Writing the Conclusion of a Review Paper

Recall from the initial discussion of Review papers that these publications make two kinds of
contribution: 1) an organized summary of the current state of an area of research; 2) critical
commentary from the writer who eventually recommends directions for further research.
There are two ways of furnishing critical commentary. First, critique may be provided at the end
of each topical subsection. Sometimes, recommendations are also provided, especially if the
Review is particularly complex. Second, all critique/recommendations are saved for the
conclusion. Which is the best pattern? As always, consider the reader. The more complicated
the reading task, the more difficult it is for the reader to absorb the writers message. If the
topical subsections are very straightforward, with little controversy/conflict involved, then its okay
to save all critique/recommendations for the end of the paper. More often, the topics are not so
straightforward. In that case, it is easier for the reader (and also for the writer) to finish each
section with the writers critical evaluation of the material. In this manner, each topical subsection
reads like a fairly complete mini-essay; the reader can pause, grab a cup of coffee and a
Snickers, and return to the review without sacrificing comprehension.
How does all of this relate to the conclusion? In a review paper, the conclusion is a short, upfront piece of writing. First, the conclusion offers a brief review of the main ideas of each topic
subsection (generally, only a single sentence long) this is the summary function of a conclusion.
Second, the conclusion finishes with critique + recommendations or just recommendations. If the
critique is provided in the body of the paper, then the conclusion need only consist of a summary
paragraph and a recommendations paragraph. Some writers even combine both of these into a
single paragraph.
Thus, your conclusion will depend partly on the decisions made about critique. If critical
evaluation is provided in the body of the paper, it need not be repeated in the conclusion. If
critical evaluation is not provided in the body of the paper, then it is provided in the conclusion.
Organization

Critique in Body of paper

o All critical evaluation comes at the END of a subsection. If you find yourself
logically needing to provide some critique before continuing on within a particular
section, then you need to create a second-level subsection (a subtopic within
your main topic subsection for the visual thinkers, these are the main
connections coming off a central hub). Keep in mind: the prime directive here is
that all critical evaluation is written in a separate paragraph at the end of a
section.
o The Conclusion consists of the summary + recommendations for further
research.

Critique in Conclusion of Paper there are two organizational patterns

o #1 The first paragraph is summary, second paragraph is critique, third
paragraph is recommendations (note: second paragraph is more properly
understood as a functional section as you may need more than one paragraph!)
o #2 Each paragraph consists of summary of a particular section, the critique for
that section, then the recommendations for that section. The number and order
of paragraphs parallels the number and order of main topical sections of the
paper.

Outline with topics/subheadings marked: CAM Therapies for Arthritis article

Scroll on for examples!
Introduction
ACUPUNCTURE Main Topical Heading 1
o Acupuncture and Osteoarthritis second level subtopic 1A
o Acupuncture and Rheumatoid Arthritis second level subtopic 1B
o Acupuncture and Fibromyalgia Syndrome second level subtopic 1C
HOMEOPATHY Main Topical Heading 2
HERBAL THERAPY Main Topical Heading 3
o Herbal Therapy and OA second level subtopic 3A
o Herbal Therapy and RA second level subtopic 3B
NUTRITIONAL SUPPLEMENTS Main Topical Heading 4
o Glucosamine for OA second level subtopic 4A
o Chondroitin Sulfate for OA second level subtopic 4B
o SAMe (S-adenosylmethionine) second level subtopic 4C
SUMMARY
REFERENCES

HOMEOPATHY^ Main Topic Heading 2

Homeopathy is based on two main tenets. 12 The first is the principle of similars, which states that patients with a
particular pattern of signs and symptoms can be cured if they are given a drug that produces the same pattern of signs and
symptoms when given to a healthy individual. This means that treatment is individualized. The second tenet is that
remedies retain biologic activity if they are diluted and agitated or shaken between serial dilutions, even if no original
molecules remain. [definition and explanation of concept; only sections which writer felt the reader needed more
information included an extended explanation]
Only 1 meta-analysis was located that examined homeopathy and arthritis and related diseases. 13 Six trials that used
either random assignment or double-blinding were included. Three trials used patients (n = 266) with RA while subjects
in the other 3 trials had OA, FMS, and myalgia. The interventions varied and included individualized or classic
homeopathic treatment as well as complex homeopathy in which one or more remedies are administered for standard
clinical conditions. The outcomes varied alsoglobal assessment, treatment preference, or predefined responder criteria
so the results summarized do not apply strictly to pain. However, using the Jadad scale, 7 5 of the 6 trials were rated as
high quality. Results were presented as an odds ratio (OR) such that a value greater than 1 indicates greater effectiveness
of homeopathy as compared with placebo. Based on meta-analysis, homeopathy was more effective than placebo whether
one looks at all 6 trials [OR = 2.19, CI95 (1.55, 3.11)] or only the 5 high quality studies [OR = 2.11, CI95 (1.32, 3.35)];
homeopathic remedies were twice as effective as placebo. [discussion of information]
[begin critique]Although the number of studies is small and the results are mixed, it does appear that homeopathic
remedies work better than placebo for rheumatic syndromes. However, the small number of studies limits any definitive
conclusion concerning the efficacy of any one type of homeopathic treatment of any one condition. In general, there are
quality concerns for homeopathic clinical trials across all conditions. 14 Almost all studies failed to report the proportion
of subjects screened, over half did not report attrition rate, and there was little replication of conditions studied.[end
critique] Further research of homeopathy is warranted. [recommendation stated it seems obvious but the goal of
this paper is to analyze what is known about CAM and Arthritis and make definitive claims for which CAM
treatments are worth pursuing more information about] [ NOTE: the careful reader may have noticed I created a new
paragraph for this critique while this article is well written and easy to understand, a better organization is for the bodysituated critique to occur in its own paragraph so the reader knows when the writers views are being expressed.]

SUMMARY^
What have these reviews indicated about the efficacy of specific CAM therapies for pain from arthritis and related
diseases? First, there are a sufficient number of studies in some areas despite claims often heard about the lack of
evidence for CAM. Second, research findings for some of the CAM therapies reviewed here have demonstrated
consistent beneficial outcomes for patients with arthritis and related diseases. [conclusion begins with
restatement of research question and major review finding] Specifically, there is moderate support for
acupuncture in reducing pain as compared with sham acupuncture and limited support for acupuncture as
compared with a wait list for OA of the knee. However, no claims can be made for the superiority of acupuncture
across locations of OA and across comparison groups. Further, only limited support exists for the efficacy of
acupuncture for FMS with the caveat that acupuncture may actually exacerbate the pain for some patients with
FMS. At this point, little is known about acupuncture for patients with RA. [b/c critique and recommendation in
body of review, here, only a summary of BOTH is presented]
Homeopathy has been demonstrated to be twice as efficacious as placebo for rheumatic conditions, but the
outcome was not specifically pain. Furthermore, the interventions included both simple and complex homeopathy
as well as individualized and standard treatments and may not represent the system of homeopathy as practiced.
More research is needed in this area.[summary of info/critique/recs for second main topic]
Some herbals and nutraceuticals are also beneficial in reducing pain.[writer combines herbals and supplements
in one b/c they are fairly closely related medically] Both avocado/soybean unsaponifiables and devil's claw
demonstrated promising support for pain of OA with moderate support for Phytodolor and topical capsaicin.
Among the herbals used for or promoted for RA, there is strong support for GLA as found, for example, in borage
seed oil, evening primrose oil, and blackcurrant seed oil. However, evidence is lacking for other herbals and more
high quality research is needed. Research findings also support the benefits of chondroitin sulfate, glucosamine,
and SAMe in reducing pain, particularly pain related to OA of the knee. Furthermore, these treatments appear safe
to use.[thats it the end! Conclusions to Review papers often feel abrupt b/c they are pretty short and
pointed most of the information has been presented in the body of the paper, so the conclusion is truly a
brief summary]