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Ten simple rules for effective presentation slides

* E-mail: [email protected]

Affiliation Biomedical Engineering and the Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America

• Kristen M. Naegle

Published: December 2, 2021

• https://doi.org/10.1371/journal.pcbi.1009554
• Reader Comments

Citation: Naegle KM (2021) Ten simple rules for effective presentation slides. PLoS Comput Biol 17(12): e1009554. https://doi.org/10.1371/journal.pcbi.1009554

Copyright: © 2021 Kristen M. Naegle. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The author received no specific funding for this work.

Competing interests: The author has declared no competing interests exist.

Introduction

The “presentation slide” is the building block of all academic presentations, whether they are journal clubs, thesis committee meetings, short conference talks, or hour-long seminars. A slide is a single page projected on a screen, usually built on the premise of a title, body, and figures or tables and includes both what is shown and what is spoken about that slide. Multiple slides are strung together to tell the larger story of the presentation. While there have been excellent 10 simple rules on giving entire presentations [ 1 , 2 ], there was an absence in the fine details of how to design a slide for optimal effect—such as the design elements that allow slides to convey meaningful information, to keep the audience engaged and informed, and to deliver the information intended and in the time frame allowed. As all research presentations seek to teach, effective slide design borrows from the same principles as effective teaching, including the consideration of cognitive processing your audience is relying on to organize, process, and retain information. This is written for anyone who needs to prepare slides from any length scale and for most purposes of conveying research to broad audiences. The rules are broken into 3 primary areas. Rules 1 to 5 are about optimizing the scope of each slide. Rules 6 to 8 are about principles around designing elements of the slide. Rules 9 to 10 are about preparing for your presentation, with the slides as the central focus of that preparation.

Rule 1: Include only one idea per slide

Each slide should have one central objective to deliver—the main idea or question [ 3 – 5 ]. Often, this means breaking complex ideas down into manageable pieces (see Fig 1 , where “background” information has been split into 2 key concepts). In another example, if you are presenting a complex computational approach in a large flow diagram, introduce it in smaller units, building it up until you finish with the entire diagram. The progressive buildup of complex information means that audiences are prepared to understand the whole picture, once you have dedicated time to each of the parts. You can accomplish the buildup of components in several ways—for example, using presentation software to cover/uncover information. Personally, I choose to create separate slides for each piece of information content I introduce—where the final slide has the entire diagram, and I use cropping or a cover on duplicated slides that come before to hide what I’m not yet ready to include. I use this method in order to ensure that each slide in my deck truly presents one specific idea (the new content) and the amount of the new information on that slide can be described in 1 minute (Rule 2), but it comes with the trade-off—a change to the format of one of the slides in the series often means changes to all slides.

• PPT PowerPoint slide
• PNG larger image
• TIFF original image

Top left: A background slide that describes the background material on a project from my lab. The slide was created using a PowerPoint Design Template, which had to be modified to increase default text sizes for this figure (i.e., the default text sizes are even worse than shown here). Bottom row: The 2 new slides that break up the content into 2 explicit ideas about the background, using a central graphic. In the first slide, the graphic is an explicit example of the SH2 domain of PI3-kinase interacting with a phosphorylation site (Y754) on the PDGFR to describe the important details of what an SH2 domain and phosphotyrosine ligand are and how they interact. I use that same graphic in the second slide to generalize all binding events and include redundant text to drive home the central message (a lot of possible interactions might occur in the human proteome, more than we can currently measure). Top right highlights which rules were used to move from the original slide to the new slide. Specific changes as highlighted by Rule 7 include increasing contrast by changing the background color, increasing font size, changing to sans serif fonts, and removing all capital text and underlining (using bold to draw attention). PDGFR, platelet-derived growth factor receptor.

https://doi.org/10.1371/journal.pcbi.1009554.g001

Rule 2: Spend only 1 minute per slide

When you present your slide in the talk, it should take 1 minute or less to discuss. This rule is really helpful for planning purposes—a 20-minute presentation should have somewhere around 20 slides. Also, frequently giving your audience new information to feast on helps keep them engaged. During practice, if you find yourself spending more than a minute on a slide, there’s too much for that one slide—it’s time to break up the content into multiple slides or even remove information that is not wholly central to the story you are trying to tell. Reduce, reduce, reduce, until you get to a single message, clearly described, which takes less than 1 minute to present.

Rule 3: Make use of your heading

When each slide conveys only one message, use the heading of that slide to write exactly the message you are trying to deliver. Instead of titling the slide “Results,” try “CTNND1 is central to metastasis” or “False-positive rates are highly sample specific.” Use this landmark signpost to ensure that all the content on that slide is related exactly to the heading and only the heading. Think of the slide heading as the introductory or concluding sentence of a paragraph and the slide content the rest of the paragraph that supports the main point of the paragraph. An audience member should be able to follow along with you in the “paragraph” and come to the same conclusion sentence as your header at the end of the slide.

Rule 4: Include only essential points

While you are speaking, audience members’ eyes and minds will be wandering over your slide. If you have a comment, detail, or figure on a slide, have a plan to explicitly identify and talk about it. If you don’t think it’s important enough to spend time on, then don’t have it on your slide. This is especially important when faculty are present. I often tell students that thesis committee members are like cats: If you put a shiny bauble in front of them, they’ll go after it. Be sure to only put the shiny baubles on slides that you want them to focus on. Putting together a thesis meeting for only faculty is really an exercise in herding cats (if you have cats, you know this is no easy feat). Clear and concise slide design will go a long way in helping you corral those easily distracted faculty members.

Rule 5: Give credit, where credit is due

An exception to Rule 4 is to include proper citations or references to work on your slide. When adding citations, names of other researchers, or other types of credit, use a consistent style and method for adding this information to your slides. Your audience will then be able to easily partition this information from the other content. A common mistake people make is to think “I’ll add that reference later,” but I highly recommend you put the proper reference on the slide at the time you make it, before you forget where it came from. Finally, in certain kinds of presentations, credits can make it clear who did the work. For the faculty members heading labs, it is an effective way to connect your audience with the personnel in the lab who did the work, which is a great career booster for that person. For graduate students, it is an effective way to delineate your contribution to the work, especially in meetings where the goal is to establish your credentials for meeting the rigors of a PhD checkpoint.

Rule 6: Use graphics effectively

As a rule, you should almost never have slides that only contain text. Build your slides around good visualizations. It is a visual presentation after all, and as they say, a picture is worth a thousand words. However, on the flip side, don’t muddy the point of the slide by putting too many complex graphics on a single slide. A multipanel figure that you might include in a manuscript should often be broken into 1 panel per slide (see Rule 1 ). One way to ensure that you use the graphics effectively is to make a point to introduce the figure and its elements to the audience verbally, especially for data figures. For example, you might say the following: “This graph here shows the measured false-positive rate for an experiment and each point is a replicate of the experiment, the graph demonstrates …” If you have put too much on one slide to present in 1 minute (see Rule 2 ), then the complexity or number of the visualizations is too much for just one slide.

Rule 7: Design to avoid cognitive overload

The type of slide elements, the number of them, and how you present them all impact the ability for the audience to intake, organize, and remember the content. For example, a frequent mistake in slide design is to include full sentences, but reading and verbal processing use the same cognitive channels—therefore, an audience member can either read the slide, listen to you, or do some part of both (each poorly), as a result of cognitive overload [ 4 ]. The visual channel is separate, allowing images/videos to be processed with auditory information without cognitive overload [ 6 ] (Rule 6). As presentations are an exercise in listening, and not reading, do what you can to optimize the ability of the audience to listen. Use words sparingly as “guide posts” to you and the audience about major points of the slide. In fact, you can add short text fragments, redundant with the verbal component of the presentation, which has been shown to improve retention [ 7 ] (see Fig 1 for an example of redundant text that avoids cognitive overload). Be careful in the selection of a slide template to minimize accidentally adding elements that the audience must process, but are unimportant. David JP Phillips argues (and effectively demonstrates in his TEDx talk [ 5 ]) that the human brain can easily interpret 6 elements and more than that requires a 500% increase in human cognition load—so keep the total number of elements on the slide to 6 or less. Finally, in addition to the use of short text, white space, and the effective use of graphics/images, you can improve ease of cognitive processing further by considering color choices and font type and size. Here are a few suggestions for improving the experience for your audience, highlighting the importance of these elements for some specific groups:

• Use high contrast colors and simple backgrounds with low to no color—for persons with dyslexia or visual impairment.
• Use sans serif fonts and large font sizes (including figure legends), avoid italics, underlining (use bold font instead for emphasis), and all capital letters—for persons with dyslexia or visual impairment [ 8 ].
• Use color combinations and palettes that can be understood by those with different forms of color blindness [ 9 ]. There are excellent tools available to identify colors to use and ways to simulate your presentation or figures as they might be seen by a person with color blindness (easily found by a web search).
• In this increasing world of virtual presentation tools, consider practicing your talk with a closed captioning system capture your words. Use this to identify how to improve your speaking pace, volume, and annunciation to improve understanding by all members of your audience, but especially those with a hearing impairment.

Rule 8: Design the slide so that a distracted person gets the main takeaway

It is very difficult to stay focused on a presentation, especially if it is long or if it is part of a longer series of talks at a conference. Audience members may get distracted by an important email, or they may start dreaming of lunch. So, it’s important to look at your slide and ask “If they heard nothing I said, will they understand the key concept of this slide?” The other rules are set up to help with this, including clarity of the single point of the slide (Rule 1), titling it with a major conclusion (Rule 3), and the use of figures (Rule 6) and short text redundant to your verbal description (Rule 7). However, with each slide, step back and ask whether its main conclusion is conveyed, even if someone didn’t hear your accompanying dialog. Importantly, ask if the information on the slide is at the right level of abstraction. For example, do you have too many details about the experiment, which hides the conclusion of the experiment (i.e., breaking Rule 1)? If you are worried about not having enough details, keep a slide at the end of your slide deck (after your conclusions and acknowledgments) with the more detailed information that you can refer to during a question and answer period.

Rule 9: Iteratively improve slide design through practice

Well-designed slides that follow the first 8 rules are intended to help you deliver the message you intend and in the amount of time you intend to deliver it in. The best way to ensure that you nailed slide design for your presentation is to practice, typically a lot. The most important aspects of practicing a new presentation, with an eye toward slide design, are the following 2 key points: (1) practice to ensure that you hit, each time through, the most important points (for example, the text guide posts you left yourself and the title of the slide); and (2) practice to ensure that as you conclude the end of one slide, it leads directly to the next slide. Slide transitions, what you say as you end one slide and begin the next, are important to keeping the flow of the “story.” Practice is when I discover that the order of my presentation is poor or that I left myself too few guideposts to remember what was coming next. Additionally, during practice, the most frequent things I have to improve relate to Rule 2 (the slide takes too long to present, usually because I broke Rule 1, and I’m delivering too much information for one slide), Rule 4 (I have a nonessential detail on the slide), and Rule 5 (I forgot to give a key reference). The very best type of practice is in front of an audience (for example, your lab or peers), where, with fresh perspectives, they can help you identify places for improving slide content, design, and connections across the entirety of your talk.

Rule 10: Design to mitigate the impact of technical disasters

The real presentation almost never goes as we planned in our heads or during our practice. Maybe the speaker before you went over time and now you need to adjust. Maybe the computer the organizer is having you use won’t show your video. Maybe your internet is poor on the day you are giving a virtual presentation at a conference. Technical problems are routinely part of the practice of sharing your work through presentations. Hence, you can design your slides to limit the impact certain kinds of technical disasters create and also prepare alternate approaches. Here are just a few examples of the preparation you can do that will take you a long way toward avoiding a complete fiasco:

• Save your presentation as a PDF—if the version of Keynote or PowerPoint on a host computer cause issues, you still have a functional copy that has a higher guarantee of compatibility.
• In using videos, create a backup slide with screen shots of key results. For example, if I have a video of cell migration, I’ll be sure to have a copy of the start and end of the video, in case the video doesn’t play. Even if the video worked, you can pause on this backup slide and take the time to highlight the key results in words if someone could not see or understand the video.
• Avoid animations, such as figures or text that flash/fly-in/etc. Surveys suggest that no one likes movement in presentations [ 3 , 4 ]. There is likely a cognitive underpinning to the almost universal distaste of pointless animations that relates to the idea proposed by Kosslyn and colleagues that animations are salient perceptual units that captures direct attention [ 4 ]. Although perceptual salience can be used to draw attention to and improve retention of specific points, if you use this approach for unnecessary/unimportant things (like animation of your bullet point text, fly-ins of figures, etc.), then you will distract your audience from the important content. Finally, animations cause additional processing burdens for people with visual impairments [ 10 ] and create opportunities for technical disasters if the software on the host system is not compatible with your planned animation.

Conclusions

These rules are just a start in creating more engaging presentations that increase audience retention of your material. However, there are wonderful resources on continuing on the journey of becoming an amazing public speaker, which includes understanding the psychology and neuroscience behind human perception and learning. For example, as highlighted in Rule 7, David JP Phillips has a wonderful TEDx talk on the subject [ 5 ], and “PowerPoint presentation flaws and failures: A psychological analysis,” by Kosslyn and colleagues is deeply detailed about a number of aspects of human cognition and presentation style [ 4 ]. There are many books on the topic, including the popular “Presentation Zen” by Garr Reynolds [ 11 ]. Finally, although briefly touched on here, the visualization of data is an entire topic of its own that is worth perfecting for both written and oral presentations of work, with fantastic resources like Edward Tufte’s “The Visual Display of Quantitative Information” [ 12 ] or the article “Visualization of Biomedical Data” by O’Donoghue and colleagues [ 13 ].

Acknowledgments

I would like to thank the countless presenters, colleagues, students, and mentors from which I have learned a great deal from on effective presentations. Also, a thank you to the wonderful resources published by organizations on how to increase inclusivity. A special thanks to Dr. Jason Papin and Dr. Michael Guertin on early feedback of this editorial.

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• 11. Reynolds G. Presentation Zen: Simple Ideas on Presentation Design and Delivery. 2nd ed. New Riders Pub; 2011.
• 12. Tufte ER. The Visual Display of Quantitative Information. 2nd ed. Graphics Press; 2001.

Journal Club: How to Prepare Effectively and Smash Your Presentation

Journal club. It’s so much more than orally dictating a paper to your peers.

It’s an opportunity to get a bunch of intelligent people in one place to share ideas. It’s a means to expand the scientific vocabulary of you and the audience. It’s a way to stimulate inventive research design.

But there are so many ways it can go wrong.

Poorly explained papers dictated blandly to an unengaged audience. Confusing heaps of data shoehorned into long presentations. Everybody stood awkwardly outside a meeting room you thought would be free.

Whether you are unsure what journal club is, are thinking of starting one, or simply want to up your presentation game—you’ve landed on the ultimate journal club guide.

The whats, the whys, and the hows, all in one place.

What Is a Journal Club in Science?

A journal club is a series of meetings in which somebody is elected to present a research paper, its methods, and findings to a group of colleagues.

The broad goal is to stimulate discussion and ideas that the attendees may apply to their own work. Alternatively, someone may choose a paper because it’s particularly impactful or ingenious.

Usually, the presenter alternates per a rota, and attendance may be optional or compulsory.

The presenter is expected to choose, analyze, and present the paper to the attendees with accompanying slides.

The presentation is then followed by a discussion of the paper by the attendees. This is usually in the form of a series of questions and answers directed toward the presenter. Ergo , the presenter is expected to know and understand the paper and subject area to a moderate extent.

Why Have a Journal Club?

I get it. You’re a busy person. There’s a difficult research problem standing between you and your next tenure.

Why bother spending the time and energy participating in a series of meetings that don’t get you closer to achieving your scientific goals?

The answer: journal club does get you closer to achieving your scientific goals!

But it does this in indirect ways that subtly make you a better scientist. For example:

• It probably takes you out of your comfort zone.
• It makes you a better communicator.
• It makes you better at analyzing data.
• It improves your ability to critique research.
• It makes you survey relevant literature.
• It exposes you and your audience to new concepts.
• It exposes your audience to relevant literature.
• It improves the reading habits of you and your audience.
• It gets clever people talking to each other.
• It gives people a break from practical science.

It also provides a platform for people to share ideas based on their collective scientific experience. And every participant has a unique set of skills. So every participant has the potential to provide valuable insight.

This is what a good journal club should illicit.

Think of journal club as reading a book. It’s going to enrich you and add beneficially to the sum of your mental furniture, but you won’t know how until you’ve read it.

Need empirical evidence to convince you? Okay!

In 1988 a group of medical interns was split into two groups. One received journal club teaching and the other received a series of seminars. Approximately 86% of the journal club group reported improved reading habits. This compares to 0% in the group who received seminar-based teaching. [1]

Journal Club Template Structure

So now you know what journal club is, you might wonder, “how is it organized and structured?”

That’s what the rest of this article delves into. If you’re in a rush and need to head back to the lab, here’s a graphical summary (Figure 1).

Nobody likes meetings that flounder around and run over time. And while I have no data to prove it, I reckon people take less away from such meetings. Here’s a basic journal club template that assumes you are the presenter.

Introduce the Paper, Topic, Journal, and Authors

Let your audience know what you will be talking about before diving right in. Remember that repetition (of the important bits) can be a good thing.

Introducing the journal in which the paper is published will give your audience a rough idea of the prestige of the work.

And introducing the authors and their respective institutes gives your audience the option of stowing this information away and following it up with further reading in their own time.

Provide a Reason Why You Chose the Paper

Have the authors managed to circumvent sacrificing animals to achieve a goal that traditionally necessitated animal harm? Have the authors repurposed a method and applied it to a problem it’s not traditionally associated with? Is it simply a monumental feat of work and success?

People are probably more likely to listen and engage with you if they know why, in all politeness, you have chosen to use their time to talk about a given paper.

It also helps them focus on the relevant bits of your presentation and form cogent questions.

Orally Present Key Findings and Methods of the Paper

Simple. Read the paper. Understand it. Make some slides. Present.

Okay, there are a lot of ways you can get this wrong and make a hash of it. We’ll tell you how to avoid these pitfalls later on.

But for now, acknowledge that a journal club meeting starts with a presentation that sets up the main bit of it—the discussion.

Invite Your Audience to Participate in a Discussion

The discussion is the primary and arguably most beneficial component of journal club since it gives the audience a platform to share ideas. Ideas formulated by their previous experience.

And I’ve said already that these contributions are unique and have the potential to be valuable to your work.

That’s why the discussion element is important.

Their questions might concur and elaborate on the contents of the paper and your presentation of it.

Alternatively, they might disagree with the methods and/or conclusions. They might even disagree with your presentation of technical topics.

Try not to be daunted, however, as all of this ultimately adds to your knowledge, and it should all be conducted in a constructive spirit.

Summarize the Meeting and Thank Your Audience for Attending

There’s no particularly enlightening reason as to why to do these things. Summarizing helps people come away from the meeting feeling like it was a positive and rewarding thing to attend.

And thanking people for their time is a simple courtesy.

How Do You Organize It?

Basic steps if you are the organizer.

Okay, we’ve just learned what goes into speaking at the journal club. But presenter or not, the responsibility of organizing it might fall to you.

So, logistically , how do you prepare a journal club? Simply follow these 5 steps:

• Distribute copies of the research article to potential participants.
• Arrange a meeting time and location.
• Organize a speaker.
• Hold the journal club.
• Seek feedback on the quality of the meeting.

Apart from point 5, these are fairly self-explanatory. Regarding point 5, feedback is essential to growing as a scientist and presenter. The easiest way to seek feedback is simply to ask.

Alternatively, you could create a form for all the meetings in the series and ask the audience to complete and return it to you.

Basic Steps If You Are the Speaker

If somebody has done all the logistics for you, great! Don’t get complacent, however.

Why not use the time to elevate your presentation to make your journal club contribution memorable and beneficial?

Don’t worry about the “hows” because we’re going to elaborate on these points, but here are 5 things you can do to ace your presentation:

• Don’t leave it to the last minute.
• Know your audience.
• Keep your presentation slides simple.
• Keep your audience engaged.
• Be open to questions and critiques.

Regarding point 1, giving yourself sufficient time to thoroughly read the article you have chosen to present ensures you are familiar with the material in it. This is essential because you will be asked questions about it. A confident reply is the foundation of an enlightening discussion.

Regarding point 3, we’re going to tell you exactly how to prepare effective slides in its own section later. But if you are in a rush, minimize the use of excessive text. And if you provide background information, stick to diagrams that give an overview of results from previous work. Remember: a picture speaks louder than a thousand words.

Regarding point 4, engagement is critical. So carry out a practice run to make sure you are happy with the flow of your presentation and to give you an idea of your timing. It is important to stick to the time that is allotted for you.

This provides good practice for more formal conference settings where you will be stopped if you run over time. It’s also good manners and shows consideration for the attendees.

And regarding point 5, as the presenter, questions are likely to be directed toward you. So anticipate questions from the outset and prepare for the obvious ones to the best of your ability.

There’s a limit to everyone’s knowledge, but being unable to provide any sort of response will be embarrassing and make you seem unprepared.

Anticipate that people might also disagree with any definitions you make and even with your presentation of other people’s data. Whether or not you agree is a different matter, but present your reasons in a calm and professional manner.

If someone is rude, don’t rise to it and respond calmly and courteously. This shouldn’t happen too often, but we all have “those people” around us.

How Do You Choose a Journal Club Paper?

Consider the quality of the journal.

Just to be clear, I don’t mean the paper itself but the journal it’s published in.

An obscure journal is more likely to contain science that’s either boring, sloppy, wrong, or all three.

And people are giving up their time and hope to be stimulated. So oblige them!

Journal impact factor and rejection rate (the ratio of accepted to rejected articles) can help you decide whether a paper is worth discussing.

Consider the Impact and Scope of the Paper

Similar to the above, but remember, dross gets published in high-impact journals too. Hopefully, you’ve read the paper you want to present. But ask yourself what makes this particular paper stand out from the millions of others to be worth presenting.

Keep It Relevant and Keep It Interesting

When choosing a paper to present, keep your audience in mind. Choose something that is relevant to the particular group you are presenting to. If only you and a few other people understand the topic, it can come off as elitist.

How Do You Break Down and Present the Paper?

Know and provide the background material.

Before you dive into the data, spend a few minutes talking about the context of the paper. What did the authors know before they started this work? How did they formulate their hypothesis? Why did they choose to address it in this way?

You may want to reference an earlier paper from the same group if the paper represents a continuation of it, but keep it brief.

Try to explain how this paper tackles an unanswered question in the field.

Understand the Hypothesis and Methods of the Paper

Make a point of stating the  hypothesis  or  main question  of the paper, so everyone understands the goal of the study and has a foundation for the presentation and discussion.

Everyone needs to start on the same foot and remain on the same page as the meeting progresses.

Turn the Paper into a Progression of Scientific Questions

Present the data as a logical series of questions and answers. A well-written paper will already have done the hard work for you. It will be organized carefully so that each figure answers a specific question, and each new question builds on the answer from the previous figure.

If you’re having trouble grasping the flow of the paper, try writing up a brief outline of the main points. Try putting the experiments and conclusions in your own words, too.

Feel free to leave out parts of the figures that you think are unnecessary, or pull extra data from the supplemental figures if it will help you explain the paper better.

Ask Yourself Questions about the Paper Before You Present

We’ve touched on this already. This is to prepare you for any questions that are likely to be asked of you. When you read the paper, what bits didn’t you understand?

Simplify Unfamiliar and Difficult Concepts

Not everyone will be familiar with the same concepts. For example, most biologists will not have a rigorous definition of entropy committed to memory or know its units. The concept of entropy might crop up in a biophysics paper, however.

Put yourself in the audience’s shoes and anticipate what they might not fully understand given their respective backgrounds.

If you are unsure, ask them if they need a definition or include a short definition in your slides.

Sum Up Important Conclusions

After you’ve finished explaining the nitty-gritty details of the paper, conclude your presentation of the data with a list of significant findings.

Every conclusion will tie in directly to proving the major conclusion of the paper. It should be clear at this point how the data answers the main question.

How Do You Present a Journal Club Powerpoint?

Okay, so we’ve just gone through the steps required to break down a paper to present it effectively at journal club. But this needs to be paired with a PowerPoint presentation, and the two bridged orally by your talk. How do you ace this?

Provide Broad Context to the Research

We are all bogged down by minutia and reagents out of necessity.

Being bogged down is research. But it helps to come up for air. Ultimately, how will the research you are about to discuss benefit the Earth and its inhabitants when said research is translated into actual products?

Science can be for its own sake, but funded science rarely is. Reminding the journal club audience of the widest aims of the nominated field provides a clear starting point for the discussion and shows that you understand the efficacy of the research at its most basic level.

The Golden Rule: A Slide per Minute

Remember during lectures when the lecturer would open PowerPoint, and you would see, with dismay, that their slides went up to 90 or something daft? Then the last 20 get rushed through, but that’s what the exam question ends up being based on.

Don’t be that person!

A 10-15 minute talk should be accompanied by? 10-15 slides! Less is more.

Be Judicious about the Information You Choose to Present

If you are present everything in the paper, people might as well just read it in their own time, and we can call journal club off.

Try to abstract only the key findings. Sometimes technical data is necessary for what you are speaking about because their value affects the efficacy of the data and validity of the conclusions.

Most of the time, however, the exact experimental conditions can be left out and given on request. It’s good practice to put all the technical data that you anticipate being asked for in a few slides at the end of your talk.

Use your judgment.

Keep the Amount of Information per Slide Low for Clarity

Your audience is already listening to you and looking at the slides, so they have a limited capacity for what they can absorb. Overwhelming them with visual queues and talking to them will disengage them.

Have only a few clearly related images that apply directly to what you speaking about at the time. Annotate them with the only key facts from your talk and develop the bigger picture verbally.

This will be hard at first because you must be on the ball and confident with your subject area and speaking to an audience.

And definitely use circles, boxes, and arrows to highlight important parts of figures, and add a flowchart or diagram to explain an unfamiliar method.

Keep It Short Overall

The exact length of your meeting is up to you or the organizer. A 15-minute talk followed by a 30-minute discussion is about the right length, Add in tea and coffee and hellos, and you get to an hour.

We tend to speak at 125-150 words per minute. All these words should not be on your slides, however. So, commit a rough script to memory and rehearse it.

You’ll find that the main points you need to mention start to stand out and fall into place naturally. Plus, your slides will serve as visual queue cards.

How Do You Ask a Question in Journal Club?

A well-organized journal club will have clear expectations of whether or not questions should be asked only during the discussion, or whether interruptions during the presentation are allowed.

And I don’t mean literally how do you soliloquize, but rather how do you get an effective discussion going.

Presenters: Ask Questions to the Audience

We all know how it goes. “Any questions?” Silence.

Scientists, by their very nature, are usually introverted. Any ideas they might want to contribute to a discussion are typically outweighed by the fear of looking silly in front of their peers. Or they think everyone already knows the item they wish to contribute. Or don’t want to be publicly disproven. And so on.

Prepare some questions to ask the audience in advance. As soon as a few people speak, everyone tends to loosen up. Take advantage of this.

Audience: Think About Topics to Praise or Critique

Aside from seeking clarification on any unclear topics, you could ask questions on:

• Does the data support the conclusions?
• Are the conclusions relevant?
• Are the methods valid?
• What are the drawbacks and limitations of the conclusions?
• Are there better methods to test the hypothesis?
• How will the research be translated into real-world benefits?
• Are there obvious follow-up experiments?
• How well is the burden of proof met?
• Is the data physiologically relevant?
• Do you agree with the conclusions?

How to Keep It Fun

Make it interactive.

Quizzes and polls are a great way to do this! And QR codes make it really easy to do on-the-fly. Remember, scientists, are shy. So why not seek their participation in an anonymized form?

You could poll your audience on the quality of the work. You could make a fun quiz based on the material you’ve covered. You could do a live “what happened next?” You could even get your feedback this way. Here’s what to do:

• Create your quiz or poll using Google forms .
• Make a shareable link.
• Paste the link into a free QR code generator .
• Put the QR code in the appropriate bit of your talk.

Use Multimedia

Talking to your audience without anything to break it up is a guaranteed way of sending them all to sleep.

Consider embedding demonstration videos and animations in your talk. Or even just pausing to interject with your own anecdotes will keep everyone concentrated on you.

Keep It Informal

At the end of the day, we’re all scientists. Perhaps at different stages of our careers, but we’ve all had similar-ish trajectories. So there’s no need for haughtiness.

And research institutes are usually aggressively casual in terms of dress code, coffee breaks, and impromptu chats. Asking everyone to don a suit won’t add any value to a journal club.

Your Journal Club Toolkit in Summary

Anyone can read a paper, but the value lies in understanding it and applying it to your own research and thought process.

Remember, journal club is about extracting wisdom from your colleagues in the form of a discussion while disseminating wisdom to them in a digestible format.

Need some inspiration for your journal club? Check out the online repositories hosted by PNAS and NASPAG to get your juices flowing.

We’ve covered a lot of information, from parsing papers to organizational logistics, and effective presentation. So why not bookmark this page so you can come back to it all when it’s your turn to present?

While you’re here, why not ensure you’re always prepared for your next journal club and download bitesize bio’s free journal club checklist ?

And if you present at journal club and realize we’ve left something obvious out. Get in touch and let us know. We’ll add it to the article!

• Linzer M et al . (1988) Impact of a medical journal club on house-staff reading habits, knowledge, and critical appraisal skills . JAMA 260 :2537–41

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How to prepare and deliver an effective oral presentation

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• Peer review
• Lucia Hartigan , registrar 1 ,
• Fionnuala Mone , fellow in maternal fetal medicine 1 ,
• Mary Higgins , consultant obstetrician 2
• 1 National Maternity Hospital, Dublin, Ireland
• 2 National Maternity Hospital, Dublin; Obstetrics and Gynaecology, Medicine and Medical Sciences, University College Dublin
• luciahartigan{at}hotmail.com

The success of an oral presentation lies in the speaker’s ability to transmit information to the audience. Lucia Hartigan and colleagues describe what they have learnt about delivering an effective scientific oral presentation from their own experiences, and their mistakes

The objective of an oral presentation is to portray large amounts of often complex information in a clear, bite sized fashion. Although some of the success lies in the content, the rest lies in the speaker’s skills in transmitting the information to the audience. 1

Preparation

It is important to be as well prepared as possible. Look at the venue in person, and find out the time allowed for your presentation and for questions, and the size of the audience and their backgrounds, which will allow the presentation to be pitched at the appropriate level.

See what the ambience and temperature are like and check that the format of your presentation is compatible with the available computer. This is particularly important when embedding videos. Before you begin, look at the video on stand-by and make sure the lights are dimmed and the speakers are functioning.

For visual aids, Microsoft PowerPoint or Apple Mac Keynote programmes are usual, although Prezi is increasing in popularity. Save the presentation on a USB stick, with email or cloud storage backup to avoid last minute disasters.

When preparing the presentation, start with an opening slide containing the title of the study, your name, and the date. Begin by addressing and thanking the audience and the organisation that has invited you to speak. Typically, the format includes background, study aims, methodology, results, strengths and weaknesses of the study, and conclusions.

If the study takes a lecturing format, consider including “any questions?” on a slide before you conclude, which will allow the audience to remember the take home messages. Ideally, the audience should remember three of the main points from the presentation. 2

Have a maximum of four short points per slide. If you can display something as a diagram, video, or a graph, use this instead of text and talk around it.

Animation is available in both Microsoft PowerPoint and the Apple Mac Keynote programme, and its use in presentations has been demonstrated to assist in the retention and recall of facts. 3 Do not overuse it, though, as it could make you appear unprofessional. If you show a video or diagram don’t just sit back—use a laser pointer to explain what is happening.

Rehearse your presentation in front of at least one person. Request feedback and amend accordingly. If possible, practise in the venue itself so things will not be unfamiliar on the day. If you appear comfortable, the audience will feel comfortable. Ask colleagues and seniors what questions they would ask and prepare responses to these questions.

It is important to dress appropriately, stand up straight, and project your voice towards the back of the room. Practise using a microphone, or any other presentation aids, in advance. If you don’t have your own presenting style, think of the style of inspirational scientific speakers you have seen and imitate it.

Try to present slides at the rate of around one slide a minute. If you talk too much, you will lose your audience’s attention. The slides or videos should be an adjunct to your presentation, so do not hide behind them, and be proud of the work you are presenting. You should avoid reading the wording on the slides, but instead talk around the content on them.

Maintain eye contact with the audience and remember to smile and pause after each comment, giving your nerves time to settle. Speak slowly and concisely, highlighting key points.

Do not assume that the audience is completely familiar with the topic you are passionate about, but don’t patronise them either. Use every presentation as an opportunity to teach, even your seniors. The information you are presenting may be new to them, but it is always important to know your audience’s background. You can then ensure you do not patronise world experts.

To maintain the audience’s attention, vary the tone and inflection of your voice. If appropriate, use humour, though you should run any comments or jokes past others beforehand and make sure they are culturally appropriate. Check every now and again that the audience is following and offer them the opportunity to ask questions.

Finishing up is the most important part, as this is when you send your take home message with the audience. Slow down, even though time is important at this stage. Conclude with the three key points from the study and leave the slide up for a further few seconds. Do not ramble on. Give the audience a chance to digest the presentation. Conclude by acknowledging those who assisted you in the study, and thank the audience and organisation. If you are presenting in North America, it is usual practice to conclude with an image of the team. If you wish to show references, insert a text box on the appropriate slide with the primary author, year, and paper, although this is not always required.

Answering questions can often feel like the most daunting part, but don’t look upon this as negative. Assume that the audience has listened and is interested in your research. Listen carefully, and if you are unsure about what someone is saying, ask for the question to be rephrased. Thank the audience member for asking the question and keep responses brief and concise. If you are unsure of the answer you can say that the questioner has raised an interesting point that you will have to investigate further. Have someone in the audience who will write down the questions for you, and remember that this is effectively free peer review.

Be proud of your achievements and try to do justice to the work that you and the rest of your group have done. You deserve to be up on that stage, so show off what you have achieved.

Competing interests: We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None.

• ↵ Rovira A, Auger C, Naidich TP. How to prepare an oral presentation and a conference. Radiologica 2013 ; 55 (suppl 1): 2 -7S. OpenUrl
• ↵ Bourne PE. Ten simple rules for making good oral presentations. PLos Comput Biol 2007 ; 3 : e77 . OpenUrl PubMed
• ↵ Naqvi SH, Mobasher F, Afzal MA, Umair M, Kohli AN, Bukhari MH. Effectiveness of teaching methods in a medical institute: perceptions of medical students to teaching aids. J Pak Med Assoc 2013 ; 63 : 859 -64. OpenUrl

Expert Consult

Journal Club: How to Build One and Why

By Michelle Sharp, MD; Hunter Young, MD, MHS

Published April 6, 2022

Journal clubs are a longstanding tradition in residency training, dating back to William Osler in 1875. The original goal of the journal club in Osler’s day was to share expensive texts and to review literature as a group. Over time, the goals of journal clubs have evolved to include discussion and review of current literature and development of skills for evaluating medical literature. The ultimate goal of a journal club is to improve patient care by incorporating evidence into practice.

Why are journal clubs important?

In 2004, Alper et al . reported that it would take more than 600 hours per month to stay current with the medical literature. That leaves residents with less than 5 hours a day to eat, sleep, and care for patients if they want to stay current, and it’s simply impossible. Journal clubs offer the opportunity for residents to review the literature and stay current. Furthermore, Lee et al . showed that journal clubs improve residents’ critical appraisal of the literature.

How do you get started?

The first step to starting a journal club is to decide on the initial goal. A good initial goal is to lay the foundation for critical thinking skills using literature that is interesting to residents. An introductory lecture series or primer on study design is a valuable way to start the journal club experience. The goal of the primer is not for each resident to become a statistician, but rather to lay the foundation for understanding basic study designs and the strengths and weaknesses of each design.

The next step is to decide on the time, frequency, and duration of the journal club. This depends on the size of your residency program and leadership support. Our journal club at Johns Hopkins is scheduled monthly during the lunch hour instead of a noon conference lecture. It is essential to pick a time when most residents in your program will be available to attend and a frequency that is sustainable.

How do you get residents to come?

Generally, if you feed them, they will come. In a cross-sectional analysis of journal clubs in U.S. internal medicine residencies, Sidorov found that providing food was associated with long-lasting journal clubs. Factors associated with higher resident attendance were fewer house staff, mandatory attendance, formal teaching, and an independent journal club (separate from faculty journal clubs).

The design or format of your journal club is also a key factor for attendance. Not all residents will have time during each rotation to read the assigned article, but you want to encourage these residents to attend nonetheless. One way to engage all residents is to assign one or two residents to lead each journal club, with the goal of assigning every resident at least one journal club during the year. If possible, pick residents who are on lighter rotations, so they have more time outside of clinical duties to dissect the article. To enhance engagement, allow the assigned residents to pick an article on a topic that they find interesting.

Faculty leadership should collaborate with residents on article selection and dissection and preparation of the presentation. Start each journal club with a 10- to 20-minute presentation by the assigned residents to describe the article (as detailed below) to help residents who did not have time to read the article to participate.

What are the nuts and bolts of a journal club?

To prepare a successful journal club presentation, it helps for the structure of the presentation to mirror the structure of the article as follows:

Background: Start by briefly describing the background of the study, prior literature, and the question the paper was intended to address.

Methods: Review the paper’s methods, emphasizing the study design, analysis, and other key points that address the validity and generalizability of the results (e.g., participant selection, treatment of potential confounders, and other issues that are specific to each study design).

Results: Discuss the results, focusing on the paper’s tables and figures.

Discussion: Restate the research question, summarize the key findings, and focus on factors that can affect the validity of the findings. What are potential biases, confounders, and other issues that affect the validity or generalizability of the findings to clinical practice? The study results should also be discussed in the context of prior literature and current clinical practice. Addressing the questions that remain unanswered and potential next steps can also be useful.

Faculty participation: At our institution, the faculty sponsor meets with the assigned residents to address their questions about the paper and guide the development of the presentation, ensuring that the key points are addressed. Faculty sponsors also attend the journal club to answer questions, emphasize key elements of the paper, and facilitate the open discussion after the resident’s presentation.

How do you measure impact?

One way to evaluate your journal club is to assess the evidence-based practice skills of the residents before and after the implementation of the journal club with a tool such as the Berlin questionnaire — a validated 15-question survey that assesses evidence-based practice skills. You can also conduct a resident satisfaction survey to evaluate the residents’ perception of the implementation of the journal club and areas for improvement. Finally, you can develop a rubric for evaluation of the resident presenters in each journal club session, and allow faculty to provide feedback on critical assessment of the literature and presentation skills.

Journal clubs are a great tradition in medical training and continue to be a valued educational resource. Set your goal. Consider starting with a primer on study design. Engage and empower residents to be part of the journal club. Enlist faculty involvement for guidance and mentorship. Measure the impact.

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How to Prepare an Outstanding Journal Club Presentation

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Rishi Sawhney; How to Prepare an Outstanding Journal Club Presentation. The Hematologist 2006; 3 (1): No Pagination Specified. doi: https://doi.org/10.1182/hem.V3.1.1308

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Dr. Sawhney is a member of the ASH Trainee Council and a Fellow at the Medical University of South Carolina.

Journal club presentations provide a forum through which hematology trainees keep abreast of new developments in hematology and engage in informal discussion and interaction. Furthermore, honing presentation skills and mastering the ability to critically appraise the evidence add to our armamentarium as clinicians. Outlined here is a systematic approach to preparing a journal club presentation, with emphasis on key elements of the talk and references for electronic resources. Use of these tools and techniques will contribute to the success of your presentation.

I. ARTICLE SELECTION:

The foundation of an outstanding journal club presentation rests on the choice of an interesting and well-written paper for discussion. Several resources are available to help you select important and timely research, including the American College of Physicians (ACP) Journal Club and the Diffusion section of The Hematologist . McMaster University has created the McMaster Online Rating of Evidence (MORE) system to identify the highest-quality published research. In fact, the ACP Journal Club uses the MORE system to select their articles 1 . Specific inclusion criteria have been delineated in order to distinguish papers with the highest scientific merit 2 . Articles that have passed this screening are then rated by clinicians on their clinical relevance and newsworthiness, using a graded scale 3 . With the help of your mentors and colleagues, you can use these criteria and the rating scale as informal guidelines to ensure that your chosen article merits presentation.

II. ARTICLE PRESENTATION:

Study Background: This section provides your audience with the necessary information and context for a thoughtful and critical evaluation of the article's significance. The goals are 1) to describe the rationale for and clinical relevance of the study question, and 2) to highlight the preclinical and clinical research that led to the current trial. Review the papers referenced in the study's "Background" section as well as previous work by the study's authors. It also may be helpful to discuss data supporting the current standard of care against which the study intervention is being measured.

Study Methodology and Results: Clearly describe the study population, including inclusion/exclusion criteria. A diagrammatic schema is easy to construct using PowerPoint software and will help to clearly illustrate treatment arms in complex trials. Explain the statistical methods, obtaining assistance from a statistician if needed. Take this opportunity to verbally and graphically highlight key results from the study, with plans to expand on their significance later in your presentation.

Author's Discussion: Present the authors' conclusions and their perspective on the study results, including explanations of inconsistent or unexpected results. Consider whether the conclusions drawn are supported by the data presented.

III. ARTICLE CRITIQUE:

This component of your presentation will define the success of your journal club. A useful and widely accepted approach to this analysis has been published in JAMA's series "User's guide to the medical literature." The Centre for Health Evidence in Canada has made the complete full-text set of these user's guides available online 4 . This site offers review guidelines for a menu of article types, and it is an excellent, comprehensive resource to focus your study critique. A practical, user-friendly approach to literature evaluation that includes a worksheet is also available on the ASH Web site for your use 5 .

While a comprehensive discussion of scientific literature appraisal is beyond the scope of this discussion, several helpful tips warrant mention here. In assessing the validity of the study, it is important to assess for potential sources of bias, including the funding sources and authors' affiliations. It is also helpful to look for accompanying editorial commentary, which can provide a unique perspective on the article and highlight controversial issues. You should plan to discuss the trade-offs between potential benefits of the study intervention versus potential risks and the cost. By utilizing the concept of number needed to treat (NNT), one can assess the true impact of the study intervention on clinical practice. Furthermore, by incorporating the incidence rates of clinically significant toxicities with the financial costs into the NNT, you can generate a rather sophisticated analysis of the study's impact on practice.

IV. CONCLUSIONS, IMPLICATIONS, AND FUTURE DIRECTIONS:

Restate the authors' take-home message followed by your own interpretation of the study. Provide a personal perspective, detailing why you find this paper interesting or important. Then, look forward and use this opportunity to "think outside the box." Do you envision these study results changing the landscape of clinical practice or redirecting research in this field? If so, how? In articles about therapy, future directions may include moving the therapy up to first-line setting, assessing the drug in combination regimens or other disease states, or developing same-class novel compounds in the pipeline. Searching for related clinical trials on the NIH Web site 6  can prove helpful, as can consultation with an expert in this field.

Good journal club discussions are integral to the educational experience of hematology trainees. Following the above approach, while utilizing the resources available, will lay the groundwork for an outstanding presentation.

WEB BASED REFERENCES

www.acpjc.org

hiru.mcmaster.ca/more/InclusionCriteria.htm

hiru.mcmaster.ca/more/RatingFormSample.htm

www.cche.net/main.asp

www.hematology.org/Trainees

www.cancer.gov/clinicaltrials

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How to Make a PowerPoint Presentation of Your Research Paper

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A research paper presentation is often used at conferences and in other settings where you have an opportunity to share your research, and get feedback from your colleagues. Although it may seem as simple as summarizing your research and sharing your knowledge, successful research paper PowerPoint presentation examples show us that there’s a little bit more than that involved.

In this article, we’ll highlight how to make a PowerPoint presentation from a research paper, and what to include (as well as what NOT to include). We’ll also touch on how to present a research paper at a conference.

Purpose of a Research Paper Presentation

The purpose of presenting your paper at a conference or forum is different from the purpose of conducting your research and writing up your paper. In this setting, you want to highlight your work instead of including every detail of your research. Likewise, a presentation is an excellent opportunity to get direct feedback from your colleagues in the field. But, perhaps the main reason for presenting your research is to spark interest in your work, and entice the audience to read your research paper.

So, yes, your presentation should summarize your work, but it needs to do so in a way that encourages your audience to seek out your work, and share their interest in your work with others. It’s not enough just to present your research dryly, to get information out there. More important is to encourage engagement with you, your research, and your work.

Tips for Creating Your Research Paper Presentation

In addition to basic PowerPoint presentation recommendations, which we’ll cover later in this article, think about the following when you’re putting together your research paper presentation:

• Know your audience : First and foremost, who are you presenting to? Students? Experts in your field? Potential funders? Non-experts? The truth is that your audience will probably have a bit of a mix of all of the above. So, make sure you keep that in mind as you prepare your presentation.

Know more about: Discover the Target Audience .

• Your audience is human : In other words, they may be tired, they might be wondering why they’re there, and they will, at some point, be tuning out. So, take steps to help them stay interested in your presentation. You can do that by utilizing effective visuals, summarize your conclusions early, and keep your research easy to understand.
• Running outline : It’s not IF your audience will drift off, or get lost…it’s WHEN. Keep a running outline, either within the presentation or via a handout. Use visual and verbal clues to highlight where you are in the presentation.
• Where does your research fit in? You should know of work related to your research, but you don’t have to cite every example. In addition, keep references in your presentation to the end, or in the handout. Your audience is there to hear about your work.
• Plan B : Anticipate possible questions for your presentation, and prepare slides that answer those specific questions in more detail, but have them at the END of your presentation. You can then jump to them, IF needed.

What Makes a PowerPoint Presentation Effective?

You’ve probably attended a presentation where the presenter reads off of their PowerPoint outline, word for word. Or where the presentation is busy, disorganized, or includes too much information. Here are some simple tips for creating an effective PowerPoint Presentation.

• Less is more: You want to give enough information to make your audience want to read your paper. So include details, but not too many, and avoid too many formulas and technical jargon.
• Clean and professional : Avoid excessive colors, distracting backgrounds, font changes, animations, and too many words. Instead of whole paragraphs, bullet points with just a few words to summarize and highlight are best.
• Know your real-estate : Each slide has a limited amount of space. Use it wisely. Typically one, no more than two points per slide. Balance each slide visually. Utilize illustrations when needed; not extraneously.
• Keep things visual : Remember, a PowerPoint presentation is a powerful tool to present things visually. Use visual graphs over tables and scientific illustrations over long text. Keep your visuals clean and professional, just like any text you include in your presentation.

Know more about our Scientific Illustrations Services .

Another key to an effective presentation is to practice, practice, and then practice some more. When you’re done with your PowerPoint, go through it with friends and colleagues to see if you need to add (or delete excessive) information. Double and triple check for typos and errors. Know the presentation inside and out, so when you’re in front of your audience, you’ll feel confident and comfortable.

How to Present a Research Paper

If your PowerPoint presentation is solid, and you’ve practiced your presentation, that’s half the battle. Follow the basic advice to keep your audience engaged and interested by making eye contact, encouraging questions, and presenting your information with enthusiasm.

We encourage you to read our articles on how to present a scientific journal article and tips on giving good scientific presentations .

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5 Tips for Journal Club First-Timers

By Lucy Bauer

Monday, March 30, 2015

Research communities often uphold the ideal of scientific collaboration. But what does “collaboration” really mean? The picture that comes to mind can be people sitting, talking, and exchanging ideas that push toward the goal of creating better health. How can this exchange practically happen? One way is through a journal club. Recently, I had the privilege of presenting a journal article to my lab group’s journal club in the PAIN (Pain And Integrative Neuroscience) lab for  Dr. Catherine Bushnell . One goal of our lab is to look at the relationship and differences between itch and pain.

Me explaining part of the spinal neuron pathway in itch

So, what is the purpose of a journal club?

A journal club is a regular gathering of scientists to discuss a scientific paper found in a research journal. One or two members of the club present a summary of the chosen paper that the whole group has read. Then, the discussion begins. Attendees ask clarifying questions, inquire about different aspects of the experimental design, critique the methods, and bring a healthy amount of skepticism (or praise) to the results.

For my first journal club at the NIH, we considered a paper that looks at how itch is mediated in the spinal cord from the skin up to the brain. The authors show that mice lacking a gene for a specific type of spinal neuron constantly scratch specific areas of their bodies corresponding to the missing spinal interneuron. When these mice receive a stem cell implant, a normal reaction to itch is restored. This paper generated much discussion about neuronal development, ethical considerations, and how the results relate to our research within the National Center for Complementary and Integrative Health (NCCIH).

The ideas found and discussed at the journal club can help expand and balance each scientist’s scope of what is happening in the world of research while informing experimental plans and research directions. Here are five things I learned from my experience leading a journal club that can help you prepare to get the most out of your discussions:

1. Know the background material.

Prepare beforehand for your journal club presentation by knowing the research that has preceded and is related to the paper you will be presenting. This will make your discussion more informed and effective. Of course, it is likely impossible to know everything that would relate to your journal club presentation, but even a little bit of background information is helpful.

2. Make your presentation concise.

Every paper has many details about methods, results, discussion, future directions, etc. It is very helpful to give your audience the general flow of the entire paper and research before adding in all the details.

3. Simplify unfamiliar concepts.

Journal clubs often have members of varying backgrounds. Hence, not all concepts will be familiar to everyone in the group. It can be helpful to give a short summary of techniques and results. Detailed explanations can be provided later on, because the primary focus of presenting the paper should be giving an overview of the research.

4. Ask yourself questions about the paper before you present.

As the presenter, you may be the semi-“expert” on the paper, but as you get to know the research, you may discover some questions you have about the methods. Share with the group the questions you came across yourself and any answers you may have found to address them.

5. Ask specific questions to the members of the journal club.

When entering into discussion time, ask the group for their thoughts on specific topics found in the paper to create a starting point for conversation about the paper. Questions can be about methods, results, general ideas, and much more!

Journal clubs are great forums for the exchange of thoughts and ideas. Clubs held at the NIH are just one way through which necessary scientific discussion and collaboration can take place. Be sure to look into journal clubs happening near you!

If you’re at the NIH, the Office of Intramural Training and Education (OITE) hosts  Summer Journal Clubs  that are ideal for trainees just getting their feet wet. And for our colleagues around the world, the NIH National Library of Medicine (NLM) provides an online platform to discuss journal articles in our connected world via the  PubMed Commons Journal Clubs .

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Business Jargons

A Business Encyclopedia

Presentation

Definition : A presentation is a form of communication in which the speaker conveys information to the audience. In an organization presentations are used in various scenarios like talking to a group, addressing a meeting, demonstrating or introducing a new product, or briefing a team. It involves presenting a particular subject or issue or new ideas/thoughts to a group of people.

It is considered as the most effective form of communication because of two main reasons:

• Use of non-verbal cues.
• Facilitates instant feedback.

Business Presentations are a tool to influence people toward an intended thought or action.

Parts of Presentation

• Introduction : It is meant to make the listeners ready to receive the message and draw their interest. For that, the speaker can narrate some story or a humorous piece of joke, an interesting fact, a question, stating a problem, and so forth. They can also use some surprising statistics.
• Body : It is the essence of the presentation. It requires the sequencing of facts in a logical order. This is the part where the speaker explains the topic and relevant information. It has to be critically arranged, as the audience must be able to grasp what the speaker presents.
• Conclusion : It needs to be short and precise. It should sum up or outline the key points that you have presented. It could also contain what the audience should have gained out of the presentation.

Purpose of Presentation

• To inform : Organizations can use presentations to inform the audience about new schemes, products or proposals. The aim is to inform the new entrant about the policies and procedures of the organization.
• To persuade : Presentations are also given to persuade the audience to take the intended action.
• To build goodwill : They can also help in building a good reputation

Factors Affecting Presentation

Audience Analysis

Communication environment, personal appearance, use of visuals, opening and closing presentation, organization of presentation, language and words, voice quality, body language, answering questions, a word from business jargons.

Presentation is a mode of conveying information to a selected group of people live. An ideal presentation is one that identifies and matches the needs, interests and understanding level of the audience. It also represents the facts, and figures in the form of tables, charts, and graphs and uses multiple colours.

Related terms:

• Verbal Communication
• Visual Communication
• Non-Verbal Communication
• Communication
• 7 C’s of Communication

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October 2, 2022 at 11:33 pm

Thank you so much for providing us with brief info related to the presentation.

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• 10 Journal Club Tips: How to Run, Lead, and Present Like a Pro

Ten Tips for Scientific Journal Clubs: How to Organize, Lead, and Participate Well

What is a journal club? A scientific journal club is a dedicated meeting where researchers gather to discuss publications from peer-reviewed journals. These meetings help researchers keep up with current findings, exercise their critical thinking skills, and improve their presentation and debate abilities.

Journal club formats vary depending on the preferences of organizers and participants. Online journal clubs organized using virtual meeting platforms (e.g. Zoom, Google Meets, Webex) are increasing in popularity with research labs and institutions.

In a well-run journal club, participants engage in lively discussions, while critically and honestly evaluating a study's strengths and weaknesses. They take away insights on what to do—and what not to do—in their own work. They feel inspired by new findings and walk away with ideas for their own research. On the contrary, ineffective journal clubs lack active participation. There may be a fear of openly voicing thoughts and opinions, or attendees may just be there for the free refreshments. In the end, the attendees take away nothing useful and think it's a waste of time. Whether you’re an organizer or a participant, follow these tips to run and lead a successful journal club, and to create engaging journal club presentations.

1. Make It a Routine

Schedule the journal club at a recurring time and location, so that it becomes a regular part of everyone's schedule. Choose a time that will be the least disruptive to everyone's experiments. Perhaps host it during lunchtime and invite people to eat while the presenter is speaking. Or perhaps host it in late afternoon with coffee and snacks provided.

We try and make the meeting times agreeable to most people and at times that are conducive to the work day of a grad student. We hold our journal clubs after seminars or presentations so it doesn’t interrupt experiments.

Shan Kasal, Graduate Student, The University of Chicago

2. Designate a Leader

A designated leader(s) who can take ownership of running the journal club will contribute tremendously to its success. The responsibilities of a leader may include organizing the journal club (see below) and facilitating the meeting (e.g., starting and ending meetings on time, making speaker introductions and announcements, and moderating discussions). Skilled journal club leaders make it safe for members to openly voice their thoughts and opinions. They work to generate excitement and encourage active participation. They also provide opportunities for members to join them in organizing and leading the journal club. Great leaders inspire personal and professional growth in others within their journal club community. Download this journal club preparation checklist to help you stay organized as a leader and ensure all necessary tasks are completed before each journal club meeting.

3. Get Organized

Staying organized is key to running a successful journal club. Here are some ways that can help you organize a journal club:

• Set a consistent format and make sure members are aware of it.
• Create and share schedules so participants know it's their turn to present, facilitate, pre-read, or provide refreshments.
• Develop a communication rhythm to make sure announcements and reminders are sent out in a timely manner.
• Provide guidelines and/or a template for presenters.
• Bring attendance sheets to track member turnouts. Depending on the institute, keeping track of attendance can help with budget requests and approvals.
• Provide feedback forms to the audience to help identify areas for improvement.

Journal Club ToolKit

Get organized with these downloadable tools, including a journal club preparation checklist, attendance sheet template, presentation checklist, feedback form template, and presenter evaluation forms.

4. Pre-Read Papers

Pre-reading is a great way to ensure that you have sufficient background information to participate in journal club discussions. In an ideal world, everyone in the journal club will read the paper prior to the meeting. But due to the high demands of research , members may not have the time to pre-read before every single meeting. Journal club leaders can encourage pre-reading or even make it mandatory. Some journal clubs ask for different members to present different figures. Using this format, several individuals have to pre-read the paper and actively participate during each meeting. Other journal clubs designate one or two individuals, in addition to the presenter, to thoroughly pre-read the paper each week. The pre-readers are asked to help promote discussion by asking questions during the meetings. Organizers can set a schedule so that members know when it's their turn to pre-read.

5. Build a Community

You need to have students that are interested in the club in the first place, and I would also say, interested in hanging out with each other. Our journal club format is informal, which allows us to at least enjoy the company of each other.

Journal club organizers and leaders should aim to create a community where the members feel safe enough to share their thoughts and ask questions. Fostering community encourages active participation and the exchange of ideas, and can increase participant satisfaction and collaborations.

Successful journal clubs always come with food!!

Serena Chang, Postdoctoral Research Fellow, Stanford University

A great way to foster community is, simply, to serve food and drinks. Eating and drinking together can create a friendly, informal atmosphere conducive to open discussions, which will help encourage the flow of ideas and thoughts on the journal club paper. In addition, refreshments help to incentivize members to continue attending the journal club.

Immunology Journal Club Sponsorship Contest

Enter for a chance to win a $500 USD sponsorship budget for your immunology journal club. Use it to fund food and drinks. Be a hero and win it for your journal club community.

6. Choose Relevant Papers

Consider the composition of your journal club community when choosing a paper. A journal club may have a broad group of researchers (e.g., a general immunology journal club), or it may only involve one or two labs specifically working on immune tolerance or a particular immune cell type. Papers discussed should be be on topics relevant to the participants’ research areas so that they remain interested.

We encourage people to select papers they are not already reading to try and expand our understanding of immunology and theirs. Too many times I feel like people select papers they already have read or will read and gain nothing from it, so there is no incentive to invest more.

As a busy researcher, the additional task of preparing for a journal club can feel like an extra burden. It’s easy to choose a paper that you are already reading for your research project. But choosing a paper that is outside of your research specialty can help you and others gain new perspectives and broaden your knowledge.

7. Make Engaging Presentations

You’ve likely suffered through boring lectures with text-heavy slides, or a monotonous presentation. How can this be avoided in your journal club?

I have a one page suggestion list of things to include in the presentation, including criticisms for the methods, hypothesis, whether the results are valid/strong enough to support the hypothesis, etc. This helps keep everyone on track.

As a journal club organizer or leader, you can provide presenters with a suggested list of presentation content and best practices:

• Start with why. Capture everyone’s interest by sharing why you chose that paper or why the paper is important to discuss.
• Prepare a concise presentation. Summarize only the key points of the paper. Include enough background information but avoid the urge to include every single detail. You can provide technical details when needed during the discussion period.
• Simplify complex information. Create simple visual representations of complex ideas, pathways, or techniques to help your audience understand the information. Avoid writing out complex information in text-heavy slides that nobody will read.
• Give it more space. Make your slides easier to read by avoiding having too much text in small fonts or too many figures on one slide. If a figure is too large, you can break it up into a few slides.
• Include discussion starters. Instead of simply summarizing, include your thoughts and opinions on all aspects of the paper to initiate a discussion. What were the strengths and weaknesses? What questions did you have when reading the paper?

Download this journal club presentation checklist to help your presentation preparation.

8. Keep It Exciting

Break out of the routine once in a while to keep the journal club fresh and exciting. For example, you could invite external speakers to your journal club:

• Invite a visiting scientist to present their work.
• Ask a biotech company to present their technologies.
• Find a speaker who can discuss scientific careers.
• Ask a science communication expert to give tips.

9. Look for Ways to Improve

You’ve taken the first step towards improving your journal club by reading this article, but improvement is a continual process. What does your journal club community think? Perform regular audits of the journal club by asking for feedback every few months. Distribute feedback forms that attendees can fill out at the end of a journal club meeting. Download a journal club feedback form template > In addition to asking for feedback, pay attention to what happens during journal club meetings. Do members generally appear awake and engaged during presentations? Are you constantly running out of discussion time? You can gain a lot of insights by simply being observant in the meeting.

10. Make Time for It

Understandably, the demands of research can prevent you from making the choice to take on this additional task of leading or participating in a journal club. Adopt smart practices so you can use your time more efficiently. Working smart will help free up your time for other beneficial activities, including journal clubs. One of the ways to work smarter is to make the switch to more efficient technologies that can help you get your results in less time. For example, you can switch to a smarter way to isolate cells.

Efficient Tools and Technologies for Life Science Research

Accomplish more in less time and with less effort by making smarter choices for the tools you use in the lab, including cell isolation and cell culture technologies.

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Conference Paper vs. Journal Paper: Learn the difference

Discover conference papers and how to tell them from journal papers. Check out tips for writing a high-quality conference paper.

A major dilemma frequently arises for an academic subject: should it be a conference paper or a journal paper? That is why, in order to do and refer to the right framework, you must first comprehend the essential distinction concerning the smallest things in papers.

This article will explain more about conference papers , the differences between them and journal papers, and how to write a high-quality one.

What is a conference paper?

To begin, a conference is a place where academics, researchers, experts, and professionals deliver and present information after doing thorough research. As a result, a conference paper is essentially a mixture of a written document and an oral presentation. 

Conference papers are brief and precise documents with a limited number of pages in which academics present the findings of their research investigations. In certain cases, conference papers are published in the conference proceedings, and in others, only chosen papers are published in the conference proceedings.

Conference Paper vs. Journal Paper

The primary distinction between a journal paper and a conference paper is that, while both require writing, journal papers are intended for publication in journals, whereas conference papers are intended for presentation at conferences and may be published in conference proceedings. 

There are also significant distinctions in the reviewing process, with journal papers requiring a considerably more thorough and strict review. Furthermore, conference papers have fewer pages than journal papers, often limited to four to ten pages.

Types of conference paper

Each presentation may necessitate a different sort of conference paper since there are many. Learn about a few of them below.

• Respondent: A speaker provides a thirty-minute paper in this sort of presentation. A respondent then replies to the article for fifteen minutes. The speaker thereafter provides a fifteen-minute response to the response.
• Panel: This sort of presentation has three to four presenters, each of whom speaks for 15-20 minutes. Panels may additionally include a discussant who provides both individual and group feedback on the papers.
• Poster: This form of presentation is designed to graphically express information. Some presenters display a three to eight-page document outlining their research, providing their ideas and an explanation of their findings. Charts, graphs, illustrations or artwork are among the most visually attractive posters. 
• Roundtable: Consists of five or more presenters, each of whom speaks for 5-10 minutes.
• Workshops: Workshops might last anything from 90 minutes to a whole day. Before engaging the audience in some form of action, workshop speakers make brief comments. 

Conference paper format

In terms of formatting, the best method is to check with the conference to which your work is being submitted, since they may have specific formatting standards for the paper and abstract, such as margin size, page number usage, page limitation, and other aspects. Just remember that your conference paper should proceed logically from abstract to conclusions. 

Tips on writing a high-quality conference paper

• Start with a strong abstract, as you might need to present it before it’s accepted for the conference. 
• Get to know your audience in order to make it appealing.
• Create an outline of your work to assist you in organizing your ideas and material.
• Create an introduction that will pique the reader’s curiosity.
• Find easy methods to communicate complicated concepts. Use simple metaphors and analogies. 
• Use your ear to write. When you’ve finished a draft, read it aloud. Remove any uncomfortable parts.
• Long quotations should be avoided. They shorten listeners’ attention spans and break the flow of your statement.
• Use proper punctuation. The audience will not see dashes, semicolons, or parentheses.
• Take your time with results and conclusions, and include facts to back up your statements.
• Remember to include any references you might have used. The more thorough the references are, the better.
• Prepare for questions. Attend conferences the day before your own to see what kinds of questions people ask and to get a sense of it.

Integrate information and illustrations into beautiful and impactful slides

Remember to include graphic materials in your slides while creating a conference paper. Graphs, illustrations, and infographics can help you offer comprehension of the data you’re presenting. To improve your work, use the Mind The Graph tool.

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Kentucky Derby 2024 highlights: Mystik Dan edges Sierra Leone to win Triple Crown's first leg

The 2024 Kentucky Derby was one for the history books as the 150th Run for the Roses came down to a photo finish at Churchill Downs on Saturday.

The first leg of horse racing's Triple Crown was won by Mystik Dan , who edged Sierra Leone by less than a nose at the finish line. Sierra Leone, along with Fierceness, was one of the field's favorites among the 20-horse field .

The most exciting two minutes in sports wound up taking several more after officials had to gather to determine who crossed first between Mystik Dan and Sierra Leone, with third-place finisher Forever Young just another step behind. Forever Young  came excruciatingly close to giving Japan its first Kentucky Derby win.

USA TODAY Sports provided analysis and highlights from Churchill Downs:

Mystik Dan won by a whisker. The key? One great ride.

Saturday, in the 150th Kentucky Derby, 38-year-old journeyman Brian Hernandez delivered one of the great human performances in the history of the race.

And the horse he rode wasn’t too bad, either.

With a rail-skimming ride that was practically perfect in its boldness and timing, Hernandez got 18-1 shot Mystik Dan home by a whisker over the surging Sierra Leone and Forever Young in a three-horse photo finish that left the Churchill Downs crowd of 156,710 initially wondering who had won America’s most famous horse race.

“(Hernandez) was the difference in winning and losing today, for sure,” trainer Kenny McPeek said.

Read Dan Wolken's full column here.

Texas man wins nearly $60,000 on Mystik Dan

Dave Oblisk walked away from Churchill Downs with nearly $60,000 after placing 12 bets on Mystik Dan, the winner of the 150th Kentucky Derby.

After the photo finish between Mystik Dan, Sierra Leone and Forever Young, Oblisk was shaking, his family members said.

"I'm still shaking!" Oblisk, a resident of Austin, Texas, told the Courier Journal , part of the USA TODAY Network.

2024 Kentucky Derby official results

• 1. Mystik Dan
• 2. Sierra Leone
• 3. Forever Young
• 4. Catching Freedom
• 5. T O Password
• 6. Resilience
• 7. Stronghold
• 8. Honor Marie
• 9. Endlessly
• 10. Dornach
• 11. Track Phantom
• 12. West Saratoga
• 13. Domestic Product
• 14. Epic Ride
• 15. Fierceness
• 16. Society Man
• 17. Just Steel
• 18. Grand Mo The First
• 19. Catalytic
• 20. Just A Touch

What is Triple Crown in horse racing? 

The Triple Crown refers to the three major races in American Thoroughbred horse racing. It consists of the  Kentucky Derby , Preakness Stakes and Belmont Stakes. A horse that finishes first in all three races in the same year is said to have won the Triple Crown. 

When is the 2024 Preakness Stakes? 

The Preakness will be staged Saturday, May 18 from Pimlico Race Course in Baltimore. Coverage will begin at 1:30 p.m. ET, with the post time expected to be around 6:50 p.m. National Treasure was last year’s winner of the Preakness. 

2024 Kentucky Derby payouts

(Winnings based on a $2 bet unless otherwise noted)

• 1. Mystik Dan: $39.22 to win; $16.32 to place; $10 for show
• 2. Sierra Leone: $6.54 to place; $4.64 for show
• 3. Forever Young: $5.58 for show

2024 Kentucky Derby top three

• 1st place: Mystik Dan (trainer: Kenny McPeek)
• 2nd place: Sierra Leone (trainer: Chad Brown)
• 3rd place: Forever Young (trainer: Yoshito Yahagi)

Watch: Kentucky Derby photo finish

Trainer kenny mcpeek wins kentucky derby after winning kentucky oaks.

Trainer Kenny McPeek had the winning horse in Friday’s Kentucky Oaks and then Saturday’s Kentucky Derby. No trainer has accomplished the feat since Ben Jones in 1952.

"Just brilliant jockey and ride," McPeek said on the NBC broadcast immediately after the race. "The draw helped us from the beginning; we talked about that. I was shocked Dornach broke bad.

"But (jockey) Brian (Hernandez Jr.) is amazing, probably one of the most underrated riders in racing. Not anymore."

Hernandez won the Oaks on Thorpedo Anna on Friday at Churchill Downs before guiding Mystik Dan to the photo-finish win.

"That was the longest few minutes I’ve ever felt in my life," he said on NBC immediately after the race. "It was exciting when we hit the line, but I wasn’t sure if we won, it was quite a rush to sit there and wait for it."

Kentucky Derby winners since 2000 

Here are the Kentucky Derby winners over the years, with the winning horse and the winning time in parentheses. Eventual Triple Crown winners are in bold. 

2024 -- Mystik Dan

2023 – Mage (2:01.57) 

2022 – Rich Strike (2:02.61) 

2021 – Mandaloun (2:01.36) 

2020 – Authentic (2:00.61) 

2019 – Country House (2:03.93) 

2018  –  Justify (2:04:20)  

2017 – Always Dreaming (2:03.59) 

2016 – Nyquist (2:01.31) 

2015  –  American Pharoah (2:03.02)  

2014 – California Chrome (2:03.66) 

2013 – Orb (2:02.89) 

2012 – I'll Have Another (2:01.83) 

2011 – Animal Kingdom (2:02.04) 

2010 – Super Saver (2:04.45) 

2009 – Mine That Bird (2:02.66) 

2008 – Big Brown (2:01.82) 

2007 – Street Sense (2:02.17) 

2006 – Barbaro (2:01.36) 

2005 – Giacomo (2:02.75) 

2004 – Smarty Jones   (2:04.06) 

2003 – Funny Cide (2:01.19) 

2002 – War Emblem (2:01.13) 

2001 – Monarchos (1:59.97) 

2000 – Fusaichi Pegasus (2:01.00) 

Mystik Dan wins 2024 Kentucky Derby 

... and it’s Mystik Dan, at 18-1 odds, who crosses the finish line barely ahead of Sierra Leone to win the 150th Kentucky Derby at Churchill Downs. 

Kentucky Derby starts

And they're off ...

Kentucky Derby start time 

Post time for the 150th running of the Kentucky Derby is 6:57 p.m. ET on Saturday, May 4. 

Why was Encino scratched from Kentucky Derby? 

Lexington Stakes winner Encino  was scratched from  Saturday’s Kentucky Derby due to a soft tissue strain in his right leg, according to trainer Brad Cox. 

Cox said the colt didn’t look right after training on Tuesday and was taken to a hospital in Lexington where X-rays revealed the diagnosis. 

With Encino out of the race,  Epic Ride  will draw in from the also-eligible list and take the No. 20 spot in the starting gate. — Jason Frakes, Louisville Courier Journal  

Churchill Downs capacity 

When it's race day, Churchill Downs is one of the most packed venues in sports. The venue hosts around 165,000 people for the Kentucky Derby, a majority of which are in the grandstands of the race track. 

Latest Kentucky Derby odds

Odds as of 6:39 p.m. ET

• Fierceness, 3-1
• Sierra Leone, 9/2
• Forever Young, 6-1
• Catching Freedom, 8-1
• Just a Touch, 11-1
• Honor Marie, 14-1
• Mystik Dan, 18-1
• Just Steel, 21-1
• Dornoch, 22-1
• West Saratoga, 22-1
• Domestic Product, 28-1
• Resilience, 31-1
• Catalytic, 34-1
• Stronghold, 35-1
• Track Phantom, 40-1
• Epic Ride, 46-1
• T O Password, 47-1
• Endlessly, 47-1
• Society Man, 47-1
• Grand Mo The First, 48-1

Kentucky Derby TV coverage 

The Kentucky Derby will be broadcast live on NBC, with coverage starting at 2:30 p.m. ET. 

Kentucky Derby live stream 

For cord-cutters, the Kentucky Derby can be streamed on Peacock and Fubo .

Kentucky Derby field, odds 

Post positions were drawn Saturday  for the race. Here's where each horse will start , in addition to the horse's trainer, jockey and odds, according to BetMGM . 

Here's where each horse landed, in addition to the horse's trainer, jockey and odds: 

• 1.  Dornoch , Danny Gargan, Luis Saez, 20-1 
• 2.  Sierra Leone , Chad Brown, Tyler Gaffalione, 3-1 
• 3.  Mystik Dan , Kenny McPeek, Brian Hernandez Jr., 20-1 
• 4.  Catching Freedom , Brad Cox, Flavien Prat, 8-1 
• 5.  Catalytic , Saffie Joseph Jr., José Ortiz, 30-1 
• 6.  Just Steel , D. Wayne Lukas, Keith Asmussen, 20-1 
• 7.  Honor Marie , Whit Beckman, Ben Curtis, 20-1 
• 8.  Just a Touch , Brad Cox, Florent Geroux, 10-1 
• 9.  T O Password , Daisuke Takayanagi, Kazushi Kimura, 30-1 
• 10.  Forever Young , Yoshito Yahagi, Ryusei Sakai, 10-1 
• 11.  Track Phantom , Steve Asmussen, Joel Rosario, 20-1 
• 12.  West Saratoga , Larry Demeritte, Jesús Castañón, 50-1 
• 13.  Endlessly , Michael McCarthy, Umberto Rispoli, 30-1 
• 14.  Domestic Product , Chad Brown, Irad Ortiz Jr., 30-1 
• 15.  Grand Mo the First , Victor Barboza Jr., Emisael Jaramillo, 50-1 
• 16.  Fierceness , Todd Pletcher, John Velazquez, 5-2 
• 17.  Stronghold , Phil D’Amato, Antonio Fresu, 20-1 
• 18.  Resilience , Bill Mott, Junior Alvarado, 20-1 
• 19.  Society Man , Danny Gargan, Frankie Dettori, 50-1 
• 20.  Epic Ride , John Ennis, Adam Beschizza, 30-1 

Epic Ride replaces  Encino , which was  officially scratched Tuesday .  Mugatu  is also eligible if another competitor scratches.

Kentucky Derby: On the ground at Churchill Downs

Our friends at the Louisville Courier Journal have on the ground updates from historic Churchill Downs .

Kentucky Derby attendance

There were a reported 156,710 people at Churchill Downs Saturday for the 150th Kentucky Derby.

Aaron Rodgers, Travis Kelce in attendance 

New York Jets quarterback Aaron Rodgers is at Churchill Downs and we heard straight from the horse’s mouth. The official X page for the Kentucky Derby shared a photo of Rodgers blending in with a crowd of patrons. 

Earlier in the day, Rodgers said he’s interested in becoming an owner. When asked what he would name his horse, the QB offered up the name of his former Packers teammate, center Corey Linsley. “That boy’s got stamina,” Rodgers said.

Rodgers isn’t the only football player in the building. Kansas City Chiefs tight end Travis Kelce took in the festivities at Churchill Downs on Saturday afternoon. — Cydney Henderson

Where is the Kentucky Derby held? 

Churchill Downs in located in Louisville, Kentucky. It opened in 1875 and has hosted the Kentucky Derby ever since.

How big is Churchill Downs? 

Churchill Downs occupies 147 acres and it features a one-mile dirt, oval racetrack and a seven-furlong turf racecourse. It is also has barns behind the racetrack, which "house more than 1,400 horses each year,"  according to the facility .

How long is the Kentucky Derby? 

The Kentucky Derby is labeled "the most exciting two minutes in sports,” because it usually lasts about two minutes. In distance, the race is 1 ¼ miles long .

Race 1: Maiden Special Weight

Results of the first race at Churchill Downs on Saturday:

• 1st place: Pure Force (trainer: Brad Cox)
• 2nd place: Top Gun Rocket
• 3rd place: Culprit

Race 2: Allowance Optional Claiming

Results of the second race at Churchill Downs on Saturday:

• 1st place: Scylla (trainer: William Mott)
• 2nd place: Secret Statement
• 3rd place: Joke Sisi (CHI)

Race 3: Allowance Optional Claiming

Results of the third race at Churchill Downs on Saturday:

• 1st place: Mindframe (trainer: Todd Pletcher)
• 2nd place: Cornishman
• 3rd place: Higgins Boat

Kentucky Derby weather 

Saturday's forecast for Louisville calls for a high of 82 degrees with partly sunny skies, but scattered showers and thunderstorms are expected to join the party, according to the National Weather Service . There's a 40% probability of precipitation, mainly between 11 a.m. and 2 p.m. ET, but it should be all clear by the 6:57 p.m. ET post time. 

Race 4: Knicks Go Overnight Stakes

Results of the fourth race at Churchill Downs on Saturday:

• 1st place: Strong Quality (trainer: Mark Casse)
• 2nd place: Kupuna
• 3rd place: Five Star General

Kentucky Derby ticket prices 

The available seating options to buy on  Ticketmaster  are infield general admission (standing room only with no track view), infield final turn general admission (standing room only with no track view), reserved seating, dining and premier dining. Frontside plaza walkaround seats are sold out. Here are the prices for each section on Ticketmaster: 

• Infield general admission : $130 ($135 with fees). 
• Infield final turn general admission : $320 ($387 with fees). 
• Reserved s eating : $975 ($1,160 with fees). 
• Dining : $1,786 ($2,125 with fees). 
• Premier dining : $5,814 ($7,034 with fees). 

How have Kentucky Derby favorites fared?

NBC political journalist Steve Kornacki broke down how the favorites have fared recently in the Derby. From 2013-2018, the favorites won every year.

Here’s how the betting favorites fared in the last five years:

• 2023: Angel of Empire, 4-1, 3rd
• 2022: Epicenter, 4-1, 2nd
• 2021: Essential Quality, 5/2, 3rd*
• 2020: Tiz The Law, 3/5, 2nd
• 2019: Improbable, 4-1, 4th *

Note: After the disqualification of other horses, Essential Quality and Improbable's finishes were officially recorded as 3rd and 4th place, respectively.

Race 5: Twin Spires Turf Sprint S

Results of the fifth race at Churchill Downs on Saturday:

• 1st place: Cogburn (trainer: Steven Asmussen)
• 2nd place: Filo Di Arianna
• 3rd place: Mischief Magic

Kentucky Derby 2023 winner 

Mage, who didn’t even race as a 2-year-old and had one victory in three career starts, won the 2023 Kentucky Derby with 15-1 odds . 

Jace’s Road, Reincarnate, and Kingsbarns broke out early from the pack, crossing the ¼ mile at 22:35. Coming down at the ½ mile mark, Verifying set the pace at 45.73, but at the top of the stretch, Two Phil’s bolted out to the lead, but the Mage came from the outside with long strides passing Two Phil’s on inside and won by a length, crossing the finish at 2:01.57. 

The day was marred by the death of two horses . Freezing Point and Chloe’s Dream were euthanized after racing earlier in the day. 

Race 6: Derby City Distaff S.

Results of the sixth race at Churchill Downs on Saturday:

• 1st place: Vahva (trainer: Cherie DeVaux)
• 2nd place: Alva Starr
• 3rd place: Flying Connection

How many races are there on Kentucky Derby day?

The 2024 Kentucky Derby is  one of 14 races  that will be held Saturday, making it one event – albeit easily the most high-profile – on a busy day at Churchill Downs .

The 2024 Kentucky Derby is the 12th race that will go off Saturday at Churchill Downs, beginning about 90 minutes after the preceding race, the Old Forester Bourbon Turf Classic. — Craig Meyer, USA TODAY Network

Kentucky Derby 2024 purse 

The purse for this year's Kentucky Derby has reached a staggering $5 million, which will be divided among the top five finishers. The winner will receive the largest portion of the prize pool, amounting to $3.1 million, while the runner-up will receive $1 million. The third-place finisher will receive a prize of $500,000. 

Race 7: Longines Churchill Distaff Turf Mile Stakes

Results of the seventh race at Churchill Downs on Saturday:

• 1st place: Chili Flag (FR) (trainer: Chad Brown)
• 2nd place: Coppice
• 3rd place: Delahaye

Race 8: Pat Day Mile Stakes

Results of the eighth race at Churchill Downs on Saturday:

• 1st place: Seize the Grey
• 2nd place: Nash
• 3rd place: Vlahos

Race 9: American Turf

Results of the ninth race at Churchill Downs on Saturday:

• Formidable Man

Race 10: Churchill Downs Stakes

Results of the 10th race at Churchill Downs on Saturday:

• Here Mi Song

Race 11: Old Forester Bourbon Turf Classic Stakes

Results of the 11th race at Churchill Downs on Saturday:

• Program Trading
• Naval Power

Kentucky Derby on NBC

On Saturday, NBC Sports and Churchill Downs announced an extension on their broadcasting partnership through 2032.

“As we celebrate the 150th running of the Kentucky Derby, Churchill Downs is proud to extend the relationship with NBC Sports,” Churchill Downs CEO Bill Carstanjen said in a statement. “As our media partner for the last 23 years, NBC has artfully captured the most exciting two minutes in sports and the spectacle of the senses that surrounds it.”

Forever Young looks to give Japan first Kentucky Derby win 

It’s a small sample size, but Japan-breds are 0-for-4 at the Kentucky Derby since 2019, with Master Fencer (2019) and Derma Sotogake (2023) sharing the best finishes at sixth place. 

Forever Young  carries Japan’s hopes this year, and many believe the undefeated colt gives the country its best chance ever in the Kentucky Derby . -- Jason Frakes, Louisville Courier Journal  

Looking ahead to a superstar sprinter this summer

NBC used its Derby Day coverage to promote another big event, the Summer Olympics in Paris.

World champion sprinter Sha’Carri Richardson appeared in a spot with Cardi B talking about the Olympics, which begin July 26. Richardson is expected to be a medal contender in the women’s 100 meters, an event she won at last summer’s world championships in Budapest. At worlds, Richardson also won gold in the women’s 4x100 relay and bronze in the 200.

Saturday she told Cardi B to come to Paris to watch her sprint for Olympic gold.

“I will come just for you … and shopping,” Cardi B said. 

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Article Contents

Introduction, case presentation, conflict of interest statement, ethics statement.

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An unusual presentation of penile fracture with complete transection of urethra: a case report

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Vasanth Dunna, Srinivasa Rao Giduturi, K S N Chary, L V Simhachalam Kutikuppala, Anna Mary Jose, Varshitha Golla, An unusual presentation of penile fracture with complete transection of urethra: a case report, Journal of Surgical Case Reports , Volume 2024, Issue 5, May 2024, rjae290, https://doi.org/10.1093/jscr/rjae290

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Penile fracture is one such urologic emergency that occurs when the penis is struck bluntly during sexual activity, and in less than 5–10% of cases, the concurrent urethral damage is evident, but complete transection is very rare. A 37-year-old male presented with a history of ‘snap’ sound and immediate detumescence of penis during intercourse, when he fell and hit the pubic bone of his partner. There was acute retention of urine, an attempt to pass a catheter failed and the patient underwent supra-pubic catheterization. On examination, there was classical ‘eggplant deformity’ of the penis with blood at the tip of the meatus. MRI showed a tunical tear on both sides at the penoscrotal junction with indistinct urethra and extensive hematoma in the proximal penile shaft. Surgical management was successfully done by anastomotic urethroplasty and cavernosal repair.

Penile fracture is one such urologic emergency that is characterized by traumatic rupture of the tunica albuginea along with corpora cavernosa [ 1 ]. It occurs when the penis is struck bluntly during sexual activity and in less than 5–10% of cases, the concurrent urethral damage is evident, but complete transection is very rare [ 2 ]. An intra-corporeal pressure of 1500 mmHg or more is needed during erection to tear tunica albuginea [ 3 ]. Due to potential complications, such as the development of strictures and extravasation of urine, it is essential to investigate the degree of urethral damage in the penile fracture as soon as possible [ 3 , 4 ]. We present a case report of penile fracture with complete urethral transection and its successful surgical outcome. We describe the presentation, diagnostic workup and management of a patient who presented with a fractured penis with complete transection of the urethra.

A 37-year-old male presented with a history of a ‘snap’ sound and immediate detumescence of penis during intercourse, when he fell and hit the pubic bone of his partner. There was generalized swelling and pain in the penis. There was acute retention of urine, an attempt to pass a catheter failed and the patient underwent supra-pubic catheterization. On examination, there was classical ‘eggplant deformity’ of the penis with blood at the tip of the meatus. MRI showed a tunical tear on both sides at the penoscrotal junction with indistinct urethra and extensive hematoma in the proximal penile shaft ( Fig. 1 ). With the diagnosis of a fractured penis and possible urethral injury, after proper counselling, the patient was taken up for surgery. On the table, a retrograde urethrogram (RGU) was done showing evidence of partial urethral disruption. On exploration with penoscrotal vertical incision, there was total transection of proximal penile urethra, and a 1.5 cm tunical injury of corpus cavernosum on both sides ventrally ( Fig. 2 ). There was extensive hematoma. Corpora sutured with 4.0 prolene after reconstructing the midline septum. Urethral ends mobilized and anastomosed with 3.0 vicryl in a single layer with minimal spatulation ( Fig. 3 ). The patient was discharged on the 5th post-operative day; Foley catheter was removed on day 21. Follow-up RGU done after 3 months showed no evidence of stricture ( Fig. 4 ).

An MRI with (1) left corporeal tear on the left side with surrounding hematoma and (2) right corporeal tear with hematoma and disruption of urethra.

(1) On table RGU showing evidence of partial urethral disruption and (2) total transection of proximal urethra on exploration with penoscrotal vertical incision.

Reconstruction of midline septum with mobilized and anastomosed penile urethral ends.

Follow-up RGU done after 3 months showing no evidence of stricture.

Penile fracture is an uncommon urological emergency that occurs when the tunica albuginea in an erect penis rupture due to excessive external bending stress during sexual activity and the injury is most caused at the time of coitus [ 1 , 2 ]. Other less common causes are masturbation and the practice of Taqaandaan [ 3 , 4 ]. In most cases, a penile fracture results in a cracking sound, fast detumescence, abrupt enlargement and ecchymosis of the penis, which gives it the appearance known as ‘eggplant deformity’ [ 5 ]. The rupture occurs more often in the proximal shaft and is located ventrally in coital injuries. In our case, there was a bilateral corporal tear. Literature states that bilateral corporal ruptures are often accompanied by urethral injury [ 6 ]. Urethral rupture, although infrequent, has an incidence that varies between 1 and 38%. This rupture may be partial or complete [ 7 , 8 ]. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture, but the absence of these findings does not exclude urethral lesions [ 9 ]. Our patient presented with swelling, pain and acute retention of urine, which was followed by a failed attempt at urethral catheterization and on examination of the penis, we found blood at the tip of the meatus. All these findings yielded a high suspicion of urethral injury and we decided to perform an RGU. In suspected cases of urethral injury, RGU may demonstrate contrast leakage at the lesion site and reveal the exact point of urethral injury. However, RGU can show false negative results in up to 28.5% of cases [ 10 ]. In this case report, RGU could only show evidence of a partial rupture but, intraoperatively, there was found to be a complete transection of the proximal penile urethra. Compared to the traditional non-operative options, surgical restoration of the tear has proven to provide patients with the greatest results in terms of both sexual function, cosmetic appearance and fewer complications [ 9 , 11 , 12 ]. Penile degloving using a circumferential or subcoronal incision is the most used technique followed by penoscrotal and longitudinal incisions directly over the hematoma. The sub-coronal degloving incision is useful in cases with significant penile swelling or extensive hematomas, as well as in cases where the location of tunical rupture cannot be determined clinically or radiographically, or when the rupture is located dorsally [ 13 ]. Major disadvantages of the sub coronal degloving incision are the extensive dissection of Buck’s fascia and its risk of distal penile/preputial skin necrosis. In this case, we performed a penoscrotal incision. We chose this technique because it gives easy exposure to the base of the corpora cavernosa where fractures tend to occur more often and in addition would give us direct access to the urethral transection. With the penoscrotal incision, we have the flexibility of extending the incision and can also avoid futile dissection in the buck’s fascia [ 13 ]. We reconstructed the midline septum and closed the corpora using 4.0 prolene. Urethral ends were mobilized and anastomosed with 3.0 vicryl in a single layer with minimal spatulation. The patient was discharged on the 5th postoperative day, and the Foley catheter was removed on day 21. A follow-up RGU performed after 3 months showed no evidence of stricture.

Complete transection of the urethra in a case of penile fracture is an infrequent presentation. Evaluation by history, presenting symptoms, imaging and retrograde urethrography can establish the diagnosis. Surgical management can be successfully done by anastomotic urethroplasty and cavernosal repair, with better outcomes and minimal complications.

None to disclose.

Informed consent was taken from the patient for publication of the case report.

Sharma AP , Narain TA , Devana SK , et al.    Clinical spectrum, diagnosis, and sexual dysfunction after repair of fracture penis: is no news good news?   Indian J Urol   2020 ; 36 : 117 – 22 .

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Zargooshi J . Sexual function and tunica albuginea wound healing following penile fracture: an 18-year follow-up study of 352 patients from Kermanshah, Iran . J Sex Med   2009 ; 6 : 1141 – 50 .

Koifman L , Cavalcanti AG , Manes CH , et al.    Penile fracture -experience in 56 cases . Int Braz J Urol   2003 ; 29 : 35 – 9 .

Hoag NA , Hennessey K , So A . Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review . Can Urol Assoc J   2011 ; 5 : E23 – 6 .

Derouiche A , Belhaj K , Hentati H , et al.    Management of penile fractures complicated by urethral rupture . Int J Impot Res   2008 ; 20 : 111 – 4 .

Muentener M , Suter S , Hauri D , Sulser T . Long-term experience with surgical and conservative treatment of penile fracture . J Urol   2004 ; 172 : 576 – 9 .

Amer T , Wilson R , Chlosta P , et al.    Penile fracture: a meta-analysis . Urol Int   2016 ; 96 : 315 – 29 .

Mydlo JH , Hayyeri M , Macchia RJ . Urethrography and cavernosography imaging in a small series of penile fractures: a comparison with surgical findings . Urology   1998 ; 51 : 616 – 9 .

Ibrahiem el- HI , el-Tholoth HS , Mohsen T , et al.    Penile fracture: long-term outcome of immediate surgical intervention . Urology   2010 ; 75 : 108 – 11 .

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• penile fracture

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• Management and outcome of oncological patients under immune checkpoint inhibitors presenting at the emergency department
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• http://orcid.org/0009-0004-2545-3062 Francesco Pini ,
• Bogdan Grigoriu ,
• Ameye Lieveke ,
• Anne-Pascale Meert
• Jules Bordet Institute , Brussels , Belgium
• Correspondence to Dr Francesco Pini, Jules Bordet Institute, Brussels, Belgium; francesco.pini{at}hotmail.com

Introduction With the rising use of immune checkpoint inhibitors ( ICIs ) in oncology, emergency physicians are increasingly confronted with their immune-related adverse events ( irAEs ). We described the types of irAEs presenting to the ED of a Belgian cancer centre and determined associations with the development of an irAE and other patient’s characteristics. Secondary objectives describe the therapeutic management and determine 7 and 30-day mortality.

Methods A retrospective chart review of ED visits of patients on ICI from 15 December 2016 to 6 December 2020 was performed. Clinical presentation, cancer characteristics and type of ICI were extracted by a single abstractor. We recorded any suspicion of irAE in the ED and confirmation of an irAE was based on the patient’s oncologist report. Outcome was based on mortality at date of last follow-up.

Results 227 patients on ICI presented to the ED, with a total of 451 visits. 54 (12%) of the visits resulted in a diagnosis of irAE. Four clinical features were associated with an irAE: gastrointestinal complaints (p=0.01), skin rashes (p=0.02), acute renal failure (p=0.002) and abnormal liver function (p=0.04). An irAE was also associated with three different factors: a cancer status in remission (OR=5.33, 95% CI 2.57 to 11.04), a combination of two ICIs (OR=4.43, 95% CI 2.09 to 9.42) and a medical history of irAE (OR=2.44, 95% CI 1.27 to 4.68). 30-day mortality was lower in the irAE group (0%) than in the non-irAE group (13%, 95% CI 9% to 19%).

Conclusions Oncological patients under ICI presenting in the ED are more likely to have an irAE if they present with gastrointestinal and dermatological complaints, acute renal failure and abnormal liver function. This is also true for patients with any history of irAE, a concomitant use of two ICIs and with a cancer status in remission.

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Data availability statement

Data are available upon reasonable request. Data are available on reasonable request.

https://doi.org/10.1136/emermed-2023-213605

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Immune checkpoint inhibitors (ICI) are increasingly used in oncology and managing them in an emergency setting can be challenging. A few studies evaluated their acute management, but little is known on how to distinguish patients presenting to the ED with side effects from other conditions.

WHAT THIS STUDY ADDS

In this observational study of oncological patients on ICI presenting to an ED, an immune-related adverse event was more likely if they had gastrointestinal and dermatological complaints, acute renal failure or abnormal liver function, as well as history of adverse reaction to ICI, a concomitant use of two ICIs and a cancer status in remission.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Our findings may allow emergency physicians to more quickly recognise an immune-related side effect and initiate treatment sooner.

Introduction

The human immune system is balanced between its action of destroying foreign antigens on the one hand, and the controlling of the development of autoimmune phenomena on the other hand. This complex balance is maintained, among other means, by cellular signalling pathways that inhibit or stimulate the immune system. Some inhibitory pathways, such as the programmed cell death protein 1 / programmed cell death ligand 1 pathway and the cytotoxic T-lymphocyte-associated protein 4 / protein B7 pathway, can be overexpressed by cancer cells to prevent their destruction. 1 Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that can overcome this immune inhibition, thereby potentially inducing cancer cell destruction.

The efficacy of ICI has been initially demonstrated in the advanced stages of melanoma 2 and certain non-small cell lung cancers. 3 4 Their indications have progressively been extended to many other cancers in combination with or as an alternative to chemotherapy, and they have now become a therapeutic standard in oncology. Patients on ICI are at risk of developing side effects that mimic autoimmune reactions, which may be challenging to differentiate from other manifestations such as cancer progression or infections. Some of these immune-related adverse events ( irAEs ) may be severe enough to require intensive care management. 5 Virtually, all organs can be affected, with variable timing and frequency depending on the type and number of ICIs used. 6–8 Prognosis is largely dependent on the nature of the irAE, with pulmonary involvement having a poor prognosis. 7 A recent British study 9 showed that among 300 ED visits of patients on ICI, 2% resulted in death associated with irAE.

Rapid identification of an irAE is essential and lack of knowledge about these toxicities may delay management and aggravate patient’s outcome. 10 This is especially important considering the specificity of the treatment, which may require high doses of corticosteroids or other immunosuppressive agents. 11 12 A 2019 French single-centre retrospective study based on 409 patients treated with ICI 13 found only 50% of irAE diagnoses are made in the ED. This study also identified potential factors favouring the development of irAE such as cancer in remission, concomitant use of multiple ICIs, as well as a higher number of ICI doses.

Previous investigations have shed some light on the acute presentation and management of oncological patients on ICI. 7 9 13 14 Unfortunately, there is insufficient evidence to guide physicians in how to differentiate irAEs from other diseases. Our study aimed to evaluate the frequency of irAE and determine which factors might be associated with the development of an adverse effect. The secondary objectives were to identify the therapeutic management as well as to determine mortality at 7 and 30 days after ED presentation.

This retrospective monocentric study was carried out at the Jules Bordet Institute in Brussels, Belgium. It is a specialised centre in oncology and onco-haematology, which possesses an ED managing the patients of the institute only.

Patients were selected by matching those who received therapy with at least one ICI (avelumab/Bavencio, durvalumab/Imfinzi, pembrolizumab/Keytruda, nivolumab/Opdivo, atezolizumab/Tecentriq or ipilimumab/Yervoy), with those who visited the ED over a 4-year period from 15 December 2016 to 6 December 2020. Of these, patients who received their last dose more than 6 months previously and those under the age of 18 years were excluded.

Data collection

Data for the study were extracted from the electronic medical records of visits documented by emergency physicians during the study period. Extraction of the data was performed by a single investigator, and then the validity of the data was crosschecked by an independent researcher. All information was then encoded and anonymised with the REDCap computer software.

Among the general data, we collected the chief complaint at the ED visit. If the patient was sent to the ED following an abnormal routine laboratory result, the laboratory result was considered as a chief complaint. Chief complaints were then categorised into seven main clinical presentations. Those categories were arbitrarily decided by the authors, based on main system involvement. We also collected the primary cancer location, a history of autoimmune diseases and irAE, as well as cancer status. A cancer in remission was considered when cancer has responded partially/completely to a treatment and is not actively progressing, based on the last oncology consultation/imagery preceding the emergency visit. Immunotherapy was assessed according to the ICI used, the time from the first dose to the ED visit, the time from the last dose to the ED visit and the total number of doses already received. The final diagnosis of the emergency physician, internist and/or oncologist was recorded. An adverse event was categorised as an irAE if the oncologist/internist in the inpatient or outpatient setting considered the irAE probable or definite; the grade of the irAE was also recorded and classified using the Common Terminology Criteria for Adverse Events from the National Cancer Institute. 15 We recorded a suspicion of irAE if the emergency doctor considered an irAE in the differential diagnosis. Therapeutic management of irAE described the necessity of discontinuation of immunotherapy, temporary or permanently. Patient prognosis was measured by mortality 7 and 30 days after consultation. Mortality was determined based on death certificates last checked on 12 June 2021, which are automatically updated every 2 weeks with the national database of Belgium.

Statistical analysis

The sample size for this study was pragmatic: a 4-year period was chosen based on limiting factors, mostly time available for data collection. Statistical analysis included a descriptive analysis, a comparison between the irAE and the non-irAE group and an assessment of mortality at 7 and 30 days after ED presentation. Categorical data were compared using χ 2 or Fisher’s exact test when appropriate. Wilcoxon test was used for continuous data comparisons. For descriptive analysis and comparison between the irAE and non-irAE groups, when the same patient visited the ED more than once, each visit was considered. If a patient presented the same irAE twice in less than 30 days, the second visit was excluded. Logistic regression was used to assess which explanatory variables are independently associated to irAE. For demographic analyses, and the assessment of mortality, only the first ED visit was considered. Mortality was assessed using the Kaplan-Meier and Cox proportional hazards model. For all statistical analyses, the significance threshold was set at p<0.05.

Patient and public involvement

Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.

During the 4-year study period, the Institute recorded a total of 9355 ED visits. Of these, 227 patients receiving ICI therapy made 451 ED visits. The population was mostly male (63.4%), with a median age of 64 (55–69) years. Bronchopulmonary cancers accounted for more than half of the cases (53.7%), followed by melanoma (21.6%) and bladder cancers (15.9%). Pembrolizumab was the most commonly used checkpoint inhibitor (43.6%), followed by nivolumab (34.8%) and atezolizumab (10.6%). The characteristics of the patients are summarised in table 1 .

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Patient characteristics on first ED visit

The chief complaints at the ED were classified into seven categories ( table 2 ). Among the 451 ED visits, the most frequent clinical presentations were 70 (15.5%) fever, 69 (15.3%) dyspnoea, 37 (8.2%) musculoskeletal pain, 36 (8%) asthenia, 30 (6.7%) abdominal pain and 28 (6.2%) diarrhoea ( table 2 ).

Clinical variables for irAE and non-irAE on all ED visits

Out of the 451 ED visits, there were 54 (12%) that resulted in a diagnosis of an irAE. 43 (79.6%) of irAEs had been suspected by the emergency doctor. Visits for gastrointestinal symptoms (p=0.01), acute renal failure (p=0.002), abnormal liver function (elevation of aspartate aminotransferase and/or alanine aminotransferase) (p=0.04) and skin rashes (p=0.02) were more frequently associated with an irAE. Within the gastrointestinal symptoms group, diarrhoea was associated with developing an irAE (p<0.001).

The most frequent irAEs were colitis/diarrhoea (24.1%), pneumonia (24.1%), hepatitis (9.3%) and dermatitis (9.3%). Most patients had severe irAEs of grades III–IV (n=36; 66.6%). Only two patients had (3.6%) grade I events. Five patients had multiple simultaneous irAEs. The characteristics of the irAE are summarised in table 3 .

Characteristics of irAE on all ED visits

The development of irAE was associated with a cancer status in remission (OR=5.33, 95% CI 2.57 to 11.04), any history of irAE (OR = 2.44, 95% CI 1.27 to 4.68) and the use of two ICIs (OR=4.43, 95% CI 2.09 to 9.42) . When added to the logistic regression model, a history of autoimmune disease, timing between the first dose of ICI and the ED visit or number of doses of immunotherapy before presenting to the ED were not retained as independently associated to irAE: respective p values of 0.21, 0.27 and 0.41 ( table 4 ). ICI treatment had to be stopped in 40 (72.7%) of patients with irAEs. This interruption was permanent in 37 (92.5%) cases.

Logistic regression model for predictive factors associated with an irAE

We assessed mortality in the 6 months after the first ED visit ( figure 1 ). Patients diagnosed with irAE had a lower mortality rate: HR 0.31 (95% CI 0.12 to 0.86; p=0.02). The 30-day mortality after ED presentation was 0% in the irAE group versus 13% (95% CI 9% to 19%) in the non-irAE group.

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Mortality rate after first ED visit. irAE, immune-related adverse event.

In this single-centre study of the ED of an oncology referral centre, 5% of visits involved patients treated with ICI. Out of those visits, 12% ultimately resulted in the diagnosis of irAE. We found that patients with gastrointestinal and dermatological chief complaints, and those diagnoses with renal failure and abnormal liver function, were more likely to have an irAE, although the last two of these were rare. Cancer in remission, history of an irAE and simultaneous treatment with two ICIs were also associated with an irAE.

The frequency of irAEs in our retrospective study is lower than in the literature. Indeed, different studies have found values of <10%, 14 14.4%, 13 25% 7 and 32.7%. 9 This low frequency is likely because our hospital is specialised in oncology, and less severe irAEs are caught earlier in consultation by the oncologist. The same is true for the high percentage of irAE suspected in the ED (79.6%), as our emergency staff only manages oncological patients and receives continuous information about new cancer drugs. Still, it is important to note that some rare and particularly severe adverse events were missed in the ED such as myocarditis, Guillain-Barré syndrome and a cytokine-releasing syndrome. It seems essential to stay aware of the high variability that these adverse events can present.

The association of an irAE with cancer status in remission has been previously shown. A recent meta-analysis of 51 studies 16 found progression-free survival (clinical endpoint measuring the time during or after treatment when the cancer does not progress) in the irAE group was 17.61 months (95% CI 10.1 to 25.1) compared with 2.23 months in the non-irAE group (95% CI 1.77 to 2.68) for melanomas, and similar figures were found for other metastatic neoplasms. The author explains this association by a potential cross-reactivity of the immune system between antigens from healthy cells and antigens from cancer cells. We hypothesised that patients with a positive therapeutic response would benefit from prolonged treatment, thus raising the probability of developing an irAE. However, in our cohort, the time between ICI therapy initiation and emergency visit was similar in both groups. Therefore, a high degree of suspicion for toxicity should remain when facing patients under immunotherapy, regardless of the time from initiation of the treatment.

We also found a significant association between a history of irAE (regardless of the grade) and the development of another irAE. Ongoing research 17 is attempting to identify markers that predispose or facilitate the development of irAEs. However, much more research is needed in this area.

The development of an irAE was three times more likely in patients treated with two ICIs than those with a single ICI. The only combination used in our population was nivolumab with ipilimumab used in the treatment of melanoma. This combination has also been linked to the development of a higher grade side effect in patients with melanoma. 18

Although a history of autoimmune disease has been associated with an almost twofold increase in hospitalisations resulting in a diagnosis of irAE by Kehl et al , 19 we did not find this to be true of our population. However, Kehl’s study excluded autoimmune hypothyroidism, which accounts for the majority of the history of autoimmune disease in our population. As the number of our patients with other autoimmune diseases is statistically insufficient, we cannot draw a clear conclusion on this subject.

ICI treatment had to be stopped in more almost three-quarters of the patients with irAEs, resulting in a permanent interruption in almost all cases. Our high frequency of permanent discontinuation of ICI may be explained by the fact that our study includes only ED presentations, which are usually severe. Indeed, two-thirds of the irAEs in our population were grade ≥III. Discontinuation may raise concerns about a possible neoplastic progression after ICI discontinuation, but this may not be a significant issue in practice. One study from Schadendorf et al evaluated patient prognosis after discontinuation of a nivolumab-ipilimumab combination due to irAE and showed no significant decrease in progression-free survival at 18 months when the development of irAE required discontinuation of ICI (p=0.97). 20 Nevertheless, we cannot confirm whether this trend is maintained in the long run. A study 21 analysed reintroduction of ICI in a population with a grade ≥II irAE, and over half of patients did not redevelop a grade ≥II irAE. Given the apparent association between the development of an irAE and a positive therapeutic response, it seems essential to assess for each patient the benefit-risk balance of reintroducing ICI after the occurrence of an irAE.

The 30-day mortality after ED presentation after the first visit only was significantly lower in the irAE group. This was also found by Grangeon et al in patients with non-small cell lung cancer (HR 0.42; 95% CI 0.32 to 0.57; p<0.001). 22 This reduction in mortality is likely related to the positive therapeutic response to the immunotherapy, as Zaorsky et al found >40% of deaths in oncological patients are related to their cancer. 23 This high difference in mortality could be explained because most irAEs are rapidly reversible if appropriately treated. This favourable outcome appears to be maintained in the long term, but further investigation is warranted to confirm this trend.

Limitations

This study suffers the inherent biases from retrospective data collection. It is important to note that our study only evaluated urgent presentations, we cannot apply these results to all patients undergoing ICI treatment. Also, as our centre is specialised in oncology, the acute management of irAE is not generalisable to non-oncological hospitals. Finally, we decided to consider multiple visits in the descriptive analysis, which may skew the data.

Conclusions

More than 1 in 10 patients under ICI presenting to the ED have an irAE. Certain presentations, the history of an irAE and cancer in remission increase the likelihood of an irAE. Early recognition is helpful as patients with irAE often need to discontinue the medication.

Ethics statements

Patient consent for publication.

Not applicable.

Ethics approval

This study involves human participants and was approved by the ethics committee of Jules Bordet Institute, Brussels, Belgium on 5 January 2021 (Reference No OM011). It was a retrospective study.

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Handling editor Darryl Wood

Contributors FP, A-PM, BG and AL take responsibility for study conception and design. FP takes responsibility for data collection and as guarantor of the integrity of the data. AL takes responsibility for the accuracy of the statistical analysis. FP, A-PM and BG take responsibility for the interpretation and drafting of the manuscript.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Provenance and peer review Not commissioned; externally peer reviewed.

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