MARCO ISLAND, FL-The key to writing an acceptable thesis-one of the requirements for membership in the Triological Society-is to remember PICO:
Explore This IssueApril 2007
Population, patient, or problem;
Control or comparison; and
Maureen Hannley, PhD, a consultant in research for the Triological Society, said that by using the PICO lesson a candidate for membership in the society could create a viable, doable thesis question.
For example, she said, a possibly PICO-based thesis question might look like: In [age] patients (P) with recurrent acute sinusitis by accepted criteria, does endoscopic sinus surgery (I) compared to medical treatment (C) improve symptoms and disease-specific quality of life (O)?
Dr. Hannley delivered an hour-long primer on how to prepare and write the critical thesis during the first combined meeting of the four Triological Society sections.
Once the researcher has conducted his or her research, collected the data, and is ready to write, Dr. Hannley said, The most important rules for writing a thesis are: Read the guidelines for thesis format and submission; read them again; and follow them to the letter.
Developing the Idea
She said that a crucial area of the thesis development is coming up with an idea that needs an answer. Read the most authoritative sources until you come to a point where the sources disagree. This is where unsolved questions may reside, she said.
Other ways to develop a thesis-quality idea, Dr. Hannley said, include:
- Talking with the leading figures in the area, attending their lectures, and being alert to problems they identify.
- Seeking out and reading strategic research plans of medical and research organization.
- Contemplating your own experience. What are the problems or questions that frustrate you? Have you found a solution you think will benefit your peers and patients?
Dr. Hannley said the thesis project should be something that the writer has a personal interest in exploring or something that he or she may be expert in doing. She said that question of interest should be refined and narrowed to a plausible topic about what the writer wants to know, and have a rationale for wanting to do the project-i.e., why is it important to know this?
She said that in selecting a topic for a thesis, the researcher should make sure the topic is relevant, that it avoids duplicating other work, that it is feasible to perform, that it is ethically acceptable, that the possible results and recommendations will be generally applicable, and that the data have some urgency.
Dr. Hannley said that once the project is determined, then the researcher needs to define the population to be studied, define the period of time for the study, and select the variables to be measured.
She said that writing the hypothesis for the study is another basic part of the process. I particularly believe you should use the null hypothesis: For example, ‘There is no difference in symptom resolution or disease-specific quality of life in children with recurrent acute sinusitis treated with endoscopic sinus surgery and those treated medically.’
Another form of hypothesis is the alternative hypothesis, such as Children with recurrent acute sinusitis treated with endoscopic sinus surgery will have significantly better symptom resolution and better disease-specific quality of life than those treated medically.
Dr. Hannley said she favors the null hypothesis because it tends to avoid bias. In the null hypothesis, the researcher is stating that he or she is looking at the two treatments as being equal, not that the researcher expects to find that one treatment is better than the other.
State your hypothesis in a clear, concise sentence, she said. It should be simple specific, and stated in advance.
She cautioned researchers to be careful in determining what will be measured in the study. Be parsimonious: If it won’t add to your answer, don’t do it. Each additional variable complicates your statistics and increases your sample size requirement, she said.
Among the variables to consider in the study are the ages of the participants, the involved site, the disease outcome, the tissue type, and whether the variables scrutinized are dependent, independent, confounding, or are background information.
She also suggested that before embarking on the project, researchers should consult a statistician to help design the type of statistical treatment and the required sample size estimations.
Dr. Hannley said that is also essential that the researcher discuss and involve a sponsor or mentor in the planning of the study and perform a careful, comprehensive literature review.
The researcher also has to determine the study strategy, Dr. Hannley said. That means choosing between a basic science and a clinical investigation, between a prospective or retrospective study, the duration of the study, and other factors.
When a researcher selects a the sample, he or she needs to describe the characteristics of the subjects who will be eligible for participation in the study and also describe the population outside the sample selected to which the researcher wishes to generalize the conclusions.
Dr. Hannley said that biases can sneak into a study to confound its findings from any number of directions, and the researcher is required to control or eliminate those biases. For example, she said, studies can be biased by the effects of historical events, by the effects of gender or ethnicity, and by the effects of repeated measurements-especially in determining quality of life or psychosocial impacts.
She also said the study could allow bias to slip into the study in the selection of patients or through loss of subjects during the course of the study. Researchers also must be vigilant against the possibility of investigator bias, Dr. Hannley said.
To enhance credibility, she said, the scientist needs to make sure there are appropriate controls, appropriate definitions of operations, appropriate design and analysis, and a balanced perspective.
Cite the work of others, but if there are two camps, make sure that you cite both sides, Dr. Hannley told the audience of about 300 members and would-be members of the society.
Managing the Data
Once the preliminaries are over, Dr. Hannley said, the next task is to manage the data. The researcher must collect the data, maintain quality control, enter the data to a database, store the data, and analyze them.
When writing the thesis, she said, the keys are accuracy, brevity, and clarity. Cover different aspects of the problem and contributing factors in coherent way and logical sequence, she said. Use specific action-oriented verbs such as ‘to verify,’ ‘to compare,’ ‘to establish,’ that correspond with goals and methodology. Objectives should be demonstrably achievable through selected methodology and subjects. State assumptions underlying your project.
Dr. Hannley said it is helpful to dress up the thesis with illustrations, pictures, and charts, especially a flowchart to illustrate how patients were selected and fit into each part of the results of the study.
Dr. Hannley also discussed scientific integrity. She emphasized that researchers need to avoid scientific dishonesty, including:
- Fabrication of data;
- Selective, undisclosed rejection of undesired results;
- Erroneous use of statistical methods to achieve desired outcome;
- Distorted interpretation of results or conclusions;
- Plagiarism of results or writings of other authors;
- Distorted representation of other researchers’ results;
- Wrongful or inappropriate attribution of authorship; and/or
- Omission of recognition of original observations made by other scientists.
Jacquelynne Corey, MD, Associate Professor of Otolaryngology-Head and Neck Surgery at the University of Chicago, stated, In order to qualify for membership in the Triological Society, a doctor has to complete a thesis, a research project that is accepted by the society. This session provided the ground rules and hints on how to accomplish that.
©2007 The Triological Society