How To Read A Scientific Manuscript

Issues of Concern

Healthcare is continually advanced by a steady stream of new scientific discoveries and evidence that enhance clinical practice. Primary studies are at the core of this progress, serving as the main conduit for introducing novel information to the medical community. These studies form the foundation for the guidelines, presentations, and textbooks that shape our standards of care.

Given the importance of primary literature, the ability to read, interpret, and critically analyze the information in scientific studies is an essential skill for every healthcare provider.

Clinical Significance

Establishing an Objective

Before reading a scientific manuscript, the first step in exploring scientific literature is to establish a clear objective for the type of information you seek. This often begins with a precise clinical question, such as "Which treatments for disease X are most effective?" or "Is medication Y indicated for the treatment of disease Z?" A well-defined objective guides your focus and shapes how you approach reading and interpreting the research article.

Literature Search

The next step is to search for existing literature based on your research objective. Specific tactics for conducting a thorough literature search are not covered in this topic, but using multiple databases—such as OVID, PubMed, and Google Scholar—is essential for an effective literature search.[1][2] When searching scientific databases, you can filter studies by factors such as publication year, subject type (human or animal), and article type (such as trials or reviews), which helps narrow and target your search.

Pay close attention to the journals in which papers are published. For example, a Google Web search might return non-peer-reviewed papers or non-indexed manuscripts, which are generally less reliable. Reading low-quality papers from less reputable or predatory journals can lead to inaccurate conclusions.[3] 

Original research manuscripts: Original research manuscripts typically include the below-mentioned sections in chronological order.

• Title 
• Abstract
• Introduction (Background and Objectives)
• Methods (Study design, Inclusion and exclusion criteria, Participants, Variables, and Statistics)
• Results (Participants, Descriptives, Outcomes, and Subgroups)
• Tables and Figures     
• Discussion (Key findings, Limitations, and Interpretations)
• Conclusion
• Conflict of Interest (COI), Author Affiliations, Acknowledgments, and Funding Disclosures
• References [4]

Review articles: These articles typically include the sections mentioned below, although the structure can vary.

• Title
• Abstract
• Objective or Purpose
• Methods (Data sources, Study selection, Data extraction, and Statistics)
• Results (Participating studies, Literary matrices, and Outcomes)
• Tables and Figures
• Conclusion
• Conflict of Interest (COI), Author affiliations, Acknowledgments, and Funding Disclosures
• References

Efficient Manuscript Reading

While individual practices may vary, a common and effective method for reading scientific manuscripts is mentioned below.

• Title and Abstract
• Introduction (if needed)
• Tables and Figures
• Results and Discussion
• Abstract (again)
• Methods
• Study Limitations, Future Directions, and Author Disclosures

Efficient manuscript reading starts with the Title and Abstract. The Title conveys the main take-home point of a scientific publication, while the Abstract provides a brief synopsis of the study's or review's Purpose, Methods, Results, and Conclusions. Reading the Title and Abstract is an effective way to screen scientific articles for relevance, as not every article that matches the keyword search will necessarily fall within the true scope of the literature search.[1]

The next step in reading a manuscript depends on one's prior knowledge of the topic, reading goals, level of concentration or time to devote to reading, and overall interest. For those with limited background knowledge, it is advisable to start with the Introduction. A well-structured Introduction typically includes 2 components—a brief background on the topics or concepts being investigated and an overview of the study's objective, which often highlights the purpose, hypotheses, and/or study design. The second component is usually found in the final paragraph of the Introduction. If one has a strong understanding of the topic, they may choose to skip directly to this final paragraph.[5]

After reading the Introduction, the most efficient next step is to review either the Tables and Figures or the Results. Tables and Figures present study data in numerical or visual formats, offering a snapshot of the most relevant data. As Tables and Figures are often easier to read or interpret than the text, many readers choose to examine them before delving into the Results section. However, some readers prefer to read the Results first and refer to the Tables and Figures as needed. The Results section provides a summary of the study's objective findings, ideally without any interpretation of their significance. The choice of which components to read first is a matter of personal preference.

After reviewing the Tables, Figures, and Results, the next step is to independently interpret and critically appraise the study's findings before reading the Discussion. One should use their background knowledge to compare the results with what has already been established in the literature.[6] The goal is to interpret the study's results, question the statistical methods used, and critique the author's decision-making. Consulting other publications for tips on detecting misleading or inaccurate statistical claims is also recommended.[7]

Next, the Discussion section should be read, which often includes the following components—Data summary, Data interpretation, and Study implications. Given that scientific papers can be complex, with extensive data and/or detailed analyses, the Data summary represents the author's effort to highlight the key findings, allowing for further exploration in the Data interpretation and Study implications sections of the Discussion. In this section, the authors provide their subjective interpretation of the study and compare their results with those of similar studies on the topic. Essentially, the authors contextualize their findings within the broader research landscape. Identifying any gaps is useful—such as whether the authors have omitted pertinent papers from their Discussion—and to evaluate if their connections are reasonable and logical. This section can also be used to follow up on the studies referenced and find other sources that more directly address the original clinical question.[4]

While reading the Discussion, any critical appraisal that raises questions about the study design should direct the reader to the Methods section. Authors typically describe the study design (such as case-controlled, retrospective chart review, and prospective), inclusion and exclusion criteria, and an overview of their statistical analysis. Key questions to consider in the Methods section include whether the sample size is adequate, whether the inclusion and exclusion criteria are appropriately strict or lenient, and whether the statistical tests used are suitable for the study. The Methods section is the primary reference for those aiming to replicate the study.

The final sections of a scientific paper include Study Limitations, Future Directions, and Conflicts of Interest (COI). In these sections, authors address the shortcomings of their study, such as limitations in study design (eg, small sample size and retrospective nature) and limitations in the results (eg, confounding variables and unreliable data). Considering the authors' affiliations and COI helps the reader assess how these limitations impact the generalizability of the results beyond the study population. The Future Directions section often outlines areas for further research to address these limitations.

After reading the entire paper, one should take a broad approach to summarize it by mentally reciting the study, writing notes, or teaching it to others. While reviewing the complete study, it is important to continue critically appraising the major themes: Did the study make sense? Did it address its hypotheses? Were appropriate methods used? What did the results reveal? 

Next, consider the study in a broader context. Did this study or any of the referenced materials address the original clinical question? Does the study inform clinical practice? What questions remain unanswered? If there are still outstanding questions, continue engaging with primary literature using the outlined approach. Critical appraisal of scientific literature is a crucial skill in all areas of healthcare, and the more one practices this skill, the more proficient one becomes at it.[4][8]

Nursing, Allied Health, and Interprofessional Team Interventions

While critical appraisal of scientific literature is a skill every healthcare provider should possess, not all providers interact with scientific literature similarly. For example, a surgeon may consult primary literature to find evidence-based practices that inform their surgical decisions. In contrast, nurses might focus on quality improvement studies to understand patient flow through a ward.

Regardless of how each healthcare professional engages with literature, the core principle of appraising sources of information remains consistent. This commitment to evidence-based care by every member of an interprofessional healthcare team is crucial, as it collectively enhances patient care.