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DEVELOPING AND WRITING YOUR TRIOLOGICAL THESIS
THE ROAD TO TRIOLOGICAL SOCIETY MEMBERSHIP
Dana M Thompson, MD, FACS
The Triological Society
Chair, Thesis Review Committee
THE TRIOLOGICAL SOCIETY
Founded in 1895 in New York
Best and brightest in academic and clinical otolaryngology
Society membership benefits
Provides role models Fellowship with like-minded peers who share
common values, interests, and concerns
WHY CONSIDER WRITING A THESIS?
Unique contribution to otolaryngology
Distinction of being elected to the most prestigious society in otolaryngology
Career advancement - early and mid-career Requirement for promotion at many
academic centers Career defining and recognition
Career-distinguishing - senior candidates
REQUIREMENTS FOR CANDIDACY
Board-certified otolaryngologistIn practice > 3 yearsPublished > 2 papers after residencyAttended 3 national meetings in last 5
years: At least 1 must be TrioBe proposed by 2 active members &
approved by Council
Write a thesis for review & approval
SUCCESSFUL THESESTopic Areas
2001 – 2015 (n = 369)
115
116
14
48
4318 15 Otology
Head & neck
Bronchoesoph
Laryngology
Rhinology
Plastic Surgery
Other
SUCCESSFUL THESESProject Approach
2009 – 2015 (n = 190)
90(47.4%)
4021.05%
3618.9%
147.4%
105.3%
2015: A YEAR OF CHANGE
Through 2014 2015 Project categories
Basic research
Clinical research
Project categories Basic research
Clinical research
Health services research
Technology/procedure development
Otolaryngology status and trends
Historical perspectives
TYPES OF PROJECTS BY CATEGORY
Clinical Prospective or retrospective clinical data collection Direct clinical application
Basic Laboratory studies, in vivo, in vitro Animal studies Genetic studies
Health services Patient outcomes, health-related QoL Epidemiology, diversity, population statistics Cost analysis
TYPES OF PROJECTS BY CATEGORY
Technology/procedure development Development, standardization, beta testing of new
technology Development of new surgical or diagnostic
procedure (incl. validation of HRQOL survey)
ORL status and trends Resident and medical education Impact of healthcare delivery systems in society
Historical perspectives Medical history as it has influenced contemporary
ORL knowledge and practice
2015: A YEAR OF CHANGE
Review criteria Tailored to project category
Three scoring components
General (all)
Methods, Approach, & Conclusions (varies with project) Overall impact (all)
Numerical scoring
Guidelines and criteria published on Triological Society website
http://www.triological.org/pdf/thesissubmissionguidelines.pdf
GENERAL CRITERIA
Objectives/hypothesis (where appropriate)
Focused background and review
Statement of type of project
Clearly written
Adherence to format and structure guidelines
OVERALL IMPACT
Significance Was question or gap in knowledge answered, clarified, or
resolved? Will scientific knowledge and/or clinical practice be
improved?
Innovation Offer new insights into development of principles & practice
of OTL-HNS? Concepts, approaches, methods novel but valid and
appropriate?
Contribution Contribute to body of knowledge in ways consistent with
mission of Triological Society? Can project contribute to principles & practice of ORL-HNS,
medicine, and/or society?
THE NUTS AND BOLTS OF WRITING A THESIS
Maureen Hannley, PhD
The Triological Society
Research Consultant and Advisor
BE PREPARED
THE MOST IMPORTANT RULE
Read the guidelines for thesis format and submission
Read them again
Follow them to the letter
FOUR TESTS OF THESIS TOPIC
Is it new?
Is it true?
So what?
Who cares?
Fontanarosa, 2008
THE ANATOMY OF A THESIS
What I did
Why I did it
How I did it
What I found
What it means
FILL A GAP
ASKING THE RIGHT QUESTION
Clinical relevance, not just clinical application
Will have sustainable interest
Either a positive or negative answer will be interesting
Be specific, focused, realistic
Time, resources available
Subjects
Database/access, technical assistance Collaborators if appropriate Expertise!
A WORD ABOUT RETROSPECTIVE CASE SERIES
Go beyond simple descriptive study
Should have reason for reporting
Some unique feature that would be generalizable
Some value as hypothesis-generating study
Causal comparative study Correlation study
Grimes DA, Schulz KF. Descriptive studies: what they can and cannot do. Lancet 359(9301): 145-9, 12 Jan 2002
A WORD ABOUT SURGICAL EXPERIENCE
Should not be limited to “how I do it” or “in my hands” reports with clinical outcome
Comparison to published or alternative procedure for same indication
Solve problems with previous approaches
Disadvantages of previous approaches with new approach advantages related to patient characteristics, complications, novel instrumentation
Current or historical outcomes
USE YOUR TEAM
YOUR NEW BEST FRIEND
Consult a statistician UP FRONT! Question design statistical treatment Sample size estimations
Bias issues
Involve sponsor/mentor in planning process
Careful, comprehensive literature review
DESIGN THE PROJECT
TYPES OF STUDIES
Descriptive
Observational
Experimental
Analytical
THE CLINICAL RESEARCH QUESTION
Begin by asking the question as a general statement
“In patients with recurrent acute sinusitis by accepted criteria is ESS the best treatment option to improve symptoms and disease-specific QOL?”
Use PICO to help structure the question, identify elements
REFINE YOUR RESEARCH QUESTION
Define the population or material to be studied
Define the period of time for the study
Select the variables to be measured
Change non-specific variables into variables that can be measured.
WRITE THE HYPOTHESIS
Write what you expect to find from your study.
State your hypothesis in a clear, concise sentence.
Should be directional and quantifiable
Should be simple, specific, and stated in advance
DOES EVERY STUDY NEED AN HYPOTHESIS?
NO Used when tests of statistical significance will
be used to compare findings among groups or search for causes, effects, relationships
Key words in research question
Greater/better than, less than, more likely than Causes, leads to, results in, produces Associated with, related to, similar, correlated
USE THE RIGHT TOOLS
TO ENHANCE CREDIBILITY
Appropriate controls
Appropriate operational definitions
Appropriate measurement tools
Appropriate design and analysis
Balanced perspective
CONDUCTING THE THESIS PROJECT
BE SPECIFIC
DESIGN AND METHODOLOGY
Who? What? Where? When? How/how much?
WHY?
DATA ANALYSIS
Descriptive (should always be included) Numbers, demographics: n, age, gender, ethnicity
Central tendency: mean, median, mode, quartile
Variance: range, standard deviation, percentile
Inferential (depends on design, question, characteristics of study group)
WRITING THE THESIS
process, a uniform level
of scientific rigor can be
attained to achieve three
objectives: 1) provide
support for the most
meritorious research in
otolaryngology and head
TELL A STORY
THE ESSENCE OF THE STORY
What you did
Why you did it
How you did it
What you found
What it means
BE CREATIVE
THE BAIT AND THE PUNCHLINE : ONE APPROACH
Introduction Opening quotation
or fact Context of past
research Condition of
ignorance Cost of that
ignorance Gist of solution
Conclusion Gist of solution Larger significance
or application What is still not
known Call for further
research Closing quotation or
factBooth, Colomb, & Williams, 1995
LEAD THE READER
METHODS AND PROCEDURES
Sections Subjects, participants, or material
Project design
Equipment, measures, or approach
Relevant procedures Subject/material selection
Measurement of dependent variables
References to support choice of procedures, especially if options available
Statistical analysis as needed
Only results that bear on central question Possible contributing factors to data
outcomes A good Results section should tell a story
Analyses that support the integrity of the study (internal consistency, variance, etc)
Present analyses in logical sequence
Use tables & figures to relieve clutter of numbers
No results in Discussion; no discussion in Results
RESULTS
SHOW YOUR TRAIN OF THOUGHT
DISCUSSION/CONCLUSION
Put findings in context of other theories and past research
Begin with brief overview of problem and your findings
Relevance to clinical problems & practice
Identify limitations of your research
GET ANOTHER OPINION