Sandra Tilmon, MPH Research Manager The University of Chicago Clinical Directors Network, (CDN) Webcast November 9 th, 2018
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1 { Sandra Tilmon, MPH Research Manager The University of Chicago Clinical Directors Network, (CDN) Webcast November 9 th, 2018
2 ACKNOWLEDGEMENT This presentation was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (6043-ACCH). Disclaimer: The statements presented in this webinar are solely the responsibility of the author(s) and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee. The Patient-Centered Outcomes Research Institute (PCORI) is an independent, nonprofit organization authorized by Congress in Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence -based information needed to make better-informed healthcare decisions. PCORI is committed to continually seeking input from a broad range of stakeholders to guide its work.
3 Session Objectives Understand a journal article s structure and how to navigate your way around it Gain an intuitive understanding of pesky biostatistics and what common terms mean Read an academic article and summarize the main points
4 What We ll Cover Peer-reviewed journal article structure Biostatistics 101 Group exercise Main points Strengths Weaknesses
5 What is a Peer-Reviewed Journal Article? Articles/manuscripts written by subject matter experts reviewed by other experts in the field to ensure scientific validity and importance in the field. Example: A. Mokdad, C. Murphy, S. Pruitt, J. Mansour, J. Marrero, A. Singal, A. Yopp. Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Cancer Oct 26. Who might be considered to review this article?
6 Journal Article Structure Abstract Introduction Methods Results Discussion
7 Journal Article Structure Abstract Introduction Methods Results Discussion A brief summary of the whole article to make pubmeddling* ( 34% less time intensive Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26. * Pubmed pun 2005, S. Tilmon
8 If the article is of interest to you, how often do you move past the abstract? 1. Never 2. Sometimes 3. Most of the time 4. Always Question! Answer online.
9 Journal Article Structure Abstract Introduction Methods Results Discussion Places problem into context Includes a review of current literature Why: do this study? What s the goal? What is the research question, Makes the problem into a testable question. Sometimes called Background
10 Journal Article Structure Abstract Introduction Methods Results Discussion Designed to give YOU, a reasonable person, a headache and to start spats among biostat/epi types. Sample Who are the participants? How were they selected? Materials How did you define happiness? Procedures What comparison procedure did you use to test your research question? Odds ratios? Hazard ratios? Chi-square?
11 Journal Article Structure Abstract Introduction Methods Results Discussion Good results include tables and graphs, but no further interpretation. Just the facts, y all Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
12 Journal Article Structure Abstract Introduction Methods Results Discussion Interpretation -- place the results in a larger context Discuss implications and next steps. Identify the study limitations Sometimes called Conclusion
13 Journal Article Structure Abstract Introduction Methods Results Discussion Interpretation -- place the results in a larger context Discuss implications and next steps. Identify the study limitations Sometimes called Conclusion NO journal article is complete without the phrase More research is needed
14 Biostatistics 101 Descriptive statistics Percentages, counts, and averages of the actual sample Estimates and probability Leave the study sample and INFER about larger population Accounting for random error not study bias or flaw Probability curve 95% Confidence interval P-values
15 Biostatistics 101: Your standard local normal probability curve
16 Biostatistics 101: Your standard local normal probability curve The area reflects the population included and the probability
17 Biostatistics 101: The 95% Confidence Interval 2.5%
18 Biostatistics 101: The 95% Confidence Interval 2.5% 2.5% 2.5%
19 Biostatistics 101: The 95% Confidence Interval 100% - 95% = 5% = % on each side 2.5% 2.5% 2.5% P value <.05 We are 95% confident that the true mean is between the LOWER and UPPER limits
20 Different (a), More (b), Less (c) Tests can have direction
21 Which is an example of a question with direction? 1. Drug A is different then Drug B 2. The treatment and control cohorts differed at baseline 3. Symptoms were reduced with the new dosage Question! Answer online.
22 Other distributions Can be nonsymmetric Background data tables differ P-values will still be interpretable
23 Group exercise
24 Abstract Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
![Compared with non-snhs [non-safety net hospitals], overall survival was similar at l-snhs [low safety net hospitals] (hazard ratio [HR], 0.93; 95% CI, 0.89-0.](/docs-images/96/128454731/images/25-1.jpg "98) but significantly worse at h-snhs [high safety net hospitals] (HR, 1.30; 95% CI, 1.22-1.39).")
25 Compared with non-snhs [non-safety net hospitals], overall survival was similar at l-snhs [low safety net hospitals] (hazard ratio [HR], 0.93; 95% CI, ) but significantly worse at h-snhs [high safety net hospitals] (HR, 1.30; 95% CI, ). Abstract Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
26 Data sources Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
27 Figure 1 Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
28 Table 4 Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
29 Table 4 Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
30 Earlier stage Figure 2: By Later stage tumor stage Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
31 Earlier stage Where is the problem here? 1. Earlier stages of disease 2. Later stages of disease Later stage Question! Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
32 Table 2 Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
33 Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
34 Earlier stage Insurance status Receiving treatment? Figure 2: By Later stage tumor stage Effect of hospital safety net designation on treatment use and survival in hepatocellular carcinoma. Ali A. Mokdad, Caitlin C. Murphy, Sandi L. Pruitt, John C. Mansour, Jorge A. Marrero, Amit G. Singal, Adam C. Yopp Cancer Oct 26 Published online 2017 Oct 26.
35 Thank you!
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