formulating a research question - moving academy workshop at niirh
TRANSCRIPT
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Formulating a ResearchQuestion / Hypothesis
Dilip R KarnadMD, FACP, FRCP
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Getting the idea
Developing the research hypothesis
Defining the objective of the research
Framing a tentative research question
Appropriate study design
Framing the final research question
Doing Research the first steps towards the Nobel Prize
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Single incident RepeatedobservationUnusual
UnexpectedParadoxical
Chance? Pattern
Why did it happen? Is it really exceptional?
Case Report Hypothesis
Getting the research idea - Curiosity
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Interesting Observation
Pattern
Tentative hypothesis
Hypothesis
Experiment
Observation
Confirmation
Process of Research
Problem
Convert to research studyGetting the idea
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Identify What is the problem?
Prioritize Why is this important?
Rationale Can the problem be solved?
Importance What are the benefits to society?
Is the idea worth pursuing?
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Lets plan a research study
Hypothesis:Computer games make children smarter
Important? Can be solved? Benefits to society?
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Is an answer already available?
Literature search
Is the question fully answered?
Have previous attempts failed? Why?
If answered, is this being used in clinicalpractice? Why not?
Limitations of previous studies
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Converting Hypothesis into Research study
Hypothesis: Computer games make children smarter
Start with a broad, general question / hypothesis
Narrow down or focus on a specific problem
Design a study to address specific hypothesis
Computer games What type? Which one? How muchtime?
Children Age? Gender? Class in school? Language
Smarter IQ? Maths? Interview? Problem-solving?
General knowledge? Marks in exam?
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Structured, holistic approach for researchplanning - SHARP
1 Set up a causal model2 Establish a fact-hypothesis matrix3 Develop a variable indicator measurement
matrix4 Select the study design5 Define sampling method, sample size
6 Define statistical methods7 Consider ethical issues8 Set up operational plan
Charlton KE et al. S A J Clin Nutr 2000;13:1
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Hypothesis Fact (published literature)
Playing with other children betteradjusted in society
Play helps in cognitive, social andemotional development
Negative emotions channelized inharmless activities Play allows expression of negativeemotions - hate, gaining control of situation, conflicts
Games - More cerebral stimuli -Imagination
Computer games vast range of images, sounds, animation,information
Recreation Break from routine studiesGames help in Concentration -Important for preparing for boardexaminations
Computer games teach children tosit in one place, prolongedconcentration
Therefore computer games improve
students scholastic performance?? ? ? ?
Research question
Fact hypothesis matrixHypothesis: Computer games make children smarter
Computer games may improve scholastic performance
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Characteristics of a good hypothesis
Must be based on facts (publishedstudies)
Should not have already been proven. Should be convincing
Often fills gaps in current knowledge
Usually explains more than one
situation
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Should we have several alternativeexplanations for all possible resultseven before we start the study?
Are there any other possibilities that
explain the problem?
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Hypothesis generationAlternative hypothesis
Our conclusion:Cause effect relationship Coffee drinking causes HT
Other possible explanations:
75% of pts with hypertension (HT) drink coffee 20% of healthy controls drink coffee (p < 0.001)
1 Chance Coffee drinking not related
2 Bias Coffee drinking not related
3 Effect (not cause) HT causes coffee drinking
4 Effect effect HT and coffee drinkingcaused by a third factor
5 Partial cause effect Coffee drinking is one of the causes of HT
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Mills canons of inductive reasoning
John Stuart Mill (1806-1873) - British Philosopher
Method of difference disease present/absentrisk factor present/absent
Method of agreement presence of risk factor anddisease
Method of concomitant dose response effectvariation
Method of analogy 2 diseases occurring togethermay have common cause
J S Mill. System of Logic. 1843
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Causal Inference Kochs postulates
1 Microbe found in diseased tissue or animals andnot in normal tissue or animal
2 Can be cultured from diseased tissue
3 Organisms from culture can cause disease if introduced in animals or man
4 Organism can be re-isolated from experimentallyinfected animal or man
5 Treatment or preventive measures can eliminatedisease
Robert Koch (1843-1910) German microbiologist
Robert Koch, 1884
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Criteria for causation (weakest to strongest)
1 A is associated (correlated) with B (Strength of association correlation coefficient, odds ratio)
2 A precedes B (Temporality)
3 Plausible biological mechanisms lead from A to B(Plausibility)
4 A graded dose-response relationship exists between Aand B (Dose-response)
5 Presence of A always leads to B (Longitudinal studies)
6 Removal of A always prevents B (Treatment effect)
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Variable Indicator MeasurementType of game WCCG category - C Name of game
DoseTimeAttemptsDuration
Hours/weekNumber of tries/weekNumber of months
Expertise Performance in game Highest score everyweek
Concentration onstudies
Duration of studyEfficiency of study
Hours/dayChapters/day
Quality of study Comprehension, Recall- Periodic tests Scores in monthly tests
Ultimate benefit Exam marks / scores Mark sheet of XIIth
board exam
Variable indicator - measurement matrixHypothesis: Computer games may improve scholastic performance
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Is it possible to answer the initial question?
Do we have the subjects, technology,budget, time to complete the study?
Can the question be broken down into smallerparts, which can be answered separately?
Do we need to rephrase the initial question?
Develop a specific, focused research question
Review the objectives
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Components of an ideal research question
PICO Population: Normal/disease, human/animal
Intervention: Therapy, risk factor,diagnostic test, preventive measure
Comparison or Control: Better / worse,placebo / active control
Outcome: Clinical, functional, laboratory,economic
Schwatrz MD, et al. ACP Journal Club 2007;147:A8,9
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Ideally framed research questionsPICO (Population Intervention Control Outcome)
Is low-dose dopamine infusion superior to noradrenaline indecreasing need for dialysis and in-hospital mortality inadults with septic shock?
Does addition of aspirin to standard treatment decreaseneed for hospitalization in diabetic females with coronaryartery disease?
Is the quantiferon test superior to the tuberculin test indetecting presence of active tuberculosis in asymptomatichealthcare workers?
Does salt fortified with folic acid and Vit B12 decreaseserum homocysteine levels more than unfortified salt invegetarians with previous myocardial infarction?
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Ideally framed research questionHypothesis:
Computer games improve scholastic performance
Population:Intervention:
Control:Outcome:
Research Question:
Does playing with Brain Tickler 2010 daily for 2 yearsimprove performance of female X th Grade students in the
XII th Grade examinations when compared to students
with unrestricted access to all computer games ?
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Summary1 Conceptualize the problem
Identify - what is the problem?Prioritize - why is this important?
Rationale - can the problem be solved?
Importance - are there benefits to society?
2 Define a testable hypothesis
3 Frame a broad research question
3 Break the problem / hypothesis / study into parts
4 Refine question - specific, focused
Can be answered with available resources - time, budget,facilities
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It is worthwhile to put in a lot of thought and effort
before starting even a simple study!