how to read the paper?

Question 1

what is trashing papers

Answer 1

Papers that should be in the bin

Question 2

Why do papers get trashed?

Answer 2

The study did not address an important scientific issue

The study was not original (someone else had already
done the same or a similar study)

The study did not actually test the authors’ hypothesis

A different type of study should have been done

Practical difficulties (in recruiting subjects, for example) led the authors to compromise on the original study protocol

The sample size was too small

The study was uncontrolled or inadequately controlled

The statistical analysis was incorrect or inappropriate

The authors drew unjustified conclusions from their data

There is a significant conflict of interest (one of the authors, or a sponsor, might benefit financially from the publication of the paper and insufficient safeguards were seen to be in place to guard against bias)

The paper is so badly written that it is incomprehensible

Question 3

how should drug treatment or other medical interventions be addressed

Answer 3

by double blind, randomised controlled trials

Question 4

prognosis require longitudinal cohort studies, and those about causation require which study?

Answer 4

require either cohort or case-control studies

Question 5

How can Case reports, though methodologically weak, be produced

Answer 5

rapidly and have a place in alerting practitioners to adverse drug reactions

Question 6

Primary studies, the stuff of most published research in medical journals, usually fall into one of three categories:?

Answer 6

Experiments E in which a manoeuvre is performed on an animal or a volunteer in artificial and controlled surroundings;

Clinical trials, in which an intervention, such as a drug treatment, is offered to a group of patients who are then followed up to see what happens to them; or

Surveys, in which something is measured in a group of patients, health professionals, or some other sample of individuals.

Question 7

What is Parallel group comparison?

Answer 7

Each group receives a different treatment, with both groups being entered at the same time; results are analysed by comparing groups

Question 8

What are Paired (or matched) comparison ?

Answer 8

subjects receiving different treatments are matched to balance potential confounding variables such as age and sex; results are analysed in terms of differences between subject pairs

Question 9

what is Factorial designA study ?

Answer 9

permits investigation of the effects (both separately and combined) of more than one independent variable on a given outcome (for example, a 2x2 factorial design tested the effects of placebo, aspirin alone, streptokinase alone, or aspirin plus streptokinase in acute heart attack23)

Question 10

Overviews divide into two division?

Answer 10

systemic review

non systemic review

Question 11

What is non systemic review?

Answer 11

[Non-systematic] reviews, which summarise primary studies;

Question 12

what is systemic review?

Answer 12

Systematic reviews, which do this according to a rigorous and predefined methodology; and

Question 13

what is decision analysis?

Answer 13

Decision analyses, which use the results of primary studies to generate probability trees to be used by health professionals and patients in making choices about clinical management.24 25 26

Question 14

what is economic analysis?

Answer 14

Economic analyses, which use the results of primary studies to say whether a particular course of action is a good use of resources.

Question 15

What 5 broad field research are there?

Answer 15

Therapy 
diagnosis 
screening 
prognosis 
causation

Question 16

A randomised controlled trial should answer questions such as the following:?

Answer 16

s this drug better than placebo or a different drug for a particular disease?

Is a leaflet better than verbal advice in helping patients make informed choices about the treatment options for a particular condition?

Question 17

What are advantages of randomised controlled trail design

Answer 17

Allows rigorous evaluation of a single variable (effect of drug treatment versus placebo, for example) in a precisely defined patient group (postmenopausal women aged 50-60 years)

Prospective design (data are collected on events that happen after you decide to do the study)

Uses hypotheticodeductive reasoning (seeks to falsify, rather than confirm, its own hypothesis)

Potentially eradicates bias by comparing two otherwise identical groups (but see below)

Allows for meta-analysis (combining the numerical results of several similar trials at a later date)

Question 18

Disadvantages of randomised controlled trail design

Answer 18

Expensive and time consuming; hence, in practice:

Many randomised controlled trials are either never done, are performed on too few patients, or are undertaken for too short a period

Top The science of “trashing”… Critical appraisal Randomised controlled trials Cohort studies Case-control studies Cross sectional surveys Case reports The hierarchy of evidence References

Most are funded by large research bodies (university or government sponsored) or drug

companies, who ultimately dictate the research agenda
Surrogate endpoints are often used in preference to clinical outcome measures may introduce “hidden bias,” especially through:

Imperfect randomisation (see above)\

Failure to randomise all eligible patients (clinician only offers participation in the trial to patients he or she considers will respond well to the intervention)

Failure to blind assessors to randomisation status of patients