Episode 3 | Types of Research & Article Categories| A Med-Student’s Guide to Research! -By Kiran Abbas ’20
Before I start, I want to personally thank all of you for the appreciative response. Your positive response is helping me continue this guide – even if it means working at 3 AM in the morning! So, I strongly advocate you to bring on constructive criticism, genuine queries, and approving remarks.
As a naive ambitious student, I used to think, that research is some sort of inventory science where I would end up winning a Nobel prize for some huge discovery I made! However, this is far from the truth. Most of the time, researchers do not end up with significant results yielding unpublishable work. But, they never stop trying. Note that the three most important elements of success in health research are:
- being very patient with your research and with yourself.
- never giving up – no matter how disappointing the results are.
- keep striving – be persistent in whatever you do!
If you follow the above rules religiously, you’d forever end up with a positive outcome.
Before you can design your study. You’ll need to decide what type of study it will be and in which category will your article fall into!
In principle, medical research is classified into primary and secondary research.
These are the actual studies that are considered as original research. There are three main types of primary research: basic medical research, clinical research, and epidemiological research.
- Basic Medical Research or Experimental Research: It includes animal experiments, cell studies, biochemical, genetic and physiological investigations, and studies on the properties of drugs and materials. As a Pakistani MBBS student, it is highly unlikely that you’ll get an opportunity to work in a wet lab. Therefore, it is futile to talk about it right now. However, if you go abroad for Research Electives, you might find an opportunity to work in a wet lab. At this point, it is alright to just know the difference between a wet lab and a dry lab.
Wet labs are laboratories where chemicals, drugs or other biological matter are tested and analyzed. Whereas, dry lab are laboratories where computers are used for analysis. My personal experience is that of a dry lab where I worked with a child psychiatrist at John Hopkins University for two months. Working in any lab gets tiring, I guess it is because you are continuously working for over 10 hours a day without any break in between. I even used to go on Saturdays. I’d recommend if you guys do get a chance to work in any research lab, make sure you find time for relaxation or sightseeing.
- Clinical Research: This is the most suitable type of study for you, as a medical student. Clinical studies include both interventional studies and non-interventional studies. The interventional study includes drug trials* but can also include any study in which surgical, physical or psychotherapeutic procedures are investigated.
*A drug trial is done with the purpose of demonstrating the pharmacological effects of drugs, to establish side effects, or to investigate absorption, distribution, metabolism or elimination, with the aim of providing clear evidence of the efficacy or safety of the drug. Most of these type of studies are done by the pharmaceutical companies, introducing a new drug in the market and desire to establish the efficacy and potency of their drug.
In contrast, a non-interventional study is one in which subjects are merely observed and analyzed without any intrusion or intercession. A study is entitled as “non-interventional” when a patient takes regular medicine, prescribed according to the approved medical practice. In a non-interventional study, the researcher sets out to exert as little influence as possible on the patient’s condition while studying a medicine’s effectiveness, safety, and tolerability under real-life conditions. It includes therapeutic studies, prognostic studies, observational drug studies, secondary data analyses, case series, and case reports.
III. Epidemiological Research: This type of study is done to investigate the distribution pattern and historical changes in the frequency of diseases and the causes of these changes. It is further divided into experimental epidemiological study and observational epidemiological study.
In very simple terms, an experimental epidemiological study is like a drug trial that is done in a community setting instead of a controlled environment.
Example: “The investigation of the iodine supplementation of cooking salt to prevent cretinism in a region with iodine deficiency.” The researchers intervened in this study by adding iodine into the cooking salt and then recording any differences in prevalence of iodine deficiency between the experimental group and the control group. Note that, these type of studies involve a very specific target community based on its epidemiological, geographical, ethnic, or social uniqueness. Also, there is always a non-exposed group called “control” with which comparison is made.
Observational epidemiological studies include cohort studies (follow-up studies), case-control studies, cross-sectional studies (prevalence studies), and ecological studies (correlation studies). Majority of the students in their undergraduate years are advised to stick to this type of study.
The secondary research summarizes the findings of previous studies in the form of reviews and meta-analyses.
Now that you know what type of study you want to pursue, it will be a child’s play for you to categorize your article. Following are the article categories we will be discussing:
- Case Report
- Case Series
- Narrative review
- Systemic review
- Original article
- Letter to Editor
“A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin).” I recommend you to at least write 5 case reports and publish them during your undergraduate years. Instead of aimlessly and uselessly wandering through the JPMC wards, keep a vigilant eye for a mind-boggling case.
Always note and record the unusual…Publish it. Place it on permanent record as a short, concise note. Such communications are always of value.
– Sir William Osler
A case report is a powerful tool to disseminate information on unusual clinical syndromes, disease associations, unusual side effects to therapy, or response to treatment.
An example of a rare case report is given below. Give it a read to get an idea.
“A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment.”
An example of a rare case series is given below. Give it a read to get an idea.
“A method often used to combine results from several studies of the same statistical test, treatment or other intervention to estimate the overall effect of the treatment.”
An example of a meta-analysis is given below. Give it a read to get an idea.
“A systematic review summarises the results of available carefully designed healthcare studies (controlled trials) and provides a high level of evidence on the effectiveness of healthcare interventions. Judgments may be made about the evidence and inform recommendations for healthcare.”
“Narrative reviews are aimed at identifying and summarizing what has been previously published, avoiding duplicates, and seeking new study areas not yet addressed.”
This is the first review I wrote back in the second year, please do give it a read. Your feedback is always welcome. https://journals.lww.com/ijsoncology/Fulltext/2018/03000/Evaluation_of_different_treatment_and_management.2.aspx
A manuscript will be considered in the original article category if it is a randomized controlled trial, a single or a multi-center study.
Following is a link to the first original article I was a part of https://jpma.org.pk/article-details/9206
A research article may include knowledge, attitude, and practice (KAP) studies, survey reports, pilot studies, innovation, laboratory research or diagnostic studies, or education research. They can be a single center or small multi-center studies.
Hope you guys are ready to start off with a research project now. Next time, we will be talking about the literature review.