Same things about your dissertation

and something more!

Outline
General Aspects Organizing your dissertation Writing style

Homeopathy is witchcraft: Brit docs*

BMA said taxpayers should not foot the bill for remedies with no scientific basis to support them.

* Times of India, May 16, 2010

Challenges in Siddha research

System related
Lack of generalizability No uniformity (in diagnosis, drug standards, treatment) Safety issues

Person related
Lack of interest / mentality Technical knowledge Lack of personnel Lack of collaboration

Funding

An overview of dissertation
Disserto (latin) discuss A research report History

Purpose of dissertation
Promote the development of critical judgment, habits of self education, imagination and scholarship as well as the acquisition of knowledge and research skills Produce physicians who can evaluate data critically Learn how to understand scientific methods practically

The beginning
When to start Have 3 or 4 topics Prepare a concept paper Pilot study If change needed Can finish well in advance

Choosing a research topic

FINER*

Feasible Interesting Novel Ethical Relevant No controversies

*Hulley et al, 2001

Planning your dissertation

Develop a protocol; get it approved by technical committee (may be the guide) and ethics committee and stick to it Make a time-table (using software, GANTT chart)

List of things to get done inside college and outside

List the people to discuss with, places/labs to contact

Make a folder for each chapter

Keep your time and budget limits in mind

Aug-06

Sep-06

Oct-06

Nov-06

Dec-06

Jan-07

Feb-07

Mar-07

Apr-07

May-07

June-07

July-07

Aug-07

Sep-07

Oct-07

Nov-07

Dec-07

Jan-08

Feb-08

Mar-08

Apr-08

May-08

June-08

July-08

Task Name 1. Planning & Preparation 2. Workshop to develop the tool (NDST) and CCC 3. Pilot the tool 4. Finalize the tool 5. Validation of NDST 5.1Training workshop (National & Zonal)

Duration 12 weeks

4 weeks 4 weeks 4 weeks

4 weeks 5.2Data Collection 5.3Data analysis 5.4 Report writing 5.5Dissemination 8 weeks 4 weeks 4 weeks

4 weeks

6.Prevalence survey
6.1Training workshop (National & Zonal) 4 weeks 6.2 Data Collection 6.3 Data analysis 6.4 Report writing 6.5 Dissemination Total Duration 24 weeks 8 weeks 8 weeks 4 weeks

24 months

The layout (Structure)

The Beginning:
Title Page Dedication Acknowledgements Table of Contents List of Figures / Tables / Appendices / Abbreviations (also known as Nomenclature in some disciplines)

IMRaD structure Introduction Methods Results (And) Discussion References (also known as Bibliography in some disciplines) Glossary Appendices

Proportion of contents
Introduction (incl. RoL) Methods Results Discussion - 20 30% - 10 20% - 30 40% - 20 25%

Title
Clear Specific but comprehensive Short / crispy but sufficiently descriptive Interesting and attractive No abbreviations Should be easy to catalogue

Introduction
Background material to make the reader understand Existing state of knowledge Gaps in knowledge which research will fill State what you Intend to do How the topic was chosen How it is related to the contemporary world It does not
Review the history of the subject Does not identify all the other gaps in knowledge Do not include methods, results and discussion

Objectives
What is to be achieved by the study General objective Specific objective State whether you will be
Estimating a quantity Testing a hypothesis

Examples of objectives to estimate a quantity

Measure the level of decline of blood pressure among patients treated with venthamarai chooranam (Gunapadam, Maruthuvam) Estimate the correlation between envagai thervu and allopathic diagnostic methods for mega noi patients (Noi nadal) Descriptive analysis of similarities between xxxx varma points in Siddha system with xxxx acupuncture points in traditional Chinese medicine (Sirappu maruthuvam)

Examples of objectives to test a hypothesis

Determine the effectiveness of venthamarai chooranam versus asai chooranam in reducing blood pressure among newly diagnosed patients with pithathikkam Determine the diagnostic validity of neer kuri and nei kuri compared with Hb1Ac among newly diagnosed patients with Diabetes mellitus Determine the efficacy of Aya pringaraja panitham as compared to banana panitham in the treatment of anaemia among children

Review of literature
Relevant material of past Global National Local Progressively zoom in Dont just copy/paste Sources
Previous dissertations Journals Websites Books

References

Methods
Explain what you did in simple terms Provide key information
Variables Type of study Data collection techniques Sampling Sample size Plan for data collection Plan for data processing and analysis Ethical considerations Pretest / Pilot study

Do not add results

Statistical analysis
Clinical trial
Descriptive statistics For before and after treatment assessments
Paired t test for means McNemars Chi-square for proportions

For two groups

t test for means Chi-square for proportions

Multivariate analysis to study the independent effect of the trial drug

Toxicology study
Descriptive statistics

Diagnostic study
Descriptive statistics Sensitivity, specificity, predictive values, likelihood ratios, ROC curves (if applicable) McNemars Chi-square

Results
Describe your findings in simple terms Do not use general sentences Start with baseline characteristics Do not explain methods (e.g., criteria used) Always give numbers, and not only proportions
Of the XX subjects, XX (XX%) reported doing

Describe the information in the tables as captions

Cases and controls did not differ with respect to baseline characteristics (Table 1).

Back up statements with data in the sentence, data in the tables or mention data not shown Do not discuss results nor use references

Discussion
Discuss by
Objectives Variables

Basis for conclusion and recommendation Other studies Support or contradict

Summary & Conclusion

Summarize all in short paragraphs (one page) Draw conclusion from your summary

Recommendations
Dont confuse conclusions & recommendations Based on your observations For the betterment of To whom administrative people, policy makers, fellow researchers and practitioners, community at large Suggestions for future works

Limitations
Imposed mainly by
Budget Time constraints

Possible limitations
Sample size Investigations

State them directly State to which extend the study would have been degraded

Appendix
Case Report Form Questionnaire Proforma Consent form Others

Reference citation
Follow guidelines of the ICMJE (www.icmje.org) For an article: Author(s) Surname followed by initials - Title of article - Name of Journal Year, Volume, (number): page numbers of article. For a book: Author(s) Surname followed by initials. Title of book. Place: Publisher, year, Edition For a website: Author Title of the webpage Name of the website Date of publication URL

Problems you may face during your dissertation study

Poor number of cases Laboratory results not so encouraging Mid-time changes Controversies with guide / authorities Unexpected health conditions Psychological lack of enthusiasm after some time

Regulations of TNMMU (1/2)

Students will be assigned a topic within 4 months of his admission and be intimated to the COE. HOD will assign a topic In lieu of Dissertation, Proof of publication or acceptance as a principal author in a reputed medical journal Bound Volume. Minimum 50 pages and maximum 75 pages. Typed matter. Doublespacing. One side only excluding certificate, acknowledgement, annexure & bibliography 4 copies to be submitted 4 months prior to the exam to the COE

Regulations of TNMMU (2/2)

Evaluated by 4 examiners at the time of Clinical/Practical exam Dissertation is approved but examiners suggest minor corrections & resubmission. The candidates' results shall be withheld, again reexamined. If failed in the written/practical, Dissertation mark will be carried over to the subsequent exams If Dissertation is rejected by two exams or more, Candidate is permitted to appear for written/practical exams but results will not be declared/withheld. Resubmit prior to the next exam.

Regulations of CCIM
General expectations
Must contain own account of research Able to re-express observations and draw conclusions Be suitable for its publication in an abridged form

Contents
Contain a summary < 150 words Outer cover: title, the names of dissertation, department, student, guide and year of submission 50-150 pages including chart, diagram, photograph. Bibliography etc.

Number of copies
One each for the libraries of University, College and the guide

Publication requirements
Shall become the property of the University and seek permission to publish from the university In no case, it should be published before it is accepted

Regulations of CCIM : Time-line

Title be registered with the University within one month from the declaration of the result of the second year examination Submission by 1 October of the year preceding the year of final examination Should be submitted during the third year of the examination If not approved
Returned to the student with the remarks of the examiner Resubmit the same after complying with the observations of the examiners Two chances for resubmission of the dissertation at the end of six months period each after the first submission

Points to consider (1/4)

Be brief & to the point Avoid repetition and duplication of ideas Spare and allow enough time for writing Use a simple direct style which is condensed but not so condensed as to be critic or sacrifices precision and clarity of results Organize the material in a logical sequence and not according to the order in which experiments were conducted Revise the material until it has unity, coherence, emphasis and accuracy and so clear that it cannot be misunderstood

Points to consider (2/4)

Avoid unnecessary details. However give all the facts necessary for a trained person to repeat the experiment(s) Design suitable headings, sub-headings and sub-subheadings. The paragraphs and sentences should be short, to enable the reader to skim the thesis for its general subject matter and to locate quickly any detailed part he/she seeks or interested Let the tabular data and illustrations speak for themselves. Confine the text discussion for meaning of data. Plan the illustrations and tables according to the page dimensions

Points to consider (3/4)

Insert the photos that are glossy, have plenty of contrast and pertain to the text. Avoid long and complex or undigested (unclassified) data or too many tables Arrange the tables that to portrait or landscape on a page wherever possible and so cast these that they could be accommodated in the prescribed format Provide a complete caption/title for every table, figure and illustration which is self explanatory and nouns in the caption /title should preferably start in capital

Points to consider (4/4)

Provide clear and concise column headings and subheadings Explain every symbol used in a table as a footnote of the same Avoid footnotes for the citation of references, if any, should be included in the text and quoted in the list of references at the end of the thesis proceeding to appendices Include letter, survey forms, raw data, statistical computations and other materials which have been used or collected during the study in the appendices

Scientific writing style

Use the past to report what you did Use the present for established facts Write short, sequential sentences Place one idea per sentence Be specific Do not use bold nor underlining Do not include footnotes

Things to avoid in scientific writing

Avoid qualifiers
This was a very large outbreak

Avoid emphasis
This is the largest outbreak ever reported as thousands and thousands of people were affected

Avoid accusations
Irresponsible behaviours among health care workers lead to the spread of this Lassa fever outbreak

Avoid apologies
Because of a lack of resources we could not

Avoid clearly
If it is clear, you dont need the word clearly

Passive and active voice

Passive voice
Suggest lack of ownership in the process Imprecise OK if subject is unknown or irrelevant

Active voice
Reflects the responsibility taken Precise To use by default (use grammar checkers)

Examples of passive and active voice use

Passive voice
A study was conducted A sample was selected Questionnaires were administered

Active voice
We conducted a study We selected a sample Field workers administered the questionnaires

Documenting the evidence

Verbs to use
Clear evidence: Use Indicate Partial evidence: Use Suggest

Words to avoid
Probably use may Show use indicate Prove use indicate Reveal use indicate or suggest It appears Spell out what data suggests that

Optimizing the center of gravity of the sentence

Each sentence contains a main idea The verb constitutes the centre of gravity of a sentence Make sure the verb contains the key idea Avoid neutral verbs

Optimizing the centre of gravity of the sentence: Examples

We conducted an investigation of the outbreak We investigated the outbreak We took a sample of the population We sampled the population We made an assessment of the situation We assessed the situation

Measuring and testing

The verb estimate denotes measurement The verb determine denotes hypothesis testing Assess is generic and must be replaced when dealing with measurement or hypothesis testing (OK for the general idea of assessment) Examples
We determined the prevalence of trachoma We estimated the prevalence of trachoma The objective was to assess the use of short course treatment The objective was to determine whether short course treatment can be used

Proof reading (1/2)

Names, initials and affiliations Formatting errors Typos Symbols Reference numbering Reference format

Proof reading (2/2)

Tables
Alignment Totals Calculations Digit loss

Figures
Re-drawn OK No format loss

Resources
http://www.who.int http://www.whoindia.org http://www.icmr.nic.in http://www.ijaronline.nic.in http://www.cdc.gov http://www.idrc.ca/openebooks/069-1/ http://www.annals.org http://www.biomedcentral.com

Examiners point of view

Review of literature
To what extent is the review relevant to the research study? Has the candidate slipped into Here is all I know about x? Is there evidence of critical appraisal of other work, or is the review just descriptive? How well has the candidate mastered the technical or theoretical literature? Does the candidate make the links between the review and his or her methodology explicit? Is there a summary of the essential features of other work as it relates to this study?

Examiners point of view

Methodology
What precautions were taken against likely sources of bias? What are the limitations in the methodology? Is the candidate aware of them? Is the methodology for data collection appropriate? Are the techniques used for analysis appropriate? In the circumstances, has the best methodology been chosen? Has the candidate given an adequate justification to the methodology?

Examiners point of view

Results
Have the hypotheses in fact been tested? Do the solutions obtained relate to the questions posed? Is the level and form of analysis appropriate for the data? Could the presentation of the results been made clearer? Are patterns and trends in the results accurately identified and summarized? Does the software appear to work satisfactorily?

Examiners point of view

Discussion & Conclusion
Is the candidate aware of possible limits to confidence/reliability/validity of the work? Have the main points to emerge from the results been picked up for discussion? Are there links made to the literature? Is there evidence of attempts at theory building or reconceptualisation of problems? Are there speculations? Are they well grounded in the results?

Defense
Lets see, what can I ask the candidate?
The examiners may have decided before the exam whether to pass you. Abstract References Summary & Conclusion

Defense, viva, exam, ...

viva = viva voce = lively discussion

The exam is to check its your work...

Talk fluently about the work; show youve thought about it (which you have!).

...and a chance to clarify things that arent clear in the thesis.

These are areas where corrections are likely.

After passing
Go far more detailed, next level studies Practice it! Publish Disseminate Effort of DoS, TNMMU

Definition of levels of evidence and grading of recommendation

Level Ia Ib IIa IIb III IV Type of evidence available from Meta-analysis of RCTs At least one RCT At least one well-designed controlled study without randomization At least one other type of well-designed quasiexperimental study Well-designed non-experimental descriptive studies Expert committee reports or opinions and/or clinical experience of respected authorities C Grade A

Phases of trial
Phase I Clinical pharmacology & toxicity Human volunteers Hospital study

Phase II Initial clinical investigation for treatment effects Patients Hospital study Phase III Full-scale evaluation Patients Hospital study Phase IV Post-marketing surveillance

Possible study designs in Siddha

Observational Exploratory Literature Clinical trial
Siddha Vaithiya Thirattu

What is the biochemical profile of patients taking siddha medicine for more than six months

Case control Cohort

Open, non-randomized, RCT, Meta-analysis

To establish the cause as per Siddha system

Toxicity Diagnostic

Same as above

Take home message

Approach dissertation with all your sincerity Feel the joy of contribution Practice! Practice!! Practice!!! Let yourself be remembered for your dissertation Let research become routine in Siddha Synergize! Learn, Share & Progress!

siddhajoes@gmail.com 09962 01 9902