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Editorial: “So perhaps the best thing to do is to stop writing Introductions and get on with the book.”

“So perhaps the best thing to do is to stop writing Introductions and get on with the book.”

A wise man once wrote: “So perhaps the best thing to do is to stop writing Introductions and get on with the book.” Although there is no disagreeing with this statement, there are a few things to mention before kicking off the 3th edition of the Amsterdam Medical Student journal.

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Solving Statistics: Should I test for differences in baseline characteristics, for example in a randomised controlled study?

Should I test for differences in baseline characteristics, for example in a randomised controlled study?

Background

Researchers usually present the characteristics of the participants in each group at the start of a study in a table. This table is often the first table in a paper and, hence, called Table 1.  This table gives the reader an overview of the study participants and examines whether the participants are similar to patients he or she encounters. The reader can also use the information in the table to judge whether the participants in the two groups were comparable. Sometimes the two groups differ with respect to relevant demographic and clinical characteristics. Then it is important to correct for these differences in further analyses and take them into account when interpreting the results of the study.

Question

I am analyzing data from a small randomized controlled clinical trial with two arms. Should I test whether there are differences in baseline characteristics between the two groups and present the p-values in Table 1 of my manuscript? What do the results of these tests mean for further analysis that I carry out?

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Radiology Image: A 42-year-old male

A 42-year-old male

[headline_subtitle title=”” subtitle=”Can you solve the radiology image of this edition?”]
Patient data
  • Age: 42
  • Gender: Male
  • Medical history: Recurrent upper gastrointestinal bleeding (six times). No current medication.
  • Intoxications: 7-8 EH alcohol per day.
  • Initial presentation: Acute pain upper abdomen.
  • Examination: Pressure pain upper abdomen, active muscular resistance.
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Interview: drs. F. Oldenburger

drs. F. Oldenburger

At that time the head of the Department of Radiation Oncology & Nuclear Medicine was Prof. dr. Ismail Kazem. He was of Egyptian descent and had received his medical training in the UK and Germany. He was quite a character, best illustrated by the fact that apart from being an excellent physician, he was also a poet. As a teacher he believed in throwing his trainees in at the deep end, which was challenging at times, but also resulted in rapid acquisition of knowledge in a very short time. He considered his trainees ompetent physicians from day one and considered every treatment plan you came up with carefully before making some suggestions for improvement. During my training he left and was succeeded by Prof. dr. W.A.J. van Daal. I finished my training in 1986. During my training I was also involved in pediatric radiotherapy.

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Trial and Error: Attitude leads to gratitude

Attitude leads to gratitude

The term „trial and error” might make one think of failed experiments. However in this article I would like to point out that one of the biggest mistakes in research is not blowing up the laboratory but having the wrong attitude.

After becoming a Medical Doctor, a PhD seems an excellent opportunity to increase your knowledge, skills and career opportunities. With this in mind I enrolled in such a program, concerning both the Internal Medicine and the Pathology department. During my first year it became clear that the bulk of the work was going to be laboratory work, very much pathology orientated. For a person who loves the clinical practice and whom has his heart set on becoming an Internal Medicine specialist, this meant I had to adapt. Nonetheless, I presented myself as extremely confident regarding my abilities, supposedly obtained whilst working in the clinic as an intern. I was trained as a doctor ergo, how difficult could laboratory work possibly be…

Funnily enough, this overconfident attitude towards colleagues and my blatant disregard for standard operating procedures, nine to five mentality or cleaning duty in the laboratory, did not prevent my lab-mates from being kind and helpful. However this attitude did have a negative influence on my state of mind and therefore on the quality and progress of my research.

In retrospect, insecurity was the basis of my overconfident attitude, as it often is. The moment I recognized and acknowledged my insecurities, was a moment of personal growth. I became more susceptible to advise and therefore was able to learn a great deal more. Furthermore, I learned not to compare myself to the well-trained laboratory technicians and biomedical scientists. We all have a role to play in the lab. They have experience and skills, while doctors can be a link between the laboratory and clinic. And lastly, I learned that it’s OK to be vulnerable and to show your insecurities.

Halfway  through my 4-years of PhD-training, I am becoming more and more comfortable in the lab. When looking ahead to my return to the clinic, I feel that this “switch-back” will form a test as well. Hopefully I have learned to present myself, even when I feel insecure, and how to set achievable goals in order not to make the same mistakes again. My (t)error  illustrates the challenge of choosing the right attitude for recently graduated doctors whom enroll in laboratory orientated PhD programs. For this much needed attitude adjustment I am grateful.

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