You Can Be Involved in Research Right Now, Wherever You Are

A few months ago I wrote a ‘publication explainer’ post on the PRioRiTy Study. That post focussed on this paper: Identifying trial recruitment uncertainties using a James Lind Alliance Priority Setting Partnership – the PRioRiTy (Prioritising Recruitment in Randomised Trials) study. Read that post here if you’re interested.

Anyway, back to this post; we are now in the midst of the PRioRiTy II Study. PRioRiTy I prioritised questions about recruitment of participants to trials so that we could provide focus for the research community. PRioRiTy II takes a similar approach, but this time we’re prioritising questions about retention of participants that have been recruited into trials. It makes sense if you think about it; there’s no point in figuring out how to effectively recruit participants into trials if they then go on to drop out later on – we need participants to be recruited and retained in order for trial results to be reliable and useful to patients, members of the public healthcare professionals, researchers and policymakers.

The method that we are using to conduct this project has been used lots of times by the James Lind Alliance (again, more information on that in the publication explainer post I mentioned earlier), and we’re currently in the middle of it.

A few months ago we did an initial scoping survey (I say we, I hadn’t actually joined the team at that point!), that survey generated lots of responses. Those responses were questions and statements about things that people want to know about retention – once this survey closed, I joined the team and worked on data analysis for some of the results.

That data analysis resulted in a list of questions that have now gone on to be included in the ‘interim prioritisation survey’. This is a survey that asks respondents to look at the 27 questions that we currently have, and pick the 10 questions that they think is most important.

If you are:

  • A person who has been asked to take part, or has taken part, in a randomised trial
  • A parent or carer of someone who has been asked to take part, or has taken part, in a randomised trial
  • A person who has taken part in aspects of randomised trials as a partner in the research (eg, helped to get the funding, been on a trial steering committee, commented on patient information such as leaflets, letters etc)
  • A health professional or any member of a research team whose work includes encouraging people to stay involved in randomised trials once they have agreed to take part
  • Someone who has designed, run, analysed, reported on or regulated (eg, ethics committees) randomised trials
  • Someone with experience of the methods of randomised trials (ie, how trials are done)

Then we’d love for you to spare a few minutes to complete that survey – take a look here.
For more information on the PRioRiTy II project, head to the Trial Forge website, and take a look at the video below.

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Organisation for PhD Success: Task Management

A few months ago I published a post on organisation to do with reading and referencing – that post was triggered by a conversation with my friend and fellow PhD student Lyuba (side-note, she’s started blogging – hoorah! Check out her blog here). This is the second post that came out of that conversation – how on Earth to keep track of all the things that you juggle as a PhD student?

Over the past 2 and a half years I’ve tried lots of different things, some have stuck, and others lasted little more than a week. Now I have a pretty set way to organise and keep track of everything; I’ve been using this method for about 18 months or so and it’s working well. I’m hoping that this post will help those of you who are struggling to keep track of multiple projects, and might encourage you to get a structured method of organisation in place going forward.

Working from a single, continual to do list

This is the thing that most people disagree with – but give me a chance. I work from one single to do list that never ends. It covers PhD work, other project work that I’m involved with, public engagement stuff, blog posts I want to write, Science On A Postcard work, household chores, self-care stuff, everything.

Previously, I’ve split tasks into different to do lists – one for work, one for home for example. That didn’t really work for me because I was spending too much time writing the lists, sorting tasks into lists, and then attempting to keep up with them all. One continual to do list means that everything I need to get done is written down in one place – granted, if I lose the list everything becomes a nightmare, but luckily that hasn’t happened yet! That list spans includes everything, at the moment it includes: ‘manicure before Thursday’, ‘book dentist appointment’, ‘drop dry cleaning off’, ‘finish systematic review chapter edits’, ‘review comments for journal manuscript’, ‘pay for writing retreat’, ‘upload new products to Etsy‘, ‘check interview location for Thursday’, ‘buy batteries for hallway clock’… I could go on.

I use a small To Do list pad I got from Paperchase last year  (left)- it’s nothing fancy, it was pretty cheap, and I don’t mind scribbling in it. It’s also got little boxes at the end of each line, meaning I can tick tasks off and easily see what’s done/needs doing. At the start of every year I used to spend so much money on stationery in an effort to get organised, none of those tools ever worked as well as this single list pad.

Long term tasks

When I spoke to Lyuba a few months ago, I explained the wonder of my single to do list, and she said ‘but what about really long term tasks?’. When she first asked I didn’t think that I had any one to keep track of these, but when I thought about it, I’m doing this without actively thinking about it. I use the desktop version of Outlook on my computer at work, and the Office 365 version at home – to track long term tasks that don’t fit on my single to do list, I use the ‘tasks’ function on Outlook.

For really long term tasks, I track these as ‘no date’ tasks – and the fact they’re on the list means that I’m still aware of them, but might not be actively be working on them. Other tasks get ‘next week’ or a custom date, which tends to be the following month. I check these tasks regularly because they’re right there when I’m writing and sending emails, which means that I don’t forget those tasks that I’ve said I’ll do months into the future.

Tracking your time

I’m aware that I’m in danger of looking like an organisation freak at this point, but my methods seem to be working so hopefully they’re helpful, rather than just something that people can mock.. Anyway, alongside my to do list and long term tasks list, I’ve started to block periods of time out of my calendar too. I use an Outlook calendar which is also on my iPhone too. At the start of each week I sit down and figure out when all my meetings are, what tasks need doing, and when I’m going to achieve each of those tasks.

An example week looks something like this:

This started because I was writing to do lists for each day, but I was finding it hard to strike the balance between lists that were too long (i.e. days when I had lots of meetings and not much time to get through work), or too short (i.e. days when I had no meetings, where I’d end up ‘finishing’ my daily to do list early on in the day). Blocking out pieces of time helps me to manage what I’m getting done and when, and also means that I’m more likely to say ‘no’ to things that aren’t working towards my goals for the day. Saying no isn’t something I like doing a lot a work, but with my thesis hand in date getting closer all the time, I’m finding that I really need to get my head down and write rather than helping out with this project and that. Blocking out a few hours to write makes me think twice about saying yes straight away – and that’s something I think a lot of postgraduate students need to do more often.

How do you keep track of everything that goes into your day-to-day life? Are you a fan of to do lists, or do you track everything through your phone? Leave a comment below – let’s share tips 🙂

Organisation for PhD Success: Reading & Referencing

A few weeks ago my lovely friend Lyuba sent me a message on WhatsApp: “How do you manage a bucket of readings? Do you use mendeley?” The conversation that ensued after this initial message was a few days of absolute organisational-nerd filled glory. Lyuba has just started her PhD at McMaster University, and she’s not the first relatively new PhD student to ask me for advice on how to organise things.

This post will focus on how I track my academic reading, how I make sure I can find papers months later, and how I reference. Later on I have another post planned that will cover task management and to do lists, but I suspect that’s going to take a little while to pull together, so I’m starting with the easier one first!

Tracking your reading

Reading is a massive part of the PhD process. Throughout my first year and into the early part of my second year I read, probably not as often as I should, but wasn’t particularly good at keeping track of what I’d read or what I thought about the studies. That changed in January when I started the #365papers project. I knew I needed to get more organised with my reading, and this was a surefire way to make it happen.

To track my reading I use a simple Word document; the image below shows part of this year’s document.

The table you can just about make out in the image above, is made up of 4 columns; ‘Date’, ‘Number’, ‘Title, First Author, Link’, and ‘Notes’. The ‘Number’ column refers to the amount of papers I’ve read in that month, so that I can easily look back when putting together my #365papers blog posts. Another thing to note is that the ‘Link’ in the third column is always a hyperlink to a full text of the paper – this makes things much easier than if you accidentally link to an abstract and then have to waste time finding the full text again each time you want to refer to the study.

The ‘Notes’ section is the most important part of this document – in it I write comments about the paper, whether I think it’s useful, comments on the quality of it, what I would change if I did the study myself etc. I also include ‘tags’ in this section – these tags help me to re-find papers weeks after I’ve first read them. Tags I use regularly include; ‘recruitment research’, ‘public engagement’, ‘patient involvement’, ‘methodology’, ‘qualitative research’. These are so incredibly helpful when I want to go back and find the notes I’ve written about papers covering different topics.
In the ‘Notes’ section I also highlight sections of text – you can see the yellow areas in the image above. Again, these help to remind me of papers that I’ve read and know I’ll want to refer back to. Usually the highlighted areas are notes to myself, e.g. ‘useful for thesis introduction’, ‘check if this included in systematic review’, or ‘very clear writing style – refer back to when writing up qualitative findings’.

I’ve used this system since January, and I’ve found it so useful – I’m going to start a new Word document in January and keep the 2017 #365papers document for reference, so I’ll eventually have a big archive of all the papers I’ve read. For me, this is a really easy and simple way to track my reading; I have never used Mendeley because it’s not supported by my University, so if anything went wrong with it I’d freak out and not have anywhere to get help – seriously, the librarians at Aberdeen Medical Library are absolute superheroes, and have helped me tonnes in the past with various things. This brings me neatly on to referencing..

Referencing

Referencing is my least favourite part of academic writing – I don’t mean the whole finding information and referring to it thing, I mean the painful task of formatting the names of authors, papers, journals etc into a very specific format. What I find particularly infuriating about it is the time that it takes, and the fact that I know that no one reads reference lists with as much effort as it takes to write them.

As you might expect, referencing software is one of my favourite things about academic writing. I use RefWorks. It doesn’t allow me to store entire papers, just the reference for that paper (as far as I know anyway..), hence the big Word document of reading I talked about earlier. What it does have though, is folders. These enable me to make buckets of references that I know I’ll refer to in pieces of writing later on, speeding up the process of referencing whilst writing.

RefWorks is the reference software that Aberdeen University uses, so I’ve used the same account since I started my undergraduate degree – meaning that I can track references back throughout every assessment I’ve submitted for the last 7 years. The major perk of using the system that’s supported by the University is that the librarians know exactly how to do just about anything linked to RefWorks. On the very rare occasion that something goes wrong with RefWorks – it’s happened once in 7 years – the support team there are really good. I emailed the support desk a copy of my undergraduate thesis along with a very panicked email because the referencing just wasn’t working, and it was sent back to me the next day with the references exactly where I wanted them.

If your university doesn’t use RefWorks, check what they do support – and go with that. Lots of PhD students I know don’t use referencing software and honestly, I have no idea how they have got this far without being driven insane by the process. I can’t imagine trying to reference my entire thesis by hand; I’d probably need a 3 month extension and then time off afterwards to recover.

Using Your (Research) Superpowers for Good

Yesterday I spent the afternoon at a foodbank in Aberdeen conducting interviews as part of a project with the University of Aberdeen’s Enterprising Researchers Programme. Enterprising Researchers gets PhD students out of their usual environment and into local businesses. The aim of this is not only to empower researchers to think differently about their research through developing enterprising behaviours, but it allows local businesses to benefit from the skills of PhD students too.

I applied for the programme towards the end of last year; after passing the group interview stage I was then able to apply to a variety of projects advertised. These projects spanned every industry you could think of; oil & gas, food & drink, scientific research, third sector and beyond. I applied for one project based with Community Food Initiatives North East (CFINE). CFINE is a unique business in that it’s part enterprise (selling wholesale fruit and vegetables to businesses and within the community, and offering cookery classes through their ‘Cook at the ‘Nook’ facility), and part charity (offering foodbank services, financial capabilities help and support across Aberdeen City & Shire and Moray). I interviewed with CFINE’s Chief Executive and an Enterprising Researchers Project Officer from the University, and was offered the project.

CFINE’s Cook at the ‘Nook facility

The work itself took a while to properly get off the ground – getting admin sorted, protocols written and the project registered took around 2 months as I was fitting this around usual PhD work, and the freelance work I do as well. This month I’m starting data collection, and it’s going so well! With this project I’m speaking to a variety of people across CFINE’s business and charity sectors; volunteers, beneficiaries of the foodbank and people using the other support services they offer. The work aims to build on some work CFINE have done internally, and figure out what impact the organisation has on its volunteers and users, and how CFINE can improve going forward.

This isn’t a paid project. Every student that’s part of the Enterprising Researchers Programme (ERP) is juggling their own PhD projects, conference attendances, report writing, academic reading etc, with their ERP project.

I’m not writing this post to demonstrate that the people taking part in this programme are great (though we are pretty great!). I wanted to write this post to encourage other PhD students and established researchers to use their research skills to help others. CFINE runs largely on the work and generosity of volunteers; some people volunteer for an afternoon each week, others are there packing orders and manning the foodbank every day – for some it’s like a full time job.

Foodbanks in Aberdeen are reaching their limit; CFINE put out a call last week because they are low on food, a few months before another foodbank in the north of the city completely ran out of supplies. Initially I wanted to donate and volunteer at CFINE, but using my time to carry out research for them means they’re getting better value from the time I’m giving.

The CFINE foodbank

As PhD students we’re building lots of different skills; we’re figuring out how to design, conduct and report research. We’re also working to juggle multiple things at once, communicate complex information in oral and written forms, and get everything done before funding runs out. These skills are all transferable, and could be hugely valuable to the charities and local businesses around you. If you’re thinking of volunteering, I’d really recommend reaching out to charities to see if they could use your research skills. The services we can offer could save them the effort of finding research companies, and the financial costs involved.

My day at CFINE yesterday wasn’t just of benefit to them. I came back home after a jam-packed day feeling motivated and enthusiastic, and really excited to carry on with the project. Use your research superpowers for things other than your PhD; it’ll give you that warm fuzzy feeling and it’ll help your community too.

When Was the First Clinical Trial?

As you’ve probably (hopefully!) picked up from other posts on this blog, my research is centred around clinical trials and their methodology. Trials can be intimidating for people that don’t know a whole lot about them, and as I’ve mentioned before, the ‘guinea pig‘ concept seems to haunt trial participation.

In this series of posts I want to answer any questions people have – from the basic to the obscure and everything in between – and demystify clinical trials. I asked a few friends who don’t work in a trials environment what they don’t know about trials, and the obvious starting point was ‘when was the first clinical trial?’, so here we are. Read on to find out when and how and first clinical trial came about.

Some sources say the first clinical trial was conducted in 605-562 BC, as outlined in the Old Testament’s Book of Daniel. Put simply, King Nebuchagnezzar II ordered the children of royal blood to eat only meat and wine for 10 days. Daniel asked that he and three other children be allowed only to eat vegetables, bread and water. After the 10 days was over, Daniel and the three children were noticeably healthier than the children who had eaten only meat and wine. Whilst this is clearly research (though as Ben Goldacre points out, probably underpowered research), the groups were not controlled. This was probably one of the first times in evolution of human species that an open uncontrolled human experiment guided a decision about public health.

James Lind is credited with the first controlled clinical trial; controlled meaning that his study included a comparison, or control, group. The comparison group received a placebo, another treatment or no treatment at all. Lind, a Scottish Naval Surgeon, conducted the first controlled clinical trial on the 20th May 1747 on a group of sailors suffering from scurvy.

He included 6 pairs of sailors in his trial; placed them all on the same diet, and then gave each of the pairs an additional intervention. One pair had a quart of cider each day; one pair took 25 drops of elixir vitriol (sulphuric acid) three times a day; one pair had 2 spoonfuls of vinegar three times a day; one pair were put on what Lind describes as a ‘course of sea-water’; one pair each had 2 oranges and 1 lemon given to them each day; and another had what’s described as a ‘bigness of a nutmeg’ three times a day.

I know which of the treatments I have preferred at that time (i.e. not a course of seawater!).

At the end of day 6 of Lind’s trial, the pair that had eaten 2 oranges and 1 lemon each day were fit for duty and taking care of the other 5 pairs of sailors. Lind notes in his book ‘Treatise on Scurvy’ (published in Edinburgh in 1753) that he thought after the citrus fruits, the cider had the best effects.

We now know scurvy is caused by a deficiency in vitamin C, hence why fruits rich in vitamin C had his sailors fighting fit again after just 6 days.

Clinical trials like James Lind’s are what we base our current practice on. Over the years since Lind found the cure for scurvy, huge advances have been made in the methodology of trials; we now have placebos, use randomisation, adhere to various codes of conduct, and work with huge groups of patients and teams of research staff across the world in an effort to answer clinical questions.

This is the first post in a series I’m calling ‘Clinical Trials Q&A’. If you have any questions about clinical trials, what they are, why we do them, what their limitations are.. etc, please pop them in a comment or tweet me @heidirgardner and I’ll be sure to answer them in upcoming blog posts.

Self-Care Tips to Keep You Sane: Reading for Pleasure

At the end of January I wrote about the importance of academic self-care for PhD students; I didn’t delve too far into the specifics of what I do in my downtime and a lot of people asked. ‘It’s hard to switch off’ and ‘I find it hard to relax’ were the two phrases I encountered most frequently, so I thought I’d introduce a series of posts that provide more information, and recommendations, on what to do to give yourself a break during the inevitable stressful periods that come with doing a PhD.

This is the second installment in this ‘self-care tips to keep you sane’ series, and this week I’m talking about reading for pleasure. I read a lot, and I think it’s really important to make time to read exciting and imaginative stories that are in no way linked to your work. It gives you a chance to switch off.

A few years ago I joined my local library – it’s free and you get to keep books for a month, perfect for those of us on a budget! I’d really recommend checking out your local library; and make sure to venture further afield than your university library, you’ll end up picking up books related to your studies and that defeats the point.

I feel like I’m really making progress with my PhD, and this month I decided to treat myself. I don’t often re-read books so I don’t often buy books – they end up on shelves forever and I’d much rather borrow or swap books with other people to prevent me from building up a ridiculous collection of books I’ll never read again. I also really like surprises. Enter, Moth Box.

Moth Box is a small business set-up by Youtuber Mercedes Mills. It’s a book postal service with a difference; you don’t know what books you’re getting, and each is from an independent publisher. Each box is £20, and for that you get 2 books fitting that month’s theme – May’s was novels – neatly wrapped in tissue paper, and a bookmark that features a quote from each of the books.

The two books I got in my box are: Ties by Domenico Starnone, and Star-Shot by Mary-Ann Constantine. I hadn’t heard of either, but they both sound like stories I’ll enjoy. Overall I’m really happy with my May Moth Box and can see myself ordering again in the future; great value, brilliant books I wouldn’t otherwise have found, and beautifully packaged too.

Struggling to find time to read? I often do too. Lately I’ve been turning the TV off and closing my laptop an hour and a half before I plan to go to bed; that gives me time to read for an hour or so before sorting my life out for the next day (ironing clothes, making lunch etc etc) and getting ready for bed. It’s been such a lovely way to switch off at the end of a busy day, and I think it’s made my sleep quality improve too.

Doing a Systematic Review and Not Being Beaten by Piles of Paper

As with most PhDs based in Health Services Research, my project started with a systematic review. This seems to differ hugely from lab-based PhDs which (from my experience anyway) largely begin with traditional literature reviews. Not sure what the difference is between the two types of review? I’ll point you in the direction of this blog post from Students 4 Best Evidence. In short, systematic reviews can take an absolute age and they require a certain level of patience and persistence that I didn’t realise I had.

Last year HealthPsychTam posted two different posts talking about her experience of doing a systematic review. ‘A Confession…’ which was a brutally honest post about the feeling of wanting to drop out, and ‘Conducting a Systematic Review’ with lots of absolutely brilliant tips on getting through the process. I’d recommend you read both. In this post I want to add to Tamsyn’s experiences and give my own thoughts on the process so far.

What do I aim to achieve with this review?
My primary PhD supervisor has a Cochrane review that looks at methods to improve recruitment to randomised controlled trials, and mine is sort of the mirror of that review. It looks at methods to improve recruitment to randomise controlled trials that are evaluated using only non-randomised evaluations. We know there’s a lot of publications that cover this topic, but as yet there has been no systematic review including only data from non-randomised studies.

What stage am I at now?
Currently I’ve published the protocol for my systematic review (huge gold star to my supervisor for encouraging me to do this – it was a massive motivator), I’ve finished data extraction and we’re now tackling the task of data analysis and synthesis. In very simple terms, I have created a large pile of paper that I now need to shape into something useful.

Things I wish I’d known at the start that I know now

  • Search strategies can never ever weed out all the studies you don’t need
    I worked with an Information Specialist to create my search strategy – put bluntly, I am not an expert in search strategy development and the Information Specialist based in our unit is. She was brilliant to work with, and she made the whole process much easier and quicker than if I was going to figure out how to do this whole thing myself. Still, search strategies can never be perfect and you will always end up with a big pile of studies that won’t make it into your review. I began with over 9,500 abstracts, whittled that down to ~270 full texts to assess, and then ended up with 103 studies in the final review.
  • You will never finish a systematic review of this size in a year
    I still haven’t finished the review and I’m entering month 19th of working on it. That’s a really long slog to go through, most of which was spent reading stuff and meticulously tracking where every abstract, full text and included study was in the biggest spreadsheet I’ve ever made. Be realistic, it’s unlikely you’ll be done within a year unless you’ve got a really small amount of included studies (if this is the case well done you, I am very jealous).
  • A review cannot be done by one person – get people involved as soon as you can
    All of my abstract screening, full text assessments and data extraction were done in duplicate; once by me and once by whichever person I managed to sweet talk that week. It took a lot of time and effort to find people willing to help, and then explain tasks to them via telephone/Skype and a lot of Dropbox files. I couldn’t have done the review without them and I’m so grateful that they offered to help (I had no funds to offer them – they were just being top notch humans). I would thoroughly recommend getting other people involved in your review as early as you can; whether they can help with screening/data extraction or just give you a new perspective on how you’re going to analyse your data, it’s all helpful.

This systematic review has been a really brilliant learning process, but it’s been the longest slog I’ve had over the course of my PhD. Two of my desk drawers are now crammed with papers, some scribbled with ‘include’, others ‘exclude’ – the further down the pile the less clear and politically correct they become, my personal favourite being ‘this is crap, total crap, exclude on the basis it’s utter crap’. I’m on the way with it though! I’ve got the big cloud of screening and extraction out of the way, and I’m on to the fun stuff and seeing what the review itself shows! Hoorah!

If you’re thinking of doing a systematic review, please be realistic with your timescales – and make sure you have snacks along the way. It’s a long process but chocolate definitely helps.