What it is
A narrative review synthesises literature using a more flexible approach than a systematic review. It can be valuable for explaining a field, mechanism, historical development or clinical concept, but its search and selection are typically less exhaustive and therefore more vulnerable to selection bias. Transparency about methods is essential.
Approval and governance
Usually needs formal review / authorisation
- Institutional publication/research-office approval if local policy requires it.
- Permission for copyrighted figures/tables not covered by licence or fair-use/fair-dealing rules.
May follow a lighter or different route
- A review based only on published literature often does not involve human participants; ethics review may not be required in many systems, subject to institutional determination.
Do not do this
- Do not call the work a “systematic review” unless it actually follows explicit systematic-review methods.
- Do not select only papers that support a predetermined conclusion while implying comprehensive coverage.
Mediclinic Middle East publicly states that research projects carried out at MCME are to receive approval from its internal Research and Ethics Committee and applicable local regulatory authorities before initiation. The exact route varies by project, facility and emirate. Dubai projects may involve DSREC depending on applicability. This hub must therefore route users to the Research Office and current local forms rather than declaring a project “ethics exempt.” Institution-specific forms and contacts will be inserted after verification.
Step-by-step workflow
Define the purpose and audience
Choose whether the review explains current practice, controversies, mechanisms, an emerging field or an educational framework.
Write a focused scope statement
Define what is included and explicitly what is outside scope. This prevents the review from becoming an unstructured textbook chapter.
Use a transparent search approach
Even when not fully systematic, record databases/sources, core search concepts, approximate dates and how key papers were selected.
Build a concept map
Group the literature into themes or questions rather than summarising one paper after another.
Prioritise evidence appropriately
Use high-quality guidelines, systematic reviews and pivotal studies for major claims. Distinguish mechanistic hypotheses, observational associations and trial evidence.
Identify disagreement and uncertainty
Present credible competing explanations and areas where evidence is weak or inconsistent.
Draft around synthesis, not citation accumulation
Each section should answer a question and explain what the literature collectively suggests, with limitations.
Audit claims against sources
For every strong clinical/scientific statement, confirm that the cited source actually supports the wording and that newer evidence has not materially changed the conclusion.
Prepare the manuscript and declarations
Follow journal requirements for narrative reviews, authorship, conflicts, funding and any AI-use disclosures.
Final checklist
- Purpose and scope explicit.
- Search/selection approach disclosed.
- Major claims supported by appropriate evidence.
- Conflicting evidence represented.
- Not mislabeled as systematic.
- Permissions and institutional publication requirements addressed.
A practical evidence hierarchy for narrative reviews
- Use current high-quality systematic reviews/guidelines to orient major clinical claims, then use pivotal primary studies where they add necessary detail.
- For safety claims, actively look for harms evidence rather than assuming the efficacy literature is enough.
- Distinguish association from causation and mechanistic plausibility from demonstrated clinical benefit.
- For controversial topics, define the strongest evidence on each side and explain why conclusions differ (population, design, outcome, bias, date or interpretation).
- Keep a source table with citation, study design, population, key finding, major limitation and where it is used in the manuscript.
Suggested manuscript structure
- Focused title and structured/unstructured abstract according to journal.
- Introduction with purpose and scope.
- Methods paragraph explaining how literature was identified and selected.
- Thematic sections that synthesise evidence rather than summarising papers sequentially.
- Controversies, uncertainty and evidence gaps.
- Practical implications that are proportionate to the evidence.
- Conclusion that does not imply systematic certainty when methods were narrative.