How do I Get Funding for My Research and How do I Get My Paper Published?

1. How do I Get Funding for My Research and How do I Get My Paper Published? Andrew Bush MD FRCP FRCPCH Imperial College & Royal Brompton Hospital a.bush@imperial.ac.uk

2. Getting Started • What is the first thing you need? • A question that really interests you • What are the two most important questions about any project? • So what? • What for? • What is different from paper writing?

3. Hypothesis Confirmed Move on Hypothesis Focussed experiment Confirmation MANDATORY GENERATES Hypotheses!! Fishing Expedition

4. Think First! • What clinical or experimental question am I trying to answer? • Why? Clinical benefit or mechanisms of disease?

5. Mechanisms vs. Individuals • Statistically significant differences between groups • May help predict mechanisms (beware guilt by association) • No use for clinic decisions

6. Think First! • What clinical or experimental question am I trying to answer? • Why? Clinical benefit or mechanisms of disease? • In an ideal world, what would I measure?

7. Think Second! • What ethically and prectically can I measure? • What are the best tools? • Does the act of measurement alter what I am measuring? • What is the shortfall between what I can measure and what I would like to measure? Does it matter?

8. Getting Started • It takes longer than you think! • Disorganisation on your part does not constitute a crisis on my part! • Ethics • Research office • Costings, overheads, FEC • Etc., etc.

9. Getting Started • Get real, get help • What is your own track record? • Who will be your collaborators? • Statistics? • Health economics? • Qualitative? • Patient involvement?

10. Getting Started • Why do Grant awarding bodies award grants? • Read the Instructions • Read the Instructions • Yes, I know you have, but READ THE INSTRUCTIONS AGAIN!!

11. So, you want to start writing? • Background • Why is this logical and important to do • Systematic reviews, meta-analyses etc. • Is it realistic? • ‘I’ll find the cure for cancer’ • Has the group got the right pedigree • Pilot data – a MUST

12. Writing: The Basics • Hypotheses aims and objectives • Must be clearly stated at the end of background • Must be a logical development from the background • Must be attainable • Must have the ‘wow’ factor!

13. Methods Section • Do the numbers add up? • ‘I will recruit 157 patients with Type 4 Hermansky-Pudlak syndrome’ • Has the group got a pedigree for this? • ‘I will do Taqman Reverse PCR in Prof Bush’s lab’ • Statistics • Power calculation • Analysis plan • DO NOT WING IT!

14. Other Issues • Do not skip the ‘bits’ • Abstract – first port of call • Lay summary • Make costings realistic • Should there be • Health economics? • Qualitative? • Make sure all boxes have been filled in!

15. And Finally • Spell out the implications • ‘These findings will have important clinical implications for X’ • Translation: ‘I’d like to believe these are important, but I know they are not really in any clear way • If you cannot spell out in detail the implications, you are Toast! • Clinical Trials: Register on Line

17. Writing: Getting Started • Are YOU excited? • Because if you are not, no-one else will be! • Does it fit the Journal? • Do they publish this sort of thing? • Style it so it fits the Journal

18. Hypothesis/ Question Design Analysis/ Power

19. The Introduction:WHY you did it • Focussed and relevant, not an essay • Importance of the problem • Why not solved before • And why you might solve it • MUST end with a logical HYPOTHESIS • MUST generate enthusiasm

20. The Methods:WHAT you did it • Can I reproduce the study from what you have written? • Including selection criteria • Use the on-line supplement if one is permitted • How did you check data entry accuracy? • Must have a statistical section • There must be a power calculation (or a reason why you have not done one) • You must cope with multiple comparisons • You must set a logical level of significance • You must say what tools you used

21. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • STROBE = STrengthening the Reporting of OBservational Studies in Epidemiology

22. CONSORT: Randomised controlled trials

23. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • Start with patient population • KISS for the Tables

24. Keep It Simple, Stupid! KISS

25. The Results:WHAT you found • Use CONSORT and STROBE as appropriate • Start with patient population • KISS for the Tables • Focussed analyses • Not hopeful comparisons and trawling • Do not do endless post hoc analyses • These are at best hypothesis generating • Do not fudge the findings – p=0.07 is not significant • My girlfriend is slightly pregnant!

26. The Discussion:WHAT it means • Do NOT repeat Introduction • General issues of interpretation • Association is not the same as causation • You cannot draw longitudinal conclusions from cross-sectional studies

27. Association vs. Causation • ‘A’ correlates with ‘B’ therefore ‘A’ causes B!!!! • B could cause A • C could cause A and B • Causation requires longitudinal studies • A comes before B • Or Intervention studies • Block A leads to no B

28. The Discussion:WHAT it means • Do NOT repeat Introduction • General issues of interpretation • Association is not the same as causation • You cannot draw longitudinal conclusions from cross-sectional studies • Do not extrapolate wildly • Are the data important clinically or mechanistically?

29. Structured Discussion • Statement of Principle Findings • Strengths and weaknesses of the study • There are always some problems! • Strengths and weaknesses with respect to other studies • Discrepant results? • Meaning of the study • Unanswered questions and future research

30. Special Circumstances:Case reports • We all love to talk about cases • Editors hate to publish them • They are not cited • Must be a take-home message: SO WHAT! • This is a report of the 17th HPS type 7 in the literature • This is a report of the 1st HPS type 7 in Lithuania • This is the first report of an association between Type 7 HPS and Brain-lung-thyroid syndrome

31. Special Circumstances:Genetics • Pitfalls to avoid if possible • SNPs with no biological readout • Mere association with no biological plausibility or validation elsewhere, e.g. animal studies • No validation population • Validation population replicates different SNPs in the same gene

32. Make life easy for everyone • Say you are grateful, even if you are not • Thank them for the helpful comments (even if you think they were idiotss) • Do NOT do a “Jaffe”! • Answer point by point • Say what you have done • Say what you have inserted • Say where you have inserted it

33. Summary: Vic’s Top 10 Tips • You did not read the instructions • There is a major COI • The manuscript was not checked for typos • This is the 19th case of X • No changes after submission elsewhere

34. Summary: Vic’s Top 10 Tips • There is no hypothesis anywhere to be found • Plagiarism including self-plagiarism, key references omitted or misquoted • No power calculation; crap statistics • Rambling, unfocussed, authors from IFES • BORING!

35. Further Reading • Chernick V. How to get your paper rejected. Pediatr Pulmonol 2008; 43: 220-3 • Stratton IM, Neil A. How to ensure your paper is rejected by the statistical reviewer. Diabetic Medicine 2004; 22: 371-3 • Sterk PJ, Rabe KF. The joy of writing a paper. Breathe 2008; 4: 225-32 • Hoppin FG. How I review an original scientific article. Am J Respir Crit Care Med 2002; 166: 1019-23