This document provides an introduction to medical research. It defines different types of research including primary and secondary research. It describes various research study designs such as in vitro studies, animal studies, case reports, observational studies including cross-sectional, case-control and cohort studies, as well as clinical trials. It also discusses different types of literature reviews including traditional reviews, systematic reviews and meta-analyses. Key differences between these review types include the use of checklists, inclusion/exclusion criteria, and quality assessments. The document concludes by outlining the typical sections of a research paper and listing some common medical databases.

1. introduction to medical research
by Dr Nuaman Ahmad Danawar
General surgeon.
Member of the royal college of surgeons (RCSI).
Syrian & Arab board in general surgery.
Diploma in laparoscopic surgery.
Member of the editorial board of Ocean Journal of Psychiatry and Mental Health Research.
reviewer in the CUREUS journal of medical science-California.

2. Research
Search/re-search
Is looking knowledge.
Research types: Primary VS secondary
Primary: When you are doing a study, this is a primary
research.
Secondary: when you are studying the already published
studies, this is secondary research.

3. Types& designs of research studies:
A- in vitro (test tube).
B- study on animals.
C- ideas, opinions, editorials.
D- case report/ series:
Case series provide stronger evidence with multiple cases

4. E- Observational studies:
cross sectional, case control, and cohort study.
Observational?
No intervention.

5. Cross sectional:
prevalence /survey study.
studying one point (risk factor/outcome) at one time or place.
(If multiple points at time= longitudinal or serial cross sectional study).
Easy and quick: like a snapchat.
priority which disease to start with is a specific group, time or place.
Example: A Cross-sectional Study of depression Among Patients With Colostomy.

6. Case control:
-focus on the case (disease, outcome).
-control group.
-Going to the past, to see the exposure (risk factors).
-Example: exposure < ---------colon cancer
-Fast
-Cheap.
-The evidence in weak relative to cohort.
Example: Lung Cancer and Physical Activity : A Case-Control Study.

7. Cohort study:
-Focus on the exposure (risk factors).
-control group.
-Prospective cohort: looking to the future.
-Need long time.
-Expensive.
-Stronger than case control.
In another words: cohort study is the opposite of the case
control study.
Example: Cigarette smoking and thyroid cancer risk: a cohort
study

8. F- Clinical trials:
interventional or experimental studies
RCTs VS non RCTs.

9. g-Articles review:
means studying or collecting data from the already published studies
on specific topic( secondary research) without new results.
Why I am studying the already published work?!
Can a review articles bring something new?
To know what already published in this topic.
To know what new in this topic.
To know best available evidence on this topic.
To raise a new question/s or problem for future work.

11. Articles review of three types:
Traditional review.
Systematic review.
Meta-analysis.
4 parameters are make the difference:
checklist.
research question: general or specific
inclusion/exclusion criteria
quality assessment.

12. Traditional review:
×checklist.
research question: general
× inclusion/exclusion criteria
× quality assessment.
+/-Method.
+/- Result.
Example: Sutureless only hernia repair: a review of 97 patients.
Conclusions: This approach has proven to be durable with a comparable complication profile to other tech

13. Systematic review:
Is a systematic process. Not systemic.
research question: specific (PICO).
√ checklist/guidelines.
√ inclusion/exclusion criteria
√ quality assessment.
√ Method.
√ Result.
PRISMA or Cochrane guidelines.
PRISMA= preferred reporting in systematic review and meta-analysis.
PICO:
P:patint.
I: intervention.
C: control.
O: outcome.

14. Example: Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review.
PICO
P: laparoscopic cholecystectomy.
I: cholecystectomy.
C: Open cholecystectomy.
O: In acute cholecystitis, post-operative morbidity, mortality and hospital stay were reduced by laparoscopic
cholecystectomy.

15. Meta-analysis MA:
Is a systematic and statistical process.
research question: specific (PICO).
√ checklist.
√ statistics.
√ inclusion/exclusion criteria
√ quality assessment.
√ Method.
√ Result.

16. NOTE:
MA can be designed from the beginning
or can be a result of systematic review by:
adding a statistical process.
Homogenous data ( in all selected studies the participants, intervention, outcome should be similar)
Simply: MA is a systematic review with statistics.

17. Example: Timing of Laparoscopic Cholecystectomy After Mild Biliary Pancreatitis: A Meta-Analysis study.
P: early Laparoscopic Cholecystectomy. ELC
I: Laparoscopic Cholecystectomy.
C: late Laparoscopic Cholecystectomy. LLC
O: This meta-analysis provides evidence that ELC is better than DLC in many aspects for acute mild
pancreatitis patients undergoing laparoscopic cholecystectomy. ELC associated with lower complications
(6.8%) than LLC (13.45%).and readmissions, as well as a short length of hospital stay.

18. Why we have to do MA?
-The different systematic studies
may report different effects of the intervention:
In MA we, as a reviewer, will give the summary of these effects.
-The different systematic study
may of a small sample sizes (the believability ??):
by synthesis the result from all these study MA will increase the sample size.
The answer in simple words the MA will solve the limitations of the systematic studies.

19. h-Clinical guidelines:
Usually related to specific institute: ACS, RCS, SAGES
summarize the best (BUT NOT THE ONLY) available medical
knowledge, and ensure that patients receive appropriate
treatment and care.
In simple words, clinical guidelines mean the best current
evidence in clinical practice.
What is the difference between guidelines and policy?

21. The format of research paper:
The research paper to be accepted should be written in scientific format:
IMRaD
Abstract
I= introduction
M= method.
R= result.
D= discussion
Conclusion
References

22. What does each section mean?
Abstract= the summary of the paper.
Introduction= the research question or problem.
Method= your way and tools to solve the problem or answer the
question.
Result= your findings.
Discussion= explanation and interpretation of your findings (the
meaning of your findings)
Conclusion= the learned lesson/s. NOT a summary.
References= your data source.

23. Databases: (sources)
PubMed (is the commonest).
PubMed Central (PMC)
EMBASE
Cochrane Library
Google scholar
MEDLINE
Medscape
Wikipedia
UpToDate
The last 2 are typicall not accepted for references in academic
papers.

24. Thank you
Nuaman,