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Successful Scientific Writing Paul Z. Siegel, M.D., M.P.H. Based on materials developed in collaboration with Richard A. Goodman, M.D., J.D.

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Presentation on theme: "Successful Scientific Writing Paul Z. Siegel, M.D., M.P.H. Based on materials developed in collaboration with Richard A. Goodman, M.D., J.D."— Presentation transcript:

1 Successful Scientific Writing Paul Z. Siegel, M.D., M.P.H. Based on materials developed in collaboration with Richard A. Goodman, M.D., J.D.

2 in close proximity to - near the predominant number of in a large number of cases on a previous occasion in the absence of with regard to at some future time due to the fact that serves the function of being

3 heretofore

4 heretofore- until now theretofore- before then remuneration- payment promulgate- to publish - make widely known

5 I am a bear of very little brain… and long words bother me.

6 A Dictionary of Useful Research Phrases From Thurlbeck, WM. Glasnost and communication. Am Rev Respir Dis 1989;139:

7 A Dictionary of Useful Research Phrases "It has long been known..."

8 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references.

9 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..."

10 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think.

11 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..."

12 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..." My friends think so too.

13 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..." My friends think so too. "Correct within an order of magnitude..."

14 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..." My friends think so too. "Correct within an order of magnitude..." Wrong.

15 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..." My friends think so too. "Correct within an order of magnitude..." Wrong. "A statistically oriented projection..."

16 A Dictionary of Useful Research Phrases "It has long been known..." I didn't look up the original references. "It is believed that..." I think. "It is generally believed that..." My friends think so too. "Correct within an order of magnitude..." Wrong. "A statistically oriented projection..." Wild guess.

17 PURPOSE Communicate more effectively

18 PURPOSE Communicate more effectively Publish more efficiently

19

20 Communicate effectively

21 To assess reliability of the questionnaire, a test-retest study was conducted. Agreement was high for sociodemographic variables. Reliability of information on chronic conditions was also high. Do reliability andagreement mean the same thing?

22 To assess reliability of the questionnaire, a test-retest study was conducted. Agreement Reliability was high for sociodemographic variables. Reliability of information on chronic conditions was also high.

23 To assess reliability of the questionnaire, a test-retest study was conducted. Reliability was high for sociodemographic variables and chronic conditions. Clear Smooth

24 reliability agreement reliability ? ?

25 of thought reliability agreement reliability ? ?

26 If heterosexual transmission was, in fact, the mode of HIV infection for persons who reported other risks as well as heterosexual contact, for persons who are currently reported without risks but who may be reclassified in the future to the heterosexual contact category, as well as for persons formerly classified as "Pattern II – heterosexually acquired," then 12% of cumulative and 16% of cases reported in 1993 may be attributable to heterosexual transmission. or ?

27 If heterosexual transmission was, in fact, the mode of HIV infection for persons who reported other risks as well as heterosexual contact, for persons who are currently reported without risks but who may be reclassified in the future to the heterosexual contact category, as well as for persons formerly classified as "Pattern II – heterosexually acquired," then 12% of cumulative and 16% of cases reported in 1993 may be attributable to heterosexual transmission. Strain factors long sentences (>25 words) conjecture

28 If heterosexual transmission was, in fact, the mode of HIV infection for persons who reported other risks as well as heterosexual contact, for persons who are currently reported without risks but who may be reclassified in the future to the heterosexual contact category, as well as for persons formerly classified as "Pattern II – heterosexually acquired," then 12% of cumulative and 16% of cases reported in 1993 may be attributable to heterosexual transmission. Conjecture

29 SECTIONS OF A SCIENTIFIC ARTICLE 2. ABSTRACT 3. INTRODUCTION 4. METHODS 5. RESULTS 6. DISCUSSION

30 SECTIONS OF A SCIENTIFIC ARTICLE 1. TITLE 2. ABSTRACT 3. INTRODUCTION 4. METHODS 5. RESULTS 6. DISCUSSION

31 The ABSTRACT Purpose: to highlight key points from the major sections of the article Component of abstract Abstracted from Major purpose of study Basic procedures Main findings Principal conclusions Methods Results Discussion

32 The ABSTRACT Purpose: to highlight key points from the major sections of the article Component of abstract Abstracted from Major purpose of study Basic procedures Main findings Principal conclusions Introduction Methods Results Discussion

33 The ABSTRACT Purpose: to highlight key points from the major sections of the article Component of abstract Abstracted from Major purpose of study Basic procedures Main findings Principal conclusions Introduction Methods Results Discussion List Medical Subject Headings (MeSH) key words under the abstract Emphasize what is new and useful.

34 Emphasize what is new and useful.

35 Screening research papers by reading abstracts Please get the abstract right, because we may use it alone to assess your paper. -- British Medical Journal

36 Reliability of Information on Chronic Disease Risk Factors Collected in the Missouri Behavioral Risk Factor Surveillance System Abstract (initial draft words) small-group exercise

37 Background Info BRFSS – what is it? Validity vs. Reliability Kappa values

38 Editing SUBSTANCE –Mistakes –Ambiguity –Missing key info –Extraneous/misleading info –Empty statements STYLE

39 PURPOSE The Behavioral Risk Factor Surveillance System (BRFSS) is widely used by state health agencies to measure the prevalence of chronic disease risk factors. Despite the widespread use of BRFSS, few studies exist on the reliability and validity of BRFSS-collected data. To assess the reliability of the Missouri BRFSS...

40 The Behavioral Risk Factor Surveillance System (BRFSS) is a population-based telephone survey of health-related behaviors among adults ages 18 and older that is used by nearly all state health agencies to measure the prevalence of chronic disease risk factors. Despite widespread use, the reliability of BRFSS-collected data is not well described (understood... characterized... ). To assess the reliability of the Missouri BRFSS...

41 METHODS..., a test-retest study was conducted. The authors conducted telephone reinterviews for 222 respondents of completed BRFSS interviews from March and April The second interview was completed between six and 30 days of the first interview.

42 PASSIVE VOICE Expresses action without specifying who or what performed the action (the agent of the action is omitted) "James Watson was awarded the Nobel Prize for discovering the molecular structure of DNA.

43 PASSIVE VOICE Expresses action without specifying who or what performed the action (the agent of the action is omitted) "James Watson was awarded the Nobel Prize for discovering the molecular structure of DNA. vs. "The Nobel Committee awarded James Watson the Nobel Prize for discovering the molecular structure of DNA."

44 A Controlled Trial of Web-Based Diabetes Disease Management Meigs, JB et al. A Controlled Trial of Web-Based Diabetes Disease Management. Diabetes Care 26: , 2003 One group of physicians (intervention group) was trained to use a web-based information management/ clinical decision support tool. The other group of physicians (control group) was not. The study was a group randomized, controlled trial. A coin was tossed to select an intervention group and a control group.

45 Preventing Pneumococcal Disease Among Infants and Young Children All children aged <23 months should be vaccinated with PCV7. Diffuse the locus of responsibility

46 METHODS..., a test-retest study was conducted. The authors conducted Telephone reinterviews were conducted for 222 respondents of completed BRFSS interviews from March and April The second interview was completed between six and 30 days of the first interview.

47 METHODS..., a test-retest study was conducted. Telephone reinterviews were conducted for 222 respondents of completed BRFSS interviews from March and April The second interview was completed between six and 30 days of the first interview.

48 METHODS..., a test-retest study was conducted. Interviews from 222 of 252 respondents (response rate = 88%) who completed the survey during March and April, 1993, were repeated between six and 30 days after the original interview.

49 METHODS..., a test-retest study was conducted. Interviews from 222 of 252 respondents (response rate = 88%) who completed the survey during March and April, 1993, were repeated between six and 30 days after the original interview. What if your abstract has 210 words and the maximum is 200? Can we make this any shorter?

50 ..., a test-retest study was conducted: interviews from 222 of 252 respondents (response rate = 88%) who completed the survey during March and April, 1993, were repeated between six and 30 days after the original interview.... interviews from 222 of 252 respondents who completed the survey during March and April, 1993, were repeated 6-30 days after the original interview. 34 words 23 words

51 RESULTS Agreement was high for sociodemographic variables (kappa values from 0.85 to 1.00). Reliability of information on chronic conditions and risk factors was also high, with kappa values from 0.82 for hypertension to 1.00 for current smoking status. Regarding cancer screening practices, reliability was lower for knowledge of the prostate-specific antigen test (kappa = 0.21) than for women's cancer screening practices (i.e., the mammogram and Pap smear). Questions on attitudes toward environmental tobacco smoke showed lower reliability than did questions on individual actions to reduce exposure to environmental tobacco

52 RESULTS Agreement was high for sociodemographic variables (kappa values from 0.85 to 1.00). Reliability of information on chronic conditions and risk factors was also high, with kappa values from 0.82 for hypertension to 1.00 for current smoking status. Regarding cancer screening practices, reliability was lower for knowledge of the prostate-specific antigen test (kappa = 0.21) than for women's cancer screening practices (i.e., the mammogram and Pap smear). Questions on attitudes toward environmental tobacco smoke showed lower reliability than did questions on individual actions to reduce exposure to environmental tobacco

53 RESULTS Agreement was high for sociodemographic variables (kappa values from 0.85 to 1.00). Reliability of information on chronic conditions and risk factors was also high, with kappa values from 0.82 for hypertension to 1.00 for current smoking status. Regarding cancer screening practices, reliability was lower for knowledge of the prostate-specific antigen test (kappa = 0.21) than for women's cancer screening practices (i.e., the mammogram and Pap smear). Questions on attitudes toward environmental tobacco smoke showed lower reliability than did questions on individual actions to reduce exposure to environmental tobacco

54 Agreement was high for sociodemographic variables (kappa values from 0.85 to 1.00). Reliability of information on chronic conditions and risk factors was also high, with kappa values from 0.82 for hypertension to 1.00 for current smoking status.

55 Regarding cancer screening practices, reliability was lower for knowledge of the prostate-specific antigen test (kappa = 0.21) than for women's cancer screening practices (i.e., the mammogram and Pap smear).

56 Questions on attitudes toward environmental tobacco smoke (kappa = ) showed lower reliability than did questions on individual actions to reduce exposure to environmental tobacco smoke (kappa = ).

57 Reliability was high for sociodemographic variables, chronic conditions and risk factors (kappa > 0.82). Reliability was lower for knowledge of the prostate- specific antigen test (kappa = 0.21) than for women's cancer screening practices (kappa = ). Questions on attitudes toward environmental tobacco smoke (kappa = ) showed lower reliability than did questions on individual actions to reduce exposure to environmental tobacco smoke (kappa = ).

58

59 Reliability was high for sociodemographic variables, chronic conditions and risk factors (kappa > 0.82), lower for cancer screening practices (kappa = ), and lowest for knowledge about prostate specific antigen testing (kappa = 0.21). Reliability of questions about attitudes toward environmental tobacco smoke (kappa = ) was lower than for questions about individual actions to reduce environmental tobacco smoke (kappa = ).

60 one final detail

61 Reliability was highest for sociodemographic variables, chronic conditions and risk factors (kappa > 0.82), lower for cancer screening practices (kappa = ), and lowest for knowledge about prostate specific antigen testing (kappa = 0.21). Reliability of questions about attitudes toward environmental tobacco smoke (kappa = ) was lower than for questions about individual actions to reduce environmental tobacco smoke (kappa = ).

62 RESULTS Original – 87 words Revision – 65 words (and more information)

63 CONCLUSION These findings demonstrate the overall flexibility and utility of the BRFSS. We conclude that the reliability of most BRFSS questions is high. New, more reliable, questions to measure knowledge of prostate-specific antigen testing need to be developed.

64 The Abstract Purpose RELIABILITY VALIDITY

65 The Abstract Purpose Methods RELIABILITY VALIDITY RELIABILITY

66 The Abstract Purpose Methods Results RELIABILITY VALIDITY RELIABILITY

67 The Abstract Purpose Methods Results Conclusions RELIABILITY VALIDITY RELIABILITY FLEXIBILITY UTILITY

68 The Abstract Purpose Methods Results Conclusions RELIABILITY VALIDITY RELIABILITY FLEXIBILITY UTILITY

69 The Behavioral Risk Factor Surveillance System (BRFSS), a population based telephone survey of health related behaviors among adults ages 18 and older, is used by nearly all state health agencies to measure the prevalence of chronic disease risk factors. Despite widespread use, the reliability of BRFSS collected data is not well described. To assess the reliability of the Missouri BRFSS, interviews from 222 of 252 respondents who completed the survey during March and April, 1993, were repeated 6 30 days after the original interview. Reliability was highest for sociodemographic variables, chronic conditions and risk factors (kappa > 0.82), lower for cancer screening practices (kappa = ), and lowest for knowledge about prostate specific antigen testing (kappa = 0.21). Reliability of questions about attitudes toward environmental tobacco smoke (kappa = ) was lower than for questions about individual actions to reduce environmental tobacco smoke (kappa = ). We conclude that the reliability of most BRFSS questions is high. New, more reliable, questions to measure knowledge of prostate specific antigen testing need to be developed. (165 words) summary of results + recommendation

70 The Behavioral Risk Factor Surveillance System (BRFSS), a population based telephone survey of health related behaviors among adults ages 18 and older, is used by nearly all state health agencies to measure the prevalence of chronic disease risk factors. Despite widespread use, the reliability of BRFSS collected data is not well described. To assess the reliability of the Missouri BRFSS, we conducted a test-retest study among 222 (88%) of 252 respondents who completed the survey during March and April, We also tested the flexibility and utility of the BRFSS by adding questions to the core questionnaire about use/knowledge of prostate specific antigen screening and exposure to environmental tobacco smoke. Reliability was highest for sociodemographic variables, chronic conditions and risk factors (kappa > 0.82), lower for cancer screening practices (kappa = ), and lowest for knowledge about prostate specific antigen testing (kappa = 0.21). Reliability of questions about attitudes toward environmental tobacco smoke (kappa = ) was lower than for questions about individual actions to reduce environmental tobacco smoke (kappa = ). These findings demonstrate the flexibility and utility of the BRFSS as well as the high reliability of most BRFSS questions. New, more reliable, questions to measure knowledge of prostate specific antigen testing need to be developed. (199 words)

71 Structured Abstracts

72 Context Objective Design and Setting Patients Main Outcome Measure Results Conclusions Background Methods Results Conclusions

73 Structured Abstracts Context Objective Design and Setting Patients Main Outcome Measure Results Conclusions Background Methods Results Conclusions

74 Any Volunteers?

75 The INTRODUCTION

76 Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful

77 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful

78 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction

79 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem).

80 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap).

81 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful.

82 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies.

83 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies. Present your approach to filling the gap (Study purpose).

84 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies. Present your approach to filling the gap (Study purpose). - Be clear that your approach is new.

85 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies. Present your approach to filling the gap (Study purpose). - Be clear that your approach is new. - Emphasize that your approach addresses the limitations of previous studies in a logical/compelling way.

86 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies. Present your approach to filling the gap (Study purpose). - Be clear that your approach is new. - Emphasize that your approach addresses the limitations of previous studies in a logical/compelling way.

87 The INTRODUCTION Purpose: to convince the reader that your study will yield knowledge or knowhow that is new and useful Components of the Introduction Identify a gap in knowledge or knowhow (Study problem). - Provide key background (scope/nature/magnitude of the gap). - Be clear that filling this gap will be useful. - Describe the relevant limitations of previous studies. Present your approach to filling the gap (Study purpose). - Be clear that your approach is new. - Emphasize that your approach addresses the limitations of previous studies in a logical/compelling way. (often requires just three paragraphs)

88 Elements of the Introduction GAP G B – Key BACKGROUND to the gap. G U – Why filling the gap will be USEFUL. G L – Key LIMITATION(S) of previous studies responsible for the gap. APPROACH A B – BACKGROUND to the approach (not always necessary) A N – What is NEW about the approach taken in the current study. A L – How does this new approach address the LIMITATIONS of previous studies.

89 [G U : If radiofrequency exposure from mobile phone use increases the risk of cancer, acoustic neuroma would be of potential concern.] [G B : The exposure from mobile phones is concentrated in the head close to the handset; exposure is relatively high only for the glial and meningeal tissue closest to the surface of the head, the parotid gland, and the vestibular portion of the eighth cranial nerve where acoustic neuromas arise.] [Gap: Six studies have investigated the association between mobile phone use and acoustic neuroma, with inconsistent results.] [G L : All available studies are limited by a small number of exposed cases and a short follow-up since the time hand-held mobile phones first became available.]

90 [A B : In Sweden, mobile phone use became common in the general population relatively early; handheld mobile phones were introduced at the end of the 1980s with an exponential increase of users during the 1990s. Slightly less than 6% of the population used mobile phones in 1990, 23% in 1995, and over 80% today.] Therefore, [Approach: a study based on the Swedish population (is this new?)] [A L : will have a large proportion of long-term users, which is crucial for the possibility of detecting any increased risk of tumors related to long-term mobile phone use.]

91 [G U : If radiofrequency exposure from mobile phone use increases the risk of cancer, acoustic neuroma would be of potential concern.] [G B : The exposure from mobile phones is concentrated in the head close to the handset; exposure is relatively high only for the glial and meningeal tissue closest to the surface of the head, the parotid gland, and the vestibular portion of the eighth cranial nerve where acoustic neuromas arise.] [Gap: Six studies have investigated the association between mobile phone use and acoustic neuroma, with inconsistent results.] [G L : All available studies are limited by a small number of exposed cases and a short follow-up since the time hand-held mobile phones first became available.] [A B : In Sweden, mobile phone use became common in the general population relatively early; handheld mobile phones were introduced at the end of the 1980s with an exponential increase of users during the 1990s. Slightly less than 6% of the population used mobile phones in 1990, 23% in 1995, and over 80% today.] Therefore, [Approach: a study based on the Swedish population] [A L : will have a large proportion of long-term users, which is crucial for the possibility of detecting any increased risk of tumors related to long-term mobile phone use.]

92 Lung Cancer Risk and Workplace Exposure to Environmental Tobacco Smoke Group Exercise What is the Gap (G)? Does the study approach address the limitations of previous studies in a logical/compelling way? Why will filling this gap be useful (Gu)?

93 Exposure to environmental tobacco smoke (ETS) has been recognized as a cause of human cancer by the US Surgeon General, 1 the National Institute for Occupational Safety and Health, 2 the US Environmental Protection Agency, 3 the California Environmental Protection Agency, 4 the National Health and Medical Research Council of Australia, 5 the Great Britain Department of Health, 6 and most recently, the International Agency for Research on Cancer. 7 Evidence for this association has come primarily from studies of nonsmokers who are married to a smoker, and meta-analyses of these studies have demonstrated strong and consistent evidence for an association. 3,8,9 Demonstrating an association between workplace ETS exposure and lung cancer risk has been more difficult. Early meta-analyses failed to demonstrate an association between workplace ETS exposure and lung cancer risk among nonsmokers, 10–14 but a statistically significant association has been reported in the 3 most recently published meta-analyses. 15–17 We sought to extend the previous meta-analyses by including additional studies and by conducting analyses stratified by level of exposure, which was not performed in the previous meta-analyses. What is the Gap (G)?

94 Exposure to environmental tobacco smoke (ETS) has been recognized as a cause of human cancer by the US Surgeon General, 1 the National Institute for Occupational Safety and Health, 2 the US Environmental Protection Agency, 3 the California Environmental Protection Agency, 4 the National Health and Medical Research Council of Australia, 5 the Great Britain Department of Health, 6 and most recently, the International Agency for Research on Cancer. 7 Evidence for this association has come primarily from studies of nonsmokers who are married to a smoker, and meta-analyses of these studies have demonstrated strong and consistent evidence for an association. 3,8,9 Demonstrating an association between workplace ETS exposure and lung cancer risk has been more difficult. Early meta-analyses failed to demonstrate an association between workplace ETS exposure and lung cancer risk among nonsmokers, 10–14 but a statistically significant association has been reported in the 3 most recently published meta-analyses. 15–17 We sought to extend the previous meta-analyses by including additional studies and by conducting analyses stratified by level of exposure, which was not performed in the previous meta-analyses. What is the Gap (G)?

95 Exposure to environmental tobacco smoke (ETS) has been recognized as a cause of human cancer by the US Surgeon General, 1 the National Institute for Occupational Safety and Health, 2 the US Environmental Protection Agency, 3 the California Environmental Protection Agency, 4 the National Health and Medical Research Council of Australia, 5 the Great Britain Department of Health, 6 and most recently, the International Agency for Research on Cancer. 7 Evidence for this association has come primarily from studies of nonsmokers who are married to a smoker, and meta-analyses of these studies have demonstrated strong and consistent evidence for an association. 3,8,9 Demonstrating an association between workplace ETS exposure and lung cancer risk has been more difficult. Early meta-analyses failed to demonstrate an association between workplace ETS exposure and lung cancer risk among nonsmokers, 10–14 but a statistically significant association has been reported in the 3 most recently published meta-analyses. 15–17 We sought to extend the previous meta-analyses by including additional studies and by conducting analyses stratified by level of exposure, which was not performed in the previous meta-analyses. Does the study approach address the limitations of previous studies in a logical/compelling way?

96 Exposure to environmental tobacco smoke (ETS) has been recognized as a cause of human cancer by the US Surgeon General, 1 the National Institute for Occupational Safety and Health, 2 the US Environmental Protection Agency, 3 the California Environmental Protection Agency, 4 the National Health and Medical Research Council of Australia, 5 the Great Britain Department of Health, 6 and most recently, the International Agency for Research on Cancer. 7 Evidence for this association has come primarily from studies of nonsmokers who are married to a smoker, and meta-analyses of these studies have demonstrated strong and consistent evidence for an association. 3,8,9 Demonstrating an association between workplace ETS exposure and lung cancer risk has been more difficult. Early meta-analyses failed to demonstrate an association between workplace ETS exposure and lung cancer risk among nonsmokers, 10–14 but a statistically significant association has been reported in the 3 most recently published meta-analyses. 15–17 We sought to extend the previous meta-analyses by including additional studies and by conducting analyses stratified by level of exposure, which was not performed in the previous meta-analyses. Does the study approach address the limitations of previous studies in a logical/compelling way?

97 Exposure to environmental tobacco smoke (ETS) has been recognized as a cause of human cancer by the US Surgeon General, 1 the National Institute for Occupational Safety and Health, 2 the US Environmental Protection Agency, 3 the California Environmental Protection Agency, 4 the National Health and Medical Research Council of Australia, 5 the Great Britain Department of Health, 6 and most recently, the International Agency for Research on Cancer. 7 Evidence for this association has come primarily from studies of nonsmokers who are married to a smoker, and meta-analyses of these studies have demonstrated strong and consistent evidence for an association. 3,8,9 Demonstrating an association between workplace ETS exposure and lung cancer risk has been more difficult. Early meta-analyses failed to demonstrate an association between workplace ETS exposure and lung cancer risk among nonsmokers, 10–14 but a statistically significant association has been reported in the 3 most recently published meta-analyses. 15–17 We sought to extend the previous meta-analyses by including additional studies and by conducting analyses stratified by level of exposure, which was not performed in the previous meta-analyses. Why will filling this gap be useful?

98 Reducing the Illegal Sale of Cigarettes to Minors Group Exercise Read Abstract and Introduction What is the gap?

99 What gap are the authors trying to fill?

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101 [Gap: Although most states, including California, have laws regulating the access of minors to tobacco, they are rarely enforced. By all accounts, tobacco is readily accessible to minors.] [G B : In field trials, minors have successfully purchased tobacco from stores and vending machines 70% to 100% of the time. National survey data indicate that 57% of high school seniors who report daily smoking began by the age of 14 years.] [G U : Stopping the sale of tobacco to minors through enforcement of existing laws is, therefore, a critical step in any effort to prevent tobacco use.] What about the limitations of previous studies (G L )?

102 [Gap: Although most states, including California, have laws regulating the access of minors to tobacco, they are rarely enforced. By all accounts, tobacco is readily accessible to minors.] [G B : In field trials, minors have successfully purchased tobacco from stores and vending machines 70% to 100% of the time. National survey data indicate that 57% of high school seniors who report daily smoking began by the age of 14 years.] [G U : Stopping the sale of tobacco to minors through enforcement of existing laws is, therefore, a critical step in any effort to prevent tobacco use.] [A B : We are aware of only two published studies that measured the effect of efforts to enforce existing laws against the sale of cigarettes to minors. In Decatur, IL, a voluntary merchant education program reduced the ability of minors to purchase cigarettes from stores by 18%. In Avon, England, a voluntary merchant education program combined with a media campaign reduced the ability of minors to purchase tobacco from 91% of tobacconists to 44%. ] [Approach: The purpose of the current study was to determine the effectiveness of a program to reduce illegal sales of cigarettes to minors that includes [A N(L) : three components]: voluntary merchant education, a media campaign, and grassroots community organization.]

103 Original ~ 500 words Revision ~ 200 words

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113 Passive voice exercise On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that a 4- dose PCV7 regimen should be given to all children aged <2 years. Try to convert this to active voice without changing the meaning.

114 Passive voice exercise On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that a 4- dose PCV7 regimen should be given to all children aged <2 years.

115 Passive voice exercise On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that a 4- dose PCV7 regimen should be given to all children aged <2 years. On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that all children aged <2 years should receive a 4-dose PCV7 regimen should be given to.

116 Passive voice exercise On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that a 4- dose PCV7 regimen should be given to all children aged <2 years. On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that all children aged <2 years should receive a 4-dose PCV7 regimen should be given to. Can you find an extraneous word in this revision?

117 On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that a 4- dose PCV7 regimen should be given to all children aged <2 years. On the basis of evidence from clinical trials, the Advisory Committee on Immunization Practices (ACIP) recommended in February 2000 that all children aged <2 years should receive a 4-dose PCV7 regimen should be given to.

118 Methods Excerpt from: Neonatal Intensive Care Nurse Stressors: An American Study All NICU nurses in an upper Midwestern state were invited to participate in this study (N=167); 59 nurses responded, yielding a 35% response rate. The study sample consisted of 58 females; 46 (78%) were married and 12 (20%) were single. The mean age was years (SD=5.97). Thirty-four (58%) nurses were baccalaureate prepared, compared to 18 (30%) who were diploma nurses and 4 (7%) who held associate degrees. The mean for years practiced in NICU was 9.2 (SD=5.39). This compares to a mean of (SD=5.76) for years practiced as a RN.

119 Methods Excerpt from: Neonatal Intensive Care Nurse Stressors: An American Study All NICU nurses in an upper Midwestern state were invited to participate in this study (N=167); 59 nurses responded, yielding a 35% response rate.

120 All NICU nurses in an upper Midwestern state were invited to participate in this study (N=167). Participants in this study were randomly chosen from health care units located in the upper Midwest of the United States.

121 All NICU nurses in an upper Midwestern state were invited to participate in this study (N=167). Participants in this study were randomly chosen from health care units located in the upper Midwest of the United States.

122 All NICU nurses in an upper Midwestern state were invited to participate in this study (N=167). Participants in this study were randomly chosen from health care units located in the upper Midwest of the United States.

123 Method Data sources. Behavioral Risk Factor Surveillance System (BRFSS). Cross- sectional general population survey data from 1987 to 1990, collected by the BRFSS, were analyzed. The number of participating states (including the District of Columbia) increased from 33 in 1987 to 45 in The primary objective of this system is to obtain state specific prevalences of behavioral risks in adult populations that are associated with the leading causes of death and morbidity. Using random-digit dialing, each state selects a random sample of its noninstitutionalized adult population (age 18 or older) who have a telephone. For instance, in 1990, thirty-seven states used a multistage cluster-sampling design based on the Waksberg method. A trained interviewer reaches a representative household, randomly selects one adult 18 years or older and administers a standard questionnaire (See Marks et al, 1985 or Remington et al, 1988, for more detailed description of method). To meet individual needs, states may choose to use different sampling methods, such as simple random or stratified sample designs. The interviewing instrument consisted of three parts: 1) a core of questions asked by all states, 2) standardized modules of questions that are developed by CDC and added at each states discretion, and 3) state questions that are developed at the discretion of each participating state to meet its specific needs. When possible, questions have been adopted from national surveys, such as the National Health and Nutrition Examination Surveys (NHANES) and the National Health Interview Surveys (NHIS). The edited data were weighted to the age-, race-, and sex- specific population counts from the most current census (or intercensal estimate) in each state, as well as for the respondents probability of selection. The total sample available in 1987 was 50080; in 1988, 56447; in 1989, 66867; and in 1990,

124 Method Data sources. Behavioral Risk Factor Surveillance System (BRFSS). Cross- sectional general population survey data from 1987 to 1990, collected by the BRFSS, were analyzed. The number of participating states (including the District of Columbia) increased from 33 in 1987 to 45 in The primary objective of this system is to obtain state specific prevalences of behavioral risks in adult populations that are associated with the leading causes of death and morbidity. Using random-digit dialing, each state selects a random sample of its noninstitutionalized adult population (age 18 or older) who have a telephone. For instance, in 1990, thirty-seven states used a multistage cluster-sampling design based on the Waksberg method. A trained interviewer reaches a representative household, randomly selects one adult 18 years or older and administers a standard questionnaire (See Marks et al, 1985 or Remington et al, 1988, for more detailed description of method). To meet individual needs, states may choose to use different sampling methods, such as simple random or stratified sample designs. The interviewing instrument consisted of three parts: 1) a core of questions asked by all states, 2) standardized modules of questions that are developed by CDC and added at each states discretion, and 3) state questions that are developed at the discretion of each participating state to meet its specific needs. When possible, questions have been adopted from national surveys, such as the National Health and Nutrition Examination Surveys (NHANES) and the National Health Interview Surveys (NHIS). The edited data were weighted to the age-, race-, and sex- specific population counts from the most current census (or intercensal estimate) in each state, as well as for the respondents probability of selection. The total sample available in 1987 was 50080; in 1988, 56447; in 1989, 66867; and in 1990,

125 Analysis variables. Definition of hypertension. Hypertension case was defined by a yes to the question: Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? and more than once to: Have you been told on one or more occasions that your blood pressure was high, or have you been told this only once? Definition of employment status. We defined employment status (employed, unemployed less than one year, and unemployed more than one year) by the respondent self- classifying him/herself as: employed for wages; self- employed; out of work for less than one year; homemaker; student; or retired. Respondents who identified themselves as a homemaker, student, or retired (not in the labor force) were excluded from the analysis. Those who were self-employed or employed for wages were considered employed. The two categories of unemployment represented two levels of exposure. Definition of covariates. Ethnic group. The three ethnic/racial groups used were white, African-American or black, and Hispanic. Two questions on the BRFSS defined these groups: (1) What is your race? Would you say [White; black; Asian, pacific islander; Aleutian; Eskimo or American Indian; or Other]; and (2) Are you of Hispanic origin, such as Mexican American; Latin American; Puerto Rican; or Cuban? [yes; no; dont know/not sure refused]. White was defined as a response of white to (1) and a no, dont know/not sure, or refused to (2) ; African American by Black to (1) and no, dont know/not sure or refused to (2) ; and Hispanic by White or Black to (1) and yes to (2). Age group. Each respondent was assigned to one of five age groups (18 to 30 years old; years; years; years; and 60 or more years) by using the answer to the question How old were you on your last birthday? 32

126 Alcohol consumption. A measure of alcohol consumption was derived using the following BRFSS questions that asked about number of days per month or week alcohol was consumed and number of drinks on each occasion. In 1987 and 1988, the questions asked specifically about beer, wine, and spirits, while 1989 and 1990 combined these categories of alcoholic beverages into single items. The procedure for computing consumption of ounces of ethanol per week was structured on the basis of these two approaches. For all years the first question established whether the respondent consumed alcohol regularly: Have you had any beer, wine, wine coolers, cocktails, or liquors during the past month, that is since ____? [yes, no]. For 1987 and 1988, two questions for each category were asked: During the past month, how many days per week or per month did you drink __ ? and; On the days when you drank __, about how many beers did you drink on the average?. The questions for 1989 and 1990 were asked similarly, except that the second question consisted of: A drink is one can or bottle of beer, one glass of wine, one can or bottle of wine cooler, one cocktail, or one shot of liquor. On days when you drank, about how many drinks did you drink on the average?. On the basis of responses to these questions, an estimate of ounces of ethanol was computed. We assumed that.16 oz of ethanol were consumed in one drink, using as a proportion of all drinks consumed being 45% beer (for 1989 and 1990) (.04oz of ethanol per drink), 35% wine (.15 oz), and 20% spirits (.45 oz). Six consumption categories were used after Laforge et al (1990): None, >0-1 ounces per week, >2-4, >4-10 oz, >10 oz. 33

127 Alcohol consumption. A measure of alcohol consumption was derived using the following BRFSS questions that asked about number of days per month or week alcohol was consumed and number of drinks on each occasion. In 1987 and 1988, the questions asked specifically about beer, wine, and spirits, while 1989 and 1990 combined these categories of alcoholic beverages into single items. The procedure for computing consumption of ounces of ethanol per week was structured on the basis of these two approaches. For all years the first question established whether the respondent consumed alcohol regularly: Have you had any beer, wine, wine coolers, cocktails, or liquors during the past month, that is since ____? [yes, no]. For 1987 and 1988, two questions for each category were asked: During the past month, how many days per week or per month did you drink __ ? and; On the days when you drank __, about how many beers did you drink on the average?. The questions for 1989 and 1990 were asked similarly, except that the second question consisted of: A drink is one can or bottle of beer, one glass of wine, one can or bottle of wine cooler, one cocktail, or one shot of liquor. On days when you drank, about how many drinks did you drink on the average?. On the basis of responses to these questions, an estimate of ounces of ethanol was computed. We assumed that.16 oz of ethanol were consumed in one drink, using as a proportion of all drinks consumed being 45% beer (for 1989 and 1990) (.04oz of ethanol per drink), 35% wine (.15 oz), and 20% spirits (.45 oz). Six consumption categories were used after Laforge et al (1990): None, >0-1 ounces per week, >2-4, >4-10 oz, >10 oz words !

128

129

130 Value of flow diagrams in reports of randomized controlled trials JAMA 2001;285: 1996–1999

131

132

133 The METHODS Purpose: to describe how you collected, organized and analyzed the data Describe what you did, not what you found (Results) Respect chronology Describe original methods in detail; otherwise give references. (length varies depending on originality of methods used)

134 The METHODS Purpose: to describe how you collected, organized and analyzed the data (that are relevant to the purpose of the study) Clearly present and define all analysis variables. Organize into logical subsections that illustrate the steps you took to collect, organize and analyze the data. Describe what you did, not what you found (Results) Respect chronology Describe original methods in detail; otherwise give references. (length varies depending on originality of methods used)

135 Analysis variables. Definition of hypertension. Hypertension case was defined by a yes to the question: Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? and more than once to: Have you been told on one or more occasions that your blood pressure was high, or have you been told this only once? Definition of employment status. We defined employment status (employed, unemployed less than one year, and unemployed more than one year) by the respondent self- classifying him/herself as: employed for wages; self- employed; out of work for less than one year; homemaker; student; or retired. Respondents who identified themselves as a homemaker, student, or retired (not in the labor force) were excluded from the analysis. Those who were self-employed or employed for wages were considered employed. The two categories of unemployment represented two levels of exposure. Definition of covariates. Ethnic group. The three ethnic/racial groups used were white, African-American or black, and Hispanic. Two questions on the BRFSS defined these groups: (1) What is your race? Would you say [White; black; Asian, pacific islander; Aleutian; Eskimo or American Indian; or Other]; and (2) Are you of Hispanic origin, such as Mexican American; Latin American; Puerto Rican; or Cuban? [yes; no; dont know/not sure refused]. White was defined as a response of white to (1) and a no, dont know/not sure, or refused to (2) ; African American by Black to (1) and no, dont know/not sure or refused to (2) ; and Hispanic by White or Black to (1) and yes to (2). Age group. Each respondent was assigned to one of five age groups (18 to 30 years old; years; years; years; and 60 or more years) by using the answer to the question How old were you on your last birthday? 32

136 Reliability of Information on Chronic Disease Risk Factors Collected in the Missouri Behavioral Risk Factor Surveillance System Are the analysis variables clearly defined?

137 If we read references 16-20, what can we expect to learn about the analysis variables? how to measure/interpret agreement? how to measure/interpret reliability? whether reliability and agreement mean the same thing? how Pearson and Spearman correlation coefficients are used to measure agreement?

138 The METHODS Purpose: to describe how you collected, organized and analyzed the data (that are relevant to the purpose of the study)

139 The METHODS Purpose: to describe how you collected, organized and analyzed the data (that are relevant to the purpose of the study) Clearly present and define all analysis variables.

140 The METHODS Purpose: to describe how you collected, organized and analyzed the data (that are relevant to the purpose of the study) Clearly present and define all analysis variables. Organize into logical subsections that illustrate the steps you took to collect, organize and analyze the data.

141 Examples of Subsection Headings Study population –How many subjects were eligible (eligibilty criteria) –How many declined to participate (and why) –How many participated –How many dropped out Sampling methods Laboratory methods Epidemiologic investigation Baseline data collection Diagnostic Evaluation Intervention Follow-up Definition of variables –Exposure variables –Outcome variables –Case definition Statistical analysis

142 Risk Factors for Invasive Pneumococcal Disease among Navajo Adults METHODS Setting and Case Ascertainment Participants Data Collection Definitions of Study Variables Statistical Analysis Ethical Considerations

143 Soft Drink Consumption and Risk of Developing Cardiometabolic Risk Factors and the Metabolic Syndrome in Middle-Aged Adults in the Community METHODS Study Sample Measurement of Covariates Assessment of Soft Drink Consumption and Dietary Intake of Other Foods Definition and Components of the Metabolic Syndrome Statistical Analyses Soft Drink Consumption and Prevalence of the Metabolic Syndrome Soft Drink Consumption and Incidence of the Metabolic Syndrome Incidence of Individual Components of Components of the Metabolic Syndrome

144 METHODS Participants Intervention Process and Outcome Measures Statistical Analysis

145 METHODS Participants Intervention Process and Outcome Measures Diet and Physical Activity Data Anthropometric Data Metabolic Measures Statistical Analysis

146 Enrollment Allocation Follow-up Analysis

147 The METHODS Purpose: to describe how you collected, organized and analyzed the data Clearly present and define all analysis variables. Organize into logical subsections that illustrate the steps you took to collect, organize and analyze the data. Describe what you did, not what you found (Results) Respect chronology Describe original methods in detail; otherwise give references. (length varies depending on originality of methods used)

148 Health Perceptions and Survival: Do Global Evaluations of Health Status Really Predict Mortality? Methods (excerpt).... A total of 624 deaths occurred in the four years, 334 among the 1,166 men (28.6%) and 290 among the 1,646 women (17.6%). Because these mortality rates were quite different, all analyses were performed separately by sex. Because sex-specific death rates were unequal (male = 28.6%, female = 17.6%), all analyses were performed separately by sex. Idler EL, Kasl S. J Gerontol 991;46(2):S55-65

149 Influence of Social Factors on Avoidable Mortality: A Hospital-Based Case-Control Study patients died of some type of avoidable mortality cause Public Health Reports. Jan-Feb 2005: 55-62

150 patients died of an avoidable cause.... Of the 124 eligible cases, 42 were excluded from the analysis... Is the term patient who died of an avoidable cause interchangeable with eligible case? ??

151 patients died of an avoidable cause.... Of the 124 eligible cases, 42 were excluded from the analysis...

152 patients died of an avoidable cause. Forty-two of them were excluded from the analysis, including seven whose relatives declined, 11 who had no known telephone or address, and 24 who did not answer after five calls. The remaining 82 cases were included and interviewed. Huh??? Poor Pooh is REALLY confused now. How about you?

153 Lets look at this a different way: Forty-two of them were excluded from the analysis, including seven whose relatives declined 11 who had no known telephone or address 24 who did not answer after five calls Bullets are used to delineate the items in a... ? What is the grammatical tool for introducing a list?

154 Strunk and White – Rule 7, page 7 use a colon to introduce a list

155 Forty-two of them were excluded from the analysis: eleven had no known telephone or address; in seven cases relatives declined to participate; and in 24 cases no family member could be contacted within five call attempts. Relatives of the remaining 82 cases were interviewed. Strunk and White – Principle of Composition #15: Put statements in positive form.

156 patients died of an avoidable cause. Relatives of 82 were interviewed. The remaining 42 were excluded, either because they had no known telephone or address (n=11), relatives declined to participate (n=7), or no family member could be contacted within five call attempts (n=24). Put statements in positive form.

157 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience

158 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience

159 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title?

160 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included.

161 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting:

162 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where

163 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where In addition, choose one or two of the following:

164 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where In addition, choose one or two of the following: – Methods (M)

165 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where In addition, choose one or two of the following: – Methods (M) – Results (R)

166 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where In addition, choose one or two of the following: – Methods (M) – Results (R) – Conclusions (C)

167 The TITLE Purpose: to provide a brief, informative summary that will attract your target audience What goes into the title? The Topic (T) being studied is always included. – study subjects and setting: who, what, when, where In addition, choose one or two of the following: – Methods (M) – Results (R) – Conclusions (C) – Specific named data set or study (N) Important: Emphasize what is new and useful!

168 TITLE T M R C N Longitudinal Evaluation of Prostate-specific Antigen Levels in Men With and Without Prostate Disease + + An Injury Prevention Program in an Urban African-American Community + Smoking, Pregnancy, and Source of Prenatal Care: Results from the Pregnancy Risk Assessment Monitoring System + + Reduction of High-risk Sexual Behavior among Heterosexuals Undergoing HIV Antibody Testing: A Randomized Clinical Trial + + ? Mass Mailings Have Little Effect on Utilization of Influenza Vaccine Among Medicare Beneficiaries + + Neonatal Intensive Care Nurse Stressors: an American study Substance abuse in remand prisoners: a consecutive case study Atopic dermatitis and birth factors: historical follow up by record linkage

169 Elimination of Haemophilus influenzae type b (Hib) disease from The Gambia after the introduction of routine immunisation with a Hib conjugate vaccine: a prospective study Lancet, 2005, 9 July - 15 July: TITLE T M R C N + + ? Methods: Surveillance for Hib disease was maintained in the western half of The Gambia... Results: The annual incidence rates of Hib meningitis before any use of the vaccine (1990–93) dropped from over 200 per children aged younger than 1 year to none per in 2002, and from 60 to no cases per in children younger than 5 years.

170 TITLE T M R C N Longitudinal Evaluation of Prostate-specific Antigen Levels in Men With and Without Prostate Disease + + An Injury Prevention Program in an Urban African-American Community + Smoking, Pregnancy, and Source of Prenatal Care: Results from the Pregnancy Risk Assessment Monitoring System + + Reduction of High-risk Sexual Behavior among Heterosexuals Undergoing HIV Antibody Testing: A Randomized Clinical Trial + + ? Decreased Rate of Coronary Restenosis after Lowering of Plasma Homocysteine Levels + + Mass Mailings Have Little Effect on Utilization of Influenza Vaccine Among Medicare Beneficiaries + + Neonatal Intensive Care Nurse Stressors: an American study Substance abuse in remand prisoners: a consecutive case study Atopic dermatitis and birth factors: historical follow up by record linkage

171 Widening Socioeconomic Disparities in US Childhood Mortality, AJPH, Sept 2007, p1658 No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preload Am J of Clin Nutrition, Dec 2007, p1586 Complete Genomic Screen in Parkinson Disease: Evidence for Multiple Genes JAMA, Nov 14, 2001, p2239 TITLETMRCN+

172 Widening Socioeconomic Disparities in US Childhood Mortality, AJPH, Sept 2007, p1658 No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preload Am J of Clin Nutrition, Dec 2007, p1586 Complete Genomic Screen in Parkinson Disease: Evidence for Multiple Genes JAMA, Nov 14, 2001, p2239 TITLETMRCN+

173 Longitudinal Evaluation of Prostate-specific Antigen Levels in Men With and Without Prostate Disease + + An Injury Prevention Program in an Urban African-American Community + Smoking, Pregnancy, and Source of Prenatal Care: Results from the Pregnancy Risk Assessment Monitoring System + + Reduction of High-risk Sexual Behavior among Heterosexuals Undergoing HIV Antibody Testing: A Randomized Clinical Trial + + ? Decreased Rate of Coronary Restenosis after Lowering of Plasma Homocysteine Levels + + Mass Mailings Have Little Effect on Utilization of Influenza Vaccine Among Medicare Beneficiaries + + Neonatal Intensive Care Nurse Stressors: an American study Substance abuse in remand prisoners: a consecutive case study Atopic dermatitis and birth factors: historical follow up by record linkage

174 British Medical Journal (BMJ) title should include the study design if the paper presents original research.

175 AJPH Titles should be concise, specific, and informative, and should contain the key points of the work. Preventive Medicine: The title should be informative and brief.

176 STROBE Indicate the study's design with a commonly used term in the title or the abstract

177 Risk factors for meningococcal disease in college students Risk factors for meningococcal disease during an outbreak on a college campus

178 Racial Differences in Survival with Oral Cancer in Georgia What is the time frame of the study? Racial Differences in Survival with Oral Cancer in Georgia: Which race(s) is at increased risk? Reduced Survival among Black Patients with Oral Cancer in Georgia: Did the authors try to control for known risk factors? Reduced Survival among Black Patients with Oral Cancer in Georgia after Controlling for Known Risk Factors: What is the data source? Reduced Survival among Black Patients with Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Is the increased risk equal among all subgroups of black patients? Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry,

179 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

180 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

181 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

182 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

183 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

184 Racial Differences in Survival with Oral Cancer in Georgia Topic:Who – What – W – henWhere Methods: (+/- survival) Results: – Conclusion: – Named Data Set:– Subgroups of Black Patients with Reduced Survival from Oral Cancer after Controlling for Known Risk Factors: Georgia SEER Registry, Topic:Who – What – When – Where Methods: (survival – subgroups – controlling for...) Results:reduced survival Conclusion: – Named Data Set:Georgia SEER TITLES – Information Content

185 Ability of minor elevations of troponins I and T to predict benefit from an early invasive strategy in patients with unstable angina and non-ST elevation myocardial infarction: Results from a randomized trial – JAMA, Nov 21, 2001, p2405 Effects of physical activity counseling in primary care: The activity counseling trial: A randomized controlled trial

186 Shoulder dystocia: a fetal-physician risk

187 Physician Compliance With Pneumococcal Conjugate Vaccine Shortage Recommendations in 2004 Discussion: Does this title capture the essence of who, what, when, where? Small Group Exercise: How can this title be improved?

188 One possible revision: Compliance with Pneumococcal Conjugate Vaccine Shortage Recommendations at a Managed Care Organization, 2004

189 A Community Manifesto for Gay and Bisexual Men: An Appeal to Control HIV/STDs Discussion: Does this title capture the essence of who, what, when, where? Exercise: How can this title be improved?

190 A Community Manifesto for Gay and Bisexual Men: An Appeal to Control HIV/STDs Considerations for revision: A Community Manifesto for Gay and Bisexual Men: An Appeal to Control HIV/STDs in Seattle/King County A Community Manifesto for Gay and Bisexual Men: An Appeal for Personal and Collective Responsibility to Control HIV/STDs in Seattle/King County HIV/STD Control among Gay and Bisexual Men in Seattle/King County: A Community Manifesto to Promote Personal and Collective Responsibility Time frame would be appropriate, but not available from the abstract


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