RESEARCH & MEDICINE

DR. VIJAY SARDANAMEDICAL SUPERINTENDENTSENIOR PROFESSOR & HEAD

DEPARTMENT OF NEUROLOGYMBS HOSPITAL, KOTA

WHAT IS KNOWLEDGE & FACT ??

• Knowledge is what is believed to be true about something, what is believed to be a correct understanding of something.

• Facts are just data. Knowledge is an expert’s best interpretation of facts.

What is Research ?

Research is the search for or creation of (valid) knowledge.

• Defined as “the systematic approach to obtaining new and reliable knowledge”.

• Critical thinking is an essential element for research. Ethridge (1995)

What is Research ?

• It is the systematic investigation into and study of materials, sources etc. in order to establish facts and reach new conclusions.

• An endeavour to discover new or collate old facts etc. by the scientific study of a subject or by a course of critical investigation.

What is Research ?

In other words, it is the systematic :- Collection, analysis and interpretation of data

AIM :- To answer a certain question or solve a problem

What is Research ?

Health is a state of “complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”

Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by

the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

What is Health ?

DETERMINANTS OF HEALTH

What is Medicine ?

• The science or practice of the diagnosis, treatment, and prevention of disease

• What people believe (God, past deeds, planetary alignment, hot and cold, etc…)

• Actual cause of illness ?

• Pathway to cure/ wellbeing?

Beliefs about Health & Illness

• To discover what is normal • To identify what is abnormal • To find out what is associated with the abnormality • To determine “causality”• To test new interventions

• And finally “explore strange new phenomena, seek out the truth & to boldly go where no one has gone before”

Why should we do Research ?

Evidence Based Medicine (EBM) :- conscientious, explicit, and judicious use of

current best evidence in making decisions about the care of individual patients.

Evidence Based Practice (EBP) :- integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.

Clinical expertise refers to the clinician's cumulated experience, education and clinical skills.

• Don’t know how to conduct Research • Don’t have the time• Don’t have adequate facilities • Don’t see a need to conduct research • Conduct research but don’t publish it • Research evidence not taken up for action • Very Important - No culture for “research”

Why don’t we conduct enough Research ?

Result – Lack of Research

Components of a Research• Statement of the problem • Literature review • Aims• Design of study • Ethical issues• Study setting• Study population• Study sample and sample size calculation• Sampling Methods• Data collection methods and study instruments• Data collectors • Analysis of data and presentation of results• Discussion• Conclusions

• Conducting a literature review• Referencing and bibliography• Calculating sample size• Developing instruments • Adhering to ethics• Preparation of a research proposal • Data base development• Data quality assessment • Performing simple analysis• Writing a research report

A Researcher should be capable of

• Demands a clear statement of the problem.• Requires clear objectives and a plan ( rather than

aimlessly looking for something in the hopes of coming come across a solution).

• Builds on existing data, using both positive and negative findings.

• New data should be systematically collected and analyzed to answer the original research objectives.

Characteristics of Research

• First priority is to formulate your research question

• Then figure out how you are going to answer it– How have others answered it?– How does your proposal fit in with what others

have done?– How will you know when you have answered it?

• Then you can present your answer

How should I begin ??

Steps of Scientific Research

Selection of area

Selection of topic

Crude research question no answer

Refined research question

Research hypothesis, goals and objectives

Study design

Population & sampling

Variables confounding bias

Research tools

Pilot study

Work plan

Collection of data

Data management

Interpretation

Reporting

no need for studyanswers found

Literature review

Ethical issues

1. Relevance 2. Avoidance of duplication 3. Urgency of data need 4. Feasibility of the study 5. Applicability of results 6. Ethical considerations

Criteria for selecting a Research Topic

Problem Analysis

Literature Review

It should not end up like this

Identify researchable areas in the problem

State Objectives

General Objective Specific Objectives

To find Out Objectives ??

Research objectives should be

• S -Specific• M -Measurable• A -Achievable • R -Realistic/reliable• T -Time bound

Study Designs

Descriptive studies Analytical studies

Case report

Case seriesreports

Cross-sectionalstudies

Ecological studies

Observational studies

Experimentalstudies

Case-controlstudies

Cohort studies

Prospective Retrospective(historical)

RandomizedControlled Clinical

trials

RandomizedControlled field

trials

Non-randomizedexperiments

Different data collection techniques

• Using available information• Observing• Interviewing• Administering questionnaires• Observational check list • Focus Group Discussions / In depth interview• Other methods

Department of Research– NIHS : Inspiring Public Health through Innovative Research

The following needs to be thought of and decided upon……1.Who is going to collect the data ?2.From whom ?3.Where ?4.How ?5.Using what?6.How is information given to the participants?7.How are they recruited to the study?8.How is consent to be obtained?9.How to conclude the data collection?10.What to do with positive cases?11.Checking for quality of the collected data? Who? When ? Where ? How ?12.Entering the data?13.Analysis of the data

Data collection Flow

– Do no harm – Do good – Voluntary participation – Informed consent – Conflict of interest – Scientific validity

Ethical Considerations

Item description MAR APR MAY JUN JUL

AUG

SEP OCT

NOV DEC

Initial discussion XLiterature review X XFinalizing methodology

X X

Ethical clearance XPre testing X XData collection proper

X X

Data entry X XInitial analysis X XDraft report XFinal report submission

X

Presentation of findings

X

Example of a Time Series chart

1. Abstracts and key words 2. An introduction including a justification 3. Appropriate review of literature 4. Objectives and methodology 5. Results 6. Discussion 7. Conclusions and recommendations 8. References 9. Annexure

Report Writing

Importance of References

• Avoid accusations of Plagiarism• Acknowledge others work• Support academic arguments• Prove that you have researched a topic

Research Team

• Conducting a literature review • Referencing and bibliography • Calculating of sample size • Developing instruments • Adhering to ethics and getting • Preparation of a research proposal • Data base development • Data quality assessment • Performing simple analysis • Writing a research report

A Research team should be capable of

1. Research reports 2. Abstract presentation: poster or oral 3. Journal articles 4. Advocacy briefs 5. Policy briefs

Disseminating Research into Policy & Practice

Together Everyone Achieves More

Example of a Team work Research

THANK YOU