Discussion

[fixed, level 1 heading]

A structured discussion can aid the consideration of the implications of the review (Docherty 1999).

See also

 

Summary of main results

[recommended, level 2 heading]

Summarize the main findings (without repeating the ‘Effects of interventions’ section) and outstanding uncertainties, balancing important benefits against important harms. Refer explicitly to any ‘Summary of findings’ tables.

 

Overall completeness and applicability of evidence

[recommended, level 2 heading]

Describe the relevance of the evidence to the review question. This should lead to an overall judgement of the external validity of the review. Are the studies identified sufficient to address all of the objectives of the review? Have all relevant types of participants, interventions and outcomes been investigated? Comments on how the results of the review fit into the context of current practice might be included here, although authors should bear in mind that current practice might vary internationally.

 

Quality of the evidence

[recommended, level 2 heading]

Does the body of evidence identified allow a robust conclusion regarding the objective(s) of the review? Summarize the amount of evidence that has been included (numbers of studies, numbers of participants), state key methodological limitations of the studies, and reiterate the consistency or inconsistency of their results. This should lead to a description of the overall judgement of the quality of a body of evidence contributing to the results of the review. The reasons or rationale for up- or downgrading the quality of a body of evidence in the ‘Summary of findings’ table (as described in the footnotes of that table) should be described.

 

Potential biases in the review process

[recommended, level 2 heading]

State the strengths and limitations of the review with regard to preventing bias. These may be factors within, or outside, the control of the review authors. The discussion might include the likelihood that all relevant studies were identified, whether all relevant data could be obtained, or whether the methods used (for example, searching, study selection, data collection, analysis) could have introduced bias.

 

Agreements and disagreements with other studies or reviews

[recommended, level 2 heading]

Comments on how the included studies fit into the context of other evidence might be included here, stating clearly whether the other evidence was systematically reviewed.