Editorial
Don’t Put the Cart Before the Horse (If You want to Publish in a Journal with Impact Factor)
No se debe empezar la casa por el tejado (si queremos publicar en una revista de impacto)
a Grupo de Investigación de Salud Global, Universidad de Cantabria, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria, Spain
b Servicio de Neumología, Hospital de Laredo, Laredo, Cantabria, Spain
c Servicio de Neumología-Debilidad muscular y caquexia en las enfermedades respiratorias crónicas y el cáncer de pulmón, IMIM-Hospital del Mar, Barcelona, Spain
d Departament de Ciències Experimentals i de la Salut (CEXS), Universitat Pompeu Fabra (UPF), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Spain
e Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
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(IDIVAL), Santander, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de Laredo, Laredo, Cantabria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología-Debilidad muscular y caquexia en las enfermedades respiratorias crónicas y el cáncer de pulmón, IMIM-Hospital del Mar, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departament de Ciències Experimentals i de la Salut (CEXS), Universitat Pompeu Fabra (UPF), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "No se debe empezar la casa por el tejado (si queremos publicar en una revista de impacto)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1875 "Ancho" => 2500 "Tamanyo" => 334985 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Scientific method cycle and the role of the statistics.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The main reasons for rejecting papers submitted to Archivos de Bronconeumologia and other journals with an impact factor are methodological shortcomings in the scientific design and lack of originality in the research question.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Clinicians, for different reasons, tend to lose sight of the scientific method cycle (SMC),<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and attempt to jump in directly at the stage of statistical exploitation of a clinical database, without passing through the previous steps of formulating the research question and objectives and selecting the correct methodology to achieve the proposed objectives. At the same time, too much faith is often placed in the famous<span class="elsevierStyleItalic">p</span>of significance, without taking into account that inferential statistics occupy only a small part of the overall SMC.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this editorial, inspired by the workshop entitled “We have to publish in a journal with an impact factor”, held during the 6thACINAR Conference organized by the Cantabrian Association for Respiratory System Research, we will try to explain why we should never put the cart before the horse, and remind authors that research is a systematic, sequential, and orderly process aimed at answering a research question. We have summarized the SMC is diagram form in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The process of analytical quantitative research must first begin with the so-called “FINER” research question, i.e., it should be feasible, interesting, novel, ethical, and relevant.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Let us pause at “N” for novel, since this the key that opens the door to the SMC. If the question is completely novel, the research results will be original, and the cycle will culminate in an original article — the epitome of research excellence</p><p id="par0025" class="elsevierStylePara elsevierViewall">This research question, once it is part of the SMC, is transformed into a written, working hypothesis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Once the hypothesis has been formulated, the objectives are laid out, i.e., the explicit statement of what is to be achieved with the study. Once the study objectives have been formulated, the methodology used to achieve the proposed objectives is developed. This includes both the study design and other epidemiological and statistical factors. If a study is poorly designed, it is unlikely to have sufficient statistical power, or it will lack internal validity.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the field of public health, a cohort design necessarily involves individuals that are disease-free (epidemiologically healthy) at the beginning of the study, but are at risk of developing disease (lung cancer, for example), and undergo a period of prospective follow-up. A clinical trial is a study in which patients are susceptible to cure or improvement from the outset, and are prospectively followed up. As it is experimental, randomizing the intervention and blinding participants minimizes the possibility of bias in favor of the internal validity of the results.</p><p id="par0035" class="elsevierStylePara elsevierViewall">When it comes to studying COPD patients seen consecutively in pulmonology departments to estimate the percentage of alpha-1 antitrypsin deficiency in this population, by the end of the recruitment stage the study will include both patients with and without the event i.e., with and without the deficiency. Therefore, the design will be cross-sectional, and its frequency measurement will be prevalence.</p><p id="par0040" class="elsevierStylePara elsevierViewall">A case-control design differs from a cross-sectional design: cases are first recruited (new cases of lung cancer identified each week in the participating hospitals), then individuals without cancer (controls) are interviewed, and the data on the exposure under study are collected retrospectively.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Once the database with quality information is generated, descriptive statistics are used to calculate the “analytical measure”. Examples of this type of measurement include the odds ratio or relative risk, and the hazard ratio or the difference in means.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Inferential statistics will then be used to rule out the role of chance in our results, and chance or random error is quantified using the corresponding standard error formula. Once this is quantified, it will be weighed up against the analytical measure, resulting in a <span class="elsevierStyleItalic">p</span> of significance that, by convention, is statistically significant if it is less than 0.05 (which is synonymous with rejecting the famous statistical null hypothesis with an alpha error of 5%). Another option is to use the standard error to build confidence intervals, which also allow us reject the null hypothesis. The breadth or narrowness of confidence intervals give the so-called “effect size”, and, therefore, the precision of the study.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Thus, it should be clear that precision is the lack of randomized error, and that if a result is statistically significant, it does not mean it is true.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Internal validity is a parallel world to precision, as it measures the lack of bias or systematic errors. If the study is biased, the result may be statistically significant, but not necessarily true. Multivariate statistics can be used in this respect to control a type of bias that is the confounding bias, if this could not be controlled in the design phase.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Assuming that a study has internal validity, the fact that a result is statistically significant will only tell us that the chance of this occurring cannot be fully explained. It is important to bear in mind that this does not imply that the result is clinically relevant.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Finally, we must not forget external validity, which refers to the degree to which the results of a study can be generalized and applied to our patients.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> The greater the number of exclusion criteria in the selection of the study population, the lower the external validity.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santibáñez M, García-Rivero JL, Barreiro E. No se debe empezar la casa por el tejado (si queremos publicar en una revista de impacto). Arch Bronconeumol. 2020;56:70–71.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1875 "Ancho" => 2500 "Tamanyo" => 334985 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Scientific method cycle and the role of the statistics.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Designing Clinical Research. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 1 | 6 |
| 2024 October | 40 | 20 | 60 |
| 2024 September | 50 | 29 | 79 |
| 2024 August | 64 | 29 | 93 |
| 2024 July | 33 | 21 | 54 |
| 2024 June | 61 | 26 | 87 |
| 2024 May | 63 | 25 | 88 |
| 2024 April | 39 | 27 | 66 |
| 2024 March | 41 | 25 | 66 |
| 2024 February | 37 | 16 | 53 |
| 2023 November | 3 | 3 | 6 |
| 2023 May | 2 | 0 | 2 |
| 2023 March | 10 | 6 | 16 |
| 2023 February | 48 | 23 | 71 |
| 2023 January | 35 | 31 | 66 |
| 2022 December | 55 | 20 | 75 |
| 2022 November | 74 | 39 | 113 |
| 2022 October | 63 | 34 | 97 |
| 2022 September | 50 | 29 | 79 |
| 2022 August | 40 | 43 | 83 |
| 2022 July | 31 | 40 | 71 |
| 2022 June | 46 | 36 | 82 |
| 2022 May | 39 | 35 | 74 |
| 2022 April | 41 | 43 | 84 |
| 2022 March | 57 | 41 | 98 |
| 2022 February | 35 | 39 | 74 |
| 2022 January | 1 | 0 | 1 |
| 2021 November | 1 | 0 | 1 |
| 2020 April | 2 | 2 | 4 |
| 2020 February | 3 | 2 | 5 |
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