Chapter 2: How to Read a Journal Article

Introduction

This book intends to equip you with a foundational knowledge of landmark articles in general surgery. The introductory chapter, “Finding Answers,” provides tools with which to conduct literature searches and identify high-impact articles. In this chapter, we describe a method for reading and interpreting journal articles in order to apply them to your clinical practice. Whether you are reading a landmark study within a field, running a literature search to answer a clinical question, or scanning an interesting abstract in the latest issue of a journal, assessment of the literature requires a logical and systematic approach to reading scientific manuscripts. The following discussion outlines key questions to consider when reading each section of a journal article.

1. Title and abstract

   Should I read this paper?

   Despite your new-found skills in literature searching, PubMed often produces lists of articles that vary in relevance to your clinical question. A good title and abstract should hint whether the study is worth your time to read.

   Abstracts are insufficient, however, to answer any clinical question, and should be used only to gauge whether to spend time reading the full article. Remember that the abstract is a 200–300-word advertisement for the paper. It is designed as much to hook the reader as to summarize the study. The abstract’s conclusion section will provide one or two sentences that usually showcase the most impressive results, and most abstracts will avoid stating negative results.

   For example, a study evaluating a new imaging test may reveal that the test has very poor sensitivity and specificity in the general population, but works well in a narrowly defined subset. The abstract’s conclusion may state only the positive findings, ignoring the narrow range of applicability. The abstract will not reliably tell you whether the article’s conclusions are generalizable, applicable to your patient population and practice, or conclusive. To answer such questions, you need to continue reading.

2. Introduction

   Why was this study done?

   The introduction section orients you to the study’s topic with relevant citations to other important papers in the field. If you are not familiar with the field, the introduction is particularly helpful, and it serves as a good starting point in a search for landmark articles. Finally, the introduction provides insight into the authors’ motivations for writing the article.

3. Methods and results

   The methods and results are the most important sections of the paper. These are the only sections that, taken alone, can answer a clinical question. If you want to read only two sections, after deciding a paper is relevant on the basis of its title and abstract, those sections should be the methods and results.

   Does this paper apply to my patient?

   Clinical studies generally present a description of the included patient population in “Table 1.” This table provides the overall picture of the included population, and if the study has more than one group, it will indicate whether these groups have similar baseline ...