Meaning and Implications: The Discussion

Sometimes seen as an afterthought, the discussion is a key part of any review. This is where review authors reflect on their results and put them in the context of a wider body of literature. The discussion is also very important for the non-expert, as important findings can be explained. Additionally, the discussion should discuss key limitations in both the literature and the review process and make recommendations for policy, practice, research, and education if appropriate. Key tools for this include GRADE, GRADE CERQual, and the JBI ConQual for assessing the body of evidence which assists in turning this evidence into recommendations, ROBIS for addressing risk of bias within the review, and AMSTAR 2 which is a more general critical appraisal tool. When addressing these, it is important to remember the hierarchical nature of reviews, that is that they are comprised of individual studies that are then combined. Critical appraisal and risk of bias occur at both levels, in this chapter, the concentration is on review-level appraisal.