Clinical Writing for Interventional Cardiologists

1. Clinical Writing for Interventional Cardiologists

2. What you will learn - hopefully! • Introduction • General principles for clinical writing • Specific techniques • Practical session: critical review of a published article • Writing the Title and the Abstract • Bibliographic search and writing the Introduction • Principles of statistics and writing the Methods • Practical session: writing the Abstract • Writing the Results • Writing the Discussion • Writing Tables and preparing Figures • Principles of peer-review • Principles of grant writing/regulatory submission • Clinical writing at a glance • Conclusions and take home messages

3. What you will learn • Specific techniques • focus on journal and readership • IMRAD approach • guidelines for specific study designs (eg CONSORT, QUOROM, MOOSE) • other tips & tricks

4. What you will learn • Specific techniques • focus on journal and readership • IMRAD approach • guidelines for specific study designs (eg CONSORT, QUOROM, MOOSE) • other tips & tricks

5. First tip to effective writing

6. First tip to effective writing Read a lot…

7. First tip to effective writing Read a lot… To learn something, you must see how it should be done, and how it should NOT be done!

8. Second tip to effective writing

9. Second tip to effective writing What is the message you want to sell?

10. Second tip to effective writing What is the message you want to sell? It may be the core message, or the corollary/cosmetic message of your paper

11. Third tip to effective writing

12. Third tip to effective writing Who is the audience?

13. Third tip to effective writing Who is the audience? You have to adjust your message, tailor your style, and prepare yourself for potential criticisms based on the target audience…

14. Fourth tip to effective writing

15. Fourth tip to effective writing No matter what, keep clear writing!

16. Fourthtiptoeffectivewriting No matter what, keep clear writing! “Clear writing that is incapable of being misunderstood” Quintilian, I A.D.

17. Fifth tip to effective writing

18. Fifth tip to effective writing Do not mistake the tree for the forest!!!

19. Fifth tip to effective writing Do notmistake the treefor the forest!!! The goal is the forest, ofcourse

20. What you will learn • Specific techniques • focus on journal and readership • IMRAD approach • guidelines for specific study designs (eg CONSORT, QUOROM, MOOSE) • other tips & tricks

21. IMRAD algorithm Introduction (± Aim) Methods Results And Discussion

22. IMRAD algorithm Introduction (± Aim) Methods Results And Discussion

23. IMRAD algorithm Introduction (± Aim) Methods Results And Discussion

24. IMRAD algorithm Introduction (± Aim) Methods Results And Discussion

25. IMRAD algorithm Introduction (± Aim) Methods Results And Discussion

26. Expanded IMRAD algorithm IntroductionBackground Limitations of current evidence Study hypothesis MethodsDesign Patients Procedures Follow-up End-points Additional analyses Statistical analysis Results Baseline and procedural data Early outcomes Mid-to-long term outcomes Additional analyses DiscussionSummary of study findings Current research context Implications of the present study Avenues for further research Limitations of the present study Conclusions

27. Expanded IMRAD algorithm IntroductionBackground Limitations of current evidence Study hypothesis MethodsDesign Patients Procedures Follow-up End-points Additional analyses Statistical analysis Results Baseline and procedural data Early outcomes Mid-to-long term outcomes Additional analyses DiscussionSummary of study findings Current research context Implications of the present study Avenues for further research Limitations of the present study Conclusions

28. Expanded IMRAD algorithm IntroductionBackground Limitations of current evidence Study hypothesis MethodsDesign Patients Procedures Follow-up End-points Additional analyses Statistical analysis ResultsBaseline and procedural data Early outcomes Mid-to-long term outcomes Additional analyses DiscussionSummary of study findings Current research context Implications of the present study Avenues for further research Limitations of the present study Conclusions

29. Expanded IMRAD algorithm IntroductionBackground Limitations of current evidence Study hypothesis MethodsDesign Patients Procedures Follow-up End-points Additional analyses Statistical analysis Results Baseline and procedural data Early outcomes Mid-to-long term outcomes Additional analyses DiscussionSummary of study findings Current research context Implications of the present study Avenues for further research Limitations of the present study Conclusions

30. What you will learn • Specific techniques • focus on journal and readership • IMRAD approach • guidelines for specific study designs (eg CONSORT, QUOROM, MOOSE) • other tips & tricks

31. CONSORT guidelines for RCT Moher et al, JAMA 2001

32. CONSORT statement Moher et al, JAMA 2001

33. CONSORT statement Moher et al, JAMA 2001

34. STARD guidelines for diagnostic studies Bossuyt et al, Lancet 2003

35. STARD guidelines Bossuyt et al, Lancet 2003

36. STARD guidelines Bossuyt et al, Lancet 2003

37. QUADAS guidelines to assess diagnostic studies Whiting et al, BMCMRM 2003

38. QUADAS guidelines Whiting et al, BMCMRM 2003

39. QUOROM statement for RCT meta-analyses Moher et al, Lancet 1999

40. MOOSE guidelines for non-RCT meta-analyses Stroup et al, JAMA 2000

41. MOOSE guidelines Stroup et al, JAMA 2000

42. MOOSE guidelines Stroup et al, JAMA 2000

43. What you will learn • Specific techniques • focus on journal and readership • IMRAD approach • guidelines for specific study designs (eg CONSORT, QUOROM, MOOSE) • other tips & tricks

44. Never throw away a good sentence, but never keep a bad one! • “There is no good writing… only good re-writing” • Rationale: We are better at editing than writing • Methods of conserving sentences: • Write about the same thing • Use similar methods • Dictation

45. General tips • Include one thought per sentence, one idea per paragraph • Use active voice whenever possible • Keep words simple • Be as succinct as possible • Avoid adjectives, too much description • Keep sentences short (< 22 words) and clear • Use subject-verb-object constructions: • Of the 22 patients, 5 (22.7%) developed restenosis

46. General tips • Use transitions and key words • Outline • Consult a statistician • Install spell-check software • Consult grammar and writing websites • Buy the AMA Manual of Style • Hire an editor • Remember the question

47. Other tips • Use “men” and “women,” not “males” and “females” (except when male and female are used as adjectives, e.g., male patients) • Use “died,” not “expired” • Use “humanely killed” or “killed” for animal studies, not “sacrificed” • Replace “prior to” with “before” • Patients are not implanted, i.e., “Patients who had the Jarvik 2000 implanted,” not “The implanted patients…” • Be careful of “due to” and “because of.” Use “due to” only when you could substitute “caused by” • Recovery of brisk flow was due to thrombectomy • Because of thrombectomy, recovery of brisk flow occurred

48. Tips for better writing: words • Simple words are better than long ones • Concrete terms are better than abstract ones • Specific terms are better than general ones

49. Tips for better writing: grammar • Avoid wordiness • Know when to use active & passive voice • Avoid faulty parallelism • Paragraphs should hang together • Paragraphs should have transitions

50. Phrases “The device, with long-term durability and reliability, is enhanced by the simplicity of its design and the clinical quality of its implantable platform. The ease of stent implantation in all patients, that enables avoidance of recoil, with the superior elastic properties and the extreme biocompatibility, are unique to this technology.”