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Yale Medicine Thesis Digital Library

Starting with the Yale School of Medicine (YSM) graduating class of 2002, the Cushing/Whitney Medical Library and YSM Office of Student Research have collaborated on the Yale Medicine Thesis Digital Library (YMTDL) project, publishing the digitized full text of medical student theses on the web as a valuable byproduct of Yale student research efforts. The digital thesis deposit has been a graduation requirement since 2006. Starting in 2012, alumni of the Yale School of Medicine were invited to participate in the YMTDL project by granting scanning and hosting permission to the Cushing/Whitney Medical Library, which digitized the Library’s print copy of their thesis or dissertation. A grant from the Arcadia Fund in 2017 provided the means for digitizing over 1,000 additional theses. IF YOU ARE A MEMBER OF THE YALE COMMUNITY AND NEED ACCESS TO A THESIS RESTRICTED TO THE YALE NETWORK, PLEASE MAKE SURE YOUR VPN (VIRTUAL PRIVATE NETWORK) IS ON.

Theses/Dissertations from 2023 2023

Radiomics: A Methodological Guide And Its Applications To Acute Ischemic Stroke , Emily Avery

Characterization Of Cutaneous Immune-Related Adverse Events Due To Immune Checkpoint Inhibitors , Annika Belzer

An Investigation Of Novel Point Of Care 1-Tesla Mri Of Infants’ Brains In The Neonatal Icu , Elisa Rachel Berson

Understanding Perceptions Of New-Onset Type 1 Diabetes Education In A Pediatric Tertiary Care Center , Gabriel BetancurVelez

Effectiveness Of Acitretin For Skin Cancer Prevention In Immunosuppressed And Non-Immunosuppressed Patients , Shaman Bhullar

Adherence To Tumor Board Recommendations In Patients With Hepatocellular Carcinoma , Yueming Cao

Clinical Trials Related To The Spine & Shoulder/elbow: Rates, Predictors, & Reasons For Termination , Dennis Louis Caruana

Improving Delivery Of Immunomodulator Mpla With Biodegradable Nanoparticles , Jungsoo Chang

Sex Differences In Patients With Deep Vein Thrombosis , Shin Mei Chan

Incorporating Genomic Analysis In The Clinical Practice Of Hepatology , David Hun Chung

Emergency Medicine Resident Perceptions Of A Medical Wilderness Adventure Race (medwar) , Lake Crawford

Surgical Outcomes Following Posterior Spinal Fusion For Adolescent Idiopathic Scoliosis , Wyatt Benajmin David

Representing Cells As Sentences Enables Natural Language Processing For Single Cell Transcriptomics , Rahul M. Dhodapkar

Life Vs. Liberty And The Pursuit Of Happiness: Short-Term Involuntary Commitment Laws In All 50 US States , Sofia Dibich

Healthcare Disparities In Preoperative Risk Management For Total Joint Arthroplasty , Chloe Connolly Dlott

Toll-Like Receptors 2/4 Directly Co-Stimulate Arginase-1 Induction Critical For Macrophage-Mediated Renal Tubule Regeneration , Natnael Beyene Doilicho

Associations Of Atopic Dermatitis With Neuropsychiatric Comorbidities , Ryan Fan

International Academic Partnerships In Orthopaedic Surgery , Michael Jesse Flores

Young Adults With Adhd And Their Involvement In Online Communities: A Qualitative Study , Callie Marie Ginapp

Becoming A Doctor, Becoming A Monster: Medical Socialization And Desensitization In Nazi Germany And 21st Century USA , SimoneElise Stern Hasselmo

Comparative Efficacy Of Pharmacological Interventions For Borderline Personality Disorder: A Network Meta-Analysis , Olivia Dixon Herrington

An Examination Of Honor Society Membership, Mistreatment, And Discrimination By Medical Student Demographics , Katherine Ann Hill

Factors Influencing Decision For Contralateral Prophylactic Mastectomy Versus Unilateral Mastectomy , Julian Huang

Beta-Catenin Nuclear Transport In Wnt Signaling: Kap-Beta2/transportin Mediates Nuclear Import Of Beta-Catenin Via A Py-Nls Motif In A Ran Gtpase Dependent Manner , Woong Y. Hwang

Perspectives On Emergency Department-Initiated Buprenorphine Among Clinical Pharmacists , Marissa Justen

Examination For Independent Predictors Of Seasonality Of Birth Across Forty-Nine Low- And Middle-Income Countries: Analyses Of The United States Agency For International Development Demographic And Health Survey Data , Jehanzeb Kayani

Pediatricians, Social Identity, And The Law In The Early-Twentieth-Century United States , Christopher R. Keys

Single Neuronal Firing Dynamics In A Mouse Model For Absence Seizures , Waleed Khan

The Impact Of Cannabidiol In Patients With Early Psychosis: A Randomized Controlled Trial , Sreeja Kodali

Renalase Agonist Therapy And The Cardiac Response To Pressure Overload In Chronic Kidney Disease , Govind Krishna Kumar Nair

Sociodemographic And Insurance Disparities In Urologic Oncology Care Access And Surgical Outcomes , Folawiyo Laditi

How Ethics Committees Deliberate Resource Allocation For Undocumented Children, A Qualitative Analysis , YuKyung Lee

Mental Health Service Use Among Immigrant And U.S. Born Asian American Pacific Islanders , Hieronimus Loho

Severity And Operative Age In Metopic Synostosis: The Association With Neurocognitive Outcomes , Aaron Samuel Long

Comparison Of The Bone Bruise Patterns In Contact And Non-Contact Acute Anterior Cruciate Ligament Injuries , Jay Thomas Moran

Multi-Omic Differences Between Right And Left Sided Colorectal Cancer Liver Metastases , Montana Tremaine Morris

Almajiri Health; A Scoping Review On Disease, Health Literacy And Space For Participatory Research , Muzzammil Imran Muhammad

Investigating Effects Of Glycolysis Inhibition On Metabolism And Extracellular Ph In A Mouse Model Of Hepatocellular Carcinoma , David Nam

Applying Deep Learning To Identify Imaging Biomarkers To Predict Cardiac Outcomes In Cancer Patients , Aishwarya Kishore Nene

Incarcerated Patients Have Higher Mortality After Trauma: An Unreported Healthcare Disparity , Harry NewmanPlotnick

The Association Between Social Needs Care Coordination And Social Needs Status Amongst Patients In A Federally Qualified Health Center , Autumn Nobles

Diagnosis Of Polycystic Ovary Syndrome And Non-Hispanic Black Race Are Predictive Of Hypertension In Reproductive Age Women -Analysis Of Real World Electronic Medical Record Data , Nyerovwo Okifo

Utility Of Shear Wave Elastography In Breast Cancer Diagnosis: A Systematic Review And Meta-Analysis , Aishwarya Pillai

“I Was Reaching Out For Help And They Did Not Help Me”: Mental Healthcare In The Carceral State , Anna Grace Preston

Associations Of Frailty With Tumor Characteristics & Longitudinal Outcomes In Patients With Meningiomas , Hanya M. Qureshi

A Single Nucleotide Polymorphism In An Rgs6 Enhancer Regulates Heart Rate Variability And Parasympathetic Modulation , Namita Ravi

Firearm Injury Prevention Strategies In Children And Young Adults , Christopher Schenck

Assessing Quality Of Oral Cancer Care Across A Health System And Region: Opportunities To Improve Care , Hemali Parimal Shah

Single-Cell Transcriptomic Atlas Reveals Molecular Drivers Of Human Inner Ear Development , Amar H. Sheth

More Than Meets The Eye: Improving Recognition Of Child Abuse In Emergency Departments , May Shum

A Novel Smarcc1-Mutant Bafopathy Implicates Epigenetic Dysregulation Of Fetal Neural Progenitors In The Pathogenesis Of Congenital Hydrocephalus , Amrita K. Singh

Baseline Skin Cytokine Profiles Determined By Rna In Situ Hybridization Correlate With Response To Dupilumab In Patients With Eczematous Dermatitis , Katelyn Singh

Barriers To Identifying Learning Disabilities: A Qualitative Study Of Clinicians And Educators , Lauren Stone

"Come On. I Need An Answer." A Mixed-Methods Study Of Barriers And Disparities In Diagnostic Odysseys , Zeyu Tang

Cognitive Impairment And Long-Term Health Outcomes In Patients With Coronary Microvascular Dysfunction , Abriana Tasillo

Family Dyads, Emotional Labor, And The Theater Of The Clinical Encounter: Co-Constructive Patient Simulation As A Reflective Tool In Child And Adolescent Psychiatry Training , Isaiah Thomas

Comparative Effectiveness Of Digital Breast Tomosynthesis For Breast Cancer Screening In Older Women , Akhil Upneja

Analysis Of Prices And Outcomes For Common Hospitalized Conditions In 2021 , Lina Vadlamani

Recording Multiunit Activity Of The Locus Coeruleus In An Awake Mouse Model Of Focal Limbic Seizures , Marcus Valcarce-Aspegren

Improving Cancer Classification With Domain Adaptation Techniques , Juliana Veira

Soil-Transmitted Helminthiases And Deworming Response In School-Aged Children In Retalhuleu, Guatemala , Rebeca Esther Vergara Greeno

The Synergy Between Physiologic Dendritic Cells And Mrna-Loaded Lipid Nanoparticles And Its Potential As A Cellular Immunotherapy , Brian Myles Wei

Lipid Profiles Help Explain Protection From Atherosclerosis In Ascending Aortic Aneurysm Patients , Gabe Weininger

The Impact Of Peer Interventions On Physical Activity For Individuals Living With Mental Illness , Julia Wolfe

Perioperative Outcomes In Patients With Systemic Sclerosis: An Analysis Of A Large Case Series , Luying Yan

Engineering And Evaluating Biodegradable Bioadhesive Nanoparticle-Encapsulated Sunscreens , Beverly Xi Yu

Theses/Dissertations from 2022 2022

Contested Spaces, Stigmatized Treatment: Methadone In 1970s New York, Boston, And New Orleans , Zoe Miranda Adams

Comorbid Pad And Mvd: A Retrospective Nrd Analysis Of Trends, Outcomes, And Readmissions , Miguel Algara

Epidemiology Of Domestic Violence-Related Ocular Injuries Among Adult Patients , Joana E. Andoh

Longitudinal Modeling Of Early Hiv Burden In The Central Nervous System , Victor Diego Armengol

Generating Clinical Evidence Using Real World Data And Personal Digital Devices , Victoria L. Bartlett

Incidence And Prognosis Of Cranial Neuropathies In Children With Covid-19: A Systematic Review And Meta-Analysis , Priyanka Bisarya

A Deep Dive In Head & Neck Cancer: Machine Learning Applications In Diagnostic And Prognostic Evaluations , Alexandra Tan Bourdillon

A Serological Survey Of Sars-Cov-2 Infection In Casino Employees , Julian Campillo Luna

The Real Cause Of The Broken Rib: Developments In Pediatricians' Approach To Child Abuse; 1960 - 2020 , Sofia Charania

Identification Of A Novel Link Between Adiposity And Visuospatial Ability , Herbert Alexander Chen

Predictors Of Very Late Onset Infection In Kidney Transplant Recipients At Least Ten Years Post Transplant , Harry Cheung

Deep Learning Algorithms For Predicting Response To Neoadjuvant Chemotherapy For Breast Cancer , Rachel Choi

Testing Ictal Conscious Awareness: Responsiveness Versus Recall Of Experiences During Seizures , Violeta Contreras Ramirez

Mechanisms Of Progestin Resistance In Reproductive-Age Women With Atypical Endometrial Hyperplasia , Katherine Mcmaster Cooke

Biomarkers Of Egfr Decline After Pediatric Cardiac Surgery In The Assess-Aki Cohort , Christina Anne-Josiane De Fontnouvelle

Amd3100 Administration For The Treatment Of Asherman’s Syndrome In A Murine Model , Pablo Antonio Delis

Fracture Callus Evaluation In The Setting Of Breast Cancer Metastasis And Rescue Of Healing Via Inhibition Of Erk1/2 , Christopher Dussik

Primary Care Characteristics And Medication Management Among Patients Receiving Office Based Opioid Treatment With Buprenorphine , Xinxin Du

Factors Impacting Trauma-Specific Quality Of Life Following Injury: A Multi-Center Assessment In Lebanon , Ali Elreichouni

Consciousness: Mechanisms And Neuropsychiatric Outcomes , Isaac Gilbert Freedman

Investigation Of Outcomes Following Cervical Spine Surgery In Patients With Pre-Existing Non-Spinal Neurological Conditions , Anoop Raj Galivanche

Medical Students’ Experiences, Knowledge, And Perceptions Of Patients With Substance Use Disorder , Sophia Francesca Gamez

“people Fall Through The Cracks”: Prolonged Lengths Of Stay Beyond Medical Necessity , Lucy Gao

Housing As Healthcare: The Role Of Homelessness In Patient Characteristics And Retention In Outpatient Medication For Opioid Use Disorder Treatment , Marina Gaeta Gazzola

Sleep Apnea In Veterans With Schizophrenia: Estimating Prevalence And Impact On Cognition , Stephen Edward Ghazikhanian

Self-Injurious Behavior And Problematic Video Gaming In Adolescents With Problematic Shopping , Norman Robert Greenberg

Importance Of Social Support In Older Adults After Hospitalization For Acute Myocardial Infarction , Yaakov Green

In-Vivo Nanoparticle Delivery To Fetal Mouse Pancreas And Liver , Mary Elizabeth Guerra

Characteristics Of Inpatient Behavioral Health Services And Hormonal Treatment Decision-Making In Transgender/gender-Expansive Youth , Justin William Halloran

Preferential Utilization Of Resident Physicians To Care For Patients With Medicaid And Persons Of Color At Us Academic Health Centers , Samer Hassan

Atypical Presentation Of Hereditary Hypophosphatemic Rickets With Hypercalciuria Due To Digenic Mutations , Bryan Bo-Ran Ho

Gender Differences In Outcomes Of Coordinated Specialty Care For Early Psychosis , Seong Im Hong

Resident Physician Thriving And The Residency Experience During The Covid-19 Pandemic: A Qualitative Study , Joshua Hyman

Early Experience With The Fda’s Breakthrough Devices Program And Potential Payment Mechanisms , James Johnston

Page 1 of 31

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Edinburgh Medical School thesis and dissertation collection

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Edinburgh Medical School is one of two schools at the College of Medicine and Veterinary Medicine at the University of Edinburgh. The Edinburgh Medical School integrates research and teaching across our three Deaneries: Biomedical Sciences, Clinical Sciences and Molecular,Genetic and Population Health Sciences.

Recent Submissions

Phenotype of newly generated neurons following spinal cord injury in zebrafish , exploration of relationships between life course measures of socioeconomic status and structural brain changes linked with older life cognitive decline , high resolution analysis of the tumour microenvironment of high grade serous ovarian cancer (hgsoc) using single cell transcriptomics and quantitative histopathological examination , complications of portal hypertension: clinical studies , imaging of abdominal aortic aneurysm disease activity and implications for endovascular aneurysm repair , hallmarks of cotranslational protein complex assembly and its relationship with the dominant-negative effect , optimising islet transplantation therapy for the treatment of type 1 diabetes by targeting the liver niche with etanercept-loaded microparticles to promote the long term function of islets , developing a systematic, data-driven framework to identify, evaluate, and prioritise candidate drugs for clinical trials in motor neuron disease , investigating an arginase 1⁺ monocyte- macrophage population in driving fibrosis in chronic kidney disease. , in vivo investigation of component-specific functions of the hippo pathway , prevalence of female infertility in the uk armed forces , understanding colorectal cancer risk loci that alter transcriptional dynamics , behaviour change intervention for smokeless tobacco (st) cessation delivered by dentists in a dental setting: a feasibility study , dna methylation & its regulation in colorectal tumours , lesion reversibility in small vessel disease: understanding changes contributing to vascular dementia , effect of autologous macrophage therapy in cirrhosis in response to individual immune reparative pathways: developing a novel therapy , computational techniques to interpret the neural code underlying complex cognitive processes , identifying genomic and phenotypic risks factors for the clinical progression of depressive symptoms , investigating the essential extracellular invadolysin metalloprotease , defining novel regulators of inflammatory signalling in pancreatic cancer .

Harvey Cushing/John Hay Whitney Medical Library

Search for theses.

• Orbis , Yale Online Catalog Search for all Yale theses using Orbis by including the words "Yale" and  "thesis" as keywords in your search.  Items cataloged in Orbis will have both a call number and a "handle" URL for the catalog record. Please include both if if you make an email inquiry about access.  
• Dissertations & Theses - Full Text  Digital Dissertations contains more than 1.6 million entries with information about doctoral dissertations, including Yale MD/PhD dissertations. It is the same database as Dissertation Abstracts, but with the significant advantage that titles published since 1997 are available in PDF digital format.  
• Yale Medicine Thesis Digital Library Project Starting in 2006, each YSM graduating class is required to deposit an electronic thesis. Theses from 2011-onward are also accessible through Dissertations & Theses - Full Text . Note: If a medical student selects a temporary or permanent embargo for campus-only access, the full-text will not be available in the Proquest system during the embargo. Thesis abstracts should be available in either EliScholar or Proquest.  
• EliScholar Alumni theses can be found in Yale University’s institutional repository. If you would like to have your thesis added to EliScholar, please complete this form .

Theses in the Library

The Medical Library receives one copy of each Yale School of Medicine thesis and two copies of each School of Nursing thesis. School of Public Health theses are in the Medical Library through 2008. In 2009, SPH theses are electronic only and available in the Proquest Dissertations & Theses - Full Text  product. Each thesis is cataloged with author and subject entries for Orbis, the Yale online catalog. In addition, a historical list of theses arranged by year , indicating the call numbers for requesting the thesis, is shelved in the Medical Library Information Room. To view a print thesis, thesis request forms are available at the Circulation Desk. Theses from 1974 to the present are shelved within the Medical Library and are retrieved twice a day, at 11:00 a.m. and 4:30 p.m. Monday through Friday. Earlier theses are stored in the Library Shelving Facility (LSF). Theses at LSF may be delivered to the Medical Library via the campus library delivery service. The second copy of the School of Nursing theses may be checked out for home use, but all other theses must be used in the Library. For more information, please call the Circulation Desk 203-785-5354.

UKnowledge > College of Medicine > Medical Sciences > Theses & Dissertations

Theses and Dissertations--Medical Sciences

Theses/dissertations from 2023 2023.

Examining a Blood Biomarker Approach to Blood-Brain Barrier Disruption , Samantha Ford

Theses/Dissertations from 2022 2022

Establishment and Verification of a SARS CoV2 Antibody Detection Assay Comparing Venous and Mitra Samples , Stephen C. Mayer

Mammalian Target of Rapamycin Cell Signaling Pathway in Phosphatase and Tensin Homolog Induced Kinase 1 Knockout Rat Model of Familial Parkinson's Disease , Martha Helena Mortell

Classification and Effect of Correctors on Sitosterolemia-Associated Mutants in ABCG8 , Brittney Poole

Membrane Palmitoylated Protein Magu-3 Regulates the C. elegans Locomotor Circuit via Modulation of Cholinergic Activity , Henry Richburg

TREM2: Gene Expression and Role in Alzheimer’s Disease , Henry Snider

APOE Genotype and Sex Modulate Ketogenic Diet Enhancements to Metabolism and Gut Microbiome in Young Mice , Andrew T. Yackzan

Investigating The Effects of In-vivo Therapeutics Hypoxia Treatment Paradigms In Neurite Outgrowth Patterns , Jae Hyun Yoo

Theses/Dissertations from 2021 2021

ACL Injury, a Time Course Study of Transcriptional Changes , Thomas Carter

S. gordonii -PRODUCED HYDROGEN PEROXIDE MODULATES miR-663A AND CCL20 EXPRESSION IN ORAL EPITHELIAL CELLS , Marshall Houston Maynard

THE ROLE OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN LEUKEMIA TRAFFICKING , Shaw Powell

Theses/Dissertations from 2020 2020

ETHANOL INDUCED NEUROTOXICITY THROUGH DYSREGULATION OF AMPK IN A FETAL ALCOHOL SYNDROME MODEL , Jessica Gebhardt

Involvement of the Sigma-1 Receptor in Methamphetamine-Mediated Changes to Astrocyte Structure and Function , Richik Neogi

MEASURING THE EFFECTS OF LOBINALINE-N-BIOXIDE (419) ON ALCOHOL CONSUMPTION, NICOTINE LOCOMOTOR SENSITIZATION, AND CONDITIONED PLACE PREFERENCE IN MICE AND RATS , Cocanut M. Suhail

Theses/Dissertations from 2019 2019

The Stimulation of Dendritic Cells by Cationic Lipids , John Peyton Bush

RAPID NO• MEASURES IN RAT NUCLEUS ACCUMBENS AND FRONTAL CORTEX FOLLOWING NASAL ADMINISTRATION OF NITROGLYCERIN , Victoria A. Scott

Theses/Dissertations from 2018 2018

MYOSIN-XVA IS KEY MOLECULE IN ESTABLISHING THE ARCHITECTURE OF MECHANOSENSORY STEREOCILIA BUNDLES OF THE INNER EAR HAIR CELLS , Shadan Hadi

Theses/Dissertations from 2017 2017

THE EFFECTS OF EXERCISE PRECONDITIONING ON FOCAL ISCHEMIC STROKE , Gillian Grohs

Theses/Dissertations from 2016 2016

CEREBROVASCULAR RISK FACTORS, ARTERIOLAR SCLEROSIS, AND COGNITIVE DECLINE IN THE KENTUCKY APPALACHIAN “STROKE-BELT” , Omar M. Al-Janabi

VARIANCE OF THE AMYLOID BETA PEPTIDE AS A METRIC FOR THE DIAGNOSIS OF ALZHEIMER'S DISEASE , Christina Beckett

EVALUATING THE USE OF SECOND LIFE TM FOR VIRTUAL TEAM-BASED LEARNING IN AN ONLINE UNDERGRADUATE ANATOMY COURSE , Christena Gazave

Theses/Dissertations from 2014 2014

Listeria Monocytogenes can Utilize both M Cell Transcytosis and InlA-Mediated Uptake to Cross the Epithelial Barrier of the Intestine during an Oral Infection Model of Listeriosis , Hilary Denney

MODULATION OF VACCINE-INDUCED RESPONSES BY ANTHELMINTIC TREATMENT IN PONIES , Emily Rubinson

Immobilizing Mutation in an Unconventional Myosin15a Affects not only the Structure of Mechanosensory Stereocilia in the Inner Ear Hair Cells but also their Ionic Conductances , Diana Syam

Theses/Dissertations from 2013 2013

GLUTAMATE DYSREGULATION AND HIPPOCAMPAL DYSFUNCTION IN EPILEPTOGENESIS , Seth R. Batten

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Home > FACULTIES > Family Medicine > FAMMED-ETD

Family Medicine Theses and Dissertations

This collection contains theses and dissertations from the Department of Family Medicine, collected from the Scholarship@Western Electronic Thesis and Dissertation Repository

Theses/Dissertations from 2023 2023

The Attainment of Obstetrical Competency in Postgraduate Family Medicine Training: A Qualitative Study , Nisha Arora

The Population-Centered Medical Model: A Theory of Practice for Public Health and Preventive Medicine , Sudit Ranade

Jumping Ship and Going to the Other Side: Experiences of Nurses who retrain as Doctors , Anne Robinson

Theses/Dissertations from 2020 2020

The experiences of Family Medicine teachers and Family Medicine residents in multimorbidity care and education , Julie A. Copeland

The Health Experiences of Long-haul Truck Drivers and their Relationship with their Primary Care Provider , Jennifer K. Johnson

Gestational Weight Gain - Its Importance To Pregnant Women And Their Children , Helena Piccinini-Vallis

Utilization of Healthcare by Immigrants in Canada: A Cross-Sectional Analysis of the Canadian Community Health Survey , Nisanthini Ravichandiran

Theses/Dissertations from 2019 2019

Japanese patients' preference for Patient-centered medicine and its association with the satisfaction of patients with their family physicians , Tesshu Kusaba

Measuring Multimorbidity , Eng Sing E S Lee

Focused Practice and Enhanced Skills PGY3 Training in Family Medicine: A Mixed Methods Study. , Melad I. Marbeen

Family Physician's Clinical Inertia in the Management of Hypoglycemia , Caroline V. Martignoni Rebicki

Knowledge and Attitudes Towards Breastfeeding Among Medical Students at Memorial University , Amanda L. Pendergast

Theses/Dissertations from 2018 2018

Transitions in Medical Education , Britta Laslo

Theses/Dissertations from 2017 2017

The impact of an EMR on the management of adult patients with type two diabetes by family physicians in ruralnewfoundland , John A. Campbell

Patient-centered Primary Care of Adults with Severe or Profound Developmental Disabilities: The Patient–Physician Relationship , Katherine C. Stringer

Theses/Dissertations from 2016 2016

An Evaluation of the Determinants of Job Satisfaction in Canadian Family Physicians , Jana L. Malhotra

Theses/Dissertations from 2015 2015

Psychotherapy in Family Medicine , Saadia N. Hameed

How Family Physicians in Saskatchewan Make Lung Cancer Screening Decisions , Nusrat Jamil

"A family doctor can do that!" Is there a role for a formalized referral network for office procedures in family practices of Newfoundland and Labrador? , Annabeth J. Loveys

Theses/Dissertations from 2014 2014

Integrating Spirituality and Medical Education: What Students and Teachers Have to Say - A Qualitative Study , Sharon N. Hatcher

Theses/Dissertations from 2013 2013

Bio-Identical Hormone Therapy: Understanding Women's Decision-Making Process and Family Physicians' Views , Lemmese AlWatban

What Shapes Family Physicians' Patterns of Care for Community Patients at End of Life? , Joshua D. Shadd

Theses/Dissertations from 2012 2012

Functional Recovery and Caregiver Support of Stroke Patients Admitted for Rehabilitation in Singapore Community Hospitals (1996 to 2005) , Gerald Koh

The Role of Religion and Spirituality in the Care of Patients in Family Medicine , Michael F. Lee-Poy

Understanding Compassion in Family Medicine: A Qualitative Study , Jane Melek Uygur

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Home > MAHE Student Work > KMCMLR

Kasturba Medical College, Mangalore Theses and Dissertations

Theses/dissertations from 2021 2021.

“The Impact of Self-Stigma of Seeking Help and Perceived Social Support on Burnout among Clinical Psychologists” , Aavrita A

The impact of self-stigma of seeking help &percieved social support on burnout among clinical psychologists. , Aavrita .

Immediate Effects of Novel Hand Rehabilitation Board on Fine Motor Skills in Children with Cerebral Palsy. , Romita Fernandes. Abraham

"COMPARISON OF THREE SCORING CRITERIA TO ASSESS RECOVERY FROM GENERAL ANAESTHESIA IN THE POST-ANAESTHESIA CARE UNIT- A LONGITUDINAL OBSERVATIONAL STUDY " , Shagun Aggarwal

Comparative predictive validity of Alberta Infant Motor Scale and Infant Neurological International Battery in Low Birth Weight Infants- A Prospective Longitudinal Study. , Polisetti Siva Sai Anand

Antagonistic Asynchrony in Muscle Recruitment Pattern of Forward Reach Movement In Children With Cerebral Palsy. , Sanya Anklesaria

Muscle fatigue response of rotator cuff muscles in sitting and standing postures , Lisanne Aranha

Effectiveness of static weight bearing versus modified constraint induced movement therapy on improving hand function in hemiplegic cerebral palsy- A Randomized Clinical Trial. , Ruth Bavighar

How informed are our patients about generic medicines? – A study from coastal South India , Darshan BB

Morphological variants of the human spleen, a cadaveric study , Murlimanju BV

Association between cervical breast cancer and Diabtetes mellitus among women seeking health care in tertiary hospitals od south India: A cross sectional study , Pratik Kumar Chatterjee

Carcinoma Breast in among Women with Diabetes Mellitus: A Case Control Study , Pratik Kumar Chatterjee

Perception of Empathy among medical students: A cross sectional study , Pratik Kumar Chatterjee

CLINICOMYCOLOGICAL PROFILE OF DERMATOPHYTOSIS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA , Adyashree Dalai

Study of outcome of Ponseti technique of management for idiopathic clubfoot in a tertiary center in south India , Lulu Damsas

Comparative study of emotional labour &burnout on life satisfaction among school teachers across different educational settings , Meghana Dharampalan

“Comparative Study of Emotional Labor and Burnout on Life Satisfaction Among School Teachers Across Different Educational Settings” , Meghana V. Dharmapalan

“Relationship Between Sexual Fantasy, Sexual Communication, Personality Traits and Sexual Satisfaction in Married Individuals” , Rhea Dhir

Comparing the efficacy of USG guided supraclavicular brachial plexus block with or without intercostobrachial nerve block for forearm surgeries – an observational study , DIKSHA D’MELLO

Does Quality of Sitting influence Functional Mobility in Cerebral Palsy? A cross-sectional study , Kaiorisa N. Doctor

Factors effecting gait velocity in osteoarthritis knee-An observational study. , Lisha Gretal D’silva

Effect of Inspiratory Muscle Training on Pulmonary Function, Functional Capacity, Quality Of Life And Length Of Stay in individuals undergoing Cardiac Surgery , Fiona Verdine Dsouza

Relationship of Academic Resilience with Self-Efficacy, and Perceived Social Support; Among Civil Service Aspirants , Neha Eldho

EFFICACY, FEASIBILITY, AND SAFETY OF PERCUTANEOUS IMAGE-GUIDED CATHETER DRAINAGE OF THORACIC, ABDOMINAL, AND PELVIC FLUID COLLECTION , Aishwarya Gadwal

Comparison of efficacy of two different bolus doses of norepinephrine as prophylac-tic to prevent post-spinal hypotension during elective caesarean section , PRANATHI GARAPATI

Trends in Frailty and its Associated factors in Community Dwelling Elderly Indian Population during COVID-19 Pandemic- A Prospective Analytical Study , Karan Gautam

Speech Sound acquisition in some south Indian Dravidian languages: A systematic review , Jesica George

Comparison of Femoral nerve block with Dexmedetomidine and Adductor canal block with Dexmedetomidine for postoperative analgesia for Total Knee Arthroplasty . , NEHA GEORGE

Assessment Of Cardiovascular Risk Factors In Patients With Osteoarthritis Knee , Sagar Goel

Effectiveness of Intermittent Cervical Traction with and without Neural Mobilization in Discogenic Cervical Radiculopathy , Aditi Goyal

Study of maternal and cord blood vitamin B12 levels with anthropometry in term neonates born to normal and malnourished mothers: a hospital based cross sectional study , Sugapradha a. GR

Development of a Questionnaire to Determine the Intervention and Service Delivery Practices of Speech-Language Pathologists for Children with Speech Sound Disorders in India , Shaily Gupta

Relationship between Physical Activity, Objective Sleep Parameters and Circadian Rhythm in Patients with Head and Neck Cancer receiving Chemoradiotherapy- A Longitudinal Study , Rachita Gururaj

“Emotional Contagion, Perceived Stress and Coping Strategies Among Nurses” , Saumya Hariharan

Assessment of knowledge and belief about stuttering among undergraduate medical students , Anushree Harihar

Association of serum lipid levels and other systemic risk factors with retinal hard exudates in diabetic retinopathy patients. , Harshita Mukesh Hiran

Assessment of risk of Diabetes Mellitus by using Indian Diabetes Risk Score among Housekeeping staff , Ramesh Holla

“Emotional Intelligence, Self-compassion, and Life-Satisfaction In Clinical Psychologists” , Vania Jacob

UPPER-CROSSED SYNDROME AND DISABILITY IN SHOULDER ADHESIVE CAPSULITIS. , Aishwarya Jaideep

Study to assess the role of doppler ultrasound in evaluation of arteriovenous hemodialysis fistula and the complications of hemodialysis access , Ishank Jain

Relationship between burnout compassion fatigue, work environment & mindfulness in medical residents , Pranay Javeri

“Relationship Between Burnout, Compassion Fatigue, Work Environment and Mindfulness in Medical Residents” , Pranay Harichandra Javeri

“Dating Anxiety in Emerging Adults” , Jisha V. Jayaprakash

“Relationship Between Tolerance for Disagreement and Mindfulness in Married Males and Married Females” , Jahnavi Jha

Antibiotic usage and susceptibility patterns in Uncomplicated UTI in a Tertiary Hospital in South India , Christy John

Association of bed rise difficulty scale with trunk impairment and functional scales among stroke patients , Leena G. John

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Fatal Traffic Risks With a Total Solar Eclipse in the US

• 1 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
• 2 Evaluative Clinical Science Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada
• 3 Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
• 4 Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
• 5 Center for Leading Injury Prevention Practice Education & Research, Toronto, Ontario, Canada
• 6 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
• 7 Centre for Clinical Epidemiology & Evaluation, University of British Columbia, Vancouver, British Columbia, Canada

A total solar eclipse occurs when the moon temporarily obscures the sun and casts a dark shadow across the earth. This astronomical spectacle has been described for more than 3 millennia and can be predicted with high precision. Eclipse-related solar retinopathy (vision loss from staring at the sun) is an established medical complication; however, other medical outcomes have received little attention. 1

Read More About

Redelmeier DA , Staples JA. Fatal Traffic Risks With a Total Solar Eclipse in the US. JAMA Intern Med. Published online March 25, 2024. doi:10.1001/jamainternmed.2023.5234

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• v.66(1); 2022 Jan

Dissertation writing in post graduate medical education

Department of Anaesthesiology, Dr. B R Ambedkar Medical College, Bengaluru, Karnataka, India

Mridul M Panditrao

1 Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research (AIMSR), Bathinda, Punjab, India

2 Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India

Sukhminder Jit Singh Bajwa

3 Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Patiala, Punjab, India

Nishant Sahay

4 Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India

Thrivikrama Padur Tantry

5 Department of Anaesthesiology, A J Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, Karnataka, India

Associated Data

A dissertation is a practical exercise that educates students about basics of research methodology, promotes scientific writing and encourages critical thinking. The National Medical Commission (India) regulations make assessment of a dissertation by a minimum of three examiners mandatory. The candidate can appear for the final examination only after acceptance of the dissertation. An important role in a dissertation is that of the guide who has to guide his protégés through the process. This manuscript aims to assist students and guides on the basics of conduct of a dissertation and writing the dissertation. For students who will ultimately become researchers, a dissertation serves as an early exercise. Even for people who may never do research after their degree, a dissertation will help them discern the merits of new treatment options available in literature for the benefit of their patients.

INTRODUCTION

The zenith of clinical residency is the completion of the Master's Dissertation, a document formulating the result of research conducted by the student under the guidance of a guide and presenting and publishing the research work. Writing a proper dissertation is most important to present the research findings in an acceptable format. It is also reviewed by the examiners to determine a part of the criteria for the candidate to pass the Masters’ Degree Examination.

The predominant role in a dissertation is that of the guide who has to mentor his protégés through the process by educating them on research methodology, by: (i) identifying a pertinent and topical research question, (ii) formulating the “type” of study and the study design, (iii) selecting the sample population, (iv) collecting and collating the research data accurately, (v) analysing the data, (vi) concluding the research by distilling the outcome, and last but not the least (vii) make the findings known by publication in an acceptable, peer-reviewed journal.[ 1 ] The co-guide could be a co-investigator from another department related to the study topic, and she/he will play an equivalent role in guiding the student.

Research is a creative and systematic work undertaken to increase the stock of knowledge.[ 2 ] This work, known as a study may be broadly classified into two groups in a clinical setting:

• Trials: Here the researcher intervenes to either prevent a disease or to treat it.
• Observational studies: Wherein the investigator makes no active intervention and merely observes the patients or subjects allocated the treatment based on clinical decisions.[ 3 ]

The research which is described in a dissertation needs to be presented under the following headings: Introduction, Aim of the Study, Description of devices if any or pharmacology of drugs, Review of Literature, Material and Methods, Observations and Results, Discussion, Conclusions, Limitations of the study, Bibliography, Proforma, Master chart. Some necessary certificates from the guide and the institute are a requirement in certain universities. The students often add an acknowledgement page before the details of their dissertation proper. It is their expression of gratitude to all of those who they feel have been directly or indirectly helpful in conduct of the study, data analysis, and finally construction of the dissertation.

Framing the research question (RQ)

It is the duty of the teacher to suggest suitable research topics to the residents, based on resources available, feasibility and ease of conduct at the centre. Using the FINER criteria, the acronym for feasibility, topical interest, novelty, ethicality and relevance would be an excellent way to create a correct RQ.[ 4 ]

The PICOT method which describes the patient, intervention, comparison, outcome and time, would help us narrow down to a specific and well-formulated RQ.[ 5 , 6 ] A good RQ leads to the derivation of a research hypothesis, which is an assumption or prediction of the outcome that will be tested by the research. The research topic could be chosen from among the routine clinical work regarding clinical management, use of drugs e.g., vasopressors to prevent hypotension or equipment such as high flow nasal oxygen to avoid ventilation.

Review of literature

To gather this information may be a difficult task for a fresh trainee however, a good review of the available literature is a tool to identify and narrow down a good RQ and generate a hypothesis. Literature sources could be primary (clinical trials, case reports), secondary (reviews, meta-analyses) or tertiary (e.g., reference books, compilations). Methods of searching literature could be manual (journals) or electronic (online databases), by looking up references or listed citations in existing articles. Electronic database searches are made through the various search engines available online e.g., scholar.google.com, National Library of Medicine (NLM) website, clinical key app and many more. Advanced searches options may help narrow down the search results to those that are relevant for the student. This could be based on synthesising keywords from the RQ, or by searching for phrases, Boolean operators, or utilising filters.

After choosing the topic, an apt and accurate title has to be chosen. This should be guided by the use of Medical Subject Headings (MeSH) terminology from the NLM, which is used for indexing, cataloguing, and searching of biomedical and health-related information.[ 7 ] The dissertation requires a detailed title which may include the objective of the study, key words and even the PICOT components. One may add the study design in the title e.g. “a randomised cross over study” or “an observational analytical study” etc.

Aim and the objectives

The Aims and the Objectives of the research study have to be listed clearly, before initiating the study.[ 8 ] “Gaps” or deficiencies in existing knowledge should be clearly cited. The Aim by definition is a statement of the expected outcome, while the Objectives (which might be further classed into primary and secondary based on importance) should be specific, measurable, achievable, realistic or relevant, time-bound and challenging; in short, “SMART!” To simplify, the aim is a statement of intent, in terms of what we hope to achieve at the end of the project. Objectives are specific, positive statements of measurable outcomes, and are a list of steps that will be taken to achieve the outcome.[ 9 ] Aim of a dissertation, for example, could be to know which of two nerve block techniques is better. To realise this aim, comparing the duration of postoperative analgesia after administration of the block by any measurable criteria, could be an objective, such as the time to use of first rescue analgesic drug. Similarly, total postoperative analgesic drug consumption may form a secondary outcome variable as it is also measurable. These will generate data that may be used for analysis to realise the main aim of the study.

Inclusion and exclusions

The important aspect to consider after detailing when and how the objectives will be measured is documenting the eligibility criteria for inclusion of participants. The exclusion criteria must be from among the included population/patients only. e.g., If only American Society of Anesthesiologists (ASA) I and II are included, then ASA III and IV cannot be considered as exclusion criteria, since they were never a part of the study. The protocol must also delineate the setting of the study, locations where data would be collected, and specify duration of conduct of the dissertation. A written informed consent after explaining the aim, objectives and methodology of the study is legally mandatory before embarking upon any human study. The study should explicitly clarify whether it is a retrospective or a prospective study, where the study is conducted and the duration of the study.

Sample size: The sample subjects in the study should be representative of the population upon whom the inference has to be drawn. Sampling is the process of selecting a group of representative people from a larger population and subjecting them for the research.[ 10 ] The sample size represents a number, beyond which the addition of population is unlikely to change the conclusion of the study. The sample size is calculated taking into consideration the primary outcome criteria, confidence interval (CI), power of the study, and the effect size the researcher wishes to observe in the primary objective of the study. Hence a typical sample size statement can be - “Assuming a duration of analgesia of 150 min and standard deviation (SD) of 15 min in first group, keeping power at 80% and CIs at 95% (alpha error at 0.05), a sample of 26 patients would be required to detect a minimum difference (effect size) of 30% in the duration of analgesia between the two groups. Information regarding the different sampling methods and sample size calculations may be found in the Supplementary file 1 .

Any one research question may be answered using a number of research designs.[ 11 ] Research designs are often described as either observational or experimental. The various research designs may be depicted graphically as shown in Figure 1 .

Graphical description of available research designs

The observational studies lack “the three cornerstones of experimentation” – controls, randomisation, and replication. In an experimental study on the other hand, in order to assess the effect of treatment intervention on a participant, it is important to compare it with subjects similar to each other but who have not been given the studied treatment. This group, also called the control group, may help distinguish the effect of the chosen intervention on outcomes from effects caused by other factors, such as the natural history of disease, placebo effects, or observer or patient expectations.

All the proposed dissertations must be submitted to the scientific committee for any suggestion regarding the correct methodology to be followed, before seeking ethical committee approval.

Ethical considerations

Ethical concerns are an important part of the research project, right from selection of the topic to the dissertation writing. It must be remembered, that the purpose of a dissertation given to a post-graduate student is to guide him/her through the process by educating them on the very basics of research methodology. It is therefore not imperative that the protégés undertake a complicated or risky project. If research involves human or animal subjects, drugs or procedures, research ethics guidelines as well as drug control approvals have to be obtained before tabling the proposal to the Institutional Ethics Committee (IEC). The roles, responsibilities and composition of the Ethics Committee has been specified by the Directorate General of Health Services, Government of India. Documented approval of the Ethics committee is mandatory before any subject can be enroled for any dissertation in India. Even retrospective studies require approval from the IEC. Details of this document is available at: https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadEthicsRegistration/Applmhrcrr.pdf .

The candidate and the guide are called to present their proposal before the committee. The ethical implications, risks and management, subjects’ rights and responsibilities, informed consent, monetary aspects, the research and analysis methods are all discussed. The patient safety is a topmost priority and any doubts of the ethical committee members should be explained in medically layman's terms. The dissertation topics should be listed as “Academic clinical trials” and must involve only those drugs which are already approved by the Drugs Controller General of India. More commonly, the Committee suggests rectifications, and then the researchers have to resubmit the modified proposal after incorporating the suggestions, at the next sitting of the committee or seek online approval, as required. At the conclusion of the research project, the ethics committee has to be updated with the findings and conclusions, as well as when it is submitted for publication. Any deviation from the approved timeline, as well as the research parameters has to be brought to the attention of the IEC immediately, and re-approval sought.

Clinical trial registration

Clinical Trial Registry of India (CTRI) is a free online searchable system for prospective registration of all clinical studies conducted in India. It is owned and managed by the National Institute of Medical Statistics, a division of Indian Council of Medical Research, Government of India. Registration of clinical trials will ensure transparency, accountability and accessibility of trials and their results to all potential beneficiaries.

After the dissertation proposal is passed by the scientific committee and IEC, it may be submitted for approval of trial registration to the CTRI. The student has to create a login at the CTRI website, and submit all the required data with the help of the guides. After submission, CTRI may ask for corrections, clarifications or changes. Subject enrolment and the actual trial should begin only after the CTRI approval.

Randomisation

In an experimental study design, the method of randomisation gives every subject an equal chance to get selected in any group by preventing bias. Primarily, three basic types employed in post-graduate medical dissertations are simple randomisation, block randomisation and stratified randomisation. Simple randomisation is based upon a single sequence of random assignments such as flipping a coin, rolling of dice (above 3 or below 3), shuffling of cards (odd or even) to allocate into two groups. Some students use a random number table found in books or use computer-generated random numbers. There are many random number generators, randomisation programs as well as randomisation services available online too. ( https://www-users.york.ac.uk/~mb55/guide/randsery.htm ).

There are many applications which generate random number sequences and a research student may use such computer-generated random numbers [ Figure 2 ]. Simple randomisation has higher chances of unequal distribution into the two groups, especially when sample sizes are low (<100) and thus block randomisation may be preferred. Details of how to do randomisation along with methods of allocation concealment may be found in Supplementary file 2 .

Figure depicting how to do block randomisation using online resources. (a) generation of a random list (b) transfer of the list to an MS excel file

Allocation concealment

If it is important in a study to generate a random sequence of intervention, it is also important for this sequence to be concealed from all stake-holders to prevent any scope of bias.[ 12 ] Allocation concealment refers to the technique used to implement a random sequence for allocation of intervention, and not to generate it.[ 13 ] In an Indian post-graduate dissertation, the sequentially numbered, opaque, sealed envelopes (SNOSE) technique is commonly used [ Supplementary file 2 ].

To minimise the chances of differential treatment allocation or assessments of outcomes, it is important to blind as many individuals as possible in the trial. Blinding is not an all-or-none phenomenon. Thus, it is very desirable to explicitly state in the dissertation, which individuals were blinded, how they achieved blinding and whether they tested the success of blinding.

Commonly used terms for blinding are

• Single blinding: Masks the participants from knowing which intervention has been given.
• Double blinding: Blinds both the participants as well as researchers to the treatment allocation.
• Triple blinding: By withholding allocation information from the subjects, researchers, as well as data analysts. The specific roles of researchers involved in randomisation, allocation concealment and blinding should be stated clearly in the dissertation.

Data which can be measured as numbers are called quantitative data [ Table 1 ]. Studies which emphasise objective measurements to generate numerical data and then apply statistical and mathematical analysis constitute quantitative research. Qualitative research on the other hand focuses on understanding people's beliefs, experiences, attitudes, behaviours and thus these generate non-numerical data called qualitative data, also known as categorical data, descriptive data or frequency counts. Importance of differentiating data into qualitative and quantitative lies in the fact that statistical analysis as well as the graphical representation may be very different.

Data collection types

In order to obtain data from the outcome variable for the purpose of analysis, we need to design a study which would give us the most valid information. A valid data or measurement tool, is the degree to which the tool measures what it claims to measure. For example, appearance of end tidal carbon dioxide waveform is a more valid measurement to assess correct endotracheal tube placement than auscultation of breath sounds on chest inflation.

The compilation of all data in a ‘Master Chart’ is a necessary step for planning, facilitating and appropriate preparation and processing of the data for analysis. It is a complete set of raw research data arranged in a systematic manner forming a well-structured and formatted, computable data matrix/database of the research to facilitate data analysis. The master chart is prepared as a Microsoft Excel sheet with the appropriate number of columns depicting the variable parameters for each individual subjects/respondents enlisted in the rows.

Statistical analysis

The detailed statistical methodology applied to analyse the data must be stated in the text under the subheading of statistical analysis in the Methods section. The statistician should be involved in the study during the initial planning stage itself. Following four steps have to be addressed while planning, performing and text writing of the statistical analysis part in this section.

Step 1. How many study groups are present? Whether analysis is for an unpaired or paired situation? Whether the recorded data contains repeated measurements? Unpaired or paired situations decide again on the choice of a test. The latter describes before and after situations for collected data (e.g. Heart rate data ‘before’ and ‘after’ spinal anaesthesia for a single group). Further, data should be checked to find out whether they are from repeated measurements (e.g., Mean blood pressure at 0, 1 st , 2 nd , 5 th , 10 th minutes and so on) for a group. Different types of data are commonly encountered in a dissertation [ Supplementary file 3A ].

Step 2. Does the data follow a normal distribution?[ 14 ]

Each study group as well as every parameter has to be checked for distribution analysis. This step will confirm whether the data of a particular group is normally distributed (parametric data) or does not follow the normal distribution (non-parametric data); subsequent statistical test selection mainly depends on the results of the distribution analysis. For example, one may choose the Student's’ test instead of the ‘Mann-Whitney U’ for non-parametric data, which may be incorrect. Each study group as well as every parameter has to be checked for distribution analysis [ Supplementary File 3B ].

Step 3. Calculation of measures of central tendency and measures of variability.

Measures of central tendency mainly include mean, median and mode whereas measures of variability include range, interquartile range (IQR), SD or variance not standard error of mean. Depending on Step 2 findings, one needs to make the appropriate choice. Mean and SD/variance are more often for normally distributed and median with IQR are the best measure for not normal (skewed) distribution. Proportions are used to describe the data whenever the sample size is ≥100. For a small sample size, especially when it is approximately 25-30, describe the data as 5/25 instead of 20%. Software used for statistical analysis automatically calculates the listed step 3 measures and thus makes the job easy.

Step 4. Which statistical test do I choose for necessary analysis?

Choosing a particular test [ Figure 3 ] is based on orderly placed questions which are addressed in the dissertation.[ 15 ]

Chosing a statistical test, (a). to find a difference between the groups of unpaired situations, (b). to find a difference between the groups of paired situations, (c). to find any association between the variables, (d). to find any agreement between the assessment techniques. ANOVA: Analysis of Variance. Reproduced with permission from Editor of Indian Journal of Ophthalmology, and the author, Dr Barun Nayak[ 15 ]

• Is there a difference between the groups of unpaired situations?
• Is there a difference between the groups of paired situations?
• Is there any association between the variables?
• Is there any agreement between the assessment techniques?

Perform necessary analysis using user-friendly software such as GraphPad Prism, Minitab or MedCalc,etc. Once the analysis is complete, appropriate writing in the text form is equally essential. Specific test names used to examine each part of the results have to be described. Simple listing of series of tests should not be done. A typical write-up can be seen in the subsequent sections of the supplementary files [Supplementary files 3C – E ]. One needs to state the level of significance and software details also.

Role of a statistician in dissertation and data analysis

Involving a statistician before planning a study design, prior to data collection, after data have been collected, and while data are analysed is desirable when conducting a dissertation. On the contrary, it is also true that self-learning of statistical analysis reduces the need for statisticians’ help and will improve the quality of research. A statistician is best compared to a mechanic of a car which we drive; he knows each element of the car, but it is we who have to drive it. Sometimes the statisticians may not be available for a student in an institute. Self-learning software tools, user-friendly statistical software for basic statistical analysis thus gain importance for students as well as guides. The statistician will design processes for data collection, gather numerical data, collect, analyse, and interpret data, identify the trends and relationships in data, perform statistical analysis and its interpretation, and finally assist in final conclusion writing.

Results are an important component of the dissertation and should follow clearly from the study objectives. Results (sometimes described as observations that are made by the researcher) should be presented after correct analysis of data, in an appropriate combination of text, charts, tables, graphs or diagrams. Decision has to be taken on each outcome; which outcome has to be presented in what format, at the beginning of writing itself. These should be statistically interpreted, but statistics should not surpass the dissertation results. The observations should always be described accurately and with factual or realistic values in results section, but should not be interpreted in the results section.

While writing, classification and reporting of the Results has to be done under five section paragraphs- population data, data distribution analysis, results of the primary outcome, results of secondary outcomes, any additional observations made such as a rare adverse event or a side effect (intended or unintended) or of any additional analysis that may have been done, such as subgroup analysis.

At each level, one may either encounter qualitative (n/N and %) or quantitative data (mean [SD], median [IQR] and so on.

In the first paragraph of Results while describing the population data, one has to write about included and excluded patients. One needs to cite the Consolidated Standards of Reporting Trials (CONSORT) flow chart to the text, at this stage. Subsequently, highlighting of age, sex, height, body mass index (BMI) and other study characteristics referring to the first table of ‘patients data’ should be considered. It is not desirable to detail all values and their comparison P values in the text again in population data as long as they are presented in a cited table. An example of this pattern can be seen in Supplementary file 3D .

In the second paragraph, one needs to explain how the data is distributed. It should be noted that, this is not a comparison between the study groups but represents data distribution for the individual study groups (Group A or Group B, separately)[ Supplementary file 3E ].

In the subsequent paragraph of Results , focused writing on results of the primary outcomes is very important. It should be attempted to mention most of the data outputs related to the primary outcomes as the study is concluded based on the results of this outcome analysis. The measures of central tendency and dispersion (Mean or median and SD or IQR etc., respectively), alongside the CIs, sample number and P values need to be mentioned. It should be noted that the CIs can be for the mean as well as for the mean difference and should not be interchanged. An example of this pattern can be seen in Supplementary file 3F .

A large number of the dissertations are guided for single primary outcome analysis, and also the results of multiple secondary outcomes are needed to be written. The primary outcome should be presented in detail, and secondary outcomes can be presented in tables or graphs only. This will help in avoiding a possible evaluator's fatigue. An example of this pattern can be seen in Supplementary file 3G .

In the last paragraph of the Results, mention any additional observations, such as a rare adverse event or side effect or describe the unexpected results. The results of any additional analysis (subgroup analysis) then need to be described too. An example of this pattern can be seen in Supplementary file 3H .

The most common error observed in the Results text is duplication of the data and analytical outputs. While using the text for summarising the results, at each level, it should not be forgotten to cite the table or graph but the information presented in a table should not be repeated in the text. Further, results should not be given to a greater degree of accuracy than that of the measurement. For example, mean (SD) age need to be presented as 34.5 (11.3) years instead of 34.5634 (11.349). The latter does not carry any additional information and is unnecessary. The actual P values need to be mentioned. The P value should not be simply stated as ‘ P < 0.05’; P value should be written with the actual numbers, such as ‘ P = 0.021’. The symbol ‘<’ should be used only when actual P value is <0.001 or <0.0001. One should try avoiding % calculations for a small sample especially when n < 100. The sample size calculation is a part of the methodology and should not be mentioned in the Results section.

The use of tables will help present actual data values especially when in large numbers. The data and their relationships can be easily understood by an appropriate table and one should avoid overwriting of results in the text format. All values of sample size, central tendency, dispersions, CIs and P value are to be presented in appropriate columns and rows. Preparing a dummy table for all outcomes on a rough paper before proceeding to Microsoft Excel may be contemplated. Appropriate title heading (e.g., Table 1 . Study Characteristics), Column Headings (e.g., Parameter studied, P values) should be presented. A footnote should be added whenever necessary. For outputs, where statistically significant P values are recorded, the same should be highlighted using an asterisk (*) symbol and the same *symbol should be cited in the footnote describing its value (e.g., * P < 0.001) which is self-explanatory for statistically significance. One should not use abbreviations such as ‘NS’ or ‘Sig’ for describing (non-) significance. Abbreviations should be described for all presented tables. A typical example of a table can be seen in Figure 4 .

Example of presenting a table

Graphical images

Similar to tables, the graphs and diagrams give a bird's-eye view of the entire data and therefore may easily be understood. bar diagrams (simple, multiple or component), pie charts, line diagrams, pictograms and spot maps suit qualitative data more whereas the histograms, frequency polygons, cumulative frequency, polygon scatter diagram, box and whisker plots and correlation diagrams are used to depict quantitative data. Too much presentation of graphs and images, selection of inappropriate or interchanging of graphs, unnecessary representation of three-dimensional graph for one-dimensional graphs, disproportionate sizes of length and width and incorrect scale and labelling of an axis should be avoided. All graphs should contain legends, abbreviation descriptions and a footnote. Appropriate labelling of the x - and the y -axis is also essential. Priori decided scale for axis data should be considered. The ‘error bar’ represents SDs or IQRs in the graphs and should be used irrespective of whether they are bar charts or line graphs. Not showing error bars in a graphical image is a gross mistake. An error bar can be shown on only one side of the line graph to keep it simple. A typical example of a graphical image can be seen in Figure 5 . The number of subjects (sample) is to be mentioned for each time point on the x -axis. An asterisk (*) needs to be put for data comparisons having statistically significant P value in the graph itself and they are self-explanatory with a ‘stand-alone’ graph.

Example of an incorrect (a) and correct (b) image

Once the results have been adequately analysed and described, the next step is to draw conclusions from the data and study. The main goal is to defend the work by staging a constructive debate with the literature.[ 16 ] Generally, the length of the ‘ Discussion ’ section should not exceed the sum of other sections (introduction, material and methods, and results).[ 17 ] Here the interpretation, importance/implications, relevance, limitations of the results are elaborated and should end in recommendations.

It is advisable to start by mentioning the RQ precisely, summarising the main findings without repeating the entire data or results again. The emphasis should be on how the results correlate with the RQ and the implications of these results, with the relevant review of literature (ROL). Do the results coincide with and add anything to the prevalent knowledge? If not, why not? It should justify the differences with plausible explanation. Ultimately it should be made clear, if the study has been successful in making some contribution to the existing evidence. The new results should not be introduced and any exaggerated deductions which cannot be corroborated by the outcomes should not be made.

The discussion should terminate with limitations of the study,[ 17 ] mentioned magnanimously. Indicating limitations of the study reflects objectivity of the authors. It should not enlist any errors, but should acknowledge the constraints and choices in designing, planning methodology or unanticipated challenges that may have cropped up during the actual conduct of the study. However, after listing the limitations, the validity of results pertaining to the RQ may be emphasised again.

This section should convey the precise and concise message as the take home message. The work carried out should be summarised and the answer found to the RQ should be succinctly highlighted. One should not start dwelling on the specific results but mention the overall gain or insights from the observations, especially, whether it fills the gap in the existing knowledge if any. The impact, it may have on the existing knowledge and practices needs to be reiterated.

What to do when we get a negative result?

Sometimes, despite the best research framework, the results obtained are inconclusive or may even challenge a few accepted assumptions.[ 18 ] These are frequently, but inappropriately, termed as negative results and the data as negative data. Students must believe that if the study design is robust and valid, if the confounders have been carefully neutralised and the outcome parameters measure what they are intended to, then no result is a negative result. In fact, such results force us to critically re-evaluate our current understanding of concepts and knowledge thereby helping in better decision making. Studies showing lack of prolongation of the apnoea desaturation safety periods at lower oxygen flows strengthened belief in the difficult airway guidelines which recommend nasal insufflations with at least 15 L/min oxygen.[ 19 , 20 , 21 ]

Publishing the dissertation work

There are many reporting guidelines based upon the design of research. These are a checklist, flow diagram, or structured text to guide authors in reporting a specific type of research, developed using explicit methodology. The CONSORT[ 22 ] and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiatives,[ 23 ] both included in the Enhancing the Quality and Transparency of Health Research (EQUATOR) international network, have elaborated appropriate suggestions to improve the transparency, clarity and completeness of scientific literature [ Figure 6 ].

Equator publishing tree

All authors are advised to follow the CONSORT/STROBE checklist attached as Supplementary file 4 , when writing and reporting their dissertation.

For most dissertations in Anaesthesiology, the CONSORT, STROBE, Standards for Reporting Diagnostic accuracy studies (STARD) or REporting recommendations for tumour MARKer prognostic studies (REMARK) guidelines would suffice.

Abstract and Summary

These two are the essential sections of a dissertation.

It should be at the beginning of the manuscript, after the title page and acknowledgments, but before the table of contents. The preparation varies as per the University guidelines, but generally ranges between 150 to 300 words. Although it comes at the very beginning of the thesis, it is the last part one writes. It must not be a ‘copy-paste job’ from the main manuscript, but well thought out miniaturisation, giving the overview of the entire text. As a rule, there should be no citation of references here.

Logically, it would have four components starting with aims, methods, results, and conclusion. One should begin the abstract with the research question/objectives precisely, avoiding excessive background information. Adjectives like, evaluate, investigate, test, compare raise the curiosity quotient of the reader. This is followed by a brief methodology highlighting only the core steps used. There is no need of mentioning the challenges, corrections, or modifications, if any. Finally, important results, which may be restricted to fulfilment (or not), of the primary objective should be mentioned. Abstracts end with the main conclusion stating whether a specific answer to the RQ was found/not found. Then recommendations as a policy statement or utility may be made taking care that it is implementable.

Keywords may be included in the abstract, as per the recommendations of the concerned university. The keywords are primarily useful as markers for future searches. Lastly, the random reader using any search engine may use these, and the identifiability is increased.

The summary most often, is either the last part of the Discussion or commonly, associated with the conclusions (Summary and Conclusions). Repetition of introduction, whole methodology, and all the results should be avoided. Summary, if individually written, should not be more than 150 to 300 words. It highlights the research question, methods used to investigate it, the outcomes/fallouts of these, and then the conclusion part may start.

References/bibliography

Writing References serves mainly two purposes. It is the tacit acknowledgement of the fact that someone else's written words or their ideas or their intellectual property (IP) are used, in part or in toto , to avoid any blame of plagiarism. It is to emphasise the circumspective and thorough literature search that has been carried out in preparation of the work.

Vancouver style for referencing is commonly used in biomedical dissertation writing. A reference list contains details of the works cited in the text of the document. (e.g. book, journal article, pamphlet, government reports, conference material, internet site). These details must include sufficient details so that others may locate and access those references.[ 24 ]

How much older the references can be cited, depends upon the university protocol. Conventionally accepted rule is anywhere between 5-10 years. About 85% of references should be dispersed in this time range. Remaining 15%, which may include older ones if they deal with theories, historical aspects, and any other factual content. Rather than citing an entire book, it is prudent to concentrate on the chapter or subsection of the text. There are subjective variations between universities on this matter. But, by and large, these are quoted as and when deemed necessary and with correct citation.

Bibliography is a separate list from the reference list and should be arranged alphabetically by writing name of the ‘author or title’ (where no author name is given) in the Vancouver style.

There are different aspects of writing the references.[ 24 ]

Citing the reference in the form of a number in the text. The work of other authors referred in the manuscript should be given a unique number and quoted. This is done in the order of their appearance in the text in chronological order by using Arabic numerals. The multiple publications of same author shall be written individually. If a reference article has more than six authors, all six names should be written, followed by “ et al .” to be used in lieu of other author names. It is desirable to write the names of the journals in abbreviations as per the NLM catalogue. Examples of writing references from the various sources may be found in the Supplementary file 5 .

Both the guide and the student have to work closely while searching the topic initially and also while finalising the submission of the dissertation. But the role of the guide in perusing the document in detail, and guiding the candidate through the required corrections by periodic updates and discussions cannot be over-emphasised.

Assessment of dissertations

Rarely, examiners might reject a dissertation for failure to choose a contemporary topic, a poor review of literature, defective methodology, biased analysis or incorrect conclusions. If these cannot be corrected satisfactorily, it will then be back to the drawing board for the researchers, who would have to start from scratch to redesign the study, keeping the deficiencies in mind this time.

Before submission, dissertation has to be run through “plagiarism detector” software, such as Turnitin or Grammarly to ensure that plagiarism does not happen even unwittingly. Informal guidelines state that the percentage plagiarism picked up by these tools should be <10%.

No work of art is devoid of mistakes/errors. Logically, a dissertation, being no exception, may also have errors. Our aim, is to minimise them.

The dissertation is an integral part in the professional journey of any medical post-graduate student. It is also an important responsibility for a guide to educate his protégé, the basics of research methodology through the process. Searching for a gap in literature and identification of a pertinent research question is the initial step. Careful planning of the study design is a vitally important aspect. After the conduct of study, writing the dissertation is an art for which the student often needs guidance. A good dissertation is a good description of a meticulously conducted study under the different headings described, utilising the various reporting guidelines. By avoiding some common errors as discussed in this manuscript, a good dissertation can result in a very fruitful addition to medical literature.

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Conflicts of interest.

There are no conflicts of interest.

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