LMMHC Medicine Research rotation B Kanna MD MPH

LMMHC Medicine Research rotation B Kanna MD, MPH, FACP Associate Program Director of Internal Medicine Associate Director of Graduate Medical Education for Research

Part I Introduction Goals & Objectives Structure of rotation Required Elements Topics Required reading Research plan

Introduction • Research education is a requirement for all residents as per ACGME • Research project requirement at LMMHC • Research rotation – Educating residents in research – Provides a customized learning experience – Assists in “kick off “ of research ideas

Goals & Objectives • The goals of the curriculum in Evidence Based Medicine and Research elective is to ensure that All Internal Medicine residents are able to: • 1. Ascertain limitations in their critical appraisal of literature and means to address those deficiencies. • 2. Understand the limitations and advantages of original peer-reviewed medical literature. • 3. Discuss and understand sensitivity, specificity and predictive values of diagnostic tests, how they are used, and how tests are selected and interpreted; understand the impact of the underlying prevalence of disease on the predictive values (and the interpretation) of a diagnostic test. • 4. Understand the meaning of statistical significance and differentiate it from clinical significance. • 5. To know the ways to evaluate risk and prognosis, including the differences between observational study designs such as cross-sectional, case-control, and cohort studies. • 6. Understand the anatomy of the randomized control trial, its strengths and weaknesses; discuss the importance of power and the number-needed-to-treat in the interpretation of a treatment. • 7. Comprehend if a treatment actually works or not based on the medical literature; Adapted and modified for our residents from Ref: http: //www. medinfo. ufl. edu/year 2/ebm/compentencies. htm

Structure of rotation • • 2 week rotation Could be repeated based on assessment & needs Rotation supervisor Mentor No clinics Calls as per Schedule Holidays off ACGME competency based evaluation

Elements of the rotation • Critique of a study – Recent – Randomized trial – Area of interest • Research topics review – Research module test • Designing a study – Initiate and organize a study plan

Research Topics review 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. p-value Confidence Intervals Odds ratio & Relative risk Study designs Number needed to treat & Number needed to harm Sensitivity, specificity, PPV, NPV Measures of central tendency- mean, median, mode How to critique an article with randomized controlled trial Bias Confounding and how to analyze the effect of confounding in studies How to write a research protocol

Required reading • Available in a research rotation binder • Will be based on critique of literature

Resident research portfolio • • • Research portfolio meetings annually Research rotation elements to be completed Case reports QA/PI projects Publications Research presentations – LMMHC – Local/regional – National • Designing a study – – Protocol Time lines IRB approval Research assistant / volunteer support available