A brief introduction to Research Methodology
By Dr.Shaikh Shaffi Ahamed Ph.d., Asst. Professor Dept. of Family & Community Medicine
What is Research?What is Research? A systematic investigation, involving the
collection of information (data), to solve aproblem or contribute to knowledge about a theory or practice.
Research is critical in medicine because itleads to new discoveries and can changepeoples’ lives by improving health and well being.
Research helps to provide scientificunderstanding and solves practical problems.
Research (cont.)Research (cont.)
Relies on methods and principles that willproduce credible and verifiable results.
All research starts with an idea or
question based on personal experiences.
Scientific ApproachScientific ApproachThe most sophisticated method of acquiringknowledge is by scientific approach.
Combines important features of inductionand deduction together with other methodsto create a system of acquiring knowledge.
Generally more reliable than other methods.
Approach used most often to performmedical research.
Scientific researchis an integrated approach of deduction and induction
DeductionHypothesis generation
Testing the hypothesis
Induction(Inference on hypothesis)generalization of the results
In sample population
Universe
Known/unknown truths
Aims of epidemiologic research
• Describe the health status of a population
• Explain the etiology of disease
• Predict the disease occurrence
• Control the disease distribution
Definition of Epidemiology
• The study of the distribution and determinants of health-related states or events in specified population, and the application of this study to control of health problems.
[source: Last (ed.) Dictionary of Epidemiology, 1995]
Definition of Epidemiology• Study: surveillance, observation, hypothesis
testing, analytic research, and experiments.
• Distribution: analysis by time, place, and person.
• Determinants: physical, biological, social, cultural, and behavioral factors that influence health.
• Health-related states or events: diseases, causes of death, behavior, reactions to preventive regimens, and provision and use of health services.
Epidemiology and Biostatistics
Epidemiology:Study design andinterpretation
Biostatistics:Methods for analysis
Policy making, planning,Management evaluation
Health systems research
Epidemiological
Biomedical
Statistical
Behavioral
Social & economic
MODEL OF THE RELATIONSHIP BETWEEN DIFFERENT TYPES OF RESEARCH
BCG vaccination is not effective. Why ?(a) BCG vaccination coverage is good but not effective(i) Immuno-microbiological factors Poor nutrition (low protein intake) Poor immune reaction (race-specific) Tubercle bacillus strains Atypical mycobacterial infection ---- BIOMEDICAL PROBLEMS(ii) Technical factors Quality of BCG vaccine ---- BIOMEDICAL PROBLEMS(iii) Operational factors Storage and transport of vaccine Handling of vaccine after reconstitution Technique of vaccination Logistic support (supply of vaccine, vaccinating equipment) ----- HEALTH SYSTEMS RESEARCH
(b) BCG vaccination coverage is poor
(i) Operational factors
Coverage and efficiency of local
health services
---- HEALTH SYSTEMS RESEARCH
(ii) Human factors
Indifference of population toward
immunization
Fear of reaction and low level of
confidence in BCG
Decline in concern about tuberculosis
----- BEHAVIOURAL PROBLEMS
Preventable Causes of Disease
BEINGS
• Biological factors and Behavioral Factors
• Environmental factors
• Immunologic factors
• Nutritional factors
• Genetic factors
• Services, Social factors, and Spiritual factors
[JF Jekel, Epidemiology, Biostatistics, and Preventive Medicine, 1996]
Causal model of risk factors for CVDCausal model of risk factors for CVD
Morbidity and Mortality(Stroke, MI)
Biological Risk Factors
(Hypertension, Blood Lipids, Homocysteine)
Genetic Risk Factors(Family History)
Behavioral Risk Factors(Cigarette, Diet, Exercise)
Environmental Factors(Socioeconomic Status, Work Environment)
Clinical issues and questions in Clinical issues and questions in the practice of medicinethe practice of medicine
Issue QuestionNormality/abnormality Is a person sick or well? What abnormalities are associated
with having a disease ?
Diagnosis
How accurate are diagnostic tests or strategies used to find a disease ?
Frequency How often does a disease occur ?
Risk What factors are associated with an increased likelihood of disease ?
Prognosis What are the consequences of having a disease ?
Treatment How does treatment change the future course of a disease ?
Prevention Does intervention on people without disease keep disease from arising?
Does early detection and treatment improve the course of disease ?
Cause What conditions result in disease ? What are the pathogen tic mechanisms of disease ?
Execution of Research:Conceptualizing the problem: Need Background & RationaleFormulating the Objectives Generating hypotheses Testing hypothesesDesigning the Approach Research design Methods and Materials Target population Study population Methods of collectionAnalysis and Interpretation of results
THERE ARE ONLY A THERE ARE ONLY A HANDFUL OF WAYS TO HANDFUL OF WAYS TO DO A STUDY PROPELY DO A STUDY PROPELY BUT A THOUSAND WAYS BUT A THOUSAND WAYS TO DO IT WRONG --- TO DO IT WRONG --- Sackett (1986)Sackett (1986)