Why learn Research Methodology

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					  Why learn Research Methodology?


                         DR. BARUN KUMAR NAYAK
        CONSULTANT AND HEAD OPHTHALMOLOGIST
        P.D.HINDUJA NATIONAL HOSPITAL & MEDICAL
RESEARCH CENTRE VEER SAVARKAR MARG- MUMBAI -16
     EDITOR - INDIAN JOURNAL OF OPHTHALMOLOGY
             Medical Science
•   Not an exact science
•   No two humans are similar
•   Effect is varying
•   Based on trial and error
•   Not much is known unlike other science eg.
    Physics (can predict solar eclipse even
    500yrs from now and will be correct)
     Evidence based medicine
• Now is era of EBM
• Mid 19th century Pierre Charles Alexander Louis-
  Introduced statistical analysis – Blood letting was
  valueless form of treatment
• 1920s genecist Ronald Fisher enumerated
  principles of numerically based experimental
  design
• After world war II it started picking up the
  acceptance
           Definition of EBM
“The conscientious, explicit & judicious use of
  current best evidence in making decisions
  about care of individual patients”

 EBM ensures the practice of up to date
 medicine
Alternative definition by critics
• The increasingly fashionable tendency of a
  group of young, confident, and highly
  numerate medical academics to belittle the
  performance of experienced clinicians by
  using a combination of epidemiological
  jargon and statistical sleight-of-hand”
• The argument, usually presented with near
  evangelistic zeal, that no health related
  action should ever be taken by a doctor, a
  nurse, a purchaser of health services, or a
  politician unless and until the results of
  several large and expensive research trials
  have appeared in print and approved by a
  committee of experts”
• “Evidence based medicine seems to [
  replace] original findings with subjectively
  selected, arbitrarily summarized, laundered
  and biased conclusion of indeterminate
  validity or completeness. It has been carried
  out by people of unknown ability,
  experience, and skills using methods whose
  opacity prevents assessment of the original
  data”
     Five essential steps of EBM
• To convert our information needs into answerable
  questions (that is, to formulate the problem)
• To track down, with maximum efficiency, the best
  evidence with which to answer these questions –
  which may come from the clinical examination, the
  diagnostic laboratory, the published literature, or
  other sources
• To appraise the evidence critically (that is, weigh it
  up) to assess its validity (closeness to the truth) and
  usefulness (clinical applicability)
• To implement the results of this appraisal in our
  clinical practice.
• To evaluate our performance.
         Critical Appraisal
• Critical appraisal skills are essential in any
  residency training program
• Excellence in critical appraisal depends
  largely on knowledge of research methods
  and pitfalls.
• By acquiring research skills and
  understanding the research process, one
  should be able to better evaluate the medical
  literature, distinguish strong evidence from
  weak, and be more judicious in therapy
  recommendations to individual patients
       If not EBM then what?
•   Decision making by anecdote
•   Decision making by press cutting
•   Decision making by expert opinion
•   Decision making by cost minimisation
                  EBM
• In 1980s only 10-20 % decisions were
  based on EBM
• Later surveys reported it as 21%
• Recent study will definitely show much
  higher percentage
• Speciality practice 60-90%
  Why learn Research Methodology?
• As a researcher for conducting a research
• For analysis of published articles
• As a practitioner, to understand and analyze
  a published research in right perspective
• Job promotion
     Undergraduate curriculum

• No separate program
• Although included as part of PSM
• Usually importance is not given
        Post graduate course

• Requirement to have a thesis / dissertation
• Students are supposed to have
  understanding to dissect a publication
• To pass examination only text book
  knowledge is not sufficient
• May be helpful in a research career
• Thesis done properly and meticulously may
  culminate in publication in Peer –reviewed
  journal
       Basic ingredients of research
• Identify the topic
• Literature search
• Research question formulation PICOT
• Materials and Methods
 Research Design
 Sample size
 Ethical committee approval
 Analysis
• Results
 Honesty
• Discussion and conclusion
                   1 st   Study
• King of Sicily & Jerusulem Frederick II
• 1200 AD
• Wanted to know the effect of exercise on the
  digestion
• King called 2 knights
• Gave them a good identical meal
• One was sent for hunting and another was asked to
  sleep
• Then what?
           Basic Principles

• Be ethical
• Do no harm to others
• Proper study design and research
  methodology will eliminate unnecessary
  work and expense
• BE HONEST
            Aim of course

Introduction to research
Knowledge will help in conducting research
 properly
Will be able to critically evaluate the
 published paper
Will be able to incorporate evidence based
 medicine in practice