Writing the Conclusion of a Review Paper
Writing the Conclusion of a Review Paper
Recall from the initial discussion of Review papers that these publications make two kinds of contribution: 1) an organized summary of the current state of an area of research; 2) critical commentary from the writer who eventually recommends directions for further research.
There are two ways of furnishing critical commentary. First, critique may be provided at the end of each topical subsection. Sometimes, recommendations are also provided, especially if the Review is particularly complex. Second, all critique/recommendations are saved for the conclusion. Which is the best pattern? As always, consider the reader. The more complicated the reading task, the more difficult it is for the reader to absorb the writer’s message. If the topical subsections are very straightforward, with little controversy/conflict involved, then it’s okay to save all critique/recommendations for the end of the paper. More often, the topics are not so straightforward. In that case, it is easier for the reader (and also for the writer) to finish each section with the writer’s critical evaluation of the material. In this manner, each topical subsection reads like a fairly complete mini-essay; the reader can pause, grab a cup of coffee and a Snickers, and return to the review without sacrificing comprehension.
How does all of this relate to the conclusion? In a review paper, the conclusion is a short, up-front piece of writing. First, the conclusion offers a brief review of the main ideas of each topic subsection (generally, only a single sentence long) – this is the summary function of a conclusion. Second, the conclusion finishes with critique + recommendations or just recommendations. If the critique is provided in the body of the paper, then the conclusion need only consist of a summary paragraph and a recommendations paragraph. Some writers even combine both of these into a single paragraph.
Thus, your conclusion will depend partly on the decisions made about critique. If critical evaluation is provided in the body of the paper, it need not be repeated in the conclusion. If critical evaluation is not provided in the body of the paper, then it is provided in the conclusion.
Organization
• Critique in Body of paper –
o All critical evaluation comes at the END of a subsection. If you find yourself logically needing to provide some critique before continuing on within a particular section, then you need to create a second-level subsection (a subtopic within your main topic subsection – for the visual thinkers, these are the main connections coming off a central hub). Keep in mind: the prime directive here is that all critical evaluation is written in a separate paragraph at the end of a section.
o The Conclusion consists of the summary + recommendations for further research.
• Critique in Conclusion of Paper – there are two organizational patterns
o #1 – The first paragraph is summary, second paragraph is critique, third paragraph is recommendations (note: second paragraph is more properly understood as a functional section as you may need more than one paragraph!)
o #2 – Each paragraph consists of summary of a particular section, the critique for that section, then the recommendations for that section. The number and order of paragraphs parallels the number and order of main topical sections of the paper.
Scroll on for examples!
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Outline with topics/subheadings marked: CAM Therapies for Arthritis article
• Introduction
• ACUPUNCTURE Main Topical Heading 1
o Acupuncture and Osteoarthritis second level subtopic 1A
o Acupuncture and Rheumatoid Arthritis second level subtopic 1B
o Acupuncture and Fibromyalgia Syndrome second level subtopic 1C
• HOMEOPATHY Main Topical Heading 2
• HERBAL THERAPY Main Topical Heading 3
o Herbal Therapy and OA second level subtopic 3A
o Herbal Therapy and RA second level subtopic 3B
• NUTRITIONAL SUPPLEMENTS Main Topical Heading 4
o Glucosamine for OA second level subtopic 4A
o Chondroitin Sulfate for OA second level subtopic 4B
o SAMe (S-adenosylmethionine) second level subtopic 4C
• SUMMARY
• REFERENCES
HOMEOPATHY^ Main Topic Heading 2
Homeopathy is based on two main tenets. 12 The first is the principle of “similars,” which states that patients with a particular pattern of signs and symptoms can be cured if they are given a drug that produces the same pattern of signs and symptoms when given to a healthy individual. This means that treatment is individualized. The second tenet is that remedies retain biologic activity if they are diluted and agitated or shaken between serial dilutions, even if no original molecules remain. [definition and explanation of concept; only sections which writer felt the reader needed more information included an extended explanation]
Only 1 meta-analysis was located that examined homeopathy and arthritis and related diseases. 13 Six trials that used either random assignment or double-blinding were included. Three trials used patients (n = 266) with RA while subjects in the other 3 trials had OA, FMS, and myalgia. The interventions varied and included individualized or classic homeopathic treatment as well as complex homeopathy in which one or more remedies are administered for standard clinical conditions. The outcomes varied also—global assessment, treatment preference, or predefined responder criteria—so the results summarized do not apply strictly to pain. However, using the Jadad scale, 7 5 of the 6 trials were rated as high quality. Results were presented as an odds ratio (OR) such that a value greater than 1 indicates greater effectiveness of homeopathy as compared with placebo. Based on meta-analysis, homeopathy was more effective than placebo whether one looks at all 6 trials [OR = 2.19, CI95 (1.55, 3.11)] or only the 5 high quality studies [OR = 2.11, CI95 (1.32, 3.35)]; homeopathic remedies were twice as effective as placebo. [discussion of information]
[begin critique]Although the number of studies is small and the results are mixed, it does appear that homeopathic remedies work better than placebo for rheumatic syndromes. However, the small number of studies limits any definitive conclusion concerning the efficacy of any one type of homeopathic treatment of any one condition. In general, there are quality concerns for homeopathic clinical trials across all conditions. 14 Almost all studies failed to report the proportion of subjects screened, over half did not report attrition rate, and there was little replication of conditions studied.[end critique] Further research of homeopathy is warranted. [recommendation stated – it seems “obvious” but the goal of this paper is to analyze what is known about CAM and Arthritis and make definitive claims for which CAM treatments are worth pursuing more information about] [ NOTE: the careful reader may have noticed I created a new paragraph for this critique – while this article is well written and easy to understand, a better organization is for the body-situated critique to occur in its own paragraph so the reader knows when the writer’s views are being expressed.]
SUMMARY^
What have these reviews indicated about the efficacy of specific CAM therapies for pain from arthritis and related diseases? First, there are a sufficient number of studies in some areas despite claims often heard about the lack of evidence for CAM. Second, research findings for some of the CAM therapies reviewed here have demonstrated consistent beneficial outcomes for patients with arthritis and related diseases. [conclusion begins with restatement of research question and major review finding] Specifically, there is moderate support for acupuncture in reducing pain as compared with sham acupuncture and limited support for acupuncture as compared with a wait list for OA of the knee. However, no claims can be made for the superiority of acupuncture across locations of OA and across comparison groups. Further, only limited support exists for the efficacy of acupuncture for FMS with the caveat that acupuncture may actually exacerbate the pain for some patients with FMS. At this point, little is known about acupuncture for patients with RA. [b/c critique and recommendation in body of review, here, only a summary of BOTH is presented]
Homeopathy has been demonstrated to be twice as efficacious as placebo for rheumatic conditions, but the outcome was not specifically pain. Furthermore, the interventions included both simple and complex homeopathy as well as individualized and standard treatments and may not represent the system of homeopathy as practiced. More research is needed in this area.[summary of info/critique/recs for second main topic]
Some herbals and nutraceuticals are also beneficial in reducing pain.[writer combines herbals and supplements in one b/c they are fairly closely related medically] Both avocado/soybean unsaponifiables and devil's claw demonstrated promising support for pain of OA with moderate support for Phytodolor and topical capsaicin. Among the herbals used for or promoted for RA, there is strong support for GLA as found, for example, in borage seed oil, evening primrose oil, and blackcurrant seed oil. However, evidence is lacking for other herbals and more high quality research is needed. Research findings also support the benefits of chondroitin sulfate, glucosamine, and SAMe in reducing pain, particularly pain related to OA of the knee. Furthermore, these treatments appear safe to use.[that’s it – the end! Conclusions to Review papers often feel abrupt b/c they are pretty short and pointed – most of the information has been presented in the body of the paper, so the conclusion is truly a brief summary]
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