NARRATIVE VS. SYSTEMATIC VS. SCOPING REVIEWS: METHODOLOGICAL DIFFERENCES
High-quality literature reviews are not only an integral component of evidence generation but also of evidence synthesis. In the realm of evidence synthesis, systematic reviews have traditionally been regarded as the gold standard due to their rigorous methodology and clear focus.[1] Over the last decade, India has seen a growing emphasis on conducting systematic reviews in public health. Since 2014, there has been a notable increase in the use of systematic review evidence to inform national health program guidelines.[2] Apart from systematic review, the other popular type is narrative review, mainly due to its flexibility.[3] Many narrative reviews have been published in Indian journals, providing expert overviews on various topics, albeit with less formal methodology.[3,4]
In contrast, scoping reviews, which aim to map the breadth of literature on a broad question, remain relatively rare in Indian public health research. A scan of leading Indian public health journals suggests that only a handful of scoping review articles have been published in recent years, especially when compared to the number of systematic and narrative reviews. For example, the Indian Journal of Community Medicine only began publishing scoping reviews in the past few years, covering topics such as e-health programs[5] and maternal health literacy.[6] The Indian Journal of Public Health has featured scoping reviews on specific issues, such as hypertension interventions[7] and snakebite management, only in special issues or supplements.[8] This editorial examines the differences between systematic, scoping, and narrative reviews and debates why scoping reviews are underrepresented in Indian public health literature despite their potential value for guiding research and policy.
Narrative vs. systematic vs. scoping reviews: Methodological differences
Narrative reviews, also known as traditional or literature reviews, are the most flexible and least structured of the three. A narrative review is typically an expert-driven overview of a topic without a predetermined comprehensive search strategy or a formal appraisal of all available evidence. A narrative review lacks a specified protocol or search strategy; it is guided solely by the author’s area of interest, which allows for a broad, interpretive summary but not a reproducible or exhaustive one.[4] Narrative reviews help provide context, discuss opinions, and synthesize literature in a conversational, readily digestible manner.[3] They often leverage the perspective of an experienced author to highlight important aspects of a topic, which can be valuable for readers, for example, busy clinicians seeking a quick overview.[3] However, because they do not follow a systematic method, narrative reviews are inherently prone to selection bias and lack transparency.[3,4] The evidence included is at the discretion of the author, which means essential studies could be overlooked, and the conclusions may reflect the author’s viewpoint more than the totality of data. In summary, narrative reviews offer breadth and expert insight, scoping reviews offer structured mapping of broad terrains, and systematic reviews offer focused, rigorously filtered synthesis.
Systematic reviews, on the contrary, attempt to answer a focused research question by comprehensively and systematically searching for all relevant high-quality studies and critically appraising and synthesizing their results. They follow predefined protocols, which are registered in advance, and adhere to reporting standards such as PRISMA. By design, a systematic review narrows in on a specific issue, for example, the effect of a particular intervention on an outcome, and uses explicit, reproducible methods to minimize bias.[4] Systematic reviews occupy the top of the evidence hierarchy and are widely used to inform clinical and public health guidelines.[2,4] However, because of their tubular scope and strict inclusion criteria, systematic reviews may not fully capture multifaceted or emerging issues. They can end up excluding contextually critical studies and often cannot address broad or exploratory questions.[3]
Scoping reviews, in contrast, are designed for broader exploration. As one definition puts it, “a scoping review is a preliminary assessment of the potential size and scope of available literature on a topic. It aims to identify the nature and extent of research evidence, including ongoing studies, and provide an overview of a potentially large and diverse body of literature.”[4] Scoping reviews also employ systematic search strategies and transparent inclusion criteria, but they typically address open-ended or wide-ranging questions rather than testing a specific hypothesis. They are beneficial for mapping key concepts, gaps in evidence, types of available evidence, and research gaps on a given topic.[9] Further, methodological guidance such as the PRISMA-ScR extension in 2018 has solidified standards for conducting and reporting scoping reviews similar to how PRISMA guides systematic reviews, indicating the approach’s growing legitimacy.[10] Importantly, scoping reviews usually do not appraise the in-depth quality of studies or can culminate in meta-analysis; instead, they chart the literature to reveal patterns or scope. Omitting formal risk-of-bias assessment is a standard feature and is not expected to be reported under PRSIMA-ScR guidelines.[7,10]
Types of reviews published in selected Indian Public Health Journals
In the Indian public health research landscape, systematic reviews and narrative reviews have predominated, while scoping reviews have been comparatively scarce. The push for evidence-based healthcare over the past 15 years in India, catalyzed by organizations such as Cochrane and the Indian Council of Medical Research, led to a surge in systematic reviews addressing public health questions. Many Indian researchers have been trained in systematic review methods, and as a result, systematic reviews are frequently published in both international and national journals. These reviews have also penetrated policy circles, especially after 2014, as highlighted by a recent analysis of National Health Program guidelines (2007–2021), in areas such as maternal and child health, communicable disease control, and health systems.[2] It is now common to find systematic reviews either conducted by Indian teams or cited in Indian health policy documents, underscoring their recognized importance.[2,5,6,7]
Narrative reviews have likewise remained popular in Indian journals, likely due to their accessibility. It is not unusual to see an issue of an Indian journal carry a narrative overview on a timely topic authored by a senior expert. Such articles are generally well-received for continuing education. Narrative reviews can distil expert perspectives and even highlight practical insights that a rigid systematic review might miss.[3] Thus, the narrative format persists alongside more rigorous approaches.
Against this backdrop, scoping reviews have been scarce. A review of publications in two major Indian public health journals over the last decade illustrates the point. Only in the past few years did IJCM start featuring occasional scoping review articles, which are systematically done. For instance, in 2021, IJCM published a scoping review on approaches to evaluating e-health programs,[5] which explicitly followed the Arksey and O’Malley framework for scoping studies. Later, a few more scoping reviews appeared, such as one exploring parental influence on marriage stability,[11] another examining maternal health literacy outcomes,[6] and another exploring a multisectoral response to oxygen demand in the COVID pandemic.[12] Similarly, the Indian Journal of Public Health has only a handful of scoping reviews in its archive. Notably, a 2023 supplement of IJPH included a scoping review compiling evidence on hypertension prevention and control in India,[7] and another on epidemiological factors of snakebite envenomation in India.[8] Both aimed at broadly mapping available studies to inform program strategies. Outside of these instances, however, one would be hard-pressed to find many scoping review articles in Indian public health literature. The vast majority of “review” articles in Indian journals are either narrative discussions or systematic reviews, with scoping reviews comprising only a small fraction.
This discrepancy is also evident in academic training and output. Many doctoral and postgraduate students in community medicine or public health in India are now encouraged to undertake systematic reviews or meta-analyses as part of their dissertations, and narrative literature reviews are commonly included in thesis introductions. Scoping reviews, on the contrary, are rarely part of academic curricula or thesis work, pointing to a gap in awareness and mentorship. Even when Indian researchers conduct scoping reviews on topics relevant to India, they often publish them in international journals rather than Indian journals, possibly because they perceive international forums as more familiar with or welcoming of the scoping review format. The net result is that within domestic publications, scoping reviews remain an underutilized approach.
Why are scoping reviews underutilized in India?
Several factors may explain the low prevalence of scoping reviews in Indian public health research:
Relatively new concept and poor acceptability of scoping reviews: The concept of scoping reviews gained traction only in the past two decades globally, with formal guidance such as PRISMA-ScR and JBI manuals emerging around 2015–2018. By this time, Indian researchers were already well-versed with systematic reviews, but scoping review training lagged behind. In short, the scoping methodology is a relatively new concept, and many scholars, public health researchers, and practitioners in India are less familiar with the same. There are far fewer workshops or courses on “how to do a scoping review” compared to the numerous trainings on systematic review methodology. This awareness gap means researchers might not consider a scoping review even when it would be appropriate.
Preference for established formats: Both authors and journals may prefer established review formats for the sake of credibility. Systematic reviews, being seen as high rigor, carry academic prestige, often counting toward promotions or funding credentials, while narrative reviews are a long-standing tradition for expressing expert opinions. Scoping reviews, situated between systematic reviews and narrative reviews, might be perceived as neither as prestigious as a systematic review, as they generally do not yield a definitive answer or practice-changing conclusion, nor as easy to write as a narrative review. This middle-ground status can make scoping reviews a harder sell. Few reviewers or editors unfamiliar with scoping methods might even critique a scoping review submission for lacking a meta-analysis or for not assessing bias, mistakenly viewing it as a flawed systematic review rather than a different design. Such misunderstandings could have discouraged some authors from pursuing scoping reviews.
Resource and time constraints: Conducting a scoping review with proper methodology can be quite resource-intensive, sometimes almost as much effort as a systematic review, but without the clear “answer” or quantitative synthesis at the end. In Indian research settings, which often have limited manpower and library resources, it may be challenging to invest in a scoping review unless there is a clear payoff. Researchers may debate that if scoping reviews also need an extensive search, why not perform a full systematic review and attempt a meta-analysis? This calculus can tilt people either toward doing a full systematic review for a narrow question or, if the question is too broad, toward doing a simpler narrative summary. The distinct value-add of a scoping review, that is, systematically mapping a broad topic, might not be immediately evident to those weighing the effort versus the reward.
Journal policies and indexing: Indian public health and community medicine journals historically lacked a separate article category for scoping reviews. They typically categorize articles simply as “Review Article,” without differentiation. An author might worry that a scoping review could be lumped in with narrative reviews and not appreciated for its methodology. Moreover, if journals or reviewers expect to see assessments of study quality, a scoping review’s omission of quality appraisal could be viewed negatively.
Academic incentives: In the Indian academic system, systematic reviews and meta-analyses are often highly valued for their contributions to science and can attract citations, thereby boosting an author’s profile. Narrative reviews by senior authors are valued for showcasing expertise. Scoping reviews, unless they break new ground on a highly contentious topic, may be perceived as less impactful. Even the NMC guidelines for promotion are restricted to original studies, case series, and systematic reviews and meta-analyses. Hence, scoping reviews are not as popular among junior researchers and mid-career academic professionals.
In summary, a combination of poor awareness, entrenched preferences, and perceived lower payoff has kept scoping reviews on the margins of Indian public health literature so far.
Are scoping reviews for public health the need of the hour?
The well-documented underrepresentation of scoping reviews in Indian journals is unfortunate because this format offers distinct advantages that address some gaps in the evidence synthesis ecosystem. Scoping reviews are particularly well-suited to public health and community medicine research in the following ways:
Ease of mapping of complex issues: Public health issues are often complex and multifactorial, for example, social determinants of health, health system strengthening, and environmental health challenges. Scoping reviews enable researchers to cast a wide net and capture diverse forms of evidence, ranging from epidemiological studies to program evaluations and policy documents, providing a comprehensive “big picture” view. This is valuable in identifying which aspects of an issue are well-studied versus those that present knowledge gaps.[9] For instance, if policymakers want to understand the landscape of research on air pollution and health in India, a scoping review could map out all studies on health effects, interventions, policies, and public perceptions related to air pollution, something a narrow systematic review cannot do. In this way, scoping reviews can inform research prioritization by highlighting which subtopics have abundant evidence and which are under-researched.
Flexibility in including various study designs: Unlike classical systematic reviews, which may focus only on RCTs or a specific study type, scoping reviews typically include multiple levels of evidence, such as qualitative studies, quantitative studies, and grey literature, to comprehensively cover a topic.[9] This inclusive approach is crucial in public health, where evidence may come from diverse sources. For example, to collate evidence on the inclusion of post-organ transplant care under India’s National Health Insurance scheme, one might need to include policy analyses, operational research studies, qualitative interviews, and economic evaluations. Scoping reviews encompass such a wide range, painting a richer picture that can inform multifaceted policy decisions.
Informing policy and program development: Scoping reviews can directly support policymakers by collating all relevant information on broad policy questions. While scoping reviews do not necessarily provide an explanation and simple answer, as they do not evaluate interventions the way systematic reviews do, they serve as an evidence map for decision-makers. In India’s context, where policymakers often have to make decisions in areas that are not backed by Cochrane-style evidence, scoping reviews can bridge the gap. For example, before rolling out a new public health program, officials could commission a scoping review to learn about the strategies that have been tried in similar contexts, the existing guidelines or models, and the documented barriers. Indeed, globally scoping reviews have been recognized as useful in setting research agendas and even guiding funding by identifying what is known and not known on a topic.[9] By summarizing broad evidence in an accessible way, scoping reviews in Indian public health could help ensure that policies are informed by the totality of knowledge, including local studies, dissertations, policy briefs, and reports, often left out of international syntheses.
Foundation for Future Research: Another value of scoping reviews is that they often lay the groundwork for more focused studies. They can reveal, for instance, that while some aspects of a problem have been systematically reviewed, others have not, thereby justifying new systematic reviews or primary research in those areas. Many scoping reviews conclude with recommendations on the types of studies that should be conducted next. In the Indian scenario, where research resources are limited, utilizing scoping reviews to direct those resources efficiently is prudent. For example, a scoping review on “models of palliative care in India” could show that plenty of studies exist on palliative care programs but very few on delivering palliative care in primary health care settings, suggesting a clear direction for upcoming research efforts.
Engaging Stakeholders: Scoping reviews often involve consultation with stakeholders as an optional step, such as per Arksey and O’Malley’s framework, to ensure the findings resonate with real-world needs. This aspect aligns well with public health practices in India, where community and stakeholder engagement are crucial. By involving program implementers or community representatives in interpreting broad evidence, scoping reviews can make research more connected to on-ground realities.
Ultimately, the strength of scoping reviews lies in breadth and utility. They might not provide a definitive answer like a well-conducted systematic review with meta-analysis would, but they provide context and comprehensive coverage. In a country as large and diverse as India, with wide-ranging public health challenges, there is clear value in systematically mapping evidence in areas such as traditional medicine use, climate change and health, one health, and many other domains. Scoping studies can help Indian public health researchers and policymakers see the forest for the trees.
CONCLUSION AND WAY FORWARD
The low prevalence of scoping reviews in Indian public health literature is a gap that needs to be addressed. As we have discussed, scoping reviews occupy an important niche alongside systematic and narrative reviews. They enable researchers to systematically explore broad questions and inform high-level decision-making functions that are increasingly important for tackling complex health issues. The underutilization in India appears to stem largely from historical and awareness factors, rather than a lack of relevance. Encouragingly, we are starting to see positive changes: a few Indian journals have begun publishing scoping reviews on topics of national importance, and methodological guidance is more accessible now than ever.
To build on this momentum, the public health research community in India can take several steps. Capacity building is key; integrating scoping review methodology into research methods workshops, medical curricula, and guideline development training will demystify this approach for investigators. Journals and peer reviewers should also be sensitized to the purpose and proper appraisal of scoping reviews so that well-conducted scoping studies are recognized and not held to inappropriate criteria. The editorial boards of Indian journals could explicitly welcome scoping review submissions in their instructions to authors, signaling that these are valued contributions. Funding agencies and academic leaders might consider supporting scoping reviews on priority health topics as standalone projects or as preliminary phases of larger projects, thereby legitimizing them further.
Most importantly, Indian researchers should recognize when a scoping review is the right tool for the job. Not every question requires the narrow lens of a systematic review; some warrant a wider gaze. For instance, as India works toward Sustainable Development Goals or universal health coverage, many research questions will be broad (e.g., “What strategies have been tried to improve X?”, “What is known about Y in diverse contexts?”), where scoping reviews are ideal. By embracing scoping reviews for such purposes, we can generate comprehensive evidence overviews that guide both policy and future research more effectively. As Khalil et al. (2025)[9] noted, when performed rigorously, “scoping reviews are potentially helpful in determining the gap in the evidence pool and identifying new and relevant research priorities”- a potential which should be harnessed in public health sector in India.
In conclusion, it is time for the Indian public health community to add scoping reviews to its toolkit in a bigger way. They are not a replacement for systematic reviews or narrative reviews; rather, they complement them, filling a critical gap in evidence synthesis. By increasing the uptake of scoping reviews, we can ensure that our understanding of public health challenges is as comprehensive and strategic as possible. This will ultimately strengthen evidence-informed public health practice and policy in India. As authors and editors, let us encourage more scoping reviews in our journals and more discussions about them in our conferences and classrooms. The result will be a richer, more nuanced evidence base to support the health of India’s people.
REFERENCES
- 1.Rother ET. Systematic literature review X narrative review. Acta Paul Enferm. 2007;20:v–vi. [Google Scholar]
- 2.Rajwar E, Pundir P, Parsekar SS, S AD, B D SR, Nayak BS, et al. The utilization of systematic review evidence in formulating India’s National Health Programme guidelines between 2007 and 2021. Health Policy Plan. 2023;38:435–53. doi: 10.1093/heapol/czad008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Sarkar S, Bhatia G. Writing and appraising narrative reviews. J Clin Sci Res. 2021;10:169–72. [Google Scholar]
- 4.Nundy S, Kakar A, Bhutta ZA. Systematic, scoping and narrative reviews. How to practice academic medicine and publish from developing countries? A Practical Guide. 2021. pp. 277–81. Available from: https://link.springer.com/chapter/10.1007/978-981-16-5248-6_29 . [Last accessed on 2025 Jul 04]
- 5.Joshi N, Bhardwaj P, Saxena D, Suthar P, Joshi V. Approaches to assess e-health programs: A scoping review. Indian J Commun Med. 2021;46:374–9. doi: 10.4103/ijcm.IJCM_340_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Chandrakar A, Ramasamy S, Galhotra A, Shenoy MS. Maternal Health Literacy (MHL) for improved maternal and child outcomes: A scoping review. Indian J Commun Med. 2025 doi: 10.4103/ijcm.ijcm_390_24. [Google Scholar]
- 7.Pawar P, Mukherjee R, Mohapatra A, Sharma D. A scoping review of interventions for prevention and control of hypertension in India. Indian J Public Health. 2023;67:41–9. doi: 10.4103/ijph.ijph_673_23. [DOI] [PubMed] [Google Scholar]
- 8.Saha S, Behera S, Kotekar SU, Hameed S, Vyas N. A scoping review on epidemiological risk factors and treatment modalities for snakebites in India. Indian Journal of Public Health. 2025;69:203–10. doi: 10.4103/ijph.ijph_824_24. [DOI] [PubMed] [Google Scholar]
- 9.Khalil H, Jia R, Moraes EB, Munn Z, Alexander L, Peters MDJ, et al. Scoping reviews and their role in identifying research priorities. J Clin Epidemiol. 2025;1(181):111712. doi: 10.1016/j.jclinepi.2025.111712. [DOI] [PubMed] [Google Scholar]
- 10.Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169:467–73. doi: 10.7326/M18-0850. [DOI] [PubMed] [Google Scholar]
- 11.Singh A, Shanbhag T. Parental interference and marital stability: A scoping review of sociocultural influences on Indian families. Indian J Community Med. 2025 doi: 10.4103/ijcm.ijcm_470_24. [Google Scholar]
- 12.Mirza M, Verma M, Sahoo S, Roy S, Kakkar R, Singh D. India’s multi-sectoral response to oxygen surge demand during COVID-19 pandemic: A scoping review. Indian J Community Med. 2023;48:31–40. doi: 10.4103/ijcm.ijcm_665_22. [DOI] [PMC free article] [PubMed] [Google Scholar]