1. Charles R Clark, MD Deputy Editor, JBJS
Insights into the Editorial Process in 2016 Career Development Series How to Achieve Excellence in Research Methodology
Charles R Clark, MD
Deputy Editor, JBJS
Dr Michael Bonfiglio Professor of Orthopedic Surgery
University of Iowa, Iowa City, Iowa

3. Introduction - Can’t learn it in a day - Can learn an approach
Goal
- Enable an individual, particularly a young investigator, to ask the correct questions to get answers

4. The Basics Know your topic Do a good literature review
Many “novel” ideas have been pursued before
More data doesn’t always mean better data
Old adage, ‘garbage in/garbage out’

5. Why Studies ‘Die’ Not feasible Not vetted (not an important question)
Poor study design to adequately answer the question
Submitted to the wrong journal/the wrong audience

6. Approach Develop an idea for a study Ask the correct question
is it an important question?
is the answer already known?
Critically analyze feasibility
adequate patient numbers, large numbers needed, long follow-up needed, etcetera
cost: money, time, resources, etcetera

7. Study Design Need appropriate design to answer the question
‘tension’ between design and feasibility
‘conflict’ between Level I/RCTs and retrospective reviews
value in retrospective reviews (may be the basis for more rigorous study)
RCT may be cost prohibitive

8. Engage ‘Partners’ Early
Successful investigator surrounded by smarter and more experienced persons
Seek wisdom and listen even if painful
‘Friendly fire’ better than ‘polite nods’ and preferred to manuscript rejection
Statistician is not a ‘hired hand’
Partner early with statistician; serves an author
Value to survey work with peers to establish value of clinical question (e.g. proving there is a lack of concensus on a treatment question)

9. ‘Big Data’/Database Studies
Useful when the topic is complicated
Before electing a methodology that few understand ask whether traditional methods can answer the question; they generally can!

10. Know and Seek Valuable Resources
Consult Instructions to Authors for the particular journal:
JBJS:
Randomized Controlled Trials (RCTs):
- CONSORT checklist:
Cohort, Case-Control and Cross-Sectional studies:
- STROBE Panel format:
Meta-analyses:
- PRISMA criteria:

11. Summary Ask correct question Review the literature
Seek wisdom and listen
Partner with a statistician
Assess feasibilty
Use appropriate study design
Know and use resources for study design
Consult the Instructions for Authors

12. Developing the correct approach to answer an important question is the best way to obtain meaningful results