Zašto je važno znati

čitati i napisati znanstveni

rad?

Pisanje zasnovano na

dokazima

Znanstveni rad

novo znanje

prvi puta

Izvorni znanstveni članak (=primarna znanstvena publikacija) je prvi objavak rezultata

znanstvenog istraživanja koji sadrži dovoljno podataka da drugi znanstvenici (kolege) mogu

(1) proučiti dokaze,(2) ponoviti pokuse i(3) procijeniti donesene zaključke.Objavak mora biti dostupan znanstvenoj javnosti u trajnom obliku i bez ograničenja, te dostupan redovitom pretraživanju koji rade glavne (poznate) sekundarne (indeksne) publikacije (Index Medicus, Excerpta Medica, Current Contents, ...).

Hijerarhijska vrijednost članaka u časopisu

1. N of 1 RCT2. Sustavni pregled RCT-ja ( i meta-analiza)3. Randomizirani kontrolirani klinički pokus

(RCT)4. Sustavni pregledi opažajnih istraživanja5. Opažajno istraživanje (kohortna studija,

istraživanje parova, presječno istraživanje)

6. Fiziološka istraživanja7. Nesustavna klinička opažanja

1665

Journal des Scavans

Philosophical Transactions of the Royal Society of London

A naturalist’s life would be a happy one if he had only to observe and never to write.

–Sir Charles Darwin

The man of science appears to be the only man who has something to say just now, and the only man who does not know how to say it.

–Sir James Barrie

Obilježja komunikacije u znanosti

jasnoća točnost

jednostavnost razumljivost

Beauty of style and harmony and grace and good rhythm depend on simplicity.

–Plato

Pisanje zasnovano na dokazima(Evidence-based writing)

Zasniva se na istraživanjima iz:• kognitivne psihologije• grafičkog dizajna i tipografije• instrukcijskog dizajna• lingvistike• istraživanja čitanja• retorike

Evidence-based writing

Gunning Fog Index: mjera čitljivosti pisanoga teksta– Robert Gunning. The Techniques of Clear Writing. New York:

McGraw-Hill, 1968.

• Interpretacija: – Lagano čitanje 6-10.– Prosječna osoba čita

na razini 9.– Sve iznad 17. razine je

teško za studente.

Dječje knjige 6-10

Dnevne novine 12-14

Medicinski časopisi 14-16

Pravni časopisi 16-18

Police osiguranja 18-20

Evidence-based writing

Lexical difficulty indeks (Donald Hayes): 87000 riječi na osnovu čestoće uporabe u udžbenicima, romanima, časopisima i encikopedijama (American Heritage Word Frequency Book).

1. pojam: “the”; 10,000. pojam: “whooping”; neuron – 23,595. pojam

Majčin govor djetetu

Novinski članak

Članak u časopisu Nature

Evidence-based writing

Nature

Science

LEX score

Lex ratings:

Nature +35

New Scientist +7

Time +2

US/UK newspapers 0

Ranger Rick -18

TV (prime show) -36

Farmer talking -56to cows

Introduction Što sam htio?

Method Kako sam radio?

Results Što sam dobio?

And

Discussion Što to znači?

NASLOV

Why whip egg whites in copper bowls?

Nature 1984;308

Naslov mora biti razumljiv:

• čitatelji imaju prethodna iskustva i znanje• odgovarajući naslov pomaže stvaranje korisnih

asocijacija

“Postupak je zapravo jako jednostavan. Prvo se stvari rasporede u različite skupine ovisno o njihovoj vrsti i građi. Naravno, može biti dostatna i jedna skupina ako …”

Pranje rublja u perilici

SAŽETAK

Klasični

Strukturirani

Aim ObjectiveMethod SettingResults ParticipantsConclusions Design

InterventionMain outcome measureResultsConclusions

SAŽETAK

Kao dio rada:

– pomaže čitatelju da se odluči čitati rad– usmjeruje čitatelja na istraživački problem

Tiskan posebno:

– pomaže čitatelju koji odluči potražiti članak– zamjenjuje članak ako članak nije dostupan

UVOD

Pišite Uvod krećući od općeg, širokog konteksta vašegrada, recite čitatelju što je već poznato pa

onda ono što se još ne zna,koji su problemi,

te što ste vi odlučili

raditi

TVORIVA I POSTUPCI

daju informacije koje omogućuju znanstvenicima/čitateljima:

– ponavljanje pokusa – procjenu vrijednosti pokusa

TVORIVA I POSTUPCI

Pediat Res 1972;6:26

Krv za analizu uzeta je od 48 osoba koje smo upoznali s pokusom i koje su

pristale na istraživanje (informed and consenting subjects); dob ispitanika bila

je od 6 mjeseci do 22 godine.

REZULTATI

tekst

tablice

slike

Rezultati

Slike i tablice bi trebale:

•Dodati nove podatke

•Štediti prostor

•Biti razumljive same za sebe

•Ne biti pretrpane brojkama ili crnilom

REZULTATI

REZULTATI

Pisati za čitatelja

Dođite brzo do glagola

• duge rečenice nisu nužno nerazumljivije nego kratke

• dužina nije problem nego složena sintaksa

• kad pročitamo subjekt rečenice, očekujemo odmah i glagol

• informacija između subjekta i glagola slabo se zadržava u radnoj memoriji

Pisati za čitatelja

Pišite “scenarij” - subjekt, aktivni glagoli

• aktivne rečenice su obično razumljivije od pasivnih, posebice ako govore o ljudima

• ne mora svaka rečenica biti u aktivnom obliku

Grafički prikaz podataka

Brojke prikazujte da ih čitatelj može bolje razumjeti

• ne pišite previše decimalnih brojki

• napišite i frakciju uz postotak, a samo brojeve za male uzorke

• budite svjesni da ljudi nemaju dobar pojam o velikim brojevima (>1 000 000)

Grafički prikaz podataka

Brojke prikazujte da ih čitatelj može bolje razumjeti

• izbjegavajte rimske brojeve (osim za kranijalne živce, čimbenike zgrušavanja i svjetske ratove)

• u tablici na lijevu stranu stavite ono što čitatelj već zna

• ako ne stavite 0 u grafikon, čitatelj može misliti da je rezultat veći nego što jest

RASPRAVA

Nakonsažimanja rezultata,

identificirajte ograničenja iotklone,usporedite ih s drugim

nalazima i raspravite teorijske i praktičneposljedice vašeg istraživanja; oprezno izvedite

zaključke iz opisanih istraživanja i predložite buduća istraživanja, pokažite što je novo i kako se Vaši rezultati

uklapaju u šire područje koje ste opisali na početku Uvoda.

Obilježja komunikacije u znanosti

jasnoća točnost

jednostavnost razumljivost

Scientific jargon:

From the time immemorial, it has been known that the ingestion of an “apple” (i.e., the pomme fruit of any tree of the genus Malus, said fruit being usually round in shape and red, yellow, or greenish in color) on a diurnal basis will with absolute certainty keep a primary member of the health care establishment absent from one’s local environment.

An apple a day keeps doctor away.

The Six Honest Serving MenR. Kipling

I keep six honest serving men

(They taught me all I know):

Their names are What and Why and When

And How and Where and Who.

A survey of the writer’s personal methodology in general inquiry has been carried out, and the results analyzed to determine components of the interrogatory technique. Six distinct forms of question were isolated, as tabulated below. It is claimed that responses evoked by these were responsible for the total quantity of knowledge acquired by the author (3).

The basics of writing a paper: Topping and tailing

• Title: Include design; Don’t try to be clever• Abstract: Make it structured even if not in form;

Include some numbers, not all• References: Keep to the essentials• Covering letter: Something very crisp• Authorship, acknowledgements, competing

interests

•Don’t select it because of its impact factor•Don’t select it because of its “reputation”•Select it because of the audience•Who will be interested in your paper?

–Doctors - all or a particular group–Researcher–Policy makers–Public

Find the right journal

90% relevant information is published in 10% of the journals

• only 10-15% articles from a field are useful

• half of the articles are never cited

• half of the journals on library shelves are

never opened

US National Library of Medicine:

gets 24,000 journals per yearindexes 4,000 in MEDLINE

Science Citation Index (SCI):

indexes 5,600 leading journals from different scientific disciplines

Peer review processes

• “Stand at the top of the stairs with a pile of papers and throw them down the stairs. Those that reach the bottom are published.”

• “Sort the papers into two piles: those to be published and those to be rejected. Then swap them over.”

Will editors like your paper?

• At (big) journals, it is editors, not peer reviewers, who decide on publication

• General journal editors like papers with general appeal

• How do (big) journal editors decide?

The right study design• Exploration of hypotheses: Qualitative research• History taking: Case-control study• Diagnostic testing: Cross sectional study• Treatment experience: Randomized clinical trial• Individual trial and error: n of 1 trial• Following clinical course: Cohort study• Record keeping: Systematic registry based

(computer supported) research• Individual peer review: Quality of care

research/process evaluation

How editors triage studies?

• We like valid studies with messages that will make a difference to patients

• Fewer than 1% of original studies published in medical journals are valid and relevant to patients

Editor’s approach I:

• Read covering letter

• But remember it’s a sales pitch

Editor’s approach II:

Signs of a totally unsuitable paper:

• Biblical quotations

• A cure for schizophrenia or cancer

• Incomprehensible first two paragraphs

Editor’s approach III:

Title page:

• Original study or something else?

• “Unknown” authors regularly produce great work. “Known” authors sometimes produce dreadful papers.

Editor’s approach IV:

Structured abstract:

• Does it show what the paper is about and how it is structured?

• If not, it’s looking bad.

Editor’s approach V:• Is the question one that we want to know

the answer to?

• Or is the question too–specialist–inconsequential–far removed from patient care or public

policy–well known – but lots of things that are well

known have no evidence to support them.

Editor’s approach VI:

• Papers with interesting questions and “negative” answers can be important.

• The research question is more important than the answer.

• Have the researchers used correct methods to answer the question?

Triage: treatment paper

• If it is an RCT, was it really randomized?

• If it wasn’t, reject unless you can find a good reason for not randomizing.

Triage: diagnosis paper• Is the test compared prospectively and blind

with a gold standard?

• Does the test population include patients with the condition, with related conditions that could be confused with the main condition, and people without the condition?

• Does the paper include information on sensitivity, specificity, etc?

• If no to any of above the journal will usually reject.

Triage: prognosis studies

• Is there a cohort of patients followed prospectively from when they were first identified with the disease?

• Are 80% of patients followed up?

• If the answer to these questions is no, we probably don’t want the paper.

Triage: systematic reviews

• Was a clear question asked?

• Was a search described?

• Were quality criteria set?

• Were studies appraised and discarded?

• If not to any of these questions, reject.

Triage: qualitative research

• Were qualitative methods appropriate for the question? Is it a “why” or “how” study rather than a “does it work” or “how often” study?

• Were the methods and the analysis described in detail and justified?

• If the answer is no to either question, you should probably reject.

Triage: questionnaire survey

• If it reports what people say they do, rather than what they really do, reject

• Does it tell us something important we probably can’t investigate in any other way?

• If the response rate is below 55% most journals will almost certainly reject.

Triage: economic evaluation

• Is the underlying methodology valid? For example, an evaluation of treatment should be based on an RCT or systematic review.

• If not, reject.

• A a good case must be:

– not so common that everybody knows it

– nor so rare that it won’t matter if they don’t

– a good read.

• If not, reject.

Triage: case report

Triage: two sorts of studies editors don’t like• Prevalence study

– Limited usefulness– Usually can’t generalise beyond the particular

population

• Cost of illness study– Rarely interesting enough– Again hard to generalize

Accept

Minor revision

Major revision

Reject