This document discusses how to critically appraise the discussion, funding, and conflicts of interest sections of a research article. It provides guidance on properly structuring the discussion section and things to avoid. Regarding funding, it notes that industry-sponsored studies often produce biased results favoring the sponsor. Conflicts of interest can compromise objectivity and increase risk of bias. The document stresses the importance of evaluating funding sources and conflicts to properly assess and interpret a study's findings and limitations.

1. Dr. S. A. Rizwan, M.D.
Public Health Specialist
SBCM, Joint Program – Riyadh
Ministry of Health, Kingdom of Saudi Arabia
Critical appraisal:
Discussion, funding, conflicts of
interest

2. Learning objectives
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Critically appraise the following elements of a
research article:
• Discussion, funding, conflicts of interest
2

3. Section 1:
Discussion
Critical appraisal of health literature SBCM, Joint Program – Riyadh

4. Things to consider in discussion
Critical appraisal of health literature SBCM, Joint Program – Riyadh
1. General rules
2. The content
3. Organization and structure
4. Overall objectives
5. Problems to avoid
4

5. Discussion: General rules
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Do not be verbose or repetitive
• Be concise
• Avoid using jargon
• Follow a logical stream of thought; significance of
findings in the same sequence described them in
your results section
• Categorize your interpretations into themes
5

6. Discussion: Content
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Explanation of results
• References to previous research
• Deduction
• Hypothesis
6

7. Discussion: Structure
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Organize the discussion from the general to the specific
• Use the same key terms, narrative style, and verb tense
• Answer all of the research questions underpinning the problem
• Describe the patterns, principles, and relationships
• Analysis of any unexpected findings
• Identify potential limitations and weaknesses
• End with a concise summary of the principal implications of the findings
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8. Discussion: Objectives
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Reiterate the Research Problem/State the Major Findings
• Explain the Meaning of the Findings and Why They are Important
• Relate the Findings to Similar Studies
• Consider Alternative Explanations of the Findings
• Acknowledge the Study’s Limitations
• Make Suggestions for Further Research
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9. Discussion: Problems to avoid
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Do not introduce new results in the discussion section
• Use of "bridge sentences“
• Too much use of the first person can actually distract the reader from the main
points
9

10. Section 2:
Role of funding
Critical appraisal of health literature SBCM, Joint Program – Riyadh

11. Why evaluate the funder?
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Studies of research sponsored by the industries show
that such studies are more likely to produce findings
that favor the sponsor’s intervention
• A recent Cochrane review has shown that
pharmaceutical industry-sponsored studies
overestimate the efficacy and underestimate the
harm of their treatments
• Study funding sources considered as risks of bias
11

12. Example of good practices
Critical appraisal of health literature SBCM, Joint Program – Riyadh 12

13. Section 3:
Conflicts of interest
Critical appraisal of health literature SBCM, Joint Program – Riyadh

14. What is COI?
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Researchers have a tradition of free inquiry and
free exchange of ideas
• But, sometimes
• The researcher has a financial interest in the company
sponsoring the research
• The researcher holds a position in an enterprise (e.g.
as director) that may wish to restrict (or otherwise
manage) adverse research findings
• A conflict of interest is a situation in which financial or
other personal considerations have the potential to
compromise or bias professional judgment and
objectivity
14

15. Why is COI important?
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• COIs increase the risk that studies
may be biased
• In design, conduct, or reporting
• Study sponsorship and the industry
ties of investigators
• Affect ability of consumers to use
research to make good evidence-
based decisions
15

16. Example of COI
Critical appraisal of health literature SBCM, Joint Program – Riyadh 16

17. Take home messages
Critical appraisal of health literature SBCM, Joint Program – Riyadh
• Discussion is an important part of the
article which gives the research context
• Role of funding agency and COI are
important for interpreting the biases of a
study
17

18. Thank you!
Email your queries to sarizwan1986@outlook.com