Research Guides: DNP: Doctor of Nursing Practice: Grey Literature

What is Grey Literature

Grey Literature (GL) is defined as "[t]hat which is produced on all levels of government, academics, business and industry in print and electronic formats, but which is not controlled by commercial publishers" (The Fourth International Conference on Grey Literature, 1999). GL is an important part of the evidence base and can help mitigate biases found in traditional publications.

Some characteristics of GL :

Are not produced by traditional publishers which can make them difficult to find
Can be in unconventional, ephemeral formats
Can showcase work often produced by diverse and non-traditional voices
May not be archived or available in a stable format for long-term use

To learn more about GL and healthcare, browse the articles linked below:

Finding Grey Literature Evidence and Assessing for Outcome and Analysis Reporting Biases When Comparing Medical Interventions: AHRQ and the Effective Health Care Program Systematic reviews attempt to identify, appraise and synthesize the available empirical evidence in order to minimize bias when representing the results of medical interventions and therapies. However, there is a growing recognition that often evidence is difficult to find because of decisions that are made about where, how, and when to publish the results of studies based on the findings of those studies. Notwithstanding, when unpublished data are actually available (for example as a result of legal action), reporting bias associated with suppression of unfavorable results has been fairly easy to detect.2,3 A review by Song, et al. notes that the results of half of all clinical trials are never published. Other findings were that studies with positive or statistically significant effects tend to report greater treatment effect, tend to be published sooner and in higher impact journals than those with negative or nonsignificant effects, and that exclusion of non-English language literature may bias our understanding of treatment effects, particularly in the area of complementary and alternative medicine.4
Health Services Research and Health Policy Grey Literature Project: Summary Report AcademyHealth is defining the scope of grey literature in health services research/health policy for the National Information Center on Health Services Research and Health Care Technology (NICHSR) at the National Library of Medicine. In considering the scope and status of grey literature, it is important to know who the major users are and what they are using grey literature for. In addition, knowledge of what grey literature is being produced and what the preservation procedures are for major producers is critical. Only by better understanding current practice can we make recommendations about what can be done to archive and preserve grey literature.
Grey Matters: a practical tool for searching health-related grey literature
This checklist can be used to enhance the quality, results, and evaluation of literature searches.

Some Examples of Grey Literature

Reports (technical, annual, government, etc.)
Pre-prints (version of a scholarly/research paper before review and publication)
Newsletters
Conference/symposia proceedings, poster presentations, etc.
Memos
Blogs, podcasts, videos
Theses & Dissertations
Listserv archives
Social media

Where can I find Grey Literature?

You can find GL through a variety of ways:

Searching Library Databases: while research databases contain much more traditionally published works (i.e. journal articles, book/ebooks, etc.), databases do provide access to some forms of GL like dissertations and theses, conference proceedings, reports, and more. Use Content Type filters within the databases to find these.
Visiting organizations websites: professional associations, non-profit organizations, think-tanks, academic institutions, etc. are all good sources of GL and often will have libraries with GL produced by them and their partners. (see Organization Websites tab)
Visiting government websites: federal government agency sites like NIH, CDC, and HHS provide a plethora of data, research, and other information. Don't forgot there are also state and local government agencies and international government agencies that also provide excellent information. (see Government Websites tab)
Searching aggregation sites: there are some aggregation sites that allow you to search a variety of GL sources. (see Aggregation Website tab)
Doing Advanced Google Searches: You can use some Advanced Google Search tools to help locate GL. (see Google Search tab)

Professional associations, non-profit organizations, think-tanks, academic institutions, etc. are all good sources of GL and often will have libraries with GL produced by them and their partners. Here are a few examples sites that might be of interest to nursing students:

Centre for Reviews and Dissemination
From the University of York, this databases provides easy access to quality assessed systematic reviews and economic evaluations and to health technology assessments conducted around the world.
Kaiser Family Foundation
Nonprofit organization focusing on national health issues, as well as the U.S. role in global health policy. KFF develops and runs its own policy analysis, journalism and communications programs, sometimes in partnership with major news organizations.
Pew Research Center
Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping America and the world. We conduct public opinion polling, demographic research, content analysis and other data-driven social science research.
Sigma Repository
Sigma Repository (formerly the Virginia Henderson Global Nursing e-Repository) is the only repository solely dedicated to sharing works created by nurses around the world. It is an open digital academic and clinical focused service that freely collects, preserves, and disseminates full-text nursing research, educational, and evidence-based practice materials in a variety of formats and item types. The repository is a resource of Sigma Theta Tau International (Sigma).
World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP)
The mission of the WHO International Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making. This will improve research transparency and will ultimately strengthen the validity and value of the scientific evidence base.
IHI White Papers
White papers are designed to share with readers the problems IHI is working to address; the ideas, changes, and methods we are developing and testing to help organizations make breakthrough improvements; and early results where they exist.

Federal government agency sites like NIH, CDC, and HHS provide a plethora of data, research, and other information. Don't forgot there are also state and local government agencies and international government agencies that also provide excellent information. Here are some examples below:

Agency for Healthcare Research and Quality (AHRQ)
The Agency for Healthcare Research and Quality's (AHRQ) mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used.
CDC Stacks
A free, digital archive of scientific research and literature produced by the Centers for Disease Control and Prevention (CDC). This online archive is composed of curated collections tailored for public health research needs.
Clinical Trials.gov
A database of privately and publicly funded clinical studies conducted around the world.
Drugs@FDA
Includes most of the drug products approved since 1939. The majority of patient information, labels, approval letters, reviews, and other information are available for drug products approved since 1998.
Open-i
Open Access Biomedical Search Engine.

There are some aggregation sites like repositories, preprint servers, etc. that allow you to search a variety of GL sources. Here a few examples below that might be of interest to nursing students:

Digital Commons Network: Medicine and Health Sciences Commons
Search for open access research from from hundreds of academic institutions.
The Grey Literature Report
The report is a publication produced by the The New York Academy of Medicine between 1999 - 2016, alerting readers to new grey literature publications in health services research and selected urban health topics.
Kennedy School of Government Think Tank Search
A Google Custom Search of more than 1200 think tanks and research centers.
LILACS
Health information from Latin America and the Caribbean countries.
medRxiv
A preprint server for Health Sciences, operated by Cold Spring Harbor Laboratory, a research and educational institution.
Preprints.org: Nursing & Health Studies
A platform dedicated to making early versions of research outputs permanently available and citable. Posts original research articles and comprehensive reviews, and papers can be updated by authors at any time. Content is not peer-reviewed and can receive feedback from readers.
PROSPERO
An international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health related outcome. Key features from the review protocol are recorded and maintained as a permanent record.
The Winnower: Medicine
An open access online scholarly publishing platform that employs open post-publication peer review.

Search engines like Google have some helpful tools and search tricks to help you locate Grey Literature:

To find organizational, educational, and governmental resources on Google, you can do a search by domain. Just add site:org or site:edu or site:gov to your search terms. When you add those domain searches, you limit your results to only websites that end in .org or .edu or .gov.
- Example Google Search: quality nursing care site:gov
Use the same domain search to search specific websites using Google.
- Example Google Search: quality nursing care site:https://www.brighamandwomens.org/