How do I Get Funding for My
Research and How do I Get My
Paper Published?
Andrew Bush MD FRCP FRCPCH
Imperial College & Royal Brompton Hospital
a.bush@imperial.ac.uk
Getting Started
• What is the first thing you need?
– A question that really interests you
• What are the two most important
questions about any project?
– So what?
– What for?
• What is different from paper writing?
Hypothesis
Confirmed
Hypothesis
Focussed experiment
Fishing Expedition
GENERATES
Hypotheses!!
Move on
Confirmation
MANDATORY
Think First!
• What clinical or experimental question
am I trying to answer?
• Why? Clinical benefit or mechanisms of
disease?
Mechanisms vs. Individuals
• Statistically significant
differences between
groups
• May help predict
mechanisms (beware
guilt by association)
• No use for clinic
decisions
Think First!
• What clinical or experimental question
am I trying to answer?
• Why? Clinical benefit or mechanisms of
disease?
• In an ideal world, what would I
measure?
Think Second!
• What ethically and prectically can I measure?
• What are the best tools?
• Does the act of measurement alter what I am
measuring?
• What is the shortfall between what I can
measure and what I would like to measure?
Does it matter?
Getting Started
• It takes longer than you think!
– Disorganisation on your part does not
constitute a crisis on my part!
•
•
•
•
Ethics
Research office
Costings, overheads, FEC
Etc., etc.
Getting Started
• Get real, get help
– What is your own track record?
– Who will be your collaborators?
– Statistics?
– Health economics?
– Qualitative?
– Patient involvement?
Getting Started
• Why do Grant awarding bodies award
grants?
• Read the Instructions
• Read the Instructions
• Yes, I know you have, but READ THE
INSTRUCTIONS AGAIN!!
So, you want to start writing?
• Background
– Why is this logical and important to do
– Systematic reviews, meta-analyses etc.
• Is it realistic?
– ‘I’ll find the cure for cancer’
– Has the group got the right pedigree
• Pilot data – a MUST
Writing: The Basics
• Hypotheses aims and objectives
– Must be clearly stated at the end of
background
– Must be a logical development from the
background
– Must be attainable
– Must have the ‘wow’ factor!
Methods Section
• Do the numbers add up?
– ‘I will recruit 157 patients with Type 4 HermanskyPudlak syndrome’
• Has the group got a pedigree for this?
– ‘I will do Taqman Reverse PCR in Prof Bush’s lab’
• Statistics
– Power calculation
– Analysis plan
– DO NOT WING IT!
Other Issues
• Do not skip the ‘bits’
– Abstract – first port of call
– Lay summary
• Make costings realistic
• Should there be
– Health economics?
– Qualitative?
• Make sure all boxes have been filled in!
And Finally
• Spell out the implications
– ‘These findings will have important clinical
implications for X’
– Translation: ‘I’d like to believe these are
important, but I know they are not really in
any clear way
– If you cannot spell out in detail the
implications, you are Toast!
• Clinical Trials: Register on Line
Writing: Getting Started
• Are YOU excited?
– Because if you are not, no-one else will be!
• Does it fit the Journal?
– Do they publish this sort of thing?
• Style it so it fits the Journal
Hypothesis/
Question
Design
Analysis/
Power
The Introduction:
WHY you did it
• Focussed and relevant, not an essay
• Importance of the problem
• Why not solved before
– And why you might solve it
• MUST end with a logical HYPOTHESIS
• MUST generate enthusiasm
The Methods:
WHAT you did it
• Can I reproduce the study from what you have
written?
– Including selection criteria
• Use the on-line supplement if one is permitted
• How did you check data entry accuracy?
• Must have a statistical section
– There must be a power calculation (or a reason why you
have not done one)
– You must cope with multiple comparisons
– You must set a logical level of significance
– You must say what tools you used
The Results:
WHAT you found
• Use CONSORT and STROBE as appropriate
– STROBE = STrengthening the Reporting of
OBservational Studies in Epidemiology
CONSORT:
Randomised controlled trials
The Results:
WHAT you found
• Use CONSORT and STROBE as appropriate
• Start with patient population
• KISS for the Tables
KISS
• Keep
• It
• Simple,
• Stupid!
The Results:
WHAT you found
• Use CONSORT and STROBE as appropriate
• Start with patient population
• KISS for the Tables
• Focussed analyses
– Not hopeful comparisons and trawling
• Do not do endless post hoc analyses
– These are at best hypothesis generating
• Do not fudge the findings – p=0.07 is not significant
– My girlfriend is slightly pregnant!
The Discussion:
WHAT it means
• Do NOT repeat Introduction
• General issues of interpretation
– Association is not the same as causation
– You cannot draw longitudinal conclusions from crosssectional studies
Association vs. Causation
• ‘A’ correlates with ‘B’ therefore ‘A’ causes B!!!!
– B could cause A
– C could cause A and B
• Causation requires longitudinal studies
– A comes before B
• Or Intervention studies
– Block A leads to no B
The Discussion:
WHAT it means
• Do NOT repeat Introduction
• General issues of interpretation
– Association is not the same as causation
– You cannot draw longitudinal conclusions from crosssectional studies
– Do not extrapolate wildly
– Are the data important clinically or mechanistically?
Structured Discussion
• Statement of Principle Findings
• Strengths and weaknesses of the study
– There are always some problems!
• Strengths and weaknesses with respect to
other studies
– Discrepant results?
• Meaning of the study
• Unanswered questions and future research
Special Circumstances:
Case reports
• We all love to talk about cases
• Editors hate to publish them
– They are not cited
• Must be a take-home message: SO WHAT!
– This is a report of the 17th HPS type 7 in the
literature
– This is a report of the 1st HPS type 7 in Lithuania
– This is the first report of an association between
Type 7 HPS and Brain-lung-thyroid syndrome
Special Circumstances:
Genetics
• Pitfalls to avoid if possible
– SNPs with no biological readout
– Mere association with no biological
plausibility or validation elsewhere, e.g.
animal studies
– No validation population
– Validation population replicates different
SNPs in the same gene
Make life easy for everyone
• Say you are grateful, even if you are not
• Thank them for the helpful comments (even if
you think they were idiotss)
– Do NOT do a “Jaffe”!
• Answer point by point
– Say what you have done
– Say what you have inserted
– Say where you have inserted it
Summary: Vic’s Top 10 Tips
• You did not read the instructions
• There is a major COI
• The manuscript was not checked for typos
• This is the 19th case of X
• No changes after submission elsewhere
Summary: Vic’s Top 10 Tips
• There is no hypothesis anywhere to be found
• Plagiarism including self-plagiarism, key
references omitted or misquoted
• No power calculation; crap statistics
• Rambling, unfocussed, authors from IFES
• BORING!
Further Reading
• Chernick V. How to get your paper rejected. Pediatr
Pulmonol 2008; 43: 220-3
• Stratton IM, Neil A. How to ensure your paper is
rejected by the statistical reviewer. Diabetic
Medicine 2004; 22: 371-3
• Sterk PJ, Rabe KF. The joy of writing a paper.
Breathe 2008; 4: 225-32
• Hoppin FG. How I review an original scientific article.
Am J Respir Crit Care Med 2002; 166: 1019-23