Knowledge comes only to the prepared mind and what the mind does not know, the eyes do not see. These are two well known aphorisms which are seemingly contradictory. In fact, our sense organs continuously feed the mind with data, which is constantly being analyzed, stored and expressed. When a new fact is observed, the inquisitive mind starts asking how? Why? And thus a problem is born. The pursuit of a better understanding of facts and phenomenon around us in order to discover or revise facts is called Research. In recent times, research in a subject or a problem has become the keyword of all scientific endeavor.
It has been repeatedly shown in many jurisdictions that a close relationship exists between the quality of a nation's health services and its medical research programs. Health care is critically dependent upon the introduction of new concepts and technology and upon the availability within the health care system of a capability to evaluate, adopt and wisely distribute new resources.
Stagnation of traditional forms of medicine is attributable to the absence of a research spirit amongst its practitioners. Without research, modern medicine will also lose its pre-eminent position and will lapse into a closed and stagnating system. In that sense, research is comparable to the biological phenomenon of reproduction and adaptability.
Research aims at bringing to light facts hitherto unknown or not clearly envisaged. It clarifies and illumines the connection between facts which had not been perceived earlier or if perceived, were perceived wrongly. It is an urge, just as art or literature to bring obscure facts into the foreground.
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Many people hold the view that all research is a waste of time. This is a misconception of the purpose of research. Of course, all research is trivial if measured by its contribution to public useable knowledge. Few people are destined to be Nobel prize winners or to make a lasting contribution to the sum of public knowledge. Evaluating research efforts by that yardstick is going to prove futile. Research should be perceived as an intellectual activity which enlivens and enriches practice.
Yet another way to view research is to visualize it as a means of systematic problem solving. After a problem has been identified, you try to explain its occurrence in view of known facts and offer a hypothesis to fill gaps in the existing body of knowledge. Then you collect data and analyze it to accept or reject your hypothesis. If you accept the hypothesis, you try to apply it to the next problem and this helps in the generation of new knowledge.
Research in the form of thesis work has been made an integral part of postgraduate medical training in our country and to our mind, the basic purpose of this endeavor is to train you in systematic problem solving. To elaborate further, the objectives of thesis as part of post graduate medical training are to enable you to:
- Identify a researchable problem
- State a hypothesis,
- Collect data related to the problem,
- Analyze the data,
- Make interpretations
- Scientifically write and present the report of your work and
- Help in the advancement of knowledge.
Additionally, if the thesis work is written in the form of a scientific paper and presented or published in reputed organizations, it gives you recognition and may sometimes help you in career advancement.
As already stated, most of the topics, on which a postgraduate student conduct research may not be ‘Original’ but the steps involved in solving a given problem – old or new – will help to train your mind in adopting a scientific approach when faced with any problem in your later life. In other words, thesis exposes you to the world of medical uncertainties and stimulates you to look the clinical problems in a scientific way.
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However, often the PG thesis is reduced to a mere formality – it is seen as a passport to enable a student to appear for his examination. To a great extent, this attitude stems from a lack of awareness in research methodology. Often a topic is given to the student who collects some data on it. At the end of this, he is sent to a statistician ‘to calculate p value and find the significance’. Depending on the calculations thus made, the results are written down and a thesis is submitted. The students (and often the supervisor) demonstrate a total lack of understanding of the concept of data analysis.
The present book has been written with this objective in mind. It deals with basic concepts of the subject omitting out the unnecessary details. We are confident that the style of presentation will attract your attention and motivate you to learn the basic principles of research methodology. The book will be equally useful to not only PG students but also to practitioners of medicine in general.
The extent of statistical knowledge and skills that you need to know will vary depending upon the subject area and health care delivery system – however there is a core area of ‘must know’ contents and it is this area that we have primarily addressed. Before we go over the methodology, we would like you to know that all aspects of diagnosis and prognosis are very closely related to the rule of probability. If you approach your thesis with this perspective, you will find it an extremely challenging source of knowledge which promotes ‘learning by doing’. It will emerge as a unique learning experience, the benefits of which you will reap in your day to day practice.