HOW TO WRITE THE RESULTS SECTION Stephen A. Boorjian, MD Carl Rosen Professor of Urology Vice Chair of Research Director, Urologic Oncology Fellowship Department of Urology Mayo Clinic, Rochester, MN
DISCLOSURES Financial: none Intellectual: “this is how I do it” Many approaches can be successful
KEY THEME Consider the same features in writing a paper as when reviewing
OUTLINE FOR TALK Writing the text of the Results section of the manuscript Tables/Figures What to include in the results section of the Abstract
WRITING THE RESULTS SECTION OF THE MANUSCRIPT KEY SECTION OF MANUSCRIPT “Non-fixable” with revisions “50,000-foot view”: broad specific First paragraph = overall number included/excluded in study If large number excluded – provide evidence that population excluded not significantly different than population included Exclude selection bias
WRITING THE RESULTS SECTION OF THE MANUSCRIPT First paragraph (continued): Cohort demographics i.e. median age, sex distribution CAVEAT – DO NOT RECAPITULATE IN THE TEXT WHAT IS IN TABLES Should provide one or two critical demographic details, and/or points not included in the tables
BROAD TO NARROW AT START, WITH COHORT DEMOGRAPHICS FIRST
WRITING THE RESULTS SECTION OF THE MANUSCRIPT After first paragraph, should move from broad to specific Demographics treatment details outcomes Critical that all relevant treatment details be included i.e. for manuscript on RP number who received adjuvant therapy, number who received salvage therapy
REPORTING OF OUTCOMES IN THE TEXT OF THE RESULTS SECTION KEY: Report median follow-up in survivors, with interquartile range KEY: Report the number of specific events for each outcome measure of interest (recurrence, cancer death, all cause mortality) Not just percentages! i.e. don’t just say “The 5 year survival was 65% versus 42%...”
REPORTING OF OUTCOMES IN THE TEXT OF THE RESULTS SECTION “The median follow-up after surgery was 10.1 years (IQR 8.4, 12.2), during which time 780 patients experienced biochemical recurrence, 560 were diagnosed with clinical metastases, and 600 died, including 380 who died of prostate cancer.”
SECOND PARAGRAPH OF THE RESULTS: FOLLOW-UP AND EVENTS
REPORTING OF OUTCOMES IN THE TEXT OF THE RESULTS SECTION KEY: After reporting demographics, treatment, raw number of events, when reporting statistical analyses, move from univariable (Kaplan Meier) data first to multivariable model data second KEY: Make sure that every table/figure is referenced in the text (including supplemental) And vice versa – make sure that context is provided in the text for the data from every table/figure After reporting analyses from overall cohort, then report subgroup (sensitivity) analyses
WRITING THE RESULTS SECTION: A CHANCE FOR A DATA “CHECK POINT” As you are writing, make sure that the “story” you are telling makes sense i.e. are you reporting an association of a treatment with outcomes that demonstrates congruous findings with recurrence, cancer- specific mortality, and all-cause mortality? Do you see a dose-effect with treatment? If not, re-evaluate the data/analyses, and be prepared to explain discrepancies in Discussion
MAKING SURE THE DATA MAKES SENSE
RESULTS SECTION OF TEXT: WHAT NOT TO INCLUDE Key - Results section should not include authors’ editorializing or offering interpretation of their data That is for the Discussion section of the manuscript Results section should be comprehensive of most relevant data but also concise Should not read like a “laundry list”
MANUSCRIPT TABLES: KEY POINTS “Readability” Too much/too little data provided to easily read Do the numbers in the table add-up? Confirm that no conflicting data (number discrepancies) between tables and text of results
Before After Spread over two pages
2. Appearance & detail Table 4
Risk score <2 Risk score >2 (n=689, 66%) Overall (n=689) No radiotherapy (n=399, 58%) Radiotherapy (n=290, 42%) p value Overall (n=689) Age Mean (range%) 65.3 (40.5-83.4%) 65.6 (40.5-83.4%) 64.7 (41.1-79.6%) 0.09 PSA (ng/ml%) 12.6 (0.6-417.0%) 11.1 (0.6-417.0%) 14.9 (1.6-113.0%) 0.02 Gleason score ≤ 3+3=6 634 (93.3%) 380 (77.7%) 212 (73.1%) <0.001 3+4=7 145 (21.3%) 234 (54.1%) 121 (21.1%) 4+3=7 89 (12.3%) ≥ 8 80 (10.0%) Pathological stage pT2 580 (87.1%) 231 (57.9%) 135 (46.6%) pT3a 323 (46.9%) 168 (42.1%) 155 (53.4%) pT3b 109 (15.8%) 37 (9.3%) 72 (24.8%) pT4 1 (0.2%) 1 (0.1%) 0 (0%) Lymph node status pN0 612 (88.8%) 353 (88.5%) 259 (89.3%) 0.8 pN1 77 (11.2%) 46 (11.5%) 31 (10.7%) Surgical margin Negative 271 (39.3%) 149 (37.3%) 122 (42.1%) 0.2 Positive 418 (60.7%) 250 (62.7%) 168 (57.9%) Adjuvant therapy status None 399 (57.9%) 399 (100%) Radiotherapy only 290 (42.1%) 290 (100%) Radiotherapy & ADT 137 (19.9%) 53 (13.3%) 84 (29.0%) ADT only 552 (80.1%) 346 (86.7%) 206 (71.1%) Risk factors 1 2 3 * ADT = Androgen derpivation therapy Data are stratified according to the novel risk score and adjuvant radiotherapy status. Risk score derived from the sum of each risk factor (ie, pathologic Gleason score >8, pathologic stage pT3b/T4, and lymph node invasion) shared by each single patient
MANUSCRIPT TABLES: KEY POINTS Sequence/completeness of tables Demographic data – Table 1 +/- Univariable comparisons – Table 2 Often not provided, and that is ok Multivariable models – Tables 3+ HR, 95% CI, p values provided
TABLES: INCLUSIVE OF HR, 95% CI, p value
MANUSCRIPT FIGURES Make sure all the figures included are necessary No duplication with tables No present the obvious (i.e. CT image of renal mass biopsy) Is data presentation clear and not mis-labeled? Appropriate axis/scales on graphs Can figures be read “stand-alone” (without accompanying text)? For Kaplan-Meier curve: p values provided Number of patients at risk at various timepoints provided
p value Number at risk
CAPITALS No capitals What is this line doing here? No p value Where is the fourth line (Arm A, Censored) ? p value in a different place No p value
Midpoint Arm A Allocated (n=51) Received treatment (n=51) Did not receive treatment (n=0) Arm B Allocated (n=50) Received treatment (n=50) Did not receive treatment (n=0)
MANUSCRIPT FIGURES Randomized trial CONSORT diagram = Figure 1 Systematic review/meta-analysis diagram showing inclusion/exclusion criteria for studies Kaplan Meier analyses If presenting nomogram/statistical model calibration curve
RESULTS SECTION OF THE ABSTRACT Key: Results section of the Abstract should be able to STAND ALONE For the casual reader who only reads the Abstract of the manuscript
RESULTS SECTION OF THE ABSTRACT: WHAT TO INCLUDE Number of patients included for study Critical demographic feature (pending word count) Duration of follow-up Number of events (i.e. deaths) – if possible within word count limits Kaplan Meier and multivariable results KM with p values (i.e. not just %) For multivariable analysis, HR with either 95% CI and/or p value (ideally all 3)
SAMPLE ABSTRACT WITH CRITICAL DATAPOINTS INCLUDED
HOW TO WRITE THE RESULTS SECTION: SUMMARY Move from broad to specific in text Demographicstreatmentoutcomes Provide median follow-up + specific number of events! Comprehensive but concise Avoid duplication of data in tables/figures
HOW TO WRITE THE RESULTS SECTION: SUMMARY Tables/Figures Follow logical sequence All are referenced in and consistent with text Key = ease of “readability”/interpretation Results section of the Abstract Provide critical demographic/outcome details such that can be read as “stand alone”
THANK YOU Questions?