conducting successful em resident research : generating research ideas and hypotheses
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Conducting Successful EM Resident Research : Generating Research Ideas and Hypotheses. 2008 UIC Research Course UIC EM Residency Program Chicago, IL September 25, 2008. - PowerPoint PPT PresentationTRANSCRIPT
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Edward P. Sloan, MD, MPH, FACEP
Conducting Successful EM Resident Research:
Generating Research Ideas and Hypotheses
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Edward P. Sloan, MD, MPH, FACEP
2008 UIC Research Course
UIC EM Residency ProgramChicago, IL
September 25, 2008
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Edward P. Sloan, MD, MPH, FACEP
Edward P. Sloan, MD, MPH FACEP
Professor
Department of Emergency MedicineUniversity of Illinois College of Medicine
Chicago, IL
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Edward P. Sloan, MD, MPH, FACEP
Attending PhysicianEmergency Medicine
University of Illinois Hospital
Chicago, IL
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Edward P. Sloan, MD, MPH, FACEP
Disclosures• FERNE Chairman and President
• ACEP Clinical Policy Committee
• ACEP Scientific Review Committee
• No individual financial disclosures
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Edward P. Sloan, MD, MPH, FACEP
Background to a Research Project
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Edward P. Sloan, MD, MPH, FACEP
Physician
A Doctor of Medicine
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Edward P. Sloan, MD, MPH, FACEP
Why Conduct Research?
• Curiosity.• Improve Patient Care.• Improve medical education.• Make clinical practice more
interesting.• Career enhancement.• Stay employed.
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Edward P. Sloan, MD, MPH, FACEP
Research
Scholarly or scientific investigation or inquiry.
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Edward P. Sloan, MD, MPH, FACEP
Study
Research, detailed examination, and/or analysis of an organism,
object or phenomena.
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Edward P. Sloan, MD, MPH, FACEP
What do we as physicians do?
• Prevent disease.• Diagnose disease.• Treat disease.• Research to prevent further disease.• Do no harm.• Improve public health.• Improve the healthcare system.• Educate young physicians.
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Edward P. Sloan, MD, MPH, FACEP
So what can we research?
• Epidemiology.• Diagnostic tests.• Disease treatment.• Lifestyle vs. disease.• Iatrogenic disease.• Public health.• Cost, quality, and access.• Physician education.
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Edward P. Sloan, MD, MPH, FACEP
The Research Perspective
• CIA model.
• Information control.
• Analyzing the past.
• Predicting the future.
• Shaping the future.
• Ball bearing factory model.
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Edward P. Sloan, MD, MPH, FACEP
A “Realistic” Approach
• Nothing is as it seems.
• Slow and steady wins.
• Build one brick at a time.
• All work is flawed.
• All work has value.
• The Walkman model.
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Edward P. Sloan, MD, MPH, FACEP
A “Realistic” Approach
• What to study? What they’ll pay for.
• Work with the end product in mind.
• Thinking like a researcher.
• Feeling it in your gut.
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Edward P. Sloan, MD, MPH, FACEP
Developing a Research Idea and Hypothesis for Study
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Edward P. Sloan, MD, MPH, FACEP
Idea Development
Objective: To find simple answers to important questions.
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Edward P. Sloan, MD, MPH, FACEP
Idea Development
• Question what others do.
• Question the medical literature.
• Do a quick chart review.
• Review the literature.
• Ask the hard questions early.
• Clarify the question.
• Propose a simple answer.
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Edward P. Sloan, MD, MPH, FACEP
Reviewing the Literature
• Be critical and systematic.
• Go to the best articles, use their references.
• Use the Index Medicus.
• Do a computer search.
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Edward P. Sloan, MD, MPH, FACEP
Hypothesis
A supposition put forth based on the known facts… which serves
as a starting point for further investigation… so that the true
theory can be established.
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Edward P. Sloan, MD, MPH, FACEP
Null Hypothesis
The hypothesis to be tested, denoted by Ho.
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Edward P. Sloan, MD, MPH, FACEP
Alternative Hypothesis
The hypothesis accepted when the null hypothesis is rejected,
denoted by Ha.
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Edward P. Sloan, MD, MPH, FACEP
Hypothesis Testing
The process of providing evidence for accepting or rejecting the null
hypothesis (Ho).
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Edward P. Sloan, MD, MPH, FACEP
Hypothesis Development
Objective: To clearly state what is being proven and disproved by
the research.
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Edward P. Sloan, MD, MPH, FACEP
Alternate Hypothesis (Ha) Development
Objective: To clearly state the quantifiable difference between
two groups that the research will study.
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Edward P. Sloan, MD, MPH, FACEP
Epidemiology:Head Injuries in Bicyclists
• Bad: Head injuries are on the rise
• Good: 1990 head injuries are 5x>than 1980
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Edward P. Sloan, MD, MPH, FACEP
Diagnostics:Pulse Oximetry in
Pulmonary Embolism
• Bad: Low pulse ox readings suggest PE
• Good: Patients with a pulse ox value <90 have a 4x higher PE rate than those >90
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Edward P. Sloan, MD, MPH, FACEP
Treatment:Acute Asthma and
Aminophylline
• Bad: Aminophylline helps in acute asthma
• Good: Patients who receive IV aminophylline have a 25% lower admission rate than those without
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Edward P. Sloan, MD, MPH, FACEP
Lifestyle:Cigarettes and Pulmonary
Disease
• Bad: Cigs cause kids to have pulmonary disease
• Good: ED visits for URI’s are 2x higher in kids whose parents smoke than those who do not
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Edward P. Sloan, MD, MPH, FACEP
Iatrogenic:Central Catheters and
Pneumothorax
• Bad: Catheter ABC causes pneumothoraces
• Good: Rates of complication using catheter XYZ are 2x lower than rates using other catheters
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Edward P. Sloan, MD, MPH, FACEP
Public Health:Conflict Resolution &
Violence
• Bad: Conflict resolution will prevent violence
• Good: School-taught conflict resolution will decrease urban teen deaths by 25% in 3 years
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Edward P. Sloan, MD, MPH, FACEP
Cost:Abdominal Stab Wound
Management
• Bad: Observation is cheaper than laprotomy
• Good: Patients observed have a similar outcome with a 50% reduction in medical costs
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Edward P. Sloan, MD, MPH, FACEP
Medical Education:USMLE and Grading
Frequency
• Bad: USMLE scores improve as grading frequency increases
• Good: Changing from semi-annual testing to bi-monthly testing improves USMLE I scores > 50pts
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Edward P. Sloan, MD, MPH, FACEP
Conclusions
• Develop hypothesis that are specific.
• Used numbers to quantify change.
• Base change on specific intervention.
• Address the health of the public.
• Relate hypotheses to ways in which to improve the health of the public.
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Edward P. Sloan, MD, MPH, FACEP
Conclusions
• Do research to impact pt care.
• Improve your own clinical practice.
• Find relevant issues.
• Ask interesting questions.
• Answer the questions.
• Move on.
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Edward P. Sloan, MD, MPH, FACEP
Thank you.
[email protected] 413 7490
ferne_2008_research_lecture_sloan_research_hypotheses_092508_final04/21/23 03:36