1. RESEARCH QUESTION & HYPOTHESIS
Lt Col A S Kushwaha

2. RESEARCH
• Introduction
• The Need for research. Why?
• Who all can do research?
• What are the types of research?
• Where do research ideas come from?
• Research Process / cycle
• What is a research question?
• How to formulate a research question?
• Criteria of research question
• Hypothesis
• Checklist?
• Questions if any

3. INTRODUCTION
• “Because we are a poor country, we cannot
afford not to do research”. PM J. L. Nehru
• Health research is not a luxury, to be conducted
only by countries with the resources to spare.

4. “ Keep on going and the chances are that you will stumble
on something, perhaps when you are least expecting it. I
have never heard of anyone stumbling on something sitting
down.”
(Heath, 1985.)
Pasteur said: “In the fields of observation, chance
favours only the prepared mind.”
Science is unpredictable. There is no guarantee that
research, actively and methodologically pursued, will lead
to the discovery of what it set out to discover. It may do;
alternatively, something completely different may be found.
e.g. Minoxidil, Sildenafil, Penicillin (Alexander Fleming)

5. DEFINITIONS
• RE·SEARCH: NOUN: 1. a detailed study of a
subject, especially in order to discover (new)
information or reach a (new) understanding.
-Cambridge Dictionaries Online, © Cambridge University Press 2003.
• Research requires a question for which no
ready answer is available.

6. HYPOTHESIS
A proposition, or set of propositions, set forth as an
explanation for the occurrence of some specified group
Of phenomena, either asserted merely as a provisional
conjecture to guide investigation (working hypothesis) or
accepted as highly probable in the light of established
fact.

7. THE NEED
• Curiosity-driven research
• Needs-driven research (Public Health)
• Profit-driven research – Ageing population
• Participation in collaborative international
research
• Publish or perish
• Database for comparison
• Seed for future research

8. NEED
• The ‘10/90 gap’
• Natural history – CCHF, H1N1
• New emerging challenges –H1N1, HIV
• Fund allocation / Budgeting
• Capacity building – Collab centres
• Knowledge generation or translation
• Knowledge utilization

9. PURPOSE OF RESEARCH
A research can be undertaken for two different
purposes:
1. To solve a currently existing problem
(applied research)
2. To contribute to the general body of
knowledge in a particular area of interest
(basic/fundamental research)
3. To enhance CV- “Publish or Perish”

10. WHO ALL CAN DO RESEARCH?
• Students
• Teachers
• Scientists
• Paramedics
• Lab workers
• Policy Planners
• Administration

11. TYPES OF HEALTH RESEARCH
• Biomedical sciences – Biological, med,
clinical, drug, vaccine
• Population sciences – Epid, Demography,
Social behavioral
• Health policy sciences – policy, system,
services

12. RESEARCH -TYPES
• Multidisciplinary research
• Basic versus applied research
scientific experiments for light (i.e. knowledge)
Basic (Not yet applied) and experiments for fruit
– Applied
• Quantitative versus qualitative research

13. RESEARCH IDEAS- WHERE?
• Read the medical literature
• Attend scientific meetings
• Teach—questions asked by students can often give
ideas for research
• Acquaint herself/himself with the lines of interest of
funding research organizations;
• Develop specific areas of scientific interest
• Get new ideas out of her/his own previous research;
• Good observer;
• Imaginative;
• Skeptical attitude - science should be questioned.

14. RESEARCH QUESTION

15. Clinical issues and Questions in the
Practice of Medicine
ISSUE Question
Normality/abnormality Is a person sick or well?
What abnormalities are
associated with having a
disease?
Diagnosis How accurate are diagnostic
tests or strategies used to find a
disease?
Risk What factors are associated with
an increased likelihood of
disease?

16. Clinical issues and Questions in the
Practice of Medicine
ISSUE Question
Prognosis What are the consequences of having a
disease?
Treatment How does treatment change the future
course of a disease?

17. Clinical issues and Questions in the
Practice of Medicine
ISSUE Question
Prevention Does intervention on people without disease
keep disease from arising?
Does early detection and treatment improve
the course of disease?
Cause What conditions result in disease?
What are the pathogenic mechanism of
disease?

18. The literature review is the mother of the
Research Question!

21. WAYS TO SELECT RESEARCH TOPICS
• Personal experience.
• Whether you want to evaluate the effectiveness of an
intervention or understand how or why it works
• Curiosity about something in the media.
• State of knowledge in the field
• Solving a problem.
• Hot topics under discussion
• Personal values
• Everyday life.
• Gaps in the research and theoretical literature.

22. (FINER) Criteria for Good Research
Question
1. Feasible
2. Interesting
3. Novel
4. Ethical
5. Relevant

23. Characteristic of a good question
• FEASIBLE
– Adequate Number of subjects
• Preliminary sample size
• Estimate No available
• No who would be excluded or refuse
• No that would be lost to follow up
– Most estimates are overly optimistic
– Conduct a pilot

24. Characteristic of a good question
• FEASIBLE
– Technical Expertise : Skills / Eqpt /Experience
• Subject recruitment
• Measurement of variables
• Data analysis
– Cost:
• Estimate early
• Modify design / abandon question
– Scope
• Dont attempt to accomplish too much
• Avoid multiple research questions
• Narrow the goal and focus on important question

25. Characteristic of a good question
• Interesting (to the researcher)
– Motivations:
• Financial support
• Logical or next important step in career building
• Getting to the truth of the matter

26. Characteristic of a good question
• Novel
– The question need not be an original
• Can previous observation be replicated
• Different study population
• Improved technology
• Confirmatory study if it avoids the drawbacks of the
previous study

27. Characteristic of a good question
• Ethical
– Check with your IRB
– Ensure no physical risk
– No invasion of privacy
• Relevant
– The most important characteristic
– Consider all possible outcomes
• ? How would each affect
– Current scientific knowledge
– Influence clinical management
– Influence health policy
– Guide further research

28. Steps in developing a research question
• Step 1 :- Do not let the research question be forced upon
you.
• Step 2 :- Find a general area of interest. ( “ AIDS ” , NCDs”,
“MCH” etc ) (basic interest, own clinical observations,
discussions with colleagues, med. Conf., Questions asked by
our own students)
• Step 3 :- Read “around” the topic in width, (broad &
extensive ) not in depth ( intensive )
• Step 4 :- Identify a specific area of interest where gaps in
knowledge exist, need to be filled up ( effect of antenatal
counselling on Postnatal care)

29. Steps in developing a research question
• Step 5 :- Read “ into ” the topic
– In depth ( intensive )
– Discussions with experts in concerned field.
– Medline search, internet
• Step 6 :- Formulate a tentative research question (
syn. Res. Hypothesis ) : a tentative guess /
proposition which we like to prove / disprove

30. Steps in developing a research question
• Step 7 :- Evaluate the tentative research
question for its “suitability” (FINER)
• Step 8:- Make the research question specific
• Step 9:- Write down the Res. Question & its
significance

31. Narrowing and Clarifying
• Narrowing, clarifying, and even redefining
your questions is essential to the research
process.
• Forming the right ‘questions’ should be seen
as an iterative process that is informed by
reading and doing at all stages.
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32. Defining and refining the research question
HRT use in Postmenopausal Women ------- Endometrial Ca
Does post-menopausal hormone replacement therapy
predispose women to develop endometrial cancer?
Is it oestrogen alone or oestrogen in combination with a progestagen?
Does the duration of therapy need to be defined as, for example,
more than one year?
Should the diagnosis of endometrial cancer be specified as
Histologically confirmed?

33. For the purpose of the research design, the question also
needs to be refined. The research will only be able to
determine if there is an association or not. The refined
question should therefore be:
Is post-menopausal hormone replacement therapy,
as defined, associated with a subsequent increased risk of
endometrial cancer?
The association, if found, will need an explanation, but
cannot be taken as meaning causation without further
questioning.

34. If we take another example for a research question,
“Is passive smoking harmful to the foetus?”
the question needs to be better defined and also refined.
“Are the children born to women whose
husbands smoke more than 20 cigarettes a day,
of lower birth weight than children born to
women whose husbands do not smoke”?

35. Problems and solutions
• Vague or inappropriate
– Write the question early on
– Get specific in the study plan
• How the subjects will be sampled
• How will the variables be measured

36. Problems and solutions
• Not feasible
– Too broad
• Reduce number of variables
• Narrow the question
– Not enough subjects
• Expand the inclusion criteria
• Reduce the exclusion criteria
• Lengthen the time frame of the study
• Use more efficient variables or designs
• Add subjects from other sources

37. Problems and solutions
• Not feasible
– Methods inadequate or beyond your skills
• Consult experts
• Learn skills / undergo training
• Collaborate
– Too expensive
• Change study design/ measurements
• Seek addl funding
• Ethical uncertainty
– Modify the question

38. Summarising : The research question
1. What topic (idea) of study are you interested in?
2. What has already been done in this area (the literature)?
3. What major outcome(s) (dependent variable) are you interested in?
4. What intervention (independent variable) are you interested in?
5. Are you looking for differences or a relationship (association)?
6. To what group (population) do you wish to apply your results?
7. What is your specific research question?
8. What answer to your question do you expect to find (the research
hypothesis)?
9. Why is this question important today (relevance)?

39. WHAT TO STUDY?
Describe / report a disease Case report / case series
Study prevalence Survey/cross sectional
Study incidence Cohort
Study causation Cohort/case control
Study associations Cross sectional/ ecological
Study usefulness of diagnostic data Diagnostic test evaluation /
clinical prediction rule
Study efficacy of treatment
Clinical / field trials
Study outcome and factors
influencing it Cohort / economic studies
Case control studies
Health services evaluation Cross-sectional surveys

40. The Hypothesis Dilemma
• Hypotheses are designed to express
relationships between variables. If this is the
nature of your question, a hypothesis can add
to your research
• If your question is more descriptive or
explorative, generating a hypothesis may not
be appropriate
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41. The Hypothesis Dilemma
A hypothesis may not be appropriate if:
• You do not have a hunch or educated guess about a particular
situation
• You do not have a set of defined variables.
• Your question centres on phenomenological description
• Your question centres on an ethnographic study of a cultural
group
• Your aim is to engage in, and research, the process of
collaborative change
41

42. • 11.Null and research hypothesis
• Null hypothesis (Ho)= Statistical hypothesis;
predict that no relationship exists between
variables.
• Research hypothesis(H1)= Alternative
hypothesis; state the expected relationship
between variables.

43. Hypothesis are used to state the relationship
between two variables and may be stated as
• Null hypotheses (no relationship between two
variables).
• Non-directional hypotheses (we don’t know or won’t
speculate about the direction of the relationship
between two variables).
• Directional hypotheses - We state the direction of
the relationship between two variables.

44. RELATIONSHIPS SPECIFY
• How the value of one variable changes in relation to
another.
• May be either positive, negative, or the two variables
may not have any relationship to one another.
• Are not necessarily correlations. The type of
relationship or association among variables is
determined by the level of measurement of each of
the two variables.

45. Examples of relationship type
Negative Positive None
1 5 1 1 1 3
2 4 2 2 2 1
3 3 3 3 3 5
4 2 4 4 4 4
5 1 5 5 5 2
BP & Age, HR & age, IQ & Colour of eyes

46. • Using the previous two examples, the research
hypotheses could be as follows.
1. Post-menopausal women who received hormone
replacement therapy, of a specified type and duration, are
more likely to develop endometrial cancer than post-
menopausal women who did not receive such therapy.
2. Children born to women whose husbands smoke more than
20 cigarettes a day are of lower birth weight than children
born to women whose husbands do not smoke.

47. HYPOTHESIS CRITERIA
• Is written in a declarative sentences.
• Is written in the present tense.
• Contains the population.
• Contains the variables.
• Is empirically testable

48. • The level of significance for rejecting the
statistical null hypothesis should always be
stated before data are collected. The level of
significance usually set at (.05). this means
that the researcher is willing to risk being
wrong 5% . Generally the aim of the
researcher is to reject the null hypothesis
because this provides support for the research
hypothesis.

49. THOUGHT FOR THE DAY: WHAT WE WANT TO AVOID
“Your manuscript is both good and original;
but the part that is good is not original, and
the part that is original is not good.”
Samuel Johnson

50. Develop a research question &
Hypothesis
• General concern – Hb of mother and Birth weight of baby.
RQ -
• Is Anemia in pregnancy associated with low birth weight in newborn?
Null Hypothesis
• There is no difference in the incidence of LBWs in the mothers who are
anemic and those who are not anemic.
Research Hypothesis
• The incidence of LBWs in mothers who are anemic is higher than those
who are not anemic

51. Just get out
and do it!

53. • What are FINER criteria of a good research
question?
• What is a null hypothesis?
• What kinds of relationship may exist between
two variables?
• Read into, Read around- which comes first?
• What is called as “mother of research”
• If we examine “ Why so” in a study- is it a
quantitative or qualitative research?
• Incidence is studied by – Descriptive/ Case
control/ Cohort/ RCT
• Drug or Vaccine for its efficacy is best studied by
which type of study? Descriptive/ Case control/
Cohort/ RCT