University of Maryland Dissemination and Implementation Program Webinar 3: Reporting Research: Results and Treatment F

1. University of Maryland Dissemination and Implementation Program Webinar 3: Reporting Research: Results and Treatment Fidelity Barbara Resnick, PhD, APRN, FAAN, FAANP University of Maryland, School of Nursing Joe Ouslander, MD University of Maryland, School of Medicine

2. Quantitative Study Results • The FACTS and only the FACTS • Start off with basic descriptives (means, medians, standard deviations, frequencies); • Provide more sophisticated within or between group comparisons; • As relevant illustrate your results using tables or graphs • try to use tables and graphs - avoid REALLY lengthy text

3. Quantitative Results • The Results section should be organized around Tables & Figures that should be sequenced to present your key findings in a logical order. • Should highlight the evidence needed to answer the questions/hypotheses you investigated.

5. Quantitative Results • The page length of this section is set by the amount and types of data to be reported. • Thus…use those figures and tables, as appropriate, to present results most effectively.

6. Quantitative Results • The purpose of a results section is to present and illustrate your findings. PERIOD! • Make this section completely objective---- all interpretation is for the discussion section.

7. Content of Results Section • Use the text to point the reader to observations that are most relevant. • Include within the text observations that are not presented in a formal Figure or Table.

8. Result Section • Present the key results of the experiment without interpreting their meaning. • DO not include findings that are not related to your study questions/hypotheses. • Avoid writing out long lists of numbers - numbers and measurements should all be tabulated. • For example, the baseline means of all outcome variables are shown in Table 1.

9. Results Section • State the results of statistical analyses in this section, but do not describe every detail of the analysis. • Assume the readers know what a null hypothesis is, a rejection rule, chi-square test, etc. • Important negative results should be reported

10. Differences, directionality, and magnitude: • Report your results so as to provide as much information as possible to the reader about the nature of differences or relationships. • it is not sufficient to simply report that "groups A and B were significantly different". • How were they different? • How much were they different?

11. Reporting Results • Statistical test summaries (test name such as chi-square, p-value) are usually reported parenthetically in conjunction with the biological or psychosocial results they support.

12. Reporting of Data Examples • If demographics are reported in text no need for a Table….OR you may highlight some demographics and refer to the Table for remaining. • The majority of the DCWs were female (n=95; 99%); 59 (62%) were black, 23 (24%) white, 3 (3%) Asian, 1 (1%) Native Hawaiian, and the remaining 10 (10%) reported multiple races.

13. Reporting of Data Examples: • Baseline descriptions of residents and DCWs have been previously reported1 and are shown within Tables 2 and 3. Briefly, at baseline DCWs had strong self-efficacy with regard to their ability to provide function focused care to residents, although they did not believe in the benefits of providing this type of care. They had fair knowledge of function focused care on a paper and pencil test, and fair job satisfaction. Based on observations they performed function focused care in 76% (SD=24%, range 0-100%) of all care interactions.

14. Reporting of Data Examples: • Treatment effects for residents are shown in Table 3. While both treatment and control groups showed a decline in function over 12 months, the decline was greater between baseline and 12 months for the control group versus the treatment group (the control group declined 6.95 points versus 4.33 points for the treatment group, p=.01).

15. Reporting of Data Examples • From baseline to 12 months, 13 (17%) residents in the treatment group versus 2 (4%) residents in the control group resumed walking functional distances versus remaining wheelchair dependent (Chi square=4.94, p=.026).

16. Reporting Results • Use a numeral, with the following exceptions: • You cannot begin a sentence with a numeral. • If the number involves a unit of measure, the unit must be spelled out. • Revise the sentence so you don't have to begin it with the number! • When < 10 use words instead of numerals • Numbers are written as numerals when a specific value is named, and when associated with a unit of measure: "270 centuries ago," "59 people...", "...47.8 g dry weight...".

17. Tables and Figures • Note that simple findings usually do not need a visual aid. • Visual aids are used to make complex findings explained in the text easier to grasp. • There are some simple but crucial findings and visuals are sometimes created to give these facts more impact or emphasis. • Any Table or Figure should be understandable without reading the results section, i.e., it must be able to stand alone and be interpretable.

18. Tables • Tables present lists of numbers or text in columns, each column having a title or label. • Do not use a Table when you wish to show a trend or a pattern of relationship between sets of values - these are better presented in a Figure.

19. Table Pointers • the presence of a period after "Table #"; • the legend (sometimes called the caption) goes above the Table; • units are specified in column headings; • lines of demarcation are used to set legend, headers, data, and footnotes apart. • footnotes are used to clarify points in the table or to denote statistical differences among groups.

20. Figures • Figures are visual presentations of results, including graphs, diagrams, photos, drawings, schematics, maps, etc. • Graphs are the most common type of figure and show trends or patterns of relationship.

22. Figures and Tables • Construct tables and figures before writing the results section. • Include a summary of each table/figure in the results section.

23. Good Figures and Tables • 􀂾 Be High Resolution. Pixilated images, fuzzy graphs, and illegible tables are the bane of a good paper. • 􀂾 Have Neat, Legible Labels. There should be zero ambiguity about what the figure or table is illustrating. • 􀂾 Be Simple. Figures and tables that cram too much information into a small space obscure their meanings and defeat their own purpose.

24. Good Figures and Tables • Be Clearly Formatted. • Tables should have lines clearly separating it from other pieces of the manuscript. • Graphs should have appropriate axes, and images should have appropriate boxes. • 􀂾 Indicate Error. All tables should have Standard Deviation information; all graphs should have error bars. • 􀂾 Have Detailed Captions.

25. Captions • A caption should be clear and succinct, yet detailed. • It should convey all the information needed for a reader to understand the figure, without reading the whole manuscript. • For example, a good caption of a graph would tell the reader what the graph illustrates, what samples were used and the relationship displayed. • A caption should tell the reader the meaning of the figure or table. Does the table illustrate a trend that the reader should be noting? Does this figure illustrate the sample site, and, if so, what are the features of note at this site? • Captions have a lot of information to relay… but they shouldn’t be longer than about 10 sentences.

26. Mistakes in Figures & Tables • 1. Inappropriate Format  Check journal guidelines. • 2. Redundant Information – do not include the same information in different places: the text, figures, and tables. • 3. Ugly – watch for blurry, unclear, unlabeled, pixilated. Shoot for clear, concise, and professionally laid-out.

27. Common Mistakes in Captions • 1. No Caption. No more need be said – just make one unless no more need be said. • 2. One-Liner. One sentence is never, ever, enough for a caption. Give the reader more information. • 3. Regurgitates Figure/Table. A caption that re-states exactly what the table/figure says is no good – the caption must explain what it means and why it is important.

28. Figure Checklist • Is the Figure necessary? • Is the Figure simple, clean, and free of extraneous detail? • Are the data plotted accurately? • Is the grid scale correctly proportioned? • Is the lettering large and dark enough to read? Is the lettering compatible in size with the rest of the Figure? • Are parallel Figures or equally important Figures prepared according to the same scale? • Are terms spelled correctly? • Are all abbreviations and symbols explained in a Figure legend or Figure caption? Are the symbols, abbreviations, and terminology in the figure consistent with those in the Figure caption? In other Figures? In the text? • Are the Figures numbered consecutively? • Are all Figures mentioned in the text?

29. Fatal Flaws in Reporting Results • Do not discuss or interpret your results, report background information, or attempt to explain anything. • Never include raw data or intermediate calculations in a research paper. • Do not present the same data more than once. • Text should complement any Figures or Tables, not repeat the same information. • Do not confuse Figures with Tables - there is a difference.

30. Additional Focus on Fatal Flaws • Present only the key results, meaning those results that bear on the question or problem being addressed. • Generally present means, percentages, standard deviations, etc. • For comparison studies, statistical significance MUST be included. NO exceptions. • Do not add additional data that is NOT relevant to a research question. A separate paper is an option!

31. Writing Style for Results • As always, use past tense when you refer to your results, and put everything in a logical order. • In text, refer to each Figure as “Figure 1," “Figure 2," etc. ; number your Tables as well. • Place figures and tables, properly numbered, in order at the end of the manuscript [of course follow journal guidelines].

32. Examples of Results Statements • The survey shows that an overwhelming percentage of the respondents — 83% — feel that rewarding nursing staff is not necessary, a disappointing finding. OR • The survey shows that 83% of respondents indicated that rewarding nursing staff is not necessary.

33. Examples of Results Statements • Do results as presented address research ? • Question: “How successful are senior centers in promoting physical activity?” • A large proportion of the respondents — 74% —indicated that senior centers do not promote physical activity.

34. Examples of Ways to Report

35. Examples of Ways Report Results • Here are four possibilities of structurally appropriate reporting: ● The survey [source] shows that [finding] ● It can be seen [writer’s voice/comment] from the survey [source] that [finding] ● From the survey [source], it was found that [finding] ● The majority [finding], as can be seen from the responses to a question about... [source]

36. Examples of Ways to Refer to a Figure • Figure 1 shows that only 15% of the respondents... • As Figure 1 shows, only 15% of the respondents... • As can be seen in Figure 1, only 15% of the respondents...

37. Writing Style Continued • Write with accuracy, brevity and clarity. • Use a good topic sentence for each of your paragraphs. • Summarize statistical analyses.

38. For Intervention Research • Report the flow of participants through each aspect of the intervention • Randomization to tx arms; • completion of treatment; • deviations from protocol as relevant

40. Qualitative Results • The presentation of qualitative results is easiest to follow if the structure is directly linked to the research question, moves in logical steps according to the theory and method, and consistently uses the concepts presented earlier in the article. • Present your data in a systematic way in the body of the text, so that quotations, field notes and other documentations are easily identifiable. • The reader should know if your are providing direct citations or if you are analyzing interpretations of what the observed or interviewed persons said. • The citations or other illustrations must be clearly contextualised. • If it is observational material, state whether you collected the data yourself or if you used data collected by someone else.

41. Reporting Qualitative Results • Give enough raw data, for instance direct citations, but not too much. • Avoid very short quotations. • If you run out of space, find out from the editor if you can use online appendices for additional material. • Do not report in the results section on data that you have not indicated you collected in the methods section -if you state that you are going to use interviews, do not report observations. • If you use grounded theory, you should be able to present a theory as a result.

42. Distinguish description,interpretation, and judgment • Use “thick” description - sufficient detail to take the reader into the setting being described. • Use direct quotations so that respondents are presented in their own terms and ways of expressing themselves. • Keep quotations and field incident descriptions in context. • Assure that interpretations follow from the qualitative data. Make the basis for judgments explicit.

43. Be explicit and detailed about analytic steps. • Provide enough information in the results so readers can determine whether the findings emerged logically from the data. • Demonstration of links from text to codes to categories to sub-themes to themes makes it easier to determine the quality of the work. • The reader needs to be able to confirm that the findings are grounded in data and not made up.

44. Different ways to report data Raw data model • 􀁺 The question followed by all participant comments Descriptive model • 􀁺 Summary description followed by illustrative quotes Interpretative model • 􀁺 Summary description followed by illustrative quotes and interpretation

45. Example: Raw Data Model • Planning service provision • Reductions in workload, stress from having to manage appointment crises at short notice, and reduced pressure from having to support staff meant that for the practice managers in the study were able to spend more time planning for the future. • "The advantage of the system is that I can plan in advance. I know exactly how many appointments we are going to have to offer each day and therefore I can plan if we need extra cover particularly for annual leave and training days."

46. Examples: Interpretative model • Theme : Managing emergencies better • Coping with sudden illness or other unforeseen circumstances was easier and less stressful with computerized appts than with the previous appointment booking system as exemplified below. • "As there are only a few pre-bookable appointments each session, it is much easier to rearrange appointments. Before this computerized system came in, it was simply hell trying to cancel appointments because you know that you would be getting a lot of abuse from the patients”

47. Example: Descriptive model • The NAs further described some of their challenging situations related to restorative care and addressed how they handled those situations to facilitate restorative care. They described how they would sneak restorative care in by “tricking” the resident into it. For example, one NA talked about a trick she had learned during the study: • …”I do little things like get them to do the handshake…the RCN called this the queen! This resident is still doing her range of motion everyday whether she wants to or not as we sneak it in through our special handshake!”

48. Example: Raw Data Model • Self-confidence was another theme that emerged from data. Thirty five participants emphasized the key role played by self-confidence in feeling and using power and authority, and a majority of them considered that as a synonym or a necessary base for power. They also identified the different factors and dimensions in self-confidence of the nurses. They believed that: • "Self-confidence provides the nurse with the feeling of power and ability, and lack of confidence causes someone to feel weak and unable to use his/her talents," so that she/he would avoid independent actions. • "Power depends on the individuals. Some people have the self-confidence to make use of their authority in their duty limits as a nurse or a nurse manager, while some are weak and unable to do so.”

49. Tips For Writing Qualitative Papers • Find your rhythm • Focus on telling the story • Data as star – data exemplars • Centrality of the respondents voice • Be creative – how else might you tell the story (visual, oral etc.) • Write with your audience in mind-Be open, explicit, reflexive, and thorough in representing the story

50. Qualitative Results • As far as possible, the Results section should be exhaustive in reporting the data. Given restricted space of a journal paper, decisions have to be made about what to put in and what to leave out. • By convention 3-4 items/theme are recommended. • Longer quotes are often better for preserving context. • Short quotes can often, either be taken out of context or seem to offer little elaboration of an idea.