Clinical Research Oriented Workshop (CROW) Meeting: April 13, 2023

 

Present:   Peter Callas, Emily Houston, Jennifer Oshita, Liliane Savard, Connie van Eeghen (5)

 1.                   Warm Up: PhD degrees… always taking longer than expected, sort of like finalizing manuscripts with many co-authors!

2.                   Jen’s methods and survival analysis: Jen will explain the project and methods, then ask for feedback on the covariates used to build her model, on a secondary analysis, and how best to present the results

a.       NHATS: National health trends survey of older adults set up as a cohort study from 2011, still ongoing

                                                   i.      This study has nine years of data: 2011-2020

                                                 ii.      What is the hazard of dying of someone with communication disabilities (CD) vs someone without?

                                               iii.      Including only community dwelling older adults: those living independently with no assistive services imbedded in an institutional setting

                                               iv.      Excluding persons who do not speak English or have a cognitive impairment (dx of dementia)

1.       Used an orientation question to assess impairment, plus word recall exercises

                                                 v.      5K+ beneficiaries

1.       No CD (about 3K)

2.       Any CD: could have single subtype of CD

a.       Hearing only (self-reported)

b.       Expressive only (self-reported)

c.       Cognitive only

d.       Multiple of above CDs

b.       Analysis

                                                   i.      If you have a CD at baseline, what is your HR over a nine year period, adjusting for covariates that might change over time (excluding gender, race, ethnicity), such as self rating of health, comorbidities, other disabilities (number of ADLs), mobility disabilities,…

1.       Not BMI or other biometric measures

2.       Not employment status (all are 65+ years of age) – Jen will recheck this for an association

3.       Not falls – Jen will recheck this too; check with Nancy Gell

4.       Consider lag time of covariates over the 9 years for a future study (not this time)

                                                 ii.      Secondary analysis

1.       Planning to break down CDs by subtypes, but Expressive group is relatively small compared to Hearing and Cognitive groups; the outcomes vary among groups

a.       Good to help assess which subtypes might be drivers of the outcomes

b.       Sample sizes are not too small

                                               iii.      Assumptions: because Jen is using time as a covariate, and death removes data for that and subsequent years, Jen had to impute missing data to prevent Stata from removing those records

1.       Checked against the UCSD check list of assumptions

2.       Reviewed Kaplan Meier plots for logical outcomes

3.       Goodness of fit analysis (Nelson-Aalen cumulative hazard compared to Cox-Snell residual): Jen will find out more about how to interpret these results

4.       How does sudden death affect the outcome?  Likely shows up similarly in both groups, so not a confounder.

5.       Include the number (median months?) with the presentation of the graph, along with IQR

6.       Table 2: represents the final model at a high level (none, any CDs) – looks good

c.       Next steps after following up on additional mediators and more investigation on interpretation

                                                   i.      Check on falls and employment

                                                 ii.      Follow up with Peter on Cox-Snell interpretation

                                               iii.      Finish writing up

3.                   Next week:  TBD

 Recorded by: CvE

Publication Shout Out for Jen Oshita, Nancy Gell, and Charlie MacLean!

Congrats to Jen, Nancy, Charlie, and others on the publication of "Prevalence and sociodemographic characteristics of US community-dwelling older adults with communication disabilities, using the national health and aging trends survey" in the March/April edition of the Journal of Communication Disorders, found at:

https://www.sciencedirect.com/science/article/pii/S0021992423000163?dgcid=author

Kudos to all!

First time (and only) time ChatGPT listed as first (and only) author in Annals of FM

Annals of Family Medicine published a one page article on "Why ChatGPT Should Not Be Used to Write Academic Scientific Manuscripts for Publication," written by ChatGPT-4.  You can find it at:

https://www.annfammed.org/content/annalsfm/early/2023/03/29/afm.2982.full.pdf  

The article ends with a disclaimer: This is the only time a chatbot will be allowed or cited as an author
in Annals of Family Medicine. See our Policy on Authorship.

Note: this was a special publication posted on April 1, 2023... just saying.

Clinical Research Oriented Workshop (CROW) Meeting: Mar 30 2023

 

Present:   Justine Dee, Nancy Gell, Emily Houston, Jennifer Oshita, Liliane Savard, Adam Sprouse Blum, Connie van Eeghen, Liz Winterbauer (8)

 1.                   Warm Up: Where’s the March “out like a lamb” by now?  Crocuses are on their way…

2.                   Justine's scoping review, focusing on Physical Therapy for survivors of torture (SOT), looking for feedback on the intro, methods and results

a.       Goal: PT Journal, but this is competitive.  Other journals are “torture” focused.

b.       Is “evidence-based” a binary condition or a scale of low to high?  If a scale, represent the evidence-based results that way.

                                                   i.      Consider a method of evaluating evidence: each study design has associated criteria

1.       Liliane: Evidence-Based Medicine How to Practice and Teach EBM Sackett, Strauss, Richardson…

                                                 ii.      A scoping review does not require assessment of evidence but is recommended

c.       Scoping reviews to not typically include outcomes, but this will help the field move

                                                   i.      Consider combining Tables 2 and 3

d.       Introduction

                                                   i.      Focuses on refugees; literature results are broader (SOT)

                                                 ii.      1^st para is great – really grabs attention

                                               iii.      2^nd para: separate what we know about torture vs PT

1.       Stronger bridge for last sentence: what is the gap in the literature being filled?

2.       Spell out SOT

                                               iv.      Differentiate more clearly: psychologically informed trauma vs trauma informed approach, which is also different from the bio-psycho-social model

                                                 v.      Remove unnecessary jargon: nociplastic, somatic…

e.       Methods

                                                   i.      Include med librarians and process included with them

1.       Reduce the terms to eligibility criteria; move the terms to an appendix

2.       Excluded SLR that referred to same papers being reviewed separately

                                                 ii.      Identify that protocol was pre-determined and not registered

                                               iii.      Analysis plan should match results reported, which can be organized around the article’s message

f.        Results

                                                   i.      Organize based on the message of the article, e.g. the use of evidence-based treatments

                                                 ii.      Table 2

1.       Organize by what the message is, e.g. strength of evidence, rather than alpha

2.       Consider power of study as well, which may be biased

3.                   Next week:  TBD

 Recorded by: CvE

FW: NHATS and NSOC Workshops

The National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) will host two hands-on virtual workshops this summer. The NHATS workshop will be held June 26 -28, 2023 and the NSOC workshop will be held July 31- August 2, 2023. Applications are due May 15, 2023. More details are available here.