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How to Write a Research Paper: the LEAP approach (+cheat sheet)

In this article I will show you how to write a research paper using the four LEAP writing steps. The LEAP academic writing approach is a step-by-step method for turning research results into a published paper .

The LEAP writing approach has been the cornerstone of the 70 + research papers that I have authored and the 3700+ citations these paper have accumulated within 9 years since the completion of my PhD. I hope the LEAP approach will help you just as much as it has helped me to make an real, tangible impact with my research.

What is the LEAP research paper writing approach?

I designed the LEAP writing approach not only for merely writing the papers. My goal with the writing system was to show young scientists how to first think about research results and then how to efficiently write each section of the research paper.

In other words, you will see how to write a research paper by first analyzing the results and then building a logical, persuasive arguments. In this way, instead of being afraid of writing research paper, you will be able to rely on the paper writing process to help you with what is the most demanding task in getting published – thinking.

The four research paper writing steps according to the LEAP approach:

I will show each of these steps in detail. And you will be able to download the LEAP cheat sheet for using with every paper you write.

But before I tell you how to efficiently write a research paper, I want to show you what is the problem with the way scientists typically write a research paper and why the LEAP approach is more efficient.

How scientists typically write a research paper (and why it isn’t efficient)

Writing a research paper can be tough, especially for a young scientist. Your reasoning needs to be persuasive and thorough enough to convince readers of your arguments. The description has to be derived from research evidence, from prior art, and from your own judgment. This is a tough feat to accomplish.

The figure below shows the sequence of the different parts of a typical research paper. Depending on the scientific journal, some sections might be merged or nonexistent, but the general outline of a research paper will remain very similar.

Here is the problem: Most people make the mistake of writing in this same sequence.

While the structure of scientific articles is designed to help the reader follow the research, it does little to help the scientist write the paper. This is because the layout of research articles starts with the broad (introduction) and narrows down to the specifics (results). See in the figure below how the research paper is structured in terms of the breath of information that each section entails.

How to write a research paper according to the LEAP approach

For a scientist, it is much easier to start writing a research paper with laying out the facts in the narrow sections (i.e. results), step back to describe them (i.e. write the discussion), and step back again to explain the broader picture in the introduction.

For example, it might feel intimidating to start writing a research paper by explaining your research’s global significance in the introduction, while it is easy to plot the figures in the results. When plotting the results, there is not much room for wiggle: the results are what they are.

Starting to write a research papers from the results is also more fun because you finally get to see and understand the complete picture of the research that you have worked on.

Most importantly, following the LEAP approach will help you first make sense of the results yourself and then clearly communicate them to the readers. That is because the sequence of writing allows you to slowly understand the meaning of the results and then develop arguments for presenting to your readers.

I have personally been able to write and submit a research article in three short days using this method.

Step 1: Lay Out the Facts

You have worked long hours on a research project that has produced results and are no doubt curious to determine what they exactly mean. There is no better way to do this than by preparing figures, graphics and tables. This is what the first LEAP step is focused on – diving into the results.

How to p repare charts and tables for a research paper

Your first task is to try out different ways of visually demonstrating the research results. In many fields, the central items of a journal paper will be charts that are based on the data generated during research. In other fields, these might be conceptual diagrams, microscopy images, schematics and a number of other types of scientific graphics which should visually communicate the research study and its results to the readers. If you have reasonably small number of data points, data tables might be useful as well.

Tips for preparing charts and tables

• Try multiple chart types but in the finished paper only use the one that best conveys the message you want to present to the readers
• Follow the eight chart design progressions for selecting and refining a data chart for your paper: https://peerrecognized.com/chart-progressions
• Prepare scientific graphics and visualizations for your paper using the scientific graphic design cheat sheet: https://peerrecognized.com/tools-for-creating-scientific-illustrations/

How to describe the results of your research

Now that you have your data charts, graphics and tables laid out in front of you – describe what you see in them. Seek to answer the question: What have I found?  Your statements should progress in a logical sequence and be backed by the visual information. Since, at this point, you are simply explaining what everyone should be able to see for themselves, you can use a declarative tone: The figure X demonstrates that…

Tips for describing the research results :

• Answer the question: “ What have I found? “
• Use declarative tone since you are simply describing observations

Step 2: Explain the results

The core aspect of your research paper is not actually the results; it is the explanation of their meaning. In the second LEAP step, you will do some heavy lifting by guiding the readers through the results using logic backed by previous scientific research.

How to define the Message of a research paper

To define the central message of your research paper, imagine how you would explain your research to a colleague in 20 seconds . If you succeed in effectively communicating your paper’s message, a reader should be able to recount your findings in a similarly concise way even a year after reading it. This clarity will increase the chances that someone uses the knowledge you generated, which in turn raises the likelihood of citations to your research paper. 

Tips for defining the paper’s central message :

• Write the paper’s core message in a single sentence or two bullet points
• Write the core message in the header of the research paper manuscript

How to write the Discussion section of a research paper

In the discussion section you have to demonstrate why your research paper is worthy of publishing. In other words, you must now answer the all-important So what? question . How well you do so will ultimately define the success of your research paper.

Here are three steps to get started with writing the discussion section:

• Write bullet points of the things that convey the central message of the research article (these may evolve into subheadings later on).
• Make a list with the arguments or observations that support each idea.
• Finally, expand on each point to make full sentences and paragraphs.

Tips for writing the discussion section:

• What is the meaning of the results?
• Was the hypothesis confirmed?
• Write bullet points that support the core message
• List logical arguments for each bullet point, group them into sections
• Instead of repeating research timeline, use a presentation sequence that best supports your logic
• Convert arguments to full paragraphs; be confident but do not overhype
• Refer to both supportive and contradicting research papers for maximum credibility

How to write the Conclusions of a research paper

Since some readers might just skim through your research paper and turn directly to the conclusions, it is a good idea to make conclusion a standalone piece. In the first few sentences of the conclusions, briefly summarize the methodology and try to avoid using abbreviations (if you do, explain what they mean).

After this introduction, summarize the findings from the discussion section. Either paragraph style or bullet-point style conclusions can be used. I prefer the bullet-point style because it clearly separates the different conclusions and provides an easy-to-digest overview for the casual browser. It also forces me to be more succinct.

Tips for writing the conclusion section :

• Summarize the key findings, starting with the most important one
• Make conclusions standalone (short summary, avoid abbreviations)
• Add an optional take-home message and suggest future research in the last paragraph

How to refine the Objective of a research paper

The objective is a short, clear statement defining the paper’s research goals. It can be included either in the final paragraph of the introduction, or as a separate subsection after the introduction. Avoid writing long paragraphs with in-depth reasoning, references, and explanation of methodology since these belong in other sections. The paper’s objective can often be written in a single crisp sentence.

Tips for writing the objective section :

• The objective should ask the question that is answered by the central message of the research paper
• The research objective should be clear long before writing a paper. At this point, you are simply refining it to make sure it is addressed in the body of the paper.

How to write the Methodology section of your research paper

When writing the methodology section, aim for a depth of explanation that will allow readers to reproduce the study . This means that if you are using a novel method, you will have to describe it thoroughly. If, on the other hand, you applied a standardized method, or used an approach from another paper, it will be enough to briefly describe it with reference to the detailed original source.

Remember to also detail the research population, mention how you ensured representative sampling, and elaborate on what statistical methods you used to analyze the results.

Tips for writing the methodology section :

• Include enough detail to allow reproducing the research
• Provide references if the methods are known
• Create a methodology flow chart to add clarity
• Describe the research population, sampling methodology, statistical methods for result analysis
• Describe what methodology, test methods, materials, and sample groups were used in the research.

Step 3: Advertize the research

Step 3 of the LEAP writing approach is designed to entice the casual browser into reading your research paper. This advertising can be done with an informative title, an intriguing abstract, as well as a thorough explanation of the underlying need for doing the research within the introduction.

How to write the Introduction of a research paper

The introduction section should leave no doubt in the mind of the reader that what you are doing is important and that this work could push scientific knowledge forward. To do this convincingly, you will need to have a good knowledge of what is state-of-the-art in your field. You also need be able to see the bigger picture in order to demonstrate the potential impacts of your research work.

Think of the introduction as a funnel, going from wide to narrow, as shown in the figure below:

• Start with a brief context to explain what do we already know,
• Follow with the motivation for the research study and explain why should we care about it,
• Explain the research gap you are going to bridge within this research paper,
• Describe the approach you will take to solve the problem.

Tips for writing the introduction section :

• Follow the Context – Motivation – Research gap – Approach funnel for writing the introduction
• Explain how others tried and how you plan to solve the research problem
• Do a thorough literature review before writing the introduction
• Start writing the introduction by using your own words, then add references from the literature

How to prepare the Abstract of a research paper

The abstract acts as your paper’s elevator pitch and is therefore best written only after the main text is finished. In this one short paragraph you must convince someone to take on the time-consuming task of reading your whole research article. So, make the paper easy to read, intriguing, and self-explanatory; avoid jargon and abbreviations.

How to structure the abstract of a research paper:

• The abstract is a single paragraph that follows this structure:
• Problem: why did we research this
• Methodology: typically starts with the words “Here we…” that signal the start of own contribution.
• Results: what we found from the research.
• Conclusions: show why are the findings important

How to compose a research paper Title

The title is the ultimate summary of a research paper. It must therefore entice someone looking for information to click on a link to it and continue reading the article. A title is also used for indexing purposes in scientific databases, so a representative and optimized title will play large role in determining if your research paper appears in search results at all.

Tips for coming up with a research paper title:

• Capture curiosity of potential readers using a clear and descriptive title
• Include broad terms that are often searched
• Add details that uniquely identify the researched subject of your research paper
• Avoid jargon and abbreviations
• Use keywords as title extension (instead of duplicating the words) to increase the chance of appearing in search results

How to prepare Highlights and Graphical Abstract

Highlights are three to five short bullet-point style statements that convey the core findings of the research paper. Notice that the focus is on the findings, not on the process of getting there.

A graphical abstract placed next to the textual abstract visually summarizes the entire research paper in a single, easy-to-follow figure. I show how to create a graphical abstract in my book Research Data Visualization and Scientific Graphics.

Tips for preparing highlights and graphical abstract:

• In highlights show core findings of the research paper (instead of what you did in the study).
• In graphical abstract show take-home message or methodology of the research paper. Learn more about creating a graphical abstract in this article.

Step 4: Prepare for submission

Sometimes it seems that nuclear fusion will stop on the star closest to us (read: the sun will stop to shine) before a submitted manuscript is published in a scientific journal. The publication process routinely takes a long time, and after submitting the manuscript you have very little control over what happens. To increase the chances of a quick publication, you must do your homework before submitting the manuscript. In the fourth LEAP step, you make sure that your research paper is published in the most appropriate journal as quickly and painlessly as possible.

How to select a scientific Journal for your research paper

The best way to find a journal for your research paper is it to review which journals you used while preparing your manuscript. This source listing should provide some assurance that your own research paper, once published, will be among similar articles and, thus, among your field’s trusted sources.

After this initial selection of hand-full of scientific journals, consider the following six parameters for selecting the most appropriate journal for your research paper (read this article to review each step in detail):

• Scope and publishing history
• Ranking and Recognition
• Publishing time
• Acceptance rate
• Content requirements
• Access and Fees

How to select a journal for your research paper:

• Use the six parameters to select the most appropriate scientific journal for your research paper
• Use the following tools for journal selection: https://peerrecognized.com/journals
• Follow the journal’s “Authors guide” formatting requirements

How to Edit you manuscript

No one can write a finished research paper on their first attempt. Before submitting, make sure to take a break from your work for a couple of days, or even weeks. Try not to think about the manuscript during this time. Once it has faded from your memory, it is time to return and edit. The pause will allow you to read the manuscript from a fresh perspective and make edits as necessary.

I have summarized the most useful research paper editing tools in this article.

Tips for editing a research paper:

• Take time away from the research paper to forget about it; then returning to edit,
• Start by editing the content: structure, headings, paragraphs, logic, figures
• Continue by editing the grammar and language; perform a thorough language check using academic writing tools
• Read the entire paper out loud and correct what sounds weird

How to write a compelling Cover Letter for your paper

Begin the cover letter by stating the paper’s title and the type of paper you are submitting (review paper, research paper, short communication). Next, concisely explain why your study was performed, what was done, and what the key findings are. State why the results are important and what impact they might have in the field. Make sure you mention how your approach and findings relate to the scope of the journal in order to show why the article would be of interest to the journal’s readers.

I wrote a separate article that explains what to include in a cover letter here. You can also download a cover letter template from the article.

Tips for writing a cover letter:

• Explain how the findings of your research relate to journal’s scope
• Tell what impact the research results will have
• Show why the research paper will interest the journal’s audience
• Add any legal statements as required in journal’s guide for authors

How to Answer the Reviewers

Reviewers will often ask for new experiments, extended discussion, additional details on the experimental setup, and so forth. In principle, your primary winning tactic will be to agree with the reviewers and follow their suggestions whenever possible. After all, you must earn their blessing in order to get your paper published.

Be sure to answer each review query and stick to the point. In the response to the reviewers document write exactly where in the paper you have made any changes. In the paper itself, highlight the changes using a different color. This way the reviewers are less likely to re-read the entire article and suggest new edits.

In cases when you don’t agree with the reviewers, it makes sense to answer more thoroughly. Reviewers are scientifically minded people and so, with enough logical and supported argument, they will eventually be willing to see things your way.

Tips for answering the reviewers:

• Agree with most review comments, but if you don’t, thoroughly explain why
• Highlight changes in the manuscript
• Do not take the comments personally and cool down before answering

The LEAP research paper writing cheat sheet

Imagine that you are back in grad school and preparing to take an exam on the topic: “How to write a research paper”. As an exemplary student, you would, most naturally, create a cheat sheet summarizing the subject… Well, I did it for you.

This one-page summary of the LEAP research paper writing technique will remind you of the key research paper writing steps. Print it out and stick it to a wall in your office so that you can review it whenever you are writing a new research paper.

Now that we have gone through the four LEAP research paper writing steps, I hope you have a good idea of how to write a research paper. It can be an enjoyable process and once you get the hang of it, the four LEAP writing steps should even help you think about and interpret the research results. This process should enable you to write a well-structured, concise, and compelling research paper.

Have fund with writing your next research paper. I hope it will turn out great!

Learn writing papers that get cited

The LEAP writing approach is a blueprint for writing research papers. But to be efficient and write papers that get cited, you need more than that.

My name is Martins Zaumanis and in my interactive course Research Paper Writing Masterclass I will show you how to  visualize  your research results,  frame a message  that convinces your readers, and write  each section  of the paper. Step-by-step.

And of course – you will learn to respond the infamous  Reviewer No.2.

Hey! My name is Martins Zaumanis and I am a materials scientist in Switzerland ( Google Scholar ). As the first person in my family with a PhD, I have first-hand experience of the challenges starting scientists face in academia. With this blog, I want to help young researchers succeed in academia. I call the blog “Peer Recognized”, because peer recognition is what lifts academic careers and pushes science forward.

Besides this blog, I have written the Peer Recognized book series and created the Peer Recognized Academy offering interactive online courses.

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13.1 Formatting a Research Paper

Learning objectives.

• Identify the major components of a research paper written using American Psychological Association (APA) style.
• Apply general APA style and formatting conventions in a research paper.

In this chapter, you will learn how to use APA style , the documentation and formatting style followed by the American Psychological Association, as well as MLA style , from the Modern Language Association. There are a few major formatting styles used in academic texts, including AMA, Chicago, and Turabian:

• AMA (American Medical Association) for medicine, health, and biological sciences
• APA (American Psychological Association) for education, psychology, and the social sciences
• Chicago—a common style used in everyday publications like magazines, newspapers, and books
• MLA (Modern Language Association) for English, literature, arts, and humanities
• Turabian—another common style designed for its universal application across all subjects and disciplines

While all the formatting and citation styles have their own use and applications, in this chapter we focus our attention on the two styles you are most likely to use in your academic studies: APA and MLA.

If you find that the rules of proper source documentation are difficult to keep straight, you are not alone. Writing a good research paper is, in and of itself, a major intellectual challenge. Having to follow detailed citation and formatting guidelines as well may seem like just one more task to add to an already-too-long list of requirements.

Following these guidelines, however, serves several important purposes. First, it signals to your readers that your paper should be taken seriously as a student’s contribution to a given academic or professional field; it is the literary equivalent of wearing a tailored suit to a job interview. Second, it shows that you respect other people’s work enough to give them proper credit for it. Finally, it helps your reader find additional materials if he or she wishes to learn more about your topic.

Furthermore, producing a letter-perfect APA-style paper need not be burdensome. Yes, it requires careful attention to detail. However, you can simplify the process if you keep these broad guidelines in mind:

• Work ahead whenever you can. Chapter 11 “Writing from Research: What Will I Learn?” includes tips for keeping track of your sources early in the research process, which will save time later on.
• Get it right the first time. Apply APA guidelines as you write, so you will not have much to correct during the editing stage. Again, putting in a little extra time early on can save time later.
• Use the resources available to you. In addition to the guidelines provided in this chapter, you may wish to consult the APA website at http://www.apa.org or the Purdue University Online Writing lab at http://owl.english.purdue.edu , which regularly updates its online style guidelines.

General Formatting Guidelines

This chapter provides detailed guidelines for using the citation and formatting conventions developed by the American Psychological Association, or APA. Writers in disciplines as diverse as astrophysics, biology, psychology, and education follow APA style. The major components of a paper written in APA style are listed in the following box.

These are the major components of an APA-style paper:

Body, which includes the following:

• Headings and, if necessary, subheadings to organize the content
• In-text citations of research sources
• References page

All these components must be saved in one document, not as separate documents.

The title page of your paper includes the following information:

• Title of the paper
• Author’s name
• Name of the institution with which the author is affiliated
• Header at the top of the page with the paper title (in capital letters) and the page number (If the title is lengthy, you may use a shortened form of it in the header.)

List the first three elements in the order given in the previous list, centered about one third of the way down from the top of the page. Use the headers and footers tool of your word-processing program to add the header, with the title text at the left and the page number in the upper-right corner. Your title page should look like the following example.

The next page of your paper provides an abstract , or brief summary of your findings. An abstract does not need to be provided in every paper, but an abstract should be used in papers that include a hypothesis. A good abstract is concise—about one hundred fifty to two hundred fifty words—and is written in an objective, impersonal style. Your writing voice will not be as apparent here as in the body of your paper. When writing the abstract, take a just-the-facts approach, and summarize your research question and your findings in a few sentences.

In Chapter 12 “Writing a Research Paper” , you read a paper written by a student named Jorge, who researched the effectiveness of low-carbohydrate diets. Read Jorge’s abstract. Note how it sums up the major ideas in his paper without going into excessive detail.

Write an abstract summarizing your paper. Briefly introduce the topic, state your findings, and sum up what conclusions you can draw from your research. Use the word count feature of your word-processing program to make sure your abstract does not exceed one hundred fifty words.

Depending on your field of study, you may sometimes write research papers that present extensive primary research, such as your own experiment or survey. In your abstract, summarize your research question and your findings, and briefly indicate how your study relates to prior research in the field.

Margins, Pagination, and Headings

APA style requirements also address specific formatting concerns, such as margins, pagination, and heading styles, within the body of the paper. Review the following APA guidelines.

Use these general guidelines to format the paper:

• Set the top, bottom, and side margins of your paper at 1 inch.
• Use double-spaced text throughout your paper.
• Use a standard font, such as Times New Roman or Arial, in a legible size (10- to 12-point).
• Use continuous pagination throughout the paper, including the title page and the references section. Page numbers appear flush right within your header.
• Section headings and subsection headings within the body of your paper use different types of formatting depending on the level of information you are presenting. Additional details from Jorge’s paper are provided.

Begin formatting the final draft of your paper according to APA guidelines. You may work with an existing document or set up a new document if you choose. Include the following:

• Your title page
• The abstract you created in Note 13.8 “Exercise 1”
• Correct headers and page numbers for your title page and abstract

APA style uses section headings to organize information, making it easy for the reader to follow the writer’s train of thought and to know immediately what major topics are covered. Depending on the length and complexity of the paper, its major sections may also be divided into subsections, sub-subsections, and so on. These smaller sections, in turn, use different heading styles to indicate different levels of information. In essence, you are using headings to create a hierarchy of information.

The following heading styles used in APA formatting are listed in order of greatest to least importance:

• Section headings use centered, boldface type. Headings use title case, with important words in the heading capitalized.
• Subsection headings use left-aligned, boldface type. Headings use title case.
• The third level uses left-aligned, indented, boldface type. Headings use a capital letter only for the first word, and they end in a period.
• The fourth level follows the same style used for the previous level, but the headings are boldfaced and italicized.
• The fifth level follows the same style used for the previous level, but the headings are italicized and not boldfaced.

Visually, the hierarchy of information is organized as indicated in Table 13.1 “Section Headings” .

Table 13.1 Section Headings

A college research paper may not use all the heading levels shown in Table 13.1 “Section Headings” , but you are likely to encounter them in academic journal articles that use APA style. For a brief paper, you may find that level 1 headings suffice. Longer or more complex papers may need level 2 headings or other lower-level headings to organize information clearly. Use your outline to craft your major section headings and determine whether any subtopics are substantial enough to require additional levels of headings.

Working with the document you developed in Note 13.11 “Exercise 2” , begin setting up the heading structure of the final draft of your research paper according to APA guidelines. Include your title and at least two to three major section headings, and follow the formatting guidelines provided above. If your major sections should be broken into subsections, add those headings as well. Use your outline to help you.

Because Jorge used only level 1 headings, his Exercise 3 would look like the following:

Citation Guidelines

In-text citations.

Throughout the body of your paper, include a citation whenever you quote or paraphrase material from your research sources. As you learned in Chapter 11 “Writing from Research: What Will I Learn?” , the purpose of citations is twofold: to give credit to others for their ideas and to allow your reader to follow up and learn more about the topic if desired. Your in-text citations provide basic information about your source; each source you cite will have a longer entry in the references section that provides more detailed information.

In-text citations must provide the name of the author or authors and the year the source was published. (When a given source does not list an individual author, you may provide the source title or the name of the organization that published the material instead.) When directly quoting a source, it is also required that you include the page number where the quote appears in your citation.

This information may be included within the sentence or in a parenthetical reference at the end of the sentence, as in these examples.

Epstein (2010) points out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Here, the writer names the source author when introducing the quote and provides the publication date in parentheses after the author’s name. The page number appears in parentheses after the closing quotation marks and before the period that ends the sentence.

Addiction researchers caution that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (Epstein, 2010, p. 137).

Here, the writer provides a parenthetical citation at the end of the sentence that includes the author’s name, the year of publication, and the page number separated by commas. Again, the parenthetical citation is placed after the closing quotation marks and before the period at the end of the sentence.

As noted in the book Junk Food, Junk Science (Epstein, 2010, p. 137), “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive.”

Here, the writer chose to mention the source title in the sentence (an optional piece of information to include) and followed the title with a parenthetical citation. Note that the parenthetical citation is placed before the comma that signals the end of the introductory phrase.

David Epstein’s book Junk Food, Junk Science (2010) pointed out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Another variation is to introduce the author and the source title in your sentence and include the publication date and page number in parentheses within the sentence or at the end of the sentence. As long as you have included the essential information, you can choose the option that works best for that particular sentence and source.

Citing a book with a single author is usually a straightforward task. Of course, your research may require that you cite many other types of sources, such as books or articles with more than one author or sources with no individual author listed. You may also need to cite sources available in both print and online and nonprint sources, such as websites and personal interviews. Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.2 “Citing and Referencing Techniques” and Section 13.3 “Creating a References Section” provide extensive guidelines for citing a variety of source types.

Writing at Work

APA is just one of several different styles with its own guidelines for documentation, formatting, and language usage. Depending on your field of interest, you may be exposed to additional styles, such as the following:

• MLA style. Determined by the Modern Languages Association and used for papers in literature, languages, and other disciplines in the humanities.
• Chicago style. Outlined in the Chicago Manual of Style and sometimes used for papers in the humanities and the sciences; many professional organizations use this style for publications as well.
• Associated Press (AP) style. Used by professional journalists.

References List

The brief citations included in the body of your paper correspond to the more detailed citations provided at the end of the paper in the references section. In-text citations provide basic information—the author’s name, the publication date, and the page number if necessary—while the references section provides more extensive bibliographical information. Again, this information allows your reader to follow up on the sources you cited and do additional reading about the topic if desired.

The specific format of entries in the list of references varies slightly for different source types, but the entries generally include the following information:

• The name(s) of the author(s) or institution that wrote the source
• The year of publication and, where applicable, the exact date of publication
• The full title of the source
• For books, the city of publication
• For articles or essays, the name of the periodical or book in which the article or essay appears
• For magazine and journal articles, the volume number, issue number, and pages where the article appears
• For sources on the web, the URL where the source is located

The references page is double spaced and lists entries in alphabetical order by the author’s last name. If an entry continues for more than one line, the second line and each subsequent line are indented five spaces. Review the following example. ( Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.3 “Creating a References Section” provides extensive guidelines for formatting reference entries for different types of sources.)

In APA style, book and article titles are formatted in sentence case, not title case. Sentence case means that only the first word is capitalized, along with any proper nouns.

Key Takeaways

• Following proper citation and formatting guidelines helps writers ensure that their work will be taken seriously, give proper credit to other authors for their work, and provide valuable information to readers.
• Working ahead and taking care to cite sources correctly the first time are ways writers can save time during the editing stage of writing a research paper.
• APA papers usually include an abstract that concisely summarizes the paper.
• APA papers use a specific headings structure to provide a clear hierarchy of information.
• In APA papers, in-text citations usually include the name(s) of the author(s) and the year of publication.
• In-text citations correspond to entries in the references section, which provide detailed bibliographical information about a source.

Writing for Success Copyright © 2015 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Paper Format

Consistency in the order, structure, and format of a paper allows readers to focus on a paper’s content rather than its presentation.

To format a paper in APA Style, writers can typically use the default settings and automatic formatting tools of their word-processing program or make only minor adjustments.

The guidelines for paper format apply to both student assignments and manuscripts being submitted for publication to a journal. If you are using APA Style to create another kind of work (e.g., a website, conference poster, or PowerPoint presentation), you may need to format your work differently in order to optimize its presentation, for example, by using different line spacing and font sizes. Follow the guidelines of your institution or publisher to adapt APA Style formatting guidelines as needed.

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Formatting Your Research Project

To learn how to set up your research project in MLA format, visit our free sample chapter on MLA Handbook Plus , the only authorized subscription-based digital resource featuring the  MLA Handbook, available for unlimited simultaneous users at subscribing institutions.

CoB Research Experience for Undergraduates (REU)

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Learn More About Your Research Topic

• Get started with reviewing the literature
• A literature review is NOT...
• Types of literature reviews
• Finding published literature reviews

A literature review examines existing contributions around a topic, question, or issue in a field of study. These contributions can include peer reviewed articles, books, and other published research. Literature reviews can be used to give an overview of a field of research to describe theories, explore methodologies, and discuss developments in a field by drawing on research from multiple studies.

A literature review can be used to:

• Ground yourself in a topic and learn more about it
• Find new ideas to explore
• Discover existing research (so you do not repeat it)
• Determine what methodologies have already been used to research a topic
• Discover flaws, problems, and gaps that exist in the literature
• Critique or evaluate existing research on a topic
• Situate your research in a larger context or advocate for your research by demonstrating that you are extending upon existing knowledge

What makes a good literature review?

A good literature review has a clear scope - don't try to collect everything about a topic that has ever been published! Instead focus in on what you want to know more about your specific research topic. A good literature review might also:

• Cover all important relevant literature - if you are finding too many sources, try narrowing in on key authors and well cited-research
• Is up-to-date - limit your review to a certain time period
• Provide an insightful analysis of the ideas and conclusions in the literature
• Point out similarities and differences, strengths and weaknesses in the literature
• Identify gaps in the literature for future research - or to set up your own research as relevant!
• Provides the context for which the literature is important - what impact does the literature have on countries, people, industries, etc.
• Systematic Review: AI's Impact on Higher Education - Learning, Teaching, and Career Opportunities Review this example to learn one way a literature review can be written.

A well conducted literature review can set up your final research product. Many researchers will write literature reviews at the beginning of their research article to situate their research within the larger context in their field or topic. This demonstrates that they have awareness of their topic and how they are building upon the topic. Keeping good notes when you are conducting your review can help set you up for success when you begin work on your final research product. When conducting your literature review AVOID:

• Summarizing articles INSTEAD draw connections between different articles
• Creating a chronological account of a topic INSTEAD focus on current literature or foundational works
• Sharing personal opinions on whether or not you liked articles INSTEAD ask questions

A strong literature review organizes existing contributions to a conversation into categories or “themes.” There are multiple ways to approach targeting a literature review to achieve your specific learning goals. Common types of reviews include:

Traditional Review

• Analyzes, synthesizes, and critiques a body of literature
• Identifies patterns and themes in the literature
• Draws conclusions from the literature
• Identifies gaps in literature

Argumentative Review

• Examines literature selectively in order to support or refuse an argument, assumption, or philosophical problem already established in the literature

Historical Review

• Examines research throughout a period of time
• Places research in a historical context

Integrative Review

• Aims to review, critique, and synthesize literature on a topic in an integrated way that new frameworks and perspectives on the topic are generated
• Might include case studies, observational studies, and meta-analysis, as well as other types of research

Methodological Review

• Focuses on method of analysis (how researchers came to the idea) rather than on findings (their final conclusions and what they found)

Published literature reviews are called review articles, however, research articles often contain brief literature reviews at the beginning to give context to the study within that article. 

By reviewing published literature reviews you can more easily ground yourself in a topic, it's main themes, and find relevant literature for your own review.

Tip: When identifying main themes related to your topic, look at the headers in a research article. Some authors choose to list their literature review themes as headers to organize their review. Others might choose to name their themes in the first few sentences of each paragraph in their review. Sometimes a literature review, especially if it is brief, will be included in the introduction or some other beginning part of the article.

Approaching a Literature Review

• Evidenced-based approach

An  Evidence-Based Management Framework  can help direct your literature review process.

"Evidence-Based" is a term that was originally coined in the 1990s in the field of medicine, but today its principles extend across disciplines as varied as education, social work, public work, and management. Evidence-Based Management focuses on improving decision-making process.

While conducting a literature review, we need to gather evidence and summarize it to support our decisions and conclusions regarding the topic or problem. We recommend you use a 4 step approach of the Evidence-Based Management Framework while working on a literature review.

During the "Ask" step , you need to define a specific topic, thesis, problem, or research question that your literature review will be focusing on.

It may require first to gain some knowledge about the area or discipline that your topic, thesis, problem, or research question originate from. At this moment, think about a type of a literature review you plan to work on. For example are you reviewing the literature to educate yourself on a topic, to plan to write a literature review article, or to prepare to situate your research project within the broader literature?

Use this to determine the scope of your literature review and the type of publications you need to use (e.g., journals, books, governmental documents, conference proceedings, dissertations, training materials, and etc.).

A few other questions you might ask are:

• Is my topic, question, or problem narrowed enough to exclude irrelevant material?
• What is the number of sources to use to fulfill the research need and represent the scope? i.e. is the topic narrow enough that you want to find everything that exists or broad enough that you only want to see what a few experts have to say?
• What facets of a topic are the focus? Am I looking at issues of theory? methodology? policy? quantitative research? or qualitative research?

During the  “Acquire” step , you are actively gathering evidence and information that relates to your topic or problem.

This is when you search for related scholarly articles, books, dissertations, and etc. to see  “what has been done”  and  “what we already know”  about the topic or problem. While doing a literature review in business, you may also find it helpful to review various websites such as professional associations, government websites offering industry data, companies’ data, conference proceedings, or training materials. It may increase your understanding about the current state of the knowledge in your topic or problem.

During this step, you should keep a careful records of the literature and website resources you review. 

During the  “Appraise” step,  you actively evaluate the sources used to acquire the information. To make decisions regarding the relevance and trustworthiness of the sources and information, you can ask the following questions:

• Is the source reputable? (e.g., peer-reviewed journals and government websites typically offer more trustworthy information)
• How old (dated) is the source? Is it still current, or is there newer updated information that you might be able to find?
• How closely does the source match the topic / problem / issue you are researching?

During this step, you may decide to eliminate some of the material you gathered during the  “Acquire” step . Similarly, you may find that you need to engage in additional searches to find information that suits your needs. This is normal—the process of the  "Appraisal" step  often uncovers new keywords and new potential sources.

During the  “Aggregate” step , you “pull together” the information you deemed trustworthy and relevant. The information gathered and evaluated needs to be summarized in a narrative form—a summary of your findings. 

While summarizing and aggregating information, use synthesis language like this: 

• Much of the literature on  [topic X]  focuses on  [major themes] .  
• In recent years, researchers have begun investigating  [facets A, B, and C]  of  [topic X] .
• The studies in this review of  [topic X]  confirm / suggest / call into question / support  [idea / practice / finding / method / theory / guideline Y].
• In the reviewed studies  [variable X]  was generally associated with higher / lower rates of  [outcome Y].
• A limitation of some / most / all of these studies is  [Y].
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Microsoft Research Lab – Asia

Probts: unified benchmarking for time-series forecasting, share this page.

Author: Machine Learning Group

Time-series forecasting is crucial across various industries, including health, energy, commerce, climate, etc. Accurate forecasts over different prediction horizons are essential for both short-term and long-term planning needs across these domains. For instance, during a public health emergency such as the COVID-19 pandemic, projections of infected cases and fatalities over one to four weeks are essential for allocating medical and societal resources effectively. In the energy sector, precise forecasts of electricity demand on an hourly, daily, weekly, and even monthly basis are crucial for power management and renewable energy scheduling. Logistics relies on forecasting short-term and long-term cargo volumes for adaptive route scheduling and efficient supply chain management.

Beyond covering various prediction horizons, accurate forecasting must extend beyond point estimates to include distributional forecasts that quantify estimation uncertainty. Both the expected estimates and the associated uncertainties are indispensable for subsequent planning and optimization, providing a comprehensive view that informs better decision-making.

Given the critical need for accurate point and distributional forecasting across diverse prediction horizons, researchers from Microsoft Research Asia revisited existing time-series forecasting studies to assess their effectiveness in meeting these essential demands. The review encompasses state-of-the-art models developed across various research threads:

• Classical time-series models : These models typically require training from scratch on each dataset, focusing on either long-term point forecasting (e.g., PatchTST, iTransformer) or short-term distributional forecasting (e.g., CSDI, TimeGrad).
• Recent time-series foundation models : These models involve universal pre-training across extensive datasets and are developed by both industrial labs (e.g., TimesFM, MOIRAI, Chronos) and academic institutions (e.g., Timer, UniTS).

Despite the advancements, researchers find that existing approaches often lack a holistic consideration of all essential forecasting needs. This limitation results in “biased” methodological designs and unverified performance in untested scenarios.

To address the gaps identified in existing time-series forecasting studies, researchers developed the ProbTS tool. ProbTS serves as a unified benchmarking platform designed to evaluate how well current approaches meet essential forecasting needs. By highlighting crucial methodological differences, ProbTS provides a comprehensive understanding of the strengths and weaknesses of advanced time-series models and unveils opportunities for future research and innovation.

Repo: https://github.com/microsoft/ProbTS (opens in new tab)

Paper: https://arxiv.org/abs/2310.07446v4 (opens in new tab)

Paradigm differences: Methodological analysis of time series forecasting

The benchmark study using ProbTS highlights two crucial methodological differences found in contemporary research: the forecasting paradigms for point and distributional estimation, and the decoding schemes for variable-length forecasting across different horizons.

Forecasting paradigms for point and distributional estimation

• Point forecasting only: Approaches that support only point forecasting, providing expected estimates without uncertainty quantification.
• Predefined distribution heads: Methods that use predefined distribution heads to generate distributional forecasts, offering a fixed structure for uncertainty estimation.
• Neural distribution estimation modules: Techniques employing neural network-based modules to estimate distributions, allowing for more flexible and potentially more accurate uncertainty quantification.

Decoding schemes for variable-length forecasting across different horizons

• Autoregressive (AR) methods: These methods generate forecasts step-by-step, using previous predictions as inputs for future time steps. They are suitable for scenarios where sequential dependencies are crucial.
• Non-Autoregressive (NAR) methods: These methods produce forecasts for all time steps simultaneously, offering faster predictions and potentially better performance for long-term forecasting.

The research results under the ProbTS framework reveals several key insights:

Firstly, due to customized neural architectures, long-term point forecasting approaches excel in long-term scenarios but struggle in short-term cases and with complex data distributions. The lack of uncertainty quantification leads to significant performance gaps compared to probabilistic models when dealing with complex data distributions. Conversely, short-term probabilistic forecasting methods are proficient in short-term distributional forecasting but exhibit performance degradation and efficiency issues in long-term scenarios.

Secondly, regarding the characteristics of different decoding schemes, NAR decoding is predominantly used in long-term point forecasting models, while short-term probabilistic forecasting models do not show such a biased preference. Meanwhile, AR decoding suffers from error accumulation over extended horizons but may perform better with strong seasonal patterns.

Lastly, for current time-series foundation models, the limitations of AR decoding are reaffirmed in long-term forecasting. Additionally, foundation models show limited support for distributional forecasting, highlighting the need for improved modeling of complex data distributions.

Detailed results and analysis on classical time-series models

Researchers benchmark classical time-series models across a wide range of forecasting scenarios, encompassing both short and long prediction horizons. The evaluation includes both point forecasting metrics (Normalized Mean Absolute Error, NMAE) and distributional forecasting metrics (Continuous Ranked Probability Score, CRPS). Additionally, researchers calculate a non-Gaussianity score to quantify the complexity of data distribution for each forecasting scenario.

Based on the data presented in Figure 2, several noteworthy observations emerge:

• Limitations of long-term point forecasting models: Customized neural architectures for time-series, primarily designed for long-term point forecasting, excel in long-term scenarios. However, their architectural benefits significantly diminish in short-term cases (see Figure 2(a) and 2(c)). Furthermore, their inability to quantify forecasting uncertainty results in larger performance gaps compared to probabilistic models, especially when the data distribution is complex (see Figure 2(c) and 2(d)).
• Weaknesses of short-term probabilistic forecasting models: Current probabilistic forecasting models, while proficient in short-term distributional forecasting, face challenges in long-term scenarios, as evidenced by significant performance degradations (see Figure 2(a) and 2(b)). In addition to unsatisfactory performance, some models experience severe efficiency issues as the prediction horizon increases.

These observations yield several important implications. Firstly, effective architecture designs for short-term forecasting remain elusive and warrant further research. Secondly, the ability to characterize complex data distributions is crucial, as long-term distributional forecasting presents significant challenges in both performance and efficiency.

Following that, researchers compare Autoregressive (AR) and Non-Autoregressive (NAR) decoding schemes across various forecasting scenarios, highlighting their respective pros and cons in relation to forecasting horizons, trend strength, and seasonality strength.

Researchers find that nearly all long-term point forecasting models use the NAR decoding scheme for multi-step outputs, whereas probabilistic forecasting models exhibit a more balanced use of AR and NAR schemes. Researchers aim to elucidate this disparity and highlight the pros and cons of each scheme, as shown in Figure 3.

• Error accumulation in AR decoding: Figure 3(a) shows that existing AR models experiences a larger performance gap compared to NAR methods as the prediction horizon increases, suggesting that AR may suffer from error accumulation.
• Impact of trend strength: Figure 3(b) connects the performance gap with trend strength, indicating that strong trending effects can lead to significant performance differences between NAR and AR models. However, there are exceptions where strong trends do not cause substantial performance degradation in AR-based models.
• Impact of seasonality strength: Figure 3(c) explains these exceptions by introducing seasonality strength as a factor. Surprisingly, AR-based models perform better in scenarios with strong seasonal patterns, likely due to their parameter efficiency in such contexts.
• Combined effects of trend and seasonality: Figure 3(d) demonstrates the combined effects of trend and seasonality on performance differences.

Based on these analyses, researchers point out that the choice between AR and NAR decoding schemes in different research branches is primarily driven by the specific data characteristics in their focused forecasting scenarios. This explains the preference for the NAR decoding paradigm in most long-term forecasting models. However, this preference for NAR may overlook the advantages of AR, particularly its effectiveness in handling strong seasonality. Since both NAR and AR have their own strengths and weaknesses, future research should aim for a more balanced exploration, leveraging their unique advantages and addressing their limitations.

Detailed results and analysis on time-series foundation models

Researchers then extend the analysis framework to include recent time-series foundation models and examine their distributional forecasting capabilities.

The results show that:

• AR vs. NAR decoding in long-term forecasting: Figure 4(a) reaffirms the limitations of AR decoding over extended forecasting horizons. This suggests that time-series data, due to its continuous nature, may require special adaptations beyond those used in language modeling (which operates in a discrete space). Additionally, it is confirmed that AR-based and NAR-based models can deliver comparable performance in short-term scenarios, with AR-based models occasionally outperforming their NAR counterparts.
• Distributional forecasting capabilities: Figure 4(b) compares the distributional forecasting capabilities of foundation models with CSDI, underscoring the importance of capturing complex data distributions. Current foundation models demonstrate limited support for distributional forecasting, typically using predefined distribution heads (e.g., MOIRAI) or approximated distribution modeling in a value-quantized space (e.g., Chronos).

These observations lead to several important conclusions: While AR-based models can be effective in short-term scenarios, their performance diminishes over longer horizons, highlighting the need for further refinement. Time-series data may require unique treatments to optimize AR decoding, particularly for long-term forecasting. The ability to accurately model complex data distributions remains a critical area for improvement in time-series foundation models.

Future directions: Evolving perspectives, models, and tools

Based on the evaluation and analysis of existing methods, researchers have proposed several important future directions for time series prediction models. These directions, if pursued, could significantly impact key scenarios across various industry sectors.

Future direction 1: Adopting a comprehensive perspective of forecasting demands. One primary future direction is to adopt a holistic perspective of essential forecasting demands when developing new models. This approach can help rethink the methodological choices of different models, understand their strengths and weaknesses, and foster more diverse research explorations.

Future direction 2: Designing a universal model. A fundamental question raised by these results is whether we can develop a universal model that fulfills all essential forecasting demands or if we should treat different forecasting demands separately, introducing specific techniques for each. While it is challenging to provide a definitive answer, the ultimate goal could be to create a universal model. When developing such a model, it is necessary to consider issues such as input representation, encoding architecture, decoding scheme, and distribution estimation module, etc. Additionally, future research is needed to address the challenge of distributional forecasting in high-dimensional and noisy scenarios, particularly for long horizons, and to leverage the advantages of both AR and NAR decoding schemes while avoiding their weaknesses.

Future direction 3: Developing tools for future research. To support future research in these directions, researchers have made the ProbTS tool publicly available, hoping this tool will facilitate advancements in the field and encourage collective efforts from the research community.

By addressing these future directions, researchers aim to push the boundaries of time-series forecasting, ultimately developing models that are more robust, versatile, and capable of handling a wide range of forecasting challenges. This progress holds the potential to significantly impact numerous industries, leading to better decision-making, optimized operations, and improved outcomes across critical sectors.

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A new webpage has been launched at the Yale Child Study Center (YCSC) to allow families and referring practitioners – and soon school-based personnel – to view and access research participation opportunities at the center. Details including brief study descriptions, eligibility criteria, applicable compensation, and contact information are provided across nearly 30 studies, with more to be added soon.

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Research reveals impact of gut microbiome on hormone levels in mice

• Date created: 26 September 2024
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Researchers at the Francis Crick Institute have shown that the balance of bacteria in the gut can influence symptoms of hypopituitarism in mice.

They also showed that aspirin was able to improve hormone deficiency symptoms in mice with this condition.

Christophe Galichet and Robin Lovell-Badge were researching mouse Sox3 mutations, which cause hypopituitarism in mice and humans, at the National Institute for Medical Research (NIMR). When they transferred mice with Sox3  mutations from the NIMR to the Crick, they made an unexpected discovery.  

People with mutations in a gene called Sox3 develop hypopituitarism, where the pituitary gland doesn’t make enough hormones. It can result in growth problems, infertility and poor responses of the body to stress.

In research published today in PLOS Genetics , the scientists at the Crick removed Sox3 from mice, causing them to develop hypopituitarism around the time of weaning (starting to eat solid food).

They found that mutations in Sox3 largely affect the hypothalamus in the brain, which instructs the pituitary gland to release hormones. However, the gene is normally active in several brain cell types, so the first task was to ask which specific cells were most affected by its absence.

The scientists observed a reduced number of cells called NG2 glia, suggesting that these play a critical role in inducing the pituitary gland cells to mature around weaning, which was not known previously. This could explain the associated impact on hormone production.

The team then treated the mice with a low dose of aspirin for 21 days. This caused the number of NG2 glia in the hypothalamus to increase and reversed the symptoms of hypopituitarism in the mice.

NG2 glia (red) in the median eminence, which connects the hypothalamus and the pituitary gland, are reduced in the mice with  Sox3  mutations (right-hand panel). 

Although it’s not yet clear how aspirin had this effect, the findings suggest that it could be explored as a potential treatment for people with Sox3 mutations or other situations where the NG2 glia are compromised.

It was a huge surprise to find that changes in the gut microbiome reversed hypopituitarism in the mice without Sox3. Christophe Galichet

An incidental discovery revealed the role of gut bacteria in hormone production

When the National Institute for Medical Research (NIMR) merged with the Crick in 2015, mouse embryos were transferred from the former building to the latter, and this included the mice with Sox3 mutations.

When these mice reached the weaning stage at the Crick, the researchers were surprised to find that they no longer had the expected hormonal deficiencies.

After exploring a number of possible causes, lead author Christophe Galichet compared the microbiome – bacteria, fungi and viruses that live in the gut – in the mice from the Crick and mice from the NIMR, observing several differences in its makeup and diversity. This could have been due to the change in diet, water environment, or other factors that accompanied the relocation.

He also examined the number of NG2 glia in the Crick mice, finding that these were also at normal levels, suggesting that the Crick-fed microbiome was somehow protective against hypopituitarism.

To confirm this theory, Christophe transplanted faecal matter retained from NIMR mice into Crick mice, observing that the Crick mice once again showed symptoms of hypopituitarism and had lower numbers of NG2 glia. 

Although the exact mechanism is unknown, the scientists conclude that the make-up of the gut microbiome is an example of an important environmental factor having a significant influence on the consequences of a genetic mutation, in this case influencing the function of the hypothalamus and pituitary gland.

Christophe Galichet , former Senior Laboratory Research Scientist at the Crick and now Research Operations Manager at the Sainsbury Wellcome Centre , said: “It was a huge surprise to find that changes in the gut microbiome reversed hypopituitarism in the mice without Sox3 . It’s reinforced to me how important it is to be aware of all variable factors, including the microbiome, when working with animals in research and how nurture can influence nature.”

Robin Lovell-Badge , Group Leader of the Stem Cell Biology and Developmental Genetics Laboratory at the Crick, said: “Hypopituitarism can result from trauma as well as rare mutations, and it can have some profound effects on health in general. As well as suggesting potential options for treatment, our work reinforces how important the gut-brain link is. The next step for this research will be to work out exactly how aspirin and the microbiome influence NG2 glia, and then study this effect in people so we can see if these relatively accessible interventions could help treat hypopituitarism.”

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• Read the paper in PLOS Genetics

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Speaker 1: When you write a research assignment, it's important that you acknowledge the ideas or quotes from other sources that you use, right when you use them. Not only does this show that you're an honest and ethical student, but it also tells the reader exactly where you found that awesome piece of information. So, how do you give credit to other sources in your assignments? You use in-text citations, which can also be called parenthetical citations. An in-text citation connects information you're borrowing from a source to a citation in your bibliography, which helps teachers and classmates understand where the information originally came from. Include an in-text citation in your paper when you use a quote word-for-word from a source or when you borrow an idea or phrase from someone else. In-text citations have to be written in a special way. They require four things in this order. An open parenthesis, the author's last name, the page number that you found the information on, and a closed parenthesis. In-text citations are placed inside the sentence, so make sure that the period is outside of the parenthesis. If you are using a source word-for-word in your paper, you need to put quotation marks around it. This is called a direct quote. Let's say that I found a sentence on page 20 of The Giver by Lois Lowry that explains an important part of the story. If I take all or even just part of the sentence word-for-word and put it in my paper, I would need to include quotations around it and add an in-text citation, like this. Let's say you want to explain something that happened in The Giver, but you explain it in your own words instead of taking it straight out of the book. This is called a paraphrase, and while you don't need to include quotation marks, you still need to include an in-text citation. This will give credit to Lois Lowry's writing and let your teacher or classmates know where the event happened in the book. Remember, make sure that the first word in the in-text citation matches the first word in the citation of your bibliography. That way, when people want to learn more about the source in your paper, all they have to do is look for the same word in the bibliography to find it. The in-text citation takes readers to a specific citation in your bibliography, and the specific citation tells the readers where they can find the piece of information you used. There are special rules and exceptions for using in-text citations, so if you're unsure, check with your librarian or teacher, just in case. A great site for practicing the rules of in-text citations is NoWriteInc.com. Check out a practice exercise now by going to this link.

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Citing your sources is essential in  academic writing . Whenever you quote or paraphrase a source (such as a book, article, or webpage), you have to include a  citation crediting the original author.

Failing to properly cite your sources counts as plagiarism , since you’re presenting someone else’s ideas as if they were your own.

The most commonly used citation styles are APA and MLA. The free Scribbr Citation Generator is the quickest way to cite sources in these styles. Simply enter the URL, DOI, or title, and we’ll generate an accurate, correctly formatted citation.

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Table of contents

When do you need to cite sources, which citation style should you use, in-text citations, reference lists and bibliographies.

Scribbr Citation Generator

Other useful citation tools

Citation examples and full guides, frequently asked questions about citing sources.

Citations are required in all types of academic texts. They are needed for several reasons:

• To avoid plagiarism by indicating when you’re taking information from another source
• To give proper credit to the author of that source
• To allow the reader to consult your sources for themselves

A citation is needed whenever you integrate a source into your writing. This usually means quoting or paraphrasing:

• To quote a source , copy a short piece of text word for word and put it inside quotation marks .
• To paraphrase a source , put the text into your own words. It’s important that the paraphrase is not too close to the original wording. You can use the paraphrasing tool if you don’t want to do this manually.

Citations are needed whether you quote or paraphrase, and whatever type of source you use. As well as citing scholarly sources like books and journal articles, don’t forget to include citations for any other sources you use for ideas, examples, or evidence. That includes websites, YouTube videos , and lectures .

Scribbr Citation Checker New

The AI-powered Citation Checker helps you avoid common mistakes such as:

• Missing commas and periods
• Incorrect usage of “et al.”
• Ampersands (&) in narrative citations
• Missing reference entries

Usually, your institution (or the journal you’re submitting to) will require you to follow a specific citation style, so check your guidelines or ask your instructor.

In some cases, you may have to choose a citation style for yourself. Make sure to pick one style and use it consistently:

• APA Style is widely used in the social sciences and beyond.
• MLA style is common in the humanities.
• Chicago notes and bibliography , common in the humanities
• Chicago author-date , used in the (social) sciences
• There are many other citation styles for different disciplines.

If in doubt, check with your instructor or read other papers from your field of study to see what style they follow.

In most styles, your citations consist of:

• Brief in-text citations at the relevant points in the text
• A reference list or bibliography containing full information on all the sources you’ve cited

In-text citations most commonly take the form of parenthetical citations featuring the last name of the source’s author and its year of publication (aka author-date citations).

An alternative to this type of in-text citation is the system used in numerical citation styles , where a number is inserted into the text, corresponding to an entry in a numbered reference list.

There are also note citation styles , where you place your citations in either footnotes or endnotes . Since they’re not embedded in the text itself, these citations can provide more detail and sometimes aren’t accompanied by a full reference list or bibliography.

A reference list (aka “Bibliography” or “Works Cited,” depending on the style) is where you provide full information on each of the sources you’ve cited in the text. It appears at the end of your paper, usually with a hanging indent applied to each entry.

The information included in reference entries is broadly similar, whatever citation style you’re using. For each source, you’ll typically include the:

• Author name
• Publication date
• Container (e.g., the book an essay was published in, the journal an article appeared in)
• Location (e.g., a URL or DOI , or sometimes a physical location)

The exact information included varies depending on the source type and the citation style. The order in which the information appears, and how you format it (e.g., capitalization, use of italics) also varies.

Most commonly, the entries in your reference list are alphabetized by author name. This allows the reader to easily find the relevant entry based on the author name in your in-text citation.

In numerical citation styles, the entries in your reference list are numbered, usually based on the order in which you cite them. The reader finds the right entry based on the number that appears in the text.

Prevent plagiarism. Run a free check.

Because each style has many small differences regarding things like italicization, capitalization , and punctuation , it can be difficult to get every detail right. Using a citation generator can save you a lot of time and effort.

Scribbr offers citation generators for both APA and MLA style. Both are quick, easy to use, and 100% free, with no ads and no registration required.

Just input a URL or DOI or add the source details manually, and the generator will automatically produce an in-text citation and reference entry in the correct format. You can save your reference list as you go and download it when you’re done, and even add annotations for an annotated bibliography .

Once you’ve prepared your citations, you might still be unsure if they’re correct and if you’ve used them appropriately in your text. This is where Scribbr’s other citation tools and services may come in handy:

Plagiarism Checker

Citation Checker

Citation Editing

Plagiarism means passing off someone else’s words or ideas as your own. It’s a serious offense in academia. Universities use plagiarism checking software to scan your paper and identify any similarities to other texts.

When you’re dealing with a lot of sources, it’s easy to make mistakes that could constitute accidental plagiarism. For example, you might forget to add a citation after a quote, or paraphrase a source in a way that’s too close to the original text.

Using a plagiarism checker yourself before you submit your work can help you spot these mistakes before they get you in trouble. Based on the results, you can add any missing citations and rephrase your text where necessary.

Try out the Scribbr Plagiarism Checker for free, or check out our detailed comparison of the best plagiarism checkers available online.

Scribbr Plagiarism Checker

Scribbr’s Citation Checker is a unique AI-powered tool that automatically detects stylistic errors and inconsistencies in your in-text citations. It also suggests a correction for every mistake.

Currently available for APA Style, this is the fastest and easiest way to make sure you’ve formatted your citations correctly. You can try out the tool for free below.

If you need extra help with your reference list, we also offer a more in-depth Citation Editing Service.

Our experts cross-check your in-text citations and reference entries, make sure you’ve included the correct information for each source, and improve the formatting of your reference page.

If you want to handle your citations yourself, Scribbr’s free Knowledge Base provides clear, accurate guidance on every aspect of citation. You can see citation examples for a variety of common source types below:

And you can check out our comprehensive guides to the most popular citation styles:

At college level, you must properly cite your sources in all essays , research papers , and other academic texts (except exams and in-class exercises).

Add a citation whenever you quote , paraphrase , or summarize information or ideas from a source. You should also give full source details in a bibliography or reference list at the end of your text.

The exact format of your citations depends on which citation style you are instructed to use. The most common styles are APA , MLA , and Chicago .

The abbreviation “ et al. ” (Latin for “and others”) is used to shorten citations of sources with multiple authors.

“Et al.” is used in APA in-text citations of sources with 3+ authors, e.g. (Smith et al., 2019). It is not used in APA reference entries .

Use “et al.” for 3+ authors in MLA in-text citations and Works Cited entries.

Use “et al.” for 4+ authors in a Chicago in-text citation , and for 10+ authors in a Chicago bibliography entry.

The Scribbr Citation Generator is developed using the open-source Citation Style Language (CSL) project and Frank Bennett’s citeproc-js . It’s the same technology used by dozens of other popular citation tools, including Mendeley and Zotero.

You can find all the citation styles and locales used in the Scribbr Citation Generator in our publicly accessible repository on Github .

APA format is widely used by professionals, researchers, and students in the social and behavioral sciences, including fields like education, psychology, and business.

Be sure to check the guidelines of your university or the journal you want to be published in to double-check which style you should be using.

MLA Style  is the second most used citation style (after APA ). It is mainly used by students and researchers in humanities fields such as literature, languages, and philosophy.

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Purdue Online Writing Lab Purdue OWL® College of Liberal Arts

MLA Formatting and Style Guide

Welcome to the Purdue OWL

This page is brought to you by the OWL at Purdue University. When printing this page, you must include the entire legal notice.

Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission. Use of this site constitutes acceptance of our terms and conditions of fair use.

The following overview should help you better understand how to cite sources using MLA  9 th edition, including how to format the Works Cited page and in-text citations.

Please use the example at the bottom of this page to cite the Purdue OWL in MLA. See also our MLA vidcast series on the Purdue OWL YouTube Channel .

Creating a Works Cited list using the ninth edition

MLA is a style of documentation that may be applied to many different types of writing. Since texts have become increasingly digital, and the same document may often be found in several different sources, following a set of rigid rules no longer suffices.

Thus, the current system is based on a few guiding principles, rather than an extensive list of specific rules. While the handbook still describes how to cite sources, it is organized according to the process of documentation, rather than by the sources themselves. This gives writers a flexible method that is near-universally applicable.

Once you are familiar with the method, you can use it to document any type of source, for any type of paper, in any field.

Here is an overview of the process:

When deciding how to cite your source, start by consulting the list of core elements. These are the general pieces of information that MLA suggests including in each Works Cited entry. In your citation, the elements should be listed in the following order:

• Title of source.
• Title of container,
• Other contributors,
• Publication date,

Each element should be followed by the corresponding punctuation mark shown above. Earlier editions of the handbook included the place of publication and required different punctuation (such as journal editions in parentheses and colons after issue numbers) depending on the type of source. In the current version, punctuation is simpler (only commas and periods separate the elements), and information about the source is kept to the basics.

Begin the entry with the author’s last name, followed by a comma and the rest of the name, as presented in the work. End this element with a period.

Bhabha, Homi K. The Location of Culture. Routledge, 1994.

Title of source

The title of the source should follow the author’s name. Depending upon the type of source, it should be listed in italics or quotation marks.

A book should be in italics:

Henley, Patricia. The Hummingbird House . MacMurray, 1999.

An individual webpage should be in quotation marks. The name of the parent website, which MLA treats as a "container," should follow in italics:

Lundman, Susan. "How to Make Vegetarian Chili." eHow, www.ehow.com/how_10727_make-vegetarian-chili.html.*

A periodical (journal, magazine, newspaper) article should be in quotation marks:

Bagchi, Alaknanda. "Conflicting Nationalisms: The Voice of the Subaltern in Mahasweta Devi's Bashai Tudu." Tulsa Studies in Women's Literature , vol. 15, no. 1, 1996, pp. 41-50.

A song or piece of music on an album should be in quotation marks. The name of the album should then follow in italics:

Beyoncé. "Pray You Catch Me." Lemonade, Parkwood Entertainment, 2016, www.beyonce.com/album/lemonade-visual-album/.

*The MLA handbook recommends including URLs when citing online sources. For more information, see the “Optional Elements” section below.

Title of container

The eighth edition of the MLA handbook introduced what are referred to as "containers," which are the larger wholes in which the source is located. For example, if you want to cite a poem that is listed in a collection of poems, the individual poem is the source, while the larger collection is the container. The title of the container is usually italicized and followed by a comma, since the information that follows next describes the container.

Kincaid, Jamaica. "Girl." The Vintage Book of Contemporary American Short Stories, edited by Tobias Wolff, Vintage, 1994, pp. 306-07.

The container may also be a television series, which is made up of episodes.

“94 Meetings.” Parks and Recreation, created by Greg Daniels and Michael Schur, performance by Amy Poehler, season 2, episode 21, Deedle-Dee Productions and Universal Media Studios, 2010.

The container may also be a website, which contains articles, postings, and other works.

Wise, DeWanda. “Why TV Shows Make Me Feel Less Alone.”  NAMI,  31 May 2019,  www.nami.org/Blogs/NAMI-Blog/May-2019/How-TV-Shows-Make-Me-Feel-Less-Alone . Accessed 3 June 2019.

In some cases, a container might be within a larger container. You might have read a book of short stories on Google Books , or watched a television series on Netflix . You might have found the electronic version of a journal on JSTOR. It is important to cite these containers within containers so that your readers can find the exact source that you used.

“94 Meetings.” Parks and Recreation , season 2, episode 21, NBC , 29 Apr. 2010. Netflix, www.netflix.com/watch/70152031?trackId=200256157&tctx=0%2C20%2C0974d361-27cd-44de-9c2a-2d9d868b9f64-12120962.

Langhamer, Claire. “Love and Courtship in Mid-Twentieth-Century England.” Historical Journal , vol. 50, no. 1, 2007, pp. 173-96. ProQuest, doi:10.1017/S0018246X06005966. Accessed 27 May 2009.

Other contributors

In addition to the author, there may be other contributors to the source who should be credited, such as editors, illustrators, translators, etc. If their contributions are relevant to your research, or necessary to identify the source, include their names in your documentation.

Foucault, Michel. Madness and Civilization: A History of Insanity in the Age of Reason. Translated by Richard Howard , Vintage-Random House, 1988.

Woolf, Virginia. Jacob’s Room . Annotated and with an introduction by Vara Neverow, Harcourt, Inc., 2008.

If a source is listed as an edition or version of a work, include it in your citation.

The Bible . Authorized King James Version, Oxford UP, 1998.

Crowley, Sharon, and Debra Hawhee. Ancient Rhetorics for Contemporary Students. 3rd ed., Pearson, 2004.

If a source is part of a numbered sequence, such as a multi-volume book or journal with both volume and issue numbers, those numbers must be listed in your citation.

Dolby, Nadine. “Research in Youth Culture and Policy: Current Conditions and Future Directions.” Social Work and Society: The International Online-Only Journal, vol. 6, no. 2, 2008, www.socwork.net/sws/article/view/60/362. Accessed 20 May 2009.

Quintilian. Institutio Oratoria. Translated by H. E. Butler, vol. 2, Loeb-Harvard UP, 1980.

The publisher produces or distributes the source to the public. If there is more than one publisher, and they are all are relevant to your research, list them in your citation, separated by a forward slash (/).

Klee, Paul. Twittering Machine. 1922. Museum of Modern Art, New York. The Artchive, www.artchive.com/artchive/K/klee/twittering_machine.jpg.html. Accessed May 2006.

Women's Health: Problems of the Digestive System . American College of Obstetricians and Gynecologists, 2006.

Daniels, Greg and Michael Schur, creators. Parks and Recreation . Deedle-Dee Productions and Universal Media Studios, 2015.

Note : The publisher’s name need not be included in the following sources: periodicals, works published by their author or editor, websites whose titles are the same name as their publisher, websites that make works available but do not actually publish them (such as  YouTube ,  WordPress , or  JSTOR ).

Publication date

The same source may have been published on more than one date, such as an online version of an original source. For example, a television series might have aired on a broadcast network on one date, but released on  Netflix  on a different date. When the source has more than one date, it is sufficient to use the date that is most relevant to your writing. If you’re unsure about which date to use, go with the date of the source’s original publication.

In the following example, Mutant Enemy is the primary production company, and “Hush” was released in 1999. Below is a general citation for this television episode:

“Hush.” Buffy the Vampire Slayer , created by Joss Whedon, performance by Sarah Michelle Gellar, season 4, Mutant Enemy, 1999 .

However, if you are discussing, for example, the historical context in which the episode originally aired, you should cite the full date. Because you are specifying the date of airing, you would then use WB Television Network (rather than Mutant Enemy), because it was the network (rather than the production company) that aired the episode on the date you’re citing.

“Hush.” Buffy the Vampire Slayer, created by Joss Whedon, performance by Sarah Michelle Gellar, season 4, episode 10, WB Television Network, 14 Dec. 1999 .

You should be as specific as possible in identifying a work’s location.

An essay in a book or an article in a journal should include page numbers.

Adiche, Chimamanda Ngozi. “On Monday of Last Week.” The Thing around Your Neck, Alfred A. Knopf, 2009, pp. 74-94 .

The location of an online work should include a URL.  Remove any "http://" or "https://" tag from the beginning of the URL.

Wheelis, Mark. "Investigating Disease Outbreaks Under a Protocol to the Biological and Toxin Weapons Convention." Emerging Infectious Diseases , vol. 6, no. 6, 2000, pp. 595-600, wwwnc.cdc.gov/eid/article/6/6/00-0607_article. Accessed 8 Feb. 2009.

When citing a physical object that you experienced firsthand, identify the place of location.

Matisse, Henri. The Swimming Pool. 1952, Museum of Modern Art, New York .

Optional elements

The ninth edition is designed to be as streamlined as possible. The author should include any information that helps readers easily identify the source, without including unnecessary information that may be distracting. The following is a list of optional elements that can be included in a documented source at the writer’s discretion.

Date of original publication:

If a source has been published on more than one date, the writer may want to include both dates if it will provide the reader with necessary or helpful information.

Erdrich, Louise. Love Medicine. 1984. Perennial-Harper, 1993.

City of publication:

The seventh edition handbook required the city in which a publisher is located, but the eighth edition states that this is only necessary in particular instances, such as in a work published before 1900. Since pre-1900 works were usually associated with the city in which they were published, your documentation may substitute the city name for the publisher’s name.

Thoreau, Henry David. Excursions . Boston, 1863.

Date of access:

When you cite an online source, the MLA Handbook recommends including a date of access on which you accessed the material, since an online work may change or move at any time.

Bernstein, Mark. "10 Tips on Writing the Living Web." A List Apart: For People Who Make Websites, 16 Aug. 2002, alistapart.com/article/writeliving. Accessed 4 May 2009.

As mentioned above, while the MLA handbook recommends including URLs when you cite online sources, you should always check with your instructor or editor and include URLs at their discretion.

A DOI, or digital object identifier, is a series of digits and letters that leads to the location of an online source. Articles in journals are often assigned DOIs to ensure that the source is locatable, even if the URL changes. If your source is listed with a DOI, use that instead of a URL.

Alonso, Alvaro, and Julio A. Camargo. "Toxicity of Nitrite to Three Species of Freshwater Invertebrates." Environmental Toxicology , vol. 21, no. 1, 3 Feb. 2006, pp. 90-94. Wiley Online Library, doi: 10.1002/tox.20155.

Creating in-text citations using the previous (eighth) edition

Although the MLA handbook is currently in its ninth edition, some information about citing in the text using the older (eighth) edition is being retained. The in-text citation is a brief reference within your text that indicates the source you consulted. It should properly attribute any ideas, paraphrases, or direct quotations to your source, and should direct readers to the entry in the Works Cited list. For the most part, an in-text citation is the  author’s name and the page number (or just the page number, if the author is named in the sentence) in parentheses :

When creating in-text citations for media that has a runtime, such as a movie or podcast, include the range of hours, minutes and seconds you plan to reference. For example: (00:02:15-00:02:35).

Again, your goal is to attribute your source and provide a reference without interrupting your text. Your readers should be able to follow the flow of your argument without becoming distracted by extra information.

How to Cite the Purdue OWL in MLA

Entire Website

The Purdue OWL . Purdue U Writing Lab, 2019.

Individual Resources

Contributors' names. "Title of Resource." The Purdue OWL , Purdue U Writing Lab, Last edited date.

The new OWL no longer lists most pages' authors or publication dates. Thus, in most cases, citations will begin with the title of the resource, rather than the developer's name.

"MLA Formatting and Style Guide." The Purdue OWL, Purdue U Writing Lab. Accessed 18 Jun. 2018.

Global Health Research – Researcher-led bands 1 to 3

• Opportunity status: Open
• Type: Programme
• Opening date: 17 July 2024
• Closing date: 6 November 2024 at 1:00 pm
• Reference ID: 97010

Ready to apply?

Apply for this funding opportunity through our online Awards Management System

Our Global Health Research (GHR) – Researcher-led programmes are looking for applications to this new, annual funding opportunity. GHR – Researcher-led funds research that aims to improve health outcomes for the most vulnerable people in low and middle income countries (LMICs). Research must address evidence needs that are locally identified and prioritised, and must promote health equity, aligning with the aims of Sustainable Development Goal 3. Applications can span from broad, ambitious programmes of research to projects with a narrower scope.

GHR – Researcher-led replaces the previously run GHR Units and Groups Programmes and commissions research through 3 programme bands.

This is a two-stage funding opportunity.

This timeline shows each stage of the application process for this funding opportunity:

17 July 2024

Stage 1 opens

29 August 2024

Stage 1 webinar

6 November 2024

Stage 1 closes

January 2025

Stage 1 shortlisting

February 2025

Stage 1 decision

Stage 2 opens

Stage 2 closes

September 2025

Stage 2 shortlisting

November 2025

Stage 2 decision

We cannot guarantee we will be able to answer all queries about the remit or content of applications for those submitted within 2 weeks of the Stage 1 closing date. We also cannot guarantee that new application system accounts (for Lead or Co-applicants) will be verified and approved after 18 October 2024.

Funding bands

There are 3 programme bands of funding based on the scale and ambition of the proposed research, the maturity of partnerships, the teams’ experience and expected capacity strengthening plans.

GHR – Researcher-led band 1

This is for more established research partnerships and experienced teams. This band is suitable for teams proposing a broad, ambitious programme of research and capacity strengthening. Where research is being undertaken by an existing partnership, it is expected that the proposed research will be a significant extension of their previous research. The research will be delivered through linked work packages typically across multiple country contexts. Funded programmes are expected to lead to significant impact on health outcomes, policy and practice, and strengthen research capacity.

GHR – Researcher-led band 2

This is for developing or less mature research partnerships with varying levels of experience proposing to undertake a significant new programme of research, extend existing research and capacity strengthening, and/or include more LMIC settings. The scope and complexity of these programmes can include multiple linked components. Alternatively, they can comprehensively address a single research theme. Funded programmes will lead to lasting impact on health outcomes, policy and practice, and strengthen research capacity.

GHR – Researcher-led band 3

This is for new research partnerships and/or less experienced teams. This band is suitable for teams proposing a research project which may be at an early or developmental stage. It may be delivered in a single country context. Funded projects will have a narrower scope than band 1 and 2 programmes. Proportionate to the amount of funds requested, the project can range from a single to a combination of studies. Projects should offer opportunities for early to mid-career researchers to develop leadership skills and progress their own research ideas. Funded projects will have clear outcomes and defined pathways to impact on health outcomes, policy and practice.

Across all 3 bands, the scope, complexity and ambition of your proposal should be proportionate to the amount of funding you are requesting.

Regardless of your level of experience, you are eligible to apply for a band 3 award where this is appropriate to the research plans. However, where less experienced researchers apply for bands 1, 2 and 3 funding, your application should show appropriate mentoring and support is in place. Mentoring for a less-experienced lead researcher cannot be solely from a more-experienced co-lead.

Each band enables you to develop your leadership skills and those of your team.

See our funding availability section for details on funding amounts available.

Eligibility

We will accept applications in any field of applied global health research, if the research benefits people living in one or more Official Development Assistance (ODA)-eligible country/countries.

To be eligible to receive GHR – Researcher-led funding, your application must demonstrate how it meets ODA compliance criteria.

You will need to outline:

• which country/countries on the Organisation for Economic Cooperation and Development, Development Assistance Committee ( OECD DAC ) list of ODA-eligible countries will directly benefit
• how your application is relevant to the development challenges of those countries
• how the outcomes will promote the health and welfare of people in a country/countries on the OECD DAC list

Where elements of your research are undertaken outside an ODA-eligible country you must clearly state the reasons for this in your application. For example, you may need specialist expertise. If you know a country will be removed from the ODA-DAC list during the lifetime of your project, you will need to show how your research benefits ODA-eligible countries.

If the majority or sole focus of your application is health policy and systems, you should apply to future Global Health Research Health Policy and Systems (GHR HPS)  opportunities instead. However, if your research has a health policy and systems element to it which is not the sole focus, you can apply for this GHR – Researcher-led opportunity.

We reserve the right to transfer applications between Global Health Research funding opportunities where these align more closely with another programme remit.

If you are unsure which programme to apply for, please email [email protected] .

GHR – Researcher-led programmes will support applications which:

• address the programme aims, scope, eligibility and key criteria for funding
• develop or expand research partnerships and networks
• undertake LMIC-led needs analyses by engaging with policymakers, evidence users and local communities which will help refine research questions and priorities and ensure their relevance to the setting(s)
• target research areas that will lead to improved outcomes for all specifically for the most vulnerable
• address issues of health equity by considering, but not limited to, sex, gender, age, ethnicity, geographical and socioeconomic barriers to improved health, access to healthcare and economic impact.
• include interdisciplinary applied research teams with appropriate health systems, clinical, social science, political science and related disciplines, epidemiology, medical statistics, implementation science, community engagement and working with community groups, and health economics expertise. Experts should have relevant experience and/or a track record of ensuring research is transferred into benefits for people living in LMICs
• meet locally or regionally identified needs, which inform local and national plans for change
• demonstrate equity and collaboration in programme leadership, decision-making, capacity strengthening, governance, distribution of funds, ethics processes, data ownership, and dissemination of findings
• support and embed South-South, South-North and North-South bidirectional learning
• include relevant engagement with communities throughout the lifetime of the project/programme
• include a trajectory for developing future leaders, where less experienced Investigators are fully supported and mentored by an experienced Joint Lead or Co-applicant to jointly lead the research programme or selected components
• demonstrate a level of institutional commitment to support and facilitate the research partnership and provide appropriate administrative, technical and financial services

GHR – Researcher-led leadership model

Depending on the funding band you are applying for, GHR – Researcher-led applications can have either:

• one Sole Lead employed by an eligible LMIC institution. Sole Leads from UK institutions are not eligible to apply
• two Joint Leads - one must be employed by an eligible LMIC institution. The other Joint Lead can be employed by a different eligible LMIC institution, or an eligible UK institution. UK based lead organisations can only apply in equitable partnership with a LMIC Joint Lead organisation (please refer to our equitable partnership guide)

Each Sole Lead or named Joint Lead, whether LMIC or UK institutions, must be from an eligible Higher Education institution (HEI) or Research Institute.

If you are applying as a Sole Lead, your institution will need to sign the funding contract.

If you are applying as Joint Leads, the funding contract can be signed by either of your institutions.

Whichever institution signs the funding contract becomes the contracting institution.

We will disburse funding to the contracting institution only. The contracting institution will be responsible for the onward disbursement of funds to all collaborating institutions. This includes all named LMIC or UK Joint Lead institutions, as relevant. You should confirm that for your contracting organisation this disbursement is within your national government rules on receipt of ODA funds. The contracting institution must also be responsible for ensuring due diligence and financial governance is completed across the partnership.

Normally, Joint and Sole Lead applicants will be principal investigators employed by an LMIC or UK HEI or Research Institute. There may be other affiliated Co-applicants and Collaborators, including service level providers, needed to deliver the funding. There are no restrictions on the number of Co-applicants or Collaborators you can include in your application. You must, however, justify each of these roles, how these complement each other, and why they are necessary to effectively deliver the aims of the GHR – Researcher-led opportunity.

If your application includes high income country Co-applicants or Collaborators outside the UK, you must justify their role and expertise. You should also explain why this cannot be performed by an LMIC Co-applicant or Collaborator. For more detailed information, see our Core Guidance: Structure of Team .

Funding available

Through this opportunity, funding ranges from £0.25-£7 million, over a period up to 5 years, depending on the band you apply for.

The funding limits are a guide and budgets must clearly relate to the work being proposed. We welcome applications which ask for less than the maximum funding amount. We expect to fund across the range of bands (indicative numbers in table below).

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There is flexibility across the bands, for example, more experienced researchers are eligible to apply for a band 3 award where their research plans are more focused and are in the developing or early stage. A less experienced researcher can apply for bands 1, 2 or 3 with appropriate mentoring and support in place from Joint Leads or Co-Applicants, if their research plans are broader and more complex. Each band enables you to develop your leadership skills and that of your team.

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Across all bands, there is provision to include a small component:

• to respond to urgent priorities or needs which may arise during the lifetime of the funded programme
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The total funding for either of these components must not exceed 5% of the total budget requested and must fit within the maximum funding limit for that band. You must not use these funds as contingency i.e., a reserve of money set aside to cover possible unforeseen future expenses. We will regularly monitor your research activities as part of our routine checks.

In addition to academic training posts, we encourage the inclusion of wider research capacity strengthening and mentoring.

Please see our GHR finance guidance  for more information.

To help with your application, you will need to read the information on the following pages:

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Key criteria for funding

We will assess your Stage 1 application to make sure it meets the eligibility and scope of the funding opportunity. You will need to address key criteria 1 to 4 (below) at Stage 1. You should also briefly indicate the approach for meeting key criteria 5 to 8 (below). Ensure that you meet and embed all eligibility criteria throughout your proposal development.

Our Funding Committee assesses Stage 2 research proposals based on all key criteria 1 to 8. If you are successful at Stage 1, you should further develop your proposal and provide sufficient detail on meeting all key criteria at Stage 2.

At Stage 1, key criteria assessed are:

1. Relevance of the proposed research - you should demonstrate that the proposed research:

• is designed by LMIC partners from the outset based on a review of the local context/health system(s) and existing literature
• fulfils a significant gap and addresses unmet health needs and priorities in ODA-eligible countries
• aligns fully with the scope of this funding opportunity
• will enable individuals and research institutions to produce relevant high-quality evidence that addresses unmet needs in ODA-eligible countries

2. Research quality and excellence - your application should demonstrate:

• that the research plan is robust and includes clear research questions, objectives and sound design
• detailed methodology showing how the research will address the questions and meet planned objectives. You should include clear milestones, the identification and mitigation of possible risks, and ethical considerations
• appropriate plans for effective programme management, governance, institutional support and contract management

3. Strength of the research team - your application should demonstrate:

• the research team has an appropriate range and depth of relevant expertise
• the research team promotes interdisciplinary approaches to working
• appropriate mentoring arrangements where the lead applicant is a less-experienced researcher

4. Impact and sustainability - your application should demonstrate:

• the potential for research outputs which improve practice, inform policy, and support the future implementation and sustainability of research and partnerships in LMICs beyond the end of the award
• a clear and implementable strategy to achieve impact, including research uptake and dissemination

At Stage 2, in addition to 1-4 above, we also assess:

5. Capacity strengthening - this means there should be clear plans for:

• research and research management capacity and capability strengthening at individual and institutional level. These plans should be proportionate to the funding band and scale of the award
• appropriate training in research support functions (training in finance, programme and research management and informal training opportunities) and training for community stakeholders

6. Community Engagement and Involvement (CEI) - research plans should:

• include relevant and appropriate stakeholders and CEI throughout all stages of the research
• address barriers and effectively engage the most vulnerable and marginalised groups, relevant stakeholders or actors in the context over the lifetime of the research programme
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• programme leadership
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• dissemination of findings
• demonstrate promotion of equality, diversity and inclusion in all aspects of the planned research, and within and across the research teams. It is important to ensure diversity, in particular gender balance and leveraging existing expertise within ODA-eligible countries

8. Value for money - you should:

• include a clear, well-justified budget that demonstrates good value for money
• show that all planned expenditure is proportionate and appropriate against the planned activities outlined in the application. Consider economy, efficiency, effectiveness and equity

For more information, please read our Global Health Research Programmes - Core Guidance for applicants .

Selection process

Your application will be considered by an independent international funding committee. The committee will make recommendations to the Department of Health and Social Care (DHSC) on which applications should be supported.

If you have previously submitted an application which has been unsuccessful, you are still eligible to submit a revised application. However, your application should address all prior committee feedback.

DHSC retains the right to make strategic decisions at the final outcome stage (following stage 2 Funding Committee). DHSC final funding decisions will be based on available budget, overall portfolio balance, alignment with relevant UK Government policies, NIHR strategic priorities, institutional balance and ranking based on scientific quality.

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We will monitor annual milestones and deliverables. These will be reviewed/agreed annually and aligned with original approved aims and deliverables. We will also review the progress of funded applications after the first 6 months of contracting. This allows us to ensure the effective set-up and delivery of initial milestones has been achieved. We will then actively monitor contracts through quarterly finance/high-level progress reporting.

Submitting multiple applications to GHR – Researcher-led

You, as an individual, cannot be named as Joint Lead or Sole Lead on more than one application to this funding opportunity.

However, HEIs or Research Institutes may submit more than one application to this funding opportunity as Joint or Sole Lead, provided each application is distinct in its aims and objectives.

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Our expectation is that if there are multiple applications from a single institution, at least 50% of the Lead applicants should be women. You should justify where this is not possible and make plans to address this over the longer term.

If you are from an Institution submitting multiple applications as Joint/Sole leads, you should consider our position on equality, diversity and inclusion at all levels of the awards, including leadership, governance and delivery. This includes, but is not limited to, gender balance. You should also consider the aims of GHR – Researcher-led to support a breadth of research related activity. This includes research capacity strengthening and career development through a diversity of leadership models to develop future global research leaders. If you are an existing award holder, you are eligible to apply to this funding opportunity, provided you assure us that you have sufficient time and resources available to deliver concurrent awards successfully. You should make a robust and compelling case for funding in your application.

You can find further details on eligibility for this funding opportunity on our GHR – Researcher-led programmes page .

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You can download a template of the application form below. Please use this template as a guide to help you prepare your application. This Word document of the Stage 1 application form is to be used as a guide only. It is designed to help you complete the online application form only. For example, to see how many characters are accepted in each section and to see how information in the form is laid out. Please do not try to use this as an application form. You must submit your application in our online Awards Management System which you can access by clicking on the 'Apply now' links when a funding opportunity is open.

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Trends in clinical workload in UK primary care 2005–2019: a retrospective cohort study

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• ORCID record for Lyvia de Dumast
• ORCID record for Patrick Moore
• ORCID record for Kym IE Snell
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• Figures & Data

Background Substantial increases in UK consulting rates, mean consultation duration, and clinical workload were observed between 2007 and 2014. To the authors’ knowledge, no analysis of more recent trends in clinical workload has been published to date. This study updates and builds on previous research, identifying underlying changes in population morbidity levels affecting demand for primary health care.

Aim To describe the changes in clinical workload in UK primary care since 2005.

Design and setting Retrospective cohort study using GP primary care electronic health records data from 824 UK general practices.

Method Over 500 million anonymised electronic health records were obtained from IQVIA Medical Research Data to examine consulting rates with GPs and practice nurses together with the duration of these consultations to determine total patient-level workload per person–year.

Results Age-standardised mean GP direct (face-to-face and telephone) consulting rates fell steadily by 2.0% a year from 2014 to 2019. Between 2005 and 2019 mean GP direct consulting rates fell by 5.8% overall whereas mean workload per person–year increased by 25.8%, owing in part to a 36.9% increase in mean consultation duration. Indirect GP workload almost tripled over the 15 years, contributing to a 48.3% increase in overall clinical workload per person–year. The proportion of the study population with ≥3 serious chronic conditions increased from 9.7% to 16.1%, accounting for over a third of total clinical workload in 2019.

Conclusion Findings show sustained increases in consulting rates, consultation duration, and clinical workload until 2014. From 2015, however, rising demand for health care and a larger administrative workload have led to capacity constraints as the system nears saturation.

• consultation
• primary care
• staff workload
• electronic health records
• retrospective study
• Introduction

Strong primary care is associated with better population health, lower healthcare expenditure, and a more equitable distribution of health resources. 1 In the UK, primary care plays an essential role in the provision of health care, accounting for approximately 90% of all NHS contacts. 2 Although NHS activity data indicate that general practices delivered a record 356 million appointments in 2023, demand continues to outstrip capacity. 3 A recent survey reported that 71% of GPs in the UK found their job to be very or extremely stressful, with the highest proportion among the 10 high-income countries surveyed. 4

Fears that primary care in the UK is in crisis or nearing breaking point are nothing new. 5 Although pressures on general practice were undeniably exacerbated by the COVID-19 pandemic, the current situation is the outcome of many years of underinvestment, a shrinking of the GP workforce, an ageing and growing population, and national strategic objectives that sought to shift care out of hospitals and into the community. Analysis of 2023 workforce data showed an 11.8% fall in the number of full-time equivalent (FTE) GPs (excluding locums, trainees, and retainers) and a 41% increase in the number of patients per FTE GP since 2014. 1 , 6 The proportion of NHS funding directed to general practices declined from 10.6% in 2005/2006 to 6.8% in 2020/2021 as secondary care services secured a greater share of increases in healthcare spending. 7 The UK population increased by 11.4% over the same period and its median age rose from 38.7 to 40.7 years. 8

Analysis of a large database of electronic health records described a 10.5% increase in annual consultation rates per person between 2007 and 2014, mainly accounted for by an increase in GP consultations. 9 The same period also saw an increase in consultation duration. In cross-sectional analysis, consultation rates were higher in older patients, females, and those living in more deprived regions. 10 A similar analysis of duration found GP consultations were longer in older patients and females, although the differences were small. 11 The focus of much of the literature on GP workload is on direct patient care, an activity that typically accounts for 75% of patient-related clinical workload. 12 Time spent on indirect patient care (for example, referral letters or repeat prescriptions) was not included, implying that primary care workload data may under-represent total patient-related clinical activity by a third.

How this fits in

Many questions remain unanswered. There is limited understanding of the factors driving long-term trends in consultation rates. The aim of this analysis of the volume and nature of GP and practice nurse consultations was to obtain objective data on changes in clinical workload between 2005 and 2019. Overall clinical workload over time, workload by clinical role, and by multimorbidity level are examined.

Study design

A retrospective cohort study was carried out using data obtained from IQVIA Medical Research Data UK (IMRD) incorporating data from The Health Improvement Network, a Cegedim database. IMRD includes anonymised electronic primary health care records from approximately 6% of the UK population in over 800 UK general practices. General practices are largely representative of UK primary care practices in size, age, and the sex of patients, and prevalence of chronic conditions. 13

Data were extracted for all patients registered with practices contributing to IMRD, covering the period 1 January 2005 to 31 December 2019. Data extraction was facilitated using the Data Extraction for Epidemiological Research (DExtER) tool. 14

The primary outcome is individual patient clinical workload, defined as the total number of contact minutes per year that the patient has with their general practice, coded by staff role and by type of contact. A GP contact is defined as any file opening by a GP and includes face-to-face consultations, telephone calls to or from a patient, results recording, or issuance of a repeat prescription. Similarly, a nurse contact is defined as any file opening recorded as being made by a practice nurse. Patient consultations with nurses are mainly separate from those with doctors. In the UK, primary care nurses’ responsibilities include immunisation, cervical screening, health promotion, and chronic disease management. 15 All non-clinical work by a GP or practice nurse was excluded from the workload calculations, as was any work done by other clerical or administrative staff or other providers of direct care such as physiotherapists or dieticians.

File openings of 0 min have been rounded up to 30 s. File openings of ≥30 min were truncated at 30 min as long openings were considered unlikely to reflect patient work. Consultation rates are defined as the number of times a patient’s file is opened per person–year, by a nurse or a GP. Consultation rates for direct patient contacts (face-to-face surgery consultations and telephone consultations) are also reported. Clinical workload per person–year is defined as the sum of all GP and nurse contact minutes for a given patient in a given year.

Multimorbidity status

Information about patients’ long-term conditions was obtained from IMRD with medical diagnoses of these conditions recorded using the Read code clinical classification system. Read codes are a hierarchical clinical terminology system used within both primary and secondary care to record a wide range of information relating to a patient’s demography, symptoms, tests, results, and diagnoses.

Previous work by Barnett et al identified 40 long-term conditions that had a significant impact on a patient’s quality of life, risk of mortality, and need for health care. 16 In the current study the code lists associated with each of these conditions as determined by a multimorbidity research joint project between the Universities of Cambridge and Birmingham was used. 17

Consulting patterns from 2015 until 2019 were examined, comparing individual workload at 1-year pre-diagnosis to workload 1 year, 3 years, and 5 years post-diagnosis for each condition to determine the length of time that conditions should be shown as present following diagnosis.

Person–years for each age group were calculated for each year. Workload per person–year and consultation rates were age standardised to the population of the 2005 IMRD dataset to allow comparison over time. Mean annual clinical consulting rates and mean duration of file openings were calculated for all types of consultations with a GP, face-to-face and telephone consultations with a GP, and consultations with a practice nurse. Patients were grouped according to how many chronic conditions they had (0, 1, 2, and ≥3 conditions) and average workload per person–year calculated for each group over the period. Summary statistics are presented in the following section, either graphically or in tables.

Overall, data for over 550 million file openings for 10 098 454 patients from 824 practices were examined in this study, representing over 69 million person–years of observation. Descriptive statistics are given for 2005 and 2019 ( Table 1 ).

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Descriptive statistics of dataset

A comparison of the population by age group for the dataset and for the UK population as a whole in 2005 and 2019 shows that the sample is broadly similar to UK national data obtained from the World Bank databank. 18 For example, in 2005, 59.7% of the UK population was aged <45 years compared with 55.5% for the sample ( n = 2 861 740/5 159 933). In 2019, 55.7% of the UK population was aged <45 years compared with 50.2% for the sample ( n = 1 399 167/2 785 796) (see Supplementary Table S1).

GP face-to-face/telephone consulting rates

After an initial drop in the age-standardised mean consulting rate, rates climbed to a high of 3.84 (95% confidence interval [CI] = 3.84 to 3.85) direct consultations per year in 2014. From 2014 mean consulting rates fell steadily by 2.0% a year to 3.47 (95% CI = 3.46 to 3.47) consultations per year by 2019. Between 2005 and 2019 mean consulting rates fell by 5.8% overall (see Supplementary Figure S1).

Duration of file openings

Duration of file openings by practice nurses increased at a relatively constant rate over the period from a mean of 6.83 (95% CI = 6.82 to 6.83) min in 2005 to 8.99 (95% CI = 8.98 to 9.00) min in 2019, a rise of 31.7% overall (see Supplementary Figure S2).

For GP face-to-face or telephone consultations, mean duration increased by 36.0% between 2005 and 2011. From 2011 onwards, the rate of increase in mean duration of GP face-to-face consultations plateaued, remaining between 8.21 (95% CI = 8.21 to 8.21) min and 8.46 (95% CI = 8.45 to 8.46) min until 2019. The biggest change was in all GP file openings where mean duration increased by 68.4% from 4.57 (95% CI = 4.57 to 4.57) min in 2005 to 7.69 (95% CI = 7.69 to 7.70) min by 2019 (see Supplementary Figure S2). From 2005 to 2019, mean duration of GP direct consultations increased by 36.9% overall.

Clinical workload

Age-standardised mean clinical workload per person–year increased by over 48% from 39.06 (95% CI = 39.03 to 39.10) min in 2005 to 57.61 (95% CI = 57.55 to 57.66) min in 2014. From 2014 to 2019 it remained relatively stable, fluctuating between 56.98 (95% CI = 56.93 to 57.03) and 57.98 (95% CI = 57.93 to 58.03) min ( Figure 1 ).

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Mean age-standardised workload per person–year by staff role. F2F = face to face.

GP workload

In the study, GP workload was separated into two parts: patient-facing workload (GP F2F: all face-to-face consultations and telephone consultations) and patient-related administrative work (GP admin). Mean GP F2F workload per person–year increased every year between 2005 and 2012 to a maximum of just under 33 min. From 2012 to 2019 it fell by 10.6% to just below 30 min. Mean GP admin workload stood at 4.60 (95% CI = 4.60 to 4.60) min per person–year in 2005 rising to 12.53 (95% CI = 12.52 to 12.55) min by 2019, an increase of 172.4%. Administrative workload as a proportion of total GP workload nearly doubled from 16.3% in 2005 to 29.6% in 2019 ( Figure 1 ).

Practice nurse workload

Age-standardised mean practice nurse workload per person–year rose consistently over the period from 10.75 (95% CI = 10.74 to 10.76) min in 2005 to 15.58 (95% CI = 15.56 to 15.59) min in 2019, an increase of 44.9% overall ( Figure 1 ).

Changes over the period in age-standardised mean workload by staff role and type of consultation are shown in Table 2 .

Age-standardised mean workload (in minutes per person–year) by staff role

Multimorbidity levels

Analysis of the impact of a diagnosis on workload found that for most conditions clinical consultation time increased considerably in the year of diagnosis compared with the year before diagnosis, however, consultation time returned to below pre-diagnosis levels within 5 years. For 11 conditions, consultation time increased considerably in the year of diagnosis and remained at a higher level even after 5 years. These conditions were coded to show as present indefinitely, whereas all the other conditions were coded to show as present for 5 years only following diagnosis (see Supplementary Information S1 for details).

Multimorbidity increased across all older age groups between 2005 and 2019 ( Figure 2 ). Overall, 51.5% of the study population had no serious chronic conditions recorded in 2005 and accounted for 27.9% of total clinical workload. Patients with multimorbidity with ≥3 serious chronic conditions represented just 9.7% of the study population but 24.2% of the workload ( n = 499 998/5 159 933). By 2019 the share of the population without any serious chronic conditions had fallen to 43.6% whereas that for patients with multimorbidity with ≥3 conditions had increased to 16.0% ( n = 447 060/2 785 796). The share of total clinical workload accounted for by these patients was 34.5%.

Prevalence of chronic conditions by age group. a) 2005; and b) 2019.

The mean clinical workload associated with patients with no chronic conditions was 21.71 (95% CI = 21.67 to 21.75) min in 2005. Clinical workload increased linearly with the number of chronic diseases: mean workload was 41.13 (95% CI = 41.04 to 41.22) min for patients with one condition, 62.54 (95% CI = 62.37 to 62.71) min for two conditions, and 97.14 (95% CI = 96.86 to 97.42) min for ≥3 conditions. In 2019, mean workload was 31.08 (95% CI = 30.99 to 31.16) min, 54.83 (95% CI = 54.67 to 54.99) min, 79.73 (95% CI = 79.45 to 80.00) min, and 131.03 (95% CI = 130.63 to 131.42) min for 0, 1, 2, and ≥3 conditions, respectively ( Figure 3 ).

Clinical workload by number of chronic conditions.

The rate of increase in clinical workload per person–year over the study period was highest for patients with no chronic conditions at +43.2%, compared with a +33.3% increase in workload for those with one condition, +27.5% for two conditions, and +34.9% for ≥3 conditions ( Figure 3 ).

This study examined trends in consulting rates and duration of consultations for GPs and practice nurses from 2005 to 2019. To capture the full scope of patient-level activity, all aspects of GP workload were studied: both time spent in face-to-face and telephone consultations as well as patient-related administrative work, such as results recording or third-party consultations. Direct patient workload has considerably increased over the period for both GPs and practice nurses by roughly the same amount. However, the amount of time spent by GPs doing patient-related administrative work has increased enormously.

Many factors are likely to have contributed to the increased admin workload of GPs observed over the study period, including the increased ability of GPs to access diagnostic services directly, the transfer of work from secondary to primary care, as well as the introduction of the Quality and Outcomes Framework (QOF) in 2004. 19 , 20 The QOF is a pay- for-performance scheme intended to reward primary care providers for improvements in the management of long-term conditions, representing over 8% of total practice income on average in 2019/2020. 21 Little existing literature on the QOF examines its impact on administrative work undertaken by GPs. There is evidence to suggest, however, that its introduction led to a substantial increase in non-consultation GP workload, in particular that associated with tests. A study of changes in diagnostic testing in UK primary care reported a 3.3-fold increase in test use between 2000/2001 and 2015/2016, and estimated that the average GP spent 1.5 to 2 h each day reviewing test results. 22

The current study recorded a plateauing of the rate of increase in clinical workload from 2014 onwards, with the higher levels of GP admin workload making up for the decline in the GP face-to-face or telephone consulting rate.

Strengths and limitations

The main strength of this study is that it is the first, to the authors’ knowledge, to report on trends in overall clinical workload, examining duration and frequency of clinical consultations, for both patient-facing and administrative activity related to a direct patient contact, such as a repeat prescription or recording of test results. Its findings are based on nearly 70 million person–years of observation covering a 15-year period for practices throughout the UK, making it, to the authors’ knowledge, the largest analysis of clinical workload to date.

This study has several limitations. The most important limitation is that it was not possible to include data from 2020 onwards in the analysis. However, it was felt that the considerable disruption in primary care use during the COVID-19 pandemic was unlikely to be permanent and consequently that the use of data from that period and shortly after would not be representative of any underlying trend. Although the IMRD database is one of the most comprehensive data sources worldwide, as is the case for many observational studies using electronic health records, the accuracy of the recording of consultation durations and types is variable. Short file openings for face-to-face consultations may not accurately reflect the actual work associated with a particular patient if the practitioner does not open the file at the beginning of a consultation, underestimating workload. Similarly, workload will be overestimated if a practitioner forgets to close a patient’s file at the end of the session (all consultations were truncated at 30 min to mitigate this problem).

The list of chronic conditions selected to determine morbidity levels is based on highly regarded previous work: the Read codes used to define these conditions for the present study closely mirror those used by Barnett et al and Cassell et al but may differ slightly. 16 , 23 Using a different set of conditions may have given different results in terms of prevalence and workload associated with the different levels of multimorbidity.

Comparison with existing literature

This study supports previous literature that showed an increase in face-to-face and telephone GP and practice nurse workload between 2007 and 2014 in English general practices, observing both a rise in the mean number of consultations per year and a 4.9% increase in consultation duration. 9 Research by Kontopantelis et al described an increase in the number of GP consultations per year from a median of 5.3 to 8.3 between 2000 and 2019, whereas the number of face-to-face GP consultations per year per patient fell from 3.7 to 3.1. 24 Analysis of the use of primary care by children in England reported a fall in general practice consulting rates of 1% per year in all age bands (except for infants) between 2007 and 2017 while observing a corresponding rise in urgent care use. 25

Whereas literature examining overall trends in clinical workload is scarce, considerable research has examined the association between primary care use and multimorbidity. The crude prevalence rate of multimorbidity (defined as the presence of ≥2 long-term conditions) was 31.6% in the present study in 2019 compared with 22.5% in 2005, rates that are broadly consistent with previous studies of similar populations in the UK. 16 , 23 Multimorbid patients consulted a GP 2.6 times more frequently 23 and each consultation lasted 0.2 min longer on average than for patients without multimorbidity. 26 Using a different definition of multimorbidity (≥2 chronic conditions of the 17 conditions included in the QOF), the first comprehensive study published on the prevalence of morbidity in England identified 16% of patients as being multimorbid in 2008 and these patients accounted for almost a third of all primary care consultations. Patients with multimorbidity had on average 9.4 consultations per annum compared with 3.8 for those without multimorbidity. 27

Implications for research and practice

Primary care practices have had to adjust to consistent increases in the duration of nurse and GP contacts since 2005 in the face of higher numbers of patients with multimorbidity with complex care needs and a greater administrative load per patient. With fewer FTE GPs per head of population, many practices have been unable to keep pace with these changes, leading to a drop in consulting rates since 2015.

The implications of this for practice funding and access to care are important. Approximately half of practice revenue is from the global sum payment, with the amount allocated based on an estimate of a practice’s patient-level workload using demographic data that is over 20 years old. The statistical model used is commonly known as the Carr-Hill formula and it includes factors relating to patient age and gender, morbidity and mortality measures, the number of newly registered patients, staff expenses, practice rurality, and the number of patients living in nursing and residential homes. It is widely recognised that the Carr-Hill formula does not adequately reflect population healthcare needs, particularly need associated with socioeconomic deprivation. 28 , 29 Previous research reported that practices in areas of greater deprivation received 7% less funding per need-adjusted patient than those in more affluent areas. 30 An analysis of primary care funding in England for 2015–2016 found only a modest association between practice funding and morbidity burden at the regional level, with the North East and North West regions appearing to be particularly under-resourced. 28

Repeated calls on the government to replace the Carr-Hill formula with a more equitable formula that better reflects the greater workload associated with deprivation and morbidity have resulted in little progress. Acknowledging in 2015 that the current formula is ‘out of date and needs to be revised’, NHS England and the British Medical Association committed to review the Carr-Hill formula, anticipating that the work would be completed by the summer of 2016. 31 The timeline for reporting findings has since been extended several times but no details of any proposed changes to the formula have been reported to date.

• Acknowledgments

Thank you to the DExtER team at the Institute of Applied Health Research, University of Birmingham, for their assistance in extracting the data from IMRD.

Ethical approval

This article is based on independent research carried out as part of Lyvia de Dumast’s PhD thesis. Analysis of IQVIA Medical Research Data (IMRD) was approved by London — South East Research Ethics Committee pm 5 Jul 2018 (reference: 18/LO/0441), subject to independent scientific review of the analysis. Scientific Review Committee approval for this analysis of the IMRD-UK data was received in January 2021 (reference: 20SRC076).

The IMRD-UK dataset cannot be shared under the data-sharing agreement with the University of Birmingham on behalf of IQVIA.

Freely submitted; externally peer reviewed.

Competing interests

The authors have declared no competing interests.

Discuss this article:

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• Received November 14, 2023.
• Revision requested February 29, 2024.
• Accepted March 27, 2024.
• © The Authors

This article is Open Access: CC BY 4.0 licence ( http://creativecommons.org/licences/by/4.0/ ).

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