06Build the Structure Before the Prose

Writers who skip structure often spend their time solving structural problems sentence by sentence. Background expands because its boundary is unknown. Results repeat tables because the narrative purpose was never defined. Discussion becomes a second literature review. Reviewers request major reorganization after weeks of drafting because they never saw the intended shape.

The Structure makes the document arguable before it becomes polished.

A heading list is not enough

A useful Structure has two layers:

1. Skeleton: The ordered headings and subheadings required by the document type, target, and argument.
2. Section instructions: A concise statement of what each section must accomplish, which sources it uses, which claims or questions it handles, what limits apply, and how completion will be judged.

Compare:

Discussion

with:

Discussion — opening synthesis: Summarize the primary, secondary, and safety findings in Results order without repeating all values. State whether each prespecified objective was met. Use the final tables for values and the protocol/SAP for endpoint status. Do not introduce new results. Flag the unresolved analysis-population discrepancy before drafting.

The second version can guide a writer, reviewer, or tool. It also exposes what the team has not yet decided. A detailed outline can contain nearly all information intended for the final document and can be circulated while structural changes are still cheap.^1,2

Start from three maps

Build the Structure by overlaying:

• Requirement map: Sections and items required by guidance, target instructions, template, ethics, and submission format.
• Evidence map: Sources, tables, analyses, references, and gaps available to support each section.
• Reader map: The sequence of questions the audience needs answered.

Where the maps align, drafting is straightforward. Where they diverge, the Structure should show the problem. A required section without evidence becomes a gap. Important evidence without a section may signal missing structure or irrelevant material. A logical reader question without either requirement or source may require new research or a scope decision.

Give each section one primary job

Sections can contain several elements, but each needs a dominant purpose. In a research paper, the Introduction establishes the problem, current knowledge, gap, and objective. Methods establish what was done and analyzed. Results report findings without turning into interpretation. Discussion explains what the findings mean in context, including limitations and implications.

A one- or two-sentence problem statement that distinguishes the broader problem from the specific problem addressed is useful beyond manuscripts.¹ Define what is insufficient or unresolved, what the current situation is, what the document contributes, and what the reader should understand as a result. That logic can shape an introduction, executive summary, briefing document, review, or educational activity.

Write section instructions as verbs: establish, define, describe, report, compare, interpret, qualify, recommend, disclose. A heading names a place; a verb names the work.

Route sources before drafting

For every section, list the sources that govern it and the sources that support it. Keep these categories distinct. A journal instruction may govern abstract length; the results tables support its numerical content. A sponsor template governs headings; the protocol explains planned conduct; the CSR and outputs explain actual results.

Source routing prevents opportunistic searching during drafting, where the first convenient source becomes the basis for the paragraph. It also enables parallel work because a reviewer can see which materials a section is supposed to use.

When a source is large, route to the exact location: protocol section, SAP analysis, CSR table, figure, patient narrative, or article passage. This is the beginning of traceability.

Plan claims and counterclaims

List the main propositions the document expects to communicate and map each to evidence. Then list the material qualifications, alternative explanations, negative findings, and limitations that the reader needs for fair interpretation.

For a study Discussion, this might include:

• Primary outcome and precision
• Secondary and exploratory findings with status clear
• Safety and tolerability
• Agreement or disagreement with prior literature
• Methodological strengths
• Specific limitations and likely direction of their effect
• Generalizability
• Clinical or scientific implication stated proportionately

This pre-writing exercise catches unsupported enthusiasm before it becomes polished prose.

Design tables and figures early

Design tables and figures early.^2,3 A visual is not decoration appended after the text; it is a communication unit that may carry the document's most important evidence. The form should fit the intended message, data, audience, and use while preserving scientific accuracy.⁴

Decide which reader question each visual answers, which source supplies its data, and what the text should say that the visual does not. Avoid presenting the same data fully in text, table, and figure. Plan titles, legends, footnotes, abbreviations, populations, denominators, units, and statistical notation as part of the Structure.

Visual planning also tests the argument. If no clear display can be designed for a proposed message, the message may be poorly defined or unsupported.

Set budgets and constraints

Assign approximate word, table, figure, and reference budgets before prose expands. Budgets force prioritization. Give more space to the document's central reasoning and less to background the audience already knows.

Budgets are not rigid quotas. They are signals. If one section requires twice its allocation, inspect whether the Structure is wrong, the scope has expanded, or the prose is carrying information that belongs in a visual, appendix, supplement, or deep link.

Carry gaps honestly

Use precise placeholders:

• [Confirm final analysis population against SAP and Table 14.2.1]
• [Insert patient-disposition values after validated output is received]
• [Author decision required: include exploratory subgroup in abstract?]
• [Target journal not selected; abstract structure and reference limit remain provisional]

Avoid placeholders such as [TBD] that preserve no reasoning. A good placeholder states what is missing, why it matters, and what will resolve it.

Review the Structure with the right questions

Ask reviewers to evaluate shape, not sentence style:

• Does the sequence answer the reader's questions?
• Are all governing requirements represented?
• Does every key message have a credible source path?
• Are limitations and safety visible enough?
• Are planned visuals necessary and nonredundant?
• Are any sections overlapping or missing?
• Are gaps accurately stated?
• Is the scope realistic within the target and timeline?

Structure approval is valuable because it makes disagreement cheap. Moving a heading or changing a claim plan takes minutes; major changes in content or organization are far easier at the outline stage, before time has gone into crafting sentences.¹ Rewriting a polished section can take days and generate version noise.

Let reality revise the plan

An accepted Structure is a contract, not a prison. Drafting may reveal that evidence is weaker, a section needs to split, a visual works better than prose, or an important contradiction deserves more space. Reopen the Structure explicitly, record the change, and check downstream effects.

Silent structural drift is the real danger. If the working document changes shape without the plan changing, reviewers no longer know what was agreed.

Open Structure patterns by document type ↗