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Formulating Research Question

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hello welcome to today's session. In the introductory talk dr. Sanjay talked about the scope and focus of Health Research. He mentioned that the goal of research is to establish facts or principles through careful and systematic investigation in a particular area. Ultimately the result of such investigation is to improve the health of the population. The first step in such research is formulating researchquestion. Today we are going to cover three areas: spell out research question, stating research hypothesis andformulating study objectives. Any research has a lifecycle. It begins with an uncertainty or needs in a particular area and that needs is translated into research question, subsequently as studyobjectives, and a plan of analysis is formulated to guide framing datacollection instruments using these tools data is collected and then subsequently is analyzed as per the plan and as per the objectives the conclusions are drawn and recommendations are formulated.ultimately,  this particular recommendation is shared with the stakeholders for whom it matters this process ends with another uncertainty that may begin the cycle once again Therefore the first two steps clearly indicates that we need to start with a good research question Therefore we are going to see what is research question Research question is an uncertainty about something in the population that the investigator wants to resolve by making measurements in the study population the uncertainty is referred to as data needs in the life cycle therefore we need a clear question to facilitate choosing an optimal study design and identify whom to intruder what are the outcomes that we need to measure and when these outcomes to be measured a research question is all about refining your ideas into a systematic process of framing a questionit begins with a general uncertainty about a health issue in the context of health research and then it is narrowed down into a concrete researchable issue while translating uncertainty to research question one frames the problem in specific terms in health research it could be in clinical or public health terms we need to focus on only one issue at a time and it is written in everyday language so that everybody understands what the question is you may choose to use more than one operational work if needed it should link the question if answered what action will be taken and it is stated as a question that's why it's called research question a research question sets out clearly what the investigator wants to know and definitely not what he or she may do or what this results will ultimately contribute to it doesn't just include these two aspects it didn't it should spell out what the investigator wants to know there are many sources from which the research questions or ideas can arise from I'm spelling outhere for such sources First is definitely a scholarship in the area ofthe search interest an up-to-date information from literature will help in generating research questions The second is being allowed to new ideas and techniques how does that happen it can happen through attending research meetings or conferences where the latestfindings are sure and there may be a good discussion in peer group during that conference or meeting having a good attitude a skeptical attitude in particular about the prevailing beliefs and last but very important apply new technologies to old issues The third aspect could come from careful observation in your clinic or in your basic science work on your sphere of life teachers get enormous opportunities while they are preparing for teaching and teaching and interacting its students and then finally a tenacity to go to the bottom of the things Last but very important if you have a good guide or a mentor he can help you in identifying and framing research questions there are two categories of research questions that we need to remember there are only two categories let me put it that way. One is a descriptive question another is analytical question So your research question should fall into in either of these categories A descriptive question is one which involves observations to measure a quantity when is a quantity it could be height it could be knowledge it could be to what extent the problem is present in a community it could be to what extent something is present in a given context There are no comparison groups no interventions in a question that is supposed to be called descriptive question Whereas analytical question involves comparison groups or it could be involving an intervention or experimental to test a specific hypothesis So therefore even a such question when you are framing you need to find out which of these two categories your research question may fall into this has implications later while we discuss about the statement of objectives and chose six-thirty designs I am just going to give you some six steps as to how one can conceive aresearch question One a review of state of the art of information from the literature Second you raise a question and the Third you decide whether it's worth investigating through a peer review fourth by defining measurable exposures and outcomes and fifth sharpening the initial question based on double and defining the question by specifying details based on all of the steps that wasexplained earlier Suppose let us take an example should diabetics do exercise daily that's a very commonsensical question one reviews the literature as to what is the effect of exercise on human body to begin with The literature shows exercise reduces blood sugar level and body fat the exercise improves protection against developing complications due to diabetes So definitely it's worth investigatingthen let's raise a question based on our review of literature Can exercise help control blood sugar level sounds better than the earlier question but definitely this is vague we need to refine it especially what do you mean by exercise what do you mean by blood sugar level Then we go into the literature and talk to people peer group and talk to investigators who have special expertise in these areaswhat do you mean by blood sugar what is the level of reduction is it blood sugar level after you don't eat at all or any time during the day that is called random or after a meal that's called post prandial So which type of blood sugar gets reduced which of these three types of blood sugar gets reduced regarding exercise looks at the a look at the literature suggest more questions what is optimal type what is the frequency what is the intensity and what is the duration of such exercise and are there any risks for a diabetic to be engaged in exercise are there other benefits other than a possible reduction in blood sugar The fourth step is to no tighten up the framing of exposure and outcome For example here exercise could be definedas a predetermined physical activity comprising of a body movement produced by muscles resulting in an increase the energy expenditure at least one session of 16 minutes every day for one year you can be specific about this exercise or physical activity by specifying whetherit's walking jogging cycling or Arabic or even dancing finally outcome now we have specified it is fasting blood sugarlevel which means after the dinner anybody goes into sleep and the next day morning the stomach is empty after eight of us at that time if you measure a blood sugar that's called fasting blood sugar and we are defining that as our outcome the fifth question the fifth step therefore is to sharpen the initial question with these steps in which we have progressed them further among diabetics and as physical activity for one hour daily help in reducing fasting blood sugar you can still refine it by specifying for the details I have just given an example of such specifications in the form of a descriptive question as well as an analytical question when you are specifying the details you need to specify study population operational definitions of variables which is exposure and outcome and also if possible study design an example of descriptive question in the example that we are discussing is that what is the extent of walking practiced by diabeticsthat is type 2 diabetes regularly or an analytical question could be in order to improve management of type 2 diabetes we wish to know whether brisk walking by diabetics for at least one hour daily reduce first English sugar as compared to those who do not after framing a good research question we need to test this question two a test call sort this test comprises of fire elements it's called final as an acronym is this research question feasible to answer is this interesting to answer is it novel is reticle to do studies around this research question is it relevant so basically feasibility means whether we will get an adequate number of study participants do we have technicalexpertise to do this study do we have resources both material and manpower to do this is it interesting does it really enthused people to engage in this particular research is it worth doing it in terms of novelty does it confirm refute or extends the previous findings or does it provide new information that's the question that we areinterested in answering and the fourth test is ethical angle does this research based on the research question is allowable under the ethical norms will an ethics committee pass this research based on the question finally is it relevant in terms of advancing science and wants in practice and also influencing policy now let's look athypothesis what is hypothesis research hypothesis it is nothing but a specific version of the research question that summarizes the main elements of the study that establishes the basis for statistical test of significance so it's just it is stated for statistical purposes the main elements that I mentioned include the sample the exposure and an outcomes a hypothesis is stated only for analytical questions with comparison groups remember we talked about two types of researchquestions descriptive questions and analytical questions so only the second type of research questions in warming analytical aspect needs a statement of hypothesis if you have any doubts aboutwhat is an analytical question you check in your research question if that contains terms such as greater or less than causes leads to comfort with more likely than associated with related to similar to or correlated if these terms are contained in your research questionthis is an analytical question that needs a statement of hypothesis purely descriptive questions do not require a statement of hypothesis an example of research hypothesis on the basis of theexample that we are discussing on diabetes and exercise among diabetics type 2 diabetes which means they don't take insulin injection to control the blood sugar level from an area who dobrisk walking for at least one hour daily results in an average reduction of 10 milligram percentage of fast English way level as compared to those who do not this specification of what muchlevel what study area what group of study participants helps investigators in tightening the rope in terms of statement of null hypothesis statement of alternative hypothesis about as youwill see in the sample c-section and calculating sample size so research hypothesis helps in statement of specifying certain details in the context of statistics statistical test and sample size what is a goodhypothesis a good hypothesis should be simple should be specific should be stated in advance what do I mean by simple should be one exposure one outcome what do I mean by specific thereshould be no ambiguity about the study variables our study participants it should be stated in add one a priori let's the terminology used it should be stated in advance you should not bediscovered at a later part of the study and the hypothesis is focused around the primary objective now let's come back to the lifecycle of research we have now talked about research question and howresearch question is translated into research hypothesis for analyticalquestions now let's see how research question is converted into statement of objectives when you translate a research question into objective as compared to research question a statement ofobjective is stated in scientific and epidemiological terms it takes theresearch question in only few limited axes it is returned in scientific and epidemiological language it should ideally, make use of no more than an operational web for each of those questions it it is ideal to sort them out as a primary objective and secondary objective and the statement of objective should be very clear about what researchquestion it is trying to answer is it descriptive question or an analytical or experimental question so it should clearly spell out whether we are answering descriptive or analytical question an objective is again now based on this understanding whether it isdescriptive or analytical is stated as a descriptive objective or analytical objective we recommend that the statement of objective contains scientific and a premier logical terms we also recommend that it use uses the terms that denotes the descriptive nature of the study and analytical nature of state for instance for a descriptive study in which we expect that you estimate a quantity by observations the verb estimate is preferred for example to estimateprevalence of physical activity in diabetics that's a descriptive objective for analytical you use the terminal terms there are more powerful denotes this comparison connotation testing hypothesis has to be denoted in the verb for example the verb dub determinedmay be preferred for example in the diabetes Excel and exercise related study that we are discussing determine whether exercisereduces blood sugar level as you can see the verb is also equally important and therefore we do not recommend use of the word study to study in the statement of objectives at all to study is a verypoor statement of objective now let's see go back to our example the research question that we stated was in order to improve management of type of diabetes we wish to know whether brisk walking by diabetics for at least 1 hour daily reduces fasting blood sugar level as compared to those who do not we can translate this into a primary objective to determine the effect of brisk walkingfor at least or an hour daily on fast English well level of patients with type 2 diabetes compared to those who do notso determine is a very useful word especially when you have an analytical objective let me show you some of the good and bad examples of study objectives determine importance of sedentary lifestyle among diabetics the word determine is not particularlysuited for this particular statement because it seems to be a descriptive study so therefore estimate prevalence of physical activity I'm diabetics is ideally suited for this statement of objective assess physical activity and diabetic complications I think they are trying to do again a descriptive study there for estimating the effect ofphysical activity on the rate of diabetic complications in a group ofdiabetes is what they are doing so the word estimate is preferable evaluate depression and diabetes it may be preferable since this is analytical study to use the word verb determined then evaluate whether depression is more common among diabetes as compared to health individuals let me stop asking yourself the rightquestion may end up in answering right field two ways to deal with poor or irrelevant research question first you may answer it but then the answer may be of no use or there may be no answer try to reframe it if you have a poor question if your research question is wrong no good hard work will save your work if your question is correct you have an opportunity to do a good joball the best wishes to do a good job. Thank you.