Transcript pharmacotherapy for parkinson`s disease

Publication Scholarship:
The Manuscript Reviewer &
Teaching Journal Club
Henry Cohen, BS, MS, PharmD, FCCM, BCPP, CGP
Professor of Pharmacy Practice
Arnold & Marie Schwartz College of Pharmacy and Health Sciences
of Long Island University
and
Chief Pharmacotherapy Officer
Director of Pharmacy Residency Programs (PGY-1 & PGY-2)
Departments of Pharmacy and Medicine
Kingsbrook Jewish Medical Center
Brooklyn, New York
Scholarship Defined
The creation, discovery, advancement, or
transformation of knowledge
 Composed in a manner that is subject to peer review
and effective communication
 Assessed for quality by peer review and made public
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 If an activity cannot be evaluated using
universally recognized criteria, it will not be
universally valued
Standards to Assess Scholarship
 Clear goals
 Adequate preparation
 Appropriate methods
 Significant Results
 Effective presentation
 Reflective critique
Relevance of Publication
Scholarship
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Pharmacy
Requirement of a healthcare profession
Advance and improve patient care
Societal contribution
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Clinical Pharmacists
Establish & improve relationships with medical and nursing
staff
Funding opportunities for department and hospital
– Fellowships, new equipment, stipends
Enhance job satisfaction
Relevance of Publication
Scholarship
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Academicians
Requirement for reappointment, promotion and tenure
– Tenure track faculty
– Nontenure track faculty
– Research positions
Collaborative opportunities with other pharmacy disciplines
Research and practice opportunities at university-based
medical centers
Teaching Opportunities
– Undergraduate and graduate
Advantages of Serving as a Peer
Reviewer for a Journal
 Ensure robust, fair, non-bias, safe contributions
to the literature
 Critique can enhance the manuscript and
increase relevance
 Controversial publications
 Review cutting edge research
 Apply data to practice
 Provide ideas for research endeavors
Advantages of Serving as a Peer
Reviewer for a Journal
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Scholarly activity
Job requirement for reappointment promotion
Professional notoriety
Professional satisfaction
Provides new opportunities
Journal Editorial Board Member
Journal Editor
Publishing
Educational
What credentials do I need to be a
Peer Reviewer?
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Training in area of expertise
PharmD or advanced degree
General Residency and Specialty Residency
Practice in area of expertise
Experience in area of expertise
3 – 5 Years minimum
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Research in area of expertise
Fellowship
Board Certified
What credentials do I need to be a
Peer Reviewer?
Publish manuscripts
 Publish in peer reviewed journals
 Chapters in text books
 Web Chapters
 Lecture in area of expertise
 Invited presentations
 Board certification review courses
 Notoriety in area of expertise
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How can I be appointed to become a
Peer Reviewer?
Choose an area that you are competent
 Respond to peer review in a timely fashion
 Do not be an offensive Abstract reviewer
 Answer Journal “call” for peer reviewers
 Ask the Journal Editor
 Ask Journal Editorial Board Members for
recommendations
 After publishing an article – ask if opportunities exist
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How to Critically Evaluate Published Drug
Therapy & Drug-Induced Case Reports
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Introduction – relevance and brief literature review
Establish a temporal and causal relationship
Detect confounding variables
Medications, OTCs, CAM, recreational drugs
Doses of concomitant medications
Medication compliance measurements
Drug serum levels and laboratory data
Drug and food interactions
Nutrition status and compliance
Comorbid diseases
How to Critically Evaluate Published Drug
Therapy & Drug-Induced Case Reports
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Was a comprehensive literature review provided?
Focus on similarities and differences to the case report
Was a summary table with salient data provided?
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Was the case validated with established criteria
Naranjo’s Algorithm
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Conclusion
Is the conclusion valid based on the case report?
How can I apply the data from the report to my practice?
Provide a prospectus to answer unanswered questions
How to Critically Evaluate Published
Drug-Related Clinical Trials
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Hypothesis
Objectives
How many and are they attainable?
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Methodology
Sample size – was a power analysis completed?
Blinding
Length of study
Exclusion criteria
Medication source – generic or brand
Confounding variables (similar as with case reports)
Compliance statistics
How to Critically Evaluate Published
Drug-Related Clinical Trials
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Results & Discussion
Do the results answer the objectives
Did the author’s compare and contrast the results with similar
trials, and provide explanations for the differences
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Conclusion
Is the conclusion is based on study objectives and results?
How can I apply the trial conclusions to my practice?
Provide a prospectus to answer unanswered questions
Reviewing Submitted Manuscripts as a
Referee Vs Reviewing Published Articles
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Minor flaws are acceptable
Major flaws
Fatal
Recoverable
Acceptable
Uncontrollable
Are the conclusions accurate?
 Do the conclusions have any value in advancing
present practice?
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Correcting Diction, Grammar, and
Spelling
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Diction
Choice of words; clear, correct and effective
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Grammar
Syntax
Spelling
 Reject based on poor diction, grammar, or spelling
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Choppy, lengthy, redundant, awkward sentencing
Do not correct use of english
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Request medical writer to edit and rewrite
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List the different Forest Classes for GI Bleeding
List the troponin and CPK levels that were noted in patients
who did develop an acute coronary syndrome
In the clinical course section, sentence 1, shorter duration of
symptoms refers to MI or GI symptoms – please clarify?
What medications were used to treat patients with GI bleed?
Did patients receive medications prior to endoscopy?
When providing mortality data – provide the number in addition
to the percentage.
What strength of epinephrine was used for endoscopic
injection hemostasis?
The tables are not referenced in the text.
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Define in every table in the key section, pre- and post- PES
MI.
Make some preventative recommendations – should beta
blockers be considered at patients with CAD risk?
Conclusions regarding the duration of endoscopic examination
may be premature, the differences are small – please clarify.
The author concludes that the method of hemostasis did not
differ between patients who had an MI and those who did not there are too few patients in all groups to make this
conclusion.
Methods for Submitting Review
 Web-based programs
Electronic copy submitted via mail, E-mail or fax
Generally cannot write comments on the manuscript
 Not-blinded to editor
 Blinded to author
 Comments to editor and author
 Comments to editor that are not viewable by
author
Reviewer’s Guidelines
Ensure ethical and humane study
 Ensure Institutional Review Board Approval
 Ensure HIPPA rules are followed
 Appropriate use of references
 Ensure that assays & scoring systems are validated
 Recommend review for statistical analysis
 Recommend “Editorial Reply” by an expert
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Recommend experts to the editor
Reviewer’s Guidelines
 Critically review the manuscript
Focus on scientific merit and value
 Provide constructive criticism
Aim is to improve the quality
Do not be destructive
 Judge each manuscript on its own merits
Avoid personal comments and opinions
Reviewer’s Guidelines
The Final Decision
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Accept a manuscript
Perfect manuscript
Requires no changes
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Cannot accept but will reconsider if revisions are made
Provide comments on scientific method
Provide recommendations for substantive changes
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Reject
Provide a paragraph describing the merits of your decision
Reviewer’s Guidelines
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Choose only areas of expertise
May ask a colleague to review
Teaching tool for residents and new practitioners
Inform editor that this is not your area of expertise
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Editors request 2 – 6 week deadlines
Inform editor immediately when you cannot meet a deadline
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Review 2 – 6 manuscripts annually
Estimated 20 – 50 hours per year
Allow for busy-time, Vacations
Recommend an alternative reviewer
How to choose expert subjects
for review
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List of Subjects
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Disease specific
Organ specific
Subject specific
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Pulmonary Edema
Pulmonary Emboli
Pulmonary Function
Tests
CNS
Head Injury
Cerebral Function
Stroke
Parkinson’s Disease
Pulmonary
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Hepatic
Hepatic Failure
Hepatic Drug Metabolism
Hepatic Function Tests
How does drug literature evaluation enhance
the skills necessary to publish case reports
and clinical trials?
 Developing excellent drug literature evaluation
skills spawns similar applicability and strategy to
preparing case reports, and designing research
protocols
Case reports are an excellent start for beginners
Comprehensive evaluation of clinical trials is an
advanced skill, and integral to success
Repetition and experience is important to master this
skill
Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and
Pharmacists
 Journal Club Presentations
Provide goals and objectives for evaluations and
grading
Present using slides, and a handout
Teach a primer on basic presentation skills
Encourage active participation from the audience
Require the audience to read the article
Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and
Pharmacists
 Design an outline for the presentation
Faculty should review the outline BEFORE the
student proceeds with the preparation of the
presentation
 Establish time limitations based on the outline
Case reports 20 minutes + 20 minutes of Q&A
Research Trials 30 – 40 minutes + 30 minutes of
Q&A
1 or 2 presentations every 4 – 8 weeks of clerkship
Journal Club Evaluation Criteria:
Review of Article
 Accurately and concisely summarizes the
introduction, study hypothesis, methodology,
major points of results and discussion (if
applicable) of the article.
 Accurately presents the conclusion of the study.
 Elaborates on any minor or major attributes or
deficiencies of the study. If none are present,
the presenter states such.
Journal Club Evaluation Criteria:
Ability to Answer Questions
 Answers questions in a logical fashion.
 Accurately answers and corresponds with the
expected competency of the presenter.
 Thinks creatively and analytically. May theorize,
if not sure of an answer, but identifies answer as
such.
Journal Club Evaluation Criteria:
Presentation Skills
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Visual aids are appropriate
handouts and slides
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Room setup
Establishes eye contact
Pronunciations are correct
Speaks with enthusiasm
Correct use of vocabulary
Not verbose or redundant
Appropriate use of pointer
Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and
Pharmacists
 Review and master the subject and background
 Read the article at least twice
 Provide a background to the subject matter
 Provide a checklist of plausible bias and
confounding variables
 Verify the authors statistics or references
 Provide data from other case reports or trials
beyond the data from the article
Journal Club Evaluation Criteria:
Evaluation with faculty
 Ask presenter to perform self evaluation first
Areas of strengths and weakness
What strategy will they employ to improve their
weaknesses?
Consider a standard grading system
 Provide constructive criticism, and methods for
improvement
Conclusions
The definition of a profession includes publication
scholarship in peer reviewed journals
 Publication scholarship validates the role of the
pharmacist and medication management
 Peer reviewers should have expertise
 Establishing concise goals and objectives are
necessary to teach drug literature evaluation
 Mastering drug literature evaluation skills is necessary
to develop publication skills
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Questions
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