Discussion generally summarizes the main findings of the current research work and compares and contrasts with the previous work and finally explains the clinical implication of the current work with the limitations the current work had.

Discussion section of a scientific paper can be compared with a closing argument during a legal case discussion in a court. Like a lawyer’s closing argument, which largely affects the outcome of a particular court case, discussion section clarifies the important aspects of a scientific paper. Without the presence of compelling and captivating discussion section, the whole scientific experiment tends to lose its overall significance. According to famous scientists, if researchers are unable to present the meaningfulness and importance of their findings in discussion section, then the ways and methods of how the scientific experiments were performed become meaningless. What really matters is the meaning of the findings, not just the results of the experiments. A poor discussion section can reduce the worth and impact of a scientific experiment. So, in order to write an effective and impressive scientific paper, a researcher should focus on making their discussion section really strong.

A scientific paper generally consists of various sections such as introduction, methods, results, discussion and conclusion as each of which are written for different reasons. While introduction section emphasizes on providing the general background and purpose of the study, discussion section, however focuses on what the results mean and how it influence on the field of study. An introduction section can be compared to a cone or funnel, where the information flows from simple backgrounds of the study (broad) to the specific question being asked in the study (narrow). In contrary, the discussion section is just like an inverted cone where information flows from specific answer (narrow) to a larger picture (broad). The two together appear like an hour-glass.
Hour-Glass-Model-of-Learning
For writing an captivating discussion section, it can be categorized into further three parts
1. Beginning section
2. Scope oriented section
3. End or conclusion section

One way of starting the discussion is starting from the end of an introduction section. Firstly, the opening line of it may mention the introductory sentence that restates the research question or the purpose of the study. This should match with the statement of purpose in the introduction. Then, the sentences following should answer all the questions asked in the Introduction. After answering a specific question with a specific answer, description should be made on how the answer is supported by our results.

For example, if the end of introduction is,

“We therefore investigated the association between mortality and long- and short-term prescribed opioids among patients with chronic non cancer pain and to determine the risk of cancer and hospital admissions due to injuries and toxicity among opioid users with chronic non cancer pain”

beginning of the discussion could be,

In this study, we investigated the association between mortality and long- and short-term prescribed opioids among patients with chronic non cancer pain and to determine the risk of cancer and hospital admissions due to injuries and toxicity among opioid users with chronic non cancer pain. Therefore, our results show that the risk of death was higher among long-term opioid users than individuals with chronic pain and that the risk may be associated with having chronic obstructive lung disease or other chronic diseases. Also, the risk of developing cancer was not increased in long-term opioid user compared with individuals without chronic pain. However, long-term opioid users had a substantially higher risk of injuries and toxicity/poisoning resulting in hospital inpatient admissions than individuals without chronic pain.”

In the second part of discussion, the achieved results and interpretations of them are described in a way that they are related with evidences from other published studies. This section explains how the hypothesis was proven right or wrong, and how does the current paper supports or refutes the previous evidences from other papers. For example-

A recent study of approximately 2000 breast cancer patients found a polymorphism in the gene encoding MOR, which confers decreased response to opioids, and was correlated with better breast cancer specific survival. Another study of patients with advanced cancer found that those who had intractable pain on systemic opioids and received intrathecal morphine had longer survival than those who received systemic morphine. Our cohort study demonstrated that long term use of opioids does not seem to increase the risk of developing cancer and there is no any significant association between long-term opioid use and cancer mortality. Further no significant association between long-term opioid use and cardiovascular mortality was found in our survey.

The final part of discussion is the most important of all because “the big picture” is presented here. The result of the current study is presented here and the summary or conclusion of overall research is shown. Moreover, the contribution of the current study to the field and how the findings of this study results can be applied to current and future studies are discussed in this section. The section also includes the recommendations of the current study for future efforts on this field. Towards the end of this section, a one line summary is written to restate the importance of the findings. Example,

Hence, this cohort study demonstrated an increased risk of death associated with long-term opioid use, somewhat less with short-term opioid use and chronic pain but not using opioids. Importantly, long-term use of opioids did not seem to increase the risk of developing cancer.

More importantly, a separate subsection about the strengths and limitations of the study should be included. A good researcher or a good paper does not conceal their limitations and highlight only their strengths. We know that every study has its limitations and one should make sure to acknowledge and mention them. It shows the honesty of the research work which in turn helps to strengthen the paper. This will ultimately teach the readers about what can be done in future to avoid these limitations. Also, these limitations can be counterbalanced by the strengths. For example,

Talking about strengths, the significant strength of this article is that it provides fresh insights and new understanding to the previous researches conducted. With the help of analysis and results, this article proves to be path shower for upcoming researches in the same field. More to say, this article could prove to be ground breaking effort in this area of research. If we can co relate the results and progresses of previous experiments with this article, more number of unanswered questions will be easily answered and we can be able to achieve more and solve problems relating to that field with much ease. This article may also serve as a reference for further researches on association between use of opioids and its effects on cancer patients. Without doubt, like all endeavors, this article also has some short comings and limitations. No experiment is perfect and however, we try to be precise and accurate in our study. One limitation to our study is that this study has adjusted its confounders who could have played a major role in making the results biased.

Recommendation
It is important to describe the contribution your study makes to the field and how the current study findings can be applied to existing and future studies. A one line final message should be given using phrases such as “in summary…..”, “in conclusion…..” etc. For Example,

In summary, our study shows the effects of long term use of opioids is non-significant to mortality of cancer patients and the study can be of great use when researching further on opioids and mortality among patients with chronic non-cancer pain.”

About Kajol:
Kajol is a BPT 2nd year student studying in Kathmandu University School of Medical Sciences(KUSMS). She likes neurology, musculoskeletal physiotherapy and evidence based practice physiotherapy as subjects. She loves listening to music, dancing, travelling and watching movies.
Kajol Kunwar

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