Intro to Research

what is research?

systematic process used to answer questions and generate new

knowledge

“How does this work?” “What causes this?” 

what is clinical research?

Research involving human participants that seeks to understand health,

disease, injury, diagnosis, treatment, prevention, rehabilitation, or patient

outcomes

“Does this work in patients?”

“Does this improve outcomes?”

EBP triangle

• evidence

• clinical expertise

• patient preferences/ context

Efficacy

Can it work under ideal or controlled conditions?

effectiveness

Does it work under real-world conditions?

clinical research cycle

Clinical Question

↓

Find Evidence

↓

Evaluate Evidence

↓

Apply Evidence

↓

Evaluate Patient Outcome

↓

Revise the plan or continue with the plan

evidence based practice

integration of the best available research evidence with clinical expertise and patient values/preferences in making decisions about patient care

fourth component of EBP

clinical context

• resources

• time

• equipment

• practice setting

• scope of practice

• cost

• accessibility

• patient adherence

• interprofessional considerations

best evidence

evidence that appropriately answers the clinical question for your situation

confirmation bias

tending to agree with evidence that supports them

availability bias

based on how easily they can think of an example

anchoring

relying too much on the first piece of information they hear about an issue

Two athletes with the same diagnosis may choose different treatment options because their:

• goals differ

• timelines differ

• risk tolerance differs

• resources differ

• preferences differ

good clinical question should be…

Focused

Specific

Answerable

Clinically relevant

Searchable

PICO

patient or population

intervention

comparison or control

outcome

From PICO to Clinical Decision

Critically Evaluate Evidence

↓

Consider Clinical Expertise

↓

Consider Patient Values

↓

Consider Context

↓

Make Clinical Decision

↓

Evaluate Outcome

Hypothetico-Deductive Reasoning

Generate possible explanations

Gather information

Test hypotheses

Narrow possibilities

pattern recognition

Recognize familiar clinical presentations

Based on previous experience and knowledge

dual process model

System 1

• Fast

• Intuitive

• Automatic

System 2

• Slow

• Analytical

• Deliberate

Premature closure

Stopping the diagnostic process too early

Bandwagon effect

Assuming something is correct because everyone else does it

process of thinking

Ask → Acquire → Appraise → Apply → Assess

sports injury question?

PubMed / SPORTDiscus

rehab question?

PubMed / CINAHL

ex phys question?

SPORTDiscus / PubMed

healthcare delivery question?

CINAHL / PubMed

diagnostic testing question?

PubMed

athletic performance question?

SPORTDiscus

broad interdisciplinary question?

google scholar

PubMed

Free biomedical literature database

Maintained by the U.S. National Library of Medicine

SPORTDiscus

It may identify literature that is:

More sport-specific

More exercise-focused

Not easily found through a strictly biomedical search

CINAHL

Cumulative Index to Nursing and Allied Health Literature

• Rehabilitation

  Allied health

  Patient education

  Healthcare delivery

  Clinical practice

  Patient experiences

  Interprofessional care

  
  

google scholar

•Easy to use

•Broad coverage

•Familiar interface (Google)

Best for: Finding primary research, tracking citation counts, and locating open-access medical studies

Drawbacks: Less structured for precise biomedical indexing than dedicated medical databases like PubMed

30% rule in AI

using about 30% AI and 70% human efforts for tasks such as searching for relevant research

boolean operators

and (narrows)

or (broadens)

not (excludes)

search string

1. identify concepts

2. connect synonyms with OR

3. connect concepts with AND

4. test and refine

common filters to help improve results

Publication date (“2020 or newer”)

Article type

Patient Age

Humans vs Animal vs Cell

Language (“English only”)

Sex (“Males only”)

Full text (Can only view abstract vs can access full article)

Peer-reviewed

Population (athletes, patients, geriatric patients, school-aged children)

primary source

• the authors report original research/data

• ex.

• Randomized controlled trial

  Cohort study

  Case-control study

  Cross-sectional study

  Diagnostic accuracy study

  Qualitative study

  
  

secondary source

• The authors summarize, synthesize, or interpret existing research

  ex.

• Systematic review

  Meta-analysis

  Scoping review

  Narrative review

  Clinical practice guideline

  
  

quality of a review depends on:

Search strategy

Inclusion criteria

Study selection

Risk-of-bias assessment

Quality of included studies

Appropriate synthesis

three stage reading strategy

1. title

• is this potentiallly relevant?

2. abstract

• is this actually relevant?

3. full article

• can i use this evidence?

what should you identify based of the title?

Population

Intervention

Outcome

Potential relevance

what can the abstract show you?

• background

• purpose

• methods

• results

• conclusion

5 questions for any article

who?

what?

compared with what?

what happened?

does it matter?

Nazi Medical Experiments

Coercion

Lack of consent

Extreme human experimentation

Tuskegee Syphilis Study

Participants were not adequately informed

Treatment was withheld

Exploitation of a vulnerable population

Willowbrook Hepatitis Studies

Ethical concerns involving children

Questions about consent and coercion

the Belmont Report

• respect for persons

• beneficance

• justice

respect for persons

informed consent

ability to withdraw

beneficence

• minimize risk, maximize benefit

justice

Who is being asked to participate—and who benefits from the research?

Is there a fair selection of research participants, and are the risks and benefits distributed fairly?

informed consent

• Receive relevant information

• Understand what participation involves

• Have an opportunity to ask questions

• Voluntarily agree to participate

informed consent document should clarify

Purpose of the study

What participants will do

Expected duration

Potential risks

Potential benefits

Alternatives, when applicable

Confidentiality/privacy procedures

Compensation, if applicable

Contact information

Voluntary nature of participation

Right to withdraw

voluntary participation

• no coercion

• no undue influence

• no perceived obligation

consent is an ongoing process

• Be able to ask questions

• Be informed of relevant new information

• Know about changes to the study

• Be reminded that participation is voluntary

• Be able to withdraw at any time

Institutional Review Boards

committee responsible for reviewing research involving human participants

• protects the rights and welfare of research participants

privacy

person's control over access to themselves or their information

ACCESS TO PERSON

confidentiality

how researchers protect information after it has been collected

PROTECTION OF INFO

authorship

• should reflect meaningful intellectual contribution

• ex.

• Developing the research question

  • Designing the study

  • Collecting substantial research data

  • Analyzing/interpreting data

  • Writing or substantially revising the manuscript

  • Approving the final manuscript

  • Accepting responsibility for the work

gift/ honorary authorship

Adding someone because of:

• Position

• Status

• Funding

• Department leadership

• Friendship

ghost authorship

Someone makes substantial contributions but isn't credited

guest authorship

Someone is listed as an author despite little/no meaningful contribution

authorship order

Can create disputes over:

• First author

• Senior/last author

• Contribution

plagiarism

involves presenting someone else's work, ideas, words, or intellectual contributions as your own without appropriate attribution

Fabrication

Making up data or results

Falsification

Manipulating research materials, processes, or data so that the research is misrepresented

the research life cycle

Clinical Observation

↓

Research Question

↓

Literature Review

↓

Study Design

↓

Funding

↓

IRB

↓

Recruitment

↓

Data Collection

↓

Analysis

↓

Manuscript

↓

Presentation

↓

Submission

↓

Peer Review

↓

Revision

↓

Publication

Small/low-risk project timeline

6-12 months

typical grad student project timeline

12-24 months

larger clinical study timeline

18-36+ months

Multi-site or externally funded project timeline

2-5+ years

question to answer before designing reseearch study

What has already been studied?

What are the major findings?

Where is the evidence inconsistent?

What limitations exist?

What populations have been studied?

What outcomes have been used?

What methods have been successful?

What gap does your study address?

idea to research question timeline

1-4 weeks

study protocol timeline

1-3 months

developing the study protocol

Research question

Hypothesis

Study design

Participants

Inclusion/exclusion criteria

Recruitment

Intervention/exposure

Outcome measures

Data collection procedures

Data management

Statistical analysis

Ethical considerations

grant proposal

• A grant proposal basically convinces a someone that your research is worth conducting, and commonly includes:

• Significance of the study

Background

• Research question

• Specific aims

• Innovation

• Methods

• Study population

• Data analysis

• Timeline

• Budget

• Investigator qualifications

• Potential problems/alternatives

timeline of grant proposal

• 1–4 months to develop

• 1–6+ months for review/decision

what happens if your grant is rejected?

Revise and resubmit

Find another funding source

Reduce study scope

Conduct a pilot study

Seek internal funding

modify research question

IRB review timeline

2–8+ weeks

to find participants you need to est

• Eligibility (inclusion/exclusion criteria)

• Recruitment procedures

• Screening

• Consent

• Enrollment

recruitment timeline

2-12+ months

potential problems in protocol

• Missing data

• Measurement errors

• Protocol deviations

• Equipment failure

• Participant dropout

• Research staff turnover

timeline of protocol

•1–24+ months, depending on study design

data cleaning

• Missing values

• Impossible values

• Duplicate entries

• Outliers

• Inconsistent coding

• Protocol deviations

data analysis

1. clean the data

2. finalize analysis plan

3. conduct statistical analysis

4. interpret results

5. determine whether findings answer the research question

data analysis timeline

2-8 weeks

researchers should NOT

• Cherry-pick outcomes

• Remove inconvenient participants without justification

• Run endless analyses until something is significant

• Change hypotheses after seeing results without disclosure

• Hide negative findings

timeline of presenting research

1–6 months after data analysis

intro

What do we know?

What don't we know?

Why does this study matter?

methods

what did we do?

results

what did we find?

discussion

what do the findings mean?

conclusion

what should the readers take away?

timeline for preparing the manuscript

1-3 months

what to consider when selecting a journal?

• scope

• audience

• impact/reputation

• acceptance rate

• article type

• publication timeline

• open access

manuscript submission requirements

• Manuscript

• Title page

• Abstract

• Tables

• Figures

• References

• Cover letter

• Author information

• Conflict-of-interest statement

• Funding statement

• Ethics/IRB statement

• Data availability statement, when applicable

timeline from Submission → Initial editorial decision

2–8 weeks

outcomes after manuscript submission

• accept "as is”

• minor revisions

• major revisions

• reject

• reject and resubmit

peer review process

Submit

↓

Editorial Screening

↓

Editor Assigns Reviewers

↓

Peer Review

↓

Editorial Decision

↓

Revise

↓

Resubmit

↓

Additional Review

↓

Decision

↓

Publication

peer review timeline

1-6+ months