University of Talca

School of Medicine
Workshop on How to Read (Medical) Papers

Prof. Octavio COX

UTalca - Workshop: How to Read (Medical) Papers

0. 1. Outline: Greetings and presentation: What is Medical English (EMP)? Structure of Medical terminology a. Latin and Greek (Mostly) b. Prefixes Root Suffixes What is a paper and why read it Parts of a paper a. Title (Concise information) b. Abstract (Summary) c. Introduction (Background) d. Methods (Design) e. Results (Facts) f. Discussion (Interpretation) g. References (Bibliography) h. Reading the paper Reading the paper Questions

2. 3.

4.

UTalca - Workshop: How to Read (Medical) Papers

0. Greetings and presentation.

Profesor Octavio Cox (57), Chilean-born Canadian, in charge of Medical English at the School of Medicine; used to teach English and French at the Programa de idiomas, now only French (Oui, oui!) What is Medical English (EMP)? English for Medical Purposes (EMP) is a set of English for Specific Purposes (ESP): "ESP is an approach to language teaching in which all decisions as to content and method are based on the learner's reason for learning (Hutchinson et al. (1987)) In particular, EMP involves using actual medical materials and context; discourse, lexis and genres; emphasizing uses over rules (caveat). It needs an intermediate (B1.1 CEFR) level (ideally), but

Outline

UTalca - Workshop: How to Read (Medical) Papers

1. Structure of Medical terminology

a. b. Latin and Greek (Mostly) Prefixes Root Suffixes

Next, an exercise

UTalca - Workshop: How to Read (Medical) Papers

Exercise: From the root words and from the prefix and suffix tables reconstruct the medical term.

Roots abdomin acr card home laryng ot path vas

Meaning abdomen extremities; height heart sameness; unchanging larynx ear disease vessel; duct

UTalca - Workshop: How to Read (Medical) Papers

Definition
Surgical repair of the muscles of the abdominal wall Fear of heights Originating in the heart When all body systems are in balance A flexible, lighted tube used to examine the larynx Inflammation of the ear The study of diseases Surgical removal of the deferent duct in males

Medical term ?

UTalca - Workshop: How to Read (Medical) Papers

Definition
Surgical repair of the muscles of the abdominal wall Fear of heights Originating in the heart When all body systems are in balance A flexible, lighted tube used to examine the larynx Inflammation of the ear The study of diseases Surgical removal of the deferent duct in males

Medical term
abdominoplasty acrophobia cardiogenic homeostasis laryngoscope otitis pathology vasectomy

Outline

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

A medical research paper is a formal report that contains an original idea (thesis) and evidence to back up that idea (research); It is an investigative report, a question that is answered through exploration of a problem or an original idea that sheds new light on a known topic Why read it: Be up to date Influence and Change practices Improving skills Improving patients attention (Getting the innards of scientific thought) Main question: Why was the study done, and what clinical question were the authors addressing?

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

Types of studies or research: Primary: report research first hand. Experiments: maneuver is performed on an animal or a volunteer in artificial and controlled surroundings. Clinical trials: intervention, such as a drug treatment, is offered to a group of patients who are then followed up to see what happens to them. Surveys: in which something is measured in a group of patients, health professionals, or some other sample of individuals. Secondary: summarize and draw conclusions from primary studies. Reviews and Meta-analysis: integrate the numerical data from more than one study. Guidelines: draw conclusions from primary studies about how clinicians should be behaving.

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

Types of primary research designs: Randomized controlled trials (RTC): participants are randomly allocated in groups, one with intervention, the other as control. Cohort Studies: two (or more) groups of people are selected on the basis of differences in their exposure to a particular agent (such as a vaccine, a drug, or an environmental toxin), and followed up over a period of time to see how many in each group develop a particular disease or other outcome. Case-control studies: patients with a particular disease or condition are identified and matched with controls. Cross sectional surveys: a representative sample of subjects (or patients) is interviewed, examined, or otherwise studied to gain answers to a specific clinical question. Case Reports: A case report describes the medical history of a single patient in the form of a story.

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

Broad fields of research: Therapy: testing the efficacy of drug treatments, surgical procedures, alternative methods of service delivery, or other interventions. Preferred study design is randomized controlled trial (RCT). Diagnosis: demonstrating whether a new diagnostic test is valid (can we trust it?) and reliable (would we get the same results every time?). Preferred study design is cross sectional survey in which both the new test and the gold standard are performed. Screening: demonstrating the value of tests which can be applied to large populations and which pick up disease at a presymptomatic stage. Preferred study design is cross sectional survey.

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

Broad fields of research:

Prognosis: determining what is likely to happen to someone whose disease is picked up at an early stage. Preferred study design is longitudinal cohort study. Causation: determining whether a supposed harmful agent, such as environmental pollution, is related to the development of illness. Preferred study design is cohort or casecontrol study, depending on how rare the disease is, but case reports may also provide crucial Information.

UTalca - Workshop: How to Read (Medical) Papers

2. What is a paper and why read it

Types of design appropriate for the broad field of research (Type of paper): P 2 Randomized controlled trials (RTC) (Experimental) Trtmt; Intv (Thp) 3 Cohort Studies (Observational) Prg; Etgy 4 Case-control studies (Observational) Etgy 5 Cross sectional surveys (Observational) Diag 6 Case Reports (Observational) Alert S 1 Review Articles and Meta-analysis(Review of RCT) Trtmt; Intv Editorial, Letters to Editor, Comments, etc. (Opinion) Others... Best medical journals (Look at each journals guidelines): NEJM - New England Journal of Medicine

UTalca - Workshop: How to Read (Medical) Papers

3. Parts of a paper
a. b. c. d. e. f. g. Title Abstract Introduction Methods Results Discussion References (Concise information) (Summary) (Background, hypothesis) (Design) (Facts) (Interpretation) (Bibliography)

Not arbitrary: Reflects the process of scientific discovery

UTalca - Workshop: How to Read (Medical) Papers

Read In This Order (later):

Title Abstract Introduction/ Discussion Methods/ Results

Outline

UTalca - Workshop: How to Read (Medical) Papers

1. Reading the paper:

Resources: - A regular dictionary and a specialized medical dictionary. - Pencil and paper to take notes as you read. What set them apart: - Articles have a vividness that is seldom found in a text. It is exciting. - Articles lend themselves to critical, analytical thinking. - You can feel smart and powerful when you read original sources. - Articles reveal the scientific process far better than secondary sources. (Not easy, but) System for reading: a- Skimming, b- Vocabulary, c- Comprehension, d- Reflection and analysis.

UTalca - Workshop: How to Read (Medical) Papers

1. Reading the paper:

1 Skimming: Read the names of the authors; look at the date, the
publication; digest the title; identify the different sections; look at the tables, figures, photos, graphics 2 Read the abstract: try to understand as much as you can: identify the main point of the study.

3 Make a first quick reading: Mark all concepts and words you dont understand; Think and make notes about what you understood and the doubts you might get. 4 Vocabulary: Look up the terms you didnt understand, but not everything, just what is essential to get the main ideas. 5 Read the article again, but more thoroughly: take notes about questions, doubts; sum up the main ideas as you read them; answer the guiding questions as you read. 6 Think critically about the article: answer the critical questions.

UTalca - Workshop: How to Read (Medical) Papers

1. Reading the paper:

Todays Paper: Effects of Alprazolam, Zolpidem and Zopiclone, and of chronic inflammation on peripheral experimental algesia in Wistar rats Mihaela Zdrnka et al.

References

UTalca - Workshop: How to Read (Medical) Papers

Guiding questions:
What is the hypothesis the article tries to test in the study? What are the research questions? What are the objectives of the article? What research has been carried out before on the subject? How does this study contribute to the discipline?

Back

UTalca - Workshop: How to Read (Medical) Papers

Critical questions:

Introduction: What is the overall purpose of the research? Do you agree with the author's rationale for studying the question in this way? Methods: Were the measurements appropriate for the questions the researcher was approaching? Results What is the one major finding? Were enough of the data presented so that you feel you can judge for yourself how the experiment turned out? Did you see patterns or trends in the data that the author did not mention? Were there problems that were not addressed? Discussion Do you agree with the conclusions drawn from the data? Are these conclusions over-generalized or appropriately careful? Are there other factors that could have influenced, or accounted for, the results?

Back

UTalca - Workshop: How to Read (Medical) Papers

References

Structure of Medical Terminology: http://www.texashste.com/classroom_resources/course_g University of North Texas hste - A Language of its Own

Terminology: Lists of root words and affixes: http://www.mtworld.com/tools_resources/root_words.php? MTWorld - Roots http://www.globalrph.com/medterm4.htm Gobalrph Roots and affixes

UTalca - Workshop: How to Read (Medical) Papers

References.
Structure of medical papers: http://www.hkmj.org/article_pdfs/hkm1108p315.pdf Clinical Epidemiology Workshop

How to read Medical Papers: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2127173/pd Trisha Greenhalgh http://www.smj.org.sa/PDFFiles/Apr04/01Reading.pdf Reading Critically (FahadA.Al-Ateeg) Help on pronunciation: http://text-to-speech.imtranslator.net/

UTalca - Workshop: How to Read (Medical) Papers

The End Thank you very much.

Prof. Octavio COX, extension 2805