Strategies in Writing

1
Strategies in Writing
(for the medical literature)
What this presentation is not about
How to have good ideas
How to find good questions
How to obtain good data that address the
ideas/questions
How to enjoy a rich and fulfilling life...
Its about how to most easily put together the
best possible presentation of your ideas,
questions, data and findings.
And the process can improve your
2
Disclaimer
Don't ask me about parts of speech, past
participles, or split infinitives. I have no
idea what these words mean.
3
Pop Quiz How do you start writing?

• a. make a cup of coffee
• b. make two cups of coffee
• c. straighten up your desk
• d. see if the basement doesnt need cleaning...

4
(No Transcript)
5
I wonder if anything good is on TV?
6
Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

7
ABSTRACT
Motivate the reader Why should the I care about
your findings and conclusions?
Simple, directly related to finding
Must explain how result below was obtained, not
other analyses in the paper.
Primary finding What is the one piece of data you
want people to walk away with?
Must be supported by result above
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ABSTRACT
Most US professional medical societies and the
national health systems of all other
industrialized nations now recognize that most
women need not undergo Pap smear screening
annually. There are no data, however, regarding
the frequency at which women actually undergo
screening in the United States.
Most professional medical societies and the
national health sysms of all other industrialed
nations now recognize that most women need not
underghkjhko Pap smear screening annually. There
are no data, however, kk the frequency at which
women actually undergo screening in the
Unjlkjljited States.
To describe the frequency of cervical cancer
screening in the United States.
To determine the prevalence of cancer screening
of the cervix in the United States.
To consider the amount of cervical cancer
screening in the United States.
To consider the amount of cancer screening of the
cervix in the United States.
We obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers for Disease
Control and Prevention (CDC)which is a cross
sectional survey of a random sample of American
women. Sample Frame Women aged 18 and older
living in households with telephones (86,715
respondents). Our main outcome measures were
time since last Pap smear the estimated number
of American women receiving Pap smear at various
screening intervals.
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
what you are really doing is figuring out the
basic structure (as well as the basic point) of
the paper
The vast majority (YY) of American women report
having had at least one Pap smear in their
lifetime. Among women who have not had a
hysterectomy and who have been screened at least
once, ZZ report having had a Pap smear within
the past three years, XX within the past two
years and 73 within the past year. Based on
these data, we estimate that 45 million American
women undergo Pap smear screening annually and
only 6 million are screened using a 3-year
interval.
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
The majority of American women are being screened
for cervical cancer too frequently. Lengthening
the screening interval would not only reduce the
number of pelvic exams, but would also reduce
follow-up testing for abnormal smears and the
volume of specimens that cytotechnologists are
required to read.
The majority of American cytotechnologists are
being screened for cervical cancer too
frequently. Lengthening the screening interval
would not only reduce the proportion of pelvic
exams, but would also reduce follow-up testing
for abnormal smears and the volume of specimens
that cytotechnologists are required to read.
The majority of American cytotechnologists are
being screened for cervical cancer too
frequently. Lengthening the screening interval
would not only reduce the proportion of pelvic
exams, but would also reduce follow-up testing
for abnormal smears and the volume of specimens
that cytotechnologists are required to read.
9

• Get feedback

It is a lot easier to get good feedback on 1
page than on an entire paper
10
ABSTRACT
Most professional medical societies and the
national health sysms of all other industrialed
nations now recognize that most women need not
underghkjhko Pap smear screening annually. There
are no data, however, kk the frequency at which
women actually undergo screening in the
Unjlkjljited States.
To determine the prevalence of cancer screening
of the cervix in the United States.
To consider the amount of cervical cancer
screening in the United States.
To consider the amount of cancer screening of the
cervix in the United States.
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
Women aged 18 and older living in households with
telephones (86,715 respondents). Our main
outcome measures were time since last Pap smear
the estimated number of American women receiving
Pap smear at various screening intervals. We
obtained the1998 Behavioral Risk Factor
Surveillance System of the Centers the frequency
of cervic for Disease Control and Prevention
(CDC)which is a cross sectional survey of a
random sample of American women. Sample Frame
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
Based on these data, we estimate that 45 million
American women undergo Pap smear screening
annually and only 6 million are screened using a
3-year interval. The vast majority (YY) of
American women report having had at least one Pap
smear in their lifetime. Among women who have not
had a hysterectomy and who have been screened at
least once, ZZ report having had a Pap smear
within the past three years, XX within the past
two years and 73 within the past year.
The majority of American cytotechnologists are
being screened for cervical cancer too
frequently. Lengthening the screening interval
would not only reduce the proportion of pelvic
exams, but would also reduce follow-up testing
for abnormal smears and the volume of specimens
that cytotechnologists are required to read.
The majority of American cytotechnologists are
being screened for cervical cancer too
frequently. Lengthening the screening interval
would not only reduce the proportion of pelvic
exams, but would also reduce follow-up testing
for abnormal smears and the volume of specimens
that cytotechnologists are required to read.
11
Special topic Abstract numbers
1. Be clear about the comparison
The risk of prostate cancer in men with a higher
BMI was lower than that in men with a lower BMI,
but only if they were younger (RR 0.52)
The risk of prostate cancer in men with a higher
BMI was lower than that in men with a lower BMI
The risk of prostate cancer in men with a higher
BMI

• 2. Be clear about denominators

So the reader doesnt struggle with the
question of what?
3. Provide data on the magnitude of the effect,
not just ratios.
2.4 of men who were current smokers developed
prostate cancer compared to 1.2 of those never
smoked (RR 2.0, 95 CI 1.4-2.8)
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Efficient framework for the rest of the text
Introduction
Methods
Results
Discussion
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Efficient framework for the rest of the text
Introduction
1. Whats the current situation?
2. What's the the problem (or gap)?
Methods
3. How will this study help?
Results
Discussion
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Efficient framework for the rest of the text
Introduction
Methods
make sure there is a method for every result
use subheads to force structure
Overview Setting Exclusions Exposure/Intervent
ion Outcome Secondary Outcomes Analysis
Results
Discussion
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Special topic Labels
- names for things (or ideas) that appear
repeatedly in text.
Assertion a specific thing (or idea) should
always have the same name.
The provf of phoek soboh flod increased
expenditure index has bodforden implications for
grondening mawqork. Boferman etal findgrom of
exceddernon elevated resource use is potermanford
per norm. High intensity bodterformes koster mauk
be sdlamon and forwoz bedforn.
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Clear ? Dull
Make sure labels are consistent across abstract,
text, tables and figures.
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Efficient framework for the rest of the text
Introduction
Methods
Results
short and to the point driven by your figures
and tables
Discussion
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Efficient framework for the rest of the text
Introduction
Methods
Results
Discussion
1. Whats the central finding?
2. Could it be wrong?
3. What does it mean?
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Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

2 - Write less
focus on high-visibility components

• Get feedback

20
Pop QuizHow do you read?

• a. in bed, for about half hour before I go to
  sleep
• b. in bed, for about 5 minutes before I go to
  sleep
• c. in bed, naked
• d. I don't read, I look at the pictures
  instead...

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Think like your target audience
write for them, not for yourself.
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Write less - focus on high-visibility components
Focus on what readers look at
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Write less - focus on high-visibility components
Figures The most efficient way to quickly
communicate a feel for your findings
Tables The most efficient way to provide the
relevant details
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Communicate your major finding(s) using figures
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Figure Basics
1. Simple axes
2. Simple keys
Rate per 100,000
Column graphs for categories
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Figure Basics
1. Simple axes
Rate per 100,000
Year
Line graphs for continuous data
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(No Transcript)
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Figure Basics
1. Simple axes
Figure 1 Melanoma incidence and mortality in the
population age 65 and older for 9 SEER areas
(1986-2001). Early-stage refers to in-situ and
local disease late-stage refers to regional and
distant disease.
3. Legend in text
Rate per 100,000
Year
Line graphs for continuous data
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• Special settings As a vehicle to communicate
  individual data points

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• Special settings As a vehicle to communicate
  individual data points

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• Special settings As a vehicle to communicate
  sample selection

Sample Frame HIV, CD4 200 male veterans (n123)
And it doesnt have to be a randomized trial
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• Special settings As a vehicle to communicate
  sample selection

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• Special settings As a vehicle to communicate
  methods

Overview of the task presented to a woman
completing the survey and our measures of her
ability to accurately apply risk reduction
information
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• Get feedback

A good figure (and legend) should be
understandable on its own
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Table Basics
1. organize into logical groups 2. make groups
visually distinct
subheads
indents
spacing
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Table Basics
Give exact survey question whenever possible
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Table Basics
1. organize into logical groups 2. make groups
visually distinct
subheads
indents
spacing
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Table Basics
1. organize into logical groupsand make groups
visually distinct
subheads
spacing
2. make algebra explicit
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Table Basics
Male
34.8
Table body
1. right align data (i.e. on decimal point)
2. avoid excessive precision
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Table Basics
Male
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Table body
1. right align data (i.e. on decimal point)
2. avoid excessive precision
3. remove redundant data
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Table Basics
consider helping the reader with a summary column
When the table body is complex
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Special settings As a vehicle to present prior
work
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Special settings As a vehicle to highlight major
points or suggested actions
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Special settings As a vehicle to summarize the
effect of a change on multiple outcomes
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• Table/Figure combinations

RRs and CIs
Base rates
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• Table/Figure combinations

RRs and CIs
Base rates
47
Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

2 - Write less
focus on high-visibility components

• Get feedback

3 - Write again
in response to feedback from others

• Get feedback

48
Good papers are made, not born.
They are the product of multiple
revisions,revisions made in response to the
criticisms of others.
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Write again - in response to feedback from others
Get help 1. General reviewer - whose primary job
is to determine whether your writing can be
understood. 2. Expert reviewer - whose primary
job is to help prepare you for external review.
A content" expert to scrutinize specific
technical or theoretical issues. A "hostile
friend" who will look hard for flaws.
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Tactics to get useful help
Author
Use these tactics to get feedback forthe
guts of your paper ABSTRACT TABLES FIGURES
Tactics for eliciting feedback
Tactics for receiving feedback
1. Get an explicit commitment 2. Clarify the
review purpose
1. Have a conversation 2. Don't be defensive 3.
Focus on understanding problems 4. Judge
suggestions critically
3. Simple courtesies
Internal Reviewer
General Expert
51
Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

2 - Write less
focus on high-visibility components

• Get feedback

3 - Write again
in response to feedback from others

• Get feedback

4 - Write now
don't wait until you think you're done
52
Write now
It's easier to revise than write from scratch
The earlier you start the easier it is to find
time to allow yourself to step back, digest, and
read your work with a fresh perspective
53
Write now - don't wait until you think you're done
54
Write now
Even if it's a work of fiction

• Get feedback

55
Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

2 - Write less
focus on high-visibility components

• Get feedback

3 - Write again
in response to feedback from others

• Get feedback

4 - Write now
don't wait until you think you're done
56
Strategies in Writing
1 - Write smart
make use of efficient frameworks

• Get feedback

2 - Write less
focus on high-visibility components

• Get feedback

3 - Write again
in response to feedback from others

• Get feedback

4 - Write now
don't wait until you think you're done

• Get feedback