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Corso di clinical writing. What to expect today?. Core modules. Introduction General principles Specific techniques Title/ Abstract drafting Finding out relevant literature , and Introduction drafting Nuts & bolts of statistics and Methods drafting

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Core modules

What to expect today?

Core modules

  • Introduction

  • Generalprinciples

  • Specifictechniques

  • Title/Abstractdrafting

  • Finding out relevantliterature, and Introductiondrafting

  • Nuts & boltsofstatistics and Methodsdrafting

  • Practicalsession 1 – Appraisalof a publishedarticle


What is your goal in preparing an article
Whatisyour goal in preparinganarticle

Let’s think backwards…


What is your goal in preparing an article1
What is your goal in preparing an article

  • The main goals in preparing a manuscript are full reporting and disclosure of

  • relevant aspects of your study

  • Isthereanyriskofbias?

  • What are the findings?

  • Do yourfindingsapplyto the mycurrentclinicalproblem?


Internal validity appraisal according to the cochrane collaboration
Internal validity appraisalaccording to The Cochrane Collaboration

  • 4 MAIN TYPES OF BIAS POTENTIALLY UNDERMINING STUDIES

  • Ascertainment bias

    • Non-uniform adjudication of events

  • Attrition bias

    • Non-uniform follow-up or compliance to treatment

  • Performance bias

    • Non-uniform performance of corollary treatments

  • Selection bias

    • The non-random allocation of pts one of the treatment groups

http://www.cochrane.org


The ebm 3 step approach
The EBM 3-step approach

How your article should be appraised, in three steps:

Step 1 – Are the results of the study (internally) valid?

Step 2 – What are the results?

Step 3 – How can I apply these results to patient care?


First tip to effective writing
First tiptoeffectivewriting


First tip to effective writing1
First tiptoeffectivewriting

Read a lot…


First tip to effective writing2
First tiptoeffectivewriting

Read a lot…

To learn something, you must see how it should be done, and how it should NOT be done!


Second tip to effective writing
Secondtiptoeffectivewriting


Second tip to effective writing1
Secondtiptoeffectivewriting

What is the message you want to sell?


Second tip to effective writing2
Secondtiptoeffectivewriting

Whatis the messageyouwantto sell?

Itmaybe the coremessage, or the corollary/cosmeticmessageofyourpaper


Third tip to effective writing
Thirdtiptoeffectivewriting


Third tip to effective writing1
Third tip to effective writing

Whois the audience?


Third tip to effective writing2
Thirdtiptoeffectivewriting

Who is the audience?

You have to adjust your message, tailor your style, and prepare yourself for potential criticisms based on the target audience…


Fourth tip to effective writing
Fourthtiptoeffectivewriting


Fourth tip to effective writing1
Fourthtiptoeffectivewriting

No matter what, keep clear writing!


Fourth tip to effective writing2
Fourthtiptoeffectivewriting

No matter what, keep clear writing!

“Clear writing that is incapable of being misunderstood”

Quintilian, I AD


Fifth tip to effective writing
Fifthtiptoeffectivewriting


Fifth tip to effective writing1
Fifth tip to effective writing

Do not mistake the tree for the forest!!!


Fifth tip to effective writing2
Fifthtiptoeffectivewriting

Do not mistake the tree for the forest!!!

The goal is the forest, of course


Imrad algorithm
IMRADalgorithm

Introduction (± Aim)

Methods

Results

And

Discussion


Expanded imrad algorithm
Expanded IMRADalgorithm

IntroductionBackground

Limitations of current evidence

Study hypothesis

MethodsDesign

Patients

Procedures

Follow-up

End-points

Additional analyses

Statistical analysis

Results Baseline and procedural data

Early outcomes

Mid-to-long term outcomes

Additional analyses

DiscussionSummary of study findings

Current research context

Implications of the present study

Avenues for further research

Limitations of the present study

Conclusions


Consort guidelines for rct
CONSORT guidelinesfor RCT


CONSORT statement

Moher et al, JAMA 2001


CONSORT statement

Moher et al, JAMA 2001



Moose guidelines for non rct meta analyses
MOOSE guidelinesfornon-RCTmeta-analyses


Moose guidelines
MOOSE guidelines

Stroup et al, JAMA 2000


Moose guidelines1
MOOSE guidelines


General tips
Generaltips

  • Use “men” and “women,” not “males” and “females” (except when male and female are used as adjectives, e.g., male patients)

  • Use “died,” not “expired”

  • Use “humanely killed” or “killed” for animal studies, not “sacrificed”

  • Replace “prior to” with “before”

  • Patients are not implanted, i.e., “Patients who had the Jarvik 2000 implanted,” not “The implanted patients…”

  • Be careful of “due to” and “because of.” Use “due to” only when you could substitute “caused by”

    • Recovery of brisk flow was due to thrombectomy.

    • Because of thrombectomy, recovery of brisk flow occurred.

  • Consult the AMA Style Manual


Never throw away a good sentence
Neverthrowaway a goodsentence

  • “There is no good writing…… only good re-writing”

  • Rationale: We are better at editing than writing

  • Methods of conserving sentences:

    • Write about the same thing

    • Use similar methods

    • Dictation


  • General tips1
    Generaltips

    • Include one thought per sentence, one idea per paragraph

    • Use active voice whenever possible

    • Keep words simple

    • Be as succinct as possible

    • Avoid adjectives, too much description

    • Keep sentences short (< 22 words) and clear

    • Use subject-verb-object constructions:

      • Of the 22 patients, 5 (22.7%) reported rectal bleeding


    General tips2
    Generaltips

    • Use transitions and key words

    • Outline

    • Consult a statistician

    • Install spell-check software

    • Consult grammar and writing websites

    • Buy the AMA Manual of Style

    • Hire an editor

    • Remember the question


    Tips for better writing words
    Tipsforbetterwriting: words

    • Simple words are better than long ones

    • Concrete terms are better than abstract ones

    • Specific terms are better than general ones


    Tips for better writing grammar
    Tipsforbetterwriting: grammar

    • Avoid wordiness

    • Know when to use active & passive voice

    • Avoid faulty parallelism

    • Paragraphs should hang together

    • Paragraphs should have transitions


    Phrases
    Phrases

    “The device, with long-term durability and reliability, is enhanced by the simplicity of its design and the clinical quality of its implantable platform. The ease of the prosthesis implantation in all patients, that enables avoidance of recoil, with the superior elastic properties and the extreme biocompatibility, are unique to this technology.”


    Phrases1
    Phrases

    “The device, with long-term durability and reliability, is enhanced by the simplicity of its design and the clinical quality of its implantable platform. The ease of prosthesis implantation in all patients, that enables avoidance of recoil, with the superior elastic properties and the extreme biocompatibility, are unique to this technology.”

    NO!


    Phrases2
    Phrases

    “The device, with long-term durability and reliability, is enhanced by the simplicity of its design and the clinical quality of its implantable platform. The ease of prosthesis implantation in all patients, that enables avoidance of recoil, with the superior elastic properties and the extreme biocompatibility, are unique to this technology.”

    “The simplicity of its design and the clinical quality of its implantable platform enhance the durability and reliability of the device. The prosthesis is easy to implant in all patients. Moreover, it effectively prevents recoil, hassuperior elastic properties and isextremely biocompatible. All these characteristics make this novel stent unique among the others”

    NO!


    Format
    Format

    • Double space

    • Each section on a separate page

    • Use subheadings (in Methods, Results)

    • Page numbers on the right (bottom..or top)

    • Make sure font size and type consistent

    • Format the documents 2.0 to 3.0 mm form the top, bottom, sides


    Tense in scientific english
    Tense in scientific English

    • Present tense - previously published information accepted as fact

      • Spatial resolution of MR microscopy can reach 3 microns [ref].

    • Present tense - refer to other parts of your document

      • Figure 4 shows a diffusion-weighted image.

    • Past tense - methods and results/actions

      • Rats were anesthetized with isoflurane.

      • All animals exhibited significantly diminished learning capacity...

    • Past perfect - action that happened before other past action

      • Group 2 rats had been housed individually prior to the beginning of the study

    • Present perfect - action recently completed or continuing to the present

      • Since 1991, researchers at the Montefiore Medical Center have collaborated with more than thirty investigators at other institutions.


    Editing
    Editing

    • Does it make sense?

    • Is the writing clear?

    • Are there obvious factual errors?

    • Check for vague or ambiguous statements

    • Check for wordiness

    • Check for errors in grammar, spelling, punctuation, capitalization, and follow the journal’s rules



    Take home messages
    Take home messages

    • When designing and drafting your manuscript, remember to plan in advance and revise many times

    • Keep it simple and active

    • Avoid jargon and try to sell your message/product in every sentence or paragraph



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