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How to read a scientific paper: a step-by-step guide

Scientific paper format

How to read a scientific paper in 3 steps, step 1: identify your motivations for reading a scientific paper, step 2: use selective reading to gain a high-level understanding of the scientific paper, step 3: read straight through to achieve a deep understanding of a scientific paper, frequently asked questions about reading a scientific paper efficiently, related articles.

A scientific paper is a complex document. Scientific papers are divided into multiple sections and frequently contain jargon and long sentences that make reading difficult. The process of reading a scientific paper to obtain information can often feel overwhelming for an early career researcher.

But the good news is that you can acquire the skill of efficiently reading a scientific paper, and you can learn how to painlessly obtain the information you need.

In this guide, we show you how to read a scientific paper step-by-step. You will learn:

• The scientific paper format
• How to identify your reasons for reading a scientific paper
• How to skim a paper
• How to achieve a deep understanding of a paper.

Using these steps for reading a scientific paper will help you:

• Obtain information efficiently
• Retain knowledge more effectively
• Allocate sufficient time to your reading task.

The steps below are the result of research into how scientists read scientific papers and our own experiences as scientists.

Firstly, how is a scientific paper structured?

The main sections are Abstract, Introduction, Methods, Results, and Discussion. In the table below, we describe the purpose of each component of a scientific paper.

Because the structured format of a scientific paper makes it easy to find the information you need, a common technique for reading a scientific paper is to cherry-pick sections and jump around the paper.

In a YouTube video, Dr. Amina Yonis shows this nonlinear practice for reading a scientific paper. She justifies her technique by stating that “By reading research papers like this, you are enabling yourself to have a disciplined approach, and it prevents yourself from drowning in the details before you even get a bird’s-eye view”.

Selective reading is a skill that can help you read faster and engage with the material presented. In his article on active vs. passive reading of scientific papers, cell biologist Tung-Tien Sun defines active reading as "reading with questions in mind" , searching for the answers, and focusing on the parts of the paper that answer your questions.

Therefore, reading a scientific paper from start to finish isn't always necessary to understand it. How you read the paper depends on what you need to learn. For example, oceanographer Ken Hughes suggests that you may read a scientific paper to gain awareness of a theory or field, or you may read to actively solve a problem in your research.

To successfully read a scientific paper, we advise using three strategies:

• Identify your motivations for reading a scientific paper
• Use selective reading to gain a high-level understanding of the scientific paper
• Read straight through to achieve a deep understanding of a scientific paper .

All 3 steps require you to think critically and have questions in mind.

Before you sit down to read a scientific paper, ask yourself these three questions:

• Why do I need to read this paper?
• What information am I looking for?
• Where in the paper am I most likely to find the information I need?

Is it background reading or a literature review for a research project you are currently working on? Are you getting into a new field of research? Do you wish to compare your results with the ones presented in the paper? Are you following an author’s work, and need to keep up-to-date on their current research? Are you keeping tabs on emerging methods in your field?

All of these intentions require a different reading approach.

For example, if you're delving into a new field of research, you'll want to read the introduction to gather background information and seminal references. The discussion section will also be important to understand the broader context of the findings.

If you aim to extend the work presented in a paper, and this study will be the starting point for your work, it's crucial to read the paper deeply.

If your focus is on the study design and techniques used by the authors, you'll spend most of your time reading and understanding the methods section.

Sometimes you'll need to read a paper to discuss it in your own research. This may be to compare or contrast your work with the paper's content, or to stimulate a discussion on future applications of your work.

If you are following an author’s work, a quick skim might suffice to understand how the paper fits into their overall research program.

Tip: Knowing why you want to read the paper facilitates how you will read the paper. Depending on your needs, your approach may take the form of a surface-level reading or a deep and thorough reading.

Knowing your motivations will guide your navigation through the paper because you have already identified which sections are most likely to contain the information you need. Approaching reading a paper in this way saves you time and makes the task less daunting.

➡️ Learn more about how to write a literature review

Begin by gaining an overview of the paper by following these simple steps:

• Read the title. What type of paper is it? Is it a journal article, a review, a methods paper, or a commentary?
• Read the abstract . The abstract is a summary of the study. What is the study about? What question was addressed? What methods were used? What did the authors find, and what are the key findings? What do the authors think are the implications of the work? Reading the abstract immediately tells you whether you should invest the time to read the paper fully.
• Look at the headings and subheadings, which describe the sections and subsections of the paper. The headings and subheadings outline the story of the paper.
• Skim the introduction. An introduction has a clear structure. The first paragraph is background information on the topic. If you are new to the field, you will read this closely, whereas an expert in that field will skim this section. The second component defines the gap in knowledge that the paper aims to address. What is unknown, and what research is needed? What problem needs to be solved? Here, you should find the questions that will be addressed by the study, and the goal of the research. The final paragraph summarizes how the authors address their research question, for example, what hypothesis will be tested, and what predictions the authors make. As you read, make a note of key references. By the end of the introduction, you should understand the goal of the research.
• Go to the results section, and study the figures and tables. These are the data—the meat of the study. Try to comprehend the data before reading the captions. After studying the data, read the captions. Do not expect to understand everything immediately. Remember, this is the result of many years of work. Make a note of what you do not understand. In your second reading, you will read more deeply.
• Skim the discussion. There are three components. The first part of the discussion summarizes what the authors have found, and what they think the implications of the work are. The second part discusses some (usually not all!) limitations of the study, and the final part is a concluding statement.
• Glance at the methods. Get a brief overview of the techniques used in the study. Depending on your reading goals, you may spend a lot of time on this section in subsequent readings, or a cursory reading may be sufficient.
• Summarize what the paper is about—its key take-home message—in a sentence or two. Ask yourself if you have got the information you need.
• List any terminology you may need to look up before reading the paper again.
• Scan the reference list. Make a note of papers you may need to read for background information before delving further into the paper.

Congratulations, you have completed the first reading! You now have gained a high-level perspective of the study, which will be enough for many research purposes.

Now that you have an overview of the work and you have identified what information you want to obtain, you are ready to understand the paper on a deeper level. Deep understanding is achieved in the second and subsequent readings with note-taking and active reflection. Here is a step-by-step guide.

• Active engagement with the material
• Critical thinking
• Creative thinking
• Synthesis of information
• Consolidation of information into memory.

Highlighting sentences helps you quickly scan the paper and be reminded of the key points, which is helpful when you return to the paper later.

Notes may include ideas, connections to other work, questions, comments, and references to follow up on.

There are many ways for taking notes on a paper. You can:

• Print out the paper, and write your notes in the margins.
• Annotate the paper PDF from your desktop computer, or mobile device .
• Use personal knowledge management software, like Notion , Obsidian, or Evernote, for note-taking. Notes are easy to find in a structured database and can be linked to each other.
• Use reference management tools to take notes. Having your notes stored with the scientific papers you’ve read has the benefit of keeping all your ideas in one place. Some reference managers, like Paperpile, allow you to add notes to your papers, and highlight key sentences on PDFs .

Note-taking facilitates critical thinking and helps you evaluate the evidence that the authors present. Ask yourself questions like:

• What new contribution has the study made to the literature?
• How have the authors interpreted the results? (Remember, the authors have thought about their results more deeply than anybody else.)
• What do I think the results mean?
• Are the findings well-supported?
• What factors might have affected the results, and have the authors addressed them?
• Are there alternative explanations for the results?
• What are the strengths and weaknesses of the study?
• What are the broader implications of the study?
• What should be done next?

Note-taking also encourages creative thinking . Ask yourself questions like:

• What new ideas have arisen from reading the paper?
• How does it connect with your work?
• What connections to other papers can you make?
• Write a summary of the paper in your own words. This is your attempt to integrate the new knowledge you have gained with what you already know from other sources and to consolidate that information into memory. You may find that you have to go back and re-read some sections to confirm some of the details.
• Discuss the paper with others. You may find that even at this stage, there are still aspects of the paper that you are striving to understand. It is now a good time to reach out to others—peers in your program, your advisor, or even on social media. In their 10 simple rules for reading a scientific paper , Maureen Carey and coauthors suggest that participating in journal clubs, where you meet with peers to discuss interesting or important scientific papers, is a great way to clarify your understanding.
• A scientific paper can be read over many days. According to research presented in the book " Make it Stick: The Science of Successful Learning " by writer Peter Brown and psychology professors Henry Roediger and Mark McDaniel, "spaced practice" is more effective for retaining information than focusing on a single skill or subject until it is mastered. This involves breaking up learning into separate periods of training or studying. Applying this research to reading a scientific paper suggests that spacing out your reading by breaking the work into separate reading sessions can help you better commit the information in a paper to memory.

A dense journal article may need many readings to be understood fully. It is useful to remember that many scientific papers result from years of hard work, and the expectation of achieving a thorough understanding in one sitting must be modified accordingly. But, the process of reading a scientific paper will get easier and faster with experience.

The best way to read a scientific paper depends on your needs. Before reading the paper, identify your motivations for reading a scientific paper, and pinpoint the information you need. This will help you decide between skimming the paper and reading the paper more thoroughly.

Don’t read the paper from beginning to end. Instead, be aware of the scientific paper format. Take note of the information you need before starting to read the paper. Then skim the paper, jumping to the appropriate sections in the paper, to get the information you require.

It varies. Skimming a scientific paper may take anywhere between 15 minutes to one hour. Reading a scientific paper to obtain a deep understanding may take anywhere between 1 and 6 hours. It is not uncommon to have to read a dense paper in chunks over numerous days.

First, read the introduction to understand the main thesis and findings of the paper. Pay attention to the last paragraph of the introduction, where you can find a high-level summary of the methods and results. Next, skim the paper by jumping to the results and discussion. Then carefully read the paper from start to finish, taking notes as you read. You will need more than one reading to fully understand a dense research paper.

To read a scientific paper critically, be an active reader. Take notes, highlight important sentences, and write down questions as you read. Study the data. Take care to evaluate the evidence presented in the paper.

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How to read and understand a scientific paper

How to read and understand a scientific paper: a guide for non-scientists, london school of economics and political science, jennifer raff.

From vaccinations to climate change, getting science wrong has very real consequences. But journal articles, a primary way science is communicated in academia, are a different format to newspaper articles or blogs and require a level of skill and undoubtedly a greater amount of patience. Here  Jennifer Raff   has prepared a helpful guide for non-scientists on how to read a scientific paper. These steps and tips will be useful to anyone interested in the presentation of scientific findings and raise important points for scientists to consider with their own writing practice.

My post,  The truth about vaccinations: Your physician knows more than the University of Google  sparked a very lively discussion, with comments from several people trying to persuade me (and the other readers) that  their  paper disproved everything that I’d been saying. While I encourage you to go read the comments and contribute your own, here I want to focus on the much larger issue that this debate raised: what constitutes scientific authority?

It’s not just a fun academic problem. Getting the science wrong has very real consequences. For example, when a community doesn’t vaccinate children because they’re afraid of “toxins” and think that prayer (or diet, exercise, and “clean living”) is enough to prevent infection, outbreaks happen.

“Be skeptical. But when you get proof, accept proof.” –Michael Specter

What constitutes enough proof? Obviously everyone has a different answer to that question. But to form a truly educated opinion on a scientific subject, you need to become familiar with current research in that field. And to do that, you have to read the “primary research literature” (often just called “the literature”). You might have tried to read scientific papers before and been frustrated by the dense, stilted writing and the unfamiliar jargon. I remember feeling this way!  Reading and understanding research papers is a skill which every single doctor and scientist has had to learn during graduate school.  You can learn it too, but like any skill it takes patience and practice.

I want to help people become more scientifically literate, so I wrote this guide for how a layperson can approach reading and understanding a scientific research paper. It’s appropriate for someone who has no background whatsoever in science or medicine, and based on the assumption that he or she is doing this for the purpose of getting a  basic  understanding of a paper and deciding whether or not it’s a reputable study.

The type of scientific paper I’m discussing here is referred to as a  primary research article . It’s a peer-reviewed report of new research on a specific question (or questions). Another useful type of publication is a  review article . Review articles are also peer-reviewed, and don’t present new information, but summarize multiple primary research articles, to give a sense of the consensus, debates, and unanswered questions within a field.  (I’m not going to say much more about them here, but be cautious about which review articles you read. Remember that they are only a snapshot of the research at the time they are published.  A review article on, say, genome-wide association studies from 2001 is not going to be very informative in 2013. So much research has been done in the intervening years that the field has changed considerably).

Before you begin: some general advice

Reading a scientific paper is a completely different process than reading an article about science in a blog or newspaper. Not only do you read the sections in a different order than they’re presented, but you also have to take notes, read it multiple times, and probably go look up other papers for some of the details. Reading a single paper may take you a very long time at first. Be patient with yourself. The process will go much faster as you gain experience.

Most primary research papers will be divided into the following sections: Abstract, Introduction, Methods, Results, and Conclusions/Interpretations/Discussion. The order will depend on which journal it’s published in. Some journals have additional files (called Supplementary Online Information) which contain important details of the research, but are published online instead of in the article itself (make sure you don’t skip these files).

Before you begin reading, take note of the authors and their institutional affiliations. Some institutions (e.g. University of Texas) are well-respected; others (e.g.  the Discovery Institute ) may appear to be legitimate research institutions but are actually agenda-driven.  Tip:  g oogle  “Discovery Institute” to see why you don’t want to use it as a scientific authority on evolutionary theory.

Also take note of the journal in which it’s published. Reputable (biomedical) journals will be indexed by  Pubmed . [EDIT: Several people have reminded me that non-biomedical journals won’t be on Pubmed, and they’re absolutely correct! (thanks for catching that, I apologize for being sloppy here). Check out  Web of Science  for a more complete index of science journals. And please feel free to share other resources in the comments!]  Beware of  questionable journals .

As you read, write down  every single word  that you don’t understand. You’re going to have to look them all up (yes, every one. I know it’s a total pain. But you won’t understand the paper if you don’t understand the vocabulary. Scientific words have extremely precise meanings).

Step-by-step instructions for reading a primary research article

1. Begin by reading the introduction, not the abstract.

The abstract is that dense first paragraph at the very beginning of a paper. In fact, that’s often the only part of a paper that many non-scientists read when they’re trying to build a scientific argument. (This is a terrible practice—don’t do it.).  When I’m choosing papers to read, I decide what’s relevant to my interests based on a combination of the title and abstract. But when I’ve got a collection of papers assembled for deep reading, I always read the abstract last. I do this because abstracts contain a succinct summary of the entire paper, and I’m concerned about inadvertently becoming biased by the authors’ interpretation of the results.

2. Identify the BIG QUESTION.

Not “What is this paper about”, but “What problem is this entire field trying to solve?”

This helps you focus on why this research is being done.  Look closely for evidence of agenda-motivated research.

3. Summarize the background in five sentences or less.

Here are some questions to guide you:

What work has been done before in this field to answer the BIG QUESTION? What are the limitations of that work? What, according to the authors, needs to be done next?

The five sentences part is a little arbitrary, but it forces you to be concise and really think about the context of this research. You need to be able to explain why this research has been done in order to understand it.

4.   Identify the SPECIFIC QUESTION(S)

What  exactly  are the authors trying to answer with their research? There may be multiple questions, or just one. Write them down.  If it’s the kind of research that tests one or more null hypotheses, identify it/them.

Not sure what a null hypothesis is? Go read this one  and try to identify the null hypotheses in it. Keep in mind that not every paper will test a null hypothesis.

5. Identify the approach

What are the authors going to do to answer the SPECIFIC QUESTION(S)?

6. Now read the methods section. Draw a diagram for each experiment, showing exactly what the authors did.

I mean  literally  draw it. Include as much detail as you need to fully understand the work.  As an example, here is what I drew to sort out the methods for a paper I read today ( Battaglia et al. 2013: “The first peopling of South America: New evidence from Y-chromosome haplogroup Q” ). This is much less detail than you’d probably need, because it’s a paper in my specialty and I use these methods all the time.  But if you were reading this, and didn’t happen to know what “process data with reduced-median method using Network” means, you’d need to look that up.

Image credit: author

You don’t need to understand the methods in enough detail to replicate the experiment—that’s something reviewers have to do—but you’re not ready to move on to the results until you can explain the basics of the methods to someone else.

7.   Read the results section. Write one or more paragraphs to summarize the results for each experiment, each figure, and each table. Don’t yet try to decide what the results  mean , just write down what they  are.

You’ll find that, particularly in good papers, the majority of the results are summarized in the figures and tables. Pay careful attention to them!  You may also need to go to the Supplementary Online Information file to find some of the results.

 It is at this point where difficulties can arise if statistical tests are employed in the paper and you don’t have enough of a background to understand them. I can’t teach you stats in this post, but  here , and here   are some basic resources to help you.  I STRONGLY advise you to become familiar with them.

Things to pay attention to in the results section:

• Any time the words “significant” or “non-significant” are used. These have precise statistical meanings. Read more about this  here .
• If there are graphs, do they have  error bars  on them? For certain types of studies, a lack of confidence intervals is a major red flag.
• The sample size. Has the study been conducted on 10, or 10,000 people? (For some research purposes, a sample size of 10 is sufficient, but for most studies larger is better).

8. Do the results answer the SPECIFIC QUESTION(S)? What do you think they mean?

Don’t move on until you have thought about this. It’s okay to change your mind in light of the authors’ interpretation—in fact you probably will if you’re still a beginner at this kind of analysis—but it’s a really good habit to start forming your own interpretations before you read those of others.

9. Read the conclusion/discussion/Interpretation section.

What do the authors think the results mean? Do you agree with them? Can you come up with any alternative way of interpreting them? Do the authors identify any weaknesses in their own study? Do you see any that the authors missed? (Don’t assume they’re infallible!) What do they propose to do as a next step? Do you agree with that?

10. Now, go back to the beginning and read the abstract.

Does it match what the authors said in the paper? Does it fit with your interpretation of the paper?

11. FINAL STEP:  (Don’t neglect doing this)  What do other researchers say about this paper?

Who are the (acknowledged or self-proclaimed) experts in this particular field? Do they have criticisms of the study that you haven’t thought of, or do they generally support it?

Here’s a place where I do recommend you use google! But do it last, so you are better prepared to think critically about what other people say.

(12. This step may be optional for you, depending on why you’re reading a particular paper. But for me, it’s critical! I go through the “Literature cited” section to see what other papers the authors cited. This allows me to better identify the important papers in a particular field, see if the authors cited my own papers (KIDDING!….mostly), and find sources of useful ideas or techniques.)

UPDATE: If you would like to see an example of how to read a science paper using this framework, you can find one  here .

I gratefully acknowledge Professors José Bonner and Bill Saxton for teaching me how to critically read and analyze scientific papers using this method. I’m honored to have the chance to pass along what they taught me.

I’ve written a shorter version of this guide for teachers to hand out to their classes. If you’d like a PDF, shoot me an email: jenniferraff (at) utexas (dot) edu. For further comments and additional questions on this guide, please see the Comments Section on  the original post .

This piece originally appeared on the  author’s personal blog  and is reposted with permission.

Featured image credit:  Scientists in a laboratory of the University of La Rioja  by  Urcomunicacion  (Wikimedia CC BY3.0)

Note: This article gives the views of the authors, and not the position of the LSE Impact blog, nor of the London School of Economics. Please review our  Comments Policy  if you have any concerns on posting a comment below.

Jennifer Raff (Indiana University—dual Ph.D. in genetics and bioanthropology) is an assistant professor in the Department of Anthropology, University of Kansas, director and Principal Investigator of the KU Laboratory of Human Population Genomics, and assistant director of KU’s Laboratory of Biological Anthropology. She is also a research affiliate with the University of Texas anthropological genetics laboratory. She is keenly interested in public outreach and scientific literacy, writing about topics in science and pseudoscience for her blog ( violentmetaphors.com ), the Huffington Post, and for the  Social Evolution Forum .

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The Reading Process

Cite this chapter.

• Kenneth S. Goodman 3  

Part of the book series: Encyclopedia of Language and Education ((LANG,volume 2))

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Scholars from many disciplines are involved in studying reading. These include, but are not limited to psychologists, linguists, literary critics, psycholinguists, sociolinguists, semioticians, anthropologists, ethnographers, neurolinguists, educational researchers, curriculum workers, and those who study reading development and the teaching of reading. Except for occasional collaborations, each field has tended to work on its own, using its own methodologies and asking questions significant within the discipline. Sometimes attempting to bring these diverse vantage points together is like trying to construct an elephant from the descriptions of the blind men of Hindustan of their personal encounters with different portions of the elephant.

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Goodman, K.S. (1997). The Reading Process. In: Edwards, V., Corson, D. (eds) Encyclopedia of Language and Education. Encyclopedia of Language and Education, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4540-4_1

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Reading a Scholarly Article or Research Paper

Identifying a research problem to investigate usually requires a preliminary search for and critical review of the literature in order to gain an understanding about how scholars have examined a topic. Scholars rarely structure research studies in a way that can be followed like a story; they are complex and detail-intensive and often written in a descriptive and conclusive narrative form. However, in the social and behavioral sciences, journal articles and stand-alone research reports are generally organized in a consistent format that makes it easier to compare and contrast studies and to interpret their contents.

General Reading Strategies

W hen you first read an article or research paper, focus on asking specific questions about each section. This strategy can help with overall comprehension and with understanding how the content relates [or does not relate] to the problem you want to investigate. As you review more and more studies, the process of understanding and critically evaluating the research will become easier because the content of what you review will begin to coalescence around common themes and patterns of analysis. Below are recommendations on how to read each section of a research paper effectively. Note that the sections to read are out of order from how you will find them organized in a journal article or research paper.

1.  Abstract

The abstract summarizes the background, methods, results, discussion, and conclusions of a scholarly article or research paper. Use the abstract to filter out sources that may have appeared useful when you began searching for information but, in reality, are not relevant. Questions to consider when reading the abstract are:

• Is this study related to my question or area of research?
• What is this study about and why is it being done ?
• What is the working hypothesis or underlying thesis?
• What is the primary finding of the study?
• Are there words or terminology that I can use to either narrow or broaden the parameters of my search for more information?

2.  Introduction

If, after reading the abstract, you believe the paper may be useful, focus on examining the research problem and identifying the questions the author is trying to address. This information is usually located within the first few paragraphs of the introduction or in the concluding paragraph. Look for information about how and in what way this relates to what you are investigating. In addition to the research problem, the introduction should provide the main argument and theoretical framework of the study and, in the last paragraphs of the introduction, describe what the author(s) intend to accomplish. Questions to consider when reading the introduction include:

• What is this study trying to prove or disprove?
• What is the author(s) trying to test or demonstrate?
• What do we already know about this topic and what gaps does this study try to fill or contribute a new understanding to the research problem?
• Why should I care about what is being investigated?
• Will this study tell me anything new related to the research problem I am investigating?

3.  Literature Review

The literature review describes and critically evaluates what is already known about a topic. Read the literature review to obtain a big picture perspective about how the topic has been studied and to begin the process of seeing where your potential study fits within the domain of prior research. Questions to consider when reading the literature review include:

• W hat other research has been conducted about this topic and what are the main themes that have emerged?
• What does prior research reveal about what is already known about the topic and what remains to be discovered?
• What have been the most important past findings about the research problem?
• How has prior research led the author(s) to conduct this particular study?
• Is there any prior research that is unique or groundbreaking?
• Are there any studies I could use as a model for designing and organizing my own study?

4.  Discussion/Conclusion

The discussion and conclusion are usually the last two sections of text in a scholarly article or research report. They reveal how the author(s) interpreted the findings of their research and presented recommendations or courses of action based on those findings. Often in the conclusion, the author(s) highlight recommendations for further research that can be used to develop your own study. Questions to consider when reading the discussion and conclusion sections include:

• What is the overall meaning of the study and why is this important? [i.e., how have the author(s) addressed the " So What? " question].
• What do you find to be the most important ways that the findings have been interpreted?
• What are the weaknesses in their argument?
• Do you believe conclusions about the significance of the study and its findings are valid?
• What limitations of the study do the author(s) describe and how might this help formulate my own research?
• Does the conclusion contain any recommendations for future research?

5.  Methods/Methodology

The methods section describes the materials, techniques, and procedures for gathering information used to examine the research problem. If what you have read so far closely supports your understanding of the topic, then move on to examining how the author(s) gathered information during the research process. Questions to consider when reading the methods section include:

• Did the study use qualitative [based on interviews, observations, content analysis], quantitative [based on statistical analysis], or a mixed-methods approach to examining the research problem?
• What was the type of information or data used?
• Could this method of analysis be repeated and can I adopt the same approach?
• Is enough information available to repeat the study or should new data be found to expand or improve understanding of the research problem?

6.  Results

After reading the above sections, you should have a clear understanding of the general findings of the study. Therefore, read the results section to identify how key findings were discussed in relation to the research problem. If any non-textual elements [e.g., graphs, charts, tables, etc.] are confusing, focus on the explanations about them in the text. Questions to consider when reading the results section include:

• W hat did the author(s) find and how did they find it?
• Does the author(s) highlight any findings as most significant?
• Are the results presented in a factual and unbiased way?
• Does the analysis of results in the discussion section agree with how the results are presented?
• Is all the data present and did the author(s) adequately address gaps?
• What conclusions do you formulate from this data and does it match with the author's conclusions?

7.  References

The references list the sources used by the author(s) to document what prior research and information was used when conducting the study. After reviewing the article or research paper, use the references to identify additional sources of information on the topic and to examine critically how these sources supported the overall research agenda. Questions to consider when reading the references include:

• Do the sources cited by the author(s) reflect a diversity of disciplinary viewpoints, i.e., are the sources all from a particular field of study or do the sources reflect multiple areas of study?
• Are there any unique or interesting sources that could be incorporated into my study?
• What other authors are respected in this field, i.e., who has multiple works cited or is cited most often by others?
• What other research should I review to clarify any remaining issues or that I need more information about?

NOTE :  A final strategy in reviewing research is to copy and paste the title of the source [journal article, book, research report] into Google Scholar . If it appears, look for a "cited by" followed by a hyperlinked number [e.g., Cited by 45]. This number indicates how many times the study has been subsequently cited in other, more recently published works. This strategy, known as citation tracking, can be an effective means of expanding your review of pertinent literature based on a study you have found useful and how scholars have cited it. The same strategies described above can be applied to reading articles you find in the list of cited by references.

Reading Tip

Specific Reading Strategies

Effectively reading scholarly research is an acquired skill that involves attention to detail and an ability to comprehend complex ideas, data, and theoretical concepts in a way that applies logically to the research problem you are investigating. Here are some specific reading strategies to consider.

As You are Reading

• Focus on information that is most relevant to the research problem; skim over the other parts.
• As noted above, read content out of order! This isn't a novel; you want to start with the spoiler to quickly assess the relevance of the study.
• Think critically about what you read and seek to build your own arguments; not everything may be entirely valid, examined effectively, or thoroughly investigated.
• Look up the definitions of unfamiliar words, concepts, or terminology. A good scholarly source is Credo Reference .

Taking notes as you read will save time when you go back to examine your sources. Here are some suggestions:

• Mark or highlight important text as you read [e.g., you can use the highlight text  feature in a PDF document]
• Take notes in the margins [e.g., Adobe Reader offers pop-up sticky notes].
• Highlight important quotations; consider using different colors to differentiate between quotes and other types of important text.
• Summarize key points about the study at the end of the paper. To save time, these can be in the form of a concise bulleted list of statements [e.g., intro has provides historical background; lit review has important sources; good conclusions].

Write down thoughts that come to mind that may help clarify your understanding of the research problem. Here are some examples of questions to ask yourself:

• Do I understand all of the terminology and key concepts?
• Do I understand the parts of this study most relevant to my topic?
• What specific problem does the research address and why is it important?
• Are there any issues or perspectives the author(s) did not consider?
• Do I have any reason to question the validity or reliability of this research?
• How do the findings relate to my research interests and to other works which I have read?

Adapted from text originally created by Holly Burt, Behavioral Sciences Librarian, USC Libraries, April 2018.

Another Reading Tip

When is it Important to Read the Entire Article or Research Paper

Laubepin argues, "Very few articles in a field are so important that every word needs to be read carefully." However, this implies that some studies are worth reading carefully. As painful and time-consuming as it may seem, there are valid reasons for reading a study in its entirety from beginning to end. Here are some examples:

• Studies Published Very Recently .  The author(s) of a recent, well written study will provide a survey of the most important or impactful prior research in the literature review section. This can establish an understanding of how scholars in the past addressed the research problem. In addition, the most recently published sources will highlight what is currently known and what gaps in understanding currently exist about a topic, usually in the form of the need for further research in the conclusion .
• Surveys of the Research Problem .  Some papers provide a comprehensive analytical overview of the research problem. Reading this type of study can help you understand underlying issues and discover why scholars have chosen to investigate the topic. This is particularly important if the study was published very recently because the author(s) should cite all or most of the key prior research on the topic. Note that, if it is a long-standing problem, there may be studies that specifically review the literature to identify gaps that remain. These studies often include the word review in their title [e.g., Hügel, Stephan, and Anna R. Davies. "Public Participation, Engagement, and Climate Change Adaptation: A Review of the Research Literature." Wiley Interdisciplinary Reviews: Climate Change 11 (July-August 2020): https://doi.org/10.1002/ wcc.645].
• Highly Cited .  If you keep coming across the same citation to a study while you are reviewing the literature, this implies it was foundational in establishing an understanding of the research problem or the study had a significant impact within the literature [positive or negative]. Carefully reading a highly cited source can help you understand how the topic emerged and motivated scholars to further investigate the problem. It also could be a study you need to cite as foundational in your own paper to demonstrate to the reader that you understand the roots of the problem.
• Historical Overview .  Knowing the historical background of a research problem may not be the focus of your analysis. Nevertheless, carefully reading a study that provides a thorough description and analysis of the history behind an event, issue, or phenomenon can add important context to understanding the topic and what aspect of the problem you may want to examine further.
• Innovative Methodological Design .  Some studies are significant and worth reading in their entirety because the author(s) designed a unique or innovative approach to researching the problem. This may justify reading the entire study because it can motivate you to think creatively about pursuing an alternative or non-traditional approach to examining your topic of interest. These types of studies are generally easy to identify because they are often cited in others works because of their unique approach to studying the research problem.
• Cross-disciplinary Approach .  R eviewing studies produced outside of your discipline is an essential component of investigating research problems in the social and behavioral sciences. Consider reading a study that was conducted by author(s) based in a different discipline [e.g., an anthropologist studying political cultures; a study of hiring practices in companies published in a sociology journal]. This approach can generate a new understanding or a unique perspective about the topic . If you are not sure how to search for studies published in a discipline outside of your major or of the course you are taking, contact a librarian for assistance.

Laubepin, Frederique. How to Read (and Understand) a Social Science Journal Article . Inter-University Consortium for Political and Social Research (ISPSR), 2013; Shon, Phillip Chong Ho. How to Read Journal Articles in the Social Sciences: A Very Practical Guide for Students . 2nd edition. Thousand Oaks, CA: Sage, 2015; Lockhart, Tara, and Mary Soliday. "The Critical Place of Reading in Writing Transfer (and Beyond): A Report of Student Experiences." Pedagogy 16 (2016): 23-37; Maguire, Moira, Ann Everitt Reynolds, and Brid Delahunt. "Reading to Be: The Role of Academic Reading in Emergent Academic and Professional Student Identities." Journal of University Teaching and Learning Practice 17 (2020): 5-12.

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Organizing Your Social Sciences Research Paper: Reading Research Effectively

• Purpose of Guide
• Writing a Research Proposal
• Design Flaws to Avoid
• Independent and Dependent Variables
• Narrowing a Topic Idea
• Broadening a Topic Idea
• The Research Problem/Question
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• The C.A.R.S. Model
• Background Information
• Theoretical Framework
• Citation Tracking
• Evaluating Sources
• Reading Research Effectively
• Primary Sources
• Secondary Sources
• What Is Scholarly vs. Popular?
• Is it Peer-Reviewed?
• Qualitative Methods
• Quantitative Methods
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism [linked guide]
• Annotated Bibliography
• Grading Someone Else's Paper

Reading a Scholarly Article or Research Paper

Reading Research Publications Effectively

It's easy to feel overwhelmed and frustrated when first reading a scholarly article or research paper. The text is dense and complex and often includes abstract or convoluted language . In addition, the terminology may be confusing or applied in a way that is unfamiliar. To help overcome these challenges w hen you first read an article or research paper, focus on asking specific questions about each section. This strategy can help with overall comprehension and understanding how the content relates [or does not relate] to the research problem you are investigating. This approach will also help identify key themes as you read additional studies on the same topic. As you review more and more studies about your topic, the process of understanding and critically evaluating the research will become easier because the content of what you review will begin to coalescence around common themes and patterns of analysis.

Think about the following in this general order:

1.  Read the Abstract

An abstract summarizes the basic content of a scholarly article or research paper. Questions to consider when reading the abstract are: What is this article about? What is the working hypothesis or thesis? Is this related to my question or area of research? The abstract can be used to help filter out sources that may have appeared useful when you began searching for information but, in reality, are not relevant.

2.  Identify the Research Problem and Underlying Questions? 

If, after reading the abstract, you believe the paper may be useful, focus on examining the research problem and identifying the questions the author is trying to address. Look for information that is relevant to your research problem and make note of how and in what way this information relates to what you are investigating.

3.  Read the Introduction and Discussion/Conclusion

The introduction provides the main argument and theoretical framework of the article. Questions to consider for the introduction include what do we already know about this topic and what is left to discover? What other research has been conducted about this topic? How is this research unique? Will this study tell me anything new related to the research problem I am investigating?

Questions to ask yourself while reading the discussion and conclusion sections include what does the study mean and why is it important? What are the weaknesses in their argument? Does the conclusion contain any recommendations for future research and do you believe conclusions about the significance of the study and its findings are valid?

4.  Read about the Methods/Methodology

If what you have read so far closely relates to your research problem, then move on to reading about how the author(s) gathered information for their research. Questions to consider include how did the author do the research? Was it a qualitative, quantitative, or mixed-methods project? What data is the study based on? Could I repeat their work and is all the information available to repeat the study?

5.  Read about the Results and Analysis

Next, read the outcome the research and how it was discussed and analyzed. If any non-textual elements [e.g., graphs, charts, tables, etc.] are confusing, focus on the explanations about them in the text. Questions to consider are what did the author find and how did they find it? Are the results presented in a factual and unbiased way? Does their analysis of results agree with the data presented? Is all the data present? What conclusions do you formulate from this data and does it match with the author's conclusions?

6.  Review the References

The list of references, or works cited, shows you the basis of prior research used by the author(s) to support their study. The references can be an effective way to identify additional sources of information on the topic. Questions to ask include what other research studies should I review? What other authors are respected in this field, i.e., who is cited most often by others? What other research should be explored to learn about issues I am unclear or need more information about?

Reading Tips

Preparing to Read a Scholarly Article or Research Paper for the First Time

Reading scholarly publications effectively is an acquired skill that involves attention to detail and the ability to comprehend complex ideas, data, and concepts in a way that applies logically to the research problem you are investigating. Here are some strategies to consider.

While You are Reading

• Focus on information in the publication that is most relevant to the research problem
• Think critically about what you read and seek to build your own arguments; not everything is 100% true or examined effectively
• Read out of order! This isn't a novel or movie; you want to start with the spoiler
• Look up the definitions of words you don't know as you read

There are any number of ways to take notes as you read, but use the method that you feel most comfortable with. Taking notes as you read will save time when you go back to examine your sources. Below are some suggestions:

• Print the article and highlight, circle, and/or underline text as you read [or, you can use the highlight text   feature in a PDF document]
• Take notes in the margins [Adobe Reader offers pop-up sticky notes]
• Focus on highlighting important quotes; consider using a different color to differentiate between quotes and other types of text you want to return to when writing
• Quickly summarize the main or key points at the end of the paper

As you read, write down questions that come to mind that relate to or may clarify your research problem. Here are a few questions that might be helpful:

• Have I taken time to understand all the terminology?
• Am I spending too much time on the less important parts of this article?
• Are there any issues that the authors did not consider?
• Do I have any reason to question the credibility of this research?
• What specific problem does the research address and why is it important?
• How do these results relate to my research interests or to other works which I have read?

Adapted from text originally created by Holly Burt, USC Libraries, April 2018. Thank you, Holly!

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Art of reading a journal article: Methodically and effectively

Rv subramanyam.

Department of Oral Pathology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram, Andhra Pradesh, India

Background:

Reading scientific literature is mandatory for researchers and clinicians. With an overflow of medical and dental journals, it is essential to develop a method to choose and read the right articles.

To outline a logical and orderly approach to reading a scientific manuscript. By breaking down the task into smaller, step-by-step components, one should be able to attain the skills to read a scientific article with ease.

The reader should begin by reading the title, abstract and conclusions first. If a decision is made to read the entire article, the key elements of the article can be perused in a systematic manner effectively and efficiently. A cogent and organized method is presented to read articles published in scientific journals.

Conclusion:

One can read and appreciate a scientific manuscript if a systematic approach is followed in a simple and logical manner.

INTRODUCTION

“ We are drowning in information but starved for knowledge .” John Naisbitt

It has become essential for the clinicians, researchers, and students to read articles from scientific journals. This is not only to keep abreast of progress in the speciality concerned but also to be aware of current trends in providing optimum healthcare to the patients. Reading scientific literature is a must for students interested in research, for choosing their topics and carrying out their experiments. Scientific literature in that field will help one understand what has already been discovered and what questions remain unanswered and thus help in designing one's research project. Sackett (1981)[ 1 ] and Durbin (2009)[ 2 ] suggested various reasons why most of us read journal articles and some of these are listed in Table 1 .

Common reasons for reading journal articles

The scientific literature is burgeoning at an exponential rate. Between 1978 and 1985, nearly 272,344 articles were published annually and listed in Medline. Between 1986 and 1993, this number reached 344,303 articles per year, and between 1994 and 2001, the figure has grown to 398,778 articles per year.[ 3 ] To be updated with current knowledge, a physician practicing general medicine has to read 17 articles a day, 365 days a year.[ 4 ]

In spite of the internet rapidly gaining a strong foothold as a quick source of obtaining information, reading journal articles, whether from print or electronic media, still remains the most common way of acquiring new information for most of us.[ 2 ] Newspaper reports or novels can be read in an insouciant manner, but reading research reports and scientific articles requires concentration and meticulous approach. At present, there are 1312 dentistry journals listed in Pubmed.[ 5 ] How can one choose an article, read it purposefully, effectively, and systematically? The aim of this article is to provide an answer to this question by presenting an efficient and methodical approach to a scientific manuscript. However, the reader is informed that this paper is mainly intended for the amateur reader unaccustomed to scientific literature and not for the professional interested in critical appraisal of journal articles.

TYPES OF JOURNAL ARTICLES

Different types of papers are published in medical and dental journals. One should be aware of each kind; especially, when one is looking for a specific type of an article. Table 2 gives different categories of papers published in journals.

Types of articles published in a journal

In general, scientific literature can be primary or secondary. Reports of original research form the “primary literature”, the “core” of scientific publications. These are the articles written to present findings on new scientific discoveries or describe earlier work to acknowledge it and place new findings in the proper perspective. “Secondary literature” includes review articles, books, editorials, practice guidelines, and other forms of publication in which original research information is reviewed.[ 6 ] An article published in a peer-reviewed journal is more valued than one which is not.

An original research article should consist of the following headings: Structured abstract, introduction, methods, results, and discussion (IMRAD) and may be Randomized Control Trial (RCT), Controlled Clinical Trial (CCT), Experiment, Survey, and Case-control or Cohort study. Reviews could be non-systematic (narrative) or systematic. A narrative review is a broad overview of a topic without any specific question, more or less an update, and qualitative summary. On the other hand, a systematic review typically addresses a specific question about a topic, details the methods by which papers were identified in the literature, uses predetermined criteria for selection of papers to be included in the review, and qualitatively evaluates them. A meta-analysis is a type of systematic review in which numeric results of several separate studies are statistically combined to determine the outcome of a specific research question.[ 7 – 9 ] Some are invited reviews, requested by the Editor, from an expert in a particular field of study.

A case study is a report of a single clinical case, whereas, a case series is a description of a number of such cases. Case reports and case series are description of disease (s) generally considered rare or report of heretofore unknown or unusual findings in a well-recognized condition, unique procedure, imaging technique, diagnostic test, or treatment method. Technical notes are description of new, innovative techniques, or modifications to existing procedures. A pictorial essay is a teaching article with images and legends but has limited text. Commentary is a short article on an author's personal opinion of a specific topic and could be controversial. An editorial, written by the editor of the journal or invited, can be perspective (about articles published in that particular issue) or persuasive (arguing a specific point of view). Other articles published in a journal include letters to the editor, book reviews, conference proceedings and abstracts, and abstracts from other journals.[ 10 ]

WHAT TO READ IN A JOURNAL? – CHOOSING THE RIGHT ARTICLE

Not all research articles published are excellent, and it is pragmatic to decide if the quality of the study warrants reading of the manuscript. The first step for a reader is to choose a right article for reading, depending on one's individual requirement. The next step is to read the selected article methodically and efficiently.[ 2 ] A simple decision-making flowchart is depicted in [ Figure 1 ], which helps one to decide the type of article to select. This flowchart is meant for one who has a specific intent of choosing a particular type of article and not for one who intends to browse through a journal.

Schematic flowchart of the first step in choosing an article to read

HOW TO START READING AN ARTICLE?

“ There is an art of reading, as well as an art of thinking, and an art of writing .” Clarence Day

At first glance, a journal article might appear intimidating for some or confusing for others with its tables and graphs. Reading a research article can be a frustrating experience, especially for the one who has not mastered the art of reading scientific literature. Just like there is a method to extract a tooth or prepare a cavity, one can also learn to read research articles by following a systematic approach. Most scientific articles are organized as follows:[ 2 , 11 ]

• Title: Topic and information about the authors.
• Abstract: Brief overview of the article.
• Introduction: Background information and statement of the research hypothesis.
• Methods: Details of how the study was conducted, procedures followed, instruments used and variables measured.
• Results: All the data of the study along with figures, tables and/or graphs.
• Discussion: The interpretation of the results and implications of the study.
• References/Bibliography: Citations of sources from where the information was obtained.

Review articles do not usually follow the above pattern, unless they are systematic reviews or meta-analysis. The cardinal rule is: Never start reading an article from the beginning to the end. It is better to begin by identifying the conclusions of the study by reading the title and the abstract.[ 12 ] If the article does not have an abstract, read the conclusions or the summary at the end of the article first. After reading the abstract or conclusions, if the reader deems it is interesting or useful, then the entire article can be read [ Figure 2 ].

Decision-making flowchart to decide whether to read the chosen article or not

Like the title of a movie which attracts a filmgoer, the title of the article is the one which attracts a reader in the first place. A good title will inform the potential reader a great deal about the study to decide whether to go ahead with the paper or dismiss it. Most readers prefer titles that are descriptive and self-explanatory without having to look at the entire article to know what it is all about.[ 2 ] For example, the paper entitled “Microwave processing – A blessing for pathologists” gives an idea about the article in general to the reader. But there is no indication in the title whether it is a review article on microwave processing or an original research. If the title had been “Comparison of Microwave with Conventional Tissue Processing on quality of histological sections”, even the insouciant reader would have a better understanding of the content of the paper.

Abstract helps us determine whether we should read the entire article or not. In fact, most journals provide abstract free of cost online allowing us to decide whether we need to purchase the entire article. Most scientific journals now have a structured abstract with separate subheadings like introduction (background or hypothesis), methods, results and conclusions making it easy for a reader to identify important parts of the study quickly.[ 13 ] Moreover, there is usually a restriction about the number of words that can be included in an abstract. This makes the abstract concise enough for one to read rapidly.

The abstract can be read in a systematic way by answering certain fundamental questions like what was the study about, why and how was the study conducted, the results and their inferences. The reader should make a note of any questions that were raised while reading the abstract and be sure that answers have been found after reading the entire article.[ 12 ]

Reading the entire article

Once the reader has decided to read the entire article, one can begin with the introduction.

The purpose of the introduction is to provide the rationale for conducting the study. This section usually starts with existing knowledge and previous research of the topic under consideration. Typically, this section concludes with identification of gaps in the literature and how these gaps stimulated the researcher to design a new study.[ 12 ] A good introduction should provide proper background for the study. The aims and objectives are usually mentioned at the end of the introduction. The reader should also determine whether a research hypothesis (study hypothesis) was stated and later check whether it was answered under the discussion.

MATERIALS AND METHODS

This section gives the technical details of how the experiments were carried out. In most of the research articles, all details are rarely included but there should be enough information to understand how the study was carried out.[ 12 ] Information about the number of subjects included in the study and their categorization, sampling methods, the inclusion criteria (who can be in) and exclusion criteria (who cannot be in) and the variables chosen can be derived by reading this section. The reader should get acquainted with the procedures and equipment used for data collection and find out whether they were appropriate.

RESULTS OF THE STUDY

In this section, the researchers give details about the data collected, either in the form of figures, tables and/or graphs. Ideally, interpretation of data should not be reported in this section, though statistical analyses are presented. The reader should meticulously go through this segment of the manuscript and find out whether the results were reliable (same results over time) and valid (measure what it is supposed to measure). An important aspect is to check if all the subjects present in the beginning of the study were accounted for at the end of the study. If the answer is no, the reader should check whether any explanation was provided.

Results that were statistically significant and results that were not, must be identified. One should also observe whether a correct statistical test was employed for analysis and was the level of significance appropriate for the study. To appreciate the choice of a statistical test, one requires an understanding of the hypothesis being tested.[ 14 , 15 ] Table 3 provides a list of commonly used statistical tests used in scientific publications. Description and interpretation of these tests is beyond the scope of this paper. It is wise to remember the following advice: It is not only important to know whether a difference or association is statistically significant but also appreciate whether it is large or substantial enough to be useful clinically.[ 16 ] In other words, what is statistically significant may not be clinically significant.

Basic statistics commonly used in scientific publications

This is the most important section of the article where the research questions are answered and the meaning of analysis and interpretation of the data are presented. Usually the study results are compared with other studies, explaining in what aspects they were different or similar. Ideally, no new data should be presented under discussion and no information from other sections should be repeated.[ 2 ] In addition, this section also discusses the various strengths and limitations/shortcomings of the study, providing suggestions about areas that need additional research.

The meaning of results and their analyses, new theories or hypotheses, limitations of the study, explanation of differences and similarities with other comparable studies, and suggestions for future research are offered in this section. It is important to remember that the discussions are the authors’ interpretations and opinions and not necessarily facts.

READING THE CONCLUSION (AGAIN !)

Though conclusion part had been read at the beginning, it is prudent to read it again at the end to confirm whether what we had inferred initially is correct. If the conclusion had not made sense earlier, it may make sense after having perused through the entire article. Sometimes, the study conclusions are included in the discussion section and may not be easy to locate. The questions that can be asked under various sub-headings of an original research paper are presented as a simple questionnaire in Table 4 . It is assumed that one who is using this questionnaire has read and analyzed the abstract and then decided to read the entire article. This questionnaire does not critically analyze a scientific article. However, answers to these questions provide a systematic approach to obtain a broad overview of the manuscript, especially to a novice. If one who is new to reading articles, writing answers to these questions and taking notes will help in understanding most aspects of a research article.

Questionnaire for original research articles

“ Let us read with method, and propose to ourselves an end to which our studies may point. The use of reading is to aid us in thinking .” Edward Gibbon

It has become mandatory to read scientific literature to be well-informed of ever-expanding information and/or for better diagnosis, prognosis and therapy. Since there is an abundance of journals and articles, it is critical to develop a modus operandi for achieving a rapid, purposeful, effective and useful method to read these manuscripts. A simple but efficient and logical approach to scientific literature has been presented here for choosing articles and reading them systematically and effectively for a better understanding.

Source of Support: Nil.

Conflict of Interest: None declared.

How to Read a Research Paper – A Guide to Setting Research Goals, Finding Papers to Read, and More

If you work in a scientific field, you should try to build a deep and unbiased understanding of that field. This not only educates you in the best possible way but also helps you envision the opportunities in your space.

A research paper is often the culmination of a wide range of deep and authentic practices surrounding a topic. When writing a research paper, the author thinks critically about the problem, performs rigorous research, evaluates their processes and sources, organizes their thoughts, and then writes. These genuinely-executed practices make for a good research paper.

If you’re struggling to build a habit of reading papers (like I am) on a regular basis, I’ve tried to break down the whole process. I've talked to researchers in the field, read a bunch of papers and blogs from distinguished researchers, and jotted down some techniques that you can follow.

Let’s start off by understanding what a research paper is and what it is NOT!

What is a Research Paper?

A research paper is a dense and detailed manuscript that compiles a thorough understanding of a problem or topic. It offers a proposed solution and further research along with the conditions under which it was deduced and carried out, the efficacy of the solution and the research performed, and potential loopholes in the study.

A research paper is written not only to provide an exceptional learning opportunity but also to pave the way for further advancements in the field. These papers help other scholars germinate the thought seed that can either lead to a new world of ideas or an innovative method of solving a longstanding problem.

What Research Papers are NOT

There is a common notion that a research paper is a well-informed summary of a problem or topic written by means of other sources.

But you shouldn't mistake it for a book or an opinionated account of an individual’s interpretation of a particular topic.

Why Should You Read Research Papers?

What I find fascinating about reading a good research paper is that you can draw on a profound study of a topic and engage with the community on a new perspective to understand what can be achieved in and around that topic.

I work at the intersection of instructional design and data science. Learning is part of my day-to-day responsibilities. If the source of my education is flawed or inefficient, I’d fail at my job in the long term. This applies to many other jobs in Science with a special focus on research.

There are three important reasons to read a research paper:

• Knowledge —  Understanding the problem from the eyes of someone who has probably spent years solving it and has taken care of all the edge cases that you might not think of at the beginning.
• Exploration —  Whether you have a pinpointed agenda or not, there is a very high chance that you will stumble upon an edge case or a shortcoming that is worth following up. With persistent efforts over a considerable amount of time, you can learn to use that knowledge to make a living.
• Research and review —  One of the main reasons for writing a research paper is to further the development in the field. Researchers read papers to review them for conferences or to do a literature survey of a new field. For example, Yann LeCun’ s paper on integrating domain constraints into backpropagation set the foundation of modern computer vision back in 1989. After decades of research and development work, we have come so far that we're now perfecting problems like object detection and optimizing autonomous vehicles.

Not only that, with the help of the internet, you can extrapolate all of these reasons or benefits onto multiple business models. It can be an innovative state-of-the-art product, an efficient service model, a content creator, or a dream job where you are solving problems that matter to you.

Goals for Reading a Research Paper — What Should You Read About?

The first thing to do is to figure out your motivation for reading the paper. There are two main scenarios that might lead you to read a paper:

• Scenario 1 —  You have a well-defined agenda/goal and you are deeply invested in a particular field. For example, you’re an NLP practitioner and you want to learn how GPT-4 has given us a breakthrough in NLP. This is always a nice scenario to be in as it offers clarity.
• Scenario 2 —  You want to keep abreast of the developments in a host of areas, say how a new deep learning architecture has helped us solve a 50-year old biological problem of understanding protein structures. This is often the case for beginners or for people who consume their daily dose of news from research papers (yes, they exist!).

If you’re an inquisitive beginner with no starting point in mind, start with scenario 2. Shortlist a few topics you want to read about until you find an area that you find intriguing. This will eventually lead you to scenario 1.

ML Reproducibility Challenge

In addition to these generic goals, if you need an end goal for your habit-building exercise of reading research papers, you should check out the ML reproducibility challenge.

You’ll find top-class papers from world-class conferences that are worth diving deep into and reproducing the results.

They conduct this challenge twice a year and they have one coming up in Spring 2021. You should study the past three versions of the challenge, and I’ll write a detailed post on what to expect, how to prepare, and so on.

Now you must be wondering – how can you find the right paper to read?

How to Find the Right Paper to Read

In order to get some ideas around this, I reached out to my friend, Anurag Ghosh who is a researcher at Microsoft. Anurag has been working at the crossover of computer vision, machine learning, and systems engineering.

Here are a few of his tips for getting started:

• Always pick an area you're interested in.
• Read a few good books or detailed blog posts on that topic and start diving deep by reading the papers referenced in those resources.
• Look for seminal papers around that topic. These are papers that report a major breakthrough in the field and offer a new method perspective with a huge potential for subsequent research in that field. Check out papers from the morning paper or C VF - test of time award/Helmholtz prize (if you're interested in computer vision).
• Check out books like Computer Vision: Algorithms and Applications by Richard Szeliski and look for the papers referenced there.
• Have and build a sense of community. Find people who share similar interests, and join groups/subreddits/discord channels where such activities are promoted.

In addition to these invaluable tips, there are a number of web applications that I’ve shortlisted that help me narrow my search for the right papers to read:

• r/MachineLearning  — there are many researchers, practitioners, and engineers who share their work along with the papers they've found useful in achieving those results.

• Arxiv Sanity Preserver  — built by Andrej Karpathy to accelerate research. It is a repository of 142,846 papers from computer science, machine learning, systems, AI, Stats, CV, and so on. It also offers a bunch of filters, powerful search functionality, and a discussion forum to make for a super useful research platform.

• Google Research  — the research teams at Google are working on problems that have an impact on our everyday lives. They share their publications for individuals and teams to learn from, contribute to, and expedite research. They also have a Google AI blog that you can check out.

How to Read a Research Paper

After you have stocked your to-read list, then comes the process of reading these papers. Remember that NOT every paper is useful to read and we need a mechanism that can help us quickly screen papers that are worth reading.

To tackle this challenge, you can use this Three-Pass Approach by S. Keshav . This approach proposes that you read the paper in three passes instead of starting from the beginning and diving in deep until the end.

The three pass approach

• The first pass —  is a quick scan to capture a high-level view of the paper. Read the title, abstract, and introduction carefully followed by the headings of the sections and subsections and lastly the conclusion. It should take you no more than 5–10 mins to figure out if you want to move to the second pass.
• The second pass —  is a more focused read without checking for the technical proofs. You take down all the crucial notes, underline the key points in the margins. Carefully study the figures, diagrams, and illustrations. Review the graphs, mark relevant unread references for further reading. This helps you understand the background of the paper.
• The third pass —  reaching this pass denotes that you’ve found a paper that you want to deeply understand or review. The key to the third pass is to reproduce the results of the paper. Check it for all the assumptions and jot down all the variations in your re-implementation and the original results. Make a note of all the ideas for future analysis. It should take 5–6 hours for beginners and 1–2 hours for experienced readers.

Tools and Software to Keep Track of Your Pipeline of Papers

If you’re sincere about reading research papers, your list of papers will soon grow into an overwhelming stack that is hard to keep track of. Fortunately, we have software that can help us set up a mechanism to manage our research.

Here are a bunch of them that you can use:

• Mendeley [not free]  — you can add papers directly to your library from your browser, import documents, generate references and citations, collaborate with fellow researchers, and access your library from anywhere. This is mostly used by experienced researchers.

• Zotero [free & open source] —  Along the same lines as Mendeley but free of cost. You can make use of all the features but with limited storage space.

• Notion —  this is great if you are just starting out and want to use something lightweight with the option to organize your papers, jot down notes, and manage everything in one workspace. It might not stand anywhere in comparison with the above tools but I personally feel comfortable using Notion and I have created this board to keep track of my progress for now that you can duplicate:

⚠️ Symptoms of Reading a Research Paper

Reading a research paper can turn out to be frustrating, challenging, and time-consuming especially when you’re a beginner. You might face the following common symptoms:

• You might start feeling dumb for not understanding a thing a paper says.
• Finding yourself pushing too hard to understand the math behind those proofs.
• Beating your head against the wall to wrap it around the number of acronyms used in the paper. Just kidding, you’ll have to look up those acronyms every now and then.
• Being stuck on one paragraph for more than an hour.

Here’s a complete list of emotions that you might undergo as explained by Adam Ruben in this article .

Key Takeaways

We should be all set to dive right in. Here’s a quick summary of what we have covered here:

• A research paper is an in-depth study that offers an detailed explanation of a topic or problem along with the research process, proofs, explained results, and ideas for future work.
• Read research papers to develop a deep understanding of a topic/problem. Then you can either review papers as part of being a researcher, explore the domain and the kind of problems to build a solution or startup around it, or you can simply read them to keep abreast of the developments in your domain of interest.
• If you’re a beginner, start with exploration to soon find your path to goal-oriented research.
• In order to find good papers to read, you can use websites like arxiv-sanity, google research, and subreddits like r/MachineLearning.
• Reading approach — Use the 3-pass method to find a paper.
• Keep track of your research, notes, developments by using tools like Zotero/Notion.
• This can get overwhelming in no time. Make sure you start off easy and increment your load progressively.

Remember: Art is not a single method or step done over a weekend but a process of accomplishing remarkable results over time.

You can also watch the video on this topic on my YouTube channel :

Feel free to respond to this blog or comment on the video if you have some tips, questions, or thoughts!

If this tutorial was helpful, you should check out my data science and machine learning courses on Wiplane Academy . They are comprehensive yet compact and helps you build a solid foundation of work to showcase.

Web and Data Science Consultant | Instructional Design

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On reading research papers

We’ll be reading a lot of research papers in this course, so over the semester you will naturally develop your own way to read a research paper. Use these guides to get started.

First, some basic points; then, concrete reading guides.

A research paper encapsulates enormous effort

A good research paper distills significant work by its authors. My group has worked for years on tens of thousands of lines of code and huge numbers of experiments, most of which got thrown away, to produce a single 12-page paper. A paper’s authors are trying to boil down everything they learned into something you can digest. A single sentence may represent a full year of misdirected effort.

Of course, there are many kinds of effort, and a great research paper may represent a flash of insight rather than toil. That insight still required real work, namely everything the researcher did to prepare themselves to receive it.

A research paper encapsulates a moment in history

Any research paper is a picture of its time. The paper was written in a context shaped by technology and society. What hardware was available? What kinds of research were exciting to the community at the time? What kinds of research were being funded? An open reading can teach you a lot about what people were thinking in the months and years before publication.

A research paper deserves critical attention

As of 2019, more than 7 million scientific papers are published per year . They are not all equally good; some are outright fraudulent. We will try to avoid the really bad ones, but you will still find that all research papers have weaknesses, and for some papers the weaknesses may overwhelm the strengths. Some papers fail on their own terms when read carefully; some will fail to interest you because of your own cast of mind. Nevertheless, you can and should learn something from each paper.

You owe a research paper nothing

When you read a paper, your goal is extractive : What can this paper teach you , now ? A paper is not a precious artwork demanding a respectful, hushed approach. Skim it, skip around in it, disagree with it, rip it apart—whatever it takes to learn what you can—and when you’ve learned what you can, drop it. Despite the effort and history that formed the paper, you owe the paper nothing.

I read best when I read with curiosity, openness, and skepticism. The skepticism keeps me curious: What’s really going on in these experiments? The openness keeps me interested: even if I’m not interested in the topic, maybe there’s some trick I could learn from; and maybe the paper will show me why I should care about the topic after all.

Concrete reading guides

These guides have concrete advice on the reading process. Keshav’s is especially well known in the systems community.

• S. Keshav’s “How to Read a Paper”
• Michael Mitzenmacher’s “How to Read a Research Paper”
• Jennifer Raff’s “How to Read and Understand a Scientific Article”

These guides are great. They also contradict. (Keshav says to read the abstract first; Raff says to never read the abstract until the end.) There’s no one right way to read a paper. The literatures in different sciences have different qualities (for example, unfortunately for you, computer systems papers tend to be verbose), and our minds are different. We also read for different goals. Reading a paper in order to review it requires more antagonism than reading a long-published, well-cited work. And particularly at the beginning of this course, when we are reading multiple historical papers per course meeting rather than one current paper, I expect you to spend less than “three to four hours” per paper!

Public reading groups

You may be interested in these public examples of reading research papers.

• Adrian Colyer’s “The Morning Paper” blog (on hiatus, but great archives)
• Papers We Love

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The science behind reading faster: Researchers unlock key brain process

COLOGNE, Germany — Learning a new language is no easy feat, especially when it comes to reading. Even if you’ve mastered the basics of grammar and vocabulary, the process of visually recognizing and understanding words can still feel slow and cumbersome. But what if there was a way to train your brain to read more efficiently in your new language? A recent study by researchers Benjamin Gagl and Klara Gregorová suggests that a computer model of how the brain processes words could hold the key.

To understand their approach, let’s start with a quick crash course on how reading works in the brain. When your eyes land on a word , the visual information is sent to a specific area in the back of your brain called the left ventral occipito-temporal cortex , or lvOT for short. This region is sometimes referred to as the “visual word form area” because it seems to specialize in recognizing and categorizing words.

The lvOT essentially acts as a gatekeeper, quickly determining if a string of letters is a real word that’s worth sending along for further processing or a nonsense jumble that can be ignored. This “lexical categorization” process is thought to be a crucial early step in efficient reading.

Here’s where Gagl and Gregorová’s work, published in the journal npj: Science of Learning , comes into play. They developed a computational model called the Lexical Categorization Model (LCM) that simulates how the lvOT makes these word/nonword decisions. The model assumes that the lvOT gauges the “word-likeness” of a letter string based on its similarity to all the words a reader knows .

Real words and totally unfamiliar jumbles are easy for the lvOT to categorize. But letter strings that fall in the fuzzy middle ground are trickier. Think of a word you’ve never seen before, but that follows the general spelling patterns of your language. The LCM captures this, showing higher uncertainty for these “hard-to-categorize” items.

The researchers reasoned that if the LCM accurately reflects how lexical categorization works in the brain, then training people to get better at this process should lead to more efficient reading. To test this, they recruited 76 German language learners and had them practice speedy word/nonword decisions using a task based on the LCM.

The results were promising: after just three 45 to 60-minute training sessions, the majority of participants showed significant improvements in their overall reading speed as measured by a standardized test. The benefits seemed to be directly related to lexical categorization, too. Those who showed the biggest reductions in uncertainty for hard-to-categorize items on the training task also tended to have the largest reading speed boosts.

The researchers didn’t stop there. They wanted to see if they could predict who would benefit most from the lexical categorization training. So they fed a machine learning algorithm a wide range of data from each participant’s initial performance – things like their baseline reading speed, their accuracy and reaction times on different types of words in the training task, and the “word-likeness” values for each item from the LCM.

The algorithm successfully predicted participants’ ultimate reading speed improvements with about 50 percent accuracy. Intriguingly, the most important predictors weren’t just things like starting reading level — they also included key parameters from the LCM, like the degree of lexical categorization uncertainty a reader showed for different items. This suggests that the model is truly capturing something meaningful about how individual brains process words .

The researchers see this as a proof-of-concept for using cognitive models to design and optimize literacy training. If you can build an accurate model of a mental process, you can target that process with training, then use the model to predict who will respond best. The LCM-based training could be a boon for language learners , who often struggle with slow, effortful reading even when they’ve mastered other aspects of their new tongue.

But the implications could extend even further. The researchers note that many types of reading difficulties, from developmental dyslexia to the challenges faced by adults learning to read for the first time, are associated with reduced lvOT activation during word recognition. Tailoring lexical categorization training to these populations could potentially be a game-changer.

Of course, there’s still work to be done to refine and validate the approach. The current study relied on fancy cross-validation techniques to avoid overfitting the prediction model to the data, but testing it on a totally independent sample will be an important next step. And integrating lexical categorization training with other evidence-based approaches, like phonics instruction, could make it even more effective.

Still, this research represents an exciting melding of computational modeling, neuroimaging insights, and educational application. It’s a reminder that the better we understand the brain bases of complex skills like reading, the more powerfully we can intervene when those skills are lagging. So the next time you’re struggling through a page of text in an unfamiliar language, take heart — a little bit of LCM-inspired practice might be just what your visual word form area needs.

StudyFinds Editor-in-Chief Steve Fink contributed to this report.

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The Code of Ethics aims to guide the NeurIPS community towards higher standards of ethical conduct as it pertains to elements of research ethics and the broader societal and environmental impact of research submitted to NeurIPS. It outlines conference expectations about the ethical practices that must be adopted by the submitting authors, members of the program and organizing committees. The Code of Ethics complements the NeurIPS Code of Conduct , which focuses on professional conduct and research integrity issues, including plagiarism, fraud and reproducibility concerns. The points described below also inform the NeurIPS Submission Checklist, which outlines more concrete communication requirements. 

Potential Harms Caused by the Research Process 

Research involving human subjects or participants:

• Fair Wages: all human research subjects or participants must receive appropriate compensation. If you make use of crowdsourcing or contract work for a particular task as part of your research project,  you must respect the minimum hourly rate in the region where the work is carried out.
• Research involving human participants: if the research presented involves direct interactions between the researchers and human participants or between a technical system and human participants, authors are required to follow existing protocols in their institutions (e.g. human subject research accreditation, IRB) and go through the relevant process. In cases when no formal process exists, they can undergo an equivalent informal process (e.g. via their peers or an internal ethics review).

Data-related concerns:

The points listed below apply to all datasets used for submissions, both for publicly available data and internal datasets.

• Privacy: Datasets should minimize the exposure of any personally identifiable information, unless informed consent from those individuals is provided to do so. 
• Consent: Any paper that chooses to create a dataset with real data of real people should ask for the explicit consent of participants, or explain why they were unable to do so.
• Deprecated datasets: Authors should take care to confirm with dataset creators that a dataset is still available for use. Datasets taken down by the original author (ie. deemed obsolete, or otherwise discontinued), should no longer be used, unless it is for the purposes of audit or critical assessment. For some indication of known depreciated datasets, please refer to the NeurIPS list of deprecated datasets.
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Authors should transparently communicate the known or anticipated consequences of research: for instance via the paper checklist or a separate section in a submission.

The following specific areas are of particular concern:

• Safety: Contributors should consider whether there are foreseeable situations in which their technology can be used to harm, injure or kill people through its direct application, side effects, or potential misuse. We do not accept research whose primary goal is to increase the lethality of weapons systems.
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• Discrimination: Researchers should consider whether the technology they developed can be used to discriminate, exclude, or otherwise negatively impact people, including impacts on the provision of services such as healthcare, education or access to credit.  
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We propose some reflection and actions taken to mitigate potential harmful consequences from the research project. 

• Data and model documentation: Researchers should communicate the details of the dataset or the model as part of their submissions via structured templates.
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Violations to the Code of Ethics should be reported to [email protected] . NeurIPS reserves the right to reject the presentation of scientific works that violate the Code of Ethics. Notice that conference contributors are also obliged to adhere to additional ethical codes or review requirements arising from other stakeholders such as funders and research institutions.

Further reading

UNDERSTANDING LICENSES

• Towards Standardization of Data Licenses: The Montreal Data License
• Behavioral Use Licensing for Responsible AI  
• Choose an open source license  

MODEL AND DATA DOCUMENTATION TEMPLATES

• Model Cards for Model Reporting
• Datasheets for Datasets
• Using AI Factsheets for AI Governance
• ML Lifecycle Documentation Practices

SOCIETAL IMPACT

• Safety: Key Concepts in AI Safety: An Overview
• Security: SoK: Security and Privacy in Machine Learning
• Discrimination:  Bias in algorithms – Artificial intelligence and discrimination ; What about fairness, bias and discrimination?
• Surveillance: The Human Right to Privacy in the Digital Age
• Deception & Harassment: Generative Language Models and Automated Influence Operations: Emerging Threats and Potential Mitigations  
• Environment: Quantifying the Carbon Emissions of Machine Learning  
• Human Rights: Technology and Rights | Human Rights Watch  
• Bias and fairness:  Fairness and machine learning  
• Dual use problem:  Dual use of artificial-intelligence-powered drug discovery 
• Data Enrichment: Responsible Sourcing for Data Enrichment
• Synthetic Media: PAI’s Responsible Practices for Synthetic Media

RELATED ENDEAVORS

• ACM Code of Ethics  
• ACL Ethics FAQ
• ICLR Code of Ethics
• Responsible Conduct of Research Training  

RELATED RESEARCH COMMUNITIES

• IEEE SaTML 2023
• Aies Conference
• FORC 2022  

Cultural Relativity and Acceptance of Embryonic Stem Cell Research

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Main Article Content

There is a debate about the ethical implications of using human embryos in stem cell research, which can be influenced by cultural, moral, and social values. This paper argues for an adaptable framework to accommodate diverse cultural and religious perspectives. By using an adaptive ethics model, research protections can reflect various populations and foster growth in stem cell research possibilities.

INTRODUCTION

Stem cell research combines biology, medicine, and technology, promising to alter health care and the understanding of human development. Yet, ethical contention exists because of individuals’ perceptions of using human embryos based on their various cultural, moral, and social values. While these disagreements concerning policy, use, and general acceptance have prompted the development of an international ethics policy, such a uniform approach can overlook the nuanced ethical landscapes between cultures. With diverse viewpoints in public health, a single global policy, especially one reflecting Western ethics or the ethics prevalent in high-income countries, is impractical. This paper argues for a culturally sensitive, adaptable framework for the use of embryonic stem cells. Stem cell policy should accommodate varying ethical viewpoints and promote an effective global dialogue. With an extension of an ethics model that can adapt to various cultures, we recommend localized guidelines that reflect the moral views of the people those guidelines serve.

Stem cells, characterized by their unique ability to differentiate into various cell types, enable the repair or replacement of damaged tissues. Two primary types of stem cells are somatic stem cells (adult stem cells) and embryonic stem cells. Adult stem cells exist in developed tissues and maintain the body’s repair processes. [1] Embryonic stem cells (ESC) are remarkably pluripotent or versatile, making them valuable in research. [2] However, the use of ESCs has sparked ethics debates. Considering the potential of embryonic stem cells, research guidelines are essential. The International Society for Stem Cell Research (ISSCR) provides international stem cell research guidelines. They call for “public conversations touching on the scientific significance as well as the societal and ethical issues raised by ESC research.” [3] The ISSCR also publishes updates about culturing human embryos 14 days post fertilization, suggesting local policies and regulations should continue to evolve as ESC research develops. [4]  Like the ISSCR, which calls for local law and policy to adapt to developing stem cell research given cultural acceptance, this paper highlights the importance of local social factors such as religion and culture.

I.     Global Cultural Perspective of Embryonic Stem Cells

Views on ESCs vary throughout the world. Some countries readily embrace stem cell research and therapies, while others have stricter regulations due to ethical concerns surrounding embryonic stem cells and when an embryo becomes entitled to moral consideration. The philosophical issue of when the “someone” begins to be a human after fertilization, in the morally relevant sense, [5] impacts when an embryo becomes not just worthy of protection but morally entitled to it. The process of creating embryonic stem cell lines involves the destruction of the embryos for research. [6] Consequently, global engagement in ESC research depends on social-cultural acceptability.

a.     US and Rights-Based Cultures

In the United States, attitudes toward stem cell therapies are diverse. The ethics and social approaches, which value individualism, [7] trigger debates regarding the destruction of human embryos, creating a complex regulatory environment. For example, the 1996 Dickey-Wicker Amendment prohibited federal funding for the creation of embryos for research and the destruction of embryos for “more than allowed for research on fetuses in utero.” [8] Following suit, in 2001, the Bush Administration heavily restricted stem cell lines for research. However, the Stem Cell Research Enhancement Act of 2005 was proposed to help develop ESC research but was ultimately vetoed. [9] Under the Obama administration, in 2009, an executive order lifted restrictions allowing for more development in this field. [10] The flux of research capacity and funding parallels the different cultural perceptions of human dignity of the embryo and how it is socially presented within the country’s research culture. [11]

b.     Ubuntu and Collective Cultures

African bioethics differs from Western individualism because of the different traditions and values. African traditions, as described by individuals from South Africa and supported by some studies in other African countries, including Ghana and Kenya, follow the African moral philosophies of Ubuntu or Botho and Ukama , which “advocates for a form of wholeness that comes through one’s relationship and connectedness with other people in the society,” [12] making autonomy a socially collective concept. In this context, for the community to act autonomously, individuals would come together to decide what is best for the collective. Thus, stem cell research would require examining the value of the research to society as a whole and the use of the embryos as a collective societal resource. If society views the source as part of the collective whole, and opposes using stem cells, compromising the cultural values to pursue research may cause social detachment and stunt research growth. [13] Based on local culture and moral philosophy, the permissibility of stem cell research depends on how embryo, stem cell, and cell line therapies relate to the community as a whole. Ubuntu is the expression of humanness, with the person’s identity drawn from the “’I am because we are’” value. [14] The decision in a collectivistic culture becomes one born of cultural context, and individual decisions give deference to others in the society.

Consent differs in cultures where thought and moral philosophy are based on a collective paradigm. So, applying Western bioethical concepts is unrealistic. For one, Africa is a diverse continent with many countries with different belief systems, access to health care, and reliance on traditional or Western medicines. Where traditional medicine is the primary treatment, the “’restrictive focus on biomedically-related bioethics’” [is] problematic in African contexts because it neglects bioethical issues raised by traditional systems.” [15] No single approach applies in all areas or contexts. Rather than evaluating the permissibility of ESC research according to Western concepts such as the four principles approach, different ethics approaches should prevail.

Another consideration is the socio-economic standing of countries. In parts of South Africa, researchers have not focused heavily on contributing to the stem cell discourse, either because it is not considered health care or a health science priority or because resources are unavailable. [16] Each country’s priorities differ given different social, political, and economic factors. In South Africa, for instance, areas such as maternal mortality, non-communicable diseases, telemedicine, and the strength of health systems need improvement and require more focus. [17] Stem cell research could benefit the population, but it also could divert resources from basic medical care. Researchers in South Africa adhere to the National Health Act and Medicines Control Act in South Africa and international guidelines; however, the Act is not strictly enforced, and there is no clear legislation for research conduct or ethical guidelines. [18]

Some parts of Africa condemn stem cell research. For example, 98.2 percent of the Tunisian population is Muslim. [19] Tunisia does not permit stem cell research because of moral conflict with a Fatwa. Religion heavily saturates the regulation and direction of research. [20] Stem cell use became permissible for reproductive purposes only recently, with tight restrictions preventing cells from being used in any research other than procedures concerning ART/IVF.  Their use is conditioned on consent, and available only to married couples. [21] The community's receptiveness to stem cell research depends on including communitarian African ethics.

c.     Asia

Some Asian countries also have a collective model of ethics and decision making. [22] In China, the ethics model promotes a sincere respect for life or human dignity, [23] based on protective medicine. This model, influenced by Traditional Chinese Medicine (TCM), [24] recognizes Qi as the vital energy delivered via the meridians of the body; it connects illness to body systems, the body’s entire constitution, and the universe for a holistic bond of nature, health, and quality of life. [25] Following a protective ethics model, and traditional customs of wholeness, investment in stem cell research is heavily desired for its applications in regenerative therapies, disease modeling, and protective medicines. In a survey of medical students and healthcare practitioners, 30.8 percent considered stem cell research morally unacceptable while 63.5 percent accepted medical research using human embryonic stem cells. Of these individuals, 89.9 percent supported increased funding for stem cell research. [26] The scientific community might not reflect the overall population. From 1997 to 2019, China spent a total of $576 million (USD) on stem cell research at 8,050 stem cell programs, increased published presence from 0.6 percent to 14.01 percent of total global stem cell publications as of 2014, and made significant strides in cell-based therapies for various medical conditions. [27] However, while China has made substantial investments in stem cell research and achieved notable progress in clinical applications, concerns linger regarding ethical oversight and transparency. [28] For example, the China Biosecurity Law, promoted by the National Health Commission and China Hospital Association, attempted to mitigate risks by introducing an institutional review board (IRB) in the regulatory bodies. 5800 IRBs registered with the Chinese Clinical Trial Registry since 2021. [29] However, issues still need to be addressed in implementing effective IRB review and approval procedures.

The substantial government funding and focus on scientific advancement have sometimes overshadowed considerations of regional cultures, ethnic minorities, and individual perspectives, particularly evident during the one-child policy era. As government policy adapts to promote public stability, such as the change from the one-child to the two-child policy, [30] research ethics should also adapt to ensure respect for the values of its represented peoples.

Japan is also relatively supportive of stem cell research and therapies. Japan has a more transparent regulatory framework, allowing for faster approval of regenerative medicine products, which has led to several advanced clinical trials and therapies. [31] South Korea is also actively engaged in stem cell research and has a history of breakthroughs in cloning and embryonic stem cells. [32] However, the field is controversial, and there are issues of scientific integrity. For example, the Korean FDA fast-tracked products for approval, [33] and in another instance, the oocyte source was unclear and possibly violated ethical standards. [34] Trust is important in research, as it builds collaborative foundations between colleagues, trial participant comfort, open-mindedness for complicated and sensitive discussions, and supports regulatory procedures for stakeholders. There is a need to respect the culture’s interest, engagement, and for research and clinical trials to be transparent and have ethical oversight to promote global research discourse and trust.

d.     Middle East

Countries in the Middle East have varying degrees of acceptance of or restrictions to policies related to using embryonic stem cells due to cultural and religious influences. Saudi Arabia has made significant contributions to stem cell research, and conducts research based on international guidelines for ethical conduct and under strict adherence to guidelines in accordance with Islamic principles. Specifically, the Saudi government and people require ESC research to adhere to Sharia law. In addition to umbilical and placental stem cells, [35] Saudi Arabia permits the use of embryonic stem cells as long as they come from miscarriages, therapeutic abortions permissible by Sharia law, or are left over from in vitro fertilization and donated to research. [36] Laws and ethical guidelines for stem cell research allow the development of research institutions such as the King Abdullah International Medical Research Center, which has a cord blood bank and a stem cell registry with nearly 10,000 donors. [37] Such volume and acceptance are due to the ethical ‘permissibility’ of the donor sources, which do not conflict with religious pillars. However, some researchers err on the side of caution, choosing not to use embryos or fetal tissue as they feel it is unethical to do so. [38]

Jordan has a positive research ethics culture. [39] However, there is a significant issue of lack of trust in researchers, with 45.23 percent (38.66 percent agreeing and 6.57 percent strongly agreeing) of Jordanians holding a low level of trust in researchers, compared to 81.34 percent of Jordanians agreeing that they feel safe to participate in a research trial. [40] Safety testifies to the feeling of confidence that adequate measures are in place to protect participants from harm, whereas trust in researchers could represent the confidence in researchers to act in the participants’ best interests, adhere to ethical guidelines, provide accurate information, and respect participants’ rights and dignity. One method to improve trust would be to address communication issues relevant to ESC. Legislation surrounding stem cell research has adopted specific language, especially concerning clarification “between ‘stem cells’ and ‘embryonic stem cells’” in translation. [41] Furthermore, legislation “mandates the creation of a national committee… laying out specific regulations for stem-cell banking in accordance with international standards.” [42] This broad regulation opens the door for future global engagement and maintains transparency. However, these regulations may also constrain the influence of research direction, pace, and accessibility of research outcomes.

e.     Europe

In the European Union (EU), ethics is also principle-based, but the principles of autonomy, dignity, integrity, and vulnerability are interconnected. [43] As such, the opportunity for cohesion and concessions between individuals’ thoughts and ideals allows for a more adaptable ethics model due to the flexible principles that relate to the human experience The EU has put forth a framework in its Convention for the Protection of Human Rights and Dignity of the Human Being allowing member states to take different approaches. Each European state applies these principles to its specific conventions, leading to or reflecting different acceptance levels of stem cell research. [44]

For example, in Germany, Lebenzusammenhang , or the coherence of life, references integrity in the unity of human culture. Namely, the personal sphere “should not be subject to external intervention.” [45]  Stem cell interventions could affect this concept of bodily completeness, leading to heavy restrictions. Under the Grundgesetz, human dignity and the right to life with physical integrity are paramount. [46] The Embryo Protection Act of 1991 made producing cell lines illegal. Cell lines can be imported if approved by the Central Ethics Commission for Stem Cell Research only if they were derived before May 2007. [47] Stem cell research respects the integrity of life for the embryo with heavy specifications and intense oversight. This is vastly different in Finland, where the regulatory bodies find research more permissible in IVF excess, but only up to 14 days after fertilization. [48] Spain’s approach differs still, with a comprehensive regulatory framework. [49] Thus, research regulation can be culture-specific due to variations in applied principles. Diverse cultures call for various approaches to ethical permissibility. [50] Only an adaptive-deliberative model can address the cultural constructions of self and achieve positive, culturally sensitive stem cell research practices. [51]

II.     Religious Perspectives on ESC

Embryonic stem cell sources are the main consideration within religious contexts. While individuals may not regard their own religious texts as authoritative or factual, religion can shape their foundations or perspectives.

The Qur'an states:

“And indeed We created man from a quintessence of clay. Then We placed within him a small quantity of nutfa (sperm to fertilize) in a safe place. Then We have fashioned the nutfa into an ‘alaqa (clinging clot or cell cluster), then We developed the ‘alaqa into mudgha (a lump of flesh), and We made mudgha into bones, and clothed the bones with flesh, then We brought it into being as a new creation. So Blessed is Allah, the Best of Creators.” [52]

Many scholars of Islam estimate the time of soul installment, marked by the angel breathing in the soul to bring the individual into creation, as 120 days from conception. [53] Personhood begins at this point, and the value of life would prohibit research or experimentation that could harm the individual. If the fetus is more than 120 days old, the time ensoulment is interpreted to occur according to Islamic law, abortion is no longer permissible. [54] There are a few opposing opinions about early embryos in Islamic traditions. According to some Islamic theologians, there is no ensoulment of the early embryo, which is the source of stem cells for ESC research. [55]

In Buddhism, the stance on stem cell research is not settled. The main tenets, the prohibition against harming or destroying others (ahimsa) and the pursuit of knowledge (prajña) and compassion (karuna), leave Buddhist scholars and communities divided. [56] Some scholars argue stem cell research is in accordance with the Buddhist tenet of seeking knowledge and ending human suffering. Others feel it violates the principle of not harming others. Finding the balance between these two points relies on the karmic burden of Buddhist morality. In trying to prevent ahimsa towards the embryo, Buddhist scholars suggest that to comply with Buddhist tenets, research cannot be done as the embryo has personhood at the moment of conception and would reincarnate immediately, harming the individual's ability to build their karmic burden. [57] On the other hand, the Bodhisattvas, those considered to be on the path to enlightenment or Nirvana, have given organs and flesh to others to help alleviate grieving and to benefit all. [58] Acceptance varies on applied beliefs and interpretations.

Catholicism does not support embryonic stem cell research, as it entails creation or destruction of human embryos. This destruction conflicts with the belief in the sanctity of life. For example, in the Old Testament, Genesis describes humanity as being created in God’s image and multiplying on the Earth, referencing the sacred rights to human conception and the purpose of development and life. In the Ten Commandments, the tenet that one should not kill has numerous interpretations where killing could mean murder or shedding of the sanctity of life, demonstrating the high value of human personhood. In other books, the theological conception of when life begins is interpreted as in utero, [59] highlighting the inviolability of life and its formation in vivo to make a religious point for accepting such research as relatively limited, if at all. [60] The Vatican has released ethical directives to help apply a theological basis to modern-day conflicts. The Magisterium of the Church states that “unless there is a moral certainty of not causing harm,” experimentation on fetuses, fertilized cells, stem cells, or embryos constitutes a crime. [61] Such procedures would not respect the human person who exists at these stages, according to Catholicism. Damages to the embryo are considered gravely immoral and illicit. [62] Although the Catholic Church officially opposes abortion, surveys demonstrate that many Catholic people hold pro-choice views, whether due to the context of conception, stage of pregnancy, threat to the mother’s life, or for other reasons, demonstrating that practicing members can also accept some but not all tenets. [63]

Some major Jewish denominations, such as the Reform, Conservative, and Reconstructionist movements, are open to supporting ESC use or research as long as it is for saving a life. [64] Within Judaism, the Talmud, or study, gives personhood to the child at birth and emphasizes that life does not begin at conception: [65]

“If she is found pregnant, until the fortieth day it is mere fluid,” [66]

Whereas most religions prioritize the status of human embryos, the Halakah (Jewish religious law) states that to save one life, most other religious laws can be ignored because it is in pursuit of preservation. [67] Stem cell research is accepted due to application of these religious laws.

We recognize that all religions contain subsets and sects. The variety of environmental and cultural differences within religious groups requires further analysis to respect the flexibility of religious thoughts and practices. We make no presumptions that all cultures require notions of autonomy or morality as under the common morality theory , which asserts a set of universal moral norms that all individuals share provides moral reasoning and guides ethical decisions. [68] We only wish to show that the interaction with morality varies between cultures and countries.

III.     A Flexible Ethical Approach

The plurality of different moral approaches described above demonstrates that there can be no universally acceptable uniform law for ESC on a global scale. Instead of developing one standard, flexible ethical applications must be continued. We recommend local guidelines that incorporate important cultural and ethical priorities.

While the Declaration of Helsinki is more relevant to people in clinical trials receiving ESC products, in keeping with the tradition of protections for research subjects, consent of the donor is an ethical requirement for ESC donation in many jurisdictions including the US, Canada, and Europe. [69] The Declaration of Helsinki provides a reference point for regulatory standards and could potentially be used as a universal baseline for obtaining consent prior to gamete or embryo donation.

For instance, in Columbia University’s egg donor program for stem cell research, donors followed standard screening protocols and “underwent counseling sessions that included information as to the purpose of oocyte donation for research, what the oocytes would be used for, the risks and benefits of donation, and process of oocyte stimulation” to ensure transparency for consent. [70] The program helped advance stem cell research and provided clear and safe research methods with paid participants. Though paid participation or covering costs of incidental expenses may not be socially acceptable in every culture or context, [71] and creating embryos for ESC research is illegal in many jurisdictions, Columbia’s program was effective because of the clear and honest communications with donors, IRBs, and related stakeholders.  This example demonstrates that cultural acceptance of scientific research and of the idea that an egg or embryo does not have personhood is likely behind societal acceptance of donating eggs for ESC research. As noted, many countries do not permit the creation of embryos for research.

Proper communication and education regarding the process and purpose of stem cell research may bolster comprehension and garner more acceptance. “Given the sensitive subject material, a complete consent process can support voluntary participation through trust, understanding, and ethical norms from the cultures and morals participants value. This can be hard for researchers entering countries of different socioeconomic stability, with different languages and different societal values. [72]

An adequate moral foundation in medical ethics is derived from the cultural and religious basis that informs knowledge and actions. [73] Understanding local cultural and religious values and their impact on research could help researchers develop humility and promote inclusion.

IV.     Concerns

Some may argue that if researchers all adhere to one ethics standard, protection will be satisfied across all borders, and the global public will trust researchers. However, defining what needs to be protected and how to define such research standards is very specific to the people to which standards are applied. We suggest that applying one uniform guide cannot accurately protect each individual because we all possess our own perceptions and interpretations of social values. [74] Therefore, the issue of not adjusting to the moral pluralism between peoples in applying one standard of ethics can be resolved by building out ethics models that can be adapted to different cultures and religions.

Other concerns include medical tourism, which may promote health inequities. [75] Some countries may develop and approve products derived from ESC research before others, compromising research ethics or drug approval processes. There are also concerns about the sale of unauthorized stem cell treatments, for example, those without FDA approval in the United States. Countries with robust research infrastructures may be tempted to attract medical tourists, and some customers will have false hopes based on aggressive publicity of unproven treatments. [76]

For example, in China, stem cell clinics can market to foreign clients who are not protected under the regulatory regimes. Companies employ a marketing strategy of “ethically friendly” therapies. Specifically, in the case of Beike, China’s leading stem cell tourism company and sprouting network, ethical oversight of administrators or health bureaus at one site has “the unintended consequence of shifting questionable activities to another node in Beike's diffuse network.” [77] In contrast, Jordan is aware of stem cell research’s potential abuse and its own status as a “health-care hub.” Jordan’s expanded regulations include preserving the interests of individuals in clinical trials and banning private companies from ESC research to preserve transparency and the integrity of research practices. [78]

The social priorities of the community are also a concern. The ISSCR explicitly states that guidelines “should be periodically revised to accommodate scientific advances, new challenges, and evolving social priorities.” [79] The adaptable ethics model extends this consideration further by addressing whether research is warranted given the varying degrees of socioeconomic conditions, political stability, and healthcare accessibilities and limitations. An ethical approach would require discussion about resource allocation and appropriate distribution of funds. [80]

While some religions emphasize the sanctity of life from conception, which may lead to public opposition to ESC research, others encourage ESC research due to its potential for healing and alleviating human pain. Many countries have special regulations that balance local views on embryonic personhood, the benefits of research as individual or societal goods, and the protection of human research subjects. To foster understanding and constructive dialogue, global policy frameworks should prioritize the protection of universal human rights, transparency, and informed consent. In addition to these foundational global policies, we recommend tailoring local guidelines to reflect the diverse cultural and religious perspectives of the populations they govern. Ethics models should be adapted to local populations to effectively establish research protections, growth, and possibilities of stem cell research.

For example, in countries with strong beliefs in the moral sanctity of embryos or heavy religious restrictions, an adaptive model can allow for discussion instead of immediate rejection. In countries with limited individual rights and voice in science policy, an adaptive model ensures cultural, moral, and religious views are taken into consideration, thereby building social inclusion. While this ethical consideration by the government may not give a complete voice to every individual, it will help balance policies and maintain the diverse perspectives of those it affects. Embracing an adaptive ethics model of ESC research promotes open-minded dialogue and respect for the importance of human belief and tradition. By actively engaging with cultural and religious values, researchers can better handle disagreements and promote ethical research practices that benefit each society.

This brief exploration of the religious and cultural differences that impact ESC research reveals the nuances of relative ethics and highlights a need for local policymakers to apply a more intense adaptive model.

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[36] Association for the Advancement of Blood and Biotherapies.  https://www.aabb.org/regulatory-and-advocacy/regulatory-affairs/regulatory-for-cellular-therapies/international-competent-authorities/saudi-arabia

[37] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia.  BMC medical ethics ,  21 (1), 35. https://doi.org/10.1186/s12910-020-00482-6

[38] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics , 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6

Culturally, autonomy practices follow a relational autonomy approach based on a paternalistic deontological health care model. The adherence to strict international research policies and religious pillars within the regulatory environment is a great foundation for research ethics. However, there is a need to develop locally targeted ethics approaches for research (as called for in Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6), this decision-making approach may help advise a research decision model. For more on the clinical cultural autonomy approaches, see: Alabdullah, Y. Y., Alzaid, E., Alsaad, S., Alamri, T., Alolayan, S. W., Bah, S., & Aljoudi, A. S. (2022). Autonomy and paternalism in Shared decision‐making in a Saudi Arabian tertiary hospital: A cross‐sectional study. Developing World Bioethics , 23 (3), 260–268. https://doi.org/10.1111/dewb.12355 ; Bukhari, A. A. (2017). Universal Principles of Bioethics and Patient Rights in Saudi Arabia (Doctoral dissertation, Duquesne University). https://dsc.duq.edu/etd/124; Ladha, S., Nakshawani, S. A., Alzaidy, A., & Tarab, B. (2023, October 26). Islam and Bioethics: What We All Need to Know . Columbia University School of Professional Studies. https://sps.columbia.edu/events/islam-and-bioethics-what-we-all-need-know

[39] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics.  Research Ethics ,  17 (2), 228-241.  https://doi.org/10.1177/1747016120966779

[40] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics.  Research Ethics ,  17 (2), 228-241.  https://doi.org/10.1177/1747016120966779

[41] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[42] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[43] The EU’s definition of autonomy relates to the capacity for creating ideas, moral insight, decisions, and actions without constraint, personal responsibility, and informed consent. However, the EU views autonomy as not completely able to protect individuals and depends on other principles, such as dignity, which “expresses the intrinsic worth and fundamental equality of all human beings.” Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3

[44] Council of Europe. Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) https://www.coe.int/en/web/conventions/full-list?module=treaty-detail&treatynum=164 (forbidding the creation of embryos for research purposes only, and suggests embryos in vitro have protections.); Also see Drabiak-Syed B. K. (2013). New President, New Human Embryonic Stem Cell Research Policy: Comparative International Perspectives and Embryonic Stem Cell Research Laws in France.  Biotechnology Law Report ,  32 (6), 349–356. https://doi.org/10.1089/blr.2013.9865

[45] Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3

[46] Tomuschat, C., Currie, D. P., Kommers, D. P., & Kerr, R. (Trans.). (1949, May 23). Basic law for the Federal Republic of Germany. https://www.btg-bestellservice.de/pdf/80201000.pdf

[47] Regulation of Stem Cell Research in Germany . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-germany

[48] Regulation of Stem Cell Research in Finland . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-finland

[49] Regulation of Stem Cell Research in Spain . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-spain

[50] Some sources to consider regarding ethics models or regulatory oversights of other cultures not covered:

Kara MA. Applicability of the principle of respect for autonomy: the perspective of Turkey. J Med Ethics. 2007 Nov;33(11):627-30. doi: 10.1136/jme.2006.017400. PMID: 17971462; PMCID: PMC2598110.

Ugarte, O. N., & Acioly, M. A. (2014). The principle of autonomy in Brazil: one needs to discuss it ...  Revista do Colegio Brasileiro de Cirurgioes ,  41 (5), 374–377. https://doi.org/10.1590/0100-69912014005013

Bharadwaj, A., & Glasner, P. E. (2012). Local cells, global science: The rise of embryonic stem cell research in India . Routledge.

For further research on specific European countries regarding ethical and regulatory framework, we recommend this database: Regulation of Stem Cell Research in Europe . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-europe   

[51] Klitzman, R. (2006). Complications of culture in obtaining informed consent. The American Journal of Bioethics, 6(1), 20–21. https://doi.org/10.1080/15265160500394671 see also: Ekmekci, P. E., & Arda, B. (2017). Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights.  Cultura (Iasi, Romania) ,  14 (2), 159–172.; For why trust is important in research, see also: Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent?  Research Ethics ,  13 (1), 23-41.  https://doi.org/10.1177/1747016116650235

[52] The Qur'an  (M. Khattab, Trans.). (1965). Al-Mu’minun, 23: 12-14. https://quran.com/23

[53] Lenfest, Y. (2017, December 8). Islam and the beginning of human life . Bill of Health. https://blog.petrieflom.law.harvard.edu/2017/12/08/islam-and-the-beginning-of-human-life/

[54] Aksoy, S. (2005). Making regulations and drawing up legislation in Islamic countries under conditions of uncertainty, with special reference to embryonic stem cell research. Journal of Medical Ethics , 31: 399-403.; see also: Mahmoud, Azza. "Islamic Bioethics: National Regulations and Guidelines of Human Stem Cell Research in the Muslim World." Master's thesis, Chapman University, 2022. https://doi.org/10.36837/ chapman.000386

[55] Rashid, R. (2022). When does Ensoulment occur in the Human Foetus. Journal of the British Islamic Medical Association , 12 (4). ISSN 2634 8071. https://www.jbima.com/wp-content/uploads/2023/01/2-Ethics-3_-Ensoulment_Rafaqat.pdf.

[56] Sivaraman, M. & Noor, S. (2017). Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia. Asian Biomedicine,8(1) 43-52.  https://doi.org/10.5372/1905-7415.0801.260

[57] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[58] Lecso, P. A. (1991). The Bodhisattva Ideal and Organ Transplantation.  Journal of Religion and Health ,  30 (1), 35–41. http://www.jstor.org/stable/27510629 ; Bodhisattva, S. (n.d.). The Key of Becoming a Bodhisattva . A Guide to the Bodhisattva Way of Life. http://www.buddhism.org/Sutras/2/BodhisattvaWay.htm

[59] There is no explicit religious reference to when life begins or how to conduct research that interacts with the concept of life. However, these are relevant verses pertaining to how the fetus is viewed. (( King James Bible . (1999). Oxford University Press. (original work published 1769))

Jerimiah 1: 5 “Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee…”

In prophet Jerimiah’s insight, God set him apart as a person known before childbirth, a theme carried within the Psalm of David.

Psalm 139: 13-14 “…Thou hast covered me in my mother's womb. I will praise thee; for I am fearfully and wonderfully made…”

These verses demonstrate David’s respect for God as an entity that would know of all man’s thoughts and doings even before birth.

[60] It should be noted that abortion is not supported as well.

[61] The Vatican. (1987, February 22). Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day . Congregation For the Doctrine of the Faith. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html

[62] The Vatican. (2000, August 25). Declaration On the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells . Pontifical Academy for Life. https://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_20000824_cellule-staminali_en.html ; Ohara, N. (2003). Ethical Consideration of Experimentation Using Living Human Embryos: The Catholic Church’s Position on Human Embryonic Stem Cell Research and Human Cloning. Department of Obstetrics and Gynecology . Retrieved from https://article.imrpress.com/journal/CEOG/30/2-3/pii/2003018/77-81.pdf.

[63] Smith, G. A. (2022, May 23). Like Americans overall, Catholics vary in their abortion views, with regular mass attenders most opposed . Pew Research Center. https://www.pewresearch.org/short-reads/2022/05/23/like-americans-overall-catholics-vary-in-their-abortion-views-with-regular-mass-attenders-most-opposed/

[64] Rosner, F., & Reichman, E. (2002). Embryonic stem cell research in Jewish law. Journal of halacha and contemporary society , (43), 49–68.; Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[65] Schenker J. G. (2008). The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law).  Journal of assisted reproduction and genetics ,  25 (6), 271–276. https://doi.org/10.1007/s10815-008-9221-6

[66] Ruttenberg, D. (2020, May 5). The Torah of Abortion Justice (annotated source sheet) . Sefaria. https://www.sefaria.org/sheets/234926.7?lang=bi&with=all&lang2=en

[67] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[68] Gert, B. (2007). Common morality: Deciding what to do . Oxford Univ. Press.

[69] World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA , 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Declaration of Helsinki – WMA – The World Medical Association .; see also: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979).  The Belmont report: Ethical principles and guidelines for the protection of human subjects of research . U.S. Department of Health and Human Services.  https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

[70] Zakarin Safier, L., Gumer, A., Kline, M., Egli, D., & Sauer, M. V. (2018). Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes.  Journal of assisted reproduction and genetics ,  35 (7), 1219–1225. https://doi.org/10.1007/s10815-018-1171-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063839/ see also: Riordan, N. H., & Paz Rodríguez, J. (2021). Addressing concerns regarding associated costs, transparency, and integrity of research in recent stem cell trial. Stem Cells Translational Medicine , 10 (12), 1715–1716. https://doi.org/10.1002/sctm.21-0234

[71] Klitzman, R., & Sauer, M. V. (2009). Payment of egg donors in stem cell research in the USA.  Reproductive biomedicine online ,  18 (5), 603–608. https://doi.org/10.1016/s1472-6483(10)60002-8

[72] Krosin, M. T., Klitzman, R., Levin, B., Cheng, J., & Ranney, M. L. (2006). Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa.  Clinical trials (London, England) ,  3 (3), 306–313. https://doi.org/10.1191/1740774506cn150oa

[73] Veatch, Robert M.  Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict . Georgetown University Press, 2012.

[74] Msoroka, M. S., & Amundsen, D. (2018). One size fits not quite all: Universal research ethics with diversity.  Research Ethics ,  14 (3), 1-17.  https://doi.org/10.1177/1747016117739939

[75] Pirzada, N. (2022). The Expansion of Turkey’s Medical Tourism Industry.  Voices in Bioethics ,  8 . https://doi.org/10.52214/vib.v8i.9894

[76] Stem Cell Tourism: False Hope for Real Money . Harvard Stem Cell Institute (HSCI). (2023). https://hsci.harvard.edu/stem-cell-tourism , See also: Bissassar, M. (2017). Transnational Stem Cell Tourism: An ethical analysis.  Voices in Bioethics ,  3 . https://doi.org/10.7916/vib.v3i.6027

[77] Song, P. (2011) The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation,  New Genetics and Society , 30:2, 141-153, DOI:  10.1080/14636778.2011.574375

[78] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[79] International Society for Stem Cell Research. (2024). Standards in stem cell research . International Society for Stem Cell Research. https://www.isscr.org/guidelines/5-standards-in-stem-cell-research

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Mifrah Hayath

SM Candidate Harvard Medical School, MS Biotechnology Johns Hopkins University

Olivia Bowers

MS Bioethics Columbia University (Disclosure: affiliated with Voices in Bioethics)

Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License .

• Open access
• Published: 13 May 2024

Sexual and reproductive health implementation research in humanitarian contexts: a scoping review

• Alexandra Norton 1 &
• Hannah Tappis 2  

Reproductive Health volume  21 , Article number:  64 ( 2024 ) Cite this article

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Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited.

A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included.

Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process.

This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Plain English summary

Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Peer Review reports

Over the past few decades, the field of public health implementation research (IR) has grown as a means by which the real-world conditions affecting health improvement efforts can be better understood. Peters et al. put forward the following broad definition of IR for health: “IR is the scientific inquiry into questions concerning implementation – the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions)” [ 1 ].

As IR emphasizes real-world circumstances, the context within which a health intervention is delivered is a core consideration. However, much IR implemented to date has focused on higher-resource settings, with many proposed frameworks developed with particular utility for a higher-income setting [ 2 ]. In recognition of IR’s potential to increase evidence across a range of settings, there have been numerous reviews of the use of IR in lower-resource settings as well as calls for broader use [ 3 , 4 ]. There have also been more focused efforts to modify various approaches and frameworks to strengthen the relevance of IR to low- and middle-income country settings (LMICs), such as the work by Means et al. to adapt a specific IR framework for increased utility in LMICs [ 2 ].

Within LMIC settings, the centrality of context to a health intervention’s impact is of particular relevance in humanitarian settings, which present a set of distinct implementation challenges [ 5 ]. Humanitarian responses to crisis situations operate with limited resources, under potential security concerns, and often under pressure to relieve acute suffering and need [ 6 ]. Given these factors, successful implementation of a particular health intervention may require different qualities than those that optimize intervention impact under more stable circumstances [ 7 ]. Despite increasing recognition of the need for expanded evidence of health interventions in humanitarian settings, the evidence base remains limited [ 8 ]. Furthermore, despite its potential utility, there is not standardized guidance on IR in humanitarian settings, nor are there widely endorsed recommendations for the frameworks best suited to analyze implementation in these settings.

Sexual and reproductive health (SRH) is a core aspect of the health sector response in humanitarian settings [ 9 ]. Yet, progress in addressing SRH needs has lagged far behind other services because of challenges related to culture and ideology, financing constraints, lack of data and competing priorities [ 10 ]. The Minimum Initial Service Package (MISP) for SRH in Crisis Situations is the international standard for the minimum set of SRH services that should be implemented in all crisis situations [ 11 ]. However, as in other areas of health, there is need for expanded evidence for planning and implementation of SRH interventions in humanitarian settings. Recent systematic reviews of SRH in humanitarian settings have focused on the effectiveness of interventions and service delivery strategies, as well as factors affecting utilization, but have not detailed whether IR frameworks were used [ 12 , 13 , 14 , 15 ]. There have also been recent reviews examining IR frameworks used in various settings and research areas, but none have explicitly focused on humanitarian settings [ 2 , 16 ].

Given the need for an expanded evidence base for SRH interventions in humanitarian settings and the potential for IR to be used to expand the available evidence, a scoping review was undertaken. This scoping review sought to identify IR approaches that have been used in the last ten years to evaluate SRH interventions in humanitarian settings.

This review also sought to shed light on whether there is a need for a common framework to guide research design, analysis, and reporting for SRH interventions in humanitarian settings and if so, if there are any established frameworks already in use that would be fit-for-purpose or could be tailored to meet this need.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was utilized to guide the elements of this review [ 17 ]. The review protocol was retrospectively registered with the Open Science Framework ( https://osf.io/b5qtz ).

Search strategy

A two-fold search strategy was undertaken for this review, which covered the last 10 years (2013–2022). First, recent systematic reviews pertaining to research or evaluation of SRH interventions in humanitarian settings were identified through keyword searches on PubMed and Google Scholar. Four relevant systematic reviews were identified [ 12 , 13 , 14 , 15 ] Table 1 .

Second, a literature search mirroring these reviews was conducted to identify relevant papers published since the completion of searches for the most recent review (April 2017). Additional file 1 includes the search terms that were used in the literature search [see Additional file 1 ].

The literature search was conducted for papers published from April 2017 to December 2022 in the databases that were searched in one or more of the systematic reviews: PubMed, Embase, PsycInfo, CINAHL and Global Health. Searches were completed in January 2023 Table 2 .

Two reviewers screened each identified study for alignment with inclusion criteria. Studies in the four systematic reviews identified were considered potentially eligible if published during the last 10 years. These papers then underwent full-text review to confirm satisfaction of all inclusion criteria, as inclusion criteria were similar but not fully aligned across the four reviews.

Literature search results were exported into a citation manager (Covidence), duplicates were removed, and a step-wise screening process for inclusion was applied. First, all papers underwent title and abstract screening. The remaining papers after abstract screening then underwent full-text review to confirm satisfaction of all inclusion criteria. Title and abstract screening as well as full-text review was conducted independently by both authors; disagreements after full-text review were resolved by consensus.

Data extraction and synthesis

The following content areas were summarized in Microsoft Excel for each paper that met inclusion criteria: publication details including author, year, country, setting [rural, urban, camp, settlement], population [refugees, internally displaced persons, general crisis-affected], crisis type [armed conflict, natural disaster], crisis stage [acute, chronic], study design, research methods, SRH intervention, and intervention target population [specific beneficiaries of the intervention within the broader population]; the use of an IR framework; details regarding the IR framework, how it was used, and any rationale given for the framework used; factors cited as impacting SRH interventions, either positively or negatively; and other key findings deemed relevant to this review.

As the focus of this review was on the approach taken for SRH intervention research and evaluation, the quality of the studies themselves was not assessed.

Twenty papers underwent full-text review due to their inclusion in one or more of the four systematic reviews and meeting publication date inclusion criteria. The literature search identified 7,016 unique papers. After full-text screening, 69 met all inclusion criteria and were included in the review. Figure  1 illustrates the search strategy and screening process.

Flow chart of paper identification

Papers published in each of the 10 years of the review timeframe (2013–2022) were included. 29% of the papers originated from the first five years of the time frame considered for this review, with the remaining 71% papers coming from the second half. Characteristics of included publications, including geographic location, type of humanitarian crisis, and type of SRH intervention, are presented in Table  3 .

A wide range of study designs and methods were used across the papers, with both qualitative and quantitative studies well represented. Twenty-six papers were quantitative evaluations [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 17 were qualitative [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], and 26 used mixed methods [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. Within the quantitative evaluations, 15 were observational, while five were quasi-experimental, five were randomized controlled trials, and one was an economic evaluation. Study designs as classified by the authors of this review are summarized in Table  4 .

Six papers (9%) explicitly cited use of an IR framework. Three of these papers utilized the Consolidated Framework for Implementation Research (CFIR) [ 51 , 65 , 70 ]. The CFIR is a commonly used determinant framework that—in its originally proposed form in 2009—is comprised of five domains, each of which has constructs to further categorize factors that impact implementation. The CFIR domains were identified as core content areas influencing the effectiveness of implementation, and the constructs within each domain are intended to provide a range of options for researchers to select from to “guide diagnostic assessments of implementation context, evaluate implementation progress, and help explain findings.” [ 87 ] To allow for consistent terminology throughout this review, the original 2009 CFIR domains and constructs are used.

Guan et al. conducted a mixed methods study to assess the feasibility and effectiveness of a neonatal hepatitis B immunization program in a conflict-affected rural region of Myanmar. Guan et al. report mapping data onto the CFIR as a secondary analysis step. They describe that “CFIR was used as a comprehensive meta-theoretical framework to examine the implementation of the Hepatitis B Virus vaccination program,” and implementation themes from multiple study data sources (interviews, observations, examination of monitoring materials) were mapped onto CFIR constructs. They report their results in two phases – Pre-implementation training and community education, and Implementation – with both anchored in themes that they had mapped onto CFIR domains and constructs. All but six constructs were included in their analysis, with a majority summarized in a table and key themes explored further in the narrative text. They specify that most concerns were identified within the Outer Setting and Process domains, while elements identified within the Inner Setting domain provided strength to the intervention and helped mitigate against barriers [ 70 ].

Sarker et al. conducted a qualitative study to assess provision of maternal, newborn and child health services to Rohingya refugees residing in camps in Cox’s Bazar, Bangladesh. They cite using CFIR as a guide for thematic analysis, applying it after a process of inductive and deductive coding to index these codes into the CFIR domains. They utilized three of the five CFIR domains (Outer Setting, Inner Setting, and Process), stating that the remaining two domains (Intervention Characteristics and Characteristics of Individuals) were not relevant to their analysis. They then proposed two additional CFIR domains, Context and Security, for use in humanitarian contexts. In contrast to Guan et al., CFIR constructs are not used nor mentioned by Sarker et al., with content under each domain instead synthesized as challenges and potential solutions. Regarding the CFIR, Sarker et al. write, “The CFIR guided us for interpretative coding and creating the challenges and possible solutions into groups for further clarification of the issues related to program delivery in a humanitarian crisis setting.” [ 51 ]

Sami et al. conducted a mixed methods case study to assess the implementation of a package of neonatal interventions at health facilities within refugee and internally displaced persons camps in South Sudan. They reference use of the CFIR earlier in the study than Sarker et al., basing their guides for semi-structured focus group discussions on the CFIR framework. They similarly reference a general use of the CFIR framework as they conducted thematic analysis. Constructs are referenced once, but they do not specify whether their application of the CFIR framework included use of domains, constructs, or both. This may be in part because they then applied an additional framework, the World Health Organization (WHO) Health System Framework, to present their findings. They describe a nested approach to their use of these frameworks: “Exploring these [CFIR] constructs within the WHO Health Systems Framework can identify specific entry points to improve the implementation of newborn interventions at critical health system building blocks.” [ 65 ]

Three papers cite use of different IR frameworks. Bolan et al. utilized the Theoretical Domains Framework in their mixed methods feasibility study and pilot cluster randomized trial evaluating pilot use of the Safe Delivery App by maternal and newborn health workers providing basic emergency obstetric and newborn care in facilities in the conflict-affected Maniema province of the Democratic Republic of the Congo (DRC). They used the Theroetical Domains Framework in designing interview questions, and further used it as the coding framework for their analysis. Similar to the CFIR, the Theoretical Domains Framework is a determinant framework that consists of domains, each of which then includes constructs. Bolan et al. utilized the Theoretical Domains Framework at the construct level in interview question development and at the domain level in their analysis, mapping interview responses to eight of the 14 domains [ 83 ]. Berg et al. report using an “exploratory design guided by the principles of an evaluation framework” developed by the Medical Research Council to analyze the implementation process, mechanisms of impact, and outcomes of a three-pillar training intervention to improve maternal and neonatal healthcare in the conflict-affected South Kivu province of the DRC [ 67 , 88 ]. Select components of this evaluation framework were used to guide deductive analysis of focus group discussions and in-depth interviews [ 67 ]. In their study of health workers’ knowledge and attitudes toward newborn health interventions in South Sudan, before and after training and supply provision, Sami et al. report use of the Conceptual Framework of the Role of Attitudes in Evidence-Based Practice Implementation in their analysis process. The framework was used to group codes following initial inductive coding analysis of in-depth interviews [ 72 ].

Three other papers cite use of specific frameworks in their intervention evaluation [ 19 , 44 , 76 ]. As a characteristic of IR is the use of an explicit framework to guide the research, the use of the frameworks in these three papers meets the intention of IR and serves the purpose that an IR framework would have in strengthening the analytical rigor. Castle et al. cite use of their program’s theory of change as a framework for a mixed methods evaluation of the provision of family planning services and more specifically uptake of long-acting reversible contraception use in the DRC. They describe use of the theory of change to “enhance effectiveness of [long-acting reversible contraception] access and uptake.” [ 76 ] Thommesen et al. cite use of the AAAQ (Availability, Accessibility, Acceptability and Quality) framework in their qualitative study assessing midwifery services provided to pregnant women in Afghanistan. This framework is focused on the “underlying elements needed for attainment of optimum standard of health care,” but the authors used it in this paper to evaluate facilitators and barriers to women accessing midwifery services [ 44 ]. Jarrett et al. cite use of the Centers for Disease Control and Prevention’s (CDC) Guidelines for Evaluating Public Health Surveillance Systems to explore the characteristics of a population mobility, mortality and birth surveillance system in South Kivu, DRC. Use of these CDC guidelines is cited as one of four study objectives, and commentary is included in the Results section pertaining to each criteria within these guidelines, although more detail regarding use of these guidelines or the authors’ experience with their use in the study is not provided [ 19 ].

Overall, 22 of the 69 papers either explicitly or implicitly identified IR as relevant to their work. Nineteen papers include a focus on feasibility (seven of which did not otherwise identify the importance of exploring questions concerning implementation), touching on a common outcome of interest in implementation research [ 89 ].

While a majority of papers did not explicitly or implicitly use an IR framework to evaluate their SRH intervention of focus, most identified factors that facilitated implementation when they were present or served as a barrier when absent. Sixty cite factors that served as facilitators and 49 cite factors that served as barriers, with just three not citing either. Fifty-nine distinct factors were identified across the papers.

Three of the six studies that explicitly used an IR framework used the CFIR, and the CFIR is the only IR framework that was used by multiple studies. As previously mentioned, Means et al. put forth an adaptation of the CFIR to increase its relevance in LMIC settings, proposing a sixth domain (Characteristics of Systems) and 11 additional constructs [ 2 ]. Using the expanded domains and constructs as proposed by Means et al., the 59 factors cited by papers in this review were thematically grouped into the six domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Within each domain, alignment with CFIR constructs was assessed for, and alignment was found with 29 constructs: eight of Means et al.’s 11 constructs, and 21 of the 39 standard CFIR constructs. Three factors did not align with any construct (all fitting within the Outer Setting domain), and 14 aligned with a construct label but not the associated definition. Table 5 synthesizes the mapping of factors affecting SRH intervention implementation to CFIR domains and constructs, with the construct appearing in italics if it is considered to align with that factor by label but not by definition.

Table 6 lists the CFIR constructs that were not found to have alignment with any factor cited by the papers in this review.

This scoping review sought to assess how IR frameworks have been used to bolster the evidence base for SRH interventions in humanitarian settings, and it revealed that IR frameworks, or an explicit IR approach, are rarely used. All four of the systematic reviews identified with a focus on SRH in humanitarian settings articulate the need for more research examining the effectiveness of SRH interventions in humanitarian settings, with two specifically citing a need for implementation research/science [ 12 , 13 ]. The distribution of papers across the timeframe included in this review does suggest that more research on SRH interventions for crisis-affected populations is taking place, as a majority of relevant papers were published in the second half of the review period. The papers included a wide range of methodologies, which reflect the differing research questions and contexts being evaluated. However, it also invites the question of whether there should be more standardization of outcomes measured or frameworks used to guide analysis and to facilitate increased comparison, synthesis and application across settings.

Three of the six papers that used an IR framework utilized the CFIR. Guan et al. used the CFIR at both a domain and construct level, Sarker et al. used the CFIR at the domain level, and Sami et al. did not specify which CFIR elements were used in informing the focus group discussion guide [ 51 , 65 , 70 ]. It is challenging to draw strong conclusions about the applicability of CFIR in humanitarian settings based on the minimal use of CFIR and IR frameworks within the papers reviewed, although Guan et al. provides a helpful model for how analysis can be structured around CFIR domains and constructs. It is worth considering that the minimal use of IR frameworks, and more specifically CFIR constructs, could be in part because that level of prescriptive categorization does not allow for enough fluidity in humanitarian settings. It also raises questions about the appropriate degree of standardization to pursue for research done in these settings.

The mapping of factors affecting SRH intervention implementation provides an example of how a modified CFIR framework could be used for IR in humanitarian contexts. This mapping exercise found factors that mapped to all five of the original CFIR domains as well as the sixth domain proposed by Means et al. All factors fit well within the definition for the selected domain, indicating an appropriate degree of fit between these existing domains and the factors identified as impacting SRH interventions in humanitarian settings. On a construct level, however, the findings were more variable, with one-quarter of factors not fully aligning with any construct. Furthermore, over 40% of the CFIR constructs (including the additional constructs from Means et al.) were not found to align with any factors cited by the papers in this review, also demonstrating some disconnect between the parameters posed by the CFIR constructs and the factors cited as relevant in a humanitarian context.

It is worth noting that while the CFIR as proposed in 2009 was used in this assessment, as well as in the included papers which used the CFIR, an update was published in 2022. Following a review of CFIR use since its publication, the authors provide updates to construct names and definitions to “make the framework more applicable across a range of innovations and settings.” New constructs and subconstructs were also added, for a total of 48 constructs and 19 subconstructs across the five domains [ 90 ]. A CFIR Outcomes Addendum was also published in 2022, based on recommendations for the CFIR to add outcomes and intended to be used as a complement to the CFIR determinants framework [ 91 ]. These expansions to the CFIR framework may improve applicability of the CFIR in humanitarian settings. Several constructs added to the Outer Setting domain could be of particular utility – critical incidents, local attitudes, and local conditions, each of which could help account for unique challenges faced in contexts of crisis. Sub-constructs added within the Inner Setting domain that seek to clarify structural characteristics and available resources would also be of high utility based on mapping of the factors identified in this review to the original CFIR constructs. As outcomes were not formally included in the CFIR until the 2022 addendum, a separate assessment of implementation outcomes was not undertaken in this review. However, analysis of the factors cited by papers in this review as affecting implementation was derived from the full text of the papers and thus captures content relevant to implementation determinants that is contained within the outcomes.

Given the demonstrated need for additional flexibility within an IR framework for humanitarian contexts, while not a focus of this review, it is worth considering whether a different framework could provide a better fit than the CFIR. Other frameworks have differing points of emphasis that would create different opportunities for flexibility but that do not seem to resolve the challenges experienced in applying the CFIR to a humanitarian context. As one example, the EPIS (Exploration, Preparation, Implementation, Sustainment) Framework considers the impact of inner and outer context on each of four implementation phases; while the constructs within this framework are broader than the CFIR, an emphasis on the intervention characteristics is missing, a domain where stronger alignment within the CFIR is also needed [ 92 ]. Alternatively, the PRISM (Practical, Robust Implementation and Sustainability Model) framework is a determinant and evaluation framework that adds consideration of context factors to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes framework. It has a stronger emphasis on intervention aspects, with sub-domains to account for both organization and patient perspectives within the intervention. While PRISM does include aspects of context, external environment considerations are less robust and intentionally less comprehensive in scope, which would not provide the degree of alignment possible between the Characteristics of Systems and Outer Setting CFIR domains for the considerations unique to humanitarian environments [ 93 ].

Reflecting on their experience with the CFIR, Sarker et al. indicate that it can be a “great asset” in both evaluating current work and developing future interventions. They also encourage future research of humanitarian health interventions to utilize the CFIR [ 51 ]. The other papers that used the CFIR do not specifically reflect on their experience utilizing it, referring more generally to having felt that it was a useful tool [ 65 , 70 ]. On their use of an evaluation framework, Berg et al. reflected that it lent useful structure and helped to identify aspects affecting implementation that otherwise would have gone un-noticed [ 67 ]. The remaining studies that utilized an IR framework did not specifically comment on their experience with its use [ 72 , 83 ]. While a formal IR framework was not engaged by other studies, a number cite a desire for IR to contribute further detail to their findings [ 21 , 37 ].

In their recommendations for strengthening the evidence base for humanitarian health interventions, Ager et al. speak to the need for “methodologic innovation” to develop methodologies with particular applicability in humanitarian settings [ 7 ]. As IR is not yet routinized for SRH interventions, this could be opportune timing for the use of a standardized IR framework to gauge its utility. Using an IR framework to assess factors influencing implementation of the MISP in initial stages of a humanitarian response, and interventions to support more comprehensive SRH service delivery in protracted crises, could lend further rigor and standardization to SRH evaluations, as well as inform strategies to improve MISP implementation over time. Based on categorizing factors identified by these papers as relevant for intervention evaluation, there does seem to be utility to a modified CFIR approach. Given the paucity of formal IR framework use within SRH literature, it would be worth conducting similar scoping exercises to assess for explicit use of IR frameworks within the evidence base for other health service delivery areas in humanitarian settings. In the interim, the recommended approach from this review for future IR on humanitarian health interventions would be a modified CFIR approach with domain-level standardization and flexibility for constructs that may standardize over time with more use. This would enable use of a common analytical framework and vocabulary at the domain level for stakeholders to describe interventions and the factors influencing the effectiveness of implementation, with constructs available to use and customize as most appropriate for specific contexts and interventions.

This review had a number of limitations. As this was a scoping review and a two-part search strategy was used, the papers summarized here may not be comprehensive of those written pertaining to SRH interventions over the past 10 years. Papers from 2013 to 2017 that would have met this scoping review’s inclusion criteria may have been omitted due to being excluded from the systematic reviews. The review was limited to papers available in English. Furthermore, this review did not assess the quality of the papers included or seek to assess the methodology used beyond examination of the use of an IR framework. It does, however, serve as a first step in assessing the extent to which calls for implementation research have been addressed, and identify entry points for strengthening the science and practice of SRH research in humanitarian settings.

With one in 23 people worldwide in need of humanitarian assistance, and financing required for response plans at an all-time high, the need for evidence to guide resource allocation and programming for SRH in humanitarian settings is as important as ever [ 94 ]. Recent research agenda setting initiatives and strategies to advance health in humanitarian settings call for increased investment in implementation research—with priorities ranging from research on effective strategies for expanding access to a full range of contraceptive options to integrating mental health and psychosocial support into SRH programming to capturing accurate and actionable data on maternal and perinatal mortality in a wide range of acute and protracted emergency contexts [ 95 , 96 ]. To truly advance guidance in these areas, implementation research will need to be conducted across diverse humanitarian settings, with clear and consistent documentation of both intervention characteristics and outcomes, as well as contextual and programmatic factors affecting implementation.

Conclusions

Implementation research has potential to increase impact of health interventions particularly in crisis-affected settings where flexibility, adaptability and context-responsive approaches are highlighted as cornerstones of effective programming. There remains significant opportunity for standardization of research in the humanitarian space, with one such opportunity occurring through increased utilization of IR frameworks such as a modified CFIR approach. Investing in more robust sexual and reproductive health research in humanitarian contexts can enrich insights available to guide programming and increase transferability of learning across settings.

Availability of data and materials

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Availability, Accessibility, Acceptability and Quality

Centers for Disease Control and Prevention

Consolidated Framework for Implementation Research

Democratic Republic of the Congo

Exploration, Preparation, Implementation, Sustainment

• Implementation research

Low and middle income country

Minimum Initial Service Package

Practical, Robust Implementation and Sustainability Model

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Reach, Effectiveness, Adoption, Implementation, Maintenance

• Sexual and reproductive health

World Health Organization

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. Literature search terms: Exact search terms used in literature search, with additional detail on the methodology to determine search terms and definitions used for each component of the search

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Norton, A., Tappis, H. Sexual and reproductive health implementation research in humanitarian contexts: a scoping review. Reprod Health 21 , 64 (2024). https://doi.org/10.1186/s12978-024-01793-2

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Microsoft at chi 2024: innovations in human-centered design.

Published May 15, 2024

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The ways people engage with technology, through its design and functionality, determine its utility and acceptance in everyday use, setting the stage for widespread adoption. When computing tools and services respect the diversity of people’s experiences and abilities, technology is not only functional but also universally accessible. Human-computer interaction (HCI) plays a crucial role in this process, examining how technology integrates into our daily lives and exploring ways digital tools can be shaped to meet individual needs and enhance our interactions with the world.

The ACM CHI Conference on Human Factors in Computing Systems is a premier forum that brings together researchers and experts in the field, and Microsoft is honored to support CHI 2024 as a returning sponsor. We’re pleased to announce that 33 papers by Microsoft researchers and their collaborators have been accepted this year, with four winning the Best Paper Award and seven receiving honorable mentions.

This research aims to redefine how people work, collaborate, and play using technology, with a focus on design innovation to create more personalized, engaging, and effective interactions. Several projects emphasize customizing the user experience to better meet individual needs, such as exploring the potential of large language models (LLMs) to help reduce procrastination. Others investigate ways to boost realism in virtual and mixed reality environments, using touch to create a more immersive experience. There are also studies that address the challenges of understanding how people interact with technology. These include applying psychology and cognitive science to examine the use of generative AI and social media, with the goal of using the insights to guide future research and design directions. This post highlights these projects.

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Best Paper Award recipients

DynaVis: Dynamically Synthesized UI Widgets for Visualization Editing   Priyan Vaithilingam, Elena L. Glassman, Jeevana Priya Inala , Chenglong Wang   GUIs used for editing visualizations can overwhelm users or limit their interactions. To address this, the authors introduce DynaVis, which combines natural language interfaces with dynamically synthesized UI widgets, enabling people to initiate and refine edits using natural language.  

Generative Echo Chamber? Effects of LLM-Powered Search Systems on Diverse Information Seeking   Nikhil Sharma, Q. Vera Liao , Ziang Xiao   Conversational search systems powered by LLMs potentially improve on traditional search methods, yet their influence on increasing selective exposure and fostering echo chambers remains underexplored. This research suggests that LLM-driven conversational search may enhance biased information querying, particularly when the LLM’s outputs reinforce user views, emphasizing significant implications for the development and regulation of these technologies.  

Piet: Facilitating Color Authoring for Motion Graphics Video   Xinyu Shi, Yinghou Wang, Yun Wang , Jian Zhao   Motion graphic (MG) videos use animated visuals and color to effectively communicate complex ideas, yet existing color authoring tools are lacking. This work introduces Piet, a tool prototype that offers an interactive palette and support for quick theme changes and controlled focus, significantly streamlining the color design process.

The Metacognitive Demands and Opportunities of Generative AI   Lev Tankelevitch , Viktor Kewenig, Auste Simkute, Ava Elizabeth Scott, Advait Sarkar , Abigail Sellen , Sean Rintel   Generative AI systems offer unprecedented opportunities for transforming professional and personal work, yet they present challenges around prompting, evaluating and relying on outputs, and optimizing workflows. This paper shows that metacognition—the psychological ability to monitor and control one’s thoughts and behavior—offers a valuable lens through which to understand and design for these usability challenges.  

Honorable Mentions

B ig or Small, It’s All in Your Head: Visuo-Haptic Illusion of Size-Change Using Finger-Repositioning Myung Jin Kim, Eyal Ofek, Michel Pahud , Mike J. Sinclair, Andrea Bianchi   This research introduces a fixed-sized VR controller that uses finger repositioning to create a visuo-haptic illusion of dynamic size changes in handheld virtual objects, allowing users to perceive virtual objects as significantly smaller or larger than the actual device. 

LLMR: Real-time Prompting of Interactive Worlds Using Large Language Models   Fernanda De La Torre, Cathy Mengying Fang, Han Huang, Andrzej Banburski-Fahey, Judith Amores , Jaron Lanier   Large Language Model for Mixed Reality (LLMR) is a framework for the real-time creation and modification of interactive mixed reality experiences using LLMs. It uses novel strategies to tackle difficult cases where ideal training data is scarce or where the design goal requires the synthesis of internal dynamics, intuitive analysis, or advanced interactivity. 

Observer Effect in Social Media Use   Koustuv Saha, Pranshu Gupta, Gloria Mark, Emre Kiciman , Munmun De Choudhury   This work investigates the observer effect in behavioral assessments on social media use. The observer effect is a phenomenon in which individuals alter their behavior due to awareness of being monitored. Conducted over an average of 82 months (about 7 years) retrospectively and five months prospectively using Facebook data, the study found that deviations in expected behavior and language post-enrollment in the study reflected individual psychological traits. The authors recommend ways to mitigate the observer effect in these scenarios.

Reading Between the Lines: Modeling User Behavior and Costs in AI-Assisted Programming   Hussein Mozannar, Gagan Bansal , Adam Fourney , Eric Horvitz   By investigating how developers use GitHub Copilot, the authors created CUPS, a taxonomy of programmer activities during system interaction. This approach not only elucidates interaction patterns and inefficiencies but can also drive more effective metrics and UI design for code-recommendation systems with the goal of improving programmer productivity. 

SharedNeRF: Leveraging Photorealistic and View-dependent Rendering for Real-time and Remote Collaboration   Mose Sakashita, Bala Kumaravel, Nicolai Marquardt , Andrew D. Wilson   SharedNeRF, a system for synchronous remote collaboration, utilizes neural radiance field (NeRF) technology to provide photorealistic, viewpoint-specific renderings that are seamlessly integrated with point clouds to capture dynamic movements and changes in a shared space. A preliminary study demonstrated its effectiveness, as participants used this high-fidelity, multi-perspective visualization to successfully complete a flower arrangement task. 

Understanding the Role of Large Language Models in Personalizing and Scaffolding Strategies to Combat Academic Procrastination   Ananya Bhattacharjee, Yuchen Zeng, Sarah Yi Xu, Dana Kulzhabayeva, Minyi Ma, Rachel Kornfield, Syed Ishtiaque Ahmed, Alex Mariakakis, Mary P. Czerwinski , Anastasia Kuzminykh, Michael Liut, Joseph Jay Williams   In this study, the authors explore the potential of LLMs for customizing academic procrastination interventions, employing a technology probe to generate personalized advice. Their findings emphasize the need for LLMs to offer structured, deadline-oriented advice and adaptive questioning techniques, providing key design insights for LLM-based tools while highlighting cautions against their use for therapeutic guidance.

Where Are We So Far? Understanding Data Storytelling Tools from the Perspective of Human-AI Collaboration   Haotian Li, Yun Wang , Huamin Qu This paper evaluates data storytelling tools using a dual framework to analyze the stages of the storytelling workflow—analysis, planning, implementation, communication—and the roles of humans and AI in each stage, such as creators, assistants, optimizers, and reviewers. The study identifies common collaboration patterns in existing tools, summarizes lessons from these patterns, and highlights future research opportunities for human-AI collaboration in data storytelling.

Learn more about our work and contributions to CHI 2024, including our full list of publications , on our conference webpage .

Related publications

Dynavis: dynamically synthesized ui widgets for visualization editing, generative echo chamber effects of llm-powered search systems on diverse information seeking, understanding the role of large language models in personalizing and scaffolding strategies to combat academic procrastination, sharednerf: leveraging photorealistic and view-dependent rendering for real-time and remote collaboration, big or small, it’s all in your head: visuo-haptic illusion of size-change using finger-repositioning, llmr: real-time prompting of interactive worlds using large language models, reading between the lines: modeling user behavior and costs in ai-assisted programming, observer effect in social media use, where are we so far understanding data storytelling tools from the perspective of human-ai collaboration, the metacognitive demands and opportunities of generative ai, piet: facilitating color authoring for motion graphics video, continue reading.

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