Describes the steps needed to be followed for selecting a research topic for medical research that is relevant and makes an impact

1. Abhaya Indrayan
MSc,MS,PhD(OhioState),FAMS,FRSS,FASc
Biostatistics Consultant, Max Healthcare
Selecting a
Research Topic

2. RECOMMENDED BOOK

3. Fascinating World of
Medical Research
Despite enormous advances, the unknown segment is far more
than known segment
Do we have knowledge, skills, procedures, equipment for
instant diagnosis of health problems?
Do we have magic treatments that alleviate the sufferings
immediately?
Can we replace irreparable body parts that work as effectively
as the originals?
Can we accurately predict the outcome - when, how much
residues will remain?
Medical research very different from research in physics,
chemistry, history, literature because health is vital to life

4. What is Research?
RELENTLESS SEARCH FOR TRUTH (“Truth” changes -
Ptolemy)
Discovery of new facts (never thought of, in the
domain of conjecture, or being looked at with
suspicion)
Enunciation of a new principle – wider ramifications
(if two drugs work the same way, can we use one on
the basis of established efficacy of the other)
Fresh interpretation of the existing ideas
(repurposing the existing drugs for COVID
- plasma therapy)
Research opens up new questions and it is endless
search

5. Further on Research
Why and how of a phenomenon (why Coronavirus does
not affect children as much - how much is the difference in
the incidence)
Also, what, when, how much (what biochemical changes
occur by eating citrus fruits, how much and for how long
should be eaten for a significant change, how much
change occurs)
What the world will know that was not known earlier (key
messages) – how does it add to the present knowledge
For a PhD thesis, the topic can be confirmation (or denial) of
the previous finding in a new setup (effect of celecoxib in
osteoarthritis in old women in India)
Detailed study of a phenomenon also sometimes comes in
the ambit of research - low birth weight (why, how, where,
how much, who, how to control, etc.)

6. Levels of Medical Research
First level - PG thesis (proposing a hypothesis) -
Use resources of the guides, generally two years,
part-time - training in research methodology
Second level - Doctoral dissertation (frank
research as explained earlier), at least three years
full time, must be publishable
Third level - Institutional research, generally
collaborative among the departments or among
the faculty, may be externally funded -
publishable in a good journal
Fourth level - Huge multi-centric studies, requiring
enormous resources, supported by scientific
bodies such as ICMR, DBT in India

7. Scientific Methods of Reasoning
(All sciences – not restricted to medical)
1. Induction – From a collection of specifics to a general statement
– 95% of diabetics of age 60 seen in a clinic have survived
for at least five years – thus P(5-year survival) = 0.95
– Used in most medical research by observing a sample
of patients
2. Deduction – From general to specific
– Positive predictivity of a PCR-CoViD test is 0.97 –
thus, test +ve person has CoViD
– Used in clinics for diagnosis
3. Abduction – Hypothetical best explanation of a phenomenon
then test it
– A patients gets repeated fracture – may have low BMD
– By chance (doing something else but find another –
– Alexander Flaming’s penicillin (Contaminated mold)

8. What is a Problem for Research? -1
GAP IN KNOWLEDGE OR DIFFICULT TO USE
Unknown magnitude of the problem - unknown profile
Perceived difficulty (premature delivery in anemic women)
Feeling of discomfort about the way the things are
(frequent monitoring of low birth weight babies)
Presence of discrepancy (deterioration despite treatment)
Two or more plausible answers (exercise or diet for weight
control)
Better (easy to administer, economical, less discomfort,
etc.) way of managing patients – medical vs. surgery
Propounding a new idea is also research provided it is
rooted in science (the idea of positive health)

9. How to Find Problems for Research?
Your own practice - encountering patients (management
of a patient with long-standing pain in abdomen)
Talk to your colleagues or guides
Search literature
- Choose reputed journals
- Last paragraph may indicate what more is needed to be done
- See if the results can be extended to other kind of patients or other
areas
- Whether new procedure can be used for the problem investigated
earlier
- Will the findings apply to your setup - what modifications can be
considered
Research into researches

10. CHARACERISTICS OF A GOOD RESEARCH QUESTION
Timely – Cancer
- Monkey pox
Original – Not much discussed earlier – anti-ageing diet
Novel – Biological markers of positive health
Justified – People tried earlier but failed
- medical therapy of breast cancer
Anchored with prior evidence – sleep for health
Focused – Which group (age, severity, hospitalized, low
nutrition)
Specific – Diet and cancer (contribution of diet to
different types of cancer or its prevention)

11. What is a Good Problem for Research?
Specify what the world does not know and you would
like the world to know
Merely filling up a knowledge gap is not enough - must
have application to the real world now or in the future
(speed of growth of nails) - DNA structure, genome
sequence
Must have a theoretical backup (biological plausibility -
diet and heart diseases, mRNA-based vaccine)
If you want to do research on age distribution of deaths
by cancer, why do you want to do this research, how
will it help the public or the science - what the world
will gain
The topic currently in discussion – positive health

12. Hot Topics for Medical Research
BROAD AREAS – Fine tune as needed
Prevention of chronic diseases (cancer, CVD,
COPD, CKD) - diet, lifestyle, supplements, stress
and anxiety
Cancer cure (back to original health)
Living healthy all through the life (without
disease)
Geriatric disorders - degenerative diseases
Early signs of various diseases
Diet and diseases
Treatment of cognitive impairment

13. CHOICE DICTATED BY - 1
Researchability – Tractable – Vaccine for obesity
Feasible – Sufficient resources available
(expertise, time, equipment, enough cases, and
facilities such as lab and radiological
investigations)
• How genes affect health
• Phase I clinical trial – 24-hour monitoring,
handling emergencies
Capability – Interest, caliber, skill (Do you know
enough about genomics)

14. CHOICE DICTATED BY – 2
Rational – Theoretical back-up
Reasons available or can be speculated –
biological plausibility (may emerge later) –
impact of highly processed food in children
Relevant – Useful – how will it contribute to improved
health – applicability
Ethical – No harm to anybody (no serious effects
anticipated, patient’s time, money,
convenience, pain, etc.)

15. TYPES OF RESEARCH QUESTIONS – 1
Questioning the existing practice – Dialysis in certain
complicated cases
Verification or refutation of a recent result
- vitamin K2 linked to hyper-glycemia
- epilepsy drugs causing birth defects
Extension to a new group or emerging diseases
- plasma therapy for CoViD
Modification – chemotherapy for certain cancer

16. TYPES OF RESEARCH QUESTIONS – 2
Descriptive – Incidence, course and outcomes in
septic shock in ICU cases
Analytical – Cause-effect (childhood weight gain for
adult disease) – Barker’s hypothesis
– Efficacy of a treatment modality (clinical
trials)
Diagnostic – Biomarkers for diagnosis of liver diseases
Prognostic – Prediction of outcome after cancer surgery
Models – Development of scoring systems
Statistical models for diagnosis and prognosis

17. R
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Possible Research Topics
(Universal) Knowledge limitation (Gaps in the knowledge)
Unknown magnitude of the problem (patients requiring dialysis)
Varying profile of cases (liver diseases)
Difficulty in managing a patient (non-responders)
Discomfort about the way the things are (lack of staff/facilities)
Presence of discrepancy (high BP feeling OK)
Two or more answers to the same question (medical/surgery)
New (modified) method
New drug/regimen/procedure/management
New surgery
New types of cases
Existing method – validation in local conditions
Doubt about its efficacy
Different age-group
Different population (obese, anaemic, diabetic, pregnant, etc.)
Do not re-invent the wheel

18. Refine
Improve the focus of your problem by
defining the subjects, condition,
population
Decide depth (how much detail you
would like) - correlates
Prepare broad and specific objectives
(measurable)