HOW TO PREPARE A GOOD ACCEPTED

Transcription

1 HOW TO PREPARE A GOOD ABSTRACT AND GET IT ACCEPTED

2 This is an interactive session; be free to interrupt and ask questions at any time during the talk!

3 Some useful points when deciding if and where to submit an abstract Choose the meeting: only the best material gets into AATS, STS or EACTS conference. Prospective studies, especially when randomized, have by far the best chance. Retrospective studies carry less weight, especially when analysed over a longer time period (methods change). Institutional experience (unless it involves thousands of cases) should go to local meetings. New techniques and devices are always welcome, but beware of becoming an industry spokesman.

4 Start your work by carefully reading instructions for abstract submission

5 EACTS instructions for abstract submission

6 Automatic rejection! Institution identified, violation of rules.

7 EACTS RULES: If your work has already been presented elsewhere, it will be automatically dismissed by program committee. If it gets erroneously accepted, you will be barred from program for 2 years ( blacklisted ).

8 Read instructions carefully, and re-read your text before hitting submit button: EACTS does not correct your spelling and writing mistakes!

9 From a recent EACTS abstract 212 selected patients t included d to the study with retrospective ti data scan on postoperative bleeding after elective CABG with cardiopulmonary bypass (CPB). Study derived from two different centers: Group A patients (n=107) from our center at an altitude of 1985 meters and Group B patients (n=105) from a center in approximately sea level with 150 meters altitude. Be precise in your statements! This author s approximately sea level corresponds elsewhere to the highest peak in Denmark. Abstract was rejected!

10 EACTS Instructions for reviewers (as a rule, 5 or more for each abstract) Maximum score can be 10 (never reached); abstracts with Maximum score can be 10 (never reached); abstracts with score 1-3 are rejected, 4-5 might get in, 6 9 always get in.

11 Abstract selection for EACTS meetings Each abstract category has 5 8 experts. Grading is always anonymous! First round of abstract grading results in pre-selection of good, possible, and useless abstracts. Second round of grading (app % of remaining abstracts) is done by the program committee, first electronically, and finally during a face-face meeting of the committee. During this meeting, anonymity is usually broken to simplify the selection ( Didn t I hear this talk before? ) Finally, program committee makes detailed program, with placing abstracts in sessions, and selecting chairmen and invited discussants.

12 One of the most common errors in abstracts: False labeling of groups Give your groups self-explanatory, materialrelated labels: control and intervention ; treatment and placebo ; OPCAB and On- Pump; etc. Avoid labels like A, B and C; or Group I and Group II. Reader has to refer back to Methods to find the meaning of these labels, and your message is difficult to comprehend.

13 When analyzing an abstract, watch for following quality features Check if it is a consecutive series. Look for exclusion criteria (missing groups, elimination of high risk subsets). Data must be complete, including operative mortality. Observe the follow-up: methods, completeness (95% minimum) and length Look for conflict of interest.

14 Some examples: good, mediocre, and hopeless ones

15 Format of this session: 1. An abstract (or parts thereof) will be shown. 2. You will vote to accept, reject or leave abstract as possible 3. Vote of the program committee will be shown, with some comments.

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17 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

18 Typical paper for a local meeting. Mortality is atrocious. What is new here, what can be learned from this material? Rejected.

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20 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

21 No mention of selection criteria for LAD revascularization; obviously the two groups are not comparable, and other factors than additional CABG might have played a role in survival differences. Surprise: Accepted (??)

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23 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

24 How were these particular 100 patients selected? Seems that 100% of CABG patients have depression, and 84% must be treated. Is this possible??? Conclusions are not supported by results. Rejection.

25 When planning an abstract submission to a major meeting, avoid : Small series of few patients, even in rare conditions: any achieved results can be due to chance. Reports about standard procedures, or about institutional experience. Reviewers asks: what is new? Large series of standard d procedures: everything is known about mortality in CABG, AVR or MVR, or Fallot. Presenting some extraordinary results from an unknown institution: e.g. 0.2% mortality in CABG with LVEF<20%; or some 500 arterial corrections in TGA without mortality, etc. Credibility problem! Massive number crunching from your institutional data base: this is not science, but only tabulation of results. Some significances might emerge by chance, with large number of variables. Still very common!

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27 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

28 Perfect abstract: something new (TAVI), well documented multicentre study, good follow-up, important findings (difference in incidence of AV block). Accepted, with high score

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30 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

31 Never introduce an abbreviation or acronym without explaining i it first time when used. Rejected: might be good work, but not for a clinically-oriented meeting like EACTS. MSC stands for mesenchymal y stem cell ; 5-aza stands for 5-aza-cytidine» Proper spelling is hyaluronic, not hyauronic

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33 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

34 This is a very small group of patients for a 3 year period. How were they selected? Only a retrospective analysis: are both groups equivalent? Too many confounders (CABG, CTE). All patients receive a careful examination (pleonasm)! But still: ACCEPTED!

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36 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

37 Excellent abstract, highest note at 2011 STS meeting in San Diego

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39 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

40 Where are the actual values of echo measurements? We get only SD. Results do not support the conclusion. Authors state that the annulus is variable, but flexible devices should not be used? REJECTION

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42 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

43 Very good abstract: a new method (ILR) with complete, long-term follow-up, and with important results. Accepted, with high grades

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45 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

46 Standard surgical procedure since early sixties, very few patients. What is new?

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48 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

49 Only two cases: what can be learned from these examples? There is even no data about outcome

50 RADIAL ARTERY GRAFTING: A TEN-YEAR PERSPECTIVE. (3.91) Objectives: To evaluate the results of the radial artery used as a second coronary graft to achieve arterial revascularization in a ten-year period. Methods: From August 1996 to December 2005 radial artery was employed as a coronary graft in 424 patients. The features of the patients were: Euroscore 4.0±3.1, expected mortality 4.8±1.1, mean age 68.9±8.4 years, left main disease 35.0%, unstable angina 66.6%, previous AMI 47.4% and mean ejection fraction 61.5±12.6%. Radial arteries were harvested as skeletonized grafts in all cases. A total of 543 anastomoses (48.2%) were constructed with 454 radial arteries. The mean of distal anastomoses per patient was 2.6±0.6, being 1.2±0.5 of radial artery. Therefore, the LIMA was used as a graft in 413 cases, the RIMA in 50, the right inferior epigastric artery in 16 and the saphenous vein in 101. OPCAB revascularization a a was performed in 56 cases (13.2%). Results: RESULTS. Exclusive arterial revascularization was achieved in 83.4% (354 patients). Hospital-in and/or 30 day-mortality was 3.7% (16 patients). There was 2.5% of perioperative AMI. No major complications were found related to radial artery harvesting. Thirty patients underwent radionuclide exercise test with tecnecium 22.4 months after the operation. Stress-induced defects were detected only in 2 cases (5%), which were reversible at rest in areas revascularizated with a radial artery graft. Conclusions: The radial artery is an excellent conduit for myocardial revascularization that provides very few local complications and should it be considered as a true alternative to the right internal mammary for arterial graft revascularization

51 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

52 Very mediocre abstract, only an institutional experience. Early mortality substantial. 48.2% of what? Calculations not correct (2/30 is 6.7% and not 5%). Very few late observations (7%). REJECTION RADIAL ARTERY GRAFTING: A TEN-YEAR PERSPECTIVE. (3.91) Objectives: To evaluate the results of the radial artery used as a second coronary graft to achieve arterial revascularization in a ten-year period. Methods: From August 1996 to December 2005 radial artery was employed as a coronary graft in 424 patients. The features of the patients were: Euroscore 4.0±3.1, expected mortality 4.8±1.1, mean age 68.9±8.4 years, left main disease 35.0%, unstable angina 66.6%, previous AMI 47.4% and mean ejection fraction 61.5±12.6%. Radial arteries were harvested as skeletonized grafts in all cases. A total of 543 anastomoses (48.2%) were constructed with 454 radial arteries. The mean of distal anastomoses per patient was 2.6±0.6, being 1.2±0.5 of radial artery. Therefore, the LIMA was used as a graft in 413 cases, the RIMA in 50, the right inferior epigastric artery in 16 and the saphenous vein in 101. OPCAB revascularization a a was performed in 56 cases (13.2%). Results: RESULTS. Exclusive arterial revascularization was achieved in 83.4% (354 patients). Hospital-in and/or 30 day-mortality was 3.7% (16 patients). There was 2.5% of perioperative AMI. No major complications were found related to radial artery harvesting. Thirty patients underwent radionuclide exercise test with tecnecium 22.4 months after the operation. Stress-induced defects were detected only in 2 cases (5%), which were reversible at rest in areas revascularizated with a radial artery graft. Conclusions: The radial artery is an excellent conduit for myocardial revascularization that provides very few local complications and should it be considered as a true alternative to the right internal mammary for arterial graft revascularization

53 NEUROPROTECTIVE STRATEGIES: A WAY TO IMPROVE NEUROLOGICAL OUTCOME IN CARDIAC SURGERY (3.83) Objectives: To evaluate the usefulness of some measures aimed to avoid brain injury during cardiac surgery. Methods: We analyzed 141 patients with high-risk of stroke (CAD and/or age 70 years) who underwent open cardiac surgery during Their features were: mean age years, previous neurological dysfunction 3.6%, extra cardiac arteriopathy 4.3%, diabetes mellitus 26.2% and hypertension 62.4%. Preoperative treatment with aspirin was present in 63% of patients. The following five steps were taken in a regular way: 1) Routine preoperative doppler scan of supraaortic trunks. 2) Arterial head with a centrifugal pump 3) Adequate systemic pressure during the CPB equal to the age of the patient. 4) Coated circuits. 5) Aprotinin in medium dose. We did not use epiaortic ultrasound. Of this population 67% underwent CABG, and 95% of their proximal anastomoses were performed on the aorta. Results: Following Roach s classification, there were no type I neurological complications, and 2 patients (1.2%) had type II outcomes (new seizures and encephalopathy). In-hospital mortality was 3.6% (5 patients), t none of them due to neurological l complications. The predicted d mortality according to logistic EuroSCORE was 5.7%. Conclusions: The low incidence of neurological complications suggests that our protective strategies were effective. Although many factors remain unclear, our results suggest that neurological deficit could be due to low cerebral blood flow rather than to atherosclerotic emboli. So, we strongly recommend putting these measures into practice. However, further prospective randomized clinical trials are warranted to prove new innovative concepts in clinical practice.

54 Vote about this abstract: Press 1: Accept Press 2 Reject Press 3 Possible

55 Very mediocre abstract. This is not a high-risk group! Lot of opinions without scientific proof. Conclusions not supported by the results. REJECTED NEUROPROTECTIVE STRATEGIES: A WAY TO IMPROVE NEUROLOGICAL OUTCOME IN CARDIAC SURGERY (3.83) Objectives: To evaluate the usefulness of some measures aimed to avoid brain injury during cardiac surgery. Methods: We analyzed 141 patients with high-risk of stroke (CAD and/or age 70 years) who underwent open cardiac surgery during Their features were: mean age years, previous neurological dysfunction 3.6%, extra cardiac arteriopathy 4.3%, diabetes mellitus 26.2% and hypertension 62.4%. Preoperative treatment with aspirin was present in 63% of patients. The following five steps were taken in a regular way: 1) Routine preoperative doppler scan of supraaortic trunks. 2) Arterial head with a centrifugal pump 3) Adequate systemic pressure during the CPB equal to the age of the patient. 4) Coated circuits. 5) Aprotinin in medium dose. We did not use epiaortic ultrasound. Of this population 67% underwent CABG, and 95% of their proximal anastomoses were performed on the aorta. Results: Following Roach s classification, there were no type I neurological complications, and 2 patients (1.2%) had type II outcomes (new seizures and encephalopathy). In-hospital mortality was 3.6% (5 patients), t none of them due to neurological l complications. The predicted d mortality according to logistic EuroSCORE was 5.7%. Conclusions: The low incidence of neurological complications suggests that our protective strategies were effective. Although many factors remain unclear, our results suggest that neurological deficit could be due to low cerebral blood flow rather than to atherosclerotic emboli. So, we strongly recommend putting these measures into practice. However, further prospective randomized clinical trials are warranted to prove new innovative concepts in clinical practice.

56 You stand the highest chance of getting your abstract accepted, when you have: Properly designed prospective randomized d study (admittedly, dl very difficult in our field). Apply accepted statistical methods (e.g. propensity score matching, metaanalysis) Present something new: technique, idea, experimental observation. Question an established belief or a presumed fact.

57 Evaluation of session Joint abstracts analysis in a moderated session Good exercise (Press 1) Somewhat useful (Press 2) Waste of time (Press 3)