Purpose of the discussion segment is to validate the findings in your study

Issues to be addressed in discussion are 

  • Merits and appropriateness of your study design and methodology.
  • Reliability and validity of your results
  • Possible bias and confounders: how are those dealt

Merits and appropriateness of your study design and methodology.

  • Identify comparable studies on the issue
    • Document in the review of literature
    • Validate your study design by quoting their examples
  • Identify ( if any ) comparable studies has cohort or case control design
    • Yes: justify why that study design ( cohort/ case control) could not adopted in your case
    • Tips:
      • Institutional infrastructure and resources
      • Study objectives
      • Issues in follow –up : cohort studies
      • Issue in recruitment of control : case control studies
    • Why an ambi-directional study was not planned
      • Why retrospective data was not included, in spite of available medical records in a hospita

Merits and appropriateness of your study methodology

  • Highlight the merit patient screening methodology
    • Define study population and reason why it was taken
    • Screening method
      • Steps taken to facilitate patient recruitment
    • Prevalence of the disease ( if seen) in the studied population
      • Compare the prevalence reported in your study with that reported in other similar studies
        • Justify the difference if any
        • Efforts done to avoid false negative and false positive selection of patients

Merits and appropriateness of your methodology

  • Procedures
    • Procedure/investigation/clinical assessment/Criteria for diagnosis
    • Substantiate with references for choosing a particular Procedure/investigation/clinical assessment method/Criteria for diagnosis
    • How does type 1 and type 2 errors are reduced

Reliability and validity of your results

  • Implications of your findings
    • Mention your important findings but do not give your results all over again.
    • Most important findings first and least important findings last
    • Discuss extent to which objectives are fulfilled and research question answered
    • How your study has enhanced the knowledge on the topic
    • What extent gaps in knowledge are covered
  • Comparison with existing literature
    • Discuss your findings in comparison to other studies
    • Take those studies with good methodology and validity
    • Emphasize the area of your finding in agreement with other reports
    • Also emphasize those findings not in agreement with other reports
    • Explain the reason for difference
      • Methodology
      • Sample size
      • Study population

Limitations

  • Limitations in the screening and recruitment of cases
  • Accuracy of the test/procedure/investigation
  • Difficulty if clinical diagnosis

Strength

  • screening and recruitment of cases
  • Accuracy of the test/procedure/investigation

Implications of your study in improving the clinical practice

  • Do not over interpret the findings
  • Studies results are not universally applicable but only on the patients on which the study was done
  • Do not be over enthusiastic in drawing conclusion
  • Lack of evidence of adverse effect do not means no adverse events
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