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How to Write Justification of the Study in Research

Justification of the study

  • Latest Blog

The justification of the study is also referred to as the rationale for the study . It is what inspired you to research a given topic. As students, it is very important to know that research writing is not just one of the things we do for leisure, research is a vital part of human endeavour, it is through research done in the past that a lot of improvements are seen today around the world. Research should be able to fill a gap and provide solutions to an existing problem, hence researchers must do due diligence in identifying the reasons for starting a research work and be able to justify their reasons for embarking on a research journey.

If a research project is to be carried out on “Introduction of Digital Libraries for Students in Nigeria Senior Secondary Schools” it is expected that the researcher has found some setbacks in the study pattern of students or the limitations of using the physical libraries on campus.

The researcher must be able to give the reasons behind his choice of research topic, the importance of digital library should outweigh the challenges it poses.

The researcher should be able to justify the reasons for selecting a chosen project topic and discuss why the research study is needed.

For research to be justified, four main criteria must be discussed to convince the supervisor or readers that a study is worthy of undertaking.

  • The size or area involved in the study should be discussed, the researcher needs to show the geographical area or locations that the research would cover and provide reasons for the choice of area and what the outcome of the study will do for such area.
  • The research gaps found in previous literature of similar studies should be discussed. The researcher must show the missing piece from other literature that needs to be bridged and the reasons for the endeavour. The importance of filling research gaps should be told including the necessary contributions to the body of knowledge that the study would project at the end of the investigations and findings.
  • The researcher should be able to justice that there has been an improved methodology or the processes of carrying out the type of research undertaken and should show how the study intends to incorporate the enhanced methods of carrying out research in the selected field or subject to investigate.
  • The researcher should discuss the main benefits of the research to the general public, profession, group, institutions, the government policies and practices in the concerned field of study and how these benefits will enable future researchers and authors to make or develop future theories, literature and additional inputs in the coming days.

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How to Write the Rationale of the Study in Research (Examples)

meaning of justification of the study in research

What is the Rationale of the Study?

The rationale of the study is the justification for taking on a given study. It explains the reason the study was conducted or should be conducted. This means the study rationale should explain to the reader or examiner why the study is/was necessary. It is also sometimes called the “purpose” or “justification” of a study. While this is not difficult to grasp in itself, you might wonder how the rationale of the study is different from your research question or from the statement of the problem of your study, and how it fits into the rest of your thesis or research paper. 

The rationale of the study links the background of the study to your specific research question and justifies the need for the latter on the basis of the former. In brief, you first provide and discuss existing data on the topic, and then you tell the reader, based on the background evidence you just presented, where you identified gaps or issues and why you think it is important to address those. The problem statement, lastly, is the formulation of the specific research question you choose to investigate, following logically from your rationale, and the approach you are planning to use to do that.

Table of Contents:

How to write a rationale for a research paper , how do you justify the need for a research study.

  • Study Rationale Example: Where Does It Go In Your Paper?

The basis for writing a research rationale is preliminary data or a clear description of an observation. If you are doing basic/theoretical research, then a literature review will help you identify gaps in current knowledge. In applied/practical research, you base your rationale on an existing issue with a certain process (e.g., vaccine proof registration) or practice (e.g., patient treatment) that is well documented and needs to be addressed. By presenting the reader with earlier evidence or observations, you can (and have to) convince them that you are not just repeating what other people have already done or said and that your ideas are not coming out of thin air. 

Once you have explained where you are coming from, you should justify the need for doing additional research–this is essentially the rationale of your study. Finally, when you have convinced the reader of the purpose of your work, you can end your introduction section with the statement of the problem of your research that contains clear aims and objectives and also briefly describes (and justifies) your methodological approach. 

When is the Rationale for Research Written?

The author can present the study rationale both before and after the research is conducted. 

  • Before conducting research : The study rationale is a central component of the research proposal . It represents the plan of your work, constructed before the study is actually executed.
  • Once research has been conducted : After the study is completed, the rationale is presented in a research article or  PhD dissertation  to explain why you focused on this specific research question. When writing the study rationale for this purpose, the author should link the rationale of the research to the aims and outcomes of the study.

What to Include in the Study Rationale

Although every study rationale is different and discusses different specific elements of a study’s method or approach, there are some elements that should be included to write a good rationale. Make sure to touch on the following:

  • A summary of conclusions from your review of the relevant literature
  • What is currently unknown (gaps in knowledge)
  • Inconclusive or contested results  from previous studies on the same or similar topic
  • The necessity to improve or build on previous research, such as to improve methodology or utilize newer techniques and/or technologies

There are different types of limitations that you can use to justify the need for your study. In applied/practical research, the justification for investigating something is always that an existing process/practice has a problem or is not satisfactory. Let’s say, for example, that people in a certain country/city/community commonly complain about hospital care on weekends (not enough staff, not enough attention, no decisions being made), but you looked into it and realized that nobody ever investigated whether these perceived problems are actually based on objective shortages/non-availabilities of care or whether the lower numbers of patients who are treated during weekends are commensurate with the provided services.

In this case, “lack of data” is your justification for digging deeper into the problem. Or, if it is obvious that there is a shortage of staff and provided services on weekends, you could decide to investigate which of the usual procedures are skipped during weekends as a result and what the negative consequences are. 

In basic/theoretical research, lack of knowledge is of course a common and accepted justification for additional research—but make sure that it is not your only motivation. “Nobody has ever done this” is only a convincing reason for a study if you explain to the reader why you think we should know more about this specific phenomenon. If there is earlier research but you think it has limitations, then those can usually be classified into “methodological”, “contextual”, and “conceptual” limitations. To identify such limitations, you can ask specific questions and let those questions guide you when you explain to the reader why your study was necessary:

Methodological limitations

  • Did earlier studies try but failed to measure/identify a specific phenomenon?
  • Was earlier research based on incorrect conceptualizations of variables?
  • Were earlier studies based on questionable operationalizations of key concepts?
  • Did earlier studies use questionable or inappropriate research designs?

Contextual limitations

  • Have recent changes in the studied problem made previous studies irrelevant?
  • Are you studying a new/particular context that previous findings do not apply to?

Conceptual limitations

  • Do previous findings only make sense within a specific framework or ideology?

Study Rationale Examples

Let’s look at an example from one of our earlier articles on the statement of the problem to clarify how your rationale fits into your introduction section. This is a very short introduction for a practical research study on the challenges of online learning. Your introduction might be much longer (especially the context/background section), and this example does not contain any sources (which you will have to provide for all claims you make and all earlier studies you cite)—but please pay attention to how the background presentation , rationale, and problem statement blend into each other in a logical way so that the reader can follow and has no reason to question your motivation or the foundation of your research.

Background presentation

Since the beginning of the Covid pandemic, most educational institutions around the world have transitioned to a fully online study model, at least during peak times of infections and social distancing measures. This transition has not been easy and even two years into the pandemic, problems with online teaching and studying persist (reference needed) . 

While the increasing gap between those with access to technology and equipment and those without access has been determined to be one of the main challenges (reference needed) , others claim that online learning offers more opportunities for many students by breaking down barriers of location and distance (reference needed) .  

Rationale of the study

Since teachers and students cannot wait for circumstances to go back to normal, the measures that schools and universities have implemented during the last two years, their advantages and disadvantages, and the impact of those measures on students’ progress, satisfaction, and well-being need to be understood so that improvements can be made and demographics that have been left behind can receive the support they need as soon as possible.

Statement of the problem

To identify what changes in the learning environment were considered the most challenging and how those changes relate to a variety of student outcome measures, we conducted surveys and interviews among teachers and students at ten institutions of higher education in four different major cities, two in the US (New York and Chicago), one in South Korea (Seoul), and one in the UK (London). Responses were analyzed with a focus on different student demographics and how they might have been affected differently by the current situation.

How long is a study rationale?

In a research article bound for journal publication, your rationale should not be longer than a few sentences (no longer than one brief paragraph). A  dissertation or thesis  usually allows for a longer description; depending on the length and nature of your document, this could be up to a couple of paragraphs in length. A completely novel or unconventional approach might warrant a longer and more detailed justification than an approach that slightly deviates from well-established methods and approaches.

Consider Using Professional Academic Editing Services

Now that you know how to write the rationale of the study for a research proposal or paper, you should make use of our free AI grammar checker , Wordvice AI, or receive professional academic proofreading services from Wordvice, including research paper editing services and manuscript editing services to polish your submitted research documents.

You can also find many more articles, for example on writing the other parts of your research paper , on choosing a title , or on making sure you understand and adhere to the author instructions before you submit to a journal, on the Wordvice academic resources pages.

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How to Justify Your Methods in a Thesis or Dissertation

How to Justify Your Methods in a Thesis or Dissertation

4-minute read

  • 1st May 2023

Writing a thesis or dissertation is hard work. You’ve devoted countless hours to your research, and you want your results to be taken seriously. But how does your professor or evaluating committee know that they can trust your results? You convince them by justifying your research methods.

What Does Justifying Your Methods Mean?

In simple terms, your methods are the tools you use to obtain your data, and the justification (which is also called the methodology ) is the analysis of those tools. In your justification, your goal is to demonstrate that your research is both rigorously conducted and replicable so your audience recognizes that your results are legitimate.

The formatting and structure of your justification will depend on your field of study and your institution’s requirements, but below, we’ve provided questions to ask yourself as you outline your justification.

Why Did You Choose Your Method of Gathering Data?

Does your study rely on quantitative data, qualitative data, or both? Certain types of data work better for certain studies. How did you choose to gather that data? Evaluate your approach to collecting data in light of your research question. Did you consider any alternative approaches? If so, why did you decide not to use them? Highlight the pros and cons of various possible methods if necessary. Research results aren’t valid unless the data are valid, so you have to convince your reader that they are.

How Did You Evaluate Your Data?

Collecting your data was only the first part of your study. Once you had them, how did you use them? Do your results involve cross-referencing? If so, how was this accomplished? Which statistical analyses did you run, and why did you choose them? Are they common in your field? How did you make sure your data were statistically significant ? Is your effect size small, medium, or large? Numbers don’t always lend themselves to an obvious outcome. Here, you want to provide a clear link between the Methods and Results sections of your paper.

Did You Use Any Unconventional Approaches in Your Study?

Most fields have standard approaches to the research they use, but these approaches don’t work for every project. Did you use methods that other fields normally use, or did you need to come up with a different way of obtaining your data? Your reader will look at unconventional approaches with a more critical eye. Acknowledge the limitations of your method, but explain why the strengths of the method outweigh those limitations.

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What Relevant Sources Can You Cite?

You can strengthen your justification by referencing existing research in your field. Citing these references can demonstrate that you’ve followed established practices for your type of research. Or you can discuss how you decided on your approach by evaluating other studies. Highlight the use of established techniques, tools, and measurements in your study. If you used an unconventional approach, justify it by providing evidence of a gap in the existing literature.

Two Final Tips:

●  When you’re writing your justification, write for your audience. Your purpose here is to provide more than a technical list of details and procedures. This section should focus more on the why and less on the how .

●  Consider your methodology as you’re conducting your research. Take thorough notes as you work to make sure you capture all the necessary details correctly. Eliminating any possible confusion or ambiguity will go a long way toward helping your justification.

In Conclusion:

Your goal in writing your justification is to explain not only the decisions you made but also the reasoning behind those decisions. It should be overwhelmingly clear to your audience that your study used the best possible methods to answer your research question. Properly justifying your methods will let your audience know that your research was effective and its results are valid.

Want more writing tips? Check out Proofed’s Writing Tips and Academic Writing Tips blogs. And once you’ve written your thesis or dissertation, consider sending it to us. Our editors will be happy to check your grammar, spelling, and punctuation to make sure your document is the best it can be. Check out our services for free .

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Research-Methodology

Rationale for the Study

It is important for you to be able to explain the importance of the research you are conducting by providing valid arguments. Rationale for the study, also referred to as justification for the study, is reason why you have conducted your study in the first place. This part in your paper needs to explain uniqueness and importance of your research. Rationale for the study needs to be specific and ideally, it should relate to the following points:

1. The research needs to contribute to the elimination of a gap in the literature. Elimination of gap in the present literature is one of the compulsory requirements for your study. In other words, you don’t need to ‘re-invent the wheel’ and your research aims and objectives need to focus on new topics. For example, you can choose to conduct an empirical study to assess the implications of COVID-19 pandemic on the numbers of tourists visitors in your city. This might be previously undressed topic, taking into account that COVID-19 pandemic is a relatively recent phenomenon.

Alternatively, if you cannot find a new topic to research, you can attempt to offer fresh perspectives on existing management, business or economic issues. For example, while thousands of studies have been previously conducted to study various aspects of leadership, this topic as far from being exhausted as a research area. Specifically, new studies can be conducted in the area of leadership to analyze the impacts of new communication mediums such as TikTok, and other social networking sites on leadership practices.

You can also discuss the shortcomings of previous works devoted to your research area. Shortcomings in previous studies can be divided into three groups:

a) Methodological limitations . Methodology employed in previous study may be flawed in terms of research design, research approach or sampling.

b) Contextual limitations . Relevance of previous works may be non-existent for the present because external factors have changed.

c) Conceptual limitations . Previous studies may be unjustifiably bound up to a particular model or an ideology.

While discussing the shortcomings of previous studies you should explain how you are going to correct them. This principle is true to almost all areas in business studies i.e. gaps or shortcomings in the literature can be found in relation to almost all areas of business and economics.

2. The research can be conducted to solve a specific problem. It helps if you can explain why you are the right person and in the right position to solve the problem. You have to explain the essence of the problem in a detailed manner and highlight practical benefits associated with the solution of the problem. Suppose, your dissertation topic is “a study into advantages and disadvantages of various entry strategies into Chinese market”. In this case, you can say that practical implications of your research relates to assisting businesses aiming to enter Chinese market to do more informed decision making.

Alternatively, if your research is devoted to the analysis of impacts of CSR programs and initiatives on brand image, practical contributions of your study would relate to contributing to the level of effectiveness of CSR programs of businesses.

Additional examples of studies that can assist to address specific practical problems may include the following:

  • A study into the reasons of high employee turnover at Hanson Brick
  • A critical analysis of employee motivation problems at Esporta, Finchley Road, London
  • A research into effective succession planning at Microsoft
  • A study into major differences between private and public primary education in the USA and implications of these differences on the quality of education

However, it is important to note that it is not an obligatory for a dissertation   to be associated with the solution of a specific problem. Dissertations can be purely theory-based as well. Examples of such studies include the following:

  • Born or bred: revising The Great Man theory of leadership in the 21 st century
  • A critical analysis of the relevance of McClelland’s Achievement theory to the US information technology industry
  • Neoliberalism as a major reason behind the emergence of the global financial and economic crisis of 2007-2009
  • Analysis of Lewin’s Model of Change and its relevance to pharmaceutical sector of France

3. Your study has to contribute to the level of professional development of the researcher . That is you. You have to explain in a detailed manner in what ways your research contributes to the achievement of your long-term career aspirations.

For example, you have selected a research topic of “ A critical analysis of the relevance of McClelland’s Achievement theory in the US information technology industry ”.  You may state that you associate your career aspirations with becoming an IT executive in the US, and accordingly, in-depth knowledge of employee motivation in this industry is going to contribute your chances of success in your chosen career path.

Therefore, you are in a better position if you have already identified your career objectives, so that during the research process you can get detailed knowledge about various aspects of your chosen industry.

Rationale for the Study

My e-book, The Ultimate Guide to Writing a Dissertation in Business Studies: a step by step assistance offers practical assistance to complete a dissertation with minimum or no stress. The e-book covers all stages of writing a dissertation starting from the selection to the research area to submitting the completed version of the work within the deadline.

John Dudovskiy

learnonline

Research proposal, thesis, exegesis, and journal article writing for business, social science and humanities (BSSH) research degree candidates

Topic outline, introduction and research justification.

meaning of justification of the study in research

Introduction and research justification, business, social sciences, humanities

Introduction.

  • Signalling the topic in the first sentence
  • The research justification or 'problem' statement 
  • The 'field' of literature
  • Summary of contrasting areas of research
  • Summary of the 'gap' in the literature
  • Research aims and objectives

Summary of the research design

Example research proposal introductions.

This topic outlines the steps in the introduction of the research proposal. As discussed in the first topic in this series of web resources, there are three key elements or conceptual steps within the main body of the research proposal. In this resource, these elements are referred to as the research justification, the literature review and the research design. These three steps also structure, typically, but not always in this order, the proposal introduction which contains an outline of the proposed research.

These steps pertain to the key questions of reviewers:

  • What problem or issue does the research address? (research justification)
  • How will the research contribute to existing knowledge? (the 'gap' in the literature, sometimes referred to as the research 'significance')
  • How will the research achieve its stated objectives? (the research design)

Reviewers look to find a summary of the case for the research in the introduction, which, in essence, involves providing summary answers to each of the questions above.

The introduction of the research proposal usually includes the following content:

  • a research justification or statement of a problem (which also serves to introduce the topic)
  • a summary of the key point in the literature review (a summary of what is known and how the research aims to contribute to what is known)
  • the research aim or objective
  • a summary of the research design
  • concise definitions of any contested or specialised terms that will be used throughout the proposal (provided the first time the term is used).

This topic will consider how to write about each of these in turn.

Signaling the topic in the first sentence

The first task of the research proposal is to signal the area of the research or 'topic' so the reader knows what subject will be discussed in the proposal. This step is ideally accomplished in the opening sentence or the opening paragraph of the research proposal. It is also indicated in the title of the research proposal. It is important not to provide tangential information in the opening sentence or title because this may mislead the reader about the core subject of the proposal.

A ‘topic’ includes:

meaning of justification of the study in research

  • the context or properties of the subject (the particular aspect or properties of the subject that are of interest).

Questions to consider in helping to clarify the topic:

  • What is the focus of my research?
  • What do I want to understand?
  • What domain/s of activity does it pertain to?
  • What will I investigate in order to shed light on my focus?

The research justification or the ‘problem’ statement

The goal of the first step of the research proposal is to get your audience's attention; to show them why your research matters, and to make them want to know more about your research. The first step within the research proposal is sometimes referred to as the research justification or the statement of the 'problem'. This step involves providing the reader with critical background or contextual information that introduces the topic area, and indicates why the research is important. Research proposals often open by outlining a central concern, issue, question or conundrum to which the research relates.

The research justification should be provided in an accessible and direct manner in the introductory section of the research proposal. The number of words required to complete this first conceptual step will vary widely depending on the project.

Writing about the research justification, like writing about the literature and your research design, is a creative process involving careful decision making on your part. The research justification should lead up to the topic of your research and frame your research, and, when you write your thesis, exegesis or journal article conclusion, you will again return to the research justification to wrap up the implications of your research. That is to say, your conclusions will refer back to the problem and reflect on what the findings suggest about how we should treat the problem. For this reason, you may find the need to go back and reframe your research justification as your research and writing progresses.

The most common way of establishing the importance of the research is to refer to a real world problem. Research may aim to produce knowledge that will ultimately be used to:

  • advance national and organisational goals (health, clean environment, quality education),
  • improve policies and regulations,
  • manage risk,
  • contribute to economic development,
  • promote peace and prosperity,
  • promote democracy,
  • test assumptions (theoretical, popular, policy) about human behaviour, the economy, society,
  • understand human behaviour, the economy and social experience,
  • understand or critique social processes and values.

Examples of 'research problems' in opening sentences and paragraphs of research writing

Management The concept of meritocracy is one replicated and sustained in much discourse around organisational recruitment, retention and promotion. Women have a firm belief in the concept of merit, believing that hard work, education and talent will in the end be rewarded (McNamee and Miller, 2004). This belief in workplace meritocracy could in part be due to the advertising efforts of employers themselves, who, since the early 1990s, attempt to attract employees through intensive branding programs and aggressive advertising which emphasise equality of opportunity. The statistics, however, are less than convincing, with 2008 data from the Equal Employment for Women in the Workplace agency signalling that women are disproportionately represented in senior management levels compared to men, and that the numbers of women at Chief Executive Officer level in corporate Australia have actually decreased (Equal Opportunity for Women Agency, 2008). Women, it seems, are still unable to shatter the glass ceiling and are consistently overlooked at executive level.

Psychology Tension-type headache is extremely prevalent and is associated with significant personal and social costs.

Education One of the major challenges of higher education health programs is developing the cognitive abilities that will assist undergraduate students' clinical decision making. This is achieved by stimulating enquiry analysis, creating independent judgement and developing cognitive skills that are in line with graduate practice (Hollingworth and McLoughlin 2001; Bedard, 1996).

Visual arts In the East, the traditional idea of the body was not as something separate from the mind. In the West, however, the body is still perceived as separate, as a counterpart of the mind. The body is increasingly at the centre of the changing cultural environment, particularly the increasingly visual culture exemplified by the ubiquity of the image, the emergence of virtual reality, voyeurism and surveillance culture. Within the contemporary visual environment, the body's segregation from the mind has become more intense than ever, conferring upon the body a 'being watched' or 'manufacturable' status, further undermining the sense of the body as an integral part of our being.

meaning of justification of the study in research

Literature review summary

The next step following the research justification in the introduction is the literature review summary statement. This part of the introduction summarises the literature review section of the research proposal, providing a concise statement that signals the field of research and the rationale for the research question or aim.

It can be helpful to think about the literature review element as comprised of four parts. The first is a reference to the field or discipline the research will contribute to. The second is a summary of the main questions, approaches or accepted conclusions in your topic area in the field or discipline at present ('what is known'). This summary of existing research acts as a contrast to highlight the significance of the third part, your statement of a 'gap'. The fourth part rephrases this 'gap' in the form of a research question, aim, objective or hypothesis.

For example

Scholars writing about ... (the problem area) in the field of ... (discipline or sub-discipline, part one) have observed that ... ('what is known', part two). Others describe ... ('what is known', part two). A more recent perspective chronicles changes that, in broad outline, parallel those that have occurred in ... ('what is known', part two). This study differs from these approaches in that it considers ... ('gap', research focus, part three). This research draws on ... to consider ... (research objective, part four).  

More information about writing these four parts of the literature review summary is provided below.

1. The 'field' of literature

The field of research is the academic discipline within which your research is situated, and to which it will contribute. Some fields grow out of a single discipline, others are multidisciplinary. The field or discipline is linked to university courses and research, academic journals, conferences and other academic associations, and some book publishers. It also describes the expertise of thesis supervisors and examiners. 

The discipline defines the kinds of approaches, theories, methods and styles of writing adopted by scholars and researchers working within them.

For a list of academic disciplines have a look at the wikipedia site at: https://en.wikipedia.org/wiki/List_of_academic_disciplines

The field or discipline is not the same as the topic of the research. The topic is the subject matter or foci of your research. Disciplines or 'fields' refer to globally recognised areas of research and scholarship.

The field or discipline the research aims to contribute to can be signalled in a few key words within the literature review summary, or possibly earlier withn the research justification.

Sentence stems to signal the field of research 

  • Within the field of ... there is now agreement that ... .
  • The field of ... is marked by ongoing debate about ... .
  • Following analysis of ... the field of ... turned to an exploration of ... .

2. A summary of contrasting areas of research or what is 'known'

The newness or significance of what you are doing is typically established in a contrast or dialogue with other research and scholarship. The 'gap' (or hole in the donut) only becomes apparent by the surrounding literature (or donut). Sometimes a contrast is provided to show that you are working in a different area to what has been done before, or to show that you are building on previous work, or perhaps working on an unresolved issue within a discipline. It might also be that the approaches of other disciplines on the same problem area or focus are introduced to highlight a new angle on the topic.

3. The summary of the 'gap' in the literature

The 'gap' in the field typically refers to the explanation provided to support the research question. Questions or objectives grow out of areas of uncertainty, or gaps, in the field of research. In most cases, you will not know what the gap in knowledge is until you have reviewed the literature and written up a good part of the literature review section of the proposal. It is often not possible therefore to confidently write the 'gap' statement until you have done considerable work on the literature review. Once your literature review section is sufficiently developed, you can summarise the missing piece of knowledge in a brief statement in the introduction.

Sentence stems for summarising a 'gap' in the literature

Indicate a gap in the previous research by raising a question about it, or extending previous knowledge in some way:

  • However, there is little information/attention/work/data/research on … .
  • However, few studies/investigations/researchers/attempt to … .

Often steps two and three blend together in the same sentence, as in the sentence stems below.

Sentence stems which both introduce research in the field (what is 'known') and summarise a 'gap'

  • The research has tended to focus on …(introduce existing field foci), rather than on … ('gap').
  • These studies have emphasised that … …(introduce what is known), but it remains unclear whether … ('gap').
  • Although considerable research has been devoted to … (introduce field areas), rather less attention has been paid to … ('gap').

The 'significance' of the research

When writing the research proposal, it is useful to think about the research justification and the  ‘gap in the literature’ as two distinct conceptual elements, each of which must be established separately. Stating a real world problem or outlining a conceptual or other conundrum or concern is typically not, in itself, enough to justify the research. Similarly, establishing that there is a gap in the literature is often not enough on its own to persuade the reader that the research is important. In the first case, reviewers may still wonder ‘perhaps the problem or concern has already been addressed in the literature’, or, in the second, ‘so little has been done on this focus, but perhaps the proposed research is not important’? The proposal will ideally establish that the research is important, and that it will provide something new to the field of knowledge.

In effect, the research justification and the literature review work together to establish the benefit, contribution or 'significance' of the research. The 'significance' of the research is established not in a statement to be incorporated into the proposal, but as something the first two sections of the proposal work to establish. Research is significant when it pertains to something important, and when it provides new knowledge or insights within a field of knowledge.

4. The research aim or objective

The research aim is usually expressed as a concise statement at the close of the literature review. It may be referred to as an objective, a question or an aim. These terms are often used interchangeably to refer to the focus of the investigation. The research focus is the question at the heart of the research, designed to produce new knowledge. To avoid confusing the reader about the purpose of the research it is best to express it as either an aim, or an objective, or a question. It is also important to frame the aims of the research in a succinct manner; no more than three dot points say. And the aim/objective/question should be framed in more or less the same way wherever it appears in the proposal. This ensures the research focus is clear.

Language use

Research generally aims to produce knowledge, as opposed to say recommendations, policy or social change. Research may support policy or social change, and eventually produce it in some of its applications, but it does not typically produce it (with the possible exception of action research). For this reason, aims and objectives are framed in terms of knowledge production, using phrases like:

  • to increase understanding, insight, clarity;
  • to evaluate and critique;
  • to test models, theory, or strategies.

These are all knowledge outcomes that can be achieved within the research process.

Reflecting your social philosophy in the research aim

A well written research aim typically carries within it information about the philosophical approach the research will take, even if the researcher is not themselves aware of it, or if the proposal does not discuss philosophy or social theory at any length. If you are interested in social theory, you might consider framing your aim such that it reflects your philosophical or theoretical approach. Since your philosophical approach reflects your beliefs about how 'valid' knowledge can be gained, and therefore the types of questions you ask, it follows that it will be evident within your statement of the research aim. Researchers, variously, hold that knowledge of the world arises through:

  • observations of phenomena (measurements of what we can see, hear, taste, touch);
  • the interactions between interpreting human subjects and objective phenomena in the world;
  • ideology shaped by power, which we may be unconscious of, and which must be interrogated and replaced with knowledge that reflects people's true interests; 
  • the structure of language and of the unconscious;
  • the play of historical relations between human actions, institutional practices and prevailing discourses;
  • metaphoric and other linguistic relations established within language and text.

The philosophical perspective underpinning your research is then reflected in the research aim. For example, depending upon your philosophical perspective, you may aim to find out about:

  • observable phenomenon or facts;
  • shared cultural meanings of practices, rituals, events that determine how objective phenomena are interpreted and experienced;
  • social structures and political ideologies that shape experience and distort authentic or empowered experience;
  • the structure of language;
  • the historical evolution of networks of discursive and extra-discursive practices;
  • emerging or actual phenomenon untainted by existing representation.

You might check your aim statement to ensure it reflects the philosophical perspective you claim to adopt in your proposal. Check that there are not contradictions in your philosophical claims and that you are consistent in your approach. For assistance with this you may find the Social philosophy of research resources helpful.

Sentence stems for aims and objectives

  • The purpose of this research project is to … .
  • The purpose of this investigation is to … .
  • The aim of this research project is to … .
  • This study is designed to … .

The next step or key element in the research proposal is the research design. The research design explains how the research aims will be achieved. Within the introduction a summary of the overall research design can make the project more accessible to the reader.

The summary statement of the research design within the introduction might include:

  • the method/s that will be used (interviews, surveys, video observation, diary recording);
  • if the research will be phased, how many phases, and what methods will be used in each phase;
  • brief reference to how the data will be analysed.

The statement of the research design is often the last thing discussed in the research proposal introduction.

NB. It is not necessary to explain that a literature review and a detailed ouline of the methods and methodology will follow because academic readers will assume this.

Title: Aboriginal cultural values and economic sustainability: A case study of agro-forestry in a remote Aboriginal community

Further examples can be found at the end of this topic, and in the drop down for this topic in the left menu. 

In summary, the introduction contains a problem statement, or explanation of why the research is important to the world, a summary of the literature review, and a summary of the research design. The introduction enables the reviewer, as well as yourself and your supervisory team, to assess the logical connections between the research justification, the 'gap' in the literature, research aim and the research design without getting lost in the detail of the project. In this sense, the introduction serves as a kind of map or abstract of the proposed research as well as of the main body of the research proposal.

The following questions may be useful in assessing your research proposal introduction.

  • Have I clearly signalled the research topic in the key words and phrases used in the first sentence and title of the research proposal?
  • Have I explained why my research matters, the problem or issue that underlies the research in the opening sentences,  paragraphs and page/s?
  • Have I used literature, examples or other evidence to substantiate my understanding of the key issues?
  • Have I explained the problem in a way that grabs the reader’s attention and concern?
  • Have I indicated the field/s within which my research is situated using key words that are recognised by other scholars?
  • Have I provided a summary of previous research and outlined a 'gap' in the literature?
  • Have I provided a succinct statement of the objectives or aims of my research?
  • Have I provided a summary of the research phases and methods?

This resource was developed by Wendy Bastalich.

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The rationale for one’s research is the justification for undertaking a given study. It states the reason(s) why a researcher chooses to focus on the topic in question, including what the significance is and what gaps the research intends to fill. In short, it is an explanation that rationalises the need for the study. The rationale is typically followed by a hypothesis/ research question (s) and the study objectives.

When is the rationale for research written?

The rationale of a study can be presented both before and after the research is conducted. 

  • Before : The rationale is a crucial part of your research proposal , representing the plan of your work as formulated before you execute your study.
  • After : Once the study is completed, the rationale is presented in a research paper or dissertation to explain why you focused on the particular question. In this instance, you would link the rationale of your research project to the study aims and outcomes.

Basis for writing the research rationale

The study rationale is predominantly based on preliminary data . A literature review will help you identify gaps in the current knowledge base and also ensure that you avoid duplicating what has already been done. You can then formulate the justification for your study from the existing literature on the subject and the perceived outcomes of the proposed study.

Length of the research rationale

In a research proposal or research article, the rationale would not take up more than a few sentences . A thesis or dissertation would allow for a longer description, which could even run into a couple of paragraphs . The length might even depend on the field of study or nature of the experiment. For instance, a completely novel or unconventional approach might warrant a longer and more detailed justification.

Basic elements of the research rationale

Every research rationale should include some mention or discussion of the following: 

  • An overview of your conclusions from your literature review
  • Gaps in current knowledge
  • Inconclusive or controversial findings from previous studies
  • The need to build on previous research (e.g. unanswered questions, the need to update concepts in light of new findings and/or new technical advancements). 

Example of a research rationale

Note: This uses a fictional study.

Abc xyz is a newly identified microalgal species isolated from fish tanks. While Abc xyz algal blooms have been seen as a threat to pisciculture, some studies have hinted at their unusually high carotenoid content and unique carotenoid profile. Carotenoid profiling has been carried out only in a handful of microalgal species from this genus, and the search for microalgae rich in bioactive carotenoids has not yielded promising candidates so far. This in-depth examination of the carotenoid profile of Abc xyz will help identify and quantify novel and potentially useful carotenoids from an untapped aquaculture resource .

In conclusion

It is important to describe the rationale of your research in order to put the significance and novelty of your specific research project into perspective. Once you have successfully articulated the reason(s) for your research, you will have convinced readers of the importance of your work!

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Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies

Jane Andreasen

1 Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark and Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark

Birgitte Nørgaard

2 Department of Public Health, University of Southern Denmark Odense, Denmark

Eva Draborg

Carsten bogh juhl.

3 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark and Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark

Jennifer Yost

4 M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, United States of America

Klara Brunnhuber

5 Digital Content Services, Elsevier, London, United Kingdom

Karen A. Robinson

6 Johns Hopkins University School of Medicine, Baltimore, MD, United States of America

7 Department of Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway

Associated Data

All relevant data are within the paper and its Supporting Information files.

Redundancy is an unethical, unscientific, and costly challenge in clinical health research. There is a high risk of redundancy when existing evidence is not used to justify the research question when a new study is initiated. Therefore, the aim of this study was to synthesize meta-research studies evaluating if and how authors of clinical health research studies use systematic reviews when initiating a new study.

Seven electronic bibliographic databases were searched (final search June 2021). Meta-research studies assessing the use of systematic reviews when justifying new clinical health studies were included. Screening and data extraction were performed by two reviewers independently. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. Results were synthesized narratively and quantitatively using a random-effects meta-analysis. The protocol has been registered in Open Science Framework ( https://osf.io/nw7ch/ ).

Twenty-one meta-research studies were included, representing 3,621 original studies or protocols. Nineteen of the 21 studies were included in the meta-analysis. The included studies represented different disciplines and exhibited wide variability both in how the use of previous systematic reviews was assessed, and in how this was reported. The use of systematic reviews to justify new studies varied from 16% to 87%. The mean percentage of original studies using systematic reviews to justify their study was 42% (95% CI: 36% to 48%).

Justification of new studies in clinical health research using systematic reviews is highly variable, and fewer than half of new clinical studies in health science were justified using a systematic review. Research redundancy is a challenge for clinical health researchers, as well as for funders, ethics committees, and journals.

Introduction

Research redundancy in clinical health research is an unethical, unscientific, and costly challenge that can be minimized by using an evidence-based research approach. First introduced in 2009 and since endorsed and promoted by organizations and researchers worldwide [ 1 – 6 ], evidence-based research is an approach whereby researchers systematically and transparently take into account the existing evidence on a topic before embarking on a new study. The researcher thus strives to enter the project unbiased, or at least aware of the risk of knowledge redundancy bias. The key is an evidence synthesis using formal, explicit, and rigorous methods to bring together the findings of pre-existing research to synthesize the totality what is known [ 7 ]. Evidence syntheses provide the basis for an unbiased justification of the proposed research study to ensure that the enrolling of participants, resource allocation, and healthcare systems are supporting only relevant and justified research. Enormous numbers of research studies are conducted, funded, and published globally every year [ 8 ]. Thus, if earlier relevant research is not considered in a systematic and transparent way when justifying research, the foundation for a research question is not properly established, thereby increasing the risk of redundant studies being conducted, funded, and published resulting in a waste of resources, such as time and funding [ 1 , 4 ]. Most importantly, when redundant research is initiated, participants unethically and unnecessarily receive placebos or receive suboptimal treatment.

Previous meta-research, defined as the study of research itself including the methods, reporting, reproducibility, evaluation and incentives of the research [ 9 ] have shown that there is considerable variation and bias in the use of evidence syntheses to justify research studies [ 10 – 12 ]. To the best of our knowledge, a systematic review of previous meta-research studies assessing the use of systematic reviews to justify studies in clinical health research has not previously been conducted. Evaluating how evidence-based research is implemented in research practices across disciplines and specialties when justifying new studies will provide an indication of the integration of evidence-based research in research practices [ 9 ]. The present systematic review aimed to identify and synthesize results from meta-research studies, regardless of study type, evaluating if and how authors of clinical health research studies use systematic reviews to justify a new study.

Prior to commencing the review, we registered the protocol in the Open Science Framework ( https://osf.io/nw7ch/ ). The protocol remained unchanged, but in this paper we have made adjustments to the risk-of-bias assessment, reducing the tool to 10 items and removing the assessment of reporting quality. The review is presented in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines [ 13 ].

Eligibility criteria

Studies were eligible for inclusion if they were original meta-research studies, regardless of study type, that evaluated if and how authors of clinical health research studies used systematic reviews to justify new clinical health studies. No limitations on language, publication status, or publication year were applied. Only meta-research studies of studies on human subjects in clinical health sciences were eligible for inclusion. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. The secondary outcome was how the systematic reviews of previous research were used (e.g., within the text to justify the study) by the original studies.

Information sources and search strategy

This study is one of six ongoing evidence syntheses (four systematic reviews and two scoping reviews) planned to assess the global state of evidence-based research in clinical health research. These are; a scoping review mapping the area broadly to describe current practice and identify knowledge gaps, a systematic review on the use of prior research in reports of randomized controlled trials specifically, three systematic reviews assessing the use of systematic reviews when justifying, designing [ 14 ] or putting results of a new study in context, and finally a scoping review uncovering the breadth and characteristics of the available, empirical evidence on the topic of citation bias. Further, the research group is working with colleagues on a Handbook for Evidence-based Research in health sciences. Due to the common aim across the six evidence syntheses, a broad overall search strategy was designed to identify meta-research studies that assessed whether researchers used earlier similar studies and/or systematic reviews of earlier similar studies to inform the justification and/or design of a new study, whether researchers used systematic reviews to inform the interpretation of new results, and meta-research studies that assessed if there were published redundant studies within a specific area or not.

The first search was performed in June 2015. Databases included MEDLINE via both PubMed and Ovid, EMBASE via Ovid, CINAHL via EBSCO, Web of Science (Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Arts & Humanities Citation Index (A&HCI), and the Cochrane Methodology Register (CMR, Methods Studies) from inception (Appendix 1 in S1 File ). In addition, reference lists of included studies were screened for relevant articles, as well as the authors’ relevant publications and abstracts from the Cochrane Methodology Reviews.

Based upon the experiences from the results of the baseline search in June 2015, an updated and revised search strategy was conducted in MEDLINE and Embase via Ovid from January 2015 to June 2021 (Appendix 1 in S1 File ). Once again, the reference lists of new included studies were screened for relevant references, as were abstracts from January 2015 to June 2021 in the Cochrane Methodology Reviews. Experts in the field were contacted to identify any additional published and/or grey literature. No restrictions were made on publication year and language. See Appendix 1 and Appendix 2 in S1 File for the full search strategy.

Screening and study selection

Following deduplication, the search results were uploaded to Rayyan ( https://rayyan.qcri.org/welcome ). The search results from the 1st search (June 2015) were independently screened by a pair of reviewers. Twenty screeners were paired, with each pair including an author very experienced in systematic reviews and a less experienced author. To increase consistency among reviewers, both reviewers initially screened the same 50 publications and discussed the results before beginning screening for this review. Disagreements on study selection were resolved by consensus and discussion with a third reviewer, if needed. The full-text screening was also performed by two reviewers independently. Disagreements on study selection were resolved by consensus and discussion. There were also two independent reviewers who screened following the last search, using the same procedure, as for the first search, for full-text screening and disagreements. The screening procedures resulted in a full list of studies potentially relevant for one or more of the six above-mentioned evidence syntheses.

A second title and abstract screening and full-text screening of the full list was then performed independently by two reviewers using screening criteria specific to this systematic review. Reasons for excluding trials were recorded, and disagreements between the reviewers were resolved through discussion. If consensus was not reached, a third reviewer was involved.

Data extraction

We developed and pilot tested a data extraction form to extract data regarding study characteristics and outcomes of interest. Two reviewers independently extracted data, with other reviewers available to resolve disagreements. The following study characteristics were extracted from each of the included studies: bibliographic information, study aim, study design, setting, country, inclusion period, area of interest, results, and conclusion. Further, data for this study’s primary and secondary outcomes were extracted; these included the percentage of original studies using systematic reviews to justify their study and how the systematic reviews of previous research were used (e.g., within the text to justify the study) by the original studies.

Risk-of-bias assessment

No standard tool was identified to assess the risk of bias in empirical meta-research studies. The Editorial Group of the Evidence-Based Research Network prepared a risk-of-bias tool for the planned five systematic reviews with list of items important for evaluating the risk of bias in meta-research studies. For each item, one could classify the study under examination as exhibiting a “low risk of bias”, “unclear risk of bias” or “high risk of bias”. We independently tested the list of items upon a sample of included studies. Following a discussion of the different answers, we adjusted the number and content of the list of items to ten and defined the criteria to evaluate the risk of bias in the included studies ( Table 1 ). Each of the included meta-research studies was appraised independently by two reviewers using the customized checklist to determine the risk of bias. Disagreements regarding the risk of bias were solved through discussion. No study was excluded on the grounds of low quality.

Data synthesis and interpretation

In addition, to narratively summarizing the characteristics of the included meta-research studies and their risk-of-bias assessments, the percentage of original studies using systematic review of previous similar studies to justify a new study (primary outcome) was calculated as the number of studies using at least one systematic review, divided by the total number of original studies within each of the included meta-research studies. A meta-analysis using the random-effects model (DerSimonian and Laird) was used to estimate the overall estimate and perform the forest plot as this model is the default when using the metaprop command. Heterogeneity was evaluated estimating the I 2 statistics (the percentage of variance attributable to heterogeneity i.e., inconsistency) and the between study variance tau 2 . When investigating reasons for heterogeneity, a restricted maximum likelihood (REML) model was used and covariates with the ability to reduce tau 2 was deemed relevant. [ 15 ].

All analyses were conducted in Stata, version 17.0 (StataCorp. 2019. Stata Statistical Software : Release 17 . College Station, TX: StataCorp LLC).

Study selection

In total, 30,592 publications were identified through the searches. Of these, 69 publications were determined eligible for one of the six evidence syntheses. A total of 21 meta-research studies fulfilled the inclusion criteria for this systematic review [ 10 , 11 , 16 – 34 ]; see Fig 1 .

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Object name is pone.0276955.g001.jpg

Study characteristics

The 21 included meta-research studies were published from 2007 to 2021, representing 3,621 original studies or protocols and one survey with 106 participants; only three of these studies were published before 2013 [ 10 , 18 , 26 ]. The sample of the original study within each of the included meta-research studies varied. One meta-research study surveyed congress delegates [ 29 ], one study examined first-submission protocols for randomized controlled trials submitted to four hospital ethics committees [ 17 ], and 14 studies examined randomized or quasi-randomized primary studies published during a specific time period in a range of journals [ 10 , 11 , 18 , 21 – 28 , 31 , 32 , 34 ] or in specific databases [ 16 , 19 , 20 , 30 ]. Finally, one study examined the use of previously published systematic reviews when publishing a new systematic review [ 33 ]. Further, the number of original studies within each included meta-research study varied considerably, ranging from 18 [ 10 ] to 637 original studies [ 27 ]. The characteristics of the included meta-research studies are presented in Table 2 .

SR: systematic review; MA: meta–analysis; RCT: randomized controlled trial.

Risk of bias assessment

Overall, most studies were determined to exhibit a low risk of bias in the majority of items, and all of the included meta-research studies reported an unambiguous aim and a match between aim and methods. However, only a few studies provided argumentation for their choice of data source [ 17 , 20 , 24 , 30 ], and only two of the 21 studies referred to an available a-priori protocol [ 16 , 21 ]. Finally, seven studies provided poor or no discussion of the limitations of their study [ 10 , 19 , 22 , 26 – 28 , 34 ]. The risk-of-bias assessments are shown in Table 3 .

Synthesis of results

Of the included 21 studies, a total of 18 studies were included in the meta-analysis. Two studies included two cohorts each, and both cohorts in each of these studies were included in our meta-analysis [ 21 , 30 ]. The survey by Clayton and colleagues, with a response rate of 17%, was not included in the meta-analysis as the survey did not provide data to identify the use of systematic reviews to justify specific studies. However, their results showed that 42 of 84 respondents (50%) reported using a systematic review for justification [ 29 ]. The study by Chow, which was also not included in the meta-analysis, showed that justification varied largely within and between specialties. However, only relative numbers were provided, and, therefore, no overall percentage could be extracted [ 11 ]. The study by Seehra et al. counted the SR citations in RCTs and not the number of RCTs citing SRs and is therefore not included in the meta-analysis either [ 23 ].

The percentage of original studies that justified a new study with a systematic review within each meta-research study ranged from 16% to 87%. The pooled percentage of original studies using systematic reviews to justify their research question was 42% (95% CI: 36% to 48%) as shown in Fig 2 . Where the confidence interval showed the precision of the pooled estimate in a meta-analysis, the prediction interval showed the distribution of the individual studies. The heterogeneity in the meta-analysis assessed by I 2 was 94%. The clinical interpretation of this large heterogeneity is seen in a the very broad prediction interval ranging from 16 to 71%, meaning that based on these studies there is 95% chance that the results of the next study will show a prevalence between 16 to 71%.

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Object name is pone.0276955.g002.jpg

Forest plot prevalence and 95% confidence intervals for the percentage of studies using an SR to justify the study.

Further, we conducted an explorative subgroup analysis of the study of Helfer et al. and the study of Joseph et al. as these two studies were on meta-analyses and protocols and therefore differ from the other included studies. This analysis did only marginally change the pooled percentage to 39% (95% CI; 33% to 46%) and the between-study variance (tau 2 ) was reduced with 23%.

The 21 included studies varied greatly in their approach and in their description of how systematic reviews were used, i.e., if the original studies referred and whether the used systematic reviews in the original studies were relevant and/or of high-quality. Nine studies assessed, to varying degrees, whether the used systematic reviews were relevant for the justification of the research [ 16 – 20 , 25 , 30 , 32 , 34 ]. Overall, the information reported by the meta-research studies was not sufficient to report the percentage of primary studies referring to relevant systematic reviews. No details were provided regarding the methodological quality of the systematic reviews used to justify the research question or if they were recently published reviews, except for Hoderlein et al., who reported that the mean number of years from publication of the cited systematic review and the trial report was four years [ 30 ].

We identified 21 meta-research studies, spanning 15 publication years and 12 medical disciplines. The findings showed substantial variability in the use of systematic reviews when justifying new clinical studies, with the incidence of use ranging from 16% to 87%. However, fewer than half of the 19 meta-analysis-eligible studies used a systematic review to justify their new study. There was wide variability, and a general lack of information, about how systematic reviews were used within many of the original studies. Our systematic review found that the proportion of original studies justifying their new research using evidence syntheses is sub-optimal and, thus, the potential for research redundancy continues to be a challenge. This study corroborates the serious possible consequences regarding research redundancy previously problematized by Chalmers et al. and Glasziou et al. [ 35 , 36 ].

Systematic reviews are considered crucial when justifying a new study, as is emphasized in reporting guidelines such as the CONSORT statement [ 37 ]. However, there are challenges involved in implementing an evidence-based research approach. The authors of the included meta-research study reporting the highest use of systematic reviews to justify a new systematic review study point out that even though the authors of the original studies refer to some of the published systematic reviews, they neglect others on the same topic, which may be problematic and result in a biased approach [ 33 ]. Other issues that have been identified are the risk of research waste when a systematic review may not be methodologically sound [ 12 , 38 ] and that there is also redundancy in the conduct of systematic reviews, with many overlapping systematic reviews existing on the same topic [ 39 – 41 ]. In the original studies within the meta-research studies, the use of systematic reviews was not consistent and, further, it was not explicated whether the systematic reviews used were the most recent and/or of high methodological quality. These issues speak to the need for refinement in the area of systematic review development, such as mandatory registration in prospective registries. Only two out of the included 21 studies in this study referred to an available a-priori protocol [ 16 , 21 ]. General recommendations in the use of systematic reviews as justification for a new study are difficult as these will be topic specific, however researchers should be aware to use the most robust and methodologically sound of recently published reviews, preferably with á priori published protocols.

Efforts must continue in promoting the use of evidence-based research approaches among clinical health researchers and other important stakeholders, such as funders. Collaborations such as the Ensuring Value in Research Funders Forum, and changes in funding review criteria mandating reference to previously published systematic reviews when justifying the research question within funding proposals, are examples of how stakeholders can promote research that is evidence-based [ 8 , 41 ].

Strengths and limitations

We conducted a comprehensive and systematic search. The lack of standard terminology for meta-research studies resulted in search strategies that retrieved thousands of citations. We also relied on snowballing efforts to identify relevant studies, such as by contacting experts and scanning the reference lists of relevant studies.

There is also a lack of tools to assess risk of bias for meta-research studies, so a specific risk-of bias tool for the five conducted reviews was created. The tool was discussed and revised continuously throughout the research process; however, we acknowledge that the checklist is not yet optimal and a validated risk-of-bias tool for meta-research studies is needed.

Many of the included meta-research studies did not provide details as to whether the systematic reviews used to justify the included studies were relevant, high-quality and/or recently published. This may raise questions as to the validity of our findings, as the majority of the meta-research studies only provide an indication of the citation of systematic reviews to justify new studies, not whether the systematic review cited was relevant, recent and of high-quality, or even how the systematic review was used. We did not assess this further either. Nonetheless, even if we assumed that these elements were provided for every original study included in the included meta-research studies (i.e. taking a conservative approach), fewer than half used systematic reviews to justify their research questions. The conservative approach used in this study therefore does not underestimate, and perhaps rather overestimates, the actual use of relevant systematic reviews to justify studies in clinical health science across disciplines.

Different study designs were included in the meta-analysis, which may have contributed to the high degree of heterogeneity observed. Therefore, the presented results should be interpreted with caution due to the high heterogeneity. Not only were there differences in the methods of the included meta-research studies, but there was also heterogeneity in the medical specialties evaluated [ 42 , 43 ].

In conclusion, justification of research questions in clinical health research with systematic reviews continues to be inconsistent; fewer than half of the primary studies within the included meta-research studies in this systematic review were found to have used a systematic review to justify their research question. This indicates that the risk of redundant research is still high when new studies across disciplines and professions in clinical health are initiated, thereby indicating that evidence-based research has not yet been successfully implemented in the clinical health sciences. Efforts to raise awareness and to ensure an evidence-based research approach continue to be necessary, and such efforts should involve clinical health researchers themselves as well as important stakeholders such as funders.

Supporting information

S1 checklist, s1 protocol, acknowledgments.

This work has been prepared as part of the Evidence-Based Research Network ( ebrnetwork.org ). The Evidence-Based Research Network is an international network that promotes the use of systematic reviews when justifying, designing, and interpreting research. The authors thank the Section for Evidence-Based Practice, Department for Health and Function, Western Norway University of Applied Sciences for their generous support of the EBRNetwork. Further, thanks to COST Association for supporting the COST Action “EVBRES” (CA 17117, evbres.eu) and thereby the preparation of this study. Thanks to Gunhild Austrheim, Head of Unit, Library at Western Norway University of Applied Sciences, Norway, for helping with the second search. Thanks to those helping with the screening: Durita Gunnarsson, Gorm Høj Jensen, Line Sjodsholm, Signe Versterre, Linda Baumbach, Karina Johansen, Rune Martens Andersen, and Thomas Aagaard.

We gratefully acknowledge the contribution from the EVBRES (COST ACTION CA 17117) Core Group, including Anne Gjerland (AG) and her specific contribution to the search and screening process.

Funding Statement

The authors received no specific funding for this work.

Data Availability

  • PLoS One. 2022; 17(10): e0276955.

Decision Letter 0

Transfer alert.

This paper was transferred from another journal. As a result, its full editorial history (including decision letters, peer reviews and author responses) may not be present.

PONE-D-22-02383Justification of research using systematic reviews continues to be inconsistent in clinical health science - a systematic review and meta-analysis of meta-research studiesPLOS ONE

Dear Dr. Andreasen,

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Thank you for the opportunity to review this interesting meta-research paper, which is part of a series of papers.

Basing new research on systematic reviews is clearly important and has been the subject of a number of reviews. This paper essentially reviews the meta-research in this area, to give a global assessment of the issue taking into account all of the evidence

The content of the rest of the series was not made clear, but a decision has been made to publish them singly. I think the short description of the rest of the programme could be expanded a little to put the work in context and help the reader understand how the work fits together. How do the different studies relate, and are other papers needed to put the current work in context?

The introduction defines meta-research in broad terms, but it is not until the results that the reader is given a sense of the actual designs included and of relevance to the research question. Were these defined a priori, or were these study designs that fit the broad definition which happened to be found in the search? Are there meta-research designs of relevance to the research question which were not found in the searches?

Personally, I would bring a description of the range of study design forward into the introduction, as getting a sense of the sorts of approaches to meta-research of relevance will help non-specialists in this area. I was not clear of the likely designs until quite late in the paper

The review methods seemed very rigorous, and I had no major comments on those beyond one clarification. When they said, ‘No study was excluded on the grounds of low quality’, did they mean that no studies were considered so bad, or that as a rule no studies were every going to be excluded on that basis?

As noted above, there were a number of study designs included, and all were assessed using the generic risk of bias tool. Presumably some designs are just stronger than others? The survey must be considered a weaker design that the others. Again, this links to the earlier comment about the need for more detail on design of the meta research, which I felt was lost in the use of a generic risk of bias assessment.

I did not understand the statement ‘The clinical interpretation of the large heterogeneity is seen in a broad prediction interval with a range from 16 to 71%’ and that needs clarification

The discussion is balanced, but there are a few significant issues that are given a fairly cursory consideration and would benefit from greater detail

I was interested in the issue of the ‘quality’ of the reviews used. I accept that the data here was not enough for analysis, but felt that the authors (as experts in this area) could be pushed to provide a stronger statement about what criteria should be used by further studies (for example, how do we judge if a review used as the basis for research is a strong basis. How long before a quoted review is too ‘old’?)

They acknowledge that ‘the checklist is not yet optimal and a validated risk-of-bias tool for meta-research studies is needed’. Given their experience and expertise, what would that look like, and how would it be best developed and tested? How would it take into account the role of different designs noted above, given variation in the approaches to meta-research they found?

I appreciate the simple and elegant assessment of the main findings, but they present only vague statement on the role of design and medical specialities. Is it not possible for them to say more on this, or explore the data more fully? What about change over time, which seems very relevant. I did feel the authors could be pushed a little more here, given that they have a programme of work and must be in a position to present more substantive statements. I think that would add to the contribution of the paper

Reviewer #2: The article is on interesting topic but several points needs emphasis:

the inclusion criteria should be defined more clearly in the text

Systematiic review and meta analysis are relatively new and first papers go to late seventies in previous century.

This should be considered when reviewing papers.

The risk of redundancy could not be well defined from the meta search papers rather it should be from the original articles . This would not be possible unless a focused issue is chosen as an example.

The different disciplines have different research out puts as the basis for systematic reviews which makes the comparison difficult .

I realize some studies are based on the disclosure of the authors whether they have used the previous systematic reviews or not . This should be confirmed by evidence .

These should be mentioned as the limitations of this work .

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Reviewer #1:  Yes:  Peter Bower

Reviewer #2: No

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Author response to Decision Letter 0

25 Apr 2022

Response letter to the editor and reviewers,

Thank you for the opportunity to revise the manuscript. Thank you to the reviewers for the positive and constructive comments concerning the manuscript. We have now revised the manuscript in accordance with these comments by addressing all issues from the editor and from the reviewers below.

Answer: we have addressed the requirements, see our answers below.

Answer: We believe we meet the style requirements, including correct file naming.

Answer: We agree that there are overlap in parts of the methods section with the mentioned publication. The paper was published in the period of this manuscript being in review, we have therefore now referred to the publication in this manuscript. This manuscript and the publication are both part of a series of papers assessing the global status of evidence-based research in clinical health research and therefore the overlap in the methods section was expected. We have thoroughly scrutinized the full manuscript and found no full sentences that are overlapping, except for the methods section. To be sure of this, we further have conducted a legal comparison in MS Words with the mentioned publication and again found no full sentences except in the methods section. This is to our sincere knowledge only in the methods section, please let us know if we are mistaken.

Answer: We have uploaded the data set necessary to replicate our study findings in a supplementary file and described the changes to the “Data Availability statement” in the cover letter.

Reviewer comments Reviewer #1:

1. Thank you for the opportunity to review this interesting meta-research paper, which is part of a series of papers.

Response: Thank you for this response and that is exactly the purpose.

2. The content of the rest of the series was not made clear, but a decision has been made to publish them singly. I think the short description of the rest of the program could be expanded a little to put the work in context and help the reader understand how the work fits together. How do the different studies relate, and are other papers needed to put the current work in context?

Response: We have expanded the text and especially regarding how the work fits together and shows our purpose of taking a global assessment of the on evidence-based research in the following six papers:

1. Meta-research evaluating redundancy and use of systematic reviews when planning new studies in health research – a scoping review

2. A Systematic Review on the Use of Prior Research in Reports of Randomized Clinical Trials

3. Justification

6. The problem of citation bias – a scoping review

We do not have other papers in pipeline at the moment, but we are currently working on a Handbook for Evidence-Based Research to provide tools and models to make it easier for researchers to work evidence- based in their research.

Changes to text: This study is one of six ongoing meta-syntheses (four systematic reviews and two scoping reviews) planned to assess the global state of evidence-based research in clinical health research. These are; a scoping review mapping the area broadly to describe current practice and identify knowledge gaps, a systematic review on the use of prior research in reports of randomized controlled trials specifically, three systematic reviews assessing the use of systematic reviews when justifying, designing [14] or putting results of a new study in context, and finally a scoping review uncovering the breadth and characteristics of the available, empirical evidence on the topic of citation bias . Further, the research group is working with colleagues on a Handbook for Evidence-based Research in health sciences.

3. The introduction defines meta-research in broad terms, but it is not until the results that the reader is given a sense of the actual designs included and of relevance to the research question. Were these defined a priori, or were these study designs that fit the broad definition which happened to be found in the search? Are there meta-research designs of relevance to the research question which were not found in the searches?

Response: We get your point. A very broad and inclusive definition was defined a priori in the published protocol: “Types of study to be included: We will include meta-research studies (or studies performing research on research)” in order not to miss out on relevant studies, because the research field was quite new and further, we did not identify other meta-research studies to guide our process. Due to our very broad and sensitive search strategy we believe we identified all relevant meta-research studies.

Only data regarding justification from original papers were included in our meta-analysis as the study design of a survey of delegates use of systematic reviews to justify their studies, was assessed as seriously subjected to a social desirability bias.

Changes to text:

Introduction: The present systematic review aimed to identify and synthesize results from meta-research studies, regardless study type, evaluating if and how authors of clinical health research studies use systematic reviews to justify a new study.

Methods section, eligibility criteria: Studies were eligible for inclusion if they were original meta-research studies, regardless study type, that evaluated if and how authors of clinical health studies used systematic reviews to justify new clinical health studies.

4. Personally, I would bring a description of the range of study design forward into the introduction, as getting a sense of the sorts of approaches to meta-research of relevance will help non-specialists in this area. I was not clear of the likely designs until quite late in the paper

Response: We agree and have made it clear that all meta-research studies regardless design was included.

Changes to text: see above.

5. The review methods seemed very rigorous, and I had no major comments on those beyond one clarification. When they said, ‘No study was excluded on the grounds of low quality’, did they mean that no studies were considered so bad, or that as a rule no studies were every going to be excluded on that basis?

Response: The latter, as a rule no studies were excluded, as our intention was not to guide clinical practice. This is stated in the manuscript as the last sentence in the Risk-of-Bias Assessment section. No changes are therefore made.

6. As noted above, there were a number of study designs included, and all were assessed using the generic risk of bias tool. Presumably some designs are just stronger than others? The survey must be considered a weaker design that the others. Again, this links to the earlier comment about the need for more detail on design of the meta research, which I felt was lost in the use of a generic risk of bias assessment.

Response: We agree on this point, but we did take a very open approach to monitor the field of justification. And we did not range the study designs in a hierarchical order in our “premature” Risk of Bias tool, as we aimed to assess the area and not to provide any clinical recommendations. However, the author group and colleagues are currently working on an improved checklist tool.

No further changes to text.

7. I did not understand the statement ‘The clinical interpretation of the large heterogeneity is seen in a broad prediction interval with a range from 16 to 71%’ and that needs clarification

Response: We agree that an explanation is appropriate.

Changes to text: The clinical interpretation of the large heterogeneity is seen in a broad prediction interval with a range from 16 to 71%, meaning that there is 95% confidence that the results of the next study will be between a prevalence of 16 to 71%.

8. The discussion is balanced, but there are a few significant issues that are given a fairly cursory consideration and would benefit from greater detail

Response: We have addressed the issues mentioned below and provided more detail

9. I was interested in the issue of the ‘quality’ of the reviews used. I accept that the data here was not enough for analysis, but felt that the authors (as experts in this area) could be pushed to provide a stronger statement about what criteria should be used by further studies (for example, how do we judge if a review used as the basis for research is a strong basis. How long before a quoted review is too ‘old’?)

Response: Very interesting topic to address further, which we have continuously discussed in the author group, but this is both complex and context dependent in specific topics. Therefore, we have chosen not to elaborate further on the topic in the manuscript, to give an appropriate consideration more space is needed.

Instead, we have mentioned these considerations as important to address further in future publications as to guide researchers when using systematic reviews to justify. As mentioned earlier, the research group is working with colleagues on a Handbook for Evidence-based Research in health sciences, which will elaborate on the topics in detail.

Changes to text in Discussion section:

General recommendations in the use of systematic reviews as justification for a new study are difficult as these will be topic specific, however researchers should be aware to use the most robust and methodologically sound of recently published reviews, preferably with á priori published protocols.

10. They acknowledge that ‘the checklist is not yet optimal and a validated risk-of-bias tool for meta-research studies is needed’. Given their experience and expertise, what would that look like, and how would it be best developed and tested? How would it take into account the role of different designs noted above, given variation in the approaches to meta-research they found?

Response: We fully agree with you on this topic and the author group and colleagues are currently working on an improved checklist tool. Your suggestion about ranging the study designs is very relevant and will be considered in the author group in this thorough work that we expect to publish in the near future. We find the work requires space and thorough analysis and we therefore have decided this should be published in an independent paper.

11. I appreciate the simple and elegant assessment of the main findings, but they present only vague statement on the role of design and medical specialities. Is it not possible for them to say more on this, or explore the data more fully? What about change over time, which seems very relevant. I did feel the authors could be pushed a little more here, given that they have a programme of work and must be in a position to present more substantive statements. I think that would add to the contribution of the paper

Response: The role of design is only considered in relation to that the studies has done meta - research on the topic “justification”. We do not find it was appropriate to explicate more about the roles of medical specialties as the approach in the different studies were very diverse ranging from participants in the survey, to specialties or to specific journals (mostly high ranking) or more broad aimed journals or databases.

Change over time is an important and relevant question. We did not address the issue for two reasons. Firstly, most of the papers are published after 2012 and it would be a short timeline to assess. But most importantly, as most of the included studies in our meta-research study were cross-sectional, we would not be able to validly assess change over time with the data at hand.

Reviewer comments Reviewer #2 :

1. The article is on interesting topic but several points needs emphasis

Response: Thank you. We have answered each point above.

2. The inclusion criteria should be defined more clearly in the text

Response: Methods section: we have clarified the inclusion criteria in the methods section.

3. Systematic review and meta analysis are relatively new and first papers go to late seventies in previous century. This should be considered when reviewing papers.

Response: Yes, it is a fairly new discipline, however it has been recommended to be evidence-based by the use of systematic reviews and meta-analyses for many years. Our aim was therefore to look at meta-research in a broad sense by using previously published studies investigating how large a percentage are using systematic reviews as justification when initiating new health science.

4. The risk of redundancy could not be well defined from the meta search papers rather it should be from the original articles . This would not be possible unless a focused issue is chosen as an example.

Response: Risk of redundancy can, in our perspective, be thoroughly assessed by the use of systematic reviews with meta-analyses included, and especially cumulative meta-analyses can pinpoint this in a specific research topic. Therefore, we agree that we cannot point it to a specific field but have taken this meta-research perspective to provide a more global status on the topic.

We hope you can follow our reasoning.

5. The different disciplines have different research out puts as the basis for systematic reviews which makes the comparison difficult

Response: In this paper, we did not look for the output, but the “input” so to speak, as we assess whether the authors have used justification by using systematic reviews, when initiating a new study in health science. We agree, it is important to define the aim and approach and the outcomes more specifically, if you look into a specific topic.

No changes to text.

6. I realize some studies are based on the disclosure of the authors whether they have used the previous systematic reviews or not. This should be confirmed by evidence.

These should be mentioned as the limitations of this work.

Response: We agree on this point and have clarified in the limitations that we have taken “the face value” reported by the authors in the included studies.

Changes to text: Discussion, Strengths and Limitations section:

This may raise questions as to the validity of our findings, as the majority of the meta-research studies only provide an indication of the citation of systematic reviews to justify new studies, not whether the systematic review was relevant, recent or of high-quality, or even how the systematic review was used. We did not assess this further either.

Submitted filename: Response letter_25042022.docx

Decision Letter 1

19 Sep 2022

PONE-D-22-02383R1Justification of research using systematic reviews continues to be inconsistent in clinical health science - a systematic review and meta-analysis of meta-research studiesPLOS ONE

Please submit your revised manuscript by Nov 03 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at  gro.solp@enosolp . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

2. Is the manuscript technically sound, and do the data support the conclusions?

3. Has the statistical analysis been performed appropriately and rigorously?

4. Have the authors made all data underlying the findings in their manuscript fully available?

5. Is the manuscript presented in an intelligible fashion and written in standard English?

6. Review Comments to the Author

Reviewer #1: I am happy with the responses and thank the authors for their detailed replies, but just had 2 minor issues

This probably reflects my ignorance so apologies to the authors, but I still do not understand the relationship between the 95% CI around the pooled percentage, and the 'broad prediction interval' which follows it. Could they add a line to explain?

There are some typos remaining. The phrase 'regardless study type' should read 'regardless of study type'. There are some rogue apostrophes in the tables (SR's, RCT's) which need to be edited

7. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files.

Reviewer #1: No

Author response to Decision Letter 1

21 Sep 2022

Response letter

Thank you for the opportunity to revise the manuscript. Thank you to the reviewer for the relevant comments concerning the manuscript. We have revised the manuscript in accordance with these comments by addressing all issues from the editor and from the reviewers below.

Reviewer #1: I am happy with the responses and thank the authors for their detailed replies, but just had 2 minor issues

Response: Thank you very much.

Response: We have revised and explained more in detail and hope the revised text explains this more clearly.

Where the confidence interval showed the precision of the pooled estimate in a meta-analysis, the prediction interval showed the distribution of the individual studies. The heterogeneity in the meta-analysis assessed by I2 was 94%. The clinical interpretation of this large heterogeneity is seen in a the very broad prediction interval ranging from 16 to 71%, meaning that based on these studies there is 95% chance that the results of the next study will show a prevalence between 16 to 71%.

There are some typos remaining. The phrase 'regardless study type' should read 'regardless of study type'.

Response: Thank you, we have revised as suggested.

There are some rogue apostrophes in the tables (SR's, RCT's) which need to be edited

Response: Thank you for pointing this out. We have edited this now.

On behalf of the author group,

Submitted filename: Response letter 20092022.docx

Decision Letter 2

18 Oct 2022

Justification of research using systematic reviews continues to be inconsistent in clinical health science - a systematic review and meta-analysis of meta-research studies

PONE-D-22-02383R2

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Additional Editor Comments (optional):

Reviewer #1: (No Response)

Acceptance letter

21 Oct 2022

Dear Dr. Andreasen:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

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Examples Lab

7 Examples of Justification (of a project or research)

The justification to the part of a research project that sets out the reasons that motivated the research. The justification is the section that explains the importance and the reasons that led the researcher to carry out the work.

The justification explains to the reader why and why the chosen topic was investigated. In general, the reasons that the researcher can give in a justification may be that his work allows to build or refute theories; bring a new approach or perspective on the subject; contribute to the solution of a specific problem (social, economic, environmental, etc.) that affects certain people; generate meaningful and reusable empirical data; clarify the causes and consequences of a specific phenomenon of interest; among other.

Among the criteria used to write a justification, the usefulness of the research for other academics or for other social sectors (public officials, companies, sectors of civil society), the significance in time that it may have, the contribution of new research tools or techniques, updating of existing knowledge, among others. Also, the language should be formal and descriptive.

Examples of justification

  • This research will focus on studying the reproduction habits of salmon in the Mediterranean region of Europe, since due to recent ecological changes in the water and temperatures of the region produced by human economic activity , the behavior of these animals has been modified. Thus, the present work would allow to show the changes that the species has developed to adapt to the new circumstances of its ecosystem, and to deepen the theoretical knowledge about accelerated adaptation processes, in addition to offering a comprehensive look at the environmental damage caused by growth. unsustainable economic, helping to raise awareness of the local population.
  • We therefore propose to investigate the evolution of the theoretical conceptions of class struggle and economic structure throughout the work of Antonio Gramsci, since we consider that previous analyzes have overlooked the fundamentally dynamic and unstable conception of human society that is present. in the works of Gramsci, and that is of vital importance to fully understand the author’s thought.
  • The reasons that led us to investigate the effects of regular use of cell phones on the health of middle-class young people under 18 years of age are centered on the fact that this vulnerable sector of the population is exposed to a greater extent than the rest of society to risks that the continuous use of cell phone devices may imply, due to their cultural and social habits. We intend then to help alert about these dangers, as well as to generate knowledge that helps in the treatment of the effects produced by the abuse in the use of this technology.
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Research Article

Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies

Roles Conceptualization, Data curation, Methodology, Project administration, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark and Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark

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Roles Conceptualization, Data curation, Methodology, Writing – review & editing

Affiliation Department of Public Health, University of Southern Denmark Odense, Denmark

Roles Conceptualization, Data curation, Formal analysis, Methodology, Writing – review & editing

Affiliation Department of Sports Science and Clinical Biomechanics, University of Southern Denmark and Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark

Roles Conceptualization, Methodology, Writing – review & editing

Affiliation M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, United States of America

Affiliation Digital Content Services, Elsevier, London, United Kingdom

Affiliation Johns Hopkins University School of Medicine, Baltimore, MD, United States of America

Roles Conceptualization, Data curation, Methodology, Project administration, Supervision, Writing – review & editing

Affiliation Department of Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway

  • Jane Andreasen, 
  • Birgitte Nørgaard, 
  • Eva Draborg, 
  • Carsten Bogh Juhl, 
  • Jennifer Yost, 
  • Klara Brunnhuber, 
  • Karen A. Robinson, 

PLOS

  • Published: October 31, 2022
  • https://doi.org/10.1371/journal.pone.0276955
  • Peer Review
  • Reader Comments

Table 1

Redundancy is an unethical, unscientific, and costly challenge in clinical health research. There is a high risk of redundancy when existing evidence is not used to justify the research question when a new study is initiated. Therefore, the aim of this study was to synthesize meta-research studies evaluating if and how authors of clinical health research studies use systematic reviews when initiating a new study.

Seven electronic bibliographic databases were searched (final search June 2021). Meta-research studies assessing the use of systematic reviews when justifying new clinical health studies were included. Screening and data extraction were performed by two reviewers independently. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. Results were synthesized narratively and quantitatively using a random-effects meta-analysis. The protocol has been registered in Open Science Framework ( https://osf.io/nw7ch/ ).

Twenty-one meta-research studies were included, representing 3,621 original studies or protocols. Nineteen of the 21 studies were included in the meta-analysis. The included studies represented different disciplines and exhibited wide variability both in how the use of previous systematic reviews was assessed, and in how this was reported. The use of systematic reviews to justify new studies varied from 16% to 87%. The mean percentage of original studies using systematic reviews to justify their study was 42% (95% CI: 36% to 48%).

Justification of new studies in clinical health research using systematic reviews is highly variable, and fewer than half of new clinical studies in health science were justified using a systematic review. Research redundancy is a challenge for clinical health researchers, as well as for funders, ethics committees, and journals.

Citation: Andreasen J, Nørgaard B, Draborg E, Juhl CB, Yost J, Brunnhuber K, et al. (2022) Justification of research using systematic reviews continues to be inconsistent in clinical health science—A systematic review and meta-analysis of meta-research studies. PLoS ONE 17(10): e0276955. https://doi.org/10.1371/journal.pone.0276955

Editor: Andrzej Grzybowski, University of Warmia, POLAND

Received: January 24, 2022; Accepted: October 18, 2022; Published: October 31, 2022

Copyright: © 2022 Andreasen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Research redundancy in clinical health research is an unethical, unscientific, and costly challenge that can be minimized by using an evidence-based research approach. First introduced in 2009 and since endorsed and promoted by organizations and researchers worldwide [ 1 – 6 ], evidence-based research is an approach whereby researchers systematically and transparently take into account the existing evidence on a topic before embarking on a new study. The researcher thus strives to enter the project unbiased, or at least aware of the risk of knowledge redundancy bias. The key is an evidence synthesis using formal, explicit, and rigorous methods to bring together the findings of pre-existing research to synthesize the totality what is known [ 7 ]. Evidence syntheses provide the basis for an unbiased justification of the proposed research study to ensure that the enrolling of participants, resource allocation, and healthcare systems are supporting only relevant and justified research. Enormous numbers of research studies are conducted, funded, and published globally every year [ 8 ]. Thus, if earlier relevant research is not considered in a systematic and transparent way when justifying research, the foundation for a research question is not properly established, thereby increasing the risk of redundant studies being conducted, funded, and published resulting in a waste of resources, such as time and funding [ 1 , 4 ]. Most importantly, when redundant research is initiated, participants unethically and unnecessarily receive placebos or receive suboptimal treatment.

Previous meta-research, defined as the study of research itself including the methods, reporting, reproducibility, evaluation and incentives of the research [ 9 ] have shown that there is considerable variation and bias in the use of evidence syntheses to justify research studies [ 10 – 12 ]. To the best of our knowledge, a systematic review of previous meta-research studies assessing the use of systematic reviews to justify studies in clinical health research has not previously been conducted. Evaluating how evidence-based research is implemented in research practices across disciplines and specialties when justifying new studies will provide an indication of the integration of evidence-based research in research practices [ 9 ]. The present systematic review aimed to identify and synthesize results from meta-research studies, regardless of study type, evaluating if and how authors of clinical health research studies use systematic reviews to justify a new study.

Prior to commencing the review, we registered the protocol in the Open Science Framework ( https://osf.io/nw7ch/ ). The protocol remained unchanged, but in this paper we have made adjustments to the risk-of-bias assessment, reducing the tool to 10 items and removing the assessment of reporting quality. The review is presented in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines [ 13 ].

Eligibility criteria

Studies were eligible for inclusion if they were original meta-research studies, regardless of study type, that evaluated if and how authors of clinical health research studies used systematic reviews to justify new clinical health studies. No limitations on language, publication status, or publication year were applied. Only meta-research studies of studies on human subjects in clinical health sciences were eligible for inclusion. The primary outcome was defined as the percentage of original studies within the included meta-research studies using systematic reviews of previous studies to justify a new study. The secondary outcome was how the systematic reviews of previous research were used (e.g., within the text to justify the study) by the original studies.

Information sources and search strategy

This study is one of six ongoing evidence syntheses (four systematic reviews and two scoping reviews) planned to assess the global state of evidence-based research in clinical health research. These are; a scoping review mapping the area broadly to describe current practice and identify knowledge gaps, a systematic review on the use of prior research in reports of randomized controlled trials specifically, three systematic reviews assessing the use of systematic reviews when justifying, designing [ 14 ] or putting results of a new study in context, and finally a scoping review uncovering the breadth and characteristics of the available, empirical evidence on the topic of citation bias. Further, the research group is working with colleagues on a Handbook for Evidence-based Research in health sciences. Due to the common aim across the six evidence syntheses, a broad overall search strategy was designed to identify meta-research studies that assessed whether researchers used earlier similar studies and/or systematic reviews of earlier similar studies to inform the justification and/or design of a new study, whether researchers used systematic reviews to inform the interpretation of new results, and meta-research studies that assessed if there were published redundant studies within a specific area or not.

The first search was performed in June 2015. Databases included MEDLINE via both PubMed and Ovid, EMBASE via Ovid, CINAHL via EBSCO, Web of Science (Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Arts & Humanities Citation Index (A&HCI), and the Cochrane Methodology Register (CMR, Methods Studies) from inception (Appendix 1 in S1 File ). In addition, reference lists of included studies were screened for relevant articles, as well as the authors’ relevant publications and abstracts from the Cochrane Methodology Reviews.

Based upon the experiences from the results of the baseline search in June 2015, an updated and revised search strategy was conducted in MEDLINE and Embase via Ovid from January 2015 to June 2021 (Appendix 1 in S1 File ). Once again, the reference lists of new included studies were screened for relevant references, as were abstracts from January 2015 to June 2021 in the Cochrane Methodology Reviews. Experts in the field were contacted to identify any additional published and/or grey literature. No restrictions were made on publication year and language. See Appendix 1 and Appendix 2 in S1 File for the full search strategy.

Screening and study selection

Following deduplication, the search results were uploaded to Rayyan ( https://rayyan.qcri.org/welcome ). The search results from the 1st search (June 2015) were independently screened by a pair of reviewers. Twenty screeners were paired, with each pair including an author very experienced in systematic reviews and a less experienced author. To increase consistency among reviewers, both reviewers initially screened the same 50 publications and discussed the results before beginning screening for this review. Disagreements on study selection were resolved by consensus and discussion with a third reviewer, if needed. The full-text screening was also performed by two reviewers independently. Disagreements on study selection were resolved by consensus and discussion. There were also two independent reviewers who screened following the last search, using the same procedure, as for the first search, for full-text screening and disagreements. The screening procedures resulted in a full list of studies potentially relevant for one or more of the six above-mentioned evidence syntheses.

A second title and abstract screening and full-text screening of the full list was then performed independently by two reviewers using screening criteria specific to this systematic review. Reasons for excluding trials were recorded, and disagreements between the reviewers were resolved through discussion. If consensus was not reached, a third reviewer was involved.

Data extraction

We developed and pilot tested a data extraction form to extract data regarding study characteristics and outcomes of interest. Two reviewers independently extracted data, with other reviewers available to resolve disagreements. The following study characteristics were extracted from each of the included studies: bibliographic information, study aim, study design, setting, country, inclusion period, area of interest, results, and conclusion. Further, data for this study’s primary and secondary outcomes were extracted; these included the percentage of original studies using systematic reviews to justify their study and how the systematic reviews of previous research were used (e.g., within the text to justify the study) by the original studies.

Risk-of-bias assessment

No standard tool was identified to assess the risk of bias in empirical meta-research studies. The Editorial Group of the Evidence-Based Research Network prepared a risk-of-bias tool for the planned five systematic reviews with list of items important for evaluating the risk of bias in meta-research studies. For each item, one could classify the study under examination as exhibiting a “low risk of bias”, “unclear risk of bias” or “high risk of bias”. We independently tested the list of items upon a sample of included studies. Following a discussion of the different answers, we adjusted the number and content of the list of items to ten and defined the criteria to evaluate the risk of bias in the included studies ( Table 1 ). Each of the included meta-research studies was appraised independently by two reviewers using the customized checklist to determine the risk of bias. Disagreements regarding the risk of bias were solved through discussion. No study was excluded on the grounds of low quality.

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https://doi.org/10.1371/journal.pone.0276955.t001

Data synthesis and interpretation

In addition, to narratively summarizing the characteristics of the included meta-research studies and their risk-of-bias assessments, the percentage of original studies using systematic review of previous similar studies to justify a new study (primary outcome) was calculated as the number of studies using at least one systematic review, divided by the total number of original studies within each of the included meta-research studies. A meta-analysis using the random-effects model (DerSimonian and Laird) was used to estimate the overall estimate and perform the forest plot as this model is the default when using the metaprop command. Heterogeneity was evaluated estimating the I 2 statistics (the percentage of variance attributable to heterogeneity i.e., inconsistency) and the between study variance tau 2 . When investigating reasons for heterogeneity, a restricted maximum likelihood (REML) model was used and covariates with the ability to reduce tau 2 was deemed relevant. [ 15 ].

All analyses were conducted in Stata, version 17.0 (StataCorp. 2019. Stata Statistical Software : Release 17 . College Station, TX: StataCorp LLC).

Study selection

In total, 30,592 publications were identified through the searches. Of these, 69 publications were determined eligible for one of the six evidence syntheses. A total of 21 meta-research studies fulfilled the inclusion criteria for this systematic review [ 10 , 11 , 16 – 34 ]; see Fig 1 .

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https://doi.org/10.1371/journal.pone.0276955.g001

Study characteristics

The 21 included meta-research studies were published from 2007 to 2021, representing 3,621 original studies or protocols and one survey with 106 participants; only three of these studies were published before 2013 [ 10 , 18 , 26 ]. The sample of the original study within each of the included meta-research studies varied. One meta-research study surveyed congress delegates [ 29 ], one study examined first-submission protocols for randomized controlled trials submitted to four hospital ethics committees [ 17 ], and 14 studies examined randomized or quasi-randomized primary studies published during a specific time period in a range of journals [ 10 , 11 , 18 , 21 – 28 , 31 , 32 , 34 ] or in specific databases [ 16 , 19 , 20 , 30 ]. Finally, one study examined the use of previously published systematic reviews when publishing a new systematic review [ 33 ]. Further, the number of original studies within each included meta-research study varied considerably, ranging from 18 [ 10 ] to 637 original studies [ 27 ]. The characteristics of the included meta-research studies are presented in Table 2 .

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https://doi.org/10.1371/journal.pone.0276955.t002

Risk of bias assessment

Overall, most studies were determined to exhibit a low risk of bias in the majority of items, and all of the included meta-research studies reported an unambiguous aim and a match between aim and methods. However, only a few studies provided argumentation for their choice of data source [ 17 , 20 , 24 , 30 ], and only two of the 21 studies referred to an available a-priori protocol [ 16 , 21 ]. Finally, seven studies provided poor or no discussion of the limitations of their study [ 10 , 19 , 22 , 26 – 28 , 34 ]. The risk-of-bias assessments are shown in Table 3 .

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https://doi.org/10.1371/journal.pone.0276955.t003

Synthesis of results

Of the included 21 studies, a total of 18 studies were included in the meta-analysis. Two studies included two cohorts each, and both cohorts in each of these studies were included in our meta-analysis [ 21 , 30 ]. The survey by Clayton and colleagues, with a response rate of 17%, was not included in the meta-analysis as the survey did not provide data to identify the use of systematic reviews to justify specific studies. However, their results showed that 42 of 84 respondents (50%) reported using a systematic review for justification [ 29 ]. The study by Chow, which was also not included in the meta-analysis, showed that justification varied largely within and between specialties. However, only relative numbers were provided, and, therefore, no overall percentage could be extracted [ 11 ]. The study by Seehra et al. counted the SR citations in RCTs and not the number of RCTs citing SRs and is therefore not included in the meta-analysis either [ 23 ].

The percentage of original studies that justified a new study with a systematic review within each meta-research study ranged from 16% to 87%. The pooled percentage of original studies using systematic reviews to justify their research question was 42% (95% CI: 36% to 48%) as shown in Fig 2 . Where the confidence interval showed the precision of the pooled estimate in a meta-analysis, the prediction interval showed the distribution of the individual studies. The heterogeneity in the meta-analysis assessed by I 2 was 94%. The clinical interpretation of this large heterogeneity is seen in a the very broad prediction interval ranging from 16 to 71%, meaning that based on these studies there is 95% chance that the results of the next study will show a prevalence between 16 to 71%.

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Forest plot prevalence and 95% confidence intervals for the percentage of studies using an SR to justify the study.

https://doi.org/10.1371/journal.pone.0276955.g002

Further, we conducted an explorative subgroup analysis of the study of Helfer et al. and the study of Joseph et al. as these two studies were on meta-analyses and protocols and therefore differ from the other included studies. This analysis did only marginally change the pooled percentage to 39% (95% CI; 33% to 46%) and the between-study variance (tau 2 ) was reduced with 23%.

The 21 included studies varied greatly in their approach and in their description of how systematic reviews were used, i.e., if the original studies referred and whether the used systematic reviews in the original studies were relevant and/or of high-quality. Nine studies assessed, to varying degrees, whether the used systematic reviews were relevant for the justification of the research [ 16 – 20 , 25 , 30 , 32 , 34 ]. Overall, the information reported by the meta-research studies was not sufficient to report the percentage of primary studies referring to relevant systematic reviews. No details were provided regarding the methodological quality of the systematic reviews used to justify the research question or if they were recently published reviews, except for Hoderlein et al., who reported that the mean number of years from publication of the cited systematic review and the trial report was four years [ 30 ].

We identified 21 meta-research studies, spanning 15 publication years and 12 medical disciplines. The findings showed substantial variability in the use of systematic reviews when justifying new clinical studies, with the incidence of use ranging from 16% to 87%. However, fewer than half of the 19 meta-analysis-eligible studies used a systematic review to justify their new study. There was wide variability, and a general lack of information, about how systematic reviews were used within many of the original studies. Our systematic review found that the proportion of original studies justifying their new research using evidence syntheses is sub-optimal and, thus, the potential for research redundancy continues to be a challenge. This study corroborates the serious possible consequences regarding research redundancy previously problematized by Chalmers et al. and Glasziou et al. [ 35 , 36 ].

Systematic reviews are considered crucial when justifying a new study, as is emphasized in reporting guidelines such as the CONSORT statement [ 37 ]. However, there are challenges involved in implementing an evidence-based research approach. The authors of the included meta-research study reporting the highest use of systematic reviews to justify a new systematic review study point out that even though the authors of the original studies refer to some of the published systematic reviews, they neglect others on the same topic, which may be problematic and result in a biased approach [ 33 ]. Other issues that have been identified are the risk of research waste when a systematic review may not be methodologically sound [ 12 , 38 ] and that there is also redundancy in the conduct of systematic reviews, with many overlapping systematic reviews existing on the same topic [ 39 – 41 ]. In the original studies within the meta-research studies, the use of systematic reviews was not consistent and, further, it was not explicated whether the systematic reviews used were the most recent and/or of high methodological quality. These issues speak to the need for refinement in the area of systematic review development, such as mandatory registration in prospective registries. Only two out of the included 21 studies in this study referred to an available a-priori protocol [ 16 , 21 ]. General recommendations in the use of systematic reviews as justification for a new study are difficult as these will be topic specific, however researchers should be aware to use the most robust and methodologically sound of recently published reviews, preferably with á priori published protocols.

Efforts must continue in promoting the use of evidence-based research approaches among clinical health researchers and other important stakeholders, such as funders. Collaborations such as the Ensuring Value in Research Funders Forum, and changes in funding review criteria mandating reference to previously published systematic reviews when justifying the research question within funding proposals, are examples of how stakeholders can promote research that is evidence-based [ 8 , 41 ].

Strengths and limitations

We conducted a comprehensive and systematic search. The lack of standard terminology for meta-research studies resulted in search strategies that retrieved thousands of citations. We also relied on snowballing efforts to identify relevant studies, such as by contacting experts and scanning the reference lists of relevant studies.

There is also a lack of tools to assess risk of bias for meta-research studies, so a specific risk-of bias tool for the five conducted reviews was created. The tool was discussed and revised continuously throughout the research process; however, we acknowledge that the checklist is not yet optimal and a validated risk-of-bias tool for meta-research studies is needed.

Many of the included meta-research studies did not provide details as to whether the systematic reviews used to justify the included studies were relevant, high-quality and/or recently published. This may raise questions as to the validity of our findings, as the majority of the meta-research studies only provide an indication of the citation of systematic reviews to justify new studies, not whether the systematic review cited was relevant, recent and of high-quality, or even how the systematic review was used. We did not assess this further either. Nonetheless, even if we assumed that these elements were provided for every original study included in the included meta-research studies (i.e. taking a conservative approach), fewer than half used systematic reviews to justify their research questions. The conservative approach used in this study therefore does not underestimate, and perhaps rather overestimates, the actual use of relevant systematic reviews to justify studies in clinical health science across disciplines.

Different study designs were included in the meta-analysis, which may have contributed to the high degree of heterogeneity observed. Therefore, the presented results should be interpreted with caution due to the high heterogeneity. Not only were there differences in the methods of the included meta-research studies, but there was also heterogeneity in the medical specialties evaluated [ 42 , 43 ].

In conclusion, justification of research questions in clinical health research with systematic reviews continues to be inconsistent; fewer than half of the primary studies within the included meta-research studies in this systematic review were found to have used a systematic review to justify their research question. This indicates that the risk of redundant research is still high when new studies across disciplines and professions in clinical health are initiated, thereby indicating that evidence-based research has not yet been successfully implemented in the clinical health sciences. Efforts to raise awareness and to ensure an evidence-based research approach continue to be necessary, and such efforts should involve clinical health researchers themselves as well as important stakeholders such as funders.

Supporting information

S1 checklist..

https://doi.org/10.1371/journal.pone.0276955.s001

S1 Protocol.

https://doi.org/10.1371/journal.pone.0276955.s002

https://doi.org/10.1371/journal.pone.0276955.s003

https://doi.org/10.1371/journal.pone.0276955.s004

Acknowledgments

This work has been prepared as part of the Evidence-Based Research Network ( ebrnetwork.org ). The Evidence-Based Research Network is an international network that promotes the use of systematic reviews when justifying, designing, and interpreting research. The authors thank the Section for Evidence-Based Practice, Department for Health and Function, Western Norway University of Applied Sciences for their generous support of the EBRNetwork. Further, thanks to COST Association for supporting the COST Action “EVBRES” (CA 17117, evbres.eu) and thereby the preparation of this study. Thanks to Gunhild Austrheim, Head of Unit, Library at Western Norway University of Applied Sciences, Norway, for helping with the second search. Thanks to those helping with the screening: Durita Gunnarsson, Gorm Høj Jensen, Line Sjodsholm, Signe Versterre, Linda Baumbach, Karina Johansen, Rune Martens Andersen, and Thomas Aagaard.

We gratefully acknowledge the contribution from the EVBRES (COST ACTION CA 17117) Core Group, including Anne Gjerland (AG) and her specific contribution to the search and screening process.

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  • THE DIFFERENCE BETWEEN JUSTIFICATION OF THE STUDY AND SIGNIFICANCE OF THE STUDY

meaning of justification of the study in research

Over the years justification and significance of study has always been confusing to students especially the undergraduate students. I have seen lots of undergraduate research works that students write justification of the study thinking it was significance of the study. These mistakes are not only seen at undergraduate level but also with project supervisors.

        Justification of the study and significance of the study are always very important in all research works. There is no research work that does not contain significance of the study or justification of the study. The positioning might differ depending on the requirement or the format demanded by the tertiary institution a student finds his/her self. But the most important thing is that a student understands when and why having a significance of the study or justification of the study is very important.

        The justification of the study is mostly preferred by supervisors working with post graduate students during the MBA thesis or dissertation; though some supervisors still demand for justification of the study in place of significance of the study from their undergraduate students.

The Justification And Significance Of Study Nexus

The correlation between justification of the study and significance of the study is that they are both found on the chapter one of any research project work. We all know that all chapters one of any undergraduate research project work are numbered. You can see the position of justification and significance of the study as shown below:

Chapter one: Introduction

  • background of the study
  • statement of the problem
  • aim and objectives of the study
  • research questions
  • statement of the hypothesis
  • significance or justification of the study
  • scope of the study
  • limitation/delimitation of the study
  • operational definition of terms

You can see from the table of content for the chapter one of a complete project/research work; the significance of the study or justification of the study is at number 1.6 though it might change depending on the topic you are working on. It can also change depending on the department upon which the project is carried out. The table of content of the chapter one presented above is basically for the project topics under the education departments ; but those from other departments might differ especially those under history and international relations .

The Difference Between Justification And Significance Of The Study

The justification of the study is basically why a particular research work was carried out. What was the problem identified that made a student want to carry out such research work. Here you will also capture why the methodology was adopted and also why the experiment was conducted; could it be practical or scholastic purposes.

        The significance of the study is actually all about what was found during the research work. The findings could be the nature of the relationship between one variable and the other. This result will be gotten by the use of statistical tools like chi-square, correlation, regression, MANOVA, ANOVA etc; then you back it up with some empirical findings.

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Explaining research performance: investigating the importance of motivation

  • Original Paper
  • Open access
  • Published: 23 May 2024
  • Volume 4 , article number  105 , ( 2024 )

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meaning of justification of the study in research

  • Silje Marie Svartefoss   ORCID: orcid.org/0000-0001-5072-1293 1   nAff4 ,
  • Jens Jungblut 2 ,
  • Dag W. Aksnes 1 ,
  • Kristoffer Kolltveit 2 &
  • Thed van Leeuwen 3  

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In this article, we study the motivation and performance of researchers. More specifically, we investigate what motivates researchers across different research fields and countries and how this motivation influences their research performance. The basis for our study is a large-N survey of economists, cardiologists, and physicists in Denmark, Norway, Sweden, the Netherlands, and the UK. The analysis shows that researchers are primarily motivated by scientific curiosity and practical application and less so by career considerations. There are limited differences across fields and countries, suggesting that the mix of motivational aspects has a common academic core less influenced by disciplinary standards or different national environments. Linking motivational factors to research performance, through bibliometric data on publication productivity and citation impact, our data show that those driven by practical application aspects of motivation have a higher probability for high productivity. Being driven by career considerations also increases productivity but only to a certain extent before it starts having a detrimental effect.

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Introduction

Motivation and abilities are known to be as important factors in explaining employees’ job performance of employees (Van Iddekinge et al. 2018 ), and in the vast scientific literature on motivation, it is common to differentiate between intrinsic and extrinsic motivation factors (Ryan and Deci 2000 ). In this context, path-breaking individuals are said to often be intrinsically motivated (Jindal-Snape and Snape 2006 ; Thomas and Nedeva 2012 ; Vallerand et al. 1992 ), and it has been found that the importance of these of types of motivations differs across occupations and career stages (Duarte and Lopes 2018 ).

In this article, we address the issue of motivation for one specific occupation, namely: researchers working at universities. Specifically, we investigate what motivates researchers across fields and countries (RQ1) and how this motivation is linked to their research performance (RQ2). The question of why people are motivated to do their jobs is interesting to address in an academic context, where work is usually harder to control, and individuals tend to have a lot of much freedom in structuring their work. Moreover, there have been indications that academics possess an especially high level of motivation for their tasks that is not driven by a search for external rewards but by an intrinsic satisfaction from academic work (Evans and Meyer 2003 ; Leslie 2002 ). At the same time, elements of researchers’ performance are measurable through indicators of their publication activity: their productivity through the number of outputs they produce and the impact of their research through the number of citations their publications receive (Aksnes and Sivertsen 2019 ; Wilsdon et al. 2015 ).

Elevating research performance is high on the agenda of many research organisations (Hazelkorn 2015 ). How such performance may be linked to individuals’ motivational aspects has received little attention. Thus, a better understanding of this interrelation may be relevant for developing institutional strategies to foster environments that promote high-quality research and research productivity.

Previous qualitative research has shown that scientists are mainly intrinsically motivated (Jindal-Snape and Snape 2006 ). Other survey-based contributions suggest that there can be differences in motivations across disciplines (Atta-Owusu and Fitjar 2021 ; Lam 2011 ). Furthermore, the performance of individual scientists has been shown to be highly skewed in terms of publication productivity and citation rates (Larivière et al. 2010 ; Ruiz-Castillo and Costas 2014 ). There is a large body of literature explaining these differences. Some focus on national and institutional funding schemes (Hammarfelt and de Rijcke 2015 ; Melguizo and Strober 2007 ) and others on the research environment, such as the presence of research groups and international collaboration (Jeong et al. 2014 ), while many studies address the role of academic rank, age, and gender (see e.g. Baccini et al. 2014 ; Rørstad and Aksnes 2015 ). Until recently, less emphasis has been placed on the impact of researchers’ motivation. Some studies have found that different types of motivations drive high levels of research performance (see e.g. Horodnic and Zaiţ 2015 ; Ryan and Berbegal-Mirabent 2016 ). However, researchers are only starting to understand how this internal drive relates to research performance.

While some of the prior research on the impact of motivation depends on self-reported research performance evaluations (Ryan 2014 ), the present article combines survey responses with actual bibliometric data. To investigate variation in research motivation across scientific fields and countries, we draw on a large-N survey of economists, cardiologists, and physicists in Denmark, Norway, Sweden, the Netherlands, and the UK. To investigate how this motivation is linked to their research performance, we map the survey respondents’ publication and citation data from the Web of Science (WoS).

This article is organised as follows. First, we present relevant literature on research performance and motivation. Next, the scientific fields and countries are then presented before elaborating on our methodology. In the empirical analysis, we investigate variations in motivation across fields, gender, age, and academic position and then relate motivation to publications and citations as our two measures of research performance. In the concluding section, we discuss our findings and implications for national decision-makers and individual researchers.

Motivation and research performance

As noted above, the concepts of intrinsic and extrinsic motivation play an important role in the literature on motivation and performance. Here, intrinsic motivation refers to doing something for its inherent satisfaction rather than for some separable consequence. Extrinsic motivation refers to doing something because it leads to a separable outcome (Ryan and Deci 2000 ).

Some studies have found that scientists are mainly intrinsically motivated (Jindal-Snape and Snape 2006 ; Lounsbury et al. 2012 ). Research interests, curiosity, and a desire to contribute to new knowledge are examples of such motivational factors. Intrinsic motives have also been shown to be crucial when people select research as a career choice (Roach and Sauermann 2010 ). Nevertheless, scientists are also motivated by extrinsic factors. Several European countries have adopted performance-based research funding systems (Zacharewicz et al. 2019 ). In these systems, researchers do not receive direct financial bonuses when they publish, although such practices may occur at local levels (Stephan et al. 2017 ). Therefore, extrinsic motivation for such researchers may include salary increases, peer recognitions, promotion, or expanded access to research resources (Lam 2011 ). According to Tien and Blackburn ( 1996 ), both types of motivations operate simultaneously, and their importance vary and may depend on the individual’s circumstances, personal situation, and values.

The extent to which different kinds of motivations play a role in scientists’ performance has been investigated in several studies. In these studies, bibliometric indicators based on the number of publications are typically used as outcome measures. Such indicators play a critical role in various contexts in the research system (Wilsdon et al. 2015 ), although it has also been pointed out that individuals can have different motivations to publish (Hangel and Schmidt-Pfister 2017 ).

Based on a survey of Romanian economics and business administration academics combined with bibliometric data, Horodnic and Zait ( 2015 ) found that intrinsic motivation was positively correlated with research productivity, while extrinsic motivation was negatively correlated. Their interpretations of the results are that researchers motivated by scientific interest are more productive, while researchers motivated by extrinsic forces will shift their focus to more financially profitable activities. Similarly, based on the observation that professors continue to publish even after they have been promoted to full professor, Finkelstein ( 1984 ) concluded that intrinsic rather than extrinsic motivational factors have a decisive role regarding the productivity of academics.

Drawing on a survey of 405 research scientists working in biological, chemical, and biomedical research departments in UK universities, Ryan ( 2014 ) found that (self-reported) variations in research performance can be explained by instrumental motivation based on financial incentives and internal motivation based on the individual’s view of themselves (traits, competencies, and values). In the study, instrumental motivation was found to have a negative impact on research performance: As the desire for financial rewards increase, the level of research performance decreases. In other words, researchers mainly motivated by money will be less productive and effective in their research. Contrarily, internal motivation was found to have a positive impact on research performance. This was explained by highlighting that researchers motivated by their self-concept set internal standards that become a reference point that reinforces perceptions of competency in their environments.

Nevertheless, it has also been argued that intrinsic and extrinsic motivations for publishing are intertwined (Ma 2019 ). According to Tien and Blackburn ( 1996 ), research productivity is neither purely intrinsically nor purely extrinsically motivated. Publication activity is often a result of research, which may be intrinsically motivated or motivated by extrinsic factors such as a wish for promotion, where the number of publications is often a part of the assessment (Cruz-Castro and Sanz-Menendez 2021 ; Tien 2000 , 2008 ).

The negative relationship between external/instrumental motivation and performance and the positive relationship between internal/self-concept motivation and performance are underlined by Ryan and Berbegal-Mirabent ( 2016 ). Drawing on a fuzzy set qualitative comparative analysis of a random sampling of 300 of the original respondents from Ryan ( 2014 ), they find that scientists working towards the standards and values they identify with, combined with a lack of concern for instrumental rewards, contribute to higher levels of research performance.

Based on the above, this article will address two research questions concerning different forms of motivation and the relationship between motivation and research performance.

How does the motivation of researchers vary across fields and countries?

How do different types of motivations affect research performance?

In this study, the roles of three different motivational factors are analysed. These are scientific curiosity, practical and societal applications, and career progress. The study aims to assess the role of these specific motivational factors and not the intrinsic-extrinsic distinction more generally. Of the three factors, scientific curiosity most strongly relates to intrinsic motivation; practical and societal applications also entail strong intrinsic aspects. On the other hand, career progress is linked to extrinsic motivation.

In addition to variation in researchers’ motivations by field and country, we consider differences in relation to age, position and gender. Additionally, when investigating how motivation relates to scientific performance we control for the influence of age, gender, country and funding. These are dimensions where differences might be found in motivational factors given that scientific performance, particularly publication productivity, has been shown to differ along these dimensions (Rørstad and Aksnes 2015 ).

Research context: three fields, five countries

To address the research question about potential differences across fields and countries, the study is based on a sample consisting of researchers in three different fields (cardiology, economics, and physics) and five countries (Denmark, Norway, Sweden, the Netherlands, and the UK). Below, we describe this research context in greater detail.

The fields represent three different domains of science: medicine, social sciences, and the natural sciences, where different motivational factors may be at play. This means that the fields cover three main areas of scientific investigations: the understanding of the world, the functioning of the human body, and societies and their functions. The societal role and mission of the fields also differ. While a primary aim of cardiology research and practice is to reduce the burden of cardiovascular disease, physics research may drive technology advancements, which impacts society. Economics research may contribute to more effective use of limited resources and the management of people, businesses, markets, and governments. In addition, the fields also differ in publication patterns (Piro et al. 2013 ). The average number of publications per researcher is generally higher in cardiology and physics than in economics (Piro et al. 2013 ). Moreover, cardiologists and physicists mainly publish in international scientific journals (Moed 2005 ; Van Leeuwen 2013 ). In economics, researchers also tend to publish books, chapters, and articles in national languages, in addition to international journal articles (Aksnes and Sivertsen 2019 ; van Leeuwen et al. 2016 ).

We sampled the countries with a twofold aim. On the one hand, we wanted to have countries that are comparable so that differences in the development of the science systems, working conditions, or funding availability would not be too large. On the other hand, we also wanted to assure variation among the countries regarding these relevant framework conditions to ensure that our findings are not driven by a specific contextual condition.

The five countries in the study are all located in the northwestern part of Europe, with science systems that are foremost funded by block grant funding from the national governments (unlike, for example, the US, where research grants by national funding agencies are the most important funding mechanism) (Lepori et al. 2023 ).

In all five countries, the missions of the universities are composed of a blend of education, research, and outreach. Furthermore, the science systems in Norway, Denmark, Sweden, and the Netherlands have a relatively strong orientation towards the Anglo-Saxon world in the sense that publishing in the national language still exists, but publishing in English in internationally oriented journals in which English is the language of publications is the norm (Kulczycki et al. 2018 ). These framework conditions ensure that those working in the five countries have somewhat similar missions to fulfil in their professions while also belonging to a common mainly Anglophone science system.

However, in Norway, Denmark, Sweden, and the Netherlands, research findings in some social sciences, law, and the humanities are still oriented on publishing in various languages. Hence, we avoided selecting the humanities field for this study due to a potential issue with cross-country comparability (Sivertsen 2019 ; Sivertsen and Van Leeuwen 2014 ; Van Leeuwen 2013 ).

Finally, the chosen countries vary regarding their level of university autonomy. When combining the scores for organisational, financial, staffing, and academic autonomy presented in the latest University Autonomy in Europe Scorecard presented by the European University Association (EUA), the UK, the Netherlands, and Denmark have higher levels of autonomy compared to Norway and Sweden, with Swedish universities having less autonomy than their Norwegian counterparts (Pruvot et al. 2023 ). This variation is relevant for our study, as it ensures that our findings are not driven by response from a higher education system with especially high or low autonomy, which can influence the motivation and satisfaction of academics working in it (Daumiller et al. 2020 ).

Data and methods

The data used in this article are a combination of survey data and bibliometric data retrieved from the WoS. The WoS database was chosen for this study due to its comprehensive coverage of research literature across all disciplines, encompassing the three specific research areas under analysis. Additionally, the WoS database is well-suited for bibliometric analyses, offering citation counts essential for this study.

Two approaches were used to identify the sample for the survey. Initially, a bibliometric analysis of the WoS using journal categories (‘Cardiac & cardiovascular systems’, ‘Economics’, and ‘Physics’) enabled the identification of key institutions with a minimum number of publications within these journal categories. Following this, relevant organisational units and researchers within these units were identified through available information on the units’ webpages. Included were employees in relevant academic positions (tenured academic personnel, post-docs, and researchers, but not PhD students, adjunct positions, guest researchers, or administrative and technical personnel).

Second, based on the WoS data, people were added to this initial sample if they had a minimum number of publications within the field and belonged to any of the selected institutions, regardless of unit affiliation. For economics, the minimum was five publications within the selected period (2011–2016). For cardiology and physics, where the individual publication productivity is higher, the minimum was 10 publications within the same period. The selection of the minimum publication criteria was based on an analysis of publication outputs in these fields between 2011 and 2016. The thresholds were applied to include individuals who are more actively engaged in research while excluding those with more peripheral involvement. The higher thresholds for cardiology and physics reflect the greater frequency of publications (and co-authorship) observed in these fields.

The benefit of this dual-approach strategy to sampling is that we obtain a more comprehensive sample: the full scope of researchers within a unit and the full scope of researchers that publish within the relevant fields. Overall, 59% of the sample were identified through staff lists and 41% through the second step involving WoS data.

The survey data were collected through an online questionnaire first sent out in October 2017 and closed in December 2018. In this period, several reminders were sent to increase the response rate. Overall, the survey had a response rate of 26.1% ( N  = 2,587 replies). There were only minor variations in response rates between scientific fields; the variations were larger between countries. Tables  1 and 2 provide an overview of the response rate by country and field.

Operationalisation of motivation

Motivation was measured by a question in the survey asking respondents what motivates or inspires them to conduct research, of which three dimensions are analysed in the present paper. The two first answer categories were related to intrinsic motivation (‘Curiosity/scientific discovery/understanding the world’ and ‘Application/practical aims/creating a better society’). The third answer category was more related to extrinsic motivation (‘Progress in my career [e.g. tenure/permanent position, higher salary, more interesting/independent work]’). Appendix Table A1 displays the distribution of respondents and the mean value and standard deviation for each item.

These three different aspects of motivation do not measure the same phenomenon but seem to capture different aspects of motivation (see Pearson’s correlation coefficients in Appendix Table A2 ). There is no correlation between curiosity/scientific discovery, career progress, and practical application. However, there is a weak but significant positive correlation between career progress and practical application. These findings indicate that those motivated by career considerations to some degrees also are motivated by practical application.

In addition to investigating how researchers’ motivation varies by field and country, we consider the differences in relation to age, position and gender as well. Field of science differentiates between economics, cardiology, physics, and other fields. The country variables differentiate between the five countries. Age is a nine-category variable. The position variable differentiates between full professors, associate professors, and assistant professors. The gender variable has two categories (male or female). For descriptive statistics on these additional variables, see Appendix Table A3 .

Publication productivity and citation impact

To analyse the respondents’ bibliometric performance, the Centre for Science and Technology Studies (CWTS) in-house WoS database was used. We identified the publication output of each respondent during 2011–2017 (limited to regular articles, reviews, and letters). For 16% of the respondents, no publications were identified in the database. These individuals had apparently not published in international journals covered by the database. However, in some cases, the lack of publications may be due to identification problems (e.g. change of names). Therefore, we decided not to include the latter respondents in the analysis.

Two main performance measures were calculated: publication productivity and citation impact. As an indicator of productivity, we counted the number of publications for each individual (as author or co-author) during the period. To analyse the citation impact, a composite measure using three different indicators was used: total number of citations (total citations counts for all articles they have contributed to during the period, counting citations up to and including 2017), normalised citation score (MNCS), and proportion of publications among the 10% most cited articles in their fields (Waltman and Schreiber 2013 ). Here, the MNCS is an indicator for which the citation count of each article is normalised by subject, article type, and year, where 1.00 corresponds to the world average (Waltman et al. 2011 ). Based on these data, averages for the total publication output of each respondent were calculated. By using three different indicators, we can avoid biases or limitations attached to each of them. For example, using the MNCS, a respondent with only one publication would appear as a high impact researcher if this article was highly cited. However, when considering the additional indicator, total citation counts, this individual would usually perform less well.

The bibliometric scores were skewedly distributed among the respondents. Rather than using the absolute numbers, in this paper, we have classified the respondents into three groups according to their scores on the indicators. Here, we have used percentile rank classes (tertiles). Percentile statistics are increasingly applied in bibliometrics (Bornmann et al. 2013 ; Waltman and Schreiber 2013 ) due to the presence of outliers and long tails, which characterise both productivity and citation distributions.

As the fields analysed have different publication patterns, the respondents within each field were ranked according to their scores on the indicators, and their percentile rank was determined. For the productivity measure, this means that there are three groups that are equal in terms of number of individuals included: 1: Low productivity (the group with the lowest publication numbers, 0–33 percentile), 2: Medium productivity (33–67 percentile), and 3: High productivity (67–100 percentile). For the citation impact measure, we conducted a similar percentile analysis for each of the three composite indicators. Then everyone was assigned to one of the three percentile groups based on their average score: 1: Low citation impact (the group with lowest citation impact, 0–33 percentile), 2: Medium citation impact (33–67 percentile), and 3: High citation impact (67–100 percentile), cf. Table  3 . Although it might be argued that the application of tertile groups rather than absolute numbers leads to a loss of information, the advantage is that the results are not influenced by extreme values and may be easier to interpret.

Via this approach, we can analyse the two important dimensions of the respondents’ performance. However, it should be noted that the WoS database does not cover the publication output of the fields equally. Generally, physics and cardiology are very well covered, while the coverage of economics is somewhat lower due to different publication practices (Aksnes and Sivertsen 2019 ). This problem is accounted for in our study by ranking the respondents in each field separately, as described above. In addition, not all respondents may have been active researchers during the entire 2011–2017 period, which we have not adjusted for. Despite these limitations, the analysis provides interesting information on the bibliometric performance of the respondents at an aggregated level.

Regression analysis

To analyse the relationship between motivation and performance, we apply multinomial logistic regression rather then ordered logistic regression because we assume that the odds for respondents belonging in each category of the dependent variables are not equal (Hilbe 2017 ). The implication of this choice of model is that the model tests the probability of respondents being in one category compared to another (Hilbe 2017 ). This means that a reference or baseline category must be selected for each of the dependent variables (productivity and citation impact). Furthermore, the coefficient estimates show how the probability of being in one of the other categories decreases or increases compared to being in the reference category.

For this analysis, we selected the medium performers as the reference or baseline category for both our dependent variables. This enables us to evaluate how the independent variables affect the probability of being in the low performers group compared to the medium performers and the high performers compared to the medium performers.

To evaluate model fit, we started with a baseline model where only types of motivations were included as independent variables. Subsequently, the additional variables were introduced into the model, and based on measures for model fit (Pseudo R 2 , -2LL, and Akaike Information Criterion (AIC)), we concluded that the model with all additional variables included provides the best fit to the data for both the dependent variables (see Appendix Tables A5 and A6 ). Additional control variables include age, gender, country, and funding. We include these variables as controls to obtain robust effects of motivation and not effects driven by other underlying factors. The type of funding was measured by variables where the respondent answered the following question: ‘How has your research been funded the last five years?’ The funding variable initially consisted of four categories: ‘No source’, ‘Minor source’, ‘Moderate source’, and ‘Major source’. In this analysis, we have combined ‘No source’ and ‘Minor source’ into one category (0) and ‘Moderate source’ and ‘Major source’ into another category (1). Descriptive statistics for the funding variables are available in Appendix Table A4 . We do not control for the influence of field due to how the scientific performance variables are operationalised, the field normalisation implies that there are no variations across fields. We also do not control for position, as this variable is highly correlated with age, and we are therefore unable to include these two variables in the same model.

The motivation of researchers

In the empirical analysis, we first investigate variation in motivation and then relate it to publications and citations as our two measures of research performance.

As Fig.  1 shows, the respondents are mainly driven by curiosity and the wish to make scientific discoveries. This is by far the most important motivation. Practical application is also an important source of motivation, while making career progress is not identified as being very important.

figure 1

Motivation of researchers– percentage

As Table  4 shows, at the level of fields, there are no large differences, and the motivational profiles are relatively similar. However, physicists tend to view practical application as somewhat less important than cardiologists and economists. Moreover, career progress is emphasised most by economists. Furthermore, as table 5 shows, there are some differences in motivation between countries. For curiosity/scientific discovery and practical application, the variations across countries are minor, but researchers in Denmark tend to view career progress as somewhat more important than researchers in the other countries.

Furthermore, as table 6 shows, women seem to view practical application and career progress as a more important motivation than men; these differences are also significant. Similar gender disparities have also been reported in a previous study (Zhang et al. 2021 ).

There are also some differences in motivation across the additional variables worth mentioning, as Table  7 shows. Unsurprisingly, perhaps, there is a significant moderate negative correlation between age, position, and career progress. This means that the importance of career progress as a motivation seems to decrease with increased age or a move up the position hierarchy.

In the second part of the analysis, we relate motivation to research performance. We first investigate publications and productivity using the percentile groups. Here, we present the results we use using predicted probabilities because they are more easily interpretable than coefficient estimates. For the model with productivity percentile groups as the dependent variable, the estimates for career progress were negative when comparing the medium productivity group to the high productivity group and the medium productivity group to the low productivity group. This result indicates that the probability of being in the high and low productivity groups decreases compared to the medium productivity group as the value of career progress increases, which may point towards a curvilinear relationship between the variables. A similar pattern was also found in the model with the citation impact group as the dependent variable, although it was not as apparent.

As a result of this apparent curvilinear relationship, we included quadric terms for career progress in both models, and these were significant. Likelihood ratio tests also show that the models with quadric terms included have a significant better fit to the data. Furthermore, the AIC was also lower for these models compared to the initial models where quadric terms were not included (see Appendix Tables A5 – A7 ). Consequently, we base our results on these models, which can be found in Appendix Table A7 . Due to a low number of respondents in the low categories of the scientific curiosity/discovery variable, we also combined the first three values into one to include it as a variable in the regression analysis, which results in a reduced three-value variable for scientific curiosity/discovery.

Results– productivity percentile group

Using the productivity percentile group as the dependent variable, we find that the motivational aspects of practical application and career progress have a significant effect on the probability of being in the low, medium, or high productivity group but not curiosity/scientific discovery. In Figs.  2 and 3 , each line represents the probability of being in each group across the scale of each motivational aspect.

figure 2

Predicted probability for being in each of the productivity groups according to the value on the ‘practical application’ variable

figure 3

Predicted probability of being in the low and high productivity groups according to the value on the ‘progress in my career’ variable

Figure  2 shows that at low values of application, there are no significant differences between the probability of being in either of the groups. However, from around value 3 of application, the differences between the probability of being in each group increases, and these are also significant. As a result, we concluded that high scores on practical application is related to increased probability of being in the high productivity group.

In Fig.  3 , we excluded the medium productivity group from the figure because there are no significant differences between this group and the high and low productivity group. Nevertheless, we found significant differences between the low productivity and the high productivity group. Since we added a quadric term for career progress, the two lines in Fig.  3 have a curvilinear shape. Figure  3 shows that there are only significant differences between the probability of being in the low or high productivity group at mid and high values of career progress. In addition, the probability of being in the high productivity group is at its highest value at mid values of career progress. This indicates that being motivated by career progress increases the probability of being in the high productivity group but only up to a certain point before it begins to have a negative effect on the probability of being in this group.

We also included age and gender as variables in the model, and Figs.  4 and 5 show the results. Figure  4 shows that age especially impacts the probability of being in the high productivity and low productivity groups. The lowest age category (< 30–34 years) has the highest probability for being in the low productivity group, while from the mid age category (50 years and above), the probability is highest for being in the high productivity group. This means that increased age is related to an increased probability of high productivity. The variable controlling for the effect of funding also showed some significant results (see Appendix Table A7 ). The most relevant finding is that receiving competitive grants from external public sources had a very strong and significant positive effect on being in the high productivity group and a medium-sized significant negative effect on being in the low productivity group. This shows that receiving external funding in the form of competitive grants has a strong effect on productivity.

figure 4

Predicted probability of being in each of the productivity groups according to age

Figure  5 shows that there is a difference between male and female respondents. For females, there are no differences in the probability of being in either of the groups, while males have a higher probability of being in the high productivity group compared to the medium and low productivity groups.

figure 5

Results– citation impact group

For the citation impact group as the dependent variable, we found that career progress has a significant effect on the probability of being in the low citation impact group or the high citation group but not curiosity/scientific discovery or practical application. Figure  6 shows how the probability of being in the high citation impact group increases as the value on career progress increases and is higher than that of being in the low citation impact group, but only up to a certain point. This indicates that career progress increases the probability of being in the high citation impact group to some degree but that too high values are not beneficial for high citation impact. However, it should also be noted that the effect of career progress is weak and that it is difficult to conclude on how very low or very high values of career progress affect the probability of being in the two groups.

figure 6

Predicted probability for being in each of the citation impact groups according to the value on the ‘progress in my career’ variable

We also included age and gender as variables in the model, and we found a similar pattern as in the model with productivity percentile group as the dependent variable. However, the relationship between the variables is weaker in this model with the citation impact group as the dependent variable. Figure  7 shows that the probability of being in the high citation impact group increases with age, but there is no significant difference between the probability of being in the high citation impact group and the medium citation impact group. We only see significant differences when each of these groups is compared to the low citation impact group. In addition, the increase in probability is more moderate in this model.

figure 7

Predicted probability of being in each of the citation impact groups according to age

Figure  8 shows that there are differences between male and female respondents. Male respondents have a significant higher probability of being in the medium or high citation impact group compared to the low citation impact group, but there is no significant difference in the probability between the high and medium citation impact groups. For female respondents, there are no significant differences. Similarly, for age, the effect also seems to be more moderate in this model compared to the model with productivity percentile groups as the dependent variable. In addition, the effect of funding sources is more moderate on citation impact compared to productivity (see Appendix Table A7 ). Competitive grants from external public sources still have the most relevant effect, but the effect size and level of significance is lower than for the model where productivity groups are the dependent variable. Respondents who received a large amount of external funding through competitive grants are more likely to be highly cited, but the effect size is much smaller, and the result is only significant at p  < 0.1. Those who do not receive much funding from this source are more likely to be in the low impact group. Here, the effect size is large, and the coefficient is highly significant.

figure 8

Predicted probability for being in each of the citation impact groups according to gender

Concluding discussion

This article aimed to explore researchers’ motivations and investigate the impact of motivation on research performance. By addressing these issues across several fields and countries, we provided new evidence on the motivation and performance of researchers.

Most researchers in our large-N survey found curiosity/scientific discovery to be a crucial motivational factor, with practical application being the second most supported aspect. Only a smaller number of respondents saw career progress as an important inspiration to conduct their research. This supports the notion that researchers are mainly motivated by core aspects of academic work such as curiosity, discoveries, and practical application of their knowledge and less so by personal gains (see Evans and Meyer 2003 ). Therefore, our results align with earlier research on motivation. In their interview study of scientists working at a government research institute in the UK, Jindal-Snape and Snape ( 2006 ) found that the scientists were typically motivated by the ability to conduct high quality, curiosity-driven research and de-motivated by the lack of feedback from management, difficulty in collaborating with colleagues, and constant review and change. Salaries, incentive schemes, and prospects for promotion were not considered a motivator for most scientists. Kivistö and colleagues ( 2017 ) also observed similar patterns in more recent survey data from Finnish academics.

As noted in the introduction, the issue of motivation has often been analysed in the literature using the intrinsic-extrinsic distinction. In our study, we have not applied these concepts directly. However, it is clear that the curiosity/scientific discovery item should be considered a type of intrinsic motivation, as it involves performing the activity for its inherent satisfaction. Moreover, the practical application item should probably be considered mainly intrinsic, as it involves creating a better society (for others) without primarily focusing on gains for oneself. The career progress item explicitly mentions personal gains such as position and higher salary and is, therefore, a type of extrinsic motivation. This means that our results support the notion that there are very strong elements of intrinsic motivation among researchers (Jindal-Snape and Snape 2006 ).

When analysing the three aspects of motivation, we found some differences. Physicists tend to view practical application as less important than researchers in the two other fields, while career progress was most emphasised by economists. Regarding country differences, our data suggest that career progress is most important for researchers in Denmark. Nevertheless, given the limited effect sizes, the overall picture is that motivational factors seem to be relatively similar regarding disciplinary and country dimensions.

Regarding gender aspects of motivation, our data show that women seem to view practical application and career progress as more important than men. One explanation for this could be the continued gender differences in academic careers, which tend to disadvantage women, thus creating a greater incentive for female scholars to focus on and be motivated by career progress aspects (Huang et al. 2020 ; Lerchenmueller and Sorenson 2018 ). Unsurprisingly, respondents’ age and academic position influenced the importance of different aspects of motivation, especially regarding career progress. Here, increased age and moving up the positional hierarchy are linked to a decrease in importance. This highlights that older academics and those in more senior positions drew more motivation from other sources that are not directly linked to their personal career gains. This can probably be explained by the academic career ladder plateauing at a certain point in time, as there are often no additional titles and very limited recognition beyond becoming a full professor. Finally, the type of funding that scholars received also had an influence on their productivity and, to a certain extent, citation impact.

Overall, there is little support that researchers across various fields and countries are very different when it comes to their motivation for conducting research. Rather, there seems to be a strong common core of academic motivation that varies mainly by gender and age/position. Rather than talking about researchers’ motivation per se, our study, therefore, suggests that one should talk about motivation across gender, at different stages of the career, and, to a certain degree, in different fields. Thus, motivation seems to be a multi-faceted construct, and the importance of different aspects of motivation vary between different groups.

In the second step of our analysis, we linked motivation to performance. Here, we focused on both scientific productivity and citation impact. Regarding the former, our data show that both practical application and career progress have a significant effect on productivity. The relationship between practical application aspects and productivity is linear, meaning that those who indicate that this aspect of motivation is very important to them have a higher probability of being in the high productivity group. The relationship between career aspects of motivation and productivity is curve linear, and we found only significant differences between the high and low productivity groups at mid and high values of the motivation scale. This indicates that being more motivated by career progress increases productivity but only to a certain extent before it starts having a detrimental effect. A common assumption has been that intrinsic motivation has a positive and instrumental effect and extrinsic motivation has a negative effect on the performance of scientists (Peng and Gao 2019 ; Ryan and Berbegal-Mirabent 2016 ). Our results do not generally support this, as motives related to career progress are positively linked with productivity only to a certain point. Possibly, this can be explained by the fact that the number of publications is often especially important in the context of recruitment and promotion (Langfeldt et al. 2021 ; Reymert et al. 2021 ). Thus, it will be beneficial from a scientific career perspective to have many publications when trying to get hired or promoted.

Regarding citation impact, our analysis highlights that only the career aspects of motivation have a significant effect. Similar to the results regarding productivity, being more motivated by career progress increases the probability of being in the high citation impact group, but only to a certain value when the difference stops being significant. It needs to be pointed out that the effect strength is weaker than in the analysis that focused on productivity. Thus, these results should be treated with greater caution.

Overall, our results shed light on some important aspects regarding the motivation of academics and how this translates into research performance. Regarding our first research question, it seems to be the case that there is not one type of motivation but rather different contextual mixes of motivational aspects that are strongly driven by gender and the academic position/age. We found only limited effects of research fields and even less pronounced country effects, suggesting that while situational, the mix of motivational aspects also has a common academic core that is less influenced by different national environments or disciplinary standards. Regarding our second research question, our results challenge the common assumption that intrinsic motivation has a positive effect and extrinsic motivation has a negative effect on the performance of scientists. Instead, we show that motives related to career are positively linked to productivity at least to a certain point. Our analysis regarding citation patterns achieved similar results. Combined with the finding regarding the importance of current academic position and age for specific patterns of motivation, it could be argued that the fact that the number of publications is often used as a measurement in recruitment and promotion makes academics that are more driven by career aspects publish more, as this is perceived as a necessary condition for success.

Our study has a clear focus on the research side of academic work. However, most academics do both teaching and research, which raises the question of how far our results can also inform our knowledge regarding the motivation for teaching. On the one hand, previous studies have highlighted that intrinsic motivation is also of high importance for the quality of teaching (see e.g. Wilkesmann and Lauer 2020 ), which fits well with our findings. At the same time, the literature also highlights persistent goal conflicts of academics (see e.g. Daumiller et al. 2020 ), given that extra time devoted to teaching often comes at the costs of publications and research. Given that other findings in the literature show that research performance continues to be of higher importance than teaching in academic hiring processes (Reymert et al. 2021 ), the interplay between research performance, teaching performance, and different types of motivation is most likely more complicated and demands further investigation.

While offering several relevant insights, our study still comes with certain limitations that must be considered. First, motivation is a complex construct. Thus, there are many ways one could operationalise it, and not one specific understanding so far seems to have emerged as best practice. Therefore, our approach to operationalisation and measurement should be seen as an addition to this broader field of measurement approaches, and we do not claim that this is the only sensible way of doing it. Second, we rely on self-reported survey data to measure the different aspects of motivation in our study. This means that aspects such as social desirability could influence how far academics claim to be motivated by certain aspects. For example, claiming to be mainly motivated by personal career gains may be considered a dubious motive among academics.

With respect to the bibliometric analyses, it is important to realise that we have lumped researchers into categories, thereby ‘smoothening’ the individual performances into group performances under the various variables. This has an effect that some extraordinary scores might have become invisible in our study, which might have been interesting to analyse separately, throwing light on the relationships we studied. However, breaking the material down to the lower level of analysis of individual researchers also comes with a limitation, namely that at the level of the individual academic, bibliometrics tend to become quite sensitive for the underlying numbers, which in itself is then hampered by the coverage of the database used, the publishing cultures in various countries and fields, and the age and position of the individuals. Therefore, the level of the individual academic has not been analysed in our study, how interesting and promising outcomes might have been. even though we acknowledge that such a study could yield interesting results.

Finally, our sample is drawn from northwestern European countries and a limited set of disciplines. We would argue that we have sufficient variation in countries and disciplines to make the results relevant for a broader audience context. While our results show rather small country or discipline differences, we are aware that there might be country- or discipline-specific effects that we cannot capture due to the sampling approach we used. Moreover, as we had to balance sufficient variation in framework conditions with the comparability of cases, the geographical generalisation of our results has limitations.

This article investigated what motivates researchers across different research fields and countries and how this motivation influences their research performance. The analysis showed that the researchers are mainly motivated by scientific curiosity and practical application and less so by career considerations. Furthermore, the analysis shows that researchers driven by practical application aspects of motivation have a higher probability of high productivity. Being driven by career considerations also increases productivity but only to a certain extent before it starts having a detrimental effect.

The article is based on a large-N survey of economists, cardiologists, and physicists in Denmark, Norway, Sweden, the Netherlands, and the UK. Building on this study, future research should expand the scope and study the relationship between motivation and productivity as well as citation impact in a broader disciplinary and geographical context. In addition, we encourage studies that develop and validate our measurement and operationalisation of aspects of researchers’ motivation.

Finally, a long-term panel study design that follows respondents throughout their academic careers and investigates how far their motivational patterns shift over time would allow for more fine-grained analysis and thereby a richer understanding of the important relationship between motivation and performance in academia.

Data availability

The data set for this study is available from the corresponding author upon reasonable request.

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Acknowledgements

We are thankful to the R-QUEST team for input and comments to the paper.

The authors disclosed the receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Research Council Norway (RCN) [grant number 256223] (R-QUEST).

Open access funding provided by University of Oslo (incl Oslo University Hospital)

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Silje Marie Svartefoss

Present address: TIK Centre for Technology, Innovation and Culture, University of Oslo, 0317, Oslo, Norway

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Nordic Institute for Studies in Innovation, Research and Education (NIFU), Økernveien 9, 0608, Oslo, Norway

Silje Marie Svartefoss & Dag W. Aksnes

Department of Political Science, University of Oslo, 0315, Oslo, Norway

Jens Jungblut & Kristoffer Kolltveit

Centre for Science and Technology Studies (CWTS), Leiden University, 2311, Leiden, The Netherlands

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Silje Marie Svartefoss, Jens Jungblut, Dag W. Aksnes, Kristoffer Kolltveit, and Thed van Leeuwen. The first draft of the manuscript was written by all authors in collaboration, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Silje Marie Svartefoss .

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A modern way to teach and practice manual therapy

  • Roger Kerry 1 ,
  • Kenneth J. Young   ORCID: orcid.org/0000-0001-8837-7977 2 ,
  • David W. Evans 3 ,
  • Edward Lee 1 , 4 ,
  • Vasileios Georgopoulos 1 , 5 ,
  • Adam Meakins 6 ,
  • Chris McCarthy 7 ,
  • Chad Cook 8 ,
  • Colette Ridehalgh 9 , 10 ,
  • Steven Vogel 11 ,
  • Amanda Banton 11 ,
  • Cecilia Bergström 12 ,
  • Anna Maria Mazzieri 13 ,
  • Firas Mourad 14 , 15 &
  • Nathan Hutting 16  

Chiropractic & Manual Therapies volume  32 , Article number:  17 ( 2024 ) Cite this article

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Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment , patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care.

The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety , comfort , and efficiency . These practical elements are contextualised by positive communication , a collaborative context , and person-centred care . The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies.

A literature review stimulated by a new method of teaching manual therapy, reflecting contemporary evidence, being trialled at a United Kingdom education institute. A group of experienced, internationally-based academics, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through reviews of contemporary literature and discussions in an iterative process. Public presentations were made to multidisciplinary groups and feedback was incorporated. Consensus was achieved through repeated discussion of relevant elements.

Conclusions

Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.

Musculoskeletal (MSK) conditions are leading contributors to the burden of global disability and healthcare [ 1 ]. Amongst other interventions, manual therapy (MT) has been recommended for the management of people with MSK conditions in multiple clinical guidelines, for example [ 2 , 3 ].

MT has been described as the deliberate application of externally generated force upon body tissue, typically via the hands, with therapeutic intent [ 4 ]. It includes touch-based interventions such as thrust manipulation, joint mobilisation, soft-tissue mobilisation, and neurodynamic movements [ 5 ]. For people with MSK conditions, this therapeutic intent is usually to reduce pain and improve movement, thus facilitating a return to function and improved quality of life [ 6 ]. Patient perceptions of MT are, however, vague and sit among wider expectations of treatment including education, self-efficacy and the role of exercise, and prognosis [ 7 ].

Although the teaching and practice of MT has invariably changed over time, its foundations arguably remain unaltered and set in biomedical and outdated principles. This paper sets out to review contemporary literature and propose a revised model to inform the teaching and practice of MT.

The aim of this paper is to stimulate debate about the future teaching and practice of manual therapy through the proposal of an evidence-informed re-conceptualised model of manual therapy. The new model dismisses traditional elements of manual therapy which are not supported by research evidence. In place, the model offers a structure based on common humanistic principles of healthcare.

Consenus methodology

We present the literature synthesis and proposed framework as a consensus document to motivate further professional discussion developed through a simple three-stage iterative process over a 5-year period. The consensus methodology was classed as educational development which did not require ethical approval. Stage 1: a change of teaching practice was adopted by some co-authors (VG, RK, EL) on undergraduate and postgraduate Physiotherapy programmes at a UK University in 2018. This was a result of standard institutional teaching practice development which includes consideration of evidence-informed teaching. Stage 2: Input from a broader spectrum of stakeholders was sought, so a group of experienced, internationally-based educators, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through discussions in an iterative process. Stage 3: Presentations were made by some of the co-authors (VG, RK, SV, KY) to multidisciplinary groups (UK, Europe, North America) and feedback via questions and discussions was incorporated into further co-author discussions on the development of the framework. Consensus was achieved through repeated discussion of relevant elements. Figure  1 summarises the consensus methodology.

figure 1

Summary and timeline of iterative consensus process for development of framework (MT: Manual Therapy; UG: Undergraduate; PG: Postgraduate)

Clinical & cost effectiveness of manual therapy

Manual therapy has been suggested to be a valuable part of a multimodal approach to managing MSK pain and disability, for example [ 8 ]. The majority of recent systematic reviews of clinical trials report a beneficial effect of MT for a range of MSK conditions, with at least similar effect sizes to other recommended approaches, for example [ 9 ]. Some systematic reviews report inconclusive findings, for example [ 10 ], and a minority report effects that were no better than comparison or sham treatments, for example [ 11 ].

Potential benefits must always be weighed against potential harms, of course. Mild to moderate adverse events from MT (e.g. mild muscle soreness) are common and generally considered acceptable [ 12 ], whilst serious adverse events are very rare and their risk may be mitigated by good practice [ 13 ]. MT has been reported by people with MSK disorders as a preferential and effective treatment with accepted levels of post-treatment soreness [ 14 ].

MT is considered cost-effective [ 15 ] and the addition of MT to exercise packages has been shown to increase clinical and cost-effectiveness compared to exercise alone in several MSK conditions [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Further, manual therapy has been shown to be less costly and more beneficial than evidence-based advice to stay active [ 24 ].

In summary, MT is considered a useful evidence-based addition to care packages for people experiencing pain and disability associated with MSK conditions. As such, MT continues to be included in national and international clinical guidelines for a range of MSK conditions as part of multimodal care.

Principles of traditional manual therapy (TMT)

Manual therapy has been used within healthcare for centuries [ 4 ] with many branches of MT having appeared (and disappeared) over time [ 25 ]. In developed nations today, MT is most commonly utilised by the formalised professional groups of physiotherapy, osteopathy, chiropractic, as well as groups such as soft tissue therapists. All of these groups have a history that borrows heavily from traditional healers and bone-setters [ 26 ].

Although there are many elements of MT, three principles appear to have become ubiquitous within what we shall now refer to as ‘traditional manual therapy’ (TMT): clinician-centred assessment , patho-anatomical reasoning , and technique specificity [ 27 , 28 , 29 , 30 ]. These principles continue to influence the teaching and practice of manual therapy over recent years, for example [ 31 ].

However, they have become increasingly difficult to defend given a growing volume of empirical evidence to the contrary.

Traditional manual therapy (TMT) principles: origins and problems

Clinician-centred assessment.

TMT has long had an emphasis on what we shall refer to as clinician-centred assessments . Within this, we claim, is an assumption that clinical information is both highly accurate and diagnostically important, for example [ 32 ]. Clinician-centred assessments include, for example, routine imaging, the search for patho-anatomical 'lesions’ and asymmetries, and specialised palpation. Although the focus of this paper is on the ‘hands-on’ examples of client-centred assessment, the notion of imaging is presented below to expose some of the flaws in the underlying belief system for TMT.

The emphasis on clinician-centred assessments has probably been driven, in part, by a desire for objective diagnostic tests which align well with gold-standard imaging. Indeed, since the discovery of x-rays, radiological imaging been used as an assessment for spinal pain – and a justification for using spinal manipulation – particularly in the chiropractic profession [ 33 ]. Contrary to many TMT claims, X-ray imaging is not without risk [ 34 ]. Additionally, until relatively recently (with the advent of magnetic resonance imaging) it was not widely appreciated that patho-anatomical ‘lesions’ believed to explain MSK pain conditions were nearly as common in pain-free individuals as those with pain [ 35 ]. Accordingly, the rates of unnecessary treatments, including surgery, are known to increase when imaging is used routinely [ 36 ]. For patients with non-specific low back pain, for example, imaging does not improve outcomes and risks overdiagnosis and overtreatment [ 37 ]. Hence, despite being objective in nature, the value of imaging for many MSK pain conditions (particularly spinal pain) has reduced drastically with clinical guidelines across the globe recommending against routine imaging for MSK pain of non-traumatic origin [ 38 ]. Even so, the practice of routine imaging continues [ 39 ].

Hands-on interventions are inextricably related to hands-on assessment [ 40 ], and often associated with claims of ‘specialisation’ [ 41 ]. By this we mean where a great level of training and precision are claimed to be necessary for influencing the interpretation of assessment findings, treatment decisions, and/or treatment outcomes. Implicit within this claim is that therapists who are unable to achieve such precision are not able to perform MT to an acceptable level (and thereby are not able to provide benefit to patients).

There are numerous studies that cast doubt over claims of highly specialised palpation skills. Palpation of anatomical landmarks does not reach a clinically acceptable level of validity [ 42 ]. Specialised motion palpation does not appear to be a good method for differentiating people with or without low back pain [ 43 ]. Poor content validity of specialised motion tests have been reported, in line with a lack of acceptable reference standards [ 44 ]. Palpable sensations reported by therapists are unlikely to be due to tissue deformation [ 45 ]. Furthermore, the delivery of interventions based on specialised palpatory findings is no better than non-specialised palpation [ 46 ]. Generally poor reliability of motion palpation skills has been reported, for example [ 47 ] and appear to be independent of clinician experience or training, for example [ 48 ]. Notably, person-centred palpation—for pain and tenderness for example—has slightly higher reliability, but is still fair at best [ 49 ].

This does not mean that palpation is of no use at all though; just that effective manual therapy does not depend upon it. For example, expert therapists can display high levels of interrater reliability during specialised motion palpation [ 50 ]. Focused training can improve the interrater reliability of specialised skills [ 51 ]. However, the validity of the phenomenon remains poor. Given the weight of the evidence and consistency of data over recent decades, we suggest that the role of clinician-centred hands-on assessment is no longer central to contemporary manual therapy.

Patho-anatomical reasoning

The justification for selecting particular MT interventions has historically been based upon the patho-anatomical status of local peripheral tissue [ 52 , 53 , 54 , 55 ]. Patho-anatomical reasoning, we propose, is the framework that links clinician-centred assessments to the desire for highly specific delivery of MT interventionsKey to this is the relationship between a patho-anatomic diagnosis and the assumed mechanisms of action of the intervention employed.

Theories for the mechanisms of action of MT interventions are many. Some of the most prominent include reductions of disc herniations [ 56 ], re-positioning of a bone or joint [ 32 ], removal of intra-articular adhesions [ 57 ], changes in the biomechanical properties of soft tissues [ 58 ], central pain modulation [ 59 ], and biochemical changes [ 60 ]. These theories have been used to justify the choice of certain interventions: a matching of diagnosis (i.e., existence of a lesion) to the effect of treatment takes place. However, most of these mechanistic theories either lack evidence or have been directly contested [ 61 ].

The causal relationship between proposed tissue-based factors such as posture, ergonomic settings, etc. and painful experience has also been disputed [ 62 ]. Although local tissue stiffness has been observed in people with pain, this is typically associated with neuromuscular responses, rather than patho-anatomical changes at local tissue level [ 63 , 64 , 65 , 66 ]. Overall, although some local tissue adaptions have been identified in people with recurrent MSK pain, this is inconsistent and the evidence is currently of low quality [ 67 ] are generally limited to short-term follow-up measures [ 68 ].

Technique specificity

TMT techniques have been taught with an emphasis that a particular direction, ‘grade’ of joint movement, or deformation of tissue at a very specific location in a certain way, is required to achieve a successful treatment outcome.

One problem with a demand for technique specificity in manual therapy is that an intervention does not always result in the intended effect. For example, posteroanterior forces applied during spinal mobilization consistently induce sagittal rotation, as opposed to the assumed posteroanterior translation, for example [ 69 ]. Furthermore, irrespective of the MT intervention chosen, restricting movements to a particular spinal segment is difficult and a regional, non-specific motion is typically induced, for example [ 70 ].

To support technique specificity, comparative data must repeatedly and reproducibly show superiority of outcome from specific MT interventions over non-specific MT, which is consistently not observed [ 71 , 72 , 73 ]. Some studies have demonstrated localised effects of targeted interventions [ 74 ] but there appears to be no difference in outcome related to: the way in which techniques are delivered [ 75 ]; whether technique selection is random or clinician-selected [ 41 ]; or variations in the direction of force or targeted spinal level [ 76 ]. Conversely, there is evidence that non-specific technique application may improve outcomes [ 77 , 78 , 79 ]. Further, sham techniques produce comparable results to specialised approaches [ 11 ].

Passive movement and localised touch have been associated with significant analgesic responses [ 80 ]. These data indicate the presence of an analgesic mechanism. Unfortunately, mechanistic explanation for the therapeutic effects of MT upon pain and disability still remain largely in a ‘black box’ state [ 81 ]. Nevertheless, there are several plausible mechanisms of action to explain the analgesic action of MT interventions, including the activation of modulatory spinal and supraspinal responses [ 82 , 83 , 84 , 85 ]. In support of this, MT interventions have been associated with a variety of neurophysiological responses [ 61 ]. However, it must be acknowledged that these studies provide mechanistic evidence based on association, which is insufficient to make causal claims [ 86 ]. Importantly, none of these neurophysiological responses have been directly related to either the analgesic mechanisms or clinical outcome and may therefore be incidental.

There is evidence that MT does not provide analgesia in injured tissues [ 87 , 88 ]. Conversely, MT has been shown to decrease inflammatory biomarkers [ 89 , 90 , 91 , 92 , 93 ], although these changes have not been evaluated in the longer-term, nor associated with clinical outcomes.

A modern framework for manual therapy

We propose a new direction for the future of MT in which the teaching and practice of this core dimension of MSK care are no longer based on the traditional principles of clinician-centred assessment , patho-anatomical reasoning , and technique specificity .

In doing so, this framework places MT more explicitly as part of person-centred care and appeals to common principles of healthcare, best available evidence, and contemporary theory which avoids unnecessary and over-complicated explanations of observed effects. The framework is simple in terms of implementation and delivery and contextualised by common elements of best practice for healthcare, in line with regulated standard of practice, e.g., [ 94 , 95 , 96 , 97 ]. Our proposal simply illustrates the operationalisation of these common elements through manual therapy.

Too much emphasis has been given to clinician-centred assessments and this should be rebalanced with an increased use of patient-centred assessments, such as a thorough case history, the use of validated patient-reported outcome measures (PROMS), and real-time patient feedback during assessments.

The new framework considers fundamental and humanistic dimensions of touch-based therapies, such as non-specific neuromodulation, communication and sense-making, physical education, and contextual clinical effectiveness. This aligns to contemporary ideas regarding therapeutic alliance and a move towards genuinely holistic healthcare [ 98 , 99 ]. The framework needs to be “open” in order to represent and allow expression of the complexity of the therapeutic encounter. However, to prevent the exploitation of this openness the framework is underpinned by evidence, and any manual therapy approaches without plausible and measurable mechanisms are not supported.

To provide the best care, common healthcare elements such as the safety and comfort of the person seeking help and therapist must be considered, and care should be provided as efficiently as possible. Our framework embraces these dimensions and employs an integration of current evidence. It is transdisciplinary in nature and may be adopted by all MT professions. Figure  1 provides a graphical representation of the framework. It is acknowledged that all components overlap, relate, and influence each. There are two main components: the practical elements on the inside, comprised of safety, comfort, and efficiency, and the conceptual themes on the outer regions, consisting of communication, context, and person-centred care Fig. 2 .

figure 2

Representation of a modern teaching and practice framework for manual therapy. The image is purposefully designed to be simple, and has been developed primarily to be used as a teaching aid. When displayed in a learning environment, learners and clinicians can quickly refer to the image to check their practice against each element. To keep the image clear, each element of the image is described in detail in the text below”

Practical elements

Safety for people seeking help is a primary concern for all healthcare providers, with the aims to “ prevent and reduce risks, errors and harm that occur to patients [sic] during provision of health care… and to deliver quality essential health services ” [ 100 ]. This, and the notion of safety more generally (including that of the therapist), should be central to way MT is taught and practised.

A fundamentally safe context should be created where there is an absence of any obvious danger or risk of harm to physical or mental health. Consideration should be given to ensuring that communication and consent processes are orientated towards the safety of both the person seeking help and the therapist. The therapist should pay attention to any sense of threat that could be present in the physical, emotional, cognitive and environmental domains of the clinical encounter, and use skilful communication to mitigate anxiety about the assessment or therapeutic process.

Safety should also be considered in the clinical context of the assessment and treatment approach, ensuring that relevant and meaningful safety screenings have been undertaken [ 67 , 101 ]. There remains a need for good, skilful practice and development of manually applied techniques, but this can be achieved without reference to the principles of TMT and without the dogma of a proprietary therapeutic approach.

Comfort suggests that both the person seeking help and the therapist are physically and emotionally content during the assessment and therapeutic process. For example, the person seeking help is agreeable with any necessary state of dress (sociocultural difference should be considered); the person is relaxed and untroubled in whatever position they are in, and is adequately supported whether sitting, standing or recumbent during assessment and treatment; the therapist is comfortable with their positioning and posture; any discomfort produced by the therapeutic process is negotiated and agreed. Any physical mobilisation or touch should be applied with respect to the feedback from the person in relation to their comfort, rather than a pre-determined force based on the notion of resistance. This process requires clinical phronesis, sensitivity, responsivity, dexterity, and embodied communication [ 102 ].

The therapeutic process should be undertaken in a well-organised, competent manner aiming to achieve maximum therapeutic benefit with minimum waste of effort, time, or expense. To enhance the efficiency dimension, the assessment and therapeutic process should be an integral part of a holistic educational and/or activity-based approach to the management of the people which might also address psychological, nutritional, or ergonomic aspects of care, while being aware of social determinants to health. Recommendations exist which serve as a useful guide for enhancing care and promoting self-management in an efficient way [ 103 ].

A principle of this new model of MT is that therapists should not lose sight of the goals they develop with the people they help and ensure that there is coherence between their management aims and their techniques. Therapists should aim to support a person’s self-efficacy and use active approaches to empower them in their recovery. The overall number of therapeutic applications should be made in the context of fostering therapeutic alliance and supporting people to make sense of their situation and symptoms. This should be informed by contemporary views of the effects of manual therapy, emphasising a “physical education process” to promote sense-making and self-efficacy in alliance with the people they aim to help.

Clinical interactions need to be reproducible under a person’s own volition, serving to enhance self-empowerment. For example, someone could be taught how to “self-mobilise” if a positive effect is found with a particular therapeutic application. This should be appropriately scaffolded with behavioural change principles and functional contextualism that promote autonomy and self-management, rather than inappropriate reliance on the therapist [ 103 , 104 ].

An important and emergent notion from the proposed model is to question what constitutes indications for MT given that the model excludes traditional factors which would have informed whether manual therapy is indicated or not for a particular person. The response to this sits within the efficiency and safety dimensions: MT can be beneficial as part of a multi-dimensional approach to management across a broad population of people with musculoskeletal dysfunction, with no evidence to suggest any clinician-centered or patho-anatomical finding influences outcomes. The choice of whether or not to include MT as part of a management strategy should therefore be a product of a lack of contraindications and shared-decision making.

This framework aligns with evidence-based propositions that effectiveness and efficiency in assessment, diagnosis, and outcomes are not reliant on the therapist’s skill set of specialised elements of TMT, but rather other factors—for example variations in pain phenotypes [ 5 ].

Conceptual themes

Communication.

Communication is the overriding critical dimension to the whole therapeutic process and should be aimed at addressing peoples’ fundamental needs to make sense of their symptoms and path to recovery. The delivery and uptake of the therapy should therefore be operationalised in a communication process that meaningfully represents shared-decision making and the best possible attempt to contextualise the therapy in positive and evidence-informed explanations of the process and desired effects [ 105 ].

Within a therapeutic encounter, practitioners must give the time to listen to peoples’ accounts and explanations of their symptoms, including their ideas about their cause [ 106 ]. The assessment and diagnostic process should be a shared endeavour, for example, the negotiation of symptom reproduction. This should be done in a manner that facilitates sense-making, and which simultaneously encourages people to move on from unhelpful beliefs about their symptoms [ 107 , 108 ], encouraging understanding of the uncertain nature of pain and injury. Person-centered communication requires attention to what we communicate and how we communicate across the entire clinical interaction including interview, examination, and management planning [ 109 ]. Therapists need to be open, reflective, aware and responsive to verbal and non-verbal cues, and demonstrate a balance between engaging with people (e.g. eye-gaze) and writing/typing notes during the interview [ 110 , 111 , 112 ].

People should be given the opportunity to discuss their understanding of the diagnosis and options for treatment and rehabilitation. The decision-making process is dialogical, in which alternative options to the offered therapy should also be discussed with the comparative risks and benefits of all available management options, including doing nothing [ 113 , 114 ].

The therapist must fully appreciate the potential consequences of touch without consent. Continual dialogue should ensure that all parties are moving towards mutually agreed goals. The context of the therapy should be explicitly communicated to give appropriate context for any particular intervention as part of a holistic, evidence-based approach [ 115 , 116 , 117 ]. Therapists should be aware that their own beliefs can affect the way they communicate with their people; in the same way, a person’s context affects how they communicate what they expect from their treatment [ 107 , 118 , 119 , 120 ]. The construction of contextual healing scenarios which support positive outcomes, whilst minimising nocebic effects, is critical to effective healthcare [ 121 , 122 , 123 ].

There is a growing academic interest in the nature, role, and purpose of social and affective touch, and any re-framing of MT should consider touch as a means of communication to develop and enhance cooperative communications and strengthen the therapeutic relationship [ 124 , 125 , 126 , 127 , 128 , 129 ]. It can be soothing for a person in pain to experience the caring touch of a professional therapist [ 130 ]; on the other hand, probing, diagnostic, and touch can be experienced as alienating [ 131 , 132 , 133 ]. Touch can alter a person’s sense of body ownership and their ability to recognise and process their emotions by modulating interoceptive precision [ 129 , 134 , 135 ], and intentional touch may be perceived differently from casual, unfocussed touch [ 136 , 137 ]. There is also a thesis that touch generates shared understanding and meaning [ 138 , 139 , 140 ]. This wider appreciation of touch should be embedded in modern MT communication.

The contextual quality of a person’s experience of the therapeutic encounter can affect satisfaction and clinical outcomes [ 141 , 142 , 143 , 144 , 145 ]. The context in which therapeutic care takes place should therefore be developed to enhance this experience. There could be very local, practical aspects of the context, such as the type of passive information available in the clinical space, e.g. replacing biomedical and pathological imagery and objects with positive, active artefacts; judicious and thoughtful organisation and use of treatment tables to discourage a sense of passivity and disempowerment; allocating a comfortable space where communication can take place; colour schemes and light sources which facilitate positivity; ensuring consistency through all clinical and administrative staff promoting encouraging and non-nocebic messages. Importantly, the way the therapist dresses influences peoples’ perception of their healthcare experience [ 146 , 147 ], and that in turn should be contextually and culturally sensitive [ 148 , 149 , 150 ].

Beyond the local clinical space is the broader social environment. The undertaking of MT should serve a role in a person’s engagement with their social environment. For example, someone returning home after engaging with their therapist and disseminating positive health messages within their home and social networks; people acting as advocates for self-empowered healthcare. Furthermore, early data have demonstrated that aligning treatment with the beliefs and values of culturally and linguistically diverse communities enhances peoples’ engagement with their healthcare [ 151 ].

Person-centred care

Here we borrow directly from one of the most established and clinically useful definitions of Person-Centered Medicine [ 152 ]:

“(Person-Centered Medicine is) an affordable biomedical and technological advance to be delivered to patients [sic] within a humanistic framework of care that recognises the importance of applying science in a manner that respects the patients [sic] as a whole person and takes full account of [their] values, preferences, aspirations, stories, cultural context, fears, worries and hopes and thus that recognises and responds to [their] emotional, social and spiritual necessities in addition to [their] physical needs” [ 152 ] , p219.

Person-centred care incorporates a person’s perspective as part of the therapeutic process. In practice, therapists need to communicate in a manner that creates adequate conversational space to elicit a person’s agenda (i.e. understanding, impact of pain, concerns, needs, and goals), which guides clinical interactions. This approach encourages greater partnership in management [ 109 , 153 , 154 ].

A roadmap outlining key actions to implement person-centeredness in clinical practice has been outlined in detail elsewhere [ 155 ]. This includes screening for serious pathology, health co-morbidities and psychosocial factors; adopting effective communication; providing positive health education; coaching and supporting people towards active self-management; and facilitating and managing co-care (when needed) [ 154 ].

It is critical and necessary now to make these features explicit and central to the revised model of MT proposed in this paper. We wish to identify common ground across all MT professions in order to achieve a trans-disciplinary understanding of the evidence supporting the use of MT.

We acknowledge that our arguments here are rooted in empiricism and deliberately based on available research data from within the health science disciplines. We also acknowledge that there is a wider debate about future directions in person-centred care arising from the current evolution of the evidence-based health care movement, which has pointed to the need to learn more about peoples’ lived experiences, to redefine the model of the therapeutic relationship. Although beyond the scope of this paper, a full exploration of modern health care provision involves reconsideration of the ethics and legal requirements of communication and shared decision-making [ 156 , 157 , 158 , 159 ]. The authors envision this paper as a stimulus for self-reflection, stakeholder discussions, and ultimately change that can positively impact outcomes for people who seek manual therapy interventions.

Manual therapy has long been part of MSK healthcare and, given that is likely to continue. Current evidence suggests that effectiveness does not rely on the traditional principles historically developed in any of the major manual therapies. Therefore, the continued teaching and practice based on the principles of clinician-centred palpation , patho-anatomical reasoning , and technique specificity are no longer justified and may well even limit the value of MT.

A revised and reconceptualised framework of MT, based on the humanistic domains of safety, comfort and efficiency and underpinned by the dimensions of communication, context and person-centred care will ensure an empowering, biopsychosocial, evidence-informed approach to MSK care. We propose that the future teaching and practice of MT in physiotherapy, osteopathy, chiropractic, and all associated hands-on professions working within the healthcare field should be based on this new framework.

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School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK

Roger Kerry, Edward Lee & Vasileios Georgopoulos

Allied Health Research Unit, University of Central Lancashire, Preston, PR1 2HE, UK

Kenneth J. Young

Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

David W. Evans

Nottingham CityCare Partnership, Bennerley Rd, Nottingham, NG6 8WR, UK

School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2HA, UK

Vasileios Georgopoulos

Department of Orthopaedics, West Herts Hospitals Trust, Watford, WD18 0HB, UK

Adam Meakins

School of Physiotherapy, Manchester Metropolitan University, Manchester, M15 6GX, UK

Chris McCarthy

Department of Orthopaedics, Duke University, 200 Morris Street, Durham, NC, 27701, USA

School of Sport and Health Sciences, University of Brighton, Darley Rd, Eastbourne, BN20 7UR, UK

Colette Ridehalgh

Clinical Neuroscience, Trafford Building, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK

University College of Osteopathy, 275 Borough High St, London, SE1 1JE, UK

Steven Vogel & Amanda Banton

Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, S-90187, Umeå, Sweden

Cecilia Bergström

The School of Soft Tissue Therapy, Exmouth, Devon, EX8 1DQ, UK

Anna Maria Mazzieri

Department of health, LUNEX, Differdange, 4671, Luxembourg

Firas Mourad

Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, Differdange, 4671, Luxembourg

Department of Occupation and Health, School of Organization and Development, HAN University of Applied Sciences, Nijmegen, the Netherlands

Nathan Hutting

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Concept and research design: RK, KJY, DWE, EL, AM, VG. Data collection: All authors. Data analysis: All authors. Writing and editing of the manuscript: All authors.

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Correspondence to Kenneth J. Young .

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Kerry, R., Young, K.J., Evans, D.W. et al. A modern way to teach and practice manual therapy. Chiropr Man Therap 32 , 17 (2024). https://doi.org/10.1186/s12998-024-00537-0

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meaning of justification of the study in research

COMMENTS

  1. What is the justification of a research?

    Answer: Research is conducted to add something new, either knowledge or solutions, to a field. Therefore, when undertaking new research, it is important to know and state why the research is being conducted, in other words, justify the research. The justification of a research is also known as the rationale.

  2. How to Write Justification of the Study in Research

    The justification of the study is also referred to as the rationale for the study.It is what inspired you to research a given topic. As students, it is very important to know that research writing is not just one of the things we do for leisure, research is a vital part of human endeavour, it is through research done in the past that a lot of improvements are seen today around the world.

  3. How to Write the Rationale of the Study in Research (Examples)

    The rationale of the study is the justification for taking on a given study. It explains the reason the study was conducted or should be conducted. This means the study rationale should explain to the reader or examiner why the study is/was necessary. It is also sometimes called the "purpose" or "justification" of a study.

  4. Q: How to write the rationale or justification of a study?

    1 Answer to this question. The term used to imply why the study was needed in the first place is "rationale for research" or "rationale of a study." It is also sometimes referred to as the justification of the study. I have edited your question to reflect this. The rationale of a study is a very important part of the manuscript.

  5. (PDF) Study Justification in Social Research

    It is an explanation of. the potential values that research has to offer—to science, policy and the study population. Social research justification is not just about identifying the ...

  6. How to Justify Your Methods in a Thesis or Dissertation

    Two Final Tips: When you're writing your justification, write for your audience. Your purpose here is to provide more than a technical list of details and procedures. This section should focus more on the why and less on the how. Consider your methodology as you're conducting your research.

  7. Rationale for the Study

    Rationale for the study, also referred to as justification for the study, is reason why you have conducted your study in the first place. This part in your paper needs to explain uniqueness and importance of your research. Rationale for the study needs to be specific and ideally, it should relate to the following points: 1. The research needs ...

  8. Topic: Introduction and research justification

    The research justification should lead up to the topic of your research and frame your research, and, when you write your thesis, exegesis or journal article conclusion, you will again return to the research justification to wrap up the implications of your research. ... The aim of this research project is to … . This study is designed to ...

  9. The Qualitative Methodology: Scientific Justification

    The methodological positioning of a topic is known to have a significant influence on its further exploration and not least on the development of a theory (cf. Schachtner in Keupp, 1992, p. 278).However, the way in which a research field is explored is highly controversial and is often taken across the board as a touchstone for the plausibility of all results - even those that obviously ...

  10. PDF Sample Project Justification

    Justification Statement. The justification statement should include 2 to 3 paragraphs that convey the relevance of the over-arching topic in which the proposed research study is grounded. The purpose of this project is to examine the personal perceptions and safety concerns of workers in assumed low-risk. organizations.

  11. How to write the rationale for your research

    The rationale for one's research is the justification for undertaking a given study. It states the reason (s) why a researcher chooses to focus on the topic in question, including what the significance is and what gaps the research intends to fill. In short, it is an explanation that rationalises the need for the study.

  12. Justification of research using systematic reviews continues to be

    Due to the common aim across the six evidence syntheses, a broad overall search strategy was designed to identify meta-research studies that assessed whether researchers used earlier similar studies and/or systematic reviews of earlier similar studies to inform the justification and/or design of a new study, whether researchers used systematic ...

  13. Justification for Research

    Justification for Research What makes a good research question is often in the eye of the beholder, but there are several general best-practices criteria that can be used to assess the justification for research. Is the question scientifically well-posed, i.e. is it stated in a hypothetical form that leads to a research design and analysis with ...

  14. Significance of the Study

    Definition: Significance of the study in research refers to the potential importance, relevance, or impact of the research findings. It outlines how the research contributes to the existing body of knowledge, what gaps it fills, or what new understanding it brings to a particular field of study. In general, the significance of a study can be ...

  15. 7 Examples of Justification (of a project or research)

    The justification to the part of a research project that sets out the reasons that motivated the research. The justification is the section that explains the importance and the reasons that led the researcher to carry out the work. The justification explains to the reader why and why the chosen topic was investigated.

  16. Justification of research using systematic reviews continues to be

    Background Redundancy is an unethical, unscientific, and costly challenge in clinical health research. There is a high risk of redundancy when existing evidence is not used to justify the research question when a new study is initiated. Therefore, the aim of this study was to synthesize meta-research studies evaluating if and how authors of clinical health research studies use systematic ...

  17. Background of The Study

    Here are the steps to write the background of the study in a research paper: Identify the research problem: Start by identifying the research problem that your study aims to address. This can be a particular issue, a gap in the literature, or a need for further investigation. Conduct a literature review: Conduct a thorough literature review to ...

  18. The Difference Between Justification of The Study and Significance of

    Justification of the study and significance of the study are always very important in all research works. There is no research work that does not contain significance of the study or justification of the study. The positioning might differ depending on the requirement or the format demanded by the tertiary institution a student finds his/her ...

  19. Explaining research performance: investigating the importance of

    In this article, we study the motivation and performance of researchers. More specifically, we investigate what motivates researchers across different research fields and countries and how this motivation influences their research performance. The basis for our study is a large-N survey of economists, cardiologists, and physicists in Denmark, Norway, Sweden, the Netherlands, and the UK. The ...

  20. Q: How can I write about the justification of my research

    The justification is also known as the rationale and is written in the Introduction. You may thus refer to these resources for writing the justification of your research: How to write the rationale for research? Can you give an example of the "rationale of a study"? 4 Step approach to writing the Introduction section of a research paper.

  21. A modern way to teach and practice manual therapy

    Background Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles ...

  22. PDF AP Central

    AP Central

  23. PDF Work-in-Progress Draft Report of the IoT Advisory Board

    projected to reach $270.2 billion by 2033.6 Research published in the 2021 Microsoft IoT Signals found that 94% of business decision-makers, IT decision-makers and developers at U.S. enterprise organizations (1000+ employees) surveyed are IoT adopters7, meaning that they are either learning about IoT, conducting a trial or proof

  24. PDF University of Washington / Fred Hutch Center for AIDS Research (CFAR)

    community. Applicants proposing a study in the field of implementation science should request an expert consult regarding their study by completing the Core's online Request for Consultation form. Contact [email protected] (cc: [email protected]) for assistance completing the form as needed. MIIA applicants should also email [email protected] (cc:

  25. Can you tell me the difference among 'significance,' 'justification

    Hello Abdulkadir - Welcome to the forum! Although all three terms seek to explain why the study in question was undertaken and - at least to us - can be used interchangeably, we can distinguish some differences in the shades of their meaning. 'Significance' relates to the importance of the study; 'justification' (also called 'rationale') implies that some readers may not see its ...

  26. PDF Platform Technology Designation Program for Drug Development

    A sponsor with an approved NDA or BLA that incorporates or uses the platform technology can 331. submit a request for a platform technology designation concurrent with or at any time after the 332 submission of an IND application. 27. The timing of the request for designation should consider 333.

  27. What is justification in research work?

    You may find more information about the justification (also known as rationale) of a study in these resources: How to write the rationale for research? Can you give an example of the "rationale of a study"? Hope that helps. All the best for your research work! Answered by Irfan Syed on 31 Aug, 2020.

  28. Can you provide a sample of the justification of the research for my

    Answer: Firstly, your topic sounds both interesting and relevant. Now, the justification or the rationale explains why the research is needed - what gaps it aims to fill in existing literature, how it aims to add to the existing body of knowledge, or what solutions it aims to provide. In the research paper, it is meant to set the context for ...