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Medical Research Papers: Translation Needed

I used to have the “bedside stack.” This pile of journals that I planned to read was always topped by. . . the latest Stephen King novel.

Now my e-mail in-box is filled with “online first” and “table of contents” announcements from numerous journals.

The problem with reading journal articles is obvious: they are hard to read. They seem to be written in English, but not in a language I use day to day.

That’s why Stephen King wins out at bedtime (unless I need a paper-based sleep aid). Though medical journals deal with life or death situations, there is no suspense in a research article – they tell what killed or helped the most patients up front in the abstract. There are no quirky characters, awkward relationships, or plot twists in the final act.

Researchers are talking to each other, not us

Sometimes, though, we furrow our brows, turn off our music so we can concentrate, and read a paper. Maybe we want to be able to casually drop, “did you see the article in this week’s Archives. . .” into a conversation. Maybe it’s guilt, or our turn to run tomorrow’s journal club. And so we start reading, trying to avoid MEGO (my eyes glaze over).

But we’re not the problem. The highly stylized, often impenetrable writing style that is de rigueur of research articles is the result of researchers talking to other investigators in the same field of study. Research is not written to be understood by non-researchers or even researchers outside of the field. The rest of us, by reading journals, are just listening in on the conversation.

Soul-sucking statistics in research articles

The Scream- {{PD-US}}

Then there’s the problem with – don’t stop reading after the next word – statistics. Even brave souls who undertake reading the methods section will stop short after reading something like: “A fixed sequence test procedure was used to handle multiplicity, with superiorities of NVA237 over placebo tested sequentially in three families (primary outcome; key secondary outcomes; important secondary outcomes) using a hierarchical procedure with Hochberg step up adjustment and type one error rate controlled at the 0.05 level within each family.” Whaa. . .?

Journals sanitize research

The big journals try to make study descriptions more accessible. In doing so, they tend to sanitize the papers, removing important details, skipping steps, and prettifying graphs — anyone who has done any research knows graphs aren’t nearly as smooth, noise-free, and straightforward as those in a major journal.

Why? Journals want their research featured on the evening news and on newspaper front pages. So, they try to make the articles reader-friendly to journalists. Frustrating, though, for those critically reading the study to determine its validity.

Research translation

The business of journal translation is booming. Daily POEMs from Essential Evidence Plus is one (which I edit). DynaMed Updates tries to package and interpret new research. Richard Lehman’s blog as part of BMJ (British Medical Journal) regularly skewers overhyped research in delightful and insightful entries. On the other hand, DocAlerts from the medical reference Epocrates regularly slips in advertising disguised as research updates.

Do we care if they aren’t easy to read?

In a recent series of blogs I outlined alternatives to medical journals. In addition to the journal translators, witty Tweeters, other bloggers, and even Wikipedia writers read, debate, and interpret research for us. These sources of new info are not risk-free; behind some of these lurk pharmaceutical company shills trying to mislead us. In my next blog I will highlight some of the research-into-English translators and outline a method to evaluate them for relevance and validity of their information.

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