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  • 1.  Research Challenges in a Rural Hospital Setting

    Posted 10-13-2022 10:57
    Hello!

    I'm the only Biostatistician -- who doubles as the IRB Coordinator -- working at a rural hospital in western Massachusetts.  Given limited resources, we have a number of challenges doing high-quality research.  I would be interested in connecting with other statisticians in similar circumstances to brainstorm creative ways to address these challenges.  I would also welcome any suggestions/resources.

    Thank you,

    Paul Mange Johansen
    Berkshire Medical Center
    iguanaphoto@gmail.com

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    Paul Johansen
    Biostatistician / IRB Coordinator
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  • 2.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-14-2022 10:59
    I saw your post and have some questions.

    1) Is there a reason you are the only biostatistician? 

    2) Have you looked into hiring part time or remote workers?

    3) Have you looked into getting interns from the local universities?

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    Andrew Ekstrom

    Statistician, Chemist, HPC Abuser;-)
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  • 3.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-17-2022 12:20
    Hi Andrew --

    Thanks for your questions.  In a nutshell, there are limited resources to support Biostats.  I like your ideas, although I'm trying to expand my own duties in the Biostats realm, not so much to farm them out.  One frustration I'm having is the emphasis on IRB administration over Biostats work (I'm responsible for both).  There is limited understanding (outside of one administrator) of the importance of Biostats, so I could have been more specific in my request for help:  in part I'm trying to brainstorm ways of increasing the profile of Biostats generally.

    Cheers,

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    Paul Johansen
    Biostatistician / IRB Coordinator
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  • 4.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-18-2022 10:43
    If you want to increase the importance of stats at your facility, when you look at how the researchers are planning to use statistical analysis of their subjects if you think they can do better. 

    For example, I am teaching for an MPH program. There is potential for another group to get into the class too. But,  the dept head wasn't sure their students needed a stats class. I had my class critique posters around the campus. Most found that dept's posters to be poorly done with major analysis issues. That dept uses human subjects AND a poor job with the analysis. We discussed how bad things could go, if one used say 7 simple linear regressions instead of 1 multiple linear regression. Or 9 t-tests without corrections for multiple comparisons instead of say an ANOVA with corrections or multiple linear regression. 


    I would LOVE to be on an IRB so I could take a stand for stats and force better designs and analysis on the researchers. Once you make the discussion about ethics of poor designs vs good designs, all the benefits, etc, it should be easy to force that change.

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    Andrew Ekstrom

    Statistician, Chemist, HPC Abuser;-)
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  • 5.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-19-2022 10:05
    Thanks Andrew.  I appreciate your optimism about how easy it could be to bring about change.  While I think the biostats perspective is important to IRB discussions, I sometimes find my two roles in opposition.  Technically, a poor statistical design is outside the (legal) purview of an IRB, in the sense that it's not grounds for denying permission to do an otherwise acceptable proposal.  But it's certainly helpful to have a seat at the table, and to make suggestions to Principal Investigators about how their study could be improved.  I suspect you could find a local IRB to join, and would be happy to help track one down for you if you'd like.

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    Paul Johansen
    Biostatistician / IRB Coordinator
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  • 6.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-20-2022 07:53
    Hi Paul,

    I suggest a "show by doing" approach to increase the profile of Biostats. You're trying to "sell" the value of Stats, and it's hard to do it by just describing why. 
    If you can find a particular problem to solve, or question to answer, and then go solve that problem/answer that question and put together a presentation that tells a "story" of the result, that could be a way forward. We (not all) statisticians are often times very modest and not good at self-promotion. But, like any other field, we're just providing a service. Hence, sell your service by starting with a freebie.

    --Iyue

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    Iyue Sung
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  • 7.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-20-2022 11:13
    Hi Paul,

    The Statistical Consulting Section has a networking group for collaborative statisticians in healthcare (link contains contact information of organizer) as well as other networking groups that may help you answer your question (for example, the consultants meet-up group). You don't have to be a member of the Section to participate, but you may want to consider membership. The Section has a lot of isolated statisticians and the Section's active message board may be a fruitful venue for your question. At any rate, the networking groups may be an opportunity to connect with other statisticians who've been in a similar situation and be able to trade ideas. 

    I've been in a similar role, and from my experience, you'll have to 1) look for ways to show the power of statistics to the decision makers at your institution, and 2) be patient.

    Best regards,

    Todd

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    Todd Coffey
    Chair and Associate Professor of Research and Biostatistics
    Idaho College of Osteopathic Medicine
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  • 8.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-23-2022 15:57
    Thanks, Todd.  Good suggestions, which I'll follow up on.

    Cheers,

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    Paul Johansen
    Biostatistician / IRB Coordinator
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  • 9.  RE: Research Challenges in a Rural Hospital Setting

    Posted 10-23-2022 21:17
    Hi Lyue --

    Yes, I agree that statisticians are not always good at PR.  And that in theory the work should justify itself.  As Todd pointed out, patience may be an important ingredient here as well.

    Cheers,

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    Paul Johansen
    Biostatistician / IRB Coordinator
    ------------------------------