Just the Key Points, Please

Transcription

1 Just the Key Points, Please Karen Dodson Office of Faculty Affairs, School of Medicine

2 Who Am I? Editorial Manager of JAMA Otolaryngology Head & Neck Surgery (American Medical Association The JAMA Network) Managing Editor of the American Journal of Physiology-Endocrinology and Metabolism (American Physiological Society) Manager of Professional Development and Academic Publishing Services, Office of Faculty Affairs, Washington University School of Medicine Instructor, Scientific Writing and Publishing and Grantsmanship, Clinical Research Training Center, Washington University School of Medicine

3 Today s Objectives Learn how the Key Points process works at The JAMA Network Learn how to write your own effective key points and twitter feeds

4 What Are Key Points? (The JAMA Network) With the manuscript, a separate Supplemental file called "Key Points," should be submitted. This feature provides a quick structured synopsis of the findings of your manuscript (required only for research and review manuscripts), following 3 key points: Question, Findings, and Meaning. Limit this section to words or less*. Question Focused question based on the study hypothesis or goal/purpose. Limit to 1 sentence. Findings Results of the study/review. Include the design (eg, clinical trial, cohort study, case-control study, meta-analysis, systematic review). Focus on primary outcome(s) and finding(s). Do not emphasize secondary outcomes. Report basic numbers only but state if results are statistically significant or not significant; do not include results of statistical tests or measures of variance (see example below). Can include 1-2 sentences. Meaning Key conclusion and implication based on the primary finding(s). Limit to 1 sentence. *Hyphenated words count as 1 word Numbers count as 1 word

5 Right Now: Think about your own research question and prepare to tell us about it at the end of this presentation. Time Goal: 10 seconds

6 Why are Key Points Important? The JAMA Network Altmetrics

7 Key Points: Clear and Concise Communication Manuscripts Grant Proposals Presentations Reference Letters

8 Say It, Write It

9 To Demonstrate: William Faulkner and Ernest Hemingway

10 Faulkner: The Artist Loving all of it even while he had to hate some of it because he knows now that you don t love because: you love despite; not for the virtues, but despite the faults.

11 Hemingway: The Journalist All you have to do is write one true sentence. Write the truest sentence that you know.

12 Hemingway: The Journalist When challenged to write a full story in six words, he responded: For Sale: baby shoes, never worn. --Courtesy of Dr. Jay Piccirillo

13 Tools Hemingway App: An experienced copy editor (Academic Publishing Services, Elements of Style, originally published in 1920: Jr/dp/ The following tips.

14 Word Choice Use the word that conveys your meaning most accurately. When deciding between two such words, choose the shorter word: Approximately Commence Finalize Prioritize Terminate Utilize About Begin Finish Rank End Use

15 Sentence Structure Sentences are clearest, most forceful, and easiest to understand if they are simple and direct.

16 Sentence Structure Put parallel ideas in parallel form. Simplify by using active voice. Use strong verbs, not nouns. Write tight.

17 Put parallel ideas in parallel form. To give a comfortable rhythm to your writing, use the same pattern for ideas that have the same logical function. Balance elements of the sentence. For example: Instead of: Tissue samples were weighed, then frozen, and analyses were performed. Write: Tissue samples were weighed, frozen, and analyzed.

18 Simplify by using active voice. To simplify, use active, not passive, voice: The new drug caused a decrease in heart rate. Revised: The new drug decreased the heart rate.

19 Use strong verbs, not nouns. Make an adjustment Make a judgment Make a decision Perform an investigation Make a referral Reach a conclusion Adjust Judge Decide Investigate Refer Conclude

20 Write tight. At the present time Due to the fact that It may be that In the event that Prior to the start of... On two separate occasions Now Because Perhaps If Before Twice

21 Sentence Structure When two or more words are combined to form a compound adjective, a hyphen is usually required, e.g., disease-related sleepiness. *Hyphenated words count as 1 word

22 Examples JAMA Otolaryngology-Head & Neck Surgery

23 What Are Key Points? (The JAMA Network) With the manuscript, a separate Supplemental file called "Key Points," should be submitted. This feature provides a quick structured synopsis of the findings of your manuscript (required only for research and review manuscripts), following 3 key points: Question, Findings, and Meaning. Limit this section to words or less*. Question Focused question based on the study hypothesis or goal/purpose. Limit to 1 sentence. Findings Results of the study/review. Include the design (eg, clinical trial, cohort study, case-control study, meta-analysis, systematic review). Focus on primary outcome(s) and finding(s). Do not emphasize secondary outcomes. Report basic numbers only but state if results are statistically significant or not significant; do not include results of statistical tests or measures of variance (see example below). Can include 1-2 sentences. Meaning Key conclusion and implication based on the primary finding(s). Limit to 1 sentence. *Hyphenated words count as 1 word Numbers count as 1 word

24 General Example Question What is the immunogenicity of an inactivated influenza A vaccine with and without adjuvant? Findings In this randomized clinical trial that included 980 adults, the proportion achieving an effective antibody response was 84% with adjuvant vs 2% without adjuvant, a significant difference. Meaning In an influenza pandemic the use of an adjuvant with inactivated influenza A vaccine may be warranted.

25 Specific Example: Parent Experience of Care and Decision-Making for Children Who Snore (Abstract) Importance Sleep-disordered breathing (SDB) is prevalent and has an impact on the physical and behavioral health of children. Adenotonsillectomy (AT), the primary treatment, is subject to unexplained variation in utilization, which may be reduced by improving physician-patient communication and decision quality for this elective procedure. Objective To identify which factors are associated with parental experience and decision-making in pediatric SDB and AT surgery. Design, Setting, and Participants In this qualitative study, parents of children with prior SDB evaluation participated in semistructured, audiorecorded interviews. Open-ended questions regarded experiences of having a child with SDB, communication with pediatric clinicians and surgeons, and experiences with AT surgery. Recordings were transcribed and analyzed for emergent themes using grounded theory methodology. Eleven parents of children ages 2 to 17 years who had previously been diagnosed or treated for SDB were identified via purposive sampling and interviewed between January and April Interviews were conducted at locations convenient for the participants and separate from the pediatric clinic. A goal of this study was to ascertain how parents perceived sharing decisions with their physicians. Main Outcomes and Measures Themes of parental experiences and treatment decision-making processes with pediatric SDB. Results Overarching themes were inclusive of (1) clinical factors of SDB and AT and (2) clinician interpersonal behaviors and communication. Parents described an urgency that led them to seek evaluation or treatment, including fear that the child would stop breathing, or behavioral and/or cognitive delays. Parents often viewed surgery as a last resort and had explored alternate therapies prior to seeing the surgeon. Nearly all parents feared anesthesia more than AT surgery itself. Parents described satisfaction when physicians provided them with options, engaged their child in conversation, depicted SDB visually, and were responsive or accessible to questions. Parents regarded a trusting relationship with their pediatrician, confidence in the surgeon, and inclusion in decision-making as important. Conclusions and Relevance While clinical factors were influential for decision-making, interpersonal factors helped parents feel comfortable and influenced their overall experience. Shared decision-making, in which parents receive evidence-based information allowing them to accurately perceive risks, benefits, and alternatives about SDB treatment in the setting of trusting clinician-family relationships, may reduce parental decision conflict and improve decision quality toward AT surgery.

26 Parent Experience of Care and Decision-Making for Children Who Snore (Key Points) Question What factors influence parental experience and decision-making in pediatric sleep-disordered breathing (SDB) and adenotonsillectomy (AT) surgery? (16 words) Findings In this qualitative study, interviews with 11 parents of children previously treated for SDB indicated that choice for AT is influenced most by clinical factors, such as disease severity, surgical risks and benefits, but also by interpersonal factors, including physician-family communication and interpersonal relationships. (44 words) Meaning Parental decisional conflict and overutilization of AT may be mitigated when clinicians share clinical information on risks and benefits of all treatment options with parents and communicate in a family-centered manner. (31 words) TOTAL: 91 words (range allowed is words)

27 Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States (Abstract) Importance Tinnitus is a common problem for millions of individuals and can cause substantial negative effects on their quality of life. A large epidemiologic study of tinnitus and its management patterns in the US adult population is lacking. Objectives To quantify the epidemiologic features and effect of tinnitus and to analyze the management of tinnitus in the United States relative to the 2014 American Academy of Otolaryngology Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines. Design, Methods, and Participants This cross-sectional analysis of the representative 2007 National Health Interview Survey (raw data, respondents) identified a weighted national sample of adults (age, 18 years) who reported tinnitus in the preceding 12 months. Data were collected in November 2014 at the University of California, Irvine, and Harvard Medical School. Main Outcomes and Measures In addition to quantifying prevalence, severity, duration, and regularity of tinnitus, specific data regarding noise exposure and tinnitus management patterns during health care visits were analyzed. Results Among an estimated (SE) (3.4) million US adults, 21.4 (3.4) million (9.6% [0.3%]) experienced tinnitus in the past 12 months. Among those who reported tinnitus, 27% had symptoms for longer than 15 years, and 36% had nearly constant symptoms. Higher rates of tinnitus were reported in those with consistent exposure to loud noises at work (odds ratio, 3.3; 95% CI, ) and during recreational time (odds ratio, 2.6; 95% CI, ). Years of work-related noise exposure correlated with increasing prevalence of tinnitus (r = 0.13; 95% CI, ). In terms of subjective severity, 7.2% reported their tinnitus as a big or a very big problem compared with 41.6% who reported it as a small problem. Only 49.4% had discussed their tinnitus with a physician, and medications were the most frequently discussed recommendation (45.4%). Other interventions, such as hearing aids (9.2%), wearable (2.6%) and nonwearable (2.3%) masking devices, and cognitive behavioral therapy (0.2%), were less frequently discussed. Conclusions and Relevance The prevalence of tinnitus in the United States is approximately 1 in 10 adults. Durations of occupational and leisure time noise exposures correlated with rates of tinnitus and are likely targetable risk factors. Management options suggested by the recently published AAO-HNSF guidelines were followed infrequently.

28 Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States (Key Points) Question How are the epidemiologic features and management of tinnitus before the implementation of the 2014 American Academy of Otolaryngology Head and Neck Surgery Foundation clinical practice guidelines on tinnitus quantified? (29 words) Findings Results from this cross-sectional analysis indicated that in 9.6% of respondents experienced tinnitus in the past year, 36.0% of whom had nearly constant symptoms. Fewer than half of the patients had discussed their problem with a physician, who most commonly provided medications for management of tinnitus. (46 words) Meaning The national prevalence of tinnitus is approximately 1 in 10 adults, who were typically not treated in accordance with recent guidelines. (21 words) TOTAL: 96 words (range allowed is words)

29 Say It, Write It

30 Exercise Form partnerships Tell your partner your research question (1 minute) Tell your partner again (30 seconds) Tell your partner again (10 seconds) Tell us your research question (10 seconds) Thank you to Jamie Pitt and DeAnna Massie Using improv in faculty education and training