How the introduction section of a manuscript can be made interesting to entice a reader to read the article

For a published article, journals always ask for an abstract, which can provide the reader with a gist of the article so that a reader can judge if it is relevant for him/her and proceed towards the full text. However, in the case of #narrativereview article, an abstract cannot do justice to the content since they are very short. The #introduction section gives the reader a better idea of what the #narrativereview is about. If you can get the reader hooked here, the article stands a good chance of being read, else the reader will simply move on. In the case of an #originalarticle, do readers really read the introduction or directly move to Methods and Results?

I have often seen that the introduction sections of most manuscripts on some of the common disease conditions and commonly performed procedures are often very identical. Pick up any article on #diabetes and it starts with the number of people with diabetes in the world, the projected numbers by 2040, rate of complications, death etc. Pick up #heartfailure (HF) or #coronaryarterydisease (#CAD) and it is the same story. Pick up #percutaneouscoronaryintervention (PCI) and all articles talk about the disadvantages of balloon angioplasty, how it led to bare-metal stents, 1st generation stents, 2nd generation stents, rates of success and failure with each etc.

Think about it from the point of view of a reader. A diabetologist, cardiologist, and interventional cardiologist knows these numbers like the back of the hand by now. If these specialists are reading even 5 new articles a week, it would be quite boring for them to read the same, week after week. In the bargain, some articles with really good insights might often remain unread. Moreover, these standard introductions often do not directly connect with the topic at hand, and an opportunity to provide more relevant information on the topic and setting the context is being missed.

Can we make it more interesting to the reader and more relevant to the context at hand? I share some random examples below. Of course, whatever the content in the Introduction section, you have to be able to link it to the main focus of the manuscript for a smooth flow.

• In an Indian consensus manuscript on #angiotensin receptor/neprilysin inhibitor (#ARNI) in HF, we can possibly have the introduction section talking of data on the extent of use of guideline-directed medical therapy (#GDMT) globally, or how the profile of Indian HF patients is different from those in Western countries, the geographical variation in epidemiology within India, or the discrepancy in Indian data between various studies, or the outcomes with use of GDMT vs. without use of GDMT, or how the benefits quickly reduce once GDMT is discontinued. There is also new information and data emerging on ARNI in Heart failure with preserved ejection fraction (#HFpEF), which could be an added attraction for the reader.
• A manuscript on #diabetes need not always have the IDF data, WHO data, the global numbers etc. For e.g., if the manuscript is about #metformin, one can always start with how the treatment landscape has evolved over the years and yet how metformin continues to remain relevant. Another option could be to focus more on the patient profiles that are more challenging to treat and why, or about the need to focus on cardio-protection in patients with diabetes, or the challenges of blood sugar control with monotherapy, or the correlation between weight loss and blood sugar, or the statistics about the correlation between atherosclerosis and diabetes. These topics are relevant in a manuscript on #metformin because it has these pleotropic benefits. Each anti-diabetic drug has so much data related to different situations and different patient profiles, that based on the main topic of your manuscript, the Introduction section can be very unique.
• Similarly, in a manuscript on #PCI if the focus is on treating long lesions or bifurcation lesions, a standard Introduction section about how PCI has evolved from balloon angioplasty to the current generation of stents seems very generic. There is plenty of data about the challenges of treating long and bifurcation lesions, the reasons for the challenges, some possible techniques for overcoming them, and how the success still does not match that of the more standard lesions, what features in stents might lead to better success rates etc.

The Introduction section of an article can be the lever that determines the readability and maybe even the number of citations it receives in the future. All it needs is a creative mind while writing.

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