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Hi, everyone. I'm a, I went to Cardiff University. I recently graduated and I'm doing one up in Manchester in Salford. I'm on my second block rotation now and I'm on gastroenterology. So, and her kindly asked me to come back and do a talk for a fit who I used to be the lead for and LA Well, when I was in medical school, um, running series like this for you guys. Um, but you guys probably don't remember. Uh Essentially today's talk is gonna be on research as a student and beyond. It's not very detailed in terms of statistical analysis, et cetera because that's a whole topic and talk in itself. I just thought I'd give you an overview of what um different things are in research and how you can get involved student and how I got involved when I was a medical student myself. Um, and it'll be interactive as well at the end so you can ask me any questions that you want. So, so, yes, sorry, I couldn't hear you. Yeah, I just want to double check. Can you hear me now? It's fine. Now, what part did you miss? Oh, no, it's fine, you can carry on. OK, perfect. So I was just saying that I won't be doing a talk on the different statistical test because that's a topic on its own. But we'll go over some of the basics and it'll be quite interactive. So um one thing that's most important basics of research studies that you need to know whatever talk you attend, they'll go over this. And also if you're gonna be doing research yourself, it's good to know about different study designs. So you might have seen this hierarchy called case the cross sectional studies, cohort randomized controlled trials and systematic reviews. Now, the different reasons for doing this is because different things, different kind of researches can fall into different of these categories. Secondly, in terms of for yourself, if you're a medical student or if you're a doctor at different stages is it's only way is at different stages of your career, you'll be able to do some of these and not the other one. So you have to be realistic about the kind of research that you can get involved in. For example, case series or something quite much easier to get involved in as a medical student than say like a randomized controlled trial, you could get um involved in a randomized controlled trial. However, it might be that you're like um helping out you're recruiting participants, et cetera. It's very rare that as a medical student, unless you're doing a phd in between your med school years, you'll actually put the funding for doing a randomized controlled trial because there's a lot of things that go into the background of it. You have to come up with a study design takes years. You have to get funding. You have to tell people why this randomized controlled trial is something worth funding and you have to fight a lot for doing them as a medical student is obviously not very realistic where whereas case series is honestly anything interesting that you might see in the ward, which is different. So I know like if you go, if you have a pediatric placement, for example, that's that's somewhere you can get a lot of case theories. Are you you something odd on the ward or like someone with a complication that's quite easy to get involved in? Now the other question is why is there a hierarchy? So as you can see case series, it is much bigger. So the things that are at the bottom of the hierarchy give you less points per se if you go to applications and things. So case series are not seen that ideal for getting points, that doesn't mean they don't get points. But if you are involved in like a review that gives you much more um points on your portfolio system, depending on whether you're validity increases. Whereas if you go up the hierarchy, if the internal oh my little arrow system, how it disappeared Um So yeah, if you go up the hierarchy, it's the internal VVI that increases. Now, what is the difference between the two? Because I know people often get confused between external validity with internal validity. A defining to the general population. The um if you've got an individually studied people randomly, like you pick these people randomly off the streets and you've decided to see what factors they have, you haven't controlled anything about them. You're most likely to get people who represent the general population, isn't it? Um Say, for example, you go and you want to speak to Bob and Bob, you haven't picked for any reason. You're just like, OK, Bob's just on the board. Let's just speak to him. Um You, he's more likely to represent the population that he's in. So if you're studying lung cancer, for example, then you'll get to see all of the background factors for him. So Bob might be a smoker, a drinker. He might have lived and worked in like Asbestos lived area. Like all of this would go into him where I think you look at internal vivid that tells me how, well you can be confident in the causation. If you wanted to conclude that Bob's smoking caused the cancer, for example, that might be very difficult because you haven't controlled any of the other factors. It might have been that in his case, the one we didn't know about asbestos, it might have been that the asbestos might have contributed to it and could have been drinking, contributes to non cancer, could have been smoking, contributes. So you don't control any of his other external factors of the term we use. Whereas an internal validity, you're trying to have a causation effect is what you're trying to figure out. So you control everything really perfectly apart from the thing that you're trying to manipulate and study. So if you, for example, wanna study the difference between l if you really wanna see if smoking and lung cancer are linked, you will control for every other factor that you think possibly that could cause lung cancer. And then you can be like, actually smoking can definitely be. So you can like say that the internal validity of that is quite high ie you can be confident of the result that you've gotten. If it shows smoking has cau does cause cancer, you can be very confident because you know, you controlled everything else. Whereas if you were to say that for external validity, you couldn't do that. So what you see with internal validity a lot of the time, sorry guys, I don't know why the animations are being so weird. Um And this is like a timer on this, let me do it this way. So it, you usually see what this table and it's usually called the table one. If you look at research papers, most likely table one, otherwise sometimes people two et cetera. Um, so you'll often get this table where they tell you, ok, like it has to be a 5050 match between, between the placebo group and the drug that you're studying or the thing that you're studying, the education's controlled age weight, et cetera, it's all controlled, whereas in a case series that won't happen. Um, and you'll, you often find this as well. Like, actually most of the things in our life are not. So like correlated, it's a lot of things that might lead to the same thing. So for example, with lung cancer exposure to asbestos, smoking, et cetera, everything plays a part in causing um that thing that intern things are very important when we're trying to find treatments for things. So we're trying to find drug treatments, um particularly we wanna say one drug is better than the other or not. It's not good to have any other factors because we don't like these are things that people are gonna be funding into, they're gonna be spending a lot of money into and we're trying to always improve our medicine and get medically advanced. So it's very important to know if anything that you're altering, is it gonna be beneficial for the patient or not? And vice versa or is it gonna cause risk or not? So that's the difference between um extern and internal validity. So other different types of things. So um case studies are a collection of sort of case reports regarding a group of patients, usually those with like a rare disease. So for example, um all of the weird and wonderful genetic um for about the word genetic modifications that you get what people usually because there's not that many patients with that, there's a lot of researchers will then have to go and find case reports about those group of patients or like certain group of symptoms and see if anyone else like those, pick up anything on their system. And if people have written case studies about it. So your genetic modifications are quite a good example of that. Lots of people write um like case reports on atrial myomas because there's different ways you manage them. They're not that common but anything that's not very, very common that you're not gonna get a lot of patients for um to study, then you write that usually as a case report but anything interesting as well, you can write as a case report. That's something you can get involved in as a medical student quite a lot. Um cases that do end up publishing this P MJ case reports is a really, really good one. They, they're always up for finding interesting. So recently I literally just searched it and they had