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CONTINUING MEDICAL EDUCATION FORMATION MÉDICALE CONTINUE

PRACTICAL TIPS FOR SURGICAL RESEARCH

Research questions, hypotheses and objectives
Patricia Farrugia, BScN* Bradley A. Petrisor, MSc, MD† Forough Farrokhyar, MPhil, PhD‡§ Mohit Bhandari, MD, MSc†§ From the *Michael G. DeGroote School of Medicine, the †Division of Orthopaedic Surgery and the Departments of ‡Surgery and §Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. Accepted for publication Jan. 27, 2009 Correspondance to: Dr. M. Bhandari 293 Wellington St. N, Ste. 110 Division of Orthopaedic Surgery McMaster University Hamilton ON L8L 2X2 bhandam@mcmaster.ca

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here is an increasing familiarity with the principles of evidence-based medicine in the surgical community. As surgeons become more aware of the hierarchy of evidence, grades of recommendations and the principles of critical appraisal, they develop an increasing familiarity with research design. Surgeons and clinicians are looking more and more to the literature and clinical trials to guide their practice; as such, it is becoming a responsibility of the clinical research community to attempt to answer questions that are not only well thought out but also clinically relevant. The development of the research question, including a supportive hypothesis and objectives, is a necessary key step in producing clinically relevant results to be used in evidencebased practice. A well-defined and specific research question is more likely to help guide us in making decisions about study design and population and sub1 sequently what data will be collected and analyzed.

OBJECTIVES OF THIS ARTICLE
In this article, we discuss important considerations in the development of a research question and hypothesis and in defining objectives for research. By the end of this article, the reader will be able to appreciate the significance of constructing a good research question and developing hypotheses and research objectives for the successful design of a research study. The following article is divided into 3 sections: research question, research hypothesis and research objectives.

RESEARCH QUESTION
Interest in a particular topic usually begins the research process, but it is the familiarity with the subject that helps define an appropriate research question for a study.1 Questions then arise out of a perceived knowledge deficit within a subject area or field of study.2 Indeed, Haynes suggests that it is important to know “where the boundary between current knowledge and ignorance lies.”1 The challenge in developing an appropriate research question is in determining which clinical uncertainties could or should be studied and also rationalizing the need for their investigation. Increasing one’s knowledge about the subject of interest can be accomplished in many ways. Appropriate methods include systematically searching the literature, in-depth interviews and focus groups with patients (and proxies) and interviews with experts in the field. In addition, awareness of current trends and technological advances can assist with the development of research questions.2 It is imperative to understand what has been studied about a topic to date in order to further the knowledge that has been previously gathered on a topic. Indeed, some granting institutions (e.g., Canadian Institute for Health Research) encourage applicants to conduct a systematic review of the available evidence if a recent review does not already exist and preferably a pilot or feasibility study before applying for a grant for a full trial. 278

J can chir, Vol. 53, N 4, août 2010
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© 2010 Association médicale canadienne

CONTINUING MEDICAL EDUCATION

In-depth knowledge about a subject may generate a number of questions. It then becomes necessary to ask whether these questions can be answered through one study or if more than one study needed. 1 Additional research questions can be developed, but several basic...
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