3. Purpose of Research
• Magnitude of problem or phenomenon (what?)
• Distribution of problem (who?, when? and where?)
• Causes of, risk factors for or solutions to a problem or
phenomenon (why?)
• Mechanism/s for a problem or phenomenon (how?)
Address GAP in knowledge
Need to identify and clarify the gap before
addressing it
4. John Snow and Modern Researchers
Cholera epidemic in
Golden Square of
London 1853-54The
mechanism unknown
(cholera vibrio haven’t
been identified yet)
Work illustrates the
sequence from
descriptive
epidemiology to
hypothesis generation
to hypothesis testing
(analytic epidemiology)
to application
Determined where
persons with cholera
lived and worked.
Map the distribution of
cases
Areas were supplied by
different water
companies having
different water sources
Areas served by
Southwark and
Vauxhall company had
8-fold mortality
compared to areas
served by Lambeth
company
Postulated that cholera
was transmitted by
contaminated water
5. Ignaz Semmelweis and Childbed
fever Observed higher rates of
peuperal sepsis in a ward staffed
by physicians and medical
students (16%) compared to ward
staffed by midwives (7%)
Policy formulation and
implementation: Hand washing
•Edward Jenner and smallpox
Observed that “dairy maids” were
unaffected by smallpox outbreaks
Performed first vaccination on
James Phipps
6. Pioneers of
Modern
Health-
Research
Case-control design -Doll and Hill: smoking and lung
cancer
Cohort design -Framingham Heart Study
Clinical trials The field trial of the polio vaccine in
early 1950s, nearly 1 million children were
randomized to vaccine and placebo groups (Francis
et al. Am J Publ Health 1955:45)
9. How to Identify a Gap in Knowledge
Literature Review
(Wednesday, 2nd
Sept)
Review papers
Personal
Observations in
practice
Associating with
experts in the field
Attending scientific
conferences
Without reading
literature, meeting
experts and
attending
conferences–
difficult to identify
gap in knowledge
10. How do
the Gaps
exist?
Nobody has looked at
the problem or
phenomenon before –
RARE !!!!!!
Problem or
phenomenon has
changed over time
Problem is the same
but previous
investigators
tools/methods were
inadequate/inappropr
iate
•Better tools/methods have
been found
Old approaches or
interventions not
working optimally
11. Major
Pitfalls Even worse—duplicating previous
research efforts using weaker
methodology
Inferior study
design
Smaller sample
size
Unrepresentativ
e sample
Weaker tools
Weaker
analytical
approaches
Simply duplicating previous research
efforts
12. Types of
Research
Basic research Ask fundamental questions
about disease causation
Epidemiological
research
Magnitude, distribution &
determinants of diseases and
efficacy of interventions
Implementation
research
Facilitators and barriers of
implementing proven
interventions or policies
(different contexts)
Strategies for scaling up
interventions (different contexts)
Operations research
evaluate challenges of
implementation and impact of
an intervention in a specific area
15. Evaluating research questions
Is it important?
Must pass the “so what” test? If the question has
been answered what clinical or public health
problem will be solved?
Is it practical/feasible to answer
the question – can the question be
addressed?
Is it novel? Are you addressing a gap
in knowledge or duplicating previous
results?
16. Evaluating
research
questions
Political acceptability - Will this
receive interest and support
from authorities?
Applicability-can the answers to
the questions be applied to
solve problems?
Urgency - How urgent are the
answers to the questions
needed to develop
interventions?
Ethical acceptability-How will
the study affect participants?
17. THE “WH”
QUESTIONS OF
RESEARCH
• Who is Eligible?
• Licensed health professionals (e.g., medical doctors,
nurses, pharmacists)
• Researchers with biomedical, public health, or social
science backgrounds
• Ethics-certified investigators or teams approved by
an IRB/REC
• What Qualifications should they Have?:
• At least a Bachelor’s degree in a health or science-
related field
• Good Clinical Practice (GCP) and Research Ethics
certification
• Advanced studies (MSc, PhD, or MPH) preferred for
principal investigators
• Where Can Research Take Place?
• Hospitals, clinics, health centers
• Universities or research institutions
• Communities, schools, workplaces (depending on
the study design)
19. LITERATURE SOURCES/DIGITAL
DATABASES
• PubMed
• Website: https://pubmed.ncbi.nlm.nih.gov
• A free database of biomedical and life sciences literature, maintained by the U.S. National Library of Medicine.
• Google Scholar
• Website: https://scholar.google.com
• Broad academic search engine that includes medical journals, theses, and conference papers.
• ScienceDirect
• Website: https://www.sciencedirect.com
• A leading full-text scientific database offering journal articles and book chapters in health and medicine.
• The Lancet
• Website: https://www.thelancet.com
• One of the world’s oldest and most respected peer-reviewed general medical journals.
• BMJ (British Medical Journal)
• Website: https://www.bmj.com
• Cochrane Central Register of Controlled Trials (CENTRAL)
• Excerpta Medical Database (EMBASE)
#2:Systematic collection and analysis of data to answer a certain question or solve a problem
If there is no question or a problem– there is no research.
#4:John Snow was a British physician who developed of modern epidemiology and is considered the "father of field epidemiology". He's best known for identifying the source of a cholera outbreak in London's Soho in 1854, attributing it to a contaminated water pump
#5:Ignaz-He demonstrated that the infection was largely preventable through hand disinfection.
Edward-milkmaids who had contracted cowpox, a related but milder disease, seemed to be immune to smallpox
#6:was a landmark prospective study that definitively linked smoking to lung cancer and other diseases. This study, which followed over 34,000 male British doctors for decades
