LEAH Research Seminar Series: Preparing for Research

1. LEAHResearch Seminar Series: Preparing for Research Cari McCarty, Ph.D. November 2, 2012

2. Outline The purpose of research questions Getting started: identifying your BIG questions Literature reviews Finding questions you can answer as a fellow Refining your research question Putting together your Team Assignment: define your research question

3. Goal of Research Questions A successful Research Question will specify and interest the reader in an important question your study will answer

4. Getting Started… Identify Your BIG Questions • Novel: Is there an important question you have not been able to find a good answer to? • Important: What do you think are the essential questions facing patients, clinicians, clinical leaders or policymakers? • Reading: research, reviews, reports & books (IOM) • Experts: meetings, phone, conferences • Your clinical discipline • Topic or methods experts

5. Wrong….DO think outside the box…

6. Case Study:From Big Questions to Literature Reviews BIG Questions • How do mental health and physical health problems intersect? Intermediate question(s) • Is drinking alcohol associated with poorer mental health? In what direction? • Still too general and big…. What kind of people? Where? In what setting? What level of drinking? More suitable to literature searches: • Does depression predispose adolescents to use alcohol or have alcohol-related problems?

7. Literature Reviews – Getting Started Choose & Set-up a Citation Management System Why? Saves your library of citations, inserts markers in your writing, formats your bibliography for different journals Which tools are used most frequently at UW? http://guides.lib.washington.edu/content.php?pid=69943&sid=518591

8. Citation Management Systems Refworks: free, great online “help”, web, transferable, no updates needed, tutorial and UW librarian support Zotero: free, saves your library on your local computer but allows you to sync, Endnote: many faculty use and like; costs; “updates” often pain Endnote Web: free, limited to 10,000 citations, can import citations from a bookmark

9. Literature Reviews: Librarians Meet with a Health Sciences Librarian • Write your research question(s) down • Identify the optimal librarian liaison http://www.lib.washington.edu/subject/librarians/ • Email him/her and set up a meeting (in person or phone); they are expecting you! • Meet with a librarian to refine your search

10. Literature Reviews Benefits of Standardized Literature Reviews • Research ideas: Gaps in literature, patterns in what has been examined • Publishing: Write a standardized literature review or an editorial • Save time when writing later: • Research manuscripts: intro & discussions; Tables when asked for (efficiency) • Grants: Significance and Background

11. Standardize Your Literature Reviews • Develop a Table/Form to Abstract Key Information • For a specific question and a specific search • Specify inclusion/exclusion criteria for articles • Author/year, Sample, Measures, Results, Notes • Start simple; add detail as specific use(s) becomes clear • What is it you want to know about the literature?

12. Case Study Research Questions for Literature Review • Is there an association between depression and alcohol use during adolescence? • Mixed findings, no consensus • Limited understanding of timing, sequence, severity, role of conduct problems

13. Case StudyResults of Standardized Review

14. Example 1: Studies on Depression as a Risk Factor for Alcohol Use

15. Example 2: Meta-Analysis of Treatment Studies for Youth Depression

16. Summary - Literature Reviews • Set up a reference Library: endnote or refworks • Meet with a librarian liaison: select from website • Standardize important literature reviews

17. Finding Questions You Can Answer Data Sources Fellows Have or Could Use • Literature reviews • Seattle investigators’, public health, & clinical data • Children’s Hospital, Harborview, VA, UW Schools of Medicine, Public Health, & Pharmacy, Fred Hutch Cancer Research Center; UW Institute for Health Metrics and Evaluation • Group Health Cooperative Center for Health Studies • Dept. of Public Health Seattle King County • Medic 1, Emergency data systems, etc.

18. Finding Questions You Can Answer Ask investigators: do they have data for important analyses they have not had time to do?

19. Finding Questions You Can Answer Data Sources Fellows have Used • Washington state data: Comprehensive Hospital Abstract Reporting System (CHARS), Medicaid data, prison data; death records. • National publicly available datasets: CDC Behavioral Risk Factor Surveillance Survey (BRFSS), National Health National Health and Nutrition Examination Survey (NHANES), AHRQ Healthcare Cost and Utilization Project (HCUP), Adolescent Health (ADD Health);

20. Finding Questions You Can Answer Data Sources Fellows have Used • Primary data collection • Surveys: physician, patient, or community surveys • Qualitative research: ethnography, focus groups, etc. • Instrument development (e.g. health literacy screen) • Find other data sources… • Specific trials or disease specific NIH datasets? • FDA? • Etc.

21. Finding Questions You Can Answer Tension between Ideal and Feasible • Feasibility • Access to data • Access to patients • Access to expertise • IRB and DUA approvals • Time • Budget • Ideal Research Question and Design • Interesting • Novel • Relevant • High internal validity • High external validity

22. SummaryFinding Questions You Can Answer • Literature reviews • Secondary data from both local and distant investigators • Local, state and federal datasets (non-VA and VA): administrative, clinical and public health • Primary data collection: surveys, qualitative, instrument development • Find other data sources…

23. Refining Your Research Question(s) Qualities of Strong Research Questions • Important and interesting: Check it out with your mentor and parents, spouse, friends, etc.

24. Does Your Question Interest Others?

25. Refining Your Research Question(s) Qualities of Strong Research Questions • Important and interesting: Check it out with your mentor and parents, spouse, friends, etc. • Clearly written, with unambiguous language: Does it mean to others what it means to you?

26. Is it Clear and Unambiguous?

27. Refining Your Research Question(s) Qualities of Strong Research Questions • Important and interesting: Check it out with your mentor and parents, spouse, friends, etc. • Clearly written, with unambiguous language: Does it mean to others what it means to you? • Specific enough to tell the reader what you’ll learn: Population? Exposure? Outcomes? Timeframes?

28. Research Questions Tensions in creating a a simple yet specific question in lay language • Specificity: Vague  Detailed • Length: Long  Short • Wording: Unclear  Excessive lingo

29. Refining Your Research Question(s) Qualities of Strong Research Questions • Imply a hypothesis: Can you phrase it “To determine or test whether “ ______ “? Does it imply the “directionality” of your hypothesis? • Ethical: If unsure, discuss it with the IRB • Answerable (by you): How sure are you that YOU can do the study that answers the question? What is your data source? Are you sure you can get the data? Do you have or can you recruit the needed expertise?

30. Refining Your Research Question(s) Summary • Have lots of other people review it • Have non-researchers review it • Re-review it yourself • Make sure the study you are doing answers it • Make sure you can do the study • Make sure the IRB approves

31. Choosing between Projects • Choosing between projects • Your interest • Feasibility • Educational value • Foundation for later work • Work with and learn from a specific mentor • Recommendation • Primary (passion) research question • Secondary (safer) research question (back-up thesis) • At least 1 quantitative study w/ multivariable analyses

32. Putting Together yourInterdisciplinary Study Team • Senior researcher from your own discipline: adolescent medicine, nursing, psychology, nutrition, social work, etc. • Topic expert(s): who knows your area • Methodologist +/or biostatistician: from start • Investigator who knows dataset • Other necessary expertise: clinical, analytic or design expertise?

33. Learning Many New Languages During fellowship you will consult with diverse experts (technology, IRB, data management, research design, data analysis, biostatistics, scientific writing, etc.) … each speaking a different language… Ask for help when you are unsure what is meant …

34. Summary • Identify your “big” questions • Focus them down to searchable questions • Review the literature – standardized tables • Write your RQ(s) • Find data or design a study to answer it • Put together your study team • Get lots of feedback from mentors at every stage

35. Optional AssignmentDevelop a Research Question Title and Study Team Background /significance Research question: feasible, interesting, novel, ethical, relevant