You are on page 1of 48


Joe Pozdol, MLIS
Evans Whitaker, MD, MLIS
Norris Medical Library
University of Southern California
2003 Zonal Ave.
Los Angeles, CA 90089-9130

Before We Begin…
• Ask!
• PowerPoint at under
Key Resources for Students
• Interactive questions
• Handouts
• Article later
• Evaluation
• Unwanted handouts

Outline For Today
I. Parts of a paper
A. Abstract
B. Introduction/Background
C. Methods
D. Results
E. Discussion
F. References (Bibliography)
II. Study types
A. Primary
1. Observational
2. Experimental
B. Secondary
III. Group work
IV. Evaluations


Part I Objectives • Learn the basic structure of papers • Develop an approach to reading papers • Learn how to interpret an article citation .

The Basic Parts • Title • Abstract • Introduction • Methods • Results • Discussion • References .

Read In This Order • Title • Abstract • Introduction/ Discussion • Methods/ Results .

False .The discussion section occurs before the author presents the results of the study. 1. True 2.

3.Which occurs first in a scientific journal article? 1. 5. Abstract Discussion Introduction Methods Results . 2. 4.

Abstract • • • • Summarizes Often only part read Don’t act on abstracts alone Structured abstracts are norm – Background – Methods – Results – Conclusions .

Introduction • • • • • • • Context What is known Supporting literature (citations) Gaps in literature The research question Newness Relevance to field .

Methods • Steps taken to – gather data – analyze data • Statistical methods • Not a “cookbook” • Replicable .

Results • • • • Report of data Tables and graphs Statistical results No interpretation .

Discussion • Interpretation of results • Answer to research question • Goals met? • Often includes – relation to previous research – limitations – future directions .

5. 4. 2. 3.Which should allow other researchers to replicate the study? 1. Abstract Discussion Introduction Methods Results .

2. 3. 5. Abstract Discussion Introduction Methods Results .Limitations of the study are found in the… 1. 4.

AMA vs.References • List of sources cited in intro • Usually other journal articles • Previous studies in same field • Citation styles differ depending on – field of study (e. APA) – journal • EndNote and RefWorks .g.

Understanding Journal Article References Weiss. PA. Does smoking marijuana contribute to the risk of developing lung cancer? Clinical Journal of Oncology Nursing. 2008.12(3):517-519. Journal Volume Number Issue Number Researcher’s Article .

Which cannot be determined from a reference list citation? 1. Title of the journal article 3. None of the above . Title of the journal 2. Number of pages in the journal 4. Number of pages in the journal article 5.

False . 1. True 2.Whether marijuana use causes lung cancer is still unknown and will likely be a subject of research in the next 5 years.


Part II Objectives • Learn the common study types • Be able to extract the research question • Be able to identify an article’s study type • Be able to determine the conclusions .

Outline For This Section • Focus on 4 study designs o Case-control o Cohort o Randomized Control Trial o Review • Narrative • Systematic • Meta Analysis .

What was the research question? 2. (2006). Was the research design appropriate to the question? Will try to find answers to 1 and 2 in excerpts of 4 articles (A-D) provided * . Malden. MA: Blackwell .Greenhalgh. What was the research design? 3.“3 questions to get your bearings” * 1. T. How to read a paper: the basis of evidencebased medicine.

Study Designs • Primary Literature oObservational • Case-Control • Cohort oExperimental • Randomized Control Trial • Secondary Literature oNarrative (Subject/Journalistic) Reviews oSystematic Review oMeta Analysis .

Case-Control Patients with a disease or exposure --compared to-Similar group without disease or exposure • Best uses o o Rare conditions Diseases or conditions that may take a long time to develop .

Background: DES • Used in the United States from 1947 until 1971 • Boston area doctors noted an unusual cancer • Study compared the group with the cancer to similar people without the cancer • The major difference between the cases and the controls was DES exposure .

478-481.C. 284(16).D.L. Adenocarcinoma of the vagina: association of maternal stilbestrol therapy with tumor appearance in young women.. (1971). H..Example: DES and Cancer • Herbst. • Look at article: – Last sentence in Introductory area = research question – First paragraph in methods = research design . & Poskanzer. A. Ulfelder. NEJM.

To reduce socioeconomic differences To examine whether the cancer was related to infectious disease exposures To decide if chemical disinfectants used to clean wards caused cancer All of the above * -see page 879 . 3. 2.Why did the authors match cases and controls by the type of service mothers received?* 1. 4.

Cohort • Two groups compared over time • One group with “exposure”. the other without the “exposure” • Best used: o when exposures can’t be controlled o when outcomes occur infrequently o when RCT is not ethical .

J..38142. Peto. (2004).1136/bmj. health outcomes of non-smokers • Research question = • Research design = . Boreham. Mortality in Relation to Smoking: 50 years' observations on male British doctors. R.554479.AE • 50 years (and counting) Cohort Study of British doctors • Most recent of a series of reports • Compared health outcomes of smokers vs. R. BMJ... doi:10. Non-Smoking British Physicians • Doll. & Sutherland.Example: Smoking vs. I.

4.When was there enough evidence from this study to show the link between smoking and lung cancer? 1. 3. 2. 1954 1966 1978 1991 .

Randomized Control Trial • A treatment group is compared to a control group • Group members are assigned randomly • Best uses: – Drug therapies – Medical treatments .

C. Hennrikus. Preventive 47(2)194-199. D. L.J.research question o The last paragraph of the introduction . Perry..C. 196 . The RealU online cessation intervention for college smokers: a randomized control trial.L.research design o Study flow chart .Example: Smoking cessation intervention • An.. • Look at the article: o The last paragraph of the introduction .. et al.. (2008). Klatt. C.B. E. Lein.

3. 4.25.007 2. 2.000 UM students were recruited by email How many UM students ended up in the intervention group? 1.407 257 107 7 . 24. 5.

2. 3. 5. 6. 4.What percent of RealU participants had 30 days of no smoking at week 30? 1. 100% 80% 60% 40% 20% none 30 .

Narrative (Journalistic/Subject) Reviews • The “traditional” or “classic” review • “Review” limit in Ovid/PubMed includes: – Narrative reviews – Systematic reviews • Authors choose articles included • Author bias is a concern – research verifies this effect .

Systematic Review • Reproducible methods to find and select articles are included • Should include both inclusion and exclusion criteria • Why? Decrease author bias .

2. Section 4. (2008).036 • Look at article: – Pg. 3.1.1016/j.09.Example: Is HPV Vaccine Cost-Effective? • Techakehakij.D. first paragraph = research question – Pg. Feldman. Vaccine.2008. first to third paragraphs = research design .vaccine.. doi:10.1. R. Costeffectiveness of HPV vaccination compared to Pap smear screening on a national scale: a literature review. Section 3. W.

4.It is recommended that HPV vaccine be given as a 3 shot series. $500-$1000 $300-$500 $200-$300 $100-$200 30 . 2. 3. How much do 3 doses of vaccine cost? 1.

Meta Analysis • Similar to Systematic Review except… • Numeric data from separate studies combined in meta analysis • Uses statistical/mathematical methods to combine numerical data from studies • Combining data increases the confidence we have in the conclusions reached by a meta analysis .


OR 4) • Spend 10 min. 3.Group Work • Groups of 3 • Everyone in group gets same article (#1. 2. working together on questions • Class discussion .


not distinguishing between correlation and causation (in medicine etiology is used for the cause of a disease or condition) ** . 2008) -Drug treatment -Medical interventions -Low susceptibility to bias -Strongest level of evidence -Many topics have no systematic review -Methods section has explicit information about information sources. 2004) (Metcalf. Ethical limitations) -Generalizability** -Randomization method -Experimental and control groups Systematic Review (Techakehakij. 2008) (Gordon.used loosely here. 1971) (Peled. how articles were chosen or excluded * . 2008) .g.can results of an RCT be applied to groups that do not match the study group? . great cost -Longitudinal -Usually prospective -Can be retrospective (less cost) Randomized Control Trial (RCT) (An et al.Prognosis -Causation* .2008) (Gallicchio.Feasible when studying conditions or exposures over which the investigator has no control -Susceptible to bias -Limited validity -May require large groups. et al. 2008) -Rare disorders or conditions -Slow developing disorders -Causation* -Short time frame to examine correlations between disorder and other factors -Susceptible to bias -Limited validity -Cross sectional Cohort** (Doll.Article Type What kind of question is it good for? Strengths Weaknesses Identifying Characteristics Case-Control (Herbst. 1997) -Drug treatment -Medical interventions -Strong level of evidence -Low susceptibility to bias -Feasibility (e. long durations.

edu • Please complete evaluations! .edu – Evans Whitaker – ewhitake@usc.Thanks for your attention • We will post these slides on the Student Portal on the Norris Medical Library website • Contact us with questions – Joe Pozdol – pozdol@usc.

et al. G. Doll. (2008).. MA: Blackwell. Carey.. Effects of a drinking event on behavioral skills and condom attitudes in men: Implications for HIV risk from a controlled experiment. How to read a paper: the basis of evidencebased medicine. I. L. L.554479. The RealU online cessation intervention for college smokers: a randomized control trial.P. User’s guides to the medical literature: essentials of evidence-based clinical practice.. Mortality in Relation to Smoking: 50 years' observations on male British doctors.J. (2006).. D. 372-383.. (2001). J. Peto..B. G.B.. Greenhalgh..38142. Gordon. (eds. K. doi:10. C. R. Guyatt. Chicago: AMA Press.. Am.1136/bmj. BMJ. (2004).M. Boyd. 16(5).AE Gallicchio. Boreham. Lein. C. & Sutherland.Clin. K. E. Matanoski..). M. (2008). Hennrikus. Nutrit. T.References • • • • • • An.C.. Rennie.J. 490-495.. et al. 47(2)194-199. & Carey. .. Malden. Preventive Medicine.. D. Carotenoids and the risk of developing lung cancer: A systematic review. (1997). C.L.. 88. Health Psychology. R. Perry. Klatt.

478-481. H. 245-250. Peled.D. psychological distress and life events among young women. Siboni-Samocha.. O... L. (2008). R.L.T. J. Adenocarcinoma of the vagina: association of maternal stilbestrol therapy with tumor appearance in young women. Breast cancer. 93.D. Hosking. (2008). B. Archives of Diseases of Childhood (Early Bird 37). I.References • • • Herbst. 284(16).722-777. J.C. . 8. & Shoham-Vardi. D. Metcalf. Voss. & Wilkin.S. Carmil.. & Poskanzer. (1971). A.. NEJM... Ulfelder. BMC Cancer. Physical activity at the government-recommended level and obesityrelatedhealth outcomes: a longitudinal study (Early Bird 37).