Identifying a topic

The hardest part of research is to come up with a good idea. It appears that all the best trials have already been completed, but a careful consideration of scientific support for surgical action reveals deficiencies in surgical knowledge. Facts commonly taken for granted often have no basis. The best research often answers the simplest question. Once an idea has been formed, or a question asked, it needs transforming into a hypothesis. It is helpful to approach surgeons who regularly publish research articles and who have a special interest in the surgical area being considered. As ideas are suggested, keep thinking whether the question posed by the proposed research really matters. Spend some time refining the question because this is probably the most important part of research. Choosing the wrong topic at this stage can lead to many wasted hours.

Once a topic has been identified do not rush into the study. It is worth spending a considerable time investigating the subject in question. The worst possible thing is to find at the end of a long arduous study that the research has already been done.

First port of call for information is the medical library. Avoid textbooks, as most are out of date as soon as they are published. Look for current articles about the proposed research; review articles and meta-analyses can be particularly helpful. At this stage most clinicians go to an electronic library and perform a database search. It is very important to learn how to do an accurate and efficient search as early as possible. Details are beyond the scope of this chapter, but most librarians will help out if a little interest and enthusiasm is shown. Current techniques involve searching on Medline or other collected databases but as electronic information advances and the worldwide web becomes more user-friendly new search strategies may emerge. Collections of reviews are becoming available — the Cochrane Collaboration brings together evidence-based medical information and is available in most libraries (Table 72.1).

Once a stack of articles on the subject has been obtained it is important that these are carefully perused. If the proposed research project is still looking good after some thorough reading it is worth further discussion with experts. Do not be afraid to contact authors who have written a paper on a similar subject. All scientists are flattered by interest in their work and most will not pilfer your ideas.

Now it should be possible to start to plan the research project. During the first phase it is very important to keep in the mind the following questions.

Why do the study?

Will it answer a useful question?

Is it practical?

Can it be accomplished in the available time and with available resources?

What findings are expected?

What impact will it have?