Happy Labor Day, everyone! Follow the most excellent advice found in this NY Times Op-Ed piece by Clive Thompson and take some time for yourself!
Archive | August, 2014
Repeat After Me
22 Aug
Reproducibility is the ability of an entire experiment or study to be reproduced, either by the researcher or by someone else working independently. It is one of the main principles of the scientific method and relies on ceteris paribus. Wikipedia
I was going to start this post with a similar statement in my own words, but couldn’t resist the chance to quote Latin. It always makes you sound so smart. But regardless of whether these are a Wikipedia author’s words or my own, the point is the same – one of the foundations of good science is the ability to reproduce the results.
My work for the neuroimaging project involves developing a process for researchers in this field to cite their data in such a way that makes their work more easily reproducible. The current practice of citing data sets alone doesn’t always make reproducibility possible. A researcher might take different images from a number of different data sets to create an entirely new data set, in which case citing the previous sets in whole doesn’t tell exactly which images are being used. Thus, this gap can make the final research harder to replicate, as well as more difficult to review. We think that we may have a way to help fix this problem and that’s what I’ve been working on for the past few months.
At the same time, I’ve been working on a systematic review with the members of the mammography study team. This work has me locating and reading and discussing a whole slew of articles about the use of telephone call reminders to increase the rate of women receiving a mammogram within current clinical guidelines. It also has me wondering about the nature of clinical research and the concept of reproducible science, for in all of my work, I’ve yet to come across any two studies that are exactly alike. In other words, it doesn’t seem to be common practice for anyone to repeat anyone else’s study. And I can’t help but wonder why this is so.
I imagine it has something to do with funding. Will a funding agency award money to a proposal that seeks to repeat something; something unoriginal? Surely they are more apt to look to fund new ideas.
Maybe it has to do with scientific publishing. Like funding agencies, publishers probably much prefer to publish new ideas and new findings. Who wants to read an article that says the same thing as one they read last year?
Of course, it may also be that researchers look to improve on previous studies, rather than simply repeat them. This is what I see in all of the papers I’ve found for this particular systematic review. The methods are tweaked from study to study; the populations differ just a bit, the length of time varies, etc. It makes sense. The goal of this body of research is to determine what intervention works the best and in changing things slightly, you might just find the answer. What has me baffled about this process, though, is that as we continue to tweak this aspect or that aspect of a study’s methodology, when and/or how do we ever discover what aspect actually works and then put it into practice?
Working on this particular review, I’ve collected easily 50+ relevant articles, yet as we pull them together – consolidate them to discover any conclusions – the task seems, at times, impossible. Too often, despite the relevancy of the articles to the question asked, what you really end up comparing is apples to oranges. How does this get to the heart of scientific discovery? How does it influence or generate “best practice”? I can’t help but wonder.
Yesterday, during my library’s monthly journal club, we discussed an article that had been recommended reading to me by one of the principal investigators on the mammography study. How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care, is the latest User’s Guide on the subject from the Journal of the American Medical Association (JAMA). It prompted a lively session about everything from how research is done, to how medical students are taught to read the literature, to how the media portrays medical news. I recommend it.
Of course, there are many explanations to my question and many factors at play. My wondering and our journal club discussion doesn’t afford any concrete solution and/or answer, still I feel it’s a worthwhile topic for medical librarians to think about. If you have any thoughts, please keep the discussion going in the comments section below.
Hello Darkness, My Old Friend
12 Aug[This is not an ordinary post for this blog, but this is not an ordinary day.]
Photo by Charles Haynes, FLICKR, Creative Commons
Robin Williams
July 21, 1951 – August 11, 2014
His death is a shock. The tributes from the many people who knew and/or loved him continue to spread across every form of media. People are sad. I am sad. Robin Williams’ death is sad. But it is the thoughts and images of his suffering, the unfathomable depth of pain, and the cruelty of depression, that leaves me heartbroken. Many people more qualified than I can and will speak to the disease that took his life. Many people will share of the importance of reaching out and finding help when depression hits and/or life becomes too much to bear. Asking for help is hard, though, and harder still when one is dealing with a disease that takes rational thought away.
Maybe one small thing that can ease that barrier is knowing someone who knows what you’re going through. If you sense that there’s at least one other soul who experiences what you experience, maybe that person is a lifeline to another day. Maybe. And maybe this is why I’ve noticed a number of people sharing their experiences over the past 24 hours. Rob Delaney, Kathleen Edwards, Harvey Fierstein… these are just a few celebrities that I follow who I’ve seen post thoughts; telling readers or fans, in a way, that they are not alone.
I’m not a celebrity by any stretch of my imagination, but there is something about Williams’ death and the public reaction that makes me want to share a story, too. My story. For me, clinical depression is a palpable black cloud that hovers over my shoulder. It is a dark basement. A place of unhealthy solitude; of isolation. It is both terrifying and seductive and that, for me, is the crux of the cruelty that this disease can be. Sometimes, it can be exhausting to ward it off. Scarier still, is how it first appeared (from Ordinary Year, Chapter 1):
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So in the summer of 2009, I was in a healthy, well-established, loving relationship. I lived in a nice apartment, had nice neighbors, a dog and a cat, and interests both in and outside of work. I’d been sober for years. I dabbled in writing. I learned to play the mandolin. I reconciled with my brother, a relationship that had been damaged for a decade. I finally got to know my nieces and nephew, and the chance to start being an aunt to them. They wanted both Lynn and me to be in their lives. Things with my dad were so-so. We didn’t see each other very often, but I don’t see any of my family very often. Still, we were all okay. Everything was okay.
But every day, from late May through September, I cried. At some point, every day, I found it impossible to stop the tears from falling. I’d turn to the wall in my cubicle to hide my face, grabbing tissues and hoping no one noticed. I’d be in my car, driving to or from work, and start sobbing. I started to wonder if I was going a bit mad.
I knew that I was lonely for some of my old friends and so I decided to make a trip to Louisville to reconnect with some of them. I ordered my plane tickets and started to think about sitting at a patio table outside of a coffee shop, talking for hours with one of my closest confidantes, Dina. I thought about catching up with my good friend Kevin. I thought of taking Dina’s kids trick or treating. I looked forward to some time on my own, some time for myself. It would be a good, well-needed and well-deserved long weekend.
A few weeks before my planned trip, I was walking from the parking lot to the library, to work, when the thought crossed my mind that it might not be a bad thing if the plane I took from Providence to Louisville crashed. I had no plans to make it crash and I didn’t exactly wish for it to crash, but the thought of it crashing gave me such a feeling of relief. It would finally be over.
It scared the hell out of me.
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Thanks to medication and a few years of therapy, I’ve learned how to live with the darkness. I’ve learned how to recognize it. I’ve learned how to ask for help before that voice gets silenced. It’s heartbreaking when that voice dies. And it’s heartbreaking, the lives it takes with it.
To echo the message of so many others in health care, if you feel you’re struggling with depression, seek medical care. If you’re experiencing thoughts of suicide, there are people who can help. National Suicide Prevention Lifeline, 1-800-273-TALK (8255).
A Librarian by Any Other Name 