Abstract WritingAbstract Writing

Nuts and BoltsResearch Methods Symposium

September 29, 2006

Mukta Panda MD, FACPTransitional Year Residency and Department of Internal Medicine

University of TennesseeCollege of Medicine Chattanooga

Goals Goals

How to write an abstract• For a case report• For a scientific research paper

Writing is easy. All you do is stare at a blank sheet of paper until drops of blood form on your forehead ~ Gene Fowler

Case ReportsCase Reports

• What is a case report?• Why to case report?• When to case report?• How to case report?

What is a Case Report?

Report of an instance of disease with its attendant circumstances

What is the place of case reports What is the place of case reports in an evidence-based world?in an evidence-based world?

• Case reports are a necessary complement to the aims of evidence-based medicine

• The First Line of Evidence

-Recognize the unexpected

-Report a rare event

Strength of Evidence in Case Reports•High sensitivity in detecting novelty•Lesser specificity for medical decision making•Detection of adverse or beneficial effects by case reports and series may lead to action

Why to Case Report?What are the Benefits of Case Reports?

•Recognition and description of new diseases•Detection of drug side effects•Study of mechanisms of disease•Medical education•Recognition of rare manifestations of disease•Case reporting is great fun

When to Case Report

•To describe a new or innovative treatment or approach to a particular disease •Address a rare condition•Highlight an unusual manifestation of a common problem

How to Case Report?

•Clear about the single message that you want to bring•Emphasize why the message is important•Emphasize what the message teaches•Does it affirm or contradict a previously cherished truth? – if so, explain how•Emphasize the unexpected association if present

Abstract for aAbstract for a Scientific Research Paper Scientific Research Paper

Objective is to provide a document which contains sufficient information to enable readers to:

• Assess the observations you made• Repeat the experiment if they wish• Determine whether the conclusions drawn are

justified by the data

How to Write an Abstract

•Narrate your thought process crisply, openly and precisely•The abstract should contain the essence of the whole paper and should stand alone

Four Basic Parts of an Four Basic Parts of an AbstractAbstract

• Title• Follow the “IMRAD” format

-Introduction (What question/ message)

-Methods (How was it studied/identified)

-Results (What was found/concluded)

-And

-Discussion (What do the findings mean)

The TitleThe Title

• The simpler the title, the better• Concise summary of abstract• Demonstrate that the work is important,

relevant and innovative• Consider the target readership• Be brief – short titles are clearer and more

arresting• Avoid excessive adjectives and noun stings• Do not be a sensationalist

Short, Descriptive, Eye CatchingShort, Descriptive, Eye Catching

An epidemiological geographically based study of the quantity of ionizing radiation received by male employees of a nuclear reprocessing plant and nearby male residents working elsewhere in the same vicinity shows an increased risk of childhood leukemia in the children of the nuclear workers only.

An epidemiological study of radiation received by male employees of a nuclear plant and other residents in the vicinity and its relation to the incidence of childhood leukemia.

Be Brief, Be Interesting!Be Brief, Be Interesting!

Radiation to residents near a nuclear reprocessing plant and its relation to childhood leukemia: an epidemiological study.

Nuclear reprocessing, radiation exposure, and childhood leukemia:

an epidemiological study.

Eye catching!Eye catching!

Ventricular fibrillation, a cardiac arrhythmia caused by ingestion of poke weed salad in a patient with no underlying cardiac history.

Poke weed salad associated cardiac arrhythmias.

Not all salads are good for the heart.

IntroductionIntroduction• Before beginning, answer the following

questions• Be Brief1. What do I have to say

2. Is it worth saying

3. What is the right format for this message

4. What is the audience for this message

5. What is the journal for this message

IntroductionIntroduction

• State clearly the question you tried to answer• A review of literature should not appear in the

introduction• Tell the readers why you have undertaken the

study• Clarify what your work adds

Several studies have shown that regular Ecstasy use creates anesthetic difficulties, and several others have shown that it does not. We report 2 further patients, one of whom experienced problems and one of whom did not, and review the literature.

Many studies have addressed the problem of Ecstasy and anesthesia.

Two previous studies have reported that regular Ecstasy use may give rise to respiratory problems during anesthesia. These studies were small and uncontrolled, used only crude measurements of respiratory function, and did not follow up the patients. We report a larger, controlled study, with detailed measurements of respiratory function and two year follow up.

Four Basic Parts of an Four Basic Parts of an AbstractAbstract

– Introduction (What question/ message)

– Methods (How was it studied/identified)

– Results (What was found/concluded)

– Discussion (What do the findings mean)

MethodsMethods

How the study was designed:• Keep the description brief• Say how randomization was done

How was the study carried out:• How subjects were recruited and reasons for exclusion• Consider mentioning ethical features• Give accurate details of materials used• Give exact drug dosages, form of treatment or unusual

apparatus

How the data were analyzed:• Give the exact tests used for statistical analysis (chosen

a priori)

Four Basic Parts of an Four Basic Parts of an AbstractAbstract

– Introduction (What question/ message)

– Methods (How was it studied/identified)

– Results (What was found/concluded)

– Discussion (What do the findings mean)

ResultsResults

• Provides the answers to the questions you pose in the introduction

• Tell the story of how you arrived at the answers• Develop the story in a number of ways, add

tables and illustrations when necessary• State and explain the unexpected results• Statistical presentation-so much information so

little space, present enough for the intelligent reader to believe what you are saying

Four Basic Parts of an Four Basic Parts of an AbstractAbstract

– Introduction (What question/ message)

– Methods (How was it studied/identified)

– Results (What was found/concluded)

– Discussion (What do the findings mean)

DiscussionDiscussion

• State the main findings• Highlight any shortcomings of the methods• Compare the results with other published

findings• Discuss the implications of the findings

AuthorshipAuthorship

• All authors should have made “substantial contributions” to all three of the following

1. The concept and design of experiment or analysis

2. Drafting of article or revising it critically

3. Final approval of the version to be published

PHYSICIAN ATTITUDES AND BELIEFS REGARDING PATIENTS WITHCHRONIC PAIN: M Panda1, M Menon2 for the 4P Group (Patient-PhysicianPerception of Pain) 1University of TN- Chattanooga, University of PittsburgObjective Worldwide, chronic pain is the most frequent cause of suffering anddisability. Despite great interest in the study of pain, chronic pain is under treated byclinicians. The objective of our study is to assess physician attitudes and beliefstowards patients with chronic pain.Methods The 4P study is a multi-center, structured survey of patient and physicianattitudes and preferences regarding their perceptions of patients’ pain. A patient-physician perception of pain survey was developed and administered to 325physicians at nine university centers in the United States. The survey containedquestions on communication, comfort, and satisfaction. Demographic data were alsoobtained. Besides the compilation of descriptive data, we also performed bivariateanalyses looking for associations with more positive physician attitudes. Regressionanalysis was then performed to control for possible confounders. Results We report preliminary data based on the first 325 surveys returned. Eighty-six percent of respondents were general internists, 7% family practitioners, and 7%medical or surgical subspecialists. Participants ages ranged from 24 to 74 yrs (mean35 yrs), 58% were male and 18% reported a history of suffering from chronic pain.Seventy four percent of physicians agreed that caring for chronic pain patients wasfrustrating, 92% felt that chronic pain patients took more time than their otherpatients and only 34% agreed that they were comfortable caring for chronic painpatients. Physician comfort level was associated with the belief that patients withchronic pain usually get better (62%) and want frequent appointments, while ahistory of suffering from chronic pain was not. In multivariate analysis theassociation of the belief that patients with chronic pain want to get better remainedsignificant after adjustment for demographic variables and other beliefs (p=0.000). Conclusion Though primary care physicians believe that their patients with chronicpain want to get better, they harbor negative attitudes that could adversely affecttheir care of chronic pain patients. Interventions that improve these attitudes such aseducational programs, discussion groups and academic detailing should beconsidered.

A CASE OF RECURRENT ACUTE URINARY TRACT INFECTION (UTI) AND PROSTATITIS – THE VALUE OF A DETAILED HISTORY J. SHAH1

; M. PANDA2. 1University of Tennessee, Chattanooga, Chattanooga, TN; 2University of Tennessee at Chattanooga, Chattanooga, TN. (Tracking ID # 132598)

LEARNING OBJECTIVES: Recognize the differential diagnosis and workup of recurrent UTI in males and the importance of a detailed sexual history CASE: A 23-year-old male with a one-day history of dysuria, fever, chills and flank pain. He had acute prostatitis 16 months prior. Cystoscopy then revealed an inflamed prostatic urethra. Exam revealed a febrile tachycardic male; abdomen was soft, no costo-vertebral angle or suprapubic tenderness. Rectal exam: enlarged, tender, boggy prostate. WBC-16.6 TH, normal BUN/Cr. Urine analysis: pH 5.5, large albuninuria, leukocyte esterase, blood, WBC´s, gram-negative rods. Culture: pseudomonas aeruginosa. Kidney ultrasound: normal. Patient was treated with IV antibiotics. He was afebrile in 48 hours and was placed on 6 weeks oral antibiotics. Due to recurrent urinary tract infection, after repeated direct inquiry, the patient admitted to using different types and sizes of objects as anal toys. DISCUSSION: Prostatitis, a lower urinary tract infection occurs by retrograde entry of organisms into the prostatic ducts via urethra from oral, anal, genital intercourse or masturbating practices, by hematogenous spread from other foci, or lymphatic extension from infected kidneys. Diagnosis is made from history, tender prostate on exam with pyuria, positive urine culture and leukocytosis. Common organisms are E. coli, proteus, enterococci, staphlylococcus aureus and epidermidis. Antibiotic treatment should be given for 4-6 weeks to assure eradication. In our patient, repeated trauma by use of anal toys increased his risk for urinary tract infection. This case helps to remind physicians of the value of detailed sexual history even though it can be embarrassing.

PHYSICIAN ATTITUDES AND BELIEFS REGARDING PATIENTS WITH CHRONIC PAIN: M Panda1, M Menon2 for the 4P Group (Patient-Physician Perception of Pain) 1University of TN- Chattanooga, University of Pittsburg Objective Worldwide, chronic pain is the most frequent cause of suffering and disability. Methods The 4P study is a multi-center, structured survey of patient and physician attitudes and preferences regarding their perceptions of patients’ pain. A patient-physician perception of pain survey was developed and administered to 325 physicians at nine university centers in the United States. The survey contained questions on communication, comfort, and satisfaction. Results We report preliminary data based on the first 325 surveys returned. Eighty-six percent of respondents were general internists, 7% family practitioners, and 7% medical or surgical subspecialists. Participants ages ranged from 24 to 74 yrs (mean 35 yrs), 58% were male and 18% reported a history of suffering from chronic pain. Conclusion Though primary care physicians believe that their patients with chronic pain want to get better, they harbor negative attitudes that could adversely affect their care of chronic pain patients. Interventions that improve these attitudes such as educational programs, discussion groups and academic detailing should be considered.

PHYSICIAN ATTITUDES AND BELIEFS REGARDINGPATIENTS WITH CHRONIC PAIN: M Panda1, M Menon2 forthe 4P Group (Patient-Physician Perception of Pain) 1Universityof TN- Chattanooga, University of PittsburgObjective Worldwide, chronic pain is the most frequent causeof suffering and disability.Methods The 4P study is a multi-center, structured survey ofpatient and physician attitudes and preferences regarding theirperceptions of patients’ pain. A patient-physician perception ofpain survey was developed and administered to 325 physiciansat nine university centers in the United States. The surveycontained questions on communication, comfort, andsatisfaction. Results To follow

Conclusion To follow

ReferencesReferences

• RB Hayes, MD, PhD; CD Mulrow: More Informative Abstracts Revisited

• GM Hall MD; How to write a paper• JR Hoffman, MA, MD; Rethinking Case

Reports

SummarySummary

Care for your Readers, your Editors, and Yourself

Remember the following points:• Provide short interesting titles• Painstakingly construct concise readable, and

informative abstracts• Share the credit but ensure that all co-authors

contributed

Making the simple complicated is commonplace; making the complicated simple, awesomely simple , that’s CREATIVITY!

Charles Mingus