Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22

Jun. 28, 2017
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22
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Rhetorical moves and audience considerations in the discussion sections of randomized controlled trials of health interventions--ECA--2017-06-22

Editor's Notes

  1. Rhetorical moves and audience considerations in the discussion sections of Randomized Controlled Trials of health interventions In order to inform clinical practice about human health, evidence- based medicine calls for various forms of evidence to be used, including controlled experiments, observations, and clinical case studies. Clinicians and medical researchers are taught to consider the strength of the evidence in medical sciences, typically using a hierarchy of evidence. In such a hierarchy, one of the highest forms of evidence is generally considered to be randomized controlled trial (RCT) experiments. In said hierarchies, RCTs are superseded only by evidence syntheses (i.e., systematic reviews and meta-analyses) over multiple randomized controlled trial experiments. The current work draws on two ongoing projects. First, in a recent theoretical paper we have considered the iterative development of RCTs and evidence syntheses over the past century through an argumentative lens; we have described how shortcomings in new methods are revealed and iteratively overcome through argumentation, until these methods become trusted within a given community of experts, at which point they may find application in new areas addressing new audiences. Second, in an empirical project, we are annotating citation-related discourse in a corpus of open access RCT articles drawn from PubMed Central, which describes itself as "a free full- text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine". In this paper we study the argumentation in discussion sections. Our data source is a corpus of 37 research articles reporting on RCTs in diverse areas. Articles in our RCT corpus relate to wide range of conditions – including malaria, degenerative eye disease, postpartum back pain, and brain injury. These articles may test the efficacy of medical treatments or may compare physiological measures (such as methods to measure cardiac output). We will document and classify rhetorical moves in the discussion sections of these RCT reports. Our preliminary research suggests that, in writing these articles, the RCT authors have targeted multiple audiences including other researchers, grant funders, and clinicians. This finding would be consistent with the importance of RCTs in the biomedical hierarchy of evidence yet it seems in stark contrast with our expectation that scientific papers are written for, and primarily address, other experts in a given area of science. This paper will present our first findings, grounded in quotations from our corpus of RCTs, characterizing fine-grained rhetorical moves in discussion sections. We will use these moves in order to determine which higher-level argumentative goals seem salient in RCTs discussion section across a wide range of sub-disciplines. We will also seek to associate each move and each goal with the audience or audiences that it addresses, in order to test our hypothesis that RCT authors address multiple audiences in reporting RCTs. We believe that our findings could be used in teaching authors to write effective RCT reports, to reach their intended audiences. In the future, this work might also support the automatic detection of rhetorical moves; the related area of argumentation mining is under active development within the natural language processing community. We envision that future computer augmentation using a human-in-the-loop design and natural language processing might assist authors in writing reports of RCTs and aid evidence synthesizers in extracting relevant data from RCTs.
  2. Image credit: Mellis, Craig. "Evidence-based Medicine: What Has Happened in the Past 50 Years?" J Paediatr Child Health 51, no. 1 (2015): doi:10.1111/jpc.12800.
  3. Image credit: Mellis, Craig. "Evidence-based Medicine: What Has Happened in the Past 50 Years?" J Paediatr Child Health 51, no. 1 (2015): doi:10.1111/jpc.12800.
  4. Can also compare physiological measures (e.g. methods to measure cardiac output)
  5. e.g. for former, “A dozen trained scientists working to resolve exigencies that the discourse addresses”
  6. ;only then can understanding and appreciation be achieved, and only then can approval and authorization ever be hoped for.”