Royal College of Surgeons in Ireland - Medical University of Bahrain

Evidence based health (EBH) /

Public health and epidemiology
(PHE)
Project guidelines 2015 - 2016

Marks&allocated&to&this&project:&35%&
&

Getting&started&
Locate&the&paper&assigned&to&your&team&
Each&team&has&a&number.&
Project&papers&on&Moodle&are&numbered&from&01&to&10&
If&your&team&number&ends&in&a&1,&then&you&have&been&assigned&01,&and&if&it&ends&in&a&2,&
then&you&are&assigned&02.&Teams&whose&number&ends&in&a&zero,&as&you&might&expect,&are&
assigned&10.&
Download&the&paper&for&your&team&project&from&Moodle.&
&

Writing&and&submitting&your&report&
1.&One&person&should&submit&each&project&report&on&behalf&of&the&team.&
2.&Please&name&each&document&EBH/PHE&2015&Project&Team&X.doc,&where&X&is&the&number&
of&your&team.&
3.&Make&sure&to&put&the&team&number&into&the&header&or&footer&of&your&document&too.&
4.&Please&give&the&names&and&examination&numbers&of&the&team&members&at&the&start&of&the&
project.&This&helps&to&identify&people&who&were&missing&from&class&lists&etc&when&the&
original&project&teams&were&selected.&&
&

Feedback&&
Your&team&report&will&be&peerVreviewed&by&academic&staff&and&you&will&receive&detailed&
project&feedback.&&&
&
&

&
&

The&task:&Appraising&a&public&health&research&paper&and&
selecting&prevention&strategies&
The&idea&is&to&evaluate&a&scientific&paper&in&context&&both&its&contribution&to&knowledge&
and&the&ethical&context&of&the&research.&&You&will&also&review&other&literature&on&the&topic&
and&apply&the&available&evidence&to&select&and&advise&on&appropriate&evidenceVbased&
prevention&strategies.&Finally,&you&are&required&to&provide&an&analysis&of&the&teamwork&
experience.&This&task&is&divided&into&a&number&of&sections.&The&table&shows&the&structure&of&
your&project&report,&the&size&limits&for&each&section&and&the&marks.&&
Section

Words

1. Scientific evaluation

%
40%

Background to the paper

500

Evaluation of the paper itself

800

What has happened since

700

Evidence-based prevention strategies

1000

2. Ethics

20%

Ethical appraisal of the research

1000

Information leaflet and consent form

Be brief

3. Search strategy and references

No limit

4. Analysis of team work experience

5%

20%

Team performance reports

1000

Writing style, structure, presentation

5%

Total

100%

Project&aim&
&
Research& builds& on& previous& work& and,& in& turn,& contributes& to& the& development& of&
knowledge&in&the&field.&The&aim&of&your&project&is&to&show:&&
&
a)& How& this& particular& research& project& arose& by& placing& it& in& the& context& of& what& was&
known&and&what&was&not&known&at&the&time,&&
&
b)&To&assess&how&well&the&paper&contributed&to&our&knowledge,&&
&
c)& To& summarise& how& knowledge& and& practice& have& developed& since,& and& to& evaluate& the&
contribution&that&the&paper&made&to&this&and&&
&
d)&To&select&and&advise&on&three&evidenceVbased&prevention&strategies&to&reduce&or&prevent&
the&health&problem.&
&
Don't& forget& the& external& validity& of& the& paper& & the& degree& to& which& the& paper& tells& us&
something&that&we&can&relate&to&real&life&(or&real&clinical&practice).&There&is&a&whole&lecture&
on& external& validity,& but& the& key& points& are& that& research& must& study& an& appropriate&
population,&must&measure&things&using&methods&that&make&realVlife&sense&and,&in&the&case&of&
interventions,&these&interventions&must&be&realistic&and&practical.&

&
&

The&sections&
1.&Scientific&evaluation&(3000&words&max&in&total)&
1.1&Background&to&the&paper&(500&words&max)&
In&this&section,&you&should&summarise&the&knowledge&at&the&time&the&study&was&carried&out,&
and&show&how&the&question&that&the&paper&attempted&to&answer&fitted&into&the&development&
of&knowledge&in&the&area.&You&will&get&a&head&start&by&reading&the&authors'&introduction,&but&
be&warned,&more&marks&will&go&for&a&broader&introduction&to&the&research&question&than&
you&will&get&in&the&paper&itself.&
You&should&also&show&the&value&of&the&paper&&in&what&way&was&it&important&to&answer&the&
question&addressed&by&the&paper.&This&is&the&first&criterion&of&ethical&research:&that&the&
research&has&social&value&&either&in&terms&of&offering&an&immediate&benefit&to&the&
population&being&studied,&or&in&the&longer&term.&

&
Sections&
These&sections&are&suggestions,&and&may&not&apply&to&all&papers.&
Describe&the&health&problem&that&the&paper&addresses.&Use&available&epidemiological&
evidence,&such&as&the&incidence,&prevalence&and&mortality&rates,&to&describe&the&health&
problem&including&trends&over&time,&where&possible.&Include&evidence&on&behavioural&and&
biological&risk&factors.&Cover&the&basic&medicine,&but&don't&forget&that&a&problem&may&have&
important&social,&economic&or&ethical&importance.&&
Describe&the&state&of&knowledge&at&the&time&the&research&was&designed.&What&was&known,&
what&was&unknown,&what&gave&rise&to&the&question&that&the&paper&addresses?&
Describe&the&state&of&practice&at&the&time.&Your&paper&may&have&implications&for&clinical&
practice,&or&for&policy&or&some&other&practical&implications;&give&background&on&these.&
Evaluate&the&social&value&of&the&research&question.&How&did&the&research&contribute&to&
improving&the&wellbeing&of&the&population&being&studied?&Of&the&participants&themselves?&
Did&it&hold&out&promise&of&longer&term&benefits?&
What&was&the&potential&social&value&of&the&research?&In&what&way&would&society&be&better&
off&by&knowing&the&answer&to&the&research&question?&Dont&jump&ahead&and&talk&about&the&
results&of&the&paper&&this&section&should&make&a&case&for&the&importance&of&the&question,&
not&the&usefulness&of&the&results.&&

Note:&You&will&find&much&of&what&you&need&in&the&paper&itself,&but&reading&around&the&area&
will&help&you&to&understand&where&the&research&question&came&from,&and,&of&course,&will&get&
you&a&higher&mark.&
&

1.2&Evaluate&the&paper&itself&(800&words&max)&
How&well&did&the&paper&answer&the&question&it&set&out&to&address?&&
You&can&use&one&of&the&critical&appraisal&checklists&which&you&will&find&on&the&internet.&The&
Moodle&page&gives&links&to&useful&collections&of&checklists.&You&don't&have&to&use&a&checklist,&
but&they&are&helpful&because&they&remind&you&of&the&questions&that&your&appraisal&should&
cover.&&
Teams&using&one&of&the&Glasgow&checklists&tend&to&perform&well&in&our&experience,&and&we&
would&recommend&checking&them&out.&There&are&checklists&for&different&types&of&research.&
You&will&find&them&at&
http://www.gla.ac.uk/departments/generalpracticeprimarycare/ebp/checklists/&
Your&appraisal&should&include&the&following&information&(not&all&items&may&be&applicable&to&
every&paper)&
Participants:&Whom&did&the&researchers&study?&
&Did&they&select&a&relevant&population&to&study?&
&Did&their&sampling&method&give&them&a&representative&group&from&the&population?&
&What&sources&of&bias&were&there&in&recruitment&that&might&limit&the&applicability&of&
the&findings?&
&Did&they&have&a&significant&problem&with&nonVresponse&or&dropVout&that&might&
make&the&sample&unrepresentative?&
&Was&the&sample&big&enough&to&draw&reliable&conclusions?&
Measures:&How&did&the&researchers&measure&the&variables&they&studied?&
&Were&diagnoses&made&following&recognised&criteria?&
&Were&the&variables&relevant&to&the&study&question?&
&Were&the&methods&used&reliable&and&valid?&
&Were&all&relevant&outcomes&or&factors&measured?&
Results&summarise&the&findings&of&the&paper:&
&Are&there&unanswered&questions?&

&Could&the&authors&have&answered&these&with&the&data&they&had?&
&Are&the&results&presented&in&such&a&way&that&you&can&judge&their&clinical&
importance?&
Conclusions&summarise&the&authors'&conclusions.&
&What&are&the&implications&of&the&findings&for&our&knowledge&and&for&practice?&
&Are&the&authors'&conclusions&justified&by&the&data&they&present?&
Note:&Sometimes&teams&are&so&keen&to&evaluate&the&findings&of&the&paper&that&they&forget&to&
tell&us&what&the&findings&were.&Don't&forget!&
Note:&Don't&forget&the&important&topic&of&external&validity&&the&degree&to&which&the&
research&is&applicable&to&realVlife&situations&such&as&clinical&practice&or&public&health.&
&

1.3.&What&has&happened&since?&(700&Words&max)&
Summarise&the&development&of&our&knowledge&and&its&impact&on&practice&since&the&
publication&of&the&paper.&You&will&find&Google&Scholar&very&useful&here,&as&it&will&link&you&to&
papers&which&cited&your&paper.&Check,&too,&on&PubMed's&related&articles&option.&&
A&visit&to&ResearchGate&is&highly&recommended&for&several&reasons.&The&first&is&that&there&
are&many&pdfs&on&ResearchGate,&put&up&by&researchers,&which&you&can&download.&You&can&
also&ask&researchers&for&private&copies&of&papers.&Also&important,&you&can&ask&questions.&
Indeed,&its&really&useful&to&see&if&people&have&been&discussing&the&problem&that&your&paper&
focusses&on.&This&can&lead&to&understanding&the&main&issues&and&points&of&view,&and,&of&
course,&to&useful&web&links.&ResearchGate&is&an&excellent&place&to&put&your&own&questions,&
too,&of&course.&You&might&consider&starting&your&own&profile&there.&&

&
Dont&be&too&narrow&
Some&teams&only&search&papers&that&cited&their&paper.&You&do&not&have&to&limit&yourself&to&
the&papers&that&cited&your&paper!&Your&paper&may&not&have&been&cited&for&various&reasons&&
subsequent&researchers&may&not&have&read&it,&or&may&not&have&thought&it&contributed&
anything&important.&
You&should,&rather,&concentrate&on&the&research&question&that&the&paper&set&out&to&answer,&
and&find&out&how&much&more&we&know&now.&If&you&are&finding&the&literature&very&small,&you&
may&be&thinking&of&the&research&question&in&too&narrow&terms.&For&example,&if&your&paper&is&
in&the&area&of&hepatitis&C,&you&might&widen&the&question&to&blood&borne&viruses&or&to&
infectious&diseases&groups&at&risk&of&hepatitis&C.&

Link&it&to&practice&
And&remember&that&research&also&informs&clinical&practice.&Has&the&research&produced&or&
changed&any&clinical&guidelines&since&the&paper&was&published?&Have&prevention&or&
screening&programmes&been&started,&or&changed?&
As&a&general&rule,&if&you&have&found&less&than&ten&relevant&publications&to&discuss,&you&have&
focused&this&section&too&narrowly,&or&you&havent&been&using&a&good&search&strategy.&
This&section&is&where&you&can&really&impress.&It's&worth&putting&your&best&minds&to&work&on&
it.&
&

1.4&What&can&be&done&about&it?&(1000&words&max)&
What&can&be&done&to&prevent&the&health&problem&in&the&population?&The&next&step&is&to&find&
suitable&evidenceVbased&interventions&to&prevent&or&reduce&the&health&problem.&What&
evidenceVbased&public&health&strategies&could&work&to&reduce&or&prevent&the&health&
problem:&&
Do&possible&interventions&target&the&whole&population?&Do&they&focus&on&those&at&
high&risk?&&
Will&the&strategies&require&changes&to&public&policy&or&the&creation&of&supportive&
environments&to&enable&communities&and&individuals&to&increase&control&over&and&to&
improve&their&health?&
Prevention&strategies&for&populations&include&primordial,&primary&and/or&secondary&
prevention&approaches.&Some&prevention&strategies&may&act&at&the&level&of&the&population,&
e.g.&through&policies&and&legislation&to&improve&the&safety&of&water&or&air,&laws&to&ban&
cigarette&smoking&in&public&places,&and&legislation&to&tax&fatty&foods&and&soft&drinks&sold&
near&schools.&Other&prevention&strategies&act&at&the&level&of&the&individual,&e.g.&
immunisations&given&to&infants.&&Health&education&campaigns&limited&to&the&doctors&
surgery&would&not&be&sufficient&to&constitute&a&public&health&intervention,&unless&efforts&are&
made&to&target&all&eligible&infants&in&the&population.&&
You&need&to&select&three%suitable%population/based%prevention%strategies;&&
Evaluate&their&advantages%and%disadvantages;&
Also,&remember&that&important&evidence&on&the&effectiveness&of&a&public&health&
intervention&may&have&been&produced&in&a&different&setting&to&the&one&that&
presented&in&your&paper.&If&you&include&such&evidence&in&your&review,&you&will&need&
to&justify&its&appropriateness%for%your%setting.%%
&
8

Public&health&strategies&are&broadlyVdefined&activities&that&are&evaluated&using&a&wide&
variety&of&approaches&and&study&designs,&including&clusterVrandomized&trials.&For&some&
questions,&the&best&available&evidence&may&be&from&nonVrandomized&studies,&often&because&
trials&are&not&feasible&or&not&ethical.&&
There&are&two&sources&of&evidence&that&you&can&use&to&find&research&evidence&of&the&
effectiveness&of&many&interventions:&the&Cochrane&library&and&PubMed.&&&
&

2&Ethics&&
2.1&Ethical&appraisal&of&the&paper&(1000&words&max)&
It&is&unlikely&that&you&will&find&major&ethical&problems&with&your&paper.&After&all,&ethical&
issues&are&likely&to&have&been&spotted&by&the&ethics&board&that&reviewed&it&and&during&peer&
review&before&publication.&The&purpose&of&this&section&is&to&show&that&you&know&the&ethical&
principles&governing&research,&that&you&can&apply&them&to&a&specific&research&project,&and&
say&what&the&duties&of&the&researchers&were&under&each&principle,&and&how&the&researchers&
put&these&duties&into&practice&in&carrying&out&the&study.&
Not&all&papers&have&the&same&ethical&issues&V&for&example,&if&the&participants&don't&belong&to&
a&vulnerable&group,&there&will&be&effectively&nothing&to&discuss.&For&this&reason,&you&should&
allocate&space&to&write&about&the&most&interesting&or&important&ethical&aspects&of&the&study.&
The&headings&below&are&intended&as&guidance&to&make&sure&you&examine&the&key&ethical&
aspects&of&the&paper.&
You&may&find&that&it&is&not&possible&to&answer&some&of&the&questions&concerning&the&ethical&
conduct&of&the&research&V&authors&are&more&likely&to&leave&out&key&ethical&information&than&
key&methodological&information.&You&may&consider&emailing&the&corresponding&author&&
this&has&been&known&to&work.&Before&doing&so,&collaborate&with&other&teams&who&have&been&
assigned&the&same&paper,&and&make&sure&that&the&author&does&not&receive&requests&for&the&
same&information&from&different&teams.&

Headings&to&use&
Fair&selection&of&participants&
&Did&the&participants&belong&to&any&vulnerable&group?&If&so,&was&this&the&most&appropriate&
group&to&investigate&the&research&question?&Did&this&group&stand&to&benefit&from&the&
results?&How&were&their&interests&protected?&
&Did&the&participants&belong&to&a&group&with&limited&autonomy,&or&a&group&in&which&there&
may&be&pressure&to&take&part?&If&so,&was&this&the&most&appropriate&group&to&investigate&the&
research&question?&What&steps&were&taken&to&safeguard&participants'&freedom&to&choose&to&
take&part?&
9

&Did&the&participants&belong&to&a&group&with&diminished&ability&to&give&informed&consent?&
If&so,&was&this&the&most&appropriate&group&to&investigate&the&research&question?&How&did&
the&researchers&obtain&informed&consent?&
&

Minimising&risks,&maximising&benefits&
&What&potential&risks&were&there&for&participants&and&how&were&these&avoided&or&
managed?&Did&any&unforeseen&risks&emerge&during&the&study?&
&Were&there&any&ethical&risks&involved&for&the&participants?&
&What&benefits&did&the&study&stand&to&bring&to&participants&and&how&did&the&researcher&
ensure&that&these&benefits&actually&occurred?&
&

Independent&review&
&What&independent&ethical&evaluation&has&been&carried&out&on&the&study?&
Informed&consent&
&How&did&the&authors&secure&informed&consent?&
&If&a&person&decided&to&withdraw&consent,&what&arrangements&were&in&place?&
&What&fears&might&a&participant&have&had&about&not&participating&or&about&withdrawing?&
How&were&these&fears&addressed?&

&
Respect&for&participants&
&Was&the&study&anonymous&or&confidential?&In&either&case,&what&steps&were&taken&to&
maintain&the&confidentiality/anonymity&of&participant&information?&
&Could&the&research&have&revealed&important&information&about&the&participant,&such&as&
the&presence&of&a&disease&or&disorder?&How&was&this&managed&when&it&occurred?&
&Did&participants&have&to&disclose&information&which&was&sensitive,&such&as&behaviour&
which&went&against&laws&or&professional&codes&of&conduct?&
&Could&the&research&have&resulted&in&distress&or&discomfort&for&participants?&What&
safeguards&and&management&systems&were&in&place&to&minimise&risk&and&to&manage&
problems?&
&Could&the&research&have&uncovered&any&other&issues&which&would&have&placed&an&ethical&
duty&on&the&investigator&to&act,&either&by&informing&someone&or&by&intervening?&

10

Ethics:&summary&
&Summarise&any&ethical&weaknesses&you&found&in&the&paper&
&Summarise&the&ethical&aspects&of&the&study&that&are&not&described&sufficiently&&or&at&all&&
in&the&paper.&Are&any&of&these&critical&to&making&a&decision&on&whether&the&research&was&
ethical&or&not?&
&

2.2.&Information&and&consent&form&(be&brief)&
Write&an&information&sheet&describing&the&study&and&asking&for&informed&consent&to&
participate.&The&sheet&should&be&written&simply,&and&should&cover&all&aspects&of&informed&
consent.&See&guidance&notes&on&Moodle.&
Make&sure&you&write&in&simple,&nonVtechnical&language.&
There&is&no&word&limit,&but&try&to&keep&the&information&sheet&short&&you&will&lose&marks&for&
a&document&that&is&excessively&long&or&detailed.&About&a&page&is&ideal,&but&some&studies&may&
be&easier&to&explain&than&others,&so&there's&no&prescribed&size.&
Remember&that&you&need&to&describe&the&research&in&enough&detail&so&that&consent&is&really&
informed,&without&swamping&the&participant&with&so&much&information&that&they&cannot&
really&decide.&
&

3.&Search&strategy&and&references&(no&limit)&
Describe&the&search&strategy&used&to&identify&references&(not&more&than&200&words)&and&
insert&the&Reference&List&of&research&papers,&books&or&websites&you&used,&using&Vancouver&
reference&format.&You&will&find&complete&details&here:&
http://www.lib.monash.edu.au/tutorials/citing/vancouver.html&
&
Note:&Don't&forget&to&list&the&search&engines&you&used,&the&terms&you&used,&and&mention&any&
clever&use&you&made&of&facilities&like&PubMed's&related&articles&search.&You&get&more&marks&
for&a&thorough,&well&described&strategy,&so&don't&undersell&yourselves&here.&
Note:&Don't&forget&to&reference&articles&you&used&in&your&Ethics&review!&
Note:&Your&bibliography&should&be&laid&out&in&Vancouver&format.&You&can&do&this&by&using&
the&insert&footnote&command&in&Word,&and&using&the&dialogue&to&change&the&entry&to&an&
endnote.&Once&you&do&this&once,&all&subsequent&entries&will&be&endnotes.&This&will&allow&you&
to&build&up&a&numbered&reference&list.&

11

4.& Team&performance&(1000&words&max)&
&
1. Provide&a&list&and&attendance&record&[date,&time,&specific&task&for&meeting&attendance&
and&the&tasks&assigned&to&each&team&member.&As&a&general&guide,&6V8&meetings&should&
suffice&for&project&teamwork.&&
&
2. Complete&an&analysis&of&the&team&role&balance&using&Belbin&roles.&This&will&offer&direct&
individual&feedback&and&will&support&you&in&the&analysis&of&team&strengths&and&
weaknesses&and&in&developing&a&tailored&plan&to&compensate&for&any&team&weaknesses.&
&
3. Complete&an&analysis&of&team&performance&describing&how&you&worked&together&as&a&
team.&&Focus&on&four&main&areas:&preparation,&contribution,&respect&for&others&ideas,&
and&flexibility.&
&
4. Outline&five&strategies,&on&the&basis&of&this&team&project&experience,&for&improving&the&
functioning&of&any&new&team&project&you&may&undertake&in&the&future.&
&
Preparation Were all team members prepared when they came to class? Did they
complete tasks they were assigned to? How did the team deal with poorly prepared team
members?
Contribution Did team members contribute productively to group discussion and work?
Were discussions mostly at deep (rather than superficial) conceptual levels? Were team
members recognised when something they said helped the team to reach a good decision?
Respect for others ideas Did team members encourage others to contribute their ideas?
Did team members share and receive criticism without making it personal? Did team
members worked to come up with solutions that satisfied all members?
Flexibility&&Were&team&members&flexible&when&disagreements&occurred?&

&

&
&

12

Submissions&and&Deadlines:&
Submission&team&report&1:&&&
Download&the&form&from&the&download&and&upload&section&of&the&PIH&project&on&moodle.&
Submission&Team&Report&1&Word&document&&
&

Submission&team&report&2:&&&
Download&the&form&from&the&download&and&upload&section&of&the&PIH&project&on&moodle.&
Submission&Team&Report&2&Word&document&&
&

Submission&team&report&3:&&&
Download&the&form&from&the&download&and&upload&section&of&the&PIH&project&on&moodle.&
Submission&Team&Report&3&Word&document&&
&

Submission&completed&project&report:&&&
For&the&final&report&the&leader&of&the&group&should&submit&one&document&in&a&pdf&format.&
&
&
&

13

14