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• How to Write Recommendations in Research | Examples & Tips

How to Write Recommendations in Research | Examples & Tips

Published on 15 September 2022 by Tegan George .

Recommendations in research are a crucial component of your discussion section and the conclusion of your thesis , dissertation , or research paper .

As you conduct your research and analyse the data you collected , perhaps there are ideas or results that don’t quite fit the scope of your research topic . Or, maybe your results suggest that there are further implications of your results or the causal relationships between previously-studied variables than covered in extant research.

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Table of contents

What should recommendations look like, building your research recommendation, how should your recommendations be written, recommendation in research example, frequently asked questions about recommendations.

Recommendations for future research should be:

• Concrete and specific
• Supported with a clear rationale
• Directly connected to your research

Overall, strive to highlight ways other researchers can reproduce or replicate your results to draw further conclusions, and suggest different directions that future research can take, if applicable.

Relatedly, when making these recommendations, avoid:

• Undermining your own work, but rather offer suggestions on how future studies can build upon it
• Suggesting recommendations actually needed to complete your argument, but rather ensure that your research stands alone on its own merits
• Using recommendations as a place for self-criticism, but rather as a natural extension point for your work

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There are many different ways to frame recommendations, but the easiest is perhaps to follow the formula of research question   conclusion  recommendation. Here’s an example.

Conclusion An important condition for controlling many social skills is mastering language. If children have a better command of language, they can express themselves better and are better able to understand their peers. Opportunities to practice social skills are thus dependent on the development of language skills.

As a rule of thumb, try to limit yourself to only the most relevant future recommendations: ones that stem directly from your work. While you can have multiple recommendations for each research conclusion, it is also acceptable to have one recommendation that is connected to more than one conclusion.

These recommendations should be targeted at your audience, specifically toward peers or colleagues in your field that work on similar topics to yours. They can flow directly from any limitations you found while conducting your work, offering concrete and actionable possibilities for how future research can build on anything that your own work was unable to address at the time of your writing.

See below for a full research recommendation example that you can use as a template to write your own.

The current study can be interpreted as a first step in the research on COPD speech characteristics. However, the results of this study should be treated with caution due to the small sample size and the lack of details regarding the participants’ characteristics.

Future research could further examine the differences in speech characteristics between exacerbated COPD patients, stable COPD patients, and healthy controls. It could also contribute to a deeper understanding of the acoustic measurements suitable for e-health measurements.

While it may be tempting to present new arguments or evidence in your thesis or disseration conclusion , especially if you have a particularly striking argument you’d like to finish your analysis with, you shouldn’t. Theses and dissertations follow a more formal structure than this.

All your findings and arguments should be presented in the body of the text (more specifically in the discussion section and results section .) The conclusion is meant to summarize and reflect on the evidence and arguments you have already presented, not introduce new ones.

The conclusion of your thesis or dissertation should include the following:

• A restatement of your research question
• A summary of your key arguments and/or results
• A short discussion of the implications of your research

For a stronger dissertation conclusion , avoid including:

• Generic concluding phrases (e.g. “In conclusion…”)
• Weak statements that undermine your argument (e.g. “There are good points on both sides of this issue.”)

Your conclusion should leave the reader with a strong, decisive impression of your work.

In a thesis or dissertation, the discussion is an in-depth exploration of the results, going into detail about the meaning of your findings and citing relevant sources to put them in context.

The conclusion is more shorter and more general: it concisely answers your main research question and makes recommendations based on your overall findings.

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Research Recommendations – Guiding policy-makers for evidence-based decision making

Research recommendations play a crucial role in guiding scholars and researchers toward fruitful avenues of exploration. In an era marked by rapid technological advancements and an ever-expanding knowledge base, refining the process of generating research recommendations becomes imperative.

But, what is a research recommendation?

Research recommendations are suggestions or advice provided to researchers to guide their study on a specific topic . They are typically given by experts in the field. Research recommendations are more action-oriented and provide specific guidance for decision-makers, unlike implications that are broader and focus on the broader significance and consequences of the research findings. However, both are crucial components of a research study.

Difference Between Research Recommendations and Implication

Although research recommendations and implications are distinct components of a research study, they are closely related. The differences between them are as follows:

Types of Research Recommendations

Recommendations in research can take various forms, which are as follows:

These recommendations aim to assist researchers in navigating the vast landscape of academic knowledge.

Let us dive deeper to know about its key components and the steps to write an impactful research recommendation.

Key Components of Research Recommendations

The key components of research recommendations include defining the research question or objective, specifying research methods, outlining data collection and analysis processes, presenting results and conclusions, addressing limitations, and suggesting areas for future research. Here are some characteristics of research recommendations:

Research recommendations offer various advantages and play a crucial role in ensuring that research findings contribute to positive outcomes in various fields. However, they also have few limitations which highlights the significance of a well-crafted research recommendation in offering the promised advantages.

The importance of research recommendations ranges in various fields, influencing policy-making, program development, product development, marketing strategies, medical practice, and scientific research. Their purpose is to transfer knowledge from researchers to practitioners, policymakers, or stakeholders, facilitating informed decision-making and improving outcomes in different domains.

How to Write Research Recommendations?

Research recommendations can be generated through various means, including algorithmic approaches, expert opinions, or collaborative filtering techniques. Here is a step-wise guide to build your understanding on the development of research recommendations.

1. Understand the Research Question:

Understand the research question and objectives before writing recommendations. Also, ensure that your recommendations are relevant and directly address the goals of the study.

2. Review Existing Literature:

Familiarize yourself with relevant existing literature to help you identify gaps , and offer informed recommendations that contribute to the existing body of research.

3. Consider Research Methods:

Evaluate the appropriateness of different research methods in addressing the research question. Also, consider the nature of the data, the study design, and the specific objectives.

4. Identify Data Collection Techniques:

Gather dataset from diverse authentic sources. Include information such as keywords, abstracts, authors, publication dates, and citation metrics to provide a rich foundation for analysis.

5. Propose Data Analysis Methods:

Suggest appropriate data analysis methods based on the type of data collected. Consider whether statistical analysis, qualitative analysis, or a mixed-methods approach is most suitable.

6. Consider Limitations and Ethical Considerations:

Acknowledge any limitations and potential ethical considerations of the study. Furthermore, address these limitations or mitigate ethical concerns to ensure responsible research.

7. Justify Recommendations:

Explain how your recommendation contributes to addressing the research question or objective. Provide a strong rationale to help researchers understand the importance of following your suggestions.

8. Summarize Recommendations:

Provide a concise summary at the end of the report to emphasize how following these recommendations will contribute to the overall success of the research project.

By following these steps, you can create research recommendations that are actionable and contribute meaningfully to the success of the research project.

Download now to unlock some tips to improve your journey of writing research recommendations.

Example of a Research Recommendation

Here is an example of a research recommendation based on a hypothetical research to improve your understanding.

Research Recommendation: Enhancing Student Learning through Integrated Learning Platforms

Background:

The research study investigated the impact of an integrated learning platform on student learning outcomes in high school mathematics classes. The findings revealed a statistically significant improvement in student performance and engagement when compared to traditional teaching methods.

Recommendation:

In light of the research findings, it is recommended that educational institutions consider adopting and integrating the identified learning platform into their mathematics curriculum. The following specific recommendations are provided:

• Implementation of the Integrated Learning Platform:

Schools are encouraged to adopt the integrated learning platform in mathematics classrooms, ensuring proper training for teachers on its effective utilization.

• Professional Development for Educators:

Develop and implement professional programs to train educators in the effective use of the integrated learning platform to address any challenges teachers may face during the transition.

• Monitoring and Evaluation:

Establish a monitoring and evaluation system to track the impact of the integrated learning platform on student performance over time.

• Resource Allocation:

Allocate sufficient resources, both financial and technical, to support the widespread implementation of the integrated learning platform.

By implementing these recommendations, educational institutions can harness the potential of the integrated learning platform and enhance student learning experiences and academic achievements in mathematics.

This example covers the components of a research recommendation, providing specific actions based on the research findings, identifying the target audience, and outlining practical steps for implementation.

Using AI in Research Recommendation Writing

Enhancing research recommendations is an ongoing endeavor that requires the integration of cutting-edge technologies, collaborative efforts, and ethical considerations. By embracing data-driven approaches and leveraging advanced technologies, the research community can create more effective and personalized recommendation systems. However, it is accompanied by several limitations. Therefore, it is essential to approach the use of AI in research with a critical mindset, and complement its capabilities with human expertise and judgment.

Here are some limitations of integrating AI in writing research recommendation and some ways on how to counter them.

1. Data Bias

AI systems rely heavily on data for training. If the training data is biased or incomplete, the AI model may produce biased results or recommendations.

How to tackle: Audit regularly the model’s performance to identify any discrepancies and adjust the training data and algorithms accordingly.

2. Lack of Understanding of Context:

AI models may struggle to understand the nuanced context of a particular research problem. They may misinterpret information, leading to inaccurate recommendations.

How to tackle: Use AI to characterize research articles and topics. Employ them to extract features like keywords, authorship patterns and content-based details.

3. Ethical Considerations:

AI models might stereotype certain concepts or generate recommendations that could have negative consequences for certain individuals or groups.

How to tackle: Incorporate user feedback mechanisms to reduce redundancies. Establish an ethics review process for AI models in research recommendation writing.

4. Lack of Creativity and Intuition:

AI may struggle with tasks that require a deep understanding of the underlying principles or the ability to think outside the box.

How to tackle: Hybrid approaches can be employed by integrating AI in data analysis and identifying patterns for accelerating the data interpretation process.

5. Interpretability:

Many AI models, especially complex deep learning models, lack transparency on how the model arrived at a particular recommendation.

How to tackle: Implement models like decision trees or linear models. Provide clear explanation of the model architecture, training process, and decision-making criteria.

6. Dynamic Nature of Research:

Research fields are dynamic, and new information is constantly emerging. AI models may struggle to keep up with the rapidly changing landscape and may not be able to adapt to new developments.

How to tackle: Establish a feedback loop for continuous improvement. Regularly update the recommendation system based on user feedback and emerging research trends.

The integration of AI in research recommendation writing holds great promise for advancing knowledge and streamlining the research process. However, navigating these concerns is pivotal in ensuring the responsible deployment of these technologies. Researchers need to understand the use of responsible use of AI in research and must be aware of the ethical considerations.

Exploring research recommendations plays a critical role in shaping the trajectory of scientific inquiry. It serves as a compass, guiding researchers toward more robust methodologies, collaborative endeavors, and innovative approaches. Embracing these suggestions not only enhances the quality of individual studies but also contributes to the collective advancement of human understanding.

Frequently Asked Questions

The purpose of recommendations in research is to provide practical and actionable suggestions based on the study's findings, guiding future actions, policies, or interventions in a specific field or context. Recommendations bridges the gap between research outcomes and their real-world application.

To make a research recommendation, analyze your findings, identify key insights, and propose specific, evidence-based actions. Include the relevance of the recommendations to the study's objectives and provide practical steps for implementation.

Begin a recommendation by succinctly summarizing the key findings of the research. Clearly state the purpose of the recommendation and its intended impact. Use a direct and actionable language to convey the suggested course of action.

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How To Write Recommendations In A Research Study

Published by Alvin Nicolas at July 12th, 2024 , Revised On July 12, 2024

The ultimate goal of any research process is not just to gather knowledge, but to use that knowledge to make a positive impact. This is where recommendations come in.  A well-written recommendations section in your research study translates your findings into actionable steps and guides future research on the topic. 

This blog is your ultimate guide to understanding how to write recommendations in a research study. But before that, let’s see what is recommendation in research. 

What Is Recommendation In Research 

In a research study, the recommendation section refers to a suggested course of action based on the findings of your research . It acts as a bridge between the knowledge you gained and its practical implications. 

Recommendations take your research results and propose concrete steps on how to use them to address a problem or improve a situation. Moreover, you can suggest new avenues and guide future research in building upon your work. This will improve the credibility of your research. For studies that include real-world implications, recommendations are a great way to provide evidence-based suggestions for policymakers or practitioners to consider. 

Difference Between Research Recommendations and Implication

Research recommendations and implications often confuse researchers. They cannot easily differentiate between the two. Here is how they are different. 

Where To Add Recommendations 

Recommendations are mostly part of your conclusion and discussion sections. If you are writing a practical dissertation , you can include a separate section for your recommendations. 

Types of Research Recommendations

There are different forms of recommendations in research. Some of them include the following. 

How To Construct The Recommendations Section

There are different ways in which different scholars write the recommendations section. A general observation is a research question → conclusion → recommendation.

The following example will help you understand this better.

Research Question

How can the education of mothers impact the social skills of kindergarten children?

The role of mothers is a significant contributor towards the social skills of children. From an early age, kids tend to observe how their mother interacts with others and follow in her footsteps initially. Therefore, mothers should be educated and interact with good demeanour if they want their children to have excellent social skills.

Recommendation

The study revealed that a mother’s education plays an important role in building the social skills of children on kindergarten level. Future research could explore how the same continues in junior school level children.

How To Write Recommendations In Research

Now that you are familiar with the definition and types, here is a step-by-step guide on how to write a recommendation in research.

Step 1: Revisit Your Research Goals

Before doing anything else, you have to remind yourself of the objectives that you set out to achieve in your research. It allows you to match your recommendations directly to your research questions and see if you made any contribution to your goals.

Step 2: Analyse Your Findings

You have to examine your data and identify your key results. This analysis forms the foundation for your recommendations. Look for patterns and unexpected findings that might suggest new areas for other researchers to explore.

Step 3: Consider The Research Methods

Ask these questions from yourself: were the research methods effective? Is there any other way that would have been better to perform this research, or were there any limitations associated with the research methods?

Step 4: Prioritise Recommendations

You might have a lot of recommendations in mind, but all are not equal. You have to consider the impact and feasibility of each suggestion. Prioritise these recommendations, while remaining realistic about implementation.

Step 5: Write Actionable Statements

Do not be vague when crafting statements. Instead, you have to use clear and concise language that outlines specific actions. For example, if you want to say “improve education practices,” you could write “implement a teacher training program” for better clarity.

Step 6: Provide Evidence

You cannot just make suggestions out of thin air, and have to ground them in the evidence you have gathered through your research. Moreover, cite relevant data or findings from your study or previous literature to support your recommendations.

Step 7: Address Challenges

There are always some limitations related to the research at hand. As a researcher, it is your duty to highlight and address any challenges faced or what might occur in the future.

Tips For Writing The Perfect Recommendation In Research

Use these tips to write the perfect recommendation in your research.

• Be Concise – Write recommendations in a clear and concise language. Use one sentence statements to look more professional.
• Be Logical & Coherent – You can use lists and headings according to the requirements of your university.
• Tailor According To Your Readers – You have to aim your recommendations to a specific audience and colleagues in the field of study.
• Provide Specific Suggestions – Offer specific measures and solutions to the issues, and focus on actionable suggestions.
• Match Recommendations To Your Conclusion – You have to align your recommendations with your conclusion.
• Consider Limitations – Use critical thinking to see how limitations may impact the feasibility of your solutions.
• End With A Summary – You have to add a small conclusion to highlight suggestions and their impact.

Example Of Recommendation In Research

Context of the study:

This research studies how effective e-learning platforms are for adult language learners compared to traditional classroom instruction. The findings suggest that e-learning platforms can be just as effective as traditional classrooms in improving language proficiency.

Research Recommendation Sample

Language educators can incorporate e-learning tools into existing curriculums to provide learners with more flexibility. Additionally, they can develop training programs for educators on how to integrate e-learning platforms into their teaching practices.

E-learning platform developers should focus on e-learning platforms that are interactive and cater to different learning styles. They can also invest in features that promote learner autonomy and self-directed learning.

Future researchers can further explore the long-term effects of e-learning on language acquisition to provide insights into whether e-learning can support sustained language development.

Frequently Asked Questions

How to write recommendations in a research paper.

• Revisit your research goals
• Analyse your findings 
• Consider the research methods 
• Prioritise recommendations 
• Write actionable statements 
• Provide evidence 
• Address challenges

How to present recommendations in research?

• Be concise 
• Write logical and coherent 
• Match recommendations to conclusion 
• Ensure your recommendations are achievable

What to write in recommendation in research?

Your recommendation has to be concrete and specific and support the research with a clear rationale. Moreover, it should be connected directly to your research. Your recommendations, however, should not undermine your own work or use self-criticism. 

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The Ultimate Guide to Crafting Impactful Recommendations in Research

Are you ready to take your research to the next level? Crafting impactful recommendations is the key to unlocking the full potential of your study. By providing clear, actionable suggestions based on your findings, you can bridge the gap between research and real-world application.

In this ultimate guide, we'll show you how to write recommendations that make a difference in your research report or paper.

You'll learn how to craft specific, actionable recommendations that connect seamlessly with your research findings. Whether you're a student, writer, teacher, or journalist, this guide will help you master the art of writing recommendations in research. Let's get started and make your research count!

Understanding the Purpose of Recommendations

Recommendations in research serve as a vital bridge between your findings and their real-world applications. They provide specific, action-oriented suggestions to guide future studies and decision-making processes. Let's dive into the key purposes of crafting effective recommendations:

Guiding Future Research

Research recommendations play a crucial role in steering scholars and researchers towards promising avenues of exploration. By highlighting gaps in current knowledge and proposing new research questions, recommendations help advance the field and drive innovation.

Influencing Decision-Making

Well-crafted recommendations have the power to shape policies, programs, and strategies across various domains, such as:

• Policy-making
• Product development
• Marketing strategies
• Medical practice

By providing clear, evidence-based suggestions, recommendations facilitate informed decision-making and improve outcomes.

Connecting Research to Practice

Recommendations act as a conduit for transferring knowledge from researchers to practitioners, policymakers, and stakeholders. They bridge the gap between academic findings and their practical applications, ensuring that research insights are effectively translated into real-world solutions.

Enhancing Research Impact

By crafting impactful recommendations, you can amplify the reach and influence of your research, attracting attention from peers, funding agencies, and decision-makers.

Addressing Limitations

Recommendations provide an opportunity to acknowledge and address the limitations of your study. By suggesting concrete and actionable possibilities for future research, you demonstrate a thorough understanding of your work's scope and potential areas for improvement.

Identifying Areas for Future Research

Discovering research gaps is a crucial step in crafting impactful recommendations. It involves reviewing existing studies and identifying unanswered questions or problems that warrant further investigation. Here are some strategies to help you identify areas for future research:

Explore Research Limitations

Take a close look at the limitations section of relevant studies. These limitations often provide valuable insights into potential areas for future research. Consider how addressing these limitations could enhance our understanding of the topic at hand.

Critically Analyze Discussion and Future Research Sections

When reading articles, pay special attention to the discussion and future research sections. These sections often highlight gaps in the current knowledge base and propose avenues for further exploration. Take note of any recurring themes or unanswered questions that emerge across multiple studies.

Utilize Targeted Search Terms

To streamline your search for research gaps, use targeted search terms such as "literature gap" or "future research" in combination with your subject keywords. This approach can help you quickly identify articles that explicitly discuss areas for future investigation.

Seek Guidance from Experts

Don't hesitate to reach out to your research advisor or other experts in your field. Their wealth of knowledge and experience can provide valuable insights into potential research gaps and emerging trends.

By employing these strategies, you'll be well-equipped to identify research gaps and craft recommendations that push the boundaries of current knowledge. Remember, the goal is to refine your research questions and focus your efforts on areas where more understanding is needed.

Structuring Your Recommendations

When it comes to structuring your recommendations, it's essential to keep them concise, organized, and tailored to your audience. Here are some key tips to help you craft impactful recommendations:

Prioritize and Organize

• Limit your recommendations to the most relevant and targeted suggestions for your peers or colleagues in the field.
• Place your recommendations at the end of the report, as they are often top of mind for readers.
• Write your recommendations in order of priority, with the most important ones for decision-makers coming first.

Use a Clear and Actionable Format

• Write recommendations in a clear, concise manner using actionable words derived from the data analyzed in your research.
• Use bullet points instead of long paragraphs for clarity and readability.
• Ensure that your recommendations are specific, measurable, attainable, relevant, and timely (SMART).

Connect Recommendations to Research

By following this simple formula, you can ensure that your recommendations are directly connected to your research and supported by a clear rationale.

Tailor to Your Audience

• Consider the needs and interests of your target audience when crafting your recommendations.
• Explain how your recommendations can solve the issues explored in your research.
• Acknowledge any limitations or constraints of your study that may impact the implementation of your recommendations.

Avoid Common Pitfalls

• Don't undermine your own work by suggesting incomplete or unnecessary recommendations.
• Avoid using recommendations as a place for self-criticism or introducing new information not covered in your research.
• Ensure that your recommendations are achievable and comprehensive, offering practical solutions for the issues considered in your paper.

By structuring your recommendations effectively, you can enhance the reliability and validity of your research findings, provide valuable strategies and suggestions for future research, and deliver impactful solutions to real-world problems.

Crafting Actionable and Specific Recommendations

Crafting actionable and specific recommendations is the key to ensuring your research findings have a real-world impact. Here are some essential tips to keep in mind:

Embrace Flexibility and Feasibility

Your recommendations should be open to discussion and new information, rather than being set in stone. Consider the following:

• Be realistic and considerate of your team's capabilities when making recommendations.
• Prioritize recommendations based on impact and reach, but be prepared to adjust based on team effort levels.
• Focus on solutions that require the fewest changes first, adopting an MVP (Minimum Viable Product) approach.

Provide Detailed and Justified Recommendations

To avoid vagueness and misinterpretation, ensure your recommendations are:

• Detailed, including photos, videos, or screenshots whenever possible.
• Justified based on research findings, providing alternatives when findings don't align with expectations or business goals.

Use this formula when writing recommendations:

Observed problem/pain point/unmet need + consequence + potential solution

Adopt a Solution-Oriented Approach

Foster Collaboration and Participation

• Promote staff education on current research and create strategies to encourage adoption of promising clinical protocols.
• Include representatives from the treatment community in the development of the research initiative and the review of proposals.
• Require active, early, and permanent participation of treatment staff in the development, implementation, and interpretation of the study.

Tailor Recommendations to the Opportunity

When writing recommendations for a specific opportunity or program:

• Highlight the strengths and qualifications of the researcher.
• Provide specific examples of their work and accomplishments.
• Explain how their research has contributed to the field.
• Emphasize the researcher's potential for future success and their unique contributions.

By following these guidelines, you'll craft actionable and specific recommendations that drive meaningful change and showcase the value of your research.

Connecting Recommendations with Research Findings

Connecting your recommendations with research findings is crucial for ensuring the credibility and impact of your suggestions. Here's how you can seamlessly link your recommendations to the evidence uncovered in your study:

Grounding Recommendations in Research

Your recommendations should be firmly rooted in the data and insights gathered during your research process. Avoid including measures or suggestions that were not discussed or supported by your study findings. This approach ensures that your recommendations are evidence-based and directly relevant to the research at hand.

Highlighting the Significance of Collaboration

Research collaborations offer a wealth of benefits that can enhance an agency's competitive position. Consider the following factors when discussing the importance of collaboration in your recommendations:

• Organizational Development: Participation in research collaborations depends on an agency's stage of development, compatibility with its mission and culture, and financial stability.
• Trust-Building: Long-term collaboration success often hinges on a history of increasing involvement and trust between partners.
• Infrastructure: A permanent infrastructure that facilitates long-term development is key to successful collaborative programs.

Emphasizing Commitment and Participation

Fostering Quality Improvement and Organizational Learning

In your recommendations, highlight the importance of enhancing quality improvement strategies and fostering organizational learning. Show sensitivity to the needs and constraints of community-based programs, as this understanding is crucial for effective collaboration and implementation.

Addressing Limitations and Implications

If not already addressed in the discussion section, your recommendations should mention the limitations of the study and their implications. Examples of limitations include:

• Sample size or composition
• Participant attrition
• Study duration

By acknowledging these limitations, you demonstrate a comprehensive understanding of your research and its potential impact.

By connecting your recommendations with research findings, you provide a solid foundation for your suggestions, emphasize the significance of collaboration, and showcase the potential for future research and practical applications.

Crafting impactful recommendations is a vital skill for any researcher looking to bridge the gap between their findings and real-world applications. By understanding the purpose of recommendations, identifying areas for future research, structuring your suggestions effectively, and connecting them to your research findings, you can unlock the full potential of your study. Remember to prioritize actionable, specific, and evidence-based recommendations that foster collaboration and drive meaningful change.

As you embark on your research journey, embrace the power of well-crafted recommendations to amplify the impact of your work. By following the guidelines outlined in this ultimate guide, you'll be well-equipped to write recommendations that resonate with your audience, inspire further investigation, and contribute to the advancement of your field. So go forth, make your research count, and let your recommendations be the catalyst for positive change.

Q: What are the steps to formulating recommendations in research? A: To formulate recommendations in research, you should first gain a thorough understanding of the research question. Review the existing literature to inform your recommendations and consider the research methods that were used. Identify which data collection techniques were employed and propose suitable data analysis methods. It's also essential to consider any limitations and ethical considerations of your research. Justify your recommendations clearly and finally, provide a summary of your recommendations.

Q: Why are recommendations significant in research studies? A: Recommendations play a crucial role in research as they form a key part of the analysis phase. They provide specific suggestions for interventions or strategies that address the problems and limitations discovered during the study. Recommendations are a direct response to the main findings derived from data collection and analysis, and they can guide future actions or research.

Q: Can you outline the seven steps involved in writing a research paper? A: Certainly. The seven steps to writing an excellent research paper include:

• Allowing yourself sufficient time to complete the paper.
• Defining the scope of your essay and crafting a clear thesis statement.
• Conducting a thorough yet focused search for relevant research materials.
• Reading the research materials carefully and taking detailed notes.
• Writing your paper based on the information you've gathered and analyzed.
• Editing your paper to ensure clarity, coherence, and correctness.
• Submitting your paper following the guidelines provided.

Q: What tips can help make a research paper more effective? A: To enhance the effectiveness of a research paper, plan for the extensive process ahead and understand your audience. Decide on the structure your research writing will take and describe your methodology clearly. Write in a straightforward and clear manner, avoiding the use of clichés or overly complex language.

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• Julie Glanville , associate director/information service manager 5 ,
• Nicholas J Hicks , consultant in public health medicine 6 ,
• Janet Moody , identification and prioritisation manager 6 ,
• Sara Twaddle , director 7 ,
• Hazim Timimi , systems developer 8 ,
• Pamela Young , senior programme manager 6
• 1 BMJ Publishing Group, London WC1H 9JR,
• 2 National Institute for Health and Clinical Excellence, London WC1V 6NA,
• 3 Database of Uncertainties about the Effects of Treatments, James Lind Alliance Secretariat, James Lind Initiative, Oxford OX2 7LG,
• 4 UK Cochrane Centre, Oxford OX2 7LG,
• 5 Centre for Reviews and Dissemination, University of York, York YO10 5DD,
• 6 National Coordinating Centre for Health Technology Assessment, University of Southampton, Southampton SO16 7PX,
• 7 Scottish Intercollegiate Guidelines Network, Edinburgh EH2 1EN,
• 8 Update Software, Oxford OX2 7LG
• Correspondence to: PBrown
• Accepted 22 September 2006

“More research is needed” is a conclusion that fits most systematic reviews. But authors need to be more specific about what exactly is required

Long awaited reports of new research, systematic reviews, and clinical guidelines are too often a disappointing anticlimax for those wishing to use them to direct future research. After many months or years of effort and intellectual energy put into these projects, authors miss the opportunity to identify unanswered questions and outstanding gaps in the evidence. Most reports contain only a less than helpful, general research recommendation. This means that the potential value of these recommendations is lost.

Current recommendations

In 2005, representatives of organisations commissioning and summarising research, including the BMJ Publishing Group, the Centre for Reviews and Dissemination, the National Coordinating Centre for Health Technology Assessment, the National Institute for Health and Clinical Excellence, the Scottish Intercollegiate Guidelines Network, and the UK Cochrane Centre, met as members of the development group for the Database of Uncertainties about the Effects of Treatments (see bmj.com for details on all participating organisations). Our aim was to discuss the state of research recommendations within our organisations and to develop guidelines for improving the presentation of proposals for further research. All organisations had found weaknesses in the way researchers and authors of systematic reviews and clinical guidelines stated the need for further research. As part of the project, a member of the Centre for Reviews and Dissemination under-took a rapid literature search to identify information on research recommendation models, which found some individual methods but no group initiatives to attempt to standardise recommendations.

Suggested format for research recommendations on the effects of treatments

Core elements.

E Evidence (What is the current state of the evidence?)

P Population (What is …

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• > How to Do Research
• > Draw conclusions and make recommendations

Book contents

• Frontmatter
• Acknowledgements
• Introduction: Types of research
• Part 1 The research process
• 1 Develop the research objectives
• 2 Design and plan the study
• 3 Write the proposal
• 4 Obtain financial support for the research
• 5 Manage the research
• 6 Draw conclusions and make recommendations
• 7 Write the report
• 8 Disseminate the results
• Part 2 Methods
• Appendix The market for information professionals: A proposal from the Policy Studies Institute

6 - Draw conclusions and make recommendations

from Part 1 - The research process

Published online by Cambridge University Press:  09 June 2018

This is the point everything has been leading up to. Having carried out the research and marshalled all the evidence, you are now faced with the problem of making sense of it all. Here you need to distinguish clearly between three different things: results, conclusions and recommendations.

Results are what you have found through the research. They are more than just the raw data that you have collected. They are the processed findings of the work – what you have been analysing and striving to understand. In total, the results form the picture that you have uncovered through your research. Results are neutral. They clearly depend on the nature of the questions asked but, given a particular set of questions, the results should not be contentious – there should be no debate about whether or not 63 per cent of respondents said ‘yes’ to question 16.

When you consider the results you can draw conclusions based on them. These are less neutral as you are putting your interpretation on the results and thus introducing a degree of subjectivity. Some research is simply descriptive – the final report merely presents the results. In most cases, though, you will want to interpret them, saying what they mean for you – drawing conclusions.

These conclusions might arise from a comparison between your results and the findings of other studies. They will, almost certainly, be developed with reference to the aim and objectives of the research. While there will be no debate over the results, the conclusions could well be contentious. Someone else might interpret the results differently, arriving at different conclusions. For this reason you need to support your conclusions with structured, logical reasoning.

Having drawn your conclusions you can then make recommendations. These should flow from your conclusions. They are suggestions about action that might be taken by people or organizations in the light of the conclusions that you have drawn from the results of the research. Like the conclusions, the recommendations may be open to debate. You may feel that, on the basis of your conclusions, the organization you have been studying should do this, that or the other.

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• Draw conclusions and make recommendations
• Book: How to Do Research
• Online publication: 09 June 2018
• Chapter DOI: https://doi.org/10.29085/9781856049825.007

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Writing the parts of scientific reports

22 Writing the conclusion & recommendations

There are probably some overlaps between the Conclusion and the Discussion section. Nevertheless, this section gives you the opportunity to highlight the most important points in your report, and is sometimes the only section read. Think about what your research/ study has achieved, and the most important findings and ideas you want the reader to know. As all studies have limitations also think about what you were not able to cover (this shows that you are able to evaluate your own work objectively).

Possible structure of this section:

Use present perfect to sum up/ evaluate:

This study has explored/ has attempted …

Use past tense to state what your aim was and to refer to actions you carried out:

• This study was intended to analyse …
• The aim of this study was to …

Use present tense to evaluate your study and to state the generalizations and implications that you draw from your findings.

• The results add to the knowledge of …
• These findings s uggest that …

You can either use present tense or past tense to summarize your results.

• The findings reveal …
• It was found that …

Achievements of this study (positive)

• This study provides evidence that …
• This work has contributed to a number of key issues in the field such as …

Limitations of the study (negative)

• Several limitations should be noted. First …

Combine positive and negative remarks to give a balanced assessment:

• Although this research is somewhat limited in scope, its findings can provide a basis for future studies.
• Despite the limitations, findings from the present study can help us understand …

Use more cautious language (modal verbs may, can, could)

• There are a number of possible extensions of this research …
• The findings suggest the possibility for future research on …
• These results may be important for future studies on …
• Examining a wider context could/ would lead …

Or indicate that future research is needed

• There is still a need for future research to determine …
• Further studies should be undertaken to discover…
• It would be worthwhile to investigate …

Academic Writing in a Swiss University Context Copyright © 2018 by Irene Dietrichs. All Rights Reserved.

Home » Blog » How to Write Conclusions and Recommendations in a Research Paper

How to Write Conclusions and Recommendations in a Research Paper

Table of Contents

How to Write Conclusions and Recommendations

Writing a research paper can be very stressful but as you go deeper into writing it, it becomes easier. Like every form of writing, research papers have formats that you must follow to enable you to write one that is worthy of Nobel recognition.

The conclusions and recommendations are an essential part of research papers and also, mark the end of a research paper. Both must be taken seriously as they are the very last impression you leave in the minds of your readers. They have the ability to add beauty and technicality to your piece of writing. No matter how much or how best you have written other chapters of your paper, it wouldn’t matter if your conclusion or recommendation lacks soul.

It is important to note that the conclusion and recommendations may be combined or presented in separate sections depending on the type of research paper.

How to write a conclusion for your research paper

The conclusion section of a research paper focuses on discussing the essential features and the significant outcomes of your research. It highlights to your readers the importance of your research to them after they have read through it. It also serves as a round off to the story in your research. The conclusion should be written in relation to the introduction in your research paper. This means that your conclusion should be written in such a way that it relates to the aims of the research paper.

Here are a few steps to follow to enable you write a good conclusion for your research paper.

Find logical connections

The conclusion should summarize your research paper. Don’t begin a new idea in this section. You should restate main points, and provide a basic synthesis for them. This means that you should find a logical connection between your aims, objectives or hypothesis to your conclusions. This will ensure that your conclusion doesn’t sound like a single thought to your readers or sound different from what was discussed throughout the research paper. When you are able to draw logical connections to previous ideas stated in your research paper, you leave your readers with a lasting impression.

Ensure your conclusion is linked to your introduction

The best structure for a conclusion in a research paper is to draft your conclusion in such a way that it links back to your introduction and your introduction links back to it, just like a perfect cycle. This can be done by restating the question asked in the introduction. But in this section, you would be providing an answer that your readers can understand. This is the same method used in short stories, when the writer leaves you guessing at the start and then tells you all you need to know at the very end of the story.

Don’t forget logic

It is ok to have opposing points in your research paper. However, it is solely your duty to ensure that your readers are not left confused as a result of the opposing points. Your conclusion is the perfect place to tell your readers your opinion on the issues highlighted in your research paper. All the questions that were unanswered or partially answered in your research paper should be answered in your conclusion. If at this point you can’t give a clear answer to those questions, let your readers know what further research is needed or the future actions that would provide a clear answer to the questions. Restate your thesis statement, let your readers know if you still believe it or a new finding has caused you to think otherwise.

Let the readers draw their own conclusions

Note that this approach is inappropriate in some types of research papers. However, it is accepted mostly in research papers on social or political issues. In this method, you ask your readers the question instead of providing them with answers. The questions asked must be centered on the purpose of the paper.

Give recommendations

If you choose to merge your conclusion and recommendation into one section, then now is the time to state your recommendation.

How to write a recommendation for your research paper

Recommendations are used to call for action or solutions to the problems you have investigated in your research paper. Your recommendations highlight specific solutions and measures to be implemented based on the findings of your research.

Here are a few guidelines to enable you to write a good recommendation for your research paper.

Should be concrete and specific

Avoid beating around the bush. You can choose to restate the problem and then explain specific measures that can be used to solve those problems. The solutions or call for action should be specific for the problems you have stated earlier. Do not introduce new questions or problems at this point.

The recommendations should connect to your conclusion

Your recommendation should logically support your conclusions and should be achievable. You should limit yourself to a few recommendations. It is possible that a single recommendation can be fitting for all your conclusions.

Explain how the solution you suggested can contribute to solving the problems you stated

You shouldn’t just stop at putting down possible solutions. You should also explain how it can solve the problems highlighted in your research paper.

The conclusion and recommendation section in any research paper is very important. It tells the reader that he has come to the end of the paper. It also breaks down everything your research paper discusses into more digestible chunks. As earlier stated, you should avoid introducing new information in your conclusion and recommendation. Goodluck!

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Style and Grammar Guidelines

APA Style provides a foundation for effective scholarly communication because it helps writers present their ideas in a clear, concise, and inclusive manner. When style works best, ideas flow logically, sources are credited appropriately, and papers are organized predictably. People are described using language that affirms their worth and dignity. Authors plan for ethical compliance and report critical details of their research protocol to allow readers to evaluate findings and other researchers to potentially replicate the studies. Tables and figures present information in an engaging, readable manner.

The style and grammar guidelines pages present information about APA Style as described in the Publication Manual of the American Psychological Association, Seventh Edition and the Concise Guide to APA Style, Seventh Edition . Any updates to APA Style are noted on the applicable topic pages. If you are still using the sixth edition, helpful resources are available in the sixth edition archive .

Looking for more style?

• Accessibility of APA Style
• Line Spacing
• Order of Pages
• Page Header
• Paragraph Alignment and Indentation
• Sample Papers
• Title Page Setup
• Appropriate Level of Citation
• Basic Principles of Citation
• Classroom or Intranet Sources
• Paraphrasing
• Personal Communications
• Quotations From Research Participants
• Secondary Sources
• Abbreviations
• Capitalization
• Italics and Quotation Marks
• Punctuation
• Spelling and Hyphenation
• General Principles for Reducing Bias
• Historical Context
• Intersectionality
• Participation in Research
• Racial and Ethnic Identity
• Sexual Orientation
• Socioeconomic Status
• Accessible Use of Color in Figures
• Figure Setup
• Sample Figures
• Sample Tables
• Table Setup
• Archival Documents and Collections
• Basic Principles of Reference List Entries
• Database Information in References
• DOIs and URLs
• Elements of Reference List Entries
• Missing Reference Information
• Reference Examples
• References in a Meta-Analysis
• Reference Lists Versus Bibliographies
• Works Included in a Reference List
• Active and Passive Voice
• Anthropomorphism
• First-Person Pronouns
• Logical Comparisons
• Plural Nouns
• Possessive Adjectives
• Possessive Nouns
• Singular “They”
• Adapting a Dissertation or Thesis Into a Journal Article
• Correction Notices
• Cover Letters
• Journal Article Reporting Standards (JARS)
• Open Science
• Response to Reviewers

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How to Write Recommendations in a Research Paper Correctly and Appropriately

Updated 25 Jul 2024

Completing a research paper can be daunting, but it becomes more manageable if you delve deeper into the process. Academic papers adhere to specific formats that must be followed to ensure high-quality content.

The conclusion and recommendations sections are crucial components of a research paper. They mark the end of your research, leave a lasting impression on your readers, and should be approached with great care. No wonder many students search for information about how to write recommendations in research papers. Explore this comprehensive guide to infuse your content with thoughtfulness and coherence, thereby elevating the impact of your research paper. Crafting clear and actionable recommendations in a research paper is essential, and a personal statement writing service can provide the expertise needed to present your findings and suggestions convincingly.

Recommendations in a research paper: meaning and goals

Before you start learning how to write recommendations in a research paper, the first thing is to clarify the meaning of this term. It is a significant element in the research paper structure, as it is critical to your discussion section and conclusion. While conducting research and analyzing gathered data, you may come across ideas or results that only partially align with the scope of your research topic. Alternatively, your findings offer possible implications or causal relationships between the aspects not covered in existing research.

Based on your conclusions and findings, this section will provide practical solutions for further research. The particular goals of this section depend on the research nature and usually include the following:

• Providing strategies to address the issues considered in the paper;
• Delivering suggestions on how the investigation findings can be applied in practice;
• Identifying gaps in the subject area and suggesting ways to extend existing knowledge;
• Enhancing reliability and validity of the research findings. 

Where to put recommendations?

To better understand how to write recommendations in research, you should know where to insert them. These elements are typically added in the conclusion (a short version) and discussion sections. Still, if you’re doing research with a practical or business focus, you can also include your suggestions in an advisory report or separate section. This text part should be completed based on the research findings and evidence. It should be clear, specific, and actionable, targeted to the intended audience, such as researchers, practitioners, or policymakers.

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What should recommendations look like?

When providing your solutions for further research, it’s important to ensure they are specific, fully connected to your investigation, and supported by a comprehensible rationale. The essential goal is to show how other researchers can generate the same results to make conclusions and offer potential directions for future research. 

Recommendations should be clear and include actionable words. While completing this section, the writer should show a solution-oriented approach by highlighting the scope for future investigation. Using bullet points is a better way to ensure clarity instead of writing long paragraphs.

Look at the following recommendation in a research paper example:

It is recommended that company X should create and promote sugar-free biscuits along with their existing product range. The marketing department should focus on creating a positive and healthy image. 

Let’s rewrite this paragraph to make it clear and well-structured:

• The corporation has to introduce and promote sugar-free products;
• The company has to create a new positive image;
• The company has to launch an advertising campaign to show their products’ benefits for health.

When visiting the EduBirdie website, you’ll find many helpful tips on writing a research paper, ranging from completing a research paper conclusion to exploring examples of a well-thought-out recommendations section. Don’t miss your chance to improve your paper with our assistance!

Structure of recommendations

Let’s consider the typical structure of this part. You’ll come across many various ways to organize it. The most common approach uses a simple formula with three elements: research question, conclusion, and recommendation. Now, you’ll see how this structure can be implemented.

Research question:

Which category of people is more prone to social exclusion? 

Conclusion:

The study found that individuals over 65 have a greater risk of being isolated from society.

Recommendation:

It is recommended that the institutions dealing with overcoming social exclusion should focus on this particular group. 

In this example, the author delivers a suggestion based on the research findings (the risk of social isolation grows among people aged 65 and more). The measures to improve this situation are indicated (the organizations dealing with problems of social isolation should pay more attention to people over 65 years old).

How to write recommendations in research papers: essential guidelines

Look at some tips from EduBirdie research paper writing services to help you complete a flawless chapter for your papers.

• Be concise in your statements.  Ensure that your suggestions are written in clear and concise language, avoiding jargon or technical terms difficult to understand. Try to limit yourself to one-sentence statements to present your recommendation. Not only it can help with language learning overall, but will also look more professional.
• Organize your ideas logically and coherently . You may use lists or paragraphs depending on your institution's guidelines or field of study. Use headings and subheadings to structure your section for easy navigation.
• Provide specific and concrete suggestions.  Clearly state the issues you explore and offer specific measures and solutions. Your call to action and suggestions should be related to the issues mentioned in the previous sections. Focusing on the most relevant and actionable suggestions directly stemming from your research is crucial.
• Match recommendations to your conclusion.  Ensure that your suggestions logically align with your conclusions. Refrain from suggesting too many solutions. You can create one recommendation addressing several conclusions when you must provide numerous suggestions for every study conclusion.
• Ensure your solutions are achievable.  Your recommendations should be practical and feasible to implement. Suggest specific and actionable steps to effectively address the considered issues or gaps in the research, avoiding vague or impractical suggestions.
• Use a comprehensive approach.  Make sure your solutions cover all relevant areas within your research scope. Consider different contexts, stakeholders, and perspectives affected by the recommendations. Be thorough in identifying potential improvement areas and offering appropriate actions.
• Don’t add new information to this part of your paper.  Avoid introducing new issues or ideas to complete your argument when writing recommendations in a research paper. Your academic paper has to stand on its own merits. 
• Create content tailored to your readers.  Ensure that your recommendations are aimed at your audience, namely your colleagues in the field of study who work on similar topics. The ideas you provide in the paper should be based on limitations identified during research. They should offer concrete possibilities for further study to rely on areas your investigation could not cover when completed.
• Explain how your recommendations can solve the issues you explore.  Go beyond listing suggestions and provide a rationale for each, including why it is essential, how it handles the research problem, and what evidence or theory supports it. Use relevant literature citations to strengthen your content. Explain how the suggested solutions can effectively answer the research question. This can be done by adding the following:
• Ideas for improving the methodology or approach;
• Policy suggestions;
• Perspectives for future research.
• Don’t undermine your research contribution or criticize yourself.   Avoid criticizing yourself in this section. Instead, use it as a perfect opportunity to provide ideas on how future studies can build upon your findings, making them a natural extension point. 
• Acknowledge any limitations or constraints of your research.  Reflect on how these limitations may impact the feasibility or generalizability of your solutions. This demonstrates critical thinking and awareness of the limitations of your study.
• End this section with a summary.  Highlight the key suggestions and their potential impact in a short conclusion. Emphasize the significance of your ideas and their valuable contribution to the field.

Don’t forget to consult and adhere to the requirements and specific guidelines provided by your institution for this section.

How do the discussion and the conclusion sections differ in a research paper? 

The discussion usually entails a comprehensive analysis of the results, delving into the significance of your findings and providing contextualization using citations of relevant sources. On the other hand, the conclusion is typically more concise and general. It briefly considers the main research question and provides suggestions from your findings.

Can the research paper conclusion come with new arguments? 

Although adding fresh evidence or arguments in the conclusion might be tempting, especially if you have a compelling point, we don’t recommend doing it. Research papers, dissertations, or theses typically adhere to a formal structure. Exposing all your arguments and findings in the thesis body is crucial. It’s better to do it in the discussion and results chapters. The conclusion should serve as a summary and reflection of your evidence and arguments rather than a place to introduce new ideas.

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Written by Steven Robinson

Steven Robinson is an academic writing expert with a degree in English literature. His expertise, patient approach, and support empower students to express ideas clearly. On EduBirdie's blog, he provides valuable writing guides on essays, research papers, and other intriguing topics. Enjoys chess in free time.

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How to write recommendations in a research paper

Many students put in a lot of effort and write a good report however they are not able to give proper recommendations. Recommendations in the research paper should be included in your research. As a researcher, you display a deep understanding of the topic of research. Therefore you should be able to give recommendations. Here are a few tips that will help you to give appropriate recommendations. 

Recommendations in the research paper should be the objective of the research. Therefore at least one of your objectives of the paper is to provide recommendations to the parties associated or the parties that will benefit from your research. For example, to encourage higher employee engagement HR department should make strategies that invest in the well-being of employees. Additionally, the HR department should also collect regular feedback through online surveys.

Recommendations in the research paper should come from your review and analysis For example It was observed that coaches interviewed were associated with the club were working with the club from the past 2-3 years only. This shows that the attrition rate of coaches is high and therefore clubs should work on reducing the turnover of coaches.

Recommendations in the research paper should also come from the data you have analysed. For example, the research found that people over 65 years of age are at greater risk of social isolation. Therefore, it is recommended that policies that are made for combating social isolation should target this specific group.

Recommendations in the research paper should also come from observation. For example, it is observed that Lenovo’s income is stable and gross revenue has displayed a negative turn. Therefore the company should analyse its marketing and branding strategy.

Recommendations in the research paper should be written in the order of priority. The most important recommendations for decision-makers should come first. However, if the recommendations are of equal importance then it should come in the sequence in which the topic is approached in the research. 

Recommendations in a research paper if associated with different categories then you should categorize them. For example, you have separate recommendations for policymakers, educators, and administrators then you can categorize the recommendations. 

Recommendations in the research paper should come purely from your research. For example, you have written research on the impact on HR strategies on motivation. However, nowhere you have discussed Reward and recognition. Then you should not give recommendations for using rewards and recognition measures to boost employee motivation.

The use of bullet points offers better clarity rather than using long paragraphs. For example this paragraph “ It is recommended  that Britannia Biscuit should launch and promote sugar-free options apart from the existing product range. Promotion efforts should be directed at creating a fresh and healthy image. A campaign that conveys a sense of health and vitality to the consumer while enjoying biscuit  is recommended” can be written as:

• The company should launch and promote sugar-free options
• The company should work towards creating s fresh and healthy image
• The company should run a campaign to convey its healthy image

The inclusion of an action plan along with recommendation adds more weightage to your recommendation. Recommendations should be clear and conscience and written using actionable words. Recommendations should display a solution-oriented approach and in some cases should highlight the scope for further research. 

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Writing a Research Paper Conclusion | Step-by-Step Guide

Published on October 30, 2022 by Jack Caulfield . Revised on April 13, 2023.

• Restate the problem statement addressed in the paper
• Summarize your overall arguments or findings
• Suggest the key takeaways from your paper

The content of the conclusion varies depending on whether your paper presents the results of original empirical research or constructs an argument through engagement with sources .

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Table of contents

Step 1: restate the problem, step 2: sum up the paper, step 3: discuss the implications, research paper conclusion examples, frequently asked questions about research paper conclusions.

The first task of your conclusion is to remind the reader of your research problem . You will have discussed this problem in depth throughout the body, but now the point is to zoom back out from the details to the bigger picture.

While you are restating a problem you’ve already introduced, you should avoid phrasing it identically to how it appeared in the introduction . Ideally, you’ll find a novel way to circle back to the problem from the more detailed ideas discussed in the body.

For example, an argumentative paper advocating new measures to reduce the environmental impact of agriculture might restate its problem as follows:

Meanwhile, an empirical paper studying the relationship of Instagram use with body image issues might present its problem like this:

“In conclusion …”

Avoid starting your conclusion with phrases like “In conclusion” or “To conclude,” as this can come across as too obvious and make your writing seem unsophisticated. The content and placement of your conclusion should make its function clear without the need for additional signposting.

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Having zoomed back in on the problem, it’s time to summarize how the body of the paper went about addressing it, and what conclusions this approach led to.

Depending on the nature of your research paper, this might mean restating your thesis and arguments, or summarizing your overall findings.

Argumentative paper: Restate your thesis and arguments

In an argumentative paper, you will have presented a thesis statement in your introduction, expressing the overall claim your paper argues for. In the conclusion, you should restate the thesis and show how it has been developed through the body of the paper.

Briefly summarize the key arguments made in the body, showing how each of them contributes to proving your thesis. You may also mention any counterarguments you addressed, emphasizing why your thesis holds up against them, particularly if your argument is a controversial one.

Don’t go into the details of your evidence or present new ideas; focus on outlining in broad strokes the argument you have made.

Empirical paper: Summarize your findings

In an empirical paper, this is the time to summarize your key findings. Don’t go into great detail here (you will have presented your in-depth results and discussion already), but do clearly express the answers to the research questions you investigated.

Describe your main findings, even if they weren’t necessarily the ones you expected or hoped for, and explain the overall conclusion they led you to.

Having summed up your key arguments or findings, the conclusion ends by considering the broader implications of your research. This means expressing the key takeaways, practical or theoretical, from your paper—often in the form of a call for action or suggestions for future research.

Argumentative paper: Strong closing statement

An argumentative paper generally ends with a strong closing statement. In the case of a practical argument, make a call for action: What actions do you think should be taken by the people or organizations concerned in response to your argument?

If your topic is more theoretical and unsuitable for a call for action, your closing statement should express the significance of your argument—for example, in proposing a new understanding of a topic or laying the groundwork for future research.

Empirical paper: Future research directions

In a more empirical paper, you can close by either making recommendations for practice (for example, in clinical or policy papers), or suggesting directions for future research.

Whatever the scope of your own research, there will always be room for further investigation of related topics, and you’ll often discover new questions and problems during the research process .

Finish your paper on a forward-looking note by suggesting how you or other researchers might build on this topic in the future and address any limitations of the current paper.

Full examples of research paper conclusions are shown in the tabs below: one for an argumentative paper, the other for an empirical paper.

• Argumentative paper
• Empirical paper

While the role of cattle in climate change is by now common knowledge, countries like the Netherlands continually fail to confront this issue with the urgency it deserves. The evidence is clear: To create a truly futureproof agricultural sector, Dutch farmers must be incentivized to transition from livestock farming to sustainable vegetable farming. As well as dramatically lowering emissions, plant-based agriculture, if approached in the right way, can produce more food with less land, providing opportunities for nature regeneration areas that will themselves contribute to climate targets. Although this approach would have economic ramifications, from a long-term perspective, it would represent a significant step towards a more sustainable and resilient national economy. Transitioning to sustainable vegetable farming will make the Netherlands greener and healthier, setting an example for other European governments. Farmers, policymakers, and consumers must focus on the future, not just on their own short-term interests, and work to implement this transition now.

As social media becomes increasingly central to young people’s everyday lives, it is important to understand how different platforms affect their developing self-conception. By testing the effect of daily Instagram use among teenage girls, this study established that highly visual social media does indeed have a significant effect on body image concerns, with a strong correlation between the amount of time spent on the platform and participants’ self-reported dissatisfaction with their appearance. However, the strength of this effect was moderated by pre-test self-esteem ratings: Participants with higher self-esteem were less likely to experience an increase in body image concerns after using Instagram. This suggests that, while Instagram does impact body image, it is also important to consider the wider social and psychological context in which this usage occurs: Teenagers who are already predisposed to self-esteem issues may be at greater risk of experiencing negative effects. Future research into Instagram and other highly visual social media should focus on establishing a clearer picture of how self-esteem and related constructs influence young people’s experiences of these platforms. Furthermore, while this experiment measured Instagram usage in terms of time spent on the platform, observational studies are required to gain more insight into different patterns of usage—to investigate, for instance, whether active posting is associated with different effects than passive consumption of social media content.

If you’re unsure about the conclusion, it can be helpful to ask a friend or fellow student to read your conclusion and summarize the main takeaways.

• Do they understand from your conclusion what your research was about?
• Are they able to summarize the implications of your findings?
• Can they answer your research question based on your conclusion?

You can also get an expert to proofread and feedback your paper with a paper editing service .

Here's why students love Scribbr's proofreading services

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The conclusion of a research paper has several key elements you should make sure to include:

• A restatement of the research problem
• A summary of your key arguments and/or findings
• A short discussion of the implications of your research

No, it’s not appropriate to present new arguments or evidence in the conclusion . While you might be tempted to save a striking argument for last, research papers follow a more formal structure than this.

All your findings and arguments should be presented in the body of the text (more specifically in the results and discussion sections if you are following a scientific structure). The conclusion is meant to summarize and reflect on the evidence and arguments you have already presented, not introduce new ones.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Caulfield, J. (2023, April 13). Writing a Research Paper Conclusion | Step-by-Step Guide. Scribbr. Retrieved July 30, 2024, from https://www.scribbr.com/research-paper/research-paper-conclusion/

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Ten Simple Rules for Writing Research Papers

Weixiong zhang.

Department of Computer Science and Engineering, Department of Genetics, Washington University in St. Louis, St. Louis, Missouri, United States of America

The importance of writing well can never be overstated for a successful professional career, and the ability to write solid papers is an essential trait of a productive researcher. Writing and publishing a paper has its own life cycle; properly following a course of action and avoiding missteps can be vital to the overall success not only of a paper but of the underlying research as well. Here, we offer ten simple rules for writing and publishing research papers.

As a caveat, this essay is not about the mechanics of composing a paper, much of which has been covered elsewhere, e.g., [1] , [2] . Rather, it is about the principles and attitude that can help guide the process of writing in particular and research in general. In this regard, some of the discussion will complement, extend, and refine some advice given in early articles of this Ten Simple Rules series of PLOS Computational Biology [3] – [8] .

Rule 1: Make It a Driving Force

Never separate writing a paper from the underlying research. After all, writing and research are integral parts of the overall enterprise. Therefore, design a project with an ultimate paper firmly in mind. Include an outline of the paper in the initial project design documents to help form the research objectives, determine the logical flow of the experiments, and organize the materials and data to be used. Furthermore, use writing as a tool to reassess the overall project, reevaluate the logic of the experiments, and examine the validity of the results during the research. As a result, the overall research may need to be adjusted, the project design may be revised, new methods may be devised, and new data may be collected. The process of research and writing may be repeated if necessary.

Rule 2: Less Is More

It is often the case that more than one hypothesis or objective may be tackled in one project. It is also not uncommon that the data and results gathered for one objective can serve additional purposes. A decision on having one or more papers needs to be made, and the decision will be affected by various factors. Regardless of the validity of these factors, the overriding consideration must be the potential impact that the paper may have on the research subject and field. Therefore, the significance, completeness, and coherence of the results presented as a whole should be the principal guide for selecting the story to tell, the hypothesis to focus upon, and materials to include in the paper, as well as the yardstick for measuring the quality of the paper. By this metric, less is more , i.e., fewer but more significant papers serve both the research community and one's career better than more papers of less significance.

Rule 3: Pick the Right Audience

Deciding on an angle of the story to focus upon is the next hurdle to jump at the initial stage of the writing. The results from a computational study of a biological problem can often be presented to biologists, computational scientists, or both; deciding what story to tell and from what angle to pitch the main idea is important. This issue translates to choosing a target audience, as well as an appropriate journal, to cast the main messages to. This is critical for determining the organization of the paper and the level of detail of the story, so as to write the paper with the audience in mind. Indeed, writing a paper for biologists in general is different from writing for specialists in computational biology.

Rule 4: Be Logical

The foundation of “lively” writing for smooth reading is a sound and clear logic underlying the story of the paper. Although experiments may be carried out independently, the result from one experiment may form premises and/or provide supporting data for the next experiment. The experiments and results, therefore, must be presented in a logical order. In order to make the writing an easy process to follow, this logical flow should be determined before any other writing strategy or tactic is exercised. This logical order can also help you avoid discussing the same issue or presenting the same argument in multiple places in the paper, which may dilute the readers' attention.

An effective tactic to help develop a sound logical flow is to imaginatively create a set of figures and tables, which will ultimately be developed from experimental results, and order them in a logical way based on the information flow through the experiments. In other words, the figures and tables alone can tell the story without consulting additional material. If all or some of these figures and tables are included in the final manuscript, make every effort to make them self-contained (see Rule 5 below), a favorable feature for the paper to have. In addition, these figures and tables, as well as the threading logical flow, may be used to direct or organize research activities, reinforcing Rule 1.

Rule 5: Be Thorough and Make It Complete

Completeness is a cornerstone for a research paper, following Rule 2. This cornerstone needs to be set in both content and presentation. First, important and relevant aspects of a hypothesis pursued in the research should be discussed with detailed supporting data. If the page limit is an issue, focus on one or two main aspects with sufficient details in the main text and leave the rest to online supporting materials. As a reminder, be sure to keep the details of all experiments (e.g., parameters of the experiments and versions of software) for revision, post-publication correspondence, or importantly, reproducibility of the results. Second, don't simply state what results are presented in figures and tables, which makes the writing repetitive because they are self-contained (see below), but rather, interpret them with insights to the underlying story to be told (typically in the results section) and discuss their implication (typically in the discussion section).

Third, make the whole paper self-contained. Introduce an adequate amount of background and introductory material for the right audience (following Rule 3). A statistical test, e.g., hypergeometric tests for enrichment of a subset of objects, may be obvious to statisticians or computational biologists but may be foreign to others, so providing a sufficient amount of background is the key for delivery of the material. When an uncommon term is used, give a definition besides a reference to it. Fourth, try to avoid “making your readers do the arithmetic” [9] , i.e., be clear enough so that the readers don't have to make any inference from the presented data. If such results need to be discussed, make them explicit even though they may be readily derived from other data. Fifth, figures and tables are essential components of a paper, each of which must be included for a good reason; make each of them self-contained with all required information clearly specified in the legend to guide interpretation of the data presented.

Rule 6: Be Concise

This is a caveat to Rule 5 and is singled out to emphasize its importance. Being thorough is not a license to writing that is unnecessarily descriptive, repetitive, or lengthy. Rather, on the contrary, “simplicity is the ultimate sophistication” [10] . Overly elaborate writing is distracting and boring and places a burden on the readers. In contrast, the delivery of a message is more rigorous if the writing is precise and concise. One excellent example is Watson and Crick's Nobel-Prize-winning paper on the DNA double helix structure [11] —it is only two pages long!

Rule 7: Be Artistic

A complete draft of a paper requires a lot of work, so it pays to go the extra mile to polish it to facilitate enjoyable reading. A paper presented as a piece of art will give referees a positive initial impression of your passion toward the research and the quality of the work, which will work in your favor in the reviewing process. Therefore, concentrate on spelling, grammar, usage, and a “lively” writing style that avoids successions of simple, boring, declarative sentences. Have an authoritative dictionary with a thesaurus and a style manual, e.g., [1] , handy and use them relentlessly. Also pay attention to small details in presentation, such as paragraph indentation, page margins, and fonts. If you are not a native speaker of the language the paper is written in, make sure to have a native speaker go over the final draft to ensure correctness and accuracy of the language used.

Rule 8: Be Your Own Judge

A complete manuscript typically requires many rounds of revision. Taking a correct attitude during revision is critical to the resolution of most problems in the writing. Be objective and honest about your work and do not exaggerate or belittle the significance of the results and the elegance of the methods developed. After working long and hard, you are an expert on the problem you studied, and you are the best referee of your own work, after all . Therefore, inspect the research and the paper in the context of the state of the art.

When revising a draft, purge yourself out of the picture and leave your passion for your work aside. To be concrete, put yourself completely in the shoes of a referee and scrutinize all the pieces—the significance of the work, the logic of the story, the correctness of the results and conclusions, the organization of the paper, and the presentation of the materials. In practice, you may put a draft aside for a day or two—try to forget about it completely—and then come back to it fresh, consider it as if it were someone else's writing, and read it through while trying to poke holes in the story and writing. In this process, extract the meaning literally from the language as written and do not try to use your own view to interpret or extrapolate from what was written. Don't be afraid to throw away pieces of your writing and start over from scratch if they do not pass this “not-yourself” test. This can be painful, but the final manuscript will be more logically sound and better organized.

Rule 9: Test the Water in Your Own Backyard

It is wise to anticipate the possible questions and critiques the referees may raise and preemptively address their concerns before submission. To do so, collect feedback and critiques from others, e.g., colleagues and collaborators. Discuss your work with them and get their opinions, suggestions, and comments. A talk at a lab meeting or a departmental seminar will also help rectify potential issues that need to be addressed. If you are a graduate student, running the paper and results through the thesis committee may be effective to iron out possible problems.

Rule 10: Build a Virtual Team of Collaborators

When a submission is rejected or poorly reviewed, don't be offended and don't take it personally. Be aware that the referees spent their time on the paper, which they might have otherwise devoted to their own research, so they are doing you a favor and helping you shape the paper to be more accessible to the targeted audience. Therefore, consider the referees as your collaborators and treat the reviews with respect. This attitude can improve the quality of your paper and research.

Read and examine the reviews objectively—the principles set in Rule 8 apply here as well. Often a criticism was raised because one of the aspects of a hypothesis was not adequately studied, or an important result from previous research was not mentioned or not consistent with yours. If a critique is about the robustness of a method used or the validity of a result, often the research needs to be redone or more data need to be collected. If you believe the referee has misunderstood a particular point, check the writing. It is often the case that improper wording or presentation misled the referee. If that's the case, revise the writing thoroughly. Don't argue without supporting data. Don't submit the paper elsewhere without additional work. This can only temporally mitigate the issue, you will not be happy with the paper in the long run, and this may hurt your reputation.

Finally, keep in mind that writing is personal, and it takes a lot of practice to find one's style. What works and what does not work vary from person to person. Undoubtedly, dedicated practice will help produce stronger papers with long-lasting impact.

Acknowledgments

Thanks to Sharlee Climer, Richard Korf, and Kevin Zhang for critical reading of the manuscript.

Funding Statement

The author received no specific funding for this article.

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Home » Research Paper – Structure, Examples and Writing Guide

Research Paper – Structure, Examples and Writing Guide

Table of Contents

Research Paper

Definition:

Research Paper is a written document that presents the author’s original research, analysis, and interpretation of a specific topic or issue.

It is typically based on Empirical Evidence, and may involve qualitative or quantitative research methods, or a combination of both. The purpose of a research paper is to contribute new knowledge or insights to a particular field of study, and to demonstrate the author’s understanding of the existing literature and theories related to the topic.

Structure of Research Paper

The structure of a research paper typically follows a standard format, consisting of several sections that convey specific information about the research study. The following is a detailed explanation of the structure of a research paper:

The title page contains the title of the paper, the name(s) of the author(s), and the affiliation(s) of the author(s). It also includes the date of submission and possibly, the name of the journal or conference where the paper is to be published.

The abstract is a brief summary of the research paper, typically ranging from 100 to 250 words. It should include the research question, the methods used, the key findings, and the implications of the results. The abstract should be written in a concise and clear manner to allow readers to quickly grasp the essence of the research.

Introduction

The introduction section of a research paper provides background information about the research problem, the research question, and the research objectives. It also outlines the significance of the research, the research gap that it aims to fill, and the approach taken to address the research question. Finally, the introduction section ends with a clear statement of the research hypothesis or research question.

Literature Review

The literature review section of a research paper provides an overview of the existing literature on the topic of study. It includes a critical analysis and synthesis of the literature, highlighting the key concepts, themes, and debates. The literature review should also demonstrate the research gap and how the current study seeks to address it.

The methods section of a research paper describes the research design, the sample selection, the data collection and analysis procedures, and the statistical methods used to analyze the data. This section should provide sufficient detail for other researchers to replicate the study.

The results section presents the findings of the research, using tables, graphs, and figures to illustrate the data. The findings should be presented in a clear and concise manner, with reference to the research question and hypothesis.

The discussion section of a research paper interprets the findings and discusses their implications for the research question, the literature review, and the field of study. It should also address the limitations of the study and suggest future research directions.

The conclusion section summarizes the main findings of the study, restates the research question and hypothesis, and provides a final reflection on the significance of the research.

The references section provides a list of all the sources cited in the paper, following a specific citation style such as APA, MLA or Chicago.

How to Write Research Paper

You can write Research Paper by the following guide:

• Choose a Topic: The first step is to select a topic that interests you and is relevant to your field of study. Brainstorm ideas and narrow down to a research question that is specific and researchable.
• Conduct a Literature Review: The literature review helps you identify the gap in the existing research and provides a basis for your research question. It also helps you to develop a theoretical framework and research hypothesis.
• Develop a Thesis Statement : The thesis statement is the main argument of your research paper. It should be clear, concise and specific to your research question.
• Plan your Research: Develop a research plan that outlines the methods, data sources, and data analysis procedures. This will help you to collect and analyze data effectively.
• Collect and Analyze Data: Collect data using various methods such as surveys, interviews, observations, or experiments. Analyze data using statistical tools or other qualitative methods.
• Organize your Paper : Organize your paper into sections such as Introduction, Literature Review, Methods, Results, Discussion, and Conclusion. Ensure that each section is coherent and follows a logical flow.
• Write your Paper : Start by writing the introduction, followed by the literature review, methods, results, discussion, and conclusion. Ensure that your writing is clear, concise, and follows the required formatting and citation styles.
• Edit and Proofread your Paper: Review your paper for grammar and spelling errors, and ensure that it is well-structured and easy to read. Ask someone else to review your paper to get feedback and suggestions for improvement.
• Cite your Sources: Ensure that you properly cite all sources used in your research paper. This is essential for giving credit to the original authors and avoiding plagiarism.

Research Paper Example

Note : The below example research paper is for illustrative purposes only and is not an actual research paper. Actual research papers may have different structures, contents, and formats depending on the field of study, research question, data collection and analysis methods, and other factors. Students should always consult with their professors or supervisors for specific guidelines and expectations for their research papers.

Research Paper Example sample for Students:

Title: The Impact of Social Media on Mental Health among Young Adults

Abstract: This study aims to investigate the impact of social media use on the mental health of young adults. A literature review was conducted to examine the existing research on the topic. A survey was then administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO (Fear of Missing Out) are significant predictors of mental health problems among young adults.

Introduction: Social media has become an integral part of modern life, particularly among young adults. While social media has many benefits, including increased communication and social connectivity, it has also been associated with negative outcomes, such as addiction, cyberbullying, and mental health problems. This study aims to investigate the impact of social media use on the mental health of young adults.

Literature Review: The literature review highlights the existing research on the impact of social media use on mental health. The review shows that social media use is associated with depression, anxiety, stress, and other mental health problems. The review also identifies the factors that contribute to the negative impact of social media, including social comparison, cyberbullying, and FOMO.

Methods : A survey was administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The survey included questions on social media use, mental health status (measured using the DASS-21), and perceived impact of social media on their mental health. Data were analyzed using descriptive statistics and regression analysis.

Results : The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO are significant predictors of mental health problems among young adults.

Discussion : The study’s findings suggest that social media use has a negative impact on the mental health of young adults. The study highlights the need for interventions that address the factors contributing to the negative impact of social media, such as social comparison, cyberbullying, and FOMO.

Conclusion : In conclusion, social media use has a significant impact on the mental health of young adults. The study’s findings underscore the need for interventions that promote healthy social media use and address the negative outcomes associated with social media use. Future research can explore the effectiveness of interventions aimed at reducing the negative impact of social media on mental health. Additionally, longitudinal studies can investigate the long-term effects of social media use on mental health.

Limitations : The study has some limitations, including the use of self-report measures and a cross-sectional design. The use of self-report measures may result in biased responses, and a cross-sectional design limits the ability to establish causality.

Implications: The study’s findings have implications for mental health professionals, educators, and policymakers. Mental health professionals can use the findings to develop interventions that address the negative impact of social media use on mental health. Educators can incorporate social media literacy into their curriculum to promote healthy social media use among young adults. Policymakers can use the findings to develop policies that protect young adults from the negative outcomes associated with social media use.

References :

• Twenge, J. M., & Campbell, W. K. (2019). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 15, 100918.
• Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., … & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1-9.
• Van der Meer, T. G., & Verhoeven, J. W. (2017). Social media and its impact on academic performance of students. Journal of Information Technology Education: Research, 16, 383-398.

Appendix : The survey used in this study is provided below.

Social Media and Mental Health Survey

• How often do you use social media per day?
• Less than 30 minutes
• 30 minutes to 1 hour
• 1 to 2 hours
• 2 to 4 hours
• More than 4 hours
• Which social media platforms do you use?
• Others (Please specify)
• How often do you experience the following on social media?
• Social comparison (comparing yourself to others)
• Cyberbullying
• Fear of Missing Out (FOMO)
• Have you ever experienced any of the following mental health problems in the past month?
• Do you think social media use has a positive or negative impact on your mental health?
• Very positive
• Somewhat positive
• Somewhat negative
• Very negative
• In your opinion, which factors contribute to the negative impact of social media on mental health?
• Social comparison
• In your opinion, what interventions could be effective in reducing the negative impact of social media on mental health?
• Education on healthy social media use
• Counseling for mental health problems caused by social media
• Social media detox programs
• Regulation of social media use

Thank you for your participation!

Applications of Research Paper

Research papers have several applications in various fields, including:

• Advancing knowledge: Research papers contribute to the advancement of knowledge by generating new insights, theories, and findings that can inform future research and practice. They help to answer important questions, clarify existing knowledge, and identify areas that require further investigation.
• Informing policy: Research papers can inform policy decisions by providing evidence-based recommendations for policymakers. They can help to identify gaps in current policies, evaluate the effectiveness of interventions, and inform the development of new policies and regulations.
• Improving practice: Research papers can improve practice by providing evidence-based guidance for professionals in various fields, including medicine, education, business, and psychology. They can inform the development of best practices, guidelines, and standards of care that can improve outcomes for individuals and organizations.
• Educating students : Research papers are often used as teaching tools in universities and colleges to educate students about research methods, data analysis, and academic writing. They help students to develop critical thinking skills, research skills, and communication skills that are essential for success in many careers.
• Fostering collaboration: Research papers can foster collaboration among researchers, practitioners, and policymakers by providing a platform for sharing knowledge and ideas. They can facilitate interdisciplinary collaborations and partnerships that can lead to innovative solutions to complex problems.

When to Write Research Paper

Research papers are typically written when a person has completed a research project or when they have conducted a study and have obtained data or findings that they want to share with the academic or professional community. Research papers are usually written in academic settings, such as universities, but they can also be written in professional settings, such as research organizations, government agencies, or private companies.

Here are some common situations where a person might need to write a research paper:

• For academic purposes: Students in universities and colleges are often required to write research papers as part of their coursework, particularly in the social sciences, natural sciences, and humanities. Writing research papers helps students to develop research skills, critical thinking skills, and academic writing skills.
• For publication: Researchers often write research papers to publish their findings in academic journals or to present their work at academic conferences. Publishing research papers is an important way to disseminate research findings to the academic community and to establish oneself as an expert in a particular field.
• To inform policy or practice : Researchers may write research papers to inform policy decisions or to improve practice in various fields. Research findings can be used to inform the development of policies, guidelines, and best practices that can improve outcomes for individuals and organizations.
• To share new insights or ideas: Researchers may write research papers to share new insights or ideas with the academic or professional community. They may present new theories, propose new research methods, or challenge existing paradigms in their field.

Purpose of Research Paper

The purpose of a research paper is to present the results of a study or investigation in a clear, concise, and structured manner. Research papers are written to communicate new knowledge, ideas, or findings to a specific audience, such as researchers, scholars, practitioners, or policymakers. The primary purposes of a research paper are:

• To contribute to the body of knowledge : Research papers aim to add new knowledge or insights to a particular field or discipline. They do this by reporting the results of empirical studies, reviewing and synthesizing existing literature, proposing new theories, or providing new perspectives on a topic.
• To inform or persuade: Research papers are written to inform or persuade the reader about a particular issue, topic, or phenomenon. They present evidence and arguments to support their claims and seek to persuade the reader of the validity of their findings or recommendations.
• To advance the field: Research papers seek to advance the field or discipline by identifying gaps in knowledge, proposing new research questions or approaches, or challenging existing assumptions or paradigms. They aim to contribute to ongoing debates and discussions within a field and to stimulate further research and inquiry.
• To demonstrate research skills: Research papers demonstrate the author’s research skills, including their ability to design and conduct a study, collect and analyze data, and interpret and communicate findings. They also demonstrate the author’s ability to critically evaluate existing literature, synthesize information from multiple sources, and write in a clear and structured manner.

Characteristics of Research Paper

Research papers have several characteristics that distinguish them from other forms of academic or professional writing. Here are some common characteristics of research papers:

• Evidence-based: Research papers are based on empirical evidence, which is collected through rigorous research methods such as experiments, surveys, observations, or interviews. They rely on objective data and facts to support their claims and conclusions.
• Structured and organized: Research papers have a clear and logical structure, with sections such as introduction, literature review, methods, results, discussion, and conclusion. They are organized in a way that helps the reader to follow the argument and understand the findings.
• Formal and objective: Research papers are written in a formal and objective tone, with an emphasis on clarity, precision, and accuracy. They avoid subjective language or personal opinions and instead rely on objective data and analysis to support their arguments.
• Citations and references: Research papers include citations and references to acknowledge the sources of information and ideas used in the paper. They use a specific citation style, such as APA, MLA, or Chicago, to ensure consistency and accuracy.
• Peer-reviewed: Research papers are often peer-reviewed, which means they are evaluated by other experts in the field before they are published. Peer-review ensures that the research is of high quality, meets ethical standards, and contributes to the advancement of knowledge in the field.
• Objective and unbiased: Research papers strive to be objective and unbiased in their presentation of the findings. They avoid personal biases or preconceptions and instead rely on the data and analysis to draw conclusions.

Advantages of Research Paper

Research papers have many advantages, both for the individual researcher and for the broader academic and professional community. Here are some advantages of research papers:

• Contribution to knowledge: Research papers contribute to the body of knowledge in a particular field or discipline. They add new information, insights, and perspectives to existing literature and help advance the understanding of a particular phenomenon or issue.
• Opportunity for intellectual growth: Research papers provide an opportunity for intellectual growth for the researcher. They require critical thinking, problem-solving, and creativity, which can help develop the researcher’s skills and knowledge.
• Career advancement: Research papers can help advance the researcher’s career by demonstrating their expertise and contributions to the field. They can also lead to new research opportunities, collaborations, and funding.
• Academic recognition: Research papers can lead to academic recognition in the form of awards, grants, or invitations to speak at conferences or events. They can also contribute to the researcher’s reputation and standing in the field.
• Impact on policy and practice: Research papers can have a significant impact on policy and practice. They can inform policy decisions, guide practice, and lead to changes in laws, regulations, or procedures.
• Advancement of society: Research papers can contribute to the advancement of society by addressing important issues, identifying solutions to problems, and promoting social justice and equality.

Limitations of Research Paper

Research papers also have some limitations that should be considered when interpreting their findings or implications. Here are some common limitations of research papers:

• Limited generalizability: Research findings may not be generalizable to other populations, settings, or contexts. Studies often use specific samples or conditions that may not reflect the broader population or real-world situations.
• Potential for bias : Research papers may be biased due to factors such as sample selection, measurement errors, or researcher biases. It is important to evaluate the quality of the research design and methods used to ensure that the findings are valid and reliable.
• Ethical concerns: Research papers may raise ethical concerns, such as the use of vulnerable populations or invasive procedures. Researchers must adhere to ethical guidelines and obtain informed consent from participants to ensure that the research is conducted in a responsible and respectful manner.
• Limitations of methodology: Research papers may be limited by the methodology used to collect and analyze data. For example, certain research methods may not capture the complexity or nuance of a particular phenomenon, or may not be appropriate for certain research questions.
• Publication bias: Research papers may be subject to publication bias, where positive or significant findings are more likely to be published than negative or non-significant findings. This can skew the overall findings of a particular area of research.
• Time and resource constraints: Research papers may be limited by time and resource constraints, which can affect the quality and scope of the research. Researchers may not have access to certain data or resources, or may be unable to conduct long-term studies due to practical limitations.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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The guidelines manual

NICE process and methods [PMG6] Published: 30 November 2012

• Tools and resources
• 1 Introduction
• 2 The scope
• 3 The Guideline Development Group
• 4 Developing review questions and planning the systematic review
• 5 Identifying the evidence: literature searching and evidence submission
• 6 Reviewing the evidence
• 7 Assessing cost effectiveness
• 8 Linking clinical guidelines to other NICE guidance

9 Developing and wording guideline recommendations

• 10 Writing the clinical guideline and the role of the NICE editors
• 11 The consultation process and dealing with stakeholder comments
• 12 Finalising and publishing the guideline
• 13 Implementation support for clinical guidelines
• 14 Updating published clinical guidelines and correcting errors
• Summary of main changes from the 2009 guidelines manual
• Update information
• About this manual

NICE process and methods

9.1 interpreting the evidence to make recommendations.

• 9.2 'Only in research' recommendations

9.3 Wording the guideline recommendations

9.4 prioritising recommendations, 9.5 formulating research recommendations, 9.6 further reading.

Many users of clinical guidelines do not have time to read the full document, and may want to focus only on the recommendations. It is therefore vital that recommendations are clear, can be understood by people who have not read the full guideline, and are based on the best available evidence of clinical and cost effectiveness. This chapter addresses key areas in developing guideline recommendations:

interpreting the evidence to make recommendations

wording the recommendations

prioritising recommendations for implementation

formulating research recommendations.

These processes are at the heart of the work of the Guideline Development Group (GDG). However, they are not straightforward and it may not be easy for the GDG to reach agreement. Consensus techniques may need to be used within the GDG (see section 3.5 ).

The GDG must decide what the evidence means in the context of the review questions and economic questions posed, and decide what recommendations can usefully be made to healthcare and other professionals.

In the full guideline, the aim should be to show clearly how the GDG moved from the evidence to the recommendation. This is done in a section called 'evidence to recommendations' so that it can be easily identified. This section may also be a useful way to integrate the findings from several evidence reviews that are related to the same recommendation(s).

Underpinning this section is the concept of the 'strength' of a recommendation (Schünemann et al. 2003). This takes into account the quality of the evidence but is conceptually different. Some recommendations are 'strong' in that the GDG believes that the vast majority of healthcare and other professionals and patients would choose a particular intervention if they considered the evidence in the same way that the GDG has. This is generally the case if the benefits clearly outweigh the harms for most people and the intervention is likely to be cost effective. However, there is often a closer balance between benefits and harms, and some patients would not choose an intervention whereas others would. This may happen, for example, if some patients are particularly averse to some side effect and others are not. In these circumstances the recommendation is generally weaker, although it may be possible to make stronger recommendations about specific groups of patients.

For all recommendations, a general principle of NICE clinical guidelines is that patients should be informed of their choices and be involved in decisions about their care. Patients may choose not to accept the advice to have the most cost-effective intervention, or they may opt for a treatment that has the same or lower long-term health and personal social service costs if, for example, they feel that its side effects are more tolerable. There might be little evidence of differences in cost effectiveness between drugs within a class, and the clinician and patient might choose between these drugs on the basis of side-effect profile. However, it is not usually possible to offer patients interventions that are above NICE's threshold for cost effectiveness (see section 7.3 ) because the opportunity cost of that course of action has been judged to be too great (see section 7.1.1 ).

The GRADE system (see section 6.2.1.1 ) allocates labels or symbols to represent the strength of a recommendation. NICE has chosen not to do this, but instead to reflect the concept of strength in the wording of the recommendation (see section 9.3.3 ). The GDG's view of the strength of a recommendation should be clear from its discussions, as reported in the full guideline.

The following points will need to be covered in the discussions and can also be used as a framework for reporting those discussions.

9.1.1 Relative value placed on the outcomes considered

Often more outcome data are available than are actually used in decision-making. It is therefore important to have explicit discussion of which outcomes are considered important for decision-making (including consideration of the perspective of the decision-makers) when developing review protocols (see section 4.4 ), and of what relative importance was given to them. This might be done informally (for example, 'death was considered the most important outcome') or formally (for example, by the use of utility weights).

This discussion should be clearly separated from discussion of how this will play out when the evidence is reviewed, because there is a potential to introduce bias if outcomes are selected on the basis of the results. An example of this would be choosing only outcomes for which there were statistically significant results.

It may be important to note outcomes that were not considered to be important for decision-making, and why (such as surrogate outcomes if longer-term, more relevant outcomes are available). If the same set of outcomes is used for a number of review questions, it might be more efficient to record this information once and then refer back to it.

9.1.2 Trade-off between clinical benefits and harms

A key stage in moving from evidence to recommendations is weighing up the magnitude and importance of the benefits and harms of an intervention. This may be done qualitatively (for example, 'the evidence of a reduction in mortality outweighed a small increase in side effects'), or quantitatively using a decision model.

9.1.3 Trade-off between net health benefits and resource use

If there are net health benefits from an intervention, there should be an explanation of how the implications of resource use were considered in determining cost effectiveness. Again, this may be informal, or may be more formal and include the use of economic modelling. If there is no clear evidence of net health benefit, cost and resource use could be discussed here.

9.1.4 Quality of the evidence

There should be discussion of how the presence, likely magnitude and direction of potential biases and uncertainty in the clinical and economic evidence have influenced the recommendation, and why. This should reflect the judgement on the quality of the evidence as described in the GRADE profile and the NICE economic profile. Lower-quality evidence makes it more difficult to justify a strong recommendation in general, although there may be exceptions to this. For example, evidence on the frequency of adverse effects is often of low quality, but a strong recommendation might be made not to use a particular drug thought to have teratogenic effects in women of child-bearing potential.

The discussion of uncertainty may include consideration of whether the uncertainty is sufficient to justify delaying making a recommendation to await further research, taking into account the potential harm of failing to make a clear recommendation.

9.1.5 Other considerations

If the 'evidence to recommendations' section combines consideration of several possible interventions, it may include discussion of the position of an intervention within a pathway of care.

This is also the appropriate place to note how the GDG's responsibilities under equalities legislation and NICE's equality scheme have been discharged in reaching the recommendation(s). This covers inequalities related to age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation and socioeconomic status. The GDG will need to consider whether:

the evidence review has addressed areas identified in the scope as needing specific attention with regard to equalities issues

criteria for access to an intervention might be discriminatory, for example through membership of a particular group, or by using a test that might discriminate unlawfully

people with disabilities might find it impossible or unreasonably difficult to receive an intervention

guidance can be formulated so as to promote equalities, for example by making access more likely for certain groups, or by tailoring the intervention to specific groups.

Before the guideline is signed off, an equality impact assessment (EIA) form is completed by the National Collaborating Centre (NCC) or the NICE Internal Clinical Guidelines Programme [ 14 ] and the GDG to demonstrate how equality issues have been identified and considered during development. The EIA form is signed by the NCC Director and GDG Chair, and countersigned by the Centre for Clinical Practice (CCP) lead for the guideline, before being posted on the NICE website. Further guidance on how to complete the EIA form is outlined in the document Positively equal: a guide to addressing equality issues in developing NICE clinical guidelines .

It may be useful to briefly discuss the extent of change in practice that will be needed to implement a recommendation, and the possible need for carefully controlled implementation with, for example, training programmes or demonstration projects.

9.1.6 Challenges in formulating recommendations

There are many reasons why it can be difficult for a GDG to reach a decision about a recommendation. The evidence base is always imperfect, and so there is always a degree of judgement by the GDG. There may be very little, or no, good-quality evidence that directly addresses the review question the GDG has posed. In this situation, there are several options to consider:

The GDG may wish to look at evidence that is likely to be more at risk of bias than the evidence they had hoped to find. For example, if the GDG had set out to collect only randomised trials for a question of effectiveness, but found none, they might consider looking for good-quality non-randomised studies. However, there is a risk that considerable time and effort is spent finding and reviewing studies that are likely to be biased and so are hard to interpret. This approach should be pursued only if there is reason to believe that it will help the GDG to formulate a recommendation.

The GDG may wish to extrapolate from high-quality evidence in a related area, for example in a largely similar patient group or for a closely related intervention. The GDG will need to make its approach explicit, stating the basis it has used for extrapolating from the data and the assumptions that have been made. This will need to include consideration of the plausibility of the assumptions. This approach is unlikely to be helpful if the evidence is derived from a question that is too different from the review question, or if the evidence is not of the highest quality.

The GDG may consider basing a recommendation on its view of current most cost-effective practice. Formal consensus techniques may be used to elicit opinions from the GDG, although NICE does not recommend a particular approach. Importantly, it is not usually appropriate to involve stakeholders from outside the GDG in this process, as they will be offering opinions on recommendations without having seen the evidence considered by the GDG; in addition, stakeholders will not have agreed to adhere to the principles underlying NICE's decisions on recommendations. This approach would also allow some stakeholders input to the decision-making process that other stakeholders will not have. GDGs should therefore be particularly cautious about using and interpreting the results of such exercises involving stakeholders outside the GDG, and should discuss any proposed use with NICE. The final decision on whether such work with external stakeholders is warranted will be made by NICE.

When formulating recommendations, there are likely to be instances when members of the GDG disagree about the content of the final guideline. Formal consensus methods can be used for agreeing the final recommendations (see section 3.5 ). Whatever the approach used, there should be a clear record of the proceedings and how areas of disagreement have been handled. This may be summarised in the full guideline.

9.2 'Only in research' recommendations

If evidence of effectiveness is either lacking or too weak for reasonable conclusions to be reached, the GDG may recommend that particular interventions are used within the NHS only in the context of research. Factors that will be considered before issuing such recommendations include the following:

The intervention should have a reasonable prospect of providing benefits to patients in a cost-effective way.

The necessary research can realistically be set up or is already planned, or patients are already being recruited.

There is a real prospect that the research will inform future NICE guidance.

Writing the recommendations is one of the most important steps in developing a clinical guideline. Many people read only the recommendations, so the wording must be concise, unambiguous and easy to translate into clinical practice. Each recommendation, or bullet point within a recommendation, should contain only one main action.

The wording of recommendations should be agreed by the GDG, and should:

focus on the action that needs to be taken

include what readers need to know

reflect the strength of the recommendation

emphasise the involvement of the patient (and/or their carers if needed) in decisions on treatment and care

use plain English where possible and avoid vague language

follow NICE's standard advice on recommendations about drugs, waiting times and ineffective interventions.

The rest of this section explains these points in more detail. The lead editor for the guideline from NICE can advise on the wording of recommendations.

9.3.1 Focus on the action

Recommendations should begin with what needs to be done. When writing recommendations, keep in mind a reader who is saying, 'What does this mean for me?'. Recommendations should be as specific as possible about the exact intervention being recommended and the group of people for whom it is recommended (see also section 9.3.2).

Use direct instructions because they are clearer and easier to follow. Most recommendations should be worded in this way. Assume you are talking to the healthcare professional who is working with the patient at the time.

Record the person's blood pressure every 6 months.

Ask people in high-risk groups whether they have symptoms.

Carry out and record a focused baseline assessment for people with faecal incontinence to identify the contributory factors.

Recommendations about service organisation, or if the audience is not the healthcare professional. For example:'Care should be provided by a multidisciplinary team.'

Recommendations that a specific type of healthcare professional should carry out an intervention. For example: 'An occupational therapist should assess the patient's needs.'

Recommendations that use 'must' or 'must not' (see section 9.3.3.1 ).

Start with a verb describing what the reader should do, such as 'offer', 'measure', 'advise', 'discuss', 'ask about' (see sections 9.3.3 and 9.3.4 for advice on the choice of verb).

Advise pregnant women to limit their intake of oily fish to two portions a week.

Perform surgery within 48 hours of symptom onset.

Offer relaxation techniques for managing pain, sleep problems and comorbid stress or anxiety.

Sometimes it is clearer to start with details of the patient group or other details, particularly if recommending different actions for slightly different circumstances or to make the sentence structure simpler. For example: 'If surgery is an option, refer the patient to a specialist surgeon to discuss the risks and benefits.'

9.3.2 Include what readers need to know

Recommendations should contain enough information to be understood without reference to the evidence or other supporting material. But do not add unnecessary details, because recommendations are more likely to be followed if they are clear and concise.

Define any specialised terminology that is used in the recommendations. Avoid using abbreviations unless your audience is likely to be more familiar with the abbreviation than with the term in full. If abbreviations are essential, define them at first mention and in a glossary.

Define the target population if it is not obvious from the context. Often it is necessary to define the population only in the first of a group of recommendations, if it is clear that the subsequent recommendations in that section relate to the same population.

Include cross-references to other recommendations in the guideline if necessary to avoid the need to repeat information such as treatment regimens.

Do not include reasons justifying the recommendation unless this will increase the likelihood that it will be followed – for example, if it involves a change in usual practice or needs particular emphasis.

Include only one main action in each recommendation or bullet point.

9.3.3 Reflect the strength of the recommendation

The description of the process of moving from evidence to recommendations in section 9.1 indicates that some recommendations can be made with more certainty than others. This concept of the 'strength' of a recommendation should be reflected in the consistent wording of recommendations within and across clinical guidelines. There are three levels of certainty:

recommendations for interventions that must (or must not) be used

recommendations for interventions that should (or should not) be used

recommendations for interventions that could be used.

The NICE guideline includes a standard section about how wording reflects the strength of recommendations.

9.3.3.1 Recommendations for interventions that must or must not be used

Recommendations that an intervention must or must not be used are usually included only if there is a legal duty to apply the recommendation, for example to comply with health and safety regulations. In these instances, give a reference to supporting documents. These recommendations apply to all patients.

However, occasionally the consequences of not following a recommendation are so serious (for example, there is a high risk that the patient could die) that using 'must' (or 'must not') is justified. Discuss this with the Guidelines Commissioning Manager at NICE, and explain in the recommendation the reason for the use of 'must'.

If using 'must', word the recommendation in the passive voice ('an intervention must be used') because the distinction between 'should' and 'must' is lost when the recommendation is turned into a direct instruction.

Ultra-rapid detoxification under general anaesthesia or heavy sedation (where the airway needs to be supported) must not be used. This is because of the risk of serious adverse events, including death.

Gloves used for direct patient care:

must conform to current EU legislation (CE marked as medical gloves for single use) and

should be appropriate for the task.

9.3.3.2 Recommendations for interventions that should or should not be used – 'strong' recommendations

For recommendations on interventions that 'should' be used, the GDG is confident that, for the vast majority of people, the intervention (or interventions) will do more good than harm, and will be cost effective.

Use direct instructions for recommendations of this type where possible (see section 9.3.1), rather than using the word 'should'. Use verbs such as 'offer', 'refer', 'advise' and 'discuss'.

Offer bariatric surgery as a first-line option (instead of lifestyle interventions or drug treatment) to adults with a BMI of more than 50 kg/m 2 .

Use similar forms of words (for example, 'Do not offer…') for recommendations on interventions that should not be used because the GDG is confident that they will not be of sufficient benefit for most patients.

Do not offer antibiotic prophylaxis against infective endocarditis to people at risk undergoing dental procedures.

If an intervention is strongly recommended but there are two or more options with similar cost effectiveness, and the choice will depend on the patient's values and preferences, a 'should' recommendation can be:

combined with a 'could' recommendation (see section 9.3.3.3), for example by using wording such as 'Offer a choice of drug A or drug B' or

followed by a 'could' recommendation, for example 'Offer drug treatment. Consider drug A or drug B.'

9.3.3.3 Recommendations for interventions that could be used

For recommendations on interventions that 'could' be used, the GDG is confident that the intervention will do more good than harm for most patients, and will be cost effective. However, other options may be similarly cost effective, or some patients may opt for a less effective but cheaper intervention. The choice of intervention, and whether to have the intervention at all, is therefore more likely to vary depending on a person's values and preferences, and so the healthcare professional should spend more time considering and discussing the options with the patient. It may be possible to make 'strong' recommendations for subgroups of people with different values and preferences. NICE's report Social value judgements: principles for the development of NICE guidance (2nd edition; 2008) states the following:

Use direct instructions for recommendations of this type where possible (see section 9.3.1), rather than using the word 'could'.

Use 'consider' to indicate that the recommendation is less strong than a 'should' recommendation.

Consider combination chemotherapy to treat patients with advanced breast cancer for whom a greater probability of response is important and who understand and are likely to tolerate the additional toxicity.

Consider carbamazepine and oxcarbazepine but be aware of the risk of exacerbating myoclonic or absence seizures.

Do not use 'consider offering', because of potential confusion with the wording of strong recommendations. Also, it might be misinterpreted to mean that a healthcare professional may consider offering an intervention without discussing it with the patient.

To minimise confusion, only use 'consider' to indicate the strength of a recommendation. Avoid other possible uses of 'consider'. For example, if a particular clinical sign or symptom should make a healthcare professional think about a diagnosis, use 'be aware of the possible diagnosis…', 'explore a diagnosis of…' or similar, rather than 'consider a diagnosis of'. Use 'take other factors into account' or similar, instead of 'consider other factors'. 'Assess' and 'think about' are other possible alternatives to 'consider'.

9.3.4 Emphasise the patient's involvement

To emphasise the patient's role in decision-making and the need for them to consent to treatment, generally use verbs such as 'offer', 'consider' and 'discuss' in recommendations, rather than 'prescribe' or 'give'. As described above, 'consider' is used for recommendations on interventions that could be used, and implies that more discussion will be needed.

Use 'people' or 'patients' rather than 'individuals', 'cases' or 'subjects'. Where possible, use 'people' rather than 'patients' for people with mental health problems or chronic conditions. 'Service users' can be used for people with mental health problems if 'patients' is the only alternative. Do not use 'patients' in relation to healthy pregnant women.

9.3.4.1 Recommendations about patient-centred care

The NICE guideline includes a standard section on patient-centred care that covers informed consent and taking into account the patient's individual needs. This section also cross-refers to NICE guidance on patient experience in adult NHS services , which covers subjects such as treating the person as an individual, communication, information and shared decision-making. NICE has also produced guidance on service user experience in adult mental health , which is cross-referred to in guidelines on mental health. The patient experience and service user experience guidance can be cross-referred to in recommendations, but specific recommendations should not be made on issues covered in that guidance unless there are particular reasons to do so that relate to the guideline topic. Examples include:

if there are issues relating to provision of information to patients, or to patients' support needs, that are specific to the condition covered by the guideline

if certain drugs are prescribed 'off-label' (see section 9.3.6.3 ) and more detailed forms of consent than usual are required from patients.

9.3.5 Use plain English

In general, follow the principles of effective writing as described in the 'Writing for NICE' booklet, which is available on the NICE webboard for NCCs.

Avoid vague words and phrases, such as 'may' and 'can', or general statements such as 'is recommended', 'is useful/helpful', 'is needed' and 'treatment options include'. Instead, use an active verb that tells readers what they should do, and indicates the strength of the recommendation.

Instead of 'an intervention may be offered', say 'consider the intervention'.

Instead of 'an intervention is recommended', say 'offer the intervention'.

Instead of 'an intervention is helpful', say 'offer the intervention' or 'consider the intervention' (see section 9.3.3).

'Appropriate' is often redundant: for example 'give appropriate advice', because we would never recommend giving inappropriate advice.

9.3.6 Recommendations on drugs, including off-label use

Guideline developers should follow NICE's standard procedure when referring to drugs. This includes using standard wording when off-label use of drugs is recommended.

9.3.6.1 Use generic names

Give the recommended international non-proprietary name (rINN), as listed in the British national formulary (BNF). Usually, only the generic name is needed. Occasionally (for example, if referring to a specific preparation or device), the proprietary name may be given in parentheses at first mention. Do not give the manufacturer's name.

9.3.6.2 Do not give dosages

Readers are expected to refer to the summary of product characteristics (SPC) for details of dosages. Include dosage information only if there is evidence that a particular drug is often prescribed at the wrong dosage, or there is clear evidence about the effectiveness of different dose levels. If off-label use is being recommended and there is no relevant dosage information in the BNF, include details of the dosage regimen in the full guideline. SPCs can be found in the Electronic Medicines Compendium .

9.3.6.3 Off-label use

Make it clear if the recommended use is outside the drug's licensed indication ('off label').

Recommendations are usually about the uses of drugs (often referred to as the licensed indications) for which the drug regulatory authority has granted a marketing authorisation, either in the UK or under the European centralised authorisation procedure. However, there are clinical situations when the use of a drug off-label may be judged by the prescriber to be in the best clinical interests of the patient. Off-label use may be recommended if the clinical need cannot be met by a licensed product and there is a sufficient evidence base and/or experience of using the drug to demonstrate its safety and efficacy to support this. Off-label prescribing is particularly common in pregnant women and in children and young people (see below), as these groups have often been excluded from clinical trials during drug development. When prescribing a drug off-label, the prescriber should follow relevant professional guidance (for example, the General Medical Council's Good practice in prescribing medicines – guidance for doctors ) and make a clinical judgement, taking full responsibility for the decision for the patient under his or her direct care. In addition, the patient (or those with authority to give consent on their behalf) should be made fully aware of these factors and provide informed consent, which should be documented by the prescriber.

A licensed drug is accompanied by an SPC, which describes the indications, cautions and contraindications for a drug based on an assessment of safety, quality and efficacy by the regulatory authority. The NCC and GDG should check recommended uses against the licensed indications listed in the SPC, and include a footnote if the drug does not have a UK marketing authorisation for the use being recommended. The footnote should make it clear that the drug is not licensed for the stated use.

This standard wording for the footnote captures the above points:

At the time of publication ([month year]), [name of drug] did not have a UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's Good practice in prescribing medicines – guidance for doctors for further information.

Additional information can be added as needed – for example, if off-label use is recommended and the drug is commonly used in UK clinical practice, a phrase such as 'Although this use is common in UK clinical practice' can be added. Other examples of footnote wording are shown in box 9.1. In cases where the SPC for a drug specifically mentions a caution or contraindication for its use but the GDG wishes to recommend the drug, this should be stated clearly in the recommendation or footnote. The evidence that the GDG has considered in reaching the conclusion that use in these circumstances can be justified should be clearly set out in the full guideline.

If a guideline includes recommendations for off-label use of drugs, the introduction to the NICE version should include standard wording (as in the NICE guideline template) about the responsibilities of the prescriber and the need to follow relevant professional guidance (for example, the General Medical Council's Good practice in prescribing medicines – guidance for doctors ).

If there is no information on dosage regimens available in a recognised source (such as the BNF), the NCC should document dosage information in the full guideline and alert the NICE implementation team to ensure that this is disseminated to prescribers.

Prescribing drugs outside their licensed indications to children and young people

In certain circumstances drugs are prescribed to children and young people outside their licensed indications (off-label use) because the clinical need cannot be met by licensed drugs; for example, for an indication not specified in the marketing authorisation, or administration of a different dose. The Standing Committee on Medicines (a joint committee of the Royal College of Paediatrics and Child Health and the Neonatal and Paediatric Pharmacists Group) has issued a policy statement on the use of unlicensed drugs and the use of licensed drugs for unlicensed applications in children and young people. This states clearly that such use is necessary in paediatric practice and that doctors are legally allowed to prescribe drugs outside their licensed indications where there are no suitable alternatives and where use is justified by a responsible body of professional opinion (Joint Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacists Group Standing Committee on Medicines 2010).

Therefore, where there is no alternative treatment and only where there is a sufficient evidence base and/or experience of using the drug to demonstrate its safety and efficacy, a clinical guideline may recommend use of a drug outside its licensed indications for treating a child or young person. It is expected that prescribers will use the SPC to inform their prescribing decisions for individual patients, and they should be able to justify using a drug outside its licensed indications. Informed consent should be obtained from the child and/or their parent or guardian as appropriate and documented.

Footnotes for recommendations addressing off label-use of drugs in children and young people should follow the format described above and in box 9.1.

Box 9.1 Examples of footnotes to guideline recommendations about the off-label use of drugs

9.3.7 Recommendations on waiting times and ineffective interventions

Guideline developers should follow NICE's standard advice for recommendations on waiting times. It is also acceptable to make recommendations that advise stopping the use of an ineffective intervention.

9.3.7.1 Waiting times and other policies set by other bodies

Avoid giving targets for waiting and referral times: refer to relevant targets set by the Department of Health or the Welsh Government, and where possible direct readers to the relevant document rather than including the target in the recommendation. This is because policy can change, making a guideline that includes such targets out of date. If no target exists, recommendations may include a maximum time if the GDG considers this to be essential.

Sometimes a recommendation will need to specify a waiting time, referral time or time of intervention because this relates to the safety and/or effectiveness of a clinical intervention. In this case, check that the recommendation does not conflict with relevant targets set by the Department of Health or the Welsh Government and ensure that the clinical reason for specifying the time is made clear.

9.3.7.2 Ineffective interventions

Recommend stopping ineffective interventions: state explicitly if particular treatments or activities should not be carried out or should be stopped (see box 9.2).

Box 9.2 Example of a recommendation about stopping ineffective practice

9.3.8 Using tables in recommendations

Do not use tables to summarise several actions in one recommendation. Such summaries make it more difficult to link the recommended actions to the evidence summaries. A recommendation may include a small table to improve clarity; for example, to present information that should be shared with patients, or if the information is most easily understood when tabulated. An example is shown in box 9.3.

Box 9.3 Example of a table within a recommendation

[From: Unstable angina and NSTEMI: the early management of unstable angina and non-ST-segment-elevation myocardial infarction . NICE clinical guideline 94 (2010).]

NICE's standard clinical guidelines can cover large clinical areas and, as a result, often contain a considerable number of recommendations relevant to the many review questions. The GDG will need to identify a subset of these recommendations as key priorities for implementation. These may be used to guide implementation activities (see chapter 13 ) and may be useful in the subsequent development of NICE quality standards. The number of recommendations prioritised in this way will vary depending on the guideline, but is normally between 5 and 10. There is no 'ranking' within this set of recommendations.

Key priorities for implementation are usually those that are likely to do at least one of the following:

have a high impact on outcomes that are important to patients

have a high impact on reducing variation in care and outcomes

set challenging but achievable expectations of health services

focus on key infrastructural and clinical requirements for high-quality care

include actions that are measurable

lead to more efficient use of NHS resources

promote patient choice

promote equality.

In addition, the GDG should attempt to identify recommendations that are particularly likely to benefit from support from NICE's implementation programme. Criteria overlap with those above, but include whether a recommendation:

relates to an intervention that is not part of routine care

requires changes in service delivery

requires retraining of staff or the development of new skills and competencies

highlights the need for practice to change

affects and needs to be implemented across a number of agencies or settings (complex interactions)

may be viewed as potentially contentious, or difficult to implement for other reasons.

There should be a clear record of which criteria were considered particularly important by the GDG for each prioritised recommendation. This should be reported in a short paragraph in the full guideline.

The GDG is likely to identify areas in which there are uncertainties or where robust evidence is lacking. NICE has published a Research recommendations process and methods guide , which details the approach to be used across NICE's guidance-producing programmes to identify key uncertainties and associated research recommendations.

For standard clinical guidelines where there may be many hundreds of uncertainties, it will not be possible to document every uncertainty in detail. Similarly, although GDGs could write research recommendations for dealing with each uncertainty, this is not likely to be feasible. Therefore the GDG should select up to five key research recommendations for inclusion in the NICE version of the guideline; more research recommendations may be listed in the full guideline. Further information about how these should be derived can be found in the research recommendation process and methods guide.

Brown P, Brunnhuber K, Chalkidou K et al. (2006) How to formulate research recommendations. British Medical Journal 333: 804–6

Claxton K, Sculpher MJ (2006) Using value of information analysis to prioritise health research: some lessons from recent UK experience. Pharmacoeconomics 24: 1055–68

Glasziou P, Del Mar C, Salisbury J (2003) Evidence-based medicine workbook. London: British Medical Journal Books

Guideline Implementability Appraisal (GLIA) [online]

Joint Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacists Group Standing Committee on Medicines (2010) The use of unlicensed medicines or licensed medicines for unlicensed applications in paediatric practice [online]

Lord SJ, Irwig L, Simes RJ (2006) When is measuring sensitivity and specificity sufficient to evaluate a diagnostic test, and when do we need randomized trials? Annals of Internal Medicine 144: 850–5

Sackett DL, Straus SE, Richardson WS (2000) Evidence-based medicine: how to practice and teach EBM, 2nd edition. Edinburgh: Churchill Livingstone

Schünemann HJ, Best D, Vist G et al. for the GRADE Working Group (2003) Letters, numbers, symbols and words: how to communicate grades of evidence and recommendations. Canadian Medical Association Journal 169: 677–80

Scottish Intercollegiate Guidelines Network (2002) SIGN 50. A guideline developer's handbook. Edinburgh: Scottish Intercollegiate Guidelines Network

[ 14 ] Information throughout this manual relating to the role of the National Collaborating Centres in guideline development also applies to the Internal Clinical Guidelines Programme at NICE.

Proposal Development Services

💡 Grant Writing Tip: Evaluating Your Research

• by Stephanie F Etting
• July 23, 2024

Not including an evaluation plan is one of the most common mistakes that people make in grant writing. Regardless of whether your funding solicitation requires a separate section for the plan or not, you will need to include some type of assessment strategy in your proposal. What is an evaluation plan, and how is it used? Read on to learn what assessments are and why they're critical in your grant! 

Types of assessments 

The two most common types of evaluation are formative and summative assessments. 

• Formative assessments are “progress reports." For students, midterms gauge learning progress and help determine if changes in study habits are needed mid-term. Similarly, formative assessments measure research progress and determine if adjustments are needed to correct issues before investing too heavily in a line of work. 
• Summative assessments happen at the end of a project to determine whether the research was successful, like a “final exam." In summative assessments, a project’s final results are measured against original objectives to determine if the research achieved the intended goal. 

Why are evaluation plans important? 

When former DARPA director, George Heilmeier, developed his seminal grant review criteria, the final criterion was: “What are the mid-term and final ‘exams’ to check for success?” Funding agencies are interested in supporting exciting research, but they also want to know their investment will succeed. So when applying for funding, it's critical to explain how you will determine whether you've achieved your goal. Funding agencies often request regular reports to assess your progress, but minimally, they require a final report to determine the overall success of your project. The formative and summative assessments you build into your project are the "checks for success” in your research journey, and are critical to determining the efficacy of your project both during and at the end of the funding period.

What needs an assessment plan?

Solicitations may include guidelines for evaluation plans, but generally, each objective and activity should include a means of assessment. Each activity is a step taken to toward your overall research goals (objectives), so be sure to explain how you will know each step is heading in the right direction. Since outreach and education programs typically have their own activities, they should also include means of assessment.

Bottom Line

Evaluation plans show reviewers that you’ve carefully planned your activities and are invested in their success. Not only do assessments help reviewers, they also help you reflect and develop your research—what is working, what isn’t, what needs changing now, and what should be changed in future work. Assessment is critical, so don’t forget to include an evaluation plan in your next proposal! 

How to Write a Research Proposal: (with Examples & Templates)

Table of Contents

Before conducting a study, a research proposal should be created that outlines researchers’ plans and methodology and is submitted to the concerned evaluating organization or person. Creating a research proposal is an important step to ensure that researchers are on track and are moving forward as intended. A research proposal can be defined as a detailed plan or blueprint for the proposed research that you intend to undertake. It provides readers with a snapshot of your project by describing what you will investigate, why it is needed, and how you will conduct the research.  

Your research proposal should aim to explain to the readers why your research is relevant and original, that you understand the context and current scenario in the field, have the appropriate resources to conduct the research, and that the research is feasible given the usual constraints.  

This article will describe in detail the purpose and typical structure of a research proposal , along with examples and templates to help you ace this step in your research journey.  

What is a Research Proposal ?  

A research proposal¹ ,²  can be defined as a formal report that describes your proposed research, its objectives, methodology, implications, and other important details. Research proposals are the framework of your research and are used to obtain approvals or grants to conduct the study from various committees or organizations. Consequently, research proposals should convince readers of your study’s credibility, accuracy, achievability, practicality, and reproducibility.   

With research proposals , researchers usually aim to persuade the readers, funding agencies, educational institutions, and supervisors to approve the proposal. To achieve this, the report should be well structured with the objectives written in clear, understandable language devoid of jargon. A well-organized research proposal conveys to the readers or evaluators that the writer has thought out the research plan meticulously and has the resources to ensure timely completion.  

Purpose of Research Proposals  

A research proposal is a sales pitch and therefore should be detailed enough to convince your readers, who could be supervisors, ethics committees, universities, etc., that what you’re proposing has merit and is feasible . Research proposals can help students discuss their dissertation with their faculty or fulfill course requirements and also help researchers obtain funding. A well-structured proposal instills confidence among readers about your ability to conduct and complete the study as proposed.  

Research proposals can be written for several reasons:³  

• To describe the importance of research in the specific topic  
• Address any potential challenges you may encounter  
• Showcase knowledge in the field and your ability to conduct a study  
• Apply for a role at a research institute  
• Convince a research supervisor or university that your research can satisfy the requirements of a degree program  
• Highlight the importance of your research to organizations that may sponsor your project  
• Identify implications of your project and how it can benefit the audience  

What Goes in a Research Proposal?    

Research proposals should aim to answer the three basic questions—what, why, and how.  

The What question should be answered by describing the specific subject being researched. It should typically include the objectives, the cohort details, and the location or setting.  

The Why question should be answered by describing the existing scenario of the subject, listing unanswered questions, identifying gaps in the existing research, and describing how your study can address these gaps, along with the implications and significance.  

The How question should be answered by describing the proposed research methodology, data analysis tools expected to be used, and other details to describe your proposed methodology.   

Research Proposal Example  

Here is a research proposal sample template (with examples) from the University of Rochester Medical Center. 4 The sections in all research proposals are essentially the same although different terminology and other specific sections may be used depending on the subject.  

Structure of a Research Proposal  

If you want to know how to make a research proposal impactful, include the following components:¹  

1. Introduction  

This section provides a background of the study, including the research topic, what is already known about it and the gaps, and the significance of the proposed research.  

2. Literature review  

This section contains descriptions of all the previous relevant studies pertaining to the research topic. Every study cited should be described in a few sentences, starting with the general studies to the more specific ones. This section builds on the understanding gained by readers in the Introduction section and supports it by citing relevant prior literature, indicating to readers that you have thoroughly researched your subject.  

3. Objectives  

Once the background and gaps in the research topic have been established, authors must now state the aims of the research clearly. Hypotheses should be mentioned here. This section further helps readers understand what your study’s specific goals are.  

4. Research design and methodology  

Here, authors should clearly describe the methods they intend to use to achieve their proposed objectives. Important components of this section include the population and sample size, data collection and analysis methods and duration, statistical analysis software, measures to avoid bias (randomization, blinding), etc.  

5. Ethical considerations  

This refers to the protection of participants’ rights, such as the right to privacy, right to confidentiality, etc. Researchers need to obtain informed consent and institutional review approval by the required authorities and mention this clearly for transparency.  

6. Budget/funding  

Researchers should prepare their budget and include all expected expenditures. An additional allowance for contingencies such as delays should also be factored in.  

7. Appendices  

This section typically includes information that supports the research proposal and may include informed consent forms, questionnaires, participant information, measurement tools, etc.  

8. Citations  

Important Tips for Writing a Research Proposal  

Writing a research proposal begins much before the actual task of writing. Planning the research proposal structure and content is an important stage, which if done efficiently, can help you seamlessly transition into the writing stage. 3,5  

The Planning Stage  

• Manage your time efficiently. Plan to have the draft version ready at least two weeks before your deadline and the final version at least two to three days before the deadline.
• What is the primary objective of your research?  
• Will your research address any existing gap?  
• What is the impact of your proposed research?  
• Do people outside your field find your research applicable in other areas?  
• If your research is unsuccessful, would there still be other useful research outcomes?  

  The Writing Stage  

• Create an outline with main section headings that are typically used.  
• Focus only on writing and getting your points across without worrying about the format of the research proposal , grammar, punctuation, etc. These can be fixed during the subsequent passes. Add details to each section heading you created in the beginning.   
• Ensure your sentences are concise and use plain language. A research proposal usually contains about 2,000 to 4,000 words or four to seven pages.  
• Don’t use too many technical terms and abbreviations assuming that the readers would know them. Define the abbreviations and technical terms.  
• Ensure that the entire content is readable. Avoid using long paragraphs because they affect the continuity in reading. Break them into shorter paragraphs and introduce some white space for readability.  
• Focus on only the major research issues and cite sources accordingly. Don’t include generic information or their sources in the literature review.  
• Proofread your final document to ensure there are no grammatical errors so readers can enjoy a seamless, uninterrupted read.  
• Use academic, scholarly language because it brings formality into a document.  
• Ensure that your title is created using the keywords in the document and is neither too long and specific nor too short and general.  
• Cite all sources appropriately to avoid plagiarism.  
• Make sure that you follow guidelines, if provided. This includes rules as simple as using a specific font or a hyphen or en dash between numerical ranges.  
• Ensure that you’ve answered all questions requested by the evaluating authority.  

Key Takeaways   

Here’s a summary of the main points about research proposals discussed in the previous sections:  

• A research proposal is a document that outlines the details of a proposed study and is created by researchers to submit to evaluators who could be research institutions, universities, faculty, etc.  
• Research proposals are usually about 2,000-4,000 words long, but this depends on the evaluating authority’s guidelines.  
• A good research proposal ensures that you’ve done your background research and assessed the feasibility of the research.  
• Research proposals have the following main sections—introduction, literature review, objectives, methodology, ethical considerations, and budget.  

Frequently Asked Questions  

Q1. How is a research proposal evaluated?  

A1. In general, most evaluators, including universities, broadly use the following criteria to evaluate research proposals . 6  

• Significance —Does the research address any important subject or issue, which may or may not be specific to the evaluator or university?  
• Content and design —Is the proposed methodology appropriate to answer the research question? Are the objectives clear and well aligned with the proposed methodology?  
• Sample size and selection —Is the target population or cohort size clearly mentioned? Is the sampling process used to select participants randomized, appropriate, and free of bias?  
• Timing —Are the proposed data collection dates mentioned clearly? Is the project feasible given the specified resources and timeline?  
• Data management and dissemination —Who will have access to the data? What is the plan for data analysis?  

Q2. What is the difference between the Introduction and Literature Review sections in a research proposal ?  

A2. The Introduction or Background section in a research proposal sets the context of the study by describing the current scenario of the subject and identifying the gaps and need for the research. A Literature Review, on the other hand, provides references to all prior relevant literature to help corroborate the gaps identified and the research need.  

Q3. How long should a research proposal be?  

A3. Research proposal lengths vary with the evaluating authority like universities or committees and also the subject. Here’s a table that lists the typical research proposal lengths for a few universities.  

Q4. What are the common mistakes to avoid in a research proposal ?  

A4. Here are a few common mistakes that you must avoid while writing a research proposal . 7  

• No clear objectives: Objectives should be clear, specific, and measurable for the easy understanding among readers.  
• Incomplete or unconvincing background research: Background research usually includes a review of the current scenario of the particular industry and also a review of the previous literature on the subject. This helps readers understand your reasons for undertaking this research because you identified gaps in the existing research.  
• Overlooking project feasibility: The project scope and estimates should be realistic considering the resources and time available.   
• Neglecting the impact and significance of the study: In a research proposal , readers and evaluators look for the implications or significance of your research and how it contributes to the existing research. This information should always be included.  
• Unstructured format of a research proposal : A well-structured document gives confidence to evaluators that you have read the guidelines carefully and are well organized in your approach, consequently affirming that you will be able to undertake the research as mentioned in your proposal.  
• Ineffective writing style: The language used should be formal and grammatically correct. If required, editors could be consulted, including AI-based tools such as Paperpal , to refine the research proposal structure and language.  

Thus, a research proposal is an essential document that can help you promote your research and secure funds and grants for conducting your research. Consequently, it should be well written in clear language and include all essential details to convince the evaluators of your ability to conduct the research as proposed.  

This article has described all the important components of a research proposal and has also provided tips to improve your writing style. We hope all these tips will help you write a well-structured research proposal to ensure receipt of grants or any other purpose.  

References  

• Sudheesh K, Duggappa DR, Nethra SS. How to write a research proposal? Indian J Anaesth. 2016;60(9):631-634. Accessed July 15, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037942/  
• Writing research proposals. Harvard College Office of Undergraduate Research and Fellowships. Harvard University. Accessed July 14, 2024. https://uraf.harvard.edu/apply-opportunities/app-components/essays/research-proposals  
• What is a research proposal? Plus how to write one. Indeed website. Accessed July 17, 2024. https://www.indeed.com/career-advice/career-development/research-proposal  
• Research proposal template. University of Rochester Medical Center. Accessed July 16, 2024. https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/pediatrics/research/documents/Research-proposal-Template.pdf  
• Tips for successful proposal writing. Johns Hopkins University. Accessed July 17, 2024. https://research.jhu.edu/wp-content/uploads/2018/09/Tips-for-Successful-Proposal-Writing.pdf  
• Formal review of research proposals. Cornell University. Accessed July 18, 2024. https://irp.dpb.cornell.edu/surveys/survey-assessment-review-group/research-proposals  
• 7 Mistakes you must avoid in your research proposal. Aveksana (via LinkedIn). Accessed July 17, 2024. https://www.linkedin.com/pulse/7-mistakes-you-must-avoid-your-research-proposal-aveksana-cmtwf/  

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• Summary of Recommendations
• USPSTF Assessment of Magnitude of Net Benefit
• Practice Considerations
• Update of Previous USPSTF Recommendation
• Supporting Evidence
• Research Needs and Gaps
• Recommendations of Others
• Article Information

USPSTF indicates US Preventive Services Task Force.

Yellow shaded cells indicate persons to whom the C grade recommendation applies. CVD indicates cardiovascular disease; QALY, quality-adjusted life-year.

eFigure. US Preventive Services Task Force (USPSTF) Grades and Levels of Evidence

• USPSTF Modeling Study: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer JAMA US Preventive Services Task Force April 26, 2022 This US Preventive Services Task Force modeling study provides updated estimates of the net balance in benefits and harms of routine use of low-dose aspirin for primary prevention of cardiovascular disease (CVD) and colorectal cancer for hypothetical US cohorts of men and women aged 40 to 79 years with up to 20% 10-year risk for an atherosclerotic CVD event and without prior history of CVD or elevated bleeding risks. Steven P. Dehmer, PhD; Lauren R. O’Keefe, MS; Corinne V. Evans, MPP; Janelle M. Guirguis-Blake, MD; Leslie A. Perdue, MPH; Michael V. Maciosek, PhD
• USPSTF Review: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer JAMA US Preventive Services Task Force April 26, 2022 This systematic review to support the 2022 US Preventive Services Task Force Recommendation Statement on aspirin use to prevent cardiovascular disease (CVD) and colorectal cancer (CRC) summarizes published evidence on the benefits and harms of low-dose aspirin use for prevention of CVD and CRC among adults 40 years or older without known CVD and with average risk for CRC. Janelle M. Guirguis-Blake, MD; Corinne V. Evans, MPP; Leslie A. Perdue, MPH; Sarah I. Bean, MPH; Caitlyn A. Senger, MPH
• Should Patients Take Aspirin for Primary Cardiovascular Prevention? JAMA Editorial April 26, 2022 Allan S. Brett, MD
• Patient Information: Use of Aspirin to Prevent Cardiovascular Disease JAMA JAMA Patient Page April 26, 2022 This JAMA Patient Page summarizes the US Preventive Services Task Force’s recent recommendations on use of aspirin to prevent cardiovascular disease. Jill Jin, MD, MPH
• Aspirin for the Primary Prevention of Atherosclerotic Cardiovascular Disease in Women JAMA JAMA Insights August 16, 2022 This JAMA Insights Clinical Update discusses updated recommendations on the use of aspirin for primary prevention of atherosclerotic cardiovascular disease in women and stresses the importance of shared clinical decision-making. Chrisandra L. Shufelt, MD, MS; Samia Mora, MD, MHS; JoAnn E. Manson, MD, DrPH
• Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries JAMA Original Investigation August 22, 2023 This cross-sectional study evaluates the prevalence of self-reported aspirin use for secondary prevention of cardiovascular disease (CVD) among individuals in low-, middle-, and high-income countries. Sang Gune K. Yoo, MD; Grace S. Chung, PhD; Silver K. Bahendeka, MD; Abla M. Sibai, PhD; Albertino Damasceno, PhD; Farshad Farzadfar, MD; Peter Rohloff, MD; Corine Houehanou, MD; Bolormaa Norov, MSc; Khem B. Karki, MBBS; Mohammadreza Azangou-Khyavy, MD; Maja E. Marcus, PhD; Krishna K. Aryal, PhD; Luisa C. C. Brant, MD; Michaela Theilmann, MA; Renata Cífková, MD; Nuno Lunet, PhD; Mongal S. Gurung, PhD; Joseph Kibachio Mwangi, MD; Joao Martins, PhD; Rosa Haghshenas, BSc; Lela Sturua, PhD; Sebastian Vollmer, PhD; Till Bärnighausen, MD; Rifat Atun, MD; Jeremy B. Sussman, MD; Kavita Singh, PhD; Sahar Saeedi Moghaddam, MSc; David Guwatudde, PhD; Pascal Geldsetzer, ScD; Jennifer Manne-Goehler, MD; Mark D. Huffman, MD; Justine I. Davies, MD; David Flood, MD
• Aspirin for Primary Prevention—Time to Rethink Our Approach JAMA Network Open Editorial April 26, 2022 Jeffrey S. Berger, MD, MS
• Whom to Treat for Primary Prevention of Atherosclerotic Cardiovascular Disease JAMA Internal Medicine Editorial June 1, 2022 Samia Mora, MD, MHS; Chrisandra L. Shufelt, MD, MS; JoAnn E. Manson, MD, DrPH
• USPSTF Report on Aspirin for Primary Prevention JAMA Cardiology Editorial July 1, 2022 This Editorial discusses recommendations from the US Preventive Services Task Force on aspirin use to prevent cardiovascular disease and colorectal cancer. Donald M. Lloyd-Jones, MD, ScM

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US Preventive Services Task Force. Aspirin Use to Prevent Cardiovascular Disease : US Preventive Services Task Force Recommendation Statement . JAMA. 2022;327(16):1577–1584. doi:10.1001/jama.2022.4983

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Aspirin Use to Prevent Cardiovascular Disease : US Preventive Services Task Force Recommendation Statement

• Editorial Should Patients Take Aspirin for Primary Cardiovascular Prevention? Allan S. Brett, MD JAMA
• Editorial Aspirin for Primary Prevention—Time to Rethink Our Approach Jeffrey S. Berger, MD, MS JAMA Network Open
• Editorial Whom to Treat for Primary Prevention of Atherosclerotic Cardiovascular Disease Samia Mora, MD, MHS; Chrisandra L. Shufelt, MD, MS; JoAnn E. Manson, MD, DrPH JAMA Internal Medicine
• Editorial USPSTF Report on Aspirin for Primary Prevention Donald M. Lloyd-Jones, MD, ScM JAMA Cardiology
• US Preventive Services Task Force USPSTF Modeling Study: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer Steven P. Dehmer, PhD; Lauren R. O’Keefe, MS; Corinne V. Evans, MPP; Janelle M. Guirguis-Blake, MD; Leslie A. Perdue, MPH; Michael V. Maciosek, PhD JAMA
• US Preventive Services Task Force USPSTF Review: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer Janelle M. Guirguis-Blake, MD; Corinne V. Evans, MPP; Leslie A. Perdue, MPH; Sarah I. Bean, MPH; Caitlyn A. Senger, MPH JAMA
• JAMA Patient Page Patient Information: Use of Aspirin to Prevent Cardiovascular Disease Jill Jin, MD, MPH JAMA
• JAMA Insights Aspirin for the Primary Prevention of Atherosclerotic Cardiovascular Disease in Women Chrisandra L. Shufelt, MD, MS; Samia Mora, MD, MHS; JoAnn E. Manson, MD, DrPH JAMA
• Original Investigation Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries Sang Gune K. Yoo, MD; Grace S. Chung, PhD; Silver K. Bahendeka, MD; Abla M. Sibai, PhD; Albertino Damasceno, PhD; Farshad Farzadfar, MD; Peter Rohloff, MD; Corine Houehanou, MD; Bolormaa Norov, MSc; Khem B. Karki, MBBS; Mohammadreza Azangou-Khyavy, MD; Maja E. Marcus, PhD; Krishna K. Aryal, PhD; Luisa C. C. Brant, MD; Michaela Theilmann, MA; Renata Cífková, MD; Nuno Lunet, PhD; Mongal S. Gurung, PhD; Joseph Kibachio Mwangi, MD; Joao Martins, PhD; Rosa Haghshenas, BSc; Lela Sturua, PhD; Sebastian Vollmer, PhD; Till Bärnighausen, MD; Rifat Atun, MD; Jeremy B. Sussman, MD; Kavita Singh, PhD; Sahar Saeedi Moghaddam, MSc; David Guwatudde, PhD; Pascal Geldsetzer, ScD; Jennifer Manne-Goehler, MD; Mark D. Huffman, MD; Justine I. Davies, MD; David Flood, MD JAMA

Importance   Cardiovascular disease (CVD) is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths. Each year, an estimated 605 000 people in the US have a first myocardial infarction and an estimated 610 000 experience a first stroke.

Objective   To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the effectiveness of aspirin to reduce the risk of CVD events (myocardial infarction and stroke), cardiovascular mortality, and all-cause mortality in persons without a history of CVD. The systematic review also investigated the effect of aspirin use on colorectal cancer (CRC) incidence and mortality in primary CVD prevention populations, as well as the harms (particularly bleeding) associated with aspirin use. The USPSTF also commissioned a microsimulation modeling study to assess the net balance of benefits and harms from aspirin use for primary prevention of CVD and CRC, stratified by age, sex, and CVD risk level.

Population   Adults 40 years or older without signs or symptoms of CVD or known CVD (including history of myocardial infarction or stroke) who are not at increased risk for bleeding (eg, no history of gastrointestinal ulcers, recent bleeding, other medical conditions, or use of medications that increase bleeding risk).

Evidence Assessment   The USPSTF concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit. The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit.

Recommendation   The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one. Evidence indicates that the net benefit of aspirin use in this group is small. Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit. (C recommendation) The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older. (D recommendation)

See the Summary of Recommendations figure.

Cardiovascular disease (CVD) is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths. 1 Each year, an estimated 605 000 people in the US have a first myocardial infarction and an estimated 610 000 experience a first stroke. 2

The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit .

The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit .

See the Table for more information on the USPSTF recommendation rationale and assessment and the eFigure in the Supplement for information on the recommendation grade. See Figure 1 for a summary of the recommendation for clinicians. For more details on the methods the USPSTF uses to determine the net benefit, see the USPSTF Procedure Manual. 3

This recommendation applies to adults 40 years or older without signs or symptoms of CVD or known CVD (including history of myocardial infarction or stroke) who are not at increased risk for bleeding (eg, no history of gastrointestinal ulcers, recent bleeding, other medical conditions, or use of medications that increase bleeding risk). In this recommendation statement, CVD risk and the net benefits of aspirin use are discussed using the terms “men” and “women,” although it is likely that CVD risk and net benefit estimates are driven by sex (ie, male/female) rather than gender identity.

Older age is one of the strongest risk factors for CVD. Men have a higher overall CVD disease burden, although women experience higher mortality from certain cardiovascular events, such as stroke. Men tend to experience CVD events earlier in life compared with women. The burden of CVD also differs by race and ethnicity. Among both sexes, Black persons have the highest prevalence of CVD. 2

The American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equations may be used to estimate 10-year risk of CVD. The ACC/AHA risk estimator is, to date, the only US-based CVD risk prediction tool that has published external validation studies in other US-based populations. 4 The estimator has separate equations based on sex and for Black persons and non-Black persons, which include the risk factors of age, cholesterol levels, systolic blood pressure level, antihypertension treatment, presence of diabetes, and smoking status, and focuses on hard clinical outcomes (myocardial infarction and death from coronary heart disease; ischemic stroke and stroke-related death) as the outcomes of interest. It is important to note that increasing age heavily influences the ACC/AHA estimated 10-year CVD event risk. The risk prediction equations generally show higher risk for Black persons than White persons. 4 The USPSTF recognizes that race is a social construct and an imperfect proxy for social determinants of health and the effects of structural racism. Concerns about calibration exist, with many external validation studies showing overprediction in broad populations (men and women across racial and ethnic groups). 5 - 7 Limited evidence also suggests underprediction in disadvantaged communities 8 , 9 that could lead to underutilization of preventive therapies. Clinicians should recognize that predictions of 10-year CVD events using the Pooled Cohort Equations are estimates.

The risk for gastrointestinal bleeding, intracranial hemorrhage, and hemorrhagic stroke, with or without aspirin use, increases with older age. Other risk factors include male sex, diabetes, history of gastrointestinal issues (such as peptic ulcer disease), liver disease, smoking, and elevated blood pressure. Certain medications, including nonsteroidal anti-inflammatory drugs, steroids, and anticoagulants, increase the risk of bleeding. 10 - 13 These risk factors should be considered in the overall decision about whether to start or continue aspirin therapy.

The benefits of aspirin for CVD prevention appear similar for a low dose (≤100 mg/d) and for all doses that have been studied in CVD prevention trials (50 to 500 mg/d). 14 A pragmatic approach would be to use 81 mg/d, which is the most commonly prescribed dose in the US.

Because CVD risk estimation is imprecise and imperfect at the individual level, the USPSTF suggests using these risk estimates as a starting point to discuss with appropriate candidates their desire for daily aspirin use. The benefits of initiating aspirin use are greater for individuals at higher risk for CVD events (eg, those with >15% or >20% 10-year CVD risk).

In addition to age and estimated level of CVD risk, decisions about initiating aspirin use should be based on shared decision-making between clinicians and patients about the potential benefits and harms. Persons who place a higher value on the potential benefits (decreasing an individual’s risk of a myocardial infarction or stroke) than the potential harms (the risk of gastrointestinal or intracranial bleeding) may choose to initiate low-dose aspirin use. Persons who place a higher value on the potential harms or the burden of taking a daily preventive medication than on the potential benefits may choose not to initiate low-dose aspirin use.

Annual bleeding events in individuals without risk factors for increased bleeding (eg, history of gastrointestinal bleeding risk, history of peptic ulcer disease, or use of nonsteroidal anti-inflammatory drugs or corticosteroids) are rare, but risk for bleeding increases modestly with advancing age. 12 For persons who have initiated aspirin use, the net benefits continue to accrue over time in the absence of a bleeding event. The net benefits, however, generally become progressively smaller with advancing age because of an increased risk for bleeding, and modeling data suggest that it may be reasonable to consider stopping aspirin use around age 75 years.

Million Hearts 2022 is a national initiative to prevent 1 million myocardial infarctions and strokes within 5 years. It focuses on implementing a small set of evidence-based priorities and targets that can improve cardiovascular health for all ( https://millionhearts.hhs.gov/ ).

The Centers for Disease Control and Prevention has resources related to risk of heart disease and the prevention of heart disease for patients and health professionals ( https://www.cdc.gov/heartdisease/index.htm ).

The National Heart, Lung, and Blood Institute has patient resources related to coronary heart disease ( https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease ).

The USPSTF has made several other recommendations on CVD prevention, including statin use to prevent CVD, 15 smoking cessation, 16 counseling to promote a healthful diet and physical activity in persons with and without cardiovascular risk factors, 17 , 18 and interventions to prevent obesity-related morbidity and mortality, 19 as well as screening for high blood pressure 20 and diabetes. 21 The USPSTF has also made a recommendation on screening for colorectal cancer (CRC). 22

This recommendation replaces the 2016 USPSTF recommendation on aspirin use to prevent CVD and CRC. 23 In 2016, the USPSTF recommended initiating low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years, and that the decision to initiate low-dose aspirin use in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. The USPSTF previously found that the evidence was insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years or adults 70 years or older.

For the current recommendation, the USPSTF has changed the age ranges and grades of its recommendation on aspirin use. The USPSTF recommends that the decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one and recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older. Based on new trial evidence, 24 updated analyses of the evidence from primary CVD prevention populations, 14 and longer-term follow-up data from the Women’s Health Study (WHS) (I.-M. Lee, ScD, Harvard Medical School, written communication, November 23, 2020), the USPSTF concluded that the evidence is inadequate that low-dose aspirin use reduces CRC incidence or mortality.

To update its 2016 recommendation, the USPSTF commissioned a systematic review on the effectiveness of aspirin to reduce the risk of CVD events (myocardial infarction and stroke), cardiovascular mortality, and all-cause mortality in persons without a history of CVD. The systematic review also investigated the effect of aspirin use on CRC incidence and mortality in primary CVD prevention populations, as well as the harms, particularly bleeding harms, associated with aspirin use. 14 , 25

In addition to the systematic evidence review, the USPSTF commissioned a microsimulation modeling study to assess the net balance of benefits and harms from aspirin use for primary prevention of CVD and CRC, stratified by age, sex, and CVD risk level. Modeling study parameter inputs were informed by the results of the systematic review, and the primary outcomes were net benefits expressed as quality-adjusted life-years and life-years. 26 , 27

The USPSTF considered 13 randomized clinical trials (RCTs) involving 161 680 participants that reported on the benefits of aspirin use for the primary prevention of cardiovascular morbidity and mortality. 14 , 25 Most trials used low-dose aspirin of 100 mg/d or less or aspirin every other day and included a balanced number of male and female participants and a broad distribution of ages, with mean age ranging from 53 years in the Physicians' Health Study 28 to 74 years in the Aspirin in Reducing Events in the Elderly (ASPREE) trial. 24

The evidence showed that aspirin use for primary prevention of CVD was associated with a decreased risk of myocardial infarction and stroke but not cardiovascular mortality or all-cause mortality. Results were similar when including studies using all doses of aspirin compared with studies using low-dose aspirin. 14 Since low-dose aspirin is most relevant to current practice, the analyses below report outcomes pooling studies of low-dose aspirin use. Pooled effect estimates of studies using low-dose aspirin were also used to inform the parameters and assumptions of the microsimulation modeling study. 26 , 27

A pooled analysis of 11 trials (n = 134 470) showed that low-dose aspirin use was associated with a statistically significant decreased risk of nonfatal myocardial infarction (Peto odds ratio [OR], 0.88 [95% CI, 0.80-0.96]). Similarly, a pooled analysis of 5 trials (n = 54 947) demonstrated that low-dose aspirin use was associated with a statistically significant decreased risk of nonfatal ischemic stroke (Peto OR, 0.88 [95% CI, 0.78-1.00]; P  = .046). Fatal cardiovascular events were less common, so pooled analyses showed that low-dose aspirin use was not associated with a statistically significant effect on fatal myocardial infarction, fatal stroke, cardiovascular mortality, or all-cause mortality (at 3.6 to 10.1 years of follow-up). 14 , 25 Although evidence does not suggest that the relative effect of aspirin on CVD outcomes is modified by baseline CVD risk, the absolute magnitude of the benefit is greater in persons at higher CVD risk.

New RCT data, as well as newly available information on the age distribution of participants in the WHS, show that almost 22 000 participants younger than 50 years and more than 37 000 participants 70 years or older were included in the CVD prevention trials. Most trials with age subanalyses did not find a statistically significant difference in the relative effect of aspirin on CVD outcomes by age. 14 , 25 The USPSTF thus concluded that evidence on the benefits of aspirin on CVD outcomes was adequate for all groups, including adults aged 40 to 49 years and adults 70 years or older.

The evidence review found fewer studies reporting on the effects of aspirin use on CRC incidence or mortality. Four studies conducted in primary CVD prevention populations found no association between aspirin use and CRC incidence at up to approximately 10 years of follow-up. 14 , 25 Only 1 trial, the WHS (n = 39 876), reported on the effect of low-dose aspirin use on CRC incidence beyond 10 years by including posttrial observational follow-up. Although the WHS reported a lower incidence of CRC at 17.5 years of follow-up (Peto OR, 0.82 [95% CI, 0.69-0.98]), 29 recent data showed that this effect did not persist from 17.5 to 26 years of follow-up (I.-M. Lee, ScD, Harvard Medical School, written communication, November 23, 2020). Two RCTs, ASPREE 24 and WHS (I.-M. Lee, ScD, Harvard Medical School, written communication, November 23, 2020), reported CRC mortality during the trial phase. ASPREE reported that aspirin use was associated with statistically significantly higher CRC mortality at 4.7 years of follow-up (Peto OR, 1.74 [95% CI, 1.02-2.95]), while the WHS did not find a statistically significant increase in CRC mortality at 10 years. When including observational follow-up beyond the trial phase, 2 trials of low-dose aspirin use reported reductions in CRC mortality. In the Thrombosis Prevention Trial 30 , 31 (n = 5085), low-dose aspirin use was associated with a statistically significant lower risk of CRC mortality at 18.3 years of follow-up (Peto OR, 0.62 [95% CI, 0.41-0.94]), and the WHS reported lower CRC mortality at 17.5 years of follow-up that was not statistically significant (Peto OR, 0.86 [95% CI, 0.64-1.16]) and was attenuated from 17.5 to 26 years of follow-up (I.-M. Lee, ScD, Harvard Medical School, written communication, November 23, 2020).

The body of evidence on the effects of aspirin use on CRC incidence and mortality is limited by several factors. Overall, only a small number of trials reported on CRC outcomes. The ASPREE trial in older adults found aspirin use to be associated with an increased risk of CRC mortality. 24 Although this finding does not constitute firm evidence that aspirin use is associated with increased risk of CRC mortality, it is one factor that calls into question whether aspirin use has a beneficial effect on CRC outcomes. Longer-term follow-up data suggesting that aspirin use is associated with lower CRC risk is heavily weighted by 1 trial conducted in women only, and the evidence on CRC mortality is limited by few CRC deaths. Additionally, posttrial follow-up data may be subject to biases, and in some cases, CRC outcomes data were collected by outside investigators. 14 , 25

The USPSTF reviewed 14 RCTs in CVD primary prevention populations that reported on the bleeding harms of aspirin. Studies reported a variety of outcomes, including total major bleeds (defined as a composite of intracranial hemorrhage, major gastrointestinal bleeding, or major bleeding from other sites), major gastrointestinal bleeds (defined as a gastrointestinal bleed that required a transfusion, hospital admission, or resulted in death), extracranial bleeds (defined as major bleeding that was not intracranial), hemorrhagic stroke, and intracranial bleeds (defined as hemorrhagic stroke, subarachnoid hemorrhage, and subdural hemorrhage). 14 , 25

When looking at studies reporting on the harms of low-dose aspirin use (≤100 mg/d), which is most relevant to current practice, a pooled analysis of 10 trials (n = 119 130) showed that aspirin use was associated with a 58% increase in major gastrointestinal bleeding (Peto OR, 1.58 [95% CI, 1.38-1.80]). A pooled analysis of 11 trials (n = 134 470) showed an increase in intracranial bleeds in the aspirin group compared with the control group (Peto OR, 1.31 [95% CI, 1.11-1.54]). Low-dose aspirin use was not associated with a statistically significant increase in risk of fatal hemorrhagic stroke. 14 , 25

Data suggest that the increased incidence of bleeding associated with aspirin use occurs relatively quickly after initiating aspirin, and data do not suggest that aspirin has a differential relative bleeding risk based on age, sex, presence of diabetes, level of CVD risk, or race or ethnicity. 14 , 25 Although the increase in relative risk does not appear to differ based on age, the absolute incidence of bleeding, and thus the magnitude of bleeding harm, increases with age, and more so in adults 60 years or older. Because of the very small number of fatal gastrointestinal bleeding events in trials and inconsistent reporting, it is uncertain whether aspirin use increases fatal gastrointestinal bleeding. 14 , 25

The USPSTF commissioned a microsimulation model to estimate the magnitude of net benefit of low-dose aspirin use. 26 , 27 The model incorporated findings from the systematic review to inform its parameters and assumptions, including that daily low-dose (≤100 mg/d) aspirin use reduces the risk of nonfatal myocardial infarction and nonfatal stroke, increases the risk of major gastrointestinal bleeding and intracranial hemorrhage, and has no effect on the risk of CVD mortality. As there was insufficient evidence that aspirin use reduces CRC incidence, the modeling study base case assumed no effect of aspirin on CRC incidence.

Modeling outcomes were stratified by age, decade of aspirin initiation (40-49 years, 50-59 years, 60-69 years, and 70-79 years), sex, and baseline 10-year CVD risk level (5% to 20%). When combined with primary trial data and pooled analyses from the systematic evidence review, the model provided additional information to assess the balance of benefits and harms of aspirin use. The primary model outcomes were net quality-adjusted life-years and life-years gained or lost over a lifetime as a result of aspirin use. Also considered was the effect of stopping aspirin that had been initiated for primary prevention over 5-year age intervals from ages 65 to 85 years. 26 , 27

Modeling data estimated that aspirin use in both men and women aged 40 to 59 years with 10% or greater 10-year CVD risk generally provides a modest net benefit in both quality-adjusted life-years and life-years gained. Initiation of aspirin use in persons aged 60 to 69 years results in quality-adjusted life-years gained that range from slightly negative to slightly positive depending on CVD risk level, and life-years gained are generally negative. In persons aged 70 to 79 years, initiation of aspirin use results in a loss of both quality-adjusted life-years and life-years at essentially all CVD risk levels modeled (ie, up to 20% 10-year CVD risk) ( Figure 2 ). 26 , 27 The USPSTF thus determined that aspirin use has a small net benefit in persons aged 40 to 59 years with 10% or greater 10-year CVD risk and that initiation of aspirin use has no net benefit in persons 60 years or older.

When looking at net lifetime benefit of continuous aspirin use until stopping at age 65, 70, 75, 80, or 85 years, modeling data suggested that there is generally little incremental lifetime net benefit in continuing aspirin use beyond the age of 75 to 80 years. 26 , 27 It is important to note that the net benefit of continuing aspirin use by persons in their 60s or 70s is not the same as the net benefit of initiating aspirin use by persons in their 60s or 70s. This is because, in part, CVD risk is heavily influenced by age. Persons who meet the eligibility criteria for aspirin use at a younger age (ie, ≥10% 10-year CVD risk in their 40s or 50s) typically would have even higher CVD risk by their 60s or 70s compared with persons who first reach a 10% or greater 10-year CVD risk in their 60s or 70s and may gain more benefit by continuing aspirin use than persons at lower risk might gain by initiating aspirin use.

Aspirin’s mechanism of action to promote CVD prevention is well known. At lower doses, aspirin is an irreversible cyclooxygenase 1 (COX-1) enzyme inhibitor. At higher doses, aspirin also inhibits COX-2. Aspirin reduces the risk for atherothrombosis through the inhibition of platelet function (through COX-1 inhibition) and has been used widely for the prevention of CVD events, particularly for secondary prevention. 32 The COX-1 enzyme is also responsible for producing a variety of prostaglandins that protect the gastrointestinal mucosa. 33 By inhibiting this enzyme, aspirin use can promote gastrointestinal bleeding. 34 The mechanism for the possible antineoplastic effects of aspirin is not as well understood. 14

A draft version of this recommendation statement was posted for public comment on the USPSTF website from October 12 to November 8, 2021. In response to public comment, the USPSTF wants to restate that the focus of this recommendation is the use of aspirin for the primary prevention of CVD and not for other indications. This recommendation only applies to persons who do not have a history of CVD, signs or symptoms of CVD, or other conditions for which aspirin may be indicated. Persons who are currently taking aspirin and have questions about why they are taking it, or whether they should continue or discontinue aspirin use, should discuss these questions with their clinician. Persons who are taking aspirin should not discontinue using it without consulting their clinician. For persons who are deciding with their clinician whether to continue or discontinue taking aspirin for primary prevention, clinicians may want to consider that person’s age, level of CVD risk and bleeding risk, preferences, and reasons for taking aspirin.

In response to public comment, the USPSTF clarified language about its assessment of the precision of CVD risk assessment and added information on factors that can be considered by clinicians and patients as they engage in shared decision-making about the initiation of aspirin use. Information on the evidence the USPSTF reviewed on the effect of aspirin on CRC incidence and mortality and how it considered the findings from the ASPREE trial can also be found in the Supporting Evidence section of this recommendation. Also, in response to public comment, the USPSTF wants to note that it did not review the emerging evidence on the effect of aspirin on COVID-19, the disease caused by the coronavirus SARS-CoV-2.

More research is needed to evaluate the following.

Improving the accuracy of CVD risk prediction in all racial and ethnic and socioeconomic groups.

The gastrointestinal bleeding risk associated with aspirin use in populations representative of the US primary CVD prevention population.

Characterizing the distribution of patient preferences across the spectrum of cardiovascular risk after patients are informed about the benefits and harms of aspirin.

The effects of low-dose aspirin use on CRC incidence and mortality over the long term (10 to 20 years and longer) in primary prevention populations and in the context of current CRC screening practices.

The ACC/AHA recommends that low-dose aspirin use (75 to 100 mg/d) might be considered for the primary prevention of atherosclerotic CVD among select adults aged 40 to 70 years at higher CVD risk but not at increased risk of bleeding. Low-dose aspirin use is not recommended on a routine basis for primary prevention of CVD in adults older than 70 years or among adults of any age who are at increased risk of bleeding. 35 The American Academy of Family Physicians supports the 2016 USPSTF recommendation on aspirin use. 36

Corresponding Author: Karina W. Davidson, PhD, MASc, Feinstein Institutes for Medical Research, 130 E 59th St, Ste 14C, New York, NY 10032 ( [email protected] ).

Accepted for Publication: March 21, 2022.

The US Preventive Services Task Force (USPSTF) members: Karina W. Davidson, PhD, MASc; Michael J. Barry, MD; Carol M. Mangione, MD, MSPH; Michael Cabana, MD, MA, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Alex H. Krist, MD, MPH; Martha Kubik, PhD, RN; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD.

Affiliations of The US Preventive Services Task Force (USPSTF) members: Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York (Davidson); Harvard Medical School, Boston, Massachusetts (Barry); University of California, Los Angeles (Mangione); Albert Einstein College of Medicine, New York, New York (Cabana); Virginia Commonwealth University, Richmond (Chelmow, Krist); University of Washington, Seattle (Coker); University of Pittsburgh, Pittsburgh, Pennsylvania (Davis); University of North Carolina at Chapel Hill (Donahue); University of Texas Health Science Center, San Antonio (Jaén); Fairfax Family Practice Residency, Fairfax, Virginia (Krist); George Mason University, Fairfax, Virginia (Kubik); University of Virginia, Charlottesville (Li); New York University, New York, New York (Ogedegbe); University of Massachusetts Medical School, Worcester (Pbert); University of Arizona, Tucson (Ruiz); University of Missouri, Columbia (Stevermer); University of Hawaii, Honolulu (Tseng); Tufts University School of Medicine, Boston, Massachusetts (Wong).

Author Contributions: Dr Davidson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The USPSTF members contributed equally to the recommendation statement.

Conflict of Interest Disclosures: Authors followed the policy regarding conflicts of interest described at https://www.uspreventiveservicestaskforce.org/Page/Name/conflict-of-interest-disclosures . All members of the USPSTF receive travel reimbursement and an honorarium for participating in USPSTF meetings.

Funding/Support: The USPSTF is an independent, voluntary body. The US Congress mandates that the Agency for Healthcare Research and Quality (AHRQ) support the operations of the USPSTF.

Role of the Funder/Sponsor: AHRQ staff assisted in the following: development and review of the research plan, commission of the systematic evidence review from an Evidence-based Practice Center, coordination of expert review and public comment of the draft evidence report and draft recommendation statement, and the writing and preparation of the final recommendation statement and its submission for publication. AHRQ staff had no role in the approval of the final recommendation statement or the decision to submit for publication.

Disclaimer: Recommendations made by the USPSTF are independent of the US government. They should not be construed as an official position of AHRQ or the US Department of Health and Human Services.

Additional Contributions: We thank Howard Tracer, MD (AHRQ), who contributed to the writing of the manuscript, and Lisa Nicolella, MA (AHRQ), who assisted with coordination and editing.

Additional Information: The US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment. The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision-making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Published by JAMA®—Journal of the American Medical Association under arrangement with the Agency for Healthcare Research and Quality (AHRQ). ©2022 AMA and United States Government, as represented by the Secretary of the Department of Health and Human Services (HHS), by assignment from the members of the United States Preventive Services Task Force (USPSTF). All rights reserved.

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