Blogging during PhD Life

Rational for choosing my PhD topic

In this blog post, I will briefly discuss the rational for choosing my Ph.D study. My expertise lies in the economic method as a graduate of Economics, and my interest focuses on health research. That is why I have chosen such a topic where I can combine these two aspects together. My research titled “Economic burden of diabetes-related foot disease (DFD): Evidence from New South Wales, Australia” supports this claim. The reasons for choosing this topic are dependent on several factors which I will discuss below, following a discussion on the expected outcome of the research.

First, the importance of the issue of my topic has played central role in selecting my subject matter of the PhD thesis. The issue of diabetes, a chronic health condition, is of crucial importance from both global and Australian perspective. I have found that Australia is characterised by a growing number of people with diabetes due to the high percentage of obesity, growing aged population and sedentary lifestyle which threaten to impose not only the disease burden but also the higher cost burden to the health system, society and individual. Further, I have also come to know that diabetes-related foot disease is contributing no less liability compared to other diabetic complications. In fact, in some cases, for example, in terms of hospital bed days, it has the highest average figure among all diabetic complications. I have explored the issue more deeply which reveals that Australia has one of the lower limb amputations attributed to diabetes in the world. Undoubtedly, this is a burning issue for Australia, and the economic aspects of it certainly need a detailed understanding. Hence, I choose the topic related to DFD and its economic burden given its enormous importance.

Secondly, the research gap, in combination with the importance of knowing the unknown from policy perspective, has prompted me to work on this topic. Given that there exist a very few costing studies related to diabetes in Australia, and to our surprise, none exists for DFD disease for New South Wales, I am hopeful to make significant contribution in the existing literature.

Thirdly, the concern of timely completion of the research has played an important role in the decision making process of selection my PhD topic. Since this research is a part of a large project which had its ethical approval even before the start of my PhD, I have the opportunity to access data needed for my analysis right after starting my doctoral study. I, being aware of this advantageous situation, have taken the opportunity of having less uncertain phases ahead that one would not usually expect in their Ph.D. journey. As a result of this favourable situation, I have gained enough confidence to complete the study in due time without compromising the quality, and chosen the topic thereby.

Fourthly, my expertise on economic costing methodology certainly has given me the assurance to a higher degree to choose the topic for my doctoral study. At the same, I understand that I may need to equip myself with many other relevant methodologies, currently not known. But having a good starting point is a definite advantage, and I have relied on my existing knowledge to quite a few extents to determine my thesis topic.

Fifthly, ability to meet the financial requirement effectively to complete the study is an essential part to consider while choosing the topic. After preparation of a proper expenditure plan, which involves itemising data costs, training costs, costs of conference attendance, etc., I have found my Ph.D. research to be economically feasible with the Research Training Scheme (RTS) fund provided by the university, and therefore I have decided to go ahead with the topic, mentioned in the beginning, for the Ph.D. thesis.

Finally, suggesting relevant policy implications is often a goal for research in Applied Economics, which I need to consider while choosing a topic. Since my area of research falls within the category of Health Economics research, an applied branch of Economics, I need to foresee what I can suggest to the policymakers out of my research, and hence to choose my topic wisely. At this stage, I have some expectations that I wish to achieve out of my research which worth mentioning. I expect that the study will be able to inform its audience the socio-economic profile of diabetic population and DFD population for the study cohort in terms of age, gender, country of birth, ancestry, marital status, education, income, socio-economic status, remoteness of residence. I also expect to exhibit the role of different risk factors on diabetes and diabetic foot. Most importantly, I will estimate the economic costs attributed to diabetes-related foot disease, disaggregated into components of direct and indirect costs. Overall, the audience will have detailed view of economic consequences due to diabetes-related foot disease for the study cohort in NSW region of Australia. Given the scope of informing important recommendations to the relevant policymakers and making an impact to the society with my research are the last, but not the least considerations when I choose the area of my Ph.D. thesis.

Benefit of attending a conference

In this short blog post, I am going to briefly share some benefits that I derived from of attending an academic conference, which took place from 25 to 26 September this year in Hobart, Australia. This conference was one of the most important events for the researcher of Health Economics and Public Health from Australia and overseas to present their scholarly works. Although I was in the very initial stage of my PhD. candidature, my abstract of my research work got accepted, probably due to the reason that I could address some of the very important research problems in the context of Australia. The main objective of attending this conference was to get some early feedback, as suggested by my supervisor, which I could incorporate in my confirmation of candidature document, the most important assessment to fulfil in the first year of my PhD. journey. I was well benefited from the experts’ comments to drive my research work in the right direction. Apart from valuable comments from the experts, I found this event to update myself with the recent research undertaken in my filed of interest. Moreover, it provided me a platform to network with other researchers of similar interests which would turn very important in terms getting placement in the job market in future. The other important benefit that I can mention is that I could get over the fear of presenting to a large number of audiences as a result of coming closer to many of attendees of the conference in the previous day of my presentation. Lastly, it needs no telling the sightseeing of the beautiful Hobart came as a fringe benefit while I attended this conference.

Literature Search and reference management

Literature search and reference management is a crucial part of every research, irrespective of subject discipline. It is particularly important during the thesis writing of the doctoral study because of the higher level of complexity compared to many independent research, and longer yet time-constrained nature of this tertiary education. Although I realised the importance of efficient management of these tasks, I did not have the idea that it could be achieved in a systematic way until I came across the notetaking workshop, conducted by Translational Health Research Institute of Western Sydney University in conjunction with Western Sydney University Campbelltown campus library. As a Ph.D. student of this institute, I had the opportunity to attend this workshop, which brought a significant difference in my approaches in carrying off these arduous tasks of searching and organising literature. The workshop lasted for two hours facilitated by the school of medicine librarian, relevant experts, and the Higher Degree by Research (HDR) director of the institute. I benefited from the workshop in several ways, some of which deserves mentioning. Firstly, I was introduced to PICO (P=patient, problem, or population; I=intervention; C=comparison, control or comparator; O=outcome) method of developing literature search that enlightens me with efficient and effective strategies not only for my doctoral thesis but also for my future research. Compared to my earlier approach, i.e., searching with keywords, this technique seemed to be more organised and time-saving in the long run, although it requires investing more effort and time in the shorter horizon, unlike my previous approach. Secondly, I learned to keep myself updated with the relevant literature in my research area though setting up search-alert, a method which remained completely unexplored until the point of attending the workshop. I expect that it will save me a lot of time to keep looking for a new journal in my research area, making the process more enjoyable, and allowing me to allocate the precious time to some other aspect of the thesis during this Ph.D. journey. Finally, I updated my knowledge by learning “End Note,” a better reference manager compared to “Mendeley,” from this training session. The fascinating feature of the software which proved to be the most useful was its auto-finding literature search, again giving me the hope of managing my time of Ph.D. study efficient. Overall, I found the workshop quite informative and useful for my research, thanks to the facilitators’ interactive way of delivering the lecture to its audience. However, I felt that it would have made a more positive impression on us if they could integrate some practical sessions besides delivering lecture. The organiser took our feedback to improve the future workshop. At the same time, they also welcomed us to have a one-to-one session to improve our understanding whenever needed. Later, I planned to go through the materials they provided to clarify any confusion that might exist in the workshop. Further, I requested my institute specific librarian to organise a one-to-one meeting which would enable me to learn more aspects of this amazing subject matters. As such, I am thankful to my University for hosting such in-research training workshops through which I expect and believe to be more competent.

Choice and management of statistical software

In this post, I will discuss how proper choice and effective management of statistical software contributed to significant improvement in data analysis and overall time management of my PhD study. The doctoral study may seem a long journey to many unless they get into their analysis part of dissertations. Then people may find themselves with minimal time. Therefore, the effective use of time is a must thing for all higher-degree-by-research students. The choice and management of proper statistical analysis tool can help students to optimise their time.

I started my analysis of data after successful completion of confirmation of candidature, accomplished in January this year. My method of analysis is quantitative in nature; hence, the investigation involves the use of statistical software to present my research findings. I had experience in using several analytical tools before I started my doctoral study at Western Sydney University. But I never had an experience of working with “Big Data” which was the case for my PhD study. I felt that the software I used was not performing at its best. I changed my way to use it so that the desired result could be achieved in minimum possible time. This was a new learning-by-doing experience for me because I did not find any significant difference in time previously to obtain results with the way I used that software. But I was not still satisfied. An example may clarify the problem. I had to wait more than one hour to get the mean of a variable, a basic statistic in any quantitative analysis. Obviously, my analysis is more than finding basic statistics, and I cannot imagine how much time it would take for complex computation. I do not blame “STATA.” entirely for my difficulties because my computer workspace was constrained with limited memory. Increasing memory was not a possibility because it would incur a lot of costs resulting in surpassing my allocation of research fund. As a result, I was looking for an alternative.

Fortunately, I found a workshop on advanced R programming in the month of February this year, organised by the Graduate School of Western Sydney University. I took the opportunity to register myself for the workshop in no time. In the workshop, I found two important things- how the use of R can speed up my process of analysis and how to use it most efficiently. These were challenges I was facing with my previous software named “STATA”.

Overall, I found the training quite helpful. It was an opportunity to learn industry-demanding software, which not only solved my ongoing research problems but also enhanced my skill in quantitative analysis. The mentor welcomed us to have electronic communication to improve our understanding if required. He also encouraged us to go through more advanced topics by ourselves so that we can utilise the useful features of this tool in our research. In this way, I learned more aspects of this fantastic subject matters and used it effectively to overcome the challenges of the data analysis part of my thesis.

Steps to obtain the classification of diabetes-related foot disease

In this blog post, I am going to discuss one of the essential aspects of my ongoing research- steps to obtain the classification of diabetes-related foot disease using different coding system. I have mentioned about my ongoing research my very first blog post. So, I am expecting my readers to have some understanding of my research topic before they proceed to read this blog post.

I am using administrative data sets to address my research questions which comes from various sources. The sources include hospital department, emergency department, Medicare benefits schedule, pharmaceutical benefit schedule, cancer registry and mortality database. These data sources register health-related complications in many forms. I found two types of coding in the data sets provided to me. International Classification of Disease (ICD) and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED- CT) were the systems that were used to assign diagnoses and procedures related to different health conditions. I came to realise that Australia uses slightly different versions of these codes compared to international practice. For example, ICD-10 (10th revision) codes used in Australia is termed as ICD-10 AM, where ‘AM’ means Australian modification. Again, SNOMED has its Australian version as well. As a result, I had to analyse ICD-10 AM, SNOMED-CT Australian version along ICD-9 Clinical Modification (CM) to find the diabetes-related foot complications from relevant data sets.

At first glance, it seems a straightforward task as one may understand it as mapping of different complications to its codes that are readily available. But this was just the start of a series of challenging tasks that I had to go through. First, I had to figure out what were the types of foot complications that were experienced by diabetes patients. To my surprise, the number of diseases I found was a way more than expected. Secondly, I had to search for relevant codes for diabetes and all foot diseases related to it in all of three systems, mentioned previously. Thirdly, I had to run a program in my analytical software to figure out which patients had diabetic foot complications in my data sets. The challenge I faced was that there were no specific codes for diabetes foot disease. As a result, I had to find the patients with diabetes followed by patients with foot complications and had to assign them as patients of the diabetic foot if and only if both conditions were satisfied. The identification of diabetes status from SNOMED made things more complex as the system did not have specific codes for diabetes, unlike ICD systems. At the same time, I had to be careful and efficient with my programming as I was working with large data sets, termed as “Big Data” nowadays. The efficient programming was required to get results in minimum possible time as I was constrained with limited memory of computer work-space held in cloud computers in a secured environment. In summary, the whole process required a rigorous literature review, supervisors’ directions, experts’ opinion along with proper choice of analytical software and efficient programming.

Research activities during the PhD journey

In this post, I am going briefly introduce the research projects that I am involved besides my PhD study. I involved myself in six research activities in the area of Health Economics until this point during my doctoral study. These activities involved preparation and publication of both journal articles and research reports.

First, I will summarise the subject matter of journal articles where I have contributed. Two of the four articles are related to economics of smoking of adolescent of Bangladesh. In both papers, I am working as the first author. The first paper examines the family and peer influence on the behaviour of smoking of urban young and adolescents of Bangladesh. The study also explores how knowledge on harmful effects of smoking affects the participation decision of smoking by young adults and adolescents. The second paper will estimate the price and income elasticity of demand of tobacco smoking for the same subjects mentioned above. This paper will have implication regarding taxation in the context of public policy. While the first paper is submitted for peer review in a reputed journal, the work is still in progress for the second paper. Third article presents the economic value of undertaking a Midwifery-Initiated Oral Health Dental Service (MIOH-DS) Program involving oral health education and screening by midwives with referral of pregnant women to cost free dental services compared to current practice. The research uses the data from the multi centre randomised controlled trial of the MIOH-DS program across three hospitals in Greater Western Sydney involving 638 pregnant women. We completed three-quarter of the work and expect to be ready for submission in high impact factor journal soon. The fourth paper I am working on along with co-authors is related to estimating economic burden of eating disorder in South Australia. The work is at its initial stage. We are also hopeful to get it published in a reputed journal.

Besides working on publishable papers, I also contributed in two research reports during my higher degree by research study. We analysed different aspects of the IAG compulsory third-party insurance compensation claims. The main objective of the report was to assess different factors that influence or affect the length of claim time. The report was successfully completed in the first half of my PhD. In the second report, we forecasted population with diabetes in all local government area (LGA) of South-Western Sydney local health districts (LHD) by gender and age. In addition, we incorporated uncertainty in the forecasting process in terms of incidence rate, population growth and change in technology to compare different forecasting outcomes.

Overall, I do not bind myself only with my doctoral thesis. I have realised that it is important to engage myself in various research activities because it gives an opportunity to expand the network of peers and to show the expertise in my field. Obliviously, in this process, I am making sure that I am not compromising with my PhD thesis.

Developing presentation skills

In this blog post, I will share my experiences on how I developed my presentation skills throughout my Doctor of Philosophy studies. It is an undeniable fact that presentation is one of the essential ways to let people know about your research, and I admit that it is not easy. Throughout my PhD journey until this point, I have presented my works on different platforms, including confirmation of candidature seminar, meetings and conferences. I can say that I am still learning, but I am getting better at the same time. So what approaches are making me better?

I have adopted several ways to learn and develop different skills required for presentation. The learning phase involves completing workshops on communication and presentation along with attending different seminars, workshops and conferences. Interestingly, I have found that being present at seminars, conferences and dissemination events have helped me gain a lot of confidence and different tricks to ace the presentation skill. For example, I have learned to distinguish between interactive ways and boring ways of conveying information to audiences. I have also acquired knowledge of how to handle different audiences in effective manners. Again, I have seen many unlikely events during the presentation, such as a heated talk from audiences, and ways to overcome the situation by the presenter. These are valuable experiences, without which I could not have prepared myself better.

Another strategy that I follow to do well during my presentation is to prepare myself well ahead of the event. If I am in a rush, then the likelihood that I may end up in an uncomfortable situation during my presentation is high. So, time management is crucial along with proper preparation of the presentation slides.

In regards to preparing slides, I always make sure that it is not over contented. I also take care of the font size, colour, highlighting and animation of slides. In addition, I ensure that there are not too many slides. For example, I try to make twenty slides for a 15-minute presentation, and I have found this approach to be quite successful to manage my time effectively to convey my messages to the audiences.

Practising is another tactic that I follow to make myself an excellent presenter. I rehearse either in front the mirror or with the help of a projector multiple times so that I can deliver my speech fluently in the main event. In addition, I write down my speech in the same slides underneath the main slides which are not viewable to spectators. This writing is intended for my practice purpose only, and I do not try to read it during my presentation because it can cause distraction.

The strategies I take in the presentation day include getting to know my audiences if possible, engaging my audiences actively and trying to be entertaining. Getting myself familiarised with the people around me in the seminar and conference boost my confidence. After all, I believe that most people are sympathetic, even if I do something wrong in the presentation. During the presentation, I try my best to make it entertaining whenever possible. When it comes to answering questions, it is not always the case that I can address all the queries raised by the audiences. In that case, I admit it nicely. I also welcome feedback in a courteous manner which eventually improves my research outcomes.

Overall, I think that the more chances I am getting to present, the better I am becoming. It is not only the conferences but also the monthly seminar series and workshops where I am participating to avail of these opportunities.