Characteristics of realist synthesis reviews: a systematic mapping review of realist reviews

Tags: Oral
Berg RC1, Nanavati J2
1Norwegian Knowledge Centre for the Health Services, Norway, 2Loyola/Notre Dame Library, USA


Realist synthesis reviews are a new type of literature review that aims to provide an explanatory analysis of how and why complex social interventions work, or don’t work, in particular contexts or settings. A realist review is explicitly concerned with the context-mechanisms-outcomes configurations that underlie interventions.


To describe, with regard to realist reviews, how much has been done, in what areas, what are the methodological characteristics and what are the opportunities and challenges for its methodological standardization and wider use.


A systematic mapping review approach, which captures and describes the literature in one specific field of study, is used. Systematic searches are conducted in electronic databases (The Cochrane Library, MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO), relevant websites and listservs are examined and experts contacted. Study selection is performed by two reviewers independently and data extraction is performed by one reviewer and checked by a second. For each included review, details of the methodological process are extracted, and descriptive analyses are performed.


Electronic searches identified 154 unique references and other sources 79 relevant references published from 2004-2014. Half (52%) were promoted to full text screening. The final study selection process is near completion and we anticipate about 75 included papers, approximately two-thirds of which were published in the last five years. In ten years, there has been an exponential growth of published realist reviews from a broad spectrum of health and related research areas. The included reviews vary greatly in terms of purpose, methodological rigor, and quality of reporting. Many consult stakeholders/experts as part of the review process. Quality assessment of included studies is infrequently performed.


Realist synthesis review is a new review approach of increasing focus that can be useful for taking stock of complex social programs. Due to great variability in its conduct, there may be a need for methodological standardization to ensure the utility and strength of its evidence.