literature review and case study

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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
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• Bibliography

A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE: Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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YSN Doctoral Programs: Steps in Conducting a Literature Review

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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CC0006 Basics of Report Writing

Structure of a report (case study, literature review or survey).

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The information in the report has to be organised in the best possible way for the reader to understand the issue being investigated, analysis of the findings and recommendations or implications that relate directly to the findings. Given below are the main sections of a standard report. Click on each section heading to learn more about it.

• Tells the reader what the report is about
• Informative, short, catchy

Example - Sea level rise in Singapore : Causes, Impact and Solution

The title page must also include group name, group members and their matriculation numbers.

Content s Page

• Has headings and subheadings that show the reader where the various sections of the report are located
• Written on a separate page
• Includes the page numbers of each section
• Briefly summarises the report, the process of research and final conclusions
• Provides a quick overview of the report and describes the main highlights
• Short, usually not more than 150 words in length
• Mention briefly why you choose this project, what are the implications and what kind of problems it will solve

Usually, the abstract is written last, ie. after writing the other sections and you know the key points to draw out from these sections. Abstracts allow readers who may be interested in the report to decide whether it is relevant to their purposes.

Introduction

• Discusses the background and sets the context
• Introduces the topic, significance of the problem, and the purpose of research
• Gives the scope ie shows what it includes and excludes

In the introduction, write about what motivates your project, what makes it interesting, what questions do you aim to answer by doing your project. The introduction lays the foundation for understanding the research problem and should be written in a way that leads the reader from the general subject area of the topic to the particular topic of research.

Literature Review

• Helps to gain an understanding of the existing research in that topic
• To develop on your own ideas and build your ideas based on the existing knowledge
• Prevents duplication of the research done by others

Search the existing literature for information. Identify the data pertinent to your topic. Review, extract the relevant information for eg how the study was conducted and the findings. Summarise the information. Write what is already known about the topic and what do the sources that you have reviewed say. Identify conflicts in previous studies, open questions, or gaps that may exist. If you are doing

• Case study - look for background information and if any similar case studies have been done before.
• Literature review - find out from literature, what is the background to the questions that you are looking into
• Site visit - use the literature review to read up and prepare good questions before hand.
• Survey - find out if similar surveys have been done before and what did they find?

Keep a record of the source details of any information you want to use in your report so that you can reference them accurately.

Methodology

Methodology is the approach that you take to gather data and arrive at the recommendation(s). Choose a method that is appropriate for the research topic and explain it in detail.

In this section, address the following: a) How the data was collected b) How it was analysed and c) Explain or justify why a particular method was chosen.

Usually, the methodology is written in the past tense and can be in the passive voice. Some examples of the different methods that you can use to gather data are given below. The data collected provides evidence to build your arguments. Collect data, integrate the findings and perspectives from different studies and add your own analysis of its feasibility.

For CC0006 Group Project, use one of the four methods listed below:

• Explore the literature/news/internet sources to know the topic in depth
• Give a description of how you selected the literature for your project
• Compare the studies, and highlight the findings, gaps or limitations.
• An in-depth, detailed examination of specific cases within a real-world context.
• Enables you to examine the data within a specific context.
• Examine a well defined case to identify the essential factors, process and relationship.
• Write the case description, the context and the process involved.
• Make sense of the evidence in the case(s) to answer the research question
• Gather data from a predefined group of respondents by asking relevant questions
• Can be conducted in person or online
• Why you chose this method (questionnaires, focus group, experimental procedure, etc)
• How you carried out the survey. Include techniques and any equipment you used
• If there were participants in your research, who were they? How did you select them and how may were there?
• How the survey questions address the different aspects of the research question
• Analyse the technology / policy approaches by visiting the required sites
• Make a detailed report on its features and your understanding of it

Results and Analysis

• Present the results of the study. You may consider visualising the results in tables and graphs, graphics etc.
• Analyse the results to obtain answer to the research question.
• Provide an analysis of the technical and financial feasibility, social acceptability etc

Discussion, Limitation(s) and Implication(s)

• Discuss your interpretations of the analysis and the significance of your findings
• Explain any new understanding or insights that emerged as a result of your research
• Consider the different perspectives (social, economic and environmental)in the discussion
• Explain the limitation(s)
• Explain how could what you found be used to make a difference for sustainability

Conclusion and Recommendations

• Summarise the significance and outcome of the study highlighting the key points.
• Come up with alternatives and propose specific actions based on the alternatives
• Describe the result or improvement it would achieve
• Explain how it will be implemented

Recommendations should have an innovative approach and should be feasible. It should make a significant difference in solving the issue under discussion.

• List the sources you have referred to in your writing
• Use the recommended citation style consistently in your report

Appendix (if necessary/any)

Include any material relating to the report and research that does not fit in the body of the report, in the appendix. For example, you may include survey questionnaire and results in the appendix.

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Methodology

• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
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• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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Ten Simple Rules for Writing a Literature Review

Marco pautasso.

1 Centre for Functional and Evolutionary Ecology (CEFE), CNRS, Montpellier, France

2 Centre for Biodiversity Synthesis and Analysis (CESAB), FRB, Aix-en-Provence, France

Literature reviews are in great demand in most scientific fields. Their need stems from the ever-increasing output of scientific publications [1] . For example, compared to 1991, in 2008 three, eight, and forty times more papers were indexed in Web of Science on malaria, obesity, and biodiversity, respectively [2] . Given such mountains of papers, scientists cannot be expected to examine in detail every single new paper relevant to their interests [3] . Thus, it is both advantageous and necessary to rely on regular summaries of the recent literature. Although recognition for scientists mainly comes from primary research, timely literature reviews can lead to new synthetic insights and are often widely read [4] . For such summaries to be useful, however, they need to be compiled in a professional way [5] .

When starting from scratch, reviewing the literature can require a titanic amount of work. That is why researchers who have spent their career working on a certain research issue are in a perfect position to review that literature. Some graduate schools are now offering courses in reviewing the literature, given that most research students start their project by producing an overview of what has already been done on their research issue [6] . However, it is likely that most scientists have not thought in detail about how to approach and carry out a literature review.

Reviewing the literature requires the ability to juggle multiple tasks, from finding and evaluating relevant material to synthesising information from various sources, from critical thinking to paraphrasing, evaluating, and citation skills [7] . In this contribution, I share ten simple rules I learned working on about 25 literature reviews as a PhD and postdoctoral student. Ideas and insights also come from discussions with coauthors and colleagues, as well as feedback from reviewers and editors.

Rule 1: Define a Topic and Audience

How to choose which topic to review? There are so many issues in contemporary science that you could spend a lifetime of attending conferences and reading the literature just pondering what to review. On the one hand, if you take several years to choose, several other people may have had the same idea in the meantime. On the other hand, only a well-considered topic is likely to lead to a brilliant literature review [8] . The topic must at least be:

• interesting to you (ideally, you should have come across a series of recent papers related to your line of work that call for a critical summary),
• an important aspect of the field (so that many readers will be interested in the review and there will be enough material to write it), and
• a well-defined issue (otherwise you could potentially include thousands of publications, which would make the review unhelpful).

Ideas for potential reviews may come from papers providing lists of key research questions to be answered [9] , but also from serendipitous moments during desultory reading and discussions. In addition to choosing your topic, you should also select a target audience. In many cases, the topic (e.g., web services in computational biology) will automatically define an audience (e.g., computational biologists), but that same topic may also be of interest to neighbouring fields (e.g., computer science, biology, etc.).

Rule 2: Search and Re-search the Literature

After having chosen your topic and audience, start by checking the literature and downloading relevant papers. Five pieces of advice here:

• keep track of the search items you use (so that your search can be replicated [10] ),
• keep a list of papers whose pdfs you cannot access immediately (so as to retrieve them later with alternative strategies),
• use a paper management system (e.g., Mendeley, Papers, Qiqqa, Sente),
• define early in the process some criteria for exclusion of irrelevant papers (these criteria can then be described in the review to help define its scope), and
• do not just look for research papers in the area you wish to review, but also seek previous reviews.

The chances are high that someone will already have published a literature review ( Figure 1 ), if not exactly on the issue you are planning to tackle, at least on a related topic. If there are already a few or several reviews of the literature on your issue, my advice is not to give up, but to carry on with your own literature review,

The bottom-right situation (many literature reviews but few research papers) is not just a theoretical situation; it applies, for example, to the study of the impacts of climate change on plant diseases, where there appear to be more literature reviews than research studies [33] .

• discussing in your review the approaches, limitations, and conclusions of past reviews,
• trying to find a new angle that has not been covered adequately in the previous reviews, and
• incorporating new material that has inevitably accumulated since their appearance.

When searching the literature for pertinent papers and reviews, the usual rules apply:

• be thorough,
• use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and
• look at who has cited past relevant papers and book chapters.

Rule 3: Take Notes While Reading

If you read the papers first, and only afterwards start writing the review, you will need a very good memory to remember who wrote what, and what your impressions and associations were while reading each single paper. My advice is, while reading, to start writing down interesting pieces of information, insights about how to organize the review, and thoughts on what to write. This way, by the time you have read the literature you selected, you will already have a rough draft of the review.

Of course, this draft will still need much rewriting, restructuring, and rethinking to obtain a text with a coherent argument [11] , but you will have avoided the danger posed by staring at a blank document. Be careful when taking notes to use quotation marks if you are provisionally copying verbatim from the literature. It is advisable then to reformulate such quotes with your own words in the final draft. It is important to be careful in noting the references already at this stage, so as to avoid misattributions. Using referencing software from the very beginning of your endeavour will save you time.

Rule 4: Choose the Type of Review You Wish to Write

After having taken notes while reading the literature, you will have a rough idea of the amount of material available for the review. This is probably a good time to decide whether to go for a mini- or a full review. Some journals are now favouring the publication of rather short reviews focusing on the last few years, with a limit on the number of words and citations. A mini-review is not necessarily a minor review: it may well attract more attention from busy readers, although it will inevitably simplify some issues and leave out some relevant material due to space limitations. A full review will have the advantage of more freedom to cover in detail the complexities of a particular scientific development, but may then be left in the pile of the very important papers “to be read” by readers with little time to spare for major monographs.

There is probably a continuum between mini- and full reviews. The same point applies to the dichotomy of descriptive vs. integrative reviews. While descriptive reviews focus on the methodology, findings, and interpretation of each reviewed study, integrative reviews attempt to find common ideas and concepts from the reviewed material [12] . A similar distinction exists between narrative and systematic reviews: while narrative reviews are qualitative, systematic reviews attempt to test a hypothesis based on the published evidence, which is gathered using a predefined protocol to reduce bias [13] , [14] . When systematic reviews analyse quantitative results in a quantitative way, they become meta-analyses. The choice between different review types will have to be made on a case-by-case basis, depending not just on the nature of the material found and the preferences of the target journal(s), but also on the time available to write the review and the number of coauthors [15] .

Rule 5: Keep the Review Focused, but Make It of Broad Interest

Whether your plan is to write a mini- or a full review, it is good advice to keep it focused 16 , 17 . Including material just for the sake of it can easily lead to reviews that are trying to do too many things at once. The need to keep a review focused can be problematic for interdisciplinary reviews, where the aim is to bridge the gap between fields [18] . If you are writing a review on, for example, how epidemiological approaches are used in modelling the spread of ideas, you may be inclined to include material from both parent fields, epidemiology and the study of cultural diffusion. This may be necessary to some extent, but in this case a focused review would only deal in detail with those studies at the interface between epidemiology and the spread of ideas.

While focus is an important feature of a successful review, this requirement has to be balanced with the need to make the review relevant to a broad audience. This square may be circled by discussing the wider implications of the reviewed topic for other disciplines.

Rule 6: Be Critical and Consistent

Reviewing the literature is not stamp collecting. A good review does not just summarize the literature, but discusses it critically, identifies methodological problems, and points out research gaps [19] . After having read a review of the literature, a reader should have a rough idea of:

• the major achievements in the reviewed field,
• the main areas of debate, and
• the outstanding research questions.

It is challenging to achieve a successful review on all these fronts. A solution can be to involve a set of complementary coauthors: some people are excellent at mapping what has been achieved, some others are very good at identifying dark clouds on the horizon, and some have instead a knack at predicting where solutions are going to come from. If your journal club has exactly this sort of team, then you should definitely write a review of the literature! In addition to critical thinking, a literature review needs consistency, for example in the choice of passive vs. active voice and present vs. past tense.

Rule 7: Find a Logical Structure

Like a well-baked cake, a good review has a number of telling features: it is worth the reader's time, timely, systematic, well written, focused, and critical. It also needs a good structure. With reviews, the usual subdivision of research papers into introduction, methods, results, and discussion does not work or is rarely used. However, a general introduction of the context and, toward the end, a recapitulation of the main points covered and take-home messages make sense also in the case of reviews. For systematic reviews, there is a trend towards including information about how the literature was searched (database, keywords, time limits) [20] .

How can you organize the flow of the main body of the review so that the reader will be drawn into and guided through it? It is generally helpful to draw a conceptual scheme of the review, e.g., with mind-mapping techniques. Such diagrams can help recognize a logical way to order and link the various sections of a review [21] . This is the case not just at the writing stage, but also for readers if the diagram is included in the review as a figure. A careful selection of diagrams and figures relevant to the reviewed topic can be very helpful to structure the text too [22] .

Rule 8: Make Use of Feedback

Reviews of the literature are normally peer-reviewed in the same way as research papers, and rightly so [23] . As a rule, incorporating feedback from reviewers greatly helps improve a review draft. Having read the review with a fresh mind, reviewers may spot inaccuracies, inconsistencies, and ambiguities that had not been noticed by the writers due to rereading the typescript too many times. It is however advisable to reread the draft one more time before submission, as a last-minute correction of typos, leaps, and muddled sentences may enable the reviewers to focus on providing advice on the content rather than the form.

Feedback is vital to writing a good review, and should be sought from a variety of colleagues, so as to obtain a diversity of views on the draft. This may lead in some cases to conflicting views on the merits of the paper, and on how to improve it, but such a situation is better than the absence of feedback. A diversity of feedback perspectives on a literature review can help identify where the consensus view stands in the landscape of the current scientific understanding of an issue [24] .

Rule 9: Include Your Own Relevant Research, but Be Objective

In many cases, reviewers of the literature will have published studies relevant to the review they are writing. This could create a conflict of interest: how can reviewers report objectively on their own work [25] ? Some scientists may be overly enthusiastic about what they have published, and thus risk giving too much importance to their own findings in the review. However, bias could also occur in the other direction: some scientists may be unduly dismissive of their own achievements, so that they will tend to downplay their contribution (if any) to a field when reviewing it.

In general, a review of the literature should neither be a public relations brochure nor an exercise in competitive self-denial. If a reviewer is up to the job of producing a well-organized and methodical review, which flows well and provides a service to the readership, then it should be possible to be objective in reviewing one's own relevant findings. In reviews written by multiple authors, this may be achieved by assigning the review of the results of a coauthor to different coauthors.

Rule 10: Be Up-to-Date, but Do Not Forget Older Studies

Given the progressive acceleration in the publication of scientific papers, today's reviews of the literature need awareness not just of the overall direction and achievements of a field of inquiry, but also of the latest studies, so as not to become out-of-date before they have been published. Ideally, a literature review should not identify as a major research gap an issue that has just been addressed in a series of papers in press (the same applies, of course, to older, overlooked studies (“sleeping beauties” [26] )). This implies that literature reviewers would do well to keep an eye on electronic lists of papers in press, given that it can take months before these appear in scientific databases. Some reviews declare that they have scanned the literature up to a certain point in time, but given that peer review can be a rather lengthy process, a full search for newly appeared literature at the revision stage may be worthwhile. Assessing the contribution of papers that have just appeared is particularly challenging, because there is little perspective with which to gauge their significance and impact on further research and society.

Inevitably, new papers on the reviewed topic (including independently written literature reviews) will appear from all quarters after the review has been published, so that there may soon be the need for an updated review. But this is the nature of science [27] – [32] . I wish everybody good luck with writing a review of the literature.

Acknowledgments

Many thanks to M. Barbosa, K. Dehnen-Schmutz, T. Döring, D. Fontaneto, M. Garbelotto, O. Holdenrieder, M. Jeger, D. Lonsdale, A. MacLeod, P. Mills, M. Moslonka-Lefebvre, G. Stancanelli, P. Weisberg, and X. Xu for insights and discussions, and to P. Bourne, T. Matoni, and D. Smith for helpful comments on a previous draft.

Funding Statement

This work was funded by the French Foundation for Research on Biodiversity (FRB) through its Centre for Synthesis and Analysis of Biodiversity data (CESAB), as part of the NETSEED research project. The funders had no role in the preparation of the manuscript.

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A Review of the Literature on Case Study Research

This paper presents a review of the literature on case study research and comments on the ongoing debate of the value of case study. A research paradigm and its theoretical framework is described. This review focuses extensively on the positions of

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This paper aims at exploring and discus­ sing the possibilities of applying qualitative content analysis as a (text) interpretation method in case study research. First, case study research as a research strategy within qualitative social research is briefly presented. Then, a basic introduction to (qualitative) content analysis as an interpretation method for qualitative interviews and other data material is given.

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15th NCVER conference

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casestudies journal

Qualitative case-study research has experienced an upsurge in business management fields of inquiry in the recent past. A methodology is selection, justification and sequential arranging of activities, procedures and tasks in a research project. Research methodology can no longer be confined to a set of universally applicable rules, conventions and traditions. A research paradigm is a set of propositions that explains how the world is perceived. There are three basic paradigms: positivist, interpretive and critical. Qualitative " approaches to research " , " strategies of inquiry " and " varieties of methodologies " classified into five " types " or " traditions " namely; biography, phenomenology, grounded theory, ethnography and case study. The major criticism made of qualitative methods is that they are impressionistic and non-verifiable, post-positivists who reject this charge claiming that qualitative data is auditable and therefore dependable. The less structured qualitative methodologies reject many of the positivists " constructions over what constitutes rigour, favouring instead the flexibility, creativity and otherwise inaccessible insights afforded by alternative routes of inquiry that embrace storytelling, recollection, and dialogue. Case study research is not really a " methodology " or a method, rather an approach to research. Case studies can be ethnographic or not and some scholars identified it as a strategy of social inquiry. It is argued that, case studies are more appropriate to investigate causal relationships prevailing both in the business field as well as in wider society in general.

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How to use a case study in a literature review?

I am writing a literature review and I may need to include three case studies. What is the best way to go about it? Am I allowed to include the whole case study for the reader's review and then analyze the points made?

Thank you for your advice in advance.

• literature-review

• What do you mean by 'include the whole case study'? –  henning no longer feeds AI Commented Jan 3, 2019 at 19:13
• To copy and paste it as it is, word for word. Then reference it. –  Sambo Commented Jan 3, 2019 at 19:29
• I don't know about your field, but in mine, case studies are full-length articles. These you couldn't cite verbatim from beginning to end. –  henning no longer feeds AI Commented Jan 3, 2019 at 20:28
• Noted with thanks! For clarity, I'm looking to use mini-case studies which are not that long. Hence why i am using three. But I do see your point. –  Sambo Commented Jan 4, 2019 at 6:58
• Why would you include a case study in your literature review? –  user2768 Commented Jan 5, 2019 at 15:39

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Emphysematous Cystitis

Illustrative case report and review of the literature.

Grupper, Moti MD; Kravtsov, Alexander MD; Potasman, Israel MD

From Infectious Diseases and Urology, Bnai Zion Medical Center and the Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Address reprint requests to: Moti Grupper, MD, Infectious Diseases, Bnai Zion Medical Center, PO Box 4940, Haifa, 31048, Israel. Telephone/fax: 972-4-8359755; e-mail: [email protected] .

Emphysematous cystitis is a rare disease characterized by primary infection of the urinary bladder with gas-producing pathogens. There is a paucity of information on this entity in the English-language literature covering the last 45 years, and the clinical picture is poorly outlined. We carried out a comprehensive, retrospective review of the English-language literature from 1986 to 2006, searching for reports describing cases of emphysematous cystitis. The demographic, clinical, laboratory, imaging, and outcome characteristics of every eligible patient were excerpted. In the present report, we describe a typical case of emphysematous cystitis, followed by an analysis of the literature. Of the 53 eligible cases, most were elderly women with diabetes mellitus (62.2%). Classic symptoms of urinary tract infection were present in only 53.3% of cases. Abdominal tenderness and hematuria were noted in 65.6% and 82.3% of cases, respectively. Plain abdominal X-ray was highly sensitive (97.4%), while abdominal computerized tomography was the most sensitive and specific diagnostic tool. A complicated course attributable to emphysematous cystitis was described in 18.8% of cases. The exact mechanism contributing to the formation of gas in such cases is unknown. Various theories have been suggested, including fermentation of glucose in urine, with emphasis on disequilibrium between gas formation and clearance. Emphysematous cystitis has a highly variable presentation and course, with a considerable potential for complications. Further diagnostic imaging is highly recommended in diabetic patients with urinary tract infection who present with abdominal pain and hematuria. Knowledge of this rare entity may lead to early diagnosis and appropriate management.

Abbreviations: CRP = C-reactive protein, CT = computerized tomography, DM = diabetes mellitus, EC = emphysematous cystitis, HPF = highpower field, IV = intravenous, MRI = magnetic resonance imaging, RBC = red blood cell, UTI = urinary tract infection; WBC = white blood cell.

INTRODUCTION

Gas-producing infections are usually considered fulminant and dramatic, and may occur in almost any organ or system. Gas in the urinary tract may be due to a variety of pathologic entities, including gas-forming infections, infarction, or a fistula with a hollow viscus. Air may be introduced into the genitourinary tract by instrumentation, during surgical procedures, or as a result of external penetrating trauma 24 . Gas-forming infections of the urinary tract are sporadic, and may involve any part of this system 61 .

Emphysematous cystitis (EC) is a rare complication of lower urinary tract infection (UTI), which results from primary infection of the urinary bladder with gas-producing pathogens 47 . EC or "cystitis emphysematosa" was originally described only as a pathologic entity. The pathologic changes were first described in a diabetic female dog in 1926 22 . Mills described a series of 12 autopsy cases in 1930, of whom 8 were female and none was diabetic 33-36 . In all cases, pathologic examination of the urinary bladder mucosa demonstrated varying degrees of gas-containing vesicles, inflammation, and hemorrhage. These autopsy findings set the basis for the recognition of EC as a distinct clinical entity, and this was firmly established in the following years. The central role of UTI in the pathogenesis of EC was established over the subsequent 30 years 4 . The complete clinical picture and outcome of EC are poorly defined. Because the diagnosis of EC is obtained in most cases by means of radiologic examination, a field that has been revolutionized over the past few decades with the introduction and widespread acceptance of computerized tomography (CT), we elected to review the relevant literature covering the past 20 years.

CASE REPORT

A 70-year-old woman presented to the emergency department complaining of generalized weakness, macrohematuria, lower abdominal pain, and dysuria lasting 3 days. She denied fever, chills, nausea, vomiting, diarrhea, previous events of hematuria, or urinary retention. Her past medical history was significant for type 2 diabetes mellitus (DM), complicated by diabetic retinopathy and nephropathy (baseline creatinine of 2 mg/dL), essential hypertension, and hyperlipidemia. She did not use alcohol or tobacco.

Ten days earlier, the patient had been hospitalized for 3 days with a diagnosis of hyperglycemia, uncontrolled blood pressure, and UTI, manifested by dysuria and lower abdominal pain for 2 weeks, but no chills or fever. On that occasion, blood count showed 13,100 white blood cells (WBC)/mL. Urinalysis was remarkable for large numbers of WBC, and 8-10 red blood cells (RBC) per high-power field (HPF). A urinary catheter was not inserted. A plain abdominal film showed no evidence of nephrolithiasis, ileus, free air, or air in the bladder. The patient was treated with intravenous (IV) cefuroxime for 2 days, her symptoms subsided, and she was discharged. She was prescribed oral cefuroxime-axetil for a further 4 days. The result of urine culture, received after discharge, revealed 10 6 colonies of Escherichia coli, resistant to ampicillin; first-, second-, and third-generation cephalosporins; and ofloxacin.

On readmission, the patient was in no acute distress. Blood pressure was 173/86 mm Hg, pulse was 121/minute, and rectal temperature was 36.9 °C. The physical examination was significant only for mild suprapubic tenderness, without peritoneal signs or flank tenderness on percussion. Laboratory evaluation revealed a WBC count of 18,100/mL with 90% polymorphonuclears, and the C-reactive protein (CRP) was 101.3 mg/dL. Serum glucose level was 460 mg/dL, urea level was 77 mg/dL, and creatinine was 2 mg/dL. Blood pH was 7.36, with a bicarbonate level of 25.5. Urinalysis revealed large numbers of RBC/HPF, with no WBC. Ultrasonographic examination of the urinary system demonstrated normal-sized kidneys with thin parenchyma, and renal calculi on the left side. Suspicion was raised of a staghorn calculus in the left kidney. The patient was admitted with a presumed diagnosis of UTI. Empiric treatment was commenced with IV ceftriaxone. The following day, due to persistent abdominal pain and the ultrasonographic findings, an abdominal CT scan was performed without contrast. The CT ( Figure 1 ) revealed the presence of a thickened bladder wall, with intramural and intraluminal gas bubbles and opacification of the perivesicular fat. The presence of a staghorn calculus in the left kidney was confirmed. A diagnosis was made of EC, and a urinary catheter was inserted, which drained macrohematuria with a large number of blood clots, but without pneumaturia. The empiric treatment was changed on the second hospitalization day to piperacillin/tazobactam plus gentamicin. In the days following this, the patient's condition improved, the urine cleared, and her laboratory tests gradually normalized. Urine culture grew 10 6 colonies of E.coli, with a resistance pattern identical to that observed during the prior hospitalization. Blood cultures obtained on admission were negative. A repeat abdominal CT scan ( Figure 2 ), combined with cystoscopy, was performed 9 days after admission, demonstrating a significant decrease in the number of intramural gas bubbles and the amount of intraluminal gas. The perivesicular fat opacification had cleared. No pathology was seen on cystoscopy. The patient was treated with IV antibiotics for a total of 8 days, and was discharged on oral amoxicillin/clavulanate for a further 14 days. On last follow-up, 45 days post-discharge, she was asymptomatic.

We conducted a computer-based search (MEDLINE, National Library of Medicine, Bethesda, MD) of the English-language literature for the years 1986-2006 describing patients with a diagnosis of EC or cystitis emphysematosa. We excluded cases that demonstrated gas in any other part of the urinary tract or another body organ, or a fistula between the urinary bladder and adjacent organs. From each publication we excerpted the following data: age and sex, regular use of alcohol, the presence of DM, all comorbidities, known or newly discovered urinary tract pathology, and the presence of symptoms and signs suggestive of UTI on initial presentation (dysuria, urinary urgency, increased urinary frequency, abdominal pain, flank pain, urinary retention, hematuria, chills, nausea and/or vomiting, systemic fever, abdominal or flank tenderness). We also recorded the presence of pneumaturia elicited from the medical history or as a result of urinary catheterization, impaired level of consciousness, reduced systolic blood pressure, and the presence of peritoneal signs. We looked for the following blood tests: glucose, creatinine, CRP and WBC, as well as the results of blood cultures, if taken, urinalysis, and urine cultures. We recorded the imaging modalities used (plain abdominal X-ray, intravenous pyelogram, ultrasound, CT, lower gastrointestinal barium enema, endoscopy, or cystoscopy), the results, and the time from presentation to the diagnosis of EC. We also recorded details of the treatment during hospitalization: length of antibiotic treatment and length of hospitalization, use of urinary drainage, presence of local complications, any surgical procedure related to the UTI that was carried out, and outcome (dead or alive) at the last follow-up available. When there was no information regarding a certain parameter, we recorded the data as "not available," and the case in question was excluded from the denominator for that particular parameter only in the analysis. Numerical values of data were recorded when available. For the purpose of data analysis in the present study, we have introduced a number of definitions ( Table 1 ). The time interval from presentation to the diagnosis of EC was assumed to be ≤24 hours if the diagnosis was made during the patient's evaluation on presentation. Surgical procedures that were not reported were assumed to have not been carried out. In the single case where the outcome was not reported, the patient was assumed to be alive at last follow-up.

Fifty-three cases met our inclusion criteria for analysis. Only 1 case description was excluded on technical grounds. There were 38 non-English-language studies of EC in the years we surveyed. Nine of these originated from Japan, and the remainder were from a range of European countries. These articles were not included in the current analysis because of an apparent lack of geographical clustering, and for technical reasons. Twenty-three of the non-English-language articles were not eligible for any analysis because they were either incompatible with our inclusion criteria, lacked data on the English-language abstract, or had no English-language abstract. The remaining eligible 15 non-English-language articles reported 25 cases in their abstracts; the mean age of these patients was 68.9 ± 10.6 years. Of the 25 cases, 14 (56%) were female, and 18 (72%) were diabetic.

Clinical, laboratory, and radiologic characteristics of eligible (English language) cases for the current analysis are presented in Table 2 . The mean age of the patients was 67 ± 15 years (range, 23-90 yr). The majority of patients were female, and DM was present in 62.2%. Twelve (22.6%) of the patients had documented immunosuppressive comorbidity (2 suffered from malnutrition, 4 abused alcohol, 2 were receiving immunosuppressive therapy, 1 had solid cancer, and 3 had hematologic malignancy); 4 of these cases also had DM. The most common urinary tract pathologies reported were neurogenic bladder (5 cases), and a history of recurrent UTI (4 cases). Of the 53 cases, 12 (22.6%) had neither immunosuppressive comorbidity nor DM.

In 8 of 45 eligible cases (17.8%), there was nothing in the medical history to indicate a diagnosis of UTI (1 or more symptoms such as abdominal pain, flank pain, urinary retention, dysuria, frequency, urgency, hematuria, or pneumaturia). Classic symptoms of UTI (1 or more of dysuria, urinary frequency, or urinary urgency) were present in only 24 of 45 eligible cases (53.3%).

Abdominal tenderness was found in 65.6% of eligible cases, but frank peritoneal signs in only 6.2%. It is interesting that pneumaturia was noted after catheterization in 70% of eligible patients. Eight of the patients with urinary retention were completely asymptomatic, and evidence of retention was found only on objective testing.

Urinalysis was bloodless in only 6 cases (17.6%), whereas either leukocyturia or blood was present in all eligible cases. Only 2 of the cases with elevated serum creatinine had a prior diagnosis of chronic renal failure, and 4 were reported to have had a previously normal creatinine level.

Gas in the urinary bladder wall or lumen was demonstrated in all of the 53 cases, either on plain abdominal film or CT, or both. CT demonstrated gas in the urinary bladder wall in 94.4% of eligible cases, and in the bladder lumen alone in the 2 remaining cases. Radiologic diagnosis was based on plain abdominal X-ray alone in 6 of 53 cases (11.3%). Abnormal sonographic appearance of the urinary bladder was demonstrated in 46.1% of eligible cases, with findings of multiple echoes consistent with gas in 5 of 6 cases, and a thickened bladder wall in the remaining case. Gas was demonstrated either by plain X-ray or abdominal CT in all other cases not identified by ultrasound.

A urinary tract pathogen was isolated in 90.4% of cases. E. coli was the most prevalent pathogen (57.4%), followed by Klebsiella pneumonia (21.3%). Other isolates included Enterococcus, Candida, and Clostridium perfringens in 1, 2, and 2 cultures, respectively. In 4 of the cases, the culture was polymicrobial. Over the years, E. coli and Klebsiella pneumonia have consistently been the dominant urinary isolates.

Clostridium perfringens, Candida albicans, and E. coli were isolated in the blood cultures of 2, 1, and 1 of the cases, respectively.

The median time from presentation to diagnosis in the 32 evaluable cases was up to 24 hours. In 6 of 32 eligible cases (18.7%), diagnosis was established more than 24 hours after presentation (range, 2-9 days). In 4 of these cases, none of the classic complaints indicative of a UTI was present, with macrohematuria and mild urinary urgency present in the remaining 2 cases. No complication, surgery, or mortality was reported in any of these 6 cases.

Antibiotic treatment was administered in all 53 cases. Of the 30 cases for which data were available regarding specific antibiotic treatment, most of the patients received beta-lactams (60%). The median length of the treatment period was 10 days (20 evaluable cases). The median length of hospitalization was up to 7 days (18 evaluable cases).

A complicated course was present in 10 cases (18.8%). Laparotomy was deemed necessary in 8 patients (15%) on the grounds of peritoneal signs, pneumoperitoneum, or perivesical abscess. In all of these cases, the pathologic process on laparotomy was confined to, or originated from, the urinary bladder. Total cystectomy, partial cystectomy, cystostomy, and bladder lavage were performed in 4 of these cases. No details concerning the exact surgical procedure were available for the other 4 cases. Two other patients had major sequelae directly attributable to the process of EC. One of these patients required treatment in a hyperbaric chamber, following a suspicion of cerebral air embolism due to altered mental status and femoral venous gas bubbles on abdominal CT. The other patient had hydronephrosis requiring bilateral percutaneous nephrostomy. This group of 10 complicated cases was not significantly different from the uncomplicated group for any of the demographic or comorbidity parameters examined (2-sided t test or chi-square; Table 3 ).

Five of the 53 patients (9.4%) were reported dead at the time of last follow-up. There was no discussion regarding the contribution of EC to mortality in any of these cases. The precise time from diagnosis of EC to death was explicitly reported in only 1 case (21 days).

We found that most cases of EC occur in elderly, diabetic women. A 62.2% rate of DM is remarkable. The prevalence of DM in the general population is estimated at 8.6% in people over 20 years old 45 . DM is probably overrepresented among patients with symptomatic UTI 40 , although there is still room for debate on this point. In the present study, however, we found the rate to be 7 times higher. Our figures thus concur with those of Bailey 4 , who found that DM occurred in 15/19 (80%) of the cases with EC. The advanced age of the present cohort is in agreement with the fact that complicated UTI (for example, pyelonephritis and perinephric abscesses) appears to occur more frequently among older individuals with DM than among those without 47 .

The exact mechanism of gas formation in emphysematous infections is unclear. A proposed explanation in diabetic patients includes production of CO 2 by infecting microorganisms demonstrating gas-forming ability. This is made feasible by fermentation of the high glucose concentration in the urine and tissues, leading to the accumulation of acids, and thus lowering the local pH. Gas-forming microorganisms produce enzymes, which convert the acids to CO 2 when the pH reaches 6 or lower. A variety of fermentation pathways has evolved in microorganisms, including lactic acid fermentation ( Streptococcus, Lactobacillus ), alcohol fermentation (a large number of yeasts and a smaller number of bacteria), mixed acid (formic acid) fermentation (most Enterobacteriaceae ), butyric acid fermentation ( Clostridium ), butanediol fermentation ( Enterobacter ), and propionic acid fermentation ( Propionibacterium ). The fermentation capabilities of these pathogens, which are not always considered to be classical gas producers, may explain their involvement in emphysematous infections 21 . Because emphysematous infections of the urinary tract may occur in nondiabetic patients, it has been proposed that urinary lactose or tissue proteins may serve as substrates for gas formation. A unifying mechanism for the different patient populations suggested that the pathogenesis of gas bubble formation involves rapid catabolism of any type, resulting in increased production of gas. In addition, there is impaired transportation of the formed gas, due to local inflammation or obstructive uropathy increasing the local pressure and impairing the circulation, or vascular disease (for example, in diabetes). The accumulation of gas further increases the local pressure and may lead to infarction of the adjacent tissues. The infarcted tissue might in turn provide a good culture medium for gas-forming pathogens, augmenting the barrier to gas transportation and thus creating a vicious circle 61 .

Our data indicate that the clinical presentation of EC is nonspecific, and can range from minimally symptomatic UTI to a scenario of peritonitis and septic shock. The most common symptom among eligible cases was abdominal pain, but the classic symptoms of UTI were reported in only approximately 50% of the cases. As opposed to a prevalence of only 50% in the usual form of bacterial cystitis 49 , in the present study blood was present in urine (microhematuria or gross hematuria) in 82.3% of cases. This may indicate a more invasive process in patients with EC than in those with the usual form of bacterial cystitis.

As symptoms are of no help in reaching a diagnosis, appropriate diagnostic imaging is imperative to establish the diagnosis of EC. Our data indicate that abdominal and pelvic CT is the most valuable imaging modality for the diagnosis of EC. Plain X-ray radiography ( Figure 3 ) has reportedly been regarded as a highly sensitive tool, but findings on plain X-ray may be confused with rectal gas, emphysematous vaginitis, pneumatosis cystoides intestinalis, and gas gangrene of the uterus, resulting in poor specificity. The use of CT, intravenous pyelogram, cystoscopy, and/or lower gastrointestinal imaging is important for ruling out a colo-vesical fistula secondary to diverticulitis of the colon, colonic carcinoma, or less commonly, Crohn disease 24 . Based on our review, the sensitivity of ultrasound is low (only 46.1%), but it was conducted in only 13 of 53 cases (24.5%), thus limiting our ability to evaluate its usefulness. There is no specific information regarding the use of magnetic resonance imaging (MRI) for the diagnosis of EC, but because gas-forming infections can cause signal voids, which are difficult to interpret on MRI, the value of MRI seems limited in this condition 50 .

EC usually runs a benign course, but complications may arise in up to 19% of cases. Five of the patients in the current series died, but it was difficult to establish a direct connection between their death and EC. Forty-six years ago, Bailey 4 described a more benign course among cases: none of the patients underwent a surgical procedure, and the 2 cases of death were not attributable to EC. We believe that the course of the disease in the current series derives from the fact that the patients whose cases we reviewed were significantly older (67 ± 15 vs. 54 ± 19.1 yr; p = 0.0036, 2-sided t test).

The present study has a number of limitations. As with all retrospective reports, the data were incomplete. In addition, the rarity of EC implies that each center reports its occurrence anecdotally. Therefore, to obtain as many valuable data as possible, we included every description of a case with that diagnosis, even if the article did not set out specifically to such a description. These factors may have been responsible for less than optimal data in some of the cases. Nevertheless, it is unlikely that a prospective study of EC would be conducted, leaving the retrospective analysis of existing data as the only practical tool. In addition, since the present study is a review of case reports, it is possible that there is a publication bias toward cases with a complicated course.

In conclusion, clinicians should be aware of the clinical entity of EC. Based on our findings, suspicion of this disease should be aroused by abdominal pain in a diabetic patient, with or without a clinical presentation suggestive of UTI, especially when hematuria is present. In such cases, we suggest conducting a plain abdominal X-ray for screening, followed by abdominal CT when urinary bladder gas is present.

ACKNOWLEDGMENTS

We thank Richard Lincoln and Ellen Bamberger, MD, for proofreading the manuscript.

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Organizing Your Social Sciences Research Paper: Writing a Case Study

• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Reading Research Effectively
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Multiple Book Review Essay
• Reviewing Collected Essays
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Bibliography

The term case study refers to both a method of analysis and a specific research design for examining a problem, both of which are used in most circumstances to generalize across populations. This tab focuses on the latter--how to design and organize a research paper in the social sciences that analyzes a specific case.

A case study research paper examines a person, place, event, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or among more than two subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies . Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in this writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a single case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

• Does the case represent an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
• Does the case provide important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
• Does the case challenge and offer a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in practice. A case may offer you an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to the study a case in order to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
• Does the case provide an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings in order to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• Does the case offer a new direction in future research? A case study can be used as a tool for exploratory research that points to a need for further examination of the research problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of Uganda. A case study of how women contribute to saving water in a particular village can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community throughout rural regions of east Africa. The case could also point to the need for scholars to apply feminist theories of work and family to the issue of water conservation.

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work. In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

• What was I studying? Describe the research problem and describe the subject of analysis you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
• Why was this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
• What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the research problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
• How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

• Place relevant works in the context of their contribution to understanding the case study being investigated . This would include summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
• Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to study the research problem and the underlying research questions.
• Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
• Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
• Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
• Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
• Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in the context of explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular subject of analysis to study and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that frames your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; c) what were the consequences of the event.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experience he or she has had that provides an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of his/her experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using him or her as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem.

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, cultural, economic, political, etc.], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, why study Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research reveals Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut? How might knowing the suppliers of these trucks from overseas reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should be linked to the findings from the literature review. Be sure to cite any prior studies that helped you determine that the case you chose was appropriate for investigating the research problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is more common to combine a description of the findings with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps to support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings It is important to remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations for the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and needs for further research.

The function of your paper's conclusion is to: 1)  restate the main argument supported by the findings from the analysis of your case; 2) clearly state the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place for you to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
• If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in and your professor's preferences, the concluding paragraph may contain your final reflections on the evidence presented applied to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were on social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood differently than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis.

Case Studies . Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent knowledge is more valuable than concrete, practical (context-dependent) knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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• Last Updated: Jan 17, 2023 10:50 AM
• URL: https://libguides.pointloma.edu/ResearchPaper

• Open access
• Published: 27 June 2024

Chemotherapy-related cardiotoxicity and its symptoms in patients with breast cancer: a scoping review

• Hyunjoo Kim 1 , 2 ,
• Bomi Hong 3 ,
• Sanghee Kim 4 ,
• Seok-Min Kang 5 &
• Jeongok Park   ORCID: orcid.org/0000-0003-4978-817X 4  

Systematic Reviews volume  13 , Article number:  167 ( 2024 ) Cite this article

86 Accesses

Metrics details

Chemotherapy-related cardiotoxicity is a significant concern because it is a major cause of morbidity. This study aimed to provide in-depth information on the symptoms of chemotherapy-related cardiotoxicity (CRCT) by exploring literature that concurrently reports the types and symptoms of CRCT in patients with breast cancer.

A scoping review was performed according to an a priori protocol using the Joanna Briggs Institute’s guidelines. The participants were patients with breast cancer. The concept was the literature of specifically reported symptoms directly matched with CRCT and the literature, in English, from 2010, and the context was open. The search strategy included four keywords: “breast cancer,” “chemotherapy,” “cardiotoxicity,” and “symptoms.” All types of research designs were included; however, studies involving patients with other cancer types, animal subjects, and symptoms not directly related to CRCT were excluded. Data were extracted and presented including tables and figures.

A total of 29 articles were included in the study, consisting of 23 case reports, 4 retrospective studies, and 2 prospective studies. There were no restrictions on the participants’ sex; however, all of them were women, except for one case report. The most used chemotherapy regimens were trastuzumab, capecitabine, and doxorubicin or epirubicin. The primary CRCT identified were myocardial dysfunction and heart failure, followed by coronary artery disease, pulmonary hypertension, and other conditions. Major tests used to diagnose CRCT include echocardiography, electrocardiography, serum cardiac enzymes, coronary angiography, computed tomography, and magnetic resonance imaging. In all case reports, CRCT was diagnosed through an incidental checkup according to the patient’s symptom presentation; however, only 10 of these studies showed a baseline checkup before chemotherapy. The five most common CRCT symptoms were dyspnea, chest pain, peripheral edema, fatigue, and palpitations, which were assessed by patient-reported symptom presentation rather than using a symptom assessment tool. Dyspnea with trastuzumab treatment and chest pain with capecitabine treatment were particularly characteristic. The time for first symptom onset after chemotherapy ranged from 1 hour to 300 days, with anthracycline-based regimens requiring 3–55 days, trastuzumab requiring 60–300 days, and capecitabine requiring 1–7 days.

Conclusions

This scoping review allowed data mapping according to the study design and chemotherapy regimens. Cardiac assessments for CRCT diagnosis were performed according to the patient’s symptoms. There were approximately five types of typical CRCT symptoms, and the timing of symptom occurrence varied. Therefore, developing and applying a CRCT-specific and user-friendly symptom assessment tool are expected to help healthcare providers and patients manage CRCT symptoms effectively.

Peer Review reports

Breast cancer is currently the most common cancer worldwide. Its incidence and mortality rates in East Asia in 2020 accounted for 24% and 20% of the global rates, respectively, and these rates are expected to continue increasing until 2040 [ 1 ]. In the USA, since the mid-2000s, the incidence rate of breast cancer has been increasing by 0.5% annually, while the mortality rate has been decreasing by 1% per year from 2011 to 2020 [ 2 ]. Despite the improved long-term survival rate in patients with breast cancer due to the development of chemotherapy, the literature has highlighted that cardiotoxicity, a cardiac problem caused by chemotherapy, could be a significant cause of death among these patients [ 3 ]. Chemotherapy-related cardiotoxicity (CRCT) can interfere with cancer treatment and progress to congestive heart failure during or after chemotherapy [ 4 ], potentially lowering the survival rate and quality of life of patients with cancer [ 5 ].

The term cardiotoxicity was first used in the 1970s to describe cardiac complications resulting from chemotherapy regimens, such as anthracyclines and 5-fluorouracil. The early definition of cardiotoxicity centered around heart failure, but the current definition is broad and still imprecise [ 6 ]. The 2022 guidelines on cardio-oncology from the European Society of Cardiology (ESC) define cardiotoxicity as including cardiac dysfunction, myocarditis, vascular toxicity, arterial hypertension, and cardiac arrhythmias. Some of these definitions reflect the symptoms. For example, cardiac dysfunction, which accounts for 48% of cardiotoxicity in patients with cancer, is divided into asymptomatic and symptomatic cardiac dysfunction. Asymptomatic cardiac dysfunction is defined based on left ventricular ejection fraction (LVEF), myocardial global longitudinal strain, and cardiac biomarkers. Symptomatic cardiac dysfunction indicates heart failure and presents with ankle swelling, breathlessness, and fatigue [ 7 ]. The ESC guidelines for heart failure present more than 20 types of symptoms [ 8 ]; however, to the best of our knowledge, few studies have been conducted to determine which heart failure symptoms and their characteristics are associated with CRCT in patients with breast cancer. Similarly, there is a lack of information related to vascular toxicity such as myocardial infarction [ 7 ].

Professional societies in cardiology and oncology have proposed guidelines for the prevention and management of cardiotoxicity in patients with cancer. According to the American Society of Clinical Oncology and the ESC, it is recommended to identify high-risk patients, comprehensively evaluate clinical signs and symptoms associated with CRCT, and conduct cardiac evaluations before, during, and after chemotherapy [ 7 , 9 , 10 ]. In addition, guidelines for patients with cancer, including those for breast cancer survivorship care, emphasize that patients should be aware of the potential risk of CRCT and report symptoms, such as fatigue or shortness of breath to their healthcare providers [ 7 , 11 , 12 ]. Although these guidelines encompass cardiac monitoring as well as symptom observation, many studies have focused solely on objective diagnostic tests, such as echocardiography, cardiac magnetic resonance, and cardiac biomarkers [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ], which means that there is little interest in CRCT symptoms in patients under breast cancer care.

This lack of interest in CRCT symptoms may be related to the absence of a specific symptom assessment tool for CRCT. Symptom monitoring of CRCT in patients with breast cancer was conducted through patient interviews and reported using the appropriate terminology [ 23 ]. In terms of interviews, patients with cancer experienced the burden of expressing symptoms between cardiovascular problems and cancer treatment. Qualitative research on patients with cancer indicates that these patients experience a daily battle to distinguish the symptoms they experience during chemotherapy [ 24 ]. To reduce the burden of identifying CRCT symptoms, it is crucial to educate patients with breast cancer undergoing chemotherapy about these symptoms. To report cardiotoxicity, healthcare providers in oncology can use a dictionary of terms called the Common Terminology Criteria for Adverse Events (CTCAE) for reporting adverse events in patients with cancer [ 25 ]. Patients can also use Patient-Reported Outcome (PRO), which allows unfiltered reporting of symptoms directly to the clinical database [ 26 ]. PRO consists of 78 symptomatic adverse events out of approximately 1,000 types of CTCAE [ 27 ]. Basch et al. suggested that PRO could enable healthcare providers to identify patient symptoms before they worsen, thereby improving the overall survival rate of patients with metastatic cancer [ 28 ]. This finding implies that symptoms can provide valuable clues for enhancing the timeliness and accuracy of clinical assessments of CRCT [ 29 ]. Therefore, it is necessary to explore the scope of research focusing on CRCT symptoms for prevention and early detection of CRCT in patients with breast cancer. The detailed research questions are as follows:

What are the general characteristics of the studies related to CRCT in patients with breast cancer?

What diagnostic tools and monitoring practices are used to detect CRCT?

What are the characteristics and progression of symptoms associated with CRCT?

A scoping review is a research method for synthesizing evidence that involves mapping the scope of evidence on a particular topic [ 30 ]. It aims to clarify key concepts and definitions, identify key characteristics of factors related to a concept, and highlight gaps or areas for further research [ 30 ]. This study used a scoping review methodology based on the Joanna Briggs Institute (JBI) framework. The JBI methodology, refined from the framework initially developed by Arksey and O’Malley [ 31 ], involves developing a research question, establishing detailed inclusion and exclusion criteria, and selecting and analyzing literature accordingly [ 32 ]. In contrast to systematic reviews, scoping reviews can encompass a variety of study designs and are particularly suitable when the topic has not been extensively studied [ 33 ]; hence, the decision was made to conduct a scoping review.

Development of a scoping review protocol

To conduct this review, an a priori scoping review protocol was developed to enhance transparency and increase the usefulness and reliability of the results. The protocol included the title, objective, review questions, introduction, eligibility criteria, participants, concept, context, types of evidence source, methods, search strategy, source of evidence selection, data extraction, data analysis and presentation, and deviation from the protocol [ 34 ] (Supplementary File 1).

Eligibility criteria

A participant-concept-context (PCC) framework was constructed based on the following research criteria. The participants were patients with breast cancer. The concept was that studies that specifically reported symptoms directly matched to CRCT in patients with breast cancer and the literature, published in English since 2010, in line with the year the CRCT guidelines were announced by the Cardio-Oncology Society. The context was open. We included all types of research designs. The exclusion criteria were studies that included patients with other types of cancer, involved animal subjects, and reported symptoms not directly related to CRCT.

Search strategy

The keywords consisted of “breast cancer,” “chemotherapy,” “cardiotoxicity,” and “symptoms.” The keywords for “cardiotoxicity” were constructed according to the clinical cardiotoxicity report and ESC guidelines [ 7 , 35 ]. The keywords for “symptoms” included 40 specific symptoms of arrhythmia, heart failure, and cardiac problems [ 36 , 37 ] (Supplementary Table 1). We used PubMed, Embase, and CINAHL.

Source of evidence selection

Duplicate studies were removed using EndNote 21. The titles and abstracts were then reviewed according to the inclusion criteria, the primary literature was selected, and the final literature was selected through a full-text review. Any disagreements were resolved through discussions between the investigators.

Data extraction

The data from the literature included the general characteristics of the study, as well as information on the patients, chemotherapy, cardiotoxicity, and symptoms. The general characteristics of the study included author, publication year, country of origin, study design; patient information including sample size, sex, age, cancer type, and cancer stage; chemotherapy information including chemotherapy regimen; cardiotoxicity information including type of cardiotoxicity, diagnostic tests, and times of assessment; and symptom information including type of symptom, characteristics of symptom worsening or improvement, onset time, progression time, and time to symptom improvement. Information on whether to receive chemotherapy after the diagnosis of cardiotoxicity was explored.

Data analysis and presentation

The contents of the included studies were divided into three categories: (1) general characteristics, which encompassed study designs, patients, and medications; (2) type of CRCT and cardiac assessment for CRCT; and (3) characteristics and progression of the symptoms associated with CRCT. CRCT symptom-related data are presented in tables and figures.

In total, 487 studies were identified through database searches, and 116 duplicates were subsequently removed. After reviewing the titles and abstracts, we excluded 197 studies in which participants had cancers other than breast cancer, no symptoms, or symptom-related expressions. Of the remaining 174 studies, 146 were excluded after full-text review. Among the excluded studies, 79 were mainly clinical trials that the symptoms were not directly related to CRCT, 62 did not report specific symptoms, four were in the wrong population, and one was unavailable for full-text review. An additional study was included after a review of references, bringing the final count to 29 studies included in the analysis (Fig. 1 ).

Preferred reporting items for systematic reviews flowchart

General characteristics of studies including designs, sex and age, chemotherapy regimen, and CRCT criteria

Table 1 presents the general characteristics of the studies included in this review. The majority of these studies were published in the USA ( n =14), with Japan ( n =3), and Romania ( n =2) following. The study designs primarily consisted of case reports ( n =23), retrospective studies ( n =4), and prospective studies ( n =2).

All case reports involved female patients, except for one involving a male patient. Five quantitative studies did not specify or limit the sex of the participants, and one retrospective study included only female patients. In terms of cancer stage, the majority of studies involved patients with advanced breast cancer ( n =13), while a smaller number involved patients with early-stage breast cancer ( n =4). Twelve studies did not specify the cancer stage. Approximately 20 types of chemotherapy regimens are currently in use. Trastuzumab, which is a human epidermal growth factor receptor 2 (HER2) blocker, was mentioned in the majority of studies ( n =8), followed by capecitabine (an antimetabolite) ( n =7), and doxorubicin or epirubicin (anthracycline-based chemotherapy) ( n =6). Current chemotherapy and previous treatment methods were described together, with the exception of eight studies. Six quantitative studies defined the CRCT criteria, five of which were based on decreased LVEF and one of which was based on significant cardiac symptoms and/or electrocardiogram changes. Twenty-three case reports described the cardiovascular diagnosis as CRCT.

Diagnostic tools and monitoring practice for CRCT

Table 2 displays the types of CRCT, diagnostic tools, and times of cardiac assessment according to chemotherapy regimens. The most prevalent CRCT were myocardial dysfunction and heart failure, identified in 12 case studies, respectively. This was followed by coronary artery disease, represented in 8 case studies, pulmonary hypertension in 2 case studies, and a single case study of periaortitis. The most used test for diagnosing CRCT was echocardiography ( n =22), followed by EKG ( n =20), various types of cardiac enzymes ( n =16), coronary angiography (CAG, n =12), computed tomography ( n =6), and magnetic resonance imaging (MRI, n =4). Regarding the CRCT symptom assessment tools, the CTCAE was used in two studies, the New York Heart Association classification for heart failure in two studies, the dyspnea assessment scale in one study, and symptoms of cardiac origin, which consisted of chest pain, dyspnea, and palpitations in one study.

Regarding the times of cardiac evaluation, two studies performed regular cardiac checkups including before, during, and after chemotherapy. There were 10 case studies and six quantitative studies describing cardiac function testing before chemotherapy, of which seven studies performed regular cardiac screening tests and two studies mentioned cardiac screening even after the completion of chemotherapy. The frequency of regular checkups varied from every 3 months to every two to four cycles. In all case reports ( n =23), CRCT were diagnosed through incidental checkups based on patients’ symptom presentation, and in most cases, several tests were performed subsequentially for CRCT diagnosis. In one case study, cardiac evaluation was conducted 3 days after the patient’s initial symptom presentation, when the symptoms became more severe.

Characteristics and progression of symptoms associated with CRCT

Table 3 shows the descriptive scope of the CRCT-related symptoms according to the chemotherapy regimens used in the included studies. The mapping factors included initial symptoms, symptom onset or severity, symptom progression, medical management, and CRCT results. One of the most frequent symptoms associated with CRCT was dyspnea, which was discussed in 19 studies and described as difficulty in breathing, shortness of breath, or New York Heart Association (NYHA) class II or III. When dyspnea appeared as the initial symptom of CRCT, the symptom progression was worsening in eight case studies and persistent in two cases. Chest pain was described in 12 studies as a symptom characterized by a squeezing, tingling, burning, tightened, or atypical feeling that was relieved by rest and exacerbated by exertion. Other symptoms included peripheral edema ( n =6), fatigue ( n =5), and palpitation ( n =2). The symptoms were assessed by patient-reported symptom presentation rather than using a symptom assessment tool.

The symptoms could be categorized based on the type of chemotherapy regimens used. In the case studies involving anthracycline-based regimen and HER2 blockers, dyspnea was the most frequently observed symptom ( n =7), followed by peripheral edema ( n =2), and chest pain or discomfort ( n =2). In case studies where antimetabolites were used, specifically capecitabine, chest pain was a common and prominent symptom. This chest pain typically manifested between 1 and 7 days after drug administration and persisted until treatment. Notably, four out of seven patients reported this symptom on the first day of chemotherapy, according to the case reports. The time for first symptom onset after chemotherapy ranged from 1 hour to 300 days, with anthracycline-based regimens requiring 3–55 days, trastuzumab requiring 60–300 days, and capecitabine requiring 1–7 days. Figure 2 shows the progression of symptoms in case studies, detailing the time of symptom onset, the date of symptom reporting, and the date of treatment completion following the use of chemotherapy. The studies that did not specify any of the dates of symptom onset, reporting, and completion of treatment were excluded from the figure.

Figure 3 shows symptoms according to the main types of chemotherapy regimens reported in case studies. Dyspnea with trastuzumab and chest pain with capecitabine are particularly characteristic. A retrospective study included in this scoping review reported that chest pain was the most common symptom associated with capecitabine, followed by dyspnea and palpitation [ 40 ]. Furthermore, peripheral edema was primarily observed with anthracycline, alkylating, and HER2 blockers, while fatigue was noted with various anticancer drugs, irrespective of the type of chemotherapy regimen.

Ongoing chemotherapy was discontinued after CRCT was detected in 20 case studies. When patients presented symptoms indicative of CRCT, the majority were promptly hospitalized for further evaluation, medication, or interventional treatment. The majority of studies indicated the initiation of cardiac medication ( n =21), with three case studies involving coronary intervention and two involving treatment with wearable devices. Most management procedures were conducted in a general ward or an intensive care unit.

In most case studies, symptoms improved following cardiac treatment, with either complete or partial recovery of LVEF observed in 19 instances. However, a few studies reported a poor prognosis, including two instances of death. LVEF recovered in most patients within 6 months when treated with an anthracycline-based regimen and HER2 blockers (Fig. 2 ). A retrospective study reported that the rates of complete or partial recovery of CRCT following treatment with doxorubicin-based chemotherapy and trastuzumab were 42.9% and 86.1%, respectively [ 39 ]. Another retrospective study noted that the recovery time of CRCT when treated with HER2 blockers increased in correlation with the severity of the NYHA class, ranging from 8 to 80 weeks [ 38 ]. In the case of the antimetabolite capecitabine, all patients recovered within a day to a week, except one patient who did not recover.

This scoping review was conducted to explore the scope of studies focusing on CRCT symptoms, including the general characteristics of the studies, diagnostic tools, monitoring practices related to detecting CRCT, and the characteristics and progression of symptoms associated with CRCT. The primary findings of this review were as follows: (1) common symptoms related to CRCT and differences in symptoms according to the chemotherapy regimens used were identified; (2) the symptoms reported by the patient served as clues to suspect a specific type of CRCT; and (3) regular monitoring practices for CRCT prevention and detection were insufficient.

First, the current study identified common symptoms such as dyspnea, chest pain, peripheral edema, fatigue, and palpitation associated with CRCT, as well as variations in symptoms depending on the chemotherapy regimen used in patients with breast cancer. Among these symptoms, dyspnea, edema, and chest pain were frequently observed in patients receiving anthracycline-based and/or HER2 blocker drugs. These symptoms, which are associated with heart failure, appeared later compared to those observed with capecitabine, as depicted in Fig. 2 . This may be due to the known impact of anthracycline-based and/or HER2 blocker regimens on cardiomyocytes and other cells, leading to myocardial damage [ 42 ]. Therefore, the symptoms are related to heart failure, potentially resulting from the impairment of ventricular filling or ejection in patients undergoing treatment with these regimens [ 43 ].

In a similar vein, Attin et al. (2022) documented the occurrence of symptoms such as lower extremity edema, chest pain, difficulty breathing, and fatigue before the diagnosis of CRCT in women undergoing breast cancer treatment. They conducted a retrospective and longitudinal investigation of the symptoms, signs, and cardiac tests of 15 patients who experienced CRCT, using their electronic medical records. In their study, cardiotoxicity was defined by an echocardiogram or MRI showing a decrease in LVEF of 5 to 10%, with a specialist’s confirmation note. They compared the number of symptom occurrences during the first half of the year with those during the second half of the year prior to the diagnosis of cardiotoxicity. Specifically, the frequency of lower-extremity edema significantly increased from three occurrences in the first half of the year to 17 occurrences in the second half of the year. The frequency of symptoms for dyspnea and chest pain also increased from 10 and 8 times, respectively, to 16 and 14 times in the second half of the year. While there was limited information on the doses or timing of chemotherapy, 87% of the patients received the same chemotherapy regimens, namely anthracyclines and/or HER2 blockers [ 44 ]. This suggests that the increase in symptom occurrence over time may be related to the accumulation of anthracycline and the duration of anti-HER2 therapy [ 45 ].

Salyer et al. (2019) conducted a study on the prevalent symptoms of heart failure and their clustering. They identified three symptom clusters: sickness behavior, gastrointestinal disturbance, and discomfort of illness. Notably, dyspnea, edema, and pain were grouped into the discomfort of illness cluster, which aligns with the symptoms we observed in patients treated with anthracyclines and/or HER2 blockers [ 46 ]. Therefore, it is crucial for patients undergoing treatment with anthracyclines and/or HER2 blockers to be vigilant for symptoms such as dyspnea, edema, or chest pain, as these are indicative of heart failure.

Chest pain caused by vasospasm was a predominant symptom in patients taking antimetabolite regimens such as oral capecitabine, and it manifested as the following types of cardiotoxicities: vasospasm-related arrhythmia, myocardial disease, and ischemia [ 47 ]. Vasospasm can be triggered by endothelial dysfunction, hypersensitive vascular smooth muscle, reactive oxidative stress, or chemotherapy regimens [ 48 , 49 ]. According to previous studies, in patients using antimetabolite drugs such as 5-fluorouracil or capecitabine, chest pain was usually reported to occur from several hours to 72 hours after the first administration [ 47 , 50 , 51 , 52 , 53 ]. To detect chemotherapy-related coronary vasospasm in the early stage, it is recommended to carefully monitor typical or atypical symptoms of chest pain and EKG monitoring during drug infusion [ 54 ]. Muco et al. (2022) reported severe outcomes resulting from delayed management of vasospastic angina symptoms. The patient’s cardiac evaluation was performed 3 days after the onset of symptoms, and unfortunately, she did not recover from brain damage caused by coronary vasospastic sequelae. The authors stressed the importance of medical teams recognizing the symptoms of CRCT through vigilant monitoring and patient education [ 55 ].

As seen in the symptoms of CRCT caused by heart failure and vasospasm, careful observation of symptoms and conducting appropriate tests are crucial to prevent cardiotoxicity and minimize damage. These characteristics of CRCT and the associated symptoms related to chemotherapy regimens can provide crucial educational content for healthcare providers and patients preparing for chemotherapy. In addition, CRCT and symptom progression according to chemotherapy regimens could be used to formulate research questions for future systematic reviews.

Second, the preventive management of CRCT necessitates adherence to recommended guidelines. The 2022 ESC guidelines on cardio-oncology have updated the classification of CRCT and the monitoring protocols based on the chemotherapy regimens used [ 7 ]. The CRCT identified in the current study aligns with the drug toxicity outlined in the 2022 ESC guidelines. These guidelines advocate for regular cardiac monitoring before, during, and after chemotherapy to prevent and manage CRCT induced by anthracycline and HER2 blockers [ 7 , 12 ]. In this scoping review, two of 23 records described cardiac monitoring before, during, and after chemotherapy. An Australian multicenter study revealed that 59% of patients were referred to a cardiologist before CRCT occurred, but only 15% of patients diagnosed with CRCT had consulted a cardiologist before chemotherapy [ 41 ]. Given the declining mortality rates among cancer patients, managing CRCT requires a collaborative approach between oncology and cardiology to minimize mortality and morbidity in patients with breast cancer undergoing chemotherapy [ 7 ]. Therefore, it remains crucial to emphasize adherence to cardiac monitoring guidelines and foster cooperation between oncology and cardiology.

Additionally, symptom assessment is important for the early detection of patients with CRCT. The studies included in the current scoping review assessed whether patients’ symptoms could detect CRCT using interviews with patients, the New York Heart Association classification, a dyspnea assessment scale, and CTCAE tools. The United States National Cancer Institute recommends that healthcare providers use CTCAE and patients with cancer use PRO to report adverse events, including symptoms. CTCAE is a broad and comprehensive terminology that encompasses adverse events related to cancer treatment, has been used since the 1980s [ 25 ], and is not specialized in cardiotoxicity. Additionally, a discrepancy between CTCAE and PRO discovered that healthcare providers often underestimate both the incidence and duration of symptoms compared to the patients [ 56 , 57 , 58 ]. Specifically, healthcare providers tend to report symptom severity as lower than that reported by patients. For instance, there are notable discrepancies between healthcare providers and patients when reporting severe or very severe symptoms of fatigue, dyspnea, and limb edema in patients with early-stage breast cancer undergoing chemotherapy. The reported rates were 8% and 22% for fatigue, 0% and 4% for dyspnea, and 0% and 5% for limb edema, from healthcare providers and patients, respectively. Therefore, it is necessary to develop a user-friendly questionnaire to assess the various symptoms of CRCT.

Finally, we found that once CRCT was confirmed, cardiac treatment was promptly initiated and chemotherapy was frequently halted until CRCT resolution. A Delphi study on the use of anthracycline and trastuzumab proposed altering the treatment schedule or discontinuing treatment until there was an improvement in LVEF [ 59 ]. However, the professional societies did not provide definitive recommendations regarding continuing or ceasing ongoing chemotherapy. Instead, they suggested that the decision to continue or discontinue ongoing chemotherapy should be made based on the patient’s potential risks and benefits [ 60 ]. For example, Polk et al. (2016) reported that out of 22 patients with CRCT resulting from capecitabine, six continued medications with or without cardiac treatment; some of these patients experienced the same symptoms, while others did not exhibit significant symptoms [ 40 ]. Further research is required to explore the continuation or discontinuation of chemotherapy when CRCT is confirmed.

This study has some limitations. First, although we did not restrict the patients’ sex when reviewing the literature, most patients, except for one, were female. This may be related to the lower incidence of breast cancer in men. Second, although this scoping review mapped CRCT symptoms according to chemotherapy regimens, including anthracycline-based drugs, HER2 blockers, and antimetabolites, it did not cover cardiotoxicity related to other types of chemotherapy regimens. Thus, exploring the symptoms by focusing on expanded chemotherapy regimens and cardiovascular toxic diseases will assist in overcoming this limitation. Third, of the 29 studies, 23 were case reports with some grey literature, which may be justified by the nature of scoping reviews that allow for inclusion irrespective of the data source [ 61 ] and the study type. Experimental or observational clinical studies use objective criteria, such as diagnostic tests to generate primary evidence. However, case reports have led to new medical discoveries regarding the prevention and treatment of diseases [ 62 ]. Given the nature of case reports, specific symptoms that could provide clues for evaluating CRCT in patients with breast cancer are most often found in these reports. We incorporated grey literature to gather more comprehensive information on CRCT-related symptoms. However, to mitigate the potential issue of unverified quality in grey literature, we initially organized 16 studies from peer-reviewed literature and subsequently incorporated the grey literature into our findings. This approach helped to clarify the results of the peer-reviewed literature, particularly the types of chemotherapy regimens [ 63 ]. Finally, regarding the literature selection criteria, we examined articles written in English and published since 2010, the year the cardio-oncology guidelines were announced, thereby excluding articles published before 2010.

This scoping review allowed data mapping according to the study design and chemotherapy regimens. The key messages included a type of CRCT, cardiac assessment, and in-depth information regarding the CRCT symptoms. There were approximately five typical CRCT symptoms, including dyspnea, chest pain, peripheral edema, fatigue, and palpitations, and the timing of symptom occurrence varied. The symptoms were assessed by patient-reported symptom presentation rather than using a symptom assessment tool. Therefore, developing and applying a CRCT-specific and user-friendly symptom assessment tool are expected to help healthcare providers and patients manage CRCT symptoms effectively.

Availability of data and materials

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, Vignat J, Gralow JR, Cardoso F, Siesling S, Soerjomataram I. Current and future burden of breast cancer: global statistics for 2020 and 2040. The Breast. 2022;66:15–23.

Article   PubMed   PubMed Central   Google Scholar  

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48.

Article   PubMed   Google Scholar  

Agha A, Wang X, Wang M, Lehrer EJ, Horn SR, Rosenberg JC, Trifiletti DM, Diaz R, Louie AV, Zaorsky NG. Long-term risk of death from heart disease among breast cancer patients. Front Cardiovasc Med. 2022;9: 784409.

Oikawa M, Ishida T, Takeishi Y. Cancer therapeutics-related cardiovascular dysfunction: Basic mechanisms and clinical manifestation. J Cardiol. 2023;81(3):253–9.

Piepoli MF, Adamo M, Barison A, Bestetti RB, Biegus J, Böhm M, Butler J, Carapetis J, Ceconi C, Chioncel O, et al. Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology. Eur J Heart Fail. 2022;24(1):143–68.

Chung R, Ghosh AK, Banerjee A: Cardiotoxicity: precision medicine with imprecise definitions. In., vol. 5: Archives of Disease in childhood; 2018: e000774.

Lyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): developed by the task force on cardio-oncology of the European Society of Cardiology (ESC). European Heart Journal - Cardiovascular Imaging. 2022;23(10):e333–465.

McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O et al: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022, 24(1):4-131.

Armenian SH, Lacchetti C, Lenihan D. Prevention and monitoring of cardiac dysfunction in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline Summary. J Oncol Pract. 2017;13(4):270–5.

Lanza O, Ferrera A, Reale S, Solfanelli G, Petrungaro M, Tini Melato G, Volpe M, Battistoni A: New insights on the toxicity on heart and vessels of breast cancer therapies. Med Sci (Basel) 2022, 10(2).

Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. CA Cancer J Clin. 2016;66(1):43–73.

Lee GA, Aktaa S, Baker E, Gale CP, Yaseen IF, Gulati G, Asteggiano R, Szmit S, Cohen-Solal A, Abdin A, et al. European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment. Eur Heart J Qual Care Clin Outcomes. 2022;9(1):1–7.

Alexandraki A, Papageorgiou E, Zacharia M, Keramida K, Papakonstantinou A, Cipolla CM, Tsekoura D, Naka K, Mazzocco K, Mauri D et al: New insights in the era of clinical biomarkers as potential predictors of systemic therapy-induced cardiotoxicity in women with breast cancer: a systematic review. Cancers (Basel) 2023, 15(13).

Di Lisi D, Manno G, Madaudo C, Filorizzo C, Intravaia RCM, Galassi AR, Incorvaia L, Russo A, Novo G: Chemotherapy-related cardiac dysfunction: the usefulness of myocardial work indices. Int J Cardiovasc Imaging 2023.

Kar J, Cohen MV, McQuiston SA, Malozzi CM. Can global longitudinal strain (GLS) with magnetic resonance prognosticate early cancer therapy-related cardiac dysfunction (CTRCD) in breast cancer patients, a prospective study? Magn Reson Imaging. 2023;97:68–81.

Article   CAS   PubMed   Google Scholar  

Lim A, Jang H, Jeon M, Fadol AP, Kim S. Cancer treatment-related cardiac dysfunction in breast cancer survivors: a retrospective descriptive study using electronic health records from a Korean tertiary hospital. Eur J Oncol Nurs. 2022;59: 102163.

Liu W, Li W, Li H, Li Z, Zhao P, Guo Z, Liu C, Sun L, Wang Z. Two-dimensional speckle tracking echocardiography help identify breast cancer therapeutics-related cardiac dysfunction. BMC Cardiovasc Disord. 2022;22(1):548.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Mauro C, Capone V, Cocchia R, Cademartiri F, Riccardi F, Arcopinto M, Alshahid M, Anwar K, Carafa M, Carbone A et al: Cardiovascular side effects of anthracyclines and HER2 inhibitors among patients with breast cancer: a multidisciplinary stepwise approach for prevention, early detection, and treatment. J Clin Med 2023, 12(6).

Okushi Y, Saijo Y, Yamada H, Toba H, Zheng R, Seno H, Takahashi T, Ise T, Yamaguchi K, Yagi S et al: Effectiveness of surveillance by echocardiography for cancer therapeutics-related cardiac dysfunction of patients with breast cancer. J Cardiol 2023.

Ositelu K, Trevino A, Tong A, Chen MH, Akhter N: Challenges in cardiovascular imaging in women with breast cancer. Curr Cardiol Rep 2023.

Terui Y, Sugimura K, Ota H, Tada H, Nochioka K, Sato H, Katsuta Y, Fujiwara J, Harada-Shoji N, Sato-Tadano A, et al. Usefulness of cardiac magnetic resonance for early detection of cancer therapeutics-related cardiac dysfunction in breast cancer patients. Int J Cardiol. 2023;371:472–9.

Thavendiranathan P, Shalmon T, Fan CS, Houbois C, Amir E, Thevakumaran Y, Somerset E, Malowany JM, Urzua-Fresno C, Yip P, et al. Comprehensive cardiovascular magnetic resonance tissue characterization and cardiotoxicity in women with breast cancer. JAMA Cardiol. 2023;8(6):524–34.

Trotti A, Colevas AD, Setser A, Basch E. Patient-reported outcomes and the evolution of adverse event reporting in oncology. J Clin Oncol. 2007;25(32):5121–7.

White J, Byles J, Williams T, Untaru R, Ngo DTM, Sverdlov AL. Early access to a cardio-oncology clinic in an Australian context: a qualitative exploration of patient experiences. Cardiooncology. 2022;8(1):14.

PubMed   PubMed Central   Google Scholar  

Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN, Rubin P: CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 2003, 13(3):176-181.

Basch E, Reeve BB, Mitchell SA, Clauser SB, Minasian LM, Dueck AC, Mendoza TR, Hay J, Atkinson TM, Abernethy AP et al: Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Natl Cancer Inst 2014, 106(9).

Kluetz PG, Chingos DT, Basch EM, Mitchell SA. Patient-reported outcomes in cancer clinical trials: measuring symptomatic adverse events with the National Cancer Institute’s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Am Soc Clin Oncol Educ Book. 2016;36:67–73.

Article   Google Scholar  

Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017;318(2):197–8.

Liu L, Suo T, Shen Y, Geng C, Song Z, Liu F, Wang J, Xie Y, Zhang Y, Tang T, et al. Clinicians versus patients subjective adverse events assessment: based on patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). Qual Life Res. 2020;29(11):3009–15.

Munn Z, Pollock D, Khalil H, Alexander L, Mclnerney P, Godfrey CM, Peters M, Tricco AC. What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evidence Synthesis. 2022;20(4):950–2.

Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005;8(1):19–32.

Peters M, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H: Chapter 11: scoping reviews (2020 version). In: JBI Manual for Evidence Synthesis. edn. Edited by Aromataris E MZ: JBI; 2020.

Munn Z, Peters MD, 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 medical research methodology. 2018;18:1–7.

Peters MDJ, Godfrey C, McInerney P, Khalil H, Larsen P, Marnie C, Pollock D, Tricco AC, Munn Z. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022;20(4):953–68.

Bohdan M, Kowalczys A, Mickiewicz A, Gruchala M, Lewicka E: Cancer therapy-related cardiovascular complications in clinical practice: current perspectives. J Clin Med 2021, 10(8).

Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm. 2013;10(12):1932–63.

Bozkurt B, Coats A, Tsutsui H: Universal definition and classification of heart failure. J Card Fail 2021.

Aldiab A. Cardiotoxicity with adjuvant trastuzumab use in breast cancer: a single institution»s experience. J Saudi Heart Assoc. 2010;22(3):133–6.

Russell SD, Blackwell KL, Lawrence J, Pippen JE Jr, Roe MT, Wood F, Paton V, Holmgren E, Mahaffey KW. Independent adjudication of symptomatic heart failure with the use of doxorubicin and cyclophosphamide followed by trastuzumab adjuvant therapy: a combined review of cardiac data from the National Surgical Adjuvant Breast and Bowel Project B-31 and the North Central Cancer Treatment Group N9831 clinical trials. J Clin Oncol. 2010;28(21):3416–21.

Polk A, Shahmarvand N, Vistisen K, Vaage-Nilsen M, Larsen FO, Schou M, Nielsen DL: Incidence and risk factors for capecitabine-induced symptomatic cardiotoxicity: a retrospective study of 452 consecutive patients with metastatic breast cancer. BMJ Open 2016, 6(10).

Clark RA, Marin TS, McCarthy AL, Bradley J, Grover S, Peters R, Karapetis CS, Atherton JJ, Koczwara B. Cardiotoxicity after cancer treatment: a process map of the patient treatment journey. Cardiooncology. 2019;5:14.

Anjos M, Fontes-Oliveira M, Costa VM, Santos M, Ferreira R. An update of the molecular mechanisms underlying doxorubicin plus trastuzumab induced cardiotoxicity. Life Sci. 2021;280: 119760.

Malik A, Brito D, Vaqar S, Chhabra L: Congestive heart failure. In: StatPearls. edn. Treasure Island (FL): StatPearls Publishing. Copyright © 2023, StatPearls Publishing LLC.; 2023.

Attin M, Reifenstein K, Mehta S, Arcoleo K, Lin CD, Storozynsky E. Reported signs, symptoms, and diagnostic tests before cardiotoxicity among women with breast cancer: a pilot study. J Cardiovasc Nurs. 2022;37(2):104–11.

Huang P, Dai S, Ye Z, Liu Y, Chen Z, Zheng Y, Shao X, Lei L, Wang X. Long-term tolerance and cardiac function in breast cancer patients receiving trastuzumab therapy. Oncotarget. 2017;8(2):2069–75.

Salyer J, Flattery M, Lyon DE. Heart failure symptom clusters and quality of life. Heart Lung. 2019;48(5):366–72.

Padegimas A, Carver JR. How to diagnose and manage patients with fluoropyrimidine-induced chest pain: a single center approach. JACC CardioOncol. 2020;2(4):650–4.

Sheth MA, Widmer RJ, Dandapantula HK. Pathobiology and evolving therapies of coronary artery vasospasm. Proc (Bayl Univ Med Cent). 2021;34(3):352–60.

PubMed   Google Scholar  

Hokimoto S, Kaikita K, Yasuda S, Tsujita K, Ishihara M, Matoba T, Matsuzawa Y, Mitsutake Y, Mitani Y, Murohara T, et al. JCS/CVIT/JCC 2023 guideline focused update on diagnosis and treatment of vasospastic angina (coronary spastic angina) and coronary microvascular dysfunction. J Cardiol. 2023;82(4):293–341.

Kanduri J, More LA, Godishala A, Asnani A. Fluoropyrimidine-associated cardiotoxicity. Cardiol Clin. 2019;37(4):399–405.

Garbis K, Rafiee MJ, Luu J. 5-fluorouracil-induced coronary vasospasm: a cardiovascular magnetic resonance imaging case report. Glob Cardiol Sci Pract. 2023;2023(3): e202316.

Dyhl-Polk A, Vaage-Nilsen M, Schou M, Vistisen KK, Lund CM, Kümler T, Appel JM, Nielsen DL. Incidence and risk markers of 5-fluorouracil and capecitabine cardiotoxicity in patients with colorectal cancer. Acta Oncol. 2020;59(4):475–83.

Becker K, Erckenbrecht JF, Häussinger D, Fueling T. Cardiotoxicity of the antiprolif erative compound fluorouracil. Drugs. 1999;57(4):475–84.

Lestuzzi C, Vaccher E, Talamini R, Lleshi A, Meneguzzo N, Viel E, Scalone S, Tartuferi L, Buonadonna A, Ejiofor L, Schmoll HJ. Effort myocardial ischemia during chemotherapy with 5-fluorouracil: an underestimated risk. Ann Oncol. 2014;25(5):1059–64.

Muco E, Patail H, Shaik A, McMahon S. Capecitabine-associated coronary vasospasm and cardiac arrest. Cureus. 2022;14(8): e28184.

Montemurro F, Mittica G, Cagnazzo C, Longo V, Berchialla P, Solinas G, Culotta P, Martinello R, Foresto M, Gallizioli S, et al. Self-evaluation of adjuvant chemotherapy-related adverse effects by patients with breast cancer. JAMA Oncol. 2016;2(4):445–52.

Atkinson TM, Ryan SJ, Bennett AV, Stover AM, Saracino RM, Rogak LJ, Jewell ST, Matsoukas K, Li Y, Basch E. The association between clinician-based common terminology criteria for adverse events (CTCAE) and patient-reported outcomes (PRO): a systematic review. Support Care Cancer. 2016;24(8):3669–76.

Galizia D, Milani A, Geuna E, Martinello R, Cagnazzo C, Foresto M, Longo V, Berchialla P, Solinas G, Calori A, et al. Self-evaluation of duration of adjuvant chemotherapy side effects in breast cancer patients: a prospective study. Cancer Med. 2018;7(9):4339–44.

Gavila J, Seguí M, Calvo L, López T, Alonso JJ, Farto M. Sánchez-de la Rosa R: Evaluation and management of chemotherapy-induced cardiotoxicity in breast cancer: a Delphi study. Clin Transl Oncol. 2017;19(1):91–104.

Leong DP, Lenihan DJ. Clinical practice guidelines in cardio-oncology. Heart Fail Clin. 2022;18(3):489–501.

Munn Z, Pollock D, Khalil H, Alexander L, McLnerney P, Godfrey CM, Peters M, Tricco AC. What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evid Synth. 2022;20(4):950–2.

Li YR, Jia Z, Zhu H. Understanding the value of case reports and studies in the context of clinical research, research design and evidence-based practice. J Case Reports and Studies. 2013;1(2):1–4.

Conn VS, Valentine JC, Cooper HM, Rantz MJ. Grey literature in meta-analyses. Nurs Res. 2003;52(4):256–61.

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Acknowledgements

The authors thank Nawon Kim, a librarian at the Yonsei University Medical Library, for building search terms and guiding the database searches.

This research is supported by the Brain Korea 21 FOUR Project founded by the National Research Foundation (NRF) of Korea, Yonsei University College of Nursing.

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HK, BH, SK, and JP contributed to the study conception and design. The literature search and record screening were performed by HK and BH under the supervision of JP. Material preparation, data collection, and analysis were performed by HK, BH, and JP. The first draft of the manuscript was written by HK and JP commented on each updated version of the manuscript. The tables and figures were prepared by BH under the instruction of JP. SK helped to interpret the data and provided critical feedback on the manuscript. All authors read and approved the final manuscript.

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Kim, H., Hong, B., Kim, S. et al. Chemotherapy-related cardiotoxicity and its symptoms in patients with breast cancer: a scoping review. Syst Rev 13 , 167 (2024). https://doi.org/10.1186/s13643-024-02588-z

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Enhancing urban–rural integration in china: a comparative case study of introducing small rural industries in huangyan-taizhou.

1. Introduction

2. literature review: urban–rural linkage and urban–rural integration, 3. methods and case selection, 3.1. mixed method research, 3.2. urban–rural interface as the focusing region for uri, 3.3. selected case region: taizhou in the yangtze river delta, 3.4. obtaining qualitative and quantitative data, 4. the changing role of rural industries in the trajectory of urbanisation in china, 4.1. an overview of relevant policies affecting rural industries, 4.2. inadequate rural land transfer limited rural industries, 4.3. rapid urban sprawl further ‘squeezed’ rural space for development, 4.4. transitory periods for rural industry development between the 1980s and 1990s, 4.5. small industries as the main approach of rural revitalisation guided by uri, 5. case study: village transformation under uri, 5.1. xiapuzheng village: driven by plastic manufacture and endogenous industry, 5.2. luoyu village: driven by industries related to global production chain, 5.3. waciyao village: driven by improvement in the physical environment and future rural tourism, 5.4. discussions, 6. conclusions, author contributions, data availability statement, acknowledgments, conflicts of interest, ethics statement.

• Remy, S.; Kago, J.; Zhang, X.Q.; Augustinus, C.; Tuts, R. Role of Urban–Rural Linkages in Promoting Sustainable Urbanization. Environ. Urban. ASIA 2014 , 5 , 219–234. [ Google Scholar ] [ CrossRef ]
• United Nations. Transforming Our World: The 2030 Agenda for Sustainable Development ; United Nations: New York, NY, USA, 2015. [ Google Scholar ]
• UN Habitat. Implementing the New Urban Agenda by Strengthening Urban-Rural Linkages—Leave no One and no Space Behind ; UN Habitat: Nairobi, Kenya, 2017. [ Google Scholar ]
• UN Habitat. Urban-Rural Linkages: Guiding Principles Framework for Action to Advance Integrated Territorial Development ; UN Habitat: Nairobi, Kenya, 2019; Available online: https://www.unccd.int/resources/manuals-and-guides/urban-rural-linkages-guiding-principles (accessed on 25 March 2024).
• Brenner, N. Introduction: Urban theory without an outside. In Implosions/Explosions: Towards a Study of Planetary Urbanization ; Academia: Prague, Czechoslovakia, 2014; Volume 17. [ Google Scholar ]
• The State Council of the PRC. The National Land Use Planning Framework ; Xinhua News Agency: Beijing, China, 2008.
• Liu, Y. Scientifically promoting the strategy of reclamation and readjustment of rural land in China. China Land Sci. 2011 , 25 , 3–8. [ Google Scholar ]
• Liu, Y.; Fang, F.; Li, Y. Key issues of land use in China and implications for policy making. Land Use Policy 2014 , 40 , 6–12. [ Google Scholar ] [ CrossRef ]
• Huang, H.; Yang, G.Q.; Misselwitz, P.; Langguth, H. Post-rural urbanisation andrural revitalisation: Can China learn from new planning approaches in contemporary Germany. City Plan. Rev. 2017 , 41 , 111–119. (In Chinese) [ Google Scholar ]
• Huang, H. Learning from exploratory rural practices of the Yangtze River Delta in China: New initiatives, networks and empowerment shifts, and sustainability. J. Rural. Stud. 2020 , 77 , 63–74. [ Google Scholar ] [ CrossRef ]
• CPC Central Committee and The State Council of the PRC. Opinions on Establishing and Improving the System, Mechanism and Policy System of Urban-Rural Integrated Development ; Xinhua News Agency: Beijing, China, 2019. (In Chinese)
• Lefebvre, H. The Urban Revolution ; University of Minnesota Press: Minneapolis, MN, USA, 2003. [ Google Scholar ]
• Brenner, N.; Madden, D.J.; Wachsmuth, D. Assemblage urbanism and the challenges of critical urban theory. City 2011 , 15 , 225–240. [ Google Scholar ] [ CrossRef ]
• Angelo, H. From the City Lens toward Urbanisation as a Way of Seeing: Country/City Binaries on an Urbanising Planet. Urban Stud. 2017 , 54 , 158–178. [ Google Scholar ] [ CrossRef ]
• Heley, J.; Jones, L. Relational rurals: Some thoughts on relating things and theory in rural studies. J. Rural. Stud. 2012 , 28 , 208–217. [ Google Scholar ] [ CrossRef ]
• Brenner, N.; Katsikis, N. Operational Landscapes: Hinterlands of the Capitalocene. Archit. Des. 2020 , 90 , 22–31. [ Google Scholar ] [ CrossRef ]
• López-Goyburu, P.; García-Montero, L.G. The Urban-Rural Interface as an Area with Characteristics of Its Own in Urban Planning: A Review. Sustain. Cities Soc. 2018 , 43 , 157–165. [ Google Scholar ] [ CrossRef ]
• de Bruin, S.; Dengerink, J.; van Vliet, J. Urbanisation as driver of food system transformation and opportunities for rural livelihoods. Food Sec. 2021 , 13 , 781–798. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Eakin, H.; DeFries, R.; Kerr, S.; Lambin, E.F.; Liu, J.; Marcotullio, P.J.; Messerli, P.; Reenberg, A.; Rueda, X.; Swaffield, S.R.; et al. Significance of telecoupling for exploration of land-use change. In Rethinking Global Land Use in an Urban Era ; Seto, K.C., Reenberg, A., Eds.; MIT Press: Cambridge, MA, USA, 2014; pp. 141–161. [ Google Scholar ]
• Gutu Sakketa, T. Urbanisation and rural development in sub-Saharan Africa: A review of pathways and impacts. Res. Glob. 2023 , 6 , 100133. [ Google Scholar ] [ CrossRef ]
• OECD (Organisation for Economic Co-operation and Development) & European Commission. Cities in the World: A New Perspective on Urbanization ; OECD: Paris, France, 2020. [ Google Scholar ] [ CrossRef ]
• Muffp—Milan Urban Food Policy Pact. Milan Urban Food Policy Pact and Framework for Action[EB/OL]. 2015. Available online: https://www.foodpolicymilano.org/en/the-text-of-the-milan-urban-food-policy-pact/ (accessed on 25 March 2024).
• Wolff, F.; Mederake, L.; Bleher, D.; Sosath, O.; Westphal, I. Rahmenbedingungen und Instrumente für Die Gestaltung Nachhaltiger Stadt-Land-Verknüpfungen[M/OL]. Im Auftrag des Umweltbundesamtes. 2019. Available online: https://www.umweltbundesamt.de/sites/default/files/medien/1410/publikationen/2019-08-15_texte_86-2019_run-bericht_ap3-1_3-2.pdf (accessed on 25 March 2024).
• United Nations. New Urban Agenda ; Habitat III Secretariat: Quito, Ecuador, 2017; ISBN 978-92-1-132731-1. [ Google Scholar ]
• Potts, D. Conflict and collisions in Sub-Saharan African urban definitions: Interpreting recent urbanization data from Kenya. World Dev. 2017 , 97 , 67–78. [ Google Scholar ] [ CrossRef ]
• Wineman, A.; Alia, D.Y.; Anderson, C.L. Definitions of “rural” and “urban” and understandings of economic transformation: Evidence from Tanzania. J. Rural. Stud. 2020 , 79 , 254–268. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Azmi, H.N.H.; Wijaya, B.; Wijaya, M.I.H.; Novandaya, Z.; Kurniawati, H. Mapping urban-rural linkage in promoting sustainable regional development to support rural creative economy entrepreneurs. IOP Conf. Ser. Earth Environ. Sci. 2021 , 887 , 012023. [ Google Scholar ] [ CrossRef ]
• Chen, C.; Yang, G.; Xu, H.; Wang, Y. Understanding Rural Development Driven by Small Local Industries and Its Planning Strategies: The Case of Zhejiang Province. Planners 2021 , 37 , 21–27. [ Google Scholar ]
• Yang, G. Rural Evolution: Reviewing the Rebirth of Traditional Rural Settlements from the Perspective of “Productivity-Spatial Form” Theory. J. Tongji Univ. (Soc. Sci. Ed.) 2022 , 33 , 66–73. [ Google Scholar ]
• Castillo, C.P.; van Heerden, S.; Barranco, R.; Jacobs-Crisioni, C.; Kompil, M.; Kučas, A.; Aurambout, J.P.; Silva, F.B.E.; Lavalle, C. Urban–rural continuum: An overview of their interactions and territorial disparities. Reg. Sci. Policy Pract. 2023 , 15 , 729–768. [ Google Scholar ] [ CrossRef ]
• Wang, M. Spatial Characteristics and Planning Strategies of Rural Industries Guided by Industrial Revitalization: A Case Study of the Urban Pastoral Complex in the Dongxihu District of Wuhan. City Plan. Rev. 2023 , 47 , 105–114. [ Google Scholar ]
• Wang, L.; Yang, G. The Mechanism of Socio-Spatial Evolution in Rural Areas Driven by the Development of the Planting Industry—A Case Study of Yuezhuang Village in Shandong Province, China. Land 2024 , 13 , 768. [ Google Scholar ] [ CrossRef ]
• UN-Habitat. Compendium of case studies. In For the Implementation of the “Urban-Rural Linkages”: Guiding Principles (URL-GP) and Framework for Action , 1st ed.; UN-Habitat: Nairobi, Kenya, 2020. [ Google Scholar ]
• UN-Habitat. Compendium of Inspiring Practices on Urban-Rural Linkages: Implementation of Guiding Principles and Framework for Action to Advance Integrated Territorial Development , 2nd ed.; (UN-Habitat: Nairobi, Kenya, 2021. [ Google Scholar ]
• UN-Habitat. Compendium of Inspiring Practices on Urban-Rural Linkages: Implementation of Guiding Principles and Framework for Action to Advance Integrated Territorial Development , 3rd ed.; UN-Habitat: Nairobi, Kenya, 2023. [ Google Scholar ]
• Liu, Y.; Zang, Y.; Yang, Y. China’s rural revitalization and development: Theory, technology and management. J. Geogr. Sci. 2020 , 30 , 1923–1942. [ Google Scholar ] [ CrossRef ]
• Li, Y. Urban–rural interaction patterns and dynamic land use: Implications for urban–rural integration in China. Reg. Environ. Change 2012 , 12 , 803–812. [ Google Scholar ] [ CrossRef ]
• Yang, Y.; Bao, W.; Wang, Y.; Liu, Y. Measurement of urban-rural integration level and its spatial differentiation in China in the new century. Habitat Int. 2021 , 117 , 102420. [ Google Scholar ] [ CrossRef ]
• Yan, J.; Chen, H.; Xia, F. Toward improved land elements for urban–rural integration: A cell concept of an urban–rural mixed community. Habitat Int. 2018 , 77 , 110–120. [ Google Scholar ] [ CrossRef ]
• Gong, H.; Tong, D.; Zhang, C.; Pan, X. Optimization of Comprehensive Land Consolidation Model under the Context of Urban-Rural Integration. Planners 2023 , 39 , 44–52. [ Google Scholar ]
• Luo, X.; Jin, X.; Liu, X.; Zhang, S.; Ying, S.; Zhou, Y. Mechanism and model of comprehensive land consolidation promoting urban-rural integration in peri-urban from the perspective of symbiosis theory. J. Nat. Resour. 2024 , 39 , 1053–1067. [ Google Scholar ] [ CrossRef ]
• Guo, M.; Lu, X.; Ma, Q.; Qiu, L. Review and Prospect of Settlement System in County Territory Under the Background of Urban Rural Integration. Dev. Small Cities Towns 2023 , 41 , 5–11. [ Google Scholar ]
• Wang, J.; Sun, S.; Xu, M.; Li, S.; Wu, X. Analysis on Refined Construction of Public Facilities in Agglomeration and Upgrading Villages Based on Resident Demand: A Case Study of Dongying District, Dongying City. Urban Dev. Stud. 2022 , 29 , 112–118. [ Google Scholar ]
• Wang, L.; Huang, H.; Yang, G. Research on Rural Revitalization Driven by Agricultural Headquarters from a Network Perspective: A Case Study in Huangyan District, Zhejiang Province. Dev. Small Cities Towns 2024 , 42 , 55–61. [ Google Scholar ]
• He, X.; Yan, Y. Differentiation Characteristics, Influencing Factors and Zoning Optimization of County Digital Village. Geogr. Geo-Inf. Sci. 2024 , 40 , 88–95. [ Google Scholar ]
• Li, X.; Ma, X.D.; Khuong, M.H.; Zhu, J.Y. Dynamic mechanism of rural development oriented urban-rural integration. J. Nat. Resour. 2020 , 35 , 1926–1939. [ Google Scholar ]
• Zhao, Y.; Zhang, F.; Li, Q. The path of rural revitalisation in rapidly urbanising area: The case of Southern Jiangsu Provice. Urban Forum 2018 , 2 , 98–105. [ Google Scholar ] [ CrossRef ]
• Luo, Z. E-garden city: Reconstruction of urbanization theory in the mobile internet era. City Plan. Rev. 2020 , 44 , 9–16. [ Google Scholar ]
• Wu, Z. Research on the Realistic Path of How to Promote the coordinated Development of Rural Revitalization Strategy and New Urbanization in Typical Resource-based Cities. Mod. Agric. Res. 2024 , 30 , 41–43. [ Google Scholar ]
• Shortall, S.; Brown, D.L. Guest editorial for special issue on rural inequalities: Thinking about rural inequalities as a cross-national research project. J. Rural. Stud. 2019 , 68 , 213–218. [ Google Scholar ] [ CrossRef ]
• Phillipson, J.; Tiwasing, P.; Gorton, M.; Maioli, S.; Newbery, R.; Turner, R. Shining a spotlight on small rural businesses: How does their performance compare with urban? J. Rural. Stud. 2019 , 68 , 230–239. [ Google Scholar ] [ CrossRef ]
• Spinney, J.E. Mobile positioning and LBS applications. Geography 2003 , 88 , 256–265. [ Google Scholar ]
• Sadoun, B.; Al-Bayari, O. LBS and GIS technology combination and applications. In Proceedings of the 2007 IEEE/ACS International Conference on Computer Systems and Applications, Amman, Jordan, 13–16 May 2007; pp. 578–583. [ Google Scholar ]
• Lynam, A.; Li, F.; Xiao, G.; Fei, L.; Huang, H.; Utzig, L. Capturing socio-spatial inequality in planetary urbanisation: A multi-dimensional methodological framework. Cities 2023 , 132 , 104076. [ Google Scholar ] [ CrossRef ]
• Ros-Tonen, M.; Pouw, N.; Bavinck, M. Governing beyond cities: The urban-rural interface. In Geographies of Urban Governance: Advanced Theories, Methods and Practices ; Springer International Publishers: New York, NY, USA, 2015; pp. 85–105. [ Google Scholar ]
• Hiner, C.C. Beyond the edge and in between:(Re) conceptualizing the rural–urban interface as meaning–model–metaphor. Prof. Geogr. 2016 , 68 , 520–532. [ Google Scholar ] [ CrossRef ]
• Ortiz-Báez, P.; Cabrera-Barona, P.; Bogaert, J. Characterizing landscape patterns in urban-rural interfaces. J. Urban Manag. 2021 , 10 , 46–56. [ Google Scholar ] [ CrossRef ]
• Wu, Z.; Li, D. Principles of Urban and Rural Planning ; China Architecture Publishing & Media Co., Ltd.: Beijing, China, 2010. [ Google Scholar ]
• The Standing Committee of National People’s Congress. Land Administration Law of the People’s Republic of China. 2019. Available online: http://www.npc.gov.cn/npc/c2/c30834/201909/t20190905_300663.html (accessed on 25 March 2024).
• Zhejiang Provincial Development and Reform Commission. The 14th Five-Year Plan for the Development of New Urbanization in Zhejiang Province. 2021. Available online: https://www.zj.gov.cn/art/2021/5/31/art_1229505857_2302659.html (accessed on 30 May 2024).
• National Development and Reform Commission (NDRC). Notice on Carrying Out the Work of the National Pilot Zone for Integrated Urban and Rural Development ; NDRC: Beijing, China, 2019. (In Chinese)
• Han, J. Prioritizing Agricultural, Rural Development and Implementing the Rural Revitalization Strategy. China Agric. Econ. Rev. 2020 , 12 , 14–19. [ Google Scholar ] [ CrossRef ]
• Ke, M.; Huang, Y.; Pan, Y.; Luo, C. Research on Building Urban-rural Integration Node in the Merged Township Government Resident Market Town Under the Background of Common Prosperity: A Case of Zhejiang Province. Dev. Small Cities Towns 2024 , 42 , 83–91. [ Google Scholar ]
• Wang, Y.; Zhu, Y.; Yu, M. Evaluation and Determinants of Satisfaction with Rural Livability in China’s Less-Developed Eastern Areas: A Case Study of Xianju County in Zhejiang Province. Ecol. Indic. 2019 , 104 , 711–722. [ Google Scholar ] [ CrossRef ]
• Taizhou Survey Team of the National Bureau of Statistics. A Study on the High-Quality Development of Private Economy in Taizhou: Based on a Comparative Analysis of Taizhou, Jiaxing and Jinhua. Available online: https://www.zjtz.gov.cn/art/2022/11/29/art_1229207956_3835358.html (accessed on 30 May 2024).
• National Bureau of Statistics. China Statistical Yearbook ; China Statistic Press: Beijing, China, 2021. [ Google Scholar ]
• Office of the Leading Group of the State Council for the Seventh National Population Census. Major Figures on 2020 Population Census of China ; China Statistics Press: Beijing, China, 2021. (In Chinese) [ Google Scholar ]
• Harvey, D. The Condition of Postmodernity: An Enquiry into the Origins of Cultural Change ; Wiley-Blackwell: Oxford, UK; Cambridge, MA, USA, 1991. [ Google Scholar ]
• Zhang, W.; Chong, Z.; Li, X.; Nie, G. Spatial Patterns and Determinant Factors of Population Flow Networks in China: Analysis on Tencent Location Big Data. Cities 2020 , 99 , 102640. [ Google Scholar ] [ CrossRef ]
• Luo, J.; Zhang, X.; Wu, Y.; Shen, J.; Shen, L.; Xing, X. Urban Land Expansion and the Floating Population in China: For Production or for Living? Cities 2018 , 74 , 219–228. [ Google Scholar ] [ CrossRef ]
• Zhang, Z.; Lu, Y. China’s Urban-Rural Relationship: Evolution and Prospects. China Agric. Econ. Rev. 2018 , 10 , 260–276. [ Google Scholar ] [ CrossRef ]
• Zhu, C.; Zhang, X.; Wang, K.; Yuan, S.; Yang, L.; Skitmore, M. Urban–Rural Construction Land Transition and Its Coupling Relationship with Population Flow in China’s Urban Agglomeration Region. Cities 2020 , 101 , 102701. [ Google Scholar ] [ CrossRef ]
• Li, Y. Urban-Rural Interaction in China: Historic Scenario and Assessment. China Agric. Econ. Rev. 2011 , 3 , 335–349. [ Google Scholar ] [ CrossRef ]
• Liu, S. The reform of rural land system: From the household contract responsibility system to the separation of three rights. Econ. Res. J. 2022 , 57 , 18–26. [ Google Scholar ]
• Zhang, Y.-Q. Dilemma of China’s Urbanization and Land Expropriation—Based on the Farmland Property Rights of Thinking. J. Northwest AF Univ. (Soc. Sci. Ed.) 2014 , 14 , 16–31. (In Chinese) [ Google Scholar ] [ CrossRef ]
• Xing, Z.; Chen, Y.; Deng, C. The Evolution and Enlightenment of Urban-Rural Relations of the PRC from 1949 to 2019. Reform 2019 , 6 , 20–31. [ Google Scholar ]
• The State Council of the PRC. Notice on Further Deepening the Reform of Urban Housing System and Accelerating Housing Construction ; People’s Daily: Beijing, China, 1998. (In Chinese) [ Google Scholar ]
• Fei, X. Urban-Rural Development in China-My Lifetime Reasearch Project. Chin. J. Sociol. 1993 , 01 , 3–13. [ Google Scholar ]
• Xu, S. A review of the impact of urban-rural relations on rural areas and farmers. Rural. Econ. Sci.-Technol. 2014 , 25 , 122–125. [ Google Scholar ]
• General Office of the State Council of the People’s Republic of China. Notice on Cleaning Up and Rectifying Various Development Zones and Strengthening the Management of Construction Land. 2003. Available online: http://www.gov.cn/zwgk/2005-08/14/content_22445.htm (accessed on 25 March 2024). (In Chinese)
• CPC Central Committee. Suggestions for the 11th Five-Year Plan ; CPC Central Committee: Beijing, China, 2005. (In Chinese) [ Google Scholar ]
• Yang, R.; Yang, Q. Restructuring the State: Policy Transition of Construction Land Supply in Urban and Rural China. Land 2021 , 10 , 1–17. [ Google Scholar ] [ CrossRef ]
• Hu, J. Report to the Eighteenth National Congress of the Communist Party of China: Family March on the Path of Socialism with Chinese Characteristics and Strive to Complete the Building of a Moderately Prosperous Society in All Respects. 2012. Available online: https://www.gov.cn/ldhd/2012-11/17/content_2268826.htm (accessed on 25 March 2024). (In Chinese)
• CPC Central Committee and The State Council of the PRC. Strategy for Rural Revitalization (2018–2022) ; Xinhua News Agency: Beijing, China, 2018. (In Chinese)
• Cheng, H.; Yang, Z.; Liu, S.J. Rural Stay: A New Type of Rural Tourism in China. J. Travel Tour. Mark. 2020 , 37 , 711–726. [ Google Scholar ] [ CrossRef ]
• Lin, J.; Li, H.; Lin, M.; Li, C. Rural e-commerce in China: Spatial dynamics of Taobao Villages development in Zhejiang Province. Growth Change Grow 2021 , 53 , 12560. [ Google Scholar ] [ CrossRef ]
• Crang, M.; Zhang, J. Transient Dwelling: Trains as Places of Identification for the Floating Population of China. Soc. Cult. Geogr. 2012 , 13 , 895–914. [ Google Scholar ] [ CrossRef ]
• Liu, Y. Research on the urban-rural integration and rural revitalization in the new era in China. Acta Geogr. Sin. 2018 , 73 , 637–650. [ Google Scholar ]
• Yang, G. Multiple Approaches of Rural Revitalization from the Viewpoint of Urban-rural Co-construction. Planners 2019 , 35 , 5–10. [ Google Scholar ]
• Fang, C. Theoretical analysis on the mechanism and evolution law of urban-rural integration development. Acta Geogr. Sin. 2022 , 77 , 759–776. [ Google Scholar ]
• Mubangizi, B. What is ‘Rural’ in South Africa, and Why Does it Matter? Afr. J. Gov. Dev. 2023 , 12 , 1–6. [ Google Scholar ] [ CrossRef ]

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Huang, H.; Song, D.; Wang, L.; Yang, G.; Wang, Y.; Fei, L.; Lynam, A. Enhancing Urban–Rural Integration in China: A Comparative Case Study of Introducing Small Rural Industries in Huangyan-Taizhou. Land 2024 , 13 , 946. https://doi.org/10.3390/land13070946

Huang H, Song D, Wang L, Yang G, Wang Y, Fei L, Lynam A. Enhancing Urban–Rural Integration in China: A Comparative Case Study of Introducing Small Rural Industries in Huangyan-Taizhou. Land . 2024; 13(7):946. https://doi.org/10.3390/land13070946

Huang, Huang, Daijun Song, Liyao Wang, Guiqing Yang, Yizheng Wang, Liyuan Fei, and Ava Lynam. 2024. "Enhancing Urban–Rural Integration in China: A Comparative Case Study of Introducing Small Rural Industries in Huangyan-Taizhou" Land 13, no. 7: 946. https://doi.org/10.3390/land13070946

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• DOI: 10.3389/fimmu.2024.1424243
• Corpus ID: 270551901

Paraneoplastic neuromyelitis optica spectrum disorder associated with ovarian dysgerminoma: a case report and literature review

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