Close with a crisp answer, practice points, limits, and a brief note on what to do next in care, policy, or research.
Why endings matter
Your closing paragraphs carry the last word a reader sees. Busy clinicians, editors, and students skim, then decide whether your review helps them act. A tight finish that answers the question and lays out next steps keeps trust high and saves time.
Match the close to accepted reporting practice. The PRISMA 2020 checklist asks authors to state limits, certainty, and how findings fit care or policy. The ICMJE recommendations also support a readable, balanced discussion that avoids claims beyond the data.
| Conclusion task | Why it matters | One line prompt |
|---|---|---|
| Answer the review question | Readers want the take-home, not a rerun of results | “Overall, evidence supports…” |
| State direction and size | Signals clinical meaning, not just statistics | “Benefits are small, consistent, and…” |
| Flag certainty | Helps readers judge confidence | “Certainty is high/moderate/low due to…” |
| Note limits and bias | Shows honest appraisal | “Findings are limited by…” |
| Give practice or policy takeaways | Bridges evidence and action | “Use when…, avoid when…” |
| Point to research gaps | Guides the next study | “Future trials should…” |
| Stay within scope | Prevents overreach | “Results do not support…” |
| End with a clean line | Improves recall | “The balance of evidence favors…” |
Ending a medical literature review: step-by-step finish
Return to the review question
Open the close by restating the exact question in plain words. Name the population, the exposure or intervention, the comparator when relevant, and the outcomes that matter to users of your review.
State what the body of evidence shows
Give a short synthesis rather than a list. Name the direction of effect and, when available, the size. Say when results are consistent across settings or subgroups. Avoid fresh numbers here; send readers to results if they need detail.
Add certainty and limits
Readers need to know how much trust to place in the signal. Mention study quality, risk of bias, imprecision, or inconsistency. The Cochrane Handbook advises care when moving from evidence to action and favors restraint when certainty is low.
Translate to practice or policy
Offer short, cautious advice framed as “when to use” and “when to avoid.” Anchor any action to the evidence strength you just stated. If advice could vary with values, costs, equity, or access, say so in plain terms.
Mark research gaps
Endings that name the next testable question help funders and teams plan work that matters. Be specific about design, outcomes, setting, and follow-up time.
Write a closing line that sticks
Finish with a single sentence that ties the answer, the limits, and the action into one thought. Short and direct beats ornate prose.
How to close a medical literature review without weak endings
What readers need
Readers want a short path from evidence to action. They scan for a firm answer, the strength behind it, and any guardrails. They also look for straight talk about gaps and bias.
What editors check
Editors look for alignment with reporting guidance and journal policy. PRISMA asks for clear statements on relevance and limits, while ICMJE favors accurate, transparent claims. Mention methods and results only as needed to support your final stance.
Model closing paragraphs by review type
Systematic review with meta-analysis
“Across randomized and observational studies in adults with type 2 diabetes, [intervention] produced a small improvement in HbA1c and some weight loss. Effects were consistent across outpatient clinics and primary care. Confidence is moderate due to short follow-up and some risk of bias in allocation and outcome assessment. Use may be reasonable for patients who value weight change and can access monitoring; avoid in those with recurrent hypoglycemia or cost pressure. Larger, longer trials that track patient-centered outcomes and adverse events would settle residual doubt.”
Narrative review
“Taken together, the literature suggests that [topic] has moved from early promise to cautious adoption in selected clinics. Evidence remains uneven, with small samples and varied measures. Readers should treat claims of broad benefit with care until multicenter studies with standard outcomes are available.”
Scoping review
“We mapped a diverse field with clear growth in the past five years. Most studies describe feasibility and acceptability; few report patient outcomes or cost. The map supports targeted trials in underserved groups and shared metrics that allow pooling.”
Rapid review
“Given time limits and single-reviewer screening, this assessment offers a timely signal rather than a full synthesis. Early studies suggest benefit in hospital throughput without clear harm. Leaders can pilot in low-risk units while planning a full review when more trials accrue.”
Umbrella review
“Across prior systematic reviews, high overlap exists and many base claims on the same small trials. Where meta-analyses agree, benefits are modest. Where they disagree, methods and inclusion rules differ. Readers should lean on the most current, higher-quality review until new primary trials resolve the split.”
Qualitative evidence synthesis
“Patients describe relief when care teams explain options in everyday language and invite questions. Barriers include time, jargon, and fear of judgment. Programs that train staff in plain talk and shared decisions align with these voices and merit trials that track experience and outcomes.”
| Aim | Use this line | Why it works |
|---|---|---|
| Answer the question | “On balance, the evidence favors…” | States the bottom line first |
| Signal certainty | “Confidence is high/moderate/low because…” | Sets expectations |
| Set limits | “Findings are shaped by small samples and short follow-up.” | Shows restraint |
| Guide practice | “Use in patients who…, avoid when…” | Maps action |
| Call for research | “Trials should test…, using standard outcomes.” | Points to the next step |
| Equity | “Evidence from low-resource settings is sparse; build studies with these sites.” | Prevents narrow claims |
| Safety | “Harms were rare but under-reported; watch for…” | Keeps patients safe |
| Cost | “Costs vary; add local budget impact to choices.” | Respects real-world limits |
| Patient voice | “Decisions should reflect what patients value most.” | Centers lived experience |
Common ending mistakes and fixes
Repeating the abstract
A closing section isn’t a second abstract. Swap lists for synthesis. Give readers the answer, the strength, the limits, and the next step.
Overstating thin evidence
Strong verbs with weak data erode trust. When certainty is low, say so and keep advice tentative. Label speculation and keep it short.
Hiding bias and gaps
Call out missing data, small samples, short follow-up, selective reporting, or poor measurement. State how each factor might tilt the findings.
Adding new outcomes
The end is not the place to debut results. If an outcome matters, it belongs in methods and results. Keep the finish focused on meaning and use.
Ignoring patients and context
If the signal changes with values, costs, access, or setting, say so. Readers make better choices when you surface these trade-offs.
Checklist to run before you submit
Clarity
Have you answered the review question in one clean sentence and backed it with a short synthesis?
Balance
Have you named both benefits and harms and stated certainty in plain words?
Honesty
Have you listed the main limits and any bias that could sway the message?
Action
Have you given practice or policy advice that matches the strength of evidence?
Next studies
Have you suggested one or two specific trials or designs that would change care if positive?
Mini template you can adapt
One-sentence answer: “Across [study types] in [population], [intervention or exposure] [raises/lowers/no clear change in] [outcome].”
One-paragraph synthesis: “Effects are [size] and [direction], with [consistency or variation] across subgroups or settings. Confidence is [high/moderate/low] due to [risk of bias, imprecision, inconsistency, or indirectness].”
Practice or policy: “Use when [criteria], avoid when [criteria]. Teams should watch for [harms] and revisit use as new data emerge.”
Next studies: “Randomized trials with [sample size], [follow-up], and standard outcomes in [setting] would answer the remaining questions.”
When your close answers the question, shows its strength, and points to action, readers finish with confidence and a plan.
Reporting guides cited: PRISMA 2020, Cochrane Handbook—Conclusions, and the ICMJE recommendations.