A new semester, time for new cool stuff. I am starting a Epi Journal Club for medical students. Here is the recruitment text.
Do you want to learn how to read medical literature?
What is a Kaplan Meier Curve? What is the difference between a case-control study and a case-cohort study? How do you get rid of confounding? What is confounding anyway! Or just in short, what distinguishes a good paper from a bad paper? Do you want to know? Here is a start:
Bob Siegerink is a clinical epidemiologist from the Centrum für Schlaganfallforschung Berlin (CSB) and he is starting a journal club for medical students (5th semester and up) where participants will be discussing both good and bad papers from both ancient and recent history. Although there is no previous experience needed, students have to be highly motivated as this is a fun, but hardcore, crash course in clinical epidemiology. All discussion will be held in English.
I have no clue on how many student will react: the deadline is soon, but this text will end up in the inbox of a lot of students. And as the level of science education in their curricula is limited compared to the Dutch curricula, they might not be triggered by this topic. Or they will… Who knows? I will use some of my previous teaching material, but I guess I need to adapt the content based on the number of participants and their level or knowledge, so everything is possible. I will keep you posted!
– update 18-4-2015: 11 participants… not bad for a first time! we start in 10 days. For the programme, click here
A new publication became available, again an ‘educational’. However, this time the topic is new. It is about the application of directed acyclic graphs, a technique widely used in different areas of science. Ranging from computer science, mathematics, psychology, economics and epidemiology, this specific type of graphs has shown to be useful to describe the underlying causal structure of mechanisms of interest. This comes in very handy, since it can help to determine the sources of confounding for a specific epidemiological research question.
But, isn’t that what epidemiologist do all the time? What is new about these graphs, except for the fancy concepts as colliders, edges, and backdoor paths? Well, the idea behind DAGs are not new, there have been diagrams in epidemiology since years, but each epidemiologist has his own specific ways to draw the different relationship between various variables factors. Did you ever got stuck in a discussion about if something is a confounder or not? If you don’t get it resolved by talking, you might want to draw out the your point of view in a diagram, only to see that your colleagues is used to a different way of drawing epidemiological diagrams. DAGs resolve this. There is a clear set on rules that each DAG should comply with and if they do, they provides a clear overview of the sources of confounding and identify the minimal set of variables to account for all confounding present.
So that’s it… DAGs are a nifty method to talk the same idiom while discussing the causal questions you want to resolve. The only thing that you and your colleague now can fight over is the validity of the assumptions made by the DAG you just drew. And that is called good science!
I worked together with some partners on a new workshop for young epidemiologist. The title says it all: WEON preconference workshop ‘crash course peer review’.
Unfortunately, we had to cancel the workshop because the number of participants was to low to justify the effort of not only myself, but especially all the other teachers. I think it is a pity that we had to cancel, but by cancelling we still have a fresh start whenever we want to try again in a different format.
Whilst preparing this workshop I noticed that peer review, or a better term would be refereeing, is not popular. It is seen as a task that task up to much time, with too much political consequences and little reward etc. New initiatives like Pubmed commons and other post publication peer review systems are regarded by some as answers to some of these problems. But what is the future of refereeing, when young epidemiologist are not intrinsically motivated to contribute time and effort to the publication process? Only time will tell.
For those who are still interested in this crash course, please contact me via email.
300 students reading one book, summarising it contents and discussing three propositions in order to grasp the essence of the book. This might sound a bit boring perhaps…But what if it Goldacres book Bad Pharma, you only have to read 30 pages and still get the content of the complete book, and get to Skype with the author? Great fun!
And we weren’t the only who had fun: Ben Goldacre addressed 300 students, all with critical questions, and apparently he enjoyed the whole debate:
We also invited AV, a spokesperson of NEFARMA an organisation who represents most pharmaceutical companies in the Netherlands. With him we discussed whether the AllTrials campaign was a waste of time and money. Also, BB a reporter from the Mare, who has knowledge on conflict of interest of professors joined in on the discussion whether professors should declare their COI before each lecture. All in all, it was a great day in which some of the students were shocked by the message of Ben Goldacre, whereas other students were not impressed and doubted whether there view is too one-sided… The debate still continues!
This week, the Mare decided to run a story on Bad Pharma book by Ben Goldacre and our related symposium. The author, BB did an outstanding job in describing the argument Goldacre brings forward in his book. As you might know, we are organising a symposium for our 300 students that are following our course “academic and scientific training”, because I believe that doctors should learn about their field that they will graduate in once they have graduated. A quote from me in the Mare (in Dutch)
Dokter zijn gaat verder dan alleen het behandelen van één patiënt. Onze beroepsgroep heeft een bijzondere positie in de samenleving; mensen leggen letterlijk hun leven in je handen. Naast je arts-patiëntrelatie heb je ook te maken met de wetenschap, beleidsmakers en de farmaceutische industrie. Aankomende artsen moeten daarvan bewust worden en goed op de hoogte zijn van de ontwikkelingen in hun veld. Dit boek sloeg de spijker op zijn kop.
one little error slipped in… I am not a doctor and therefore it is officially not ‘onze beroepsgroep’ but i think people will grasp the point that I try to make. The complete article can be read here.
After 7 months of preparation the new and improved version of the second year course ‘Academic and Scientific Training’ is about to start. Tomorrow, 300 students will come together for two weeks to learn the how and why of clinical epidemiology. We emphasize on testing new treatments in RCT, and how doctors should critically appraise the articles that describe these studies.
Together with AvHV, JS and others we were able to secure funding to buy 400 copies of the book “Bad Pharma” (click for more background) In order to organise a ‘Bad Pharma Symposium’. In this symposium, all students will read the whole book, do some research on three topics which will be debated in the final debate. This will take a lot of commitment of all students, but what to think of the 40+ Teaching Assistants that we need for this course!
During “conference season” I visited several conferences: ISTH, eurostroke, WEON, NVTH, UK-CIM and the ERA-EDTA. During all conferences I got the opportunity to present my own research, except for during the ERA-EDTA. For this conference I was asked to teach in a CME course on how to perform and interpret a clinical research project. The program:
– Setting up your study: study questions and study designs Vianda Stel, Amsterdam, the Netherlands
– Threats to validity of study findings: bias and confounding Kitty Jager, Amsterdam, the Netherlands
– Prognosis vs aetiology Friedo Dekker, Leiden, the Netherlands
– Interpretation and presentation of study results Bob Siegerink, Leiden, the Netherlands
Since this is a conference on kidney diseases, the examples that I use are from that field. Although not necessarily my field, I believe that the talk can be of interest for anybody who is at the start of their research career. Please click the picture below to see the talk (slides + audio)