A proposed way to choose studies for realist syntheses starts with the newest database records and stops when pre-set quotas are filled. The article presents it as a way to improve review pacing and leave more time for data immersion and analysis, while warning that screening only part of a record library can miss useful papers.
A method built around quotas
Called Reverse Chronology Quota Record Screening, or RCQRS, the method orders database records from the most recent publication backward. Screening stops when each pre-established quota of suitable papers is filled, after which the selected papers are retrieved in full and analysed.
The proposed workflow has five steps: set quotas; appraise full texts and refill quotas where needed; analyse the material and consult stakeholders; carry out targeted retrieval; and combine RCQRS with other sources for identifying literature.
The SERENITY case
The approach is illustrated through SERENITY, a realist synthesis focused on deprescribing antithrombotic therapy for people with cancer in the last phase of life. The review also drew on broader work about shared decision-making and deprescribing in palliative care.
Searches across 10 databases produced 17,036 citations. To fill its initial quotas, the team screened 230 records for 10 papers on shared decision-making and 10 on deprescribing in palliative care.
After further searching, SERENITY retained 56 papers from database searches and added 35 papers solicited from consortium experts.
Following stakeholder feedback, the team used new keywords and additional quota categories. It sought 10 papers in each category and screened 257 more records.
A time-saving estimate with a warning
The paper offers a rough contrast in screening time: about 25–50 hours for RCQRS with broader inclusion criteria, versus upwards of 1,000 hours for exhaustive title-and-abstract screening.
That comparison was illustrative, not a controlled head-to-head test, and the article reports no uncertainty estimate. It therefore does not establish that RCQRS is faster than exhaustive screening.
The cost of stopping early
The potential benefit is not simply a shorter first pass. The authors describe improved pacing and more room for immersing themselves in the data and analysing it as advantages of RCQRS.
The trade-off is coverage. Because the method screens only part of a record library, relevant papers may be missed. The authors recommend combining RCQRS with other literature-identification strategies to help offset that risk.
A gap in the specific evidence
The SERENITY case exposed a narrower evidence gap: no papers specifically addressed shared decision-making for antithrombotic-therapy deprescribing. The review therefore extrapolated from broader literature and produced area-specific recommendations.
The authors also caution that RCQRS may miss useful papers, while the SERENITY example shows that a review may need to draw on broader literature when a highly specific evidence base is sparse.
Taken together, the case presents RCQRS as a staged selection process, not as a tested replacement for exhaustive screening. How the approaches compare on completeness and time remains an open question.
Paper data and sources
Original title: Reverse chronology quota record screening for realist synthesis: Fostering causally rich extrapolations with a diverse and contemporaneous sample of literature
Authors: Jagosh J, Briscoe S, Greenley S et al.
Journal/Repository: Research Synthesis Methods
Status: Peer-reviewed
First online: 2026-08-19
DOI: Not available
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