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How do you keep up to date by the reading that you do?

How do you keep up to date by the reading that you do?. Overwhelmed by the shear quantity of reading material landing on your desk? Do not feel guilty if we do not read everything — we simply can’t. Develop practical strategies for selective, productive reading. Selective

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How do you keep up to date by the reading that you do?

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  1. How do you keep up to date by the reading that you do?

  2. Overwhelmed by the shear quantity of reading material landing on your desk? • Do not feel guilty if we do not read everything —we simply can’t. • Develop practical strategies for selective, productive reading.

  3. Selective • With a purpose in mind • Actively rather than passively • With an aim to remember • ?Reference articles to keep? • Sharing information • Topics • Critically

  4. Read selectively • Concentrate on a few sources you enjoy and benefit from. • Put journals and papers that tend to lie un­touched in a pile straight into the recycling bin.

  5. Read with purpose • Generating questions as you read helps improve understanding and retention of information. • Ask yourself Why am I reading this?If: • you have no answer, then bin it! • it is for specific information, then scan it • you want to know whether it is worth reading in detail, skim it • you identify areas to read in depth, then read critically.

  6. Read actively • Maintain a questioning approach as you read. You can ask yourself: • what does this mean and do I agree? • are statements corroborated by firm evidence? • how does it compare with what I already know? • should it change my practice? • By assimilating information in this inquiring way, you can focus on key issues and improve your retention.

  7. Read to remember • Write down the key facts you learn from the reading material. • Review this later by trying to recall the information, and go over points you have forgotten. This approach also focuses issues and helps you remember.

  8. Reference articles you keep • Many systems are used, but choose one that suits you. • You may wish to keep key articles, although these become out of date surprisingly rapidly and require space! Many GPs prefer to set up a card index and use them to record key points gained from the article. • Computer programs are also available for documenting references.

  9. Share reading • We learn better through controversy and debate, and exchanging ideas through study groups, journal clubs , debriefs. • Studying with others for examination can be more effective. Work can be shared out and more ground covered.

  10. Read around topics • Read around topics for examinations. • Use the available technology. • Search for relevant articles using Medline or the Cochrane program on evidence-based medicine. The BMA offers support for Medline users. • Google

  11. Read critically, if appropriate From time to time, read relevant scientific papers critically and in depth. The skill is not difficult, so do not be put off. • Authors generally state their aims and objectives at the end of the introduction. Focus on this. • The introduction generally contains a literature review relevant to the subject • Is the method of the study appropriate • Is there a table summary • Look at the discussion at the end of the paper

  12. Selective • With a purpose in mind • Actively rather than passively • With an aim to remember • ?Reference articles to keep? • Sharing information • Topics • Critically

  13. How to critically read a paper

  14. Outline of today's course 1st session • Paper design • RCT, Cohort, Case control, Cross sectional, Qualitative, Systematic and meta analysis • Interpreting test results • Sensitivity, Specificity, positive and negative predicted values, likelihood ratios • Interpreting study results • Relative risk, Absolute risk, Attributable risk, Number needed to treat, Odds ratio • Critical reading of selected papers • Papers 1 to 5 2nd session 3rd session

  15. 1st session • Paper design • RCT, Cohort, Case control, Cross sectional, Qualitative, Systematic and meta analysis

  16. Observational • Interventional • Qualitative Types of Data

  17. Observational • Interventional • Qualitative Three major types • 1.        Cross sectional (prevalence) studies • 2.        Cohort studies • 3.        Case-control studies Good for: • investigating ? causes of disease • risk of developing the disease to be defined and quantified. • The relative strength of the association (relative risk in the cohort study) and the estimated relative risk ( or odds ratio) in the case control study, but remember: ASSOCIATION DOES NOT IMPLY CAUSATION Three issues causing interpretation problems • Random (type 1) error corrected by having low P values P<0.001 • Bias • Confounding.

  18. Observational • Interventional • Qualitative Randomised controlled clinical trial. (RCT). Patients given treatment (intervention) cf subjects no treatment or intervention Statistical comparisons are made between the groups Any difference between the two groups is assumed to be due to the intervention i.e. DIRECT CAUSTAION

  19. Observational • Interventional • Qualitative Descriptive data, usually dealing with socio-behavioral issues. Non-statistical Classifies individuals into distinct groups which often have no obvious numerical relationship (e.g. blood pressure, sex) Tend to use smaller but focused samples. Data is categorized into patterns. Four primary methods of gathering information • Participation in a focus group • Direct observation in the focus group • In depth interviews • Analysis of documents and materials

  20. Types of Data You can look at events at different points in time 1. Observational Backward in Time Now Forward in time 2. Interventional 3. Qualitative

  21. Case report 1. Observational Backward in Time Now Forward in time 2. Interventional 3. Qualitative

  22. Case Report A single or other small number report on a particular event or finding

  23. Cross sectional (prevalence study) Casereport 1. Observational Backward in Time Now Forward in time 2. Interventional 3. Qualitative

  24. Cross sectional (or prevalence study) Looks at data at a point in time Allows calculation of prevalence

  25. Cross sectional (prevalence study) Case report 1. Observational Backward in Time Now Forward in time Case Controlled (retrospective study) 2. Interventional 3. Qualitative

  26. Case controlled (retrospective) study Compares cases and control patients (without the same outcome), and looks back in time to see if they had the exposure of interest Cheap, quick and good for rare diseases

  27. Cross sectional (prevalence study) Case report 1. Observational Backward in Time Now Forward in time Case Controlled (retrospective study) Cohort (longitudinal or prospective) 2. Interventional 3. Qualitative

  28. Cohort study (longitudinal or prospective). Often used to verify the hypothesis of causation generated by cross sectional and case control studies. Two groups are identified – one exposed group, one non-exposed group. Both groups followed for a period of time. Allows calculation of • Disease Incidence • Relative risk • Absolute risk • Attributable risk

  29. Cross sectional (prevalence study) Case report 1. Observational Backward in Time Now Forward in time Case Controlled (retrospective study) Cohort (longitudinal or prospective) 2. Interventional Randomised controlled trial 3. Qualitative

  30. Randomised Controlled Trial Randomised into an experimental group and a control group. Intervention studies. Randomisation leads to less susceptibility to confounding variables Cross over studies. Each subject receives the intervention, followed by a washout period, followed by a comparison of a different intervention or placebo. There should be suitable run-in and run-out periods. Blinding implies either the patient or investigator ( or both) are unaware which intervention the patient is receiving.

  31. Cross sectional (prevalence study) Case report 1. Observational Backward in Time Now Forward in time Case Controlled (retrospective study) Cohort (longitudinal or prospective) 2. Interventional Randomised controlled trial Systematic review & Meta-analysis 3. Qualitative

  32. Systematic review and Meta-analysis Systematic review: literature search and pooling of a number of studies with evaluation and abstraction Meta-analysis: systematic review + statistical analysis of the combined papers

  33. Cross sectional (prevalence study) Case report 1. Observational Backward in Time Now Forward in time Case Controlled (retrospective study) Cohort (longitudinal or prospective) 2. Interventional Randomised controlled trial Systematic review & Meta-analysis 3. Qualitative

  34. Outline of today's course 1st session • Paper design • RCT, Cohort, Case control, Cross sectional, Qualitative, Systematic and meta analysis • Interpreting test results • Sensitivity, Specificity, positive and negative predicted values, likelihood ratios • Interpreting study results • Relative risk, Absolute risk, Attributable risk, Number needed to treat, Odds ratio • Critical reading of selected papers • Papers 1 to 5 2nd session 3rd session

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