As you start to develop your research question, it is essential to do a literature search.1
Searching the literature at the earliest stages of your project can help:
1. Polgar S. Introduction To Research In The Health Sciences. 6th ed. Churchill Livingstone;2013.
2. Efron SE, Ravid R. Writing The Literature Review: A Practical Guide. 1st ed. Guilford Press;2019.
Designing Clinical Research
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Introduction to Research in the Health Sciences, 7e
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Introduction to Research in the Health Sciences, 6e
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Writing the Literature Review
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There are three main types of scientific literature: primary, secondary, and tertiary. See our Evidence-Based Medicine guide for where to find these different literature types.
| Strengths | Limitations | |
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Primary (e.g., clinical studies, abstracts/proceedings, theses/dissertations, patents, etc.) |
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Secondary (e.g., PubMed, Google Scholar, etc.) |
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Tertiary (e.g., guidelines, review articles, compendia, textbooks, package inserts, etc.) |
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Below are a few databases where you can start your search for information. A librarian can help you identify additional sources and assist in the development of search strategies. You can also review our Evidence-Based Medicine guide for where to find different types of scientific literature.
PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include free full-text content from PubMed Central and publisher Web sites.
EMBASE is a comprehensive biomedical database that specializes in drug-related and pharmacological research. It provides access to a wide range of journals and conference abstracts, many of which are not available in other databases like PubMed. EMBASE covers international literature on biomedicine, including the allied health fields, with strong focus on drug action, toxicity, clinical trials, and medical devices. It's an invaluable resource for healthcare professionals, researchers, and medical librarians, particularly useful for systematic reviews and developing clinical guidelines. The database includes unique non-English content and deep indexing that allows users to perform highly detailed searches.
PICO is a framework for developing clinical questions, also known as foreground questions, which is an important step in the evidence based medicine cycle. It can help you:
UNC Health Sciences Library notes three limitations to PICO: it privileges interventions, experimental research, and dominant voices.1
A recent review identified more than 38 question frameworks,2 including PICO, that are used to format research and clinical questions.
The CHSU Health Sciences Library team is happy to assist you with crafting a searching strategy.
1. https://guides.lib.unc.edu/pico/about
2. Booth A, Noyes J, Flemming K, Moore G, Tunçalp Ö, Shakibazadeh E. Formulating questions to explore complex interventions within qualitative evidence synthesis. BMJ Glob Health. 2019;4(Suppl 1):e001107. doi:10.1136/bmjgh-2018-001107
Both quality improvement (QI) and research projects are published.
What is the difference between them? The Chilidren's Hospital of Philadelphia Research Institute1 outlines key differences between research and quality improvement.
| Human Subjects Research | Quality Improvement | |
|---|---|---|
| Purpose | Designed to develop or contribute to generalizable knowledge | Designed to implement knowledge, assess a process or program as judged by established/accepted standards |
| Starting Point | Knowledge-seeking is independent of routine care and intended to answer a question or test a hypothesis | Knowledge-seeking is integral to ongoing management system for delivering health care |
| Design | Follows a rigid protocol that remains unchanged throughout the research | Adaptive, iterative design |
| Benefits | Might or might not benefit current subjects; intended to benefit future patients | Directly benefits a process, system or program; might or might not benefit patients |
| Risks | May put subjects at risk | Does not increase risk to patients, with exception of possible patients' privacy or confidentialty of data |
| Participant Obligation | No obligation of individuals to participate | Responsibility to participate as component of care |
| Endpoint | Answer a research question | Improve a program, process or system |
| Analysis | Statistically prove or disprove hypothesis | Compare program, process or system to established standards |
| Adoption of Results | Little urgency to disseminate results quickly | Results rapidly adopted into local care delivery |
| Publication/Presentation | Investigator obliged to share results | QI practitioners encouraged to share systematic reporting of insights |
1. https://irb.research.chop.edu/quality-improvement-vs-research
A hypothesis is an educated guess to help answer the research question(s). It is a clear, concise, and focused statement (NOT a question) of the anticipated results you predict will be demonstrated through the research method. E.g., "If I do X, then Y will result;" or “We hypothesize…”
A SMART Aim is an explicit statement that describes what a team hopes to achieve over a specific amount of time including the magnitude of change that will be achieved. SMART stands for Specific, Measurable, Attainable, Realistic, and Timely. E.g., By May 2023, there will be a 50% in clinic patients with hypertension participating in the home blood pressure monitoring program."
There are many different research designs or methodologies, some of which require IRB approval. Medical research can be primary (experimental or observational studies) or secondary (literature reviews).
Each study type has strengths and limitations to consider before starting a research project.
Graphic created by Katie Hoskins. CC-BY-NC.
Graphic created by Katie Hoskins. CC-BY-NC.
Graphic created by Katie Hoskins. CC-BY-NC.
Graphic created by Katie Hoskins. CC-BY-NC.
The Institutional Review Board (IRB) submission process can feel opaque and overwhelming – but it doesn’t have to be! Learn from an IRB member more about how the IRB works, what the IRB is looking for when reviewing your application, how the IRB can be an unexpected ally in the research process, and common mistakes that will stall your submission. Presented by: Kelli Hines, MLIS Western University of Health Sciences.
For questions about the IRB process at CHSU, please contact Ruchi Rawal, Director of the Office of Sponsored Research and IRB Human Subject Research Compliance Officer.
The following examples are not necessarily co-written by student doctors, but these are general ideas that may be feasible during your time at CHSU.
Examine popular websites on a specific topic/condition
Examine reading level of publicly available materials on a specific topic/condition
Examine quality of top YouTube videos on a specific topic/condition
Conduct quantitative analysis using publicly available data
Consider using critical appraisal worksheets to evaluate articles and recording your notes on an evidence analysis log if doing a literature review.
See the slides below for an overview of different article types, including their strengths and weaknesses, along with an introduction to the hierarchy of evidence. This is an important consideration when appraising the evidence, which is the third step in the evidence-based practice cycle (see our EBM/EBP Guide for more information).
Some of our Scholarly Snippets webinars review biostatistical concepts needed for critical appraisal. The playlist embedded below is titled "Evaluating Resources and Statistics."
The Health Sciences Library has electronic and print books on biostatistical concepts and evidence-based practice. Here are some of the books that may be helpful:
Jekel's Epidemiology, Biostatistics, Preventive Medicine, and Public Health, 5e
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How to Read a Paper
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Users' Guide to the Medical Literature
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Studying a Study and Testing a Test
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Basic & Clinical Biostatistics, 5e
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In January 2023, the NIH Policy on Data Management and Sharing (DMSP) went into effect for all grant applications. Other organizations and publishers may enact similar policies, but having a DMSP is a good practice even if it's not required by a funder or publisher.
The following resources were created or curated by the Working Group on NIH DMSP Guidance:
