DCEM2 Purpan. Reading skills Skimming & Scanning. Abstracts. Guidelines for authors. Research article structure. Journals

Transcription

1 Reading skills Skimming & Scanning DCEM2 Purpan Abstracts Skimming: going through the reading material to know how it is organized Scanning: trying to locate specific information by letting eyes wander over text until required information is found, retrieving information relevant to purpose Félicie Pastore November 4th Research article structure Introduction State of the art present perfect Niche Objective(s) to. Materials & Methods: what was done past Results: what was found past And Discussion What is sure present What is possible modals (can, may) What remains to be done future Guidelines for authors NEJM JAMA BMJ Journals NEJM Abstracts: 250 words Background Methods Results Conclusions JAMA Abstracts for Reports of Original Data: 300 words Context Objective Design Setting Patients (or Participants) Interventions Main Outcome Measure(s) Results Conclusions BMJ Abstracts for research articles: words 5 : 2h Title: Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial Write abstract (250 words,1h15 ) Essay: Acupuncture and other alternative medicine: your point of view (150 to 180 words,45 ) Write number of words at top of abstract & of essay 6 1

2 BMJ abstracts: structure Objectives Design Setting Participants Interventions Main outcome measures Results Conclusion BMJ abstracts: style Objective, design, setting: note-like, not full sentences Results and conclusion: write properly. Do not mix notes and full sentences in one section 7 8 BMJ objectives A clear statement of the main aim of the study and the major hypothesis tested or research question posed Objective: To investigate the benefit of adding acupuncture to a course of advice and exercise delivered by physiotherapists for pain reduction in patients with osteoarthritis of the knee 9 10 BMJ design Sort of study prospective randomised blinded / double blinded placebo controlled case control crossover criterion standards for diagnostic tests etc Design: Multicentre, randomised controlled trial

3 BMJ setting (Participating centers) - level of care (primary, secondary) - number of participating centres Be general rather than give name of specific centre, but give geographical location if important Setting: 37 physiotherapy centres accepting primary care patients referred from general practitioners in the Midlands, United Kingdom BMJ participants - Numbers (entering and completing the study) - Sex, ethnic group (if appropriate) - Give clear definitions of how selected, entry and exclusion criteria Participants: 352 adults aged 50 or more with a clinical diagnosis of knee osteoarthritis What - How - When - For how long BMJ interventions Interventions: Advice and exercise (n=116), advice and exercise plus true acupuncture (n=117), and advice and exercise plus nonpenetrating acupuncture (n=119)

4 BMJ main outcome measures - those planned in protocol - those finally measured (if different, explain why) Main outcome measures: The primary outcome was change in scores on the Western Ontario and McMaster Universities osteoarthritis index pain subscale at six months. Secondary outcomes included function, pain intensity, and unpleasantness of pain at two weeks, six weeks, six months, and 12 months BMJ results and conclusions BMJ results Write properly Do not mix notes and full sentences in one section - Main results with (for quantitative studies) 95% confidence intervals - Where appropriate, exact level of statistical significance and number need to treat/harm BMJ results Results: Follow-up rate at six months was 94%. The mean (SD) baseline First things first / top-down approach - primary outcomes - secondary outcomes - other (depending on importance or number of words) pain score was 9.2 (3.8). At six months mean reductions in pain were 2.28 (3.8) for advice and exercise, 2.32 (3.6) for advice and exercise plus true acupuncture, and 2.53 (4.2) for advice and exercise plus non-penetrating acupuncture. Mean differences in change scores between advice and exercise alone and each acupuncture group were 0.08 (95% confidence interval 1.0 to 0.9) for advice and exercise plus true acupuncture and 0.25 ( 0.8 to 1.3) for advice and exercise plus non-penetrating acupuncture. Similar non-significant differences were seen at other follow-up points. Compared with advice and exercise alone there were small, statistically significant improvements in pain intensity and unpleasantness at two and six weeks for true acupuncture and at all follow-up points for non-penetrating acupuncture

5 BMJ conclusions - Primary conclusions and their implication - Suggested areas for further research if appropriate Do not go beyond the data in the article Conclusions: The addition of acupuncture to a course of advice and exercise for osteoarthritis of the knee delivered by physiotherapists provided no additional improvement in pain scores. Small benefits in pain intensity and unpleasantness were observed in both acupuncture groups, making it unlikely that this was due to acupuncture needling effects Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial BMJ 2007;335:436 Objective To investigate the benefit of adding acupuncture to a course of advice and exercise delivered by physiotherapists for pain reduction in patients with osteoarthritis of the knee. Design Multicentre, randomised controlled trial. Setting 37 physiotherapy centres accepting primary care patients referred from general practitioners in the Midlands, United Kingdom. Participants 352 adults aged 50 or more with a clinical diagnosis of knee osteoarthritis. Interventions Advice and exercise (n=116), advice and exercise plus true acupuncture (n=117), and advice and exercise plus non-penetrating acupuncture (n=119). Main outcome measures The primary outcome was change in scores on the Western Ontario and McMaster Universities osteoarthritis index pain subscale at six months. Secondary outcomes included function, pain intensity, and unpleasantness of pain at two weeks, six weeks, six months, and 12 months. Results Follow-up rate at six months was 94%. The mean (SD) baseline pain score was 9.2 (3.8). At six months mean reductions in pain were 2.28 (3.8) for advice and exercise, 2.32 (3.6) for advice and exercise plus true acupuncture, and 2.53 (4.2) for advice and exercise plus non-penetrating acupuncture. Mean differences in change scores between advice and exercise alone and each acupuncture group were 0.08 (95% confidence interval 1.0 to 0.9) for advice and exercise plus true acupuncture and 0.25 ( 0.8 to 1.3) for advice and exercise plus non-penetrating acupuncture. Similar non-significant differences were seen at other followup points. Compared with advice and exercise alone there were small, statistically significant improvements in pain intensity and unpleasantness at two and six weeks for true acupuncture and at all follow-up points for non-penetrating acupuncture. Conclusion The addition of acupuncture to a course of advice and exercise for osteoarthritis of the knee delivered by physiotherapists provided no additional improvement in pain scores. Small benefits in pain intensity and unpleasantness were observed in both acupuncture groups, making it unlikely that this was due to acupuncture needling effects. 27 Respect BMJ abstracts Take home message - Number of words (250) - Format Objectives Design Setting Participants Interventions Main outcome measures Results Conclusion all relevant information no commentary no invention 28 Bibliography Developing Reading Skills Françoise Grellet, Cambridge University Press NEJM JAMA BMJ Cours Dr Fabrice Muscari «Epreuve de LCA : Le résumé» 29 5