The Scientific Publishing Cycle

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The Scientific Publishing Cycle

• Cleo Pappas MLIS, AHIP
• Introduction to EBM

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Knowledge Cycle

• A description of the journey from the coffee
  room to the coffee table.

http//osulibrary.oregonstate.edu/staff/averyb/Sc
iPub.htm
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Knowledge Cycle

• Idea development/research design
• Idea discussion/funding(?)
• Research
• Preliminary results shared with peer group

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• Results/findings are reported formally
• Reports (publicly funded research)
• Peer Review

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• Results/findings are generalized
• Within a discipline
• Across disciplines
• For the interested lay person
• Results/findings are Popularized
• "in the news"
• "on TV"

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TIME FRAME INFORMATION SOURCE GOOD FOR
Current Invisible College, Email, memos, lab data, conversations No access for general audiences
Finished Research Report Unpublished papers, conference proceedings, letters to the editor Current awareness of research projects
Completion 1 year Journal article (refereed) Description of completed research research methodology, findings, conclusions
6 months - Books Broader overview, placing research in historical, disciplinary, interdisciplinary contexts
2 years - Disciplinary Reference Books Compilations of different viewpoints within a discipline
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Publication Cycle
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Access Cycle

• Proprietary Information
• Talk to instructors or professors
• Meetings, Seminars, Workshops
• Databases via WWW

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Indexes

• Research Reports
• Journals of Professional Associations and
  Societies
• Peer-reviewed journals
• Newspapers
• Popular magazines
• Library catalogs

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Knowledge Cycle

• Exercise 1

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Publication Types

• A Brief Introduction

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Publication Types

• Primary
• Secondary
• Tertiary
• Popular

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Primary Literature

• First result of research results
• Opportunity for criticism of research or theory
• Document is usually a refereed or peer reviewed
  article
• Author is a researcher.
• Audience is research peers.

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Secondary Literature

• The purpose is to generalize or integrate
  research within a discipline.
• The document is a review article and may be
  published in a review series or professional
  society journal.
• Author is an authority in the field.
• Audience consists of interested colleagues from
  other fields or students looking for state of
  the art research.

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Tertiary Literature

• Purpose is to explain the ideas within a
  discipline
• May consist of textbook chapters, encyclopedia
  articles, bibliographies, or feature articles in
  scientific magazines.
• Author is a technical writer.
• Audience consists of those unfamiliar with the
  field or students.

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Popular Literature

• Purpose is to inform and to entertain.
• Found in popular magazines, radio, television,
  .com web sites.
• Author is often anonymous or a feature writer or
  reporter.
• Audience tends to be superficially curious.

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Diverse Contents of a General Medical
JournalFletcher, Robert W. and Suzanne W
Fletcher. Clinical Epidemiology. Philadelphia
Lippincott Williams Wilkins, 2005
Science Profession of Medicine
Original Research Medical Education
Preliminary Studies History
Review articles Public Policy
Editorials (synthesis and opinion) Book Reviews
Letters to the Editor News
Hypotheses Stories and Poems
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Structure of research publication

• Subject or section headings and their sequence

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Anatomy of a Research PaperBranson, Richard.
Respiratory Care October 2004 Vol 49 No.10 1222
-1228

• Title Page
• Abstract
• Introduction
• Methods

• Results
• Discussion
• Conclusions
• Acknowledgements
• Summary

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Title Page

• Title
• Authors
• Key Words
• Corresponding Author
• Financial and Equipment Support
• Conflicts of Interest

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The Organization of a Structured Abstract
Fletcher, Robert W. and Suzanne W Fletcher.
Clinical Epidemiology. Philadelphia Lippincott
Williams Wilkins, 2005
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Heading Information
Context Why is the research important? What is already known?
Objective What the investigators wished to learn.
Setting The setting to which results can be generalized.
Participants Describe patients and how many there were (speaks to statistical power/precision.
Design How strong is the study, and how well matched is it to the research question?
Intervention Is it state of the art and is it feasible in your setting?
Main outcome measures Are the outcomes clinically important?
Results What was discovered?
Conclusion Do the authors believe that the results answer their question? How convincingly?
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Introduction

• Background with seminal references
• Name or describe the problem.
• What is the issues importance?
• Research question and hypothesis.

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Methods

• How was the study performed?
• Sufficient information for replication
• Subjects
• Equipment
• Intervention or study procedures
• Data analysis

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Results

• Findings in a sequential timeline with no bias or
  interpretation.
• Results only confirm or reject the hypothesis.
• Addresses the statistics.

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Discussion

• Interprets the results.
• Draw conclusions.
• What does the statistical validity of the study
  imply?
• Includes the preponderance of references.
• Reviews the current knowledge and demonstrates
  how this study adds to that body of knowledge.

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Conclusions

• Draw inferences and hunches with the caveat that
  they are speculation.
• State what the next step in the research process
  should be.

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Acknowledgements

• Cites those individuals who contributed but not
  enough to earn authorship.

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Structure of a Research Publication

• Organization of content and its sequence.

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M.A.A.R.I.E. FrameworkRiegelman, Richard K.
Studying a Study Testing a Test. Philadelphia
Lippincott Williams Wilkins, 2005.

• Methods
• Assignment
• Assessment
• Results
• Interpretation
• Extrapolation

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Study Design

• Descriptive
• Evaluative

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Study Design - Descriptive

• Case Report
• Case Series
• Time Series
• Ecological Studies
• Cross-sectional Studies
• Design Surveys
• Surveillance Studies

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Study Designs - Evaluative

• Observational Cohort, Case-control
• Experimental Randomised/non-randomised

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Case Control Studies

• Cases are those with the disease
• Controls are those without the disease
• Prone to error and bias
• Good to demonstrate association or cause and
  effect
• Observational

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Benefits of case-controlled studies

• Efficient, relatively quick
• Useful for rare diseases
• Data mining

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Drawbacks of Case-control Studies

• Case and control selection
• Measurement of exposure
• Memory errors

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Cohort Studies

• Group of individuals who share a common
  experience
• Frequency of developing the disease is analyzed
• Observational

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Benefits of Cohort Studies

• Organized data collection
• Reliable, not memory
• Clear time order

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Drawbacks of Cohort Studies

• Time-consuming
• Expensive
• Loss to follow-up

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Both case-controlled studies and cohort studies
are observational.
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Randomized Clinical Trials

• Also called controlled clinical trials
• Employ randomization
• May be double blind
• Good for determining criteria for cause

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Criteria for Cause

• Association
• Prior association
• Altering the cause alters the effect

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Publication Characteristics (Publication Types of
PubMed) Scope Notes

• www.nlm.nih.gov/mesh/pubtypes2006.html
• Or
• Search the NLM web site for Publication
  characteristics

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Study DesignMann CJ. Observational research
methods. Research design II cohort, cross
sectional, and case-control studies. Emerg Med J.
2003 Jan20(1)54-60

• Study Purpose
• Sample
• Control Group
• Quality of Measurements and Outcomes
• Completeness
• Distorting Influences
• Validity

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Types of Studies

• Meta-Analysis
• Systematic Review
• Randomized Controlled Trial
• Cohort studies
• Case Control studies
• Case Series/Case Reports
• Animal research/Laboratory studies

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Evidence Pyramid
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Types of Questions

• Diagnosis
• Therapy
• Harm/Etiology
• Prognosis

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Type of Question Suggested Study Type
Therapy RCTgtcohort gt case control gt case series
Diagnosis prospective, blind comparison to a gold standard
Etiology/Harm RCT gt cohort gt case control gt case series
Prognosis cohort study gt case control gt case series
Prevention RCT gt cohort gt case control gt case series
Clinical Exam prospective, blind comparison to gold standard
Cost Economic analysis
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What type of study would you choose?

• A colleague confides in you that her spouse has
  been diagnosed with chronic kidney disease . She
  asks you to research the likelihood that he will
  need a transplant.

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What type of study would you choose?

• A physician asks you to research treatments for
  side effects of breast cancer radiation.

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What type of study would you choose?

• A pediatrician asks you to research the impact of
  pacifiers on SIDS.

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What type of study would you choose?

• 17 year old East Asian male presents with second
  episode of optic neuritis. MRI shows
  demyelination. In children with multiple
  sclerosis, compare the use of interferon and
  steroids to prevent relapse.

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What kind of study is this?

• N Engl J Med. 2006 Jun 22354(25)2655-66.
  Comment in N Engl J Med. 2006 Jun
  22354(25)2707-9. Cyclophosphamide versus
  placebo in scleroderma lung disease.

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What kind of study is this?

• Margolin S, Johansson H, Rutqvist LE, Lindblom A,
  Fornander T. Family History, and Impact on
  Clinical Presentation and Prognosis, in a
  Population-based Breast Cancer Cohort from the
  Stockholm County. Fam Cancer. 2006 Jul 1 PMID
  16817030

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What kind of study is this?

• 1 Kettlewell S, Moyes C, Bray C, Soutar D,
  MacKay A, Byrne D, Shoaib T, Majumder B, MacKie
  R. Value of sentinel node status as a prognostic
  factor in melanoma prospective observational
  study. BMJ. 2006 Jun 17332(7555)1423. Epub 2006
  May 30. PMID 16735303

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RCT Design http//pcpss2.rfc.ucl.ac.uk/SocInd/dat
a/58/rct.gif
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RCT Designhttp//www.endometriosisguide.com/image
s/Fig1-1.gif
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• Chalmers J, MacMahon S. Rationale and design of
  the ADVANCE study a randomized trial of blood
  pressure lowering and intensive glucose control
  in high-risk individuals with type 2 diabetes
  mellitus. J Hypertens. 200119(suppl4)S17-S24.

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Cohortwww.pitt.edu/super1/lecture/lec20271/015.h
tm

• Cohort design commences from the suspected factor
  and not from the disease as in case control
  study. It proceeds prospectively in a forward
  direction from the cause towards the occurrence
  of the expected disease.

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Shaw AK, Morrison HI, Speechley KN, Maunsell E,
Barrera M, Schanzer D, Pogany L, Desmeules M. The
late effects study design and subject
representativeness of a Canadian, multi-centre
study of late effects of childhood cancer.
Chronic Dis Can. 2004 Summer-Fall25(3-4)119-26.
PMID 15841852

• The Late Effects Study of the Program was
  designed to assess psychosocial and physical
  health outcomes among survivors of childhood
  cancer compared to general population controls.
  The objectives of this paper are to describe the
  design and methodology of the multi-centre,
  retrospective cohort study, present clinical
  characteristics of the survivor population, and
  evaluate the representativeness of study
  controls.

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http//www.ttuhsc.edu/som/FamMed/lectures/epi4/sld
004.htm
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http//clio.stanford.edu7080/cocoon/cliomods/trai
lmaps/design/design/caseControl/

• To determine if herpes simplex virus 1 (HSV1)
  infection was associated with the development of
  oral cancer, Starr et al (Cancer Res. 2001 Dec
  161(23)8459-64) first identified 259 people
  with oral cancer (cases) and 444 without oral
  cancer (controls). The investigators then
  measured the HSV1 antibody levels of each
  individual in both the case and control groups.
  Of the 259 cases, 190 (73) showed antibodies to
  HSV1, while 287 out of 444 controls (64) had
  HSV1 antibodies. Since the percentage of those
  with HSV1 antibodies is greater in cases than in
  controls (73 vs. 64), HSV1 infection might be
  positively associated with oral cancer.

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Case Controlhttp//www.slackbooks.com/excerpts/16
771/16771.asp

• In a case-control study, patients are entered
  into the study based on the presence or absence
  of the outcome (or disease) of interest. These 2
  groups (ie, those with the disease and those
  without the disease) are then compared to
  determine if they differ with regard to their
  presence of risk factors of interest.
  Case-control studies are always retrospective.

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