What is the difference between integrative, systematic and scoping reviews?

This is a common question when starting a literature review. Although these reviews share some steps, each serves a different purpose, and the choice depends on the aim of your research. In this article, we will explore those differences and when to use each approach.

Where should you start?

Before choosing a review type, you need to define what you want to investigate. Having a topic is a starting point, but you still need to narrow down the question you will address and what you hope to understand from the literature.

Let’s consider the mental health of nursing students. Within this topic, you could investigate (1) whether an intervention helps reduce anxiety, (2) the factors that make it harder to seek support, or (3) which care strategies have already been studied. Although they address the same topic, these studies have different aims.

Choosing a method simply because it appears frequently in articles in your field can therefore cause problems. The same applies when your choice is based on the impression that a particular review would be easier to conduct or publish.

First, we need to understand the question. Then we can assess which method can answer it.

What is a systematic review?

A systematic review brings together and analyses evidence to answer a clearly defined research question. It uses explicit methods to search for, select, appraise and synthesise studies, allowing readers to understand how the findings were reached.

For example, we might investigate whether practising yoga, compared with not receiving that intervention, reduces anxiety in nursing students. We would need to find studies capable of assessing this effect, examine how they were conducted and analyse what their findings allow us to conclude.

Although often associated with evaluating interventions, systematic reviews can also answer other types of questions, including those about prevalence, diagnosis and people’s experiences. The eligible studies and analytical approach depend on the question and the methodology used. Systematic reviews are therefore not limited to randomised controlled trials (Munn et al., 2018b).

For instance, a systematic review of prevalence might investigate the proportion of nursing students who experience anxiety symptoms. A review of diagnostic test accuracy could assess whether a questionnaire correctly identifies students with an anxiety disorder by comparing its results with a diagnostic interview conducted by a qualified professional. Qualitative studies could also be brought together to understand how these students experience anxiety during clinical placements, or studies could examine whether academic overload is associated with anxiety in this population. Each question requires its own procedures for appraising and synthesising the evidence (Munn et al., 2018b).

You will also often see the term “systematic review with meta-analysis”. Meta-analysis is a statistical technique that combines the results of different studies when doing so is appropriate. However, not every systematic review will include a meta-analysis. If differences between the studies make this analysis unsuitable, the findings need to be synthesised in another way, with a clear justification (Reeves et al., 2024).

What is an integrative review?

An integrative review brings together and analyses knowledge on a particular topic, combining different study types and, depending on its purpose, theoretical and empirical sources. Its contribution to evidence-based practice lies in integrating this knowledge to help inform improvements in care, protocols, educational activities and management (Whittemore; Knafl, 2005).

Returning to our example, we could investigate the factors that influence whether nursing students seek mental health support. Quantitative studies might show how many seek care and which factors are associated with doing so. Qualitative studies can help explain why some students avoid the service, such as concerns about being identified or difficulties fitting appointments around their schedules. Integrating these findings can help inform support arrangements that better meet students’ needs.

However, bringing different studies together requires careful analysis. You need to consider how each study was conducted, its limitations and what its findings allow you to conclude. The aim is to integrate and interpret the findings rather than simply present a sequence of summaries of the selected articles. Any potential applications to practice must therefore be discussed in light of the quality and limitations of the available evidence.

To carry out this process, you need a methodological framework to guide the work. Frameworks can differ both in the number of stages and in how those stages are organised and carried out. When choosing one, consider your target journal and its author guidelines as well. For an international publication, for example, it may be helpful to use a framework that is more widely known in that context, such as that of Whittemore and Knafl (2005). This does not rule out using Brazilian authors, but your choice must be grounded in how well the methodology fits your research.

What is a scoping review?

A scoping review identifies and maps the available evidence on a topic, clarifies concepts and definitions, examines how research has been conducted and identifies characteristics or factors related to a concept. It can also identify and analyse gaps in knowledge and inform the planning of a future systematic review (Aromataris et al., 2024).

In our example of nursing students’ mental health, we might ask which mental health promotion strategies have been studied in this population. The mapping could show the strategies identified, the countries where the research took place, the participants involved and the methods used.

Notice the difference from the systematic review example. Here, the aim would be to describe the strategies and the available research. To establish which intervention produces better outcomes, we would need a systematic review designed to evaluate effects.

A scoping review can also support the planning of a future systematic review by showing what evidence exists and which questions still need investigation. However, this is only one possible use. Mapping the evidence can be a research aim in its own right (Munn et al., 2018a).

Why do integrative and scoping reviews seem so similar?

Both can address broad topics and include different types of evidence. Looking only at the selected studies is therefore not always enough to tell which method was used.

In an integrative review, the researcher connects findings across studies to understand a phenomenon, discussing their relationships, differences and potential implications for practice. In a scoping review, the focus is on mapping what exists, much like an organised catalogue of the evidence. It shows what has been studied, in which populations and how, while also identifying areas that have received little attention. This mapping also involves analysing and discussing findings, with conclusions that remain aligned with its purpose. Connecting knowledge and including different study types can also occur in other approaches, such as mixed methods systematic reviews.

For example, a scoping review of barriers to seeking psychological support among nursing students could identify which barriers have been investigated, in which countries and with which groups of students. Its findings might show that some studies addressed concerns about being identified, others examined scheduling conflicts and few included students attending evening classes. This mapping would show what has already been researched and highlight aspects that still need investigation.

An integrative review, in turn, could bring together findings about these barriers to understand how they make it harder to seek care. Imagine that quantitative studies show lower service use among students who work, while qualitative studies report that appointments are only available during normal working hours. Connecting these findings would allow a discussion of how the way the service is organised may limit access, even when care is free.

That discussion could draw on other research and concepts of access to health services, recognising that offering care does not guarantee that students can use it. The review could then inform a discussion about whether opening hours and ways of welcoming students meet their needs, while respecting the quality and limitations of the studies analysed.

In a scoping review, these findings would show that the literature identifies service opening hours as a barrier to access. However, mapping alone would not establish that extending those hours would increase service use. That conclusion would require appraising and synthesising studies of the effects of the change, which goes beyond describing the available evidence.

An integrative review also needs studies that support the relationships and interpretations proposed in its discussion. Choosing this method does not, by itself, justify conclusions that go beyond the evidence found. Discussing longer opening hours as a possible improvement does not demonstrate that they would increase service use. To assess that effect, the appropriate approach would be a systematic review of interventions.

We also need to be careful with oversimplified rules. Including qualitative and quantitative studies, for example, does not automatically make a review integrative. Likewise, including theses, dissertations or reports does not automatically make it a scoping review. Grey literature is not exclusive to scoping reviews either: it can also be relevant to systematic reviews, including by reducing the risk of relying only on findings published in journals (Lefebvre et al., 2025).

Your choice needs to consider the research as a whole. If you are still unsure, return to the question and describe the result you want to produce. Do you want to assess an effect, integrate knowledge about a phenomenon or describe the available evidence? This reflection helps you compare the options, but it needs to be accompanied by reading the relevant methodological guidance.

Is a scoping review easier?

Critical appraisal of study quality is not required in every scoping review. Whether to include it depends on the aims and must be justified when it is used. However, this does not mean the method will be simpler or faster.

A scoping review can retrieve a large volume of documents and require substantial work to select sources, extract data and organise the findings. It also needs clear criteria and transparent procedures, just like the other approaches discussed here (Munn et al., 2018a).

Before starting, consider the time available, the involvement of other reviewers and the resources needed. If the project is not feasible under current conditions, discuss a more appropriate scope with your team or supervisor.

How do you justify your review?

The rationale needs to explain why the research is worth doing and why the chosen review type can achieve its aim. These are related questions, but each needs an answer.

Why is this review needed?

Saying that nursing students’ mental health matters helps introduce the topic, but it does not yet explain why a new review is needed. What do we need to understand better? Are there findings that have not been brought together, an underrepresented population or new evidence that needs to be analysed?

Preliminary searches help answer these questions. Before finalising your plan, look for studies on the topic, published reviews and protocols for work in progress. Record where and when you searched and what you found. JBI recommends this investigation during planning and advises reporting its findings in the review rationale (Aromataris et al., 2024).

An existing review does not automatically rule out a new one. In our example, the available review might address university students in general without examining the particular circumstances of nursing students. New studies or methodological limitations might also justify another review. That is the contribution you need to demonstrate. Preliminary searches support this decision, but they do not replace the search for studies to be included in the research.

Why is this review type appropriate?

After explaining why the research is needed, show how the chosen approach fits your question and the result you want to produce. It is not enough to say that an integrative review combines different studies or that a scoping review addresses a broad topic. Explain what you will do with the evidence and how the framework’s procedures allow you to achieve that result.

For an integrative review of barriers to seeking support, for example, the rationale could explain that we need to connect how often these barriers occur with students’ experiences to understand access to the service. You would still need to check whether the available sources and the chosen framework support this integration. The diversity of the studies alone does not determine the review type (Munn et al., 2018a; Whittemore; Knafl, 2005).

What needs to be planned before the search?

Once you have chosen the review type, read the methodological guidance that will shape how it is conducted. Use it to plan the research stages and check which procedures are needed to answer the question and achieve the stated aim.

For systematic and scoping reviews, this planning must be set out in a research protocol, following the chosen methodology. The document should describe the review question and aim, eligibility criteria, information sources and how searching, selection, data extraction and analysis will be carried out. It should also specify the reviewers’ roles and how disagreements will be resolved.

A protocol also helps prevent decisions made only after seeing the results. Imagine excluding studies because their findings contradict what you expected. That choice can introduce selection bias, favouring studies that confirm your expectations and undermining the review’s conclusions.

As well as writing the protocol, arrange prospective registration or publication in line with the methodological guidance and the target journal’s requirements. Eligible systematic reviews can be registered in PROSPERO, while scoping reviews can use platforms such as OSF. Registration should be planned before the review is conducted. Registering later does not demonstrate that decisions were made in advance, and journals that require prospective registration may reject an article without it (Aromataris et al., 2024).

Finally, record your decisions and any changes throughout the process. Adjustments may be necessary, but they must be justified, documented and reported in the final article. This allows readers to understand what changed from the original plan and why (Lasserson; Thomas; Higgins, 2024).

How should you set publication dates and languages for the search?

These decisions affect which evidence can be included in the review and need to be considered during planning. They also help you assess the resources needed to carry out the work. However, restricting years or languages does not, by itself, determine whether a review is integrative, systematic or scoping.

How should you set publication date limits?

Limiting an integrative review to studies from the last five or ten years is not a general requirement of the method. Scoping reviews do not have a mandatory fixed time window either. For scoping reviews, JBI advises justifying the period during planning in light of the intended breadth of the mapping. In both approaches, any limit should relate to the question and aim, rather than simply reduce the number of documents or copy a time window used in other studies (Aromataris et al., 2024).

In our example, if the question concerns mental health support provided after a university policy was introduced, that milestone may justify the start date. But if we want to understand barriers that persist over time, excluding earlier studies without justification could leave out important knowledge. Even when the focus is on current practice, a study does not become irrelevant simply because it is older.

In a systematic review, the period should allow you to locate the studies relevant to answering the question. A limit may be used when it is grounded in the eligibility criteria, such as the date an intervention first became available. Cochrane guidance for intervention reviews discourages arbitrary limits, such as searching only the last five or ten years without justification, because they can exclude evidence and change the review’s answer. Any restriction needs to be planned, reported and justified (Lefebvre et al., 2025).

How should you handle the languages of sources?

Language also needs to be part of the plan. The team should seek support to understand and analyse relevant sources in other languages, rather than automatically exclude them because team members do not speak the language. Cochrane advises its teams to seek translation assistance when needed (Lefebvre et al., 2025).

Consider from the start how your team will obtain that support. If a restriction is unavoidable, you need to justify the decision, discuss its impact and check the journal’s guidance; the journal may consider the justification insufficient when assessing the article.

Where does PRISMA fit in?

When reading review articles, you will probably encounter references to PRISMA and its study selection flow diagram. PRISMA, however, is a reporting guideline. It helps authors present the information readers need to understand the work that was carried out.

Citing PRISMA or using its flow diagram therefore does not replace the methodological framework that guides how the review is conducted. Think of it this way: the framework, such as Whittemore and Knafl’s for integrative reviews, guides how to do the research. PRISMA guides how to explain in the article what you did. Each has its own role (Page et al., 2021).

There are reporting guidelines for different review types, such as PRISMA-ScR for scoping reviews (Tricco et al., 2018). Consult the guideline relevant to your work during planning. This helps you record, from the outset, the information you will need to report in the publication (Page et al., 2021).

How do you choose the right review type for your research?

Start by writing down your question and aim, even if they still need refining. Then describe the information you will need to find and what you intend to do with it.

Source: created by the author.

Text description of the flowchart

1. Define the question and aim. What do you want to investigate?
2. Describe the intended outcome. Assess an effect, understand experiences, integrate knowledge or map evidence?
3. Compare review types. Consider the purpose of systematic, integrative and scoping reviews.
4. Consult the methodological guidance. Check that the method and procedures fit the aim. If they do not align, revisit and adjust your plan.
5. Assess feasibility. Consider your team, time, access to sources and the journal’s requirements.
6. Document your plan. Write the protocol and arrange prospective registration or publication, following the relevant guidance.

If the aim and method do not align, revisit your plan. Exploratory searches can support this preparation. Only then move on to searching for and selecting the studies for the review.

Let’s return to nursing students’ mental health and the three possibilities introduced at the start. The topic is the same, but what you want to find out changes the choice of review.

In the first option, we want to know whether an intervention helps reduce anxiety. We could ask whether a mindfulness programme, compared with the support usually offered by the university, reduces these students’ anxiety symptoms. A systematic review of intervention effects would be appropriate for assessing the studies’ findings and how much confidence we can place in the answer.

In the second, we want to understand the factors that make it harder to seek support. An integrative review can bring together studies on concerns about being identified, service opening hours and other barriers, connecting how often these problems occur with students’ reported experiences. The aim would be to understand how these factors relate to one another and what the findings allow us to discuss about access to the service, without concluding that a change in care would work simply because it seems sensible.

In the third, we want to map the care strategies that have already been studied. A scoping review can organise the strategies identified, such as psychological care, peer support and mindfulness programmes, showing which students they were investigated with, in what settings and using which methods. It can also reveal areas that have received little research. This mapping alone does not establish which strategy is most effective.

These paths help you compare the options, but they are not exclusive. A question about students’ experiences of seeking support, for example, could also guide a systematic review of qualitative evidence. Discuss your question and intended result with your team and supervisor, checking what each methodological framework requires (Munn et al., 2018b).

The following table summarises the requirements and characteristics of each review type. Check the requirements in your chosen methodological guidance and the journal’s author instructions.

On a phone, swipe the table sideways. With a keyboard, focus this area and use the arrow keys.

Source: created by the author based on Munn et al. (2018a), Munn et al. (2018b), Whittemore and Knafl (2005), Aromataris et al. (2024), Lefebvre et al. (2025), Page et al. (2021) and Tricco et al. (2018).

PICO stands for population, intervention, comparison and outcome. PICo stands for population, phenomenon of interest and context, so it can help frame questions about experiences. PCC stands for population, concept and context. These frameworks help organise the question, but they do not determine the review type on their own.

References

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