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  1. How do I Get Funding for My Research and How do I Get My Paper Published? Andrew Bush MD FRCP FRCPCH Imperial College & Royal Brompton Hospital a.bush@imperial.ac.uk

  2. Getting Started • What is the first thing you need? • A question that really interests you • What are the two most important questions about any project? • So what? • What for? • What is different from paper writing?

  3. Hypothesis Confirmed Move on Hypothesis Focussed experiment Confirmation MANDATORY GENERATES Hypotheses!! Fishing Expedition

  4. Think First! • What clinical or experimental question am I trying to answer? • Why? Clinical benefit or mechanisms of disease?

  5. Mechanisms vs. Individuals • Statistically significant differences between groups • May help predict mechanisms (beware guilt by association) • No use for clinic decisions

  6. Think First! • What clinical or experimental question am I trying to answer? • Why? Clinical benefit or mechanisms of disease? • In an ideal world, what would I measure?

  7. Think Second! • What ethically and prectically can I measure? • What are the best tools? • Does the act of measurement alter what I am measuring? • What is the shortfall between what I can measure and what I would like to measure? Does it matter?

  8. Getting Started • It takes longer than you think! • Disorganisation on your part does not constitute a crisis on my part! • Ethics • Research office • Costings, overheads, FEC • Etc., etc.

  9. Getting Started • Get real, get help • What is your own track record? • Who will be your collaborators? • Statistics? • Health economics? • Qualitative? • Patient involvement?

  10. Getting Started • Why do Grant awarding bodies award grants? • Read the Instructions • Read the Instructions • Yes, I know you have, but READ THE INSTRUCTIONS AGAIN!!

  11. So, you want to start writing? • Background • Why is this logical and important to do • Systematic reviews, meta-analyses etc. • Is it realistic? • ‘I’ll find the cure for cancer’ • Has the group got the right pedigree • Pilot data – a MUST

  12. Writing: The Basics • Hypotheses aims and objectives • Must be clearly stated at the end of background • Must be a logical development from the background • Must be attainable • Must have the ‘wow’ factor!

  13. Methods Section • Do the numbers add up? • ‘I will recruit 157 patients with Type 4 Hermansky-Pudlak syndrome’ • Has the group got a pedigree for this? • ‘I will do Taqman Reverse PCR in Prof Bush’s lab’ • Statistics • Power calculation • Analysis plan • DO NOT WING IT!

  14. Other Issues • Do not skip the ‘bits’ • Abstract – first port of call • Lay summary • Make costings realistic • Should there be • Health economics? • Qualitative? • Make sure all boxes have been filled in!

  15. And Finally • Spell out the implications • ‘These findings will have important clinical implications for X’ • Translation: ‘I’d like to believe these are important, but I know they are not really in any clear way • If you cannot spell out in detail the implications, you are Toast! • Clinical Trials: Register on Line

  16. Writing: Getting Started • Are YOU excited? • Because if you are not, no-one else will be! • Does it fit the Journal? • Do they publish this sort of thing? • Style it so it fits the Journal

  17. Hypothesis/ Question Design Analysis/ Power

  18. The Introduction:WHY you did it • Focussed and relevant, not an essay • Importance of the problem • Why not solved before • And why you might solve it • MUST end with a logical HYPOTHESIS • MUST generate enthusiasm

  19. The Methods:WHAT you did it • Can I reproduce the study from what you have written? • Including selection criteria • Use the on-line supplement if one is permitted • How did you check data entry accuracy? • Must have a statistical section • There must be a power calculation (or a reason why you have not done one) • You must cope with multiple comparisons • You must set a logical level of significance • You must say what tools you used

  20. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • STROBE = STrengthening the Reporting of OBservational Studies in Epidemiology

  21. CONSORT: Randomised controlled trials

  22. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • Start with patient population • KISS for the Tables

  23. Keep It Simple, Stupid! KISS

  24. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • Start with patient population • KISS for the Tables • Focussed analyses • Not hopeful comparisons and trawling • Do not do endless post hoc analyses • These are at best hypothesis generating • Do not fudge the findings – p=0.07 is not significant • My girlfriend is slightly pregnant!

  25. The Discussion:WHAT it means • Do NOT repeat Introduction • General issues of interpretation • Association is not the same as causation • You cannot draw longitudinal conclusions from cross-sectional studies

  26. Association vs. Causation • ‘A’ correlates with ‘B’ therefore ‘A’ causes B!!!! • B could cause A • C could cause A and B • Causation requires longitudinal studies • A comes before B • Or Intervention studies • Block A leads to no B

  27. The Discussion:WHAT it means • Do NOT repeat Introduction • General issues of interpretation • Association is not the same as causation • You cannot draw longitudinal conclusions from cross-sectional studies • Do not extrapolate wildly • Are the data important clinically or mechanistically?

  28. Structured Discussion • Statement of Principle Findings • Strengths and weaknesses of the study • There are always some problems! • Strengths and weaknesses with respect to other studies • Discrepant results? • Meaning of the study • Unanswered questions and future research

  29. Special Circumstances:Case reports • We all love to talk about cases • Editors hate to publish them • They are not cited • Must be a take-home message: SO WHAT! • This is a report of the 17th HPS type 7 in the literature • This is a report of the 1st HPS type 7 in Lithuania • This is the first report of an association between Type 7 HPS and Brain-lung-thyroid syndrome

  30. Special Circumstances:Genetics • Pitfalls to avoid if possible • SNPs with no biological readout • Mere association with no biological plausibility or validation elsewhere, e.g. animal studies • No validation population • Validation population replicates different SNPs in the same gene

  31. Make life easy for everyone • Say you are grateful, even if you are not • Thank them for the helpful comments (even if you think they were idiotss) • Do NOT do a “Jaffe”! • Answer point by point • Say what you have done • Say what you have inserted • Say where you have inserted it

  32. Summary: Vic’s Top 10 Tips • You did not read the instructions • There is a major COI • The manuscript was not checked for typos • This is the 19th case of X • No changes after submission elsewhere

  33. Summary: Vic’s Top 10 Tips • There is no hypothesis anywhere to be found • Plagiarism including self-plagiarism, key references omitted or misquoted • No power calculation; crap statistics • Rambling, unfocussed, authors from IFES • BORING!

  34. Further Reading • Chernick V. How to get your paper rejected. Pediatr Pulmonol 2008; 43: 220-3 • Stratton IM, Neil A. How to ensure your paper is rejected by the statistical reviewer. Diabetic Medicine 2004; 22: 371-3 • Sterk PJ, Rabe KF. The joy of writing a paper. Breathe 2008; 4: 225-32 • Hoppin FG. How I review an original scientific article. Am J Respir Crit Care Med 2002; 166: 1019-23