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results. How valid are these conclusions that you've got Because you yourself admitted that in this population or in this intervention? Um, I mean, because they weren't blinded, they might have, you know, confounder hours. And so, um, how did you, you know, limit these limit the effects of these confounder. So I think the most important thing I don't know how long you have left for you. I see a But I would say the most important thing when you're choosing a paper or if you're still in the process of doing so, It's, um look at the type of paper. Look at the type of message. Look at also similar paper surrounding it. So, for example, um, for this, um, space trial, that's like the one I suggested the A. C s a. C S t to trial. Um, it's quite similar. So read around the different kind of major trials in that in that topic that you want to go into and see what kind of things they've done as well, because that normally gives you an idea of what would be a good study design and autism. Because ultimately what you're trying to say is you're trying to praise the conclusions that they that they got to. And I would say that the I see one is really just a stepping stone by the time you finish. You know, by the time you get to your BST right up essentially doing your projects and you're writing it up, and even for that, you need to place the literature. So this is just a small stepping stone and getting into practice and praising the literature. Okay. Makes sense. Thank you so much. Any other questions? Anyone? Hi. I'm good. Question high. So I was wondering when I'm spotting limitations and things. Uh, and other times, um, they mentioned my limitation in their discussion. Um, so I was wondering just I mean, I call it so praise that point because they've already accomplished it. I mean, um, it depends because, um if you're the the the other thing I think about the ICS is, um if you try and stick to lots. If you try and say lots of different points, you're not really building up on the on your kind of discussion points. So in order to score like high marks, you want to pick four or five solid points and really kind of explain why, you know, it really take the reader through. So the whole point is, you know, if I was reading this your letter and I haven't necessarily, you know, read the trial itself. Um, I still get to get an understanding of what? You know what they essentially said. And what? You know what so fundamentally wrong or what was so, so good that you commended them for so in terms of limitations, you can't. You know, if you have a if you have a point to prove like, so you can take that limitation, expand on it. So you can say that, you know, thank you. You know, the authors where thank you very much for, you know, or say something Lance line of you know, um, the orders were right to identify. This is a potential limitation. But the extent of this limitation is, you know, depends on that. That's that's your skill there. So that's a critical appraisal. So just because they mentioned it doesn't stop you from critically appraising because that happens all the, uh, but it's about, you know, really backing up your point of backing up your perspective and trying to make sure that the readers understand. You know why you chose to focus on that particular limitation and how that would either reinforce or weaken the study. Yeah. Nice. Oh, yeah. Also, I was going to ask, So some of the studies are good. Um, they do have power calculation, but for the study, for whatever reason, Um, they don't like they lose some of the patients, so but But they include all the patients, Um, in the intention to treat analysis. Um and so I was wondering because they lost people during the study. Does that mean the power of the studies has decreased? Now, um, that's a question that's very controversial, I think, uh, but like because even, like even I think I lost the academics like, um, like, it would be quite hard for them. Like to kind of justify, But normally, you know, when you normally have a study, it's it's you're always going to have drop outs and start. When you do your power calculations, you always recruit more than your what's required as a result of your power calculation, so that even after drop, you still have you still have, you know patients. And if it depends on what kind of reason, what's the reason for dropout? So, for example, if it's mortality, or if it's something that happens to them that they just can't take part in that study anymore, then it then itself. It's a result. So the intention to treat would be right would be, you know, the right thing to use because you're still getting an endpoint, a measurable end point, whether it's mortality, whether its complications and as a result, they can't carry on. But if it's something like lost to follow up, well, you can still say that. But again, like you said, you know that's going to that's going to affect on the quality of the quality of the kind of findings and the reliability of the findings. Because, let's say you know, you have 500 patients in one and 500 patients another and you, um, you have you have, you know, surgical as a conservative, and you find that in the surgical group, half of them didn't, you know, fill in the questionnaire. Um, that could be quite, you know, a fundamental thing that's wrong. Regardless of what the conclusion says, because you're losing up, you're You're losing patience. Um, for pretty much has lost to follow up. So it's really like I said, it really depends on what is the reason that they drop out. So if there's an end point, which is like mortality or, you know, complications, then down itself, that's still a measurable thing because they can't live or they can't simply can't partake in that study anymore. So that that's the end point right there. Hold down to a question. Yeah, I was wondering, um, so they say they do some calculations, they decide how much they want to recruit. Yeah, but what they actually end up with is different. And are they expected to like this? Is follow up from one of those points I think you made. But are they expected to say, Are they expected to calculate what the new power is, or the actual power of the study or not? And state that So, what's the definition of power in the study? Um, a chance of Yeah, but what does that mean? Um, how good? The studies in preventing full full centers Is that Is that settlement or is that minimum that you need. Um, yeah, that's fine. But you know the number that you get. So let's say 100 people, you do a power calculation and you get 100 people. Is that is that a set number? Or is that the minimum that you need to get? Okay, so So you can get things like overpowering the study, which means that any results they find are simply statistically significant. But they're not, you know, realistically significant, Right? So that's the definition of overpowering. But if it if it you know, like I said, any large trials, they will always recruit most of the times they will recruit more than what they were, just, you know, just slightly more in order to accommodate for lost to follow ups and any of the other drop outs. So unless you know, let's say your power analysis only needs 100 people and you end up taking like this is just an example once again. But, um, you know, an example of overpowering as you know you only need 100 people and you end up getting 10,000 people. That's probably like a place in overpowering of the study, Uh, and say any results you might find that might be statistically statistically significant, but clinically clinically. Not so right. And I think the most important thing, I think just, um is it still the Lancet they used? Uh, yeah, and is it still 1000 words? Okay, Cool. Um, so I remember doing my I see a And, um, I didn't Don't feel pressure to write up to the word limit. The worst thing that you can do is writing for the sake of it, because because one you're probably not going to make any points any other points and two, you are just kind of not being concise. So I think my sister said it was only 800. So if you if you don't feel that there aren't any other points to make, don't feel compelled to fill up all 1000 words. And I would probably say I think in terms of, you know, um, I would in order to kind of go through, I'm sure in a Josh covered in the lecture before, but just to recap, start with the methods. Like when you read the paper. Of course. You read the abstracts and things like that, but I'm sure. You know, Doctor Able and Mr Murphy, um, they might have talked to you how to read the paper. But when you read the paper, go through the name of the study, then go through the conclusions to see if they do meet and then go through the methods and actually analyze what they did and the results as well, Because that in itself can tell you a lot of points. And, um, once you're done with the methods, try and go beyond, like, the generic points that you want to make this a try and think about what might be specific weakness or strength of the article that you're praising. And in order to get those kind of points. Like I said before, it might be worth reading around the subjects of reading other trials similar to in the in the in the area that you are researching. And so, for example, like I used before safer endarterectomy um, space trial A. C s too, I think for, um, Triple A if you ever considering doing like, um open versus, um, endovascular repairs, there's quite a few. So evolve one. Um, that's, uh that's, uh, uh dvt. Um Um and I think for the endarterectomy, that's like Crest one quest too. So definitely do read around the subject. And also a tip that I found quite a quite good with a lot of these big trials. Um, they already they normally have, You know, a letter to the editor already written. So look at you know, that will give you an idea of how to, um, how to actually go about writing it in the form that they want to, You know, Let's take let's take, you know, a C s too or like Quest. I think that's a Lancet trial and then pretty sure that they had lettuce editors there. So if you have, if you have a look, you can look at the type of points the way their straw. It doesn't mean they have to copy it, but it just gives you an idea of the level that's expected, the style that's expected. But again, I know I'm saying so many things, but a word of caution is the standard that's expected of you for your B S. C for you. I see one might not be the standard that they might exhibit in their writing because journal standards and BS, the standards are slightly different. Right. I was going to ask you a question. Um, So, um, after speaking to, um, some of the course directors, whatever, I realized that there's, like, certain red flags that if you mentioned your great just plummets. Okay. Well, uh, like one of them was, if you site a systematic review, then there's no way you can get first. There are a few other ones that will, but probably one of the actually another one was if you mentioned, um, if your points are two similar or you don't mention anything original compared to things that are already published about the article already, uh, that could be due to a grade a lot. Um, So I was wondering, is there any other sort of red flags Uh, you know, uh, I think I mean, I remember doing my formative, but I don't know if you still have the group form to task to. Yeah. Yeah. So remember, in mine, and it's it's still Eduardo does it? Yeah. Okay. So I remember the doctor Monday, and he was basically, um, you know, he told us so. We made like, most. I think we made about eight or 10 points and we tried to, you know, you know, condense everything into one. But, um, he basically said if I was marking this, this redness scored highly because you just didn't expand on the points. That's the most important thing. So when you are doing a critical appraisal, it's not about the quantity. It's about the quality. And that goes to all the ICS and just any work in general that you do. Um, so if you take a point in to disappoint, then really take you know, you hear this time and time again, you know, you have to say, it's a story. You're telling the story. You're selling a story. You go, You're taking someone on a journey. So you're into this point. You explain what? Why? This is wrong. You give the evidence and then you know you you tie it all together. And if you do that, then you know even within 1000 words, you'll only get five or six points because you've gone into that sort of death. And in order to score the high marks, the first or whatever you're you're aiming for, um That's what they're expecting you today. So not just read that particular paper, but read, you know, different papers. So, for example, I don't know what's your specialty of interest, but there are lots of different kind of, um, you know, different teams or different papers always have different kind of opinions of particular interventions. Particular approach is so reading both sides of the argument, um, is what's really important. And one thing that you'll start to pick up is formulating your own ideas and opinions. When once you read a page, um, and that only comes with practice, they just keep reading papers. Um and, um, you can, you know, just keep writing. I think that another kind of general thing is, um, this goes for any I see is, um, try and look at it with a fresh pair of eyes at the end, So if you work on it in the morning, you know, shut to your laptop computer down, and then go do something else and come back in the evening or in the afternoon, because that will give you an entirely new perspective. Um, and, um, you know, you might come up with a new idea a few new ideas as well. So, um, those are probably just the general tips I would give, um, and kind of I can't think of any other red flags. Um, I guess I don't Definitely. Yeah, definitely. Don't you know, take an existing letter day this and try and try and edit it so that, you know, or rewrite in your own words, because it would definitely be found out. Um, but apart from that, I can't I can't think of too many other things. Cool. Any other questions? Anyone? Hello? Yeah, I just wanted, uh, but how? The support for me now is like choosing a paper to write on. I've had several papers have, like, selected so far because I think one of the conditions was it has to be relevant to surgery. Yeah, I'm not sure, Is it like one of the top of my list is something about one second. So it's been management of the total knee replacement, so I don't know, counts as surgery or not any well, as the title. Sorry. Uh, so the full title is the stocking up of your patient? We've been at three months after total knee replacement. Okay, so what was sorry? Was you already cut off for me? Um, was the first part of the title the store care pathway for patients with pain at three months after a total knee replacement? A randomized controlled trial? Yeah. So, yeah, I mean, it's technique. I mean, it's all Phoenix, which is, you know, it is good, you know, by step. But, um, the most important thing is is there enough for you to talk about things? Because that sounds more just like a follow up of a of a random kind of of a random trial that they've done. It might be like a three month or six month follow up. Um, and it doesn't really seem like you're comparing to into engines. Make life as easy for yourself as possible. So this is something that you can appraise. But if you don't have in depth knowledge in terms of, you know, your total knees and your partner needs it, you know you're different scores the Oxford School and the school year and your new school, Um And like you're a max, schools and things like that, or they're the equivalent of the Flomax school. It's quite hard, you know, to appraise it, just make your life as easy as possible and to something. That's probably the reason why most people are suggesting RCT because you have two interventions and something like, um, something like, you know, conservative surgical that might be better suited rather than looking at patient's perspective for outcomes. Because these kind of studies are more kind of outcome studies which are generally speaking a bit harder to praise compared to our CT. So there, I think I know Lancet. I mean, I try to look, look for an orthopedic on, um, but unfortunately, couldn't because Lance, it doesn't really publish orthopedic randomized control trials at least at least a large kind of large, large case kind of trials. But, um, some of the things I suggest that you don't always have to kind of stick to a particular especially or your own special interest. You can always, um, if you want to make your life easier, go for one of the general surgery, the vascular ones, because there's always something that's published, like every week. Um, and you're more likely to have some luck trying to find something along those kind of surgical specialty kind of topics. All right. Thank you very much. Any other questions? Oh, just questions with B S C. In general, I know it's just a stop. It's looking like there's no more questions. Hope hopefully, unless anyone has any more to ask. Go ahead. But from this point on her, you can just you can excuse yourself as it's gone past time. Fantastic. Great. Thank you. Um, yeah. So yeah, I'll leave. But if anyone wants to kind of email me, I'll just let me put my email on the chat and, um, feel free to email me. Um and, yeah, good luck with my CS. And, um, the Bs in general, it's It's quite it's quite busy, but it's quite fun along the way as well. Brilliant. Thank you so much. And have a lovely evening. Have a lovely evening, everyone as well. Great. Thank you.