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7.3.8 Discussion

By Carolyn Phillips
2 min

 

This section should discuss the results of the synthesis as well as any limitations of the primary studies included in the review and of the review itself (i.e. language, access, timeframe, study design, etc.). The results should be discussed in the context of current literature, practice and policy.

The aim of this section is to explain and discuss the main findings – including the strength of the evidence, for each main outcome. It should address the issues arising from the conduct of the review including limitations and issues arising from the findings of the review (such as search limitations). The discussion does seek to establish a line of argument based on the findings regarding the exposure and its association with the outcomes identified in the protocol. The application and relevance of the findings to relevant stakeholders (e.g. healthcare providers, patients and policy makers) should also be discussed in this section.

Points to consider this section include:

  • Where any problems identified undertaking the search (perhaps there is little primary research on this topic or perhaps it is poorly indexed by the databases that were searched or perhaps the search was insufficient)?

  • What limitations were found in the included primary research (e.g. were there inconsistencies or errors in reporting)?

  • How do the review findings fit with what is currently known on the topic (from issues highlighted in the Background section)?

  • Are the findings generalizable to other populations of participants/healthcare settings etc.?

Suggested layout of Discussion section:

Paragraph 1 – Begin your discussion with the: 

  • Amount and weight of available evidence

  • Any particular feature/s associated with future risk of disease/harm/outcome

  • Limitations to establish the reliability of results of the included studies (e.g. biases, data issues)

Paragraph 2 – set in context.

  • Set the results in context of other knowledge on the topic, i.e. compare your work with previous systematic reviews or current opinions and guidelines.

Paragraph 3 – outline strengths and weaknesses of the meta-analytic methods used. 

  • Strengths: e.g. multiple reviewers reduced inclusion bias; which moderating variables were identified and how they were managed e.g. study design; determined that the effect estimate was sufficiently large in practical as well as statistical terms; determined precision of the effect; determined heterogeneity of the participants to enable generalisation of findings; conducted sensitivity analyses to assess any changes in the pooled effect estimator.

  • Weaknesses: bias e.g. included only English language publications, unable to access suitable grey literature; possibility of missing (explanatory) variable/s, some issues with interpretation of findings.

Paragraph 4 – discuss limitations to establish the reliability of result/s.

  • Of your review (bias)



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