1 Teaching a statistical program in emergency medicine research rotations: Command- driven or click-driven? Muhammad Waseem, MD Research Director Emergency Medicine Lincoln Medical & Mental Health Center Bronx, New York

2 Disclosure Financial disclosures: None

3 Background Stata is a command-driven program It is a general-purpose statistical software package used by people of different backgrounds and professional disciplines Most Stata users are non-physicians

4 Background No matter which book you choose or which course you attend…. Since Stata is used by people in many fields, most training programs offered are geared toward programmers and non-physicians

5 Background Although Stata has simple commands, these may be difficult for non-programmers to use Generally, physicians are familiar with “clicking on” rather than writing commands

6 Background Research is an important part of curriculum of emergency medicine residency training A Research Project is necessary for graduation of EM residents

7 Background In order to fulfill this requirement EM residents have a mandatory research rotation

8 Background ACGME fully accredited 3 year Emergency Medicine Residency Training Program 33 EM residents (11 / year)

9 EM Research Rotation Formulating a research question Basic research design Protocol writing and submission to IRB Data Collection Basic statistical concepts

10 EM Research Rotation Data recording Data entry Data analysis

11 Background First step is to organize the raw data into a format which is compatible with Stata

12 Objectives Does introduction of a Statistical program (such as Stata) improve the accuracy of data recording and data entry?

13 Methods Design: Observational Setting: Emergency Department of an Urban Teaching Hospital Participants: Emergency Medicine Residents

14 Methods Research Elective –Two blocks of 14 days each –1-2 per month (1:1 learning)

15 Methods Emergency Medicine Stata Manual describing basic operation of Stata created with version 10

16 Methods This manual was developed keeping in mind the needs of in-training Emergency Medicine Residents EM residents may have some basic knowledge of statistics but no knowledge of Stata –Emphasis on data entry and data import

17 Emergency Medicine Stata Manual Just an introduction designed for first time users

18 Methods Teaches EM residents the essential skills for successful data entry and data import to Stata Purpose is to reduce the number of incorrect entries and make the data set usable to Stata Hands-on experience using Stata

19 Methods Strengths –Tailored to the needs of a specific audience (EM residents) –Discusses only simple and basic operation of Stata

20 Methods Weaknesses –Tailored to the needs of a specific rotation (EM residents research elective) –Does not teach residents detailed statistical analysis –Does not discuss programming

21 Methods Keep it simple Utilize pull-down menus (rather than commands) –No discussion on commands

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23 Methods Getting started Stata screen 4 Windows, 9 Tabs

24 Methods 4 Windows –Review –Variables –Results –Command

25 Methods 9 Tabs File, Edit, Prefs, Data, Graphics, Statistics, User, Window, and Help

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27 Methods Basic commands with pull-down menus Describe and summarize data Data input and output Data Import Saving files

28 Methods Describe data Data editor Data browser

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31 Conclusions Basic operation of Stata can be learned quickly by EM residents Teaching Stata to the EM residents expanded their research related knowledge Providing introduction of Stata prior to data entry improve accuracy of data recording and facilitates data analysis

32 Limitations Observational study –No standardized method Small sample Single center study

33 Implications It is necessary to develop a training program that addresses the needs of physicians

34 Acknowledgement Biostatistics Course (2009) Weill Medical College of Cornell University New York