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      Exploring statistical analysis in medical research: A journey of self, with a statistician or both

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      Indian Journal of Anaesthesia
      Wolters Kluwer - Medknow

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          Abstract

          Medical research is the core of clinical practice and its advancements, eventually leading to evidence-based practices. In any academic writing, a statistician is involved in various stages of research, from the initial planning phase to the final analysis, to ensure accuracy and transparency in scholarly manuscripts.[1] Biostatistics is a pivotal tool in any biomedical research, and inadequate knowledge of biostatistical fundamentals can have far-reaching consequences, even incorrect method selection or misrepresentation of data.[2,3] We assessed the current state of statistical analysis in research papers published in the Indian Journal of Anaesthesia (IJA) by a Google survey-based questionnaire. The primary objective was to gain insight into how authors engaged with statistical analysis, collaborated with a statistician, their training in statistics and their confidence in interpreting the statistical observations. Data for this was collected over one month by sending a survey questionnaire of 10 questions to 44 random corresponding authors of original research articles recently published in IJA, using Google Forms to collect responses. The survey questions were pre-validated by experts with vast experience in research and biostatistics. Each question was strategically prepared to explore various aspects of statistical analysis in research papers. The participants were informed about the anonymity and confidentiality of all responses to the survey. Out of 44 authors contacted via email, 20 participants responded. After completing the study, we downloaded the data into a Microsoft Excel sheet and summarised the data by radar charting [Figure 1]. Figure 1 Summary of survey findings The study revealed that collaboration with statisticians is widespread among authors. Among the respondents, 36% involved the statistical department of their institutes, while 40% engaged private statisticians. This diversity in collaboration strategies highlights the acknowledgement of the complexity inherent in statistical analysis.[4 5 6 7 8] Moreover, 24% of participants conducted statistical analysis themselves, demonstrating their willingness to be deeply involved in research methodology using basic and advanced statistical techniques. Authors with varying levels of statistical knowledge bring different perspectives to research, which is a good thing. It means they can offer unique and valuable insights.[6 7 8 9] A significant observation from the study was that a substantial number of authors (72%) lacked formal training or coursework in statistics, with only 22% having completed relevant coursework or formal statistical training. This observation prompts early collaboration with experts in biostatistics.[6 7 8 9 10] Nevertheless, it underscores a distinct requirement for enhanced statistical education, especially within medical research. Enhancing statistical literacy among authors can lead to better informed decisions during study design, data collection and analysis, ultimately improving the research quality.[8 9 10 11 12] The authors’ varied confidence levels in interpreting and communicating statistical results were another notable aspect of the study. Although most respondents indicated a moderate confidence level, there was some variability in their responses.[13 14 15 16] Addressing this inconsistency through targeted training and support from journals can empower authors to engage more effectively with statistical methodologies. The study further revealed that many authors have been asked to provide additional resources and justification for the statistical analysis used in their research. This common occurrence underscores the rigorous scrutiny of research papers.[14 15 16 17] Furthermore, insufficient comprehension of the mathematical principles underpinning statistical techniques and statistical fundamentals may result in inappropriate utilisation of software packages and data errors, necessitating reanalysis of statistical data during the review process.[16 17 18 19 20] We also explored authors’ perspectives on recognising statisticians in research publications. Most respondents (64%) favoured acknowledging statisticians in the acknowledgement section of research papers. However, 20% considered statisticians eligible for co-authorship. Acknowledgement follows established ethical norms and recognises statisticians’ assistance without assigning authorship.[8-11] Conversely, co-authorship signifies statisticians’ substantial contribution and collaborative role in the research.[12 13 14 15 16 17] The nuanced viewpoints emphasise the importance of transparent communication between authors and statisticians to ensure that recognition aligns with the nature and extent of their involvement.[5,6,18 19 20 21] It is worth noting that there may be constraints or guidelines for naming statisticians as co-authors, which could potentially hinder collaboration. Nevertheless, collaborative efforts between researchers and statisticians are critical for ensuring robust study designs, accurate analyses and meaningful interpretations.[22] Authors should view the feedback provided by reviewers or editors as an opportunity to improve the clarity and comprehensiveness of their statistical methods sections.[5 6 7,9,11 12 13 14 15 16 17] By providing comprehensive descriptions of statistical analyses, authors can ensure that readers and reviewers can assess the robustness of the study design and validity of the conclusions drawn.[4 5 6 7 8 9 10 11,19,23,24] Transparent reporting enhances research credibility and contributes to scientific knowledge advancement.[22 23 24] The study's limitations include a restricted survey of only corresponding authors from IJA, potentially not representing all authors’ perspectives, and a small sample size. Expanding the study to authors from a broader range of journals could yield more comprehensive insights. In conclusion, the survey highlights several essential aspects of the collaboration of statisticians, authors and research publications. Collaboration with statisticians is ubiquitous, and authors employ diverse strategies to ensure robust statistical analysis. Transparent reporting of statistical methodologies is essential for research reproducibility and integrity. Effective collaboration between authors and statisticians can lead to more robust research outcomes and higher-quality publications, ultimately advancing the field of anaesthesiology and scientific research.

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          Most cited references23

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          Serratus anterior plane block and erector spinae plane block in postoperative analgesia in thoracotomy: A randomised controlled study

          Background and Aims: Managing pain after thoracic surgery is crucial and the traditional methods have many adverse effects. We aimed to evaluate serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) in acute pain control in thoracic cancer surgeries. Methods: This randomised controlled, triple-blind study was performed on 90 patients, between 18 and 70 years old, scheduled for elective thoracic cancer surgery. Patients were allocated into three equal groups: Control group: received sham ESPB and sham SAPB. SAPB group received SAPB (20 ml bupivacaine 0.5%) and sham ESPB. ESBP group received ESPB (20 ml bupivacaine 0.5%) and sham SAPB. Results: Postoperative morphine consumption was significantly lower in ESBP and SAPB groups than control group [ESPB (8.52 ± 4.29 mg) < SAPB (19.57 ± 7.63 mg) < control (36.37 ± 8.27 mg)] ( P < 0.001). Numerical rating scale pain score was comparable among the groups at rest, but was significantly lower at 30 min, 2, 4 h in ESPB and SAPB groups, than control group on coughing. The scores were better in SAPB compared to control group till 4 h. At 8, 12, 24 h, the difference between control and SAPB groups became insignificant, but it remained the least in ESPB group. Postoperative forced vital capacity and forced expiratory volume in the first second after 24 h were the best in ESPB group and better in SAPB group compared to the control group. Conclusion: Both ESPB and SAPB reduced intraoperative and postoperative opioid consumptions and postoperative dynamic pain scores with improved postoperative pulmonary functions in thoracic surgery with the ESPB being superior.
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            Application of biostatistics in research by teaching faculty and final-year postgraduate students in colleges of modern medicine: A cross-sectional study

            Context: Biostatistics is well recognized as an essential tool in medical research, clinical decision making, and health management. Deficient basic biostatistical knowledge adversely affects research quality. Surveys on this issue are uncommon in the literature. Aims: To study the use of biostatistics in research by teaching faculty and postgraduate students from colleges of modern medicine. Settings and Design: Cross-sectional study in colleges of modern medicine. Materials and Methods: A pretested proforma was used to collect information about the use of biostatistics by teaching faculty and final-year postgraduate students from colleges of modern medicine. The study period was 6 months. Statistical Analysis: Chi-square test, Spearman rank correlation coefficient, and multivariate analysis were used for analysis of data. Results: With this questionnaire, the maximum possible score for appropriate use of biostatistics in research was 20. The range of scores obtained by the study subjects was 1–20 and the median was 11. Appropriate use of biostatistics was independent of sex, designation, and education (P>.05). Spearman coefficient showed low—but significant—correlation between the score and the number of papers presented and published (P=.002 and P=.000, respectively). Conclusions: The study showed that nearly half of the respondents were not using statistics appropriately in their research. There was also lack of awareness about the need for applying statistical methods from the stage of planning itself.
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              Comparative evaluation of airway dynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia with controlled ventilation using ProSeal laryngeal mask airway, I-Gel™ and Baska mask

              Background and Aims: TheProSeal™ laryngeal mask airway (PLMA) and I-Gel™ are second-generation supraglottic airway devices (SADs). The Baska mask is a SAD having a non-inflatable cuff with a tendency to increase the perilaryngeal seal with an increase in airway pressures. This study compared the efficacy of I-Gel™, PLMA and Baska mask with respect to airway dynamics in patients scheduled for laparoscopic surgeries under general anaesthesia (GA). Methods: Ninety patients, of American Society of Anesthesiologists physical status I and II, aged 20–65 years scheduled for laparoscopic cholecystectomy under GA were enroled. The patients were randomised into three groups: Group P (n = 30): airway secured using PLMA, Group I (n = 30): airway secured using I-Gel™ and Group B (n = 30): airway secured using Baska mask. The primary outcome was the change in dynamic compliance, and the secondary outcomes included insertion time, changes in peak inspiratory pressure (PIP) and oropharyngeal leak pressure (OLP) at different time intervals. Results: After insertion of the SADs, the dynamic compliance was highest in group B and least in the group I (p = 0.01). The maximum decrease in dynamic compliance was observed in group I. The insertion time for SAD placement was more in group P. The group B had least PIP as compared to groups P, I at insertion. After carboperitonium, groups P and B had comparable PIP, and group I had highest PIP (p = 0.001). OLP was highest in group B, whereas group I had least OLP. Conclusion: The airway dynamics are better maintained with Baska mask as compared to the PLMA and I-Gel™.
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                Author and article information

                Journal
                Indian J Anaesth
                Indian J Anaesth
                IJA
                Indian J Anaesth
                Indian Journal of Anaesthesia
                Wolters Kluwer - Medknow (India )
                0019-5049
                0976-2817
                October 2023
                16 October 2023
                : 67
                : 10
                : 927-929
                Affiliations
                [1]Department of Anaesthesia and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India
                Author notes
                Address for correspondence: Dr. Lalit Gupta, Department of Anaesthesia and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi - 110 002, India. Email: lalit.doc@ 123456gmail.com
                Article
                IJA-67-927
                10.4103/ija.ija_833_23
                10691598
                38044916
                8c1b14ff-7521-4529-8799-0241ffaa0882
                Copyright: © 2023 Indian Journal of Anaesthesia

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 28 August 2023
                : 10 September 2023
                : 12 September 2023
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                Anesthesiology & Pain management
                Anesthesiology & Pain management

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