

Data synthesis in a scoping review involves collating, combining, and summarizing findings from the included studies.

This process aims to provide a reliable and comprehensive answer to the review question by considering the strength of the evidence, examining the consistency of observed effects, and investigating any inconsistencies.

The data synthesis will be presented in the results section of the scoping review.

• Develop a clear text narrative that explains the key findings
• Use a logical heading structure to guide readers through your results synthesis
• Use tables to summarise findings (can be same table as data extraction)

Scoping reviews often use a more descriptive approach to synthesis, summarizing the types of evidence available, key findings, and research gaps.

• Research design (e.g., experimental, observational, qualitative)
• Population characteristics
• Intervention types
• Outcome measures
• Theoretical frameworks
• Geographic regions
• Time periods
• The predominant study designs used in the field
• The range of methodologies employed
• The diversity (or lack thereof) in research approaches
• Primary outcomes
• Major conclusions drawn by the authors
• Any notable or unexpected findings
• Recurring themes in the literature
• Evolving research focuses over time
• Commonly used methodologies or theoretical frameworks
• Consistency (or inconsistency) in findings across different studies
• Identifying areas that have been extensively studied
• Noting topics that have received less attention
• Highlighting any shifts in research focus over time
• Populations that have been understudied
• Methodologies that haven’t been widely applied
• Questions that remain unanswered or inadequately addressed
• Contradictions in the literature that need further investigation
• Summarizing key concepts: Identify and describe the central ideas, theories, or constructs that emerge from the literature. This helps to provide a conceptual overview of the field.
• Tables summarizing study characteristics
• Charts showing the distribution of studies across categories
• Concept maps illustrating relationships between key ideas

Remember, the goal in a scoping review is not to critically appraise the quality of individual studies or to provide a definitive answer to a narrow research question.

Instead, the synthesis aims to provide a broad overview of the field, mapping out the existing literature and identifying areas for further research.

This descriptive approach allows for a comprehensive understanding of the landscape of a particular research area.

“We grouped the studies by the types of behavior they analyzed, and summarized the type of settings, populations and study designs for each group, along with the measures used and broad findings. Where we identified a systematic review, we counted the number of studies included in the review that potentially met our inclusion criteria and noted how many studies had been missed by our search.”

Hutchinson, J., Prady, S. L., Smith, M. A., White, P. C., & Graham, H. M. (2015). A scoping review of observational studies examining relationships between environmental behaviors and health behaviors.  International journal of environmental research and public health ,  12 (5), 4833-4858.

9. Presenting the results

The findings should be presented in a clear and logical way that answers the research question(s). This section might include tables, figures, or narrative summaries to illustrate the data.

Narrative Summaries

Write a clear, concise narrative that brings together all of these elements. This should provide readers with a comprehensive overview of the current state of knowledge in the field, highlighting both what is known and what remains to be explored.

The primary goal of a narrative summary is to weave together the information extracted from multiple sources into a cohesive and understandable narrative. This story should focus on why a specific action is necessary, should be discontinued, or lacks sufficient evidence to determine its efficacy

A well-crafted narrative summary often utilizes headings and subheadings to organize the synthesized information logically.

This approach makes it easier for readers to follow the thought process and understand the relationships between different pieces of evidence.

Strategies on how to be sensitive to patient needs were primarily discussed in the qualitative research articles included in this review. Such strategies included acknowledging and adapting to unique patient identifiers [19,24,25]. For example, clinicians are urged to observe and reflect on fluctuating levels of patient alertness, patient comfort levels in the presence or absence of family members, and different communication barriers such as hearing loss, in order to facilitate clinical interactions [15,19,22]. Of the articles reviewed, 58% identified that careful observation of unique patient characteristics is necessary to providing care that will lead to optimal patient receptiveness and positive health outcomes.

While narrative summaries primarily use text, incorporating tables, charts, or diagrams can enhance clarity, particularly when presenting complex data patterns.

However, always accompany these visual aids with a clear textual explanation to ensure comprehensive understanding.

PRISMA Flowchart

Using a PRISMA flowchart in a scoping review is considered good practice. It promotes transparency and allows for a clear understanding of how sources were selected.

The flowchart illustrates the step-by-step process of screening, filtering, and selecting studies based on predefined inclusion and exclusion criteria.

The flowchart visually depicts the following stages:

• Identification:  The initial number of titles and abstracts identified through database searches.
• Screening:  The screening process, based on titles and abstracts.
• Eligibility:  Full-text copies of the remaining records are retrieved and assessed for eligibility.
• Inclusion:  Applying the predefined inclusion criteria resulted in the inclusion of publications that met all the criteria for the review.
• Exclusion:  The flowchart details the reasons for excluding the remaining records.

Petersen, B., Koshy-Chenthittayil, S., DeArmond, M., & Caromile, L. A. (2023). Assessment of diversity-based approaches used by American Universities to increase recruitment and retention of biomedical sciences research faculty members: A scoping review protocol.  Plos one ,  18 (6), e0276089.

10. Discussion Section And Conclusion

Summarizing the evidence in relation to the purpose of the review, making conclusions and noting any implications of the findings.

It is also essential to remember that scoping reviews, unlike systematic reviews, do not aim to provide concrete recommendations for practice or policy.

Their primary function is to map the existing evidence, identify knowledge gaps, and clarify concepts, rather than synthesize results for direct application in clinical or policy settings

Summarizing the Evidence

• Summarize key findings in relation to your research questions
• Highlight main themes or patterns across studies
• Explain the nuances and complexities in the evidence
• Tailor overall findings of the scoping review to the relevant knowledge users such as policymakers, health care providers and patients or consumers
• Discuss the consistency of the evidence
• This provides a clear takeaway message for readers

“In this scoping review we identified 88 primary studies addressing dissemination and implementation research across various settings of dementia care published between 1998 and 2015. Our findings indicate a paucity of research focusing specifically on dissemination of knowledge within dementia care and a limited number of studies on implementation in this area. We also found that training and educating professionals, developing stakeholder interrelationships, and using evaluative and iterative strategies are frequently employed to introduce and promote change in practice. However, although important and feasible, these strategies only partly address what is repeatedly highlighted in the evidence base: that organisational factors are reported as the main barrier to implementation of knowledge within dementia care. Moreover, included studies clearly support an increased effort to improve the quality of dementia care provided in residential settings in the last decade.”

Lourida, I., Abbott, R. A., Rogers, M., Lang, I. A., Stein, K., Kent, B., & Thompson Coon, J. (2017). Dissemination and implementation research in dementia care: a systematic scoping review and evidence map.  BMC geriatrics ,  17 , 1-12.

Limitations

When considering the limitations of a review process, particularly scoping reviews, it’s essential to acknowledge that the goal is breadth, not depth, of information.

This means that unlike systematic reviews, scoping reviews generally don’t involve a formal appraisal of the methodological quality of included studies, unless specifically required by the review’s aim.

• One significant limitation frequently encountered in reviews is the restriction to English-language sources. This decision, often made for feasibility, can inadvertently introduce bias by excluding valuable research from non-English speaking communities and potentially limiting the generalizability of the findings.
• For instance, if a scoping review protocol initially excludes gray literature but later incorporates it due to the emergence of relevant findings during the review process, this change needs to be explicitly stated and justified in the final report.

“Our scoping review has some limitations. To make our review more feasible, we were only able to include a random sample of rapid reviews from websites of rapid review producers. Further adding to this issue is that many rapid reviews contain proprietary information and are not publicly available. As such, our results are only likely generalizable to rapid reviews that are publicly available. Furthermore, this scoping review was an enormous undertaking and our results are only up to date as of May 2013.”

Tricco, A. C., Antony, J., Zarin, W., Strifler, L., Ghassemi, M., Ivory, J., … & Straus, S. E. (2015). A scoping review of rapid review methods.  BMC medicine ,  13 , 1-15.

Conclusions

Discuss implications:.

• Note that recommendations for practice and policy will not be relevant for most scoping reviews as the goal is to provide a preliminary map of the evidence without appraising the quality and validity of the results.
• Consider both positive and negative implications.
• This helps translate your findings into real-world applications.

Identify gaps and future research:

• Point out areas where evidence is lacking or inconsistent.
• Suggest specific research questions or study designs to address these gaps.
• Recommendations for future research are often a key element, particularly suggestions for more focused systematic reviews based on the scoping review’s findings.
• For instance, a scoping review might reveal a need for research linking specific features of expertise to mental and physical health outcomes. Similarly, there might be methodological gaps regarding the validation of certain measures or understanding experiences across diverse contexts and populations.

“The lack of evidence to support physiotherapy interventions for this population appears to pose a challenge to physiotherapists. The aim of this scoping review was to identify gaps in the literature which may guide a future systematic review. However, the lack of evidence found means that undertaking a systematic review is not appropriate or necessary […]. This advocates high quality research being needed to determine what physiotherapy techniques may be of benefit for this population and to help guide physiotherapists as how to deliver this.”

Hall, A. J., Lang, I. A., Endacott, R., Hall, A., & Goodwin, V. A. (2017). Physiotherapy interventions for people with dementia and a hip fracture—a scoping review of the literature.  Physiotherapy ,  103 (4), 361-368.

Potential Challenges

• Balancing breadth and depth: Scoping reviews necessitate a careful balance between covering a wide range of literature (breadth) and providing sufficient depth of analysis. A scope that is too broad can become unmanageable and result in superficial treatment of the topic. Conversely, excessive focus on depth might compromise the comprehensiveness of the review. This balance requires careful consideration during the planning stages, particularly when defining the review question and inclusion criteria.
• Lack of standardized terminology and methods: While frameworks for scoping reviews exist, there is still a lack of consensus on terminology and methods, potentially leading to inconsistencies in how they are conducted and reported. This variability can make it challenging to assess the quality and reliability of scoping review findings.
• Difficulty in analyzing and presenting findings: Scoping reviews often involve synthesizing information from a large and diverse body of literature. Analyzing and presenting this information in a meaningful and concise way can be demanding, requiring a high level of analytical skill and clarity of presentation. The absence of standardized analysis methods further exacerbates this challenge, leading to potential inconsistencies in how data is extracted, analyzed, and presented.
• Limited resources and time constraints: Scoping reviews, although sometimes perceived as a quicker alternative to systematic reviews, can still be resource-intensive. They require meticulous planning, comprehensive searching, and rigorous analysis.

Reading List

• Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework .  International journal of social research methodology ,  8 (1), 19-32.
• Levac, D., Colquhoun, H., & O’brien, K. K. (2010). Scoping studies: advancing the methodology .  Implementation science ,  5 , 1-9.
• Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach.  BMC medical research methodology ,  18 , 1-7.
• Pearson, A., Wiechula, R., & Lockwood, C. (2005). The JBI model of evidence-based healthcare.  JBI Evidence Implementation ,  3 (8), 207-215.
• Peters, M. D., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Scoping reviews .  JBI manual for evidence synthesis ,  10 .
• Peters, M., Godfrey, C., McInerney, P., Soares, C. B., Khalil, H., & Parker, D. (2015). Methodology for JBI scoping reviews. In  The Joanna Briggs institute reviewers manual 2015  (pp. 3-24). Joanna Briggs Institute.
• Peters, M., Godfrey, C., Khalil, H., McInerney, P., Soares, C., & Parker, D. (2017). 2017 guidance for the conduct of JBI scoping reviews .  Joana Briggs Inst Rev Man ,  13 , 141-6.
• Pollock, D., Davies, E. L., Peters, M. D., Tricco, A. C., Alexander, L., McInerney, P., … & Munn, Z. (2021). Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics .  Journal of advanced nursing ,  77 (4), 2102-2113.
• Pollock, D., Peters, M. D., Khalil, H., McInerney, P., Alexander, L., Tricco, A. C., … & Munn, Z. (2023). Recommendations for the extraction, analysis, and presentation of results in scoping reviews.  JBI evidence synthesis ,  21 (3), 520-532.
• Scott, H., Sweet, L., Strauch, L., & Muller, A. (2019). Expressed breastmilk handling and storage guidelines available to mothers in the community: A scoping review. Women and Birth, 33 (5), 426–432.
• Tricco, AC, Lillie, E, Zarin, W, O’Brien, KK, Colquhoun, H, Levac, D, Moher, D, Peters, MD, Horsley, T, Weeks, L, Hempel, S et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018,169(7):467-473.

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• v.5(3); 2021 Jul

The scoping review: A flexible, inclusive, and iterative approach to knowledge synthesis

Michael gottlieb.

1 Department of Emergency Medicine, Rush University Medical Center, Chicago Illinois, USA

Mary R. C. Haas

2 Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor Michigan, USA

Michelle Daniel

3 Department of Emergency Medicine, University of California at San Diego School of Medicine, La Jolla California, USA

Teresa M. Chan

4 Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton Ontario, Canada

INTRODUCTION

The body of medical education research has exploded in recent years. A push for a communal effort among education researchers to answer the “big questions” and support evidence‐based approaches to education has resulted in a significant rise in the number of medical education publications. 1 , 2 , 3 Sifting through this expanding body of work can present a daunting task. For example, PubMed, which is generally considered one of the primary databases for health sciences literature, contains over 30 million citations and counting. 4 Additional education‐specific and other searchable databases contain billions more citations through which to sort. 5

For medical educators balancing clinical work with teaching and research, finding efficient ways to manage a rapidly expanding volume of literature has become increasingly difficult. In addition to the challenges of time constraints and the sheer size of available databases, knowledge syntheses in medical education are fraught with challenge due to the breadth and complexity of the field. Out of this milieu, collaborations such as the Best Evidence in Medical Education (BEME) that works to publish high‐quality systematic reviews have emerged to address the increasing need for efficient yet comprehensive assessment and synthesis of the literature. 6

The health educator's toolbox for knowledge synthesis includes a variety of methods, ranging from traditional health professions education systematic reviews to newer methodologies such as realist and scoping reviews. 7 Although scoping reviews have become an increasingly popular method, concerns have been raised about the rigor, merit, and appropriate application of this approach. 8 Herein, we describe scoping review methodology, the study questions to which this method is optimally suited, a rigorous approach for conducting them, and common pitfalls to avoid.

WHY AND WHEN TO PERFORM THIS METHODOLOGY

Scoping studies are particularly well suited to complex topics, where the literature base is broad and not yet comprehensively reviewed. The intent is to rapidly map key concepts corresponding to a particular research domain, including the primary sources and types of evidence currently available. 9 Arksey and O’Malley 10 provide four goals with which scoping review methodology appropriately aligns: to investigate the extent, range, and nature of research activity; to determine the value of performing more in‐depth or focused systematic reviews; to summarize and disseminate research findings; and to identify existing gaps in the literature.

The inclusive, flexible, and iterative nature of scoping reviews distinguishes them from other forms of knowledge synthesis. 11 In contrast to traditional health professions education systematic reviews, scoping reviews do not adhere to strict methodological rules nor necessitate assessment of quality of evidence. 10 Whereas systematic reviews typically involve a well‐defined question and preidentification of inclusion criteria, scoping studies tend to examine broader topics; include a variety of study designs; and allow for evolution in the population (P), intervention (I), comparator (C), and outcomes (O) under study. 10 In contrast to narrative or literature reviews, scoping reviews require authors to perform analytical reinterpretation of the literature. 12 , 13 Accordingly, the final write‐up of the scoping review is also flexible; its structure, content, and length can be adapted to the volume and type of literature reviewed. 11 The scoping review also uniquely entails “charting” of the literature, whereby the authors generate a “map” reflective of the primary studies, corresponding to the review question(s). 10 , 12 Because the map generally reflects researchers who may represent different disciplines examining the topic in question from different lenses, it is often multilayered. 11 , 14 Finally, unlike other review methodologies, the scoping review process is iterative, allowing those conducting this type of review to deal with themes that are noted in the literature on a whole. This aspect of scoping reviews corresponds to a more constructivist approach and makes scoping reviews more aligned with other knowledge syntheses that seek to amalgamate large swaths of literature instead of deductively narrowing down a larger body of literature to a singular answer.

HOW TO PERFORM THIS METHODOLOGY

Scoping reviews must be conducted in a rigorous and transparent manner (i.e., the approach to searching for and synthesizing the evidence should be “systematic”). 15 They should be documented with sufficient detail to enable them to be replicated by others. While scoping reviews differ from other forms of systematic reviews because they do not have a rigid, preset protocol, some recommend that an a priori protocol should still be created and made publicly available. 16 A number of key steps must be followed to properly perform a scoping review. Table  1 provides an illustrative example. Table  2 highlights common pitfalls encountered with this technique.

Illustrative example of a scoping review

Abbreviation: WBA, workplace‐based assessment.

Common pitfalls encountered in scoping reviews

Abbreviations: BEME, Best Evidence in Medical Education.

The first step comprises identifying the research question. 10 Researchers should formulate one overarching question in the area of interest. For scoping reviews, initial searches should be broad and inclusive. Investigators can narrow the inclusion criteria after they have a better sense of the data. Ultimately, the research team must clearly articulate the scope of their inquiry. 12 The researchers should define terms, because these will be used to inform their search strategy. Minimally, the target population, overarching concept, and outcomes of interest should be articulated to clarify the focus of the review. 12 Researchers should consider the purpose and goals of the review when articulating their research question, to ensure that the study has meaningful and relevant implications for educational policy, practice, or research. Prior to proceeding to the next step, reviewers must conduct a pilot search and iteratively refine their question and inclusion criteria, to ensure both the viability and the feasibility of the review. Scoping reviews aim to “map” the literature and are unlikely to add value if the number of primary papers is too small. If the number of primary papers is too large, the research team must consider their capacity (e.g., available time, budget, resources, and personnel) to successfully conduct the review. When limiting the scope, researchers need to provide a rationale and justification for their decisions as well as acknowledge the potential limitations with regard to scope and applicability. 12 Those new to the field should be wary of this phase of the study since it can prevent wasting time on a question where a scoping review is simply not feasible (e.g., there is no literature to synthesize or the literature is simply too vast and unwieldy).

The second step involves identifying relevant studies. 10 In this stage, reviewers must determine their search strategy. The strategy should be exhaustive and rigorous. Engaging a medical librarian to assist with the search can improve the quality of the search. 12 Once the search has been created, pilot the search strategy and ensure that it captures the key articles in the field of interest. The investigators should consider time span and whether the search will include all articles since database inception or only those within a certain time period. Any time limitations should have a clear rationale (e.g., Twitter emerged in 2006). In addition to common medical education research databases (e.g., PubMed, PsychINFO, CINAHL, ERIC, EMBASE), investigators should consider hand searching reference lists of relevant articles and reviews, key journals, conference abstracts, and online journals (e.g., MedEdPublish, MedEdPORTAL) as well as engaging with experts to assess for potential missed articles. Investigators should consider using a review reference manager (e.g., Covidence [Melbourne, Australia], DistillerSR [Ontario, Canada], Rayyan [Doha, Qatar]) to facilitate tracking and storage of articles.

The third step is study selection. 10 Two investigators should independently screen all abstracts and full texts, with disagreements resolved by discussion or involvement of a third person. Authors less familiar with the rigor required of systematic reviews often negate this step and charge through a structured review on their own. However, having at least two investigators screening is critical to minimize bias and error. The screening investigators should meet at the outset for calibration. Since coding behavior changes both between and within individuals over time, screeners should plan to reconvene several times to ensure consistency. Study selection is an iterative process that often involves post hoc modifications to the inclusion and exclusion criteria. Investigators should engage in this process in a reflexive manner, which may require repeating steps and components of the search as the reviewers gain familiarity with and understanding of the literature. During this stage, investigators should track the number of studies screened, assessed for eligibility, and included in the review as well as the reasons for exclusion at each stage. This should ideally be presented as a flow chart in the form of a modified PRISMA diagram. 17 Measures of inter‐rater reliability should be considered whenever feasible, but the evolving nature of the inclusion criteria in scoping reviews can make measurement of kappa statistics challenging beyond the initial title and abstract screening.

The fourth step involves charting the data. 10 During this step, investigators should utilize a “narrative” or “descriptive‐analytic” model when approaching the data collection. 10 Typically, at least two independent reviewers will be needed for this stage. Early on, reviewers should meet to determine whether their approach to data extraction is consistent with the research question and purpose. Reviewers should use a data extraction form to facilitate extraction and sorting. The data extraction will also likely be iterative, and researchers should continually update the data extraction form. When charting the data, researchers should focus on synthesizing and interpreting the data to identify themes. Once data extraction is complete, the researchers will need to present the data in a more narrative format to contextualize the findings within the study design and setting, so it is important to keep this in mind when selecting the data for extraction.

The fifth step consists of collating, summarizing, and reporting the results. 10 Data will then need to be charted and thematically organized. Charting of the data often consists of basic numerical analyses, such as grouping by geographic region, population, and time period. This can help to identify trends in research efforts and where there are significant gaps. Next, researchers should organize the information through thematic analysis. Arksey and O’Malley 10 recommend using the data table as a starting point, combined with researcher discussion using the “descriptive‐analytic” model to determine the final themes. This often shares similarities with qualitative content analytic techniques. Reviewers should utilize a clear and consistent reporting structure to reduce biases and better allow others to replicate the findings. While Arksey and O’Malley 10 espouse that scoping reviews should not include quality analyses, these can be important components of mapping and contextualizing the current literature. To understand the data and future directions for research, one must first understand the quality of said data; however, this point remains controversial. 7 , 14 In fact, Pham et al. 18 reported that only 22% of scoping reviews reported a quality assessment. When presenting the data, researchers should utilize tables and figures to demonstrate the main data while the text should serve to supplement and enhance, but not duplicate, the table. Researchers should also ensure that the final outcome or end‐product aligns with the purpose of the intended study. Finally, researchers must consider and present the findings in light of the broader context of research, policy, and practice.

The final step is consultation. Arksey and O’Malley listed consultation as a highly encouraged but optional sixth step while Levac et al. 10 , 12 proposed that it should be a required component. We highly recommend this sixth step, because it often significantly enhances the quality of the work. This step may provide additional information, including references and resources. This may also provide valuable perspectives, meaning, and applicability to the study findings. Consultation is typically performed immediately after stage five and should involve multiple stakeholders, including experts in the field, as well as users and recipients of the interventions. Researchers should describe how they will collect the data (e.g., interviews, focus groups, surveys) and how the data will be analyzed, reported, and integrated into the overall study outcome. Investigators may also want to utilize this stage to identify dissemination strategies and also to get a sense from target audience members about the implications of the findings for the field at large. The experts consulted can often provide thoughtful insights into the relevance and broader implications the findings and help investigators better engage with scholarly conversation around the topic.

MARKERS OF RIGOR

Various groups have worked to define the structure and content of methodologically sound scoping reviews. Arksey and O’Malley 10 initially defined a six‐step approach in 2007. In 2010, Levac and colleagues 12 expanded this to provide additional details and rigor. In 2018, Tricco et al. 17 created the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) to provide clear reporting guidelines. In Table  3 , we provide a summary of the major frameworks for scoping reviews.

Summary of the major frameworks for scoping reviews

Abbreviation: PRISMA‐ScR, Preferred Reporting Items for Systematic Review and Meta‐Analysis–Scoping Review Extension.

Scoping reviews can be a powerful tool to map the current literature for the purposes of determining gaps and problems within a new field or area. Once completed, a scoping review may provide new insights into existing gaps in the literature and lead to further research, innovation, and scholarship. Those new to medical education may find scoping reviews to be a useful methodology to apply when venturing into a new scholarly conversation within a particular field of study.

Gottlieb M, Haas MRC, Daniel M, Chan TM. The scoping review: A flexible, inclusive, and iterative approach to knowledge synthesis . AEM Education and Training . 2021; 5 :e10609. 10.1002/aet2.10609 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

Supervising Editor: Susan Farrell, MD.

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Cochrane Training

Scoping reviews: what they are and how you can do them.

In these videos from a  Cochrane Learning Live  webinar delivered in partnership with  GESI: the Global Evidence Synthesis Initiative , Dr Andrea C. Tricco presents the definition of a scoping review, examples of scoping reviews, steps of the scoping review process, and methods used in 494 scoping reviews from the literature. In the second video, Kafayat Oboirien presents her experiences of conducting a scoping review on strengthening clinical governance in low and middle income countries.

• Scoping reviews: an overview with examples
• Example: Strengthening clinical governance in low- and middle-income countries
• Examples of non-health related scoping reviews
• Doing scoping reviews
• Polling questions and Q&A session

Presenters Bio

Dr. Andrea C. Tricco (PhD, MSc) holds a Tier 2 Canada Research Chair in Knowledge Synthesis. Her research interests are related to responding to knowledge users (including patients, healthcare providers, and policy-makers) through knowledge synthesis. Her research also focuses on advancing the science of knowledge synthesis and she is leading research projects related to rapid reviews, network meta-analysis, and scoping reviews.

Kafayat Oboirien has a MPH in Health Economics. She has been involved in the analysis of utilisation in South Africa and a cross-country project evaluating reforms towards universal health coverage. Her present research interest lies in knowledge synthesis, specifically in mapping and documenting health systems’ work practices in LMICs.

Part 1: Scoping reviews: an overview with examples

Part 2: Example: Strengthening clinical governance in low- and middle-income countries

Part 3: Examples of non-health related scoping reviews

Part 4: Doing scoping reviews

Part 5: Polling questions and Q&A session

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• ScR overview
• Systematic or scoping?
• Other review types
• Define objective & question/s
• Top tools and techniques
• How to search
• Where to search
• Subject headings
• Search filters
• Review your search
• Run your search on other databases
• Search the grey literature
• Report search results
• Updating a search
• How to Screen
• Data extraction
• Report & write

Overview of scoping reviews

• Why a scoping review? Peters MDJ et al., JBI Manual for Evidence Synthesis 11.1.1. Chapter 11: Scoping Reviews (2020 version). Details why scoping reviews may be conducted, including key characteristics and differences from systematic reviews
• What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis Munn, Z., Pollock, D., Khalil, H., Alexander, L., McInerney, P., Godfrey, C. M., Peters, M., & Tricco, A. C. (2022). JBI Evidence Synthesis. doi:10.11124/jbies-21-00483
• What are scoping reviews? (Video length: 5:58) In this 2022 video (YouTube), Assoc Prof Zachary Munn and Dr Danielle Pollock discuss the definition for scoping reviews formalised by the JBI Scoping Reviews Methodology Group

• Decision tree for selecting scoping review methodology (PDF) Infographic from the JBI (source - 'Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics' Pollock et al., 2021

Guidelines and standards

• Key historical papers

Using a standard or guideline will help you conduct your scoping review correctly.

Scoping review methodology has evolved over time. A number of key papers that were fundamental to this evolution are available on the Key historical papers  tab of this box. These are not recommended to be used as current methodology, but can be useful to provide background and context.

Watch the video below, narrated by Dr Micah Peters, UniSA Clinical & Health Sciences, to learn how the scoping review methodology evolved (to 2017).

Video Length:  4:03

Current standards and guidelines: 

The Joanna Briggs Institute's (JBI) approach is widely considered the standard. It aims to consolidate and build on earlier works describing scoping review methodologies. The Cochrane Collaboration follows a similar approach.

• JBI Manual for Evidence Synthesis - Chapter 11: Scoping reviews (2020 version) Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. This chapter provides a comprehensive explanation, discussion and recommendations for conducting scoping reviews.
• Updated methodological guidance for the conduct of scoping reviews (2020) '...describe the updated methodological guidance for conducting a JBI scoping review' - Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. JBI Evidence Synthesis, 18(10), 2119-2126. doi:10.11124/jbies-20-00167
• Practical guide to undertaking scoping reviews for pharmacy clinicians, researchers and policymakers (2022) Khalil, H., McInerney, P., Pollock, D., Alexander, L., Munn, Z., Tricco, A. C., Godfrey, C. M., & Peters, M. D. J. Journal of Clinical Pharmacy and Therapeutics, 47(2), 129-134. doi:10.1111/jcpt.13558
• Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics (2021) Pollock, D., Davies, E. L., Peters, M. D. J., Tricco, A. C., Alexander, L., McInerney, P., Godfrey, C. M., Khalil, H., & Munn, Z. (2021). Journal of Advanced Nursing, 77(4), 2102-2113. doi:10.1111/jan.14743
• Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Includes links to key documents including the PRISMA 2020 Statement, Checklist, Flow Diagram, Explanation and Elaboration, and all PRISMA Extensions.
• PRISMA for Scoping Reviews webpage Access the PRISMA Extension for Scoping Reviews checklist and explanation (2018), fillable version of the checklist, and tip sheets
• Current best practices for the conduct of a scoping review (2016) A presentation by Heather Colquhoun, from the Equator Network and the University of Toronto.
• Scoping reviews - what they are and how you can do them (2017) Cochrane Training suite of videos on scoping reviews, presented by Dr Andrea Tricco
• Scoping studies: towards a methodological framework (Arksey & O'Malley 2005) International Journal of Social Research Methodology, 8(1), 19-32. doi:10.1080/1364557032000119616. The paper distinguishes different types of scoping reviews and framework.
• Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services (Anderson et al. 2008) Health Research Policy and Systems, 6(7). doi:10.1186/1478-4505-6-7. This article highlights four objectives of scoping reviews in the context of the UK's Service Delivery and Organisation Research Programme (SDO).
• What are scoping studies? A review of the nursing literature (Davis, Drey & Gould 2009) International Journal of Nursing Studies, 46(10), 1386-1400. doi:10.1016/j.ijnurstu.2009.02.010. The paper explores the nature and status of the scoping review within the nursing literature.
• Scoping studies: advancing the methodology (Levac, Colquhoun & O'Brien 2010) Implementation Science, 5(69). doi:10.1186/1748-5908-5-69. Based on Arksey and O'Malley's framework (2005), this paper further clarifies and enhances each stage of the scoping review framework.
• Scoping the scope of a Cochrane Review (Armstrong et al. 2011) Journal of Public Health, 33(1), 147-150. doi:10.1093/pubmed/fdr015. Comments on the scoping review framework from a public health perspective
• A scoping review of scoping reviews: advancing the approach and enhancing the consistency (Pham et al. 2014) Research Synthesis Methods, 5(4), 371-385. doi:10.1002/jrsm.1123
• A scoping review on the conduct and reporting of scoping reviews (Tricco et al. 2016) Based on 494 scoping reviews between 1999 and 2014, this scoping review summarises the conduct and reporting guidelines of scoping reviews.
• An evidence-based approach to scoping reviews (Khalil et al. 2016) Worldviews on Evidence-Based Nursing, 13(2), 118-123. doi:10.1111/wvn.12144. This article explains the methodological development for scoping reviews based on the Arksey and O'Malley framework, the Levac, Colquhoun, and O'Brien, and the JBI methods of evidence synthesis

The scoping review process

The steps below are based on Chapter 11 of the JBI Manual for Evidence synthesis.

This is the plan for your review.

• Eligibility criteria (inclusion/exclusion)
• Screening process
• Critical appraisal process (optional -not typical)
• Charting process

Then, per your protocol:

Exemplar reviews

• Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review Tricco, AC, Zarin, W, Rios, P, Nincic, V, Khan, PA, Ghassemi, M & Langlois, EV 2018, Implementation Science : IS, vol. 13, no. 1, pp. 1–19.
• Scoping review of pediatric tonsillectomy quality of life assessment instruments Kao, ST, Peters, MD, Dharmawardana, N, Stew, B & Ooi, EH 2017, Laryngoscope, vol. 127, no. 10, pp. 2399-2406.
• Nursing minimum data sets for documenting nutritional care for adults in primary healthcare: a scoping review Håkonsen, SJ, Pedersen, PU, Bjerrum, M, Bygholm, A & Peters, DJ 2018, JBI Database of Systematic Reviews and Implementation Reports, vol. 16, no. 1, pp. 117.

Not sure if this is the review type for you?

• Right Review - decision support tool Not sure of the most suitable review method? Answer a few questions and be guided to suitable knowledge synthesis methods. New 2022 and featured in the Journal of Clinical Epidemiology 10.1016/j.jclinepi.2022.03.004
• Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach Munn, Z. et al. (2018). BMC Medical Research Methodology, 18(1), 143. doi:10.1186/s12874-018-0611-x. Explains the different purposes and processes of systematic reviews and scoping reviews
• Should I undertake a scoping review or a systematic review? (Video length: 12:43) In this video (YouTube), Assoc Prof Zachary Munn discusses the purpose of a scoping review and the difference between scoping reviews and systematic reviews
• Systematic Reviews Research Guide UniSA Library guide detailing the methodology and search requirements of a systematic review
• Scoping Reviews Research Guide > Other review types Find out more about narrative and scoping reviews.

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• Last Updated: Sep 6, 2024 5:24 PM
• URL: https://guides.library.unisa.edu.au/ScopingReviews

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How to write a scoping review

This article explains how to conduct a scoping review. If you’re interested in a free tool that helps you write literature reviews quicker, check out Avidnote .

A scoping review presents a relatively “new” approach to synthesizing research literature which is different from the traditional systematic review. The difference of scoping review concern primarily the purpose and aims of the review. With a scoping review, the primary goal is to give the reader an overview of the current evidence from the literature with respect to a specific research topic without giving a summary answer to a discrete research question. Scoping reviews are typically less exhaustive than systematic reviews. The general purpose for conducting a scoping review is to map and identify the available evidence (Anderson et al., 2008; Arksey and O’Malley, 2005)

Scoping reviews can be preferred to systematic reviews in cases where the review’s objectives include identification of gaps in knowledge, interrogating a body of literature, describing concepts, or scrutinizing research conduct. They can also act as useful precursors to systematic reviews (Munn et al., 2018) as well as help determine the suitability of inclusion criteria and likely research questions. Because of the exploratory nature of scoping reviews, it is not necessary that each review must be a holistic coverage of all the extant body of knowledge in the subject matter being reviewed.

What is a scoping review?

According to the Canadian Institutes for Health Research, scoping reviews are:

“exploratory projects that map the literature available on a topic, identifying key concepts, theories, sources of evidence and gaps in the research.”

A more extensive definition was given by Colquhoun, et al (2014).

“A scoping review or scoping study is a form of knowledge synthesis that addresses an exploratory research question aimed at mapping key concepts, types of evidence, and gaps in research related to a defined area or field by systematically searching, selecting, and synthesizing existing knowledge” Colquhoun, et al. J of Clin Epi. 2014, 67, p. 1292-94

How to perform a scoping study in 5 easy steps

In the sections below, I intend to summarize the guidelines provided by the Joana Briggs Institute for conducting a scoping review.

Step 1 – Define the topic that you will be reviewing; its objectives and any potential sub-questions.

Step 2 – Develop a review protocol. The protocols functions as the plan behind your review. Here you’ll state eligibility criteria (for inclusion/exclusion), how you screened the literature and the charting process that you utilized.

Step 3 – Apply PCC framework

Step 4 – Perform systematic literature searches

Step 5 – Screen the obtained results and only include studies that meet your eligibility criteria

Step 6 – Extract and chart the data you extracted from the collected studies

Step 7 – Write a summary of the evidence to answer your research question(s).

The list above summarizes the process behind performing a scoping review. Below, we elaborate further, based on recommendations from the Joana Briggs Institute.

Title of the review protocol

The suggested length according to JBI of the length for the introduction section of the scoping review protocol is roughly 1,000 words. The protocol (and the review itself) should have an informative title that helps shed light on the topic of the scoping review. To this end, the phrase – “…: a scoping review” should be attached to the title.  Such an attachment will enable readers to easily have an idea of what the document is about. Be sure to include the word “protocol” if that is what the document is about.

For example, “Assessing the impact of treating anxiety using nigella sativa: a scoping review protocol.”

You should also avoid constructing titles in question format. The Joana Briggs Institute (JBI) recommends a “PCC” mnemonic to help in generating a clear and meaningful title for a scoping review. The acronym PCC stands for population, concept, and context. According to the Institute:

• the population aspect focuses on “important characteristics of participants, including age and other qualifying criteria.”
• concept may include details related to elements that would appear in a standard systematic review. Among such details are “interventions” and/or “phenomena of interest” and/or “outcomes.”
• context can be made up of cultural factors like geographic location and/or particular gender or racial-based interests. In some reviews, context can also include information about the particular setting.

Adopting the PCC mnemonic also enables the reviewers to craft a title that conveys important details to readers, e.g., the focus and scope of the review as well as how the reviews can be applied to their needs. In a nutshell, the PCC concept is necessary to establish concord between the title, review question(s), and inclusion criteria.

Scoping review question(s)

Just like the title, the scoping review question(s), should also reflect the PCC elements. The question guides and directs the reviewers to develop inclusion criteria that are suitable for the scoping review. Moreover, a clearly expressed question helps in constructing the protocol, makes for an optimal literature search, and offers a clarified structure for developing the scoping review. A Scoping review will usually come with only one primary question. For example,

Are there any side effects in the various treatments for depression?

However, sub-questions may be necessary, especially if the primary question neither sufficiently reflects the PCC nor the review’s objective(s). In such a scenario, sub-questions can help shed more light on the specific characteristics of a population, concept, or context. Sub-questions can also help to highlight the most likely way to map evidence with respect to the PCC elements. Using context, for example, the above primary question which deals with just the side effects of depression treatments can be expanded to:

Are there any geographical contexts that depression treatments have been associated with side effects? 

Introduction

The introduction should be broad enough to capture all the key elements of the topic being reviewed. It should include the reason for carrying out the scoping review (including the rationale behind each of the elements as well as the information the review intends to disseminate in addition to the objective(s) of the review.

Be sure to explain any definitions that are relevant to the topic under review. You should also ensure that the introductory information must be presented in a way that sufficiently sheds light on the inclusion criteria. For instance, information about the existence or otherwise of scoping reviews, systematic reviews, research syntheses, and/or primary research papers on the topic. This will help reinforce your reason or rationale for undertaking the scoping review. 

The concluding phase of the introduction should indicate that the reviewer has already conducted a preparatory search for available scoping reviews (and maybe systematic reviews as well) on the topic. The dates of such searches, the databases, and journals searched and search platforms used must also be included. Some examples in this regard include the JBI Evidence Synthesis, Evidence for Policy and Practice Information (EPPI), and the Cochrane Database of Systematic Reviews.

If scoping and/or systematic reviews about the topic are available, the reviewers then have to clearly justify how their proposed review will differ from those they have identified. This will enable readers to easily determine any new insight or knowledge which the forthcoming review espouses when compared to existing evidence syntheses.

Finally, the concluding phase of the introduction should explain how the review’s objective(s) align with the main elements of the inclusion criteria, for example, the PCC.

Inclusion criteria

The inclusion criteria capture the reviewers’ reasons for selecting which sources that will be part of their scoping review (or otherwise). These reasons should be clearly explained in a way that enables readers to easily comprehend the reviewers’ ideas. As stated earlier, there must be concord or synergy between the title, question(s), and inclusion criteria.

Search strategy

Even with time and resource constraints, the search strategy for a scoping review should try to be as broad-based as possible. This will help the reviewers to fish out both published and unpublished primary sources of evidence and reviews. The reviewers should endeavor to narrate and rationalize any limitations that negatively impacted the scope of their search strategy.

It is recommended that the search strategy follows the three steps enumerated below.

1) Conducting a preliminary search on not less than a couple of web-based databases determined to be relevant to the topic. 

2) A second search that includes all identified keywords and index terms to be conducted on all the selected databases.

3) Identified reports and articles should be searched.

The reviewer has to specify both the languages he or she will consider for inclusion and the timeframe. They should also provide clear reasons for such specifications. To ensure an optimal search strategy, several search iterations may be necessary especially if the evidence base becomes clearer to reviewers thus leading to the knowledge of additional keywords, sources, and search terms. Because of this possibility for repetitions, it is very essential to ensure that the whole search strategy is characterized by transparency and audit capacity. To this end, a research librarian or information/data scientist can be a useful partner to help design and refine the search strategy. 

The process of conducting a literature search can itself be divided into 5 steps:

• Decide on research question(s) in your specific subject area
• Find relevant databases you will search
• Create a list of relevant keywords and phrases for your literature search
• Begin the literature search while taking notes from each database to keep track of your queries
• Begin the scoping review and compile your results into an article
• If needed, revise your original research question(s)

Source of evidence selection

A scoping review protocol should include a description of all the stages of the source selection process based on title and abstract examination as well as on full-text examination. It should be premised on the inclusion criteria and also explain the mechanisms for resolving disagreements among reviewers.  The source selection (both the title and abstract examination and the full-text screening) should be conducted by a couple of reviewers or more. Disagreements arising between the reviewers can be resolved either by consensus or by a third reviewer. 

The process should be explained through a narrative description which has to include a flowchart of the review process (from the PRISMA-ScR statement). The chart shows the flow from the search through source selection, duplicates, full-text retrieval, and all inclusions from the third search, data extraction, and presentation of the evidence.

Information on the retrieved full-text articles should be provided. Separate appendices providing information on included sources should also be provided. The appendices should briefly disclose all excluded sources as well as the reasons for their exclusion.

The reviewers should mention the software used to manage the results of the search. Examples include Covidence, JBI SUMARI, etc. Before venturing into source selection across a team, it may be necessary to pilot test the source selectors to enable the team to refine their source selection tool (assuming they are using such a tool).

Data extraction

The data extraction process is often referred to as “data charting” in scoping reviews. Data charting is a logical and descriptive summary of the results which are in alignment with the objective(s) and question(s) of the scoping review. It is necessary to construct and pilot a data charting table or form during the protocol stage. This will help the reviewers to record important details about the source such as those below.

• Publication year
• Origin/country of origin (where the source was published or conducted)
• Aims or purposes
• Population and sample size within the source of evidence (if applicable)
• Methodology / methods
• Intervention type, comparator, and information on these (e.g. duration of the intervention) (if applicable). Duration of the intervention (if applicable)
• Outcomes and information on these (e.g. how it was measured, if applicable)
• Important findings relating to the scoping review question(s)

These details can be refined in the review stage albeit this will necessitate an updating of the charting table. Careful record-keeping is necessary on the part of the reviewers since it will ensure ease of reference and tracking as well as help them to identify and chart every source as well as any other additional unanticipated data. This implies that charting the results can be a repetitive process of continuous updating of data.

In summary, it is very important that the reviewers exhibit transparency and clarity in their data extraction methods. Like in source of evidence selection, pilot testing is also necessary.

Analysis of the evidence

Many scoping reviews are usually analyzed through simple counting of concepts, populations, characteristics and so forth. However, other reviews may need a more complex analyses, e.g., descriptive qualitative content analysis which includes basic coding of data .  

For quantitative data, more sophisticated techniques can be utilized instead of simple frequency counts to determine the occurrence of concepts, characteristics, populations, etc. However, such in-depth analyses are not common in scoping reviews. Areas like meta-analysis and interpretive qualitative analysis have very small probabilities of being used in scoping reviews.

The nature of data analysis in scoping reviews is largely determined by the purpose of the review and the reviewers’ evaluations. The most vital concern is the level of transparency of the analytical method used and the ability of the reviewers to rationalize their approach in addition to a priori planning of the review.

Presentation of the results                                                                                                        

It is important provide a plan for the presentation of results (one that includes the type of charts, tables and/or figures that will be used) during protocol development. The essence of early planning is to have some knowledge of the kinds of data that might emerge and the best way to present such data with respect to both the objective(s) and research question(s) of the scoping review. This knowledge can be modified during the review process when the reviewers must have become more aware of all data from the included sources.

It is possible to present the results of a scoping review in a descriptive format and/or as a map of the data from the included sources, e.g., tables and other diagrams. The PCC concept can be an essential guide on how to map data efficiently.

For more information regarding scoping reviews, please refer to Arksey, H. and O’Malley paper [1] or JBI Manual for Evidence Synthesis [2], this article is based primarily on the latter source.

✅ Also check out

This post was produced as part of a research guide series by  Avidnote  which is a free web-based app that helps you to write and organize your academic writing online.  Click here  to find out more.

Anderson S, Allen P, Peckham S, Goodwin N. Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services. Health Research Policy and Systems. 2008;6(1):1.

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

Arksey, H. and O’Malley paper (2015). Scoping studies: towards a methodological framework.  International journal of social research methodology ,  8 (1), pp.19-32.        

Colquhoun, H.L., Levac, D., O’Brien, K.K., Straus, S., Tricco, A.C., Perrier, L., Kastner, M. and Moher, D., 2014. Scoping reviews: time for clarity in definition, methods, and reporting.  Journal of clinical epidemiology ,  67 (12), pp.1291-1294.

JBI Manual for Evidence Synthesis. Source: https://wiki.jbi.global/display/MANUAL/11.2.6+Source+of+evidence+selection

Munn, Z., Peters, M.D., Stern, C., Tufanaru, C., McArthur, A. and Aromataris, E., 2018. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach.  BMC medical research methodology ,  18 (1), pp.1-7.        

Osman, M.A., Schick-Makaroff, K., Thompson, S., Featherstone, R., Bialy, L., Kurzawa, J., Okpechi, I.G., Habib, S., Shojai, S., Jindal, K. and Klarenbach, S., 2018. Barriers and facilitators for implementation of electronic consultations (eConsult) to enhance specialist access to care: a scoping review protocol.  BMJ open ,  8 (9), p.e022733.                                                                           

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