DEVELOPING AND WRITING YOUR TRIOLOGICAL THESIS

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DEVELOPING AND WRITING YOUR TRIOLOGICAL THESIS

• Maureen Hannley, PhD

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SUCCESSFUL THESES2001 2006 (n 126)
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SOME EXCELLENT REFERENCES

• Troidl, H et al., Surgical Research Basic
  Principles and Clinical Practice (3rd Ed.). New
  York Springer, 1998
• Booth, W, Colomb, G, Williams, J, The Craft of
  Research. Chicago The University of Chicago
  Press, 1995
• Belsher, J, Jacobsen, J, From Idea to Funded
  Project. Phoenix Oryx Press, 1992
• Spilker, B., Guide to Clinical Trials. New York
  Raven Press, 1991
• Norman, G, Streiner, D, PDQ Statistics (2d Ed.).
  St. Louis B.C. Decker, Inc., 1999

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BUILDING A THESIS
the-sis. A proposition stated or put forward
for consideration, especially one to be proved
or maintained against objections. Random
House College Dictionary
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Practical Problem
motivates
helps to solve
?
Research Answer
Research Question
finds
defines
Research Problem
Booth, Columb, Williams, 1995
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Clinical Problem
Research Question
Design
Method
Observation
Experiment
Consultation
Laboratory
Case Reports
Qualitative Research
Clinical
Series
Surveys
Troidl et al., 1998
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INTERESTS, TOPICS, QUESTIONS, PROBLEMS

• Find an interest in a broad subject area
• What am I interested/expert in?
• Narrow the interest to a plausible topic
• What are unsolved gaps or inconsistencies in
  this area?
• Develop questions within the topic
• What do I want to know?
• Develop a rationale for the project
• Why is it important to know this?

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DEVELOP AN IDEA

• Read the most authoritative sources until you
  come to a point where the sources disagree. This
  is where unsolved questions may reside.
• Talk with the leading figures in the area.
  Attend their lectures and be alert to problems
  they identify.
• Seek out and read strategic research plans of
  medical and research organizations.
• Contemplate your own experience. What are the
  problems or questions that frustrate you? Have
  you found a solution you think will benefit your
  peers and patients?

Naumann in Belcher Jacobsen, 1992
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INVESTIGATIONAL CATEGORIES

• Descriptions of problems required for planning
  interventions
• Transtympanic vs. Sustained Release
  Administration of Gentamicin Kinetics,
  Morphology, and Function
• Carcinoma of the Oropharynx Factors Affecting
  Outcomes
• Improving Surgical Wound Healing with Basic
  Fibroblast Growth Factor After Radiation
• A Standardized Regimen of Antibiotics Prevents
  Infectious Complications in Skull Base Surgery
• Clinical and Symptom Criteria for the Active
  Diagnosis of Chronic Rhinosinusitis

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INVESTIGATIONAL CATEGORIES

• Information required to evaluate ongoing
  interventions, assess progress
• The Long-term Effect of Adenotonsillectomy on
  Quality of Life in Pediatric Patients
• Therapeutic Selective Neck Dissection 25 Year
  Review
• Long-term Follow-up for Children Treated with
  Surgical Intervention for Chronic Sinusitis
• Intratympanic Dexamethasone for Sudden
  Sensorineural Hearing Loss Following Failure of
  Systemic Therapy
• Therapeutic Efficacy of the Epley Canalith
  Repositioning Maneuver
• Endoscopic Percutaneous Dilational Tracheotomy A
  Prospective Evaluation of 500 Consecutive Cases

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INVESTIGATIONAL CATEGORIES

• Information required to define problems
• Direct Evidence of Bacterial Biofilms in Otitis
  Media
• Herpes Simplex Virus and Menieres Disease
• Analyze possible causes
• Direct Nasopharyngeal Reflux of Gastric Acid is
  a Contributing Factor in Refractory Chronic
  Rhinosinusitis
• The Role of Nitric Oxide in the Development of
  Distant Metastases from Squamous Cell Carcinoma
• or offer solutions
• Regular Tracheostomy Tube Changes to Prevent
  Formulation of Granulation Tissue

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SELECT A TOPIC

• Relevance
• Avoidance of duplication originality
• Feasibility
• Ethical acceptability
• Applicability of possible results and
  recommendations
• Urgency of data needed
• The Big So-What

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Clinical Problem
Research Question
Design
Method
Observation
Experiment
Consultation
Laboratory
Case Reports
Qualitative Research
Clinical
Series
Surveys
Troidl et al., 1998
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ESSENTIAL PRELIMINARIES

• Consult a statistician
• Question design statistical
  treatment
• Sample size estimations
• Involve sponsor/mentor in planning process
• Careful, comprehensive literature review

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SELECT A STUDY STRATEGY

• Basic vs. clinical
• Prospective vs. retrospective
• Efficacy vs. efficiency
• Duration of study
• Cross-sectional vs. longitudinal
• Medical vs. patient outcome

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SELECT VARIABLES

• Numerical
• Age
• Number of documented recurrences
• Categorical
• Involved site
• Disease outcome
• Tissue type
• Operational
• Dependent
• Independent
• Confounding
• Background

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THE DOOMED DESIGN
v. A.1.a
V. A.1
..
v.A.1.b
Variable A
v.A.2.a
..
V. A.2
v.A.2.b
v.B.1.a
V. B.1
..
Variable B
v.B.1.b
v.B.2.a
..
V. B.2
v.B.2.b
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FORMULATE PROJECT OBJECTIVES, HYPOTHESES

• Formulation of objectives will help
• Focus the study, narrowing it to essentials
• Avoid collection of data not strictly necessary
  for solving defined problem
• Organize the study in clearly defined parts or
  phases

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TO ENHANCE CREDIBILITY

• Appropriate controls
• Appropriate operational definitions
• Appropriate measurement tools
• Appropriate design and analysis
• Balanced perspective
• Cite others work
• If there are 2 camps, make sure you cite both
  sides

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CONDUCTING THE THESIS PROJECT
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SCIENTIFIC INTEGRITY AND ETHICS

• Ethics in scientific design and conduct
• Ethical justifiability
• Clinical equipoise
• Informed, comprehending, voluntary consent
• Confidentiality
• Use of animals
• Scientific adequacy
• Conflict of interest

Riis, in Troidl, et al., 1998
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MANAGE THE DATA

• Collect the data
• Maintain quality control over the data
• Enter the data to a database
• Store the data
• Analyze the data

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WRITING THE THESIS
process, a uniform level of scientific rigor can
be attained to achieve three objectives 1)
provide support for the most meritorious research
in otolaryngology and head
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THE ABCs OF SCIENTIFIC WRITING

• Accuracy
• Brevity
• Clarity

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STATE OBJECTIVES

• Cover different aspects of problem and
  contributing factors in coherent way and logical
  sequence.
• Use specific action-oriented verbs (to verify
  to compare to establish etc.) that correspond
  with goals and methodology.
• Objectives should be demonstrably achievable
  through selected methodology and subjects.
• State assumptions underlying your project.

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MAKING YOUR CASE
Warrant
Claim
Evidence
Qualifications
Booth, Colomb, Williams, 1995
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Tonsillectomy increases the risk of breast
cancer in women
Warrant
Claim
Evidence
Qualifications
Booth, Colomb, Williams, 1995
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80 of all women with breast cancer have had
tonsillectomy
Warrant
Claim
Evidence
Qualifications
Booth, Colomb, Williams, 1995
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There should be more stringent indications for
tonsillectomy in females
Warrant
Claim
Evidence
Qualifications
Booth, Colomb, Williams, 1995
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Wait a minute!
Warrant
Claim
Evidence
Qualifications Oversimplification Overgeneralizati
on Special cases Other accounts Limiting
conditions
Booth, Colomb, Williams, 1995
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THE BEST DEFENSE..

• Your Answers
• I claim that
• I limit it to
• I offer as evidence
• I offer this principle
• I can rebut that. First.
• My claim stands as long as...
• Well, I have to admit that

• The Questions
• What is your point?
• What is your claims scope?
• What evidence do you have?
• What links evidence to claim?
• But what about.?
• But what if.?
• No problems at all?

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THE BAIT AND THE PUNCHLINE

• Introduction
• Opening quotation or fact
• Context of past research
• Condition of ignorance
• Cost of that ignorance
• Gist of solution

• Conclusion
• Gist of solution
• Larger significance or application
• What is still not known
• Call for further research
• Closing quotation or fact

Booth, Colomb, Williams, 1995
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ILLUSTRATIONS

• To illustrate this
• Process
• Logical relationships
• Object
• Parts of complex object
• Action, step in process
• Results

• Use this
• Flow chart, decision tree
• Diagram, matrix
• Photo, drawing
• Microscopic view, drawing
• Schematic, photo, diagram
• Photo, graph, matrix

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SCIENTIFIC INTEGRITY

• Scientific dishonesty
• Fabrication of data
• Selective, undisclosed rejection of undesired
  results
• Erroneous use of statistical methods to achieve
  desired outcome
• Distorted interpretation of results or
  conclusions
• Plagiarism of results or writings of other
  authors
• Distorted representation of other researchers
  results
• Wrongful or inappropriate attribution of
  authorship
• Omission of recognition of original observations
  made by other scientists

Riis, in Troidl, et al., 1998
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SOURCES OF FUNDING

• NIH
• Small grant (R03) program
• Exploratory grant (R21) programs
• AAO-HNSF
• Percy Memorial Research Award (experienced inv.)
• Health Services Research Grant
• Combined grants (PSEF, AHNS)
• CORE program
• Other
• www.grantsnet.com
• www.cos.com

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MOTIVATIONS FOR DOING RESEARCH
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Improve health through better medical practice
Influence others behavior or viewpoint
4
Change the body of knowledge
3
Gain personal satisfaction
2
Improve curriculum vitae
1
Kramer, 1995
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CONTACT

• Maureen Hannley, PhD
• 919-668-4604
• Maureen.hannley_at_duke.edu