Abstract
There are few things in life I enjoy more than being on a boat in the summer. Writing, however, often falls on the opposite side of most people’s enjoyment spectrum. Despite the dichotomy, my aim is to show you that writing a first-rate literature review is what provides smooth sailing in our profession. They are the sailboats that help us as sonographers navigate the seemingly overwhelming waters of information. This editorial will provide you with tips regarding what constitutes a high-quality literature review, provide some guidance on preparing and pulling literature, and, ultimately, underscore the importance of this work—the clinical impact.
Raising the Mast: Defining a First-Rate Literature Review
Sometimes in defining something, we first rule out what it is not. When it comes to a literature review, it is not just about just choosing any topic and then reviewing it. Before hoisting any sails, there must first be a mast. It is the author’s rationale that raises the mast of a high-quality review, which should aim to fill in the gaps of clinical knowledge by updating and refreshing previous work with newly published empirical evidence. 1
A literature review summarizes pertinent research findings found in journal articles or textbooks. Yet, what makes the literature review so valuable is that it provides a synthesis of this information. 1 “A literature review might help the reader determine what the best sonographic protocol to image an organ/pathology is, or what sonographic signs are best to diagnose a pathology. It might compare a new technology to an old one, or compare the diagnostic accuracy of multiple imaging modalities for diagnosing a pathology.” 1
Hoisting the Sails—Preparing and Pulling Literature
Once a rationale or gap in clinical knowledge is identified, it is time to gather the literature. It is critical that the information is thorough, accurate, and up-to-date. 2 The evidence-based pyramid can be a helpful tool to quickly evaluate the information.3,4 The evidence pyramid shows us that the low-quality evidence is on the bottom and the higher evidence is at the top. If the evidence is what makes our sails, the higher the evidence, the higher the quality of the literature review (see Figure 1).
The evidence-based pyramid.
While there is no set number of references to be included, literature reviews frequently will have up to 20 or more citations. 1 With so much information, keeping your references organized is critical. Varieties of databases can aid in organization with online tools. 1 Due to the amount of information that needs to be synthesized, a guide is provided.
Literature Review Guide to Preparing and Pulling Data
Read, read, read—staying up-to-date on literature requires daily and weekly reading. This should be a habit and made a priority—especially before diving into writing on a topic. Regular and systematic article searches are helpful. One such online tool is PubCrawler, which integrates with PubMed.
Choose effective key terms—deciding which key terms you search for can have a big impact on the quality of results that you receive from the database that you search. Talking with a librarian or someone who knows how to do these searches can save a lot of time and will give insight on how to maximize your effectiveness.
Include and exclude properly—deciding what you will include or exclude should be done early in the process. I tend to base inclusion criteria on where it falls within the evidence-based pyramid, usually eliminating all low-level evidence. Of course, for some topics, this may not be possible.
Collect quality evidence—this process involves searching for key terms to find literature within databases. There are many databases options, the best of which include PubMed, Ovid MEDLINE, CINAHL, TRIP Database Plus, Cochrane Database of Systematic Reviews, or Google Scholar.
Evaluate your findings—once you have found an article, you must evaluate its relevancy. In general, information over 10 years old should be eliminated, unless it is a landmark paper and still relevant. A rubric for evaluation is also helpful, and I would recommend using one based on the PICO method (population, intervention, comparison group, outcome). Being selective is important in making your research as relevant and timely as possible.
Write your results—writing is how the sails of evidence get stitched together. Scientific writing should be clear and concise, with the strongest argument written first. A flow diagram of your study selection can be helpful. 5 Also I would highly recommend an outline and careful consideration on how you organize the article.
Revise, revise, revise—again you can’t do this too many times. It is highly advised to have a mentor or trusted adviser help you to critique and revise your work. 6
Sailing at Last—Impact on Clinical Practice
Once published, a high-quality literature review serves to inform and shape our clinical practice. They are vital in a profession of constant technological innovation and shifting practices. If done correctly, these studies can become the backbone for clinical appropriateness criteria that are constructed by industry organizations and directly affect patient outcomes. Clinical topics that are well reviewed not only have a long-term impact but also help to inform clinicians immediately with what are the best choices for patients. Sonographers deserve more than a rowboat of staggered information. They should come to expect a smooth summer sailboat ride through synthesized clinical information.
