This short commentary was published in the Journal of Evaluation in Clinical Practice and it was propelled by a discussion which took place on a private email list serve regarding the role EBM might play in the emerging fields of person centred medicine and precision medicine. Unfortunately, the article is behind a pay wall!
Price AI, Djulbegovic B, Biswas R, Chatterjee P. Evidence-based medicine meets person centred care: a collaborative perspective on the relationship. J Eval Clin Pract. 2015 Sep 10. doi: 10.1111/jep.12434. [Epub ahead of print] PubMed PMID: 26358758.
In a recent list-serve, the way forward for evidence-based medicine was discussed. The purpose of this paper was to share the reflections and multiple perspectives discussed in this peer-to-peer encounter and to invite the reader to think with a mind for positive change in the practice of health care. Let us begin with a simple question. What if we dared to look at evidence-based medicine (EBM) and informed shared decision making like two wheels on a bike? They both need to be full of substance, well connected, lubricated and working in balance, propelled and guided by a competent driver, with good vision to get the bike where we want it to go. We need all the tools in the toolkit for the bike to stay operational and to meet the needs of the driver. By the same rationale, evidence alone is necessary but not sufficient for decision making; values are necessary and if neglected, may default to feelings based on social pressures and peer influence. Medical decisions, even shared ones, lack focus without evidence and application. Just as a bike may need a tune up from time to time to maintain optimal performance, EBM may benefit from a tune up where we challenge ourselves to move away from general assumptions and traditions and instead think clearly about the issues we face and how to ask well-formed, specific questions to get the answers to meet the needs we face in health care.
© 2015 John Wiley & Sons, Ltd.
KEYWORDS: evidence-based medicine; person-centred medicine; philosophy of medicine
A review article contributed to the special series on “Research Methodology” in Astrocyte.
Study design forms a core component of research, mainly determined by the study objectives, and it in turn further decides the type of statistical analyses to be carried out. Observational studies are devoid of the investigator’s control over assignment of a subject to the treated or control group, in contrast to interventional studies Even though randomized controlled trials are seen as the best study design, evidence shows that properly conducted observational studies give similar results, and is relevant in medical research where ethics and feasibility concerns assume great significance. Observational studies point out towards possible causal associations, are less resource intensive than trials and have a better external validity. This review article discusses various types of observational study designs such as case reports, cross sectional, cohort, case-control and nested case-control studies with real literature examples.
Keywords: Case control, case series, cohort, ecologic, nested case control, observational study
This short article was published in RHiME (Research and Humanities in Medical Education), which is the flagship journal of the University College of Medical Sciences, New Delhi, and is run by the Medical Humanities Group and Medical Education Unit. I wrote this article in honour of William Shakespeare’s 450th birth anniversary in 2014.
Chatterjee P., Seth B.Melodies and maladies: reflections on Shakespeare and his portrayal of disease and death.RHiME [serial online] 2014[cited 2014 Jul 6];1:. Available here.
Shakespeare has long been acknowledged to be a pioneer in understanding the functions and dysfunctions of the human mind. However, very little discussion has centered on his knowledge of the physical science of medicine. In this article the authors reflect on Shakespeare’s portrayal of diseases and death in his work and conclude that he had significant knowledge of the contemporary medical sciences.
Keywords: Humanities, Literature, William Shakespeare
The reviewer was a keen student of the Bard’s work and wanted us to focus on his depiction of the various fluids and their impact on health or disease as portrayed in his work; and of course, the vagaries of the mental faculties of man, one of the most widely used dramatic elements.
Dr. Bhavna Seth, Lady Hardinge Medical College, New Delhi. Dr. Seth helped search the Bard’s work for medical references and in the drafting of the article as well.
An editorial on the need to have person-centered research agenda, published in the Annals of Neuroscience.
Price A, Chatterjee P, Biswas R. time for person centered research in neuroscience: users driving the change. Annals of Neuroscience. 2014 Apr;21(2):37-40. doi: 10.5214/ans.0972.7531.210201. PubMed PMID: 25206057; PubMed Central PMCID: PMC4117163.
There is an exciting opportunity to change the landscape of clinical trials and new interventions. Research can now be tailored to the needs of the public through the use of public led online trials (PLOTs) and participatory research interventions in the form of user driven healthcare. We explore some of the advantages and pitfalls of collaborative participant centered research. Collaboration is made possible through online communication, social media, and the desire of researchers, the public and clinicians to work collaboratively for the common good.
A review article which was specially written for the series on “RESEARCH METHODOLOGY: STATISTICS IN MEDICAL RESEARCH” in Astrocyte.
Khan AM, Kumar R, Chatterjee P. Understanding the basic statistical questions that disturb a medical researcher. Astrocyte 2014;1(1):62-6
Medical research does not deal with only medical sciences; it is also dependent on other disciplines, and statistics is an integral part in its conduct. It is challenging for a medical researcher to grasp the importance of statistics and also to decide the types of statistical issues in the various phases of his/her medical research. There are inherent variations within and between the human/animal subjects used in medical research and these uncertainties can only be grasped using statistical tools. Initiating a medical research while taking into account the statistical aspects right at the planning stage is one of the best ways to conduct better evidence-based research. The validity of the results of a medical research depends not only on the methodology of conducting the study but also on the analysis of data collected. As opposed to the general perception, statistics not only deals with analysis of data but is also intricately interwoven with the methodology section of the research where sample sizes, inclusion/exclusion criteria, and others are mentioned. Although statistical softwares simplify the computational aspect of statistics, the confusing conceptual aspects make interpretation of the outputs difficult and incorrect. Seemingly simple terms such as population, sample, parameters, and variables have been explained keeping the medical researchers’ perspective in mind. This first article in the series “Statistics in Medical Research” makes an attempt to facilitate the medical researcher to overcome the initial questions that challenge him/her with regard to statistics.
This article focusing on the History of Medicine was published in the Journal of Medical Biography.
Chatterjee P, Chandra S, Biswas T. Daniel Alcides Carrion (1857-1885) and a history of medical martyrdom. J Med Biogr. 2015 Nov;23(4):224-7. doi: 10.1177/0967772013479532. Epub 2014 Jan 27. PubMed PMID: 24585618.
Daniel Carrion, a sixth-year medical student, died while investigating the effects of self-inoculation of the causative organism of Oroya Fever and Bartonellosis and thereby contributed to understanding of the disease before the organisms had been identified.
Albero Barton; Autoexperimentation; Bartonella bacilliformis; Bartonellosis; Carman Peredes; Daniel Alcides Carrion; Dos de May Hospital; Dr Richard Strong; Lima; Oroya Fever; Verruga Peruana
This was a special article published as a “Student Contribution” in the journal Education for Health.
Thawani R, Kaur G, Chatterjee P, Biswas T. From the editors of a Student journal. Education for Health 2013;26:115-6.
Formal training in research is lacking most of the medical training programs of the world. Research can be of great help in producing more physician scientists. Students’ journals can encourage research amongst medical students. But student journals face a lot of problems. The editors are students who are busy with their curricula. Moreover, there is no compensation. Additionally, since, not many student journals are visible, students doing research try and submit to prestigious journals and when face rejection, get de-motivated. There is no single solution to all the problems faced by a student journal. However, it needs to be appreciated that they are a necessity, hence, they should be encouraged actively. Collaboration between the multiple stakeholders involved (funding agencies, institutions, experts on biomedical ethics, student researchers and their faculty mentors) is the need of the hour to further expand and empower the existing student journals and set up new ones.
Medical education, medical research, student journal