Category: Collaboration

Health care research is untidy – what does it mean for postdocs? #CochraneCalgary2015

Why do we study health? Because we want to help patients. It’s no rocket science. And yet, most clinical trials do not measure outcomes that are important for patients. Besides, researchers don’t agree on what the core set of outcomes should be. “Health care research is untidy.” — Mike Clarke. In this post, I write about my experience of a conference about outcomes for clinical research and how it relates to postdoc training.


Systematic reviews are often required as part of a PhD or a postdoc training. Over 30,000 authors produce Cochranesystematic reviews of literature for the Cochrane library worldwide. The Canadian Cochrane centre hosted about a hundred of them at a recent joint conference, together with the COMET initiative (Core Outcome Measures in Trials), in Calgary, Canada (#CochraneCalgary2015).

Many junior postdocs who were at the conference struggled to publish papers. Yet, the number of publications is considered a core outcome of a postdoc training. Is it enough? What’s a core outcome set for a postdoc fellowship? “Not everything that can be counted counts, and not everything that counts can be counted.” — Albert Einstein.

 Ultimately, the fellowship should result in a faculty position. But we know that there aren’t enough positions for all PhD’s and postdocs. The truth is that we don’t need so many PhDs. “PhD ‘overproduction’ is not new and faculty retirements won’t solve it,” writes Melonie Fullick in her speculative diction at University Affairs (March 25, 2015): “Yet somehow no matter how many PhDs enrol and graduate, academic careers are the goal.”


What lessons can postdocs take from the Cochrane collaboration to improve their career prospects? All Cochrane reviews must have a protocol. Cochrane protocols get published in the Cochrane library. However, protocols for non-Cochrane systematic reviews are difficult to publish in journals. Nevertheless, postdocs who decide to do a systematic review and can upload the review protocol on to their open-access universities’ depositories. They get picked up by the google.scholar and can be counted in the H-index. This way, junior postdocs can improve one of their core outcome measures – the track record. Although it’s probably not the best measure of a successful training, it’s the currency of science. 

How Do We Make Tracks? Meeting of The Society for Technical Communication

January 31, 2015– The STC Canada West Coast chapter hosted a day for technical communicators, both new and those more seasoned, which included tips for finding writing jobs, successful grant proposals, benefits of career coaching and many more. In this post, I focus on two sessions that I attended about mistakes made by non-native users of English and informational interviews.
“Everybody makes mistakes; non-native users just add one more layer to the mistakes ecosystem.” Matsuno
Non-native users of English: who they are
Mark Matsuno is a technical writer with more than 12 years of experience as a technical translator specializing in Japanese-to-English translations of engineering and manufacturing documents.
 Despite the disadvantage inherent in being born in a non-English speaking country, the Non-native users of English have much strength. They are SMEs, i.e., subject matter experts. Her engineering-ese is her first language. His accent is terrible, but he writes almost flawlessly. Some cultures may be afraid of speaking, but may be great writers. Their fluency equals how well you they trick someone to think that they’re fluent
Lost in translation
There’s nothing really wrong with their writing, but it sounds awkward. The questions are how much energy do you put into the piece as an editor? How do you see yourself? As a champion of the end user; A defender of the English language; A teacher; someone trying to get on top of their workload
Common mistakes in non-native users of English
Adjective order; Plurals; Articles are something that gives Asian people a lot of problems;
Prepositions; Tense; Direct translation; Dated English (for example, I was once stung by a bumble-bee); Mixed formality.
How to stay sane
Learn another language. In Japanese you can improve quickly, because people in Japan laugh at you; the feedback on errors is instant. Use machine translations. Read plenty of well-written English.
Write lots. Engage in English conversation.
Informational interviews and networking
Wendy Hollingshead and Autumn Jonssen discussed how powerful networking and informational interviews job search tools can be.
Network. Become a member of writing organisations. Meet up. Decide what your industry of interest is and go to the industry specific events. Volunteer; get your email and your work out there. Not just random things but more focussed work that will help your career and the organisation that you volunteer for. Your goal for networking events should be to make at least one quality conversation and one quality connection. Do at least one event p/week. The more work you put in, the better results you’re going to get.
101 Informational interviews: Let them know your goal
The informational interviews can help you to figure out what you want. Find out how your interviewees got to where they are and get some advice from them. A good output from an II is a referral to someone who can bring you closer to your dream job. Always send a thank you note after the interview.

Finally, check out Michelle Vinci’s article on the STC website about using social media for your jobsearch: http://stcwestcoast.ca/chapter/using-social-media-for-your-job-search

Which talking therapies work for drug users with alcohol problems? A Cochrane update

Have you ever had an unresolved question and you kept asking again, again and again, until you got the answer? We wanted to find out whether talking therapies have an impact on alcohol problems in adult people who use illicit drugs (mainly opiates and stimulants), and which therapy is the best. We queried the scientific literature in 2012 and this year again.

Drinking above the recommended safe drinking limits can lead to serious alcohol problems or dependence. Excessive drinking in people who also have problems with other drugs is common and often makes these problems worse; their health deteriorates. Talking therapies may help people drink less but their impact in people who also have problems with other drugs is unknown. Talking treatments were the focus for an updated Cochrane review (Figure 1) published today (Dec 3).
Figure 1. Cochrane
We found four studies that included 594 people with drug problems. One study focused on the way people think and act, versus an approach based on Alcoholics Anonymous, aiming to motivate the person to develop a desire to stop using drugs or alcohol. One study looked at a practice that aimed to identify an alcohol problem and motivate the person to do something about it, versus usual treatment. One study looked at a counselling style for helping people to explore and resolve doubts about changing their behaviour (group and individual form), versus hepatitis health promotion. The last study looked at the same style versus assessment only.
In sum, the studies were so different that we could not combine their results to answer our question. As of June 2014, we still don’t know whether talking therapies affect drinking in people who have problems with both alcohol and other drugs because of the low quality of the evidence. We still don’t know whether talking therapies for drinking affect illicit drug use in people who have problems with both alcohol and other drugs. There was not enough information to compare different types of talking therapies. Many of the studies did not account for possible sources of bias. New clinical trials would help us to answer our question.
Citation example: Klimas J, Tobin H, Field C-A, O’Gorman CSM, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C, Cullen W. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 2014 , Issue 11 . Art. No.: CD009269. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009269.pub3/abstract

Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. Read more at www.cochrane.org

How Cochrane Keeps the Addiction Science in Check

Science isn’t infallible. Humans make mistakes even in this highly sophisticated method of understanding the world around us. Thanks God, addiction researchers get a chance to correct their error. If they publish a big error, the publication may be withdrawn. In smaller cases, the publisher issues a correction. It is interesting to see how such a correction has been issued following publication of our Cochrane systematic review of literature which. Probably this helped to keep the addiction science in check. See it for yourself below.

August 2011: “Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study”

Before our review included this study, the authors reported the following figures in tables 3 and 7.

November 2011: “Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: a Cochrane review”

 Our review was published in November 2011 and re-stated the findings of the above study as: higher rates of decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment as usual group– See more at: http://summaries.cochrane.org/CD009269/ADDICTN_which-talking-therapies-counselling-work-for-drug-users-with-alcohol-problems#sthash.RcVZGdQA.dpuf

August 2013 “Correction: Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study”

After the publication of our review, the authors corrected their figures in tables 1 and 5. The care-as-usual treatment for the control group was no longer stronger than the experimental intervention, the “alcohol-related brief intervention.”

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A note on causality in science

Because causal relationships are hard to prove (i.e. cause -> effect), majority of scientific publications rely on correlations. An example of a correlation is a relationship between shorter living expectancy and male gender. Men die younger than women. Although there are many plausible explanations, we cannot pinpoint a single cause.  Similarly, if an article gets corrected following a review in a major synthesis of scientific evidence – the Cochrane review – it may be a pure coincidence or it may be a consequence of the review. 

Substance Abuse Treatment, Prevention and Policy is an open-access peer-reviewed online journal that encompasses all aspects of research concerning substance abuse, with a focus on policy issues. Text taken from www.substanceabusepolicy.com

Cochrane Collaboration hosts the largest database of systematic reviews to inform healthcare decisions. Cochrane reviews are the jaguars of medical evidence synthesis. Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. Cochrane is a not-for-profit organisation with collaborators from over 120 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Text taken from www.cochrane.org

Finding the Evidence for Talking Therapies: Article in the Forum magazine

In an attempt to prove that counseling works for reducing drinking in concurrent problem alcohol and illicit drug users, I ended up on a journey through research and review. Read the full article in the November issue of the Forum Magazine (Volume 31, Issue 10)

Figure 1. Photo of the article in the Forum
 

This article was inspired by an essay which won the 4th place in the 2014 Aindreas McEntee prize of the Irish Medical Writers. The competition is open to members of Irish Medical Writers, a group of doctors and journalists specialising in healthcare. Parts of it were posted in my September post here.

The Forum magazine is the official journal of the Irish College of General Practitioners ICGP. Published monthly by MedMedia since 1991, it is Ireland’s premier journal of medical education. Text taken from: http://www.icgp.ie/go/library/library_home/

Founded in 1984, the Irish College of General Practitioners or ICGP is the recognised national professional body for general practice training in Ireland.