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Therapeutic decision making and the multidisciplinary team As the management of cancer becomes more complex, it becomes impossible for an individual clinician to have the competence that is necessary to manage all patients presenting with a particular type of...

Therapeutic decision making and the multidisciplinary team As the management of cancer becomes more complex, it becomes impossible for an individual clinician to have the competence that is necessary to manage all patients presenting with a particular type of...

WHAT IS CANCER? History The word ‘cancer’ is credited to Hippocrates (460 /uni00A0 /b.sc/c.sc/e.sc –370 /uni00A0/b.sc/c.sc/e.sc ), who is widely agreed to be the father of medicine, and comes from the Greek word for a crab, referring to the finger-like project...

ANAL YSING A SCIENTIFIC ARTICLE The simplest way to analyse an article from a scientific journal is to look at the checklist of requirements for good scientific research. A group of scientists and editors developed the Consolidated Standards of Reporting Tria...

AUDIT AND SERVICE EVALUATION Clinical audit is a process used by clinicians who seek to improve patient care. The process involves comparing aspects of care (structure, process and outcome) against explicit criteria and defined standards. Keeping track of pers...

AUDIT OR RESEARCH? Health professionals are expected to undertake audit and service evaluation as part of quality assurance. These usually involve minimal additional risk, burden or intrusion for partici pants. It is important to determine at an early stage w...

Computer software packages available Statistical computer packages o ff er a quick way of analysing descriptive statistics such as mean, median and range, as well as the most commonly used statistical tests such as the chi-squared test. Various packages are av...

EVIDENCE-BASED SURGERY Surgical practice has been considered an art: ask 50 surgeons how to manage a patient and you will probably get 50 di ff erent answers. There is so much clinical information available that no surgeon can know it all. Evidence-based surger...

Eliminating bias It is important to imagine how a study could be invalidated by thinking of things that could go wrong. One way to eliminate any bias inherent in the data collection is to have observers or recorders who do not know which treatment has been us...

Ethics In the first instance, common sense is the best guide to whether or not a study is ethical. It is still important to seek advice from an independent research ethics committee whenever research is contemplated. In the UK the requirement is that an NHS Res...

FORMING A TEAM One of the most common reasons for the failure of an other wise good research project is failure to involve others. Only the smallest single-centre project can be delivered by an individual researcher working alone; almost any project worth do...

FURTHER READING Altman DG, Machin D, Bryant TN, Gardner MJ. Statistics with confi - dence , 2nd edn. London: BMJ Publishing Group, 2002. Dindo D, Demartines N, Clavien P-A. Classification of surgical com - plications: a new proposal with evaluation of a coho...

I SE R essure dressing for R eduction I n S urgical E mergency laparotomy 840 patients Inclusion criteria: • Adults undergoing emergency laparotomy laparotomy Exclusion criteria: • Abdominal surgery within the preceeding 3 months • Age <16 years • Dressing ...

IDENTIFYING A RESEARCH TOPIC Research is designed to generate new knowledge and might involve testing a new treatment or regimen. Once an idea has been formed, or a question asked, it needs to be transformed into a hypothesis. It is helpful to approach surgeon...

INTRODUCTION Surgeons are innovators and a key aspect of a surgical career is to constantly adapt, tweak and improve surgical techniques and treatments to provide the best outcomes for those under our care. In addition, few others in the hospital use more tech...

Learning objectives To understand: The planning and conduct of surgical audit and • research How to write up a project • Learning objectives To understand: The planning and conduct of surgical audit and • research How to write up a project • Learning objective...

ONLINE RESOURCES AcoRD: https://www .gov .uk/government/publications/guidance-on - - attributing-the-costs-of-health-and-social-care-research CLAHRC: https://clahrcprojects.co.uk/about Clinical Evidence: www .clinicalevidence.com Cochrane Library: www .cochran...

PRESENTING AND PUBLISHING AN ARTICLE There is no point in conducting a research or audit project and then leaving the results unreported. Even when results are negative, they are worth distributing; no project if properly conducted is worthless. Under-reporti...