Nurturing a Research Mindset
Raja Selvaraj, JIPMER
What this talk is about
The Clinician - Researcher dichotomy
- I am a clinician, not a researcher
- Busy practice with little additional time
- Not necessary outside academic practice
Good Clinical practice is a form of research
- Find best way to treat a patient (systematic review / metaanalysis)
- Find reasons for gap between evidence and practice (implementation research)
- Fill evidence gaps (Retrospective review of data / prospective study)
- Help others learn from your experience (publish)
"Hidden" outcomes revealed by registries
- Hidden outcomes can blur clinical judgement
- Sudden deaths in patients post myocardial infarction
- Mortality in RHD patients on anticoagulation
Remaining on medical management
Sudden death. "Hidden" from clinician
Evidence based medicine
"Integrating individual clinical expertise with the best external evidence" - David Sackett
Stay Curious, Stay Disinterested, Stay Sceptical
Maintain records
- Handwritten records
- Spreadsheets
- Full fledged EMR
Quantify what can be measured
- Qualitative information may be useful in situations
- But quantitative information lends itself better to analysis
- Key performance indicators
Promote research in medical curriculum
- Undergraduates should learn research
- Changing trend
Sedation for EP procedures
Computerized Heart Failure Clinic
- Multi-disciplinary clinic for patients with heart failure
- Computerised algorithm driven suggestions to promote evidence based rules
- Limited clinic capacity
- Options - First come, first serve / Historical controls / RCT
Paul Wood
- Learn from meticulous and scientific evaluation of each case
- Described ihss without surgical / pathologic correlation
- Described acyanotic fallot
- Measure everything
- Grading for effort tolerance
- Maintain and collate data
- Graph of effort tolerance in ASD
- Filter / sort
- Index cards with punch holes
Clinician - researcher ahead of his time
Rheumatic heart disease - AF and embolism
Paul Wood's system
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Nurturing a Research Mindset
Raja Selvaraj, JIPMER
15 + 5 minutes