Methods for Research Evidence Synthesis: The Scoping Review Approach

Like other studies, scoping reviews are at risk for bias from different sources. Critical appraisal of the risk of bias in scoping reviews is not considered mandatory, but some scoping reviews may include a bias assessment. Even if bias is not formally assessed, that does not mean that bias does not exist. For example, selection bias may occur if the scoping review does not identify all available data on a topic and the resulting descriptive account of available information is flawed.

Fan et al. used the scoping review approach to examine the available information on contributors to and safeguards against controlled-drug losses and theft (drug diversion) in the hospital setting.³ The authors addressed the following questions: (1) “What clinical units, health professions, or stages of the medication-use process are commonly discussed?” (2) “What are the identified contributors to diversion in hospitals?” and (3) “What safeguards to prevent or detect diversion in hospitals have been described?” Part of the rationale for using a scoping review approach was to permit the inclusion of a wide range of sources falling outside the typical peer-reviewed article. The authors comment that the stigmatized topic of drug diversion frequently falls outside the peer-reviewed literature and emphasize the importance of including such sources as conferences, news articles, and legal reports. The search strategy included electronic research databases, such as Web of Science, as well as an extensive gray literature search. Multiple reviewers were included in the process and a calibration exercise was conducted to ensure consistency in the selection of articles and to improve interrater agreement. The scoping review identified contributors to controlled-drug diversion and suggested safeguards to address them in the hospital setting.

Methodological approaches to evidence synthesis vary, and new methods continue to emerge to meet different research objectives, including evidence mapping,⁹ concept analysis,¹⁰ rapid reviews,¹¹ and others.¹² Choosing the right approach may not be straightforward. Researchers may need to seek guidance from methodologists, including epidemiologists, statisticians, and information specialists, when choosing an appropriate review approach to ensure that the review methods are suitable for the objectives of the review.

Disclosures

The authors have no conflicts of interest to disclose.

Financial Disclosures

The authors have no financial relationships relevant to this article to disclose.