Title: Art of reading a journal article: Methodically and effectively
Author: RV Subramanyam
Journal: Journal of Oral and Maxillofacial Pathology
Year of Publication: 2013
Have you ever sat down with a research journal article in hand, staring at it thinking, Where do I even start? Or What exactly is this saying? Maybe you’re even thinking, Why am I doing this? Whether we want to admit it or not, we have ALL been there. Sometimes with more excitement, other times more begrudgingly (I’ve definitely experienced the two and have accepted this love-hate relationship).
So why do we even put ourselves through this studious torture? Here’s what the article sums up (which actually references Sackett (1981) and Durbin (2009)):
Okay, so now we all are on the same page on why we’re doing this. But how do we even know where to start when there is just SO MUCH INFORMATION available at our fingertips these days? Again, if this has been your thought, you are NOT alone.
“To be updated with current knowledge, a physician practicing general medicine has to read 17 articles a day, 365 days a year.” p. 65
First off, could you imagine 17 articles a day?! Don’t get overwhelmed, just breathe and keep reading (that might even be what you say reading an article 😉 ). I agree that reading preferable information like magazines, social media, *cough* blogs (hopefully) requires much less effort, mental strain, and time compared to meticulous, often technically-termed research literature. This point is also taken from the author (note the year published):
“At present, there are 1,312 dentistry journals listed in Pubmed. How can one choose an article, read it purposefully, effectively, and systematically?” p. 65
Been there too my friends. And that is only JOURNALS they are referring to, not to mention the actual hundreds of articles within a journal! Luckily, this article really does provide a great skeleton of reference to help you understand just what a scientific research article typically looks like, the different types, and identify what may or may not be an adequate, peer-reviewed article to see if it’s worth your time or not.
Think all research articles are the same? Think again. Just like there are different shoes for different occasions, research articles also depend on a) what information the authors are trying to share and b) what the reader is looking to gain from the article. This article explains this beautifully and even made me rethink about articles differently:
“ Reports of original research form the ‘primary literature’, the “core” of scientific publications. These are the articles written to present findings on new scientific discoveries or describe earlier work to acknowledge it and place new findings in the proper perspective.
‘Secondary literature’ includes review articles, books, editorials, practice guidelines, and other forms of publication in which original research information is reviewed. An article published in a peer-reviewed journal is more valued than one which is not.” p. 65 [emphasis added]
That last part is amazing—just because I may have an idea, a) doesn’t mean others agree with it and b) doesn’t make it correct or right (just don’t tell my S.O. that 😉 ). Another reason this point is important to consider is because it’s good to know the very basis of what you’re reading, meaning you wouldn’t want to be reading about tabloid gossip when you’re really trying to get info on U.S. landmarks.
The article continues to provide a great detailed summary of what the different classifications under those two categories are such as systematic review vs. meta-analysis and case study vs. case series among others, so I highly recommend perusing it more. A major point I am continuously working on:
“Not all research articles published are excellent, and it is pragmatic to decide if the quality of the study warrants reading of the manuscript.” p. 66
So now you’re hopfeully a little more aware of the different types of research categories. Next is knowing the kind of information you are looking for. This can be just as important because like mentioned above, there is a LOT of information out there, so it’s really like trying to pick a fish out of the ocean– if you don’t know what end result you’re wanting, you may end up with one of those poisonous puffer fish blowing up at your face (don’t try this at home..).
Maybe you’re wondering if a specific intervention is applicable to a certain population? Or wanting to see if your facility’s outcomes are consistent with others or possibly better using a different protocol? Or maybe just a quick-but in-depth understanding what the consensus is in our field as far as a topic goes (e.g. pulse oximetry) is all you need. Use the chart taken from the article below to help guide you:
Keeping with the catching a fish in the ocean analogy…
Maybe now you’re not feeling as intimidated by stepping foot in the ocean (research territory), and even may have a better idea what fish you are wanting to catch—let’s say, rockfish (therapy effectiveness). Now you’re going to need to figure out where rockfish are found (journals), what’s the best strategy to catch them (accessing journal articles), and how to tell if the fish you caught is actually what you wanted (article outline/content).
“At first glance, a journal article might appear intimidating for some or confusing for others with its tables and graphs. Reading a research article can be a frustrating experience, especially for the one who has not mastered the art of reading scientific literature. Just like there is a method to extract a tooth or prepare a cavity, one can also learn to read research articles by following a systematic approach.” p. 66
First off, reading research can be frustrating and confusing for clinicians and researchers (trust me, the more honest ones will admit it). Second, just because something is scary doesn’t mean you can’t use a nightlight to guide you or a “cliffnotes” to help your understanding, because we all have to start somewhere.
So let’s say you caught your fish (article)….
This article keeps giving you the pointers you need for your journey.
The rest of the article provides the guide you can follow to better understand the basic parts of the rockfish (article). I’m only going to provide a synopsis here because in all honesty even though it’s a research article about “How-To” read research, it’s not nearly as complicated as reading Ikea instructions.
Title–Some titles give us a story, some entertain us, and some leave us thinking, huh?? Don’t judge an article by its title, but also don’t throw out an article because of it either.
Abstract–“helps us determine whether we should read the entire article or not,” so it’s really recommended to read first before the entire article to essentially save you time and sanity.
Introduction–“A good introduction should provide proper background for the study.” Usually includes a short history of why this topic is relevant as well as the purpose of the study.
Materials/Methods–“gives the technical details of how the experiments were carried out. The reader should get acquainted with the procedures and equipment used for data collection and find out whether they were appropriate.” Why would this be important? Well, should I care if my mechanic is using toy tools or a hot glue gun on my car? That’s a big YES.
Results–“researchers give details about the data collected, either in the form of figures, tables and/or graphs. The reader should meticulously go through this segment of the manuscript and find out whether the results were reliable (same results over time) and valid (measure what is supposed to measure). An important aspect is to check if all the subjects present in the beginning of the study were accounted for at the end of the study. If the answer is no, the reader should check whether any explanation was provided.”
I’m going to go into the Results section a bit more because a) I think it can be important and b) this is where I think most can get tripped up and the brain can get tangentially lost (I know I have!).
“Results that were statistically significant and results that were not, must be identified. One should also observe whether a correct statistical test was employed for analysis and was the level of significance appropriate for the study. To appreciate the choice of a statistical test, one requires an understanding of the hypothesis being tested.” p. 68
Luckily the authors provide a good chart that lists some common statistics used, which I’ve also gone back to at times (see full article for this). While there’s obviously more to this snippet, a VERY IMPORTANT point to remember is layed out beautifully:
“It is wise to remember the following advice: It is not only important to know whether a difference or association is statistically significant but also appreciate whether it is large or substantial enough to be useful clinically. In other words, what is statistically significant may not be clinically significant.” p. 68 [emphasis added]
I think this can be one of the most frequent arguments heard between research and clinic—“It said it’s important but doesn’t matter clinically.”However, I also think it can be an important point for both sides of the aisle to remember, and hopefully will continue to melt into agreeance.
Discussion–“research questions are answered and the meaning of analysis and interpretation of the data are presented..discusses the various strengths and limitations/shortcomings of the study.. It is important to remember that the discussions are the authors’ interpretations and opinions and not necessarily facts.”
Personally, this can sometimes be my favorite section. But I think the Discussion section sometimes can get a bad wrap because this is where authors present their ideas and opinions along with what may have went wrong in their study or why the study may not have been carried out to its fullest potential. Yes, it is our duty to critically evaluate these explanations, and maybe it’s just because I thoroughly understand how innately hard it can be for human beings to be vulnerable (which is essentially what the authors are doing), but I like to recognize this section with a bit more respect while accepting what it is and is not.
At the same time, I also sometimes find the Discussion section to be either the most intuitive (ya know, that sarcastic teenage ‘duh’ comment) or the most contradicting. I’ve read articles where what they are trying to explain seems like it is so far from where the original article started, it just leaves me confused and a bit upset I’d just spent the last 60 minutes trying to understand this thing (phew, had to get that off my chest!).
Conclusion–“Though conclusion part had been read at the beginning, it is prudent to read it again at the end to confirm whether what we had inferred initially is correct. If the conclusion had not made sense earlier, it may make sense after having perused through the entire article.”
I’ve only skimmed the surface of the referenced article, but seriously do recommend full inspection for further information, and can attest that it shouldn’t make you fall asleep (sorry, can’t say for certain just because #kids #latenights #busydays). In case you’re also wanting something a bit more concrete, the authors also provide a quick questionnaire to use as your “fishing guide” while acknowledging: “This questionnaire does not critically analyze a scientific article. However, answers to these questions provide a systematic approach to obtain a broad overview of the manuscript, especially to a novice.”
So now that you have a better idea what part of the ocean you should head towards in order to catch the specific chili pepper rockfish (it’s a thing I swear), what equipment you’ll need to catch it, and what to do with it to know for sure it’s what you want….
How can you use this article?!?
What articles will YOU be reading next?!?!?! I’d love to hear any experiences with this info, articles you’ve read afterwards or maybe beforehand that you’re willing to give it another shot, plus any other tips/tricks to share!!!
- “It has become mandatory to read scientific literature to be well-informed of ever-expanding information and/or for better diagnosis, prognosis and therapy.”
- “The first step for a reader is to choose a right article for reading, depending on one’s individual requirement. The next step is to read the selected article methodically and efficiently”
- “The cardinal rule is: Never start reading an article from the beginning to the end. It is better to begin by identifying the conclusions of the study by reading the title and the abstract…After reading the abstract or conclusions, if the reader deems it is interesting or useful, then the entire article can be read”
Article Referenced: [FREE ACCESS]
Subramanyam R V. Art of reading a journal article: Methodically and effectively. J Oral Maxillofac Pathol [serial online] 2013 [cited 2019 Apr 4];17:65-70. Available from: http://www.jomfp.in/text.asp?2013/17/1/65/110733