Research protocol writting

D
Dawal SalveResident Medical Officer(Community Medicine)
L-9:Writing research protocol 
Presented by: Dr.Dawal S. Salve. 
PG student MD(Community medicine) 
Activity guide: Dr. N.R.Aswar MD(PSM). 
Associate Professor. 
DR.S.C.G.M.C.Nanded. 
Date:04/10/12
L-9:Writing research protocol 
Components of a research protocol 
Title and abstract 
Introduction, aims and objective 
Context-review of relevant literature 
Methodology-research question, study design, description of 
methodology, plan of analysis 
References- Citation, Citing styles, citing journals, books, internet 
references.
What is research? 
• Research is the systematic collection, analysis 
and interpretation of data to answer a certain 
question or solve a problem
Why a protocol? 
To clarify the 
research 
question 
To compile 
existing 
knowledge 
To formulate a 
hypothesis and 
objectives 
To decide about 
a study design 
To clarify 
ethical 
considerations 
To apply for 
funding 
To have a 
guideline and 
tool for the 
research team
How to judge well-thought out and well-written 
protocol? 
Is it adequate to answer the research 
question(s)and achieve the study 
objective? 
Is it feasible in the particular set-up for 
the study? 
Does it provide enough detail that can 
allow another investigator to do the study 
and arrive at comparable conclusions?
Content of the protocol 
• Project title 
• Project summary 
• Project description: 
− Rationale 
− Objectives 
− Methodology 
− Data management and analysis 
• Ethical considerations 
• Gender issues 
• References
Project Title 
• Accurate, short, concise 
• Descriptive: should make the main objective 
clear, should mention the target population 
• Key words: should contain key words for 
referencing 
– i.e. „Anemia in hiv infected ANC“ 
– Better: „prevalence of anemia among 
HIV infected ANC attending ICTC centre Nanded.“
• Concise, one page (about 300 words) 
• Stands on its own – no reference to protocol 
content 
• Summarizes central elements (rationale, 
methodology, populations, time frame, expected 
outcomes)
Statement of the problem 
• Why …is the research needed? 
• What …is the relevance of the results? 
Logical flow of statements: 
Magnitude, frequency, and distribution: Affected geographical areas and 
population groups. Ethnic and gender considerations. 
Probable causes of the problem: What is the current knowledge of the 
problem and its causes? Is there consensus? Is there controversy? Is there 
conclusive evidence? 
Possible solutions: In what ways have solutions to the problem been 
attempted? What has been proposed? What are the results? 
Unanswered questions: What remains to be answered? What areas have not 
been possible to understand, determine, verify, or test?
Statement of the problem 
Literature review 
• Prevents duplication of work, which has been 
done 
• Clarifies, what others have found addressing the 
problem 
• Familiarizes with potential methodologies and 
methodological errors 
• Should convince, that the research is needed!
Justification of research 
Should be a convincing statement for the need to do 
this research 
• How does the research relate to the priorities of 
the region and the country? 
• What knowledge and information will be 
obtained? 
• What is the ultimate purpose that the knowledge 
obtained from the study will serve? 
• How will the results be disseminated? 
• How will the results be used, and who will be the 
beneficiaries?
Research hypothesis 
Independent 
variable 
• Describes the relationship between INDEPENDENT 
variables (risk factors, predisposing factors) and 
DEPENDENT variables (outcome) 
• Determines the type of data to be collected and the 
type of analysis to be conducted 
Dependent 
variable 
Intervention, 
Observation, Control 
variable 
Make clear 
statements!
Research objectives 
• Simple 
• Specific 
• Stated in advance.
Research objectives 
Define a GENERAL OBJECTIVE and derive SPECIFIC 
OBJECTIVES 
The formulation of objectives will help to: 
• Focus the study (narrowing it down to essentials) 
• Avoid the collection of data which are not strictly 
necessary for understanding and solving the 
problem you have identified 
• Organize the study in clearly defined parts or phases
Research objectives 
Objectives should be: 
• Logical and coherent 
• Feasible 
• Realistic, considering local conditions 
• Defined in operational terms that can be 
measured 
• Phrased to clearly meet the purpose of the study 
(relevant) 
Objectives should be stated in action verbs that illustrate their purpose: 
i.e. “To determine…, To compare..., To verify..., To calculate...,To reduce..., To describe..., 
etc.
Methodology 
Important aspect of the protocol 
• Assures, that the hypothesis will be proved or 
disproved, using the right tools 
• Presents a detailed strategy, how the objectives 
are achieved 
Consider 
• operational definitions 
• study design 
• definition of variables 
• sample size 
• ethical aspects
Methodology 
Study design 
• The decision on study design needs to be based 
on ethics, logistic consideration, economic 
aspects and scientific thoroughness. 
• The validity of the results including potential bias 
and confounding and the generalizability of the 
results needs to be a prime concern defining the 
study design. 
• A causal relationship between exposure and 
outcome can be best established in a Clinical 
trial 
– > Cohort study > Case - control study > Cross-sectional 
study > Ecological study
Methodology 
Study design 
Interventional study Observational study 
Clinical trial Cohort study 
Cross-sectional study 
Case – control study 
Ecological study
Methodology 
Definition of variables
Methodology 
Measurement of observations 
• Describe how, when and where the observations 
are made? Describe instruments used! 
– Questionaire (attach to the protocol) 
– Type of interview (describe structure of the interview) 
– Laboratory test (refer to literature or personal 
knowledge, if established test, or describe in detail, if 
not established) 
– Clinical examinations (describe gadget/procedure) 
Describe all instruments or refer to literature if tools are established. 
(for intervention studies or drug trials refer to specific literature/regulations)
Methodology 
Subjects/ participants 
Depending on the type of study, answer the 
following questions: 
•What are the criteria for inclusion or selection? 
•What are the criteria for exclusion? 
•In intervention studies, how will subjects be 
allocated to index and comparison groups 
(Randomization procedure)? 
•What are the criteria for discontinuation?
Methodology 
Data quality control 
• Describe measures of data quality control: 
– Double data entry 
– Consistancy checking 
– Data monitor 
– Verfication procedures of source data 
– Interrater variability measurements
Methodology 
Sample size 
• Sample size calculation is recommeded for 
economical and ethical reasons 
• Simple statistical packages in the internet 
• Level of error, power and expected impact 
of exposure on outcome have to be set
Methodology 
(Intervention) 
If applicable, describe: 
• Who will be responsible for the 
intervention? 
• Where will it take place? 
• What activities will be performed, and 
with what frequency and intensity?
Ethical considerations 
One of the most important aspects of biomedical 
research! 
Ask local ethics committee for advice! 
Important aspects to consider: 
• Data safety / confidentiality 
• Any possibly harm/ side effects/ consequences 
• Right of discontinuation at any time 
• Role of data safety and monitoring board (in trials) 
• Alternative treatments/ approaches (in trials) 
• Incentives/ Rewards
Ethical considerations 
Informed consent 
Outline how, when and where the patient will be 
consented! 
Information form should contain: 
• Justification for research 
• Responsibilities (Who) 
• Outline of study 
• Risks 
• Insurance 
• Confidentiality (legal framework) 
• Voluntary participation 
• A separate consent form is required! 
Simple language! 
Patients mother tongue!
Ethical considerations 
Ethics checklist 
• Should answer potential questions regarding the 
ethics 
• Should discuss pros and cons of research design, 
selection of subject, measurement and outcome 
assessment. 
• Should discuss the advantages and 
disadvantages of the subject or communities 
involved 
• Should discuss physical, social and psychological 
implications of the research 
• Should discuss confidentiality
Data management and analysis 
Based on objectives consider: 
• Coding for variables/ type of variables 
• Analysis plan depending on type of variables 
• Statistical tests implicated 
• (Style of presentation i.e. tables, graphs) 
• Data safety and storage
References/Bibliography 
• Use of standard referencing system: 
– Harvard style 
• Name and publication year in text 
• Alphabetical bibliography 
– Vancouver style 
• Numbered references 
• Continous referencing in text 
• Make use of software 
– Reference Manager 
– Endnote software 
See also „A Pratical Guide for Health Researchers“
Definitions 
• Citing – this is the process of formal recognition, 
within your text, of the resources from which you 
have gathered your information 
• A Citation – this is a passage or phrase quoted 
within your text which is supported with evidence 
of its source 
• Bibliography – a list of the sources that you have 
used 
• Reference – a detailed description of the item 
from which you have obtained your information 
Version 1.0 
Copyright 
© 2009 AQA and its
What is the Harvard System? 
• Developed in the USA 
• Most common system in use 
internationally 
• A flexible, simple, clear system both for 
author and reader 
• References are listed alphabetically in the 
bibliography and cited in the body of the 
text so no footnotes or chapter references 
needed
What is the Vancouver Referencing Style? 
It is a uniform set of requirements for 
bibliographic references. 
It is a "numbered" style. 
It follows rules established by the International 
Committee of Medical Journal Editors. 
It is also known as: Uniform Requirements for 
Manuscripts submitted to Biomedical Journals.
How to do in-text citations 
 A number is assigned to each reference as it is cited 
- in brackets [ ] ( ) or superscript.1 
 If the source is referred to again, the same number is 
used. 
Example:...as one author has put it "the darkest days 
were still ahead" [1]: which is well documented in the 
literature. [2-5] This proves that "the darkest days were 
still ahead". [1]
How to create a Reference List 
 Reference list should appear at the end of the assignment / report. 
 Entries are listed numerically and in the same order that they were 
cited in the text. 
Example: 
1. Baker PN, editor. Obstetrics by ten teachers. 18th ed. London: 
Hodder Arnold; 2006. 
2. Delbridge ML, Harry JL, Toder R. A human candidate 
spermatogenesis gene, RBM1, is conserved and amplified on 
marsupial Y chromosome. Nat Genet. 1997; 15: 131-136.
Work plan 
Who? 
Tasks 
When? 
Where?
Budget 
The budget should be broken down by: 
• Items 
– Personnel 
– Consumables, equipment, supplies, 
communication, funds for patients, data 
processing 
• Budget justification 
– Jusitify the use of each item, considering the 
workplan of the study
Annexes 
• Case Record Forms (CRFs) 
• Questionaires 
• Patient information form (in required 
languages) 
• Consent form (in required languages) 
• CV of investigators
PAHO 2004
Research protocol writting
Methodology 
• Research design: 
• Research subjects or participants: 
• Interventions: drugs or devices. 
• Observations: 
• Sample size:
Ethical considerations 
• Approval by ethics review committees: 
• Informed decision-making: 
Consent form: 
A) A statement describing the study and the nature of the subject’s 
involvement in it; and 
b) A certificate of consent attesting to the subject’s consent. 
• Ethics checklist 
.
Questionnaire Design 
•Review of data source and data collection 
•Instruments for data collection 
•Questionnaire as a tool for data collection tool-types, strengths and 
limitations 
•Principles of questionnaire design-purpose, type of information, wording 
the questions, response rate and rating scales 
•Questionnaire Administration-prevalidation,response rate, reliability and 
validity
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Research protocol writting

  • 1. L-9:Writing research protocol Presented by: Dr.Dawal S. Salve. PG student MD(Community medicine) Activity guide: Dr. N.R.Aswar MD(PSM). Associate Professor. DR.S.C.G.M.C.Nanded. Date:04/10/12
  • 2. L-9:Writing research protocol Components of a research protocol Title and abstract Introduction, aims and objective Context-review of relevant literature Methodology-research question, study design, description of methodology, plan of analysis References- Citation, Citing styles, citing journals, books, internet references.
  • 3. What is research? • Research is the systematic collection, analysis and interpretation of data to answer a certain question or solve a problem
  • 4. Why a protocol? To clarify the research question To compile existing knowledge To formulate a hypothesis and objectives To decide about a study design To clarify ethical considerations To apply for funding To have a guideline and tool for the research team
  • 5. How to judge well-thought out and well-written protocol? Is it adequate to answer the research question(s)and achieve the study objective? Is it feasible in the particular set-up for the study? Does it provide enough detail that can allow another investigator to do the study and arrive at comparable conclusions?
  • 6. Content of the protocol • Project title • Project summary • Project description: − Rationale − Objectives − Methodology − Data management and analysis • Ethical considerations • Gender issues • References
  • 7. Project Title • Accurate, short, concise • Descriptive: should make the main objective clear, should mention the target population • Key words: should contain key words for referencing – i.e. „Anemia in hiv infected ANC“ – Better: „prevalence of anemia among HIV infected ANC attending ICTC centre Nanded.“
  • 8. • Concise, one page (about 300 words) • Stands on its own – no reference to protocol content • Summarizes central elements (rationale, methodology, populations, time frame, expected outcomes)
  • 9. Statement of the problem • Why …is the research needed? • What …is the relevance of the results? Logical flow of statements: Magnitude, frequency, and distribution: Affected geographical areas and population groups. Ethnic and gender considerations. Probable causes of the problem: What is the current knowledge of the problem and its causes? Is there consensus? Is there controversy? Is there conclusive evidence? Possible solutions: In what ways have solutions to the problem been attempted? What has been proposed? What are the results? Unanswered questions: What remains to be answered? What areas have not been possible to understand, determine, verify, or test?
  • 10. Statement of the problem Literature review • Prevents duplication of work, which has been done • Clarifies, what others have found addressing the problem • Familiarizes with potential methodologies and methodological errors • Should convince, that the research is needed!
  • 11. Justification of research Should be a convincing statement for the need to do this research • How does the research relate to the priorities of the region and the country? • What knowledge and information will be obtained? • What is the ultimate purpose that the knowledge obtained from the study will serve? • How will the results be disseminated? • How will the results be used, and who will be the beneficiaries?
  • 12. Research hypothesis Independent variable • Describes the relationship between INDEPENDENT variables (risk factors, predisposing factors) and DEPENDENT variables (outcome) • Determines the type of data to be collected and the type of analysis to be conducted Dependent variable Intervention, Observation, Control variable Make clear statements!
  • 13. Research objectives • Simple • Specific • Stated in advance.
  • 14. Research objectives Define a GENERAL OBJECTIVE and derive SPECIFIC OBJECTIVES The formulation of objectives will help to: • Focus the study (narrowing it down to essentials) • Avoid the collection of data which are not strictly necessary for understanding and solving the problem you have identified • Organize the study in clearly defined parts or phases
  • 15. Research objectives Objectives should be: • Logical and coherent • Feasible • Realistic, considering local conditions • Defined in operational terms that can be measured • Phrased to clearly meet the purpose of the study (relevant) Objectives should be stated in action verbs that illustrate their purpose: i.e. “To determine…, To compare..., To verify..., To calculate...,To reduce..., To describe..., etc.
  • 16. Methodology Important aspect of the protocol • Assures, that the hypothesis will be proved or disproved, using the right tools • Presents a detailed strategy, how the objectives are achieved Consider • operational definitions • study design • definition of variables • sample size • ethical aspects
  • 17. Methodology Study design • The decision on study design needs to be based on ethics, logistic consideration, economic aspects and scientific thoroughness. • The validity of the results including potential bias and confounding and the generalizability of the results needs to be a prime concern defining the study design. • A causal relationship between exposure and outcome can be best established in a Clinical trial – > Cohort study > Case - control study > Cross-sectional study > Ecological study
  • 18. Methodology Study design Interventional study Observational study Clinical trial Cohort study Cross-sectional study Case – control study Ecological study
  • 20. Methodology Measurement of observations • Describe how, when and where the observations are made? Describe instruments used! – Questionaire (attach to the protocol) – Type of interview (describe structure of the interview) – Laboratory test (refer to literature or personal knowledge, if established test, or describe in detail, if not established) – Clinical examinations (describe gadget/procedure) Describe all instruments or refer to literature if tools are established. (for intervention studies or drug trials refer to specific literature/regulations)
  • 21. Methodology Subjects/ participants Depending on the type of study, answer the following questions: •What are the criteria for inclusion or selection? •What are the criteria for exclusion? •In intervention studies, how will subjects be allocated to index and comparison groups (Randomization procedure)? •What are the criteria for discontinuation?
  • 22. Methodology Data quality control • Describe measures of data quality control: – Double data entry – Consistancy checking – Data monitor – Verfication procedures of source data – Interrater variability measurements
  • 23. Methodology Sample size • Sample size calculation is recommeded for economical and ethical reasons • Simple statistical packages in the internet • Level of error, power and expected impact of exposure on outcome have to be set
  • 24. Methodology (Intervention) If applicable, describe: • Who will be responsible for the intervention? • Where will it take place? • What activities will be performed, and with what frequency and intensity?
  • 25. Ethical considerations One of the most important aspects of biomedical research! Ask local ethics committee for advice! Important aspects to consider: • Data safety / confidentiality • Any possibly harm/ side effects/ consequences • Right of discontinuation at any time • Role of data safety and monitoring board (in trials) • Alternative treatments/ approaches (in trials) • Incentives/ Rewards
  • 26. Ethical considerations Informed consent Outline how, when and where the patient will be consented! Information form should contain: • Justification for research • Responsibilities (Who) • Outline of study • Risks • Insurance • Confidentiality (legal framework) • Voluntary participation • A separate consent form is required! Simple language! Patients mother tongue!
  • 27. Ethical considerations Ethics checklist • Should answer potential questions regarding the ethics • Should discuss pros and cons of research design, selection of subject, measurement and outcome assessment. • Should discuss the advantages and disadvantages of the subject or communities involved • Should discuss physical, social and psychological implications of the research • Should discuss confidentiality
  • 28. Data management and analysis Based on objectives consider: • Coding for variables/ type of variables • Analysis plan depending on type of variables • Statistical tests implicated • (Style of presentation i.e. tables, graphs) • Data safety and storage
  • 29. References/Bibliography • Use of standard referencing system: – Harvard style • Name and publication year in text • Alphabetical bibliography – Vancouver style • Numbered references • Continous referencing in text • Make use of software – Reference Manager – Endnote software See also „A Pratical Guide for Health Researchers“
  • 30. Definitions • Citing – this is the process of formal recognition, within your text, of the resources from which you have gathered your information • A Citation – this is a passage or phrase quoted within your text which is supported with evidence of its source • Bibliography – a list of the sources that you have used • Reference – a detailed description of the item from which you have obtained your information Version 1.0 Copyright © 2009 AQA and its
  • 31. What is the Harvard System? • Developed in the USA • Most common system in use internationally • A flexible, simple, clear system both for author and reader • References are listed alphabetically in the bibliography and cited in the body of the text so no footnotes or chapter references needed
  • 32. What is the Vancouver Referencing Style? It is a uniform set of requirements for bibliographic references. It is a "numbered" style. It follows rules established by the International Committee of Medical Journal Editors. It is also known as: Uniform Requirements for Manuscripts submitted to Biomedical Journals.
  • 33. How to do in-text citations  A number is assigned to each reference as it is cited - in brackets [ ] ( ) or superscript.1  If the source is referred to again, the same number is used. Example:...as one author has put it "the darkest days were still ahead" [1]: which is well documented in the literature. [2-5] This proves that "the darkest days were still ahead". [1]
  • 34. How to create a Reference List  Reference list should appear at the end of the assignment / report.  Entries are listed numerically and in the same order that they were cited in the text. Example: 1. Baker PN, editor. Obstetrics by ten teachers. 18th ed. London: Hodder Arnold; 2006. 2. Delbridge ML, Harry JL, Toder R. A human candidate spermatogenesis gene, RBM1, is conserved and amplified on marsupial Y chromosome. Nat Genet. 1997; 15: 131-136.
  • 35. Work plan Who? Tasks When? Where?
  • 36. Budget The budget should be broken down by: • Items – Personnel – Consumables, equipment, supplies, communication, funds for patients, data processing • Budget justification – Jusitify the use of each item, considering the workplan of the study
  • 37. Annexes • Case Record Forms (CRFs) • Questionaires • Patient information form (in required languages) • Consent form (in required languages) • CV of investigators
  • 40. Methodology • Research design: • Research subjects or participants: • Interventions: drugs or devices. • Observations: • Sample size:
  • 41. Ethical considerations • Approval by ethics review committees: • Informed decision-making: Consent form: A) A statement describing the study and the nature of the subject’s involvement in it; and b) A certificate of consent attesting to the subject’s consent. • Ethics checklist .
  • 42. Questionnaire Design •Review of data source and data collection •Instruments for data collection •Questionnaire as a tool for data collection tool-types, strengths and limitations •Principles of questionnaire design-purpose, type of information, wording the questions, response rate and rating scales •Questionnaire Administration-prevalidation,response rate, reliability and validity

Notas del editor

  1. Formation of the topic Hypothesis Conceptual definitions Operational definition Gathering of data Analysis of data Test, revising of hypothesis Conclusion, iteration if necessary
  2. Study design – causal relationship between exposure and outcome is relevant Ethical considerations - in new TB drugs I still need to cure the patients Order is not relevant
  3. Methodological errors – effectiveness of DOTS in Chochrane – did not look at resistance, not Rifa – resistance – missed important outcome.
  4. After statement of the primary objective, secondary objectives may be mentioned. Young investigators are advised to resist the temptation to put too many objectives or over-ambitious objectives that cannot be adequately achieved by the implementation of the protocol.
  5. Good example for the superiority of trial – HRT from woman – later WHI trial......
  6. Simple language mother tongue!
  7. For studies in humans (or involving human biological materials), the protocol must be approved by the local, institutional or equivalent ethics committee and/or national ethics committee. For animal studies approval is required from the animal welfare committee of the institute or its equivalent. If no such committee exists, a statement signed by the principal investigator(s) should indicate that the research will be carried out in accordance with the International Guiding Principles for Biomedical Research involving Animals