Monday, September 9, 2013

The Long Journey of a Research Article

 Most health care providers are in a hurry and have little time to devote to reading medical articles. Often browsing just the title and summary, they want to know, “what does this mean for me or my patients?” They have little time to get into the details of how the study was done, who participated, or even the results. This short post is an attempt to demystify the research process to encourage health professionals to seek more from the studies they read and to pass on these findings to others in the field who can make a difference. As an illustration, I will use a recent publication from our research team that appears online at the Journal of Pain and Symptom Management, “I’m not a doctor, and I don’t know if I helped her go faster or slower”

The research, funded by a government grant, began long before the article was published. Our team began thinking about and writing the proposal for funding in the fall of 2008. It was submitted to the National Institutes of Health (NIH) six months later, where it was reviewed by experts. These people were skilled scientists with a wide variety of knowledge and experience. They returned our proposal to us with recommendations for improvement; research proposals are rarely funded the first time without changes. NIH accepts proposals on three dates each year, so we revised and resubmitted our proposal at the next possible opportunity. It was reviewed positively in February 2010. At NIH, reviewers give proposals scores – and this time our proposal’s score was good enough to be funded! We were finally awarded funding (that is, given the money!) in July 2010. By that fall we began gathering the data. Finally, two years later (Fall 2012) we had sufficient data and findings to write our paper. FIVE YEARS from the initial proposal requesting funding to data collection to data analysis to paper writing to publication.

Getting funding to do research and collecting data is hard work, but just the beginning! Analyzing the data is an important process and, in this case, involved the participation of our entire research team. We all read and interpreted interviews that had been typed up. As first author, I integrated the work of the others into a first draft of the manuscript. After many emails and drafts, the team submitted our article to the journal. The journal then sent the paper to three experts who carefully read the paper and made several recommendations aimed at improving our paper. This “peer review” is a very important part of the process, and helps maintain high standards for research publications. Based on these recommendations, our team revised the paper and sent it back to the journal. The journal approved of the changes we made, and the paper was published online May 2013, six months after initial submission.

It is gratifying to know that peer-reviewed research has scientific credibility, but the real test is whether or not it makes a difference in the lives of patients and families. For example, our study has considerable more value if it gets into the hands of hospice staff, the ones who, on a daily basis, can help caregivers manage the pain of their dying loved ones. But many hospice staff never read medical journals, and are often unable to attend conferences, another place where the results of studies like ours are presented. In short, research findings need to translate to the bedside. Years of hard work to produce information that can improve practice deserve attention. As scholars who produce research findings and health care professionals who read them, we have a responsibility to share important results to those who can implement them.

This post was written by Debra Parker Oliver with contributions from The Caregiving Network Research Team (Elaine Wittenberg Lyles, Karla Washington, Robin Kruse and George Demiris)

Photo Credits: Unknown

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