• How-To: Read a Paper

    by Alan Batt. Last modified: 21/02/14

    journals

    When you read a research paper, your goal is to understand the scientific contributions the authors are making to the field. This may require going over the paper several times. You should expect to spend several hours to read a complex paper, such as ones describing large RCTs or large systematic reviews.

    Combine reading this post with Part 1 & Part 2 of Jason Merrill’s excellent article on Evidence Based EMS and you should be well on your way to critically reading papers.

    Learning to read a paper is a vitally important, but unfortunately rarely taught skill. There are many different approaches to reading a paper; this happens to be my favoured approach. It is a combination of a number of different readings on approaching evidence-based papers. This method is not perfect – whatever method works best for you is the one that you should use.

    Step 1. Glance at the paper

    I find that it is always helpful to do a “quick-glance” of a paper prior to getting deeper into analysing it. Firstly look at:

    • Title, abstract and introduction
    • Headings of sections and sub-sections
    • Statistical methods used, mathematical and data content
    • Conclusion
    • References

    At this stage you can note any references that you’ve read already. Having done your first quick glance over the paper, you should now be able to

    • Determine what type of paper it is (e.g. systematic review, original research, RCT, animal study, study description etc.).
    • Determine if the paper and its conclusions are valid to you and your practice.
    • Determine what other papers it is related to, either by building upon them, citing them or refuting them.
    • Determine if the assumptions made are valid – e.g. are the statistical methods used reliable, and are they applicable.

    Now you can decide if this paper is worth reading or not. Is it useful to you? For old-school print types, this wll help you to decide whether to print this paper or not. You’ve decided it is? Great, on to the next step!

    ipadmini1nexusWhat you will need

    Old school

    • Printed copy of paper
    • Pencil, pen
    • Highlighter

    New-kid

    • Tablet device/computer with PDF software capable of allowing annotations
    • PDF copy of paper

    Both approaches

    • Patience
    • Healthy dose of skepticism

    Step 2. Read the paper

    Reading a research paper must be a critical process. Don’t assume the authors are always correct. Instead, become skeptical – apply the rigours of the scientific model to all research. Critical reading involves asking appropriate questions. Here are some questions you should ask yourself when critically reading a paper:

    • If the authors attempt to solve a problem, are they solving the right problem?
    • Are there other solutions the authors do not seem to have considered?
    • What are the good ideas in this paper?
    • What are the limitations of the solution (including limitations the authors might not have noticed or admitted)?
    • Are the assumptions the authors make reasonable?
    • Is the logic of the paper clear and justifiable, given the assumptions, or is there a flaw in the reasoning?
    • If the authors present data, did they gather the right data to substantiate their argument?
    • Did they gather and interpret the data in the correct manner?
    • Would other data or other means of collection of data be more compelling?
    • Can the results or ideas be generalised to wider populations?
    • Are there improvements that might make important differences?
    • If you were going to start doing research from this paper, what would be the next thing you would do?

    highlight

    During this reading, you should

    • Make notes either in the margin, on sticky notes, or annotate the document if using a tablet device.
    • Go through the references in the paper, marking those you’ve read, or if the paper makes claims regarding any of them, you can highlight them for future reading.
    • Highlight the key points made by the authors.
    • Highlight key data such as population size, sample size, inclusion and exclusion criteria, limitations, data collection methods used.
    • Highlight any statements, data or results that are questionable.

    You may need to read the paper again having completed this reading. Some papers may require a number of readings to fully understand what the authors were trying to achieve, and to fully understand the results. A good trick to test your knowledge and understanding of the paper is to try to summarise it in 2-3 sentences.

    Step 3. Compare the paper

    Now that you’ve read and understand the paper, you should try to compare it to similar papers. Are the ideas presented in this paper really novel, or have they appeared before? Some papers offer new ideas; others examine the practical implementation of previous research ideas, and show how they work and others bring previous studies or research together and unite them. Knowing other important works in your area of interest can help you to determine the kind of contribution a paper actually makes.

    Step 4. Archive

    Personally, I keep a running library in EndNote where I archive all papers I have read and analysed. I annotate the PDF copy (which I keep in the cloud) whilst reading on a tablet device (Asus Transformer or Google Nexus 7 – affiliate links), which I then attach to the reference record in EndNote. This allows me to search through articles, find the paper, and see my notes all with relative ease. I also arrange papers by type/subject, allowing me to quickly compare related papers (see screenshot below).

    Why do I use this method?

    After much trial and error I found this system works best for me – here’s why:

    1. It’s easy to add new references to EndNote from PubMed, journals etc.
    2. Endnote can easily find the full text PDFs for me when I add a new reference.
    3. I always have access to my library PDFs with annotations.
    4. I nearly always have my tablet with me.
    5. I don’t need to print out volumes of pages.
    6. By using EndNote, I can also easily insert the articles as references in any writing I’m working on.
    7. Highlighters never seem to work when I go to use one.

    endnotescreen

    What do you need to use this method?

    • A tablet device, or computer/laptop
    • PDF software which allows for annotation
      • Android: ezPDF Reader, iAnnotate PDF, RepliGo, Lecture Notes
      • iOS: Read by QxMD, PDF Reader, iAnnotate PDF
      • PC: Adobe Reader, Foxit Reader, Mendeley
    • A cloud provider account: Dropbox, Box, Skydrive, Google Drive etc.  (this is where your library and your PDFs will be saved)
    • EndNote (or EndNote Web) or a free alternative such as Mendeley (which has web access built-in) or Zotero
    • Some interesting apps if you’re using Mendeley include Droideley & Referey, which allow you to access your Mendeley library on Android devices.

    Read by QxMD, a free app that this site is fully compatible with, also allows for direct annotation of PDFs and saving of articles in collections.

    If you’ve printed out the paper, you can always begin a filing system for archiving papers, using alphabetical title, journal title, subject or similar to organise your collection.

    In the references section below you will find some useful papers on…reading papers! We’d love to hear anything you have to add – how do you read a paper? Is there anything extra that you do? Do you prefer printing out papers and highlighting by hand?

    Recommended reading: How to Read a Paper: The Basics of Evidence-Based Medicine (HOW – How To) (affiliate link)

    References

     
    1.

    Lee P. Understanding and critiquing qualitative research papers. Nurs Times. 2006 Jul 18-24;102(29):30-2. PMID: 16895246.

     
    2.

    Sale JE. How to assess rigour . . . or not in qualitative papers. J Eval Clin Pract. 2008 Oct;14(5):912-3. PMID: 19018925.

     
    3.

    Greenhalgh T1, Taylor R. Papers that go beyond numbers (qualitative research) BMJ. 1997 Sep 20;315(7110):740-3. PMID: 9314762.

     
    4.

    Greenhalgh T. Papers that summarise other papers (systematic reviews and meta-analyses). BMJ. 1997 Sep 13;315(7109):672-5. PMID: 9310574.

     
    5.

    Greenhalgh T. Assessing the methodological quality of published papers. BMJ. 1997 Aug 2;315(7103):305-8. PMID: 9274555.

     
    6.

    Greenhalgh T. How to read a paper. Getting your bearings (deciding what the paper is about). BMJ. 1997 Jul 26;315(7102):243-6. PMID: 9253275.

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    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

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