Reviews
Vol. 3 (2026)
https://doi.org/10.4081/ahr.2026.142

Enhancing rigor in narrative reviews: protocol for the validation of a structured narrative review framework via Delphi consensus

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Published: 3 July 2026
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Structured narrative review, Delphi study, consensus methodology, evidence synthesis

Authors

Matteo Luigi Giuseppe Leoni
matteolg.leoni@gmail.com
Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Italy.
Y Van Tran
Department of Anesthesiology, Tam Anh General Hospital, Ho Chi Minh City, Viet Nam.
Van Phong Pham
Department of Anesthesiology, Tam Anh General Hospital, Ho Chi Minh City, Viet Nam.
Giustino Varrassi
Research Department, Fondazione Paolo Procacci, Rome, Italy.

Narrative reviews remain essential for synthesizing complex, multidisciplinary evidence, particularly in heterogeneous and evolving fields. However, their intrinsic subjectivity, risk of selection bias and limited reproducibility have raised important methodological concerns. This study aims to describe the development of the Structured Narrative Review (SNR) Framework, an advanced model designed to enhance methodological rigor while preserving interpretative flexibility, and to present the protocol for its formal validation through an international expert consensus process. The SNR Framework integrates established reporting standards, including SANRA, PRISMA 2020 and PRISMA-ScR. It is organized into core domains addressing reproducible search strategies, evidence stratification, mechanistic synthesis and epistemological transparency. Although the framework is conceptually grounded in methodological triangulation, formal validation is required to confirm its clarity, feasibility and applicability across disciplines. This protocol describes an international modified Delphi consensus study designed to validate the SNR Framework. The primary objective is to achieve expert agreement on the relevance, clarity, and feasibility of each core domain, as well as on the overall framework structure, standardized scoring system and recommendations for integration into editorial and peer-review workflows. The consensus process will involve two to three sequential electronic rounds conducted in accordance with CREDES and ACCORD recommendations. An international panel of 30-50 experts will independently rate each SNR domain across dimensions of relevance, clarity and feasibility. Consensus will be defined as ≥80% agreement. Items failing to reach consensus will be revised and resubmitted in subsequent rounds. As this is a protocol, no results are yet available. Upon completion, the study is expected to yield a validated SNR Framework with expert-endorsed core domains, a standardized scoring system and consensus-based implementation recommendations, thereby advancing transparency, rigor and reproducibility in narrative review methodology.

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How to Cite



1.
Leoni MLG, Tran YV, Pham VP, Varrassi G. Enhancing rigor in narrative reviews: protocol for the validation of a structured narrative review framework via Delphi consensus. Adv Health Res [Internet]. 2026 Jul. 3 [cited 2026 Jul. 16];3(1). Available from: https://www.ahr-journal.org/site/article/view/142
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